Printed Digital Wax-up Model as a Blueprint for Layered Pressed-ceramic Laminate Veneers: Technique Description and Case Report
This article presents a clinical technique for transferring Digital Smile Design (DSD) information and a digital wax-up to fabricate highly personalized ceramic laminate veneers. The hybrid workflow of digitally designed wax-up and conventional hand-crafted veneers is showcased in a female adult who sought to improve her smile due to maxillary anterior incisal wear. The ceramic veneers, layered by feldspathic porcelain, followed the contours and shade blueprint planned with the digital wax-up. The DSD improved the harmony of the facial-and-smile relationship, and the ceramic restorations fulfilled the patient’s esthetic and functional demands. Guides based on the printed model with the digitally designed wax-up can provide a reference for pressed lithium disilicate veneers layered with feldspathic porcelain.SUMMARY
Frontal initial situation. A) Face smiling. B) Extraoral close-up. C) Intraoral view of maxillary arch.
Frontal view of digital smile design evaluation to initial smile. A) Full face view smiling. B) Cheek and lip retraction to obtain intraoral images. C) Tooth lengths and proportions assessment.
Digital smile design evaluation. A) Extraoral photo displaying maxillary anterior teeth. B) Teeth contours designed with ideal measurements. C) Use of digital ruler to obtain the desired teeth length.
Digital design and printed models. A) Digital file of initial situation. B) Printed model of initial situation. C) Digital wax-up design. D) Printed digital wax-up.
Conservative tooth preparations aided by injected composite mock-up. A) Injected flowable composite for mockup. B) Intraoral mock-up. C) Frontal view horizontal and incisal reduction grooves. D) Lateral view of horizontal and incisal reduction grooves.
Teeth preparation phase. A) Final conservative tooth preparations. B) Cord packing for gingival retraction. C) Final polyvinyl siloxane impression.
Frontal view of provisional restorations. A) Face smiling. B) Extraoral close-up. C) Intraoral view of maxillary arch.
Putty guides fabrication and master cast relation. A) Facial view of putty guide on printed digital wax-up model. B) Lingual view of putty guide on printed digital wax-up model. C) Facial view of putty guide on master cast. D) Lingual view of putty guide on master cast.
Waxing up of dies with putty guides. A) Initiating the wax-up with buccal guide. B) Completion of wax-up. C) Individualization of wax-up. D) Frontolateral view of final wax-up for pressable ceramic veneers.
From wax-up to ceramics. A) Wax-up for pressable veneers. B) Wax ready to be pressed. C) Pressed ceramic veneers.
Layered feldspathic porcelain on pressed lithium disilicate cut-back assisted by lingual putty guide. A) Pressed ceramic on master cast. B) Incisal edge cutback. C) Blue opalescent effect layer. D) Pink opalescent effect layer. D) Final glazed restorations.
Evaluation of layered pressed lithium disilicate on master cast. A) Frontal view with black background. B) Lateral view with black background. C) Frontal view with white background.
Treatment and bonding of the laminate veneers. A) Hydrofluoric acid treatment to intaglio surface. B) Phosphoric acid treatment to intaglio surface. C) Veneers bonded under complete isolation with rubber dam.
Frontal view of delivered final restorations. A) Intraoral view of maxillary arch. B) Extraoral close-up. C) Face smiling.
Five-year follow-up images. A) Lateral view of maxillary anterior close-up. B) Intraoral view of maxillary arch. C) Extraoral smile close-up.
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