Mohamed Saad El Hachemi
A 35-year-old female patient comes to consult at the office for an aesthetic problem, she is not satisfied with her smile and would like to restore especially her central which is Dyschromy and a bit short -Initial situation
Lateral view
Polarised photography The tooth is whitening resistant, according to the classification of Pascal Magne (TYPE 1 ,GROUP IB « Nonresponse to external or internal bleaching ») We offered her to make a ceramic veneer
J Esthet Dent 1993;5:239-246
Natural and restorative oral esthetics .Part IIEsthetic treatment modalities
Magne P, Magne M, Belser U
Aesthetic analysis; clinical picture for planning shape and color of the future restoration.
Gingivoplasty
Direct mock up with a flow composite
The result of the direct mock up after one weak
it is our vision that limits our manual precision ,thus the importance of magnification that allows us to improve the detail of the gesture ,So the Microscope can significantly improve it
According to Mallet and Roussel, the microscope does not save time, but the result is predictable and of higher quality.
Operative Dentistry, 2010, 30-5, 246-249
The Clinical Microscope and Direct Composite Veneer
RC Pascotto • AR Bene
Operative dentistry 2017
Effect of Magnification on the Precision of Tooth Preparation in Dentistry
M Eichenberger N Biner M Amato A Lussi P Perrin
Marking of the restauration perimeter with a green bur 801L.314.016
First reduction of 0,3mm depth thickness control: with depth cutter green ring 868A.314.021 along the crown axis
Along the incisal axis
And along the root axis
Homogénéisation of facial surface allong the crown and the root axis with green bur 856.314.016
The proximal areas and the tobogan are prepared with a burr Green bur 856.314.012
The silicone guide was placed. Here is the occlusal view of the teeth after being prepared
Management of peripheral limite
Finishing a margin with a high magnification must be achieved with a red bur 856.314.016 along the crown and the root axis .
The proximal areas and the tobogan are carefully finished with a red ring finishing burr 856.314.012
the enamel chisel allows us to have an extreme and optimal polishing of the limits, and also allows us the total elimination of the enamel excess created during the realization of the finish line
Polishing the labial surface with the socles disc
Polishing the proximal area with a fine abrasive strips
J Prosthet Ressort Dent 2005;17:144-54;
Immediate dentin sealing: a fundamental procedure for indirect bonded restorations.
Pascal Magne
For this case we used the digital impressions
The shade taking was done by my dental technician in his laboratory following the eLAB protocol who was created by SACHA HEIN , JAVIER TAPIA & PANOS BAZOS
the use of cross polarised photography is required in order to eliminate the reflections which facilitate the taking of the shade
Following the pre-model , the dental technician did a silicone key to be more accurate .
For the framework we used an MO0 lingot in order to increase the value ,to get a good value to counter the underlying coloring
For the ceramic mixture we used about 6 powder from eMAX ivoclar (PDA1/PDA1+TN/LAVENDER/T BLUE/OE1/MM LIGHT/PI BLEACH)
Odovtos 2017, vol.19, n.2, pp.33-46. ISSN 2215-3411.
Effect of Different Silane Treatments on Long-Term Bonding Between Non-Etched Glass-Ceramic and Resin Cement. MURILLO GOMEZ , FABIAN and GOES , MARIO F .DE
One of the crucial steps in adhesive dentistry is the field isolation using rubber dam to avoid any contamination and to have full vision of the teeth we are working on
Veneer is cemented under complete isolation. In this image, the detail of the isolation of tooth 21 with a 212 clamp
And the KNOT LIGATURES ;
The Knot ligatures allow the rubber dame to be maintained immobile during the restoration procedure.
Try in and check the precision
the labial surface is previously treated with 29 micron Aluminum Oxide particle sandblasting to guarantee maximum boding levels
1-sandblasting
2-We decided to follow a total etch technique. The tooth is etched for 30 seconds with 37% phosphoric acid.
Etching is still the gold standard in adhesion even if we want to use autoeching systems (Universal Adhesive) to bond
3-Autoetching system (Universal Adhesive) is used to bond the resin, three coats to obtain a uniform layer
eliminates the excess of resin before curing with brush and dental floss
After the first polymerization , we eliminate the excesses of the resin at the margin using a blade scalpel type 12.
Inter proximal resin removed with a soft abrasive strips
Final lightcuring is done under glycerine gel to avoid the oxygen inhibiting at the external surface of the composite.
Silicone polisher
Day 0_This result is obtained immediately after eviction of the rubber dam, we notice a dehydration of the teeth that denatures the shade. In general dehydration leads to decrease of chromacity and increase of luminescence, the teeth need to be rehydrated
One weak after bonding ,we have a reequilibration of shade
soft tissues control under high magnification
high degree of marginal precision is observed which will minimize the amount of adhesive at the margin and thus(so) increase the durability of the restoration