After several years of working as a dentist I collected a lot of experience and scientific data about ceramic restorations. I learn from every case and analyze my protocols after follow-ups to improve efficiency of my practice, ease my daily routine and obtain more predicable results.
Mostly I perform e.max restorations in frontal area. In rare cases such such metal core post or severe decayed teeth I make zirconia crowns and almost ended up with porcelain fused metal crowns due to compromised aesthetics and issues with gums.
As you see on the pictures we deal with non-vital teeth, old fillings, decay and abnormalities of position so we have to consider this issues in our treatment plan.
First of all I always perform wax-up of the future smile. It allows us to plan aesthetics, drill more conservative and create nice temporaries that is essential during the treatment.
After obtaining the model I start to prepare the teeth. I perform endodontic treatment, core post in non-vital teeth and remove all the decay and old fillings. This step is very important for future stability of our restorations.
Then I start the preparation itself. I try to be conservative as much as possible and leave an enamel as much as possible for proper adhesion and preserving a pulp from inflammation. Also I always place a finishing line above the gums for better periodontal health, precise impression, control of the restoration fit and removing the excesses of fixation cement.
I usually perform impression with one thin retraction cord and hemostatic gel and use A-silicone material.
Then I make temporary restorations and always share this pictures with dental technician so he can improve the final ceramics.
During the fixation process I isolate the teeth with rubberdam and use composite fixation with full adhesive protocol. After light cure I completely remove excesses of cement with scalpel, curettes and finishing burs and polish the seal margin.
Control after 1 year
Control after 3 years
As you see understanding the dental technology and biology of human body we can obtain stable aesthetic and functional result after years and of course happy and thankful patients.