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Jurado CA, Villalobos-Tinoco J, Mekled S, Sanchez R, Afrashtehfar KI. Printed Digital Wax-up Model as a Blueprint for Layered Pressed-ceramic Laminate Veneers: Technique Description and Case Report. Oper Dent 2023; 48:618-626. [PMID: 37881104 DOI: 10.2341/22-144-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2023] [Indexed: 10/27/2023]
Abstract
This article presents a clinical technique for transferring Digital Smile Design (DSD) information and a digital wax-up to fabricate highly personalized ceramic laminate veneers. The hybrid workflow of digitally designed wax-up and conventional hand-crafted veneers is showcased in a female adult who sought to improve her smile due to maxillary anterior incisal wear. The ceramic veneers, layered by feldspathic porcelain, followed the contours and shade blueprint planned with the digital wax-up. The DSD improved the harmony of the facial-and-smile relationship, and the ceramic restorations fulfilled the patient's esthetic and functional demands. Guides based on the printed model with the digitally designed wax-up can provide a reference for pressed lithium disilicate veneers layered with feldspathic porcelain.
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Affiliation(s)
- C A Jurado
- Carlos Alberto Jurado, DDS, MS, associate professor, Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - J Villalobos-Tinoco
- Jose Villalobos-Tinoco, DDS, MS, visiting faculty, Specialty Program in Periodontics, National University of Rosario School of Dentistry, Rosario, Argentina
| | - S Mekled
- Salwa Mekled, DDS, MBA, associate professor, Department of Restorative Dentistry, Temple University Kornberg School of Dentistry, Philadelphia, PA, USA
| | - R Sanchez
- Ramon Sanchez, MDT, dental technician, private practice, San Felipe, BC, Mexico
| | - K I Afrashtehfar
- *Kelvin I. Afrashtehfar, DDS, MSc, Dr, FDS RCS, FRCDC, assistant professor, Division of Restorative Dental Sciences, Clinical Sciences Department, College of Dentistry, Ajman University, AE, UAE; adjunct research associate professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, BE, Switzerland
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Villalobos-Tinoco J, Jurado CA, Sanchez-Hernandez RA, Elgreatly A, Alshabib A, Tsujimoto A. Injectable Flowable Resin-based Composite Veneers Prior to Ceramic Veneers. Oper Dent 2023:493891. [PMID: 37352465 DOI: 10.2341/22-048-t] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2022] [Indexed: 06/25/2023]
Abstract
OBJECTIVES This case report describes the clinical protocols for using injectable flowable resin-based composite veneers without tooth reduction as long-term prototype restorations, followed by conservative feldspathic veneer restorations. CLINICAL CONSIDERATION The patient's primary concern was to improve her smile. After clinical evaluation, injectable flowable resin composite veneers were recommended as long-term prototypes followed by conservative tooth preparation and ceramic veneers. Flowable composite veneers were created with a transparent silicone index fabricated from a diagnostic wax-up approved by the patient. No tooth reduction was required to place this type of composite veneer. Later, a printed reduction guide was used to provide conservative tooth preparation followed by the cementation of thin feldspathic porcelain veneers under full isolation with a rubber dam. CONCLUSIONS Injectable flowable resin-based composite veneers can successfully act as long-term esthetic prototypes before ceramic veneers. The outcome of these restorations is very predictable because the diagnostic wax-up anatomy is transferred to the mouth through the transparent silicone index, and they can be placed without tooth reduction. Conservative tooth preparation can be performed on the composite veneers so that minimal tooth structure is removed to maximize the bonding performance of ceramic veneers.
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Affiliation(s)
- J Villalobos-Tinoco
- Jose Villalobos-Tinoco, DDS, MS, visiting professor, Specialty Program in Periodontics, National University of Rosario School of Dentistry, Rosario, Argentina
| | - C A Jurado
- Carlos A Jurado, DDS, MS, associate professor, Texas Tech University Health Sciences Center El Paso Woody L Hunt School of Dental Medicine. El Paso, TX, USA
| | | | - A Elgreatly
- Amira Elgreatly, BDS, MS, assistant professor, Department of Operative Dentistry, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - A Alshabib
- Abdulrahman Alshabib, DDS, PhD, assistant professor, Department of Restorative Dentistry, College of Dentistry, King Saud University, Saudi Arabia
| | - A Tsujimoto
- *Akimasa Tsujimoto, BDS, PhD, associate professor, Department of Operative Dentistry, University of Iowa College of Dentistry, Iowa City, IA, USA
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Karimi K, Fischer NG, Jurado CA, Villalobos-Tinoco J, Tsujimoto A. Polychromatic Composite and Resin Infiltration Restorations in the Esthetic Zone: A Five-year Clinical Report. Oper Dent 2023:491444. [PMID: 36917631 DOI: 10.2341/22-033-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2022] [Indexed: 03/15/2023]
Abstract
OBJECTIVE This case report describes the use of a combination of a polychromatic resin composite restoration and resin infiltration to achieve a satisfactory esthetic outcome that has lasted over five years. CLINICAL CONSIDERATIONS The patient's primary complaint was a desire to replace an existing stained resin composite on the facial and mesial surfaces of the maxillary left central incisor, and a white spot on the facial surface of the maxillary right central incisor. After clinical evaluation, the patient was offered either replacement of the restoration with a polychromatic restoration simulating a white spot, or a combined treatment with polychromatic composite and resin infiltration restorations, which was recommended. The patient selected the latter treatment. A putty matrix was fabricated, and a quick mock-up was done using various enamel and dentin shades of resin composite to determine proper material selection. The previous resin composite restoration was removed, and layers of new dentin, body, and enamel composite were placed. An interproximal matrix was used in order to provide ideal contour and contact. Finishing and polishing procedures were performed. The maxillary right central incisor was treated with resin infiltration in order to subdue the white spot on the facial surface. CONCLUSIONS Polychromatic resin composite and resin infiltration restorations to replace a stained restoration and mask a white spot can achieve desired results in the esthetic zone and maintain them for five years.
