Utilizing Dentsply Sirona’s Single-Unit Crown Total Practice Solution™
The two most common procedures in my clinical practice are direct posterior resins and single-unit crowns. Despite the high frequency that my team and I complete these restorations, I am always looking for increased efficiency, not only through time savings, but also in procedure reliability. Pointedly, it is not enough for a new technique or material to allow me to work more quickly, it also must simplify the procedure and consistently equate to better outcomes.
The procedure for single-unit crown restorations can be broken up into several procedural elements. Anesthesia, preparation, and tissue management are all vital, but the next steps and the products required help bridge the gap between the first and second patient visit, and ultimately to clinical success. To help simplify and streamline the techniques, Dentsply Sirona has designed the Single-Unit Crown Total Practice Solution™ with aligned products to help dentists fabricate and cement excellent provisional restorations, record accurate final impressions, and de-stress definitive cementation
When I sit down with the patient to begin the single-unit crown procedure in my office, my two goals for the appointment are to record a precise final impression and to fabricate a well-fitting and well-marginated provisional restoration. Prior to beginning the preparation AlginX™ Alginate Alternative material is used in a closed-bite tray to fabricate a matrix. In this case, AlginX is used to create a detailed pattern impression that will be used to fabricate a provisional restoration, but also can be stored long-term in case the patient breaks or loses the restoration. After completing the tooth preparation, Integrity® Multi-Cure Temporary Crown & Bridge Material is dispensed into the matrix and reseated into the mouth. Ninety-seconds later the matrix is removed with the still-setting provisional inside. This is usually a time that dentists must wait several minutes for final set of the provisional material, however Integrity Multi-Cure can be light cured for twenty-seconds to facilitate final set and immediate trimming.
The latest generation of Aquasil® Ultra+ Smart Wetting® Impression Material is then used to create a precise and error-free final impression because it offers three important clinical benefits: market-leading tear strength, improved hydrophilicity for detail reproduction, and several viscosity and timing options for any clinical situation. Finally, the provisional is cemented with Integrity® Tempgrip Temporary Crown & Bridge Cement which is designed to provide strong retention in the presence of natural moisture for decreased post-operative sensitivity.
The goal of the second visit is to definitely cement the final restoration. The choice of cement can depend on factors such as prep design, crown material, and esthetics, but in most cases a self-adhesive resin is an appropriate option. To minimize the stress of cementation, Calibra® Universal Self-Adhesive Resin Cement is used because it provides the strength of resin and features an extended gel phase for easier cleanup.
In my office, we are able to do better dentistry by sticking to a predictable and reliable formula. The Dentsply Sirona Total Practice Solution provides high-performance products at every step to help me create consistently excellent restorations for my patients that will last for years to come.
Scott C. Dickinson, DMD, maintains an active general practice in Pensacola, Florida. He graduated from the University of Pennsylvania School Of Dental Medicine and completed his AEGD in the United States Army.
- Figure 1: AlginX Alginate Alternative Material is used in a closed-bite tray to create a matrix impression that will be used as a pattern for fabrication of the provisional crown restoration
- Figure 2: Preparation of tooth No. 3 is completed
- Figure 3: The AlginX matrix impression is filled with Integrity Multi-Cure Crown and Bridge Material and re-seated in the mouth for 90 seconds.
- Figure 4: After 90 seconds the impression is removed with the setting Integrity Multi-Cure still inside the matrix. Final set of the material can be accelerated by light curing the material for 20 seconds.
- Figure 5: The final impression is recorded by syringing Aquasil Ultra+ XLV Fast Set wash material around tooth No. 3 using the digit Targeted Delivery System. Note, syringe the wash material from the margins to occlusal/incisal surface, keeping the syringe tip within impression material during delivery and push material forward while moving around the tooth.
- Figure 6: Evaluating the final Aquasil Ultra+ final impression.
- Figure 7: For definitive cementation, Calibra SelfAdhesive Resin Cement is placed into the final all-ceramic crown.
- Figure 8: After tack curing the excess Calibra SelfAdhesive Resin Cement for 5 seconds on each the buccal and lingual surfaces, it is easily peeled away for easy cleanup