Fig. 13: Alternating Cured Composites Fig. 16: Pre-op, Retracted Bite Fig. 15: Post-Op Bonding types, this approach utilizes both diagnostic waxups and injection molding composites. Then, things are taken a step further and an in-office mill is utilized for indirect restorations. Similar to previous cases, this patient suffered from wear, chipping and flattening of the teeth. (Fig.16) A “trial smile” was first performed to assess the viability of a restorative-only solution. The VDO was then raised and the teeth transitionally restored via compos-ite bonding using an injection mold approach. (Fig. 17) Once the occlusion, VDO and esthetics were acceptable, the upper arch was prepared for indirect restorations. In this case, Emax blocks (Ivoclar Vivadent Inc, Amherst, NY) were milled on a Ceramill Motion 2 mill (Amann Girrbach North America, Charlotte, NC). (Fig. 18) This approach allowed for a staged approach to restore function and esthetics. It should be noted Fig. 14: G Aenial Universal Injectable Composite Fig. 17: Composite Addition Guide that we converted the lower arch to indirects two years later. (Fig. 19) Technology has been called the great equalizer and for good reason. Never before has digital workflows in dentistry been more accessible, more efficient and more affordable for the general practitioner. This article only scratches the surface of leveraging this power in multidisci-plinary care. The fabrication of other applications such as in-house aligners, indirect bonding trays, dentures, surgical guides for implants, full arch hybrids, splints and nightguards, just further shows how powerful this technology is and how transformative it can be in how we deliver patient care. An alternating tooth bonding approach is used for ease of placement and clean up. The composite used G Aenial Universal Injectable (GC America Inc, Alsip, IL) (Figs. 11-15) This procedure is great for practi-tioners who provide orthodontics as it allows for a very efficient and low cost way to offer esthetic enhancements post-orthodontics to the patient. It also allows for easier management of multidisciplinary care. Case Type 3: The Staged Full Mouth Rehabilitation Building on the first two case Fig. 18: Milled Emax Crowns on model Fig. 19: Post op Upper Indirects 14 Fall 2022 JAOS
Journal of the American Orthodontic Society Fall 2022: Page 14
