28
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CERECDOCTORS.COM
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QUARTER 2
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2016
C A S E S T U D Y
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B Y D H AVA L PAT E L , D . D . S .
as a long-time cerec user, i have often struggled with the gingival papillae
on my anterior cases getting blunted
due to incorrect design — and I end up with long contacts. This sometimes leads to less than an ideal esthetic outcome, which
can be very frustrating. In this article, I want to share a case where I ended up with a compromised result, and how I used the
software to my advantage in another case to better the esthetic outcome.
Always Scan Biocopy Folder
for Anterior Restorations
A Tip to Prevent a Compromised Result
MISTAKE
Let’s start with this case. This is a 20-year-old female patient who
has been in my practice for more than 10 years (Fig #1). She has
been through orthodontic treatment, and was non-compliant with
her retainers. At this time, she was not happy with her smile. Her
chief concern was the overlap of tooth #9 over #10, and the discol-
oration of #8. Here I would like to mention that both #8 and #9
are endo-treated because of a history of trauma few years ago. All
treatment options were discussed, and the patient declined ortho-
dontics. Internal bleaching was done on #8, but that did not change
the appearance much, so we decided to crown both #8 and 9. I used
Biogeneric Individual to design both the crowns as I was not happy
with the pre-operative position of the teeth. I won’t go in to much
detail about the case, but here is the final post-op picture (Fig #2).
Thepatientwas verypleasedwith thefinal outcome as bothher chief
concerns were taken care of. But after further analysis of the case, I
realized that I hadmade the contact a lot longer than the pre-op situ-
ation and, as a result, the papillae between #8 and #9 were blunted.
LESSON LEARNED
I learned that I needed to conserve the original position of the
gingival papillae. The software has that provision in the form
of using Biocopy. Now, I understand that most of you will be
wondering, why would I need to use Biocopy when I chose to
design my case with Bio-Individual. What I propose is, even
though you choose to design the case with Biogeneric Individual,
you should also have Biocopy as a folder so you can refer back to
the papillae position, and maintain that in your final design.
LESSON APPLIED
In this section, I would like to discuss a case where I put my
learning to work, which helped me improve my final result.
Here is a pre-operative picture of a 25-year-old female patient who
Fig. 1: Pre-op, #s 8 and 9
Fig. 2: Post-op, #s 8 and 9
Fig. 3: Fractured #s 8 and 9
