Submit Manuscript | http://medcraveonline.com Introduction The demand for all-ceramic restoration has increased substantially because of their esthetics and biocompatibility. All-ceramic crowns were used to be made up of single layer glass ceramic-Dicor (Dentsply/ Caulk), IPS Empress (IVOCLAR) etc. Their failure rate was high in certain cases. 1 A new system was developed to overcome these failures, utilizing a bilayer design, where an Alumina base core, either glass infltrated (Inceram, Vivadent) or densely sintered (Procera, Novel Biocare), 2 support the veneering porcelain applied over this core for aesthetic reason. These systems have shown a lower failure rate for single crown 3 and can also be used for 3-unit fxed dental prosthesis. Clinical studies of fxed partial denture made some of above mentioned system showed discouraging results for the posterior region after the mean follow-up period of approximately 3 years. 4,5 Therefore, an improvement in their clinical success rate is needed if performance similar to metal ceramic is expected. 4 The literature mentions that new core material with improved physical properties should be developed. 5 Recently, densely sintered zirconia based cores have become available (Lava, 3MEspe; DCS Smart-Fit, Austenal; Ceron Smart Ceramics, Dentsply Ceramco; procera Zirconia, Nobel Biocare; Vita inCeram YZ, Vident). 6,7 These ceramic systems utilize yttrium- tetragonal zirconia polycrystal (Y-TZP or partially stabilized zirconia) for the fabrication of anterior and posterior crown and fxed partial dentures. “Transformation toughing” where the presence of stabilizing oxide yttrium oxide holds the material in a stable tetragonal state which provides a unique toughing mechanism to enhance the ceramic properties for load-bearing application, 6 Y-TZP has a fexural strength of 900 to 1200Mpa which is considerably higher than that reported for densely sintered alumina 8 & glass infltrated alumina/zirconium dioxide material. 9 In addition, Y-TZP does not seem to be as sensitive to moisture-induced strength degradation as are other ceramics. 10 The following case report describes the restoration of maxillary central incisors and left lateral incisor and illustrates a successful aesthetic and functional application of this exciting digital zirconia-based system for a smile makeover. Case report A 21 yr old young female patient reported to the Dept of Prosthodontics. There was protrusion of anterior teeth with spacing .The dental history revealed that she had a trauma 1yr back and her teeth got fractured. At that time the teeth were treated with Root Canal Treatment but crowns were not fxed on teeth. Treatment plan As there was anterior spacing, this case was discussed with orthodontist. Patient was having Bimaxillary Protrusion also (Figure 1). Orthodontic correction was advised with fxed appliance for malocclusion (anterior spacing) and all-ceramic crowns on maxillary central incisors and left lateral incisor. Orthodontic Treatment was refused by the patient and she demanded whiter teeth from her natural teeth as she was getting married within one month and she wanted her treatment done before her marriage. Then preferred are all-ceramic crowns. Diagnostic impressions were made, A1 shade was determined with a shade guide (Vita) in place of A2 shade according to her demand and crown preparation done for all-ceramic crowns. Final impression was made after retraction by using Impragum polyether elastomeric impression material (3MESPE). Temporary crowns were cemented using non-eugenol Temp cement. Then dies were made from fnal impression and dies of prepared crowns were scanned in scanner (Cercon-eye) (Figure 2). The dimensions and shape of zirconia copings on 3D images of maxillary central incisors and left lateral incisor were modifed and fnalized with the help of cercon-art (Figure 2). The saved data was then sent to the milling machine (Cercon-brain) for fabrication of copings for prepared teeth (Figure 3). After two days temporary crowns were removed then all-ceramic coping trial was done and after one week temporary crowns were removed and internal ft of the all-ceramic restoration was evaluated J Dent Health Oral Disord Ther. 2014;1(4):85‒87. 85 © 2014 Bhardwaj et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Advance all-ceramic restoration by CAD/CAM: a case report Volume 1 Issue 4 - 2014 Atul Bhardwaj, 1 Smita Singh, 2 Koyena Mishra, 3 Mazood Ahamad 4 1 Department of Prosthodontics, Majmaah University, Saudi Arabia 2 Department of Pedodontic and Preventive Dentistry, Sharda University, India 3 Department of Oral Surgery, Kalka Dental College, India 4 Department of Periodontics, Majmaah University, Saudi Arabia Correspondence: Atul Bhardwaj, Department of Prosthodontics, Al-Zulf Dental College, Majmaah University, Saudi Arabia, Tel 966-550165825, Email Received: April 25, 2014 | Published: July 30, 2014 Abstract The demand for the dentist to achieve excellence in aesthetics and function has driven modern advances in materials and restoration fabrication. The development of various casting alloys and precise casting systems has contributed to the successful use of metal- based restorations. However, patient requests for more aesthetic and biologically ‘safe’ materials that has led to an increased demand for metal-free restorations. The following case presentation illustrates a successful aesthetic and functional application of this exciting CAD/CAM-digital Zirconia-based system in combination with porcelain veneers for a natural smile. Keywords: all-ceramic, CAD/CAM, zirconia Journal of Dental Health Oral Disorders & Terapy Case Report Open Access