Efficient layering for high-quality dental implant aesthetics: Case study

A natural looking and aesthetically pleasing restoration can be achieved using simple technique and complementary materials. Master Dental Technician Marcio Breda describes how beauty can be created with ease on six implants using the highly translucent zirconia VITA YZ HT White and the universal veneering ceramic VITA LUMEX AC.

CASE STUDY
A 35-year-old patient was dissatisfied with the functionality and aesthetics of the full dentures in his upper jaw. The patient complained of the insufficient suction effect, which generally made him feel insecure in public and was accompanied by rocking when biting and chewing. As a result, he avoided hard foods. The denture teeth and the base of the full denture also appeared lifeless and artificial.

The patient wanted a fixed restoration on implants that would give him security and age-appropriate aesthetics. After detailed diagnostics and a consultation, he decided on six implants and a superstructure made of zirconia and veneer ceramics that could be fitted individually and match the natural teeth in his lower jaw. The base tooth shade A3 was determined for the incisors in the lower jaw using the VITA classical A1-D4 shade guide.

CLINICAL STEPS AND CAD/CAM
After the insertion and healing of the implants, an impression with model analogues and an opposing jaw impression provided the basis for the production of a master model and its articulation in the registered jaw relation.

The model situation was then digitised in the laboratory scanner Ceramill Map 400+. The construction was anatomically reduced, incorporating six GM Mini Conical Abutments with the exocad software. The zirconia substructure was finally milled from the zirconia VITA YZ HT White using the Ceramill Motion 2 (Fig. 1). The highly translucent framework structure was intended to ensure natural translucency in the area of the teeth right from the start.

Fig. 1: The stained zirconia substructure made of VITA YZ HT after sintering

INFILTRATION AND LAYERING
After finishing, the dental parts of the framework were infiltrated with VITA YZ HT SHADE LIQUID A3 to match the base tooth shade of the lower jaw teeth. A corresponding infiltration with VITA YZ EFFECT LIQUID Pink was carried out in the gingival area for the basic reproduction of the gingiva. After drying, the framework was sintered. The washbake was done in the dental area with VITA LUMEX AC FLUO INTENSE sand to implement a natural fluorescence in the depths. Strong GINGIVA rosewood was used in the mucosal area for an initial reproduction (Fig. 2).

Fig. 2: The washbake with FLUO INTENSE sand and GINGIVA rosewood

The dentine cores were layered with more chromatic DENTINE A3 on the canines and with DENTINE A2 on the other teeth (Fig. 3). Next, anatomical cut-backs were performed (Fig. 4).

To read the full article, click here or refer to Dental Asia January/February 2024 issue.

ABOUT THE AUTHOR

Master Dental Technician Marcio Breda is a specialist in dental ceramics and challenging aesthetics. Since 1989, he has been managing his own dental lab in Vitória, Brazil, and has authored and co-authored various international publications on the topics of aesthetics and implantology.

Currently, he is a consultant for VITA Zahnfabrik in Latin America and director of the educational institution, Centro de Estudios y formacion.