Chairside Workflow for In-Office Milled Crowns

Contents:

• Advantages of CEREC in-office milled crowns
• Overview of digital in-office milling workflow with CEREC
• Delegating steps in the workflow
• Efficiencies that can be gained with in-office manufacturing
• Deliver high-strength, esthetic in-office milled crowns efficiently with help from Dentsply Sirona

Developments in equipment, software, dental ceramics and adhesion technology have given clinicians the ability to process (scan, design, mill, fire and finish) indirect restorations in-office, making single-visit dentistry popular among both clinicians and patients. 

Advantages of CEREC in-office milled crowns

• Produce premium restorations easier, faster, and more precisely.
• Deliver crowns in a single-visit
• Increase in case acceptance¹

¹2022 Global Exevia Chairside Milling Study N=450 For more information, contactConsumables-Data-Requests@dentsplysirona.com

5. Manufacturing: When the design is done, the software automatically positions the restoration in the block. With one click, the user can now send the job to the milling unit – all required information about the block has already been entered during the administration phase. After manufacturing, the restoration can easily be removed from the block and finalized.  Depending on the chosen material, the restoration will either need to be sintered (zirconium oxides) or glazed (glass ceramics) to achieve the desired strength and esthetics.  Refer to the specific Instructions for use for the restorative material selected.

6. Cementation: The method used depends on the thickness of the restoration and the material used. Refer to the specific Instructions for Use for the restorative material selected. For lithium disilicate and zirconia, conditioning of the restoration’s inner surface is required before cementation. 

Delegating steps in the workflow  

Within the phases of the CEREC workflow, here are some steps that often can be delegated to a dental assistant:

• Entry of all information during the administrative phase.  
• Conducting the scan of the patient’s dentition.
• Showing and discussing the (initial) design of the crown with patients.
• Inserting the block with all necessary information such as the block size or color, to the milling unit.
• Overseeing the milling process, including separating milled restorations from the residual block material.
• Managing the sintering and/or glazing process, depending on the  material.

Depending on what a dental assistant/Expanded Function Dental Assistant (EFDA) is permitted to do in the state or country where you practice, and your philosophy, it may be possible to delegate soft tissue management, scans, and/or crown cementation.

The information provided herein does not, and is not intended to, constitute legal advice; instead, all information, content and materials are available for general informational purposes only.

Efficiencies that can be gained with in-office manufacturing  

In-office milling of single-unit crowns increases efficiency. For the office, efficiencies include the following:

• Elimination of provisional restorations - this obviously eliminates the possibility of failures and remakes, as well as situations where a patient wears a provisional for extended periods of time instead of returning for the final restoration at the recommended time.
• Physical models and dies are not needed, nor impression disinfection/transportation as there is a digital model.
• Turnover time is shortened to a single-patient visit
• In-office CEREC workflow single-unit crowns can be delivered in about an hour, with quick chairside milling and firing processes.
• Devices designed for a seamless transfer and documentation of data throughout the entire workflow.
• Scheduling is simplified:
  - A second appointment is not needed to seat the crown
  - An unanticipated visit for a second provisional is eliminated.
  - Immediate scan evaluation leads to early recognition of errors in scans, preparations correction (if needed) and an immediate retake.

Leveraging properly trained auxiliary staff by delegating steps in the workflow can further lead to improved practice efficiency.

The CEREC digital chairside workflow can also lead to greater patient experience. For patients, reduced overall chair time, reduced time for digital scans compared to analog impressions (and greater comfort), no travel or time required for a second visit for a crown seating appointment are efficiencies that patients appreciate.

It’s easy to see why clinicians are increasingly using in-house milling solutions to fabricate in-office crowns and why patients appreciate single-visit crowns!

Deliver high-strength, esthetic in-office milled crowns efficiently with help from Dentsply Sirona  

Here at Dentsply Sirona we want to support you with products that help you efficiently deliver strong, esthetic and durable restorations.

Last but not least, efficient, and reliable cementation with easy clean-up  is essential. Calibra^® Ceram is an adhesive resin cement formulated for maximum strength, making it ideal for glass ceramics like CEREC Tessera^™ blocks. This fluoride-containing cement can be light-cured, self-cured or dual-cured. Simplified, reliable cementation is designed in, with a rapid 5-second tack cure and a 45-second gel phase for easy clean-up. When used with Dentsply Sirona’s Prime&Bond active^® adhesive, no primer is needed, and superior strength is obtained.^*

^{* When compared to 3M RelyX Ultimate Resin Automix Cement and Ivoclar MultiLink Dental Luting Material.} 

Dentsply Sirona’s Calibra^® Universal cement is ideal for zirconia like CEREC MTL^™ Zirconia blocks. It is a two-component, dual-cure, high strength self-adhesive cement which contains fluoride. Calibra®  Universal combines esthetic shading with a self-etching adhesive, making it suitable for the permanent cementation of metal, PFM, resin/composite, ceramic and porcelain inlays, onlays, crowns and bridges and endodontic posts without application of a separate dentin/enamel adhesive bonding agent/system. It is the simple choice for successful results and no need for additional etchant or adhesive. With its wide tack-cure window of up to 10 seconds and an extended 45-second gel-phase, Calibra®  Universal cement ensures an easy, stress-free cleanup for all.  

At Dentsply Sirona, we want to support you further with our entire Online Dental Academy complete with webinars, how-to videos, and real-world examples on how to create streamlined solutions with efficient procedures and even greater patient satisfaction. Contact us now and let’s get started!