An implant, a couple lasers and CEREC

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May 12, 2004 at 2:23 pm #3332 Reply

kellyjblodgettdmd
Spectator

Yesterday, I thought I’d try something new (new to me, anyway). The idea was to remove the plug of tissue on top of the implant w/ the Erbium laser, due to it’s great ability to cut through fibrous tissue. The seat the restorative abutment and do any soft tissue contouring with the 810nm diode. So that’s what we did. The we took pictures w/ the CEREC cam and fabricated his crown. In two hours we went from an tissue-covered implant to a fully restored “tooth”. The patient was really happy.

Best to all.

Kelly

(Edited by kellyjblodgettdmd at 11:25 am on May 12, 2004)

May 12, 2004 at 5:33 pm #10305 Reply

Kenneth Luk
Spectator

Great work!
Is the implant replace select?

May 12, 2004 at 8:02 pm #10299 Reply

mickey frankl
Spectator

Great result
nice restoration and photos
Did you use Antagosist mode for bite?

May 13, 2004 at 4:36 pm #10294 Reply

kellyjblodgettdmd
Spectator

Thanks Ken and Mickey. It is Replace Select. And I did use the Antagonist mode for the bite.

Here’s another case I did the next day. This woman is Brazilian. She recently moved to the U.S. and has never had her implant restored. It’s been in for 3.5 years. Fortunately, we had email contact w/ her dentist in Brazil. This was a Steri-Oss 3.8mm implant. I got the correct abutment, troughed the tissue w/ the Waterlase to expose the head of the implant. We torqued down the abutment, prepped the abutment and took the CEREC photos. Again, I used the antagonist mode for the bite. She was thrilled w/ the result. It took about 2 hours start to finish. Not bad for something that used to take 6-8 weeks! (Exposure, healing abutment and lab time). With results like these and patients as happy as this woman, I just don’t understand why every dentist doesn’t use lasers and CEREC. Of course, I’m slightly biased.

Kelly

May 13, 2004 at 6:12 pm #10307 Reply

arrowsmith
Spectator

I don’t know Kelly . . . you’re making it awfully difficult to steer clear of the Cerec! Nice work my friend. I hear that Shein is to come out with a Cerec knock-off, for a whole lot less. Whaddya think?

aaroN

May 14, 2004 at 2:23 am #10306 Reply

Kenneth Luk
Spectator

Hi Kelly,
Great work!
BTW, can you stain the cerec crown ?

May 14, 2004 at 4:27 am #10297 Reply

kellyjblodgettdmd
Spectator

Thanks, Aaron and Ken.

Aaron – How are you? Great to see you on the forum again. I’ll be very interested to see the technology that Schein comes out with. Any way you cut it, the CEREC is CHEAP compared to what it costs to send stuff to a lab. People think that &#3693K over five years sounds expensive, yet their spending &#3660K/year at the lab. That’s &#36300K over five years! All of a sudden the CEREC isn’t so expensive after all. (You know I dig it!)

Ken: There is a way to stain and glaze. I’m taking a course on that in either June or July. I look forward to learning how to do it, so I can get into veneers and other anterior cases. I’ll keep you posted. The combination of the lasers and CEREC is unbeatable, in my opinion.

Talk to y’all later.

Kelly

May 14, 2004 at 6:19 am #10300 Reply

ASI
Spectator

Hi Kelly,

Nice combination indeed. Good result as well on both cases but certainly some stain work might be a good thing.

Are you using the Cerec 3-D software? How long have you had it?

Thanks for sharing.

Andrew

May 15, 2004 at 6:22 pm #10298 Reply

kellyjblodgettdmd
Spectator

Andrew, I totally agree about the staining. Next month I’m taking a class on staining which I am looking forward to. I think it will help me really dial in the esthetics. Of course, with both of these cases, the patient’s esthetic concerns weren’t very high.

I’ve had the CEREC about 2.5 months. With the 3D software, it’s very easy to pick up.

Kelly

May 17, 2004 at 12:33 am #10301 Reply

Glenn van As
Spectator

Kelly: neat stuff and well done from a documentation standpoint. Really like what you did there. Nice contacts and to be honest the crown looks better than the bridge that was there (hope that saying that is ok)

Thanks for sharing with us and the excitement you show for lasers and cerec is infectious…….thanks for posting such a nice case.

Do you have a post op radiograph to let us see how radiopaque the Cerec is?

Thanks ……..

Cool

Glenn

May 18, 2004 at 4:49 pm #10295 Reply

kellyjblodgettdmd
Spectator

Glenn – I’ll check the chart for a post-op X-ray. I think that we only took one with the abutment in place and not after cementation. The CEREC porcelain does not show up opaque, as it is porcelain. The cement underneath it does, though. Thanks for the kind words.

Kelly

May 18, 2004 at 10:17 pm #10304 Reply

John Eaton
Spectator

Kelly, great stuff. You’re pissing me off! What, now I’ve got to get a cerec too?!?

May 19, 2004 at 12:51 am #10296 Reply

kellyjblodgettdmd
Spectator

John – Great to hear from you. Hey, just think of the 179 deduction! I know you didn’t max out with the Periolase!

Kelly

December 16, 2004 at 5:35 pm #10303 Reply

Hubert
Spectator

Kelly,

very cool stuff and great documentation! I do these procedures usually without any anesthesia and Er/Yag alone, although I have CO² and or Diode should hemorhage occur. I picked up a nice hint the other day for opening up gingiva on implants: Make a semilunar incision with the shallow facing bucally and then use your abutment to push the tissue buccaly, thus gaining more tissue-volume. Proceed as ususal with making the cerec-crown ( the new form tool lets you easily add some ceramic to create a slight pressure on the gingiva to creat a smooth emergence profile). Works like a charm! I use Zimmer(Tapered Screw Vent) Implants and the new abutments that need hardly any “prepping” so the procedure usually is no longer than 1 hour. I do not stain, just a luster-like polish, finishing off with Dia-Glaze (Brasseler). Sorry, no pictures so far.
Re the Schein Unit, they still have to come up with the real thing. Being a beta-tester for Sirona, I think Cerec is still the best bet these days. Just my two cents

H.

July 7, 2005 at 7:58 pm #10293 Reply

gurleymann
Spectator

Hey guys,

I’m cerec user for several years and a new laser user.
I’ve been staing and glazing cerec crowns for about 2 years with great results. If anyone is intersted I can give specifics on the technique. Thanks for the helpful hints on using the laser . I’ve not had the oportunity to uncover an implant yet but am looking forward to it.

gurleymann
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