Digital Workflow for Virtually Designing and Pressing Ultra-Thin Lithium-Disilicate Veneers for Esthetic Rehabilitation of Fractured Maxillary Incisors – A Case Report

Abstract

The aim of this case report is to explain the clinical and laboratory procedures for fabricating ultra-thin lithium-disilicate pressed veneers using a mixed analog/ digital workflow. Summary: Four ultra-thin pressed lithium-disilicate veneers were produced for maxillary fractured incisors with the help of virtual smile design, digital wax-up and intraoral mock-up. With initial photos from the patient, the smile design could be performed considering the patient's individual face form. An intraoral scan was taken for the digital wax-up, which was guided by the contour line of smile design on the face photo. A printed model and template were manufactured for the mock-up. After a guided minimally invasive preparation and digital impression, the final veneers were designed as an exact copy of the mock-up. Wax pattern was designed on computer and fabricated by milling machine. Finally, lithiumdisilicate veneers were pressed, individualized and cemented using an adhesive technique. Key learning points: 1. digital workflow is convenient for a predictable procedure making ultra-thin lithium-disilicate pressed veneers. 2. the virtual smile designdigital wax-up-intraoral mock-up scheme presents an opportunity for effective communication with the patient and laboratory. 3. smile design software recommends an ideal smile curve for the patient with the help of definitive points and reference lines on the face. 4. guided preparation through mock-up preserves the greatest amount of enamel structure, which is important with regards to adhesive cementation. 5. when pressing lithium-disilicate veneers, a mixed analog/digital workflow using CAD and a milled wax pattern results in better physical properties and marginal fit than fully digitally milled veneers.