4 one visit crowns with one mill in under 3 stressless hours.
We recently undertook the challenge of completing a 28 crown full mouth rehab case with strict orders of getting it done in 5 visits only due to travel and time constraints.
More on that later but today we did visit #4 and it took 2 hours and 40 minutes.
4 crowns. 2 ovens. 1 mill. 1 scanner. 160 minutes.
Sure a second mill would be great, but using the Speedfire and Programmat simultaneously can really boost efficiency. There are many ways to treat a quadrant in one visit and here is the workflow we chose today.
Numbed patient at 1:30pm. Teeth #'s 28, 29, 30 and 31 were prepped for emax by 2:30pm. Preps scanned, designed #28 and we began milling #28 which took 5.5 minutes. While 28 was milling we started designing the others.
Milled #30 for 8.5 minutes.
#28 & #30 placed in the Speedfire for 26 minutes.
Milled #29 for 5.5 minutes and #31 for 8.5 minutes.
Placed #29 and #31 in the Programmat for 16 minutes, checked contact and occlusion and bonded #28 & #30. As clean up was finished, #29 & #31 were ready. #29 & 31 were checked, bonded and final checks completed.
The patient walked out at 4:10pm.
Sure we could have done it with just one oven but it was a lot less stressful utilizing both simultaneously.
So if you dont have a Speedfire, get one! Dont have a Programmat, get one!
Its a lot cheaper to add an oven than a mill.
That is a perfect way to leverage your time with the equipment you have. You planned and executed this case beautifully Jake, great job!
Hi
Thank you for sharing your workflow.
May i ask why you prepped teeth 28 & 29 for full coverage crowns??
On 10/16/2018 at 5:32 am, Harry Abachi said... Hi Thank you for sharing your workflow. May i ask why you prepped teeth 28 & 29 for full coverage crowns??
Hello, of course!
28 crown full mouth restorative and cosmetic rehab. She was in a bad automobile accident and broke several bones in her ear/skull and cracked many of her teeth.
We recommended restoring with a variety of veneers, onlays, crowns, and leaving virgin teeth alone. She sought other opinions and brought back several tx plans of 28 crowns from other offices and adamantly pleaded for me to do it. Wanted BL2, crowns on all 28. It was a difficult decision that I really struggled with but eventually agreed to provide her wishes. We have the lower left quad left on Thursday and she couldn't be happier. Countless stories of emotional joy in the short weeks she has had the anteriors done.
Can you elaborate on details of design - were they biocopies of a waxup ? If so, any problems in stiching them together ? Did you do any transfer in the mouth if a waxup was involved ?
thank you.
Awesome planning, that is great utilization of your equipment! Thank you for sharing I'm not doing large cases yet but this is great to keep in mind for future!
On 10/16/2018 at 7:11 am, Jay Wooster said...Can you elaborate on details of design - were they biocopies of a waxup ? If so, any problems in stiching them together ? Did you do any transfer in the mouth if a waxup was involved ?
thank you.
This quadrant was done in biogeneric individual. More details to come when we present the entire case soon!
