IPS e.max: Strength in a Smile
One of the most rewarding experiences in the day-to-day operations at Burbank Dental Lab is the ability to play a significant role in changing people’s lives. The positive impact that improving a smile has on a person is enormous.
Having a beautiful smile has been shown to make people appear younger, develop confidence, and improve attractiveness. Never have there been so many actionable methods to improve a person’s smile. These methods are what make cosmetic dentistry one of the largest nonsurgical beauty enhancement industries in the United States.
"Combine the exceptional restorative material of IPS e.max with the Smiles By Design® team at Burbank Dental Lab, and your cosmetic cases will have predictable, successful outcomes every time."
--- Andrew Sedler, COO
One of the top modalities in improving a smile is the porcelain veneer. Porcelain veneers have been used to improve the esthetics of natural teeth since the 1930s. They are used in the treatment of the following:
- Correction of discoloration such as in tetracycline staining or age
- Restoring fractured or worn dentition
- Abnormal morphology
- Correction of malposition
- Repair of fractured crowns or bridge facings intra-orally
Dental materials have evolved significantly, with early materials having many disadvantages such as staining easily, being abrasive, and coming out too thick. These issues moved dental manufacturers to develop materials with improved esthetics, better bonding to enamel, and the ability to mask underlying dentition while remaining thin. Today, open any dental publication, and there is a plethora of information on new materials that boast better wear, esthetics, strength, and ease in cementation.
The Advantages of IPS e.max
One of the most successful materials in veneer fabrication over the last several years has been the IPS e.max material. The IPS e.max material is a lithium disilicate glass-ceramic. This material is well suited for e.max veneers and e.max crowns. The material provides natural-looking tooth coloring and superior light-reflective properties. Additionally, with a flexural strength of 500 MPa, this material has a high fracture toughness. The advantages of IPS e.max consists of the following:
- Can mask dark shades
- Excellent esthetics
- High strength (500 MPa)
- Versatile applications
- Conservative preparation
- Adhesive cementation
- Long-term clinical success
- Extensive scientific documented studies
Introduced to the market over 20 years ago, e.max has had a remarkable success rate. The data shows that upon evaluating the IPS e.max system and covering up to approximately ten years of clinical use, the overall survival rate is 96.8%. It is an extremely versatile and durable material. It can be fabricated in either monolithic or layered options utilizing either pressed or CAD/CAM techniques. The e.max system offers a wide selection of opacities and shades. These attributes make e.max one of the most highly prescribed materials in restorative dentistry.
Managing Patient Expectations
With information so readily available, dental consumers are incredibly knowledgeable and can be very exacting with their expectations in dental restoration procedures. The advances in cosmetics, techniques, and materials all provide the tools to meet most patient-driven expectations. But it is the communication between the dentist, patient, and laboratory that creates the desired results.
An excellent material such as IPS e.max, backed by years of clinical success and a wide variety of shades and opacities, is only part of the solution.
Working with a laboratory that understands how to approach these life-enhancing and demanding cases is necessary to ensure each case is successful.
Excellent communication with the laboratory is crucial to create a treatment plan for each step to provide ideal and predictable results for the patient.
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Smiles By Design®
The understanding of the critical role the laboratory has in supporting dentists is how the Smiles By Design® concept began at Burbank Dental Lab. Taking the best materials and marrying them with a fully supportive technical team is what makes the cosmetic cases that Burbank Dental Lab fabricates so successful.
The Smiles By Design® team is required to complete hundreds of hours in advanced training, including live patient programs, and has included the most advanced training institutes in the country like Las Vegas Institute (LVI) and the Spear Institute. In addition to the basic CDT license, our master technicians are qualified to get you AACD accredited, and are officially certified and trained by Ivoclar to use e.max.
For cases requiring high esthetic demands like veneer cases, proper planning is crucial. The Smiles By Design® team can help guide this process and give input from the laboratory perspective.
Following is a list of steps to achieve the most predictable case results:
- Take pre-op models
- Take photos
- Full face forehead to chin
- Lips at rest
- Close-up of smile
- Shade pictures
- A standard set of AACD pictures following their guidelines
- Preliminary plan
- Number of teeth
- Gum tissue evaluation
- Patient concerns/goals
- Diagnostic wax-up
- A putty stent of the wax-up for temporaries
- Prep-guide and Prep stent
- A traditional impression is taken, or you can utilize a digital workflow
- DuraTemps made
- Provisionals approved or adjusted
- A new set of photos taken with temps
Final restorations fabricated
This is the essential list of what the laboratory needs for a predictable result. However, we believe there is never "too much" information. The more details you as a clinician provide to us, the more of a predictable result your patient will receive.
During each step, the Smiles By Design® team will evaluate and identify any potential problems and collaborate to find solutions and make recommendations. It is a common practice at Burbank Dental Lab to evaluate cases after they have been articulated. This evaluation includes determining if there is proper clearance, evaluating functional issues, taking note of the underlying color, and ensuring that the best material is chosen to provide the expected esthetics and ensure long-lasting clinical results.
The Kois Dento-Facial Analyzer
Taking great impressions and bite registration is paramount to case success. One vital record that needs to be made is the horizontal plane. While there are many ways this can be recorded, a great way to capture this is with the Kois Dento-Facial analyzer. This instrument is a face-bow that has no ear-bow, movable joints, or screws to tighten. The Kois Dento-Facial analyzer relates to the facial midline and horizontal plane to the 100 mm distance of the hinge position. This face-bow is a critical piece of information to record the proper horizontal.
Following are the benefits of using a Kois Dento-facial analyzer:
- Simple to use for both doctor and lab
- Can be easily duplicated
- No movable parts in the transfer of the index tray
- Combines a face-bow transfer and a stick-bite
- Establishes the midline
The Kois Dento-Facial analyzer helps improve predictability and occlusal accuracy, another step in achieving case success.
Materials are always evolving in the dental industry. IPS e.max has been used in restoring dentition for over 20 years. It is one of the most prescribed materials and one of the most heavily studied materials with data that supports its longevity. Combine the exceptional restorative material of IPS e.max with the Smiles By Design® team at Burbank Dental Lab, and your cosmetic cases will have predictable, successful outcomes every time.