Luke S. Kahng is an accomplished lab technician, specializing in high-end ceramic restorations. Luke has served on several major dental journal boards as a contributing member. Luke invented the Chairside Shade Guide: Volumes 1 and 2 and then expanded the offering to a unique ceramic shade guide system named the Seasons of Life Selection. He is owner and President of his own lab, LSK121 Oral Prosthetics, located in Naperville, IL. He has published over 100 articles in major national dental publications.

Luke S. Kahng, CDT

	I have spent the last decade going full force into digital dentistry and mastering the most efficient and successful ways to use state of the art technology to masterfully craft the complex cases that I routinely handle.

	I recently started utilizing the Freedom HD Scanner by DOF for milling in my lab, which allows me to streamline the process of fabricating these cases. The Freedom HD Scanner is fast and compatible with our articulators and allows all-in-one milling, which combines three steps into one. Being able obtain a pre-scan, detailed scan and antagonist scan all in a single step is a remarkable, time-saving convenience for my extremely busy laboratory.

Trending article: 10 reasons for dental labs to be optimistic in 2017 and beyond

	Additionally, being able to read occlusion while the model is attached to the articulator allows us to move more quickly and efficiently through cases. The fact that the quality of the scans does not suffer at the expense of this convenience makes the Freedom HD Scanner an irreplaceable aspect of lab operations. The scans are high quality and accurate, and thanks to the innovative Implant Multi-die scanning process, are conveniently obtained. This is why we have made the Freedom HD Scanner an integral component of our daily lab operations.

, readers can see the patient wearing the maxillary and mandibular dentures fabricated by doctor. 

	Fig. 1                                                                             Fig. 2

, the author shows how to fabricate PMMA with composite gum tissues from doctor’s dentures (image specifically shows the maxillary part).

	Fig. 3                                                                          Fig. 4

 shows the mandibular PMMA, and checking the model fit against the PMMA.

, the maxillary model is placed in DOF Freedom HD Scanner and scanned. 

	 Fig. 5                                                                                    Fig. 6

 shows the author putting Maxillary PMMA provisional on the model in order to scan the two components together. The scanned preview of the digital date in exocad is shown in 

	Fig. 7                                                                              Fig. 8

, scan bodies were attached on the maxillary model for scanning together. The results of the scan are shown in 

More from the author: Technique: A new (digital) way to create a locator bar   

	 Fig. 9                                                                             Fig. 10

 shows the tissue placed on the maxillary model for scanning. The scanned maxillary model with tissue can be seen in 

	Fig. 11                                                                                   Fig. 12

	The mandibular model with tissue were scanned, using the same steps as the maxillary scan (

. The author then read the occlusion relationship directly from the mounted models on the articulator (

	 Fig. 13                                                                                      Fig. 14

	Readers can see the scan resulting from articulated models in 

 shows that all the scan data, including occlusion relation, provisional restorations, base model with implant positions and tissue data.

	Fig. 15                                                                      Fig. 16

	The ease and convenience the Freedom HD Scanner provides has vastly improved lab operations as well as my ability to conveniently and quickly complete complex cases. It is fast, efficient and accurate and is a constant time saver in the way that it combines multiple steps at once. In my opinion, the Freedom Scanner HD is a definite must-have for technicians and laboratory owners, especially those who handle complex cases.

Articles

How one scanner enables this busy lab to improve its scanning speed and efficiency.

Technique: Scan a complex implant case more efficiently

	What an exciting new way to create a locator bar! For the first time, the author has produced a full monolithic cement-retained locator bar that is removable. And it is, in the author’s opinion, absolutely beautiful and exactly what the doctor and patient ordered for this case.  

	Professional thought has been that this type of case would best involve a removable denture that, through the use of female/male locators and implants, then utilizing acrylic material, create a product that is relatively easy to clean for the patient. The cases are generally successful. The difference this time is that the case was fabricated using zirconia, not acrylic, and the esthetic case presentation recorded here is very nice, in the author’s opinion.

	The procedure for fabricating this bar is the same as an acrylic denture, other than slightly different steps than with denture locators. Technicians will find that the solution is almost the same for zirconia as opposed to acrylic, for the most part.

Trending article: Technique: Fabricating full arch implant prosthesis

	In Figure 1, the reader can view the six maxillary and six mandibular implants after mounting on the model. Vertical dimension was checked and it was decided that it would need to be increased. It was too short from implant to implant and needed to be 3-4 mm. The author made note of this and moved on to the scanning stage.

