Lab Tribune Middle East & Africa No. 1, 2017
Mastering the art of dental technology / Materials and systems for all ceramic CAD/CAM restorations / New NPM sintered metal disk inCoris CCB for the inLab MC X5 5-axis milling machine
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DTMEA_No.1. Vol.7_LT.indd
www.dental-tribune.me
PUBLISHED IN DUBAI
January-February 2017 | No. 1, Vol. 7
Mastering
the art of dental
technology
By Marc Chalupsky, DTI
SINGAPORE/BAD BOCKLET, Germany: Singapore and Germany are
about 10,000 km apart. As Singaporean dental technicians and dealers
discovered at this year’s International Dental Exhibition and Meeting
(IDEM), the world’s most comprehensive range of dental laboratory
products can be found at DT&SHOP,
located in the town of Bad Bocklet
about 100 km north-west of Nuremberg. Owing to the company’s latest
inventory and delivery systems, orders arrive in Singapore and other
Asia-Pacific countries within three
working days. DT&SHOP has big
plans for this thriving dental technology market.
According to a recent Transparency
Market Research report, the AsiaPacific dental laboratory market is
projected to expand at a substantial
rate in the next five years. Driven by
rising dental tourism and a growth
in the number of dental laboratories, the domestic sector will also see
an increase in export demand for
orthodontics, periodontics, crowns,
bridges and implants. Local dealers have yet to be prepared to satisfy demand, particularly regarding
CAD/CAM technology. As one of the
world’s main dental laboratory suppliers, DT&SHOP will soon provide a
convenient solution: “We will work
closely with these smaller and medium-sized dealers in the region by
giving them access to the company’s
product and delivery system,” said
Dr Nicolas Rohde, head of the Digital
and International Division. “This will
also include advanced marketing
and educational support. The new
digital possibilities allow us to work
with partners and clients anywhere
and anytime.” With a 96 per cent
product availability, eco-friendly
packaging and competent customer
service, the company has proved itself to be a reliable partner for local
dealers.
This year, DT&SHOP took the next
step towards securing a major position in the Asia-Pacific market, by
exhibiting at IDEM Singapore 2016.
With a 50 m² booth, the company
showcased its wide range of dental
laboratory products from leading
manufacturers. As a dental producer
itself, DT&SHOP also presented the
new FINOCAM A5 five-axis milling
unit and the FINOSCAN RELATION
high-quality optical 3-D scanner.
“Most dental technicians at IDEM
were impressed by our FINO CAD/
CAM solutions. In fact, our FINO
brand covers most of the dental
laboratory needs, including orthodontic boxes, partial denture alloys,
duplicating and addition-curing silicones, modelling wax, relining units,
porcelain brushes and much more,”
explained Roer. “I think that we have
quite successfully mastered the art
of offering the complete range of
dental technology.”
Sneek peak into the DT&Shop main building: In the foreground the DT&SHOP catalogue, in the
background an artwork by a Vietnamese artist. (Photograph: Marc Chalupsky, DTI)
talent for colour, aesthetics and technical complexity. It therefore comes
as no surprise that DT&SHOP’s corridors are filled with masterpieces,
inspirational and vivid artworks
from around the world. Roer has had
a passion for art for most of her life.
Her latest acquisition, a set of paintings from Canada, is awaiting a suitable space in one of the company’s
new course and laboratory rooms.
In 2010, she travelled to Vietnam
to purchase several paintings from
local artists. The Asia-Pacific region
and Vietnam in particular are known
for their lively art scene. “Art has always been very important to me,”
said Roer. “Our visitors do not rush
through the aisles of the building.
They stop and see the beautiful work
by artists about 10,000 kilometres
apart.”
