Sometimes we take this for granted...
Last Thursday, as I was getting ready to close down my day and meet some friends for dinner, a new patient called up and said he broke his porcelain crown. So, we told him to head on over, assuming I would just patch him with composite or tell him to be careful over the weekend and that we would address it the next week. At first glance it looked like he just had a crack line on the facial of #9...the gingival inflammation could have been a clue that there was some movement of the restoration, as he reported that wasn't always there:
No big deal, right? Well, I touched it with an explorer and the entire crown crumbled off of the tooth...and now it is my problem. Sweet...so, looks like my Gibson's bone-in ribeye will have to wait(worth the trip if you come up to Chicago, FYI). How would we have handled this before CEREC? Try to free-hand a temporary, maybe slap a bunch of composite on there to get him through the weekend? Well, this new patient was thrilled when I told him that we could get his new crown completed right then if he was willing to stick around for a bit. So, cleaned up the preparation-the previous dentist did a nice job of keeping the lingual portion of the preparation above the cingulum, so there was still plenty of tooth structure.
The software spit out a nice proposal that only required a few minor modifications:
The lessons learned from this site and Level 4 in Scottsdale have really helped me when it comes to both composite bonding and my anterior CEREC restorations...just thinking about things differently has made a huge difference for me and my patients. I ended up restoring the case using e.max A-1 MT as he had already fractured one anterior crown and clearance was a little tight on the lingual. Added some texture and a little white to the line angles to give the restoration some added life, and then bonded in place using VarioLink Esthetic Warm:
I am looking forward to seeing how the gingiva responds when he comes in for hygiene, but it was certainly nice to be able to help him out...he was blown away by the technology and the fact that we were able to solve this big problem for him on the spot.
I know we all get frustrated and focus on what else we wish this technology could do for us, but this case really reminded me how fortunate we should be for the things we already can do. This would have taken a ton of work to get an even remotely acceptable result, but instead I was able to use CEREC to impress a new patient and get myself out of a jam. The steak was fantastic, by the way...medium rare, mushrooms on the side...just want to make sure I give all the information-sorry, forgot to take a picture of that!
Great job! The title says it all. We look at this situation and can "easily" say to the patient that it is "no problem" and are they are truely impressed and appreciative of what can be done. Unfortunately this is still, by far, the exception for most dentists.
Awesome case. Great contours, characterization and staining!
Out of all the amazing things CEREC can do, the "fix it right now/emergency" is what makes it King.
Had two emergency patients today break their teeth yesterday. Did one this morning that went so perfect that I was feeling lucky and did the afternoon emergency in Veneer Mode and it dropped right in. Cerec is just too much fun.... My Dentistry BC (before cerec) just seems eons ago.
As promised, here is the 1 month follow-up on this case...gingiva have responded well but some inflammation remains-this was his first hygiene appointment with us(and also since August 2016) and home care was not great so that probably contributes to the remaining inflammation. This was also taken at the end of the appointment...all-in-all, it seems vastly improved.
Sorry, I didn't realize the retractor had slipped on my hygienist-so enjoy the free view of part of his upper lip!