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          06 clinical section                                                          DENTAL TECHNOLOGY, OCTOBER-DECEMBER 2017

                          FROM DIGITAL PLANNING TO THE

                      MOCK-UP AND FINAL RESTORATION

            Presentation of a modern work concept on the basis of a veneer fabrication

                                             CYRIL GAILLARD AND JÉRÔME BELLAMY

          “Never  promise  what  you  can’t  deliver!”
          Particularly  when  undergoing  esthetically
          motivated  dental  treatment,  patients  should
          be given a realistic visualization of the final
          outcome to avoid raising undue expectations.
            The demand for cosmetic treatments is also
          increasing  in  dental  practices.  Today’s  com-
          munication media provide patients with virtu-
          ally limitless access to a wealth of information
          on this topic. And with it comes an increase in
            This can pose a conundrum to the dentist:
          patients  want  to  be  promised  the  desired
          results  yet  they  should  not  be  given  undue
                                                     FIG 1a and 1b: Preoperative situation. Severely stained restorations in the upper anterior region. It does not bother the patient
          expectations in the run-up to the treatment.
                                                     that her upper lip is asymmetrical and her gum line is visible when she laughs.
          One of the challenges in day-to-day dentistry
          is the fact that the mock-up presented to the
          patient  is  produced  from  a  wax-up  and  is
          often not consistent with the final outcome of
          the treatment (e.g. ceramic veneers). Several
          research studies have been initiated to over-
          come  this  problem.  The  SKYN  concept  is  a
          result of this research.

          THE SOLUTION
          The  SKYN  concept  is  based  on  a  unique
          approach: it uses natural tooth shapes to cre-
                                                     FIG 2: SKYN models (according to Dr Jan Hajtó) for the fabrication of the wax-up
          ate a mock-up directly in the patient’s mouth.
          A  wax-up  is  created  on  the  basis  of  tooth
          shapes that reflect the anatomy and morphol-
          ogy of natural teeth in terms of height, width,
          curvature and surface texture.
            The predictability of the result is ensured
          by using CAD/ CAM technology to scan the
          mock-up, make adjustments in the oral cavity
          and then mill the veneers to achieve lifelike
            The reproducibility of the mock-up and the
          accuracy  of  the  result  arise,  among  others,
          from the performance of the CAD/ CAM sys-
          tem, allowing the expectations of the patient  FIG 3: The composite (IPS Empress Direct) is applied into the silicone key.
          to be met both promptly and effectively.
            CAD/CAM  technologies  have  brought
          about a revolution in dentistry. They enable
          the  efficient  manufacture  of  customized
          ceramic veneers with high accuracy and with-
          in a short period of time.
            Furthermore,  the  restorations  present  an
          accurate copy of the esthetic wax-up. The dif-
          ferent  working  steps  involved  in  the  SKYN
          concept are demonstrated below on the basis  FIG 4a and 4b: The composite veneers created with the help of the silicone key show a natural shape and surface texture on the
          of a clinical case.
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