LIFELIKE ESTHETICS –
EFFICIENTLY PRESSED
Artists and dental technicians share a
Materials and systems for
all ceramic CAD/CAM
restorations
By Drs. Christian Brenes, Ibrahim
Duqum & Gustavo Mendonza, USA
Dental crowns have been used for
decades to restore compromised,
heavily restored teeth, and for aesthetic improvements. New Computer Aided Design/Computer Aided
Manufacturing (CAD/CAM) materials and systems have been devel-
oped and evolved in the last decade
for fabrication of all-ceramic restorations. Dental CAD/CAM technology
is gaining popularity because of its
benefits in terms of time consuming,
materials savings, standardisation of
the fabrication process, and predictability of the restorations.
the fabrication of a restoration is
less compared to traditional methods (Fig. 1). Another benefit of CAD/
CAM dentistry includes the use of
new materials and data acquisition,
which represents a non-destructive
method of saving impressions, res-
The number of steps required for
ÿPage B2
IPS e.max PRESS MULTI
®
THE WORLD’S FIRST POLYCHROMATIC PRESS INGOT
• Monolithic LS2 restorations showing a lifelike shade progression
amic
all cer need
u
all yo
• Exceptional combination of strength, esthetics and efficiency
• For crowns, veneers and hybrid abutment crowns
• Coordinated with high-precision Programat press furnaces
• Maximum cost effectiveness in the press technique
www.ivoclarvivadent.com
Ivoclar Vivadent AG
Bendererstrasse 2 | 9494 Schaan | Liechtenstein
Tel.: +423 235 35 35 | Fax: +423 235 33 60
[2] =>
DTMEA_No.1. Vol.7_LT.indd
B2
LAB TRIBUNE
Dental Tribune Middle East & Africa Edition | 1/2017
◊Page B1
Fig. 1: Number of steps comparison between traditional methods of all-ceramic restorations and CAD/CAM restorations.
Fig. 2: Vita Mark II block.
mina, but veneering with feldspathic
porcelain for a more esthetic result
could follow it after the milling process.[14,15]
In early 1998, IPS ProCAD (Ivoclar
Vivadent) was introduced as a leucite reinforced ceramic, which was
similar to IPS Empress but with a
finer particle size; this material was
designed to be use with the CEREC
system (Sirona Dental) and was
available in different shades.[2]
More recently, the introduction of
IPS Empress CAD (Ivoclar Vivadent)
and Paradigm C that according to
the manufacturer (3M ESPE) is a 30
to 45 percent leucite reinforced glass
ceramic with a fine particle size.[10]
Nobel Biocare developed Procera
material; for its fabrication high purity aluminum oxide is compacted
onto an enlarged die that is fabricated from the scanned data.[16] The enlarged fabricated core shrinks to the
dimensions of the working die when
sintered at 1,550 °C; this material offers a very high strength core for allceramic restorations; the crown is
finished with the application of feldspathic porcelain.[17] More recently,
In-Coris AL (Sirona Dental) has been
introduced as a high-strength aluminum oxide block with similar mechanical properties as Procera.[18]
To overcome esthetic problems of
most CAD/CAM blocks having a
monochromatic restoration, a different version was developed as a
multicoloured ceramic block, which
Fig. 3: In-house milled crown from an E-max block.
Fig. 4: Full arch implant supported prosthesis milled from a
partially sintered sintered (green state) zirconia puck.
torations and information that is
saved in a computer and constitutes
an extraordinary communication
tool for evaluation.
The incorporation of dental technology has not only brought a new
range of manufacturing methods
and material options, but also some
concerns about the processes involving restorations’ fit, quality, accuracy, short and long-term prognosis.[1]
The purpose of this document is to
provide a review of the literature regarding the different materials and
systems available up until 2015 in
the USA.
