One-year clinical evaluation of IPS Empress CAD versus polished Celtra Duo ceramic Laminate veneers (randomized controlled clinical trial) / Avaliação clínica de um ano de IPS Empress CAD versus laminados de cerâmica Celtra Duo polidos (ensaio clínico randomizado controlado)

Objective: To evaluate fracture resistance and survival rate of IPS Empress CAD versus Polished Celtra Duo ceramic laminate veneers. Material and Methods:Thirty-six ceramic laminate veneers were fabricated for maxillary anterior teeth. The patients were divided into two groups according to the material Group 1(control group) fabricated from IPS Empress CAD laminate veneers and group 2 (intervention group) fabricated from Polished Celtra Duo laminate veneers. Standardized the same preparation with butt joint design and chamfer finish line located supra gingival were performed for all the teeth. The fabrication of the veneers was performed using Cad\Cam (Ceramill motion) machine, with software (Exocad). The veneers surfaces were treated and silanated according to the manufacture instruction of each ceramic and enamel surfaces were etched where total etch adhesive protocol was obeyed using BISCO. Follow up sessions were done every two months up to one year for each patient using dental probe and operator vision to evaluate the fracture, survival rate, marginal adaptation, sensitivity and caries. according to USPHS criteria (United States Public Health Service). This was performed by an experienced, blinded investigator. Results: Fracture resistance, marginal adaptation, retention, caries and sensitivity were evaluated according to the criteria of USPHS and we found there is no significant difference as both groups scaled zero score. Conclusion: Both IPS Empress Cad and Polished Celtra Duo laminate veneers revealed successful clinical performance in terms of fracture resistance, marginal adaptation, retention, and sensitivity after one year follow up period (AU)

Objetivo: Avaliar a resistência à fratura e a taxa de sobrevivência de laminados de cerâmica IPS Empress CAD versus Celtra Duo polidos. Material e Métodos: Trinta e seis facetas cerâmicas laminadas foram confeccionadas para dentes anteriores superiores. Os pacientes foram divididos em dois grupos de acordo com o material Grupo 1 (grupo controle) confeccionado com laminados IPS Empress CAD e grupo 2 (grupo intervenção) confeccionado com laminados Celtra Duo polidos. A mesma forma de preparo e acabamento de chanfro localizado supra-gengival padronizados foram realizados para todos os dentes. A confecção das facetas foi realizada em máquina Cad \ Cam (Ceramill motion), com software (Exocad). As superfícies laminadas foram tratadas e silanizadas de acordo com as instruções do fabricante de cada cerâmica e as superfícies de esmalte foram condicionadas seguindo o protocolo adesivo de condicionamento ácido total com BISCO. Sessões de acompanhamento foram realizadas a cada dois meses durante um ano para cada paciente usando sonda exploradora e visão do operador para avaliar a fratura, taxa de sobrevivência, adaptação marginal, sensibilidade e cárie; de acordo com os critérios USPHS (Serviço de Saúde Pública dos Estados Unidos). Isso foi realizado por um investigador experiente e cego. Resultados: a resistência à fratura, adaptação marginal, retenção, cárie e sensibilidade foram avaliadas de acordo com os critérios da USPHS e não encontramos diferença significativa, pois ambos os grupos escalonaram pontuação zero. Conclusão: As facetas laminadas IPS Empress Cad e Celtra Duo polido revelaram desempenho clínico bem-sucedido em termos de resistência à fratura, adaptação marginal, retenção e sensibilidade após um período de acompanhamento de um ano. (AU)

In vitro evaluation of marginal fit of zirconia-reinforced lithium silicate laminate veneers at two thicknesses using different CAD/CAM systems / Avaliação in vitro do ajuste marginal de folheados laminados de silicato de lítio reforçados com zircônia em duas espessuras usando diferentes sistemas CAD / CAM

