Witht the changing of economics effecting both dental offices and labs. What are the dentists go to crowns these days, emax, zirconia, captek, pfm. We have seen a slight change from zirconia to Emax. PFM and captek still our biggest request.Here's a captek case we recently got post op pictures.Rick
PFM crowns still have their place, although crowns made with the zirconia substructure are becoming more popular. We use only gold alloy (51% to 75% Au content) for the PFM crowns but with the recent high price of Gold, I think zirconia material seems to be the ideal alternative. Fortunately for us, we have the Cerec In-Lab milling system in the lab, so we mill to our heart's content. Like to share a picture of a recent case.
Like all of you, I get to see all the different materials used at every different level and capability. To be perfectly honest, the all-ceramic materials offer very nice esthetics for many situations. But, they are limited in their scope and versatility. The result can be compromises in the results with respect to tissue health, strength, accuracy, efficacy, and even sometimes esthetics. PFMs have much more versatility and applicability. However, only one material offers it all, versatility, tissue health, and esthetic potential, Captek. Rick has delivered some gorgeous Captek restorations. Attached are two 3-unit bridges I did with the original Captek in about 1997. Only 1 mm facial reduction, margins .5-1 mm below the tissue with metal to the edge, ovate pontics. The order is Pre Op, 1 month post seat, 4 year recall, all 35 mm Ektachrome converted to digital.
Forcing all-ceramics into every situation is not serving the dentist or the patient in the best way at all times. All-ceramics are a viable alternative to consider when truly appropriate. That will not always be the case. However, there is no good reason to continue to use cast PFMs. They are not esthetic, don't fit predictably well, and are horrible for tissue health. The only viable solutions for today's C&B should be an all-ceramic or Captek. If I were in practice today, I would still use primarily, if not entirely, Captek, for the very reasons I have mentioned above and have shown in the attached photos.
Russell, Nice to see you here. We have been doing mostly PFM lately and a few all ceramic. Anyone seeing an increase in work ? Seems my clients are getting pretty busy and the work is flowing pretty steady again. Here's a lava case i did a while back and I do like the VM9 porcelain.
Russell,
Nice to see you here. We have been doing mostly PFM lately and a few all ceramic. Anyone seeing an increase in work ? Seems my clients are getting pretty busy and the work is flowing pretty steady again. Here's a lava case i did a while back and I do like the VM9 porcelain.
HN PFM's are still the majority in my lab. However, I just finished a maxillary reconstruction of porcelain jackets from # 4- #13. Hand stacked the old fashioned way using d-SIGN porcelain on platinum foil substrate. # 3 & # 14 are PFMs with porcelain labial margins. As can be seen in the before photo, the patient shows very large abfractions. The Dr. decided to keep his margins short of these areas. I will be doing the mandibular arch next. I thought this was an interesting case to share.
We are in the US in the Pacific NW and run a high aesthetic boutique lab. We do 90% ceramic restorations on HN - over the last two years, as the price of gold has risen we have seen the GPs opt for Zi over HN - fixed price, better aesthetics, strong enough and very natural. Of our high precision work (we specialize in implantological reconstructions) price has not been a factor and HN is the preferred material for strength, machine-ability and working characteristics.
Right now in our lab e.Max is 50%-55% of all restorations, 30% PFM's (HN), 10%-15% FGC (HN) and I would say a ~5% Zirconia crowns per month. From what I see, our Docs switching to e.Max very fast, not without our help of course.
Got e.Max?
Zirconia has slowed down to and this month I think we are doing like 3 units. Captek and PFM (noble and high noble) are pretty popular. Doing only a few emax though.
Rick
Replies
DSCN3786.JPG
Forcing all-ceramics into every situation is not serving the dentist or the patient in the best way at all times. All-ceramics are a viable alternative to consider when truly appropriate. That will not always be the case. However, there is no good reason to continue to use cast PFMs. They are not esthetic, don't fit predictably well, and are horrible for tissue health. The only viable solutions for today's C&B should be an all-ceramic or Captek. If I were in practice today, I would still use primarily, if not entirely, Captek, for the very reasons I have mentioned above and have shown in the attached photos.
Fran pre op.jpg
Fran 30 day seat.jpg
Fran 4 yr recall.jpg
Nice to see you here. We have been doing mostly PFM lately and a few all ceramic. Anyone seeing an increase in work ? Seems my clients are getting pretty busy and the work is flowing pretty steady again. Here's a lava case i did a while back and I do like the VM9 porcelain.
Hope this comes through.Rick
Dr.002.jpg
Dr.033.jpg
Dr. B.012.jpg
Got e.Max?
We use CrCo Heraenium P from Heraeus Kulzer
Ceramics are Heraceram for metal and Heraceram Zirconia for zirconia
Jorge
Jorge Garcia said:
Rick
-
1
-
2
of 2 Next