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Figure 20: The #00 bottom cord provides about 0.5 mm of vertical retraction of the tissue. This retraction allows us to prep the gingival margin right at the free margin of the gingiva, knowing that when the #00 cord is removed, we will end up with a margin that is slightly subgingival. Even though we have many esthetic choices for anterior crowns, I still prefer to hide my margin just slightly subgingival. Figure 21: I use the 801-021 round diamond bur from the Reverse Preparation Set (Axis Dental) to cut a half-circle into the gingival third of the tooth. This half-circle is the formation for the perfect margin. After we do the axial reduction, we will be left with a perfect quarter-circle, which will end up being our deep chamfer or shallow shoulder. Not only do we end up with a simple, nearly perfect margin, but we also ensure that we reduce enough in the gingival third, an area that is typically under-reduced. 20 Figure 22: I then take the 801-021 round bur and trace it around the gingival margin on the lingual as well. BruxZir crowns work with feather-edge margins, so I don’t necessarily have to do this, but because most of our dentists would use IPS e.max ® (Ivoclar Vivadent; Amherst N.Y.) in a situation like this, this technique will provide a great margin for either restoration. As this round bur is typically too large to fit interproximally, I take the bur from mesial contact to distal contact. I will connect the facial and lingual round bur cuts later with an 856-025 diamond (Axis Dental). 21 22 22 www.chairsidemagazine.com
Figure 23: I make my next depth cut to ensure adequate incisal reduction. I use the MADC-020 bur (Axis Dental) to place 2 mm depth cuts in the incisal edge of tooth #8. This 2 mm of reduction will give the technician a good opportunity to build an esthetic, strong incisal edge. It also helps to keep the final restoration from being too far to the facial, aka too “bucky.” However, if you are planning on adding some length to the central (0.5 mm for example) you only need to reduce 1.5 mm to give your technician 2 mm of space. 23 Figure 24: I now switch to the MADC-015 bur (Axis Dental), which gives me a self-limiting depth cut of 1.5 mm. I turn the handpiece so that it is perpendicular to the facial surface of the tooth and place a 1.5 mm depth cut at the junction of the incisal and middle thirds. The placement of this depth cut ensures that there will be enough facial reduction to enable the technician to create a flat facial profile on the final crown. When crowns are too “fat” facially, they will never blend in naturally with the surrounding natural dentition. 24 Figure 25: At this point, all of the depth cuts are in place. We can see the half-circle in the gingival third that is approximately 1 mm deep. The 1.5 mm depth cut is at the junction of the incisal third and the middle third, and the 2 mm depth cuts in the incisal edge are there as well. The beauty of these depth cuts is that there is no guessing whether we have reduced enough — we simply prep until the depth cuts are no longer present. Once you break through the enamel surface with a diamond, it becomes very difficult to judge how much you have reduced. I have not found an easier way to prep teeth than with depth cuts. 25 Photo Essay: The Pursuit of BruxZir Anterior Esthetics23
Page 1: Chairside® A Publication of Glidew
Page 4 and 5: Contents 49 Case Report: The Creati
Page 6 and 7: Letters to the Editor Dear Dr. DiTo
Page 8 and 9: Contributors Michael C. DiTolla, DD
Page 10 and 11: Numbers by the 2 26% Percentage of
Page 12 and 13: Dr. DiTolla’s CLINICAL TIPS PRODU
Page 14: Dr. DiTolla’s CLINICAL TIPS PRODU
Page 17 and 18: Photo Essay The Pursuit of BruxZir
Page 19 and 20: Figure 5: This is the shade taken f
Page 21 and 22: Figure 11: Because of the pressure
Page 23: Figure 17: On the lingual, I cut th
Page 27 and 28: Figure 29: Toward the end of the pr
Page 29 and 30: Figure 35: The next step of the Rev
Page 31 and 32: Figure 41: The bottom cord provides
Page 33 and 34: Figure 47: The BruxZir crowns fit w
Page 35: Figure 53: I fill the BruxZir crown
Page 39 and 40: Interview with Dr. Dan Fischer - IN
Page 41 and 42: give you one-fourth to one-half tha
Page 43 and 44: ourselves darn hard, it’s still n
Page 45: one job I can think of in Western c
Page 48 and 49: In late 2010, Straumann introduced
Page 50 and 51: Our last step was to select Glidewe
Page 52 and 53: Strassler has written extensively o
Page 54: Dr. Len Boksman formerly was direct
Page 57 and 58: SPEED DENTISTRY Fast Is Better —
Page 59 and 60: apidly would lead to more mistakes
Page 61 and 62: 7. Move faster and have your staff
Page 63: There is no one method for speed de
Page 66 and 67: centrals at the current length or s
Page 68: Retraction cord was used to gently

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