To be continued . . ✍🏻 Three main points will be explained to complete the topic : impression, try-in and cementation procedures.
So let’s get started 💁🏻‍♂️
 Impression
The impression may be carried out with addition silicone using One-step impression technique . . check the link 👇🏻
👉🏻 The aim is to get a restoration that reproduce correctly the anatomical and morphological characteristics of natural teeth, well adapted and adjusted, with compatible shade and excellent surface luster.
Now the endocrown is received, whatever from the lab or a chairside one, and tried-in to see if there is need for adjustment before cementation.
⛔️ An interesting task is to assess the occlusal pattern before cementation which significantly eases the adjustment of the restoration at the end of the session.

 Try-in :
Remove the temporary restoration then a prophylaxis with a prophylactic paste is carried out in order to remove any debris or residual of temporary cement.
The operatory field is isolated with a rubber dam.
⛔️ Clinically, the main advantage of try-in the restoration with absolute isolation is the visibility of the margins and the dryness greatly facilitating the assessment and adjustment of the margins.
With this case the first attempt of insertion was not successful, a large space between the preparation margins and the restoration.
After it becomes apparent 👀 that the reason for this discrepancy was the presence of interferences in the proximal region, which prevented the complete seating of the restoration, one should accurately identify the points that require adjustment.
Using a sheet of articulating paper interposed between the restoration and the adjacent tooth 🦷 to demarcate the points with excessive pressure 🤬. Then these regions are gently adjusted with fine and extra fine diamond points until the endocrown has obtained proper seating to the preparation and therefore an optimal marginal adaptation.
The adjusted regions are then polished with special rubbers to remove the cracks generated by the adjustment and give it back its original shine and smoothness.

 Cementation :
For this type of restoration a successful treatment depends on the quality of adhesion, both to the tooth structure as the ceramic surface, because endocrowns do not follow the classical geometric principles responsible for retention and stability.
1️⃣ the internal surface of the restoration is etched with hydrofluoric acid for the time recommended by the manufacturer of the ceramic system then rinse and dry.
⛔️ Holding the restoration with an adhesive device will help you get through the procedures very easily, eg. Optrastick “ Ivoclar vivadent “.
2️⃣ apply several layers of a silane agent to the etched surface. “ almost for 60 seconds “
3️⃣ the preparation surface is etched with phosphoric acid for approximately 15 seconds after protecting the neighboring teeth with celluloid bands. Then rinse and remove the excess moisture.
4️⃣ multiple layers of a light cured adhesive system are applied to the tooth preparation surface.
⛔️ Be careful to remove excesses that tend to accumulate in the internal angles of the preparation. Then the adhesive is light cured.
5️⃣ a thin layer of the adhesive should also be applied to the ceramic surface previously silanized.
⛔️ An interesting tip :
Use two wooden wedges, one on each proximal surface, before the cementation itself. The point is the inversion of the wedges in order not to hinder the insertion of the restoration. In this position, the wedges will prevent excess cement from flowing towards the interproximal spaces, facilitating the finishing procedures and the removal of the marginal excesses.
6️⃣ a dual cued resin cement is then applied to the internal surface of the restoration, which is placed into position and seated with gentle finger pressure.
⛔️ After being fully seated , a spatula for composites is used to maintain slight pressure on the restoration while the adhesive device is pulled and removed.
Then , still maintaining gentle pressure on the restoration the gross excess cement along the entire margins is removed with disposable brushes, spatulas or with an explorer.
7️⃣ a tack cure is performed for about 5 seconds to keep the restoration in position allowing for the through removal of the excess cement and adhesive. The wedges are removed and all excesses are then removed using dental floss and abrasive strips. The final light curing is applied to the whole surfaces , 60 seconds per surface is recommended.
8️⃣ remove the rubber dam , check the occlusal contacts and adjust any premature contacts using fine and extra fine diamond points until obtaining an acceptable occlusal standard.
⛔️ All sites adjusted with diamond points should be polished with special abrasive rubbers for the intraoral polishing of ceramics.
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Finally, the endocrown reveals a simple and fast alternative treatment since it leads to considerable clinical time saving and can be used without damage to the quality of the final result.

Stay blessed
Regards ..