iTero Restorative

Patient Chief Concern

• First Visit:
  Reason for visit: #36 had an existing chipped acrylic crown . Furthermore, there was a gap between the tooth and the crown due to recurrent secondary caries underneath, diagnosed both clinically and radiographically. A consent form was signed for a monolithic zirconia crown on tooth #36. A preliminary alginate impression was taken in order to fabricate a temporary after the crown preparation. 2 cc Lidocaine 2% with Epinephrine 1:100,000 was administered. The existing crown was removed and the tooth was re-prepared for the new crown. A gingivectomy was performed with Waterlase, Biolase to create the gingival margin to be at the level of the tooth preparation. After the preparation, medical ozonated air was infused over the tooth and the tooth was built up with Fuji II for more retention and light cured, Clearfill bond was applied and light cured. The iTero scanner was used to capture the preparation of tooth #36, inclusive of full arches and bite registration. The tooth was temporized with Luxatemp A1 and Fleck’s cement was used to ensure stability of the temporary until the cementation appointment three weeks later due to Invisalign trays. The occlusion was adjusted and the restoration was polished. The shade for the crown was Vita D2. The case was submitted to a designated lab for fabrication.
• Second Visit:
  The patient presented for cementation of the crown #36. No local was necessary for this appointment. The temporary was removed and the crown was tried in. It was checked for tight contacts, optimized occlusion and acceptable esthetics by the dental team and the patient. A bitewing x-ray was taken to verify the interproximal fit of the crown. Once the above criteria was met and the patient was happy with the new shade, shape and look of the crown, it was agreed to proceed with permanent cementation of the crown. The tooth was micro etched, along with acid etch 35% and Universal bond was applied to the prep, lightly air dried and light cured. The internal portion of the crown was treated with Z Prime for 1 minute. The crown was filled with Rely X Unicem Translucent, placed intraoral on the tooth #36 preparation and the cement was light cured around the margins after flossing and brushing away excess cement. Once the cement was cured, the excess was removed. Again occlusion was checked with articulating papers thin and thick for centric and balancing side contacts respectively. Our patient was very happy and comfortable, verified by phone call the following day.