Beforehand, the incisal area should be prepared though. Therefore ENL and EE9 are mixed 1:1 and applied from mesial and distal to incisal. To get the right translucency in the incisal edge, alternating layers of INTERNO 1 (white) and 2 (sand), mixed with WINDOW, are applied. This is blended with INTERNO Liquid.
For the first dentin firing, Patrick uses his steady hand to place the crowns on the firing tray. He selects the program and the firing tray gradually moves upward into the firing chamber. After everything has cooled down, he first checks the result for an accurate fit, finishes it with a small stone if necessary and fits it on the model. The big moment is coming: Is Patrick on the right track?
The trial in the patient’s mouth leads the way; the incisal edge is still a bit too translucent. Also, a bit chromaticity is required cervical. That’s why he reduces it a bit for the second dentin firing, using a fine diamond.
While the coping is fired, Patrick Rutten mixes his ceramic materials with the modelling liquid. The right consistency is the crucial element here. Right after the coping has cooled down, he starts layering EC5 and EC6 in the cervical and approximal area.
He uses his brush and positions it unerringly. For the cervical area, he uses BASE DENTINE 2L2,5 with a hint of translucent pink (EE3). The crowns get their basic shape with VITA VM 9 BASE DENTINE 1M1. Always use enough liquid and never let it dry out!
Patrick Rutten’s choice for the wash firing is EFFECT LINER 4. It makes the zirconia coping look more vivid and fluorescent. He mixes fluid EL4 with modelling liquid and adds the mixture to the coping. He positions it in the furnace before it gets hot. With a firing temperature of 970 °C, the wash firing ensures the basic adhesion to the ceramic veneering.
MDT Patrick Rutten is using the VITA Toothguide 3D-MASTER to determine the basic tooth shade: the essential and crucial step for successful layering. He decides on 1M1 for the dentin core. For the cervical area, he selects 2L1,5 with a hint of translucent pink (EE3). He allows for chromaticity with a mix of orange EC5 and EC6 in the cervical-approximal area.
Not 2M1 anymore, the tooth shade was changed to 1M1. The old metal-ceramic crowns were removed in the dental practice. The two central incisors were provided with a splinted temporary solution which will be removed several times today to examine the intermediate stages of the layering.
At the age of twelve, the patient had an accident which resulted in the fracture of the anterior teeth 11 and 21 in the crown area. The teeth were still vital after the trauma. They were gently prepared for a long-term temporary and stabilized with composite crowns until the patient was full-grown. The teeth were finally treated with metal-ceramic crowns which are now, after seventeen years, to be replaced for esthetic reasons. The patient was generally wishing for brighter teeth and all-ceramic, high-esthetic crowns that fit their adjacent teeth. She had her teeth bleached beforehand in order to allow for brighter restorations.
Everything is ready for the live course with a patient. On his desk, Belgian Master Dental Technician Patrick Rutten from Tessenderlo has a master model ready with two copings made of zirconia on teeth 11 and 21. A prepared model with a wax-up serves as a morphological guide. The control model is extended with a scalpel in the sulcular area until the copings fit perfectly.
The patient has arrived…