|AFTER • IPS e.max crowns #6-#11*|
If we consider ourselves a team working towards the same goal, Renstrom (lab) and dentists should be on the same page at all stages of the dental treatment plan. When the doctor office provides the necessary information as well as the objectives of the dental patient, it makes it easier for the laboratory technician to choose a material that will deliver the best outcome.
Trying to associate each dental material with its unique brand name can be confusing, especially now when there are so many. Dental lab technicians receive a lot of training and education on products at the lab, but at times it can be overwhelming for our doctors.
Although Renstrom generally does make suggestions based on the circumstances of the case, it is beneficial for doctors to be familiar with the different options. The easiest way to differentiate dental products is to understand the technique or technology that each employs.
At Renstrom lab, usually breaks this up in to roughly four different categories, and also look at some general guidelines.
1.) Feldspathic (smile veneers on refractory die): Oldest system in metal free technology. Used when there is a conservative dentist prep design in order to preserve the natural tooth structure. Indicated primarily in the anterior region for teeth with good underlying dentition.
2.) Pressable Ceramics (i.e. Empress, Authentic): After waxed, sprued, and pressed to ingot, cut-back and layering technique is used to achieve desired smile, tooth aesthetics. Doesn’t have the masking ability that zirconia would if the tooth is darker.
3.) Zirconia (i.e. Lava, Procera, InVizion): Copings are designed and fabricated by dental CAD/CAM milling machines. The coping is designed with the required thickness needed for unsupported porcelain to maximize the longevity of the restoration. This is the strongest of the layered all-ceramics. Can be used for crowns, bridges, and dental implant abutments.
4.) Lithium Disilicate (e.Max): This universal dentistry material is either pressed or milled from a variety of translucent blocks/ingots. Applications include full dental crowns, smile makeover veneers, implant abutments, and three unit anterior bridges. Can be pressed as thin as .3 mm but must consider the stumpf shade of the prepared tooth.
The incisal cut back is done on anterior tooth restorations for added porcelain effects. A Shoulder/chamfer margin is needed for full contour crowns and sharp angles should always be eliminated. The full contour tooth structures are stained and glazed, which eliminates the possibilities for porcelain chipping, and therefore increases the strength and durability of the tooth restoration.
When selecting the best dental material choice, dentists should consider the following factors; stumpf shade, occlusion, single unit/bridge, and also cementation preferences. You should also consider the possibility of any future needs of the patient so that similar materials can be used for optimal esthetic matching.
It is always good to keep accurate records of the specific type of crown or bridge, product, and the shade of the patient. This way if something needs adjusting or future work is needed, a more predictable result can be expected.
To ensure the success of the dental material chosen, check all requirements of the product at hand. Proper tooth prep design is a must when it comes to all ceramics as sharp angles and feather edged margins can lead to early failures. Also, the required thickness of each product can vary and so the specific guidelines should always be followed.
If you are a dentist with questions regarding materials or a particular case, we encourage you to give Renstrom Dental Studio (laboratory) call so we can discuss the best treatment plan for your patient!
Vadnais Heights/St. Paul MN
Original Minnesota Dental Lab Materials Article posted here.
MN Lab) is also a Northern Dental Alliance member.
Dick is also a Northern Dental Alliance member.