CAD/CAM materials
Glass ceramics
The first in-office ceramic material was Vitablock Mark I (Vident);
it was a feldspathic-based ceramic
compressed into a block that was
milled into a dental restoration. After the invention of the Mark I block,
the next generation of materials for
CAD/CAM milling fabrication of
Material thickness
Staining technique
Cut-back technique
Layering technique
of this material is that it can be use
as a milled dense composite that was
free of polymerisation shrinkage but
cannot be sintered or glazed.[9]
Fig. 5: STL file of an intraoral scan.
all-ceramic restorations were Vita
Mark II (Vident) and Celay, which
replaced the original Mark I in 1987
for fine feldspathic porcelains primarily composed of silica oxide and
aluminum oxide.[2,3] Mark II blocks
are fabricated from feldspathic porcelain particles embedded in a glass
matrix and used for single unit restorations available in polychromatic
blanks nowadays. On the other hand,
Celay ceramic inlays have been considered clinically acceptable by traditional criteria for marginal fit evaluation.[4]
Dicor-MGC was a glass ceramic material composed of 70 percent tetrasilicic fluormica crystals precipitated
in a glass matrix; but this material
is no longer available on the market.[5] Studies from Isenberg et al.
suggested that inlays of this type of
ceramics were judged as clinically
successful in a range from 3–5 years
of clinical service.[6-8] In 1997, Paradigma MZ100 blocks (3M ESPE) were
introduced as a highly filled ultrafine
silica ceramic particles embedded in
a resin matrix; the main advantage
Anterior
1.2
1.2
0.8
Premolar
1.5
1.5
0.8
Values are expressed in millimetres
Table 1: Recommended dimensions for E-max CAD by Ivoclar Vivadent.
was called VITA TriLuxe (Vident) and
also IPS Empress CAD Multiblock;
the base of the block is a dark opaque
layer, while the outer layer is more
translucent; the CAD software allows the clinician to position or align
the restoration into the block for the
desired outcome of the restoration.
[11,12]
In 2014, the Enamic (VITA) material
was released as a ceramic network
infiltrated with a reinforcing polymer network that has the benefits of
a ceramic and resin in one material,
but no clinical data are available.[14]
Alumina-based ceramics
Alumina blocks (Vitablocs In-Ceram
Alumina, VITA) are available for milling with the CEREC system (Sirona
Dental) and now compatible with
other milling machines as well. Due
to the opacity of alumina- based ceramic materials, the In-Ceram Spinell (VITA) blocks were developed
as an alternative for anterior aesthetic restorations; it is a mixture of
alumina and magnesia. Its flexural
strength is less than In-Ceram Alu-
Molar
1.5
1.5
–
Veneers
0.6
0.6
–
Lithium disilicate
Lithium disilicate is composed of
quartz, lithium dioxide, phosphor
oxide, alumina, potassium oxide
and other components. According to
Saint-Jean (2014) the crystallization
of lithium disilicate is heterogenous
and can be achieved through a two or
three stage process depending if the
glass ceramic is intended to be used
as a mill block (e-max CAD) or as a
press ingot (e-max press). Lithium
disilicate blocks (Fig. 3) are partially
sintered and relatively soft; they are
easier to mill and form to the desired
restoration compared to fully sintered blocks; after this process the
material is usually heated to 850 °C
for 20 to 30 minutes to precipitate
the final phase. This crystallization
step is usually associated with a 0.2
percent shrinkage accounted for the
designing software.[19] Nowadays,
blocks of lithium disilicate are available for both in-office and in-laboratory fabrication of all-ceramic restorations; monolithic blocks require
layering or staining to achieve good
esthetic results.[8] Different in vitro
studies that evaluate the marginal
accuracy of milled lithium disilicate
reveal that these restorations could
be as accurate as 56 to 63 microns.
[20]
According to the manufacturer specifications, the designing principles
for lithium disilicate are produced
by default in the designing software,
but in full all-ceramic crowns structures the minimum thickness must
be applied in the preparation design
(Table I).
During the crystallisation process,
the ceramic is converted from a
lithium metasilicate crystal phase to
lithium disilicate. Some commercial
types of ceramics are Empress CAD
(Ivoclar Vivadent) and IPS E-max.
