emax ZirPress-VA-d.qxd

ZirPress

INSTRUCTIONS

FOR

USE

TABLE

OF

CONTENTS

3

IPS e.max System – all you need

4

IPS e.max ZirPress – Product Information Material Usage Composition Ingot concept Product overview and description

14

IPS e.max ZirCAD – Practical Use Shade determination Preparation guidelines and minimum thicknesses Criteria for framework design Cementation

19

IPS e.max ZirPress HT – Staining Technique Framework preparation and application of ZirLiner Wax-up Sprueing Investing Preheating Pressing Divesting Removing the reaction layer Finishing Stain and Characterization firing Glaze firing Application example inlay-retained bridge

37

IPS e.max ZirPress LT – Cut-Back Technique Framework preparation and application of ZirLiner Wax-up and cut-back Finishing Veneering with IPS e.max Ceram

46

IPS e.max ZirPress MO – Layering Technique Framework preparation and application of ZirLiner Wax-up Sprueing Divesting Removing the reaction layer Finishing Veneering with IPS e.max Ceram

54

IPS e.max ZirPress Gingiva – Gingiva Technique Criteria for framework design Framework preparation and application of ZirLiner Wax-up Sprueing Investing Finishing Veneering with IPS e.max Ceram

63

IPS e.max ZirPress – General Information Preparing for cementation Press and firing parameters Materials combination table Questions and answers

2

IPS

e.max System ÂŽ

ALL YOU NEED Your purchase of IPS e.max means you have chosen more than simply an all-ceramic system. You have taken the decision to benefit from the unlimited possibilities of allceramic. IPS e.max delivers high-strength and highly aesthetic materials for the PRESS and the CAD/CAM technologies.

The IPS e.max products are unique. They are recognized for their outstanding properties as well as exceptional versatility and flexibility - and they produce results with maximum aesthetics.

The components for the PRESS technique include the highly aesthetic IPS e.max Press glass-ceramic ingots and the IPS e.max ZirPress glass-ceramic ingots for pressing onto zirconium oxide.

Depending on the case requirements, two types of materials are available for CAD/CAM techniques: the innovative IPS e.max CAD glass-ceramic blocks and the high-strength zirconium oxide IPS e.max ZirCAD. The IPS e.max System is further enhanced by the nano-fluorapatite layering ceramic IPS e.max Ceram, which is used as a veneering material for all the IPS e.max components – either glass-ceramics or zirconium oxide ceramics.

This proves that really exceptional all-ceramic systems are well designed. The system allows you to take advantage of a single, standardized layering scheme to offer your dentists and their patients restorations with maximum individuality and naturalness.

3

IPS

e.max ZirPress – ®

P R O D U C T I N F O R M AT I O N M AT E R I A L

USAGE

IPS e.max ZirPress is a fluorapatite glass-ceramic ingot for the press-on technique on zirconium oxide. The fluorapatite crystals contained in the material are of different sizes and therefore selectively control the interplay of translucency, opalescence and brightness of the restorations.

Consequently, complete masking of the less translucent zirconium oxide frameworks is achieved. The presson technique allows you to take advantage of the benefits of the press technique (accuracy of fit) and CAD/CAM processing (milling of zirconium oxide). IPS e.max ZirPress can be pressed onto both IPS e.max ZirCAD single tooth copings and multi-unit bridge frameworks. Very little time and effort is required to press the IPS e.max ZirPress ingots onto the frameworks or copings using the proven PRESS technique. Frameworks onto which IPS e.max ZirPress has been pressed demonstrate precise heat resistant ceramic shoulders. The restorations can be either characterized or veneered with the efficient IPS e.max Ceram material. The superior aesthetic and functional restorations achieved with these materials are costeffective and fully satisfy individual patient requirements.

Indications – For pressing onto IPS e.max ZirCAD single tooth copings – For pressing onto multi-unit IPS e.max ZirCAD bridge frameworks – For pressing onto IPS e.max ZirCAD inlay-retained bridge frameworks – For pressing onto implant superstructures made of IPS e.max ZirCAD (single tooth copings and bridge frameworks) – For pressing onto frameworks, implant abutments and implant superstructures made of sintered zirconium oxide and HIP zirconium oxide, which have a CTE in the range of 10.5-11.0 x 10-6 K-1

CTE (100 - 400 °C) [10-6 /K]

9.8

CTE (100 - 500 °C) [10-6 /K]

9.9

Flexural strength (biaxial) [MPa]*

110

Vickers hardness [MPa]

5400

Chem. solubility [µg/cm2]* Press temperature [°C]

(100-500 °C).

– Veneers

Contraindications – The material should not be pressed onto zirconium oxide frameworks that have a CTE in a range other than that specified – The material should not be pressed onto non-sintered zirconium oxide frameworks – Very deep subgingival preparations – Patients with severely reduced residual dentition – Bruxism

Important processing restrictions Failure to observe the following restrictions may compromise the results achieved with IPS e.max ZirPress: – IPS e.max ZirCAD frameworks and connectors must not fall below the minimum thickness specified – IPS e.max ZirPress ingots must not be pressed on the zirconium oxide framework without prior application of IPS e.max Ceram ZirLiner – IPS e.max ZirPress ingots must not be pressed without a zirconium oxide framework (with the exception of veneers) – Veneering ceramics other than IPS e.max Ceram must not be used – The press ceramic must not fall below the required minimum thickness – Do not press onto metal frameworks – Do not press onto other zirconium oxide frameworks that do not comply with the specifications of the manufacturer regarding the minimum framework and connector thickness

30

Side effects If a patient is known to be allergic to any of the components in IPS e.max ZirPress, the material should not be used.

900-910

*according to ISO 6872

4

COMPOSITION IPS e.max ZirPress ingots and the processing accessories consist of the following main components: –

IPS e.max ZirPress Ingots Components: SiO2 Additional contents: Li2O, Na2O, K2O, MgO, Al2O3, CaO, ZrO2, P2O5 and other oxides

–

IPS e.max Alox Plunger Components: Al2O3

–

IPS e.max Alox Plunger Separator Components: Boron nitride

–

IPS e.max Press Invex Liquid Components: Hydrofluoric acid and sulphuric acid in water

–

IPS Natural Die Material Components: Polyester urethane dimethacrylate, paraffin oil, SiO2 and copolymer

–

IPS Natural Die Material Separator Components: Wax dissolved in hexane

–

IPS PressVEST Powder Components: SiO2 (quartz powder), MgO and NH4H2PO4

–

IPS PressVEST Liquid Components: Colloidal silicic acid in water

–

IPS PressVEST Speed Powder Components: SiO2 (quartz powder), MgO and NH4H2PO4

–

IPS PressVEST Speed Liquid Components: Colloidal silicic acid in water

5

INGOT CONCEPT The shading and opacity control of the IPS e.max ZirPress ingots is based on an unique translucency/opacity concept. The system is flexibly organized and can be used with both A-D and Bleach BL shades. IPS e.max ZirPress ingots are available in 3 levels of translucency. Additional IPS e.max ZirPress Gingiva ingots are available for fabricating gingival parts for e.g. implant superstructures.

The individual levels of the concept are determined by indications and application to achieve maximum flexibility and versatility. The individual opacity and translucency levels are distinguished by means of a colour code to facilitate the selection of the proper ingot.

Processing technique Translucency level

Staining technique

Cut-back technique

Layering technique

Pressing without ZrO2 framework

Pressing on ZrO2 frameworks Single tooth copings

Veneers

(anterior and posterior)

Multi-unit bridge frameworks

Implant abutments/ Superstructures

Inlay-retained bridge frameworks

3

High Translucency

3

3

3

3

Low Translucency

3

3

3

3

3

3

3

Medium Opacity

Gingival parts

3

Gingiva CR %

IPS e.max ZirPress HT (High Translucency) The ingots are available in the 9 most popular A-D and 4 Bleach BL shades. Due to their translucency, they are ideally suitable to be pressed fully anatomically on zirconium oxide frameworks (staining technique). Characterization and Glaze firing is conducted using IPS e.max Ceram Shades, Essence and Glaze materials. If adjustments are required, the IPS e.max Ceram layering materials are used.

IPS e.max ZirPress LT (Low Translucency) The ingots are available in the 9 most popular A-D and 4 Bleach BL shades. Due to their translucency, they are ideally suitable for both the cut-back and the staining technique. The cut back areas are subsequently completed using IPS e.max Ceram Incisal and Impulse materials. The restorations are characterized with Shades and Essence materials.

IPS e.max ZirPress MO (Medium Opacity) The ingots are available in the 9 most popular A-D and 4 Bleach BL shades. Because of their opacity, they are ideal for pressing a dentin core or shoulder onto zirconium oxide frameworks. The restorations are individually built up to full contour with the IPS e.max Ceram veneering materials.

IPS e.max ZirPress Gingiva The ingots are available in two shades (G3 and G4). They are particularly suitable for pressing large gingival parts to the zirconium oxide framework for fabricating implant superstructures. The restoration is layered with the IPS e.max Ceram materials, while the accuracy of fit of the gingival parts is maintained.

6

PRODUCT OVERVIEW AND DESCRIPTION IPS e.max ZirPress Basic Kit MO/LT/HT

The IPS e.max ZirPress Basic Kit MO/LT/HT contains the 12 most popular ingots for the staining, cut-back or layering technique, as well as the necessary processing accessories. The Basic Kit is supplied in a material box and can be combined as desired with other IPS e.max Basic Kits and additional assortments.

Delivery form: IPS e.max ZirPress Basic Kit – 2x 5 IPS e.max ZirPress MO ingots; Shades MO A2, MO A3 – 5x 5 IPS e.max ZirPress LT ingots; Shades LT BL2, LT A1, LT A2, LT A3, LT B1 – 5x 5 IPS e.max ZirPress HT ingots; Shades HT BL2, HT A1, HT A2, HT A3, HT B1 – 1 IPS e.max Investment Ring System, 100 g – 1 IPS e.max Investment Ring System, 200 g – 1 IPS Silicone Ring 100 g – 1 IPS Silicone Ring 200 g – 2 IPS e.max Alox Plungers – 1 IPS e.max Alox Plunger Separator, 200 mg

IPS e.max ZirPress HT (High Translucency) Ingots

IPS e.max ZirPress HT (High Translucency) ingots are particularly suitable for the staining technique. They are available in one size in the 9 most popular A–D and in 4 Bleach BL shades.

Delivery form: IPS e.max ZirPress HT Ingots – 13x 5 IPS e.max ZirPress ingots; Shades HT BL1, HT BL2, HT BL3, HT BL4, HT A1, HT A2, HT A3, HT A3.5, HT B1, HT B2, HT B3, HT C2, HT D3

IPS e.max ZirPress LT (Low Translucency) ingots for the staining and cut-back technique are available in one size and in the 9 most popular A–D and in 4 Bleach BL shades.

IPS e.max ZirPress LT (Low Translucency) Ingots

Delivery form: IPS e.max ZirPress LT Ingots – 13x 5 IPS e.max ZirPress ingots; Shades LT BL1, LT BL2, LT BL3, LT BL4, LT A1, LT A2, LT A3, LT A3.5, LT B1, LT B2, LT B3, LT C2, LT D3

7

IPS e.max ZirPress MO (Medium Opacity) Ingots

IPS e.max ZirPress MO (Medium Opacity) ingots for the layering technique are available in one size and in the 9 most popular A–D, as well as in 4 Bleach BL shades.

Delivery form: IPS e.max ZirPress MO Ingots – 9x 5 IPS e.max ZirPress ingots; Shades MO BL1, MO BL2, MO BL3, MO BL4, MO A1, MO A2, MO A3, MO A3.5, MO B1, MO B2, MO B3, MO C2, MO D3

IPS e.max ZirPress Gingiva Ingots

IPS e.max ZirPress Gingiva ingots for pressing gingival parts are available in one size and in 2 shades.

Delivery form: IPS e.max ZirPress Gingiva Ingots – 2x 5 IPS e.max ZirPress ingots; Shades G3, G4

8

IPS e.max Alox Plunger

The ceramic ingot, in its softened state, is pressed into the hollow space in the investment ring by means of the IPS e.max Alox plunger.

It features a larger diameter and is slightly shorter than the IPS Empress Alox plunger and is thus only suitable for the IPS e.max investment ring system. Both ends of the Alox plunger are rounded, which makes both sides suitable for pressing. In this respect, the new plunger is different from the existing plungers.

Delivery form: IPS e.max Alox Plunger – 2 IPS e.max Alox Plungers

IPS e.max Alox Plunger Separator

The IPS e.max Alox Plunger Separator prevents the ingot from sticking to the Alox plunger during pressing and cooling in the investment ring. The cold Alox plunger is inserted into the recess and rotated. The powder adheres to the surface and thus forms a separating layer. A very small amount of Separator is sufficient. The cold, prepared Alox plunger is subsequently inserted into the preheated investment ring immediately before pressing.

Delivery form: IPS e.max Alox Plunger Separator – 1 IPS e.max Alox Plunger Separator, 200 mg

The IPS e.max investment ring system is used to sprue the contoured restorations. The base has been enlarged so that the IPS Silicone Ring optimally fits onto the base. The larger IPS e.max investment ring base thus substantially differs from the IPS Empress investment ring base, which prevents the two bases from being confused.

IPS e.max Investment Ring System

Delivery form: IPS e.max Investment Ring System, 100 g – 3x IPS e.max Investment Ring Bases, 100 g – 3x IPS e.max Investment Ring Gauges, 100 g IPS e.max Investment Ring System, 200 g – 3x IPS e.max Investment Ring Bases, 200 g – 3x IPS e.max Investment Ring Gauges, 200 g

IPS® Silicone Rings

– IPS Silicone Ring small for the IPS Empress and IPS e.max investment ring system, 100 g – IPS Silicone Ring big for the IPS Empress and IPS e.max investment ring system, 200 g Delivery form: – IPS Silicone Ring small, 100 g – IPS Silicone Ring big, 200 g

9

IPS® Sprue Guide

The IPS Sprue Guide helps to check the correct sprueing of the objects to be pressed on the investment ring base.