Objective: The purpose of this in vitro study was to evaluate the marginal fit of laminate veneers made of zirconia-reinforced lithium silicate with two thicknesses using different CAD/CAM systems. Material and methods: 42 Laminate veneers milled from zirconia-reinforced lithium silicate were divided into three main groups according to milling machine used into: group X5, laminate veneers fabricated by inLab MCX5 milling machine; group CM, laminate veneers fabricated by Ceramill motion 2 milling machine; and group XL, laminate veneers fabricated by inLab MCXL milling machine. Each group was divided into two subgroups according to veneer thickness into: subgroup I, 0.5 mm thickness laminate veneers and subgroup II, 0.3 mm thickness laminate veneers. The marginal fit was measured using stereomicroscope. The results were tabulated and statistically analyzed using two-way ANOVA test followed by Tukey's post hoc test. Comparisons of main and simple effects were done utilizing Bonferroni correction. The significance level was set at (p ≤0.05) for all tests. Results: The mean( ± SD) highest marginal discrepancy was recorded in subgroup CMII at 85.45 ± 1.82 µm while the least mean marginal discrepancy was recorded in subgroup X5I (71.24 ± 2.64 µm). Conclusion: Both thicknesses(0.5 mm thickness and 0.3 mm thickness) and all tested CAD/CAM systems produced zirconia-reinforced lithium silicate laminate veneers with clinically acceptable marginal gaps; however, the closed CAD/CAM systems produced veneers with superior marginal fit than open systems at 0.3 mm thickness. The CAD/CAM system with the 5-axis milling machine produced the best marginal fit with 0.5 mm thickness. (AU)

Objetivo: O objetivo deste estudo in vitro foi avaliar a adaptação marginal de facetas laminadas de silicato de lítio reforçado com zircônia com duas espessuras, utilizando diferentes sistemas CAD / CAM. Material e métodos: 42 facetas laminadas fresadas a partir desilicato de lítio reforçado com zircônia foram divididos em três grupos principais de acordo com a fresadora usada em: grupo X5, facetas laminadas fabricados pela fresadora inLab MCX5; grupo CM, facetas laminadas fabricados por Ceramill motion 2; e grupo XL, facetas laminadas fabricados pelo inLab MCXL. Cada grupo foi dividido em dois subgrupos, de acordo com a espessura do laminado, em: subgrupo I, facetas laminadas com 0,5 mm de espessura e subgrupo II, facetas laminadas com espessura de 0,3 mm. A adaptação marginal foi medida usando estereomicroscópio. Os resultados foram tabulados e analisados estatisticamente usando o teste ANOVA de dois fatores seguido pelo teste post hoc de Tukey. Comparações dos efeitos principais e simples foram realizadas utilizando a correção de Bonferroni (P ≤ 0,05). Resultados: A maior discrepância marginal média ( ± DP) foi registrada no subgrupo CMII em 85,45 ± 1,82 µm, enquanto a menor discrepância marginal média foi registrada no subgrupo X5I 71,24 ± 2,64 µm. Conclusão: Ambas as espessuras (0,5 mm e 0,3 mm)e todos os sistemas CAD / CAM testados produziram facetas de laminado de silicato de lítio reforçadas com zircônia com lacunas clinicamente aceitáveis. No entanto, os sistemas CAD / CAM fechados produziam facetas com adaptação marginal superior aos sistemas abertos com 0,3 mm de espessura. O sistema CAD / CAM com a fresadora de 5 eixos produziu a melhor adaptação marginal com 0,5 mm de espessura (AU)

Repair Protocol of Porcelain Laminate Veneers Through Reattachment of the Fractured Ceramic Piece: A Technical Report / Protocolo de reparo de laminados de porcelana através de recolocação da peça de cerâmica fraturada: um relato técnico

This technical report has been developed to repair the ceramic laminate veneer without removing after fracture. The bonding between the tooth and the laminate veneer is very strict, thus removing the restoration is difficult. The disadvantages such as the loss of tissue from the tooth, the cost and time loss are eliminated with this technique. In this technical report, the cementation of porcelain to porcelain in the presence of the fractured piece is explained step by step (AU)