        Fig. 1                                                                      Fig. 2       

	When viewing and scanning the models, the author prefers the high definition Freedom Scanner (

). Note the scanner handles articulation within. Many scanners cannot accommodate this aspect, but this one can, which is a true benefit to the lab. It saves time because articulation can be checked during the scanning process and the model does not have to be re-articulated. The technician can view the color image created by the Freedom Scanner (

        Fig. 3                                                                      Fig. 4       

	A wax try-in was created without having to use a verification jig (

). The doctor would try in the case in order to make certain there was no rocking and that the implants are engaged with each other. Usually there is a hole in the model for this type of case, but as we note here, that was not necessary this time. The author did need a bite block for dimension check, which, after it was verified, allowed the lab to send the tooth try-in to the doctor. In this finalized image, readers can note contour and shape, all verified.

	In Figure 5 we are given the beginning of the case design process. The scan was copied and duplicated from the image in Figure 4, which was used to prove the wax try-in. After nesting, the author moved the case forward onto the milling stage using the Ceramill 2 machine by Amann Girrbach (

        Fig. 5                                                                                  Fig. 6       

	Once milling was completed, the author took an inside shot of the case from the locator aspect. The design would move in that direction (

). After cutting the sprue and grinding the screw area, he cleaned the restorations and applied color to the gingiva and incisal areas. After sintering, at 1530ËC with a two-hour hold time, the restorations were cooled and placed together to check the occlusion contact. Centric contact and occlusion were found to be very good. Please note, the material used was monolithic and so no porcelain layering was necessary, except to the gum tissue area (

     Fig. 7                                                                     Fig. 8                             

     Fig. 9                                                                                  Fig. 10       

	The zirconia locators were finished with GC America Initial ZR gum Lustre Paste applied (

). In this mirrored maxillary image the reader can view the implant on the model from the inside downward-including the male locator part which we easily push down and click into place, creating a perfect fit. Figure 10 is a mandibular view of the exact same procedure. Because the lab is concerned about occlusion while the patient sleeps, they created a soft night guard to be worn in order to ensure that no grinding or bruxing occurs (

     Fig. 11                                                                                  Fig. 12       

) verified color characteristics, reflection and non-reflection. Readers may note that the color is of medium value with some translucency. An underneath-the-mouth occlusion check was performed for contact (

) and found to be exact. In this last image (

), the various stages are represented from model, to wax try-in to the final restoration, for the technicians’ record.

                           Fig. 13                                                               Fig. 14       

	This case was unique and utilized for a special patient. The technique cannot always be used because sometimes there is a lack within the implant placements. However, for this particular situation with this clinician and patient, it was exactly what they preferred and was accepted with great appreciation and satisfaction in the final cementation office visit.

How to create a removable locator bar out of zirconia, CAD/CAM and esthetic expertise

Technique: A new (digital) way to create a locator bar

	Most everyone in dentistry today would argue that the rapid advancement of technology has created in-lab milling restoration possibilities that did not exist even five years ago. If technicians are willing to take advantage of these major advancements, the sky is the limit when it comes to what they can produce. It takes investment, time and educating oneself regarding all this equipment, but it’s worth it, in the author’s opinion, if one wants to control the outcome of one’s production. Waiting time is reduced, there is no anxiety regarding delayed shipments, and the results are stunningly accurate and esthetically pleasing.  

	Today’s study will focus on the up-to-date procedure for fabricating a screw retained denture and the final beautiful results. Dental technicians everywhere can benefit from these step-by-step images and directions.  

Read more: Using new technology for old cases

	Up next: How to use a scanner to achieve great results ...

	In our first image and the first step in fabrication (Fig. 1), the case was placed into the scan body. The reader is viewing the implant model screwed down, as well as the soft tissue model. It has been sprayed with a powder, visible in this image, which turns it a whitish color. This color creates density that the computer can read. In Figure 2, the reader is given a view of the 

	The DOF Freedom Scanner has many excellent qualities which make it the author’s choice for his in-lab scanning system. He has noticed a surge in productivity with the 40-percent increase in speed due to the 

addition, extra precision in design with 10 microns in measurement, an expanded scanning stage which can accommodate large articulators-possibly eliminating the need for re-articulation-and quick, efficient help from experts who test and use the equipment themselves.  His view is that it is a high quality machine that has helped him more competently fabricate his case work.

