He presented to the dental office in need of a full-mouth rehabilitation and expressed the wish to improve the aesthetics of his smile. He asked for an age-appropriate, natural-looking restorative design.

After careful observation and listening, I decided that the best way to restore his maxillary incisors would be with zirconia restorations. The plan was to mill the frameworks using low-value KATANA Zirconia YML (Shade D3; Kuraray Noritake Dental). To facilitate the integration of some natural characteristic effects, a framework design with a primarily vestibular cutback was selected. The finishing technique of choice was micro-layering with CERABIEN MiLai (Kuraray Noritake Dental), a porcelain designed specifically for this approach.

Important steps in the finishing procedure were:

• characterisation of the milled zirconia with colouring liquids;
• pretreatment of the sand-blasted zirconia surfaces with SS Fluoro shade base stain and CERABIEN ZR Margin porcelain (both Kuraray Noritake Dental);
• internal staining with CERABIEN MiLai internal stains; and
• application of CERABIEN MiLai lustre porcelains.

Laboratory workflow

Splinted zirconia crowns were designed in full contour with the aid of the Leahu Library of tailored tooth designs (part of the Truedental Library available for exocad’s DentalCAD software; Fig. 1). They were then cut back only in the vestibular area using the CALMA reduction option (Fig. 2) and then milled and characterised with colouring liquids to optimise the chroma (Fig. 3). As the fit and shape of the restorations turned out to be excellent at try-in (Fig. 4), it was time to plan the internal staining and micro-layering procedure (Figs. 5 & 6), seeking to imitate nature as closely as possible. The tricky part is wise use of the available space—the reason why a detailed layering sketch is useful even in the context of micro-layering.

Once the planned layering procedure had been implemented (Figs. 7–10), the surface texture was finalised and the restorations were tried in again for an aesthetic evaluation. Finally, they were cemented with the adhesive resin cement PANAVIA V5 (Kuraray Noritake Dental; Figs. 11 & 12).

Conclusion

The patient was thoroughly satisfied with the treatment outcome and confident that his investment was well worth it. By tailoring my approach to his unique needs, carefully observing his teeth, smile and facial expressions, and utilising my extensive knowledge of materials, I was able to fulfil his wishes.

Nonetheless, I remain committed to continuous improvement by critically evaluating each restoration and seeking areas for enhancement. My dedication to growth, supported by exceptional mentors who share innovative techniques and insights, supports me in staying at the forefront of my field, striving to consistently deliver the best possible care.

Acknowledgement

I am deeply grateful to Dr Zinonas Evagorou for his invaluable partnership and clinical expertise, which were instrumental in achieving this result.