Efficient Chairside Restoration of a Fractured Molar With a Biocompatible CAD/CAM Crown

A 62-year-old woman presented with a mesiolingual cusp fracture and existing MO amalgam restoration. The tooth tested asymptomatic for pulpal pathology. A Ceramir® CAD/CAM C-block (Directa Dental, directadental.com) was used to restore the tooth with a full-coverage crown. The tooth was prepared, all amalgam removed, and a build-up placed. A shade was selected from four shade options to match the lighter anterior dentition. Scans were taken, and the milling process took less than 15 minutes. The Ceramir CAD/CAM crown was easy to polish in less than 3 minutes, yielding a smooth, glass-like finish for long-term cleanability and patient comfort. The crown was adjusted and cemented with ease, and a post-seat x-ray showed impeccable marginal fit of the CAD/CAM block material. The procedural workflow took less than an hour, enabling an optimal patient experience for restoration of her broken tooth. Additionally, the antibacterial properties of Ceramir CAD/CAM blocks emanating from the material’s zinc oxide and fluoride help prevent biofilm and bacterial growth. Moreover, the biocompatibility and non-toxic nature of the material offers both patients and practitioners confidence and peace of mind. The patient reported immediate comfort and a natural feel to her bite 1 day post-procedure with no sensitivity concerns. The ease of use and efficiency of the material make it a valuable option to streamline care for patients.

KEY TAKEAWAYS

• Efficient chairside workflow, excellent fit and esthetics. The crown was milled in under 15 minutes and polished in under 3 minutes; the full procedure was completed in less than an hour. Radiographs confirmed flawless marginal fit, and four shade options allowed seamless matching to the patient’s lighter anterior dentition.
• Material properties support long-term health. Zinc oxide and fluoride inhibit biofilm and bacterial growth, making Ceramir CAD/CAM blocks well-suited for patients with active or dental history of decay. The material’s composition is biocompatible and non-toxic.
• Patient-centered outcomes. The patient reported immediate comfort and a natural bite feel 1 day post-procedure, with no sensitivity and appreciation for the efficient 1-hour appointment.

Figures and Images

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Krista Koehler, DDS

Figure 1

Preoperative occlusal view of tooth No. 19 showing fracture of the mesiolingual cusp and fracture on the distal marginal ridge with a halo effect on all remaining cusps.

Figure 2

Preoperative bitewing x-ray to assess restorability, showing receding pulp.

Figure 3

Preparation of the tooth, including removal of all amalgam and placement of build-up.

Figure 4

Digital image (CEREC®, Dentsply Sirona) of the tooth after preparation.

Figure 5

Digital image of the restoration design. Ceramir CAD/CAM block was selected for patient comfort given the trauma to the tooth by fracture, with minimal opposing wear risk.

Figure 6

Post-seat bitewing x-ray of the Ceramir CAD/CAM crown showing excellent marginal fit.

Figure 7

Seated restoration, occlusal view.

Figure 8

Seated restoration, buccal view.

Krista Koehler, DDS

Private Practice, Stillwater, Minnesota