Walkthroughs The first steps are to bond the E.max coping to the tooth and to choose the correct value of cure cement to bond the crown to the coping and adjacent restorations to the natural teeth. Next, while the adjacent teeth will be treated with phosphoric acid, the coping can be treated with Monobond Etch and Prime (Ivoclar Vivadent), which has received FDA clearance for intraoral use as a safe alternative for hydrofluoric acid. The bonding agent can then be placed and polymerized on the adjacent teeth only. This means waiting to place the bonding agent on the coping until just before placing the restorations loaded with cement. The cement and bonding agent between the correction coping and the crown is polymerized using the sandwich technique. The result is an aesthetic, all-ceramic smile with the block-out result of a metal coping (Figs. 9 and 10). CASE STUDY: HANDLING A MESIALLY TILTED MANDIBULAR MOLAR Although the incidence failure of fixed partial dentures from mandibular second premolar to second molar (replacing the mandibular first molar) is difficult to determine in the natural dentition, this practice is contraindicated without a nonrigid connector in implants because of mandibular flexure.22 When a mandibular first molar is missing for an extended period, the second molar typically tilts mesially into the edentulous space. The torsion and flexure rate on the abutments has now been altered because of the difference in the long axis positions of the roots. When restored with a nonrigid connector, one of the abutments typically debonds or suffers cement failure, resulting in recurrent caries and prosthetic failure.23 The solution is a telescopic coping bridge. If the patient is concerned about aesthetics-the gold coping showing (Fig. 11)-or the treating practitioner is concerned about using various temporary cements for the prosthesis, E.max telescopic copings are one solution. These copings can be fabricated and bonded to the abutments using a total-etch technique and either dual-cure or light-curedonly cement (Fig. 12). The final prosthesis can be cemented with a resin-reinforced glass ionomer or self-etching resin cement (Fig. 13). Fig. 11 Fig. 9 Fig. 12 Fig. 10 Fig. 13 52 MAY 2017 // dentaltown.comhttp://www.dentaltown.com