1. Global Ceram-X Student Case Contest 2005/2006 Name: Audrey Hesse, France University: Denis Diderot Paris 7

2. Global Ceram-X Student Case Contest 2005/2006 Introduction to the case The patient, aged 29 and a heavy soda drinker, presented with decay on 9 and 10, and abrasion and erosion of all teeth resulting in a loss of vertical dimension. Teeth 7 and 8 contained old unaesthetic composite restorations. However, all teeth reacted positively to vitality tests. After instructing the patient on better oral hygiene and dietary habits, a direct restoration of the anterior teeth using layering techniques to acheive a more aesthetic result was planned. Prosthetic restoration of the posterior area will be achieved afterwards.

3. Global Ceram-X Student Case Contest 2005/2006 Palatal view of the initial case: Tooth #10 presented with decay. Old unaesthetic composite restorations appeared on the distal aspect of #8 and on the mesial aspect of #7. Step 1

4. Global Ceram-X Student Case Contest 2005/2006 From the wax-up, a silicone guide was designed, allowing creation of the palatal and incisal aspects. By removing the guide, the palatal impression could be observed. Step 2

5. Global Ceram-X Student Case Contest 2005/2006 Shade A3.5 was selected from the Vita shade guide, corresponding to D3 dentin and E3 enamel on the Ceram-X duo shade guide. Step 3

6. Global Ceram-X Student Case Contest 2005/2006 A rubber dam was placed, followed by removal of decayed tissue and the old restorations. Diamond burs were used for the cavity preparations. Step 4

7. Global Ceram-X Student Case Contest 2005/2006 The Xeno III Self-etching Adhesive was applied, air thinned and light cured. The Ceram-XD3 was placed on the silicone guide using an incremental technique. The Xeno III Self-etching Adhesive was applied, air thinned and light cured. The Ceram-X D3 was placed on the silicone guide using an incremental technique. Step 5

8. Global Ceram-X Student Case Contest 2005/2006 The incisal edge was restored with Ceram-X E3. Light curing was achieved after removal of the silicone guide. Step 6

9. Global Ceram-X Student Case Contest 2005/2006 The buccal surface was restored using Ceram-X D3 followed by Ceram-XE3. The proximal surface was then restored using a metallic matrix and wooden wedge. The buccal surface was restored using Ceram-X D3 followed by Ceram-X E3. The proximal surface was then restored using a metallic matrix and wooden wedge. Step 7

10. Global Ceram-X Student Case Contest 2005/2006 After finishing with diamond burs, proximal edges were polished using a sandpaper strip. Final polishing was completed using Enhance ® Finishing cups and Prisma ® Gloss Polishing Paste. Step 8

11. Global Ceram-X Student Case Contest 2005/2006 BeforeAfter No sensitivity was observed after treatment and the patient was satisfied. The complexity of this clinical case benefited from a simplified layering technique using Ceram-X in order to obtain a good aesthetic result.