Chad C. Duplantis, DDS
A patient had been in the author's practice for more than 15 years. As a child, she had numerous surgeries to repair a cleft lip and palate. Approximately 30 years ago, a metal framework with an acrylic overlay and denture teeth had been placed to restore her missing maxillary left lateral incisor. In time, a failing left central incisor and prosthesis necessitated further restoration. Implants were not considered due to concerns over graft success. Through orthodontics, the patient's midline and restorative spacing between teeth Nos. 8 and 11 were addressed. A diagnostic wax-up was then ordered, with the intent of restoring the entire maxillary arch. After review of the wax-up and considering the excellent health of her dentition, however, it was decided to restore the void and her smile conservatively. A fixed partial denture was fabricated to restore missing teeth Nos. 9 and 10. The iTero Element® 2 (Align Technology, Inc., itero.com) intraoral scanner was used for final impressions. Shade was relayed to the laboratory using a digital dental camera, and the prosthesis (Nos. 8 through 11) was fabricated using a zirconia coping with porcelain and various glazes. A direct composite resin restoration was placed on tooth No. 7. Minimal adjustments were needed at the seat appointment.
Restorative goals must align with patients' desires. Communication, both verbal and nonverbal, with the laboratory is imperative for restorative success.
Intraoral scans and photographs for both single- and multiple-unit cases allow instantaneous and effective communication. Use of the iTero Element 2 intraoral scanner can decrease production time and allow for creation of an accurate restoration.
Because "beauty is in the eye of the beholder" a successful result is not always a perfect smile. Modern technology and materials allow the fabrication of a lifelike periodontium and dentition that enables patients to regain a confident smile.
Chad C. Duplantis, DDS
Private Practice, Fort Worth, Texas; Fellow, Academy of General Dentistry
Figures and Images
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