Digital workflow for virtually designing and milling ceramic lithium disilicate veneers: a clinical report

Laminate veneers have been routinely used to restore and enhance the appearance of natural dentition. The traditional pathway for fabricating veneers consisted of making conventional polyvinyl siloxane impressions, producing stone casts, and fabricating final porcelain prostheses on stone dies. Pressed ceramics have successfully been used for laminate veneer fabrication for several years. Recently, digital computer-aided design/computer-aided manufacturing scanning has become commercially available to make a digital impression that is sent electronically to a dental laboratory or a chairside milling machine. However, technology has been developed to allow digital data acquisition in conjunction with electronically transmitted data that enables virtual design of restorations and milling at a remote production center. Following the aforementioned workflow will provide the opportunity to fabricate a physical cast-free restoration. This new technique has been reported recently for all-ceramic IPS e.max full-coverage pressed-ceramic restorations. However, laminate veneers are very delicate and technique-sensitive restorations when compared with all-ceramic full-coverage ones made from the same material. Complete digital design and fabrication of multiple consecutive laminate veneers seems to be very challenging. This clinical report presents the digital workflow for the virtual design and fabrication of multiple laminate veneers in a patient for enhancing the esthetics of his maxillary anterior teeth. A step-by-step process is presented with a discussion of the advantages and disadvantages of this novel technique. Additionally, the use of lithium disilicate ceramic as the material of choice and the rationale for such a decision is discussed.