The biggest challenge I face in practice is the anterior indirect restoration.  Plain and simple they are very difficult.  It is only complicated when you are a ‘PPO Dentist’ tied by network fees.
This leaves us with a couple of choices…
1. Â Deliver aesthetic treatment at a loss.
2. Â Deliver less than excellent and justify it by the fee.
It’s not fair to be limited by these fees.  What I have been able to do is to utilize CEREC to provide the aesthetics I desire while maintaining practice profitability.  Here’s an example of a single central we completed in a single visit – about 90 minutes.
The case was done using the Biogeneric Reference mode.  This design technique ‘mirrors’ the contralateral tooth for design.  In this case we are redoing a crown on #9 and used #8 as the ‘mirror’.
Pre-Operative View
Selecting Biogeneric Reference in the Administration phase
Tooth prepared
Final design using #8 as a ‘mirror’
 Restoration ideally placed within polychromatic block.  This block has chroma near the gingivae and becomes more translucent at the incisal.
Restoration after stain and glaze. Â The stain and glaze is done directly in front of patient using her real teeth as a guide. Â A BIG ADVANTAGE!
Immediate post-op after delivery.  Note how the coloration hasn’t blended in quite yet.
Here is restoration and patient a few months later. Â After tissue healing and rehydration of the teeth look how well the restoration blends in.
Just because you participate with insurance doesn’t mean you can’t provide ‘high level’ dentistry.  I challenge you to up your game and raise the level of dentistry in your community.
