Crown Preparation and Placement with the CS 3500 and CS 3000

by Daniel C. Delrose, DDS

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Case Overview

Thirty-six year old male presents with some dental issues on his right side. A full review of his medical history reveals no medical issues and no known drug allergies. His dental history involved multiple direct restorations with a history of failure over time. Patient’s chief dental complaint is to have a restoration that will endure longer than a few years.

Treatment

A full dental examination was completed, including a CBCT scan with the CS 9300, a full series of intraoral radiographs with the RVG 6100; intra and extra oral photographs, hard tissue examination, and a soft tissue examination.

Recurrent decay was revealed on tooth #18 and a MOD direct composite was treatment planned.

Tooth #4 had an existing MOD composite with recurrent decay at the margins. The tooth was “over filled” and lacked integrity. To provide strength and function to the tooth, a full ceramic crown treatment was planned.

Tooth # 30 had recurrent decay on the lingual and a fractured MO composite. Since healthy tooth structure existed and the tooth was not a point for full coverage, an onlay treatment was planned. Porcelain onlays bond to the existing enamel which restores a tooth to contour and function without dramatically removing healthy enamel. The preparations were completed using SOLO diamonds from Premier. The burs included the 368023C; 856L108C; 801023C; 862012C; 837012C; 368023F. Traxodent from Premier Dental was placed at the margins, rinsed and then imaged with the CS 3500.

The restorations were designed on CS Restore and then milled using the CS 3000 and Vita Mark II feldspathic porcelain.

The restorations were adjusted in the mouth and then stained and glazed using the Vita Akzent Plus kit. The preparations were then cleaned with 37% phosphoric acid, and Microprime from Danville Materials was used as a primer. Clear MaxCem Elite dental resin cement was used to lute the restorations. The SOLO fine flame bur was used again to polish the margins, and then Diamond Twist SCO from premier was used intraorally for the final polish. Radiographs are always taken to verify marginal integrity.

Outcome

Patient was extremely happy with the esthetics and the idea that porcelain was milled for his specific restoration.