CDOCS a SPEAR Company

Managing Multiple Anteriors: Part 4 Breaking up the Design


The longest part of doing multiple anterior teeth is the milling process.  If you design all the teeth at once and then mill them you have 6-10 minutes a tooth if fast milled.  The problem with fast milling on most anterior cases it the margin design will be prone to chip so you have to regular mill the restorations.  So now the 6-10 minutes goes to 8-12+ minutes.  To make it easier to accomplish a multi unit anterior case in one visit the preparation time needs to be leveraged by the milling time.  To do this I prepare one tooth then send it to the milling chamber.  I scan the provisional in Biocopy for the central incisor then remove it and finalize the preparation.

 

 

Once I cut off the area of the provisional, I polish the interproximals of the adjacent ares to give a good smooth contact that will be imaged when I do the adjacent tooth.

 

 

This helps develop proper embrasures during design.  Now for the design process,  you can use either Biocopy or Bioindividual.  You will still use the Biocopy folder that you put the provisional in even if you do Bioindividual.  The Biocopy gives you a good reference point when determining the midline and the incisal edge position.   Once you have the design done and the crown sent to the milling chamber, open a new CEREC program and image the other central incisor temporary the same way but make sure to capture the interproximal areas.  This area is then either copied if doing Biocopy or used to determine where the proximal contact needs to be on the newly designed crown.