Mid 40s male approached our office complaining from an old central that looks unnatural and it has been always a headache for him. after clinical and radiographic assessment we told him the available options from restoring just that central with a LiDi silicate crown ( E-max ), but we will restore it to be exactly alike the other central, which was not as good looking as it has to be, otherwise we can do a crown on the right central and a veneer on the left central.
the patient chose to try doing the crown as a first attempt, milled and glazed PMMA crown was fabricated and delivered to the patient to try how could it look, after a week the patient returned and accepted having a veneer on the left central.
Although the job got a bit easier after he accepted to do both, still it was quite challenging because of the different abutment colors, and the natural adjacent teeth colors.
the right central composite build up was changed with much well structured and bonded composite, and with a much acceptable shade to blend with the natural abutment color.
the 2 ceramic units was obviously off-shade a bit, but this could be fixed by color of the light cure cement!
we were lucky as the paste we tried at the very beginning gave us a satisfying results, but we also tried different shades to make sure, but the very first paste was the chosen one, and it was choice 2 milky bright from Bisco.
margins checking and fitting were done previous to rubber dam application, and dry fit was checked again after rubber dam application.
LiDi silicate surface treatment was done using hydroflouric acid 9.5% followed by hydrophosphoric acid 37% and silane coupling agent application.
Tooth surface treatment was done using sand blasting with aluminum oxide 29 microns followed by hydrophosphoric acid etch 37% and universal bond application.
excess cement removed under high magnification using needle finishing burs from Komet followed by using blade #12 for deep cervical and inter proximal areas followed by Eve DiaCera and DiaComp twists, 2 steps.
here we have short period follow up as the patient was traveling abroad, but great tissue response was noted and clear marginal integrity and stability were noticed.
Pre-Operative
Right central crown preparation, in the trying to do a single central restoration.
margins checking
here it shows how they look a little bit off shaded
choice 2 milky bright try in paste.
rubber dam isolation before cementation
margins exposure
dry fit
color stability in the follow up
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