Natural functionality, lifelike beauty.
The dream team of dentist Dr Babak Varzideh and dental technician Carolin Wehning work cooperatively to provide the closest patient contact possible.
This is how they fulfilled their patient's wish for a convenient, safe and beautiful prosthesis with VITAPAN EXCELL.
RESULT: The final restoration harmonizes with the face and lip line and has a natural, lifelike effect.
INITIAL SITUATION: Esthetically and functionally insufficient initial situation in the maxilla. The strong distal occlusion position was compensated for in the new fabrication.
Going from natural teeth to removable dentures is a huge transition for any patient. First, every new restoration is always a foreign body in one's mouth. The goal of successful work must be to meet the patient's functional and esthetic needs, so that the patient quickly accepts the denture and ideally no longer perceives it as such. However, expectations are high, especially when preceded by a long period of dissatisfaction with various forms of restoration. As in this complex case that Dr. Babak Varzideh (Bocholt, Germany) and dental technician Carolin Wehning (Rhede, Germany) had to solve together. In the following interview, a 56-year-old patient from the Netherlands reports on her dental history, her treatment and her new life with the VITAPAN EXCELL and VITAPAN LINGOFORM prefabricated teeth (both VITA Zahnfabrik, Bad Säckingen, Germany).
That is a long story (laughs). It started many years ago at the age of eleven when I had a sports accident. At that time, my broken incisors were restored with metal-ceramic crowns. Even then, I didn't like the esthetics at all. The gums around the crowns were constantly irritated and inflamed. I was afraid to laugh, and when I ate, it frequently hurt. After a few years, the discomfort became worse, so my upper jaw was restored with a long-span bridge construction. But even with this new restoration, the same problems remained, which is why all the teeth in my upper jaw eventually had to be extracted. In my lower jaw, I had never had any major problems.
INITIAL SITUATION: Esthetically and functionally insufficient initial situation in the maxilla.
The strong distal occlusion position was compensated for in the new fabrication.
I was really at a loss and frustrated. Then one day I saw an ad that the Kleinsman/Varzideh Dental Center in Germany was offering free consultation appointments. Even though Rheine was an hour away from me by car, I didn't hesitate and made an appointment. I had nothing to lose. Once I was there, they suggested restoring my upper jaw with a removable denture on four implants to give me the appearance and comfort that would finally meet my wishes. I wanted security and stability when laughing, and to bite off and chew without worry. The four implants made it possible to leave the palate exposed. However, it would still take another year and a half before I could smile with VITAPAN EXCELL.
The wax try-in revealed the need for optimization.
After the four implants had been placed, we had to wait until the implants were sitting firmly in the bone. During this healing period, I temporarily wore a removable prosthesis. Even though I managed quite well with this temporary, the esthetics still didn't satisfy me. I could eat and speak, but I just couldn't get excited about the color and shape of the teeth. To me they looked unnatural, dull and lifeless. I knew that it would only be for a limited time. However, I definitely had higher expectations for the final work – especially with regard to the appearance of the teeth.
I was immediately thrilled with the final prosthesis and still am today. The whole thing was a rejuvenating experience for me. We had looked at the teeth together beforehand. I immediately liked the shape and color of the VITAPAN EXCELL teeth that were selected. When I had the new prosthesis in my mouth, it was such a huge improvement from one moment to the next compared to the temporary prosthesis. The teeth looked absolutely real and now finally matched my appearance and my age. The natural surface of the teeth made me feel like I finally had my own teeth back. Eating was no longer any problem. I could even bite into a hard apple and eat spare ribs without any limitation (laughs).
RESULT: The final restoration harmonizes with the face and lip line and has a natural, lifelike effect.
I have also managed with the VITAPAN LINGOFORM posterior teeth just fine since they were put in place. That hasn't changed over the years. My old denture teeth wore out quickly in comparison and I didn't really do well when chewing. Even the temporary denture had not been able to give me back the bite, security and stability I had hoped for. Due to the bad situation when it came to biting, I often had pain in the past. That has disappeared. A pleasant chewing sensation became immediately evident with VITAPAN LINGOFORM. I haven't noticed any wearing of the teeth at all as time goes by. The denture is absolutely stable when it comes to chewing and works perfectly, which is why I am finally satisfied with the situation in my upper jaw after such a long time.
