We have been charging more, a lot more for all anterior restoration than posteriors. We moved to this in 2008 when the economy went south and most docs were out looking for a deal. Unfortunately, we didn't go up on anterior, we went down on posteriors. Keep in mind, the price reduction was all at a loss of profitability. Any reduction in existing crown fees (unless you change your process and or cost of goods) always comes off the bottom line. And, the only way to get that profit back is to do more work
I find the difficulty with anteriors with CAD and zirconia is more related to the shrinkage, hardness and having all the needed info in the CAD. Respectfully, I don't think the 2D design is a big problem. When designing anteriors. It's more related to not having adequate info.
I like to have a matrix of the final position of the maxillary incisal edges made from a good study model attached to the lower cast when scanned. When making the matrix, the study cast is mounted to the lower model. I don't sink the incisal edge into the puddy. I make the matrix so it is flush with the labial contour of the teeth and angles as smooth transition so the labial aspect of the teeth and puddy are in the same plane. This helps in duplicating the incisal edge position and incisal embrasure locations and the contour of the buccal plane as related to the study model. Keep in mind this is only as good as the study cast so before making the matrix you may want to spend a few minutes adding wax to make the study cast ideal.
When finishing green state, this is where the shrinkage issue come in and we can't put the units on a cast. for contouring. I lay the 6 units on the bench, lined up and try to idealize each unit with rotaries. This is when I try to do everything, including surface texture. I think getting this right the first time is mostly about technique. Both digital and analog.
If designing in 3Shape, make sure you "adjust to opposing" as early in the design process as possible. The software will recognize the matrix as part of the lower occlusion and cut the design to it. If you are careful when making the matrix and have the puddy fill the gap between the overbite and overjet it is like having a custom incisal guide table. The CAD will recognise the matrix material as part of the opposing. Thus when cutting to opposing all interferences with the matrix as well as the lower teeth are removed. This essentially results in a duplication of form of the functional aspect of the lingual contours. Or, a lingual duplication from the centric stops to the incisal edge. In addition, if you try this make sure your setting for reduction to opposing are set to zero.
Kind of difficult to explained. I'll try to post some pics or a video this week.
