hello and welcome to chair side life I'm Megan strong and I'm will Schmitt registered dental
assistant here at Blackwell dental so today we've got part two of doctor cheese Brooks
ascetic case he was replacing a couple P FM's on number seven in number ten the first episode
he gave us an overview of the case showed us the the final result but so what's happening on this
second segment Omegan we're gonna continue this case we're gonna see dr. GU removed these P FM's
do the Billups and then he's gonna do what he's best known for and that's digital scanning with
the I Tarot element digital scanner that's right and he's using the incredible glial do in office
solution to fabricate provisional crowns with bio tips now really yes bio temps now with the
Gladwell dial in office solution and the fast mil yes Megan I'm telling you the provisional
revolution is upon us it's upon us so let's take a look in see part two welcome back to
part two where I'll now take you through the prep and impression for the Brooks er aesthetic
restorations that we placed on tooth number seven and ten we'll start with the removal of the pfm
crowns where I use a carbide 557 burr to create a slot through the crowns along the facial incisal
and lingual surfaces it's pretty easy to tell once we've cut the repeat of him since the transition
from metal to tooth prep beneath is pretty obvious once the slot is large enough I use a Christensen
crown remover to separate the crown from the prep for more stubborn crowns like on number 10 I make
an additional horizontal slot to help with the removal once the crowns are removed it's time to
refine the preps and also to modify the build ups if necessary the gingival zenith on number seven
is about half a millimeter lower than number ten so I'm just checking the salk Euler depth with a
probe to make sure I have enough room from the attachment to raise the margin for all my preps
I use a round ended tapered diamond bur to create the appropriate and rounded internal angles along
the axial surfaces which will result in a deep chamfer margin for brookster aesthetic we're
looking for a reduction of about point seven millimeters along the gingival margins and a
one and a half millimeter clearance to remove the temporary filling material on number ten I use
a carbide round bur at a slow speed this helps ensure I don't remove much to structure beyond
the temp material once I reach the gutta-percha I seal the top with vecher bond glass ionomer now
to start the build up I use kurz 37% phosphoric acid etch for 10 seconds followed by a PI bond
Universal after I apply a bonding agent I always use air and suction to remove excess
bonding agent and also to evaporate the solvents once the bonding agent has been like cured for 10
seconds I incremental II use camouflage Nano hybrid flowable composite so the build up is
well adapted to the teeth once the build ups are cured I'll continue refining the preps to ensure
that there is adequate reduction and the internal surfaces are rounded and smooth since the margins
are slightly sub gingival I use a size 1 chord to help retract the tissue for the impression
in tight spaces I use both a pareo probe and a serrated chord packer to place the chord just
below the margins after 5 minutes I remove the cords and dry the preps and sulcus really well
for the digital impression any excess fluids on the preps or within the sulcus can certainly
create distortions within the impression on the eye taro element scanner we first capture a
high-resolution image of each prep then the rest of the neighboring teeth in the upper arch the
opposing arch and then we finish with the patient biting together to establish the occlusion taking
impressions with a digital scanner is an active process where you sweep the scanner along all
of the surfaces of the teeth while observing the model that's generating on the screen after each
set it's important to analyze the model to ensure the necessary areas have been captured since the
final restorations will be Brux your aesthetic the digital impression has been transferred to
the lab for fabrication I also transfer the files to our glide wall in office system so
I can design and mill precise fitting bow temps now Provisionals in the fast design software I
first mark the margins and define the occlusal and facial directions once the margins are placed if
necessary it's easy to modify the margins by dragging the line around once the margins are
completed both restorations can be designed simultaneously here I'm using a tool called
freeform that can allow custom adjustments to any area of the design once the design is complete
I'll automatically set the proximal contact values using the edit contacts window here
on the right the designs are then transferred to the fast mill where it'll take six minutes
to make a perfect fitting provisional out of the bio temps now blocks once each sprue connection
has been removed we use voco by fixed temp which is a very strong and easy to use composite based
temporary cement since these restorations fit so well and the margins are so precise it certainly
offers a peace of mind during this temporary phase while we wait for the final restorations
to be fabricated that wraps things up for part two of this case on the next episode of Terra
site live I'll take you through the final delivery of these brookster aesthetic restorations on tooth
numbers 7 & 10 well thank you for that dr. chi be sure to tune back in for the third and final
installment of this very exciting case it's gonna be a good one can't wait to see it get wrapped up
speaking of wrapped up today's episode we're wrapping it up on behalf of everyone here at
Glidewell dental thank you so much for watching and we'll meet you right back here next time