I’m a dentist from Finland. I have a bit different approach to show. I work with Cerec and do all the technical work by my self.
This is one weekend makeover and Biofunctional virtual wax-up with Cerec and monolithic E-Max MT A2. This patient is suffering Sjögren’s syndrome (+some erosion) but she is higly motivated to clean her teeth. Even mouth is really dry she haven’t have any cavities for many years. Her main problem was worn composite fillings which made cleaning teeth hard. Also she had angular cheilitis because collapsed bite. Because of dry mouth there were a lot of staining and esthetics was poor. Ortho was discussed but she refused so this is what I had to play with. She came to our office from far away and stayd in hotell so we had to optimize timetable.
Plan: open vertical dimension (CR=CO) and make full crowns/Onlays and one E-max bridge with E-pontic
Treatment schedule
• Day 1: digital scanning with Cerec and clinical pictures
I did a full digital waxup and opened vertical dimension 2.1mm by using Inlab 15.1 and ordered 3d printed models. I call this Biofunctional Wax-up. This is most important step.We can design how dentist will prep the teeth and how much angulation of teeth can be changed.
• Day 2: (couple weeks after): mockup was transferred to mouth by using vacuum mold.
Patient tried her new bite during weekend and didn’t have any problems and felt good.
• Day 3+4: (8hours and 7hours) (three days after mockup transfer) Manual biocopy (CEREC) method was used to change all temporary material + old fillings to full ceramic monolithic E-max. This means that in a groups of four teeth was prepared and crowns were designed, milled, stained and bonded. This way I have same time some crowns milling, others are been crystallized and some other teeth are been prepped.
After pictures are 1 year post-op.
