Sameer Puri D.D.S. One of the things that we preach in the Level 4 workshop is that if you want a great end result with multiunit anterior cases, always get a good wax up and use the BioCopy technique instead of trying to propose multiple units with Biogeneric Individual. While the software is definitely getting more robust, at this point I would say that using BioCopy for large anterior cases is one of those rules that you just don’t want to violate. Always get a good wax up and copy the wax up.
Now my desire for the future versions of the CEREC software is that we can create our wax ups digitally. Imagine that you take a preoperative scan of the unprepared teeth, virtually prep the teeth by having the software remove 1 mm circumferentially and then give you the proposals. From there you could mill out a provisional out of the 40 mm blocks and in the mouth, use that milled provisional as a shell that is relined to fit the prepped teeth. If the patient approves, simply use a scan of that shell as your BioCopy. Even better-you already have proposals done in the software for the mock up correct? Now instead of milling a splinted temp, mill out individual units. If the software would allow this, it would make life easy. Unfortunately, we are not there just yet with regards to the capabilities of the software which is why the premise of getting a good wax up is critical.
There is however one exception to the rule of when you don’t need a wax up. Look at the case pictured below. This is probably the rare exception to the rule of not needing a wax up completed to fabricate multiple units. Why no wax up in this case? Simple, the teeth are already in the size, shape and position that we want. In fact, if you look at the existing restorations, other than discolored margins, we already have the teeth in the proper position. The only thing that needs to be done is to recreate the teeth with new restorations without the gingival discoloration.
Yes, there is a small reverse smile that needs to be corrected. Yes, there is some shape and texture issues that can be improved. Yes, the preoperative condition is not perfect by any means. But I think this is one of those cases that we can accomplish the modifications needed without having to have a whole new wax up completed by just using our Linking and Incisal Variation tools. So unless you have an almost perfect set of teeth that simply require cosmetic enhancement and not position and size enhancements, trust me and make sure you get a proper wax up and copy it as it will make the entire procedure much easier.
