hello everyone for this clinical video we have a 43 year old male patient who presented to
our office with chipped teeth and a history of pure functional habits he was unhappy with the
spacing between some of his teeth and he wanted a new smile to go on his new business cards this
clinical video will show that Obsidian lithium silicate material is a reliable material for
veneers in the interior especially when we need strength like in this case what the patient is
prone to clinching it has similar features as other all ceramic materials in terms of bonding
translucency and a better flexural strength because of the etch ability of this material
I was able to preserve a normal and minimally prep obsidian exhibits an average flexural strength of
397 mega Pascal's and that allows us to be able to fabricate very thin veneers we will begin this
case at the impression appointment this video will concentrate more on the bonding procedure
for a more detailed presentation of prepping teeth for obsidian veneers please refer to a pisode 158
because the patient has some gingival inflammation I decided to finalize the prep and take the final
impression at the second appointment you can see here at the final impression appointment after
the removal of temporaries the preps were clean with Cavett Ron and we can observe some tissue
irritation around the margins the double core technique was used for final impression the first
chord displaced the tissue 0.5 millimeters so I was able to finalize my margins using a fine round
ended burr at 2,000 rpm with no water followed by a white stone before placing the second cord I use
grip strip to separate the interproximal from any debrief so the technician can obtain clear
demarcations of in proximal margins I used size 1 cord as a second cord to displace the tissue
one millimeter in horizontal direction to ensure that medium body will enter the sulcus and after
the cord is removed to provide material beyond the margin that way the technician would be able
to fabricate the correct emergence profile Here I am syringe in capture medium body material while
my assistant was filling up the custom tray we can observe that there is material beyond the
margin and that the capture medium and heavy body material provided a predictable and easy to read
impression here I'm trying in the veneers with water to assess the fitting and the final shade
to get the veneer ready for addition the interview surface were micro edge using phosphoric acid for
20 seconds I will clean was scrubbed in for 20 seconds as well to eliminate any contaminant
prior to sitting the integral surface of each veneer was treated with mono bump last which
was scrubbed in for 60 seconds and kept away from light under a dark surface until they
were ready to be loaded with adhesive looting cement the preps were etched rinsed with water
and dried with an a deck warm air dryer to avoid moisture contamination and to displace the AMD
primer into a thin film to ensure symmetry and correct midline I like to start with the
Central's first sitting two veneers at the time then working my way back to the canines
great care is taking to apply the appropriate amount of pressure using cheeri wooden sticks
to avoid fracturing the material upon sitting at this stage is very easy to fracture the veneer
since it has a minimum thickness of sometimes less than one millimeter this case is a great example
of why I should have taken a better care with the Provisional anytime there is an open margin in the
provisional or if the patient was improperly cleaning and rinsing the bacteria or tissue
can creep under the margin and we can have a hard time controlling the hemostasis at the cementation
stage that can compromise the bonding of the restoration we saw earlier that some bleeding
occurred after the removal of the temporaries to control the clavicular fluid or bleeding I
sometimes use doubles your cord with epi that would also prevent the cement from going under
the tissue here to avoid oxygen inhibiting layer small amount of liquid strip was applied around
the margins and final cured excess cement was removed with universal curette and floss patient
occlusion and lateral exclusion were checked and restoration were evaluated for phonetics after
confirming there was no contact on the marginal interface rubber cups and porcelain polishers
were used to polish adjusted areas because obsidian exhibit an average flexural strength
of 397 mega Pascal's it will be more resistant to biomechanical complications also because of the
ability of the obsidian we can predictably achieve bonding on a minimal prep without worrying about
creating a retentive preparation thank you for watching back to you Meghan thank you for that
dr. Mershon but the fun isn't over just yet now dr. Mershon has an eye-catching little segment
with an interesting veneer case take it away dr. Mershon while I was walking through the lab
the other day I was stopped by Renee one of our customer service representatives she handed me a
very unique case that one of our doctors sent in and I would like to share it with you today here
we have six anteriors veneer restoration in solid gold in some culture this is a sign of wealth but
if you are a hip-hop artist it can be a mark of your success we don't know the patient occupation
but this reminds me of the grills jewelry taco shells that some artists wear those are usually
removable but in this case it is the real deal as you see here we fabricated six-unit gold veneers
for this patient because veneers can fall off when they are bonded on surface that is more than 50%
denting we can notice here the doctor placed some grooves possibly to increase the amount of surface
area for bonding in this case the only shade to match would probably be the gold of the opposite
teeth the maxillary central here looked like may have been made of metal as well as a clinician I
know I can get better aesthetic from other types of restorations but in the end it boils down to
patients needs wants and desires I guess a concern I'll have as a dentist is if the patient returns
after treatment to say they wish they have never done it so if the patients want their blink they
better put their money where their mouth is or should I say put their money where the theater
you