Youngbae Kim from the USA.
Highly esthetic result
The crowns the patient selected are now carefully taken off the stumps and are cleaned with alcohol. The stumps are also cleaned and dried. The self-adhesive cement is applied on the crown. Both crowns are positioned in their definitive place. What a day! What a highly esthetic result! The patient is more than happy.
Bashar Omar (Trainee in 2nd year)
One after the other, each crown pair is finished. Everyone compares their crowns with the patient’s oral situation. The moment of truth has come: Time is over! The final try-in will take place in the dental office with Dr. Jens Gebrande. Everyone is boxing their crowns. Crackling tension lies in the air while Renato Carretti and the participants leave the VITA lab to head to the dental practice.
This is the dental high noon, the dental showdown. Will the passion and the energy of the last two days be enough for a definitive cementation? The group enters the dental practice, heading straight for the treatment room. Dr. Gebrande takes off the provisional crowns carefully and cleans the tooth stumps.
One crown pair after another is slowly sliding over the stumps to find its predetermined place. The patient keeps looking into the mirror to check the shape and shade.
You can hear the people in the room whispering and discussing. It’s all or nothing! After the first round of try-ins, two pairs of crowns are on the short-list. Then there’s a determined look of the patient; she nods. She’s found the perfect match for the definitive cementation.
The shades of the restorations appear so natural, even after direct comparison with the patient, that no staining is required. The layering appears three-dimensionally from inside out.
Renato ads ceramic correction material in the proximal areas to extend the contact surfaces. He also doesn’t need to apply glaze material. For the last time, the restorations are put into the furnace for the glaze firing. The participants are highly motivated and only one step behind. They’d better be, because the appointment in the dental practice is drawing closer and everybody wants to be ready for the great final.
The patient will be spoilt for choice there. Which pair of crowns will she choose? The final glaze firing is finished. The restorations are coming down promisingly. After they have cooled down, only a gentle polishing with pumice is sufficient to reach the right brilliance level of the patient.
The furnace reveals its secret and one glimpse at the restoration shows Renato that this is exactly what he wanted to see. He nods contentedly, smiling. These are the special moments every dental technician is looking forward to. The symbiosis of human, material and technology have led to a perfect result that only needs a finish.
Renato adjusts a fine diamond-coated instrument to the handpiece and fixes the first crown safely between his fingers. He guides the rotating instrument skillfully over the surfaces. During the grinding procedure, he takes care to transfer the ridges more inwards to let the crowns appear narrower, just as they are supposed to be.
Change of instruments: He inserts fine sandpaper into the handpiece and slides it over the surfaces at slow speed. Attention: The implemented surface texture should not get lost.
Now it’s all about nuances. Tiny portions of a balanced mixture of BASE DENTINE A3 and light orange EFFECT CHROMA 5 are added in the neck area. This is how Renato Carretti reduces the translucency precisely and implements a warm appearance. He uses the same mixture to extend the contact surface towards the gingival area. Renato concentrates and dabs ceramic onto the surface again and again, spreading it evenly, at times stopping to think about the next step. It’s only about small details now.
He reduces the translucency of the rest of the crown with a very fine layer of milky NEUTRAL. Here we go: The restorations are put into the furnace.
During the correction firing, the participants are absolutely concentrated implementing changes. Renato keeps walking from one desk to another to take a look at the restorations and provide tips and advice.
After the firing, the moment of truth has arrived: the first clinical try in! The air is full of tension as Dr. Jens Gebrande takes the temporary restorations to put them on the stumps for the very first time. If you listen closely, you’ll hear the drum roll. The first glimpse into the mirror: It’s all going into the right direction! A few minor corrections will be done in accordance with the patient:
The translucency in the transition area from incisal edge to bulge area will be reduced a bit.
The contact surfaces will be extended towards the gingiva to close up on the black triangle.
The teeth are supposed to look a bit narrower morphologically.
The second dentine firing allows for the precise finalization of the effects of morphology and colors. Renato designs the neck area more chromatic with a one-to-one mixture of BASE DENTINE A3 and light orange EFFECT CHROMA 5. He adds a balanced mix of BASE DENTINE A2 and NEUTRAL for the structure of the bulge area.
He also uses NEUTRAL for the incisal area to reduce the translucency with the slightly opaque ceramic. He applies a light blocker palatinally of whitish INTERNO 01 for the same reason and covers it with chromatic EFFECT CHROMA 2 (sand-beige).
Having controlled the occlusion, layering can now be finalized. The crowns are carefully taken from the model and fixed with a pair of tweezers from the lumen side. Here we go!
Just as in the preceding ceramic layering steps, he carefully fills and smoothens the approximal areas one after the other.
Renato has a final tip for Youngbae Kim and Ryo Funaki from the US and Bashar Omar and Vanessa Bauer from Germany: “I haven’t applied too much. Make sure you leave enough space for the second dentine firing! This way you will be free to decide later if you need more chroma or translucency.”
He positions the two crowns on the firing pin and puts everything into the furnace.
He chooses a firing program and the furnace drives the restorations up into the firing chamber, step for step.