Workflow for this bonded IPS e-max MT overlay on tooth #4:
1) The pre-operative shade is always taken pre-anesthetic to ensure lack of dehydration and its effects on color perception.
2) The missing/deficient aspects of the clinical crown structure are supplemented by Opaldam (Ultradent) (unbonded). This facilitates a full contour provisional.
3) Preparations are always completed under strict full rubber dam protocol except in situations where the abutment tooth is bombed out subgingivally and there is no option. Another scenario is where the patient’s anatomy obviates placement of a rubber dam clamp (zygomatic arch proximity to the upper second molars).
4) IDS and RC to be completed before Biobase construction (microlayers: 0.25mm)
5) Margins refined under slow speed.
6) Digital scan or analogue impression
7) Stump shade acquisition using ND series from Ivoclar (Natural Die Shades)
8) Adhesive bonding ideally under rubber dam unless obviated by the above or where the clamps are unstable or where access for flossing with clamps on is unachievable.
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