CEREC Doctors

Blog Author: Jake Skowronski


Hello friends. #30 appeared to be unrestorable and the patient adamantly declined an implant.

embedded image

 

Can "Herodontia" be used for treatment plan "phasing?"


We took a cbct scan to evaluate whether we could even keep the RCT in house and did not refer. 

​After a review of symptoms and pulp vitality testing we began the procedure and here is what we saw after we removed the PFM crown. 

embedded image


 After gross decay removal we were all shocked the nerve was not exposed or even blushing.

Because Zirconia is so biocompatible with soft and hard oral tissues; we can place the crown quite subgingivally with great success.

embedded image

embedded image

embedded image

 

Of course, the very guarded prognosis was reinforced again at the end of the appointment and the patient stated,

"Well, when this fails I want an implant"

 The moral of the story is; "Herodontia" can be part of  "Treatment Plan Phasing" that allows the patient to become more comfortable with previously refuted options. He was not mentally prepared to go from a crown straight to an implant. Despite my most thorough advisement; his previous dental knowledge, exposure and experience required him a stepping stone to the implant psychologically.​ 

 


A 60 year old mother of the bride decided on a whim to fix her cracked crown before this Saturday's wedding.

A neighbor of hers told her that I could do it in 1.5 hours at their neighborhood Halloween Party on Saturday night. She called this morning and we squeezed her in. 
EMAX B1 MT. 
No heavy characterizations or stainings were needed in order to match the old PFM's. We've got one happy and excited Mother!

​It never gets old!

embedded image


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. 

 

embedded image

embedded image

embedded image

 

embedded image

embedded image

embedded image