The first one is a leucite based glass
ceramic with a composition similar to Empress ceramic. IPS E-max
was introduced in 2006 as a material with a flexural strength of 360 to
400 MPa (two to three times stronger than glass ceramics); the blocks are
blue in the partially crystallised state
but it achieves the final shade after it
is submitted to the firing process in a
porcelain oven for 20 to 25 minutes
to complete the crystallisation; the
final result is a glass-ceramic with a
fine grain size of approximately 1.5
µm and 70 percent crystal volume
incorporated in a glass matrix.[20]
In 2014, Vident released Suprinity;
the first ceramic reinforced with zirconia (10 percent weight); this material is a zirconia reinforced lithium
silicate ceramic (ZLS) available in a
precrystallized or fully crystallized
(Suprinity FC) state indicated for all
kind of single all-ceramic restorations.
fabrications since 2004; it has been
useful in the most posterior areas of
the mouth where high occlusal forces are applied and there is limited
interocclusal space.[22]
Zirconia is a polymorphic material
that can have three different forms
depending on the temperature:
monoclinic at room temperature,
tetragonal above 1,170 °C, and cubic
beyond 2,370°C. According to Piconi
(1999) ‘the phase transitions are reversible and free crystals are associated with volume expansion’. Different authors state that when zirconia
is heated to a temperature between
1,470 °C and 2,010 °C and cooled, a
volume shrinkage of 25 to 35 percent
can occur that could affect marginal
fit or passiveness of the restorations.
[22] This feature limited the use of
pure zirconia until 1970 when Rieth
and Gupta developed the yttria-tetragonal zirconia polycrystal (Y-TZP)
containing 2 to 3 percent mol-yttria
in order to minimize this effect.[10]
One of the most interesting properties of zirconia is transformation
toughening; Kelly (2008) describes
it as: ‘A phenomenon that happens
when a fracture takes place by the
extension of an already existing defect in the material structure, with
the tetragonal grain size and stabilizer, the stress concentration at the
tip of the crack constitutes an energy
source able to trigger the transformation of tetragonal lattice into the
monoclinic phase’. This process dissipates part of the elastic energy that
promotes progression of cracks in
the restoration; there is a localized
expansion of around 3.5 percent that
increases the energy that opposes
the crack propagation.[4]
Zirconia restorations can be fabricated from fully sintered zirconium
oxide or partially sintered zirconium
oxide blanks (green-state). Proponent of milling fully sintered zirconia claim that fitness of restorations
is better because it avoid volumetric
changes during the fabrication process. On the other hand, the partially
sintered zirconia (Fig. 4) is easier and
faster to mill and proponents of milling partially sintered blanks claim
that micro cracks can be induced to
the restoration during the milling
process and it also requires more
time and intensive milling processes; this micro defects or surface flaws
can affect the final strength of the final restoration and could potentially
chip the marginal areas; however
further research is needed about this
topic.[10]
One of the first systems that used zirconia was In-Ceram Zirconia (Vident),
which is a modification of the In-Ceram Alumina but with the addition
of partially stabilised zirconia oxide
to the composition. Recently many
companies have integrated zirconia
into their CAD/CAM workflow due
to its mechanical properties, which
are attractive for restorative dentistry; some of these properties are:
high mechanical strength, fracture
toughness, radiopacity for marginal
integrity evaluation, and relatively
high esthetics.[13,14]
Different manufacturers are using
zirconia as one of their main materials such as: Ceramill Zolid (Amann
Girbach), Prettau (Zirkonzahn), Cercon (DENTSPLY), BruxZir (Glidewell
Laboratories), IPS ZirCAD (Ivoclar Vivadent), Zenostar (Ivoclar Vivadent),
inCoris ZI (Sirona Dental), VITA InCeram YZ (Vident), among others.
