when the design is complete how does a 35-minute turnaround time for a fully centered bruxer crown
sound my patient presented with a fractured all-ceramic restoration on his upper left
first molar with most all ceramic restorations we can pretty much assume they're bonded in
adhesively so often requiring multiple slots to reach the prep beneath after the slots are
created i use a christensen crown removal tool to then separate the sections off the tooth by
air drying the tooth you can also get a better visualization of any remaining cement which i
prefer removing to have a fresh tooth surface to cement to i'm using a coarse grit 856 014 round
ended tapered diamond bur to reduce the buckle to a depth that blends in with the ab fraction
and also to connect to the finish line of the original prep when i'm finished making the bulk
reduction on the axial and occlusal surfaces i try to round over the internal line angles
with a football or round bur to minimize any internal stress along our restoration also
like to run a perio probe along the margins to evaluate the reduction in smoothness
the probe provides a great tactile feedback of these two aspects along this critical area of our
preparation on the mesial area the translucent roof of the pulp chamber is visible since we're
close i'll place a thin layer of vitribron glacionomer for added protection glass ionomer
does chemically bond to tooth structure but i like to do a quick acid rinse to remove the smear layer
in this case i use 37 phosphoric acid for five seconds and rinse that off i'll then place a one
minute application of gluma desensitizer suction off any excess then apply the glass ionomer
if your margins are subgingival some sort of gingival retraction must be used
otherwise margin identification at best becomes a guesstimate
here i'm using a single core technique with a size one along the buckle and a size two on the mesial
i allow the cords to sit for at least five minutes then gently pull the cords while they're wet
right before i take the digital impression i wet the cords and remove them gently to reduce
the likelihood of any bleeding once i verify that i've achieved the appropriate amount of retraction
i dry the area well then begin the digital impression using the iteral element
once the digital impression is captured of the prep opposing and bite the data is transferred
to the lab of my choice in this case it's sent to my glidewell in-office design station
the first step in the fast design software is margin marking the margin is designated
by the red dotted line i rotate the model around to ensure the line is marked correctly
once the margins are set the software generates a functional and aesthetic design that fits the
restorative space incredibly the entire design process typically takes less than three minutes
i'm so grateful to the 60 software developers that dedicated over 700 man years to create this very
easy to use design software when the design is complete how does a 35 minute turn around time
for a fully centered bruxer crown sound it kind of is unbelievable and shouldn't even
be possible but i'm amazed every time after i lock a brux or now block into my fast mill
i get a perfect fitting bruxer crown that's ready to be delivered on the milled bruxer
i snap the crown at the thinnest point of the sprue and smooth the residual down with a fine
grit red stripe diamond burr at this point i'll seat the crown and check the proximal contacts
since i've found a contact value on the software that works for me i normally have very little
to no need to make adjustments to these areas after evaluating the margins with an explorer
and a bitewing radiograph i'll check the bite for any heavy contacts when making adjustments to lab
or chair side bruxer we recommend using fine grit diamonds to limit the amount of surface roughness
following any adjustments polishing the restoration is recommended to ensure the adjusted
surfaces are as smooth as possible here i'm using the asap polishing kit by clinicians choice
that is designed to work really well on any restorative material prior to delivering the crown
i scrub a thin layer of gluma desensitizer on the prep and allow it to sit for at least a minute
the solution will help disinfect the tooth and reduce the chances of post-operative sensitivity
at this point to deliver the crown any conventional cement or resin cement of your choice
may be used with this brux or now material for this delivery we're using 3m's resin modified
glass aeonomer reliax looting plus it's very easy to use with a pretty quick cleanup after
the crown is cemented it's always a good idea to check the occlusal contacts again and there you
have it zero compromise for an immediate brux or crown using the glidewell in-office solution