Dental Asia Jul/Aug 2018

49 DENTAL ASIA JULY / AUGUST 2018 User Report A fter missing wisdom teeth, agenesis (lack of failure of development) of the upper lateral incisors 12 and 22 is the second most common cause of congenital hypodontia (developmentally missing teeth). For a young person in particular, such as the 18-year old patient shown here (Fig. 1), an anomaly of this kind is often associated with a psychological burden. The ‘Twilight’ look (fang-like) has an enormous impact on self conƤdence and reshaping the canines to create lateral incisors is an appropriate course of action. Vita Enamic o ơ ers stability and elasticity, enabling thinnerwalls forminimally-invasive restorations. The reliability of the material is also supported by integrated cracking prevention (Fig. 2). The material also o ơ ers excellent edge stability after milling. This is generally a beneƤt in itself, but is also crucial in a case such as this in order to create thin restorationmargins that taper o ơ smoothly. The tooth-colouredmaterial facilitates light transmission with a natural appearance. In this way, Vita Enamic restorations can be integrated perfectly into the remaining tooth substance, providing an attractive play of colours. Vita Enamic is available in two levels of translucency, HT (HT= highly translucent) and T (T = translucent), as well as in the Ƥve Vita System 3D-Master shades 0M1, 1M1, 1M2, 2M2 and 3M2. The product is available in packs of Ƥve in the geometry sizes EM-14 (12 x 14 x 18 mm) and EM- 10 (8 x 10 x 15 mm). The blocks can be processed using the Cerec/ inLab MC XL system from Sirona Dental with software versions > V4.0. This allows the blocks to also be milled with the small Cerec/inLab milling system, and using software versions earlier than 4.0, Vitablocs Mark II, I14 must be selected in the list of materials. Since September 2013, Vita Enamic blanks have also been available for processing using Ceramill Motion 2 (Amann Girrbach) and KaVo ARCTICA / KaVo Everest machines. Dental technology instructor Mr. Vanik Kaufmann- Jinoian demonstrates a solution to the ‘Twilight’ look (fang-like) with a Vita Enamic restoration. RESHAPING CANINES TO CREATE LATERAL INCISORS By Mr. Vanik Kaufman-Jinoian Fig. 1: An 18-year-old patient with agenesis of the upper lateral incisors However, given that the tooth substance is healthy, an approach to restoration is required that is gentle as possible on the substance. Partial, non-prep veneers fabricated using the CAD/ CAM restoration material Vita Enamic proved to be particularly suitable in this case. Decision-making process I met the patient during her visit to the dentist, where the suggested approach of treatment was initiallymet with scepticism. The Vita Enamic composite material, for which I was one of the consultant testers, was still completely new at this time and the dentist had not heard of it. The following facts helped change his mind: the hybrid ceramic combines the beneƤts of dental ceramics with those of composite materials. By combining both materials, Fig. 2: The Vita Enamic composite (a combination of ceramic and polymer material) offers integrated crack prevention (Source: VITA R&D, Vickers indentation) Product information According to themanufacturer, Vita Enamic is the first hybrid dental ceramic in the world to o ơ er a dual-network structure: a dominant ceramic network reinforced by a polymer network, with both networks fully integrated with one another. The range of indications includes all conventional single-tooth restorations, from inlays and onlays, to veneers, through to full and partial crowns. The special material properties are beneficial particularly for restorations subject to high occlusal load, for example in the molar region, as well as for minimally-invasive restorations. Fig. 3: Initial situation CAD/CAM fabrication In the practice, conventional impressions were taken of the initial situation without preparation (Fig. 3), and gypsum models fabricated in the laboratory. These were digitised using the extra-oral scanner in Eos Blue from Sirona Dental. The inLab software (V4.2) was provided for virtual modelling; custom veneer r e s t o r a t i on s we r e c r ea t ed u s i ng biogeneric mode (Fig. 4). The model axis was adjusted Ƥrst (Fig. 5) following scanning and a preparation margin then