Page 28 - CEREC Q3|2013
Basic HTML Version
26
|
cerecdoctors.com
|
quarter 3
|
2013
restorative option for anterior fixed
partial dentures, the process is now
complete and a true in-office proce-
dure. So, what is the first thing most
of us thought when we got these
blocks in our hands and added to the
software?
When, and how, am I going
to use these in the posterior?
The answer
is now, with a few guidelines, of course.
The blocks are currently available in
the B40 HT only. They are also only in
the inLab software. With the release of
software 4.2, the blocks will be available
in the new chairside version,
butinitiallywithout
the ability to check
connector
size.
This is the most
this is it!finally! ascerecusers,we
have been waiting for this moment since
the initial release of e.max. Those of us
using the inLab software have always
been impressed by the CAD-On tech-
nique available for “in-office” bridges.
But was it truly an “in-office” procedure?
The need to sinter the zirconia frame-
work, which added an extra step (and
sometimes days) to the process, has
always been the Achilles’ heel. Once
the framework was sintered, the e.max
overlay could be milled and bonded
to complete the restoration. This was
a great technique for those of us who
secretly wanted to be lab technicians.
The question always remained though:
Do I really need the framework?
With Ivoclar releasing the data for use
of the larger e.max blocks (B40/B32) as a
c a s e s t u d y
| | |
b y D av i d J u l i a n i , D . D . S .
at five years, and an 87.9 percent survival
rate at 10 years when the connector size
guidelines were followed. The best news
was that cementing or adhesive bonding
did not affect the survival rate.
So, in other words: it’s here! And, better
yet, it is here to stay. The ability for CEREC
users to continually provide more and
more in-office, single-appointment proce-
dures only seems to keep getting better.
Thank you, Sirona. Thank you, Ivoclar.
CASE STUDY
A 45-year-old male presented to the
office with a fractured distal abutment
(#3) of a fixed partial denture #3-5 (Figs.
1-2). The fractured bridge was removed,
and the preps refined for the newrestora-
tion. The case was imaged in the CEREC
chairside software (version 4.05) using
Omnicam, and then exported as
a .dxd file to the desktop.
CEREC inLab (version 4.02)
was opened, and the case was
imported for design of the final
restoration. Note: the connector
size measurements show both connec-
tors greater than the recommended 16
square millimeters (Figs. 3-4).
This is the restoration just after mill,
prior to separation from the block (Fig. 5).
The final restoration was a great fit and,
except for the slight grey tone due to
theHT block, the esthetics weremore
than acceptable (Figs. 6-7).
For questions or more information,
Dr. Juliani can be reached at
.
important step in design and fabrica-
tion of the bridge, anterior or posterior.
Ivoclar recommends the use of these
larger blocks
only
for anterior resto-
rations at this time. They also recom-
mend limiting the pontic number to one.
Research has been done on posterior use,
with the concern always being long-term
viability under daily function andocclusal
load. With that in mind, studies on the
use of e.max for anterior and posterior
bridge restorations have been very prom-
ising when certain strict guidelines are
followed with respect to connector size.
In the anterior connector, size must be a
minimum of 12 square millimeters; in the
posterior, 16 square millimeters.
A study in the
Journal of the American
Dental Association
(2012 Mar; 143(3):
234-240)noteda100percentsurvivalrate
1
2
3
4
5
6
7
The Posterior e.max Bridge
Chairside One-visit Bridges Are Now a Reality
Figs. 1-2: Fractured restoration
Figs. 3-4: Bridge proposal
Fig. 5: Milled restoration
Figs. 6-7: Final bridge in place
