A 45-year-old female patient presented with a root-filled premolar that had a composite MOD restoration present, and the unprotected buccal cusp had fractured. Examination revealed a sound root filling and that the tooth still had a reasonable volume of sound tooth structure.
Rather than weakening the tooth further by preparing a full crown that would have then required the placement of a post due to the loss of so much good tooth structure, it was decided to retain the tooth structure and design an E4D CAD/CAM, resin-bonded crown to restore and protect the tooth. The patient did not want the adjacent edentulous space restored.
The restoration design was to overlay the palatal cusp and replace the fractured buccal cusp with a resin-bonded milled porcelain restoration using an IPS Empress CAD Multiblock. Time constraints for the patient precluded a single appointment restoration, so an impression was taken and a stone model produced, which was used to create the final CAD crown.
Prior to the patient returning to have the crown bonded, a Griptab was cemented to the buccal surface of the restoration to simplify the pre-bonding preparation of HF etching and silanation, as well as aiding in the final cementation of the restoration.
Restorations can be slightly greasy after pre-bonding prep, so the crown was wiped with alcohol at this point. A medium-sized Gript ab was engaged in a pair of Triodent Pin-Tweezers, then loaded with Griptab adhesive before it was attached to the buccal surface of the crown.
The adhesive was light-cured for 20 seconds, after which the Griptab was securely bonded to the restoration. The crown could now be safely handled, without confusion over orientation, by holding the Griptab with the Pin-Tweezers.
At the cementation appointment, the temporary crown was removed, and the tooth was cleaned using low-pressure air abrasion.
Before cleaning, a Wave-Wedge was put in place to protect the interproximal papilla. The crown was then tried in by using the Pin-Tweezers and Griptab to hold the restoration, checking that the Wave-Wedge was not inhibiting full seating of the crown.
The crown was prepared for bonding by etching with HF acid, followed by silanation. The enamel margins were acid-etched prior to applying the dual-cure dentin bonding agent.
Multilink dual-cure cement was placed into the crown by the assistant and the loaded crown, still held in the Pin-Tweezers, was then handed over for placement on the tooth.
As soon as the crown was seated, the Pin-Tweezers were passively released from the Griptab without the risk of displacing the crown and accidentally incorporating an air bubble into the cement.
The cement was spot polymerized through the occlusal surface with a turbo tip before excess resin was cleaned from the margins.
The Griptab can be removed at any point from this stage. Stabilize the crown with an instrument or a finger and, using a flat-bladed metal instrument, detach the Griptab adhesive from the crown. It does not let go quickly but peels away, making it very unlikely to fly off or drop unexpectedly.
Once the Griptab has been mostly detached, the Pin-Tweezers can be re-engaged to remove it from the crown. The Griptab adhesive leaves no residue to clean up.
Variolink Esthetic (Ivoclar Vivadent), the light- and dual-curing luting composite, allows the dental professional to adhesively cement highly esthetic ...
Founded in 2005 in Paris, HYGITECH started by offering surgeons and dentists hygiene kits, comprising every component needed for surgery, helping facilitate...
As the saying goes, birds of a feather flock together. Understandably, it’s common for those with like interests, backgrounds and experiences to form ...
NEW YORK, N.Y., USA: Jack D. Griffin, DMD, has been using Shofu Dental Co. products in his St. Louis-area dental practice for more than 20 years, initially ...
Problem employees. Their performance is unsatisfactory. They consume your time and create dissatisfaction for you and their coworkers. They show little ...
KOBLACH, Austria: The key to a perfect restoration result is flawless model management. Amann Girrbach offers specifically developed and perfectly ...
Triodent, maker of the V3 Ring, has introduced a new product — the Triotray. According to the company, the Triotray is a rigid and accurate posterior ...
In the anterior region where esthetics are paramount, certain complications can preclude the use of all-ceramic material. The task then becomes finding a ...
CHICAGO, USA: NuSmile offers practitioners easy placement of esthetic stainless-steel crowns for children, said Diane Johnson Krueger, CEO and president of ...
LOUISVILLE, Ky., USA: Does gum disease indicate future joint problems? Although researchers and clinicians have long known about an association between two ...
Live webinar
Thu. 18 July 2024
8:00 PM EST (New York)
Live webinar
Tue. 6 August 2024
6:00 PM EST (New York)
Live webinar
Tue. 13 August 2024
7:00 PM EST (New York)
Live webinar
Wed. 14 August 2024
12:30 PM EST (New York)
Live webinar
Wed. 21 August 2024
9:00 AM EST (New York)
Dr. Jim Lai DMD, MSc(Perio), EdD, FRCD(C)
Live webinar
Wed. 28 August 2024
8:00 PM EST (New York)
Live webinar
Mon. 2 September 2024
5:00 AM EST (New York)
To post a reply please login or register