This article presents a clinical case involving the integrated application of CAD/CAM and DSD. DSD – Digital Smile Design – assists in obtaining a treatment plan adjusted to the patient’s facial features, achieving the best aesthetic potential. The integration between DSD and CAD/CAM allows for greater fidelity in respect to the original plan. A patient received a rehabilitation with veneers milled out of leucite-reinforced feldspathic ceramics, using the CAD/CAM system and a DSD-obtained digital wax-up. This workf low simplifies design and fabrication, providing greater accuracy and predictability to the rehabilitation process. The digital planning and development of the mockup also makes clinical conditions more predictable. Making ceramic veneers using the CAD/CAM technique requires judicious adhesive cementation, and also an accurate practical and theoretical knowledge on the part of the professional.
Objective: this study aims to evaluate, through a literature review, the adhesiveness of zirconia and lithium disilicate after different surface treatments and to establish a protocol to be followed in the clinic. Material and Methods: the methodology was developed from the electronic search in the database National Library of Medicine (PUBMED), using the terms "zirconia surface treatment bond strength" and "lithium disilicate surface treatment", including only clinical studies in humans, in-vitro or in-vivo, and literature reviews. All articles were published in the last 16 years and written in the English language. Results: after selecting the scientific articles following the inclusion and exclusion criteria, 26 studies remained for the literature review. Conclusion: after the review, it was concluded that cementation protocols for lithium disilicate and zirconia are different due to their different microstructures. Lithium disilicate should be conditioned with 4.5% hydrofluoric acid followed by phosphoric acid smearing, silane (hot air drying), and universal adhesive application. On the other hand, zirconia restorations should be sandblasted with silica-coated aluminum oxide followed by silanization or blasting with aluminum oxide, associated with zirconium primer application.
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