New approach to expedite the delivery of the final crowns for teeth requiring crown lengthening surgery: a pilot study.

BACKGROUND: The healing period from crown lengthening procedures (CLPs) often delays the final crown delivery. This study aimed to explore the feasibility of a new approach expediting the delivery of the final crowns for teeth requiring CLPs. METHODS: Teeth requiring CLPs and single-crown restorations between the canine and the second molar were included. After the initial tooth preparation, a CLP was performed. In the experimental group, the final tooth preparation and final impression were made during the CLP; the final crown was then delivered at the suture-removal appointment. In the control group, the final impression was made 8 weeks after the CLP. The level of gingival margin (GM), pocket depth (PD), and crestal bone levels (CBLs) were compared between the two groups before CLPs (T0), at delivery of the crowns (T1), and at 12 months in function (T2). RESULTS: Twenty-one lithium-disilicate crowns were delivered to 20 subjects and followed up. The mean interval between the CLPs and the delivery of crowns was 2.5 weeks for the experimental group and 12 weeks for the control group. No significant differences were observed between the two groups in the level of GM, PD, and CBLs at each time point. No significant treatment difference in crestal bone loss was observed between the two groups at T2 (Experimental = -0.11 mm, Control = -0.03 mm; p = 0.67). CONCLUSION: Making the final tooth preparation and the final impression at the CLP significantly reduced the time between the CLP and the delivery of the final crown and showed comparable clinical outcomes.

Challenges in the workflow of a digital diagnostic wax-up: a case report.

This case report demonstrates the use of digital technology to communicate with the dental laboratory during the diagnostic and fabrication phases of veneers. Digital technology has made significant advances in dentistry in the last 25 years, and there is great potential for its use in new methods for achieving excellent final restorations. One of these methods involves the use of digital technology in the diagnostic wax-up phase of dental treatment. The wax-up is a valuable, sometimes necessary tool in the cosmetic treatment plan. This esthetic preview allows the clinician to assess and adjust the function, shape, outline, and color of the restoration and to seek the patient's approval for the prosthetic design. The case reviewed in this report involved the fabrication of veneers to restore small maxillary lateral incisors. Digital scans of the existing dentition were sent to the dental laboratory with the request for a digital diagnostic wax-up. The laboratory printed 3-dimensional (3D) models and completed a conventional diagnostic wax-up. After the design was approved by the patient, the maxillary lateral incisors were prepared intraorally, the arch was digitally scanned, and the scans were sent to the dental laboratory with the request for veneer fabrication. The final restorations were made to the specifications of the digital diagnostic wax-up using computer-aided design/computer-aided manufacturing. The veneer restorations were delivered, and the patient was satisfied with the result. In this case, the dental laboratory completed a conventional diagnostic wax-up from 3D-printed models. Further software improvements might allow easier virtual alteration of existing teeth and thereby enable a fully digital workflow.