This is a challenging aesthetic and occlusal case which incorporates ceramics, resin bridge work, composites, orthodontics and implants. This case was presented at the BDA.
The patient has poor aesthetics, worn incisors, spacing issues and peg shaped teeth. She has a deep overbite and traumatic occlusion causing wear to the teeth. There are multiple restorative spaces both bottom and top.
The patient needed orthodontic work which decompensated the overbite, repositioned the canines (critical to longevity in this case) and corrected some spaces before Dominic could predictably restore the teeth.
The sinus was lifted an implant placed and implant crown to restore the space on the left. Dominic restored the lateral incisor from a peg shaped to a full sized lateral with an ultraconservative enamel only preparation 360° ceramic (Dominic liaised with the orthodontist to leave some spacing here for this). On the left side, the patient ran out of money for implant treatment so we went for an adhesive bridge. A metal bridge would give show through so Dominic built up the central incisor edges with venus pearl and went with a zirconia bridge which can be taken right up to the incisal edge.
Double abuting can be done post ortho as it now works as a retainer wire on the adjacent teeth.
Orthodontics helped us with occlusion and aesthetics, and use of composite and modern minimally invasive ceramics gives us a lovely long lasting cosmetic results.
Techniques used in this case:
- Zirconia adhesive bridge
- 360º e.max ceramic
- Ovate pontic technique
- E-max
- Whitening
- Venus pearl composite
- Posterior implant
These techniques are taught in the DHTI courses.
Use our free resource as an example of what can be achieved with online blended learning.
