(Afternoon tea pics 2052.6: IPS e-max | Closed Flap Transsulcular Crown Lengthening)
This lovely 78 year old patient presented with pre-existing incisal plane and gingival plane cants which he was not overly concerned with. Marginal leakage paired with supragingival margins, however, were plaguing the existing crown restorations, and after some consideration, he elected to replace five units from #6-10.
DSD was utilized (Smile Designer Pro, Toronto, Canada) to ascertain the proportion changes and specify the positions of required gingival modification to an intermediate degree, as a compromise in this limited replacement case.
Gingival contours were modified via a closed flap, transsulcular approach on #9 and 10 and a period of 6 weeks were allowed for healing prior to crown sectioning and preparations, which were driven by the aesthetic pre-evaluative technique (APT) as per Galip Gurel. Cores were rebuilt using a combination of Ever-X Flow Dentin shade and Rebilda DC Core Plus.
TempSmart A3 was utilized for the shrink-to-fit provisional restorations.
The final restorations were cemented under a careful combination of absolute and relative isolation using Variolink Esthetic DC Neutral. Subgingival margins really are a struggle for even the most modified of B4 clamps.
#IPSemax #TSE #SmileDesign #SmileDesignerPro #CosmeticDentistryAuckland Shinichiro Tsuji
