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material due to its nearly perfect marginal

fit and clinical longevity.

2

However, due to

its cost, and not being tooth-colored, gold

has seen a significant drop in use,

3

and is

used even less often than PFMs.

The demands of esthetically-driven

patients led to the development of

better all-ceramic systems for restoring

missing or damaged teeth.

For several years, I have been restoring

teeth in my practice using IPS e.max

(Ivoclar Vivadent, Amherst, NY) lithium

disilicate. I utilize this material due to its

nearly universal application

capabilities. IPS e.max has

superior strength, excellent

optical properties andcanbe

it’s no secret that today’s patients

desiremoreestheticsmiles.Often,however,

our patients need restorations to repair

their teeth or reach their esthetic goals.

Inthepast, ifyouneededtorestoremore

than one tooth, it was fairly common to

receive a porcelain-fused-to-metal (PFM)

restoration. In fact, PFMs have enjoyed

more than 40 years of clinical service

with proven success.

1

PFMs are inher-

ently strong due to their metal core, but

that same core causes a dark, opaque look.

Additionally, over time, the veneering

porcelainwears away or chips off.

Another option formultiple tooth resto-

rations is cast gold. Gold has been used to

restore teeth for a longer than any other

Introducing IPS e.max CAD Bridges

Another Use for an All-ceramic Material for Restoring Teeth

c a s e s t u d y

| | |

b y D av i d J u l i a n i , D . D . S .

Case 1 with Dr. Grant Olson

A 35-year-old male patient presented

with impacted canines and anuneven

smile line (Figs. 1-2). He explained

that he would be getting married

in three days and did not want to

undergo extensive orthodontic treat-

ments or implant therapy. A treat-

ment plan was developed to use two

IPS e.max bridges to restore teeth

#5-7 and #10-12, and IPS e.max

veneers for teeth #8 and #9.

Fabrication of both bridges and the

veneers tookapproximately sixhours

to complete and, since the restora-

tions were fabricated in-office, it

was possible to cement the restora-

tions in place before the patient’s

wedding day. The results were a

brighter, wider and more esthetically

pleasing smile (Fig. 3). The patient

was pleased with the results and the

quick delivery of service.

processedeitherbyheat-pressingorCAD/

CAM. It has been used with high success

rates for veneers, single-unit crowns, and

fixed partial dentures for many years.

4

As a cerecdoctors.comMentor and beta

tester, I have had the opportunity to work

with Ivoclar Vivadent and Sirona to fabri-

cate and place several IPS e.max CAD

cases prior to public availability. Having

used the CEREC system in my practice to

fabricate restorations with great results,

I was excited to learn of the new, larger

blocks from IPS e.max for bridges. This

would allow the convenience of CAD/

CAM same-day dentistry

5

to extend into

fabricating bridges.

The IPS e.max CAD LT Bridge blocks

allow clinicians and laboratory techni-

cians tomill up to three-unit bridges, using

any toothup to the secondpremolar in the

anterior region as the abutment tooth.

They also provided the option of using

the cut-back or stain-and-glaze charac-

terization techniques to provide the best

possible results to their patients. Some

individual characterization will likely be

required in most situations, although this

block is available in a variety of low trans-

lucency shades. The IPS e.max Ceram

Incisal and Transpa materials impart

intrinsic characterizations, the Ceram

Shades and Essences provide surface

characterizations and Ceram Glaze is

used to “set” the color and raise luster.

IPS e.max is lithium disilicate, so it can

be either traditionally cemented or adhe-

sively bonded, again choosing the option

that will be best for the patient.

The following presentations demon-

strate how this larger block from the

IPS e.max product line extends our capa-

bilities in offering fast, effective, monolithic

solutions to complicated restorative cases.

Fig. 1: Full preoperative view

Fig. 2: Retracted preoperative view

Fig. 3: Retracted postoperative view

of patient’s IPS e.max bridge block

restorations

1

2

3

It is our responsibility to

deliver to our patients

not only strong but

beautiful restorations

that promote oral health.