Related article: Creating an immediate load denture using digital tools

	There are five implants placed in this particular hybrid bar (Fig. 3), which was designed appropriately using the 

. In this image, we see the GC Aadva bar, a purplish color image on the screen. Figure 4 demonstrates the yellow bars nesting stage utilizing the 

 adaptable software milling strategy. The software can be used in either Classic mode, which is a pre-defined template, or in the Expert mode, where the technician can directly adapt the templates to suit the case. The size of the implant is checked with one titanium disc inserted into the nesting stage. The system is highly convenient with excellent machining precision and predictable results, in the author’s opinion.

	In Figure 5, the titanium bars are nestled within the 

 machine, having milled for about six hours in order to create a highly precise milled hybrid bar. Figure 6 illustrates the bar fit to the model in order to check the fit for the final restoration.

	Implant verification jigs with a temporary cylinder along with the final mandibular screw retained denture are pictured next (Fig. 7).  After the processing is finished, the denture is fit to the model for a fit and esthetics check. Note the beautiful tooth and tissue color (Fig. 8).

	The author has been using a product called 

material (Fig. 9) from GC for his acrylic resin work in cases such as this one, with excellent results. It worked well for the wax try-in stage in the maxillary and mandibular models, with tissue characterization shown here. Figure 10 is of a soft tissue model, both the top and bottom, with the same concept as our previous image, eight implants with a screw-retained denture, just in a different patient case.

	Next we are given the left side view of the patient case (Fig. 11) and then a centric view in order to demonstrate the harmony of the teeth and the successful finished results (Fig. 12).

Related reading: Fabricating full arch implant prosthesis

An up-to-date procedure showing how fabricating a screw retained denture can achieve beautiful results.

Technique: Successful implant case with hybrid bar design

	Our patient, a female in her 60s, had undergone a reconstructive dental process 15 years earlier with unfortunate issues involved with the work from the beginning. The porcelain popped off repeatedly, requiring frequent visits to the new dentist and numerous re-cementations.

	She was frustrated and unhappy with the overall case esthetics and the work which had been completed by the previous dentist. She approached the new doctor about re-doing her case and he agreed to undertake the process for her.

	Everything went well with the preparations and temporization process. She could not be happier with her improved bite, new shade and overall esthetics since her case was completed. We will discuss the streamlined process and the excellent outcome within our case discussion. 

Hot topic: How is dental technology REALLY being used?

	Up next: How to utilize the latest technology to achieve fantastic results

In this pre-op view, we can see that the patient had definitely had some dental work completed prior to this appointment (Fig. 1). The patient was unhappy with the appearance of her teeth for several reasons, in the author’s opinion, although she may not have been able to specifically state them. In looking at Figure 1, we can see that tooth numbers 8 and 9 are not symmetrical and are short on the incisal length. Also, number 10 is longer than number 7, and there is a big variation in color between 6, 7, 8, 9, 10 and 11. Some of the restorations are veneers and some are crowns. Veneers, as we know, are thin and we are able to see completely through them. The material we use for veneers is either porcelain or lithium disilicate. Crowns, however, have a certain thickness and a different substructure and were fabricated with either porcelain or lithium disilicate. However, we can now use zirconia with different opacity and more translucency, which translates into a more natural appearance. We can also depend on greater longevity with this material. 

	From the photo, we can also see that there is a large color differentiation between the bridges included in the dental work-specifically numbers 3-5 and 11-13. The patient is a 

, which is why there were problems with cracking and her crowns or veneers popping off. Composite bonding can patch the ceramic work but it is not the same sort of material. It will stain, leading to a mismatch in color. 

	For these reasons and more, material selection can prove to be a very important decision in the long-term. During the 15 years that had elapsed since her original dental work was completed, there were new options from which the dentist and technician could choose in order to improve the patient’s overall appearance and longevity with her case.

	The clinician’s prep work and tissue management was excellent, in the author’s opinion (Fig. 2). There was a nice, deep chamfer for the author to work with (Fig. 2). In this view, we can also see the flat occlusion of the pre-molars and molars, indicating we would need to have a very strong restoration for this bruxing patient. We are next given a close-up view of tooth numbers 7, 8, 9 and 10 after preparation (Fig. 3). 

	The author and the Digital Design Department were able to utilize the latest technology for scanning and designing our patient’s case with the 

 (Fig. 4) after the lab received the case from the dentist. After milling the copings with the 

 milling machine, and after sintering for eight hours, this is the copings’ appearance before color application (Fig. 5). 

