Dentaltown August 2018 - 34
show your work
case study
Second clinical appointment
At the second clinical visit, the provisionals were removed, the preparations cleaned
and the final restorations cemented (Figs. 24 and 25). Patient satisfaction was extremely
high because there was no need to adjust the color, margins, length or occlusion. The final
restorations precisely duplicated the proposed and approved treatment plan, which was the
basis for the provisional restorations.
Fig. 24: View of the definitive restorations
after cementation.
Fig. 25: Note the surface texture and color nuance of the final restorations, which were
designed identical to the provisionals and originally approved treatment plan.
Conclusion
There are many different digital dental workflows. Some dentists just starting out
with CAD/CAM only scan and send the scans to the laboratory for use in fabricating or
manufacturing restorations. Other dentists scan and only manufacture lithium disilicate
restorations, which requires a wet mill. Still other dentists, like myself, mill PMMA
provisionals (dry mill) and lithium disilicate restorations.
Milled PMMA provisionals look and fit better than anything I could have made by
hand, and they're much less costly because the mill does the tedious work in 20 minutes.
In the past, this took laboratory technicians two to three hours to complete. The patient
enjoys the benefit of trying a dynamic mock-up of the treatment design-as opposed to a
white wax try-in, and everyone in the restorative process experiences an improved clinical
workflow and practice efficiency when digital dental technologies are used. ■
References
1.
Miyazaki T, Hotta Y, Kunii J, et al. A review of dental CAD/CAM: current status and future perspectives from 20 years of experience.
Dent Mater J. 2009;28(1):44-56.
2.
Fasbinder DJ. Digital dentistry: innovation for restorative treatment. Compend Contin Educ Dent. 2010;31(Spec No 4):2-11; quiz 12.
3.
Beuer F, Schweiger J, Edelhoff D, et al. Reconstruction of esthetics with a digital approach. Int J Periodontics Restorative Dent.
2011;31(2):185-93.
4.
Zimmermann R, Seitz S, Evans J, et al. CAD/CAM and lithium disilicate: an anterior esthetic case study. Tex Dent J. 2013;130(2):1414.
5.
Tysowsky GW. The science behind lithium disilicate: a metal-free alternative. Dent Today. 2009;28(3):112-13.
6.
Culp L, McLaren EA. Lithium disilicate: the restorative material of multiple options. Compend Contin Educ Dent. 2010;31(9):716-20,
722, 724-5.
7.
Fasbinder DJ, Dennison JB, Heys D, et al. A clinical evaluation of chairside lithium disilicate CAD/CAM crowns: a two-year report. J
Am Dent Assoc. 2010;141 Suppl 2:10S-4S.
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