{"id":1101,"date":"2017-04-22T12:51:36","date_gmt":"2017-04-22T12:51:36","guid":{"rendered":"http:\/\/www.cerecdigest.net\/?p=1101"},"modified":"2017-07-28T16:32:59","modified_gmt":"2017-07-28T16:32:59","slug":"fun-with-staining-and-glazing","status":"publish","type":"post","link":"https:\/\/www.cerecdigest.net\/2017\/04\/22\/fun-with-staining-and-glazing\/","title":{"rendered":"Fun with Staining and Glazing
Every once in a while, we have patients who come in with broken teeth and are looking for immediate restoration. Barring complications that indicate otherwise, we are often able to provide the patient with same-day restorative treatment. Today I would like to share one of these cases that happened recently.<\/p>\n
So this 90-year-old male had a minor chewing mishap, and his tooth #21 (with previous endodontic treatment) snapped off quite cleanly as shown in the following photo.<\/p>\nInitial state with exposed GP and previous temporary filling.<\/figcaption><\/figure>\n
The patient was over 90 years old and completely uninterested in fixing his multiple non-carious cervical lesions. After some back and forth, my final treatment plan was to simply restore #21.<\/p>\nAbutment built with fiber-post and resin core. The white smudge on #11 is excess vaseline.<\/figcaption><\/figure>\n
The only remaining tooth structure was on the palatal side, but the patient also had a very deep bite, so really not the best combination of circumstances. After a precarious act of balancing occlusal clearance and tooth structure removal, the abutment was ready for gingival retraction and scanning.<\/p>\nVarious views during the restoration design step in the CEREC software.<\/figcaption><\/figure>\nShade alignment in the Triluxe Forte block.<\/figcaption><\/figure>\n
There was a lot of design flexibility for this restoration, thanks to the severity and angle of fracture. With sufficient space to play around with, a physical indentation near the cervical region was possible to mimic the cervical lesion. We chose the Triluxe Forte due to the large shade gradient between cervical and incisal regions.<\/p>\nSame-day delivery with Variolink cement.<\/figcaption><\/figure>\n
After cementation, I noticed that the cervical areas on the natural teeth are slightly less reflective, so I de-glazed the cervical regions with a twist polisher. Unfortunately, the instrument slipped a bit and lacerated the gingiva. My bad.<\/p>\nFollow up photo after 2 weeks.<\/figcaption><\/figure>\n
Luckily, things seemed to have healed over decently after a couple of weeks.<\/p>\n
Remarks<\/h1>\n
Of course, this wouldn’t have been possible without Sharon, one of our wonderful in-house dental technicians.\u00a0The reference shade used for this crown was 4R2.5, and with such an unusual color, we were fairly fortunate to get the color very close in one try; for a case like this, I typically set aside enough chair time for two attempts. The total chair time for this patient is about 90 minutes, not including endodontic re-treatment.<\/p>\n
We are still getting the hang of CEREC! So while this case may not be perfect, it was definitely an interesting learning experience.<\/p>\n
Pushing the limits of external staining.<\/p>\n","protected":false},"author":1,"featured_media":1138,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"generate_page_header":"","footnotes":"","_jetpack_memberships_contains_paid_content":false},"categories":[14],"tags":[59],"yoast_head":"\n
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