Ceramic and Metal Free Solutions
Williams Dental Laboratory has been fortunate enough to have been involved with these systems from their inception into the dental industry. For years companies have consulted with us for feedback and suggestions aimed to increase the effectiveness of these materials for strength and esthetics.
CAD/CAM technology has been successfully adapted to the dental industry with 3D imaging and Virtual Visualization.
To summarize, there are three new types of milled products that have been developed. Leucite reinforced porcelain such as Empress Esthetic (yes we still proudly fabricate Empress Veneers, prepless veneers and crowns), requires bonding and can be used full contour or cut back and layered with translucent porcelains. We prefer the cutback method. Secondly, the stronger but still translucent lithium disilicate porcelain, such as e.max CAD, and e.max press. And finally, the highly tested Zirconia oxide stabilized with yttria such as e.max ZirCad, LAVA, Bruxzir, and Zirlux, colored monolithic solid zirconium. Milled e.max is very interesting because of the greater strength when compared to a waxed and pressed restoration.
The material choice that falls between, or has the hardness of Zirconia and translucency of leucite (Empress Esthetic) is the IPS e.max CAD.
Tough but translucent, e.max CAD can be full contour or layered with porcelain and can be either bonded or cemented. Zirconia (layered with e.max) is the answer to a high strength substitute for metal.
With all of these new materials allowing us in the dentistry profession to provide amazing results, comes a confusion that is mind boggling with too many choices.
Feldspathic (PREPLESS )
Using foil and/or Refractory Technique
We first began doing veneers with these techniques in the late 70’s. A less invasive treatment (prepless or “almost” prepless is preferred by all patients nowadays. The use of feldspathic veneers is resurging. With this comes the desire for thinner veneers and preservation of natural tooth structure. Feldspathic techniques allow us to create thicknesses of less than 0.4 mm. Today, many ceramists are not trained in the art of building powder/liquid porcelains to form the highly esthetic feldspathic veneers, especially thin veneers This creates a problem because the esthetic value exhibited in these restorations depends on the ceramist’s ability to build depth of color and translucency into the restoration. Dentists and their ceramists must also know when it is appropriate to choose what materials to use in a given patients clinical situation.. We are here to help with these choices.
The more inexpensive, solid monolithic zirconia restorations are generally stained and glazed. This is the quickest way to produce them, but in our strong opinion, not the best restoration for your patient. Many studies have shown glazed zirconia is abrasive and can can produce very high wear rates against opposing natural dentition. The staining and glazing process increases the lack of translucency and vitality as well. Our process starts with internally shaded zirconium discs. Both our 1435 MPa and our 650 MPa High Translucent Zirconium are internally stained into the unsintered zirconia to achieve the final desired color, then after the sintering process, we diamond polish our zirconia to a mirror glaze. This not only looks much better than staining and glazing, it also produces highly favorable wear rates against opposing natural dentition. See graph below:
Material loss [μm]
Abrasion characteristics of different materials on the enamel; „Stawarczyk, B.; Özcan, M.; Abrasion Examinations with Different Dental Materials, Dental Materials Unit, University of Zurich, 2010 (in preparation) Based on 1.2 Million Chew Cycles
Zirconium dioxide polished
Enamel
CoCr polished
Zirconium dioxide veneered
Empress Esthetic
IPS Empress® has 20 years of highly proven clinical experience in bonded, esthetic metal-free restorations. With 30 million restorations placed worldwide, IPS Empress delivers amazingly consistent results whether we shade only, or cut back and layer.
Developed in 1991, IPS Empress has become an industry-recognized brand thanks to its esthetics and strength. When paired with our proprietary fabrication technique, every IPS Empress Esthetic restoration exhibits natural contours and vitality, while maintaining high-quality standards for an affordable price.
IPS Empress is highly recommended for anterior single crowns, inlays and onlays. PREPLESS and prepped veneers and can be used for anterior restorations to block out staining, close diastemas or to improve length and proportions.
e.max®
e.max® is a monolithic lithium disilicate ceramic and we call if the “miracle material e.max brings together outstanding esthetics and ultra-precision fit. An alternative to PFMs and zirconia-based restorations, e.max can be pressed or milled depending on the application
Prescribing e.max will ensure optimal esthetics, virtually perfect contacts and occlusion, and impressive strength. Its unique lithium disilicate ceramic provides flexural strength of 360-410 MPa, making it the ideal STRONG choice for single-unit anterior or posterior crowns, veneers, PREPLESS veneers, inlays, onlays, screw-retained implant crowns, 3-unit anterior bridges, posterior bridges in stable occlusions with tall connectors or restorations with minimum preparation.
