Crown cementation facilitated with the Triodent Griptab restoration handling aid

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.