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Dental Tribune Middle East & Africa Edition

7Dental Tribune Middle East & Africa Edition | November-December 2014 mCME Fig. 13. Lingual view of restoration. Fig. 17. Milled IPS e.max restoration. Fig. 21. Internal aspect of restoration. Fig. 25. Final implant-supported IPS e.max crown with Tempcap. Fig. 15. IPS e.max CAD/CAD block (Ivo- clar Vivadent). Fig. 19. Staining and glazing. Fig. 23. Ankylos implant with complex Tempcap and milled IPS e.max crown. Fig. 14. Facial view of restoration. Fig. 18. Ivoclar furnace. Fig. 22. Final CAD/CAM IPS e.max restoration. Fig. 16. E4D CAM unit (Editorial note: Planmeca E4D Technologies). Fig. 20. Facial aspect of final restoration. Fig. 24. Internal aspect of IPS e.max crown for three-pronged Tempcap. < Page 6 > next mCME on page 10 mCME SELF INSTRUCTION PROGRAM CAPP together with Dental Tribune provides the opportunity with its mCME- Self Instruction Program a quick and simple 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: Yearly membership subscription for mCME: 600 AED One Time article newspaper subscription: 200 AED per issue. After the payment, you will receive your membership number and Allowing you to start the program. Completion of mCME • mCME participants are required to read the continuing medical education (CME) articles published in each issue. • Each article offers 2 CME Credit and are followed by a quiz Questionnaire online, which is available on http://www. cappmea.com/mCME/questionnaires.html. • Each quiz has to be returned to events@cappmea.com or faxed to: +97143686883 in three months from the publication date. • A minimum passing score of 80% must be achieved in order to claim credit. • No more than two answered questions can be submitted at the same time • Validity of the article – 3 months • Validity of the subscription – 1 year • Collection of Credit hours: You will receive the summary report with Certificate, maximum one month after the expiry date of your membership. For single subscription certificates and summary reports will be sent one month after the publication of the article. The answers and critiques published herein have been checked carefully and represent authoritative opinions about the questions concerned. Articles are available on www.cappmea.com after the publication. For more information please contact events@cappmea.com or +971 4 3616174 FOR INTERACTION WITH THE WRITERS FIND THE CONTACT DETAILS AT THE END OF EACH ARTICLE. 19), resulting in a highly aes- thetic final restoration (Fig. 20). The restoration’s internal aspect (Fig. 21) was assessed for path of insertion, retention and fit. The IPS e.max pros- thetic crown was fur- ther assessed for fit, taking into account marginal fit, occlusion and proximal contacts (Fig. 22). A secondary investiga- tion utilized a more complex Tempcap to assess the limit of the CAD/CAM unit’s ca- pability. A stand-alone Ankylos (DENTSPLY Implants) implant body was coupled with a Temp- cap abutment with three reten- tivepinprojections(Fig.23).The abutment was digitized with the same methodology as described. An IPS e.max crown was execut- ed and assessed (Figs. 24 & 25). Discussion This study has determined that the Tempcap can be success- fully and accurately digitized and milled by in-office CAD/ CAM technology (Editorial note: Planmeca E4D Technologies) to create an ideal prosthetic crown from IPS e.max within a labora- tory setting. CAD software can be manipulated to generate forms beyond the scope of the unit. Complex units, such as the three-pronged Tempcap may be successfully designed and milled. IPS e.max has the capa- bility to be milled in complex patterns, while still maintaining its structural integrity. However, further laboratory studies, quantitatively assessing stresses and strengths and uti- lizing a larger sample size, are required to validate the concept. Subsequent clinical investiga- tions are required to assess the clinical significance and viability of the Tempcap with CAD/CAM technology. The potential to fabricate the Tempcap entirely from e.max should also be con- sidered. Conclusions In-office CAD/CAM technology can be utilized and manipulated to generate digitized forms be- yond the scope of the morpho- genesis. CAM manufacturing has limiting factors that must be realized when producing modi- fied prostheses. CAD modifica- tions must account for these discrepancies. IPS e.max has the ability to be milled in extremely detailed designs. The Tempcap can be optically scanned and digitized in order to design and create a CAD/CAM IPS e.max restoration using E4D technology. The utilization of the Tempcap as a successful provi- sional abutment has been docu- mented1; the utility of the abut- ment as a simple, efficient and cost-effective component seems promising. These advances sim- plify the procedure and reduce the cost, ultimately allowing a greater accessibility for both pa- tients and clinicians. Editorial disclaimer: Dr Les Kal- man is the co-owner of Research Driven and the inventor of the Tempcap. This article was originally pub- lished in implants CE magazine 1/2013. References 1. Kalman, L. Technique for the temporization of an anterior im- plant. Dentistry Today. 2011. Vol. 30, No.10: 128–130. 2. Mijiritsky, E., Mardinger, O., Mazor, Z. and Chaushu, G. Im- mediate provisionalization of single-tooth implants in freshex- traction sites at the maxillary esthetic zone: up to six years fol- low-up. Implant Dentistry. 2009. Vol. 18, No.4: 326–330. 3. Mijiritsky, E. Plastic temporary abutments with provisional res- torations in immediate loading procedures: A clinical report. Implant Dentistry. 2006. Vol. 15, No. 3: 236–238. 4. Romanos, G. Bone quality and the immediate loading im- plantscritical aspects based on literature, research, and clinical experience. Implant Dentistry. 2009. Vol. 18, No. 3: 203–206. 5. Vela-Nebot, X., Rodriguez- Ciurana, X., Rodado-Alonso, C. and Segela-Torres, M. Benefits of an implant platform modifi- cation technique to reduce cr- estal bone resorption. Implant Dentistry. 2006. Vol. 15, No. 3: 313–318. 6. Berlin, M. Wowing the pa- tient with chairside CAD/CAM. Dental Economics: 2008; 98(4): 92–96. 7. Ivoclar Vivadent: IPS e.max lithium disilicate: The Future of All-Ceramic Dentistry. 2009; 1–15. Dr Les Kalman, DDS, graduated from the University of Western Ontario with a doctor of dental surgery degree in 1999. He then completed a GPR at the London Health Sciences Centre. He has been involved in general den- tistry within private practice since 2000. He has served as the chief of dentistry at the Strath- roy-Middlesex General hospital. In 2011, he transitioned to full- time academics as an assistant professor at the Schulich School of Medicine and Dentistry. Kal- man’s research focuses on medi- cal devices, including the Virtual Facebow and the Tempcap. Kal- man is also the Director of the Dental Outreach Community Services (DOCS) program, which provides free dentistry within the community. Dr Kalman has authored arti- cles ranging from pediatric im- pression to immediate implant surgery in both Canadian and American journals. He has been a product evaluator for several companies, including GC Amer- ica and Clinician’s Choice. Dr Kalman is the co-owner of Re- search Driven, a company that deals with intellectual property development. He is a member of the American Society for Fo- rensic Odontology, International Team for Implantology, Academy of Osseointegration, American Academy of Implant Dentistry and the International Congress of Oral Implantology. He has been recognized as an Academic Associate Fellow (AAID) and Diplomate (ICOI). In his spare time, Kalman enjoys photogra- phy as an accredited MotoGP photojournalist. He can be contacted at: lkal- man@uwo.ca. About the Author

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