Australasian Dentist November-December 2018

Category AustrAlAsiAn Dentist 49 lInICal Robert A. Lowe , DDS received his doctor of dental surgery degree, magna cum laude, from Loyola University School of Dentistry in 1982. He is a member of Catapult Elite Speakers’ Bureau and has Fellowships in the AGD, International College of Dentists, Academy of Dentistry International, Pierre Fauchard Academy, American College of Dentists, the International Academy of Dento-Facial Aesthetics, and the American Society for Dental Aesthetics. Throughout his career, he has authored and published several hundred articles in many phases of cosmetic and rehabilitative dentistry. Conclusion: some clinical uses for the uveneer template system have been demonstrated and shown in this article. in all these situations, uveneer helps the dentist create artistically beautiful facial surfaces of maxillary anterior teeth, both as direct composite veneers and in a variety of diagnostic situations that help the dentist and patient get on the “same page” when designing an aesthetic restorative case to meet the patients’ individual goals. uveneer is another helpful tool in our armamentarium that makes composites work in the anterior zone predictable, faster and beautiful. u Case 3: Using Uveneer to do a quick Indirect Mock-up on a study model For many aesthetic cases, the clinician will send a preoperative impression to the laboratory for a diagnostic wax-up. this diagnostic wax-up model is used as a communication tool and/or as a base to fabricate provisionals for future porcelain work. in this case, the composite mock-up is made in the dental office using uveneer kit saving the additional laboratory expense of a wax-up and saving a patient visit. Fig 15: After creating the stone model of patient’s existing teeth. The first step is to determine which size of Uveneer central incisor will work the best (size of the template is labeled on the Uveneer handle. Figure 17: In a very short period of time using the Uveneer templates, the six-tooth composite mock-up is complete. This mock-up can be used directly in a thermoplastic machine to create provisional stent or by an impression of a silicon putty to create a silicone stent. A direct mock-up can be also done with Uveneer templates directly on a patient teeth, without bonding which can be used as an excellent communication and marketing tool. Fig 16: A composite resin is applied on the facial surfaces of the teeth or alternatively into the Uveneer template, Uveneer pressed, excess removed and light cured Fig 11: The Uveneer template is pressed into the composite material. Excess is removed from around the periphery of the template with IPC plastic instrument. Figure 8: This patient presented with a fractured porcelain restoration on two central incisors. The long-term treatment plan was to replace the porcelain restoration. Due to economic reasons the decision was made to overlaying the existing restorations with direct composite, given the restorations would ultimately be replaced. Fig 12: After light curing, the template is removed. Fig 9: The porcelain surface roughed with a diamond bur. Fig 13: We decided to add one more layer to mask more and create fluorosis effects with a resin tint in order to create a more natural shade effect. The surface was roughed with a bur and tinted with white tint at the incisial area for a fluorosis effect, an unfilled resin is applied between layers and second composite layer added followed by pressing Uveneer. Fig 14: The completed veneered restorations on 2 central incisors Fig 10: Clear matrix strips are placed interprox- imally. The prepared existing porcelain veneer surface (Felthpatic porcelain) was etched with hydrochloric acid 9.5% for 90 seconds, rinsed, silanated and air-thinned followed by porcelain bonding and light cured. Then Composite is applied onto the prepped porcelain surface. CASE 2: Veneering fractured Porcelain Veneers with Direct Composite