BruxZir® Full-Contour Zirconia

The dentist’s choice for posterior restorations, BruxZir® full-contour zirconia produces durable and long-lasting restorations. Formulated to provide some of the highest flexural strength of any ceramic available. Despite its strength, BruxZir is gentler on opposing enamel than traditional ceramic restorations, making it perfect for bruxing patients.

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Indications

Indicated for posterior crowns, bridges, inlays and onlays. An esthetic solution for bruxers and grinders when PFM metal occlusal/lingual or full-cast restorations are not desired or when patient lacks the preparation space for a PFM or has broken a PFM in the past. Zirconia can also be used for anterior teeth with a facial veneer of porcelain for improved esthetics

Preparation

Shoulder preparation not needed, feather edge is okay. It is a conservative preparation similar to full-cast gold, so any preparation with at least 0.5 mm of occlusal space is accepted.

Minimum occlusal reduction of 0.5 mm; 1 mm is ideal.

Adjustments and polishing:

Adjust Full Contour Zirconia crowns and bridges using water and air spray to keep the restoration cool and to avoid micro-fractures with a fine grit diamond. If using air only, use the lightest touch possible when making adjustments. A football shaped bur is the most effective for occlusal and lingual surfaces (on anterior teeth); a tapered bur is the ideal choice for buccal and lingual surfaces.

Polish Full Contour Zirconia restorations with the porcelain polishing system of your choice.

Cementation

  • Resin Ionomer cement (RelyX or RelyX Unicem, 3M ESPE)
  • Maxcem Elite (Kerr)
  • Panavia F 2.0 (Kuraray) -ideal for short, tapered preparations
  • Glass ionomer cement (GC Fuji, GC America)

Tech Notes

Solid zirconia requires a cast gold type preparation.

Anteriors may have a facial veneer of porcelain but the occlusion will remain in 100 percent zirconia. Final Zirconia restorations are glazed to a smooth surface to reduce plaque accumulation.

Codes

  • D2740 Crown – Porcelain/Ceramic Substrate
  • D6245 Pontic Porcelain/Ceramic
  • D6740 Abutment Crown Porcelain/Ceramic

BruxZir® Anterior

BruxZir® reimagines full-contour zirconia for high translucency and superior esthetics. With natural translucency that rivals pressed IPS e.max® restorations, it’s a suitable alternative to any lithium disilicate restoration in the anterior region. With monolithic fractural strengths averaging 650 MPa, it’s also suitable for posterior crowns.

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Indications

BruxZir® Solid Zirconia is indicated for crowns, bridges, veneers, inlays and onlays, screw-retained implant crowns and full-arch implant prostheses. It is an esthetic alternative to PFM metal occlusal/lingual or full-cast restorations and ideal for restorations requiring extra durability such as crowns under partials or screw-retained implant crowns. The chip-proof durability of BruxZir restorations also makes them ideal for bruxers who have broken natural teeth or previous PFM restorations. BruxZir restorations are also ideal for patients lacking the preparation space for a PFM.

BruxZir Anterior is the latest advancement in the BruxZir Solid Zirconia product line. This highly esthetic restorative material is designed specifically to satisfy the esthetic and functional requirements of the anterior region of the mouth. Exhibiting an average flexural strength of 650 MPa with translucency and color similar to natural dentition, BruxZir Anterior is an ideal, esthetic solution for your anterior cases. BruxZir Anterior restorations exceed the ISO strength requirements for cemented all-ceramic restorations and are ideal for anterior and premolar cases. Indications include single-unit crowns and bridges with one pontic.

Preparations

Preparation Requirements for BruxZir Crowns & Bridges

Shoulder preparation not needed, feather edge is OK. It is a conservative preparation similar to full-cast gold, so any preparation with at least 0.5 mm of occlusal space is accepted.

Minimum occlusal reduction of 0.5 mm; 1 mm is ideal.

For BruxZir Anterior restorations, a minimum occlusal reduction of 0.8 mm; 1.25 mm is ideal.

Cementation

Ceramir Crown & Bridge or a resin-reinforced glass ionomer cement such as RelyX™ Luting Cement (3M ESPE; St. Paul, Minn.) or GC Fuji Plus™ (GC America; Alsip; Ill.)

For short or over-tapered preparations, use a resin cement such as RelyX™ Unicem (3M ESPE) or Panavia™ F2.0 (Kuraray; New York, N.Y.)

Instructions for Seating BruxZir and Other Zirconia-Based Crowns & Bridges

BruxZir restorations are fabricated from solid zirconia oxide material, much like the zirconia oxide coping found in restorations such as Prismatik Clinical Zirconia™, Lava™ Zirconia (3M ESPE; St. Paul, Minn.), and NobelProcera™ (Nobel Biocare; Yorba Linda, Calif.). Like most metals, zirconia exhibits a strong affinity for phosphate groups, and zirconia oxide is no different. We can take advantage of this fact with phosphate-containing primers, such as Monobond Plus (Ivoclar Vivadent; Amherst, N.Y.) and Z-Prime™Plus (Bisco; Schaumburg, Ill.), or cements such as Ceramir® Crown & Bridge (Doxa Dental; Newport Beach, Calif.). Unfortunately, saliva also contains phosphates in the form of phospholipids, so when a BruxZir crown or bridge is tried in the patient's mouth and comes in contact with saliva, the phosphate groups in the saliva bind to the zirconia oxide and cannot be rinsed out with water. Attempting to use phosphoric acid (which is full of phosphate groups) to "clean" the saliva out only makes the problem worse.

