Clinical features of all-ceramic restorations in the oral cavity

BACKGROUND: Porcelain veneers make up the particular section of prosthetic dentistry. Veneers are necessary for frontal teeth restorations.

AIM: To study the principles of dental preparation and the features of the formation of a natural anatomical contour on all-ceramic restorations.

MATERIAL AND METHODS: To achieve a high-quality result of prosthetics with all-ceramic fixed prostheses, it is necessary to take into account many important aesthetic criteria: the shape of the tooth, the inclination of the axes of the teeth, the interdental space and the level of interdental contacts, the gum biotype, its color, the position of the gingival margin, the zenith of the gingival contour; tooth color (shades); the level of the cutting edge of the incisors; the relief of the teeth surface; the smile line and the position of the lower lip.

To determine the color-optical characteristics of future prostheses, it is convenient to use the Vitapan 3-D Master Shade Guide color scale.

For the manufacture of facings, it is necessary to take into account that the preparation is carried out within the enamel layer, the facings are made only for vital teeth, as clinically possible, while preserving the natural boundaries of the tooth.

Prosthetics with ceramic prostheses is not recommended for dental dystopia (lingual, palatal position); significant loss of hard tooth tissues, their increased erasability, incomplete orthopedic treatment, deep bite, parafunctions of the masticatory muscles. Before manufacturing the facings, it is necessary to perform an X-ray examination of the teeth to be restored; assess the state of oral hygiene, determine the color of the future structure, replace all failed fillings, assess the condition of the interdental gap and the contact point.

RESULTS: It is necessary to preserve the vestibular relief of the tooth surface, the uniformity of the lining, Contact with the surface (cutting edge) of the antagonist tooth should not be placed on the surface or on the border of the lining, but only on the tooth tissues.

The advantage should be given to dissection by partial or complete palatal (lingual) overlap. The facings are fixed with the help of light polymerization composite materials, removing the excess with polishing boron.

CONCLUSION: If there are significant risks and the patient refuses orthodontic treatment, the creation of contact points on veneers is a complex clinical task. In addition, with the destruction of the crown part of more than 1/3, the use of veneers is risky due to the increase in the layer of ceramic cladding, there is a possibility of chipping of the lining and the risk of manifestation of pulpitis after preparation. Under such conditions, it is desirable to carry out depulpation of teeth, restoration with zirconium stump pin tabs and prosthetics with zirconium crowns with ceramic lining.