Este relato técnico foi desenvolvido para reparar o laminado cerâmico sem remoção após fratura. A união entre o dente e o laminado é muito rígida, remover a restauração é difícil. As desvantagens como a perda de tecido do dente, o custo e a perda de tempo são eliminadas com esta técnica. Neste relato técnico, a cimentação de porcelana em porcelana na presença da peça fraturada é explicada passo a passo (AU)

Comprehensive Orthodontic and Prosthodontic Rehabilitation of Hypodontia: A Case Report of Interdisciplinary Approach

Introduction: Aesthetically compromised smile dueto hypodontia needs correction to enhance individual’sfacial appearance. Not only cosmetic but also functionalimprovement after dental rehabilitation will boost up one’sconfidence and positively influence quality of life.Case Report: The case report delineates combined orthoprostho approach during treatment of a 17-year-old femalepatient with congenitally missing maxillary lateral andmandibular central incisors, collapsed anterior arches andspacing. The treatment started with orthodontic correctionfor space creation and distribution, followed by prostheticmanagement with all ceramic fixed dental prosthesis for upperanterior arch and porcelain laminate veneers for lower anteriorteeth.Conclusion: The step by step interdisciplinary approach,which is the principal factor for treating hypodontia in an idealway among many options, gives the patient optimum estheticand functional satisfaction.

A noninvasive esthetic treatment of isolated microdontia using new high-translucent cubic-phase zirconia (5Y-PSZ) laminate veneers: A case report / 대한치과보철학회지

Current trends in restorative dentistry focus on improving the esthetics and keeping the sound dental tissues as long as possible. The aims of this case report were to describe the successful outcome of cubic-phase zirconia laminate veneers for a patient with isolated microdontia by using a digital workflow, and to describe their clinical implications. A 15-year-old female who had isolated microdontia in combination with spacing visited Ajou University Dental Hospital for esthetic treatment. In this case, 6 maxillary anterior teeth were restored with cubic-phase zirconia laminate veneers without tooth structure removal by using a digital impression, computer-aided design (CAD) software, and computer-aided manufacturing (CAM) procedures. At 6-month follow-up, no distinct mechanical and biological complications were detected and the prostheses exhibited satisfactory esthetics and functions. Due to its favorable tissue responses and enhanced translucency, cubic-phase zirconia can be a suitable strategy for a noninvasive esthetic approach.

Chuckling Smile: Ceramic Veneer.

Smiling is not a simple option in those patients who have a severe aesthetic deformity. Many definitions of aesthetics were introduced in dentistry but according to Young, beauty, harmony, naturalness and individuality are the major qualities of aesthetics. The dentist must visualize aesthetics in relation to the patient and then translate that visualization into an acceptable aesthetic result. The success of his efforts depends upon his artistic ability, his powers of observation and experience. Many treatment options are available to achieve aesthetics in compromised anterior teeth but in recent era with the introduction of advanced material (new ceramic and composite materials) has increased the demand of conservative treatment options. Porcelain laminate Veneers (PLVs) were introduced in the 1980s as an alternative to full-coverage crowns. The present case report describes the treatment of fracture & diastema in the anterior dentition with thin ceramic veneers, to restore esthetics and function.

Effectiveness of Combination of Dentin and Enamel Layers on the Masking Ability of Porcelain

