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No prep Tetric CAD case

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This case was pretty fun that I just finished today:

Patient wanted midline diastema and rotation fixed and also stated that she really did not like the translucency of her edges:

I scanned her at the hygiene appointment, designed two NO PREP Tetric CAD veneers over 8 and 9, and 3D printed a model to fit them on:

We bonded them in today with Variolink Esthetic light and did some minor bondings on 7 and 10

I suppose I could have done with ceramics and the esthetics would have been a touch better, but no way could I have milled them this thin.  I'm liking the idea of Tetric CAD MT as a no prep veneer material

 


Great result Skrammy.


VERY nice!

Mark


Very nice looking veneers.  A couple of questions

How did you control the lingual embrasure/emergence to avoid an overhang on the lingual aspect, much like how we talk about having to prep to the lingual to avoid ledging on porcelain veneers?

How long did it take you to do the case?  


EF Mill?


Yes EF mill
Darin... these were very thin at the margins and did not ledge at all.
It was not for the faint of heart. It took a couple tries to get it right with where i drew the margins and undercuts...but all the work behind the scenes was worth it i think because the appt with the patient was fairly easy... that is it was easy after i got them on right. That part is a bit stressful with no prep veneers.
Today the case took 45 min.


Also Darin to your emergence question... it was a bit lucky that # 8 was positioned lingually (see printed model)... gave me just enough room for emergence.


Beautiful result as always.  Did you prepare the intaglios of the no prep veneers with air abrasion?  Are you concerned about longevity because of the composite material?


Hi Chuck-
I do not believe they will ever debond if that is what you mean. I’m sure they will “age” like every resin does eventually.

I air abrade both the intaglio and the tooth itself.


A rookie question:

When the time comes to replace them or remove them, how do you get them off without harming the underlying enamel? That is always the hardest thing for me with bonded restorations.

Farhad


A high speed brownie point will take away the resin without harming the underlying tooth at all.  You just have to be careful because the brownie point can shrapnel pretty easily and pieces go flying. 

 


Hi, very well done.
just some questions:

-How much thin they are?? What's the minimal thickness parameter??

-Most of the times when there is not enough prep, the software gives stupid proposals. how long the design took?? Any special tricks??

-Would you do the same thing with other hybrid ceramics i.e. enamic, cerasmart....?


Nice case Mike. Not for the faint of heart.


Really nicely done.


Very nice.  It'd be a shame if the fda decides to enforce manufactures minimal thickness on restorative materials.  cool


On 10/29/2018 at 9:59 pm, Harry Abachi said... Hi, very well done. just some questions: -How much thin they are?? What's the minimal thickness parameter?? -Most of the times when there is not enough prep, the software gives stupid proposals. how long the design took?? Any special tricks?? -Would you do the same thing with other hybrid ceramics i.e. enamic, cerasmart....?

They are different thicknesses in different areas... but on average probably .2mm-.4mm thick.  The margins were so thin I was shocked they milled. I just turned off the minimal thickness.

The proposals were not a major problem.  Only took maybe 10 min to design

You could likely use other materials that you mentioned.  Tetric CAD MT has esthetics that are better than those two IMO.... 


Great result!! I'm sure she was thrilled :)


Mike,

In your opinion, is Tetric CAD the material you can mill the thinnest?? (without chipping?)


On 10/29/2018 at 7:53 pm, Farhad Boltchi said...

A rookie question:

When the time comes to replace them or remove them, how do you get them off without harming the underlying enamel? That is always the hardest thing for me with bonded restorations.

Farhad​

If you had the Fotona Lightwalker instead of that Periolase, removing veneers without harming the underlying enamel would be a piece of cake.  AND you would have a superior laser for periodontal therapy.  The Lightwalker has an NdYAG and an ErYAG in one tower.  ​


On 10/30/2018 at 5:44 am, Catherine Cech said...

Mike,

In your opinion, is Tetric CAD the material you can mill the thinnest?? (without chipping?)

no...all the composite and hybrids can mill super thin


Mike- Super impressive as always.  Looks fantastic.  Do the incisal margins stop at the incisal edge or does it wrap to the lingual at all?  Any chance you have a photo of those in place from the incisal view?


Really like this case and use of the material! 

Thanks for sharing!

Sharpie


Mike... nice case! Can you mill them at no EF mode? I am curious since I do not have EF capability...


Wonderful case Mike, with strategic materials choices/manipulation - Thanks for posting!


Great case. Another tool to our "Cerec" tool box.

Also, can't say enough about how wonderful it is to in-house 3D print the models rather then using the lab.