- Age: 27
- Gender: female
- Unsatisfactory restoration on 4.7 (LR7)
Total Treatment Visits
- First Visit:
Reason for visit: #47 had a root canal done with a permanent filling. It was advised to the patient that the tooth needed a crown to prevent a fracture of the tooth as it was now non-vital. A consent form was signed for a monolithic zirconia crown on tooth #47. 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 and crown lengthening was performed with Waterlase, Biolase to create the gingival margin to be at the level of the tooth preparation.
Expasyl paste was placed to retract the tissue with pressure from a contoured compressive molar formed cap to aid in packing the paste into the sulcus and to create a dry field. After a few minutes, the cap and paste was removed with air-water spray leaving a clean, dry preparation and a clearly visible margin.
The iTero scanner was used to capture the preparation of tooth #47, inclusive of 1st and 4th arches and a bite registration. The tooth was temporized with Luxatemp A1 and cemented with Flecks cement due to the continued use of the Invisalign passive aligners to prevent the unintentional removal of the temporary prior to her cementation visit.
The occlusion was adjusted and the restoration was polished. The shade for the crown was Vita A2. The case was submitted to a designated lab for fabrication.
- Second Visit:
The patient presented for cementation of the crown #47. No local was necessary for this appointment as the tooth had endodontic treatment. 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 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 #47 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. The existing Invisalign tray was cut back and the patient was re-scanned by the iTero for final Invisalign aligners.