Metal-ceramic restorations are now capable of providing esthetic results that are in no way inferior to all-ceramic restorations. Modern high-quality materials and a special layering strategy enable users to skillfully take advantage of the effects of light. The following patient report by Dr Patricija Žujić and Master Dental Technician Velimir Žujić show you how.
Read about how a father-and-daughter team from Rijeka/Croatia fabricated a metal-ceramic restoration with natural in-depth effect, vitality and brightness using the metal-ceramic IPS Style.
Initial situation: patient dissatisfied with upper teeth
The female patient was unhappy about the esthetic appearance of her upper teeth. When her dental history was taken, she revealed irregular tooth shapes and shades as well as various carious lesions. The X-ray did not show anything abnormal. The patient decided on a metal-ceramic restoration made of IPS Style.
Clinical and technical procedure
Clinical: First, the carious lesions were treated and the teeth prepared accordingly. Immediately after preparation, temporary crowns were made using Telio CS C&B. The permanent crowns were designed digitally on the computer and manufactured using selective laser melting (SLM).
Technical: It is advisable to preoxidize frameworks that are made of non-precious alloy such as the CoCr alloy used in this case, even if they are manufactured digitally. As a result of the oxidation process, the bonding surface and metal finish can be checked for porosities and uneven oxide.
Once the framework was clean, we began the veneering procedure by applying IPS Style Ceram Powder Opaquer – first in a thin wash and then as a covering opaque layer. The latter showed a silky matt gloss and was reflecting light beautifully already at this stage.
In order to further support the light-reflecting and fluorescent properties, dry IPS Style Ceram Margin powder can be dusted onto the opaque powder of the restoration while it is still moist.
The above materials were also used for the posterior restorations. To be in a better position to modulate the in-depth effect, we applied a thin layer of IPS Style Ceram Transpa neutral before customizing with IPS Ivocolor. The bluish-white hue of the IPS Style Ceram Inter Incisal material has resulted in a very natural appearance in this case.
Mamelons, cracks and calcifications can be easily mimicked with IPS Ivocolor. Once fired, these stains remain stable.
Contouring was achieved with "Transpa Dentin" (mixture of 50% IPS Style Ceram Dentin A2 and 50% IPS Style Ceram Transpa neutral) and IPS Style Ceram Incisal I2.
Given the light-reflecting properties of IPS Style, only minimal quantities of IPS Style Ceram Deep Dentin and IPS Style Ceram Mamelon are required to increase the value.
You can read the full report of this case in the April issue of Quintessenz Zahntechnik (German).
all pictures: courtesy of Velimir and Dr Patricija Žujić
Telio®, IPS Style® and IPS Ivocolor® are registered trademarks from Ivoclar Vivadent. The availability of certain products may vary from country to country.