The only way we have found to successfully remove these phosphate groups from the interior of a BruxZir restoration is with the use of Ivoclean™ (Ivoclar Vivadent). This is a zirconia oxide solution placed inside the restoration for 20 seconds and then rinsed out. Due to the large concentration of free zirconia oxide in the Ivoclean, it acts as a sponge and binds to the phosphate groups that were previously bound to the BruxZir restoration. Once the Ivoclean is rinsed out, you will have a fresh bonding surface for the Monobond Plus, Z-Prime Plus or Ceramir to bond to.

The BruxZir crowns fit well, and the patient has approved them, so it is time to start the cementation procedure. Since zirconia crowns are susceptible to salivary contamination from phospholipids when they are tried in the mouth, if you simply rinse them out with water, as I am doing here, you remove the visible saliva, but the phosphate groups remain bonded to the zirconia surface. The good news is that once we remove these salivary phosphate groups, we are going to take advantage of this fact when we cement or bond these crowns.

Adjustments

Instructions for Adjusting and Polishing BruxZir Crowns & Bridges

Because BruxZir restorations are made from solid zirconia, you may find them harder to adjust with conventional bur kits. To easily adjust, polish or remove these restorations, we have developed specially designed burs and polishers. The diamond burs and polishers in the new BruxZir™ Adjustment & Polishing Kit are ideal for adjusting and polishing zirconia, and the diamonds also work extremely well if you ever need to cut off or provide access for a root canal through a zirconia crown. Always use light pressure with water and air spray when adjusting ceramic restorations to avoid micro-fractures.

Finally, use the white cup with light to medium pressure to achieve a "wet" high shine.

Tech Notes

Procedure to Sterilize Aluminum Bur Block

1. Sterilizers (Dry Heat, Autoclave and Chemiclave)

  • Operate sterilizer unit at 121°C high-pressure saturated steam for 15–20 minutes.

2. Ultrasonic Cleaning

  • Do not use ultrasonic solutions containing alkali products such as sodium hydroxide, potassium hydroxide, or hydroxides.
  • Always mix solutions according to instructions.
  • A five-minute cycle time is recommended.
  • Remove the burs from ultrasonic and rinse well with water.
  • Dry the bur block thoroughly before placing in sterilization pouches.

e.max CAD

IPS e.max® CAD is made from a lithium disilicate, creating easy grinding properties for more economical production. The e.max® CAD doesn’t skimp on strength, either, as it has 360 MPa after being crystallized in a furnace. The completed tooth-colored framework provides a perfect base for a highly aesthetic restoration that has optimal fit.

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Indications

IPS e.max® CAD is indicated for full anterior or posterior crowns. IPS e.max® press is indicated for full anterior or posterior crowns and three-unit bridges having only one pontic with the second bicuspid as the most distal abutment. Veneers can also be indicated and are recommended when combining with adjacent IPS e.max® crowns or bridges, provided ample reduction is achieved. Otherwise, original IPS Empress® or IPS e.max® CAD would be indicated for veneers, inlays and onlays.

Contraindications

IPS e.max® should not be used on patients with malfunctional occlusion such as bruxers or clenchers. IPS e.max® should not be used as abutments for cast partials. IPS e.max® should not be used in situations when preparation requirements cannot be achieved. IPS e.max® is not indicated for Maryland-type bridges.

Preparation

Anterior full-coverage crowns require a chamfer or shoulder margin. A circular shoulder is prepared with rounded inner edges or a chamfer at an angle of 10-30°: the width of the shoulder/chamfer is approx. 1 mm. Facial reduction is 1.5 – 2 mm; 1 – 1.5 mm lingual contact clearance. Incisal reduction is 1.5 – 2 mm with rounded internal line angles, and an incisal edge at least 1mm wide to permit optimum milling of the incisal edge during CAD/CAM processing.

Posterior full-coverage crown requires a chamfer or shoulder margin. A circular shoulder is prepared with rounded inner edges or a chamfer at an angle of 10-30°: the width of the shoulder/chamfer is approx. 1 mm. Occlusal reduction is 1.5 – 2 mm: axial reduction (buccal, lingual and interproximal) is 1.5 mm with rounded internal line angles.

Cementation

For greatest strength, and where preparation allows for dry field (supra-gingiva margins), it is recommended to use adhesive bonding, such as VarioLink II (Ivoclar Vivadent) or similar dual cure materials (Insure, Cosmedent; Nexus, Kerr; Choice, Bisco, Inc.; Lute-It, Pentron).