Delivery form : – IPS Sprue Guide, 100 g – IPS Sprue Guide, 200 g

IPS® PressVEST Investment Material

IPS PressVEST is an optimized, phosphate-bonded investment material for the conventional heating method (overnight). It produces pressings that fit accurately and can be used with the following Ivoclar Vivadent ceramics to be pressed in the EP 500, EP 600, EP 600 Combi and Programat EP 5000 press furnaces: – IPS e.max Press – IPS e.max ZirPress – IPS Empress Esthetic – IPS Empress Cosmo IPS PressVEST cannot be used for metal casting due to the high temperatures.

Delivery form: IPS PressVEST – 25x 100 g IPS PressVEST Powder – 1x 0.5 l IPS PressVEST Liquid – 50x 100 g IPS PressVEST Powder – 1x 1 l IPS PressVEST Liquid

IPS® PressVEST Speed Investment Material

IPS PressVEST Speed is a phosphate-bonded investment material for the rapid heating method (during the day). It can be used with the following Ivoclar Vivadent ceramics to be pressed in the EP 500, EP 600, EP 600 Combi and Programat EP 5000 press furnaces: – IPS e.max Press – IPS e.max ZirPress – IPS Empress Cosmo IPS PressVEST Speed cannot be used for metal casting due to the high temperatures.

Delivery form: IPS PressVEST Speed – 25x 100 g IPS PressVEST Speed Powder – 1x 0.5 l IPS PressVEST Speed Liquid – 50x 100 g IPS PressVEST Speed Powder – 1x 1 l IPS PressVEST Speed Liquid

10

The IPS e.max Press Invex Liquid is used to soften the surface reaction layer formed on pressed IPS e.max Press and ZirPress objects during the pressing procedure.

IPS e.max Press Invex

Delivery form: IPS e.max Press Invex – 1x 1 l IPS e.max Press Invex

The light-curing IPS Natural Die Material simulates the shade of the prepared tooth and thus represents the optimum basis for natural shade reproduction of the given oral situation when fabricating allceramic restorations.

IPS Natural Die Material is available in 9 shades for all preparation variations ranging from bleached preparations (ND 1) and secondary dentin that demonstrates an intensive shade (ND 6) to severely discoloured preparations (ND 9).

IPS Natural Die Material

The following chart shows the arrangement and designations of IPS Natural Die Material shades compared to those of the IPS Empress Die material.

IPS Natural Die Material

ND 1

ND 2

ND 3

ND 4

ND 5

ND 6

ND 7

ND 8

ND 9

IPS Empress Die Material

–

St 9

St 1

St 2

St 3

–

St 8

St 5

–

Delivery form: IPS Natural Die Material KIt – 9x 8 g IPS Natural Die Material, Shades ND 1, ND 2, ND 3, ND 4, ND 5, ND 6, ND 7, ND 8, ND 9 – 1x 20 ml IPS Natural Die Material Separator – 8x 10 IPS Condensers – 8x 10 IPS Die Holders – 2x Universal Holders – 1x IPS Natural Die Material Shade Guide

11

Programat® EP 5000

The Programat EP 5000 is a combinatinon furnace which can be used as both a press and ceramic furnace. The furnace features a large high-resolution graphic colour display with touch screen function. The OSD (Optical Status Display) shows the current operating status of the furnace. The furnace is equipped with the QTK heating muffle technology, which enables optimum firing and press results.

The new press drive with IPF (Intelligent Press Function) enables high-quality press results with faster processing times. The CDS (Crack Detection System) is able to identify cracks in the investment ring in time and to interrupt the press procedure, if required.

Delivery form: Programat EP 5000 Basic Equipment – 1x Programat EP 5000 – Cooling Tray, Automatic Temperature Checking Set 2 (Test Pack), Cooling Grid for Investment Ring, Power Cord, Vacuum Hose, Press Plunger, USB Stick, USB Download Cable, CD-ROM with various programs (PrograBase 2)

Programat® P300

The Programat P300 furnace, which is reduced to the essentials, is an inspiration due to its cost-effectiveness. Furthermore, it features a convincing and easy operating concept. A simple menu structure with clearly arranged symbols guides the user during the application of the programs. The furnace is equipped in the factory with preset programs for IPS e.max, IPS d.SIGN, IPS InLine and IPS Empress System and it convinces users with its modern, timeless design.

Delivery form: Programat P300 Basic Equipment – Programat P300 – Power Cord, Vacuum Hose, Temperature Calibration Test Pack, Programat Firing Tray Kit

Programat® P500

Optimum firing results for glazing materials, stains, and ceramic materials can be achieved with the user-friendly Programat P500 ceramic furnace. This new ceramic furnace combines high-tech and design. The combination of the membrane-sealed keypad and the large, clearly arranged graphic display with touch screen function facilitates operation. The homogeneous heat emission due to the new muffle technology, the easy, precise and automatic temperature calibration, as well as the 300 firing programs make the P500 an indispensable companion in the laboratory.

Delivery form: Programat P500 Basic Equipment – Programat P500 – Power Cord, Vacuum Hose, Temperature Calibration Test Pack (ATK2), Programat Firing Tray Kit, USB Download Cable, USB Stick Programat

12

Programat® P700

The Programat P700 features a large high-resolution graphic colour display with touch screen function, which is used to show digital colour images of patients and teeth. The OSD (Optical Status Display) uses different colours to inform you about the current operating status of the furnace. Hence, the current process of the furnace can be observed, even from a distance.

The furnace is equipped with the QTK heating muffle technology, which enables optimum firing results.

Delivery form: Programat P700 Basic Equipment – Programat P700 – Power Cord, Vacuum Hose, Temperature Calibration Test Pack, Programat Firing Tray Kit, Multimedia USB Stick

13

IPS

e.max ZirPress – ®

PRACTICAL USE S H A D E D E T E R M I N AT I O N The correct tooth shade is the basis for true-to-nature restorations. After tooth cleaning, the tooth shade of the non-prepared tooth and/or the adjacent teeth is determined. Individual characteristics have to be considered when determining the tooth shade. If a crown preparation is planned, for example, the cervical shade should also be determined. In order to achieve as lifelike results as possible, shade determination should be carried out at daylight. Furthermore, the patient should not wear clothes of intensive colours and/or lipstick.

Basically, it has to be kept in mind that the final shade of the restoration is the result of the following individual shades: – Shade of the prepared tooth – Shade of the ingot – Shade of the layering ceramic – Shade of the cementation material

IPS Natural Die Material In order to reproduce the desired tooth shade more easily and reliably, the shade of the preparation can be determined using the IPS Natural Die Material shade guide. In this way, the fabrication of all-ceramic restorations is facilitated and a patient's individual characteristics can be taken into considered. As the shade of the prepared tooth is defined, the dental technician is in a position to control the shade and brightness of the restoration during the individual working steps.

14

PREPARATION GUIDELINES AND MINIMUM THICKNESSES Successful results can only be achieved with IPS e.max ZirPress if the guidelines and framework thicknesses of IPS e.max ZirCAD are strictly observed.

Single crowns and 3-unit bridges Evenly reduce the anatomical shape and observe the stipulated minimum thicknesses. Prepare a circular shoulder with rounded inner edges or chamfer at an angle of approx. 10-30째. The width of the circular shoulder/chamfer is approx. 1 mm.

Reduction of the crown third - incisal or occlusal areas - by approx. 1.5 mm. For anterior crowns, the labial and palatal/lingual part of the tooth should be reduced by approx. 1.2 mm. The incisal edge of the preparation should be at least 1 mm (milling tool geometry) in order to permit optimum milling of the incisal edge during CAD/CAM processing.

1.5

1.0

1.5 1.2

1.0

1.2

1.2

1.0

1.2

1.2

1.0

1.0 6째

1.5

1.0

Multi-unit bridges

2.0

1.0

2.0 1.5

1.0

1.5

1.5

1.0

1.0

1.5

1.0

1.5

6째

2.0

15

CRITERIA FOR FRAMEWORK DESIGN The framework design is the key to the success of durable all-ceramic restorations. The more attention given to the framework design, the better the final results and the clinical success will turn out to be.

The following basic guidelines have to be observed: – The framework material is the high-strength component of your restoration and must, therefore, be designed in such a way that it supports the shape of the restoration and the cusps. Reinforcements and supports have to be built up using the corresponding tools of the respective software.

– In large preparations, the excess in available space must be compensated by the design of the framework and not by the press material.

– If possible, the connector design should be extended in the vertical (inciso-cervical) direction, rather than in the sagittal (linguo-vestibular) or horizontal direction.

– It is not always possible to establish the necessary connector dimensions with regard to the sagittal (linguo-vestibular) region. In these cases, the connector dimensions must always be increased in the vertical (inciso-cervival) direction.

– Reducing the framework thickness always relates to a reduction in strength.

– The integrated parameters in the software are basic recommendations. Depending on the overall thickness of the restoration it can be necessary to adjust the parameters.

The following minimum thicknesses for the framework design with IPS e.max ZirCAD have to be observed: Anterior region

Crowns

Splinted crowns

3-unit bridges

4- to 6-unit bridges with 2 pontics

Cantilever bridges with 1 pontic

Minimum framework thickness

circular

0.5 mm

0.5 mm

0.5 mm

0.7 mm

0.7 mm

incisal

0.7 mm

0.7 mm

0.7 mm

1.0 mm

1.0 mm

-

7 mm2

7 mm2

9 mm2

12 mm2

Connector dimensions Design

supporting the tooth shape

Posterior region

Crowns

Splinted crowns

3-unit bridges

4- to 6-unit bridges with 2 pontics

Cantilever bridges with 1 pontic

Minimum framework thickness

circular

0.5 mm

0.5 mm

0.5 mm

0.7 mm

0.7 mm

occlusal

0.7 mm

0.7 mm

0.7 mm

1.0 mm

1.0 mm

mm2

mm2

mm2

12 mm2

-

Connector dimensions

9

9

12

supporting the tooth shape

Design

Anterior and posterior crowns

wrong

correct

16

correct

wrong

correct

wrong

correct

wrong

Bridges

correct

wrong

Failure to observe the stipulated framework design criteria, minimum thicknesses, and minimum connector dimensions may result in clinical failures, such as cracks, delamination, and fracture of the restoration.

17

C E M E N TAT I O N For the cementation of IPS e.max restorations, you may choose between the tried-and-tested cementation materials from the coordinated assortment of Ivoclar Vivadent.

Variolink® II / Variolink Veneer The dual-curing, highly aesthetic luting composite Variolink II has been successfully used for more than 10 years and offers excellent clinical results. The light-curing Variolink Veneer is especially indicated for the adhesive cementation of veneers to achieve enhanced shade and translucency effects.

Multilink® Automix The universal, dual-curing luting composite offers a wide range of indications. Furthermore, it generates a very strong bond on all material surfaces.

Vivaglass® CEM Vivaglass CEM is an aesthetic glass ionomer cement for the conventional cementation of high-strength all-ceramic restorations (zirconium oxide and lithium disilicate ceramics). Vivaglass CEM contains a particularly transparent glass filler for achieving aesthetic results.

Cementation

Thin veneers, veneers

adhesive

self-adhesive* / conventional

3

–

Partial crowns

3

Anterior and posterior crowns, 3-unit bridges up to the second premolar

3

3

IPS e.max ZirPress

Veneers

3

–

IPS e.max ZirCAD + IPS e.max ZirPress

Inlay-retained bridges

3

–

IPS e.max ZirCAD

Crowns and bridges

3

3

Veneers

3

–

IPS e.max Press

IPS e.max CAD

IPS e.max Ceram

–

Anterior and posterior crowns

3

3

Veneers

3

–

Variolink II Variolink Veneer Multilink Automix

Vivaglass CEM

Recommended cementation materials 3 – *

3

Partial crowns

–

recommended product combination not recommended/product combination not possible self-adhesive powder-liquid systems

18

IPS

e.max ZirPress HT – ®

S TA I N I N G T E C H N I Q U E The staining technique can be used to fabricate very aesthetic restorations with IPS e.max ZirPress and IPS e.max ZirCAD in conjunction with the press-on technique. The fully anatomical wax-up is reproduced in ceramic by a press procedure.

Consequently, the shape and function are maintained. Finally, the restoration is individually characterized using IPS e.max Ceram Shades and Essence materials.

Framework preparation and application of ZirLiner The sintered IPS e.max ZirCAD framework (please refer to the IPS e.max ZirCAD Instructions for Use for the fabrication) is tried in on the model. The margins can be trimmed up to the inner edge of the chamfer or shoulder preparation to make room for the pressed ceramic shoulder. After the adjustments have been made, the framework must still exhibit the required minimum thickness. Please observe the following procedure: – Clean the framework under running water or with a steam jet prior to veneering.

– The framework must not be blasted with Al2O3, since this would damage the surfaces.

– IPS e.max Ceram ZirLiner must always be applied prior to the wax-up in order to achieve a sound bond, as well as an in-depth shade effect and fluorescence.

– Direct press-on procedures on ZirCAD frameworks without using IPS e.max Ceram ZirLiner results in a poor bond and may lead to delamination.

– Mix the IPS e.max Ceram ZirLiner in the desired shade with the respective IPS e.max Ceram ZirLiner Build-Up Liquid to a creamy consistency.

– For shaded zirconium oxide frameworks, use IPS e.max Ceram ZirLiner clear.

– If a different consistency is desired, the IPS e.max Ceram Build-Up Liquids (allround or soft) as well as the IPS e.max Ceram Glaze and Stain Liquids (allround or longlife) may be used. The liquids may also be mixed with each other at any mixing ratio.

– Apply ZirLiner on the entire framework, paying special attention to the margins. If required, the restoration may be vibrated until an even, greenish colour effect is achieved. If the colour appears too pale, the layer is too thin.

– For more intensively shaded areas, 4 IPS e.max Ceram Intensive ZirLiners (yellow, orange, brown, incisal) are available.

– After that, the applied ZirLiner is dried and fired.

– The IPS e.max Ceram ZirLiner should have a layer thickness of approximately 0.1 mm after firing.

Sintered IPS e.max ZirCAD framework on the model

19

Before ZirLiner is applied, clean the framework under running water or with a steam jet.

Do not blast the framework with Al2O3 or polishing jet medium.

Mix the corresponding ZirLiner with the ZirLiner Liquid to a creamy consistency and cover the entire framework with it. Apply Intensive ZirLiner to the occlusal surfaces.

The fired ZirLiner shows a homogeneous surface.

Firing parameters for the IPS e.max Cerm ZirLiner firing – note the temperature control IPS e.max Ceram on IPS e.max ZirCAD

B

S

tÚ

T

H

V1

V2

Staining technique

°C/°F

min.

