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Griptab Crown Case By Dr Graeme Milicich, BDS
1 A 21-year-old female patient presented with a central incisor that had previously had an incisal 1/3 fracture restored with a bonded composite (Fig 1). She had suffered another blow to the tooth and the restoration and all the palatal enamel had been lost. The palatal fracture was sub-gingival and down to the bone in one area.
2 The tooth was prepared for an E4D CAD/CAM crown and the sub-gingival margin was exposed (Fig 2) using a Waterlase MD. The bone in the region of the fracture was lowered (Fig 3 & 4) to re-establish biological width using a closed flap approach.
3
4
5 An impression was taken and the patient released with a temporary crown. A model was poured and scanned into the E4D design center and a crown was designed and milled using an A1 IPS Empress multi-block
6
7 The milled restoration was then contoured to create the surface micro anatomy, stained and glazed.
8 Prior to trying in the crown, a Griptab was bonded to the incisal region of the labial surface. This was then used to control the crown while a correct shade of Variolink Veneer bonding resin was chosen using the try-in pastes. The position of the Griptab did not interfere with the selection of the correct shade of bonding resin cement.
9 Once the correct shade had been selected, the Griptab was re-engaged with pin-tweezers and the crown removed from the tooth. The try-in paste was rinsed out prior to HF etching and silanation.
10 Immediately post-cementation, the adjacent teeth were slightly desiccated, which highlighted the white spots in the enamel.
11 A couple of minutes of rehydration began to reduce the intensity of the enamel white spots on the adjacent teeth

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Griptab Crown Clinical Case Study by Dr Graeme Milicich

  • 1. Griptab Crown Case By Dr Graeme Milicich, BDS
  • 2. 1 A 21-year-old female patient presented with a central incisor that had previously had an incisal 1/3 fracture restored with a bonded composite (Fig 1). She had suffered another blow to the tooth and the restoration and all the palatal enamel had been lost. The palatal fracture was sub-gingival and down to the bone in one area.
  • 3. 2 The tooth was prepared for an E4D CAD/CAM crown and the sub-gingival margin was exposed (Fig 2) using a Waterlase MD. The bone in the region of the fracture was lowered (Fig 3 & 4) to re-establish biological width using a closed flap approach.
  • 4. 3
  • 5. 4
  • 6. 5 An impression was taken and the patient released with a temporary crown. A model was poured and scanned into the E4D design center and a crown was designed and milled using an A1 IPS Empress multi-block
  • 7. 6
  • 8. 7 The milled restoration was then contoured to create the surface micro anatomy, stained and glazed.
  • 9. 8 Prior to trying in the crown, a Griptab was bonded to the incisal region of the labial surface. This was then used to control the crown while a correct shade of Variolink Veneer bonding resin was chosen using the try-in pastes. The position of the Griptab did not interfere with the selection of the correct shade of bonding resin cement.
  • 10. 9 Once the correct shade had been selected, the Griptab was re-engaged with pin-tweezers and the crown removed from the tooth. The try-in paste was rinsed out prior to HF etching and silanation.
  • 11. 10 Immediately post-cementation, the adjacent teeth were slightly desiccated, which highlighted the white spots in the enamel.
  • 12. 11 A couple of minutes of rehydration began to reduce the intensity of the enamel white spots on the adjacent teeth