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same software you use daily in fabricating crowns, inlay and
onlays. While this is exciting as now clinicians can design their
abutments chairside, the better news is that Ivoclar has at the
same time introduced a full contour e.max abutment block that
does not require a zirconia substructure.
The abutment block is manufactured with a precision-milled
hole that fits precisely on the Sirona Tibase. With this hole pre-
manufactured, the fit of the e.max to the Tibase is perfect. The
clinician can simply mill a full contour block, cement it to the
Tibase outside of the mouth and screw the apparatus in place
and cover the hole with composite, giving
the patient an ideally designed, full-contour
screw-retained crown.
If you don’t want a screw-retained crown,
and want cement retained instead, simply
design the abutment crown, split the file and
you now have a substructure and final crown
similar to how it was done with the zirconia substructure — only
you are not using zirconia for the substructure. You are essentially
using an e.max MO (medium opacity) block for the substruc-
ture and an HT (high translucency) block for the final crown,
completely eliminating the need to sinter zirconia in the office.
It ismy belief thatmore clinicianswill incorporate theCEREC
not only because of the 4.2 software, but because we have the
ability to completely bring the design and fabrication of implant
abutments in-house. Look at your last lab bill for a custom abut-
ment and a crown: you probably paid more than $500, and now
realize that you can do this entire procedure for about $125. Has
the power of the abutment design and e.max abutment block
becomes apparent?
I hope other manufacturers will create their own abutment
blocks. I’d love to have an abutment block made from a provi-
sional material such as Teliocad, or maybe something from 3M
made from the LAVA Ultimate material, so that we have abut-
ment blocks for virtually every clinical situation.
I encourage you to watch the abutment videos onwww.cerec-
doctors.com and learn this technique. We will be teaching this
online but also in the Level 3 class at the Scottsdale Center.
4.2 software is revolutionary, but the shot heard around the
world is coming from Lichtenstein; Bravo Ivoclar for creating
this block.
h a p p e n i n g s i n t h e w o r l d o f c a d / c a m | | | b y s a m e e r p u r i , d . d . s .
The e.max Abutment Block
ADefinite Game-changer
i recently had the opportunity to tour the ivoclar
facility in Lichtenstein, Germany, with some members of our
Mentor Group. Having been to the facility before, I enjoyed the
reaction of theMentors as they saw the beauty of the countryside
and took the tour that was arranged by our friends at Ivoclar.
3M and Vita had also arranged tours and educational clinics
as part of the week-long European tour of CEREC’s partner
companies while we were in Cologne, Germany, for the Inter-
national Dental Show.
At the show, we enjoyed seeing many of the new and upcoming
products: cements, blocks, newCEREChardware andmore. Out of
all theproducts, forme, therewas one clearwinner in terms of
how it will revolutionize the practice of dentistry
for CEREC owners: the e.max abutment block.
If you have the inLab software, a CEREC and
a Galileos cone beam, you no doubt have been enjoying the
ability to create abutments using the Sirona Tibase system. In
this system, a scan body is placed on a titanium base which has
been screwed into the implant. This is scanned by the CEREC
camera — both Omnicam and Bluecam work well scanning the
scan bodies. The scan body essentially tells the software the
position of the implant in the arch. From this data, the clinician
has the ability to design the abutment and final crown.
The shortcoming in this process thus far is that the clinician
was limited to this process by using only the inLab software and
the fact that the abutment that was adhered to the metal Tibase
was milled from zirconia. Zirconia, as you know, is a strong
material but it requires a special sintering oven, which the vast
majority of dental offices do not have. The final crown could be
milled out of any material (e.max, Empress, Vita, LAVA, etc.)
but the zirconia had to be sent to a laboratory for processing.
This process took several days, as the clinician had to wait for
the zirconia substructure to arrive and cement the crown on top.
The other shortcoming of theprocesswas that the abutmentswere
designed only in the inLab software, which the majority of clini-
cians do not use. If you have been to the LEVEL 5 class with Dr.
Mike Skramstad, no doubt you have enjoyed the features of the
inLab software. But for most clinicians, who were relegated to the
chairside software, this great feature of designing your owncustom
abutments became something they were not able to participate in.
With the release of the new4.2 software, I believe thatwe have
come upon a major revolution in CEREC software. The 4.2 soft-
ware has Abutment Design (along with Smile Design, Virtual
Articulation and more) as a part of the chairside software; the
For questions and additional information, Dr. Puri can be
reached at sameer@cerecdoctors.com.