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fit, removed, and then contoured using a finishing and polishing kit
specifically designed for cerecdoctors.com (Meisinger); after which
they were fired in a fast cycle (Programat CS Furnace). The cervical
neck of the restorations at their transitions to the interproximal was
shaped and polished to impart greater depth, and developmental
grooves and line angles were also contoured to create the proper
optical effects (Note: More information and videos about this
process can be found at the cerecdoctors.com website). The final
polish was created by using Diashine fine with a Robinson brush,
followed by a ragwheel.
The restorations were then tried in again using an esthetic try-in
paste (Variolink Esthetic, light-cure warm) (Fig. 13), removed, and
the preparations and restorations were cleaned. A silanating agent
(Monobond Plus) was scrubbed onto the internal surface of the
restorations and allowed to react for 30 seconds, after which the
restorations were air dried. The tooth preparations were then
etched using 35 percent phosphoric acid for 15 seconds to treat the
enamel (Fig. 14), after which they were rinsed and lightly dried.
A universal bonding agent (Adhese Universal) was scrubbed onto
the preparation for 30 seconds (Fig. 15), air thinned, and light
cured for 10 seconds using an LED curing light (Bluephase Style).
An esthetic light- and dual-curing cement (Variolink Esthetic)
was placed into the restorations, after which they were seated. This
cement enabled easy clean-up of excess cement, shade/color stabil-
ityand high bond strengths. Once the restorations were seated, they
were tackcured fromthe facial aspect for three seconds each (Fig. 16).
The gel-like excess cement was then removed using a scaler, and
the restorations were fully cured from all angles for 10 seconds
each using the LED curing light. The occlusion was verified and
adjusted as needed.
CONCLUSION
Indirect CAD/CAM restorations represent an efficient and proven
way for dentists to provide their patientswith esthetic and predict-
able treatments in one appointment (Figs. 17-18). What can further
enhance and simplify the restorative process is using a combina-
tion of advanced adhesive materials designed to work synergisti-
cally to produce long-lasting bond strengths, esthetics and dura-
bility. Additionally, when an easy-to-use lip and cheek retractor
that promotes an unencumbered view and access to the working
field is employed, many other problematic issues that could cause
frustrating and time-consuming delays can be avoided.
For questions and more information, Dr. O’Bryan can be reached at
.
Fig. 17: Close-up retracted view of the patient with IPS Empress CAD
Multi veneers after cementation
Fig. 18: Close-up postoperative smile view of the patient showing
enhanced esthetics and height-to-width ratios of her veneer
restorations
REFERENCES
1 Poticny DJ, Klim J. CAD/CAM in-office technology: innovations after 25 years for
predictable, esthetic outcomes. J AmDent Assoc. 2010;141 Suppl 2:5s-9s.
2 Strassler H, Boksman L. Tissue management, gingival retraction and hemostasis.
Oral Health Group. July 2011.
3 Rickman LJ, Satterthwaite JD. Considerations for the selection of a luting cement.
Dent Update. 2010;37(4):247-8, 251-2, 255-6 passim.
4 Bunek S, Brown C, YakasM. The evolving impressions of digital dentistry. HowCAD/
CAM technology continues to drive innovation. Inside Dentistry. January 2014; 35-39.
5 Kurbad A. Impression-free production techniques. International Journal of
Computerized Dentistry. 2011;14(1):59.66.
6 Carville R, Quinn F. The selection of adhesive systems for resin-based luting agents.
J Ir Dent Assoc. 2008;54(5):218-22.
7 Manso AP, Silva NR, Bonfante EA, et al. Cements and adhesives for all-ceramic
restorations. Dent Clin North Am2011;55(2):311-32, ix.
8 Shenoy A, Shenoy N. Dental ceramics: An update. J Conserv Dent. 2010;13(4):195-203.
9 Ender A. (2012). CEREC basic information 4.0: A clinical guide. Sirona Dental Systems
GmbH. Retrieved fromhttp://www.sirona.com/en/products/digital-dentistry/
cerec-chairside-solutions/?tab=245.
10 MörmannWH. The evolution of the CEREC system. J AmDent Assoc. 2006;137
Suppl:7S-13S.
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