Companies have introduced materials that are in combination with
zirconia to improve its properties
Zirconia
Zirconia has been used in dentistry
as a biomaterial for crown and bridge
ÿPage B3
[3] =>
DTMEA_No.1. Vol.7_LT.indd
B3
LAB TRIBUNE
Dental Tribune Middle East & Africa Edition | 1/2017
◊Page B2
CAD System
3Shape
ARTI / Modelliere
CeraMill
Cercon Eye/Art
CEREC
Delcam
Dental Wings
PlanCAD
Exocad
InLab
Procera
Manufacturer
3Shape
Zirkonzahn
Amann Girrbach
Dentsply
Sirona Dentsply
Delcam
Dental Wings
Planmeca
Exocad
Sirona Dentsply
Nobel Biocare
File output
Propietary/STL
STL
STL
Propietary
Propietary
STL
STL
STL
STL
Propietary
Propietary/STL
other systems that were able to mill
zirconia were DCS Zirkon(DCS Dental) and Denzir.[16]
In the last decade, companies have
decided to differentiate their products by having a full CAD/CAM platform or by focusing on specific areas
of expertise like CAD software and
intraoral scanners; these companies
claim to be open platform because
their systems allow to export universal files such as STL or OBJ (Fig. 5) to
be used with the majority of nesting
softwares and milling machines that
are able to import them.
Table 2: Most popular dental CAD systems available for 2015.
in different clinical situations. Lava
Plus, for example, is a combination
of zirconia and a nano-ceramic.
CAD/CAM systems
A number of different manufacturers are providing CAD/CAM systems
that generally consist of a scanner,
design computer and a milling machine or 3-D printer. Laboratories
are able to receive digital impression
files from dentists or use a scanner to
create digital models that are used
for restorations designing or CAD.
Dental scanners vary in speed and
accuracy. Milling machines vary in
size, speed, axes, and also in which
restorative materials can be milled;
in this category milling machines
could be classified as wet or dry depending if the materials require irrigation.
The development of dental CAD/
CAM systems occurred around 1980
with the introduction of the Sopha
system developed by Dr. Francois
Duret. A few years after that event,
Dr. Werner Mörmann and the electrical engineer Marco Brandestini developed the CEREC-1 system in 1983,
the first full digital dental system created to allow dentists to design and
fabricate in-office restorations. Since
then, the continuous evolution of
systems dedicated to this field has
continued and has exponentially increased in the last decade.[14]
CEREC systems has evolved into
CEREC Bluecam scanner;accuracies
as close as 17 microns for a single
tooth have been reported by authors
using this system. Recently CEREC
Omnicam was introduced offering
true colour digital impressions without the need of a contrast medium.
In a recent study by Neves et al. (2013)
on the marginal fit of CAD/CAM
restorations fabricated with CEREC
Bluecam, they compared lithium
disilicate single unit restorations to
heat-pressed restorations and 83.8
percent of the specimens had a vertical gap measurement with less or at
least 75 microns.[15]
The CEREC InLab CAD software (Sirona Dental) was designed for dental
laboratories for a wide range of dental capabilities that can be combined
with third party systems. With this
software, the dental technician is
able to scan their own models using
Sirona inEos X5 (Sirona Dental) scanner and design the restoration; once
this process is completed, the file can
be sent to a remote milling machine
or a milling centre for fabrication in a
wide range of materials.
The Procera system, introduced in
1994, was the first system to provide
fabrication of a restoration using a
network connection. According to
research data the average ranges of
marginal fit of this restorations are
from 54 to 64 microns.[20] A computer integrated crown reconstruction system (CICERO) introduced
by Denison et al. in 1999 included
a rapid custom fabrication of highstrength alumina coping and semifinished crowns to be delivered to
dental laboratories for porcelain layering and finishing.[15]
Another system that was developed
years ago was the Celay system,
which fabricated feldpathic restorations through a copy-milling
process. The system duplicated an
acrylic resin pattern replica of a restoration. Zirkonzahn developed a
similar system called the Zirkograph
in 2003, which was able to copy-mill
zirconia prosthesis and restorations
out of a replica of the restoration.