	For comparison purposes, the author placed the copings on the model below the upper arch prepped model (Fig. 6). Next, we are given a lingual view of the zirconia copings on the pinned model, after sintering, for a fit to model check (Fig. 7).

Porcelain had not yet been applied, but the author would work toward maximum strength in order for the restorations to hold up under the patient’s grinding habit. Readers, please note that numbers 4 and 5 as well as 12 and 13 are full-contour zirconia restorations. 

	After porcelain application, glazing, polishing and baking, the restorations were placed on the model for an occlusion view
	check (Fig. 8). Maximum patient protection and beauty were the author’s goal with the fabrication of these restorations and it had been achieved.

	An opposite view from Figure 6 shows the final restorations on the model with the prepped model below for another comparison view (Fig. 9). The final restorations were placed on the solid model, with porcelain from the 

	A mirror image of the five single units and two multiple unit bridge restorations-based on color selection between A1 and A2 with translucency (Fig. 11)-follows. Looking at the protrusion view with the mandibular model and the restorations in
	our immediate post-bonding image, we can see the color blending and harmony in the patient’s mouth, as well as the contour and shape of the teeth (Fig. 12).

	In the immediate view after cementation, the differences between pre- and post-treatment are obvious and the patient is gratified with the results (Fig. 13). In this last smile view, please note the final restorations, with the accomplished esthetics sought by the patient and the dentist. Numbers 8 and 9 are 2 mm longer than her original
	restorations and narrower with room for freedom of occlusion. The tone of the restorations is actually two tones lighter than that of her natural dentition (Fig. 14).

	As we can all attest, communication between the dentist and the laboratory is essential. From the lab’s standpoint, the author considers it his duty to help lead the dentist with questions to the very best result. A dentist has the right to expect
	maximum esthetics from a well-experienced technician and will often ask questions when treatment planning a large case such as this one. Through either digital design or phone communication, everyone should have the same expectations going into the treatment stage, with great care taken regarding the reconstruction of the patient’s dentition. This was definitely the pattern that our case study took, and the results show just how well it paid off.

A look at how an existing problems was fixed with new technologies to create a fantastic, esthetic result.

Technique: Using new technology for old cases

Luke S. Kahng, CDT, demonstrates a technique for using a 3D printer, a VARSEO from Bego, to create better models in a restorative case.

Technique: Using a 3D printer for model work

	Dental laboratory techniques are changing, growing more digital and moving toward the electronic age at a rapid pace, as most technicians know. Everything happens at a lightning-fast pace and it can be overwhelming and hard to keep up.

How do we decide what to do? How much money should we spend on the equipment? What should we buy first?

Technique: Using digital dentistry for esthetic implant work

	The author will, in this case study, demonstrate the value he has found in one such piece of equipment and the benefits he believes all dental technicians would reap from purchase of the same. It’s a good value for the money.   

	Pre-operatively, the patient presented with restorations on teeth numbers 6-11. During the custom shading appointment, the patient indicated that he liked the incisal length of number 8 (

	The prep was begun with a diamond burr, with a close-up view of the vertical preparation cut to number 8 (

), sent with an STL file from the cloud by the dentist to the lab.

, the Cambridge nesting software program is put to work using the cartridges that are placed on a plate which blacks out the light using the photosensitive printer. The 

 has 20 micron layers which are flash frozen in order to solidify the liquid which hardens inside and becomes the model.  

Technique: Shade matching in the most difficult case

	The glass plate underneath the cartridge allows the light inside, flashes and hardens the liquid at the points of contact outlined within the digital file from 

 such as iTero, TRIOS, CEREC and Planmeca, among others. During contact with the lens, the program builds the model and prints it onto a face plate in a material which consists of a blended wax and plastic. When it is light cured, it hardens into a dental stone model-like consistency. Supports underneath the vertical or horizontal model are built within the Cambridge program so that the model does not sag or become distorted while being printed.

	Our next image illustrates the nested dies placed far enough apart to be successful in the printing process (

). The image was printed vertically with a full arch model which needed to be properly fit into the plate. Vertical placement will require more support underneath the model and throughout because of the way it lies within the material.

	The finished prints with separate dies and supports follow (

). The approximate time within the printer for a case such as this, vertically placed, is two-to-two-and-a-half hours. The horizontal placement time is less-approximately one-to-one-and-a-quarter hours.

	The time requirement is based on the height of the models. Our image gives the reader a look at the appearance of the liquid within a model after it has been converted to a semi-hardened state-which will be light cured and completely hardened by the technician before being given to the ceramists for completion of the restorations. The solid resolution is between 20-50 microns, with each layer of material being about 20 microns.