°C/°F

°C/°F

min.

°C/°F

°C/°F

ZirLiner firing before wax-up and pressing

403/ 757

4:00 4:00

60/ 108

960/ 1760

1:00 1:00

450/ 842

959/ 1758

20

Wax-up Fabricate the wax-up using wax that burns out without leaving residue. The following procedure has to be observed for the staining technique: – Isolate the stone dies with a commercial plaster-wax separator.

– Use calipers to measure and record the thickness of the ZirCAD framework at various points.

– Weigh the IPS e.max ZirCAD framework onto which IPS e.max Ceram ZirLiner has been fired and record the weight. The weight serves to determine the wax weight after the wax-up.

– Subsequently, secure the framework on the model in the proper position and wax the margins first.

– Design a fully anatomical wax-up as usual.

– Observe a wax thickness of at least 0.7 mm, as otherwise miscasts – e.g. incomplete pressing – may be the result.

Measure thickness with calipers.

Weigh the ZirCAD framework onto which the ZirLiner has been fired and note down the weight.

Design a fully anatomical wax-up on the ZirCAD framework.

Observe the wax thickness. Reinforce too thin layers with wax.

Check occlusal surfaces and contact points.

Final inspection of the entire wax-up on the model.

21

Sprueing Always place the sprues in the direction of flow of the ceramic and at the thickest part of the wax-up in order to ensure unimpeded flow of the viscous ceramic. Depending on the number of objects to be invested, either the 100 g or 200 g investment ring base is selected. Bridges must be pressed using the 200 g investment ring system. The following sprueing guidelines must be observed:

Single tooth crowns

Bridges

100 g and 200 g

only 200 g

3 mm

3 mm

min. 3 mm, max. 8 mm

min. 3 mm, max. 8 mm

Length of wax object including sprue

max. 15-16 mm

max. 15-16 mm

Attachment point at the wax object

Thickest part of the wax-up

at bridge abutments and every bridge unit

axial

axial

45-60°

45-60°

rounded and slightly tapered, no sharp angles or edges

rounded and slightly tapered, no sharp angles or edges

Distance between objects

min. 3 mm

min. 3 mm

Distance to the silicone ring

min. 10 mm

min. 10 mm

Investment ring base Wax sprue Ø Length of wax sprue

Sprueing angle to the wax object Sprueing angle to the investment ring base Design of the attachment points

Important

Larger bridges can be placed closer to in the center of the investment ring

Provide sprues on the IPS e.max ring base always in the direction of flow of the ceramic and at the thickest spot.

22

max .8

mm

max. 15 –16 mm

mm

3–

-8 m m

ma x. 8

ma x. 6

max. 15 –16 mm max. 15 –16 mm

3–

45–60°

-8 m m ma x. 8 mm

ma x. 6

3–

max. 15 –16 mm

max. 15 –16 mm

mm

6 3m –mm ax. 8

max. 15 –16 mm max. 15 –16 mm

3–

ma x. 8

mm

max. 15 –16 mm

Correct sprueing

45–60° 45–60°

max. 15 –16 mm

<6

6m

m

mm 3–

ma

x. 8

mm

max.max.

15 –16 mm mm 15 –16

mm

x. 6 3 – -8 m max .8 m ma

max. 15 –16 mm max. 15 –16 mm

Sprueing is carried out in the direction of the tooth preparation.

45–60°

45–60°

45–60°

45–60°

max. 15 –16 mm

mm ma x. 8

mm

3–

<6

6m

m

max. 15 –16 mm max. 15 –16 mm

The sprue and object together should not be longer than 15–16 mm. Observe an angle of 45–60°.

45–60° 45–60°

45–60°

<6

mm

max. 15 –16 mm

Provide sprues in the direction of flow of the ceramic material.

45–60°

45–60°

The attachment points of the sprues must be rounded. Observe an angle of 45–60°.

23

45–60°

If the crown is viewed from the proximal, the longer side of the object (usually the buccal surface) points outwards. Additionally, the flow of the ceramic material must be observed.

45–60°

45–60°

The attachment points of the sprues must be rounded. Observe an angle of 45-60°.

Investment gauge

ma

x. 8

mm

min. 10 mm

3–

max. 15 –16 mm

min. 10 mm

24

Investing Investing is carried out using either IPS PressVEST (e.g. overnight) or IPS PressVEST Speed. For that purpose, the IPS Silicone Ring with the matching investment ring gauge is used. Determine the precise wax weight as follows: – Weigh the ring base (seal the opening of the investment ring base with wax).

– Position the objects to be pressed on the investment ring base and attach them with wax. Weigh again.

– The wax weight is calculated as follows: Total weight minus the weight of the investment ring base minus the ZirCAD framework weight.

Small ingot

2 small ingots

Wax weight

up to max. 0.7 g

up to max. 1.7 g

Investment ring system

100 g and 200 g

only 200 g

Please refer to the Instructions for Use of the corresponding investment material regarding the detailed processing parameters. The following procedure is recommended: – Do not apply a debubblizer to the wax objects.

– Mix the investment material. The investment material contains quartz powder. Therefore, the inhalation of dust must be avoided.

– Use a suitable instrument for the fine investment of the cavity. Make sure that the delicate wax margins are not damaged.

– Carefully position the IPS Silicone Ring on the investment ring base without damaging the wax objects. The silicone ring must sit flush on the investment ring base.

– Subsequently, carefully fill the investment ring with investment material up to the marking and position the ring gauge with a hinged movement.

– Allow the investment material to set without manipulating the investment ring.

– Do not use IPS PressVEST for investment over the weekend to prevent crystallization.

Use the IPS Silicone Ring for investment.

Pour the investment material slowly and carefully.

Fill investment ring up to the marking and position the ring gauge with a hinged movement.

25

Preheating After the stipulated setting time of the respective investment material (IPS PressVEST or IPS PressVEST Speed), the investment ring is prepared for preheating as follows: – Remove the ring gauge and ring base with a turning movement.

– Carefully push the investment ring out of the IPS Silicone Ring.

– Remove rough spots on the bottom surface of the investment ring with a plaster knife and check the 90° angle.

Investment material residue must not enter the sprues. Blow into the sprues if necessary.

– If several investment rings are preheated together, mark them with the respective ingot shade.

IPS PressVEST

IPS PressVEST Speed

min. 60 minutes

min. 30 minutes, max. 45 minutes

Room temperature

850 °C (1562 °F); switch on preheating furnace in time

Towards the rear wall; tipped with the opening facing down

Towards the rear wall; tipped with the opening facing down

IPS e.max ZirPress Ingots

Do not preheat

Do not preheat

IPS e.max AlOx Plunger

Do not preheat

Do not preheat

Setting time Temperature of preheating furnace

Position of the investment ring in the furnace

Important

Place the investment ring towards the rear wall, tipped with the opening facing down.

If several Speed investments are required, they should be invested with a time difference and placed in the preheating furnace at intervals of approx. 20 minutes. When placing the investment rings in the preheating furnace, make sure that the furnace temperature does not drop too much.

The indicated holding time starts when the preheating temperature is reached.

Do not preheat the ZirPress ingot and the Alox plunger.

In order to ensure smooth working procedures in the laboratory on a daily basis, impeccable functioning of the infrastructure and the preheating furnaces is essential. This includes their maintenance, cleaning with a vacuum cleaner in a cool state as well as regular checks of the temperature controls and heating elements, etc., by the manufacturer.

Please note that a properly calibrated press furnace is also used for the subsequent press procedure. Please refer to the Operating Instructions of the press furnace for respective notes on calibration.

26

Pressing Before the preheating cycle for the investment ring has ended, the following preparations for pressing must be carried out: – Provide a cold IPS e.max Alox plunger and cold IPS e.max ZirPress ingot in the desired shade.

– After that, dip the cold IPS e.max Alox plunger into the opening of the IPS e.max Alox Plunger Separator and keep ready for use.

– Select the press program for IPS e.max ZirPress.

Once the preheating cycle has been completed, remove the investment ring from the preheating furnace and proceed as follows. Make sure that you take no more than 1 minute for these steps to prevent the investment ring from cooling down too much.

– Insert the cold IPS e.max ZirPress ingot into the hot investment ring.

– Insert the ingot with the rounded, non-imprinted side into the investment ring. The imprinted side should face upward to double-check the ingot shade.

– Place the powder-coated cold IPS e.max AlOx plunger into the hot investment ring.

– Place the completed investment ring at the center of the hot press furnace using the investment tongs.

– Press START to start the selected program.

Single crowns

100 g investment ring

200 g investment ring

1 small ingot

max. 2 small ingots

Bridges

max. 2 small ingots

IPS e.max ZirPress Ingots

cold ingot

cold ingot

IPS e.max Alox Plunger

cold ingot

cold ingot

3

3

IPS e.max Alox Plunger Separator

Provide a cold and isolated IPS e.max AlOx plunger and cold IPS e.max ZirPress ingot in the desired shade.

Insert the cold IPS e.max ZirPress ingot with the ingot shade facing upwards into the hot investment ring.

27

Subsequently, place the powder-coated IPS e.max AlOx plunger into the hot investment ring.

Place the hot and completed investment ring at the center of the hot press furnace using the investment tongs.

Press START to start the selected program.

The colour on the OSD changes when the program is started (Programat EP 5000).

Press parameters for IPS e.max ZirPress B

tÚ

T

H

V1

V2

A

EP 600 / EP 600 Combi Small investment ring

700°C 1292°F

60°C 108°F

900°C 1652°F

15:00 min

500°C 932°F

900°C 1652°F

300

EP 600 / EP 600 Combi Large investment ring

700°C 1292°F

60°C 108°F

910°C 1670°F

15:00 min

500°C 932°F

910°C 1670°F

300

EP 500 Small investment ring

700°C 1292°F

60°C 108°F

900°C 1652°F

15:00 min

500°C 932°F

900°C 1652°F

–

EP 500 Large investment ring

700°C 1292°F

60°C 108°F

910°C 1670°F

15:00 min

500°C 932°F

910°C 1670°F

–

If you use the Programat EP 5000 furnace, select the press program depending on the investment ring size and the ingot used.

Remove the investment ring from the furnace immediately after the program is completed using the investment tongs and close the furnace. Place the investment ring on the cooling grid and allow it to cool to room temperature. The grid ensures quick and even cooling of the investment ring and prevents undesired heat accumulation.

After the press program has ended, remove the hot investment ring from the furnace with the investment tongs and place the ring on a wide-meshed cooling grid, where it is left to cool to room temperature.

28

Divesting After cooling to room temperature (approximately 60 minutes), the investment ring may show cracks. These cracks developed (immediately around the Alox plunger) during cooling as a result of the different CTEs of the various materials (Alox plunger, investment material and ZirPress ingot). They do not compromise the press results. Divest the investment ring as follows: – Mark the length of the Alox plunger on the cooled investment ring.

– Separate the investment ring using a separating disk. This predetermined breaking point enables reliable separation of the Alox plunger and the ceramic material.

– Break the investment ring at the predetermined breaking point using a plaster knife.

– Always use glass polishing beads to divest the press objects (rough and fine divestment).

– Rough divestment is carried out with glass polishing beads at 4 bar (60 psi) pressure.

– Fine divestment is carried out with glass polishing beads at 2 bar (30 psi) pressure.

– Do not use Al2O3 for rough or fine divestment.

– When divesting the object, blast from the direction indicated in the schematic below and observe the appropriate distance in order not to damage the object margins.

– Any ceramic residue on the Alox plunger is removed with Al2O3 (type 100 microns).

Mark the length of the Alox plunger.

Separate the investment ring using a separating disk and break it at the predetermined breaking point.

Rough divestment is carried out with glass polishing beads at 4 bar (60 psi) pressure until the objects are visible. For fine divestment, apply 2 bar (30 psi) pressure.

29

Removing the reaction layer After fine divestment, the reaction layer formed during the press procedure is removed using IPS e.max Press Invex Liquid. The procedure is carried out as follows: – Pour the Invex Liquid into a plastic cup.

– Immerse the pressed objects into the Invex Liquid and clean in an ultrasonic cleaner for at least 5 minutes and a maximum of 10 minutes. Make sure that the objects are completely covered with Invex Liquid.

– Subsequently, clean the objects under running water and blow dry.

– Carefully remove the white reaction layer with Al2O3 (type 100 microns) at 1-2 bar (15-30 psi) pressure.

– Make sure that the reaction layer is completely removed (repeat the procedure, if necessary).

– If the reaction layer is not entirely removed, bubbles may develop, which may lead to bonding problems or even cracks in the layering ceramic.

– Replace the Invex Liquid after approximately 20 applications or after sedimentation of the liquid.

Remove the reaction layer with Invex and Al2O3 at 1-2 bar (15-30 psi) pressure.

Warnings – The Invex Liquid contains < 1% hydrofluoric acid.

– It is harmful when inhaled, swallowed, and when it comes into contact with the skin.

Furthermore, it is corrosive.

– Keep the container tightly sealed and store it in a well-ventilated place (acid cabinet).

– If the material comes into contact with the eyes, immediately rinse with copious amounts of water and see a physician immediately.

– If the material comes into contact with the skin, immediately wash with copious amounts of water.

– Use suitable protective clothing, gloves, and goggles when working.

– In case of an accident or physical discomfort, see a physician immediately (bring the Invex label, if possible).

Disposal – Neutralize the Invex Liquid – Neutralize the diluted solution by adding lime or baking soda and letting it react for 5 minutes.

– After the reaction time, pour the neutralized solution into the sink, flushing it with running water.

30

Finishing The correct grinding instruments are indispensable for finishing and adjusting glass-ceramics. If inappropriate grinding instruments are used, marginal chipping, among other flaws, and local overheating may occur (please observe the corresponding Ivoclar Vivadent recommendations).

The following procedure is recommended for finishing IPS e.max ZirPress: – Wet the area to be ground and use a fine diamond disk to cut the sprues. Try the restoration in on the model.

– Prevent overheating of the ceramic material. Low speed and light pressure is recommended. Please observe the corresponding instructions of the manufacturer.

– Smooth out the attachment points of the sprues.

– Do not 'post-separate' the bridge framework with separating disks, since this may result in undesired predetermined breaking points, which will subsequently compromise the stability of the all-ceramic restoration.

– Finish the restoration with diamonds and provide a true-to-nature shape and surface structure.

