Page 49 - CEREC Q3 | 2014

QUARTER 3 | 2014 | CERECDOCTORS.COM | 47
CASE STUDY
Lucy is a healthy 65-year-old female with
a clean medical history. In fact, her only
problemis a crown that has come loose. It
has been bothering her for a fewmonths,
but she has decided it is time to take care
of it. A driving fact is she is soon to travel
around Italy for three months.
The cone beam scan was taken, and
the true state of this tooth evaluated.
Unfortunately, we had to tell Lucy the
tooth was hopelessly split and required
extraction. You can see the extent of
the damage in Figure 4. To complicate
matters, she mentioned the need to get
a tooth in there before her trip.
She was scheduled for the removal of
the failing tooth, removal of the cyst asso-
ciated with the tooth and a provisional to
maintain her smile as she heals. To keep
Lucy smiling and to help preserve the
soft tissue, a cantilever was planned off of
#13. An ovate pontic was planned for #12
in order to maintain the papillas.
Figure5shows theprovisionaloneweek
after placement. The material selected
for the provisional was Lava Ultimate, a
material that allows flexibility due to the
ease of adding composite to it. It is simple
to modify the ovate pontic area and/or
contours if required. This was cemented
and the patient was dismissed. Normal
post-ops were done for a few weeks until
we said “arrivederci” to Lucy.
Of course, to complicate things, Lucy
had a very strong gag reflex. So, impres-
sions were out of the treatment options.
It was the digital way or noway for Lucy.
The crown was removed from the tooth
for imaging. Tooth#13was prepared and
the provisional planned and fabricated.
After Lucy’s return, another Galileos
scan was done to evaluate the bone graft
and the soft-tissue profile. My confidence
in the accuracy of the digital workflowhas
opened up possibilities that I could never
have imagined just a short time ago. Many
of the implant companies have a lab kit
to work with the various guide systems
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5
4
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Fig. 1: Replacement of a fractured
premolar
Fig. 2: A cone beam scan identifying
the problem area.
Fig. 3: A cone beam scan with the
planned restoration imported
Fig. 4: Pre-op condition of failing
premolar
Fig. 5: Cantilever provisional