	Post-vertical printing will have this appearance (

), with the longest supports varying drastically in size in order to handle the unsupported weight within the model. The liquid must be mixed each time and the glass lens cleaned thoroughly after use in order to be able to utilize the plastic film which is placed over the glass and used 50-75 times before replacing.

 is an example of a print created on a base plate and printed flatly, which is generally a highly successful technique and it eliminates the need for support. The problem is that it wastes materials because the base is simply cut away from the model and the material thrown away. Furthermore, the hollowed models contain excess liquid after printing which is drained and therefore wasted. In the author’s experience, it is better to try and print the models either vertically or horizontally for these reasons.

	In-occlusion models printed and shown on an articulator are featured next (

). Please note the layering of the model’s appearance and the excellent resolution.

), clearly showing the margins, printed out very accurately.

	The two central teeth are shown on the model during a contour and size check (

	Next the author checked the size and symmetry of four front teeth on the model (

), with a mirrored image between the model and the lithium disilicate restorations (

	An occlusion view of the finished restorations shows the reader the veneers for teeth numbers 6, 7, 8 and 11 as well as the crowns for 9, 10 and 12 (

	A final view of the restorations on the model demonstrate the beauty of the 

 restorations using OM2 base color with translucency (

). The author contoured the restorations before sending the finished product to the clinician.

	In order to meet his clients’ demands for fast turn-around, the author purchased the 

 for opportunities to learn about and utilize the technology it provides. He was amazed at how accurate the models’ marginal integrity is compared to the traditional analog method, but there was a learning curve with this piece of machinery just like everything else.

Step-by-step: An alternative approach to long-term temporaries

	The exciting part for him was that he could see the future of the industry! Not only was he impressed with the fit, interproximal contact and marginal integrity, he was glad to learn about the benefits of the STL filing system and all that it could offer. As mentioned earlier, it is a very good value for any technician who is considering what to purchase first in his laboratory and he would recommend its purchase.

	Our latest techniques in digital dentistry are getting faster and better. We have so many options available to us that we did not in years past and our esthetics and overall case design have been greatly improved as well because of these streamlined processes.

	The purpose of this article is to explain digital workflow to create zirconia porcelain layering for a screw retained unit to a full mouth case. There are considerations to look into when fabricating the final restorations securely, such as path of insertion for the implant crown. We also have to look at how deep the implant level is since this will have a major effect on the framework design.

Before we can have a basis for our frame design, we have to have a step-by-step plan from both the doctor’s and the lab’s side of the case.

Technique: An alternative approach to long-term temporaries

	From the lab’s perspective, for this case study, we needed a verification jig as our first step in making sure the six implants engaged together accurately. Secondly, we checked the bite registration and bite block for the denture teeth setting to accurately check the patient’s mid-line, smile line and occlusion.

	The wax try-in indicates the final frame design if we are making a screw-retained denture since occlusion will be lingualized. If we are fabricating a screw-retained zirconia restoration, we will need centric contact-either tri-pod or cusp to fosse. These are all working areas of necessity for the laboratory as they begin work on a case such as the one we will be describing.

	Continue to the next page to go step by step ... 

Fig. 1 Six implants with pink tissue indication

, our image is of the six implant units indicating the pink tissue color. The patient’s natural color has variety with five or six different colors and indicates a reason to utilize as many as possible. The life-like pink esthetics would prove to be essential to create natural looking restorations.

	An impression was taken by the dentist and sent in to the lab after which the technicians fabricated the soft tissue for the model (

	After that was completed, the CAD/CAM technicians completed a scan and design of the model using the 

Ceramill Map400 digital scanning machine from Amann Girrbach

	The next image demonstrates the nesting technique in which the technicians try to increase or decrease the fit of the restorations as they are placed in the zirconia block for correct milling (

	The next step was the milling process, and the technicians milled the restoration in the 

), which we see in the finished product, pictured here.

	The technicians utilized the pre-shading color, liquid shade in an A1 base with pink color for tissue and facial layering porcelain application (

	The zirconia block was modified by hand using a diamond burr. The goal was to create irregular tissue shaping (

	After sintering and applying porcelain over the zirconia blocks, we can see the appearance of the restoration (

). The author used zirconia porcelain from 

Fig. 9 GC Initial ZR second build-up stage

	The final restoration was then seated on the model after the titanium base was cemented to the zirconia framework (

), not before shown. In a mirrored image, the final restoration is shown for the reader in order to note the tissue area indentation and color, whitish-pink with texture.

