International Dentistry - Vol. 12, No. 2 - 8
G Ü T H / S T E C H E R
Fig. 13: Interfaces between tooth and restoration covered with
glycerine gel.
Fig. 14: Margins immediately after curing of the cement.
Fig. 15: Aesthetically satisfying situation after eight weeks.
Further recovery of the gingival tissues needs more time.
Fig. 16: A natural look is obtained.
Result
With regard to the restoration that was produced, the
invasive preparation is surely a matter of debate. However,
the existing preparation for the metal-ceramic bridge and the
large composite restorations limited the amount of sound
tooth structure that needed to be sacrificed at this point of
the treatment to a minimum, so that the plan became
acceptable. In general, the maximum preservation of tooth
structure should always be given highest priority when a
dental restoration is planned. Important criteria guiding the
amount of hard tissue removal are the available intermaxillary
space and the minimum wall thickness of the selected
material.
Due to the material selection in the present case, it is not
necessary to remove the restoration as long as it serves its
purpose. Thus, the planned long-term temporary might even
become a definitive restoration over time. This, of course, is
only possible with continuous monitoring and good
compliance of the patient
The aesthetic appearance was already satisfactory, although
the harmony was impaired by black triangles between the
teeth. Due to the favourable characteristics of the ceramic,
however, the soft tissue recovered quickly and closed the
gaps. Figures 15 and 16 show the results eight weeks after
the restorative procedure.
Discussion
As an alternative to the selected treatment option, it would
have been possible to place a removable partial denture or
two two-unit adhesive bridges with one wing each. The
former, however, is regarded as functionally less effective
and not capable of supporting the preservation of soft and
hard tissues. The two-unit adhesive bridges would have
required stabilisation with a retainer. The main reason to opt
against this alternative was the compromised value of the
abutment tooth 22. As the root surfaces of the maxillary
lateral incisors are small, it also seems questionable if this
design would have offered sufficient stability to ensure the
desired result.
Reprinted with permission by CAD/CAM 01/2017
First publication: 3M™ Health Care Academy Espertise™
Magazine nr.29, edition November 2016 p.28-31.
8 INTERNATIONAL DENTISTRY - AUSTRALASIAN EDITION VOL. 12, NO. 2
Table of Contents for the Digital Edition of International Dentistry - Vol. 12, No. 2
Contents
International Dentistry - Vol. 12, No. 2 - Cover1
International Dentistry - Vol. 12, No. 2 - Cover2
International Dentistry - Vol. 12, No. 2 - Contents
International Dentistry - Vol. 12, No. 2 - 2
International Dentistry - Vol. 12, No. 2 - 3
International Dentistry - Vol. 12, No. 2 - 4
International Dentistry - Vol. 12, No. 2 - 5
International Dentistry - Vol. 12, No. 2 - 6
International Dentistry - Vol. 12, No. 2 - 7
International Dentistry - Vol. 12, No. 2 - 8
International Dentistry - Vol. 12, No. 2 - 9
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International Dentistry - Vol. 12, No. 2 - 11
International Dentistry - Vol. 12, No. 2 - 12
International Dentistry - Vol. 12, No. 2 - 13
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International Dentistry - Vol. 12, No. 2 - Cover3
International Dentistry - Vol. 12, No. 2 - Cover4
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