This study evaluated the masking ability of different porcelain thicknesses and combination of enamel and/or dentin porcelain layers over simulated background dental substrates with higher (A2) and lower (C4) color values. Combination of the enamel (E) and dentin (D) monolayer porcelain disks with different thicknesses (0.5 mm, 0.8 mm, and 1 mm) resulted in the following bilayer groups (n=10): D1E1, D1E0.8; D1E0.5; D0.8E0.8; D0.8E0.5, and D0.5E0.5. CIELAB color coordinates were measured with a spectrophotometer. The translucency parameter of mono and bilayer specimens and the masking ability estimated by color variation (ΔE*ab) of bilayer specimens over simulated dental substrates were evaluated. Linear regression analysis was used to investigate the relationships translucency parameter × ΔE*, translucency parameter × porcelain thickness, and ΔE* × porcelain thickness. Data were analyzed statistically (α= 0.05). Thinner porcelain disks were associated with higher translucency. Porcelain monolayers were considerably more translucent than bilayers (enamel + dentin). Dentin porcelain was less translucent than enamel porcelain with same thickness. ΔE* was always lower when measured over A2 background. Higher ΔE* was observed for the C4 background, indicating poorer masking ability. Increased ΔE* was significantly associated with increased translucency for both backgrounds. Decreased translucency and ΔE* were associated with increased total porcelain thickness or increased dentin thickness for both backgrounds. In conclusion, increased porcelain thickness (particularly increased dentin layer) and increased porcelain opacity resulted in better masking ability of the dental backgrounds.

Resumo Este estudo avaliou a capacidade de mascaramento de diferentes espessuras de porcelana e a combinação de camadas de porcelana de esmalte e/ou de dentina sobre substratos dentais simulados de fundo com cores de maior (A2) e menor (C4) valor. Combinação de discos de porcelana em monocamadas de esmalte (E) e dentina (D) com diferentes espessuras (0,5 mm, 0,8 mm e 1 mm) resultou nos seguintes grupos bicamadas (n=10): D1E1, D1E0,8; D1E0,5; D0,8E0,8; D0,8E0,5 e D0,5E0,5. Coordenadas de cor CIELAB foram mensuradas com um espectrofotômetro. O parâmetro de translucidez de espécimes mono e bicamadas e a capacidade de mascaramento estimada pela variação de cor (ΔE*ab) dos espécimes bicamadas sobre os substratos dentais simulados foram avaliados. Análise de regressão linear foi utilizada para investigar as relações parâmetro de translucidez x ΔE*, parâmetro de translucidez x espessura da porcelana, e ΔE* x espessura da porcelana. Os dados foram analisados estatisticamente (α=0,05). Discos de porcelana mais finos foram associados a maior translucidez. Monocamadas de porcelana foram consideravelmente mais translúcidas que bicamadas (esmalte + dentina). Porcelana de dentina foi menos translúcida que porcelana de esmalte com mesma espessura. ΔE* foi sempre menor quando mensurado sobre fundo A2. Maior ΔE* foi observado para o fundo C4, indicando pior capacidade de mascaramento. Maior ΔE* foi significativamente associado à maior translucidez para ambos fundos. Menor translucidez e ΔE* foram associados ao aumento da espessura total da porcelana ou aumento da espessura de dentina para ambos fundos. Em conclusão, aumento da espessura da porcelana (particularmente aumento da camada de dentina) e aumento da opacidade da porcelana resultaram em melhor capacidade de mascaramento dos fundos dentários.

Importância do enceramento diagnóstico na reabilitação estética e funcional / The diagnostic wax-up as an important tool in the aesthetic and functional rehabilitation

Restaurações à base de resina composta direta têm mostrado boas taxas de longevidade, no entanto, apresentam comprometimento estético ao longo do tempo. Para suprir essa carência, as restaurações cerâmicas têm se tornado uma ótima opção de tratamento para dentes anteriores, sendo a cerâmica feldspática a que apresenta melhores propriedades estéticas e capacidade de reprodução de detalhes. Assim, este artigo procurou descrever a confecção de quatro laminados cerâmicos, à base de cerâmica feldspática, para restauração de incisivos superiores, inicialmente restaurados com restaurações insatisfatórias em resina composta. Após a conclusão da reabilitação, foi possível concluir que o tratamento restabeleceu satisfatoriamente a estética e a função da paciente.

Resin composite restorations show good survival rates; however, they present esthetic problems after longer clinical periods. For this, ceramic restorations are a good alternative and feldspathic ceramics present the best esthetic properties. This article describes the fabrication of four laminate veneers with feldspathic ceramics to restore the maxillary incisors with unsatisfactory composite restorations. Good levels of esthetic and function were achieved at case conclusion.

