Tooth In A Day: Telio CAD Immediate Case with Grafting

Here is a fun case where I finally got to use my stash of Telio Cad blocks!  I’m beta testing and all they had for me was A2.  I practice in LA where everyone has toilet bowl white teeth, so I was stoked when this rolled in.  I usually don’t immediately temporize second pre molars but this patient had a big smile and did not want a flipper so I went for it.  I did not do this case guided as the patient was worked in as an emergency and didn’t have the time.  #13 vertical root fracture.

 

Removed the tooth with peristomes and used a lance bur, which incidentally has a 2.8 mm shank diameter if you wanted to do it guided.  Took advantage of the bone apical to the socket.

 

Used a 4.2 by 13mm Legacy 3.  Great torque at 50 plus Ncm.  Good size gap on the buccal so we know we are going to graft.

CEREC and Telio CAD is perfect for immediate for a bunch of reasons.  First, we don’t have to take impressions, which means no worries about bleeding with the scan post.  We can visually see that we have taken the temp way out of occlusion. But most importantly, we don’t have any material going into the tooth socket, which can really mess with osseointegration.

 

Get your size 20 burs out, not sure if we will be using carbides in the future but for now we use the long diamonds.

 

Telio CAD is luted to the Ti-Base in the same was as Emax, except you need to use the SR Connect to bind the Multilink Abutment to the acrylic.  Got all fancy with the ochre stain and as you can see in the final, a little too fancy.

 

Ok now to manage that gap, I placed a healing cap over the internal connection just to not get the DFDBA grafting material in.  I snuck a little sliver of membrane over it and later tucked it in after the provisional was screwed in.

 

Ok, did my opaquing protocol and placed a little too much stain over the occlusal, but overall a really nice smooth case and the patient got to walk out with a tooth!

Patient return in 4 months ready for the final.  We have a Telio CAD temporary in the mouth with a Ti-base so we need to get that out.  Really easy!  Just take the restoration and put it in the furnace on the stain and glaze setting and the Telio CAD portion disintegrates.

 

Due to the temporary we have a nice tissue profile and as a result this was super easy to design.

Used Multilink abutment and try in was really easy.  Just a little adjustment to the contacts.

 

Etched/Silane.  Teflon tape and Flow it ALC opaque then .4 Opaque and a little stain.