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22 | cerecdoctors.com | quarter 2 | 2013
crowns. The full spectrum of IPS e.max
CAD (Fig. 8) shows the four new blocks
— C16, B32, A14(L), and A16(L) — to go
with the existing arsenal of LT and HT
chairside blocks (missing are the array of
Impulse blocks). Following are descrip-
tions of the new blocks:
ips e.max cad c16: Often when design-
ing anterior restorations that are long
(particularly canines and centrals), there
was difficulty fitting the restoration
within the C14 block. It was necessary to
do multiple rotations and movements in
the Mill Phase to correct this, sometimes
to no avail. The e.max C16 block allows
these long restorations to fit within the
block with little effort. It is a welcome
addition to those who do many anterior
restorations.
ips e.max cad b32: The e.max B32 is the
first CEREC block approved for full
contour permanent bridges. Ivoclar has
released this block specifically for ante-
rior full contour bridges (Figs. 9 and 10).
Ivoclar’s research concluded that with a
connector cross section of 16mm², it is
safe and reliable to do e.max full-contour
bridges with this block. Since the 4.2 soft-
ware allows this e.max block to be used
for full contour bridges, there are other
uses and options never available before
in the chairside software. Some include
resin-bonded (Maryland) bridges over
18mm in length and splinted anterior and
posterior crowns. This is another great
option for prosthetic needs.
ips e.max abutment blocks: Themost
highly anticipated blocks in recent
memory are Ivoclar’s two abutment
blocks, theMOA14(L) and the LT A16(L)
(Fig. 11). With the addition of the abut-
ment design mode in software V4.2, it
is now possible to produce chairside
custom e.max abutments in a single visit.
Moreover, a screw-retained hybrid abut-
ment crown a can be fabricated, skipping
the abutment all together.
Both blocks have specific purposes. The
LT A16(L) is mainly used for one-piece
| | | s k r a m s ta d
where esthetics is at a premium. One
example is an anterior custom abutment
(Fig. 15). Creating a hybrid abutment and a
separate cementable crown is often advan-
tageous over a one-piece hybrid-abutment
crown due to screw access location.
•
Usually one or two new materials
every few years will come out to aid
certain indications. Software version 4.2
has allowed for a material explosion with
more functional and esthetic options and
materials that provide additional restor-
ative capabilities.
What an exciting time to be a part of
CAD/CAM dentistry!
For questions and more information,
Dr. Skramstad can be reached at
mike@cerecdoctors.com.
8
9
10
11
12
13
14
15
Figs. 8-15: IPS
e.max CAD
choices and
uses.
screw-retained hybrid-abutment crowns.
The milled restorations are bonded to
a Sirona titanium base (one for each
supported implant manufacturer) using
an implant resin by Ivoclar (Fig. 12). This
attachment is a precise, premanufactured
attachment since no margins need to be
milled. Furthermore, there is a custom
antirotational notch built in for further
stability (Fig. 13). The final restoration (Fig.
14) shows there is no need to drill through
the restoration to create a final screw
access hole; it is premade to the position
designed in the software. It is a custom,
one-piece screw-retained restoration that
can be fabricated in a single appointment.
If cement-retained implant restorations
are desired, the MO A14(L) is available.
This medium opacity block is perfect for
blocking out the titanium base in areas