The goal of any dental restoration is to restore the patient’s oral environment back to its natural or improved appearance and functionality.
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Dental materials have come a long way since porcelain-fused-to-metal (PFM) was first introduced in the 60s. The push to provide improved materials has been driven primarily by the need to develop materials that offer improved esthetics combined with strength and durability.
Material Selection
The basic principle is to use the right dental material for every patient to have optimum results and patient satisfaction. Using the correct material helps decrease the chances of postoperative problems, which can lead to an overall negative experience of dental care.
Understanding the attributes of different materials utilized during dental procedures allows for increased case success and a better overall dental experience for the patient.
Several dental materials are available in the dental industry. Two of the most prescribed materials are zirconia and lithium disilicate. Understanding when to prescribe one over the other is important in ensuring the patient receives the best option for their unique situation.
When examining the strength of the material, it is important to note that the flexural strength of monolithic zirconia is approximately 1000 MPa, while that of lithium disilicate is approximately 400 MPa.
The problem, however, lies in the esthetics of the materials and their ability to mimic natural teeth. Monolithic zirconia results in a more opaque final restoration that may not be the most esthetic option.
As a result, monolithic zirconia is often prescribed in the posterior region and not in the smile zone. Often when zirconia is prescribed in the anterior, a coping of zirconia is fabricated, and then porcelain is layered over the coping, creating a more esthetic result. However, the porcelain used to layer over the coping usually has a flexural strength of approximately 100 MPa.
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The Importance of Material Translucency
It is important to ensure that whatever the situation, when matching a restoration to the oral environment or when the desire is to achieve a natural result, the contours, size, and surface texture are achieved. Both zirconia and lithium disilicate can offer excellent results. The difference in these materials lies in the way they behave with light.
Lithium disilicate, for example, comes in a wide range of translucent ingots and milling blocks.
Translucency is one key factor distinguishing zirconia from lithium disilicate. Both zirconia and lithium disilicate offer varying levels of translucency.
Zirconia, however, has a higher crystalline content that makes it much less translucent than lithium disilicate. The higher the translucency, the more light can penetrate the restoration. Higher translucent materials offer a more natural result that mimics natural dentition.
It is important to note that there are some instances where a lower translucent material would be better suited to achieve the desired end results.
Zirconia’s opacity can mask severely discolored situations, including metal posts and cores.
Lithium disilicate also has options that offer more opacity and maskability.
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Cementation
A zirconia restoration can be cemented with any luting cement. The process of seat zirconia restorations is less technique-sensitive. In contrast, lithium disilicate restorations are bonded to the tooth structure with a resin cement.
Lithium disilicate can be etched and bonded to the tooth, increasing the crown strength. The bonding process has many more steps, making it more technique-sensitive.
ZIRMAX M
At Burbank Dental Lab, we offer a variety of zirconia restoration options. Our ZIRMAX M brand has a high flexural strength of 1000MPa and is one of the most durable options available.
These teeth restorations resist fracture and are long-lasting. They can be used for crowns and bridges, including long-span bridges. In addition, when the option is to layer porcelain over a substructure, this is the option used to fabricate the substructure.
Some of the other benefits of ZIRMAX M include:
In addition, Burbank Dental Lab offers ZIRMAX ME zirconia. This material’s flexural strength is approximately 750 MPa. It is more suited for posterior bridges of up to 3 units and anterior bridges of up to 4 units.
This material offers more translucency than many other brands on the market. The shades have been formulated to eliminate graying in lighter shades. This is an excellent option if anterior monolithic restorations are desired.
IPS e.max
Lithium disilicate, most notably recognized as the brand E.max is an excellent option when esthetics is the number one concern. E.max preserves more tooth structure in order to provide an aesthetically pleasing result; it minimizes hypersensitivity.
E.max can be monolithic and stained for optimal strength or layered to build in tooth structures. The benefits of E.max include:
E.max is a lithium disilicate glass ceramic that can match any shade and is able to achieve a wide range of desired results.
When it comes to dental materials, there are a wide variety of options available. The two most common types are zirconia and lithium disilicate. Each material has its own set of pros and cons that make them better suited for particular situations.
When strength is the biggest concern, monolithic zirconia is a good option because it offers approximately 1000 MPa flexural strength.
However, if esthetics is your main priority, then considering using lithium disilicate may be the best option.
Contact Burbank Dental Lab today for help deciding which type of prosthetic will work best for your particular case.
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