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Introduction Single posteriors Anteriors Implants Product Information
Prime Collection
Clinical Cases
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Our product heroes:
Dear Readers,
Excellent, fascinating and inspiring: with this booklet, you are about to discover the
collection of Prime clinical cases. We are very pleased to share a variety of cases
done with the latest generation of the CEREC® system.
With CEREC® Primescan®, CEREC Primemill® and CEREC® SpeedFire®, restorations can be manufactured from
a wide variety of materials at an extremely high speed. Quality has also reached a new level with precise
designs, finely milled surfaces and margins, and excellent accuracy of fit. Everyone who has experienced
this innovation live quickly appreciates its value. This modern system is also incredibly easy and intuitive to
operate.
The clinical cases presented here originated in the clinics and practices of expert users. We would like to
take this opportunity to thank them sincerely for their critical and constructive support during the entire
development process. Without them, it would not have been possible to create the solutions that move you
and dentistry forward every day.
CEREC Primescan AC CEREC Primemill CEREC SpeedFire
By means of these clinical cases, your colleagues demonstrate the wide range of indications applicable for
CEREC – from single-visit restorations to highly esthetic challenges and comprehensive oral rehabilitation.
Be inspired and experience how this smart, sophisticated technology can support you in your work to make
the treatment experience for your patients great, and enable a high level of safety and efficiency. Our experts:
What our expert users created with the newest CEREC generation really impressed us as the developer and
manufacturer of the equipment. We invite you to share our enthusiasm for the variety of new opportunities!
We hope you find this an interesting read and look forward to hearing from you about your own experiences
with CEREC.
Dr. Andreas Bindl Dr. Frank Clark Brown Dr. Dan Butterman Dr. Gertrud Fabel Dr. Shivi Gupta
With best regards, Zurich, Switzerland Melbourne, USA Centennial, USA Munich, Germany San Diego, USA
Max Milz Swen Deussen Dr. Karyn M. Halpern Dr. Carlos Repullo Dr. Sven Rinke Claudia Scholz Dr. Mike Skramstad
DMD MS, New York, USA Sevilla, Spain Hanau, Germany Kiel, Germany DDS, Orono, USA
Global Head of Marketing & Clinical Software Global Head of Marketing
Connected Technology Solutions Connected Technology Solutions
Professionals featured in this document may have been compensated for their time.
Dr. Fernando Peixoto Soares Dr. Cecilie Terjesen Dr. Daniel Vasquez
São Paulo, Brazil Arendal, Norway San Diego, USA
Single posteriors
Single crown on first upper molar 1 Inlay on first upper molar 2 Single crown on second upper premolar 3
CEREC Tessera CEREC Tessera CEREC MTL Zirconia
before after before after before after
Quadrant rehabilitation 4 Single crown on second upper premolar 5 Single crown on first upper molar 6
CEREC Tessara crowns and inlays – each 2 IPS e.max CAD IPS e.max CAD
Single crown on first upper molar

7 Single crown on second lower premolar
8 Single crown on first upper molar
9
IPS e.max CAD Katana Zirconia STML Katana Zirconia STML
Click on a case to learn more

A CEREC Tessera crown –

First upper molar in 90 minutes Dr. Shivi Gupta
San Diego, USA
Case Description
A 49-year-old male patient visited my practice with pain in the first upper molar, which he described as Clinical Images
occurring when he bit down. The tooth had been restored with an extensive yet insufficient composite
filling that already showed visible fractures. The clinical examination also revealed a carious defect…
Discussion
The decisive factor for the restoration of the first upper molar with a crown was the patient’s pain when
biting down. Replacing the filling would have been only a temporary solution. The crown solves the problem
from a functional point of view and offers excellent esthetics simultaneously thanks to the new material…
Read more Workflow Images
Before After
A CEREC Tessera inlay –

First upper molar in 100 minutes Dr. Sven Rinke
Hanau, Germany
Case Description
A 42-year-old female patient came to my practice with mild pain and a bothersome feeling when chewing Clinical Images
on tooth 26. On examination, a fractured ceramic restoration was revealed, but no secondary caries. The
patient remembered having received this inlay 12 years ago…
Discussion
The chairside restoration of the tooth in a single visit proved to be a particularly effective and a convenient
solution for this patient, as her commute to the practice was around 50 kilometers. CEREC Tessera was
used, a material that offers a high level of fracture resistance…
Before After
A CEREC MTL Zirconia crown –

Second upper premolar in 90 minutes Dr. Cecilie Terjesen
Arendal, Norway
Case Description
A 32-year-old male patient came to the clinic for a check-up after putting off going to the dentist for seven Clinical Images
years. He presented with a large carious mesial lesion on tooth 15. The tooth showed asymptomatic apical
periodontitis and a significant loss of tooth structure. The patient was motivated for treatment…
Discussion
Together with the patient, the decision was made in favor of tooth-preserving treatment. The alternative
would have been to extract the tooth and replace it with an implant or a bridge restoration. However, this
was rejected due to the patient’s young age.
Before After
Two CEREC Tessera crowns and two

inlays – Quadrant rehabilitation Dr. Andreas Bindl
Zurich, Switzerland
Case Description
A 53-year-old female patient visited my practice with insufficient fillings in the second quadrant. According Clinical Images
to the patient, the restorations were about 15 years old. She wanted them to be completely rehabilitated
and restored metal-free…
Discussion
The restoration of the second quadrant with two inlays and two full crowns was carried out chairside in a
single visit of about four hours. This was possible due to the time-saving fabrication of the restorations with
CEREC Primemill…
Before After
An IPS e.max CAD single crown –

Second upper premolar in 60 minutes Dr. Frank Clark Brown
Melbourne, USA
Case Description
The following case refers to a 71-year-old female patient. She was diagnosed with mesial and distal marginal Clinical Images
caries on tooth 25. The ceramic veneer of the PFM crown was partially broken. The treatment plan was to
restore the tooth with an all-ceramic crown (IPS e.max CAD, Ivoclar Vivadent) after caries removal…
Discussion
The interesting aspect of this case was the workflow speed. Taking the first scan while anesthesia was
taking effect already saved a significant amount of time. With CEREC Primescan, the impression could be
taken quickly…
Read more
Before After
Workflow Images

First upper molar in 60 minutes Dr. Karyn M. Halpern DMD, MS
New York, USA
Case Description
A female patient, 47 years old, presented with a slightly intermittent sensitivity to cold at tooth 16. The Clinical Images
clinical examination as well as the radiological findings indicated a large insufficiency of the composite
filling, with distal marginal ridge cracks, a lingual wall crack, and distal recurrent decay…
Discussion
The clinical case demonstrates how quickly and efficiently the new CEREC Primemill allows a full-surface
glass-ceramic crown to be fabricated chairside in a single session, while meeting a high level of esthetic
demands. I can no longer imagine practicing without CEREC Primemill.
Read more
Before After
Workflow Images

