Long Span Bridge Updated with TiBase, Emax, and Cerec

This was a case that took too long for the patient!   Not the treatment itself, but the overall treatment time.  We felt so bad for her as she had health issues arise during treatment that had to put things on hold.

Luckily, we made her a provisional that would last!  The bridge was taken off and the recurrent caries can be seen.   Instead of making her the typical hand-made provisional, we milled her provisional with Ivoclar-Vivadent’s TelioCAD material, a bis-acrylic.   These provisionals can last a long time, just as in this case!   It took nearly two years to get her chemo completed, bone grafts, and implant integration before we could finally restore!  The TelioCAD held up beautifully, and could be easily modified during the various surgical procedures.

When she was ready for the restorative to finally complete, we scanned her with the corresponding Scan Posts for the TiBases.   Designed the restorations and then “split” them into an abutment and a separate crown.   You can see how well the two pieces fit together in the “blue stage.”

 

The restorations were fired to complete the Emax crystallization process.   The abutment portion was then bonded to the Sirona TiBase with Multilink and screw-retained in the mouth.  All the crowns were then cemented in place.   I only wish that the second molar looked more like a normal second molar!  However, it was an unusual size to begin with, and it had a strong mesial angulation.   In order to get a broad contact between it and the first molar implant crown, it morphed the shape into something “unique!”   But, that is the fun with digital restorative design with CEREC!   Total customization!