CATEGORY AUSTRALASIAN DENTIST 67 LINICAL Once design stages are complete and the design is correct from an occlusal interproximal and morphological standpoint and dynamic occlusion had been assessed and adjusted using the virtual articulator, the crown is nested in preparation for milling and the block loaded into the DGShape DWX-42W in the correct position. Fig. 8 (i, ii), Fig. 9 Following milling the restoration is cut off the reduce sprue and the remaining sprue smoothed. The restoration is then glazed stained and fired on a fifteen-minute firing cycle and allowed to cool. The restoration is tried in the mouth to confirm fit. Fig. 10 (i, ii) The restoration is seated and flash cured. Any excess removed and the contacts flossed prior to full curing. A final cure of the margins is carried out for sixty seconds on all accessible margins with a glycerine gel covering to eliminate the oxygen inhibition layer. Fig. 12 Fig. 7 (ii) Fig. 10 (i) Fig. 12 Fig. 13 Fig. 10 (ii) Fig. 11 (i) Fig. 11 (ii) Fig. 8 (i) Fig. 8 (ii) Fig. 9 The fit surface of the restoration is then prepared with Ivoclar Vivadent Monobond Etch and Prime. The tooth is isolated with rubber dam and the tooth surface prepared through sandblasting using 29-micron aluminium oxide and acid etching with 37% phosphoric acid etchant gel. Fig. 11 (i, ii) The prepared restoration is then bonded to the tooth using 3M Scotchbond universal applied twice and air thinned and left uncured, the fit surface of the restoration was loaded with 3M Rely-x Unicem. The rubber dam is removed, then static and dynamic occlusion are checked. No adjustment was necessary. Fig. 13 Case timeline Conclusion This case as completed in one day in a single appointment over the duration of two and a half hours. The initial prep and scan were completed in around 50 minutes, the design took 10-15 minutes and the milling was completed in 20-25 minutes. Glazing and firing took 20 minutes and half an hour was allowed for placement of the rubber dam and bonding of the restoration to the tooth. The use of the 3Shape TRIOS scanner and the TRIOS Design Studio software as a continuous and seamless workflow, along withthedirect integrationwiththeDGShape makes for a very easy and predictable option for in-house manufacture and same day crown workflow. The update to allow use of TRIOS Patient Specific Motion makes this kind of case even more predictable as the patients actual excursive and protrusive movements can be utilised rather than a virtual articulator. u
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