For areas subgingival, or when a dry field cannot be achieved, Ivoclar Vivadent recommends a hybrid glass ionomer cement system with less than 0.5 percent expansion. (NOTE: Resin-reinforced glass ionomers (Advance, Vitremer) are not indicated for any all-ceramic restoration.)

Some recommended resin cements:

  • Vivaglass (Ivoclar Vivadent)
  • GC Fuji (GC America)
  • Ketec Cem (3M ESPE)
  • Panavia F (J. Morita)
  • C&B Metabond
  • Variolink (Ivoclar Vivadent)

Tech Notes

If adjustment is required on the ceramic, ALWAYS CEMENT OR BOND INTO PLACE BEFORE PROCEEDING, then use a fine diamond with water to keep the crown cool. To contour the crown, polish with a porcelain polishing wheel ( Brassler, Shofu and Vident) and diamond polishing paste.

Caution: Do NOT attempt to fire porcelain. IPS e.max® ceramic requires specific stains and glaze, as well as precisely calibrated ovens at specific temperatures and vacuum settings.For best results, return crown for re-glaze firing to lab.

Codes

  • D2740 Crown
  • D2610 Inlay for 1 surface
  • D2620 Inlay for 2 surfaces
  • D2630 Inlay for 3 surfaces
  • D2962 Labial Veneer
  • D2783 Crown 3/4 Porcelain Ceramic (does not include veneers)

Porcelain Fused to Zirconia

For truly superior aesthetics, Porcelain Fused to Zirconia is a great option in restorations because of the ideal room that they are able to give for veneering ceramic. As one of the most promising restorative materials, it is lighter in color, which allows it to be less of problem than with a Porcelain Fused to Metal Restoration. Our state of the art Zirconia-based restorations feature unparalleled craftsmanship and lead to very little in the way of gingival reaction. Contact Slocomb Dental Lab to discuss using Porcelain Fused to Zirconia in your next case.

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Indications

A CAD/CAM substitute for traditional PFM our porcelain fused to zirconia can be used for anterior and posterior crowns, crowns over implants and bridges of up to fourteen units.

Preparation

The ideal preparation for PFZs is a chamfer margin preparation. If a porcelain labial margin is prescribed, then a shoulder margin preparation is required.

Feather-edge margin preparations are indicated for full-cast restorations.

Cementation

  • Resin Ionomer cement (RelyX or RelyX Unicem, 3M ESPE)
  • Maxcem Elite (Kerr)
  • Panavia F 2.0 (Kuraray) -ideal for short, tapered preparations
  • Glass ionomer cement (GC Fuji, GC America)

Tech Notes

If an adjustment is required on the ceramic, use a fine diamond with water and air to keep the crown cool.

To contour the ceramic, polish with a pink rubber wheel and diamond polishing paste (Brasseler, Shofu, Vident).

Codes

  • D2740 Crown - porcelain / ceramic substrate

Multi-layer Zirconia

Multi-layer Zirconia discs have a color gradation that closely matches real enamel, resulting in more natural-looking restorations. This highly translucent zirconia is your all-in-one choice for both posterior and anterior indications. Our Multi-Layered Zirconia restorations are the most esthetic, best-fitting option with minimal chairside adjustments.

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Indications

A highly versatile zirconia, Katana UTML is indicated for Ideal for anterior crowns and veneers, inlays/onlays and posterior single crowns.

Preparation

Shoulder preparation not needed. A mild champfer or a feather edge margin is good. 1mm buccal, lingual and occlusal reduction is ideal, but can go to .5mm in some areas, when reduction is limited.
Minimum occlusal reduction of 0.5 mm; 1 mm is ideal.
Adjustments and polishing: Adjust zirconia crowns and bridges using water and air spray to keep the restoration cool and to avoid micro-fractures with a fine grit diamond. If using air only, use the lightest touch possible when making adjustments. A football-shaped bur is the most effective for occlusal and lingual surfaces (on anterior teeth); a tapered bur is the ideal choice for buccal and lingual surfaces.
Polish zirconia restorations with the porcelain polishing system of your choice.

Feather-edge margin preparations are indicated for full-cast restorations.

Cementation

Katana UTML zirconia may be cemented using a resin reinforced glass ionomer such as Relyx Luting cement. When a greater bond is needed do to the lack of a retentive preparation, use resin cement like Relyx Unicam or Relyx Ultimate.
Before cementing all Katana UTML zirconia crowns, the interior surface of the crown needs to be cleaned with Ivoclean (Ivoclar Vivadent; Amherst N.Y.). This is critical in assuring maximum bond strength.

Tech Notes

Pearl Surface Z is a diamond paste ideal for polishing the zirconia surface to a final finish on Full Contour Zirconia Crowns. Specially developed for Katana zirconia, it is the simplest and fastest way to achieve finished Full Contour Zirconia Crowns.Polish solid zirconia restorations with the porcelain polishing system of your choice.

Codes

  • D2740 Crown – Porcelain/Ceramic Substrate
    D6245 Pontic Porcelain/Ceramic
    D6740 Abutment Crown Porcelain/Ceramic