Lab Tribune U.S. No. 4, 2011
Three-unit - full-contour ceramic bridge in one sitting / Sensable Dental debuts new version of its touch-enabled virtual articulator
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[1] =>
LAB TRIBUNE
The World’s Dental Lab Newspaper · U.S. Edition
April 2011
www.dental-tribune.com
Vol. 2, No. 4
Three-unit, full-contour
ceramic bridge in one sitting
By Chris Leinweber, RDT, CDT
In the following case, the CEREC 3D
system (software version 3.65) and its
one-appointment capabilities played
an essential part in the treatment.
The patient suffered from facial
myalgia and could not handle a
repeat visit for a second try in/insert,
owing to the potential stress it would
cause. She had previously experienced involuntary facial episodes —
the drill had been bitten on — causing more trauma.
The patient had broken tooth #31
at the gumline. The rest of the tooth
had been removed some time ago,
leaving a gap. All treatment options
were explained to her.
We offered her a same-day ceramic bridge and informed her that this
would be entirely experimental, even
though I have made many of these
types of full-contour bridges.
Dr. Carl Boyko, Welcome Smile
Dental (Calgary, Canada), and I created the bridge.
First, Boyko measured the span of
the area that needed to be bridged.
Once measured, we discovered that
the area could support an I-14 TriLuxe Forte (VITA), which would be
used to manufacture the bridge.
Boyko then prepared the teeth #41
and #32 abutments. Next, he created
a temporary bridge that would be
used by the CEREC system as a temporary reference.
Simultaneously, we measured the
shade of the surrounding teeth (Fig.
1). The patient did not wish for her
lower teeth to be straightened and,
therefore, our goal was to restore her
original smile. She felt that this would
be a more natural result and did not
wish the esthetics to be obvious when
she smiled.
Once the temporary bridge had
been put in place, the temporaries
were coated with titanium-dioxide
powder. This creates a reflective surface that allows the CEREC 3D Bluecam to capture the optical impressions of the preoperative (occlusion)
images.
Once the temporary reference
images had been captured, the temporary was removed and titanium
dioxide was sprayed onto the abutments once again. We then used the
CEREC Bluecam to capture the abutments (Fig. 2).
The bridge we wanted to copy
virtually overlapped the prepared
model. The gold color model underneath was the original prepared
image and the gray image on top was
the correlation model.
It was evident that the model
matched from the speckled look to
the grey model, as it perfectly overlaps the prepared model. We need
this kind of speckled look to occur
because there is a 20-degree pitch
and roll, yee and yaw of the camera in
order to match up the images.
Although the CEREC software
merges the images, this does not
mean that the images will correlate
100 percent.
The correlation may thus be
reduced even though we have a virtual model (Fig. 3).
When using the correlation design
technique, one can draw the margin
starting with any one of the abutments. Simply start to draw the margin close to the interproximal. As one
draws around the preparation, do not
close the loop on the preparation on
which you started.
Continue to draw the margin out
onto the tissue, thus creating a second margin on the imaginary pontic
area. Continue on to the next abutment, draw around the next abutment, then continue back onto the
tissue to continue the lingual margin
of the pontic.
Finally, join the rest of the margin
to the original abutment to close the
loop. Once the loop has been completed, one can carry on to the next
window.
In this way, we fool the CEREC
software into thinking this pontic loop
is one crown (Fig. 4).
Figure 5 shows our completed
bridge that was milled using the
VITA Forte block, which is not a
plain monochromatic block. The final
result will have a natural gradient
built into it when completed, as it has
four color steps to it (Fig. 5).
In order to achieve the proper
shading for our ceramic, I used Quick
Match (Hankins Laboratories), which
can be used to mimic the stump
shade value of the abutments (Fig. 6).
Next, I used the Ivoclar Stump
Shade Guide to match the shade tab
to the appropriate color on the Quick
Match syringe. I injected the fireable
stump shade material into the bridge
Fig. 1
(Photos/Provided by Chris Leinweber, RDT, CDT)
Fig. 2
Fig. 3
Fig. 4
Fig. 5
abutments.
Once the Quick Match had been
injected, I started applying the glaze.
The glaze turned the ceramic into
a window showing us the internal
core value. This makes staining the
ceramics an easy process once fir-
ing is completed. The process can
be repeated should more stain be
required (Fig. 7).
I personally find that using the
Quick Match product not only creg LT page 2C
[2] =>
2C
Case Study
‘The final result is a
bridge that is virtually
indistinguishable
from the original.
This was all completed
in a two-hour visit,
and the patient was
very pleased with the
final result.’
Lab Tribune | April 2011
LAB TRIBUNE
Fig. 6
The World’s Dental Lab Newspaper · U.S. Edition
Publisher & Chairman
Torsten Oemus
t.oemus@dental-tribune.com
Chief Operating Officer
Eric Seid
e.seid@dental-tribune.com
Group Editor & Designer
Robin Goodman
r.goodman@dental-tribune.com
Editor in Chief
Laura Kelly
l.kelly@dental-tribune.com
Managing Editor/Designer
Implant, Endo & Lab Tribunes
Sierra Rendon
s.rendon@dental-tribune.com
Fig. 7
f LT page 1C
ates the right stump shade value but
is also great to use when firing small
abutments that will not fit a peg (Fig.
8).
The final result is a bridge that is
virtually indistinguishable from the
original. This was all completed in
a two-hour visit, and the patient was
very pleased with the final result.