First upper molar in 75 minutes Dr. Dan Butterman
Centennial, USA
Case Description
A 32-year-old male patient consulted my practice due to decay and a failing direct composite restoration Clinical Images
on tooth 26. The treatment plan was to fabricate a full-coverage crown for this tooth in a single visit. After
infiltrative administration of anesthesia with Septocaine®, tooth 26 was prepared for a crown…
Discussion
Producing restorations in just one session is now faster than ever before. A quick and very accurate scan,
manageable and intuitive design software, combined with a milling and grinding unit that completes a
restoration in just a few minutes, makes for a significant increase in efficiency and great patient satisfaction
with my practice.
Before After
A Katana Zirconia STML single crown –

Second lower premolar in 90 minutes Dr. Gertrud Fabel
Munich, Germany
Case Description
A 21-year-old student came to my practice and wanted an esthetic solution for her tooth 45. She reported Clinical Images
dissatisfaction with a root canal treatment done elsewhere and was very unhappy about the discoloration
of the tooth now, which led to an inconsistent overall impression…
Discussion
Thanks to the newly achieved CEREC workflow time, the restoration of this premolar was very well suited
for the chairside treatment with zirconia, which took only about 90 minutes in total. We were able to use
full-contour zirconia, a material that has good properties for this area of the tooth and, thanks to…
Read more
Before After
Workflow Images

First upper molar in 90 minutes Dr. Mike Skramstad, DDS
Orono, USA
Case Description
A 72-year-old patient came to my practice with a fractured metal-ceramic crown on tooth 26, which had Clinical Images
previously been treated endodontically. The tooth was free of caries and oral hygiene was very good. Our
plan was to maximize the resistance and retention shape, and to fit the tooth with a new…
Discussion
The final restoration fit excellently and needed no post-cementation adjustments. The great thing about
the Extra Fine milling mode is that it provides us with the option to create additional detail. The CEREC
Primemill not only brings speed to the appointment, but also versatility in milling strategies…
Read more
Before After
Workflow Images
Anteriors
Upper central incisors 1 Quadrant rehabilitation 2
IPS e.max CAD VITA Suprinity PC
before after before after

Four IPS e.max CAD single crowns –

Upper central incisors in 4 hours Claudia Scholz
Kiel, Germany
Case Description
A 53-year-old patient came to my practice with problems in her front teeth. The examination revealed Clinical Images
inadequate fillings on teeth 12-22 and an uneven gingival line on 12 and 11. The patient turned down the
option of a surgical adjustment…
Discussion
For anterior teeth, particularly high esthetic requirements apply, which can also be met very well with ceramic-
veneered metal or ceramic crowns. However, the disadvantage is that a conventional impression and a
temporary restoration would have been necessary until the final restoration was completed in a lab.
Read more
Before After
Workflow Images
Ten VITA Suprinity PC single crowns –

Quadrant rehabilitation in 2 sessions Dr. Daniel Vasquez
San Diego, USA
Clinical Images
Case Description
A 62-year-old female patient came into my dental office for a check-up and dental cleaning. She has been a
patient in the practice for seven years and now complains that she hardly dares to smile. She was dissatisfied
due to discoloration and wanted to improve her smile…
Discussion
The patient wanted a beautiful smile. As teeth 15 to 25 are all visible, the decision was made to use a highly
esthetic ceramic for all 10 of them. Due to the extensive consultation and the implementation with a mock-up,
the restoration was carried out in two sessions with CEREC. The patient was very satisfied with the result.
Read more
Before After Workflow Images

Implant
Second upper premolar 1 Upper lateral incisors 2 First upper premolar 3
Astra Tech and IPS e.max Ankylos and Celtra Duo Ankylos and IPS e.max CAD

Astra Tech implant placement and an

IPS e.max CAD single crown –
Second upper premolar Dr. Andreas Bindl
Zurich, Switzerland
Case Description
A 36-year-old patient came to our practice four months after the extraction of tooth 15 due to a longitudinal Clinical Images
fracture. He wanted to close the resulting tooth gap. The patient was healthy and with good oral hygiene.
Treatment with an implant or a bridge was considered…
Discussion
The implant and screw-retained crown made of a high-quality glass-ceramic material provided the patient
with a highly esthetic and long-term stable restoration without the need to prepare healthy natural tooth
enamel. The guided procedure with CEREC Guide 3 provided a high level of safety during preparation…
Read more
Before After
Workflow Images
Ankylos implant placement and two

Celtra Duo crowns – Upper lateral
incisors in 180 minutes Dr. Fernando Peixoto Soares
São Paulo, Brazil
Case Description
A 22-year-old female patient came to my practice. Her medical history revealed that teeth 12 and 22 were Clinical Images
missing due to dental agenesis and had been replaced by implants. This solution did not please the patient
at all. She hid her smile and felt inhibited around company…
Discussion
For an adequate result from a functional and esthetic point of view, the removal of both previous implants
was unavoidable. The treatment options were an orthodontic gap closure, a restoration with bridges, or two
single-tooth restorations with implants and chairside-fabricated crowns, the latter of which…
Read more
Before After
Workflow Images
Ankylos implant placement and IPS

e.max CAD single crown – First upper
premolar in 90 minutes Dr. Carlos Repullo
Sevilla, Spain
Case Description
A 56-year-old female patient came to my practice with pain and some loosening of tooth 24. After an initial Clinical Images
examination, a CBCT scan was performed with Orthophos SL, which determined that a horizontal root
fracture and a periapical infection were the cause of the problems…
Discussion
A possible alternative would have been a conservative treatment approach with root canal treatment and
stabilization of tooth fragments. However, the patient rejected this due to the relatively high risk of failure as
well as a previous negative experience…
Read more
Before After
Workflow Images
CEREC Primescan CEREC Primemill

Accuracy. Usability. Speed. Quality. Convenience. Speed. Versatility.
An excellent choice for brilliant results: CEREC Primescan is your optimal starting point into digital The grinding and milling unit utilizes state-of-the-art technology and CAM strategies to produce
dentistry. No matter how you would like to design your workflows, CEREC Primescan is the enabler for excellent chairside restorations more easily, with a high level of usability, precision and speed. A modern
efficient digital workflows – both chairside in your practice and with your preferred partners. setup for achieving predictable results with enhanced quality chairside experience – for both the user
and patient.
Learn more Learn more
Intelligent Motion Dynamic Around 50 Validated RFID Tool

Processing Sensor Lens Super Fast Mode Materials Reader Powerful
for Zirconia Touch
Crowns Interface
Very Precise Block

Mechanical Scanner
Components
Very Short LED Light

Processing
Times
Smart Pixel Active Large Field
Sensor Heating of View
CEREC SpeedFire
Dental combination furnace for chairside digital dentistry
CEREC SpeedFire is a compact, fast sintering and glazing furnace enabling quick turnaround times for
treatments in one single visit. CEREC SpeedFire can process a great variety of different materials, from
Dentsply Sirona block materials to partner materials. All sintering and glazing programs have been
tested and validated by the corresponding material partner for high esthetics and durable restorations.
Learn more
Induction
technology
Unparalleled short
sintering and firing times. Intelligently networked
The CEREC Software sends the order
to the furnace, with all the necessary
information.
LED status display Touchscreen display

Differing colors indicate the Intuitive operation and high resolution.
current processing status.
Chamber
Space for up to three single crowns
or for bridges with up to three units.
Procedural Solutions
Preventive
Restorative
Orthodontics
Endodontics
Implants
Prosthetics
Enabling Technologies
Dentsply Sirona CAD/CAM
Sirona Dental Systems GmbH Imaging
Fabrikstraße 31, 64625 Bensheim, Deutschland Treatment Centers
dentsplysirona.com Instruments
Subject to technical changes and errors within the text, Order No. M43-C350-01-7600, 0623.

