Monolithic multilayer zirconia crowns

Even within the anterior area, stained monolithic restorations is also an possibility. Elements such because the age of the affected person, the interior color construction of the adjoining dentition, the collection of tooth to be restored (one as opposed to 4 or all six maxillary anterior tooth), the cultured calls for of the affected person and fiscal sides will have to be taken under consideration within the subject material variety procedure. Within the case described on this article, full-contour zirconia was once decided on for a number of causes.

Background

The 71-year-old feminine affected person introduced within the health center owing to aesthetic issues within the maxillary anterior area. Her oral hygiene was once excellent, and he or she was once a non-smoker. Infraposition of the present implant-based crown (Brånemark common platform, Nobel Biocare) within the place of the fitting central incisor was once obvious. Additionally, gingival retraction was once noticed at the maxillary proper lateral incisor, and the left lateral incisor (enamel #22) had a significant composite filling with discoloration (Figs. 1–3). The affected person expressed the will to have the gingival margin variations adjusted and the 4 maxillary incisors restored with ceramic crowns for optimum aesthetics.

Subject matter variety

Owing to the verdict to revive all 4 anterior incisors, monolithic zirconia was once deemed an acceptable subject material possibility. It could permit the staff to acquire the required effects throughout the monetary necessities. To be able to meet the cultured calls for of the affected person, supply for the specified mechanical homes and make allowance for right kind protecting of the underlying buildings, KATANA Zirconia YML was once decided on. It provides color, translucency and flexural energy gradation all over the multilayered clean.

Remedy process: From preparation to temporisation

To be able to design the oblique restorations, a virtual impact was once eager about an intra-oral scanner, and the knowledge was once transferred to the dental laboratory (Teknodont). The laboratory created a virtual wax-up. After the affected person’s approval, a matrix was once produced and despatched to the health center. The previous restorations have been got rid of and the 3 maxillary incisors (all however the only changed by way of an implant) ready for whole crowns. A therapeutic abutment was once positioned at the implant and a brief bridge produced chairside from Protemp 4 temporisation subject material (3M ESPE) in Color A3 the usage of the matrix (Fig. 4). Due to this fact, a gingivectomy was once performed with a ceramic bur (KT.314.016 CeraTip, Komet) on the buccal side of tooth #21 and 22.

After the affected person’s approval of the aesthetics, phonetics and serve as of the brief recovery, the location was once captured with an intra-oral scanner once more. This allowed the staff to replicate the form of the recovery. In response to the knowledge obtained, two pairs of splinted brief crowns have been milled from PMMA (HUGE Multilayer PMMA, HUGE Dental) in Color A3 within the laboratory (Figs. 5–7). They have been positioned to permit the affected person to additional evaluation the semblance and serve as for a number of weeks (Figs. 8–10). The affected person was once proud of the phonetics, serve as and look of the crowns, noting handiest that they have been somewhat too vivid compared to the adjoining tooth, and he or she authorized the form for the manufacturing of the everlasting restorations.

Ultimate recovery: Manufacturing and cementation

In response to the knowledge set of the brief restorations, 4 separate crowns—one for the implant and 3 for the tooth—have been designed in complete contour. With none anatomical relief, the restorations have been milled from KATANA Zirconia YML. In response to the analysis of the brief restorations, the colour decided on this time was once Color A3.5. CERABIEN ZR FC Paste Stain (Kuraray Noritake Dental) was once used for exterior staining and glazing of the outside. The laboratory additionally cemented the implant-based crown to the gold-shaded titanium abutment (Elos Medtech) with PANAVIA V5 (Kuraray Noritake Dental) within the colour Opaque for an advanced protecting impact (Fig. 11). Within the place of work, the abutment–crown was once screwed directly to the implant and the screw get entry to hollow closed with composite, and the 3 tooth-based crowns have been then positioned the usage of PANAVIA SA Cement Common (Figs. 12–15).

Conclusion

Multilayered zirconia is an acceptable subject material for plenty of medical scenarios. Owing to the provision of extremely translucent multilayered blanks, it’s now conceivable to supply aesthetic results even if the usage of the fabric monolithically, and that is true now not handiest within the posterior area however within the aesthetic zone in some circumstances too. The prevailing case demonstrated that superb effects and affected person delight will also be received. Additionally, on account of the fabric’s remarkable mechanical homes, those results is also anticipated to remaining for a very long time.