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New generation of anterior teeth for a new generation of patients

The new generation of active adults have extremely high expectations of restorations. They desire restorations that integrate harmoniously into their external appearance and emphasize their vitality. VITAPAN EXCELL (VITA Zahnfabrik, Bad Säckingen, Germany) is a new generation of anterior teeth that meet a number of significant expectations. The layered construction of this anterior tooth is designed in such a way that it mirrors the natural play of shades. In combination with the multifaceted surface texture, it enables restorations with an especially lifelike play of shade and light. In the following case report, Urban Christen, Denturist (Hunzenschwil, Switzerland) describes the essential steps of a total prosthesis restoration with VITAPAN EXCELL.

1. Initial situation: insufficient total restoration

A 51-year-old female patient who was dissatisfied with the esthetic appearance, chewing efficiency and phonetics of her current total denture restoration, presented at my practice. Deficits in the esthetic zone, such as the tapered incisors, which were too prominent vestibular and caudal, were immediately recognizable. It was difficult for the patient to pronounce the letter “F” with this total prosthesis. In addition, the extraoral inspection of the dentures showed significant abrasions on the denture teeth, which over time, had led to a loss of the vertical dimension. After a comprehensive consultation, the patient decided on a completely new fabrication of a total prosthesis.

2. Precise impression: for predictable results

With prefabricated Schreinemakers trays, an initial impression with alginate was taken, in which all relevant anatomical structures were reproduced. Now the individual impression trays and bite templates could be produced on the created models. Before taking the mucodynamic impression, the trays were tried in and shortened, as needed, to ensure a secure fit. On this basis, master models were created on which the bite templates were produced. For reproducible encoding with a registration silicone, retentive elements were incorporated on both sides of the mandibular wax rim, and triangular grooves were used in the maxillary wax rim for clear centric repositioning.

3. Prosthetic result: esthetic and functional harmony

The setup was based on the registered wax rims. During the setup of the anterior maxilla, attention was paid to a round and wider shape of the dental arch, which also shifted the incisal edges considerably more cranially. Thanks to the balanced length/width ratio of VITAPAN EXCELL, the anterior tooth setup was easily accomplished by hand. In the wax try-in, the denture tooth setup harmonized with the musculature, lip line and physiognomy, and allowed for flawless phonetics. After the implementation in synthetic material, the total denture restoration was very lifelike and natural, particularly with the patient’s high smile line. To be able to achieve this result, the layered construction of VITAPAN EXCELL anterior teeth was designed to mirror the shade play of natural teeth in the form of a three-dimensional structure. In combination with the multifaceted surface texture, this new generation of anterior teeth enable dentures with a lively play of shade and light.

Report 07/17

Urban Christen, DenturistHunzenschwil, Switzerland
"The layered construction of the anterior tooth VITAPAN EXCELL is designed in such way that it mirrors the natural play of shades."
Urban Christen, DenturistHunzenschwil, Switzerland
INITIAL SITUATION: The esthetic appearance shows clear deficits. Fig. 2: Chewing efficiency and phonetics were not satisfactory.
INITIAL SITUATION: The esthetic appearance shows clear deficits. Fig. 2: Chewing efficiency and phonetics were not satisfactory.
INITIAL SITUATION: The esthetic appearance shows clear deficits.
Fig. 2: Chewing efficiency and phonetics were not satisfactory.
Fig. 3: The esthetically and functionally insufficient prostheses showed massive occlusal abrasions.
Fig. 3: The esthetically and functionally insufficient prostheses showed massive occlusal abrasions.
Fig. 3: The esthetically and functionally insufficient prostheses showed massive occlusal abrasions.
Fig. 4: The alveolar ridges were molded in the maxilla and mandible with prefabricated anatomical trays. Fig. 5: The position of the individual impression trays must also be guaranteed during mucodynamic movements.
Fig. 4: The alveolar ridges were molded in the maxilla and mandible with prefabricated anatomical trays. Fig. 5: The position of the individual impression trays must also be guaranteed during mucodynamic movements.
Fig. 4: The alveolar ridges were molded in the maxilla and mandible with prefabricated anatomical trays.
Fig. 5: The position of the individual impression trays must also be guaranteed during mucodynamic movements.
Fig. 6: A retentive undercut was incorporated in the mandibular wax rim to affix the registration silicone. Fig. 7: Triangular grooves in the maxillary bite template allowed for clinical repositioning and testing of the centric.
Fig. 6: A retentive undercut was incorporated in the mandibular wax rim to affix the registration silicone. Fig. 7: Triangular grooves in the maxillary bite template allowed for clinical repositioning and testing of the centric.
Fig. 6: A retentive undercut was incorporated in the mandibular wax rim to affix the registration silicone.
Fig. 7: Triangular grooves in the maxillary bite template allowed for clinical repositioning and testing of the centric.
Fig. 8: The centric condylar position was encoded with registration silicone and then checked.
Fig. 8: The centric condylar position was encoded with registration silicone and then checked.
Fig. 8: The centric condylar position was encoded with registration silicone and then checked.
Fig. 9: Since VITAPAN EXCELL is based on the natural model, a quick and individual wax setup is possible. Fig. 10: The patient was able to pronounce the letter “F” without difficulty with the wax try-in.
Fig. 9: Since VITAPAN EXCELL is based on the natural model, a quick and individual wax setup is possible. Fig. 10: The patient was able to pronounce the letter “F” without difficulty with the wax try-in.
Fig. 9: Since VITAPAN EXCELL is based on the natural model, a quick and individual wax setup is possible.
Fig. 10: The patient was able to pronounce the letter “F” without difficulty with the wax try-in.
Fig. 11: The three-dimensional, anatomically layered structure, combined with the multifaceted surface texture, allowed a natural play of shade and light.
Fig. 11: The three-dimensional, anatomically layered structure, combined with the multifaceted surface texture, allowed a natural play of shade and light.
Fig. 11: The three-dimensional, anatomically layered structure, combined with the multifaceted surface texture, allowed a natural play of shade and light.
RESULT: The patient was enthusiastic about the highly esthetic result and the functionality of her new restoration.
RESULT: The patient was enthusiastic about the highly esthetic result and the functionality of her new restoration.
RESULT: The patient was enthusiastic about the highly esthetic result and the functionality of her new restoration.
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