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ePaper created 2018-02-16, 11:17:41 | version 1.38.0
implant restoration case report | design was created using the biogeneric individual design mode. In this design mode on the CEREC Omnicam, the software evaluates the other teeth captured in the DIOS and tries to recreate what it believes to be the closest match to the original miss- ing tooth (Figs. 9–11). This tooth design is then positioned digitally within an e.max meso block. This meso block has a predetermined hole within it that acts as the access hole for the screw-retained crown, as well as the orifice into which a TiBase will be bonded (Fig. 12). This restoration is then milled from the low trans- lucency monolithic e.max CAD Block in its purple phase (taking around 18 minutes) and checked for precision of fit on the TiBase (Figs. 13 & 14). It is tried in intraorally to assess contacts and oc- clusion in static and dynamic function (Figs. 15 & 16). The restoration is then stained using Ivoclar e.max Crystall Glaze so as to provide an aesthetically har- monious restoration and glazed with Glaze Spray. It is placed in an Ivoclar Vivadent Programat CS2 firing furnace for 15 minutes to crystalise the ceramic, turning it from purple to tooth-coloured (Fig. 17). The ceramic restoration is then bonded onto the TiBase extraorally. The fit surface of the ceramic is treated with 5 % Hydrofluoric acid and silanated with Monobond Plus (Ivoclar Vivadent). The TiBase is sandblasted and also silanated. Finally, the ceramic and TiBase are bonded with multilink hybrid resin cement (Ivoclar Vivadent; Figs. 18–21). Following the bonding, the restoration is steam cleaned to remove any residue. The final restoration (Fig. 22) is now ready to be inserted, approximately 2 hours after the patient arrived in the practice (Fig. 23). The restoration is finally torqued down to 25 Ncm. Following this, occlusion is rechecked, but no adjust- ment is required at this stage following the try-in ad- justments. PTFE is placed in the access cavity and the Fig. 27 Fig. 28 Fig. 29 access hole filled with opacious composite (OMC Venus Pearl) and stained with Venus tints (Figs. 24–26). In conclusion, as you can see in the final result (Figs. 27–29) an aesthetic, biologically designed and durable restoration has been fabricated. The patient has been delivered the final restoration in a single visit without the need for traditional analogue im- pressions._ Editorial note: A list of references is available from the publisher. about Dr Simon Chard BDS(Hons) BSc(Hons) qualified with Honours from King’s College London Dental Institute in 2012. He is direc- tor of membership for the British Academy of Cosmetic Dentistry, was voted the Best Young Dentist in the Dentistry Awards 2015 and is a member of the Association of Dental Implantology. Dr Chard is very passionate about providing beautiful, healthy smiles for his patients and is a big promoter of using digital technology to simplify cosmetic and implant dentistry. Dental education is something that is a major part of his professional career and he has dedicated thousands of hours to advanced training from the best dentists around the world. Further to this he regularly teaches other dentists in the topics of digital dentistry, dental photography and minimally invasive aesthetic dental techniques. Dr Chard comes from generations of dentists and works in private and mixed practice in London and Surrey. CAD/CAM 4 2017 15