The materials debate

Full ceramics, Aesthetic concept with safety

ZT Carsten fischer,

Frankfurt

Th e

fischer@sirius-ceramics.com

de ba

te

Mellbourne/ Sydney - 2012

safety means a condition which is free from risks of impairment or is regarded as hazard-free.

Nik Wallenda 05-2012 - Niagara Falls

Strength in MPA e.max In-Ceram Zirconia Cerec MK II

Cercon ht In-Ceram Alumina Omega

Procera Alumina Empress

900 675 450 225 0

2007

VITA Celay Dicor

Strength in MPA e.max In-Ceram Zirconia Cerec MK II

Cercon ht In-Ceram Alumina Omega

Procera Alumina Empress

900 675 450 225 0

2007

VITA Celay Dicor

e.max

Cercon ht

900 675 450 225 0

2007

Material concept

Zirconium oxide

Natural Tooth Crows Bridges

(!4-max.5 Units)

double crowns

e.Max

Implants

natural Tooth

Crowns, Bridges Abutments

1-piece, 2-piece 2째 Healingabutments

Abutments, double crowns

2째

Inlays, Onlays, Veneers Crowns

Implants Crowns Healingabutments

8-years results 96 inlays and onlays in 34 patients 8% losses after 8 years: - 6 fractures - 2 endodontic Treatments

Annual failure rate = 1% Kr채mer and Frankenberger 2005

Heat-pressed ceramic veneers 186 ceramic veneers in 61 patients 166 veneers in the maxilla 20 veneers in the mandibulare Criteria of evaluation: color matching, surface structure, marginal adaptation, fracture rate, marginal discolorations Success rate after 5 years:

98.4 % Aristidis, G.A.;Dimitra, B.; Department of Fixed Prosthodontics; University of Athens; Greece Quintessence International 2002; Vol. 33, No. 3.

e.max ! Variety of indications ! adhesive cementation ! challenging ! the technician should

see the patient ! re-polishing?

Clinical studies

(Zr02)

15 Studies about zirconiumoxyd 13 studies about bridges, 2 Single crowns

! Structure fracture non-HIP = 0-8% ! Chipping-rate non-HIP = 0-25% ! Structure fracture HIP = 0% ! Chipping-rate HIP = 6-54%

Breakdown by product name:

Cercon, Lava, denzir, DC-Zirkon, Procera, IPS e.max Zir Al-Amleh et al. , J Oral Rehab 37, 641-652 (2010)

„The most common complication is the veneering .“

Al-Amleh et al. , J Oral Rehab 37, 641-652 (2010)

Cercon smart ceramics developed in collaboration with the University of Z端rich and the Swiss Federal Institute of Technology.

Longest clinical history of available zirconiumoxyd materials from the first research undertaken by the University of Z端rich in 1998.

Cercon is the most clinically tested zirconiumoxyd.

Cercon smart ceramics

more than 6 million restorative units delivered worldwide the only system in the world with a clinically proven strategy for preventing chipping 5,7 Millionen erfolgreich eingegliederten Zirkonoxid-Zahneinheiten.

Zirconium oxide (Zr02)

Fixed resaturations Tooth Crowns , Bridges

(!4-max.5 Units)

Implants Abutments

1-piece, 2-piece Healing Abutments

removable restaurations Tooth Double crowns 2째

Implants Abutments, Double crowns 2째

Double crowns 2째 retainer

(german crown )

Double crowns 2째 retainer

(german crown )

Framework design

(Zr02)

2005

Framework design

(Zr02)

2006-2008

Framework design

(Zr02)

2003

Framework design

(Zr02)

2006-2008

Challenging design

(Zr02)

Scanning failure Retention Heat accumulation/ Chipping Gap of cementation

risc management

(Zr02)

My expectations ... premium product with maximum safety no functional or aesthetic risc through the kind or quality of cementation temporary cementation is optional possible make-up effect (stump color, limited space ...)

+

+

! natural Translucency ! monolythic

! individuell colours ! Colour zones with

receipy ! maximum safety ! no liner materials

Cercon ht /abrasion Zirconium oxide (pol) Ceramco 3 (Veneering porcelain)

Zirconium Oxide (glazeed) e.Max

1500 1125 750 375 0

2007 Wear of the Antagonist (Âľm)

Basunbul&Nathanson, abstract 1650, iadr san diego 2011

Glazed and labside high polished HT- Surfaces have a lower Abrasiveness than any Veneering porcelain. also lower than e.max

Liquides(Cercon ht)

5 sec.

Drying important facts ...

Crown, abutment including items in Premolar size

1h

Molars, three units ! 1.5 h bridge Long-span bridge, suprastructures

!2h

multi colored

Cercon ht what is new, what is different...?

Cercon ht light

Cercon ht medium

Cercon ht / liquid monochrom

Cercon ht multicolor

Cercon ht Pr채p

-reduced riscs through new Pr채pdesign

(root canal treatments)

-more retention through higher stumps

Cercon ht Pr채p

Conservative circular preparation, minimum wall thickness 0.4 mm

! 50 %

Cercon ht full contour

Cercon ht full contour

Adjustments Komet: ZR-Diamanten ZR 801 L, ZR 390, ZR 379 Edenta: DiaCut FV 801, FV 879K, FV 368

re-polishing Diamantierte Silikonpolierer Komet: 94006C, 94006 M, 94006 F Edenta: CeraGloss 332 RA, 3032RA, 30032RA

Re-Polishing

Diamanten 40 "m / Roter ring

Pre-Polish / Blue

High-Polish / Red

B端rste + Diamantpolierpaste

-no liner -colour zones are

part of the display -16 +2 colours (Vita-classical)

Dr. R. Jenatschke

Dr.Rafaela Jenatschke/ Carsten Fischer

Dr.Rafaela Jenatschke/ Carsten Fischer

one year later Dr.Rafaela Jenatschke/ Carsten Fischer

15-08-2011

Requirements

controlled cementation sufficient retention machine quality optimal tissue attachment

ďźť Dr. Paul Weigl- Frankfurt ďź˝

One piece...

Front teeth area

1st. premolar

no limitations

two piece...

Front teeth area

1st. premolar

optimal power consumption perfect machine quality perfect material surface Cercon in the posterior area

studies...

Clinical performance of custom-made zirconia abutments 25 patients with 30 implant-supported single-tooth restorations: 16 incisors, 14 premolars, molars Observationperiod: 36-44 months Bonding with Nimetic-Cem

No screw loosening or Abutment fractures Canullo , Int J Prosthodont 20, 489-493 (2007)

Abutments Titanium/ one-piece

catalog

customized

two-piece Abutments

Hybrid-Abutments (full-contour + adhesive base)

Zirkoniumoxid/ one-piece

catalog

customized

the „save harbour“ of the catalog!

the „save harbour“ of the catalog!

The vertical position of the implant and the scalloped course of the gingiva determine the high and the selection of the abutment.

„cercon ht strikes the right balance between reliable standards and customized aesthetics“

ZT Carsten Fischer - Frankfurt

Full ceramics, Aesthetic concept with safety

Frankfurt

Th e

ZT Carsten fischer,

de ba

te

Sydney - 2012