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Dr Arne Sauer, Cospeda, Germany MDT Maxi Findeiß, Grüttner dental laboratory, Pößneck, Germany

Telescopic restoration with a BioHPP frame and visio.lign veneers on natural abutments

Telescopic restorations offer a proven method for fixing removable dental prostheses to natural teeth or implants. However, the use of galvano parts with traditional framework materials such as NPM or ceramics means that this type of restoration is becoming increasingly expensive and therefore unaffordable for many patients. Many patients also complain about the unpleasant hardness of these materials. For these reasons, we tend to use the new material, BioHPP, more often for this type of restoration. It has excellent friction properties and, because there are no galvano elements, the restoration as a whole can be more delicate and manufactured more economically. We will illustrate our approach on the basis of a particular clinical scenario.

In modern dentistry, there are often demands for the materials used in restorative treatments to be biocompatible. A health-conscious 60-year-old patient was interested in an aesthetic restoration and specifically asked for a metal-free version. Primary crowns made of zirconium dioxide are often made in our laboratory, but the use of galvano elements and an NPM tertiary structure frequently means there is no room for aesthetic veneers. This is why we decided to press the secondary frame in BioHPP. Given that the secondary part is almost the same colour as teeth, the use of veneers can be kept to a minimum. An overall thickness of around 1.2 mm is achievable in practice, which means that double crowns do not have to look any different from natural teeth. The processing and manufacturing process of the secondary frame in the for2press unit is similar to that of one-piece casting, and is an approach which has been adopted with success at our laboratory for some years. As with conventional manufacture of a model-casting prosthesis, the model was duplicated with primary parts and an investment material model was made to provide the base for modelling the secondary structure in wax. In future, our laboratory will be striving to make tertiary structures out of BioHPP with the help of CAD/CAM technology. However, in cases like this, we believe the pressing-type process to be more efficient. The compression-moulding process helps deliver very good results.

Background

Case Description

Patients tend to be very taken with the highly natural appearance associated with BioHPP. This is reinforced by the aesthetic results achieved with visio.lign veneers. Patients are also very complimentary about how well restorations are held in place and how easy they are to insert and remove. The same applies to the feedback provided during follow-up visits by patients who have been wearing restorations for quite some time.

Summary