quarter 4
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2012
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cerecdoctors.com
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surgery. Both had been previously treated
endodontically. It was decided to replace
both central incisor crowns as a part of
treatment to maintain esthetic symmetry,
and it is this fact that afforded us the
opportunity to utilize this technique.
An impression of the upper arch (with
the lateral incisor crowns bonded in
place) was made with Algin-X (Kerr) PVS
impression material. The impression was
poured twice with Silky Rock die stone
(
Whip Mix). A #11 scalpel blade and
Hollenback carver were used to sharpen
and define the gingival margins and clean
up any areas of imperfection in the treat-
ment area.
One cast was set aside to be used as a
source of upper Biocopy images during
the digital design (Figs. 3-4). The other
model was altered to simulate the intra-
operative situation. To do this, the lateral
incisors were removed utilizing a large
carbide bur in a lab handpiece, taking
care to not damage the mesial prox-
imal surfaces of the canines. After their
removal, a depression was made in the
area of the existing lateral roots to aid in
creation of an ovate pontic over the newly
placed implants.
On the same model, a tapered, round-
end, hand-piece-length carbide was
used to carefully prepare conservative
“
crown preparations” of the central inci-
sors utilizing the lingual, proximal and
facial gingival margins as guides for
future margins of the interim restoration
2
3
4
Fig. 1: The Galileos cone beam scan
shows the patient’s condition.
Fig. 2: After surgical planning utilizing
the CEREC-Galileos interface,
a surgical guide is created to aid
in the implant surgery.
Figs. 3 and 4: A pre-operative wax-up
is completed to help design the
final restorations.