The Kleinsman / Varzideh Dental Center in Bocholt has always been a place where quality meets dental knowledge. The head dentist, Dr. Babak Varzideh, has been solving complex dental cases there with his dental team for many years and continues to set new standards. The motto "The Art of Smile" has become part of their everyday work. Their secret to success is the symbiotic working relationship between the seven dentists and the 13 dental technicians, who always treat each other as peers and maintain a close dialogue to provide optimal care in every situation. It goes without saying that the quality standards for the dental materials used are also high for everyone involved. In the following interview, Varzideh explains why he relies on the VITAPAN EXCELL Anterior prefabricated teeth and the VITAPAN LINGOFORM Posterior teeth in removable implant prosthetics (both VITA Zahnfabrik, Bad Säckingen, Germany).
Dr. med. dent. Babak Varzideh
INITIAL SITUATION: Esthetically and functionally insufficient initial situation in the maxilla.
The strong distal occlusion position was compensated for in the new fabrication.
Dr. Babak Varzideh: To be honest, it was not my decision at all (laughs). The dentists at our Dental Center maintain a very close professional, indeed one could say symbiotic, relationship with our dental technicians. That is why I completely trusted in the judgment of our laboratory when choosing the prefabricated teeth. After all, they are the ones who work with the materials and know from experience what works well and meets our high esthetic standards. That is why the choice of VITAPAN EXCELL for implant prosthetics was never up for debate, as far as I was concerned.
An implant-supported bite registration enabled the precise articulation of the two master models.
The new setup was scanned in and the primary, secondary and tertiary frameworks designed in keeping with the dimensions.
Varzideh: As I said, using VITAPAN EXCELL was a conscious decision by our laboratory. The large selection of shades and shapes was certainly also a decisive criterion. Prefabricated teeth that fit the individual patient must be available. After all, this is the only way for patients to feel comfortable in the long term. I do the case planning together with the dental technician in charge. Based on this, a mock-up is created to define and discuss the design elements and the esthetics. So far, the VITAPAN EXCELL range has always been able to handle this target situation.
The wax try-in revealed the need for optimization.
Varzideh: I rate the esthetics of VITAPAN EXCELL very highly. We wouldn't use this prefabricated tooth if that weren't true. It looks absolutely natural in the patient's mouth. And most importantly, our patients are thrilled with the prefabricated tooth, and – as in the case shown – often look many years younger with VITAPAN EXCELL than they did before. According to my observations, the shade of the teeth remains stable over time and does not show any tendency to discolor. The teeth are homogeneously polymerized and can be ground and polished easily. It's a good product, as it should be.
RESULT: The final restoration harmonizes with the face and lip line and has a natural, lifelike effect.
Primary framework of zirconia with green slide attachment elements and secondary framework of PEEK.
The highly esthetic final restoration with inserted implant analogs.
Varzideh: Implant prosthetics in particular are subject to strong forces, and there is no cushioning as with natural teeth. Here at Kleinsman/Varzideh Dental Center, patients come in for prophylaxis two to four times a year, depending on their risk rating for peri-implantitis, which allows me to monitor their progress. The degree of abrasion certainly varies over time, depending on the opposing jaw restoration. Generally speaking, VITAPAN LINGOFORM has proven to be abrasion-resistant and robust during my follow-up checks, even with respect to implant work during the clinical course. The prerequisite is, of course, that the occlusion to the antagonist has been properly adjusted in advance.
Varzideh: Of course, the denture should not be prone to plaque build up, so that no active biofilm endangers the implants. I have not noticed any increased plaque build up on VITAPAN EXCELL and VITAPAN LINGOFORM. This indicates a polymerized composite and a homogeneous surface. For our removable implant prosthetics, VITAPAN EXCELL in combination with VITAPAN LINGOFORM is the tool of choice. Function and esthetics are just the way we want them to be. And if it already works on implants, then it will also work with tooth and mucosa-supported partial and complete dentures as a matter of course.