San Diego, USA
Case Description
A 49-year-old male patient visited my practice with pain in the first upper molar, which he described as
occurring when he bit down. The tooth had been restored with an extensive yet insufficient composite
filling that already showed visible fractures. The clinical examination also revealed a carious defect. A
treatment plan was drawn up for a full-surface restoration. Because of the bite pain, this needed a high-
strength material. As the tooth was visible during speech, the material also had to meet high esthetic
standards. CEREC Tessera from Dentsply Sirona was selected in shade HT A2 – a material that met all the
requirements in equal measure. CEREC Tessera is an advanced lithium disilicate ceramic for the CEREC
workflow, offering a very good combination of strength and esthetics. After tooth preparation, the intraoral
scan was performed with CEREC Primescan. The crown was then designed in the CEREC Software. CEREC
Primemill was used for manufacturing: the CEREC Tessera block was placed in the milling unit and the crown
was produced using the pre-touch mode. The result was impressive with its excellent marginal stability. In
the following steps, the crown was first pre-polished, glazed and then customized with stain. The buccal Before:
stain consisted of a mixture of the Olive and Sunset shades (Universal Stains, Dentsply Sirona), while the First upper molar had been restored with an
extensive yet insufficient composite filling that
Universal Stains Mahogany shade was best suited for the occlusal stain. The desired gloss was achieved
already showed visible fractures.
by applying two coats of spray glaze (DS Universal Spray Glaze Fluo, Dentsply Sirona), one from the buccal
side and one from the lingual side. After air drying, the crown was fired in CEREC SpeedFire. This process
took only four and a half minutes. A post-polish concluded the manufacturing process. Prior to applying the
crown, the enamel of the prepared tooth was selectively etched. The translucent Calibra Ceram cement
from Dentsply Sirona enabled a stable final restoration. The patient was extremely positive about the short
treatment time of only 90 minutes in total. He was interested in the digital technology used, followed the
process with excitement, and was very satisfied with the esthetic result.
Discussion
The decisive factor for the restoration of the first upper molar with a crown was the patient’s pain when
biting down. Replacing the filling would have been only a temporary solution. The crown solves the problem
from a functional point of view and offers excellent esthetics simultaneously thanks to the new material.
Restoration in a single visit was possible due to the digital CEREC workflow, the efficient fabrication of the
After:
restoration with CEREC Primemill, and the glaze firing in CEREC SpeedFire, which took only a few minutes.
Chairside-fabricated restoration made from an
advanced lithium disilicate ceramic, CEREC Tessera.

San Diego, USA
Clinical Images
Pre-op with decay and composite filling breaking down. Crown preparation. Final crown – occlusal. Final crown – buccal.

San Diego, USA
Workflow Images
Crown margination. Final restoration – occlusal. Final restoration – buccal. Manufacture preview of final crown.
Occlusal surface of milled crown. The sprue was removed, For the glaze and optional stain step, the crown is placed on a The crown is placed on top of the CEREC SpeedFire honey-
and it was pre-polished next. moldable silicone. Buccal stain is added with a brush. A mix- comb tray with a firing pad. It must be centered on the pad.
ture of two shades – Olive and Sunset (Universal Stains by The construction is then placed in CEREC SpeedFire.
Dentsply Sirona) – was used.

Hanau, Germany
Case Description
A 42-year-old female patient came to my practice with mild pain and a bothersome feeling when chewing
on tooth 26. On examination, a fractured ceramic restoration was revealed, but no secondary caries. The
patient remembered having received this inlay 12 years ago. It consisted of a leucite-reinforced glass-
ceramic, which was adhesively cemented. The patient wanted a replacement of the inlay made of tooth-
colored material that would last as long as possible. A chairside-manufactured inlay made of a modern
lithium disilicate material (CEREC Tessera) was planned. It offers a strong combination of improved
fracture strength (>700 MPa) and translucency, enabling a reduced minimum material thickness of 1.0
mm for adhesively cemented posterior restorations. The good esthetic properties and short processing
times predestined CEREC Tessera for this indication. First, the fractured inlay was removed. Subsequently,
the margins were finished with fine-grained diamond instruments. The retraction cord placed on the
mesial approximal surface was used to control moisture and shift the preparation margin. This was
followed by intraoral scanning with CEREC Primescan, inlay design in the CEREC Software, and grinding Before:
with CEREC Primemill. The grinding process in Fine mode took just over ten minutes. The subsequent Fractured ceramic restoration made from a
leucite-reinforced glass-ceramic after a clinical
try-in focused on checking the occlusal contacts. This was possible because the material was ground out in a
service time of 12 years.
pre-crystallized stage. After application of a Spray Glaze with Fluorescence (DS Universal Spray Glaze Fluo,
Dentsply Sirona), the restoration was fired in the pre-heated CEREC SpeedFire with the glaze program
lasting four and a half minutes. The restoration was cemented using the total-etch technique with a
universal bonding agent (Prime&Bond active) and an adhesive cement (Calibra Ceram). No further occlusal
adjustments were necessary. Thanks to the excellent chameleon effect of CEREC Tessera, the restoration
blended superbly with the natural dentition. The patient was very satisfied with the esthetic result.
Discussion
The chairside restoration of the tooth in a single visit proved to be a particularly effective and a convenient
solution for this patient, as her commute to the practice was around 50 kilometers. CEREC Tessera was
used, a material that offers a high level of fracture resistance. The rapid firing cycle further shortened
the overall treatment time, enabling the patient to receive a highly esthetic and final restoration in just
100 minutes.
After:
Chairside-fabricated restoration made from an
advanced lithium disilicate ceramic, CEREC Tessera.

Hanau, Germany
Clinical Images
12-year-old inlay. Preparation for a ceramic inlay and placement of a retraction Adhesively luted CEREC Tessera inlay. The inlay was luted
cord prior to intraoral scanning. with the total-etch technique in combination with a universal
bonding agent (Prime&Bond active), and a dual-curing adhe-
sive composite cement (Calibra Ceram).

Hanau, Germany
Workflow Images
Intraoral scan of the upper and lower jaw using The preparation limit was automatically detected and marked Design proposal generated with the “biogeneric individual” Slight modification of the design proposal was needed to
CEREC Primescan. by the CEREC Software. function. adjust the occlusal contacts.
Restoration milled from an advanced lithium disilicate ceramic For the final step, a glaze firing (with e.g. DS Universal Stain & The internal surface of the inlay restoration is etched with 5% A silane coupling agent (Calibra Silane, Dentsply Sirona) was
(CEREC Tessera) in CEREC Primemill. Glaze System) is mandatory. hydrofluoric acid for 30 seconds. applied prior to adhesive luting of the restoration.

