What is the general consensus regarding e.max Lithium Disillicate restorations? Our dental laboratory has been creating e.Max restorations for approximately 6 months. Our doctors have been raving about the fit and the esthetics. We have created small bridges, crowns, inlays and onlays.Ira N. Dickerman, CDT, TEwww.dickermandental.com
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Good tip on the HT ingots- I have moved into doing many of my veneers using LT and either underwaxing or cutting back to be thin and layering to get the best of both worlds. I have found that HT ingots generally look great for partial coverage inlays and most onlays.
As a technician that has been using Emax for over 4 years now, i think that it is down to the surgeons technical know how.
A crown of any material can and will de-bond if not fixed correctly.
We have had cases of this with in experienced surgeons work de-bonding.
On the other hand, we have had surgeons with good understanding of different fixing techniques that swear by Emax and have never had one de bond.
I personally would prefer to fabricate Emax crowns that PBC. The main reason is that with minimal clearance or preparation of the tooth, you can get esthetically beautiful crowns and veneers. You cannot get the same results having to conceal a metal core with porcelain, with no clearance or very little preperation.
The HT pellets that have now been produced are great for smile makeovers and single veneers alike, whilst the LT pellets provide the good all round fail safe that we all know and love. Just a tip though, for any veneer cases that you use HT pellets on, do not make the veneers any thicker than 0.6mm. Any thicker than this causes 'Greying out' of the desired shade.
I would not cement these materials. The bonding technique has proven itself and there is no reason to risk failure when there are many simple one step materials that work wonderfully.
Richard G Knecht said:
Doug, Although many cement these amd Ivoclar advocates this, I am not sure if cementing is the best choice for emax . THis is just a personal view though but have heard many dentist not recomend cementing. Rick
Doug,
Although many cement these amd Ivoclar advocates this, I am not sure if cementing is the best choice for emax . THis is just a personal view though but have heard many dentist not recomend cementing.
Rick
I've been using emax as my main line all ceramic restoration for over a year now. No reason to change....can cement when needed. Not as strong a core as zirconium, but better looking and strong enough. All single unit crowns, though, no bridges yet (although my wife has a 3 unit Eris bridge, #10 pontic-same material) that has severved beautifully.
The flexibility of 'not having to bond' is a wonderful feature. In many arch cases, sometimes it's not practical nor predictable to bond, perhaps in the molar regions. Cementation is more managable. You can bond one tooth, cement the next, and they both look identical. Great help to doing complex cases.
No question zirconia is a very useful material but there is also no doubt about design and technique sensitivity. My migration to e-max is due to the fact that for the most part you are using a very strong monolayer ceramic with only a minimal veneering of secondary ceramic on it. I have never seen a zirconia substructure fracture, but I have seen the veneering ceramic fracture off one part or the other.
On the other hand, I would use a zirconia framework for multi unit fixed cases but limit lithium disilicate to only very short,minimally functional bridges such as replacing laterals-
My experience with zirconia has been very good. We have delivered Procera and Lava Zirconias restorations for many years with a low fracture rate. THe difficulty with zirconia from a dental laboratory perspective is that as a material it has a very high insulating value. Consiquently it requires ceramic firing cycles that allow for more heat soak to properly fuse the feldspathic porcelain That combined with a lower bond strength than PFM's make it more technique sensitive process. The understructure design of zirconia frameworks is also more critical to be sure to have proper support.
Richard Sousa said:
I am all in on e-Max and have been using it as my primary all ceramic for several years Probably 80% of my fixed individual units are done with it including partial coverage which is a major part of my restorative armamentarium.I have been using e-max a lot for veneers as well. The material is incredably strong and ever since they started making the shade matched ingots in low and high translucencies the esthetics are awesome. I have just about eliminated zirconia from my tool box because of an excessive number of material failures. The bond between the core and the layering porcelains is not very good and I have seen a lot of sheering failures.
I am all in on e-Max and have been using it as my primary all ceramic for several years Probably 80% of my fixed individual units are done with it including partial coverage which is a major part of my restorative armamentarium.I have been using e-max a lot for veneers as well. The material is incredably strong and ever since they started making the shade matched ingots in low and high translucencies the esthetics are awesome.
I have just about eliminated zirconia from my tool box because of an excessive number of material failures. The bond between the core and the layering porcelains is not very good and I have seen a lot of sheering failures.
Ira, you've done eMAX bridges from me. The fit and aesthetics are excellent. To date, no problems. I've placed many eMAX CAD crowns with no problems or fractures yet. Some were bonded with Variolink and some inserted with Fujicem.
Replies
A crown of any material can and will de-bond if not fixed correctly.
We have had cases of this with in experienced surgeons work de-bonding.
On the other hand, we have had surgeons with good understanding of different fixing techniques that swear by Emax and have never had one de bond.
I personally would prefer to fabricate Emax crowns that PBC. The main reason is that with minimal clearance or preparation of the tooth, you can get esthetically beautiful crowns and veneers. You cannot get the same results having to conceal a metal core with porcelain, with no clearance or very little preperation.
The HT pellets that have now been produced are great for smile makeovers and single veneers alike, whilst the LT pellets provide the good all round fail safe that we all know and love. Just a tip though, for any veneer cases that you use HT pellets on, do not make the veneers any thicker than 0.6mm. Any thicker than this causes 'Greying out' of the desired shade.
Richard G Knecht said:
Although many cement these amd Ivoclar advocates this, I am not sure if cementing is the best choice for emax . THis is just a personal view though but have heard many dentist not recomend cementing.
Rick
The flexibility of 'not having to bond' is a wonderful feature. In many arch cases, sometimes it's not practical nor predictable to bond, perhaps in the molar regions. Cementation is more managable. You can bond one tooth, cement the next, and they both look identical. Great help to doing complex cases.
On the other hand, I would use a zirconia framework for multi unit fixed cases but limit lithium disilicate to only very short,minimally functional bridges such as replacing laterals-
Richard Sousa said:
I have just about eliminated zirconia from my tool box because of an excessive number of material failures. The bond between the core and the layering porcelains is not very good and I have seen a lot of sheering failures.