Tag Archives: Clinical Cases

A ten-unit upper veneer case in Amber Mill, shade 1M1 to 1M2. What makes this case worth recording is that the finished restoration follows the wax-up design exactly.

Case parameters

• Restoration: ten upper veneers
• Material: Amber Mill
• Shade: 1M1 to 1M2

Why following the wax-up matters

In an esthetic workflow, the wax-up is the design the clinician and patient agree on before any tooth is prepared. If the final restoration drifts from it, everything that was agreed loses its force: the patient expected one shape and receives another.

In a CAD/CAM workflow the wax-up is digitised and becomes the reference for every step that follows. The restoration is milled from that same dataset, so the difference between the approved design and the delivered result is close to zero.

The practical benefit

When the finished work reproduces the original design, quality control becomes straightforward: compare the restoration against the wax-up rather than judging it subjectively. Chair time at try-in also shortens, because the form was approved in advance.

What clinicians can use from this

On a multi-unit esthetic case, time invested in the wax-up and mock-up early saves more time later. Sending the lab a wax-up the patient has already approved, together with intraoral mock-up photographs, is the fastest route to a restoration that meets expectations.

See our esthetic restorations range, or contact our team.

Written for dentists and technicians. Khai Nguyen Dental Lab manufactures to clinical prescription only and does not sell directly to patients.

See the full case record with the spec table, image source and step-by-step workflow: Case Study: Ten Amber Mill Veneers in 1M1–1M2 Following the Approved Wax-Up.

A ten-unit feldspathic case, which belongs to the most demanding esthetic group a laboratory receives.

Why ten units is harder than ten times one unit

A single feldspathic veneer is difficult because it has to match its neighbours. With ten units the problem inverts: there is no natural tooth left to match, but now the lab has to create deliberate difference between the teeth.

No two teeth in a natural dentition are identical. Central incisors are brighter and more translucent at the edge; lateral incisors are smaller and usually more translucent throughout; canines are more saturated with a pronounced facial convexity. Build all ten to one shade recipe and the result is perfectly uniform, and therefore reads as false.

The hardest part: translucency

Natural enamel is neither transparent nor opaque. It scatters light, producing a brighter incisal zone with a thin halo, and lets the dentine colour beneath show through cervically. In hand-layered ceramic that effect is built by stacking materials of differing opacity in the right order, and there is no way to correct it after firing.

What clinicians can use from this

For a multi-unit anterior case, send the lab natural smile photographs, not only retracted intraoral views. Smile line, tooth display in speech and the relationship with the lower lip are only visible in a portrait, and they determine the length and inclination of all ten units.

See feldspathic veneers, or contact our team.

Choosing between the two materials? See feldspathic or e.max veneers: how to choose.

Written for dentists and technicians. Khai Nguyen Dental Lab manufactures to clinical prescription only and does not sell directly to patients.

A full-mouth case with an increase in vertical dimension, recently completed at Khai Nguyen, combining veneers, onlays, ceramic crowns and implant-supported restorations in one plan.

Two challenges when a case mixes restoration types

Controlling the occlusion. Raising the vertical dimension changes the whole inter-arch relationship. Every group has to be built to the same occlusal plane and the same guidance, otherwise one group contacts early and another sits out of occlusion.

Keeping shade consistent across different restoration types. This part is routinely underestimated. Veneers are thin, so the preparation shade shows through strongly. Onlays are thicker occlusally. Crowns cover the whole preparation and can mask the substrate. Implant restorations have no natural preparation beneath them at all, only an abutment. Those four groups start from completely different backgrounds, and the result has to read as one set of teeth.

How the lab handles it

The case is planned as a whole rather than built group by group and assembled afterwards. The technician fixes the occlusal plane and the target shade for the entire arch first, then works backwards to the thickness and opacity each group needs so that all of them arrive at the same colour.

What clinicians can use from this

For a mixed case, three things should be settled before production: how much the bite is being raised, the actual preparation shade in each zone, and the target shade. A wax-up or mock-up the patient has already approved shortens try-in considerably.

See our restorations range, or contact our team.

Another bite-raising case: full-arch vertical dimension rehabilitation with 20 ZirCAD Prime crowns and LiSi overlays.

Written for dentists and technicians. Khai Nguyen Dental Lab manufactures to clinical prescription only and does not sell directly to patients.

See the full case record with the spec table, image source and step-by-step workflow: Full-Mouth Rehabilitation Combining Veneers, Onlays, Crowns and Implants: Occlusion Control and Shade Consistency.

A GC LiSi Press veneer case recently completed at Khai Nguyen. This note records the sequence of steps behind it.

Four stages that decide the result

Adjusting the coping for fit. Before shade enters the conversation, the restoration has to seat correctly on the preparation. This is settled at the framework stage, because any discrepancy left afterwards gets covered by ceramic and can no longer be corrected.

Hand layering. LiSi Press provides a good translucent base, but the shade transition and the liveliness of the incisal edge still have to be placed layer by layer by the technician.

Shaping the form. Form decides whether a veneer looks natural more than shade does. Length, outline, facial convexity and contact point position all have to suit the patient’s face and smile line.

Creating surface texture. Natural teeth are not flat. Fine horizontal ripples and vertical grooves scatter light instead of reflecting it as one bright patch. Skip this and the veneer will be evenly coloured yet still read as artificial.

What this shows

None of the four stages rescues a mistake from the one before it. A coping that does not seat makes good shade irrelevant; wrong form cannot be saved by texture. That is why the lab checks at each stage rather than only inspecting the finished unit.

What clinicians can use from this

On a high-esthetic case, ask the lab for photographs at the framework stage or before glazing. A few minutes reviewing an image then is far cheaper than one remake.

See GC LiSi Press, or our ceramic materials comparison.

Written for dentists and technicians. Khai Nguyen Dental Lab manufactures to clinical prescription only and does not sell directly to patients.

See the full case record with the spec table, image source and step-by-step workflow: Case Study: Ten GC Initial LiSi Press Veneers in BL2, Teeth 14 to 24.

Two central incisors, two hand-layered feldspathic veneers. It sounds contained, and it is the most demanding esthetic group a laboratory takes on.

Why teeth 11 and 21 are difficult

On a full arch, the lab sets its own shade and form reference and applies it throughout. On 11 and 21 the reference is already there: the patient’s own 12 and 22. The two new veneers have to match them on base shade, incisal translucency, cervical saturation and the way the surface catches light.

There is a second factor. The central incisors sit at the middle of the smile and mirror each other. A few tenths of a millimetre of difference in length or axial inclination shows immediately, while the same deviation on a molar goes unnoticed.

Why feldspathic, and why hand layering

Feldspathic ceramic produces the closest optical match to natural enamel and can be made very thin, which preserves tooth structure. In exchange it lacks the strength of lithium disilicate or zirconia and depends entirely on the quality of the bond.

Layering by hand lets the technician place opacity at the cervical, the transition through the body, and translucency with a halo effect at the incisal edge the way natural enamel behaves. That is the part a machine does not replace.

What clinicians can use from this

On a two-central case, the shade photographs matter more than the written shade. Take them with the shade tab in frame, before the teeth dehydrate, and add an angled view so the lab can read incisal translucency.

See feldspathic non-prep veneers, or contact our team.

Choosing between the two materials? See feldspathic or e.max veneers: how to choose.

Written for dentists and technicians. Khai Nguyen Dental Lab manufactures to clinical prescription only and does not sell directly to patients.