A UNION OF DIGITAL TECHNOLOGY WITH CUSTOMIZED HANDS ON ESTHETICS

Background: At New York University College of Dentistry (NYUCD), we introduce predoctoral students to the use of CAD/CAM technology for creating permanent restorations during their pre-clinical training. Later, they use this knowledge when treating patients in the clinic, as indicated. Recently, Ivoclar-Vivadent released a new material that makes the procedures more efficient and more esthetically pleasing: the IPS e.max Blue Block, a monolithic lithium disilicate. The blue e.max material starts in a soft, machinable state, which is milled to create the restoration. In this soft state, the restoration is tried intraorally and finely adjusted for fit and anatomic contour. The restoration may then be custom colored. The final step is to place the restoration in a special ovent for further crystallization and strength, creating its final color, hardness and smoothness. The new material and methodology combine the efficiency of CAD/CAM technology, which allows practitioners to create a permanent restoration in one appointment, with the ability to custom fit and color the restoration. Methods: Preclinical students are taught to prepare a plastic tooth in an ideal way to receive a CAD/CAM restoration, to use the CAD/CAM system to evaluate their results and to become acquainted with machining of premade blocks into a restoration. With the material in the soft, preprocessed state, students are taught to fine tune the fit on the cast. They are instructed how to custom color and heat-treat the restoration, preparing it for final cementation. Conclusion: This procedure allows the student to learn the efficient CAD/CAM procedures and to combine them with the beauty of custom characterization of a restoration. All this is done in a single appointment, eliminating the time consuming and completely hands on procedures of a laboratory-prepared restoration.