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Inside Dentistry
August 2016
Volume 12, Issue 8
Peer-Reviewed

Clinical Case

A 58-year-old man presented with a large disto-occlusal amalgam on tooth No. 13, with thermal and pressure sensitivity (Figure 3 and Figure 4). A full-coverage crown was proposed because of the large amalgam and the presence of a mesio-lingual fracture in the tooth.

A local anesthetic (Articadent, Dentsply Sirona Restorative) was administered. The amalgam was removed and the tooth was prepared for a monolithic zirconia restoration. This ceramic was selected because of the patient’s heavy occlusal wear and because this tooth was the primary posterior tooth of mastication on his left side. A double-zero retraction cord was soaked in aluminum chloride and placed around the marginal area of the preparation that was subgingival (Figure 5).

The preparation had lingering moisture, and Aquasil Ultra+ fast set XLV was dispensed around the prepared tooth while the Aquasil Ultra+ heavy-body tray material was loaded in the tray. The fast-set material has an intraoral working time of 35 seconds, and the mouth removal time is 2 minutes and 30 seconds from the time of mix. A clear impression with marginal detail was obtained (Figure 6).

A provisional (Integrity, Dentsply Sirona Restorative) was fabricated from a preoperative impression. The preparation was cleaned and disinfected with chlorhexidine, then lightly air-dried. Provisional cement (Integrity TempGrip, Dentsply Sirona Restorative) was then placed, the provisional was cemented, and excess cement cleaned off.

A solid (monolithic) zirconia was fabricated. The provisional was removed and the monolithic zirconia crown was tried in without cement to verify the marginal fit and occlusion. Because of the precision of the Aquasil Ultra+ there were no occlusal adjustments and the marginal fit was highly accurate. The cementation process took less than 15 minutes. The final restoration is shown in Figure 7.

Conclusion

Crown-and-bridge is an integral part of any dental practice. Trying to manage moisture and tissue in a hostile environment like the oral cavity can be challenging. Aquasil Ultra+ has been designed with this clinical need in mind. An impression material that is easy to work with and provides increased accuracy and efficiency benefits clinicians as well as patients.

References

1. American Dental Association. 2010 Survey of Dental Practice – Income from the Private Practice of Dentistry. Chicago, IL: American Dental Association; 2010.

2. Strategic Data Marketing 2016.

3. Magne P, Mahallati R, Bazos P, So WS. Direct dentin bonding technique sensitivity when using air/suction drying steps. J Esthet Restor Dent. 2008; 20(2): 130-138.

4. Dentsply Sirona Restorative. In-vitro testing results. 2016.

About the Author

Stephen D. Poss, DDS
Clinical Director of Live
Patient Esthetic Programs
The Center for Exceptional Practices
Cleveland, Ohio
Private Practice
Brentwood, Tennessee

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