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Light Management with Zolid HT+

Smart choice of framework material for full color control.

Tue. 27 April 2021, 4:00 PM

Light Management with Zolid HT+

We dental technicians have waited a long time for super high translucent zirconia like Zolid FX. The natural light transmission enables us to reproduce natural esthetics with only a low thickness of ceramics. A prerequisite, however, is the appropriate shade of the tooth stump substrate, one which has no negative influence on the shade result of the final restoration. The young female patient is troubled by the discoloration of the devitalized tooth 11 and the inwardly inclined position of the two central incisors. The meanwhile discolored composite abutments on both teeth intensify the patient’s desire to optimize her optical appearance (Fig. 2+3). Together with the patient, the dentist decides on crowning teeth 11 and 21 and reconstruction with all-ceramic crowns.

Fig. 1 - Restoration of teeth 11 and 21 with crowns made of Ceramill HT+ and Creation CT Fig. 1 - Restoration of teeth 11 and 21 with crowns made of Ceramill HT+ and Creation CT
Fig. 2 - Initial situation with insufficient composite abutments and discolored tooth 11 Fig. 2 - Initial situation with insufficient composite abutments and discolored tooth 11
Fig. 3: The patient wishes to have a prosthetic correction of the retruded middle incisors Fig. 3: The patient wishes to have a prosthetic correction of the retruded middle incisors

Masking the dark tooth stump

Due to the clearly darker tooth stump 11 we decided against the super high translucent Zolid FX in favor of the slightly less translucent Zolid HT+ (Fig. 4). The task of the frame material is to reduce the influence of the dark stump at a wall thickness of approx. 0.5 mm to such an extent, that the subsequent veneer layer can achieve an identical brightness value and keep this stable even under different light sources. The different translucencies are represented in Figure 6b. The frame is milled in Zolid HT+ White and adjusted to the desired dentin shade by applying the liquid staining technique before sintering. We therefore often choose this frame shade about half a shade lighter than the dentin of the veneer ceramics. This ensures finely dosed, just sufficient light reflection in the depth of the tooth structure, without unwanted greying at low light. Our aim is to create vibrant-looking teeth with natural translucency, true color depth and a reliable brightness value.

Intact canine guidance and diagnosed normal loading of the teeth not only allows us to veneer the crowns labially but also completely. To do this, we use Creation CT.

Fig. 4 - Dissimilar shade basis: the darker tooth 11 is devitalized and must be masked with a more opaque frame material Fig. 4 - Dissimilar shade basis: the darker tooth 11 is devitalized and must be masked with a more opaque frame material

Variations in shape

Out of mere curiosity we produced two different pairs of crowns. We varied the tooth width of the two crown sets by positioning the mesial and distal lines differently, thereby significantly changing the character of the teeth.

Both variants were tried in at two different appointments. Both sets match the patient’s face. After some minor changes, both pairs of crowns are finished. Ultimately, it is up to the patient to decide which variation of the crowns is to be used. Figures 7-9 show the optically somewhat narrower variant, which fits discreetly, inconspicuously and thus very credibly into the dental arch. My favorite. The image sequence 10-12 shows the second variant. These teeth appear bolder, larger and more rounded.

A matter of taste

At some of my courses and lectures, I presented both restoration variants to the expert audience and had them decide which execution they liked best. The majority voted in favor of the more graceful first variant. (Fig. 7-9)

Without hesitating and brimming with confidence, the patient opted for the second variant. She liked the large teeth. This pair of crowns is inserted and happily presented at the final photo shoot in Figure 13. Our goal was to fabricate prosthetics that not only please us and the dentist, but also the patient. New teeth should fully satisfy the needs of our patients. In this case, we succeeded. We would like to take this opportunity to thank Dr. Julia Lorenz for the excellent documentation, which made a significant contribution to a successful result.

Fig. 5 - Natural, simple characterization with Creation CT as full veneer Fig. 5 - Natural, simple characterization with Creation CT as full veneer
Fig. 6a - Ceramill HT+ with its reduced translucency is very suitable for masking the slightly discolored residual stump of tooth 11 Fig. 6a - Ceramill HT+ with its reduced translucency is very suitable for masking the slightly discolored residual stump of tooth 11
Fig. 6b -Comparison of translucency – from the left: ZI, Zolid HT+ and Zolid FX Fig. 6b -Comparison of translucency – from the left: ZI, Zolid HT+ and Zolid FX
Fig. 7 - Variant 1: Crowns 11 and 21 appear quite unobtrusive due to the same brightness value. The lower translucency of Zolid HT+ successfully masked the devitalized,
discolored residual stump at 11 Fig. 7 - Variant 1: Crowns 11 and 21 appear quite unobtrusive due to the same brightness value. The lower translucency of Zolid HT+ successfully masked the devitalized, discolored residual stump at 11
Fig. 8 - Variant 1: Crowns 11 and 21 appear quite unobtrusive due to the same brightness value. The lower translucency of Zolid HT+ successfully masked the devitalized,
discolored residual stump at 11 Fig. 8 - Variant 1: Crowns 11 and 21 appear quite unobtrusive due to the same brightness value. The lower translucency of Zolid HT+ successfully masked the devitalized, discolored residual stump at 11
Fig. 9 - Variant 1: Crowns 11 and 21 appear quite unobtrusive due to the same brightness value. The lower translucency of Zolid HT+ successfully masked the devitalized,
discolored residual stump at 11 Fig. 9 - Variant 1: Crowns 11 and 21 appear quite unobtrusive due to the same brightness value. The lower translucency of Zolid HT+ successfully masked the devitalized, discolored residual stump at 11
Fig. 10 - Variant 2: the line angles are positioned more to the outside to allow them to appear larger Fig. 10 - Variant 2: the line angles are positioned more to the outside to allow them to appear larger
Fig. 11 - Variant 2: the line angles are positioned more to the outside to allow them to appear larger Fig. 11 - Variant 2: the line angles are positioned more to the outside to allow them to appear larger
Fig. 12 - Variant 2: the line angles are positioned more to the outside to allow them to appear larger Fig. 12 - Variant 2: the line angles are positioned more to the outside to allow them to appear larger
Fig. 13 - The patient chooses variant 2 with the larger looking crowns Fig. 13 - The patient chooses variant 2 with the larger looking crowns
Fig. 14 - The patient chooses variant 2 with the larger looking crowns Fig. 14 - The patient chooses variant 2 with the larger looking crowns
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