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Figure 1: Tooth #9 is going to be prepped for a BruxZir crown. I
chose this case for a couple of reasons. First, tooth #8 is a natural
tooth, and it will be a good test of how the light interacts with the
BruxZir restoration versus the natural tooth. Second, tooth #7 is an
all-ceramic crown, which will be replaced later, and tooth #10 and
#11 are a PFM cantilever bridge. So, we will be able to compare
the BruxZir crown to those two restorations, as well.
Figure 2: I place PFG topical anesthetic gel (Steven’s Pharmacy;
Costa Mesa, Calif.) into the sulcus using an Ultradent syringe. I
used to use a cotton-tipped applicator, but this made it difficult to
get PFG into the sulcus. Because I am using single-tooth anesthesia
for this case, the needle is going into the sulcus, so that’s where
the topical needs to go. The tufted tip on the syringe makes it easy
to place the topical subgingivally.
Figure 3: The 30-gauge extra short needle of the STA System
(Milestone Scientific; Livingston, N.J.) is placed in the sulcus. I
prefer using the Rapid Anesthesia Technique for injections, and
a few drops of anesthetic are given as I penetrate the base of the
sulcus and contact bone. (An in-depth look at this technique is
available at www.glidewelldental.com.) I started using this technique
for single mandibular molars to avoid blocks, until I realized
patients hate anterior infiltrations just as much. So I began using
single-tooth anesthesia here, as well.
Figure 4: I use the Reverse Preparation Technique to prep the
tooth. (View a step-by-step clinical technique video online.) The
first step of this technique is to break the proximal contacts.
Because we are only preparing tooth #9, we are going to do this
with a thin 56 carbide bur on both the mesial and distal. The goal
is to break contact with the adjacent teeth just enough to place our
first retraction cord.
Photo Essay: Anterior BruxZir Solid Zirconia Crown15