In this particular scenario, I was
not worried about the bridge failing
because of the size of the connecters. I know that using a feldspathic
ceramic is not the No. 1 choice; however, the amount of load on the anteriors will not be such that the bridge
will fail (Fig. 9). LT
Managing Editor/Designer
Ortho Tribune & Show Dailies
Kristine Colker
k.colker@dental-tribune.com
Online Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.com
Account Manager
Gina Davison
g.davison@dental-tribune.com
Fig. 8
Account Manager
Humberto Estrada
h.estrada@dental-tribune.com
Marketing Manager
Anna Wlodarczyk
a.wlodarczyk@dental-tribune.com
Marketing & Sales Assistant
Lorrie Young
l.young@dental-tribune.com
C.E. Manager
Julia Wehkamp
j.wehkamp@dental-tribune.com
International C.E. Sales Manager
Christiane Ferret
c.ferret@dtstudyclub.com
AD
Fig. 9
Dental Tribune America, LLC
116 West 23rd Street, Ste. 500
New York, N.Y. 10011
Phone: (212) 244-7181, Fax: (212) 244-7185
Published by
Dental Tribune America
© 2011 Dental Tribune America
All rights reserved.
LT About the author
Dental Tribune makes every effort to
report clinical information and manufacturer’s product news accurately,
but cannot assume responsibility for
the validity of product claims, or for
typographical errors. The publisher
also does not assume responsibility
for product names or claims or statements made by advertisers. Opinions expressed by authors are their
own and may not reflect those of
Dental Tribune America.
LT
Corrections
Lab Tribune strives to maintain the utmost
accuracy in its news and clinical reports. If
you find a factual error or content that
requires clarification, please report the
details to Managing Editor Sierra Rendon
at s.rendon@dental-tribune.com.
Chris Leinweber is the owner of
Kensington Dental Ceramics located in Calgary. He is a registered
dental technologist, a certified dental technician and an ISCD-certified CEREC trainer. He currently
provides two-day advanced CEREC
courses at Vident CEREC University in Brea, Calif. He lectures
internationally and is the creator
and host of the CEREC Made Easy
DVD training series. All his training
material and an updated course
schedule are available online at
www.cerecmadeeasy.com.
Tell us what you think!
Do you have general comments or
criticism you would like to share? Is
there a particular topic you would like
to see more articles about? Let us know
by e-mailing us at feedback@dentaltribune.com. If you would like to make
any change to your subscription (name,
address or to opt out) please send us an
e-mail at database@dental-tribune.
com and be sure to include which
publication you are referring to. Also,
please note that subscription changes
can take up to 6 weeks to process.
[3] =>
Industry 3C
Lab Tribune | April 2011
Sensable Dental debuts new version
of its touch-enabled virtual articulator
Sensable Dental, a division of
Sensable, announced the newest
version of its Intellifit™ TE (TouchEnabled) Digital Restoration System
that offers dental labs even more
choice, performance and flexibility
in digitally designing and fabricating
a wide range of dental restorations.
The first and No. 1 selling system for
partials and more, according to the
company, Intellifit — formerly named
the Sensable Dental Lab System —
now adds support for touch-enabled
articulation, veneers, enhanced design
features and fabrication choices for
crown and bridge, as well as increased
3-D printing capacity.
“We’re proud to offer the industry’s first touch-enabled virtual articulator integrated into the Intellifit system,” said Bob Steingart, president of
Sensable Dental. “Allowing lab technicians to assess the fit of restorations
by ‘feel,’ in a way that they are used
to — and giving them the tools to easily make adjustments — means more
productivity for labs. Besides innovations like this, we’re committed to giv-
Intellifit, formerly
named the Sensable
Dental Lab System,
now adds support
for touch-enabled
articulation, veneers,
enhanced design features and fabrication
choices for crown and
bridge. (Photo/Provided by Sensable Dental)
ing labs more choice, more flexibility
and more restoration types from the
same system. As the economy forces
dental labs to more closely examine
their productivity, Sensable offers
labs practical solutions to better serve
their doctors while achieving a strong
return on investment.”
Driven by the need to stay competitive and leverage a declining labor
force of skilled technicians, dental
labs are transitioning from painstaking hand waxing to streamlined digital design and production at a rapid
pace. Sensable’s Intellifit is helping
transform an industry from an era of
manual hand-crafting to greater productivity, profitability and precision.
The system’s support for both fixed
and removable restorations, produced
faster and with heightened precision
through its unique touch-enabled
technology, allows dental labs of all
sizes to gain a competitive advantage.
Here are two responses to the technology:
• “We are using the Intellifit system
to create both fixed and removable restorations, including all-ceramic monolithic crowns, bridges and prepped
veneers,” said Kristine Van Cleve,
president of Dental Prosthetic Services
in Cedar Rapids, Iowa. “We especially appreciate how the system makes
pressing cost-effective by streamlining
the process. We can quickly create customized digital tooth designs with full
anatomy that perfectly match adjacent
teeth, print, invest and then press.”
• “We’ve designed more than 17,000
fixed and removable restorations during the past two and a half years using
Intellifit, and the system’s efficiency
and value for us keeps on growing,”
said John Aitchison, owner of Minot
Dental Lab in Minot, N.D. “Partials,
crowns, bridges, overstructures, substructures and veneers — we can do
them all with Intellifit. The system
gives us precise and consistent results
and accuracy that far exceeds hand
waxing.”
Contact Sensable for more information on Intellifit by calling tollfree (855) 872-7255 or visiting www.
SensableDental.com. LT
(Source: Sensable Dental)
AD
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