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ePaper created 2017-01-24, 10:47:27 | version 1.38.0
I 09 CAD/CAM 3_2016 clinical_ single-visit solution I cutting instruments may become excoriated beyond the intended design parameters. The consequence is compromised internal adaption thereby decreasing prosthesis thickness, retention and esthetics due to preparation show-through. As each restoration finished milling, the contact areasandocclusalfunctionwereadjustedandevalu- ated in the patient’s mouth. The patient had commu- nicatedherdesireforminimaltoothcharacterization. Therefore, a limited amount of cervical, body and incisal characterization with subtle surface texture was employed prior to the crystallization and glazing cycle. The insertion protocol called for treating the lithiumdisilicaterestorationwithcombinedacidetch and ceramic primer.5 The tooth preparations were conditionedwithaone-stepetchandprimeformula- tion.Therestorationswereinsertedoneatatimewith adual-curetranslucentresincement(Fig.10). _Summary There are many factors that can influence the patient’s treatment, chair time and experience with single-visit CAD/CAM restorations. In this particular patient example, the workflow was made most ef- ficient by preparing the four maxillary incisors and scanningthemasasinglefilefollowedbytheprepa- ration and scanning of the single cuspid. The patient’s ultimate satisfaction was ensured through the copious pre-treatment gathering and analysis of clinical information. An understanding and strict adherence to the protocols for acquiring scan data and mill perform- anceeliminatedinterruptionsinthedigitalworkflow. Future case controlled studies might investigate the addedaccuracyandpatientsatisfactionusingatwo- file method._ _References 1. Baroudi K, Ibraheem SN. Assessment of Chair-side Computer-Aided Design and Computer-Aided Manufacturing Restorations: A Review of the Literature. J Int Oral Health 2015;7(4): 96-104. 2. TapieL,LebonNMawussiB,FronChabouisH,DuretF,Attal JP. Understanding dental CAD/CAM for restorations: The digital workflow from a mechanical engineering viewpoint. Int J Computer Dent 2015;18(1):21-44. 3. Knoernschild KL, Campbell SD. Periodontal tissue responses after insertion of artificial crowns and fixed partial dentures. J Prosthet Dent 2000;84:492-8. 4 Patzelt SB, Emmanouilidi A, Stampf S, Strub JR, Att W. Accuracy of full-arch scans using intraoral scanners. Clin Oral Investig 2014;18(6):1687-94. 5 Ivoclar Vivadent AG, Schaan, Liechtenstein. 2014. IPS e.max Clinical Guide. Figs. 9a, 9b_Mill settings are critical with ceramic restorations to not produce over-milled restorations on anterior teeth. The reduced material thickness can not only be weak but less retentive. Compare the milling proposal of tooth #10 on the ‘standard’ setting (A) vs. ‘detailed’ setting (B). Fig. 10_Post-treatment single-visit CAD/CAM restorations. Fig. 10 Fig. 9b Fig. 9a Fig. 10