New Infrastructure Needed, Bridge Replacement
By Gregory Mark, DDS
Sponsored by Kuraray
All patients have unique cases with various solutions, but some have the opportunity to boost their confidence without worrisome procedures. This treatment applied to one patient in specific. This patient presented a failing bridge between teeth #29-31 due to secondary decay. She was an average dental patient, having medical history within normal limits, and a dental history revealing multiple restorations.
The ideal treatment plan for this patient was to remove the existing bridge, remove the secondary decay, and fabricate a new zirconia bridge. The step-by-step procedure was done using local anesthesia. First, the existing bridge made of PFM (Porcelain Fused Metal) was removed and the secondary decay was excavated. To prepare for the crowns, a CEREC Omnicam was used to scan the patient and forward the digital imaging file via CEREC Connect to the InLab software.
Figure 1: Removable dies and model digitally designed and printed.
As we all know, restorations need manual touch and precise materials to accentuate anatomy. Therefore, the crowns were developed using KATANA STML Zirconia for the final restorative material for several reasons: this restorative material had a near identical shade, exemplified the needed strength, and was extremely easy to work with.
Figure 2: Secondary occlusal anatomy carved prior to sintering and staining.
With this material, the InLab software designed a bridge milled with an MCX5 milling unit. When the final product bridge was milled, it was placed in a Vita Zirconia oven to sinter for 8 hours. In order to bring more vitality to the restoration, and stain and glaze was utilized and additionally a diamond paste to polish the bridge.
Figure 3: Stain and glaze was utilized and additionally a diamond paste to polish the bridge.
The patient returned the following week for the final steps of the procedure. The temporary bridge was removed, and the final cementation of the restoration was conducted.
Figure 4: Buccal view post cementation.
After the fitting, the patient examined the esthetic look and occlusal feel, extremely satisfied with the results. Finally, x-rays and photos were taken, and an overall happier patient was achieved.
Figure 5: Buccal view post cementation.
Figure 6: Occlusal view post cementation.
Figure 7: BW post cementation.
I would make the connectors bigger also. The main thing is this is a one visit Katana bridge in my office. It allows us to set the connectors too. I like the one visit for anesthetic, no temporary, etc. It is about a 45 minute total mill and sinter.
On 5/25/2021 at 1:53 pm, Armin Giessmann said...The connectors look amazingly small for an STML bridge for my impression.