Arendal, Norway
Case Description
A 32-year-old male patient came to the clinic for a check-up after putting off going to the dentist for seven
years. He presented with a large carious mesial lesion on tooth 15. The tooth showed asymptomatic apical
periodontitis and a significant loss of tooth structure. The patient was motivated for treatment. First, the
tooth was treated endodontically. A fiber post was inserted to build up the core. Finally, the tooth was to be
restored with a crown. At the beginning of the restorative treatment, the patient received local anesthesia.
While the anesthetic was taking effect, a preoperative scan was performed with CEREC Primescan. After
preparation, another scan was taken. The CEREC Software provided effective support in defining the
preparation margins. The restoration was then designed using the Biogeneric individual function. CEREC
MTL Zirconia was the material selected because it promises both high strength and exceptionally good
esthetics. The crown was milled in shade A3 in the CEREC Primemill in Fine mode. This process took about
12 minutes. The result was a restoration with a filigree crown margin. After polishing the occlusal surface,
the crown was sintered in CEREC SpeedFire, which took approximately 21 minutes. For individualization, the Before:
crown was glazed with the DS Universal Stains & Glaze System. The interproximal surfaces and cervical areas A large carious mesial lesion on tooth 15. The
tooth showed asymptomatic apical periodontitis
that were in contact with the gingiva were left out of the glaze. Only polishing was performed in this area.
and a significant loss of tooth structure.
Finally, the inner surfaces of the restoration were sandblasted with 50 μm aluminum oxide at a pressure of
2 bars and then vaporized. After cleaning, the restoration was incorporated and cemented in place. The
treatment lasted around 90 minutes in total. The patient was pleased that he received a complete restoration
in a single visit. He was very satisfied with the function and esthetics of the final result.
Discussion
Together with the patient, the decision was made in favor of tooth-preserving treatment. The alternative
would have been to extract the tooth and replace it with an implant or a bridge restoration. However, this
was rejected due to the patient’s young age.
After:
Chairside-fabricated restoration designed using the
Biogeneric individual function. CEREC MTL Zirconia
was the material selected because it promises both
high strength and exceptionally good esthetics.

Arendal, Norway
Clinical Images
Initial situation after endodontic treatment: the Final crown – buccal. Final crown – occlusal.
mesial wall was temporarily built up here with
composite for rubber dam placement.

Arendal, Norway
Workflow Images
Crown margination. Image of crown preparation. Design check – buccal. Manufacture preview of final crown.
Crown milling with CEREC MTL Zirconia in The crown right before sintering. The crown is placed in CEREC SpeedFire. Final crown.
CEREC Primemill.

Zurich, Switzerland
Case Description
A 53-year-old female patient visited my practice with insufficient fillings in the second quadrant. According
to the patient, the restorations were about 15 years old. She wanted them to be completely rehabilitated
and restored metal-free. At a follow-up visit, she complained about inflamed gingiva in the area of the two
left upper molars, and she was also troubled by the inadequate esthetics of the PFM crowns on teeth 26 and
27. The clinical examination revealed relatively severe bleeding on probing, with open crown margins. The
intraoral radiograph confirmed these findings. Probing depths were between 2-4 mm. Iatrogenic gingivitis
was diagnosed; the patient’s oral hygiene was very good. The composite filling on tooth 25 showed an
open discolored joint with incipient secondary caries, and a distinct step was palpable toward the cervix
of tooth 24 on the filling. All teeth were vital and pain-free. Due to the small interocclusal distances, it was
clear that very little space would be available for new crowns. For this reason, a medium-strength ceramic
was required to fabricate the crowns for teeth 26 and 27 in a correspondingly thin layer of thickness. Teeth
24 and 25 would each receive an inlay to restore optimum function. After the preparation of all four teeth,
Before:
an intraoral scan with CEREC Primescan was performed and completed in under three minutes. The inlays
Insufficient fillings in the second quadrant.
and crowns were then designed in the CEREC Software. In the lateral view, the final bite position could
The restorations were about 15 years old.
be displayed and precisely checked. The crowns were produced in CEREC Primemill using the Extra Fine
grinding mode from the advanced lithium disilicate block CEREC Tessera in 15 minutes each. The filigree
crown margin was a particularly impressive feature. The high accuracy of fit achieved in this way made post-
processing virtually superfluous. Prior to cementation, the crowns were treated with the DS Universal Stain
and Glaze System (Dentsply Sirona) and fired in CEREC SpeedFire. Adhese Universal and Variolink Esthetic
(Ivoclar Vivadent) were used for cementation. Due to the shallow cavity depth for the inlay preparations and
because of the thin tapered margins of the inlays, it was not possible to use a ceramic for this, as the layer
thickness would not have been sufficient. Instead, they were milled out of a composite block (Tetric CAD,
Ivoclar Vivadent) in Extra Fine mode and adhesively cemented with Adhese Universal & Variolink Esthetic
(Ivoclar Vivadent).
Discussion
The restoration of the second quadrant with two inlays and two full crowns was carried out chairside in a After:
single visit of about four hours. This was possible due to the time-saving fabrication of the restorations with Chairside-fabricated crowns made from
CEREC Primemill. The main challenges were the very low dye height at 26 and 27, and the shallow cavity CEREC Tessera (teeth 26/27). Inlays for teeth 24
and 25 with Tetric CAD, Ivoclar Vivadent.
depth for the inlays. These circumstances led to the decision to restore the teeth with different materials
that give a very good esthetic result, which also pleased the patient.

Zurich, Switzerland
Clinical Images
Patient with insufficient fillings in the second quadrant and Final crown and inlays – occlusal. Final crown and inlays – palatal.
inadequate esthetics of the PFM crowns on teeth 26 and 27.
The composite filling on tooth 25 showed an open discolored
joint with incipient secondary caries, and a distinct step was
palpable toward the cervix of tooth 24 on the filling.

Zurich, Switzerland
Workflow Images
Intraoral scan of the insufficient fillings, using Design proposal generated with the “biogeneric individual” A slight modification of the design proposal was needed to Buccal preview of crowns in CEREC Software.
CEREC Primescan. function. adjust the occlusal contacts.
Crown being milled in CEREC Primemill. Final crown without final preparation.

Melbourne, USA
Case Description
The following case refers to a 71-year-old female patient. She was diagnosed with mesial and distal marginal
caries on tooth 25. The ceramic veneer of the PFM crown was partially broken. The treatment plan was to
restore the tooth with an all-ceramic crown (IPS e.max CAD, Ivoclar Vivadent) after caries removal. The aim
was to create a better facial and incisal fit for the crown into the dental arch as well as to match the fixed
prosthetic structures at the front in a more visually pleasing way by using the B1 shade. The patient received
local infiltration anesthesia. This was followed by a scan with CEREC Primescan of the maxilla and mandible,
and bite registration. The existing crown was to serve as a reference for the new restoration. After removal
of the defective crown, the tooth was prepared and then scanned again. The crown designed with the
Biocopy mode was then fabricated directly in the CEREC Primemill. The fast grinding mode for IPS e.max
CAD was used, which enabled the restoration to be completed in just around seven minutes. Immediately
after grinding, the crown was tried on the patient. Following incisal staining for greater translucency and
glazing, crystallization was done in the sintering furnace. This process took approximately 20 minutes. The
Before:
restoration was then cemented with a conventional RMGI cement, with axial and occlusal wall thicknesses
Tooth 25 had mesial and distal marginal decay
of 1,000 microns and 1,500 microns respectively. A postoperative intraoral X-ray (Schick 33 sensors, Sidexis
and broken porcelain on the existing PFM.
4) was taken as a final control, confirming the successful restoration of the tooth. Including preparation,
fabrication and cementation of the restoration, the treatment took only 57 minutes. The patient was very
satisfied with the short treatment time and the pleasing esthetic result.
Discussion
The interesting aspect of this case was the workflow speed. Taking the first scan while anesthesia was
taking effect already saved a significant amount of time. With CEREC Primescan, the impression could be
taken quickly. Hardly any changes were made to the initial design, so the manufacturing process could
be started immediately. Since CEREC Primemill’s pre-touch process was already started during design,
the fabrication itself took only seven minutes. In addition, conventional cementation with an RMGI cement
proved to be timesaving.
After:
The crown on tooth 25 was remade to be brought
more in line facially and incisally with the arch.

