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ePaper created 2016-11-25, 09:21:23 | version 1.38.0
exhibitors 16 Greater New York Dental Meeting — Nov. 27, 2016 By Anamaria Muresan, DMD, ME, CDT n In the anterior region where estheticsareparamount,certaincom- plications can preclude the use of all-ceramic material. The task then becomes finding a material worthy of the anterior with the durability to meet precise standards. Obsidian® Lithium Silicate Ceramic Pressed to Metal (Prismatik Dentalcraft Inc.; Irvine, Calif.) puts an innovative spin on PFMs, with traditional porcelain passed over for lithium silicate ceramic. The result is five times the strength and more than two times the chip resistance of traditional PFMs. Case study A 27-year-old male patient presented with an old PFM crown on tooth #9, which had undergone endodontic treatment about 10 years prior to address decay. A darkened margin, visible due to gum recession on the facial, posed a distinct problem for this anterior case. In addition, the esthetics of the PFM crown were noticeably inadequate. To achieve an optimal outcome in the face of these difficulties, the first task in the treatment plan was to match the gingival height of tooth #9 to #8. Choosing Obsidian for the new crown was important in providing esthetics, as all-ceramic materials were eliminated from consideration because of the dark gingiva of the tooth in question. Inrelationtotherestofthepatient’s smile, the PFM crown on tooth #9 does not offer harmonious shade and contours and fails to mirror the natural translucency and character of tooth #8. I used a gingivectomy on tooth #9 to improve contours, which was com- pletedwithaPicasso™ Litediodelaser (AMD Lasers; Indianapolis, Ind.). To improve visibility of the gingi- val contours, I used hydrogen perox- ide to scrub away the charred tissue tags. The gingival height of tooth #8 and #9 is now more symmetrical while avoiding violation of the bio- logical width. In order to approach a normal cervical contour with the provisional and the final restoration, it is impor- tant to mirror the CEJ of the other central.Otherwise,therestoredtooth will have a narrow form and will not look esthetic. With retraction cords in place and Capture® medium- and heavy-body impression materials at the ready, a two-cord impression technique can be carried out. This case features a shoulder prep- aration to ensure enough thickness for the ceramic labial margin to block the darkness of the preparation at the gingiva. A temporary crown provides a preview of how the new anterior res- toration can blend in with the overall smile. Photos of the mocked-up tempo- rarywereincludedintheinformation provided to the lab technician. Aftertheinsideoftherestorationis sandblasted, the Obsidian Pressed to Metal crown is ready to be cemented with RelyX™ Luting Plus (3M™ ESPE™ ; St. Paul, Minn.). The Obsidian Pressed to Metal crown successfully masks the dark- ened stump shade at the gingival third while also blending in with the overall smile. Previously, a PFM was the com- mon restorative choice for a case involving a darkened stump shade. Fortunately, today’s clinicians have Obsidian Pressed to Metal, which outperforms traditional PFMs. Natural-looking esthetics and proven strength propel Obsidian Pressed to Metal past its predeces- sors. The central details: Renewing a smile with an esthetic Obsidian crown Product puts a spin on traditional PFMs Here in New York To learn more about Obsidian Pressed to Metal, stop by the Glidewell Labora- tories booth, No. 4334. 5 Before- and after-photos of a 27-year-old male patient who presented with an old PFM crown on tooth #9. It was replaced with an Obsidian Pressed to Metal crown. 5 Obsidian Pressed to Metal crowns. (Photos/Provided by Glidewell Laboratories)