– Before staining and characterization, blast the restoration with Al2O3 at 1 bar (15 psi) pressure and clean it under running water or with a steam jet.

– Some blasting machines may require different pressure settings to accomplish this procedure.

Cut the sprues using a fine diamond disk.

Blast the restoration with Al2O3 at 1 bar (15 psi) pressure.

Use low speed and light pressure to smooth out the attachment points and provide a trueto-nature shape and surface structure.

Before staining and characterization, thoroughly clean the restoration under running water or with a steam jet.

31

Optional Die fabrication with IPS Natural Die Material The light-curing IPS Natural Die Material simulates the shade of the prepared tooth. A control die is fabricated using the shade information provided by the dentist (shade determination). This control die represents the optimum basis for a trueto-nature shade reproduction of the given oral situation.

– Coat the inner surfaces of the ceramic restoration with IPS Natural Die Material Separator and allow it to react for a short time.

– Apply the IPS Natural Die Material in the corresponding shade to the inner surfaces of the restoration using the IPS Condenser and adapt so that the entire inner surface is coated and filled.

– Completely fill the restoration cavity and insert an IPS Die Holder into the material and adapt excess material around the holder. Make sure that the Die Material is well adapted to the restoration margins and that no gaps are present.

– Polymerize IPS Natural Die Material die with a commercial polymerization light, e.g. Lumamat 100, for 60 seconds.

– After polymerization, the die can be finished and or smoothed, if required.

Stain and Characterization firing The most important staining and characterization steps are described below. Detailed information about the nano-fluorapatite ceramic and its processing are contained in the IPS e.max Ceram Instructions for Use.

Firing of zirconium oxide-supported restorations – Several units (e.g. multi-unit bridges with bulky pontics) in the furnace impede even and thorough heating of the individual units.

– Heat penetration in the firing chamber depends on the type of furnace and the size of the firing chamber.

– To achieve adequate heating of large restorations the heating rate should be lowered by 5-10 °C (9-18 °F) and the holding time extended by 30 seconds.

– The parameters listed in the Instructions for Use apply to Ivoclar Vivadent furnaces (temperature tolerance +/- 10 °C/18 °F).

– If furnaces other than those from Ivoclar Vivadent are used, temperature adjustments may be necessary.

32

The restoration must be free of dirt and grease before the Stain and Characterization firing. Any contamination of the restoration after cleaning must be prevented. Please observe the following procedure: – To promote wetting, a small quantity of IPS e.max Ceram Glaze and Stain Liquid may be applied onto the surface.

– Mix the IPS e.max Ceram Shades and Essence materials with the IPS e.max Ceram Glaze and Stain Liquid (allround or longlife) until the desired consistency is achieved.

– More intensive shades are achieved by repeated staining and firing, rather than by applying thicker layers.

– IPS e.max Ceram Shade Incisal is used to imitate the appearance of the incisal edge and the translucency in the incisal third.

– Cusps and fissures can be individually characterized with Essence materials.

– Conduct Stain and Characterization firing with the stipulated firing parameters.

Use IPS e.max Ceram Shade Incisal to imitate the incisal area.

To promote wetting, a small quantity of IPS e.max Ceram Glaze and Stain Liquid may be applied onto the surface.

Fully anatomic IPS e.max ZirPress bridge after Stain and Characterization firing.

Cusps and fissures can be individually characterized with Essence materials.

Firing parameters for the Stain and Characterization firing – note the temperature control IPS e.max Ceram on IPS e.max ZirPress

B

S

tÚ

T

H

V1

V2

Staining technique

°C/°F

min.

°C/°F

°C/°F

min.

°C/°F

°C/°F

Stain and Characterization firing

403/ 757

6:00 6:00

60/ 108

770/ 1418

1:00 1:00

450/ 842

769/ 1416

Additional Stain and Characterization firing cycles can be conducted with the same firing parameters.

33

Glaze firing Glaze firing is conducted with either IPS e.max Ceram Glaze Powder, Paste or Spray. The following procedure is recommended: – Mix the Glaze material (IPS e.max Ceram Glaze Paste or Powder) with IPS e.max Ceram Glaze and Stain Liquid (allround or longlife) until the desired consistency is achieved.

– Evenly apply the glazing material to the entire surface of the restoration.

– If a higher fluorescence is desired in the cervical region, fluorescent Glaze materials (paste or powder) can be used in this area.

– If IPS e.max Ceram Glaze Spray accidentally reaches the inner aspects of the restoration, remove it with a dry brush prior to firing. Please refer to the IPS e.max Ceram Glaze Spray Instructions for Use. – Conduct Glaze firing with the stipulated firing parameters on a honey-combed firing tray.

Glaze firing with IPS e.max Ceram Glaze Paste or Powder

Glaze firing with IPS e.max Ceram Glaze Spray

Evenly apply the glazing material to the surface of the restoration and fire it according to the stipulated firing parameters.

Coat the restoration with an even layer of Glaze Spray. If Glaze Spray accidentally reaches the inner aspects of the restoration, remove it with a dry brush and conduct Glaze firing according to the firing parameters.

Firing parameters for Glaze firing – note the temperature control IPS e.max Ceram on IPS e.max ZirPress

B

S

tÚ

T

H

V1

V2

Staining technique

°C/°F

min.

°C/°F/min.

°C/°F

min.

°C/°F

°C/°F

Glaze firing

403/ 757

6:00 6:00

60/ 108

770/ 1418

1:00 1:00

450/ 842

769/ 1416

If the gloss is unsatisfactory after the first Glaze firing, further glaze firing procedures may be conducted using the same firing parameters.

Glazed IPS e.max ZirPress restoration fabricated in the Staining Technique.

View of the restoration on a mirror - IPS e.max ZirPress HT pressed to precision specifications

34

Application example: IPS e.max ZirPress HT inlay-retained bridge

Apply the ZirLiner on the sintered IPS e.max ZirCAD framework. Use ZirLiner orange for the fissures.

Fully anatomic wax-up of the inlay-retained bridge. The ZirCAD framework must be designed in such a way that all the preparation margins can be designed in wax or IPS e.max ZirPress.

Pressed inlay-retained bridge on the model.

Position the framework on metal pins on a honey-combed firing tray using IPS Object Fix Flow.

Wax-up with a wax sprue (Ă&#x2DC; 3 mm). The retention pin on the ZirCAD framework secures the framework in the investment material.

Conduct Stain and Glaze firing with IPS e.max Ceram Glaze, Shades and Essence materials.

35

Completed inlay-retained bridge made of IPS e.max ZirPress HT and IPS e.max ZirCAD

Inlay-retained bridge made of IPS e.max ZirPress HT and IPS e.max ZirCAD in transmitted light

The dental lab work was carried out by J端rgen Seger, Ivoclar Vivadent, Schaan/Liechtenstein.

36

IPS

e.max ZirPress LT – ®

C U T- B A C K T E C H N I Q U E The cut-back technique can be used to efficiently fabricate highly aesthetic restorations. The partially reduced wax-up is reproduced in ceramic by a press procedure. Subsequently, the restoration is completed using IPS e.max Ceram Incisal and Impulse materials. The restoration is characterized with IPS e.max Ceram Shades and Essence materials. Finally, Stain and Glaze firing is conducted.

Framework preparation and application of ZirLiner The sintered IPS e.max ZirCAD framework is tried on the model. The margins can be trimmed up to the inner edge of the chamfer or shoulder preparation to make room for the pressed ceramic shoulder. After the adjustments have been made, the framework must still exhibit the required minimum thickness. Please observe the following procedure: – Clean the framework under running water or with a steam jet prior to veneering.

– The framework must not be blasted with Al2O3, since this would damage the surfaces.

– IPS e.max Ceram ZirLiner must always be applied prior to the wax-up in order to achieve a sound bond, as well as an in-depth shade effect and fluorescence.

– Direct press-on procedures on ZirCAD frameworks without using IPS e.max Ceram ZirLiner results in a poor bond and may lead to delamination.

– Subsequently, mix IPS e.max Ceram ZirLiner in the desired shade with the respective IPS e.max Ceram ZirLiner Liquid to a creamy consistency.

– If a different consistency is desired, the IPS e.max Ceram Build-Up Liquids (allround or soft) and the IPS e.max Ceram Glaze and Stain Liquids (allround or longlife) may be used. The liquids may also be mixed with each other at any mixing ratio.

– Apply ZirLiner on the entire framework, pay special attention to the margins. If required, the restoration may be vibrated until an even, greenish colour effect is achieved. If the colour appears too pale, the layer is too thin.

– For more intensively shaded areas, 4 IPS e.max Ceram Intensive ZirLiners (yellow, orange, brown, incisal) are available.

– For shaded zirconium oxide frameworks, use IPS e.max Ceram ZirLiner clear.

– After that, the applied ZirLiner is briefly dried and fired.

– The IPS e.max Ceram ZirLiner should have a layer thickness of approximately 0.1 mm after firing.

Sintered IPS e.max ZirCAD framework with trimmed margins.

37

Before ZirLiner is applied, clean the framework under running water or with a steam jet.

Do not blast the framework with Al2O3 or glass polishing beads.

Mix the corresponding ZirLiner with the ZirLiner Liquid to a creamy consistency and cover the entire framework with it.

The fired ZirLiner shows a homogeneous surface.

Firing parameters for the IPS e.max Cerm ZirLiner firing – note the temperature control IPS e.max Ceram on IPS e.max ZirPress

B

S

tÚ

T

H

V1

V2

Cut-back Technique

°C/°F

min.

°C/°F

°C/°F

min.

°C/°F

°C/°F

ZirLiner firing before wax-up and pressing

403/ 757

4:00 4:00

60/ 108

960/ 1760

1:00 1:00

450/ 842

959/ 1758

38

Wax-up and cut-back Fabricate the wax-up using wax that burns out without leaving residue. The following procedure has to be observed for the cut-back technique: – Isolate the stone die with a commercial plaster-wax separator.

– Use calipers to measure and record the thickness of the ZirCAD framework at various points.

– Weigh the IPS e.max ZirCAD framework onto which IPS e.max Ceram ZirLiner has been fired and record the weight. The weight serves to determine the wax weight after the wax-up.

– Subsequently, secure the framework on the die in the proper position and wax the margins first.

– Design a fully anatomical wax-up as usual and secure by means of a silicone key.

– The waxed up framework can be reduced at this stage. Alternatively, the framework can be pressed to full contour and then reduced by grinding.

– If the wax-up is reduced, the incisal layer has to be trimmed selectively. Observe the wax thicknesses of at least 0.7 mm, as otherwise miscasts – e.g. incomplete pressing – may be the result.

Measure thickness with calipers.

Weigh the ZirCAD framework and note down the weight.

Subsequently, secure the ZirCAD framework on the die, attach margins with wax and build up the shape.

Conduct the wax cut-back and check with a silicone key.

Cut-back of the lingual/palatal surfaces is not required.

Completed wax-up, sprued on the 200-g IPS e.max investment ring system.

39

For the processing steps regarding sprueing, investing, preheating, pressing, divesting, removing the reaction layer and separating the restoration, please refer to pages 22–30.

Finishing The correct grinding instruments are indispensable for finishing and adjusting glass-ceramics. If inappropriate grinding instruments are used, marginal chipping, among other flaws, and local overheating may occur (please refer to the corresponding Ivoclar Vivadent recommendations).

The following procedure is recommended for finishing IPS e.max ZirPress: – Wet the area to be ground and use a fine diamond disk to cut the sprues. Try the restoration on the model.

– Prevent overheating of the ceramic material. Low speed and light pressure are recommended. Please observe the corresponding instructions of the manufacturer.

– Smooth out the attachment points of the sprues.

– Do not 'post-separate' the bridge framework with separating disks, since this may result in undesired predetermined breaking points, which will subsequently compromise the stability of the all-ceramic restoration.

– If a fully anatomic wax-up was pressed, the restoration is now cut back. Cut back the restoration to make room for the application of the subsequent layers of Incisal and Impulse materials. Make sure that the minimum thicknesses are maintained even after cut-back.

– If a reduced version of the restoration was waxed up, only the surface has to be slightly adjusted.

Make sure that a minimum thickness of 0.6 mm for the press ceramic is maintained to avoid irregularities in the shading.

Cut the sprues using a fine diamond disk and place the framework on the die.

Cut back IPS e.max ZirPress restoration.

Use low speed and light pressure to remove sprue attachment points and smooth out the surface.

40

Preparation for veneering – Blast the outer surfaces of the restoration with Al2O3 (type 100) at 1 bar (15 psi) pressure before veneering. Some blasting machines may require different pressure settings to accomplish this procedure.

– Before the Wash firing, thoroughly clean the restoration with the steam jet or under running water.

Blast the restoration with Al2O3 (type 100) at 1 bar (15 psi) pressure. Before the Wash firing, thoroughly clean the restoration with the steam jet and dry.

Veneering with IPS e.max Ceram The following paragraphs will explain the most important veneering steps. Detailed information about the nano-fluorapatite ceramic and its processing are contained in the IPS e.max Ceram Instructions for Use.

Firing of zirconium oxide-supported restorations – Several units (e.g. multi-unit bridges with bulky pontics) in the furnace impede even and thorough heating of the individual units.

– Heat penetration in the firing chamber depends on the type of furnace and the size of the firing chamber.

– To achieve adequate heating of the individual restorations the heating rate should be lowered by 5–10 °C (9–18 °F) and the holding time extended by 30 seconds.

– The parameters listed in the Instructions for Use apply to Ivoclar Vivadent furnaces (temperature tolerance +/- 10 °C/18 °F).

– If furnaces other than those from Ivoclar Vivadent are used, temperature adjustments may be necessary.

41

Wash firing (Foundation firing) Before the Wash firing is done, the framework must be free of dirt and grease. Any contamination of the restoration after cleaning must be prevented. Wash firing is carried out with e.g. Transpa Incisal, Impulse or Shades and Essence materials.

In order to achieve a gloss on non-veneered surfaces already at this stage, it is recommended to apply glaze (paste or powder) to these areas and conduct a Wash firing.

Variant A: Powder

Variant B: Paste

With ideal space, conduct Wash firing with the required IPS e.max Ceram Transpa Incisal and/or Impulse material.

