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Fig 3: Tooth 16 and 17 in the first quadrant did not require preparation. Fig 4: The designs fabricated using VITABLOCS TriLuxe forte in the first
and fourth quadrants.

Fig 5: In the second quadrant, tooth 25, 26 and 27 did not require Fig 6: The designs fabricated using VITABLOCS TriLuxe forte in the
preparation. second and third quadrants.

funCTIOnAL eSTheTIC dIAGnOSIS the esthetic zone could be reconstructed and a new anterior canine
During palpation of the masticatory muscles, no hardening of the alignment could be established. The goal here was that no further
muscles was evident. The patient had no complaints related to her destructive eccentric forces should impact the molar area. The first
occlusal situation. Clinically, there were also no deviations after step was restoration of the upper anterior region. Following local
deprogramming between the habitual intercuspation and the centric anesthetic, the mock-up supported gentle preparation that was limited
condyle position. There was only a loss of vertical dimension as a to the enamel area, as well as shaping of the gingival garland by means
result of abrasive and erosive processes. For this reason, the bite was of a gingivectomy. Following intraoral scanning, the dataset was
raised by one millimeter in the articulator in order to be able to carry transferred to the inLab CAD software (Dentsply Sirona, Bensheim,
out a functional esthetic wax-up. The wax-up impression was taken Germany). During the design process, the previously digitized mock-
using silicone, which then enabled transfer of the wax-up from the up was also used here to provide a morphological basis. CAD/CAM-
model to the patient’s mouth. The silicone key was filled with flowable supported fabrication of the veneers was carried out using the X5
composite (Protemp 4, 3M, Seefeld, Germany) and repositioned on milling unit (Dentsply Sirona, Bensheim, Germany). The restorations
the dentition. After curing, the composite remained on the dentition were finalized using fine diamonds and a rubber polisher and then
when the silicone key was removed. The wax-up became a mock-up characterized and glazed using the VITA AKZENT Plus stain system.
that was now used for fine adjustment of the esthetics and function Following fully adhesive placement of the veneers using RelyX Veneer
under biodynamic conditions. The modified result was scanned using (3M, Seefeld, Germany) in the upper jaw, restoration of the esthetic
the CEREC Omnicam (Dentsply Sirona, Bensheim, Germany) and zone in the lower jaw was carried out in the same way.
provided the basis for virtual design of the restorations.
fOLLOw uP And COnCLuSIOn AfTer 4.5 yeArS
reSTOrATIVe PrOCeSS To ease pressure on the stomatognathic system at night and to protect
To stabilize the occlusion, the posterior region was first reconstructed the restoration, a front-canine-guided splint was also fabricated for
with crowns and partial crowns made from VITABLOCS TriLuxe the upper jaw. The restorations were intact 18 months after placement
forte in shade 1M2. In doing so, it became clear that 17, 16, 25, 26 and the patient was free from any symptoms. VITABLOCS TriLuxe
and 27 did not require treatment due to treatment of the antagonist forte proved to be an effective booster in the treatment requiring
area. After the bite in the posterior region had proven to be stable, total reconstruction. As a result, it has the potential to make this

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Dental Practice I May-June 2024 I Vol 20 No 3 57