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Predictable Cementation of All Ceramic Dental Restorations - The "Noah" Technique

teeth xray


Robert Lowe

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Crowns and Bridges,
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Creation of an ideally prepared tooth and its detail being "captured" in a master impression are critical steps in the indirect dental restorative process. All can be for naught if a meticulous delivery technique is not followed. Most indirect definitive restorations are crafted with precision on carefully trimmed dies machined with pin placement to align the preparations on the cast in the exact position relative to one another as they appear in the patient’s oral cavity. The final test of accuracy, however, is in the patient’s mouth. Many times ceramic reconstructions may appear to have perfect fit and contact on the master dies relative to one another, yet require adjustment when tried-in the patient. This is to be expected from time to time when dealing with an indirect fabrication method. It is also true that multiple adjacent restorations may appear to have perfect fit and proximal contact upon try-in only to have a slightly altered fit after cementation. This can mean a remake if the restoration is placed in an improper position and it cannot be recovered before the set of the cement. Some clinicians espouse a "multiple cementation technique" placing eight to ten restorations at one time. This can often lead to a disastrous result, if even one restoration is placed in a slightly altered position affecting the correct seating of the remaining units.