Anthony Ponzio, DDS, of Oak Park, IL recently saw a 59-year-old female patient who presented with a chief complaint that she broke a tooth on the maxillary right side when she bit into an olive pit. Dr. Ponzio and his team reviewed her medical history, and it was unremarkable. Clinical evaluation revealed that the patient had fractured the mesial lingual cusp off of a full coverage restoration on tooth No. 3.
She presented with no discomfort other than the sharp edge of the fractured crown, and the tooth had a history of root canal therapy that appeared to be clinically acceptable. Periodontal probing revealed no concerns. After reviewing treatment options with the patient, she consented to replacement of the existing fractured restoration with a new, full-coverage crown.
KATANA™ Zirconia ONE SPEED
KATANA™ Zirconia ONE SPEED Crown is a fast-processing, multi-layered CAD/CAM block designed for chairside single-visit dentistry. Using proprietary zirconia powder, it achieves an ultra-fast 9-minute sintering time when paired with the CEREC SpeedFire furnace, while maintaining high strength and natural, gradated esthetics.
TREATMENT PLAN
Dr. Ponzio administered 1/2 carpule of 3% mepivacaine and proceeded to section the existing restoration as it appeared to be a bonded restoration on a root canal-treated tooth. It was removed in multiple small pieces rather than sectioning it. Due to the risk of fracture, the pieces are removed in this manner instead of using a crown spreader.
After removal of the restoration, Dr. Ponzio and his team refined the tooth preparation to ensure appropriate reduction, smooth contours, and clear margins prior to gingival retraction. They then rinsed the tooth and proceeded to take digital impressions.
Dr. Ponzio and his team elected to use KATANATM Zirconia ONE SPEED for this restoration because of its esthetics and efficiency. Shade A2 was selected. The restoration was designed in CEREC©.
software and then sent to the Primemill. The milling time for the restoration was 4 minutes and 10 seconds. After milling, they removed the sprue and pre-polished the restoration before putting it in the CEREC©. SpeedFire furnace. Thanks to the new speed cycle, the restoration was out of the
furnace in less than 10 minutes. Dr. Ponzio then performed a hygiene exam, and by the time he was back, the restoration was already cooling down. After taking a couple of minutes to cool, the team did a final polish and sandblasted the intaglio to prepare the restoration for cementation.
Dr. Ponzio tried in the crown, ensuring that the occlusion, contacts, and margins were acceptable, and then cleaned the restoration using KATANA™ Cleaner. Dr. Ponzio and his team delivered the restoration using CLEARFIL™ Universal Bond Quick 2 and PANAVIA™ SA Cement Universal because of their high bond strengths, combined with very easy cleanup. They tack cured and then removed the excess, allowing the cement to cure for 5 minutes. They checked the contacts and occlusion, took a final radiograph, and the patient was on her way.
Figure 1. Tooth No. 3 previously had an existing full-coverage restoration with RCT.
Figure 2. Fractured mesiolingual cusp.
Figure 3. KATANA™ Zirconia ONE SPEED was designed in CEREC© software.
Figure 4. KATANA™ Zirconia ONE SPEED intaglio ad margins are shown. It was in milled in CEREC© Primemill
Figure 5. KATANA™ Zirconia ONE SPEED was pre-sinter polished and post-sinter polished.
Figure 6. KATANA™ ZIrconia ONE SPEED share A2 is shown. It was seated with CLEARFIL Universal Bond Quick 2 and PANAVIA SA Cement Universal. These two products can be used together to create a stronger bond, especially in cases with short preps, because there is a special touch-cure chemistry between them.
PATIENT RESULTS
The patient was amazed at how quick and easy the process was. Also, Dr. Ponzio’s assistant and he continue to be impressed at the short furnace time without compromising esthetics or fi t. This has truly changed the game for single-visit dentistry. After it was dropped right into place, the color was true to what they hoped for.
Anthony Ponzio, DDS
Dr. Anthony Ponzio is a 2004 graduate of the University of Illinois College of Dentistry. He currently practices in Oak Park, IL with a special focus on technology in dentistry. He is also the Clinical Director of P1 Dental Partners, a DPO with offices throughout the midwest. Dr. Ponzio has been a CEREC© Basic and Advanced Trainer for more than a decade and is a key opinion leader and product evaluator for multiple companies. He serves as CDOCS Visiting Faculty at Spear Education and spent seven years on the Clinical Faculty at Midwestern University’s College of Dental Medicine, where he helped integrate CEREC© CAD/CAM technology into the curriculum. Dr. Ponzio has trained dentists and their team members from all over the world, coaching them on how to effectively integrate technology into their offices, and resulting in a vastly improved patient experience and a more productive dental practice.
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