Delivering a Single-Visit Restoration With the glidewell.io In-Office Solution

KEY ATTRIBUTES
This case consisted of a simple preparation process, followed by the scanning, designing, and milling of a full-coverage crown for tooth No. 19. The process was completed during a single appointment.

CASE SUMMARY
The patient presented with a cusp fracture on tooth No. 19 as well as lost marginal integrity on a large amalgam restoration (Figure 1). Dental caries and a missing portion of amalgam on the buccal necessitated a full-coverage crown. These factors, combined with the patient’s desire to receive the restoration as quickly as possible, made this case ideal for the glidewell.io In-Office Solution (Glidewell Laboratories). A BruxZir NOW (Glidewell Laboratories) milling block, the only fully sintered zirconia available for in-office use, was the material of choice due to its strength and long-lasting fracture resistance.

Figure 2. The iTero Element 2 Intraoral Scanner (Align Technology), which integrates seamlessly with the glidewell.io In-Office Solution (Glidewell Laboratories), was used to digitally scan the prepared tooth and create a virtual model for restoration design purposes.	Figure 3. A digital scan of the preparation was taken using the iTero Element 2 Intraoral Scanner, and a virtual model was created. The fastdesign.io Software (Glidewell Laboratories) created a design proposal, which required only minimal adjustment by the clinician.
Figure 4. BruxZir NOW (Glidewell Laboratories), the only fully sintered zirconia for in-office milling, was used to create the final restoration. The strength and long-lasting fracture resistance of BruxZir was ideal for use in this area, and the milling time (less than 40 minutes) suited the patient’s need for a quick turnaround.	Figure 5. The occlusal view of the final restoration, showing its excellent fit. The patient was extremely pleased with the comfort and durability of the restoration, as well as with the speed at which it was delivered.

The glidewell.io In-Office Solution Technique
The tooth preparation process began by removing the old amalgam, exposing the sound tooth structure below. Composite resin material was used to place a new core and direct base, and a minimal tooth reduction was performed. The clinician then scanned the area with the iTero Element 2 Intraoral Scanner (Align Technology) (Figure 2). The built-in features of the scanner automatically confirmed that the scan was complete and sent it as a virtual model to the fastdesign.io software (Glidewell Laboratories).
Using fastdesign.io, which draws upon a library of past cases at Glidewell Laboratories to inform its automated designs, the clinician was presented with an automated design proposal (Figure 3). The clinician then used the tools built into the software to make slight adjustments to the cusps and occlusion.
Once the design proposal was finalized, which took approximately 5 minutes, it was sent from the software to the fastmill.io (Glidewell Laboratories) milling unit with a click of a button. The fastmill.io unit was loaded with a BruxZir NOW zirconia block for milling, which took about 30 minutes (Figure 4). As no firing or glazing was required, the next step was delivery to the patient using standard cement.
The patient was extremely pleased with the quality and fit of the crown, and particularly with the speed at which it was delivered (Figure 5). The strength of the BruxZir NOW material ensures a long, durable life for the restoration so the patient can move forward with confidence.

BENEFITS OF USING THE glidewell.io IN-OFFICE SOLUTION
The components of the glidewell.io system contain a number of intuitive, automated features that ensure accurate results with minimal adjustments required. These features include:
• Simple Scanning. The iTero Element 2 Scanner is intuitively designed for easy digital scans. It’s programmed to confirm that scans are complete, and it displays color-coded flags to alert the user of any areas with missing data so they can be rescanned. In this case, where scanning of the preparation and bite were required, the process was completed in less than a minute.
• Intelligent Design. The fastdesign.io Software uses artificial intelligence and generative adversarial network (GAN) technology to create design proposals that draw upon millions of past cases digitally fabricated at Glidewell Laboratories. This ensures that the proposed crown is so precise that only minimal adjustments are needed, and those adjustments can be completed easily with the built-in software tools or with on-call assistance from Glidewell Laboratories.
• One Click to Mill. One-button operation makes it simple to mill restorations in-office. An intuitive block-loading process and automated machining ensure easy operation, and material blocks mill in less than 40 minutes.

IN SUMMARY
The glidewell.io system made it possible to create a restoration for this patient within a single visit without sacrificing fit, quality, or comfort. This was the key to success in this case and is the primary benefit for patients and clinicians alike who take advantage of the glidewell.io In-Office Solution.

For more information, visit Glidewell Laboratories at glidewell.io.