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Affiliation(s)
- K Karimi
- Kiarash Karimi, DDS, DMD, adjunct faculty, University of California Los Angeles School of Dentistry, Los Angeles, CA, USA
| | - N G Fischer
- *Nicholas G Fischer, PhD, fellow, Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, MN, USA
| | - C A Jurado
- Carlos Alberto Jurado, DDS, MS, associate professor at University of Iowa College of Dentistry, Iowa City, IA, USA
| | - J Villalobos-Tinoco
- Jose Villalobos-Tinoco, DDS, MS, assistant professor, Universidad Autonoma de Queretaro School of Dentistry, Queretaro, Mexico
| | - A Tsujimoto
- Akimasa Tsujimoto, DDS, PhD, associate professor, University of Iowa College of Dentistry, Iowa City, IA, USA
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Tsujimoto A, Jurado CA, Villalobos-Tinoco J, Fischer NG, Alresayes S, Sanchez-Hernandez RA, Watanabe H, Garcia-Godoy F. Minimally Invasive Multidisciplinary Restorative Approach to the Esthetic Zone Including a Single Discolored Tooth. Oper Dent 2021; 46:477-483. [PMID: 34624106 DOI: 10.2341/20-211-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The case report describes a minimally invasive, multidisciplinary approach to a single discolored anterior tooth, with internal bleaching using traditional Japanese paper (Washi), a gingivoplasty with a three-dimensional (3D) printed surgical guide, and ultrathin feldspathic porcelain veneers. Clinical consideration: The patient's primary concern was improving her smile. After clinical evaluation, internal tooth bleaching for the discolored tooth and gingivoplasty with restoration of the maxillary anterior six teeth and first premolars was recommended. The internal tooth whitening was accomplished with sodium perborate mixed with 30% hydrogen peroxide impregnated in Washi and sealed in the root canal with glass ionomer. Once the tooth bleaching was completed, the 3D printed surgical guide was placed in the patient's maxillary anterior region and used to guide soft tissue recontouring. After 6 months, ultrathin feldspathic porcelain veneers were placed. CONCLUSION Well-planned restorative procedures combining internal tooth bleaching using Washi, gingivoplasty performed with electrosurgery using a 3D printed surgical guide, and ultrathin feldspathic porcelain veneers can achieve the desired results in the esthetic zone and remain successful for 4 years.
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Affiliation(s)
- A Tsujimoto
- *Akimasa Tsujimoto, BDS, DDD, Department of Operative Dentistry, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - C A Jurado
- Carlos Alberto Jurado, DDS, MS, Texas Tech University Health Science Center El Paso, Woody L. Hunt School of Dental Medicine, El Paso, TX, USA
| | - J Villalobos-Tinoco
- Jose Villalobos-Tinoco, DDS, Department of Oral Rehabilitation, Autonomous University of Queretaro School of Dentistry, Queretaro, Mexico
| | - N G Fischer
- Nicholas G Fischer, PhD, Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, MN, USA
| | - S Alresayes
- Saad Alresayes, DDS, MS, Department of Restorative Dentistry, King Saud University, Riyadh, Saudi Arabi
| | - R A Sanchez-Hernandez
- Ramon Alfredo Sanchez-Hernandez, dental technician, private practice, San Felipe, Baja California, Mexico
| | - H Watanabe
- Hidehiko Watanabe, DDS, MS, Department of Restorative Dentistry, Oregon Health and Science University School of Dentistry, Portland, OR, USA
| | - F Garcia-Godoy
- Franklin Garcia-Godoy, DDS, MS, PhD, Department of Bioscience Research, College of Dentistry, University of Tennessee, Health Science Center, Memphis, TN, USA
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