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n As the R&D department of Glidewell Laboratories refines its processes, as well as improving the material’s translucency, aesthetics continue to improve. Advancements to improve the aesthetic properties of BruxZir Solid Zirconia restorations were re- cently achieved as demonstrated in this case by Dr Michael C. DiTolla, Newport Beach, USA. While Gidewell does not suggest that dentists suddenly switch all of their anterior restorations to BruxZir crowns, they may want to consider us- ing it for patients with parafunctional habitsoroldPFMs,whereanaesthetic improvement is essentially guaran- teed, the company said. During the first appointment, the PFMcrownsontooth#8and#9(Fig.1) were removed with BruxZir Solid Zir- coniacrowns(GlidewellLaboratories). Thentheshadewastaken withhelpof the VITA Easyshade Compact which displayed the shade in both VITA ClassicalandVITA3D-Master shades. Next, the selected 2M1 3D-Master shade tab was held to the tooth, along with the 1M1 3D-Master shade tab for contrast. The shade tabs in the mouth were photographed. PFG gel was placed into the sulcus of tooth #8 and #9 with an Ultradent syringe. Next, they were anaesthetised with an STA Single Tooth Anesthesia System device. The Razor Carbide bur easily cuts through porcelain and metal substructures, and when used in combination with an KaVo ELECTROtorque handpiece, it easily cuts through the existing PFM. The crown was torqued with a Christensen Crown Remover. After using a periodontal probe to ensure there is enough biologic width to safely remove some tissue (Fig. 2), a NV MicroLaser was used to remove 1.5 mm of tissue. With the margins exposed, a 856-025 bur and KaVo ELECTROtorque handpiece was used to drop the margins to the new gingi- val level. The dental assistant relined Bio- Temps Provisionals (Glidewell Labo- ratories) on tooth #8 and #9 with Luxatemp provisional material. Using a thin, perforated diamond disc, the gingival embrasures were opened to avoid blunting the interproximal papilla,aswellastomakesurethegin- gival margins were not overextended and the emergence profile was flat. TempBond Clear was used to cement theBioTemps,andloupeswereusedto inspectaroundthetempsandgingival embrasures for excess cement. After two weeks, the temps were removed and the preps cleaned with a KaVo SONICflex scaler. After trim- ming the gingival margin with the diode laser, an Ultrapak cord #00 (Ultradent) was placed, cutting the cordintraorallyonthelingualtoavoid any overlap. A second cord (Ultrapak cord #2E) was placed before refining the preparation. As the top #2E cord on tooth #8 was packed, the top cord on tooth #9 exposed the margin (Fig. 3). Now fin- ishing the preps begun using a fine grit 856-025 bur. Two moistened ROEKO Compre- cap Anatomic compression caps were placed on the preps. Then the patient bit with medium pressure for 8 to 10 minutes. The Comprecaps were re- moved and the top cords pulled. For the impression, medium body impres- sion material was applied around the preparations with a syringe and a bite registration was taken. Then the tem- poraries were replaced. Duringthethirdandfinalappoint- ment—another two weeks later—the temps were off, the BruxZir crowns were approved and a layer of de- sensitizer was placed on the teeth (G5 All-Purpose Desensitizer). A warm Air Tooth Dryer was used after applying both coats of the G5, while the assis- tant placed Z-PRIME Plus inside the crowns. The crowns were then loaded with a resin-modified glass ionomer cement (RelyX Luting Plus Automix) and seated, using a pinewood stick to ensure that they were fully seated andhadthesamelength.Inthe“after” picture (Fig. 4b), there is not any por- celain on the BruxZir crowns. 7 GLIDEWELL LABORATORIES, USA www.glidewelldental.com business10 Show Review IDS Cologne 2013 AD BruxZirSolidZirconiameetsananteriorAestheticchallenge A clinical demonstration by Dr Michael C.DiTolla,Director of Clinical Research and Education at Glidewell Laboratory 5 Fig. 4a: Before. 5 Fig. 4b: After. 5 Fig. 1 5 Fig. 2 5 Fig. 3