Tetric Cad
I've had the opportunity to use the new Tetric Cad material from Ivoclar for a few weeks now.  This material is a great addition to the current available resilient/hybrid materials that we already have.
I really despise doing quadrants of composites. There's nothing I dislike more than trying to get good contours, interproximal embrasures and contacts with sectional matrices, rings, and wedges.
I would rather let the CEREC do the work for me.
This case walked in a few days ago.
Pt needed partial coverage restoration on #14 and also a restoration on #13.
Sure, I could have prepped a crown on #14. But I prefer to save tooth structure and not do full coverage unless absolutely necessary.  Rather than filling #13 directly, with the CEREC Im able to create better emergences, and more predictable contacts.
The Tetric CAD material mills very quick and clean due to the resin component of the block. Using two Milling Units, both restorations were done in under 8 min.
After milling, my assistant removes the sprues, defines the anatomy and polishes the restorations with the Lava Ultimate Polishing kit from Diashine.
Per the IFUs, the intaglio of the restorations were sandblasted and then Adhese Universal was applied, air thinned and not cured.
Enamel was selectively etched with phosphoric acid, Adhese universal applied, air thinned and cured. Variolink Esthetic DC was placed into both preps, and the restorations were seated. This cement is great with a long tack cure making multiple units easy to clean up.
We selected Variolink Esthetic DC Warm with the MT A3 Tetric CAD and ended up with a nice final shade. The warm cement along with the MT block also helps to block out some of the underlying discolored tooth structure.
Forgive the immediate post op pic.
Entire appointment from anesthesia to post op BW was under one hour.
Pt was thrilled
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Very nice. Â A quality result like this is no accident. Â It is the result of excellent preparations. Â
Excellent.
For many years I was in a pickle.
Patients wanted failing or esthetically inadequate amalgams and resins restored and I did way more crowns than I should have due to my lack of faith in large resins and huge confidence in crowns. That would have been crown, crown all day in my practice 2 years ago.
Onlays and inlays have been the biggest unforeseen gamechanger that CEREC has blessed me and my patients with.
Keep milling those restorative quads!
I am in Amherst, NY at the Ivoclar open house and they showed your case yesterday. Great work!
Note: their lead PhD here Dr. Hill emphasized following the IFU like you did. Ivoclar has only tested the material with Adhese Universal. They also stressed to make sure to apply Adhese to the intaglio and air dry and not cure.
On 8/10/2018 at 5:44 am, Matt Parker said... I am in Amherst, NY at the Ivoclar open house and they showed your case yesterday. Great work! Note: their lead PhD here Dr. Hill emphasized following the IFU like you did. Ivoclar has only tested the material with Adhese Universal. They also stressed to make sure to apply Adhese to the intaglio and air dry and not cure.
Thanks. Â
Always surprises me when dentists don't want to follow the manufacturer's IFU and then want to blame said manufacturer when there is a failure....
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On 8/9/2018 at 9:23 pm, John Yu said...
Great case baby bird! Now go eat those Cheerios! =)
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Not Yu Too.
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Mike,  great cast and presentation.  As the Hybrid materials evolve and get better, it gets hard to choose the one that shines brighter. Tetric blocks appear to push the new hybrids even more. Â
JZÂ
Those look great. We just received some this week at MUSC. Looking forward for the students to try them.
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What about the mesial distal crack in #12?
Ray
On 8/11/2018 at 7:47 pm, Armin Giessmann said...What differences to Cerasmart did you find?
The milling was quick and the margins were clean, just as with cerasmart. I do like the availability of the MT block, compared to just HT and LT.
I like keeping things within the same family of products. It nice to have a product that was tested and developed using the bonding system/cement that I was already using.
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Great work Michael. Love the good looking polish on the Tetric Cad, hopefully it lasts (not that that is a huge concern)
On 8/13/2018 at 6:23 am, Michael Snider said...I do like the availability of the MT block, compared to just HT and LT.
Most use HT only anyway?
