Page 32 - CEREC Q3|2013

30 | cerecdoctors.com | quarter 3 | 2013
| | | H a n s o n
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10
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Fig. 7: Tooth #7 was then digitally repli-
cated by the CEREC software
Fig. 8: The “mirror image” of tooth #7 was
inserted over the preparation design so
the digital design of the restoration for
tooth #10 could be completed
Fig. 9: The facial margin was bulked
out to 0.5 mm for ease of milling and
later thinned back to 0.3 mm using a
handpiece
Fig. 10: View of a High Translucency
IPS e.max CAD block prior to milling
Fig. 11: View of an IPS e.max CAD block
during the milling fabrication process
Fig. 12: The precision and smoothness
of the mill enhances the optical
properties of the restoration, even at
0.5 mm thickness
Fig. 13: Incisal Essence stains were
applied to the restoration surface to
impart characterizations matching
the adjacent teeth
Fig. 14: The crown was cleaned with
Ivoclean, then bonded with Monobond
Plus A and B
common when the transparent porcelain
is too thick at the margin.
The proximal contact areas on the
adjacent teeth were polished with a
medium sanding disk to ensure smooth
flossing contacts, reducing the risk of
interproximal caries. The patient was
then asked to perform excursive move-
ments from maximum intercuspation to
confirm occlusal clearance was adequate
for the restorative material.
A scan of the preparation was then
accomplished with the CEREC Blucam in
Replication mode (Fig. 6).6,7 The CEREC
Blucam produced very detailed images by
utilizing a powerful LED light source.
The digital design for tooth #10 was
created by making a “mirror image” of
tooth#7 (Fig. 7). The replicawas then digi-
tally “flipped” and placed on screen (Fig.
8). Color coding and automatic occlusion
adjustment features of the software helped
ensure proper proximal contacts and
margins. The thinmargin on the facial was
bulked out for milling (Fig. 9) and would
be thinned and refined by hand using disks
and rubber wheels after fabrication.
The restoration was milled from an
IPS e.max CAD High Translucency BL2
block (Figs. 10-11). This shade was chosen
because its value is easier to tone down
after milling using IPS e.max Essence
stains, rather than attempt to raise the
value of the final restoration. The milled
restoration was evaluated and determined
tomeet the desired specifications (Fig. 12).
The partially crystallized crown was
tried in place. The proximal contacts
were assessed intraorally with blue-
handled strips, and a fine diamond disk
on low speed was used for refinement.
Very little adjustment was required to
modify the crown.
The restoration was refined, and the
incisal stain was applied in preparation
for the first firing for 26 minutes (Fig.
13). An additional try-in of the restora-
tion was performed chairside. Further
customization with Essence stains was
accomplished, adding white and sunset
characterizations to be fired. Subse-
quently, a final try-in, touch-up and final
glaze were performed prior to the third
and final firing for 26 minutes.
The completed restoration was then
prepared for bonding with Ivoclean,
“red” etch according to the manufactur-
er’s instructions, primedwithMonobond
Plus, (Fig. 14), and then prepared using
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