Melbourne, USA
Clinical Images
Preoperative occlusal view. Preoperative X-ray. Lateral view of the preparation.
Postoperative occlusal view of finished crown. Postoperative X-ray.


Melbourne, USA
Workflow Images
First proposal of the prep margin shows high level of Design proposal in the CEREC SW. Minor modifications were Examination of the design from different angles ensures that Checking contacts to ensure that they meet my desired
accuracy. made, which involved making a broader contact both mesially there is proper facial alignment. configuration.
and distally.
Demonstration of the crown and sprue position in the block

(Manufacture phase).

New York, USA
Case Description
A female patient, 47 years old, presented with a slightly intermittent sensitivity to cold at tooth 16. The
clinical examination as well as the radiological findings indicated a large insufficiency of the composite
filling, with distal marginal ridge cracks, a lingual wall crack, and distal recurrent decay. The tooth was not
sensitive either to percussion or palpation, and showed no signs of apical inflammation. A cracked tooth
syndrome was diagnosed. Due to the size of the filling and the caries to be treated, a core buildup and a
full cuspal coverage ceramic crown restoration was planned. After local anesthesia with 4% Septocaine®
(1:100,000 epi), we selected the material and the color for the restoration: IPS e.max CAD MT A3. Prior to
the preparation and design of the new restoration, my assistant prepared the CEREC Primemill by inserting
the block and starting the pre-touch process. After the initial scan of the upper and lower jaw with CEREC
Primescan, I removed the filling. This confirmed the initial diagnosis of a fracture in the lingual wall. Following
the excavation, I applied a composite core buildup (3M Vitrebond, Empress Opaque, Ivoclar Vivadent). In
this case, I was able to complete the preparation in a way that the enamel was retained in the buccal wall. Before:
Subsequently, I took a new digital impression with the CEREC Primescan. I then defined the preparation line Large insufficiency of the composite filling on
tooth 16 with distal marginal ridge cracks, a
in the digital model. The CEREC Software provides excellent support in this respect. I was satisfied with the
lingual wall crack, and distal recurrent decay.
first restoration proposal, which I accepted without any changes. During the design phase, I paid particular
attention to the fissure height and contours, the correct occlusion, and the contact points. After grinding
with CEREC Primemill, I crystallized and glazed the crown. I performed a quick final check and could place
the crown using adhesive. The patient was very happy with her experience and grateful for being able to
have her tooth restored with a permanent, strong, and highly esthetic crown in a single visit that took just
over an hour. Since then, she has been completely free of symptoms.
Discussion
The clinical case demonstrates how quickly and efficiently the new CEREC Primemill allows a full-surface
glass-ceramic crown to be fabricated chairside in a single session, while meeting a high level of esthetic
demands. I can no longer imagine practicing without CEREC Primemill.
After:
Highly esthetic full-surface glass-ceramic crown.

New York, USA
Clinical Images
The patient presented with a chief complaint of mild intermit- The previous failing restoration was removed, and both mesial After crystallizing and stream cleaning the restoration, the
tent sensitivity to cold beverages and pointed to tooth 16. and distal recurrent decay was found and excavated. No pulp e.max CAD was prepared for bonding and bonded with resin
was exposed upon completed excavation. A composite core cement.
buildup was completed using a glass ionomer liner (3M Vitre-
bond) and composite resin (Empress Opaque, Ivoclar Vivadent).
The local parameter marginal thickness was adjusted to 100 Since the touch process had been completed in advance, the The restoration was then glazed and stained using Ivoclar It was then crystallized in a furnace.
µm. The design phase was then completed with very little grinding began right away after the restoration was sent to Vivadent IPS e.max CAD Crystall Shades, Stains and Glaze
modification to the fissure height and contours. The design the CEREC Primemill. The e.max restoration was grinded in Paste.
was evaluated for proper occlusion, contacts and contours. 3 : 54 without any marginal chipping. The fit was checked, and
no further adjustments were needed.

New York, USA
Workflow Images
he patient information and the Administration Phase was

T Automargination was completed by the software and no Design proposal. The design was evaluated for proper positioning, contours,
completed, designating IPS e.max CAD for the restoration. modifications were needed. occlusion, and contacts.
In the Manufacture Phase the sprue was automatically pro- The restoration was then sent to the
posed on the lingual surface. CEREC Primemill.

Centennial, USA
Case Description
A 32-year-old male patient consulted my practice due to decay and a failing direct composite restoration
on tooth 26. The treatment plan was to fabricate a full-coverage crown for this tooth in a single visit. After
infiltrative administration of anesthesia with Septocaine®, tooth 26 was prepared for a crown. The digital
impression was then taken with CEREC Primescan and the crown was designed in CEREC Software. The
initial software proposal was very good and the design did not need to be modified. For the crown, we
chose an IPS e.max CAD block MT shade A2 size 26. After placing the block in the CEREC Primemill, we
initiated the pre-touch process, even though the crown had not yet been designed. The advantage of
the pre-touch process is that my assistant can prepare the milling unit while I work in the patient’s mouth
and the fabrication process can begin as soon as the start button is pressed. With CEREC Primemill, the
restoration was completed in a very short time. Due to the pre-touch step and the grinding protocol itself,
the entire grinding process has become faster overall. After sintering and glazing in the CEREC SpeedFire,
the crown was ready to be fixed with Calibra Ceram. In total, the treatment time was only about 75 minutes.
Before:
Tooth 26 presenting decay and a failing direct
composite restoration.
Discussion
Producing restorations in just one session is now faster than ever before. A quick and very accurate scan,
manageable and intuitive design software, combined with a milling and grinding unit that completes a
restoration in just a few minutes, makes for a significant increase in efficiency and great patient satisfaction
with my practice.
After:
Highly esthetic and functional lithium disilicate
ceramic crown.

Centennial, USA
Clinical Images
Pre-op tooth 26 with a failing composite restoration and The old restorative material and the decay were removed, and The final e.max crown bonded in place.
recurrent decay. the tooth has been prepared for a full-coverage crown.

Centennial, USA
Workflow Images
Top view of the initial model with successful automargination. Side view of the initial model. The margin did not need to be The initial crown proposal: no tools needed to be opened to
edited. edit this restoration because the initial proposal was perfect.

