Lower Anterior e.max Case
This was my first 6 unit case with PrimeScan. From the time the patient was seated until he walked out the door, this case took 4 hours with one mill. Between the faster imaging, the 5 click process and faster proposals, this is a noticeable difference in time for me.
This patient is in sales and has always wanted a better smile. We did the upper 6 last year and he like them so much he wanted to do the lower as well. This case is a perfect case to open his VDO but he has implants in all 4 quads and wasn't ready for that kind of financial commitment so we discussed what was realistic as far as how big the teeth would look and went for it.
A couple of things I wanted to share with this case...
One of my favorite things I do when I work with anteriors is to design in BioIndividual but add a BioCopy folder for reference.
This comes in handy to know where your midline is and how much you want to increase your incisal length if you have the room. The software program does not use this folder for proposals and you don't have to draw the copy line (which speeds up the case). It is purely for reference if you select the BioIndividual in Administration.
To turn on the BioCopy you click on Display Objects and then click on Lower BioCopy. Depending on which folder has the larger teeth you then use the slider bar to make the larger teeth more transparent so you can see the difference between the proposals and the original teeth. If the proposals are the larger teeth, make sure you group the teeth together so that they will all turn transparent or you will only be able to see one at a time.
My second recent find is an Ivoclar product called Cervitec Plus. It is a Chlorhexidine varnish that does not stain or taste. You dry the teeth and tissue and place it with a microbrush. It helps with sensitivity and tissue healing and I have absolutely fallen in love with this product. Here is a picture at seat date and one less than a week later. This patient has gingival hyperplasia from meds and his tissue is always a mess. I was so shocked at how fast he healed. My hygiene team has been using it a lot for perio as well and have loved the results at recall.
Beautiful preps, design and characterization, very natural result.
Plus one on Cervitec Plus, impressive healing. If you apply it a week before prepping, it helps the gingival health improve making that visit easier, too.
can u go over your spacing and minimal thickness settings for a case like this, i struggle with radial thickness guidelines when doing lower anteriors
I try to keep my spacer at 120 but if I get in a bind will take it down to 100 to give me a little more room. As far as minimal thickness, my radial is set at 500 and occlusal at 1000. I would rather mill out thicker and contour back because the contouring is what really defines an anterior case. Not reducing enough is easy to do and I have worked and worked at it. This is also why I use a lot of e.max because I have peace of mind with the added strength. I set my occlusal offset at 0 for anteriors.
Hope this helps!
Great case Kristine. Did you lengthen those teeth incisally without opening his VDO? Usually a mouth like this has the lower incisors occluding against the uppers from supra-eruption.
