Dave Juliani We’ve all been there right? Patient walks through the door for anterior esthetic work and not only are expectations high, so is the anxiety. In the past, with more traditional “lab based” dentistry, preps would be finished and the patient would leave the office in temps, with either an appointment at the lab for a custom shade, or a very detailed lab prescription complete with drawings and directions on shading. Many times the crowns would arrive back in the office and even after a custom shade appointment, the hue, chroma or value would be off.
CEREC has made all of us better at this aspect of our dentistry. I would challenge all of you to not be intimidated by the demands of anterior esthetics. The proposals we are getting are now requiring very little design time to complete. Incisal Variation Tool has made texture an easy reality. Our ovens make staining and shading the final crown or veneer (regardless of material) a simple chairside procedure. Re-firing to correct a slight discrepancy can be accomplished with the patient in the chair. No need to reschedule.
The new patient below presented unhappy with the esthetics of crowns #8/9. The crowns were done overseas so the material was unknown.
We advised the patient on the need for complete re-make to achieve the desired esthetics. e.max material was chosen for its stability and fracture resistance. Both teeth were restored with full contour e.max crowns, shade A2 LT, custom stained with the patient in the chair. Total chair time 2hrs 45mins with one re-firing to enhance the hypocalcified areas.
Given the initial esthetics, this was a perfect chair side case. Expectations were high but not unachievable based on the position and color of the other teeth in the area. With a practice and the knowledge from cerecdoctors.com Level 4 hands-on workshop, this case can become a common procedure in any CEREC users office. To learn more about the workshop call 877-295-4276.
