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20 prosthetic section DENTAL TECHNOLOGY, JANUARY-MARCH 2024

FIG 40: Lateral view: restorations are harmony with the FIG 41: Pre and post operative views : comparison with FIG 42: Pre-op, mock up and final profile of the patient with newly
vermilion border of lower lips. the newly established vertical dimension and esthetics established functional and esthetic rehabilitation.

FIG 43: Pre and post operative occlusal view of the upper arch FIG 44: Pre and post operative occlusal view of lower arch

FIG 45: A novel approach of preserving the vitality of teeth with severe erosions using a combination of lingual composite veneers and labial lithium di-silicate veneers for better esthetics
and function.

ed with lithium di-silicate (E-MAX Press) material (Figure 20), surface treatment was ini- About the authors
tiated. The intaglio surfaces were treated with 5% hydrofluoric acid from Ivoclar for 20 sec-
onds, followed by cleaning in an ultrasonic bath of isopropyl alcohol to eliminate any resid-
Dr. Pavan Kishore Nallapati, graduated from
ual salts. Then, a universal bond from Tokuyama (Japan), was applied to the intaglio sur-
Meenakshi Ammal Dental college, Chennai in
faces and air dried. 2004. Since 2006, he has been into private
Prior to bonding, the teeth underwent standard protocols including pumice cleaning to practice with key interest in microscopic
remove plaque and etching with 37% phosphoric acid (N-ETCH from Ivoclar) for 15 seconds, dentistry and minimally invasive dentistry
followed by rinsing with water for 30-40 seconds. The same universal bond was then applied with composite resins and E-max. He under-
went training in Advanced Aesthetic
to the tooth surfaces as a bonding agent.
restorations from Tokyo Dental and Medical
A week after restoring the posterior sextants, we turned our attention to the restoration university, Japan and is the key opinion
of the lower anterior teeth. Firstly, immediate dentin sealing (IDS) was done with Palifique leader for TOKUYAMA dental, Japan.
bond dentin bonding agent from Tokuyama to preserve their vitality. A resin coat was applied
to completely seal the dentinal tubules using bulk flowable material of shade A2 from Mohit Suryavanshi is a certified Dental
Tokuyama. Impressions were then made for the fabrication of lingual composite veneers. Technician based in Kolhapur. Mohit is an
Upon receiving the completed work (Figure 22), bonding of the composite veneers accomplished dental artisan with over 25
began. The intaglio surfaces of both the composite and teeth were treated with 37% phos- years’ experience and runs a boutique
Dental laboratory. He is a specialist in the
phoric acid (N-ETCH from Ivoclar), followed by the application of a bonding agent
art of cosmetic imaging and image commu-
(Universal bond from Tokuyama, Japan) (Figure 23). After bonding of the lower lingual nication between the dental office and the
surface with composite veneers, preparation of the labial surface was initiated for restoration laboratory.
with lithium di-silicate veneers made by using the E-MAX Press technique (Figures 24 and
25).
Preparations for the upper anterior teeth were carried out alongside the lower teeth, guid-
ed by the existing temporaries and the fabricated silicon keys. Impressions were made with
putty and light body material from Zhermack’s Hydrorise, and the work was sent to the lab.
Upon receiving the anterior work from the lab, all upper full veneer crowns and lower
veneers were bonded using the same protocol as mentioned above, including surface treat-
ment of the intaglio surfaces prior to bonding (Figures 26 and 27). The patient was then
reviewed after one week to assess the gingival adaptation and occlusion.