Anteriors with CEREC can be the most rewarding type of case – or they can bring you to tears.

The best way to succeed with a multiple-unit anterior case is through proper planning. Can you get away with having a patient in your chair and on the same day prep four or eight units just designing with Biogeneric? Maybe… if you’re lucky!  

If you want to do these cases with a lot less stress and more predictability, have a game plan.

The first thing you should do is to get the patient in and decide how many units are necessary. Personally, I am not a fan of doing the anterior six. I discuss four, eight or 10 units with the patient. We look at their smile, take photos and try to determine how many are necessary based on the esthetic needs of the case and how many teeth show in the smile.

I then talk to the patient about whitening their teeth. I always recommend bleaching first, letting the teeth rehydrate and then getting the shade a few weeks later. I then like to take an impression and send it off to the lab for an ideal wax-up, a putty matrix of the wax-up, and if the alignment is really far off, I will sometimes ask for a prep guide to make sure I reduce enough for the next step. 

I schedule the patient; before I get them numb I take ‘before’ images with a DSLR. I begin by prepping all the planned teeth and then I transfer the wax-up to the mouth using the putty matrix and bisacryl. I try and use a nice light shade so it does not distract the patient if it is too dark. I have them evaluate the shape and length of the teeth and I even work out the occlusion both in centric and excursives.

 Once the patient is happy with the size and shape, and function has been adjusted, I will image the teeth in a Biogeneric copy pre-op folder. The final case will now be created using Bio copy and there are very few surprises in the outcome, especially during the design phase.

There are so many videos to help you through the design process for a quad like this, but you need to know what it takes to get to the design phase. I hate to be so cliché, but if you fail to prepare, then prepare to fail!