iTero Restorative

Patient Chief Concern

First Visit:
Reason for visit:

• #36 had been heavily restored multiple times and there was a crack in tooth, transversing from buccal to lingual.
• Patient went to see endodontist for second opinion and advised patient that the crack is not deep and the tooth has a good prognosis with a crown and hence the patient should proceed.
• 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.
• The tooth was prepared for a crown and 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 a bite registration.
• The tooth was temporized with Luxatemp B1 and Fleck’s cement was used to ensure stability of the temporary until the cementation appointment three weeks later. The occlusion was adjusted and the restoration was polished. The shade for the crown was Vita B1. 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 intraoral, it was agreed to proceed with permanent cementation of the crown and a consent form was signed.
• The tooth was micro etched, along with acid etch 35% and Universal All 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.