The Top 5 Questions Dentists Ask About Restorations

1. Do I need to bond or can I conventionally cement this type of restoration?

• For Metal/PFM restorations:
  Crowns, Bridges and or Inlays/Onlays
  
  • We recommend self adhesive resin cements or resin modified glass ionomers.

• For All Porcelain/Ceramics:
  Crowns, Bridges, and Inlays/Onlays
• We recommend self adhesive resin cements
Veneers
• We recommend resin cements.

• For All Porcelain Ceramics with a strengthened Core:
  Emax, Lava, Procera, etc.
  • We recommend Self adhesive resin cements, resin- modified glass ionomers, or resin cements.

• For Composite/Reinforced Polymers:
  Artglass, Targis/Vectris, Concept, Sculpture/FibreKore, etc.
  • We recommend self adhesive resin cements or resin cements.

2. What type of preparation reduction do I need for this type of restoration?

Since this question is asked in response to all ceramics, I will address those specific restorations.

Veneer
A uniformed thickness 0.8-mm to 1.0-mm facial, 1.0-mm to 1.5-mm incisal. Try to avoid preparing the lingual surface.  Also if we are trying to close diastemas, mesial and lingual, surfaces need to be prepped to the lingual line angles.

Anterior Crown Preparation
1.5-mm to 2.0-mm incisal reduction. 1.0-mm to   1.5-mm labial and lingual reduction. Round the internal line angles. Chamfer margin or shoulder margin.

Posterior Crown Preparation
1.5 – 2.0mm occlusal reduction. 1.0 – 2.0mm axial reduction. Round the internal line angles. Chamfer or shoulder margin.

Inlay/Onlay
1.5 – 2.0mm isthmus width. 1.5-mm depth of isthmus. 1.0 – 1.5-
mm wide gingival floor. Rounded internal line angles. Butt joint margin

***Other Helpful Hints***
Two things that should be avoided are:

1. Buccal/incisal 1/3 must be adequately reduced this is often left sticking out too far.  Remember the two plane reduction.
2. The isthmus depth on MOD inlays must be at least 1.5-mm. 

3. What type of restoration(s) would be best?

Here at Payne Oral Designs, we are all about educating and helping you to achieve the optimum results for your patients. We can always help you on a case by case basis.  Give us a call!

4. What type of implant abutment is needed for this case?

The best way to select an implant abutment would be by allowing us to advise you on an abutment after we have done model work, evaluated the angle, tissue depth, occlusal and axial clearance.  We can also order all of the parts for you since we will often need to make adjustments to the abutment.

5. What is the difference between the all ceramic products?  

(Lava, Procera, Emax, IPS Empress, etc)My attempt here is not to do a side by side comparison but to give you a little knowledge of the key characteristics that I have observed.

LAVA

• Has a Milled Yttrium Zirconia sub-structure, which means it’s extremely strong.
• The sub structure has 8 shades to choose from which means it has a slight advantage over other Zirconias when it comes to aesthetics.
• The fit is great and can be used through out the mouth including long spans 40-mm. 

PROCERA

• Has a Milled Alumina or Zirconia sub-structure, depending on your need for aesthetics or strength.
• Shades are applied after milling. 
• Fit is great and can be used through out the mouth.

EMAX

• Has 4 techniques  a  Pressed, a pressed to Zirconia , a milled Yttrium Zirconia, and a milled esthetic glass.
• To cover all your needs the shades are applied to the milling technique after milling. Fit is great and can be used through out the mouth.
• The pressed technique is very similar to IPS Empress 1 but stronger, so veneers can be made in this technique. Spans processed using the pressed technique should be limited to bicuspid forward and limited to 3 unit bridges. 
• Bridges processed with Zirconia substructures can be full arch but we recommend no more than 6 units.

IPS Empress 1

• Great for Inlays, Onlays, and Veneers.
• No strengthened sub structure but that doesn’t mean that it’s not strong. 
• Fantastic aesthetics & great fit and it can be used through out the mouth.