A 25-year-old patient presented to our practice with an insufficient composite filling and secondary caries on tooth 36 (Fig. 1). Since the defective area was very large, treatment with an IPS e.max® CAD restoration was decided in order to achieve an efficient and esthetic result. After placement of the core build-up and preparation of the tooth, the tooth was scanned intraorally and a partial crown was designed (Fig. 2).
Subsequently, the non-crystallized restoration was ground and tried in to check the contact points and the fit. In order to assess the esthetic appearance and the shade effect, the characterized and fired restoration was again tried in using Variolink® Esthetic Try-In Paste Neutral (Fig. 3). During these trial placements, care was taken that the tooth was sufficiently moist to ensure a lifelike shade impression. An anatomically shaped rubber dam (OptraDam Plus) was used for absolute isolation during the final placement of the restoration (Fig. 4).
First, the enamel was etched for 15 seconds (Fig. 5), followed by the entire cavity for another 15 seconds (Fig. 5). Then, Adhese® Universal was applied onto the prepared tooth surface and dispersed with a stream of air (Fig. 6).
Special care was taken that no material pools formed at the cavity floor. Subsequently, the restoration was light-cured with a polymerization light (Bluephase® Style) for 10 seconds. To obtain an optimum bond, the IPS e.max® CAD restoration was etched with hydrofluoric acid (IPS Ceramic Etch Gel) for 20 seconds and conditioned with Monobond Plus. In a next step, Variolink® Esthetic DC was applied on the restoration, which was subsequently positioned on the tooth. After pre-polymerization of the excess material using the quarter technique (two seconds per quarter surface) (Fig. 7), the gel-like excess material could be easily removed using a scaler (Fig. 8).
Glycerine gel (Liquid Strip) was applied to prevent the formation of an inhibition layer. In a final step, each segment of the restoration was light-cured for 10 seconds (Fig. 9), the composite gap was finished and polished (Astropol) and the occlusion was checked.