Digital Workflow for Virtually Designing and Milling Ceramic Lithium Disilicate Veneers: A Clinical Report

Abstract

Laminate veneers have been routinely used to restore and enhance the appearance of natural dentition. The traditional pathway for fabricating veneers consisted of making conventional polyvinyl siloxane impressions, producing stone casts, and fabricating final porcelain prostheses on stone dies. Pressed ceramics have successfully been used for laminate veneer fabrication for several years. Recently, digital computer-aided design/computer-aided manufacturing scanning has become commercially available to make a digital impression that is sent electronically to a dental laboratory or a chairside milling machine. However, technology has been developed to allow digital data acquisition in conjunction with electronically transmitted data that enables virtual design of restorations and milling at a remote production center. Following the aforementioned workflow will provide the opportunity to fabricate a physical cast-free restoration. This new technique has been reported recently for all-ceramic IPS e.max full-coverage pressed-ceramic restorations. However, laminate veneers are very delicate and technique-sensitive restorations when compared with all-ceramic full-coverage ones made from the same material. Complete digital design and fabrication of multiple consecutive laminate veneers seems to be very challenging. This clinical report presents the digital workflow for the virtual design and fabrication of multiple laminate veneers in a patient for enhancing the esthetics of his maxillary anterior teeth. A step-by-step process is presented with a discussion of the advantages and disadvantages of this novel technique. Additionally, the use of lithium disilicate ceramic as the material of choice and the rationale for such a decision is discussed.

Chairside Restorations of Maxillary Anterior Teeth with CAD/CAM Porcelain Laminate Veneers Produced by Digital Workflow: A Case Report with a Step to Facilitate Restoration Design

“…Different clinical methods can be found in the dental literature to produce porcelain laminate veneers with CAD/CAM. Zandinejad et al [9] prepared a mock-up in the laboratory before PLVs produced with CAD/CAM and carried out the preparation via this mock-up. After preparation, they sent the digital impressions to the laboratory and produced the PLVs in the laboratory on these impressions.…”

“…With the improvements in CAD/CAM systems, such thin restorations with a thickness of 0.3 - 0.7 mm could be created almost perfectly with the help of computer design [7, 8]. Excellent esthetic results can be provided by these restorations especially with the use of digital workflow in recent years [9].…”

Full Ceramic Aesthetic Applications: 3 Case Reports

“…The first step in treating non-aesthetic smile is to determine the correct indication. Previous studies provides information to guide the treatment plan in these cases [17,18]. First, the selection of restoration type was a prominent consideration.…”

Current perspectives on digital smile design

“…The DSD used for planning a prosthetic rehabilitation is probably the most common application of the software, as it also emerged from our literature review. It allows to design treatments without needing the patient to sit on a chair and analyze the treatment plan in this way, by considering all the aesthetic parameters [16]. The key to the success of the treatment is the harmony between the various components of the smile's aesthetics, such as colour, shape, volume, texture, dental alignment, gingival contour, the relationship between the teeth of the upper arch and those of the lower arch as well as the contextualization in the face [17].…”