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There is a use for all of the tools in the mill (or manufacture) phase of the software.
Of course we all use the sprue tool to get the sprue placement away from the perfect proximal contact we just created.
Then there is the move tool which we can use with the multilayer blocks to alter where the dentin and translucent areas of the crown will be.
And both tools can be combined to effect a more gradual transition of shades on these blocks.
But both tools and both aspects of the move tool can be used to make an exceptionally large crown fit into a block that at first proposal would appear to be impossible.
VITA INTRODUCES “SMART” FIRING UNIT
FOR CHAIRSIDE RESTORATIONS
New VITA SMART.FIRE® boasts easy-to-use interface with one-step
material selection and program start
YORBA LINDA, Calif. (Feb. 7, 2018) — To meet the special needs of chairside milling dentists, VITA has introduced the VITA SMART.FIRE, a fast, efficient and compact firing unit for chairside restorations, including the crystallization, glaze, stain and corrective firing of all common chairside materials.
Featuring an intuitive user interface, materials may be selected in one simple step. In addition, customizable material-specific programs are already pre-installed for simple firing. The VITA SMART.FIRE system includes a durable firing unit for robust firing technology and reliable function, an intuitive touch control unit with a high resolution, 10-inch display and an integrated service drawer for easy access to important accessories, such as firing trays and platinum pins. The fully automatic temperature calibration produces reliable results, and a software-based assistance function is also available for supported, step-by-step firing.
With the VITA SMART.FIRE, CAD/CAM restorations can be completed chairside, even for monolithic, ceramic restorations. The convenient, compact size means VITA SMART.FIRE can also be set up quickly and simply, and is mobile for use in any treatment room.
VITA is a leading provider of innovative dental products. From premium denture teeth and veneering materials, to digital shade measurement, furnaces and CAD/CAM restorations, VITA helps laboratory technicians and clinicians deliver high quality and esthetic results to patients quickly and efficiently.
For more information on VITA SMART.FIRE, visit www.vitanorthamerica.com or call 800-828-3839.
Beautiful case as always!!!!
I see patient has a wear, how did you address her envelope of function? I see also #24 lost incisal restoration ( I might be wrong), if yes, did it happen during provisional wear? Gregory
This case represents how vital an efficient workflow can be when managing our patients. The patient presented initially with diffuse symptoms in the upper left quadrant. She reports a history of fibromyalgia and Ehlers Danlos syndrome. She has an extensive dental history, many times with significant post-operative discomfort following treatment. The patient reported sporadic pain that would vary in intensity, sometimes with no stimulation. CBCT showed no signs of periapical or radicular disease and the diagnostic testing was inconclusive. Due to the subjective and objective data giving no clear reason for her pain, I referred the patient was referred to an endodontic colleague for evaluation.
After consultation, root canal therapy was completed on both #12 and #13 and the patient was returned to my care. Because of the patient’s history with difficulty following dental treatment, I requested the endodontist fill the access openings with core build up material which reduced the number of visits and limited the patient management complications following her first stage in treatment. I also waited 8 weeks prior to initiating full coverage crowns as final restorations. The following outlines my workflow meant to maximize efficiency and speed without sacrificing quality.
Anesthesia was delivered and while it took place, I completed my pre-operative imaging. 5 minutes later, the Isolite was in place and I began prepping. Prep design was fairly straightforward, with a full coverage traditional style preparation to ensure adequate strength to the endodontically treated teeth. Retraction cord was packed around the preparations to displace the tissue and I started imaging 30 minutes into our appointment.
Since these teeth had only occlusal access resins, I was able to be very conservative with the preparations circumferentially. Yet, because irritation to the pulpal tissue was not a concern, I was able to reduce enough occlusally to obtain adequate thickness. Utilizing a material that does not require firing is a great way to keep the appointment moving along in an efficient way. As the models finished processing, I was deciding which material I wanted to use.
To me, this is the ideal case to use Celtra Duo polished only and bonded without a firing step. I obtained > 1.5mm of ceramic thickness which will provide more than adequate strength to the restoration. I prepared very thin margins along the facial aspect of the preparations, which typically requires bulking out the ceramic with many materials to avoid chipping. However, due to Celtra’s milling characteristics, I felt comfortable with ceramic thickness of 0.6mm and experienced no chipping whatsoever. At this point my design is done and sent to the milling chambers and we are 40 minutes into the appointment.
The manufacturing process took less than 9 minutes total and I got to listen to the sweet stereo sound of dueling MCXL milling chambers fabricating the crowns. Polishing the restorations to a high shine, which gives Celtra fantastic strength in addition to its wonderful appearance, took another 5 minutes. Try in and preparation of the ceramic was another 5 minutes and we were ready to bond in place. The internal surfaces of the crowns were prepared with HF etch and silanated. The crowns were then bonded using Dentsply Prime and Bond Elect with Calibra Ceram. The excess was cleaned away, occlusion verified, and a bitewing taken to verify no remaining cement, and the patient was dismissed 1 hour 15 minutes after starting anesthesia.
In this case, time was of the essence. Our patient had experienced clinical open lock, TMD symptoms, and overall pain after some of her previous dental visits. Having the ability to finish two full coverage crowns in this amount of time was huge benefit to the patient, a good use of my chair time, and a profitable procedure for the practice. When I have these types of cases, I will be sure not to double book myself in another chair at the same time. I want to devote the time needed to ensure the visit happens in an efficient manner.
I haven't posted a case in awhile... thought I would post one that I just finished...
Preop situation: Patient had very old veneers on front 6 teeth. He wanted to change them out with a "whiter" solution and also wanted a fuller smile.
We decided to do the front 8 teeth to take care of his buccal corridor issue. We imaged with Ortho software and sent to lab to have a digital waxup done
After rough prepping the teeth, we transferred the waxup to the mouth and then did final depth reduction
Here are the final preparations:
And here is the final result. Vita Mk II 1M1
Just wanted to show this screen shot of the lower image I took today. Pt had perio surgery on 18 and I removed her old crown, the recurrent decay, and was prepping for a new one. How the hell would someone get an impression tray on this pt?? Her tori were just humongous and there was no room for a tray there. She was so happy to not have that issue with the tray cutting her and tearing up her tissue. I was just happy to easily be able to image the lower so easily as if those damn things were not even there. One of the hundreds of reasons that digital is so much better than analog!
I have a patient that wants to do upper 8 and lower 6. My questions is how would you prep/bond the canines but more importantly the first premolars? The gingival margin will be on root surface. Those teeth are completely virgin.
1) Normal veneer prep and bond
2) full prep and cement with rmgi (lots of extra tooth removed)
Would love to see differing view points and the reason for each?
After a great trip to Sirona/Atlantis in Boston I thought I would post a case I did.
#14 failing molar, extracted and grafted site, guided implant surgery with a crestal sinus lift, planned for with Cerec Guide2. After healing we scanned with the FLO scan body and sent it to Altantis. After the abutment design was approved I recieved the file to make the EMax crown here and 2 days later the abutment showed up with seating tool. Don't forget the seating tool its great.
Great work flow, very little stress, If you do not feel comfortable designing custom abutments this is the way to go. Also for situations where a TiBase is not a good solution.