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Veneering metal frameworks with composite – explained step by step

Veneering metal frameworks and secondary composites have long been regarded as an esthetic and material compromise. However, with modern veneering composites, esthetic results can be obtained that are comparable to ceramic veneers. VITA VM LC flow (VITA Zahnfabrik, Bad Säckingen, Germany) is a composite of this new generation. The thixotropic property of the material offers both high stability during the application, as well as excellent flowability during the modeling process. Erfurt dental technician Norman Zacharias from Das Dentallabor - innovations for your smile (Kirchheim, Germany), shows how VITA VM LC flow can achieve highly esthetic results, step by step in the following article.

1. Concept and preparation

We have been working with VITA VM LC flow since October 2016. The following documentation shows an example of a NEM bridge on two implants, which has been veneered with the veneering composite according to the layer concept of dental technician Björn Czappa. In the first step, the framework was sandblasted and then conditioned using a primer. This was followed by the application of PRE OPAQUE bonding agent, and a thin layer of OPAQUE was then applied until a glossy cover layer was achieved.

2. Veneering steps

CHROMA PLUS materials started to be applied to the tooth necks or the basal section of the pontic. The dentine body was not layered in this case. Instead, a fully anatomic wax-up was created and transferred to the framework using a silicone key, which was completely filled with flow BASE DENTINE. The fully anatomic structure was light-cured and then roughly worked out, in order to reduce the proportions for incisal materials and effect materials. The core of the incision was reinforced with CHROMA PLUS (CP3, light orange-brown) and mamelons were applied. VITA VM LC PAINT (PT5, light orange-brown) was used to add additional accents. Then, with subtle nuances of EFFECT ENAMEL (EE11, grayish translucent), a translucent effect was achieved on the dentine that was already layered, which did not appear dark in the mouth later on. The edges were brightened with EFFECT ENAMEL (EE1, whitish) and a line of Retzius was replicated. Finally, the bridge was finished with melt material (ENL light). VITA VM LC GEL was applied to prevent the inhibition layer before final polymerization.

3. Recommendation for finalization

Fine carbide burs as well as the corresponding rubber polishers, without stones or diamonds, are suitable for the final processing. If additional materials or stains are to be applied afterwards, it is necessary to wet the surface with modeling liquid. Applied stains are thinly coated with transparent material (WIN transparent). For the polish, a goat-hair brush that does not affect the processed surface structure is recommended.

4. Conclusion and experience

"CHROMA PLUS materials have fascinated me from the very beginning. They cover the shades completely without creating a shine and ensure natural depth," Zacharias reports. As a general rule, practical knowledge with the VITA VM system can be transferred 1:1 to the VITA VM LC flow veneer composite. For example, the effect materials are processed in the same way as the VITA VM ceramics. The fully anatomic layer construction using counters works perfectly, even without insulation. “My overall conclusion: Excellent results are easily achieved with VITA VM LC flow," says Zacharias.

Report 05/17

Norman Zacharias, Dental Technician Erfurt, Germany
"Excellent results are easily achieved with VITA VM LC flow."
Norman Zacharias, Dental Technician
Erfurt, Germany
Fig. 1: INITIAL SITUATION: NEM bridge framework on two implants. RESULT: Implant bridge veneered with VITA VM LC on a model.
Fig. 1: INITIAL SITUATION: NEM bridge framework on two implants. RESULT: Implant bridge veneered with VITA VM LC on a model.
Fig. 1: INITIAL SITUATION: NEM bridge framework on two implants.
RESULT: Implant bridge veneered with VITA VM LC on a model.
Fig. 2: The glistening, thin-flowing PRE OPAQUE increases the reliability of the composite on metal frameworks and achieves a very uniform opaque layer.
Fig. 2: The glistening, thin-flowing PRE OPAQUE increases the reliability of the composite on metal frameworks and achieves a very uniform opaque layer.
Fig. 2: The glistening, thin-flowing PRE OPAQUE increases the reliability of the composite on metal frameworks and achieves a very uniform opaque layer.
Fig. 3: The framework must be completely coated with OPAQUE. The result is a well-covered and glossy surface.
Fig. 3: The framework must be completely coated with OPAQUE. The result is a well-covered and glossy surface.
Fig. 3: The framework must be completely coated with OPAQUE. The result is a well-covered and glossy surface.
Fig. 4: On the reduced dentine body, CHROMA PLUS mamelons are applied with stains and flow, and the edge is reinforced.
Fig. 4: On the reduced dentine body, CHROMA PLUS mamelons are applied with stains and flow, and the edge is reinforced.
Fig. 4: On the reduced dentine body, CHROMA PLUS mamelons are applied with stains and flow, and the edge is reinforced.
Fig. 5: Strips are created with effect materials to achieve additional translucence.
Fig. 5: Strips are created with effect materials to achieve additional translucence.
Fig. 5: Strips are created with effect materials to achieve additional translucence.
Fig. 6: Construction of the final tooth mould with melt materials.
Fig. 6: Construction of the final tooth mould with melt materials.
Fig. 6: Construction of the final tooth mould with melt materials.
Fig. 7: In order to prevent the formation of an inhibition layer, a thin but opaque layer of VITA VM LC GEL is applied with a spatula before final polymerization (2 x 180 seconds).
Fig. 7: In order to prevent the formation of an inhibition layer, a thin but opaque layer of VITA VM LC GEL is applied with a spatula before final polymerization (2 x 180 seconds).
Fig. 7: In order to prevent the formation of an inhibition layer, a thin but opaque layer of VITA VM LC GEL is applied with a spatula before final polymerization (2 x 180 seconds).
Fig. 8: Preparation with carbide burs and rubber polishers.
Fig. 8: Preparation with carbide burs and rubber polishers.
Fig. 8: Preparation with carbide burs and rubber polishers.
Fig. 9: A thin layer of modeling liquid (after about 30 seconds) allows composite and stains to be reapplied; the latter are covered with a transparent material (WIN).
Fig. 9: A thin layer of modeling liquid (after about 30 seconds) allows composite and stains to be reapplied; the latter are covered with a transparent material (WIN).
Fig. 9: A thin layer of modeling liquid (after about 30 seconds) allows composite and stains to be reapplied; the latter are covered with a transparent material (WIN).
Fig. 10: A star-shaped goat-hair brush provides the surface structure for the pre-polish and high gloss-polish (Acrypol and Abraso-Starglanz, Bredent).
Fig. 10: A star-shaped goat-hair brush provides the surface structure for the pre-polish and high gloss-polish (Acrypol and Abraso-Starglanz, Bredent).
Fig. 10: A star-shaped goat-hair brush provides the surface structure for the pre-polish and high gloss-polish (Acrypol and Abraso-Starglanz, Bredent).
Fig. 11: Final result on a model.
Fig. 11: Final result on a model.
Fig. 11: Final result on a model.
Fig. 12: VITA VM LC flow enables a high degree of individuality.
Fig. 12: VITA VM LC flow enables a high degree of individuality.
Fig. 12: VITA VM LC flow enables a high degree of individuality.
Fig. 13: Palatal view.
Fig. 13: Palatal view.
Fig. 13: Palatal view.
Fig. 14: RESULT: Convincing esthetics with natural shade reproduction can be achieved easily and efficiently.
Fig. 14: RESULT: Convincing esthetics with natural shade reproduction can be achieved easily and efficiently.
Fig. 14: RESULT: Convincing esthetics with natural shade reproduction can be achieved easily and efficiently.
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