griptab crown clinical case study by dr graeme milicich
TRANSCRIPT
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Griptab Crown CaseBy Dr Graeme Milicich, BDS
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1 A 21-year-old female patient presented with a central incisor that had previously had an incisal 1/3 fracture restored with a bonded composite (Fig 1). She had suffered another blow to the tooth and the restoration and all the palatal enamel had been lost. The palatal fracture was sub-gingival and down to the bone in one area.
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2 The tooth was prepared for an E4D CAD/CAM crown and the sub-gingival margin was exposed (Fig 2) using a Waterlase MD. The bone in the region of the fracture was lowered (Fig 3 & 4) to re-establish biological width using a closed flap approach.
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An impression was taken and the patient released with a temporary crown. A model was poured and scanned into the E4D design center and a crown was designed and milled using an A1 IPS Empress multi-block
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7 The milled restoration was then contoured to create the surface micro anatomy, stained and glazed.
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8 Prior to trying in the crown, a Griptab was bonded to the incisal region of the labial surface. This was then used to control the crown while a correct shade of Variolink Veneer bonding resin was chosen using the try-in pastes. The position of the Griptab did not interfere with the selection of the correct shade of bonding resin cement.
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9 Once the correct shade had been selected, the Griptab was re-engaged with pin-tweezers and the crown removed from the tooth. The try-in paste was rinsed out prior to HF etching and silanation.
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10Immediately post-cementation, the adjacent teeth were slightly desiccated, which highlighted the white spots in the enamel.
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11A couple of minutes of rehydration began to reduce the intensity of the enamel white spots on the adjacent teeth