Conventionally cement using resin ionomer cements or bond for maximum retention on nonretentive preparations. E.max ceramic is highly biocompatible and provides more than double the flexural strength of Empress® Esthetic and feldspathic.
- Outstanding esthetics blending combinations of Veneers, bridges and implants
- Conventional cementation with Multilink
- Choice of high strength materials, Zirconium and glass ceramic
- Pressed and/or CAD/CAM fabrication for both fit and strength
- Single overlay veneering ceramic, delivering one smile chemistry
Lab Processed Composite Restoration
At Williams Dental lab we take pride in using the latest and most durable materials that are on the market. Cristobal, Premise, and Sinfony composite have made our top three selections when considering lab processed indirect restorations. Your indirect onlays and inlays are fabricated to provide a strong, lower-cost option for conservative metal-free dentistry. All of our composites are carefully internally layered with shading, staining, dentin, enamel and incisal translucencies to blend in seamlessly with surrounding tooth structure. The physical properties of a lab processed inlay or onlay are enhanced with additional heat. And vacuum treatment to increase wear and stain-resistance. We will provide ideal marginal fit, full polymerization and lifelike esthetics, all under 20x microscopes.
Williams Dental Lab not only uses processed composite for inlays and onlays but also in addition we use them for metal-free bridges up to four units, full crowns and many orthodontic applications as you sequentially erupt and move adjacent natural teeth. Williams Dental Lab recommends that lab processed composite be used in occlusion with itself, natural enamel or dentin and composites and resin denture teeth.
Zirconia Restoration
We have 5 different zirconium restoration types we provide…. each has their own advantages.
Bruxzir, Emax zirc, Lava, Noritake press, and Zenostar
BruxZir® and Zenostar are Solid Monolithic Zirconia, a monolithic zirconia crown, bridge, screw-retained implant crown, inlay or onlay with no porcelain overlay. These provide a durable, more esthetic alternative to posterior metal occlusal PFMs or cast gold restorations for demanding situations like bruxers, implant restorations and areas with limited occlusal space, and long span bridges. Now, thanks to the new BruxZir™ Shaded formulation, BruxZir restorations exhibit improved translucency and color similar to natural dentition, making them a restorative option in the anterior as well. Complete color penetration all the way through the restorations ensures greater shade consistency and prevents any shade changes after occlusal adjustment.
Designed and milled using CAD/CAM technology, (they fit as well as any restoration we have ever seen), all of these Zirconia can be cutback and layered in the aesthetic zone or shaded for strength.
Ivoclar E.Max
| Material | Ivoclar E.Max |
| Impression Technique | Traditional or Digital |
| Indications | Anterior crown & bridge, posterior crown |
| Recommended Use | Crowns, inlays/onlays, veneers, prepless veneers, Full mouth, (cutback and layered) |
| Preparation | Chamfer, or Shoulder, Modified shoulder |
| Cementation | Adhesive bonding recommended |
| Method of Manufacture | Digitally designed, milled or waxed and pressed |
Lab Processed Composite
| Material | Lab Processed Composite |
| Impression Technique | Traditional or Digital (we print 3D model) |
| Indications | Single unit crowns, multi-unit bridges, inlays , onlays |
| Recommended Use | Conservative or large partial tooth replacement |
| Preparation | Chamfer or shoulder |
| Cementation | Adhesive bonding |
| Method of Manufacture | Traditionally hand built by LVI trained technician |
Prepless Veneers, Emax or feldspathic
| Material | Prepless Veneers, Emax or feldspathic |
| Impression Technique | Traditional or Digital |
| Indications | Aesthetic Enhancement |
| Recommended Use | Veneers |
| Preparation | 0.3mm reduction |
| Cementation | Adhesive bonding |
| Method of Manufacture | Traditionally fabricated via feldspathic build up or waxed and pressed by an LVI trained technician |