Sistemas cerámicos puros parte I: una evolución basada en la composición / Pure ceramic systems part I: an evolution based on composition

Los continuos avances en la tecnología, materiales dentales y equipamientos han contribuido significativamente con el nivel que la Odontología estética está logrando hoy. Entre estas innovaciones, el desarrollo de restauraciones de cerámica pura ha evolucionado aportando diferentes alternativas. Las cerámicas han presentado una rápida evolución desde el punto de vista tecnológico con el objetivo de mejorar las propiedades mecánicas y ópticas. En la actualidad existen varios sistemas de cerámicas libres de metal con propiedades mecánicas y ópticas excelentes, para la confección de coronas unitarias y plurales. Estos sistemas modernos se presentan con variadas composiciones y diferentes técnicas de confección, haciendo de estos más versátiles. Dentro de esta perspectiva, el mercado odontológico ofrece una gama enorme de nuevos materiales indirectos y sistemas libres de metal para la confección de prótesis, lo que proporciona nuevas opciones, más también nuevas interrogantes para decidir entre las alternativas disponibles. En este contexto esta revisión de la literatura tiene como objetivo abordar los diferentes sistemas cerámicos del punto de vista de su composición y sus diferentes técnicas de obtención

The continuing advances in technology, dental materials and equipment have contributed significantly to improve the level of esthetic dentistry today. Among these innovations, development of pure ceramic restorations has evolved to give different alternatives. Dental ceramics have presented a rapidly technological changing to improve mechanical and optical properties. Currently there are several systems of metal free ceramics with excellent mechanical and optical properties, for making crowns and plurals. These modern systems are presented with various compositions and different preparation techniques, making these more versatile. Within this perspective, the dental market offers a huge range of new indirect and metal-free materials for prostheses, providing new options, plus also new questions to decide among the available alternatives. The aim of this review is take a view of the different ceramic systems in terms of its composition and different techniques of production

Esthetic improvement in the patient with one missing maxillary central incisor restored with porcelain laminate veneers

This article describes esthetic improvement in a patient with a missing maxillary left central incisor. Space analysis of the anterior dentition showed that minor tooth rearrangement was needed. Optimal space distribution for restorations was attained by orthodontic treatment. Through transforming tooth shape with porcelain laminate veneers, the maxillary left lateral incisor was transformed into central incisor and the maxillary left canine into a lateral incisor. The maxillary right central incisor was also restored for esthetic improvement. In a case of changing a tooth shape with porcelain laminate veneers, pre-treatment evaluation, space analysis and diagnostic wax-up are important factors.

Esthetic restorations of maxillary anterior teeth with orthodontic treatment and porcelain laminate veneers: a case report

If orthodontists and restorative dentists establish the interdisciplinary approach to esthetic dentistry, the esthetic and functional outcome of their combined efforts will be greatly enhanced. This article describes satisfying esthetic results obtained by the distribution of space for restoration by orthodontic treatment and porcelain laminate veneers in uneven space between maxillary anterior teeth. It is proposed that the use of orthodontic treatment for re-distribution of the space and the use of porcelain laminate veneers to alter crown anatomy provide maximum esthetic and functional correction for patients with irregular interdental spacing.

Esthetic restorations of maxillary anterior teeth with orthodontic treatment and porcelain laminate veneers: a case report

If orthodontists and restorative dentists establish the interdisciplinary approach to esthetic dentistry, the esthetic and functional outcome of their combined efforts will be greatly enhanced. This article describes satisfying esthetic results obtained by the distribution of space for restoration by orthodontic treatment and porcelain laminate veneers in uneven space between maxillary anterior teeth. It is proposed that the use of orthodontic treatment for re-distribution of the space and the use of porcelain laminate veneers to alter crown anatomy provide maximum esthetic and functional correction for patients with irregular interdental spacing.