Biocopy and Vita Triluxe
Happy Friday all,
And GO Dawgs!!!! 
Wanted to post this case we did right before the holidays. Patient presented to the office with a failing filling we had done about 2 years ago. At that time I had informed her that it would be a temporary fix due to size of the restoration and how much tooth structure destruction the decay had caused. When she presented the composite had debonded and informed her it was time for full coverage. She has several other issues going on, but she is a "come in when something hurts or breaks patient." I find that with CEREC we can treat these patients on the same day and give them what they want (single visit emergency treatment) since she is not seeking comprehensive treatment.
Since the facial surface of the tooth is in decent shape, meaning I can copy the line angles, it gives me a great starting point for contouring. Biocopy in 4.5.2 has be great so I have been using it more and more in these scenarios. There is a lot less design time for me in these instances.
Preop Condition showing failing composites on mesial and distal:
Shade selection: when I'm looking at teeth I try and look at surrounding teeth and contralateral tooth. I see 3 clear zones in the teeth with a significant area of translucency at the incisal. Vita Triluxe and eMax would be on the list for my choices. You could use empress multi, but I think all of us have favorite materials for anteriors. Vita Triluxe 2M1 selected.
Preparation was very conservative trying to follow 3 plane reduction. Also, if find sometimes dentists will not prep subgingival at the interproximal areas. If you want to get good emergence in my opinion you have to do this. Now there are a lot of factors: bone level, tissue health, spacing, etc... But keeping the prep above the tissue in these areas will not create a great emergence. 
Immediate Delivery. Don't worry tissue will fill it. As Mike says, biology will win. My assistant did all the characterization. I still like to do the contouring, prepolishing, and post polishing. I thought she went a little too much with the white but it turned out great I think. 
Final Pics After 8 days showing great tissue response: 
Overall good outcome. I know I missed that mesial line angle. Saw it after I was loading the photos. Best advice that was given to me was to take photos of cases if you want to improve. You will see so much that you don't catch in that moment.
Everyone Stay Warm.....
Oh, and did I say GOOOOOOOO Dawgs!!!!!! My heart finally recovered after Monday, ready to go now....
I couldn't agree any more about taking photos. The more I take the more I learn and I see things I never saw before. I also think we as dentists are our own worst critics. Great result!
Sweet case -- Nice Job. I'm thinking the patient was thrilled
The only questionable thing might be your comments about the DAWGS!
But good luck next week against BAMA. I'll be on your sideline for that one
Real nice. I have been using Biocopy much more of late. I don't copy the whole tooth, just the nice contours I want to duplicate.
Beautiful work Tom! That really looks natural and blends into the surrounding teeth. Great photography.
Great work Tom! And yes...if I can encourage everyone to take photos. It’s humbling but if you actually take the time to look and be honest with yourself, you’ll get better
Thanks everyone. I wouldn’t say my photography is great when you see Yao-Lin’s day in and day out. My photography improved when I started using a dual point flash. Knocks out the glare and really helps with seeing definition of the teeth. Labs appreciate it as well.
Beautiful work Tom. Photos make a world of difference. Sometimes it’s hard to find the time but this is something we are working on in 2018.
And despite being a Tigers fan, I do like Georgia. Not a fan of bama.
Go Dawgs!!
