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46 | CERECDOCTORS.COM | QUARTER 1 | 2014
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were made to the opposing provision-
alized mandible.
With the maxilla restored against
the provisionalized mandible at the
desired new vertical dimension of
occlusion, restoration of the mandible
was completed in three segments to
ensure controlled maintenance of
this position. The posterior mandib-
ular teeth did not pose a big cosmetic
challenge and, therefore, these sepa-
rate areas were completed chairside
using the Omnicam (Sirona) over two
appointments. The teeth were scanned
(Fig. 12), and the units were designed
based off the Biocopy scan of the provi-
sionals in the 4.0-level inLab software.
The occlusion of the proposed restora-
tions was set to the restored maxilla,
and the units were milled using IPS
e.max CAD blocks and the in-office
MC XL machine.
The restorations were then tried-in
intraorally in the blue state to verify their
marginal fit (Fig. 13), and finished using
IPSe.maxGlaze(Ivoclar)anda14-minute
firing cycle in the Programat CS oven
(Ivoclar). These units were prepared
for insertion by etching for 20 seconds
with Etchgel (Ivoclar) and silanated with
Monobond (Ivoclar) and then delivered
in the same manner as the maxillary
units using Multilink (Ivoclar). Once the
two posterior mandibular segments were
restored, the six remaining mandibular
anterior teeth were scanned, designed
and milled from IPS e.max CAD blocks
Fig. 12: Mandibular CEREC Omnicam
full-arch digital impression
Fig. 13: Intraoral try-in of mandibular
posterior chairside IPS e.max
CAD units
Fig. 14: Final restorations delivered
Fig. 15: Post-operative photographic series
| | | J U R I M
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15
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which were cutback and completed
by a laboratory technician to achieve
the desired esthetics. The same protocol
as previously described was used for
delivery of these final remaining sixunits.
Final occlusal adjustments were
completed a week later. Post-operative
pictures were then taken two months
after the case was inserted (Fig. 14-15).
These pictures highlight the enhanced
cosmetics of the patient’s new smile,
with improved gingival harmony and
health, correction of tooth angulations
and uniformity in shade and restorative
material. The digital CEREC workflow
afforded a degree of predictable and
reproducible control that ensured the
final cosmetic result was long-lasting
and exactly what the patient desired.
The author would like to thank
Adrian Jurim, C.D.T., M.D.T.,
at Jurim Dental Studio for inspiration
and the exquisite technical fabrication
and esthetics of the IPS e.max
restorations featured in this case.
For questions and more information,
Dr. Jurim can be reached at
Alan@jurimdental.com.