One of our favorite blocks is the Vita Real Life. It isn’t as popular as some because people are unaware of how to use it.
It is a simple block with two layers: a dentin and an enamel. They are sloped within the block to mimic the facial slope of anterior teeth. Basically, the enamel layer is placed over the restoration to allow the natural taper of the enamel to occur. Personally, I usually make the dentin layer exposed at the gingival 1/4 to 1/3. Do not worry, you will never see the transition of the line.
The two main drawbacks to the block are : strength, and time to mill. This is a feldspathic ceramic with a flexural strength of 120-140MPa. This requires the material to be bonded. Remember! We’ve always had ceramics like this and used them to great success! Just prep them properly, evaluate the occlusion, and bond them in well! They will do very well! Milling takes longer (probably add about 5 minutes) because the restoration is virtually placed more in the center of the block. The milling unit has to mill through the block to get to the point of milling the restoration. So, if you are going to use these blocks, give yourself some extra time to mill.
This patient had “translucent zirconia” restorations completed in another office and did not like the appearance. She was unable to describe what she didn’t like about it, but once she understood how zirconia can appear opaque, she wanted to go another direction. Yes, zirconia can be sintered to a translucent state. For the zirconia purists, that is when there is less tetragonal supported crystalline structure, and more cubic crystalline form of ZrO2. Yes, this becomes more translucent, but you lose a lot of the transformational toughening that zirconia is so well regarded!
The zirconia “veneers” or 3/4 crowns were used as templates for the design. The patient bleached her teeth just for a short time because she did not want a bleach look. Her left lateral was restored with composite resin to block out the large incisal embrasure.
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