Dental Tribune U.S. Edition

Dental Tribune U.S. Edition | October 2014a12 Industry News By Michael C. DiTolla, DDS, FAGD Glidewell Laboratories’ weekly online series “Chairside Live” has given us a great opportunity to com- municate with clinicians across the nation andeducatethemontopicsthatthey’reac- tually interested in learning. If you haven’t yet had the opportunity, episodes can be viewed on-demand at www.chairsidelive. com or on YouTube and iTunes. In the Case of the Week from Episode 105, I wanted to try something that I really hadn’t done before. I’ve done some anterior BruxZir® restorations, and they turned out well, but I had yet to do an anterior crown case in conjunction with a BruxZir veneer. This is going to be a straightforward case on teeth #8 and #9 withaBruxZircrownandaBruxZirveneer adjacent to it. Case presentation This patient had a pre-existing PFM on tooth #8 that was a poor esthetic match (Fig. 1). Because of the patient’s deep over- bite, I liked the idea of using a BruxZir crown for tooth #8 because I could keep it almost as thin as that PFM was on the lingual.Ialsoplannedtohavethelabfabri- cateaBruxZirno-prepveneerfortooth#9, which happened to be facially deficient anyway. I anesthetized the patient and took off the crown. The prep had been endodonti- cally treated, and it looked like a gold post was placed in the incisal edge. We placed the first cord (size 00) and then prepared the gingival third of the tooth. Because the tooth already had a PFM, I didn’t have to do a ton of reduction; it was more about where I did the reduction. While reducing, I exposed a little bit of gold, so I covered it with a self-adher- ing composite resin and then finished smoothing off the prep (Fig. 2). I placed the top cord (size 2), which upon removal left us a wide open sulcus that would be simple to impress. That’s the benefit of using the two-cord technique. Six days later, we took off the temporary and tried in the final restorations, which the patient approved. We cemented the crown with Ceramir® Crown & Bridge ce- ment (Doxa Dental; Newport Beach, Calif.). The thing I love about Ceramir cement is thatitbondsonitsowntozirconiawithout requiring you to decontaminate the inter- nal surface of the BruxZir crown or use a zirconia primer. Plus, the cement will typi- cally clean up in just one piece (Fig. 3). With the crown placed, I then turned to the veneer. After try-in, I decontami- nated the internal portion of the BruxZir veneer by sandblasting it for 15 seconds. I then placed a layer of Z-Prime Plus and air thinned it, and then placed a layer of bond- ing agent and air thinned it. I isolated the two adjacent teeth with mylar strips and then etched with phosphoric acid, rinsed, placed the bonding agent, air thinned it, placed the veneer with the light-cured res- in cement inside and cured it. You can defi- nitely light-cure through solid zirconia. Try it yourself when you receive the case. Here’s the patient with the crown and veneer in place (Fig. 4). It looks pretty good, consideringthoseareBruxZirsolidzirconia restorations with no ceramic on the facial. BruxZir continues to look better because of the increased translucency of the mate- rial. I’m now feeling more confident that if I’m placing a crown on a single anterior tooth that I can place a BruxZir veneer on the tooth next to it. As long as #8 and #9 match, we have a chance of having a nice smile. A BruxZir solid zirconia veneer case Fig. 1: View of the patient prior to treatment. Photos/Provided by Glidewell Laboratories Fig. 3: The final BruxZir crown in place directly next to the untreated central. Fig. 4: Photo taken just after placement of the BruxZir veneer. Fig. 2: Limited reduction is necessary for this case because there is a pre-existing PFM prior to treatment. Michael C. DiTolla, DDS, FAGD, is a graduate of the University of the Pacific Arthur A. Dugoni School of Dentistry and was awarded his fellowship in the Academy of General Dentistry in 1995. In 2001, he became director of clinical research and education at Glidewell Laboratories. DiTolla is editor-in-chief of Glidewell Laboratories’ Chairside magazine and has a monthly column on restorative dentistry in Dental Economics. He also hosts an online dental series, Chairside Live. He has been lecturing on restorative dentistry topics since 1995. As a self-proclaimed “average dentist,” DiTolla has created techniques that generate predictable restorative results using a very average set of hands. His mission is to share these techniques with dentists to help them improve their preps, impressions and restorations. Chairside Live can be viewed at www.chairsidelive.com or via YouTube or iTunes. ADA BOOTH NO. 216 From left: Calasept Irrigation Needles and Calasept Irrigation Syringes. Photos/Provided by Wykle Research Wykle Research offers Calasept Endo line Wykle Research offers Cala- sept Endo products, which it distributes for Nordiska Den- tal of Sweden, the manufactur- er of Calasept and Calasept Plus. Calasept Irrigation Needles are high-quality, double-side-vented, luer- lock irrigation needles that optimize the cleansing of canals, creating a “swirl ef- fect.” The needles are available in 27 g or 31 g, in packs of 40 needles. Features include the following: • Bendability • Luer-lock hub • Sterile and disposable • Designed for ease in cleaning roots • High-quality stainless steel Calasept Irrigation Syringes are 3 ml luer-lock, single-use syringes. They are color coded to eliminate risk when us- ing multiple irrigation liquids. They are available in packs of 20 syringes, 10 white and 10 green. Features include the following: • High-quality, three-part syringe • Color coded • Luer lock These products complement Wykle’s popular Calasept line, which includes Calasept and Calasept Plus calcium hy- droxide paste for temporary filling of root canals, sold in packages of four sy- ringes with 20 needles. Calasept EDTA is 17 percent EDTA solution. Calasept CHX is 2 percent chlorhexidine solution for irri- gation. Both solutions are packaged with a luer adaptor for easy filling of syringes. For more information, contact Wykle Re- search at (800) 859-6641 or visit the com- pany online, at www.wykleresearch.com. (Source: Wykle Research) ADA BOOTH NO. 4312

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