Replicating individual tooth texture in ceramic restorations

The treatment goal is to create a long-term stable restoration on badly discolored anterior teeth

A young patient presented with the wish to have his endodontically treated and discolored middle maxillary incisors restored.

Discolored endodontically treated maxillary incisors can cause considerable aesthetic impairments and pose a special challenge to the restorative team. The reconstruction of the biomechanical and optical properties of the affected teeth at low biological costs is the focus of treatment planning.

A facial smile design was done in order to create a wax-up and mock-up.

Insertion with glass-fibre post

In a clearly coordinated procedure, internal bleaching measures, depending on the degree of destruction, the use of a glass fiber stick, selected adhesive build-up materials and a preparation that is matched to the restoration material can lead to a satisfactory treatment result.

This procedure should significantly reduce the hard tooth substance removal compared to classic full crown preparations.

A warmed, highly filled, viscous composite of the color bleach XL was used for the main volume of the structure. A Vita A1 color was utilized to mach the surrounding tooth structure. The minimally invasive preparation was carried out under the guidance of a template derived from the diagnostic wax-up.

Therefore a 0.5mm thermoformed foil, which contained all information like final tooth shape and correct the central tooth axis for the temporary restorations.

Beauty is a combination of form, color, texture and fantasy!

With the help of a set of rotating tools that are tailored to each work step, the work processes from raw firing to polishing are conveyed.

This is my daily tool for creating shape and texture.

It is actually made for the turbine and for zirconia. However, I see an advantage in that it creates a smoother surface and you are closer to the tooth surface due to the shorter drill shaft and thus feel the shape literally.

The Line angle create the contour and the reflection’s

Development of an authentic, natural shape and surface with a suitable texture for everyday laboratory work. 

Flexible ceramic polisher interspersed with diamond grain – for tooth shape finishing, glossy and high-gloss polishing.

Tipp: you can modify the line angles and tooth shape after glaze firing.

Perikymatia replicated with an inverted cone

The fine horizontal growth grooves in the tooth surface are called perikymatia. They occur in the enamel at intervals of about nine days. If a layer hits the surface, a furrow develops here, the perikymatia. These grooves can be used to determine how quickly a tooth has grown in the dentition. The growth grooves of the tooth are created every six to twelve days.

Modifiing the perikymatia structure

To create smoth perikymatia structure from middle tooth part towards the incisal tooth part. As well as interproximal and palatial.

The finest surfaces are achieved with a soft and gentle grinding sensation.

Tipp: Optimal speed is 12 000 rpm

Creates a very smooth surface for an aged tooth structure

Especially for rounding and from the middle part towards the initial part.

The sandpaper sleeves in different sizes with the grain sizes fine, medium and coarse from the original manufacturer.

Tipp: Can also be use after glaze firing.

Creates a shiny surface.

Can be also used right after creating the perikymatia for a youthful appearance.

The round hard horse hair brush is the only effective ceramic brush polisher for me.

Tipp: Check and polish under the microscope.