What's on my chair for posterior CAD/CAM restorations

By Theresa Pablos, DrBicuspid.com editor in chief

August 17, 2021 -- Chances are, you don't get to see how the dentist next door practices -- or the materials he or she uses. That's why we created What's on My Chair, a new series in which dentists share the tools and techniques they use to perform modern dental procedures.

In this episode, Dr. Steven Gold takes us behind the scenes at the Western University of Health Sciences College of Dental Medicine, where he is an assistant professor and coordinator of digital dentistry. Below are the tools Gold uses for prepping and placing posterior CAD/CAM restorations -- and teaching dental students how to do so, too.

Preparation and placement

  • Topical anesthetic (LolliCaine, Centrix)
  • Local anesthetic (lidocaine)
  • Rubber dam
  • Hand instruments (Hu-Friedy): mirror, explorer, cotton pliers, periodontal probe, No. 10 hatchet, composite placement instrument
  • Knotted retraction knitted cord pack (Ultrapak, Ultradent)
  • Bur block (Brasseler USA): cutting burs, 245 carbide bur, medium and fine grit tapered flat-head diamond burs, two "football-shaped" diamond burs, tapered diamond bur
  • Composite materials: phosphoric acid etch, light-cure dental adhesive (OptiBond FL, Kerr), flowable composite (Revolution Formula 2, Kerr), or standard composite (Herculite Ultra Enamel A2 composite, Kerr)
  • Adjustment materials: shimstock, articulating paper

CAD/CAM process

  • Intraoral scanner (Planmeca Emerald S, Planmeca)
  • CAD/CAM software (Planmeca Romexis, Planmeca)
  • Dental isolation system (Isodry, Zyris)
  • Lip and cheek retractor (OptraGate, Ivoclar Vivadent)
  • Mill (Planmeca PlanMill 40, Planmeca)
  • Glass ceramic (IPS e.max CAD, Ivoclar Vivadent)
  • Oven (Programat, Ivoclar Vivadent)

Placement

  • Hydrofluoric acid
  • Cup with gauze and rubber band
  • Small object handle (Pic-N-Stic, Pulpdent)
  • Silane primer
  • Rubber dam
  • Bur block (Brasseler USA): cutting burs, 245 carbide bur, medium and fine grit tapered flat-head diamond burs, two "football-shaped" diamond burs, tapered diamond bur
  • Try-in paste (Variolink Esthetic, Ivoclar Vivadent)
  • Cementation: phosphoric acid etch, light-cure dental adhesive (OptiBond FL, Kerr), dual-cured composite (Variolink Esthetic DC, Ivoclar Vivadent), curing light (Valo, Ultradent)
  • Microabrasion sandblaster (MicroEtcher, Danville Materials)
  • Cement cleaners: Gum Stimulator (Sunstar), Gum Proxabrush (Sunstar), dental floss
  • Polishing kit
  • No. 12 and No. 5 scalpel blades

It's a long list of products, but there's one thing you don't see on Gold's list -- a lab slip. While Gold typically places his posterior CAD/CAM restorations in multiple visits, dentists practicing in a private clinic can complete the entire workflow in just one day, he said.

See the video below to see how Gold uses the materials in his day-to-day workflow at the Western University of Health Sciences.

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What do you want to see next on What's on My Chair? Contact Theresa Pablos to let us know what topics you'd like to see in the future.


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