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CERECDOCTORS.COM
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QUARTER 1
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2016
ideal tooth arrangement (Fig. 6). We also have four different tooth
forms to choose from: Biogeneric, Ovoid, Square and Tapered. We
also have the ability to overlay the Biocopy arch to help us position
the incisal edge position (Fig. 7).
After positioning the teeth in the Bio Jaw screen, a newproposal
will be generated (make sure you uncheck “adapted” in the posi-
tion tools beforemoving to a newproposal) (Fig. 8). Spending three
minutes in the Biojaw function created a wonderful proposal with
symmetry and proper arch form. However, the pontic on #8 is a
little bit shorter than the other central incisor. This is due to the
fact that the software creates the pontic bottom line automatically
(Figs. 9- 10). There is a tool called Edit Base Line that you can use
after proposal to edit this line, copy the overall form and length of
theothercentral andget amuchbetterponticproposal (Figs. 11- 12).
Within five minutes, a great final design was achieved (Fig. 13).
In order to evaluate how the new tooth form, inclination and
incisal length were going to look in the patient's mouth, we
decided tomill provisionals out of PMMA (TelioCAD). The patient
accepted the new shape and decided to wear them for a week
to determine if there was any issue with phonetics or esthetics.
There was an issue of the dark preparation on #10 shining through
the TelioCAD provisional, but we were confident that would be
less of an issue with the final material (e.max CAD LT) and more
opaque cement (Fig. 14).
After final patient approval, the final restorations were milled
out of e.maxLT.We did use the extra-finemilling options (EFMill)
of the 4.4 software to create better immediate embrasure form
and decrease the amount of contouring that would be needed on
the bridge. Final contouring was done, and the restorations were
characterized and glazed with GC Lustre Paste. Care was taken to
make sure they were not “over glazed and shiny” and that a duller
matte finish was created to keep the texture intact.
The restorations were bonded into place using Variolink
Veneer LC Light +. All occlusion and excursive movements were
checked and adjusted as needed, and final polishing was executed
(Figs. 15-17). The patient was quite pleased with the new shape,
symmetry and color of the new restorations.
CEREC SWv4.4 has brought many wonderful new features, but
none are more welcome for anterior restorations than Biojaw. The
ability to skip the diagnostic wax-up/mock-up and have the ability
to quickly design restorations with harmonics and symmetry is an
invaluable tool for our efficiency and overall final results.
For questions and more information, Dr. Skramstad can be reached
at
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S K R A M S TA D
Fig. 9: Pontic bottom line
Fig. 10: Pontic bottom line
Fig. 11: Pontic bottom line after Edit Base Line tool used
