IPS e.max®

The most esthetic restoration material on the market, IPS e.max® is a lithium disilicate with higher translucency than zirconia. Because of its incredibly realistic esthetics, it’s the perfect option for anterior restorations when cosmetic concerns are of high importance. Despite its esthetic advantages, e.max® is still durable, with a flexural strength of 360 MPa.

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)