Use the IPS e.max Ceram Build-Up Liquids allround or soft to mix the materials. If a more plastic consistency is desired, IPS e.max Ceram Glaze and Stain Liquids (allround or longlife) can be used. Apply the wash in a thin coat on the cut back areas and fire according to the indicated firing parameters.

With limited space or to increase the in-depth chroma, the Wash firing can be conducted using IPS e.max Ceram Shades and Essence. Mix the paste or powder with the IPS e.max Ceram Glaze and Stain Liquids (allround or longlife) until the desired consistency is achieved. Apply the wash in a thin coat on the cut back areas and fire according to the indicated firing parameters.

Apply the wash using Transpa Incisal or Impulse material ...

Apply the wash using Shades and Essence materials ...

... and fire using the indicated firing parameters.

... and fire using the indicated firing parameters.

Layering materials must not be applied on unfired wash layers (powders and pastes), since this will result in a delamination of the layering ceramic. The wash must be fired before the actual layering procedure is started.

Firing parameters for the Wash firing (Foundation firing) IPS e.max Ceram on IPS e.max ZirPress Cut-back Technique

B °C/°F

S min.

Wash firing (Foundation firing)

403/ 757

4:00 4:00

tÚ °C/°F/min.

50/ 90 42

T °C/°F 750/ 1382

H min.

V1 °C/°F

V2 °C/°F

1:00 1:00

450/ 842

749/ 1380

Incisal firing The IPS e.max Ceram layering materials (e.g. Transpa, Transpa Incisal, Impulse) are used to complete the anatomical shape and to achieve the individual aesthetic appearance. The materials are mixed using the IPS e.max Ceram Build-Up Liquids allround or soft. If required, a second Incisal firing is conducted with the same firing parameters.

Apply Impulse materials, e.g. Opal Effect 1

Complete the restoration, e.g. with Incisal materials and Opal Effect 3

Position the restoration on the firing tray and fire it with the firing parameters for Incisal firing

Restoration after Incisal firing

Firing parameters for the Incisal firing IPS e.max Ceram on IPS e.max ZirPress Cut-back Technique

B °C/°F

S min.

Incisal firing

403/ 757

4:00 4:00

tÚ °C/°F/min.

50/ 90

43

T °C/°F 750/ 1382

H min.

V1 °C/°F

V2 °C/°F

1:00 1:00

450/ 842

749/ 1380

Preparing for Stain and Glaze firing Before the Stain and Glaze firing, the restoration has to be finished as follows: – Finish the restoration using diamonds and give it a true-to-nature shape and surface structure, such as growth lines and convex/concave areas.

– Areas which should exhibit a higher gloss after Glaze firing can be smoothed out and prepolished using silicone wheels.

– If gold and/or silver dust was used to visualize the surface texture, the restoration has to be thoroughly cleaned with steam. Make sure to remove all gold or silver dust in order to avoid any discolouration.

Finish the restoration with diamonds and provide a true-to-nature shape and surface structure.

Stain and Glaze firing Stain firing is conducted with IPS e.max Ceram Essence and/or IPS e.max Ceram Shades, while Glaze firing is carried out with IPS e.max Ceram Glaze. Depending on the situation, the firing cycles may be conducted together or separately. The firing parameters are identical.

In order to achieve an even gloss during Glaze firing of cut back restorations veneered with IPS e.max Ceram, two different procedures are possible:

Variant A:

Variant B:

(high-gloss appearance)

(true-to-nature appearance)

– Prepolish unlayered areas (IPS e.max ZirPress) using rubber wheels.

– Rub the surface with moist ceramic in order to improve the wetting properties of the surface.

– Apply IPS e.max Ceram Glaze (Paste, Powder or Spray) on the entire restoration.

– Prepolish unlayered areas (IPS e.max ZirPress) using rubber wheels.

– Rub the surface with moist ceramic in order to improve the wetting properties of the surface.

– Apply IPS e.max Ceram Glaze (Paste, Powder) only to unlayered areas (IPS e.max ZirPress).

– For veneered areas, use Self-Glaze.

Apply IPS e.max Ceram Glaze on the entire restoration

Apply IPS e.max Ceram Glaze only to unlayered areas

44

Firing parameters for the Stain and Glaze firing IPS e.max Ceram on IPS e.max ZirPress Cut-back Technique

B °C/°F

S min.

tÚ °C/°F/min.

T °C/°F

H min.

V1 °C/°F

V2 °C/°F

Stain firing

403/ 757

6:00 6:00

60/ 108

725/ 1337

1:00 1:00

450/ 842

724/ 1335

Glaze firing

403/ 757

6:00/ 6:00

60/ 108

725/ 1337

1:00/ 1:00

450/ 842

724/ 1335

Completed IPS e.max ZirPress restoration cut back and pressed and veneered with IPS e.max Ceram.

The dental lab work was carried out by Jürgen Seger, Ivoclar Vivadent, Schaan/Liechtenstein.

45

IPS

e.max ZirPress MO – ®

L AY E R I N G T E C H N I Q U E The layering technique is particularly used for pressing a dentin core or shoulder onto zirconium oxide frameworks.

Individual and highly aesthetic restorations can be fabricated using the IPS e.max Ceram layering materials.

Framework preparation and application of ZirLiner The sintered IPS e.max ZirCAD framework is tried in on the model. The margins can be trimmed up to the inner edge of the chamfer or shoulder preparation to make room for the pressed ceramic shoulder.

After the adjustments have been made, the framework must still exhibit the required minimum thickness. Please observe the following procedure: – The framework must not be blasted with Al2O3, since this would damage the surfaces.

– Before IPS e.max Ceram ZirLiner is applied, clean the framework under running water or with a steam jet.

– IPS e.max Ceram ZirLiner must always be applied prior to the wax-up in order to achieve a sound bond, as well as an in-depth shade effect and fluorescence.

– Direct press-on procedures on ZirCAD frameworks without using IPS e.max Ceram ZirLiner results in a poor bond and may lead to delamination.

– Subsequently, mix the IPS e.max Ceram ZirLiner in the desired shade with the respective IPS e.max Ceram ZirLiner Build-Up Liquid to a creamy consistency.

– If a different consistency is desired, the IPS e.max Ceram Build-Up Liquids (allround or soft) and the IPS e.max Ceram Glaze and Stain Liquids (allround or longlife) may be used. The liquids may also be mixed with each other at any mixing ratio.

– Apply IPS e.max ZirLiner on the entire framework, pay special attention to the margins. If required, the restoration may be vibrated until an even, greenish colour effect is achieved. If the colour appears too pale, the layer is too thin.

– For more intensively shaded areas, 4 IPS e.max Ceram Intensive ZirLiners (yellow, orange, brown, incisal) are available.

– For shaded zirconium oxide frameworks, use IPS e.max Ceram ZirLiner clear.

– After that, the applied ZirLiner is dried and fired.

– The IPS e.max Ceram ZirLiner should have a layer thickness of approximately 0.1 mm after firing.

Sintered IPS e.max ZirCAD framework onto which IPS e.max Ceram ZirLiner has been fired on the model.

Firing parameters for the IPS e.max Ceram ZirLiner firing – note the temperature control IPS e.max Ceram on IPS e.max ZirPress

B

S

tÚ

T

H

V1

V2

Cut-back Technique

°C/°F

min.

°C/°F

°C/°F

min.

°C/°F

°C/°F

ZirLiner firing before wax-up and pressing

403/ 757

4:00 4:00

60/ 108

960/ 1760

1:00 1:00

450/ 842

959/ 1758

46

Wax-up Fabricate the wax-up using wax that burns out without leaving residue. The following procedure has to be observed for the layering technique: – Isolate the stone die with a commercial plaster-wax separator.

– Use calipers to measure and record the thickness of the ZirCAD framework at various points.

– Weigh the IPS e.max ZirCAD framework onto which IPS e.max Ceram ZirLiner has been fired and record the weight. The weight serves to determine the wax weight after the wax-up.

– Subsequently, secure the framework on the die in the proper position.

– Attach restoration margins with wax.

– For bridges, contour the basal surface of the bridge pontic.

– Contour the dentin core.

– The wax thickness of at least 0.7 mm has to be observed, otherwise miscasts – e.g. incomplete pressing – may result.

Attach restoration margins with wax and contour the dentin area. For bridges, contour the basal surface of the bridge pontic. Observe the wax thicknesses of at least 0.7 mm. Attach one sprue per unit. Place sprues always in the direction of flow of the ceramic.

Sprueing Basically, the sprueing guidelines on page 22 (staining technique) apply.

Always place the sprues in the direction of flow of the ceramic and at the thickest part of the wax-up in order to ensure unimpeded flow of the viscous ceramic. Depending on the number of objects to be invested, either the 100 g or 200 g investment ring base is selected. Bridges must be pressed using the 200 g investment ring system.

Please observe the special sprueing method for the layering technique.

– In the layering technique, the thickest part of the wax-up is in the cervical area and on the pontic of the restoration.

– Place a sprue to each unit onto which a dentin core will be pressed.

Attach one sprue per unit. Place sprues always in the direction of flow of the ceramic.

47

Investing Basically, the notes on page 25 have to be observed.

Please observe the special investment method for the layering technique: – Since the inner aspects of the restoration point towards the investment ring base, make sure to avoid any air bubbles during investing.

– Fill the inner aspects of the restoration with investment material using an instrument or brush. Make sure that the delicate wax margins are not damaged.

– Tilt the investment ring when pouring the investment material and make sure to avoid air bubbles.

– Subsequently, carefully fill the investment ring with investment material up to the marking and position the ring gauge with a hinged movement.

– Allow the investment material to set without manipulating the investment ring.

Fill investment ring up to the marking and position the ring gauge with a hinged movement.

For the processing steps regarding preheating, pressing, divesting, removing the reaction layer and separating the restoration, please refer to the pages 26–31.

Note: – Blast the restoration with Al2O3 (type 100) at 1-2 bar (15-30 psi) pressure after removing the reaction layer using IPS e.max Press Invex Liquid.

– Carefully blast the non-pressed areas (exposed ZirLiner) in order to avoid complete removal of the ZirLiner.

Restoration after divesting

48

Finishing The correct grinding instruments are indispensable for finishing and adjusting glass-ceramics.

If inappropriate grinding instruments are used, marginal chipping, among other flaws, and local overheating may occur (please observe the corresponding Ivoclar Vivadent recommendations).

The following procedure is recommended for finishing IPS e.max ZirPress: – Wet the area to be ground and use a fine diamond disk to cut the sprues. Try the restoration in on the model.

– Prevent overheating of the ceramic material. Low speed and light pressure are recommended. Please observe the corresponding instructions of the manufacturer.

– Smooth out the attachment points of the sprues.

– Do not 'post-separate' the bridge framework with separating disks, since this may result in undesired predetermined breaking points, which will subsequently compromise the stability of the all-ceramic restoration.

– Before veneering, blast the restoration with Al2O3 at 1 bar (15 psi) pressure and clean it under running water or with a steam jet.

– Only carefully blast the ZirLiner in order not to completely remove it.

– Some blasting machines may require different pressure settings to accomplish this procedure.

Optional Die fabrication with IPS Natural Die Material The light-curing IPS Natural Die Material simulates the shade of the prepared tooth. A control die is fabricated using the shade information provided by the dentist (shade determination). This control die represents the optimum basis for a trueto-nature shade reproduction of the given oral situation.

– Coat the inner surfaces of the ceramic restorations with IPS Natural Die Material Separator and allow it to react for a short time.

– Apply the IPS Natural Die Material in the corresponding shade to the inner surfaces of the restoration using the IPS Condenser and adapt so that the entire inner surface is coated and filled.

– Completely fill the restoration cavity and insert an IPS Die Holder into the material and adapt excess material around the holder. Make sure that the Die Material is well adapted to the restoration margins and that no gaps are present.

– Polymerize IPS Natural Die Material die with a commercial polymerization light, e.g. Lumamat 100, for 60 seconds.

– After polymerization, the die can be finished and or smoothed, if required.

49

Veneering with IPS e.max Ceram The following paragraphs explain the most important veneering steps. Detailed information about the nano-fluorapatite ceramic and its processing are contained in the IPS e.max Ceram Instructions for Use.

Firing of zirconium oxide-supported restorations – Several units (e.g. multi-unit bridges with bulky pontics) in the furnace impede even and thorough heating of the individual units.

– Heat penetration in the firing chamber depends on the type of furnace and the size of the firing chamber.

– To achieve adequate heating of large restorations the heating rate should be lowered by 5–10 °C (9–18 °F) and the holding time extended by 30 seconds.

– The parameters listed in the Instructions for Use apply to Ivoclar Vivadent furnaces (temperature tolerance +/- 10 °C/18 °F).

– If furnaces other than those from Ivoclar Vivadent are used, temperature adjustments may be necessary.

50

Wash firing (Foundation firing) The restoration must be free of dirt and grease before the wash is applied. Any contamination of the restoration after cleaning must be prevented. Conduct the Wash firing using IPS e.max Ceram Deep Dentin or IPS e.max Ceram Dentin (the IPS e.max Ceram ZirLiner must not be used, since it works only on zirconium oxide due to the firing temperature of 960 °C/1760 °F).

Please observe the following procedure: – Use the IPS e.max Ceram Build-Up Liquids allround or soft to mix the Deep Dentin or Dentin materials. If a more plastic consistency is desired, IPS e.max Ceram Glaze and Stain Liquids (allround and longlife) can be used. Apply a thin, but complete coat of the wash on the entire restoration.

Conduct the Wash firing using Deep Dentin or Dentin materials.

Firing parameters for the Wash firing (Foundation firing) IPS e.max Ceram on IPS e.max ZirPress Layering technique

B °C/°F

S min.

Wash firing (Foundation firing)

403/ 757

4:00 4:00

tÚ °C/°F/min.

50/ 90

T °C/°F 750/ 1382

H min.

V1 °C/°F

V2 °C/°F

1:00 1:00

450/ 842

749/ 1380

Optional Wash firing (Foundation firing) characterization Intensively charcterized areas may be designed with IPS e.max Ceram Essence. These materials are ideally suited to apply individualized characterizations.

Firing parameters for the Wash firing (Foundation firing) characterization – note the temperature control IPS e.max Ceram on IPS e.max ZirPress Layering technique Wash firing (Foundation firing) characterization

B °C/°F

S min.

403/ 757

4:00 4:00

tÚ °C/°F/min.

50/ 90

T °C/°F 750/ 1382

H min.

