Sameer Puri D.D.S. One of the keys to success with anterior CEREC restorations is the ability to create an esthetic surface texture. Too often, when restorations come out of the milling unit, doctors simply assume that they can just glaze them without any other work and place them in the mouth. This leads to a good restoration but not a great one. To get a great restoration, you must take the time to remove the bur marks from the milling unit prior to stain and glaze.
In the example below, a patient presented to the office with a fractured central incisor. The patient had received porcelain veneers approximately six years earlier in another office. When the restoration fractured, we used Biogeneric Reference to match the adjacent central incisor.
Now, when the images are taken, the clinician must – and this is mandatory – follow the appropriate sequence to ensure that the surface texture and luster of the restoration matches what is on the other restorations.
Typically, when the restoration comes out, I will contour the restoration using a fine diamond. This most often is done in the mouth due to the nature of CEREC one-visit dentistry, but can obviously be done off a model.
Once the restoration is contoured, the convex areas are polished with a rubber wheel. You can typically leave the concave areas a bit dull, but polish anything that is convex. After polishing is when we do our stain and glaze.
Now here is the critical part- after stain and glaze: rubber wheel the glaze off the restoration. You want to remove the shiny look and simply have a dull finish.
It’s not the stain and glaze that gives the restoration its luster, it’s the saliva in the mouth. Prove this to yourself by looking at an extracted tooth. It’s rarely shiny, but the surface is polished. It’s the saliva that gives it the luster.
This is exactly the sequence that was followed on tooth #8 below. You can see the luster and shade matches the adjacent teeth. If I had to rate this restoration, Id rate it an 8/10 because what I should have done was given it a bit more surface texture to match #9. Close, but no cigar. Regardless, I hope you get the concept of treating anteriors with the CEREC.
