PowerPoint Presentation

e.max CAD

CadCAM Milled Crystalized Lithium Disilicate

360

Esthetic anterior & premolar crowns

Lithium Disilicate e.max Press

Pressed Lithium Disilicate

e.max ZirCAD

CadCAM Milled Sintered 1,000 Zirconia Yttrium Zirconia

Strong esthetic crown & bridge frames throughout the mouth

e.max ZirPress

Pressed Fluorapatite Glass 110

Esthetic press to zirconia esthetic anterior laminates

e.max Ceram

Layered Fluorapatite Glass

400

90

Esthetic crowns premolar & anterior bridges

Layering all e.max materials

IPS e.max Lithium Disilicate

IPS e.max Press  Lithium disilicate glass ceramic  High flexural strength 400 MPa  16 A-D, 4 Bleach BL shades – LT and HT  Adhesive or conventional cementation  Fabricated through traditional press technique for superb fit and ease of production

IPS e.max Press Indications  Anterior and posterior full-contour crowns  Implant superstructures  Veneers  3-unit anterior bridges  Inlays/Onlays  Thin Veneers

IPS e.max Press Thin Veneer IPS e.max Press can be used for the fabrication of very thin veneers (minimal Prep). If sufficient space is available, e.g. retrusion of a tooth, no preparation is required.

IPS e.max Veneers are not just for “no-prep“ but the right prep.

The following minimum thicknesses for fabricating thin veneers have to be observed:

labial

incisal

0.3 mm

0.4 mm

Advantages • • •

Higher edge strength vs. traditional glass ceramic materials (can be finished thinner without chipping) Low viscosity of heated ingot enables pressing to very thin dimension (minimal prep or no-prep veneers) Chameleon effect due to higher translucency

IPS e.max Press Thin Veneer Please observe the following procedures for the fabrication of thin veneers:  Apply the spacer to the preparation or tooth to be treated according to the veneer preparation guidelines  For thin veneers without preparation, locate the restoration margins in the proximal area as well as along the gingival margin.  Observe the minimum thickness of the veneer.  Sprue, invest, press, divest and remove the reaction layer according to the stipulations  It is possible to apply IPS e.max Ceram Incisal or Transpa.  Conduct the Stain and Glaze firing with IPS e.max Ceram.  Thin veneers have to be adhesively cemented.

Material Properties

Flexural Strength 1200 1100 1000 900 800 700 600 500 400 300 200 100 0 Felds

Pressed Leucite

Lithium

Aluminum

Zirconia

PFM

Flexural Strength 1200 1100 1000 900 800 700 600 500 400 300 200 100 0 Felds

Pressed Leucite

Lithium

Aluminum

Zirconia

PFM

Flexural Strength 1200 1100 1000 900 800 700 600 500 400 300 200 100 0 Felds

Pressed Leucite

Lithium

Aluminum

Zirconia

PFM

Flexural Strength 1200 1100 1000 900 800 700 600 500 400 300 200 100 0 Felds

Pressed Leucite

Lithium

Aluminum

Zirconia

PFM

Flexural Strength 1200 1100 1000 900 800 700 600 500 400 300 200 100 0 Felds

Pressed Leucite

Lithium

Aluminum

Zirconia

Monolithic vs. Zirconia Monolithic Lithium Disilicate Crown

Zirconia Crown

90 MPa

1000 MPa 360 – 400 MPa

Lithium Disilicate – Glass Ceramic for Press

Flexural strength:

400 MPa

CTE (100-400°C): 10.5 ·10-6 K-1 Press temperature:

920° C

Thin Veneer

Wax-up

Pressing Quality

Fitting Quality

Fitting Quality high mechanical stability

Material Thickness

temperature stability Stain / Glaze process

stone die

natural color die

Translucency Effect

Opalescence Effect

Standard Prep

Cross Section 10x magnification

Cross Section 30x magnification

Minimal Prep

Cross Section 10x magnification

Cross Section 30x magnification

No Prep (using feldspathic materials)

Cross Section 10x magnification

Cross Section 30x magnification

No Prep (using lithium disilicate)

Cross Section 10x magnification

Cross Section 30x magnification

Feldspathic Veneer (Foil Technique)

Feldspathic Veneer (Refractory Technique)

IPS e.max Press Veneer

Minimal and No-prep Veneers

Good arch form and axial contours for using a no-prep approach. Dark triangles at cervical embrasures can be easily closed without creating unsanitary contours

IPS e.max Press HT Veneer

IPS e.max Press HT Veneer

IPS e.max Press HT Veneer

IPS e.max Press HT Veneer

IPS e.max Press HT Veneer

IPS e.max Press HT Veneer

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Bonding and Thickness Effect on Fracture Load of CAD/CAM Crowns

Question asked How does thickness and cementation affect the load that a e.max CAD restoration can take?

