Dr. Daniel Vasquez DDS shows his secret to a successful Chairside CAD CAM restoration The One, Two Punch! A single crown restoration on the Dentaltown Message Boards CAD-CAM and Digital Impression Technologies CEREC Forum dentaltown/MessageBoard/thread.aspx?s=2&f=96&t=242061&v=1 Technology, Science & Passion is the secret to a successful chairside CAD CAM restoration. CEREC technology has change the way I do dentistry, since I acquire my first system “RedCam” in 2008 I become digital and made the decision to stay Digital. I’ve done all kind of restoration from a simple Onlay to the most sophisticated implant abutment restoration but the one that gives me the most satisfaction is “THE SINGLE CROWN”. In this case I demonstrate the accuracy of CEREC, the beauty, the simplicity of Ivoclar Vivadent materials and my passion. 46 year old female patient presented with pain on tooth # 19 due large decay penetrates pulp chamber, root canal therapy is recommended follow by a buildup and full coverage. After removing all decay a matrix band was place to do build up, Adhese Universal was applied by scrubbing for 30 seconds on the dentin after which the adhesive was light cure for 10 seconds then Tetric EvoFlow a Nano composite was used for build up the preparation, Cure flowable material with Bluephase Style curing light for 10 seconds in every surface. Building the preparation in this manner was important for ensuring successful milled CEREC restoration. The buildup created a preparation demonstrating nice round and smooth surface, without any sharp edges or line angles. This would facilitate a well-fitting restoration and eliminates the potential for stress concentrating areas. A COMBO design technique was used, a combination of BioCopy and BioIndividual, this way the software will copy all good information of the pre-existing tooth and Biogeneric will filled the rest. The preparation was digitally scan with CEREC Omnicam using Dr Vasquez protocol scan technique along with the adjacent teeth, opposing dentition. Buccal bite was taken using the 3D PBBB technique. Scanning in such organized manner will gives us a perfect model with perfect occlusion. With CEREC we can admire or critique our dentistry, having said that the Power of CEREC is the full control we have with it. We can manage occlusion, proximal contacts, thickness of ceramics and many more. Shade for final restoration was selected, IPS e.max Ht A2, base what would provide the greatest beauty and strength. After milled, restoration was tried in the mouth to verify a perfect fit making sure occlusion and proximal contacts are good. The monolithic restoration was then removed from the mouth, at which time it was characterized using glaze and universal stains (IPS Empress universal stains) then fired in a fast cycle. This is the moment of passion, from monolithic to mimic Mother Nature. Ready for deliver restoration, the Intaglio surface was etched with 5% hydrofluoric Acid for 20 seconds, Monobond plus Slanting agent was scrubbed onto intaglio surface and allow to react for 30 seconds. To ensure optima access and a clean, dry working field an Optragate isolation was placed. The buildup preparation was selective etch with 37% phosphoric acid for 15 seconds to treat the enamel, rinse and dry. Adhese Universal was scrub for 30 seconds, air thinned and light cured for 10 seconds using Bluephase Style. Variolink Esthetic an esthetic light and Dual-curing cement was used for this case. A DC warm shade was selected. This cement has the ability of easy clean-up of excess cement, great shade/color stability and excellent bond strengths. Easy Clean-up Tack cure for 2 seconds for gel stage and Removed excess of cement with a Scaler and floss interproximal areas. Liquid Strip (Glycerin) Is apply at the margin to inhibit the oxygen layer. Final cure for 10 seconds in every angle using Bluephase Style. Blending the color of a restoration to the surrounding dentition can make the difference to the restoration final appearance. Indirect CEREC restorations, Scan, Design, Mill, Characterized and placement is a process that has been simplified by the combination of great technology and materials working together it help us to provide immediate and long lasting esthetic restorations. This is what I call The One, Two punch! The single crown in my daily practice Daniel V. #dentistry #dental #dentist #dentalstudent #dentalschool #chairsideCADCAMrestoration #CERECtechnology #RedCam #digitaldentistry #DigitalOnlay #implantabutmentrestoration #CEREC #IvoclarVivadent #decay #AdheseUniversal #dentinadhesive #TetricEvoFlowNanocomposite #BluephaseStyle #BioCopy #BioIndividual #Biogeneric #CERECOmnicam #IPSemax #monolithicrestoration #IPSEmpress #Intaglio #VariolinkEsthetic #dentaltownonlinece #dentalceonline #dentalcontinuingeducation
Posted on: Sun, 25 Jan 2015 22:01:31 +0000
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