Friday Funday
I don't normally work on Fridays but will come in for big cases. Today I was coming in to do a hybrid case with the periodontist in my building and as I was getting ready I got a panicked voicemail from a patient that she broke her veneer on her front tooth ("you know the one you were telling me that I would need to fix?"). No one wants to go through the day, let alone the weekend, with a broken tooth so I told her I would meet her in the office.
She did a great job at busting off half of her veneer on #8 and you can see the decay at the margins of #8 and #9. She also had this funny composite on #7 and didn't like the lingual tilt of #10 so she asked if there was anyway we could fix them all today... Sure! I felt like crowns on #8 and #9 were more appropriate given her bite and did more like an aggressive veneer on #7 and #10 because I didn't want her to break those. She wears a night guard but obviously has some grinding habits.
So we got her all fixed up with 4 restorations. I chose to do e.max BL3 HT mainly because it is what I had available in my drawer. I think Vita would have been a great block choice here too, but I do like how the e.max turned out. I used white stain to give the halo effect and small decal marks and then I mixed the I1 and I2 translucent stains for the translucency just to give it a bit more pop. This is a same day seat photo and I can't wait to see what it looks like with the tissue healed all the way.
Everyday I get to use my CEREC I am a little in awe of what we can do in our practices. This case took me 4.5 hours from her being seated to her walking out the door. The new updates with 4.6 have definitely sped up my design process with the new 5-click features. She knew she was going to have to sit for a bit but was ok with that because we were taking care of her last minute and she didn't want to go without teeth.
Now I get to deliver a hybrid conversion and change another smile. Today is a really good Friday!!!
that is amazing!
I think that staining really takes it up a notch. Where did you learn to do that? (I mean that as a compliment but also I actually really kinda wanna know)
I always shy away from HT blocks cause I feel like unless that tooth underneath is exactly what you want, the finals are never exactly what you want. And this may just be the pictures, but it looks like the 7 and 10 are whiter than 8 and 9.
Very nice Kris!
I can count on one hand the number of times a same day emergency who broke one tooth casually asks to do all four, thank you very much.... you have a GIFT beyond the artistry!
Mark
On 1/4/2019 at 7:01 pm, Mark Stockwell said...Very nice Kris!
I can count on one hand the number of times a same day emergency who broke one tooth casually asks to do all four, thank you very much.... you have a GIFT beyond the artistry!
Mark
who the hell can say no to Kris??
Hi Kris- Amazing work! I have a question about your tissue management. You said this is a same day photo... how did you keep the tissue looking so nice? Did you pack cord? I feel like after a few hours in my chair, and after polishing the margins the tissue is pretty beat up and the papillas are blunted. I’m curious how you left the papillas perfect and the tissue so clean.
On 1/4/2019 at 6:44 pm, Benson Wong said...that is amazing!
I think that staining really takes it up a notch. Where did you learn to do that? (I mean that as a compliment but also I actually really kinda wanna know)
I always shy away from HT blocks cause I feel like unless that tooth underneath is exactly what you want, the finals are never exactly what you want. And this may just be the pictures, but it looks like the 7 and 10 are whiter than 8 and 9.
Hi Benson,
Thanks for the nice comments. I learned my skills in the level 4 class at Cerecdoctors. It's an amazing two day class and you get great tips on how to do just this. It gets broken down step by step. To be fair I have also been doing this for 13 years so I have had some time to work on my skills.
As far as #7 and #10, I typically characterize the laterals a little more than the centrals and add more white stain. If you start paying attention to teeth, I find that laterals tend to have a broader white band around the incisal halo than their neighbors. Maybe that is just me, but that is what I notice. The fun part is that it's all the eye of the beholder. There is room to play and be creative!
On 1/5/2019 at 7:40 am, Dennis Dobrin said...Hi Kris- Amazing work! I have a question about your tissue management. You said this is a same day photo... how did you keep the tissue looking so nice? Did you pack cord? I feel like after a few hours in my chair, and after polishing the margins the tissue is pretty beat up and the papillas are blunted. I’m curious how you left the papillas perfect and the tissue so clean.
Hi Dennis,
Thanks for the nice words!
So my trick is that I honestly don't pack a lot of cord if I can avoid it. Obviously if there is tissue falling over the margins then I need to manage that, but often my preps are pretty equaginigval and I try really hard to not traumatize the tissue. Especially in the anterior. I spend a lot of time on my margins making sure they are smooth and easy to see. She had amazing home care despite the recurrent decay so it made this case easier than most. I rarely post same day pictures but in this case I felt like it was ok because her tissue was holding up beautifully!