V1 °C/°F

V2 °C/°F

1:00 1:00

450/ 842

749/ 1380

Layering materials must not be applied on unfired wash layers, since this will result in a delamination of the layering ceramic. The wash must be fired before the actual layering procedure is started.

51

1st Dentin and Incisal firing Carry out the layering with the IPS e.max Ceram materials according to the layering diagram. In order to achieve the desired consistency of the ceramic material, the IPS e.max Ceram Build-Up Liquids (allround or soft) can be used. If another consistency is desired, the liquids may also be mixed with each other at any mixing ratio.

Build up the tooth shape using IPS e.max Ceram layering materials

Firing parameters for the 1st Dentin and Incisal firing – note the temperature control IPS e.max Ceram on IPS e.max ZirPress Layering technique 1st Dentin/Incisal firing

B °C/°F

S min.

403/ 757

4:00 4:00

tÚ °C/°F/min.

50/ 90

T °C/°F 750/ 1382

H min.

V1 °C/°F

V2 °C/°F

1:00 1:00

450/ 842

749/ 1380

H min.

V1 °C/°F

V2 °C/°F

1:00 1:00

450/ 842

749/ 1380

2nd Dentin and Incisal firing (Correction firing) Complete the missing areas and compensate for the shrinkage.

Firing parameters for the 2nd Dentin and Incisal firing – note the temperature control IPS e.max Ceram on IPS e.max ZirPress Layering technique 2nd Dentin/Incisal firing

B °C/°F

S min.

403/ 757

4:00 4:00

tÚ °C/°F/min.

50/ 90

T °C/°F 750/ 1382

Stain and Glaze firing Stain firing is conducted with IPS e.max Ceram Essence and Shades, while Glaze firing is carried out with Glaze powder or paste. Depending on the situation, the firing cycles may be conducted together or separately. The firing parameters are identical.

Firing parameters for the Stain and Glaze firing – note the temperature control IPS e.max Ceram on IPS e.max ZirPress

B °C/°F

S min.

tÚ °C/°F/min.

T °C/°F

H min.

V1 °C/°F

V2 °C/°F

Stain firing

403/ 757

6:00 6:00

60/ 108

725/ 1337

1:00 1:00

450/ 842

724/ 1335

Glaze firing

403/ 757

6:00/ 6:00

60/ 108

725/ 1337

1:00/ 1:00

450/ 842

724/ 1335

Layering technique

52

Completed restoration after Stain and Glaze firing.

Pictures courtesy of Katrin Rohde, MDT, Schorndorf, Germany.

The dental lab work was runner-up in the ÂŤGoldenes ParallelometerÂť 2007 competition.

53

IPS

e.max ZirPress Gingiva – ®

GINGIVA TECHNIQUE IPS e.max ZirPress Gingiva can be used to fabricate gingival parts in conjunction with the press-on-zirconium technology. The advantages of this technique are the more efficient working method and increased processing reliability mainly for large restorations. By using the press technique, it is possible to fabricate homogeneous precision gingival portions which make time-consuming adjustments and corrective firing cycles a thing of the past.

The tooth-shaded portions are built up using the IPS e.max Ceram layering materials, while the accuracy of fit of IPS e.max ZirPress Gingiva is maintained. In addition, it is possible to characterize the restorations with IPS e.max Ceram Gingiva in the Dentin and Incisal firing cycles.

Criteria for framework design The following guidelines have to be observed for the application of IPS e.max ZirPress Gingiva when designing the zirconium oxide framework: – The framework material is the high-strength component of the restoration and should, therefore, be designed in such a way that it supports the shape of the restoration. This applies to the cusp support and the gingival parts.

– With atrophied alveolar ridges, the excess in available space must be compensated by the design of the framework and not by IPS e.max ZirPress Gingiva.

With atrophied alveolar ridges, the framework has to be adjusted to the course of the gingiva in the basal area.

Sintered zirconium oxide framework, adjusted to the course of the gingiva in the basal area.

Failure to observe the stipulated framework design criteria and minimum thicknesses may result in clinical failures, such as cracks, delamination, and fracture of the restoration.

Note: – Observe a minimum thickness of 0.7 mm in order to achieve the desired gingiva shade and complete pressing.

– Free standing (unsupported) gingival portions must not exceed a extension of 2.5 mm.

54

Framework preparation and application of ZirLiner The framework is prepared according to the notes in chapter "IPS e.max ZirPress HT – Staining technique" (page 19). After preparing the framework, the following procedure has to be observed in the Gingiva technique: – Before ZirLiner is applied, clean the framework under running water or with a steam jet.

– The framework must not be blasted with Al2O3, since this would damage the surfaces.

– IPS e.max Ceram ZirLiner must always be applied prior to the wax-up in order to achieve a sound bond, as well as an indepth shade effect and fluorescence.

– Direct press-on procedures on zirconium oxide frameworks without using IPS e.max Ceram ZirLiner results in a poor bond and may lead to delamination. Therefore, ZirLiner must be applied to all the areas onto which the restoration will be pressed.

– Apply IPS e.max Ceram ZirLiner Gingiva to all the areas of the framework onto which IPS e.max ZirPress Gingiva will be pressed.

– Coat non-involved outer surfaces with the IPS e.max Ceram ZirLiner of the respective tooth shade.

– Mix the IPS e.max ZirLiner with the IPS e.max Ceram ZirLiner Build-Up Liquid to a creamy consistency.

– If a different consistency is desired, the IPS e.max Ceram Build-Up Liquids (allround or soft) and the IPS e.max Ceram Glaze and Stain Liquids (allround or longlife) may be used. The liquids may also be mixed with each other at any mixing ratio.

– Apply the different IPS e.max ZirLiners on the entire framework, pay special attention to the margins. If required, the restoration may be vibrated until an even, greenish colour effect is achieved. If the colour appears too pale, the layer is too thin.

– For more intensively shaded areas, 4 IPS e.max Ceram Intensive ZirLiners (yellow, orange, brown, incisal) are available.

– After that, the applied ZirLiner is briefly dried and fired.

– The IPS e.max Ceram ZirLiner should have a layer thickness of approximately 0.1 mm after firing.

Apply IPS e.max ZirLiner Gingiva to those areas to which IPS e.max ZirPress Gingiva will be subsequently pressed. Coat non-involved outer surfaces with the IPS e.max Ceram ZirLiner of the respective tooth shade and fire.

Restoration after ZirLiner firing

Firing parameters for the IPS e.max Ceram ZirLiner firing – note the temperature control IPS e.max Ceram on IPS e.max ZirPress Gingiva Technique ZirLiner firing before wax-up and pressing

B °C/°F

S min.

tÚ °C/°F

T °C/°F

H min.

V1 °C/°F

V2 °C/°F

403/ 757

4:00 4:00

60/ 108

960/ 1760

1:00 1:00

450/ 842

959/ 1758

55

Wax-up Fabricate the wax-up using wax that burns out without leaving residue. The following procedure has to be observed for the gingiva technique: – Isolate the stone model with a commercial plaster-wax separator.

– Weigh the zirconium oxide framework onto which IPS e.max Ceram ZirLiner has been fired and record the weight. The weight serves to determine the wax weight after the wax-up.

– Subsequently, secure the framework on the die in the proper position and attach the margins with wax.

– Contour the gingival portions. In order to exactly define the position and extension of gingival portions, it is also possible to fabricate a fully anatomical wax-up with subsequent cut-back.

– The wax thickness of at least 0.7 mm has to be observed, otherwise miscasts – e.g. incomplete pressing – may result.

– The maximum width of 2.5 mm for free-standing (not framework-supported) gingival parts has to be observed.

Secure the zirconium oxide framework on the model, attach margins with wax and contour the gingival portions. Width of the gingival portions between 0.7 and 2.5 mm.

Palatal view of the waxed up gingival parts.

In order to exactly define the position and extension of gingival portions, it is also possible to fabricate a fully anatomical wax-up with subsequent cut-back.

56

Sprueing, investing Basically, the sprueing guidelines on pages 22–24 (staining technique) apply.

Provide sprues for the gingival parts at the thickest part and use a 200-g investment ring base.

For the processing steps regarding preheating, pressing, divesting, removing the reaction layer and separating the restoration, please refer to the pages 26–31.

Note: – Blast the restoration with Al2O3 (type 100) at 1–2 bar (15–30 psi) pressure after removing the reaction layer using IPS e.max Press Invex Liquid.

– Carefully blast the non-pressed areas (exposed ZirLiner) in order to avoid complete removal of the ZirLiner.

Finishing The correct grinding instruments are indispensable for finishing and adjusting glass-ceramics. If inappropriate grinding instruments are used, marginal chipping, among other flaws, and local overheating may occur (please refer to the corresponding Ivoclar Vivadent recommendations).

The following procedure is recommended for finishing IPS e.max ZirPress Gingiva: – Wet the area to be ground and use a fine diamond disk to cut the sprues. Try the restoration on the model.

– Prevent overheating of the ceramic material. Low speed and light pressure is recommended. Please observe the corresponding instructions of the manufacturer.

– Smooth out the attachment points of the sprues.

– Do not 'post-separate' the bridge framework with separating disks, since this may result in undesired predetermined breaking points, which will subsequently compromise the stability of the all-ceramic restoration.

– Finish the gingival portions to create a true-tonature surface structure.

– Before staining and characterization, blast the gingival portions with Al2O3 at 1 bar (15 psi) pressure and clean them under running water or with a steam jet.

– Some blasting machines may require different pressure settings to accomplish this procedure.

Restoration with gingival portions pressed with IPS e.max ZirPress Gingiva after divesting.

57

Veneering with IPS e.max Ceram The following paragraphs will explain the most important veneering steps. Detailed information about the nanofluorapatite ceramic and its processing are contained in the IPS e.max Ceram Instructions for Use.

Firing of zirconium oxide-supported restorations – Several units (e.g. multi-unit bridges with bulky pontics) in the furnace impede even and thorough heating of the individual units.

– Heat penetration in the firing chamber depends on the type of furnace and the size of the firing chamber.

– To achieve adequate heating of large restorations the heating rate should be lowered by 5-10 °C (9-18 °F) and the holding time extended by 30 seconds.

– The parameters listed in the Instructions for Use apply to Ivoclar Vivadent furnaces (temperature tolerance +/- 10 °C/18 °F).

– If furnaces other than those from Ivoclar Vivadent are used, temperature adjustments may be necessary.

58

Wash firing (Foundation firing) The restoration must be free of dirt and grease before the wash is applied. Any contamination of the restoration after cleaning must be prevented. Conduct the Wash firing using IPS e.max Deep Dentin or Dentin materials (the IPS e.max Ceram ZirLiner must not be used, since it works only on zirconium oxide with firing temperature of 960 °C/1760 °F).

Please observe the following procedure: – Use the IPS e.max Ceram Build-Up Liquids allround or soft to mix the IPS e.max Ceram Gingiva, Deep Dentin or Dentin materials.

– If a more plastic consistency is desired, IPS e.max Ceram Glaze and Stain Liquids (allround or longlife) can be used.

– Apply a thin, but complete coat of the wash on the areas to be veneered and fire.

– If the gingival portions will be subsequently individualized using Gingiva layering materials, IPS e.max Ceram Gingiva has to be applied as a wash.

Carry out Wash firing using IPS e.max Ceram Deep Dentin or Dentin on the tooth-shaded portions and IPS e.max Ceram Gingiva on the gingival portions. Note the temperature control.

After Wash firing.

Firing parameters for the Wash firing (Foundation firing) IPS e.max Ceram on IPS e.max ZirPress Gingiva Technique

B °C/°F

S min.

tÚ* °C/°F/min.

T °C/°F

H* min.

V1 °C/°F

V2 °C/°F

L** °C/°F

Wash firing (Foundation firing)

403/ 757

4:00 4:00

50/ 90

750/ 1382

1:00 1:00

450/ 842

749/ 1380

500/ 932

*for large restorations, the heating rate should be lowered by 5-10 °C (9-18 °F) and the holding time extended by 30 seconds. **Depending on the furnace type, the cooling rate t I = 20 °C/36 °F has to be entered.

Optional Wash firing (Foundation firing) characterization Intensively charcterized areas may be designed with IPS e.max Ceram Essence. These materials are ideally suited to apply individualized characterizations.

Firing parameters for the Wash firing (Foundation firing) characterization – note the temperature control IPS e.max Ceram on IPS e.max ZirPress Gingiva Technique

B °C/°F

S min.

tÚ* °C/°F/min.

T °C/°F

H* min.

V1 °C/°F

V2 °C/°F

L** °C/°F

Wash firing (Foundation firing) characterization

403/ 757

4:00 4:00

50/ 90

750/ 1382

1:00 1:00

450/ 842

749/ 1380

500/ 932

*for large restorations, the heating rate should be lowered by 5-10 °C (9-18 °F) and the holding time extended by 30 seconds. **Depending on the furnace type, the cooling rate t I = 20 °C/36 °F has to be entered.

Layering materials must not be applied on unfired wash layers, since this will result in a delamination of the layering ceramic. The wash must be fired before the actual layering procedure is started.

59

1st Dentin and Incisal firing Carry out the layering of the teeth according to the layering diagram. In order to achieve the desired consistency of the ceramic material, the IPS e.max Ceram Build-Up Liquids (allround or soft) can be used. If another consistency is desired, the liquids may also be mixed with each other at any mixing ratio.

Build up the tooth shape according to the layering diagram using IPS e.max Ceram layering materials (Deep Dentin, Dentin, Incisal). Separate the interdental areas before firing.

Fire the restoration using the firing parameters for the 1st Dentin and Incisal firing.

Firing parameters for the 1st Dentin and Incisal firing – note the temperature control IPS e.max Ceram on IPS e.max ZirPress Gingiva Technique

B °C/°F

S min.

tÚ* °C/°F/min.

T °C/°F

H* min.

V1 °C/°F

V2 °C/°F

L** °C/°F

1st Dentin/Incisal firing

403/ 757

4:00 4:00

50/ 90

750/ 1382

1:00 1:00

450/ 842

749/ 1380

500 932

*for large restorations, the heating rate should be lowered by 5-10 °C (9-18 °F) and the holding time extended by 30 seconds. **Depending on the furnace type, the cooling rate t I = 20 °C/36 °F has to be entered.

