Dentaltown February 2018 - 94

Fig. 6: Lingual view shows the anatomical form
of the marginal ridges.

Fig. 7: The restorations displayed very good marginal
integrity straight out of the milling chamber.

Fig. 8: Try-in on #31.

Fig. 9: Selective etch of enamel.

Fig. 10: Final results. Note the disappearing margins versus
the obvious appearance of the old restoration on #30.

94

FEBRUARY 2018 // dentaltown.com

restorations for 20 seconds. The adhesive was then air-thinned and
light-cured. I then applied 3M RelyX Ultimate Adhesive Resin
Cement to the restorations and they were seated. Excess cement was
tack-cured and removed, and final light curing was then performed.
The patient was instructed to bite down on articulating paper
and minor adjustments were made to the occlusion. Final polishing
of the restorations was then completed.
The fi nal results were restorations with excellent marginal
ridges and contours, which blended beautifully into the existing
tooth structure. From start to finish, this case was completed in
just under an hour (Fig. 10).

Discussion
I am sometimes asked by other dentists why I would opt for an
indirect procedure in a case such as this, given that it probably takes
10 to 15 minutes longer than a direct procedure would. My answer
is that the process of creating these restorations is more tolerable,
and even enjoyable, when compared to a direct procedure. The labor
intensiveness of working with rings, bands and wedges, placing
and light-curing incremental layers of composite, then sculpting
and contouring can be a lengthy and involved process. This is even
setting aside the possibility of discovering a bad contact at the end
of the procedure and having to reopen the prep and pack material
again. Those procedures can be mentally taxing.
However, while an indirect restoration is being milled, I can
spend the extra 10 minutes doing a hygiene check or beginning
another appointment, so my time is not wasted. With the tedious
work outsourced to the mill, a morning full of appointments to
treat interproximal decay becomes much more enjoyable.
Another clear benefit is patients' response to the procedure, as
evidenced very well here. CAD/CAM procedures are the one thing
I do in my practice where I find that patients are consistently blown
away. They become much more interested in the procedure when
they can see their scan being done and watch restorations being
designed and milled.
The availability of a milling material that is easy to adjust,
requires no fi ring, and that delivers great aesthetics and ideal
marginal fits makes the dentist's choice between direct and indirect
treatment in situations like this much easier. With the proper
technique and bonding protocol, the Cerec system can be used to
efficiently deliver restorations that will stay in place and looking
great for years to come. ■


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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
Dentaltown February 2018 - 14
Dentaltown February 2018 - 15
Dentaltown February 2018 - 16
Dentaltown February 2018 - 17
Dentaltown February 2018 - 18
Dentaltown February 2018 - 19
Dentaltown February 2018 - 20
Dentaltown February 2018 - 21
Dentaltown February 2018 - 22
Dentaltown February 2018 - 23
Dentaltown February 2018 - 24
Dentaltown February 2018 - 25
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Dentaltown February 2018 - 29
Dentaltown February 2018 - 30
Dentaltown February 2018 - 31
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Dentaltown February 2018 - Cover3
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