Anthony Ponzio Last Thursday, as I was getting ready to close down my day and meet some friends for dinner, a new patient called up and said he broke his porcelain crown. So, we told him to head on over, assuming I would just patch him with composite or tell him to be careful over the weekend and that we would address it the next week. At first glance it looked like he just had a crack line on the facial of #9...the gingival inflammation could have been a clue that there was some movement of the restoration, as he reported that wasn't always there:
No big deal, right? Well, I touched it with an explorer and the entire crown crumbled off of the tooth...and now it is my problem. Sweet...so, looks like my Gibson's bone-in ribeye will have to wait(worth the trip if you come up to Chicago, FYI). How would we have handled this before CEREC? Try to free-hand a temporary, maybe slap a bunch of composite on there to get him through the weekend? Well, this new patient was thrilled when I told him that we could get his new crown completed right then if he was willing to stick around for a bit. So, cleaned up the preparation-the previous dentist did a nice job of keeping the lingual portion of the preparation above the cingulum, so there was still plenty of tooth structure.
The software spit out a nice proposal that only required a few minor modifications:
The lessons learned from this site and Level 4 in Scottsdale have really helped me when it comes to both composite bonding and my anterior CEREC restorations...just thinking about things differently has made a huge difference for me and my patients. I ended up restoring the case using e.max A-1 MT as he had already fractured one anterior crown and clearance was a little tight on the lingual. Added some texture and a little white to the line angles to give the restoration some added life, and then bonded in place using VarioLink Esthetic Warm:
I am looking forward to seeing how the gingiva responds when he comes in for hygiene, but it was certainly nice to be able to help him out...he was blown away by the technology and the fact that we were able to solve this big problem for him on the spot.
I know we all get frustrated and focus on what else we wish this technology could do for us, but this case really reminded me how fortunate we should be for the things we already can do. This would have taken a ton of work to get an even remotely acceptable result, but instead I was able to use CEREC to impress a new patient and get myself out of a jam. The steak was fantastic, by the way...medium rare, mushrooms on the side...just want to make sure I give all the information-sorry, forgot to take a picture of that!
