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quarter 4 | 2013 | cerecdoctors.com | 19
Followingdoctorandpatient approval,
it is now time to scan the wax transfer
into the Biocopy folder, as seen in Figure
4, ensuring capture of the entire arch in
order to acquire adequate data to stitch
the preparation images. The Cut tool is
then utilized to remove the wax transfer
images in correspondence to the desired
restorations (6-11), prior to scanning in
the preparation catalog (Fig. 5).
Nowthe stage is set for proper prepara-
tionand imagingof the teethtobe treated.
The wax-up contours
are used as a guide
to provide adequate
and proper reduction
while preparing the
teeth. Figure 6 shows
the preparations after
gingival contouring
was performed and
block-out was used
on #11 to mask the
color of the endodon-
tically treated tooth.
Special attention is
used to create smooth
and flowing preparations with no sharp
transitions and to preserve the lingual
enamel and cingulum. This technique is
conservative, yet it allows for adequate
thickness of the porcelain restoration.
When scanning, start on the poste-
rior teeth and move across the prepara-
tions, filling the upper arch catalog with
the preparation images and completing
the stitch to the Biocopy catalog (Fig. 7).
Following the process of a single resto-
ration, all restorations are defined and
proposedsimultaneously, providingexact
replications of our wax transfer (Fig. 8).
Paying special attention to interproximal
contours, adjustments are made and the
e.max veneers are milled. Now that the
CEREC 4.2 software and the Omnicam
allow custom-fit veneers to be created
predictably and efficiently, it is time to
customizethemforthepatientanddeliver
a quality cosmetic result in one visit.
patient. On the day of treatment, you
are ready to transfer the wax-up to the
patient as shown in Figure 3. Prior to the
wax transfer, I apply a bonding agent to
the teeth and thenVaseline themucosa to
aid in clean up of the temporarymaterial.
I use Luxatemp to transfer the wax-up
using the desired final shade. This is one
of our greatest advantages as CEREC
dentists. We get to view the intended
results of ourworkwithin the framework
of our patient’s smile. No other method
allows for this precision and predictable
conversion from the plan to the finished
results. When possible, perform this
before anesthetizing the patient. This is
a great time to make adjustments to any
contours that need improvement and to
verify the occlusion. After proper transfer
and assessment of the cosmetic result, we
are ready to utilize the Omnicam and the
CEREC 4.2 software.
5
6 7
8 9
Fig. 5: Cut feature of the soft-
ware improves the workflow
Fig. 6: Photo of veneer
preparations and proper
isolation for imaging
Fig. 7: Full upper arch scan
capturing the prep images
Fig. 8: Biocopy proposals in the
CEREC 4.2 software
Fig. 9: e.max try-in to verify
contours using the contrast of
the “blue-block” stage
After assessing this patient’s condi-
tion as shown in Figure 1, we discussed
the desired results based on the patient’s
concerns and what is clinically achiev-
able. With every case, I start with a
detailed diagnosis and an impression
for a quality wax-up. This information
is recorded and communicated to our
lab, aiding in the creation of a detailed
wax-up used for analysis and prepara-
tion. The wax-up (Fig. 2) is by far the
most important part of the process
when it comes to ensuring excellent and
predictable results with minimal effort.
The final result will directly reflect
the quality of the wax-up when you
follow the techniques outlined below.
Thorough communication, as well as a
quality wax-up, set the stage for efficient
cosmetic excellence.
With the wax-up back from the lab,
I approve treatment and appoint the