Munich, Germany
Case Description
A 21-year-old student came to my practice and wanted an esthetic solution for her tooth 45. She
reported dissatisfaction with a root canal treatment done elsewhere and was very unhappy about
the discoloration of the tooth now, which led to an inconsistent overall impression. For the patient,
a temporary restoration was not an option, also for cost reasons. The X-rays, which had to be done
because of the risk of a fracture or a trauma, were unremarkable. In order to optimally cover the
discoloration, it was necessary to use a slightly translucent material. We decided to use Katana Zirconia
STML in shade A3 to perfectly meet the esthetic requirements. The crown was created with the classic
CEREC workflow using CEREC Primescan for the digital impression, CEREC Software for the design,
and CEREC Primemill for milling the restoration. With the Fast mode the production time was only
8:35 minutes. The try-in of the sintered crown showed a very good fit. Before we permanently seated it
with Calibra Cement, we individualized the restoration with stains and a glaze. Our goal was to fit the crown
precisely into the overall tooth structure.
Before:
Discolored tooth 45 due to a previous root canal
treatment.
Discussion
Thanks to the newly achieved CEREC workflow time, the restoration of this premolar was very well suited
for the chairside treatment with zirconia, which took only about 90 minutes in total. We were able to use
full-contour zirconia, a material that has good properties for this area of the tooth and, thanks to the wide
range of shades available, also offers sufficient results for esthetic requirements. We deliberately decided
against a multilayer material in order to achieve the desired low translucency. The patient was very happy
with the result.
After:
Translucent zirconia crown with individualized
finishing.

Munich, Germany
Clinical Images
Discolored root-treated tooth. Discolored root-treated tooth. First try-in after sintering in CEREC SpeedFire. Final restoration with individualized finishing.
Postprocessing: stain and glaze by my dental assistant.


Munich, Germany
Workflow Images
Preparation with enough space for material. Construction. Milling mode: fast – to have more time for postprocessing. Milling time 8:35 min.
Material: Katana Zirconia STML A3.

Orono, USA
Case Description
A 72-year-old patient came to my practice with a fractured metal-ceramic crown on tooth 26, which had
previously been treated endodontically. The tooth was free of caries and oral hygiene was very good.
Our plan was to maximize the resistance and retention shape, and to fit the tooth with a new full-zirconia
crown. Since the remaining upper jaw had already been restored with IPS e.max CAD restorations, the
translucency had to be adapted as well as possible. For this reason, we chose Katana STML as the material.
The shade selection was carried out right after anesthesia. The result (A2) was then entered into CEREC
Primemill. After completing a bonded buildup, we started the preparation for the zirconia crown. We prepped
to the gumline with a 1.0 mm modified shoulder (Winter Shoulder) and reduced occlusally by 2.0 mm to
guarantee the final restoration had accurate anatomy and at least 1.0 mm thickness. We refrained from
using a retraction thread. After preparation, the lower jaw, upper jaw, and buccal bite were recorded with
CEREC Primescan in Acquisition Phase. The CEREC Software gave an excellent initial proposal and only a
few adjustments were necessary. The Extra Fine milling mode was utilized to achieve a high level of detail Before:
and esthetics. This is a feature of CEREC Primemill that allows the dentist to use a 0.5 mm finishing bur to Fractured metal-ceramic crown on tooth 26,
which had previously been treated
create extra detail and trueness when required for a particular clinical scenario. We needed approximately
endodontically.
24 minutes for the milling process and achieved a truly excellent result. We started the sintering process
immediately afterwards without any further adjustments, and it was finished after 18 minutes. After sintering,
the functional surfaces were polished and then stained and glazed in the CEREC SpeedFire. We cemented
the restoration conventionally using resin-modified glass ionomer. The total treatment time was about one
and a half hours.
Discussion
The final restoration fit excellently and needed no post-cementation adjustments. The great thing about
the Extra Fine milling mode is that it provides us with the option to create additional detail. The CEREC
Primemill not only brings speed to the appointment, but also versatility in milling strategies. In this case, we
chose the Extra Fine milling mode to achieve maximum esthetics and attention to detail.
After:
Translucent full-zirconia crown for an esthetic result
with maximum resistance and retention shape.

Orono, USA
Clinical Images
Pre-op tooth 26. Extra Fine milled crown out of milling unit. Preparation tooth 26. Pre-polished crown before sintering.
Final restoration using Extra Fine milling and Katana STML Final stain and glaze.
tooth 26.

Orono, USA
Workflow Images
Automargination. Proposal design phase. Extra Fine milling setup.


Kiel, Germany
Case Description
A 53-year-old patient came to my practice with problems in her front teeth. The examination revealed
inadequate fillings on teeth 12-22 and an uneven gingival line on 12 and 11. The patient turned down the
option of a surgical adjustment. In addition to the aforementioned problems, the contour of the incisal edges
was severely eroded and inconsistent. The patient suffered from these esthetic issues and she hardly dared
to smile. We planned to restore the four teeth in one session with single crowns. Due to the C3 tooth shade,
I decided to make her restorations with IPS e.max CAD, a lithium disilicate ceramic. The restoration of 23-
26 would be adjusted later to achieve consistent esthetics. The patient explicitly asked for this. For the
restoration, I followed the classic CEREC protocol. In the virtual model, I slightly corrected the automatically
marked preparation margins and made an intraoral comparison. I then designed the crowns chairside. We
fabricated all four crowns in succession with the CEREC Primemill. It took approximately ten minutes in
the Fine mode for each one. The crowns were smooth and esthetically pleasingly structured as planned.
After glazing and individualization, the crowns could be sintered in the CEREC SpeedFire. To create great Before:
optical transparency, enamel was simulated with blue ceramic stain. After sintering, the restorations were Inadequate fillings on teeth 12-22, an uneven
gingival line on 12-11, and incisal edges severely
fitted once again, prepared with phosphoric and hydrofluoric acid, as well as silane and adhesively bonded
eroded.
under the rubber dam, and Teflon tape for contact point isolation in two sections with Prime&Bond active
and Calibra Ceram adhesive and then trimmed. After an occlusion check, the new crowns received a final
polish. In the end, the total treatment time took under 4 hours and resulted in a patient very satisfied with
the esthetic results and with her beautiful new smile.
Discussion
For anterior teeth, particularly high esthetic requirements apply, which can also be met very well with ceramic-
veneered metal or ceramic crowns. However, the disadvantage is that a conventional impression and a
temporary restoration would have been necessary until the final restoration was completed in a lab. Not all
patients can cope with this, especially in the anterior region. In addition, the restoration with all-ceramic
crowns did not require subgingival preparation to cover the margin and no dark metal shadows disturbed the
esthetics. With CEREC Primescan and CEREC Primemill patients quickly receive a high-quality all-ceramic
restoration.
After:
Four highly esthetic and individualized lithium
disilicate ceramic crowns.

Kiel, Germany
Clinical Images
Insufficient fillings in the upper front and abrased incisal Also from palatinal the teeth 12-22 had a secure destruction. The irregular line of the gingival margin. After anesthesia, the teeth were prepared.
edges. Crowns 23-26 were made elsewhere several years ago
and should be replaced with the next procedure.
After cementation with Prime&Bond active After adhesive cementation with Prime&Bond active and After cementation with Prime&Bond active
and Calibra Ceram, lateral view. Calibra Ceram, front view. and Calibra Ceram, palatal view.