Objective To measure the fracture load of CAD/CAM lithium disilicate glass-ceramic crowns (e.maxCAD, Ivoclar Vivadent, Inc.) milled with two thicknesses and cemented either conventionally (Vivaglass CEM, Ivoclar Vivadent, Inc.) or adhesively (Multilink Automix, Ivoclar Vivadent, Inc.).

Thickness and Cementation Groups Four groups were used for this study: (1) (2) (3) (4)

Standard thickness and conventional cementation Reduced thickness and conventional cementation Standard thickness and adhesive cementation Reduced thickness and adhesive cementation.

Load to Failure was measured Standard Thickness

Reduced Thickness

Fifteen specimens were produced for each group. A standardized molar crown was scanned using the Cerec InLab (Sirona). Thirty crowns were designed with thicknesses exceeding the minimal dimensions for e.maxCAD material (Standard thickness).

Thirty more crowns were milled with the thickness reduced internally by 0.6 mm. The occlusal morphology was the same for all the crowns. The specimens were then fired and glazed in one firing according to the manufacturer’s instructions in a P500 Programat oven (Ivoclar Vivadent, Inc.).

Load to Failure was measured •The crowns were cemented to composite (Heliomolar, Ivoclar Vivadent) preparations which were formed from the internal surface of each crown using either a conventional cement (VivaglassCEM) or an adhesive cement (Multilink Automix) and stored in water for 24 h at 37°C. The crowns were loaded using a 15 mm diameter steel ball at a crosshead speed of 0.5 mm/min with an Instron Universal Testing machine until a crack was produced.

3500

Failure Load (N)

3000 2500 2000 1500 1000 500 0 e.maxCAD standard conventional

e.maxCAD reduced conventional

e.maxCAD e.maxCAD EmpressCAD standard adhesive reduced adhesive standard adhesive

Thickness and Cementation Type

Effect of Thickness and Cement Type

Conclusion Within this study, increased thickness and adhesive cementation greatly increased the failure load of CAD/CAM lithium disilicate crowns.

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Cementation Effect on the Fracture Load of Two CAD/CAM Materials

Question asked How does cementation affect the failure load for e.max CAD and zirconia core restorations?

Objective To measure the fracture load of CAD/CAM lithium disilicate glass-ceramic crowns (e.maxCAD, Ivoclar Vivadent, Inc.) and zirconia core (Lava core, Lave Ceram 3M/ESPE) cemented either conventionally (Zinc Phosphate, Fleck’s) or adhesively (Multilink Automix, Ivoclar Vivadent, Inc.).

Thickness and Cementation Groups Four groups were used for this study: (1) e.max CAD LT full contour and conventional cementation (2) zirconia core/veneered and conventional cementation (3) e.max CAD LT full contour and adhesive cementation (4) zirconia core/veneered and adhesive cementation.

Load to Failure was measured •Ten specimens were produced for each group.

A standardized molar crown was scanned using the Cerec InLab (Sirona). Twenty crowns were designed with recommended dimensions for lithium-disilicate material. The specimens were fired and glazed according to the manufacturer’s instructions in a P500 Programat oven (Ivoclar Vivadent, Inc.). Twenty copings with proper support were milled in zirconia using the Lava system. These copings were layered in a matrix to full anatomy. The occlusal morphology was the same for all the crowns in the study. All crowns were cemented to composite (Heliomolar, Ivoclar Vivadent) preparations which were formed from the internal surface of each crown using either conventional cementation (Fleck’s Zinc Phosphate) or adhesive cementation (Multilink Automix) and stored in water for 24 h at 37°C. The crowns were loaded using a 15 mm diameter steel ball at a crosshead speed of 0.5 mm/min with an Instron Universal Testing machine.

Mean breaking load [N]

crown crunch test 3500 3000 2500 2000 1500 1000 500 0 Multilink Automix

Fleck's Cement

lava zirconia lava zirconia

Multilink Automix

Fleck's Cement

e.max CAD

e.max CAD

Conclusion

Within this study, adhesive cementation increased the failure load of CAD/CAM crowns, though no statistical difference was found between the crown materials.

IPS e.max Lithium Disilicate Wear

Testing Equipment • Oral Wear Simulator 2000

Strength vs. Wear