Treatment To fabricate a crown on tooth #20 at the correct vertical dimension of occlusion (VDO), we used the STL fi le of our fi nal design and the copy feature of the Exocad program to design a lithium disilicate (e.max) crown. We decided to use e.max for its high strength and because we wanted to chemically bond the crown to the tooth structure since the existing prep tooth was short in clinical height. An IPS e.max block in shade B1 was chosen to mill out a crown using our VHF Z4 wet mill. An IPS e.max CAD Crystal stain and glaze was used to characterize the crown before using the Programat CS6 to crystallize the restoration. Th e intaglio surface of the crown was etched with 5% hydrofl uoric acid for 20 seconds, then cleaned with 30% phosphoric acid for 60 seconds. It was rinsed with water and then air dried before being primed with silane solution for 60 seconds. Tooth #20 was particle abraded with 27-micron aluminum oxide at 40 psi, rinsed and blotted dry. Tooth #20 was then etched and bonded (3M Scotchbond Universal), and light-cured for 10 seconds. 3M RelyX Unicem 2 in translucent was used to cement the crown. To prepare the natural teeth for the composite restoration, a red-striped football bur was used to roughen the enamel. All teeth were particle abraded with 27-micron aluminum oxide at 40 psi (using a PrepStart) (Fig. 16a- 16o). Tefl on was used on the adjacent teeth. Etched with 37% phosphoric acid, bonded using 3M Scothbond Universal Adhesive and then light-cured. Heated composite (Filtek Supreme Ultra in Body XW shade) was placed on vacuum shells in excess. We used a dental vibration instrument to vibrate composite through the vacuum shells. Th ey were lightcured for 60 seconds on the buccal and lingual surfaces. Th e excess was removed and the contacts were cleaned with polishing strips (Contact EZ). Every other tooth was completed using the same steps with the cast before we used the cast with all the teeth. Fig. 11 Fig. 12 Figs. 13a-b Figs. 14a-b Figs. 15a-b DECEMBER 2024 | 39 | DENTALTOWN.COMhttp://www.DENTALTOWN.COM