Kiel, Germany
Workflow Images
Scan of the upper prepared jaw. Scan of the lower jaw. Buccal occlusion. The system showed a perfect preparation line.
Only minimal corrections of the preparation line were made. Preparation analysis to identify potentially problematic areas. The construction from the labial side. The design of the proximal contact point.
In this case there were none.

San Diego, USA
Case Description
A 62-year-old female patient came into my dental office for a check-up and dental cleaning. She has been a
patient in the practice for seven years and now complains that she hardly dares to smile. She was dissatisfied
due to discoloration and wanted to improve her smile. In the first session, all the information and data
for the CEREC Smile Design process was recorded: thorough anamnesis, conversation on the treatment
goal, clinical examination. In addition to communication, documentation is an important success factor. An
intraoral scan with the CEREC Primescan was taken to create a 3D model – the basis for a mock-up. This was
then used to make the final decision for the planned treatment with the patient. A full arch scan was taken
for preparations and from mock-up, adding to a Biocopy folder. A very important step was to set the model
axis and insert axis for best grinding results. After the initial proposal, the CEREC Smile Design application
was activated to finalize the design of the restoration using the patient’s face and smile. We used a grid in
the software to align the teeth to a suitable length. Suprinity is a zirconia-reinforced, high-strength glass-
ceramic with high esthetics because of the integrated translucency, opalescence and fluorescence. In the
Before:
Fast mode of the CEREC Primemill, it took an average of six minutes to grind a single restoration. After
Patient dissatisfied with her smile due to tooth
removing the block, the interproximal line angles as well as the form of the tooth were contoured, creating
discoloration.
the ideal emergence, shape, texture, and form. Restorations were finished and polished, and showed passive
fit in the printed model. Afterwards, all ten crowns were crystallized. In order to achieve a highly esthetic
result, the crowns were individualized with stains. Restorations were fixed using adhesive (Clearfil Universal
Bond Quick, Panavia SA Cement Universal, Kuraray Noritake).
Discussion
The patient wanted a beautiful smile. As teeth 15 to 25 are all visible, the decision was made to use a highly
esthetic ceramic for all 10 of them. Due to the extensive consultation and the implementation with a mock-up,
the restoration was carried out in two sessions with CEREC. The patient was very satisfied with the result.
After:
Ten highly esthetic single crowns individualized with
stains.

San Diego, USA
Clinical Images
Initial situation. Initial impressions: CEREC Primescan was used for the Emotional mock-up is transferred to patient’s teeth; after Restorations are finished, polished and passively fitted in the
creation of 3D-printed models, the key for ideal mock-ups. patient approval, we were ready to start the proposed printed model. Next step is crystallization of the zirconia-
CEREC Digital Study models and Bite registration (MIC or CR). treatment. reinforced, high-strength glass-ceramic. All 10 restorations
will be placed in the oven.
Final restoration.

San Diego, USA
Workflow Images
Open CEREC Software and in the Administration phase we Full arch scan was taken of the preparations and from Setting the model axis and insertion axis are key for the best Upper and lower digital models articulated ready for the
add restorations and the material to be used, which in this mock-up, adding a Biocopy folder. grinding of restorations in the manufacturing phase. Design phase.
case was VITA Suprinity PC.
Restoration proposal, using grid to align teeth to length. fter the initial proposal, the CEREC Smile Design application
A Design tools are used to perform minor touch-ups in the The new CEREC Primemill was used for the grinding of the
was activated to finalize the design of the restoration using CEREC Smile Design application. restorations. Entering block information using the CEREC
the patient’s face and smile. Primemill digital touchpad. Restoration with Vita Suprinity PC.

Zurich, Switzerland
Case Description
A 36-year-old patient came to our practice four months after the extraction of tooth 15 due to a longitudinal
fracture. He wanted to close the resulting tooth gap. The patient was healthy and with good oral hygiene.
Treatment with an implant or a bridge was considered. The latter was rejected because the abutment
teeth were only slightly filled and the substance removal for bridge preparation would have been too great.
To check the bone quantity and quality, a three-dimensional radiograph with a volume of 5 cm x 5.5 cm
(Orthophos SL) was taken. Based on the findings, because of the limited space and for the most accurate
positioning of the implant, the decision was made in favor of a fully guided preparation of the implant site.
This was to ensure the exact positioning of the implant and create the conditions for a highly esthetic
restoration. After the first intraoral scan with CEREC Primescan, the model data were exported to the
implant planning software SICAT Implant 2.0, where they were overlaid with the X-ray data. Implant and
sleeve planning could now be completed for the fully guided preparation with the Astra Tech Implant System
EV. Based on this, the CEREC Guide 3 surgical guide was designed in the CEREC Software. It was then Before:
milled in the CEREC Primemill from a CEREC Guide Bloc Medi. In the final step, the EV ND metal sleeve for Tooth 15 was extracted four months before due to
a longitudinal fracture. Patient wanted to close
the Astra Tech Implant System EV was bonded into the hole in the surgical guide. Both the preparation of
the resulting tooth gap.
the implant site and the insertion of the Astra Tech EV 8.0/4.2 mm implant were completely guided. Since
only an 8 mm implant could be placed due to the reduced bone volume, a temporary prosthetic restoration
was not used. Instead, a healing abutment was used for transgingival healing. After a healing period of
two months, digital impressions were taken with ScanPost and Scanbody. These scans were then used to
design a one-piece directly screw-retained implant crown in the CEREC Software, which was subsequently
produced in CEREC Primemill (e.max CAD, Ivoclar Vivadent). For optimum esthetics, the crown was given
a crystallization firing first, including color characterization. In addition, there were two more firings, with
another color characterization and application of the glaze material. A total of two consultations were
required for this restoration.
Discussion
The implant and screw-retained crown made of a high-quality glass-ceramic material provided the patient
with a highly esthetic and long-term stable restoration without the need to prepare healthy natural tooth After:
enamel. The guided procedure with CEREC Guide 3 provided a high level of safety during preparation and A crown made of a high-quality glass-ceramic
insertion. After six months, the patient presented with healthy gingiva and bone conditions. material provided the patient with a highly esthetic
and long-term stable restoration.

Zurich, Switzerland
Clinical Images
Guided preparation with the Astra Tech Implant System EV. Guided insertion of the implant with the Astra Tech EV X-ray image after placing the implant. Transgingival healing After a healing period of 2 months, the ScanPost and
surgery kit. after mounting a healing abutment. Scanbody were mounted to record the position of the implant
using the Primescan.
Directly screw-retained implant crown made of e.max CAD. Healthy gingiva conditions around the crown after a lying Healthy bone conditions around the implant after a lying
period of 6 months. period of 6 months.

Zurich, Switzerland
Workflow Images
SICAT Implant 2.0: implant and sleeve planning for fully

guided preparation with the Astra guided system.
After importing the implant and sleeve planning, Semi-transparent representation of the CEREC Guide 3 drill Design of a one-piece direct screw-retained implant crown
the CEREC Guide 3 drill template is designed using template. The metal sleeve is shown, which is glued into the with CEREC Software.
CEREC Software. perforation after milling the surgical template.