	The author utilized and applied an A1 base color for the incisal area, with translucency (

	In an occlusion view image, the author gives the reader a view of appearance after 

 application with maximum strength and no porcelain layering involved (

	We can see the internal implant screws in the next mirrored image (

	The finished restoration was photographed in the mouth after immediate try-in (

	A wax try-in model is compared to the final restoration, after duplication (

) to verify fit and appearance based on the beginning stages.

Luke S. Kahng, CDT, explains how he uses CAD/CAM tools to get great esthetics in an implant case.

Luke S. Kahng shows an alternative method to creating a long-term temporary.

	Our case study involves a female patient who was missing her lateral teeth, numbers 7 and 10. An implant had been placed on number 10 because the patient sought longevity in the treatment plan. She also wanted esthetically pleasing provisionals for cosmetic reasons since she would be wearing the restorations long-term-for six-to-nine months.

Our purpose for this article is to demonstrate the best method for fabricating this type of excellent long-term temporization. This type of work is done through the fixed department and is cosmetic in nature.

Must-read: Understanding the reality of the digital workflow

	We have to carefully follow the tooth color in order to get the best results, in this case, matching that of centrals 8 and 9. The criteria the author used for determining whether or not to use the method we will discuss to fabricate this case was, as follows:

		Would patient be interested in long-term option? Cost is higher

		Is the dentist interested in providing this option? Some may not be aware of it

	Click the next button to go step-by-step! 

), we are given a prepped view of the patient’s laterals. (Reader please note: it is the author’s opinion that an implant would be placed on number 7 at a future date, but as of this writing it had not yet been accomplished.) The doctor and patient had agreed prior to the patient visiting the lab that they wanted good-looking, esthetically pleasing long-term temporaries for her.

How-to: How a tablet computer can ensure better esthetics

	In the author’s experience, there is often an issue when the patient presents with no teeth in fabricating a temporary that is acceptable, and it can create some difficulties. In this case as well, the reader may notice that number 10 is wider than number 7 and the teeth will therefore not be the same symmetrically. All of this was noted during the custom shade appointment, as we see in the next image.

 demonstrates custom shade matching techniques the author uses when beginning a patient case. He noted that A2 was too dark compared to her adjacent teeth-about a 20% match. Instead, he decided that a B1/A1 mixture together with 80% translucency and white opacity would be his formula for a perfect shade match.

	Fig. 3 Fiber connection in the restoration on the model

 demonstrates an important stage in the case fabrication. The fiber connection between the teeth is visible in this image, handled with 

. The ribbon is the connector and the author fabricated composite for the lingual area of numbers 6-10.

), the author light-cured the work illuminated in the previous image in order to make sure the case was solid.

	He next applied A2 dentin in order to prepare room for the facial of number 10 (

), after which he applied dentin to number 7 (

Fig. 7 Enamel Opal, white effect; number 7

	The next step in the process was the application of enamel opal, white effect to number 7 (

Fig. 8 Enamel Opal, white effect; number 10

	A Trans Opal application for number 10 followed (

). After contour and shaping, the restorations are shown on the model (

Fig. 10 After contour and shaping appearance

	A mirrored image follows and demonstrates the creation of texture (

) we can see the shape and contour of the emergence profile.

Fig. 12 Occlusion view, shape and contour

 is an occlusion checking image. The author was determining whether or not the occlusion was too heavy in order to prevent fracture.

) is of the final restoration, as completed, and then again on the model (

) after staining and glazing with GC America’s 

, with curing. The problems encountered by the author were due to the difference in width between the two teeth, creating a problem with symmetry, and the fact that one restoration involved an implant and the other did not.

Fig. 15 Final image; stain/glaze, with curing

	This case was one of the most satisfying the author has ever completed because it solves the problem of what to do about long-term temporization in a way that makes the dentist and the patient happy with the result. It’s not complicated to complete, but the technician must have an accurate understanding of occlusion, tooth shape and contour. If the patient has the right type of teeth for the connector to be placed, we can use three color composite material and get excellent results with our staining, curing and shaping techniques. This case produced the best response from a dentist ever regarding provisionals-in the author’s experience. It is with great pleasure that he passes this information on to his colleagues in the hope that you will all benefit from trying this fantastic technique!

	The author thanks Abraham E. Stein, DMD, MS, Skokie, IL for sharing his knowledge and time.