Aesthetic rehabilitation. Non invasive ceramic veneers. скачать в хорошем качестве

Aesthetic rehabilitation. Non invasive ceramic veneers.

Aesthetic rehabilitation. Non-invasive ceramic veneers. Nowadays, adhesive technology in dentistry allows us not only to create highly aesthetic and natural smiles, but also it gives us a possibility to be as much conservative, as we want to; in some cases, we even can perform high-end dentistry without any preparation at all. The laboratory work was performed by Ivan Savula, from Lviv, Ukraine, a FSC member. Initial situation. 20 years old girl wanted to have more harmonious smile. To achieve predictable results, we need to collect all available information, analyze the initial situation, patients wants and needs, make a virtual design of future smile and mock-up and only then we can create a treatment plan, choose the most appropriate technique and restorative materials. Initially, patient categorically refused the orthodontic treatment. INFORMATION COLLECTING When we are going to change the shape and size of teeth, we should understand that final teeth form must match and fit to facial appearance of our patient, otherwise, we risk to get beautiful teeth, which will disrupt the natural appearance of the face. So facial analysis is crucial step in our treatment planning and it should be performed as careful, as it is possible. As it is a lengthy process, which requires maximum attention to it, we make a video, that we scroll multiple times, trying to catch the smallest details to make the most important decisions in future smile planning. Portrait photos are also important for planning future restorations. Portraits with different smiles Portraits with different head positions Some details appear on smile close-up photo. We also do photos for evaluation of the vestibular position. Bottom view Intraoral photo Evaluation of the spaces in direct vision Vestibular view Analysis of a color was carried out using a photo with a polarizing filter and VITA shade guide. We used ring flash to better visualyze existing texture. The dimensions of the teeth can be measured during photography. Or we can measure them on the cast. Some pictures can have more artistic rather than the diagnostic value In some cases it might be useful to analyze the teeth shape of close relatives, like in this case - a sister. Such information is especially valuable in cases, where we need to replace old restorations with inadequate shape. ANALISYS AND DSD Photos transferred to Keynote Mac OS, where we perform analysis and planning Analysis of the facial aesthetics Photo with retractors, face align on the horizon, central line is determined Intraoral photo overlaid and positioned on photo with retractors. Intraoral photo of the upper anteriors with horizon and central line Gingival contour analysis Analysis of teeth row shape Analysis of the proportion of the centrals Golden ratio analysis After video, photo and models analysis, we started visualizing our decision. With collected information it’s easy to allocate optimal space for future restorations. Optimal shape of the teeth has been chosen, and it matches to allotted space. The discrepancy between the position of the gingival margin of centrals is being ignored, because of lack of gingival visualization during a smiling and conversation. This and many other information we obtain from the video. Further, the virtual ruler is calibrated. Now we can measure the size of the future restorations. Height Width Other dimensions Also, using different projections we can make a three-dimensional project of future smile. In a simple way we can make a virtual mockup if its needed WAX-UP AND MOCK-UP Next step is a wax-up. Ideally, the technician must repeat the virtual design, if it coincides with the occlusion. To verify the accuracy of matching, we have imposed the intraoral photo and photo of model changing their translucency Reference points of horizon for technitian DSD project imposed on the model DSD project imposed on the model with wax-up This projection better shows us harmony and beauty of our solution to close spaces. Wax-up is powerful diagnostic tool and it should be precisely done in articulator Silicon key is taken from the wax-up Further, we are placing a bysacril material for the temporaries (in this case - Luxatemp DMG) in silicone key, and placing it intraorally If we precisely trim the gingival outline of silicone key along the scallop of proposed gingival outline from teeth, it would be much easier for us to remove excess bisacryl material, as it will be mechanically clipped with silicone key. Mock-up matches to a virtual project Smile with mock-up Smile from right and left Mock-up should be analyzed in dynamics, which implies a video record. After proper video analysis, shape and dimensions have been approved by the patient and a team with a few corrections established by clinician - 1. centrals - shorter, guide - distal part of 11 2. centrals - rounded distal corners 3. laterals - shorter (0.2mm) 4. 22 medial highlight more medial