São Paulo, Brazil
Case Description
A 22-year-old female patient came to my practice. Her medical history revealed that teeth 12 and 22
were missing due to dental agenesis and had been replaced by implants. This solution did not please the
patient at all. She hid her smile and felt inhibited around company. She wanted to be able to laugh again
with confidence. Restorations in the anterior region pose a particular challenge, especially from an esthetic
point of view. In this case, the absence of teeth 12 and 22 and the bone loss caused by the first implants,
which had not been optimally placed, also had to be taken into account. After their removal, augmentation
with a bone graft and a collagen membrane (Bio-Oss, Bio Gide, Geistlich) was necessary. In a second
surgical step six months later, two Ankylos implants (A9) were inserted and a soft tissue graft was placed.
The patient then received chairside fabricated temporaries. After a further three months, I provided the
patient with a final CEREC restoration. I took a digital impression with CEREC Primescan in conjunction
with the TiBase Ankylos CEREC GH2, including ScanPost and Scanbody, and then designed two crowns in
the CEREC Software, which fit excellently into the patient’s dentition. Both crowns were then ground from
a Celtra Duo HT block in shade A1 using CEREC Primemill. After staining and subsequent glazing in the
Before:
CEREC SpeedFire, the restorations were cemented onto a custom zirconia abutment (inCoris Meso with
Initial situation.
TiBase), milled in the CEREC Primemill, and sintered in the CEREC SpeedFire. These steps were carried out
in a single visit, which lasted a total of approximately 180 minutes.
Discussion
For an adequate result from a functional and esthetic point of view, the removal of both previous implants
was unavoidable. The treatment options were an orthodontic gap closure, a restoration with bridges, or
two single-tooth restorations with implants and chairside-fabricated crowns, the latter of which the patient
preferred. In the end, she was able to receive two completely new restorations in only three visits and was
very happy with her new smile.
After:
Final smile.

São Paulo, Brazil
Clinical Images
Initial situation. The 3D X-ray demonstrates the suboptimally placed implants.
Nine months after removal of the old implants and three Final restoration of teeth 12 and 22. Final situation.
months after placement of the new implants. Scan of the
new implant position with ScanPosts.

São Paulo, Brazil
Workflow Images
Design of the crowns in the CEREC Software. Milled zirconia abutment. Adjustment of the Celtra Duo crown on the inCoris meso Marking for the esthetic adjustment of the crowns.
abutment.

Sevilla, Spain
Case Description
A 56-year-old female patient came to my practice with pain and some loosening of tooth 24. After an initial
examination, a CBCT scan was performed with Orthophos SL, which determined that a horizontal root
fracture and a periapical infection were the cause of the problems. Together with the patient, it was decided
to extract the fractured tooth and immediately restore the gap with an implant. At the next appointment,
the tooth was gently removed. An implant (Ankylos A11) and a gingiva former were placed in the cleaned
bony extraction socket and filled with particulated bone (Symbios Xenograft granules). The premolar crown
was subsequently trimmed and reused as a temporary solution, while retaining the soft tissue contour.
After a three-month healing period, the patient’s final prosthetic restoration was started. Three scans of the
maxilla were taken with CEREC Primescan: one scan of the temporary restoration (natural crown), which
served as a reference for the permanent crown to be fabricated; another to record the soft tissue contour;
and a third scan with the IO FLO-S scan body. In addition, a mandibular scan and a bite registration were
carried out. CEREC Software was used for the design of the restoration in which the Biocopy setting was
utilized. The gingival mask functioned as a reference for the emergence profile. The lithium disilicate crown
Before:
(e.max CAD A14 block, Ivoclar Vivadent) was produced using CEREC Primemill. After crystallization (CEREC
Initial situation.
SpeedFire) and characterization, the restoration was cemented onto an Ankylos TitaniumBase. The crown
itself was screwed to the implant and the screw channel filled with composite. This appointment took only
a total of 90 minutes. At the follow-up visit five days later, the patient was very satisfied, saying, “It is as if
nothing happened at all.”
Discussion
A possible alternative would have been a conservative treatment approach with root canal treatment and
stabilization of tooth fragments. However, the patient rejected this due to the relatively high risk of failure as
well as a previous negative experience. Restoration with a bridge after extraction of the affected tooth was
also ruled out. The advantage of the selected implant treatment, especially using the natural tooth crown as
a temporary restoration, was the preservation of esthetics and the natural soft tissue contour.
After:
Final result.

Sevilla, Spain
Clinical Images
Horizontal root fracture and a periapical infection caused Extraction of fractured tooth Three months later: final prosthetic restoration
patient pain and some loosening of tooth 24.
Result: preservation of esthetics and the natural soft tissue

contour.

Sevilla, Spain
Workflow Images
Scan of the temporary restoration (natural crown), which Scan after tooth was extracted to record the soft tissue Scan with ScanPost and Scanbody. Restoration design.
served as a reference for the permanent crown to be contour.
fabricated.
CEREC Primemill fast grinding mode was selected. After crystallization and characterization, the restoration was
cemented onto an Ankylos TitaniumBase.

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Introduction Single posteriors Anteriors Implants Product Information

Our product heroes:

before after before after before after

before after before after before after

Single crown on first upper molar

before after before after before after

Click on a case to learn more

A CEREC Tessera crown –

Read more Workflow Images

A CEREC Tessera inlay –

Read more Workflow Images

A CEREC MTL Zirconia crown –

Read more Workflow Images

Two CEREC Tessera crowns and two

Read more Workflow Images

An IPS e.max CAD single crown –

An IPS e.max CAD single crown –

An IPS e.max CAD single crown –

A Katana Zirconia STML single crown –

A Katana Zirconia STML single crown –

before after before after

Click on a case to learn more

Four IPS e.max CAD single crowns –

Ten VITA Suprinity PC single crowns –

Before After Workflow Images

before after before after before after

Click on a case to learn more

Astra Tech implant placement and an

Ankylos implant placement and two

Ankylos implant placement and IPS

CEREC Primescan CEREC Primemill

Learn more Learn more

Intelligent Motion Dynamic Around 50 Validated RFID Tool

Very Precise Block

Very Short LED Light

LED status display Touchscreen display

A CEREC Tessera crown –

A CEREC Tessera crown –

A CEREC Tessera crown –

A CEREC Tessera inlay –

A CEREC Tessera inlay –

A CEREC Tessera inlay –

A CEREC MTL Zirconia crown –

A CEREC MTL Zirconia crown –

A CEREC MTL Zirconia crown –

Two CEREC Tessera crowns and two

Two CEREC Tessera crowns and two

Two CEREC Tessera crowns and two

An IPS e.max CAD single crown –

An IPS e.max CAD single crown –

Preoperative occlusal view. Preoperative X-ray. Lateral view of the preparation.

Postoperative occlusal view of finished crown. Postoperative X-ray.

An IPS e.max CAD single crown –

Demonstration of the crown and sprue position in the block

An IPS e.max CAD single crown –

An IPS e.max CAD single crown –

An IPS e.max CAD single crown –

 he patient information and the Administration Phase was

An IPS e.max CAD single crown –

he patient information and the Administration Phase was