Daniel Wilson Hey All,
It's been a while since I've posted anything. Long summer and trying to get back at it. I think for all of us on here, we are thankful for technology and the constant evolution of materials and digital dentistry.
This case I'm sharing is something that all of us see each day. How I approach this today is different than I would have approached this pre SpeedFire and pre-Katana. I simply love the fit of Zirconia and the anatomy right out of the mill. I can be much more conservative with my margin preprations and edge stability of Zirconia during milling is wonderful. The other reason I do a lot of chairside zirconia and Katana is that I love the ability to cement on those deep margins or those patients where it is really difficult to isolate and bond well. (I will say that Kuraray-Noritake does not advocate cementing Katana STML with RMGI) To make myself feel better on these cases where I am not bonding Katana, I am making sure my fissure height on my design is 1.20mm or greater.
So here is a case that I just did. Tooth #30 had gold onlay that came off.
I tend to choose a shade that is one shade darker than I am shooting for. In this case, I wanted to match the shade of the occlusal 1/2 of tooth #29. I felt like that was A1 so I choose A2 Katana STML.
Deep recurrent decay that I removed and built back up to ideal.
It does take extra time but I do think there is significant improvement in esthetics with a Katana crown that has been glazed versus polish only. In this case, I pre-polish my crowns before I sinter them. Post sinter, I lightly air abrade the crown to take away the surface tension so the glaze will adhere uniformly. In this case, I choose to use Empress Stain and Glaze and fire on P4.
I schedule all of my crowns for 2 hours so this isn't really a huge deal for me to spend the extra time for a glaze fire. I tell the patients it will be about a 45 minute wait. During this time I am doing another procedure. I haven't received a complaint from a patient. But our team does prep all patients before they schedule to expect to be at the office for 2 hours.
Overall I'm quite happy with the final results and esthetics. I know there are some that don't have a SpeedFire and doing Katana is not possible, but for those of you that do, I think Katana is a wonderful material and I am using it more and more.