60

2nd Dentin and Incisal firing (Correction firing) Complete the missing areas and compensate for the shrinkage. If required, the gingival portions can be individualized with IPS e.max Ceram Gingiva.

Compensate for the shrinkage using Dentin, Transpa and Incisal materials. If required, the gingival portions can be individualized with IPS e.max Ceram Gingiva.

Fire the restoration using the firing parameters for the 2nd Dentin and Incisal firing.

Firing parameters for the 2nd Dentin and Incisal firing – note the temperature control IPS e.max Ceram on IPS e.max ZirPress Gingiva Technique

B °C/°F

S min.

tÚ* °C/°F/min.

T °C/°F

H* min.

V1 °C/°F

V2 °C/°F

L** °C/°F

2nd Dentin/Incisal firing

403/ 757

4:00 4:00

50/ 90

750/ 1382

1:00 1:00

450/ 842

749/ 1380

500 932

*for large restorations, the heating rate should be lowered by 5-10 °C (9-18 °F) and the holding time extended by 30 seconds. **Depending on the furnace type, the cooling rate t I = 20 °C/36 °F has to be entered.

Stain and Glaze firing Stain firing is conducted with IPS e.max Ceram Essence and Shades, while Glaze firing is carried out with Glaze powder or paste. Depending on the situation, the firing cycles may be conducted together or separately. The firing parameters are identical.

If required, the gingival portions can be characterized with IPS e.max Ceram Essence materials (rose, berry or aubergine).

Prepare the restoration for Stain and Glaze firing.

Apply IPS e.max Ceram Glaze, Essence and Shades.

Firing parameters for the Stain and Glaze firing – note the temperature control IPS e.max Ceram on IPS e.max ZirPress Gingiva Technique

B °C/°F

S min.

tÚ* °C/°F/min.

T °C/°F

H* min.

V1 °C/°F

V2 °C/°F

L** °C/°F

Stain firing

403/ 757

6:00 6:00

60/ 108

725/ 1337

1:00 1:00

450/ 842

724/ 1335

500/ 932

Glaze firing

403/ 757

6:00/ 6:00

60/ 108

725/ 1337

1:00 1:00

450/ 842

724/ 1335

500/ 932

*for large restorations, the heating rate should be lowered by 5-10 °C (9-18 °F) and the holding time extended by 30 seconds. **Depending on the furnace type, the cooling rate t I = 20 °C/36 °F has to be entered.

61

Completed restoration after Stain and Glaze firing.

The dental lab work was carried out by MDT Thorsten Michel, Schorndorf, Germany.

62

IPS

e.max ZirPress — ®

G E N E R A L I N F O R M AT I O N P R E P A R I N G F O R C E M E N TAT I O N Conditioning of the ceramic surface in preparation for cementation is decisive for generating a sound bond between the luting material and the all-ceramic restoration.

In the combination of IPS e.max ZirCAD and IPS e.max ZirPress, the conditioning measures must be conducted according to the indications. The following points have to be observed: – High-strength zirconium oxide ceramics are generally not etched with hydrofluoric acid (IPS Ceramic Etching Gel), as it does not produce an etching pattern.

– Zirconium oxide-supported restorations may be blasted at maximum 1 bar (15 psi) pressure to clean the surfaces prior to cementation.

– The glass-ceramics of inlay-retained bridges fabricated in the press-on technique – with contact of the glass-ceramic to the tooth structure – have to be etched with hydrofluoric acid (IPS Ceramic Etching Gel), silanized with Monobond-S and subsequently cemented using the adhesive technique.

IPS e.max ZirCAD – IPS e.max ZirPress Material Indication

Cementation method

Zirconium oxide

Glass-ceramics pressed on zirconium oxide

Glass-ceramics

Crowns and bridges w/w.o. pressed shoulder

Inlay-retained bridges

Veneers 2)

Adhesive cementation

Self-adhesive/ conventional cementation

Etching

Conditioning / Silanization Cementation system

2)

180 sec. with Metal/Zirconia Primer Multilink® Automix

Vivaglass® CEM

Adhesive cementation

Adhesive cementation

20 sec. with IPS Ceramic Etching Gel

20 sec. with IPS Ceramic Etching Gel

60 sec. with Monbond-S

60 sec. with Monbond-S

Multilink® Automix

Variolink® Veneer ® Variolink II

Veneers must be adhesively cemented

Observe the Instructions for Use if the IPS Ceramic Etching Gel is used.

63

P R E S S A N D F I R I N G PA R A M E T E R S Press parameters B

tÚ

T

H

V1

V2

A

EP 600 / EP 600 Combi Small investment ring

700°C 1292°F

60°C 108°F

900°C 1652°F

15:00 min

500°C 932°F

900°C 1652°F

300

EP 600 / EP 600 Combi Large investment ring

700°C 1292°F

60°C 108°F

910°C 1670°F

15:00 min

500°C 932°F

910°C 1670°F

300

EP 500 Small investment ring

700°C 1292°F

60°C 108°F

900°C 1652°F

15:00 min

500°C 932°F

900°C 1652°F

–

EP 500 Large investment ring

700°C 1292°F

60°C 108°F

910°C 1670°F

15:00 min

500°C 932°F

910°C 1670°F

–

If you use the Programat EP 5000 furnace, select the press program depending on the investment ring size and the ingot used.

Firing parameters Firing of zirconium oxide-supported restorations – Several units (e.g. multi-unit bridges with bulky pontics) in the furnace impede even and thorough heating of the individual units.

– Heat penetration in the firing chamber depends on the type of furnace and the size of the firing chamber.

– To achieve adequate heating of the individual restorations the heating rate should be lowered by 5-10 °C (9-18 °F) and the holding time extended by 30 seconds.

– The parameters listed in the Instructions for Use apply to Ivoclar Vivadent furnaces (temperature tolerance +/- 10 °C/18 °F).

– If furnaces other than those from Ivoclar Vivadent are used, temperature adjustments may be necessary.

IPS e.max ZirPress HT – Staining technique IPS e.max Ceram on IPS e.max ZirPress Staining Technique

B °C/°F

S min.

tÚ °C/°F/min.

ZirLiner firing – before wax-up and pressing

403/ 757

4:00 4:00

60/ 108

Stain and characterization firing

403/ 757

6:00 6:00

Glaze firing

403/ 757

Add-On after Glaze firing

403/ 757

T °C/°F

H min.

V1 °C/°F

V2 °C/°F

960/ 1760/

1:00 1:00

450/ 842

959/ 1758

60/ 108

770/ 1418

1:00 1:00

450/ 842

769/ 1416

6:00 6:00

60/ 108

770/ 1418

1:00 1:00

450/ 842

769/ 1416

6:00 6:00

50/ 90

700/ 1292

1:00 1:00

450/ 842

699/ 1290

If the gloss is unsatisfactory after the first glaze firing, further glaze firing procedures may be conducted using the same firing parameters.

64

IPS e.max ZirPress LT - Cut-Back Technique IPS e.max Ceram on IPS e.max ZirPress Cut-back Technique

B °C/°F

S min.

tÚ °C/°F/min.

ZirLiner firing – before wax-up and pressing

403/ 757

4:00 4:00

60/ 108

Wash firing (foundation)

403/ 757

4:00 4:00

Wash firing (foundation) characterization

403/ 757

1st Incisal / Impulse firing

T °C/°F

H min.

V1 °C/°F

V2 °C/°F

960/ 1760

1:00 1:00

450/ 842

959/ 1758

50/ 90

750/ 1382

1:00 1:00

450/ 842

749/ 1380

4:00 4:00

50/ 90

750/ 1382

1:00 1:00

450/ 842

749/ 1380

403/ 757

4:00 4:00

50/ 90

750/ 1382

1:00 1:00

450/ 842

749/ 1380

2nd Incisal / Impulse firing

403/ 757

4:00 4:00

50/ 90

750/ 1382

1:00 1:00

450/ 842

749/ 1380

Stain firing

403/ 757

6:00 6:00

60/ 108

725/ 1337

1:00 1:00

450/ 842

724/ 1335

Glaze firing

403/ 757

6:00 6:00

60/ 108

725/ 1337

1:00 1:00

450/ 842

724/ 1335

Add-On with Glaze firing

403/ 757

6:00 6:00

60/ 108

725/ 1337

1:00 1:00

450/ 842

724/ 1335

Add-On after Glaze firing

403/ 757

6:00 6:00

50/ 90

700/ 1292

1:00 1:00

450/ 842

699/ 1290

IPS e.max Ceram on IPS e.max ZirPress Layering Technique

B °C/°F

S min.

H min.

V1 °C/°F

V2 °C/°F

ZirLiner firing – before wax-up and pressing

403/ 757

4:00 4:00

60/ 108

960/ 1760

1:00 1:00

450/ 842

959/ 1758

Wash firing (foundation)

403/ 757

4:00 4:00

50/ 90

750/ 1382

1:00 1:00

450/ 842

749/ 1380

Wash firing (foundation) characterization

403/ 757

4:00 4:00

50/ 90

750/ 1382

1:00 1:00

450/ 842

749/ 1380

1st Dentin/Incisal firing

403/ 757

4:00 4:00

50/ 90

750/ 1382

1:00 1:00

450/ 842

749/ 1380

2nd Dentin/Incisal firing

403/ 757

4:00 4:00

50/ 90

750/ 1382

1:00 1:00

450/ 842

749/ 1380

Stain firing

403/ 757

6:00 6:00

60/ 108

725/ 1337

1:00 1:00

450/ 842

724/ 1335

Glaze firing

403/ 757

6:00 6:00

60/ 108

725/ 1337

1:00 1:00

450/ 842

724/ 1335

Add-On with Glaze firing

403/ 757

6:00 6:00

60/ 108

725/ 1337

1:00 1:00

450/ 842

724/ 1335

Add-On after Glaze firing

403/ 757

6:00 6:00

50/ 90

700/ 1292

1:00 1:00

450/ 842

699/ 1290

IPS e.max ZirPress MO – Layering Technique tÚ °C/°F/min.

65

T °C/°F

IPS e.max ZirPress Gingiva - Gingiva Technique B

S

H*

V1

V2

min.

tÚ* °C/°F/min.

T

°C/°F

°C/°F

min.

°C/°F

°C/°F

L** °C/°F

ZirLiner firing – before wax-up and pressing

403/ 757

4:00 4:00

60/ 108

960/ 1760

1:00 1:00

450/ 842

959/ 1758

– –

Wash firing (foundation)

403/ 757

4:00 4:00

50/ 90

750/ 1382

1:00 1:00

450/ 842

749/ 1380

500/ 932

Wash firing (foundation) characterization

403/ 757

4:00 4:00

50/ 90

750/ 1382

1:00 1:00

450/ 842

749/ 1380

500/ 932

1st Dentin/Incisal firing

403/ 757

4:00 4:00

50/ 90

750/ 1382

1:00 1:00

450/ 842

749/ 1380

500/ 932

2nd Dentin/Incisal firing

403/ 757

4:00 4:00

50/ 90

750/ 1382

1:00 1:00

450/ 842

749/ 1380

500/ 932

Stain firing

403/ 757

6:00 6:00

60/ 108

725/ 1337

1:00 1:00

450/ 842

724/ 1335

500/ 932

Glaze firing

403/ 757

6:00 6:00

60/ 108

725/ 1337

1:00 1:00

450/ 842

724/ 1335

500/ 932

Add-On with Glaze firing

403/ 757

6:00 6:00

60/ 108

725/ 1337

1:00 1:00

450/ 842

724/ 1335

500/ 932

Add-On after Glaze firing

403/ 757

6:00 6:00

50/ 90

700/ 1292

1:00 1:00

450/ 842

699/ 1290

500/ 932

IPS e.max Ceram on IPS e.max ZirPress Gingiva Technique

*for large restorations, the heating rate should be lowered by 5-10 °C (9-18 °F) and the holding time extended by 30 seconds. **Depending on the furnace type, the cooling rate t I = 20 °C/36 °F has to be entered.

- The parameters indicated represent standard values and apply to the Ivoclar Vivadent furnaces: P300, P500, P700, EP 600 Combi, Programat EP 5000. The temperatures indicated also apply to furnaces of older models, such as the P20, P80, P90, P95, P100, P200, and PX1. If one of these furnaces is used, however, the temperatures may deviate by ± 10 °C/18 °F, depending on the age and type of the heating muffle.

- If furnaces other than those from Ivoclar Vivadent are used, temperature adjustments may be necessary.

- Regional differences in the power supply or the operation of several electronic devices by means of the same circuit may render adjustments of the firing and press temperatures necessary.

66

ZL 3 ZL 1

C1

67

BL3

IPS e.max Ceram Incisal

BL2

I BL

BL1

IPS e.max Ceram Dentin BL3

BL3

BL2

BL1

IPS e.max ZirPress LT, MO

ZL clear

BL2

yellow, incisal

BL1

TI 2

IPS e.max Ceram Intensive ZirLiner

IPS e.max Ceram ZirLiner

Bleach BL

TI 1

BL4

BL4

BL4

TI 2

D A3.5 TI 3

TI 1

D B1 TI 1

D B2 TI 1

D B3

B3

TI 2

D B4 TI 1

D C1

TI 1

D A3 D A4

ZL 3

B4

IPS e.max Ceram Transpa Incisal

D A2

B1

ZL 1

B3

D A1

A3.5

ZL 1

B2

IPS e.max Ceram Dentin

A3

ZL 4

B1

B2

A2

ZL 2

A4

A1

ZL 2

A3.5

IPS e.max ZirPress LT, MO

ZL 1

A3

yellow, orange, brown, incisal

ZL 1

IPS e.max Ceram ZirLiner

A2

IPS e.max Ceram Intensive ZirLiner

A1

A-D

C U T - B A C K , L AY E R I N G T E C H N I Q U E

TI 3

D C2

C2

ZL 4

C2

TI 3

D C3

ZL 4

C3

TI 3

D C4

ZL 4

C4

TI 3

D D2

ZL 4

D2

TI 3

D D3

D3

ZL 4

D3

TI 3

D D4

ZL 4

D4

IPS

e.max ZirPress — ®

C O M B I N AT I O N T A B L E

68

ZL 3

ZL 1

C1

ZL clear

BL3

SH I1

BL3

IPS e.max Ceram Shades Incisal

BL2

yellow, incisal

BL2

SH 0

BL1

BL1

SH I1

IPS e.max Ceram Shades

IPS e.max ZirPress HT

IPS e.max Ceram Intensive ZirLiner

IPS e.max Ceram ZirLiner

Bleach BL

SH I1

SH 1

BL4

BL4

SH I2

SH 1 SH I1

SH 1 SH I1

SH 2 SH I1

SH 2

B3

SH I1

ZL 3

B4

IPS e.max Ceram Shades Incisal

SH 1

B1

ZL 1

B3

SH 1

A3.5

ZL 1

B2

IPS e.max Ceram Shades

A3

ZL 4

B1

B2

A2

ZL 2

A4

A1

ZL 2

A3.5

IPS e.max ZirPress HT

ZL 1

A3

yellow, orange, brown, incisal

ZL 1

IPS e.max Ceram ZirLiner

A2

IPS e.max Ceram Intensive ZirLiner

A1

A-D

S TA I N I N G T E C H N I Q U E

SH I2

SH 3

C2

ZL 4

C2 ZL 4

C3 ZL 4

C4 ZL 4

D2

SH I2

SH 4

D3

ZL 4

D3

ZL 4

D4

QUESTIONS AND ANSWERS Can IPS e.max ZirPress also be pressed onto other zirconium oxide frameworks?

