Dentaltown February 2018 - 91
In cases where the dentist has to make a judgment call between
a direct resin restoration and an indirect Cerec restoration, there
are a number of factors to weigh, including the demands that will
be placed on the area, timing of the procedure, aesthetics of the
available materials, and what will serve the patient best overall.
In many cases, an argument can still be made for either method
even after taking these things into account. But if you're like me,
you may find yourself leaning toward using CAD/CAM to create
an indirect restoration.
This choice is made easier by the availability of milling materials
that are resinlike in many respects. The case shared here will
illustrate the use of a resin nanoceramic that performs much like
a composite restorative. This makes it easy to adjust-something
that might sway dentists in their choice between the two treatment
options. While a direct restoration on an occlusal surface requires
considerable time to sculpt and contour, using the Cerec system
to design an easy-to-adjust indirect restoration is much simpler
for many dentists. Furthermore, the use of an indirect material
eliminates worries about polymerization shrinkage and ensures
consistency throughout the restoration.
Marginal fit is another strong benefit of the material used
here. While direct resins can often have inconsistent and rough
contacts that can be felt while flossing, this milling material results
in excellent-fitting margins and gives the dentist more control over
the contacts. The resin component of the material makes it less
brittle and enables excellent edge quality. I have found that it creates
superior margins even in difficult areas, and the high translucency
of the blocks allows the color from the tooth to radiate through and
make margins virtually disappear. Final finishing and polishing can
be time-consuming for some indirect restorations, but the material
used here has a familiar, resinlike feel under the handpiece and
polishes up very nicely.
Bonding is, of course, an important consideration for an indirect
treatment, but with simple attention to detail and use of the right
materials, dentists can alleviate many problems that come with
this step. Fourth-generation bonding agents that use a separate
etching step have always provided the strongest bonds, but can
lead to postoperative sensitivity. The adhesive in this system helps
reduce some of those worries with a moisture-tolerant feature that
provides strong bonds and low sensitivity, even in total-etch and
selective-etch procedures.
The case seen here demonstrates the use of 3M Lava Ultimate
restorative and a proper bonding protocol to create aesthetic inlays
with the Cerec system.
CAD/CAM procedures
are the one thing I do
in my practice where
I find that patients
are consistently
blown away.
dentaltown.com \\ FEBRUARY 2018
91
http://www.dentaltown.com
Table of Contents for the Digital Edition of Dentaltown February 2018
Dentaltown February 2018 - Intro
Dentaltown February 2018 - Cover1
Dentaltown February 2018 - Cover2
Dentaltown February 2018 - 1
Dentaltown February 2018 - 2
Dentaltown February 2018 - 3
Dentaltown February 2018 - 4
Dentaltown February 2018 - 5
Dentaltown February 2018 - 6
Dentaltown February 2018 - 7
Dentaltown February 2018 - 8
Dentaltown February 2018 - 9
Dentaltown February 2018 - 10
Dentaltown February 2018 - 11
Dentaltown February 2018 - 12
Dentaltown February 2018 - 13
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Dentaltown February 2018 - 29
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Dentaltown February 2018 - 104
Dentaltown February 2018 - Cover3
Dentaltown February 2018 - Cover4
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