Dental Tribune Middle East & Africa

Dental Tribune Middle East & Africa Edition | May - June 2013 ” See FILLING, page 8 Preparation and digital impression taking The existing crown restorations were removed and the teeth were prepared for IPS e.max CAD crowns. Preparations included a 2 mm occlusal re-duction and a 1–1.2 mm shouldered margin. A scan was performed of the patient’s arch and prepared teeth, and the margins were identified (Fig. 3). Digital restoration creation The autogenesis feature in the E4D DentaLogic intuitive software was used in conjunction with E4D CAD proposals (Fig. 4), which incorporated images of the buccal and occlusal aspects (Figs. 5, 6) and contact intensity (Fig. 7). The restorations were designed and then sent to the E4D milling unit, where lithium- disilicate high-translucent (HT) blocks (IPS e.max) were milled. After completion, the monophasic crowns were first tried in the patient’s mouth to appraise fit, contour and anatomical harmony, then crystallized. Customization The restorations were removed from the furnace, then cleaned and dried. To fulfill the patient’s desired goal of having a more natural colored smile, the res-torations were appropriately stained and glazed. The ideal shade stain was placed on the tip of a hygienic brush and applied to the restorations. Once staining was complete, the crowns were fully crystallized and fired. The case was ready for seating using universal cement (Multilink, Ivoclar Vivadent). Cementation Lithium-disilicateglassceramicrestorations (IPS e.max CAD) can be traditionally cemented or bonded adhesively. As a result, any restrictions that may be presented due to placement or location within the mouth are eliminated.4,5The internal aspects of the crowns were cleaned with Ivoclean and etched with Ceramic Etching Fig. 12 Excess Multilink A&B solution is air blown gently to remove excess. Fig. 13 Multilink Automix cement is loaded into the crowns. Fig. 14 The crowns are seated and the Wave technique used to facilitate easy cleanup of excess cement. Fig. 15 Postoperative, buccal view of the patient’s restored smile, complete with more natural looking IPS e.max CAD lithium-disilicate crowns. Fig. 16 Postoperative occlusal view of the final chairside fabricated E4D restorations. Fig. 12 Fig. 15 Fig. 14 Fig. 16 Fig. 13 Gel. The Ceramic Etching Gel was applied for 20 seconds, rinsed with water and dried in preparation for sila-nating using the Monobond Plus Primer (Fig. 9).The Monobond Plus Primer was applied with a microbrush for 60 seconds to the internal surfaces of the restorations to ensure a sound bond between the restorations and cement, as well as increase bond strength (Fig. 10). Excess primer was air dried. The solution was then applied to the prepared teeth and allowed to sit for 40 seconds. The Multilink A&B solution (Fig. 11) was air blown gently to remove excess. Note that the patient’s surrounding gingival tissues may turn white temporarily (Fig. 12). Next, the internal aspects of the IPS e.max CAD crowns were loaded with Multilink Automix (Ivoclar Vivadent) (Fig. 13) and seated on both the maxillary left bicuspid and molar with slight pressure applied. The “wave” technique was then used to cure the excess cement to a gel like state, which enabled easy removal (Fig. 14). Excess cement was removed from interproximal and cervical areas using a microbrush, after which complete polymerization was achieved by curing from the buccal, lingual and distal aspects. Conclusion The combination of lithium-disilicate blocks (IPS e.max CAD) and the E4D Dentist System is a state-of-the-art material and technology so-lution that enhances the predictability, esthetics and ease-of- use of in-office CAD/CAM procedures. Restorations completed with this complementary combination demonstrate excellent fit, function and esthetics (Figs. 15, 16). As a result, dentists can provide progressive, one-day treatments to patients, eliminating more invasive and time- consuming procedures that can require multiple appointments. By incorporating the essential components of smile design and accurate scanning, the E4D Dentist System helps to ensure the accuracy and predictabil-ity of resulting restorations. When milled from highly esthetic lithium- disili-cate blocks (IPS e.max CAD), the restorations enable dentists to provide exceptional treatments tailored to the patient’s authentic esthetic characteristics. References 1. Fasbinder DJ. The CEREC system: 25 years of chairside cad/cam dentistry. J Am Dent Assoc. 2010;141 Suppl 2:3S–4S. 2. Culp L, McLaren EA. Lithium disilicate: the restorative material of multiple options. Compend Contin Educ Dent. 2010;31(9):716– 720, 722, 724–725. 3. Ivoclar Vivadent. IPS e.max lithium disilicate: this changes everything. Amherst, NY: Ivoclar Vivadent; 2009:1–6. 4. Liu PR. A panorama of dental cad/cam restorative systems. Compend Contin Educ Dent. 2005;26(7):507–508, 510, 512 passim, quiz 517, 527 5. Miyazaki T, Hotta Y, Kunii J, Kuriyama S, Tamaki Y. A review of dental cad/cam: current status and future perspectives from 20 years of experience. Dent Mater J. 2009;28(1):44–56. Contact Information John C. Schwartz, DS337 Metairie Road, Suite 302 Metairie, La. 70072 (800) 346-9030 johnschwartz@drjohn- schwartz.com mCME SELF INSTRUCTION PROGRAM CAPP with Dental Tribune with its mCME- Self Instruction Program gives you the opportunity to have a quick and easy way to meet your continuing education needs. mCME offers you the flexibility to work at your own pace through the material from any location at any time. The content is international, drawn from the upper echelon of dental medicine, but also presents a regional outlook in terms of perspective and subject matter. Membership: Take membership for one year by subscription for the newspaper: 600 AED Take article with one newspaper subscription: 100 AED per issue. After the payment, you will receive your membership number and will be able to start the program. Completion of mCME • mCME participants are required to read a continuing medical education (CME) article in each issue. • Each article offers 2 CME Credit and followed by quiz questioner, which is available in http:// www.cappmea.com/mCME/questionnaires. html. • Each quiz has to be return to events@cappmea. com or fax to: +971436868883 in three months form the publication date • A minimum passing score of 80% must be achieved in order to claim credit • Not more then two answered questions can be submitted in the same time • Validity of the article – three months • Validity of the subscription – one year • Collection of Credit hours: you will receive the summary report with Certificate maximum one mouth after expire date of your membership. 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