Can IPS e.max ZirPress be used to fabricate inlays and onlays?

IPS e.max ZirPress can be pressed onto frameworks made of sintered zirconium oxide or HIP zirconium oxide in the CTE range of 10.5-11.0 x 10-6 K-1 (100–500 °C). The following zirconium oxides have been tested for this purpose: – KaVo – Bio ZS (coloured and uncoloured) and Bio ZH Blanks – Nobel Biocare – Procera Zirconia – DeguDent – Cercon Base – 3M/Espe – Lava Frame (coloured and uncoloured) – DCS – DC-Zirkon – Digident – Digizon – Cad.esthetics – Denzir – Vita – In-Ceram 2000 YZ Cubes (coloured and uncoloured) – Diatomic – Diadem/Diazir (coloured and uncoloured) – Wieland – Zeno Zr Disc

IPS e.max ZirPress has been developed for pressing onto zirconium oxide. Therefore, the shades have been specially developed for this application. From a materials science point of view, inlays and onlays can be fabricated using this material. However, the aesthetic potential of the product is limited. This must be taken into consideration during fabrication.

Can IPS e.max ZirPress be pressed onto only a part of a restoration (e.g. on a shoulder or pontic)?

IPS e.max ZirPress can be pressed onto selected parts of a restoration, if specified in the instructions for use, the necessary minimum thickness of the ceramics and the following points are observed. The sprues must be attached directly, for example, to the ceramic shoulder.

During sprueing and placement on the IPS e.max ring base, adequate stability of the restoration and the waxed up areas must be ensured.

Only carefully blast the non-pressed areas (exposed ZirLiner) with Al2O3 in order to avoid removal of the ZirLiner.

Wash firing has to be carried out, even if ceramics are only pressed onto certain areas of the restoration to improve wetting.

Can IPS e.max ZirPress be pressed onto implant abutments?

IPS e.max ZirPress can be pressed onto zirconium oxide abutments in the CTE range of 10.5–11.0 x 10-6 K-1 (100–500 °C). The abutments should not be too small and they must provide adequate support for the shape and cusps. The instructions of the individual manufacturers have to be observed.

Can IPS e.max ZirPress be used to fabricate single crowns without zirconium oxide copings?

IPS e.max ZirPress has been developed for the press-on technique. The strength of the ingots is not sufficient for crowns without zirconium oxide copings. Therefore, the ingots can not be used for this indication.

69

Can veneers be fabricated with IPS e.max ZirPress?

What is the purpose of the IPS e.max Ceram ZirLiner?

IPS e.max ZirPress has been developed for pressing onto zirconium oxide and the shades have been adjusted for this purpose. However, from a technical point of view, veneers can be fabricated with this material. For example, if veneers are required in the anterior region for a large restorative case and if the shade of the IPS e.max ZirPress ingot corresponds to the demands of the patient, veneers can be pressed (in the same investment ring). The cut-back technique allows the veneers to be individually characterized with IPS e.max Ceram. Veneers made with IPS e.max ZirPress must be placed with the adhesive technique.

IPS e.max Ceram ZirLiners are translucent. Their three major purposes are as follows: 1. They enable a strong, homogeneous bond with the zirconium oxide framework.

2. They provide the white, unshaded zirconium oxide frameworks with chroma, an in-depth effect, and a shaded character without increasing their opacity.

3. They also provide the non-fluorescent zirconium oxide framework with a natural fluorescence, thus enabling the fabrication of lifelike restorations.

Which IPS e.max Ceram ZirLiner should be used on shaded zirconium oxide frameCan IPS e.max ZirPress be pressed onto inlayretained bridges?

works?

For shaded zirconium oxide frameworks, use the IPS e.max Ceram ZirLiner clear. The transparent character of the IPS e.max Ceram ZirLiner does not affect the framework shade. An outstanding bond as well as lifelike fluorescence is achieved.

When shaded frameworks are used, the colour compatibility of the IPS e.max ZirPress ingots and that of the framework must be ensured.

IPS e.max ZirPress HT ingots can be pressed onto zirconium oxide inlay-retained bridges. In the creation of the zirconium oxide framework, the minimum thickness of the connectors and the inlays (min. 0.5 mm) must be observed. All the areas at the preparation margins should be fabricated with IPS e.max ZirPress rather than zirconium oxide, since the press ceramic can be etched. This allows a sound bond to be established between the press ceramic, the luting composite and the prepared tooth.

Can IPS e.max ZirPress be pressed onto zirconium oxide frameworks without the application of IPS e.max Ceram ZirLiner?

A suitably shaded IPS e.max Ceram ZirLiner must always be applied before waxing up. The IPS e.max Ceram ZirLiner generates an outstanding bond and gives the restoration an effect of depth with regard to colour and fluorescence.

Can IPS e.max ZirPress be pressed onto IPS Empress CosmoPost?

IPS e.max ZirPress ingots can be pressed onto IPS Empress CosmoPost. An excellent bond is achieved. Because of the large selection of IPS e.max ZirPress ingots, very natural looking restorations can be fabricated.

Why is the IPS e.max Ceram ZirLiner powder green and how should it be applied?

Since zirconium oxide is white and, therefore, shows a poor contrast to tooth coloured and/or white powders, the IPS e.max Ceram ZirLiner was given an identification colour to render its application more simple and efficient. The IPS e.max Ceram ZirLiner consists of a very fine powder and appears somewhat thick due to the dense packing of the grains. Make sure that the material is applied in an even, greenish coat. If the colour appears too pale, the layer is too thin. After firing, the IPS e.max Ceram ZirLiner will demonstrate a layer thickness of approximately 0.1 mm.

Can IPS e.max ZirPress be pressed onto glassceramic frameworks made of IPS e.max Press or IPS e.max CAD, for example?

IPS e.max ZirPress ingots can only be pressed onto zirconium oxide materials. The press temperature of 900-910 째C (1652-1670 째F) is too high for glass-ceramic frameworks. Consequently, they would become deformed during the press procedure.

70

How thick should the wax-up be?

Can other press furnaces be used to press IPS e.max ZirPress ingots?

The wax-up should be at least 0.7 mm thick all over. If the wax is not at least this thick, the restoration may not be completely covered with the pressed ceramic and deviations in the shade may occur.

IPS e.max ZirPress is specifically coordinated with the Ivoclar Vivadent press furnaces (EP 500, EP 600 and EP 600 Combi, Programat EP 5000). If other press furnaces are used, the parameters have to be adjusted accordingly by the user.

Why are IPS e.max ZirPress ingots available in different levels of translucency?

Can IPS e.max ZirPress restorations also be conventionally cemented?

The user may select the suitable ingot depending on the desired processing technique. The HT ingot is particularly suitable for the staining technique, the LT ingot for the cut-back technique and the MO ingot for the layering technique.

IPS e.max ZirPress restorations may be either adhesively, self-adhesively or conventionally cemented.

For conventional cementation however, an appropriately retentive preparation design must be observed. If this is not possible, adhesive cementation, e.g. with Multilink® should be used.

We advise against the use of conventional phosphate cements, since they negatively influence the light transmission through the all-ceramic and compromise the aesthetic appearance of the all-ceramic restorations. Inlayretained bridges as well as veneers fabricated in the press-on technique have to be adhesively cemented.

Can IPS Empress Universal Shades, Stains and Glaze be used with IPS e.max ZirPress?

IPS Empress Universal Shades, Stains and Glaze have been specially developed for the IPS Empress system. Consequently, they cannot be used with IPS e.max products.

Can IPS e.max Alox plungers also be used for IPS Empress?

IPS e.max Alox plungers are exclusively for the IPS e.max System and the corresponding investment ring system specifically developed for this purpose. Since the diameter has been increased, the Alox plunger would not fit into the IPS Empress investment ring system.

Can the IPS e.max Alox Plunger Separator also be used for other pressed ceramics, such as IPS Empress Esthetic?

IPS e.max Alox Plunger Separator can only be used for IPS e.max Press and ZirPress ingots, since the press temperature of the IPS Empress Esthetic ingots of 1075 °C (1967 °F) is too high and results in the Separator losing its effect.

71

Ivoclar Vivadent – worldwide Ivoclar Vivadent AG Bendererstrasse 2 FL-9494 Schaan Liechtenstein Tel. +423 235 35 35 Fax +423 235 33 60 www.ivoclarvivadent.com Ivoclar Vivadent Pty. Ltd. 1 – 5 Overseas Drive P.O. Box 367 Noble Park, Vic. 3174 Australia Tel. +61 3 979 595 99 Fax +61 3 979 596 45 www.ivoclarvivadent.com.au Ivoclar Vivadent GmbH Bremschlstr. 16 Postfach 223 A-6706 Bürs Austria Tel. +43 5552 624 49 Fax +43 5552 675 15 www.ivoclarvivadent.com Ivoclar Vivadent Ltda.

Rua Geraldo Flausino Gomes, 78 – 6.º andar Cjs. 61/62 Bairro: Brooklin Novo CEP: 04575-060 São Paulo – SP Brazil Tel. +5511 5102 2020 Fax. +5511 5102 4704 www.ivoclarvivadent.com Ivoclar Vivadent Inc. 2785 Skymark Avenue, Unit 1 Mississauga Ontario L4W 4Y3 Canada Tel. +1 905 238 5700 Fax +1 905 238 5711 www.ivoclarvivadent.us.com

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Ivoclar Vivadent K.K. 1-28-24-4F Hongo Bunkyo-ku Tokyo 113-0033 Japan Tel. +81 3 6903 3535 Fax +81 3 5844 3657 www.ivoclarvivadent.com

Ivoclar Vivadent S.A. c/Emilio Muñoz, 15 Esquina c/Albarracín E-28037 Madrid Spain Tel. + 34 91 375 78 20 Fax + 34 91 375 78 38 www.ivoclarvivadent.com

Ivoclar Vivadent SAS B.P. 118 F-74410 Saint-Jorioz France Tel. +33 450 88 64 00 Fax +33 450 68 91 52 www.ivoclarvivadent.fr

Ivoclar Vivadent S.A. de C.V. Av. Mazatlán No. 61, Piso 2 Col. Condesa 06170 México, D.F. Mexico Tel. +52 (55) 5062-1000 Fax +52 (55) 5062-1029 www.ivoclarvivadent.com.mx

Ivoclar Vivadent AB Dalvägen 14 S-169 56 Solna Sweden Tel. +46 8 514 93 930 Fax +46 8 514 93 940 www.ivoclarvivadent.se

Ivoclar Vivadent GmbH Dr. Adolf-Schneider-Str. 2 D-73479 Ellwangen, Jagst Germany Tel. +49 (0) 79 61 / 8 89-0 Fax +49 (0) 79 61 / 63 26 www.ivoclarvivadent.de

Ivoclar Vivadent Ltd 12 Omega St, Albany PO Box 5243 Wellesley St Auckland, New Zealand Tel. +64 9 914 9999 Fax +64 9 630 61 48 www.ivoclarvivadent.co.nz

Ivoclar Vivadent Marketing Ltd 114, Janki Centre Shah Industrial Estate Veera Desai Road, Andheri (West) Mumbai 400 053 India Tel. +91 (22) 673 0302 Fax. +91 (22) 673 0301 www.ivoclarvivadent.firm.in

Ivoclar Vivadent Polska Sp. z.o.o. ul. Jana Pawla II 78 PL-01-501 Warszawa Poland Tel. +48 22 635 54 96 Fax +48 22 635 54 69 www.ivoclarvivadent.pl

Ivoclar Vivadent Marketing Ltd. Rm 603 Kuen Yang International Business Plaza No. 798 Zhao Jia Bang Road Shanghai 200030 China Tel. +86 21 5456 0776 Fax. +86 21 6445 1561 www.ivoclarvivadent.com Ivoclar Vivadent Marketing Ltd. Calle 134 No. 7-B-83, Of. 520 Bogotá Colombia Tel. +57 1 627 33 99 Fax +57 1 633 16 63 www.ivoclarvivadent.com

Date information prepared: 01/2008 Caution: US Federal Law restricts the sale of this device by or on the order of a licensed dentist.

These materials have been developed solely for use in dentistry. Processing should be carried out strictly according to the Instructions for Use. Liability cannot be accepted for damages resulting from failure to observe the Instructions or the stipulated area of application. The user is responsible for testing the material for its suitability and use for any purpose not explicitly stated in the Instructions. Descriptions and data constitute no warranty of attributes.

Printed in Liechtenstein © Ivoclar Vivadent AG, Schaan / Liechtenstein 607612/0108/e/BVD

Ivoclar Vivadent Marketing Ltd. Derbenevskaja Nabereshnaja 11W 115114 Moscow Russia Tel. +7495 913 66 16 Fax +7495 913 66 15 www.ivoclarvivadent.ru

Ivoclar Vivadent UK Limited Ground Floor Compass Building Feldspar Close Warrens Business Park Enderby Leicester LE19 4SE United Kingdom Tel. +44 116 284 78 80 Fax +44 116 284 78 81 www.ivoclarvivadent.co.uk Ivoclar Vivadent, Inc. 175 Pineview Drive Amherst, N.Y. 14228 USA Tel. +1 800 533 6825 Fax +1 716 691 2285 www.ivoclarvivadent.us.com