Procedures for Preparing, Staining, and Cementing in Chairside CAD/CAM Dentistry: A Case Report
Sameer Puri, DDS
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This case study describes the clinical procedure involved in the use of a chairside CAD/CAM system. Upon completion of this case study, the reader should:
- Understand the benefits of working with a chairside CAD/CAM system.
- Recognize the significance of proper preparation design an digital impression capture on restorative success.
When used appropriately, direct resin procedures provide acceptable clinical results. Nevertheless, as the size of the preparation design increases and a large bulk of composite is used, a greater amount of cuspal deflection and deformation will occur within the tooth. The author recommends direct restorations be used for small or medium carious lesions and that indirect restorations should be used for restoring larger lesions or when cuspal replacement is involved.
There are numerous CAD/CAM protocols available on the market enabling practitioners to provide metal-free, aesthetic, indirect restorations. These CAD systems range from laboratory systems to chairside systems. With laboratory systems, a traditional impression is made and forwarded to the laboratory. The laboratory pours the model and scans dies using the system’s scanner. A coping is then designed on the computer and fabricated using the system’s milling chamber. The laboratory technician then layers the final porcelain on the coping material and returns the restoration to the clinician.
Chairside CAD/CAM systems work in a different manner. The tooth is prepared by the clinician in the traditional manner, but instead of a traditional polyvinyl or hydrocolloid impression, a digital scan is taken of the tooth chairside. The restoration (eg, inlay, onlay, crown, or veneer) is then designed, milled, and cemented on the tooth all in a single visit.
Ceramic reconstruction has proven to be a viable and substantiated clinical technique with acceptable clinical margins as well as enhanced aesthetics when the restorations are stained and glazed by the practitioner. By placing the final restoration on the tooth, the benefits of sealing the tooth immediately can be realized for decreased postoperative sensitivity and increased comfort for the patient.
*Director of CAD/CAM, Scottsdale Center for Dentistry, Scottsdale, Arizona; private practice, Tarzana, California.
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