J Dent Rehabil Appl Sci.  2020 Jun;36(2):128-137. 10.14368/jdras.2020.36.2.128.

Chairside computer-aided design/computer-aided manufacturing (CAD/ CAM)-based restoration of anterior teeth with customized shade and surface characterization: a report of 2 cases

• Kim HJ
• Jang JH
• Ryu GJ
• Choi KK
• Kim DS

• KMID: 2503809
• DOI: http://doi.org/10.14368/jdras.2020.36.2.128

Abstract

Over the last 30 years, the use of chairside computer-aided design (CAD) and computer-aided manufacturing (CAM) systems has evolved and has become increasingly popular in dentistry. Although CAD/CAM restorations have been used in the anterior dentition, satisfying the esthetic requirements of clinicians and patients, where the restorations are limited to the chairside, remains a challenge. To reproduce multi-shades of CAD/CAM restorations in the clinic, a preliminary experiment to express several shades on A2 lithium disilicate (LS2) blocks using a staining kit was performed. After measurement of the CIE L^*a^*b^* value of specimens, it was compared with that of the commercial shade guide. This report presents two cases with individual customization of shade and surface characterization of the CAD/CAM restorations using predictable methods based on the preliminary experimental data. The anatomical shape of restoration was obtained from ‘copy and paste technique’ and ‘mirror image acquisition technique’. All treatment procedures and fabrication of restorations performed in this report were executed in the clinic itself.

Keyword

anterior dentition; computer-aided designing; computer-aided manufacturing; shade; surface characterization; shade characterization

Figure

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  Fig. 1 Preoperative images. (A) Intraoral clinical photo and (B) Periapical radiograph. Note the periapical radiolucency on the apex of the maxillary right central incisor. (C) and (D) Occlusal and labial views of intraoral 3-dimensional scan images before removing the old restoration.

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  Fig. 2 Experimental shade and surface characterization on lithium disilicate (LS2) blocks. (A) Glaze only; application of an even layer of glaze paste, (a) after crystallization. (B) Three-tone gradual shade; application of double and single coat of shade 1 in the cervical and middle third, respectively. Application of one coat of blue incisal shade in the incisal third, (b) after crystallization. (C) Two-tone gradual shade; application of one coat of mahogany stain on the upper half, and one coat of copper stain on the lower half of the A2 lithium disilicate block, (c) after crystallization. (D) Surface characterization; surface roughening of the restoration using diamond point (F102R; Shofu, Kyoto, Japan) to reproduce the developmental grooves, (d) after crystallization.

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  Fig. 3 (A) Periapical radiographies of working length determination, (B) Periapical radiographies of the endodontic canal filling, (C) Photography of staining of the lithium disilicate crown.

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  Fig. 4 (A) Intraoral photo and (B) Periapical radiograph after final cementation.

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  Fig. 5 (A) Intraoral photo and (B) Periapical radiographs. (C) Intraoral scan image after tooth preparation and (D) Virtual placement of the crown on computer-aided designing software using the “mirror image acquisition technique.”

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  Fig. 6 (A) Intraoral photo and (B) Periapical radiograph after final cementation.

Reference

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