Anterior CEREC Time Saving Design Flow

[@silversabre75]

Hi Doc ! I am new to Cerec (acquired a second-hand BLUE CAM over lockdown) - started with single posterior cases. Your videos are truly inspirational! thank you for sharing your knowledge and guidance.

[@KlimDDS]

All the best in your journey. Thanks for your comment!!!

[@nehalzaveri7210]

You are one of the best clinicians I have seen. I took your anterior Cerec course few years ago and was amazing. I love watching your KZbin videos. Keep posting Doc!

[@KlimDDS]

You are so welcome!

[@madhurshiralkar5440]

As always, Excellent video Dr.Klim...!

[@brandontiek]

Wow doc, so happy to have found you on here! As a mid career dentist strongly considering a deep dive into the world of Cerec, I'm anxious to learn more. Thank you for your wisdom and expertise, and for raising the tide in dentistry!

[@KlimDDS]

Hi Scott, the mock-ups are accomplished in the inLab software. Wish the chairside software would let us do this. It is the Biojaw process with multiple templates to choose from in inLab, once designed and finessed, there is a virtual seat command that will make a second virtual model with the seated virtual wax-up that is then exported as a STL for printing. It is very accurate. A Siltech matrix is then formed over the printed model similar to what we do with the analogue approach.

[@karimmamdouh6246]

dear Dr Klim , greetings can we use inlab software for designing from another scanner rather than dentsply sirona by just importing the stl files from another scanner !? thx btw iam big fan for your work lloking to be a member on your site soon ...thx

[@shaniaa9287]

Really good video in information. Thank you 👍❣️

[@christinemarieleon1627]

You are so informative ! I love watching your tutorials

[@KlimDDS]

Thanks, Christine. All the best!

[@mgsmuc]

Great videos James, I like your way to teach 😀

[@KlimDDS]

Thanks Marc. All the best!

[@msc.dr.stom.fhamiti1191]

U are a very good Motivation, and Inspiration 😄😄

[@moatazmostafa1030]

Thank you Dr Klim for your informative videos I know glass ceramics are the best to use esthetically but why didn't you go for layered zirconia restoration in this case instead? Thank you in advance😊😊

[@KlimDDS]

In my hands, ceramics still have better fluorescence and conservative prep options than the newer aesthetic layered zirconia when in the smile zone, Not as critical posteriorly. Unless the zirconia is layered, it is more challenging to achieve the micro-surface texture that ceramics can bring. Another point is the e.max has on par surface toughness metrics as the newer aesthetic zirconias.

[@moatazmostafa1030]

@@KlimDDS Thank you so much😊😊 I just mentioned zirconia because I noticed some preps after root canal treatment go grey or even black so just to mask But conservatism is also essential Thank you so much dr klim..I am a big fan of you😀

[@rainaalana8596]

Dr. Klim, I love this clip! (Well, I love all of your clips.) In this video, I’m particularly interested in your new technique of masking the dark stump at the cervical and would like to give it a try in the case I’m working on. However, I don’t quite follow how exactly it’s done. 1. Do I understand correctly that you prepare the margin more subgingivally after the ceramic restoration has been fabricated to allow room for the IPS Empress Direct composite to occupy this space? If so, approx how much deeper? Is there a way to set the CAD or CAM parameters so such space is created during the fabrication of the restoration? 2. What is your reason for bonding this composite to the crown first versus just using it as the luting cement (e.g., warm this composite to reduce the viscosity)? Thank you so much for your teaching and inspiration.🙏🏻🙏🏻🙏🏻

[@KlimDDS]

Yes, the margin is dropped another 1mm after ceramic fabrication to provide room for masking. The primary impacting parameter to help block out a darker root is the spacer. However, in this case, that will not do the whole masking objective. I wanted to change the refractory index of materials to assist in the masking at the margin zone. That is for the switch to an opaque composite. The composite was bonded to the crown first rather than a warm composite technique to finish margins and polish to a high luster prior to cementation. All the best!

[@Dentistresponds]

Great vid thanks for posting. Are you able to design your prototype mock-ups using CEREC as well or are you using a traditional method? I've been doing mine lately using meshmixer and 3D printing them but having the added ability to fine tune the mock-up occlusion using CEREC's tools would be great.

[@KlimDDS]

Hi, Scott posted feed back up above. May all be well

[@andrewdvonch8]

Awesome

[@SmileInfluencers]

Who are you and why haven’t I subscribed before

[@00192ee]

Primescan question; Today i scanned the quadrant first before starting the prep and tried to add the preped tooth afterwards by scanning over it. Did not work although i was told it should! Do you have any tips? I gues its a simple trick?! Thanks alot

[@KlimDDS]

Are you on 4.61 or later version? Even though the software will auto cutout, it will take more scanning time than the manual cutout. Keep this in mind. Primescan does better than Omnicam.

[@andreniocritillo4002]

How you isolate the Express from the surface of the tooth by bonding it to the crown?

[@KlimDDS]

I am not sure I understand your question.

[@patriciaarciniega6303]

Hi I am new to cerec and I want to use the template for just a single crown #7 can you send me steps , we have a 4.6 cerec, thank you, Dr Arciniega

[@KlimDDS]

Great. Go to my online teaching site and register for online training. There are many videos that will walk you through the workflow for anterior and posterior applications. www.cadstar.org

[@nickyb.9588]

Which 3d printer do you use? And which ovens do you use?/have

[@KlimDDS]

I recommend Asiga and Sprintray Pro 55 as printers. As a clinical accessor, I have 4 zirconia and several ceramic furnaces. For Ceramics I recommend the Programat C2S and for Zirconia the SpeedFire for katana and the Programat S1 for long cycle 3Y and 4Y sintering.

[@nickyb.9588]

@@KlimDDS They thank you so much for the reply! Im a hygienist in idaho just looking into potentially starting up my own dental lab here in idaho. Just looking into the basic setup to get started as far as start up cost consumables etc. Is there a particular reason why you went with separate mills ( wet and dry) compared to say the vhf k5 wet and dry milling machine?

[@KlimDDS]

​@@nickyb.9588 Great for Idaho. I live in the Coeur da' Alene area part-time and commute to Santa Rosa. Which platform are you considering, inLab or 3Shape? With volume mills, it is better to have a separate wet and dry milling system. Switching between dry mill with zirconia to wet ceramic will create extra wear and tear due to the zirconia dust becoming moist. It is hard to clean up and will get into the system. Knowing that you are thinking of a lab environment, I definitely recommend the Asiga printer.

[@KlimDDS]

By the way, I am referring only to the Dentsply Sirona system, maybe the VHF systems handle chamber cleaning well.

[@nickyb.9588]

@@KlimDDS What a small world! No wonder why i was drawn to your videos. (Which are great btw). Ive worked in lewiston for about 11 years and commute from juliaetta. I was thinking about just setting it up in our house to start up. I havent contacted the dentists in our area yet to see if they would be interested. Just crunching numbers and helping my boss when i can at work. That makes sense. Ive been going back and forth on that for a month or two. I might end up doing to seperate sirona mills then .ive worked a little bit with that in our office with the intra oral scanner. I was considering the 3shape lab scanner as well.

[@amera77]

How long did thy last? As I only got 2 years warranty!

[@KlimDDS]

Restorations like this can last for years. Warranty is relative to the conditions of the case and risk factors that are presented.

[@amera77]

I replaced one of my veneers with one of those, now my teeth look different 🙄🙄🙄

[@KlimDDS]

It is important that one works with an office and ceramist that can establish the aesthetic objectives for the patient and clinician. Find out what the limitations are, and then work from there for the best outcome.