Anterior CEREC Veneers with Esthetic Crown Lengthening Using Solea

Case Summary:

A 43-year-old female patient presented to the practice for her regular check-up. Patient has had chipping and various composite repairs for over two decades. She was unhappy with her smile and the way her teeth looked. The oral evaluation of the patient indicated that teeth #7,8,9,10 had discrepancy in the size of the teeth. The “Golden Proportion” was disrupted due to variable interproximal bonding, chipping on incisal edges, and widely variable height to the gingival contour of those teeth. The dentist advised a mix of esthetic gingival contouring and esthetic crown lengthening to correct variations in gingival height as well as porcelain veneers to restore the maxillary central and lateral incisors. The clinical objective was to reduce gingival height to improve esthetics in placement of veneers.

Technique Used:

The treatment plan included diagnostic wax up, surgical guide fabrication (to show the height of reduction), crown lengthening using Solea, prep for veneers, fabrication of provisional crowns (to test out esthetic design and function). CEREC veneers were made using Ivoclar’s eMax. While performing the crown lengthening procedure, the dentist utilized Solea with the 1.25 spot size, 8 ml/min mist, and 40% cutting speed. He easily transitioned from soft tissue to bone by simply varying the pressure on Solea’ s footpedal. The procedure time was 4-5 minutes with Solea, whereas the average procedure time doing traditional flapped crown lengthening would be at least 45-60 min.

Results:

Without Solea, this case would have been sent to a specialist for traditional crown lengthening that involves heavy local anesthesia, raising a flap, use of a drill creating heat and friction, and placement of sutures. The healing time would have been a minimum of 6 weeks. If a diode was used, it would not have been able to remove bone, and the tissue would have been left charred and ragged. The dentist was able to utilize multiple technologies (Solea and CEREC) for improved clinical results and patient experience than any traditional method.

Solea Advantage:

• No flap and no sutures were needed for this case; the incredible precision of Solea made this procedure minimally invasive.
• Blood-free preparation, clear surgical site, and no charring of tissue.
• No heat transferred to bone causing unpredictable healing.
• Reduced procedure time to 4-5 minutes compared to approximately 45-60 minutes with traditional tools.
• Patient experience was improved compared to using traditional tools, and approach was minimally invasive resulting in faster healing (in under 1 week) and minimal discomfort in gingival tissue.