REPLACING A SINGLE POSTERIOR CROWN IN ONE APPOINTMENT
Figure 5: There were some recurrent caries on the mesial of #15 where the margin was open.
Figure 7: Clinical evaluation of the occlu- sal reduction ensured there was adequate space for the restorative material. For BruxZir Esthetic NOW Posterior, the mini- mum required thickness is 0.7 mm. I typically remove around 2 mm for the occlusal and 1 mm for axial reduction. I also made sure that there were at least two or three plane reductions and all transitions were smooth and rounded for ideal milling of the chair- side CAD/CAM crown.
Figure 9: The MarginAI ™ software, which is part of the fastdesign.io software suite, detected most of the margin, which I rechecked and confirmed.
4a
Figure 6: After refinement of the tooth preparation, the margin was exposed using the two-cord technique. For apical compression, I used Premier’s Knit-Pak ™ #00 as the first cord. For lateral deflection of the tissue, I placed a #2 cord presoaked in Hemodent ® hemostatic liquid over the first cord. The patient bit down on Roeko Comprecap compression caps (Coltène/ Whaledent GmbH + Co KG; Langenau, Germany) for five minutes for continued compression. The second cord was gently removed to expose the margin, allowing for a high-quality digital scan.
Figure 10: With a click of the mouse, CrownAI ™ generated a design to fit the space. I rechecked my preferred contact parameters.
4b
Figure 8: The final scan shows well-ex- posed margins. I used the Medit ® i900 ® scanner, which pairs seamlessly with the fastdesign.io ™ system. With just a click, the scan was sent to the fastdesign.io software.
4c
Figures 4a–4c: A pretreatment scan of the maxillary and mandibular arches and bite was done prior to delivery of local anesthetic.
Figure 11: Before sending the design to the mill, it’s important to use the milling and insertion tool to verify that the restoration has an adequate path of insertion. A green line indicates it is okay to proceed, while a red line signals an issue. I completed the design in under five minutes and sent it to the fastmill.io ™ In-Office Mill for fabrication.
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