An Esthetic Solution with IPS e.max® Veneers

November 28, 2023
Nadia Rodriguez image
Nadia Rodriguez, DMD
An Esthetic Solution with IPS e.max® Veneers

When I restore anterior teeth, delivering an esthetic outcome is the top priority. My outcome, however, is only as good as my dental lab. In the past, I have used labs that neglected the attention to detail that these cases required, making me hesitant to promise results to my patients. After my amazing experience in the 2022 Guiding Leaders program at Glidewell, I knew Glidewell was a reliable choice for posterior cases. But I was still uncertain whether such a large lab would be able to meet my expectations for more difficult anterior cases.

When a new patient named Kendall reached out to my team with an esthetic challenge, I decided to trust the case to Glidewell. Her former dentist addressed her peg laterals by placing crowns on teeth #7 and 10. Although she was satisfied with the crowns, she explained that her dentist never fully addressed the incisal chipping in tooth #9, which he repeatedly attempted to mask with composite.

After experiencing repeated fracture of the composite repair, Kendall knew she needed a more permanent solution. That’s when she came to us to discuss the placement of anterior veneers. I contacted the Glidewell technical advisor (TA) assigned to my case, expressed my concerns, and she oversaw my case personally.

CASE REPORT

Figure 1 - close-up of patient's teeth shade

Figure 1: In order to match the shade of Kendall’s adjacent crowns and obtain ideal incisal lengths, I decided to prescribe IPS e.max® veneers on teeth #8 and 9. This lithium disilicate ceramic material would allow me to match her existing crowns and meet her high esthetic expectations. While not as strong as BruxZir® Esthetic, IPS e.max veneers would fulfill the patient’s need for a more permanent esthetic solution. 

Figure 2 - Rx prescription for emax veneers

Figure 2: When completing the Rx for the lab, I specified what I had in mind for Kendall’s restorative makeover. I also included VPS impressions, printed photos, a master impression, a bite registration in maximum intercuspation position (MIP), and a bite registration in right and left lateral guidance. I wanted the lab to have all the information they needed to create beautiful veneers.

Figure 3a - Teeth before being prepped
Figure 3b - Filtered lens is used to better match color of teeth

Figures 3a, 3b: The left image (3a) was taken with the aid of a standard ring light flash and shows the teeth before being prepped. To give the lab more information about the color of the teeth, I used a polarized filter on my lens, which reduced the flash and glare on the teeth (3b). This is helpful for the lab to better match the color of teeth. I then selected the bleach shade OM1 using the VITA Toothguide 3D-MASTER®.

Figure 4 - Diagnostic wax-up

Figure 4: The TA communicated with me throughout the entire process. She sent me photographs and a diagnostic wax-up, which allowed me to modify the design before fabrication.

Figure 5a - Approved diagnostic wax-up
Figure 5b - Patient's new smile

Figures 5a, 5b: Once I approved the wax-up, the veneers arrived in my office a week later. They were exactly what I was hoping for: The shade, margins and occlusion were perfect. Most importantly, Kendall was absolutely thrilled with her new smile.

CONCLUSION

The technicians at Glidewell showed me that they will dedicate the extra time and skill needed to deliver quality esthetic restorations. The TA was an immense help and offered meaningful communication. Based on this experience, I feel confident in sending future esthetic cases to Glidewell.

IPS e.max is a registered trademark of Ivoclar Vivadent. VITA Toothguide 3D-MASTER is a registered trademark of VITA Zahnfabrik.