No prep crowns on peg laterals
Here is one more reason why I love CEREC!
This is a young woman who isn't quite finished with ortho but has senior pictures coming up and pictures trump finished occlusion so I discussed it with the orthodontist and she didn't see a reason why we couldn't restore the laterals.
What I love about this case is that it is about as conservative as you can possibly get. My assistant pumiced the tooth, imaged and then started the design process. I finished the design, we milled it with GC Cerasmart, polished and bonded them on. I did nothing fancy with this case- no characterizing, just contouring and polishing. It was efficient and effective.
Beautiful work, she must be super happy! How did you decide between an] LT block vs HT? And can you post how you drew your margins? I always have trouble with where to put the lingual margins because I usually get such a wacky proposal that I end up doing direct composites.
Very nice and conservative work. I am sure she is thrilled with the outcome! I too would like to see where you put the margins if you wouldn't mind sharing.
Kris,
Referring back to the case I sent you this past week, I would also like to see where you put your margins. Ideally, I would have not prepped the two teeth I did and just went with cerasmart like you did in this case. Would you mind showing the margins?
On 3/31/2019 at 6:24 pm, Penelope Chang said...Beautiful work, she must be super happy! How did you decide between an] LT block vs HT? And can you post how you drew your margins? I always have trouble with where to put the lingual margins because I usually get such a wacky proposal that I end up doing direct composites.
I only stock the LT. I find that the HT is a little too translucent for what I want to use Cerasmart for. I probably could have gotten away with it in this case but for me it's a stocking issue. If I wanted to add more translucency then I would have added my Cosmedent Color Tints (just like staining porcelain) and then added a layer of composite over the top of that to seal it in.
On 4/1/2019 at 6:21 am, Kirsten Andrews said...
Kris,
Referring back to the case I sent you this past week, I would also like to see where you put your margins. Ideally, I would have not prepped the two teeth I did and just went with cerasmart like you did in this case. Would you mind showing the margins?
These I did as full crowns for more retention because they were the perfect shape already for it. The margins were just around the CEJ.
When I have done no prep veneers with Cerasmart, the margins looked like this...
The key is to have a path of draw. If there is a big gap on the lingual interproximal then I will add composite.
With this no prep veneer it is flared a little facially but to stick to the no prep and being conservative it was worth the compromise to me.
thanks for sharing that. I think I was nervous about not having a distinct margin that my bur prepared. You rock!
Kirsten
Yes thanks for sharing! I never thought to fill in the gaps on the lingual with composite when the proposal was wonky.
If it is a hybrid block that you can bond composite to, then it's easy. Just don't try it with e.max ;)
I love doing these! Cerasmart is my go to. Had to redo a case (on my niece; go figure) where i just couldn't get a shade match with Cerasmart. Switched to empress multi. It seemed to mill OK but would have preferred a resin block. I almost always do a little laser before I image. It looks like your gingiva moved "north" a bit. Did you use a laser? This case looks really nice!!!
Looks fantastic. What a great result. Is the plan to remove them after her senior pictures to finish ortho? Looks like an aligner case so I'm sure her current ones don't fit anymore right?
@ Chris
I do use a laser sometimes, but not in this case. I try not to disturb the tissue. I wasn't worried about it with Cerasmart because if anything looks weird I can either polish the margin down or add composite to it. Her tissue will definitely settle after ortho is finished and she is still growing so we'll see. She is a big fan of selfies so I will definitely be alerted if it starts to look strange to her ;)
@ Derrik
The orthodontist was about to do a refinement on her to help close that open bite on the left side so it was perfect timing for new aligners so they re-imaged.
I have a case similar to this. One peg lateral and one congenitally missing. I was thinking about doing a no prep veneer and a Maryland bridge. Anybody have experience with Maryland bridges and cerasmart?
