Dr. Todd Franklin
Having used it for almost 30 years, Empress (Ivoclar) has been very good to us. It revolutionized how we approached aesthetic cases and the laboratory enjoyed its simplicity in fabrication. Pressed ceramics were here to stay, so we thought. Advancements in materials will take us in new directions and as a dentist, we will always have choices. Whether you choose stacked, pressed, or milled there will be a material of choice for your esthetic cases. We will miss the vitality and brilliance that Empress gave to us.
Hanin recently came to us for a consultation regarding her centrals. She presented with old composite bonding that she wanted to replace with veneers. While replacing her composite with porcelain would be a quick and easy process there were so many other items that caught our eye. Let’s spend a few minutes analyzing her case and how we proceeded.
I like to look at the macro esthetics first. She is a lovely person with symmetrical facial features, soft contours, and slightly darker skin tones. This sets up for a beautiful case. She can pull off a bright case as long as the optical properties of the porcelain provide depth and reflectance just as natural teeth do.
Empress was the material of choice. (Figures 1-4)
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Next, we looked at the occlusion. There were areas of occlusal load due to the constricted envelope of function. We needed to broaden her buccal corridors and eliminate the lateral group function.
Many times, we have to restore the opposing occlusion to open the vertical or to change the morphology. In her case, we provided some enameloplasty and minor composite contouring to develop the cuspid function she needed.
We still had to have the conversation in regards to how many teeth the case required for an esthetic outcome everyone would be happy with. Color, shape, broad smile, contours, bite issues were all taken into consideration. I think there is an art to having these discussions. Very few patients enjoy or understand the technical side of these cases. Hanin is an esthetician so talking more about beauty and style were things she could relate to. We allowed her to drive the conversation by asking various questions. In the end, we all agreed we needed to do 10 upper teeth.
With a quick mock-up of the centrals, we determined the length of centrals and sent the case off to Corr Dental Designs for a cosmetic wax-up.
As with all cases from Corr Dental Designs, we are given all the prep guides and temporary templates to do the case. Corr received multiple impressions, photos, bites, model of the temporaries from her smile check appointment, and a full laboratory Rx.
The case went well and Hanin is extremely happy with her new smile. (Figures 5-8)
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As we venture into new materials we want to say thank you to Empress for all the wonderful smiles we have given patients over the years. Its beauty will be greatly missed.
If you would like to send a case, please contact the Pacific Aesthetic Laboratory Group at www.pacificaestheticdentalstudio.com, Gary Vaughn, CDT, CTO (916) 786-6740, or via email [email protected].
