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Prospect Family Dental Clinical Cases

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25.01.2022 Why I love CEREC - this patient had a crown done and I hand barrelled the eMax crown prior to firing and glazing. She then disappeared for 2+ years and reappeared because another tooth broke. Hadn’t seen a dentist in that time. I spent most of the appointment admiring the soft tissue health of this tooth lol! Glad I eliminated all the undercuts and made it pretty much go straight up and down + opened the mesial contact big time so that it doesn’t become a food trap. Hopefully this lasts a long time and I have a feeling it will... CEREC has had a bad rep over the years and I put it down to in, out. There’s a steep learning curve but once you ride it you can get very predictable results.

25.01.2022 Scanning under RD

25.01.2022 Some healing photos added. I like what I’m seeing and think it’ll look better with time!

25.01.2022 22 Resin Restoration

25.01.2022 Updated with healing photos. I like what I’m seeing! Think it’ll get better with time

23.01.2022 Simple but not easy resins

22.01.2022 Simple, doesn’t mean it’s easy. Simple restoration for a 80-odd year old lady whose budget didn’t extend to an indirect (my first choice!) No staining and single shade (Estelite Sigma Quick A3) meant I could do it in a 40 min appointment. Was a balance between reducing tooth structure to have enough material and not chasing it all the way to the gingival margin - that’s always a hard call to make and I hope it was the right one in this case!... I do think this will last a long time though.

20.01.2022 Saw the patient back in for a 6 month review today and managed to get some photos. I think they are largely holding up well (especially the 22!) and there are definitely some things I’d do differently do next time. The biggest one will be to use an analogue wax up and not a printed model! You can see the grooves on the occlusals on the upper jaw. I free handed the lowers because I thought I could do it quicker this was.

18.01.2022 Had a patient present with recurrent periodontitis on the 48 and she wanted it out. At first I thought it was going to be a pretty straightforward procedure and did my usual work up with no real significance. Reflected a flap and thought the bone looked like a different colour to what I was used to - asked the patient whether she has had any tetracycline antibiotics and she went like oh yes I did! Sorry I should put it in the medical history. I’m not sure if tetracycline af...fects the hardness of bone but this was like drilling through concrete with zero flexibility in the bone. Getting this tooth out was tough! Didn’t help that the IDN was close by and the roots had crazy hooks. Also check the colour of those roots out. Certainly a memorable case for me and I hope this helps someone if they encounter a similar case sometime.

17.01.2022 I know that there are many people who say that DME works yada yada. Just like all fancy techniques such as tunnel preps and tabletop onlays I think it’s great in theory. Did a recall on a patient I did 15/16 crowns a year ago and after someone posted something about DME on DPR I thought it’ll be good to share these. This is why I usually see from DME after a couple of years. And so I redid it in CEREC which people like to dismiss as a crappy instrument I think - CEREC is not shit, DME is not the panacea, it’s all about attention to detail and knowing how to manage deep margins.

15.01.2022 This patient presented with a previous history of high acidic intake and she was not happy with the notches in her centrals. She was also keen to correct her overlapped laterals and after a lot of discussion decided that ceramic veneers would be the best fit for her (yes, ortho was discussed but she wasn’t keen at all). We first worked to control the acid erosion. We then discussed the shade and number of veneers to be placed. She wasn’t keen on pre-op whitening and wanted the minimum number of veneers to fit her current smile so we decided on doing 4 ceramic veneers. Thanks

11.01.2022 CERECs often have a reputation for being unnatural looking and ill fitting. I believe it’s garbage in, garbage out. Take some time to learn the system, have nice preps and to stain and glaze it properly and I believe you can get great results.

10.01.2022 We decided to do a free gingival graft to help this patient with the frenal pull and to improve the soft tissue quality. This was done earlier this week and I’ll post pics of follow ups when I see her for reviews. Prefer FGGs to SECTG for these sites!

08.01.2022 This patient presented because he was worried of his teeth breaking. We discussed different options to restore his teeth and decided to build his teeth back up on both the labial and palatal aspects in direct resin to protect his teeth from further erosion and to slowly transition into indirect restorations as he is able to afford it. Took records and got a wax up done. Then we fabricated a stent made of clear PVS, modifying Dr Ed Mclarens BFEP protocol to do so. We built up the second premolar to second premolar using the stent and I made sure that the areas were cleansible before sending him away. We will be getting him back in for final shaping and polishing as well as building the molars up then.

08.01.2022 12 month recall - still holding up quite nicely!

06.01.2022 Patient was worried that her lower anterior teeth were breaking and wanted something that would last her a while.

04.01.2022 Our patient was worried that her lower anterior teeth were breaking and wanted something that would last her a while. She also wanted to chew better while keeping on a budget.

03.01.2022 Sometimes a polishing tip is all you need to make a difference in your restorations