Some years after, the Cercon system
(DENTSPLY Ceramco) was able to design and mill zirconia restorations
out of a wax pattern.[1]
Almost at the same time that these
companies developed the first copy
mill prototypes, Lava (3M ESPE) introduced in 2002 the fabrication of
yttria-tetragonal zirconia polycrystal
(Y-TZP) cores and frameworks for all
ceramic restorations. With the Lava
system, the die is scanned by an
optical process, the CAD software
designs and enlarge the restoration
or framework that is milled from a
pre-sintered blank. Studies on marginal adaptation suggest that Lava
restorations have a marginal fit that
can be as low as 21 microns.[27] Some
CAM System
BruxZir Mill
CeraMill Motion
Manufacturer
Glidewell
Amann Girrbach
Type
Dry
Wet/dry
Datron D5
Datron
Wet/dry
Denzir
PlanMill
InLab MC XL
Ivoclar
Planmeca
Sirona
Dry
Wet
Wet/dry
LAVA
M1/M5
3M ESPE
Zirkonzahn
Dry
Wet/dry
Procera
Zenotec
Nobel Biocare
Ivoclar
Wet
Dry
Table 3: Most popular dental CAM systems available for 2015.
Defenders of closed platforms claim
that the integration of different
CAD/CAM systems does not allow
for a good integration between parts
and probably leads to the incorporation of fabrication errors; at this
point no research about systems integration is available. Table II shows
some of the systems used for dental
CAD with their file output; Table III
shows some of the most used CAM
systems with their material recommendations and capabilities.
Some of the main concerns from clinicians about all-ceramic CAD/CAM
restorations accuracy of fit are: scanning resolution, software designing
limitations, and milling hardware
limitations of accuracy. Clinicians’
and technicians’ experience with the
CAM/CAM system integration is also
a key factor for fabricating good restoration; the computer software per
se will not allow an inexperienced
operator to create an excellent dental restoration from scratch.[18]
Discussion
Several advantages can be drawn
from including CAD/CAM dental
technology, 3-D scanning and the
use of mill materials for all-ceramic
restorations. Even though clinical
studies have shown that marginal
fit of CAD/CAM restorations is compared to conventional restorations
the fabrication of dental restorations
is still a complex task that requires
experience, knowledge and skills.
The incorporation of new systems
and materials bring a lot of concerns
regarding system implementation,
capabilities and mechanical properties of the different materials. One
of the biggest problems that still remain in CAD/CAM dental systems is
the accuracy of each step in the CAD/
CAM chain, from digital impression
to the milling step. Using computer
aided manufacturing is dependent
on the calibration of hardware with
software in the workflow. Furthermore, the virtual configuration of
the die spacer between the tooth
and the restorations is essential for
the accuracy of the marginal adaptation and has to be calibrated for each
one of the systems. Weittstein et al.
demonstrated that the difference of
fit between CAD/ CAM restorations
is directly related to the gap parameters from the computer design and
also related to the intrinsic properties of the CAD/CAM system.[16]
Conclusion
This review of current and past literature regarding the evolution,
characteristics, and marginal fit of
milled CAD/CAM all-ceramic restorations materials and systems show
that it is possible to fabricate restorations with the same marginal fit expected from conventional methods
and within the range of clinically accepted restorations. When comparing both methods the advantage of
using CAD/CAM technology is not
to obtain the most precise level of fit,
but rather to obtain a high level of reliability in a large number of restorations; especially when high production levels are expected. However,
there are a limited number of clinical
studies and the diversity of the results between systems and protocols
does not allow us to give a definitive
conclusion.
