PRODUCT TECHNIQUES
for your PRACTICE
USING SIRONA
CONNECT
TO FABRICATE
BRUXZIR
CROWNS
B Y M I C H A E L D I T O L L A , D D S , FA G D
Even though most CEREC owners prefer to
make restorations in their offices, there are
times when clinical conditions call for a labfabricated material.
In cases such as the one documented in this
column, high-strength monolithic BruxZir®
Solid Zirconia restorations (Glidewell Laboratories) were prescribed for a patient who
had chipped or broken nearly every PFM in his mouth.
Dr. Mike Skramstad, assistant director of CAD/CAM at
www.cerecdoctors.com, submitted this case to the laboratory via Sirona Connect.
FIG. 1 — The
patient’s chipped
PFMs on teeth
Nos. 4 and 5
will be replaced
with BruxZir Solid
Zirconia crowns. Note that this
patient also broke the distolingual
porcelain off the crown on tooth
No. 3.
FIG. 2 — The broken PFM crowns
were removed along with some
decay from both preps, as well
as the amalgam
on tooth No.
5. Dual-cure
resin material
was then used
to build up both
teeth.
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04. 2013 | www.DENTALECONOMICS.com
FIG. 3 — These
preparations are universal
in the sense that they
can be used for all
restorations, including IPS
e.max, PFMs, Lava (3M ESPE), NobelProcera
(Nobel Biocare), even cast gold. Unfortunately,
nearly 90% of the PFM preps we receive at the
lab are under-reduced in the gingival third.
FIG. 4 — After generating
a digital impression scan in
full color using the powderfree CEREC Omnicam, Dr.
Skramstad was able to
clearly see and mark his
margins. At the lab, we wish every case could arrive
with the margins already marked by the doctor.
FIG. 5 — These
screenshots are from the
design station at the lab.
The upper right image
shows the occlusion
intensity markings from
the virtual articulator. This
allows us to digitally dial in the occlusion prior to
milling and sintering.
FIG. 6 — Here is an
occlusal view of the two
BruxZir crowns bonded in
place. From this view, the
shade on the occlusal table
appears to be slightly lower in value than the
lingual surface of the adjacent BruxZir bridge.
FIG. 7 — The facial view of
the BruxZir crowns shows
that it blends in much
better with the adjacent
bridge. With the 1.5 mm
of occlusal reduction we received, it will be nearly
impossible for this patient to chip or fracture these
crowns.
MICHAEL DITOLLA, DDS, FAGD, is the director of clinical
research and education at Glidewell Laboratories in
Newport Beach, Calif. He lectures nationwide on both
restorative and cosmetic dentistry. Dr. DiTolla has several
free clinical programs available on DVD through Glidewell
Laboratories or online at www.glidewelldental.com.
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