Jeremy Bewley I love being a dentist most of the time. The times I don't? Saturday afternoon is one. We all get these calls: "I broke a piece of tooth off and my filling came out! My tooth hurts every time I breathe or drink something! Can you help?"
"No," you think to yourself, because you'd rather play with your kids or go golfing, but being a decent human being, you say "yes" to the guy instead and head to the office to help a person in need.
Here's the situation: He's broken the mesiobuccal cusp off his maxillary first molar and lost the filling, exposing a deep prep and a liner. After cleaning things up a bit and refining the prep he looks like this:
Here's one of my favorite uses for HT emax: partial coverage restorations in molars. It's esthetic and strong and bonds really well to the tooth. After a very short milling cycle (about 6 minutes), it takes only 2 or 3 minutes to characterize it and get it in the oven for its firing cycle. It's very important to be careful with application of glaze in these cases, should you choose to do so as I did; sloppy application can lead to difficult to clean sharp glaze edges after firing that can resist seating. I would probably polish only if I were to do this case again. Here's what it looked like out of the oven in this case:
We all have religion when it comes to how we choose to bond our restorations. I switched to Peak Universal from Ultradent years ago (well before my CEREC journey began) when patients started asking me about BPA in my bonding agents, and Ultradent gave me the clearest answer on this. I wanted to use a cement system from the same manufacturer as my restorative material, and the good people of Ivoclar said they were comfortable with me using Peak Universal with their bonded resin cements, so I have done so without complication for the last 7 years or so. This case was one of the last Multilink cases I did before switching to Variolonk Esthetic. You can see it is still esthetic, but it was more difficult to clean up excess cement than the newer generations.
So the moral of the story? I spent less than an hour making this patient whole, provided a great service and great patient experience without a huge time investment, and this last one makes my wife happy. Hard to calculate the ROI on that one. I might not always like being a dentist when it cuts into my personal time, but I ALWAYS love what CEREC has done for me, my practice, and my patients!
