Griptab use during shade matching and bonding of an
             anterior, all-ceramic crown




         Griptab Crown Ca...
Griptab use during shade matching and bonding of an
anterior, all-ceramic crown
Graeme Milicich, BDS

Successful shade mat...
Griptab use during shade matching and bonding of an
anterior, all-ceramic crown
Graeme Milicich, BDS


3                  ...
Griptab use during shade matching and bonding of an
anterior, all-ceramic crown
Graeme Milicich, BDS


7                  ...
Griptab use during shade matching and bonding of an
anterior, all-ceramic crown
Graeme Milicich, BDS


10                 ...
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Griptab Crown Clinical Case Study by Graeme Milicich

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Griptab is a must for dentists, dental assistants and lab technicians - anyone handling crowns, inlays, onlays and veneers.
Think of the value of a handle to a cup. Triodent has applied that same principle to indirect restorations. By adhering Griptab to the restoration, you have a reliable grip and total mastery of the placement process, especially when using Triodent Pin-Tweezers for extra maneuverability, although small hemostats will do.

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Griptab Crown Clinical Case Study by Graeme Milicich

  1. 1. Griptab use during shade matching and bonding of an anterior, all-ceramic crown Griptab Crown Case by Graeme Milicich, BDS
  2. 2. Griptab use during shade matching and bonding of an anterior, all-ceramic crown Graeme Milicich, BDS Successful shade matching of a single anterior crown is 1 one of the most challenging aspects of anterior cosmetic dentistry. All-ceramic crowns provide the opportunity to subtly manage the final aesthetics by using various shades of resin cements. During the try-in process, the glycerol- based try-in pastes tend to make the crown slippery and difficult to manipulate. By attaching a Griptab to the incisal region of the crown, manipulative control of the restoration is regained, making assessment of the final shade easier for the clinician. The placement of the Griptab on the incisal edge of the restoration does not affect the cervical 2/3 of the crown where color change can be altered with the use of various resin shades. The Griptab can be used during the HF etching and A 21-year-old female patient presented with a central incisor that silanation phases of bonding and allows for easy transfer had previously had an incisal 1/3 fracture restored with a bonded of the restoration between the assistant and the dentist composite (Fig 1). She had suffered another blow to the tooth and once the bonding resin has been loaded into the crown. the restoration and all the palatal enamel had been lost. The palatal The presence of Silane tends to make the glazed surface fracture was sub-gingival and down to the bone in one area. of a porcelain restoration very slippery, and it is easy to lose manual control of the restoration during this phase of 2 bonding. The light-cured adhesive used to bond the Griptab onto the restoration is not affected by the presence of Silane, as long as the surface of the new crown is cleaned with alcohol prior to bonding the Griptab in place. If contamination is present on the surface, it can affect the Griptab adhesive bond and Silane can then track under the adhesive and cause premature release of the Griptab. 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. US: 1-800-811-3949 UK: 0800-311-2097 CA: 1-866-316-9007 NZ: 0800-TRIODENT INT: +64-7-549-5612 AU: 1-800-350-421 2
  3. 3. Griptab use during shade matching and bonding of an anterior, all-ceramic crown Graeme Milicich, BDS 3 4 5 6 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 (Fig 5 & 6). US: 1-800-811-3949 UK: 0800-311-2097 CA: 1-866-316-9007 NZ: 0800-TRIODENT INT: +64-7-549-5612 AU: 1-800-350-421 3
  4. 4. Griptab use during shade matching and bonding of an anterior, all-ceramic crown Graeme Milicich, BDS 7 8 The milled restoration was then contoured to create the surface Prior to trying in the crown, a Griptab was bonded to the incisal micro anatomy, stained and glazed. 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. The Pin-Tweezers provide secure control during this phase (Fig 9). They allow the assistant to load the crown with the selected bonding resin and hand the crown over without the risk of it being dropped. They also prevent excess cement getting on the outside of the crown, which can make it slippery and hard to handle safely. Once the crown was placed, the Pin-Tweezers were released and the cement was tacked through the labial surface to initially secure the crown prior to removing excess unset resin from the margins. The Griptab was removed from the crown by sliding a flat-bladed metal instrument, like a Wards Wax Carver, under the adhesive. The cement was then fully light-cured and any remnants of resin removed from the crown with a No 11 scalpel. US: 1-800-811-3949 UK: 0800-311-2097 CA: 1-866-316-9007 NZ: 0800-TRIODENT INT: +64-7-549-5612 AU: 1-800-350-421 4
  5. 5. Griptab use during shade matching and bonding of an anterior, all-ceramic crown Graeme Milicich, BDS 10 11 Immediately post-cementation (Fig 10), the adjacent teeth were A couple of minutes of rehydration began to reduce the intensity of slightly desiccated, which highlighted the white spots in the the enamel white spots on the adjacent teeth (Fig 11). enamel. To ensure accurate shade matching in cases like this, it pays to take images right at the beginning of the initial appointment before the adjacent teeth begin to dry out and their apparent color changes. US: 1-800-811-3949 UK: 0800-311-2097 CA: 1-866-316-9007 NZ: 0800-TRIODENT INT: +64-7-549-5612 AU: 1-800-350-421 5

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