The “Poor Man’s” CEREC Crown

Introduction to the case

I posted this technique before but wanted to show it with a little more detail: link to technique.

#3 has distal decay, existing large MO filling, separate buccal and lingual amalgam fillings and some ugly looking cracks. Tooth is periodontally involved and is also unopposed. What do you do for this tooth? In my view it’s only value is for esthetics unless she opts to restore the bottom. Considering that and the perio, I hate to recommend an expensive crown. I would also hate to try an MODBLXYZ filling. This is the perfect scenario for the poor man’s cerec crown.

  • 1. Preop dual arch impression.

  • 2. Remove all decay and old restorative – in this case that didn’t leave me with much othere than a few thin cusp tips.

  • 3. Prep for full coverage staying supra G where possible and preparing a nice readable should margin and smooth edges- much like a cerec prep.

  • 4. Using the impression, place dual cured composite (I use Injectafill) in the tooth site just as you would to make temporary.

  • 5. Remove at exactly 1:30 sec.

  • 6. Allow to self cure or hit it with light.

  • 7. Trim as you would a temp- gotta get this part right becaus this is the definitive restoration. You can leave a little excess buccal and lingual as you’ll have access to finish the margins.

  • 8. Try in and verify fit.

  • 9. Sandblast internal.

  • 10. Bond as you would any other composite/all ceramic crown.

  • 11. Clean excess, finish margins, adjust occlusion (shouldn’t be much to adjust given that it is identical to their original tooth.


First Margin Elevation Case

Introduction to the case

I’ve taken a number of courses and have seen some great cases on here with margin elevation, so I found a case worthy of trying my hand at it. I would really like some feedback for those of you who’ve done a number of these. The patient had mild sensitivity on the gingiva for a few days but said it has felt fine since.

Overall I thought the tissue looked pretty good considering. I bonded on an emax crown and the margin height made the process easy and ensured complete isolation.

We ran out of time so no final crown pic or XR.


Replacing an Over-Contoured Crown: Lessons Learned

Introduction to the case

Replaced a failing, over-contoured crown. Was overall happy, that the case is holding up and the patient has maintained their perio regime (for the most part).

Lessons learned:

  • 1. Use of resin based temp cement especially with thin bis-acryl temporaries.

  • 2. Better communication with the lab. I had only sent them one pic. Now I send a lot more info to the lab. And most importantly…

  • 3. Minimize the prep to maximize enamel, especially with a non-discolored stump and when using lithium disilicate (and a bonding protocol for cementation).


Four e.max Crowns to Fix Transposed Canine

Lewis Chen

Dental Student

Columbia University


Introduction to the case

43 year old female presented with chief complaint of “I need to fix my smile, I have a wedding to attend in August (in 3 months)”. Patient had generalized moderate chronic perio, decided to not pursue ortho tx. Initially, we decided to exo canine in lateral incisor position, and create a 4 unit FPD 8-9-x-“11”. After FPD and the wedding, we will proceed forward with endo and PCC on #9. However, due to careful preparation, we managed to preserve the teeth, avoid the extraction, and altered the treatment plan to four emax crowns.