"The definition of insanity is doing the same thing over and over again and expecting different results." Carolin Wehning (Dorsten, Germany) has made this quote from the physicist Albert Einstein her guiding principle in dental technology. And her insane dedication to individual dental restorations pays off: In their daily work, practitioners describe her as very conscientious, precise, clean and above all, passionate. In short, she is dedicated to dental perfectionism and gives her best in every case. It is clear that she wants the dental-technical team to work together as equals and maintain the closest possible contact with patients She knows that this is the only way dental technicians can realize their full potential and optimally meet individual patient requirements. In the following interview, the technician reveals the role played by VITAPAN EXCELL in implementing incredibly beautiful, patient-specific implant prosthetics.
Dental Technician Carolin Wehning
INITIAL SITUATION: Esthetically and functionally insufficient initial situation in the maxilla
The strong distal occlusion position was to be compensated for in the new fabrication.
An implant-supported bite registration enabled the precise articulation of the two master models.
A wax-up was done on a synthetic duplicate of the dental arch of the old prosthesis to define the new target situation.
The new setup was scanned in and the primary, secondary and tertiary frameworks were designed in keeping with the dimensions.
The primary structure of zirconia was milled in parallel on the capped model. The vertical dimension of the friction surfaces should be four to five millimeters.
Secondary components were milled from PMMA for the try-in of the setup and friction control so that the final components could later be implemented in PEEK using CAD/CAM.
Dental Technician Carolin Wehning: I would say from my practical experience in everyday laboratory work: It's noticeable. Because VITAPAN EXCELL makes a really good impression during processing. The composite material does not smear during grinding, can be removed and adjusted well and evenly. This is likely due to the balanced hardness and homogeneity of the prefabricated teeth. The cutter also does not get stuck or entangled anywhere. That means I always have control when grinding in and never accidentally remove too much material.
The wax try-in revealed the need for optimization.
Detailed silicone rims for checking (left) and detailed implementation with whitish VITAFOL H (right).
Last position control: The tertiary framework opaqued with gingiva shades prior to implementation in synthetic material.
Wehning: In this and many other cases, I have repeatedly noticed that VITAPAN EXCELL remains true to color even with a very thin layer thickness. The prefabricated tooth is therefore very advantageous where space is limited, as in this bridgework and other combination work. In addition, VITAPAN EXCELL allows individual, shade-matched adjustments to be made at any time with the veneering composite VITA VM LC flow or the cold-curing polymer VITA VM CC, without any transitions being noticeable.
Due to the detailed reproduction, the processing proceeded quickly.
The vestibular portions of the denture base were customized to a lifelike appearance with VITA VM LC flow.
Wehning: The coordinated proportions and the variety of shapes and shades of VITAPAN EXCELL offer several advantages: So far, I have found the right set for every clinical situation. The anterior sets generally look very natural and not too playful, which is why they can also be used very well for teaching purposes. Of course, thanks to the golden proportions, the functional aspects are also easier to implement. Due to the natural alignment of the axes, VITAPAN EXCELL has a very harmonious effect when used together.
Primary framework of zirconia with green slide attachment elements and secondary framework of PEEK.
The highly esthetic final restoration with inserted implant analogs.
Wehning: VITAPAN EXCELL and VITAPAN LINGOFORM coordinate well together. The shade effect and gradient are precisely coordinated with one another. The morphology and surface texture also match perfectly. Both sets of teeth are uncomplicated and can be used by anyone. The occlusal surface design of VITAPAN LINGOFORM is multifunctional and suitable for all conventional prosthetic concepts. The occlusal surfaces are well defined, the centric occlusion is quickly found and major grinding measures are usually not required.
RESULT: The final restoration harmonizes with the face and lip line and has a natural, lifelike effect.
Wehning: With the surface texture already in place, I no longer have to incorporate it, but can simply reduce it if necessary. This is because the surface texture and gloss level have to be adjusted to suit the individual patient and the patient's age. For each patient case, I take natural models in the form of photos or models to know where I am going. For the final polish, I use my technical handpiece and work with conventional rubber polishers, brushes and fine burrs.