References
1. Miyazaki T, Hotta Y, Kunii J, Kuriyama S, Tamaki Y. A review of dental
CAD/CAM: current status and future
perspectives from 20 years of experience. Dent Mat Journal 2009. 28:
44–56.
2. Fasbinder DJ. Restorative material
options for CAD/CAM restorations.
Compend Contin Educ Dent. 2002.
3. Pallesen U, van Dijken JW. An
8-year evaluation of sintered ceramic and glass ceramic inlays processed
by the Cerec CAD/ CAM system. Eur J
Oral Sci. 2000.
4. Kelly JR, Denry IL. Stabilized zirconia as a structural ceramic: an overview. Dent Mater 2008. 24:289–98.
5. Kelly, R. Nishimura, I. Campbell,
S. Ceramics in dentistry: Historical
roots and current perspectives. Journal of Prosthetic Dent. 1996.
6. Tinschert J, Zwez D, Marx R,
Anusavice KJ. Structural reliability
of alumina, feldspar, leucite and zirconia based ceramics. J Dent 2000.
28:529–535
7. Luthardt RG, Sandkuhl O, Reitz B.
Zirconia- TZP and alumina advanced
technologies for the manufacturing
of single crowns. Eur J Prosthodont
Restor Dent. 1999.
8. Kurbad A, Reichel K. Multicolored
ceramic blocks as an esthetic solution for anterior restorations. Int J
Comput Dent. 2006.
9. Bindl A, Mormann WH. Survival
rate of mono-ceramic and ceramiccore CAD/ CAM-generated anterior
crowns over 2–5 years. Eur J Oral Sci.
2004.
10. Esquivel-Upshaw JF, Chai J, Sansano S, Shonberg D. Resistance to staining, flexural strength, and chemical
solubility of core porcelains for allceramic crowns. Int J Prosthodont.
2001.
11. Reich SM, Peltz I, Wichmann M, Estafan D. A comparative study of two
CEREC software systems in evaluat-
Milling materials
Zirconia, wax, PMMA
Zirconia, Glass ceramic, ceramic resins, Lithium Disilicate,
Chrome Cobalt, PMMA, wax, titanium
Zirconia, Glass ceramic, ceramic resins, Lithium Disilicate,
Chrome Cobalt, PMMA, wax, titanium
Zirconia
Lithium disilicate, ceramic resin
Zirconia, Glass ceramic, ceramic resins, Lithium Disilicate,
Chrome Cobalt, PMMA, wax, titanium
Zirconia, wax, glass ceramic
Zirconia, Glass ceramic, ceramic resins, Lithium Disilicate,
Chrome Cobalt, PMMA, wax, titanium
Aluminum oxide
Zirconia, wax, PMMA
ing manufacturing time and accuracy of restorations. Gen Dent. 2005
12. Anusavice, K. Phillips’ Science of
Dental Materials. 12 edition. In: Saunders. Elsevier; 2014.
13. Kosmac T, Oblak C, Jevnikar P,
Funduk N, Marion L. The effect of
surface grinding and sandblasting
on flexural strength and reliability of
Y-TZP zirconia ceramic. Dent Mater.
1999
14. Raigrodski AJ. Contemporary allceramic fixed partial dentures: a review. Dent Clin North Am. 2004.
15. Neves F, Prado C, Prudente M, Carneiro T, Zancope K, Davi L, Mendonçe
G, Cooper L, Soares C. Marginal fit
evaluation with micro CT of lithium
disilicate crowns fabricated by chairside CAD/CAM systems and the
heat-pressing technique. J Prosthet
Dent. 2014.
16. Hertlein G. Kramer M, Sprengart
T, et al. Milling time vs marginal fit
of CAD/CAM manufactured zirconia
restorations. J. Dent Res 2003. 82:194.
17. Guazzato M, Proos K, Quach L,
Swain MV. Strength reliability and
mode of fracture of bilayered porcelain/zirconia (Y-TZP) dental ceramics.
Biomaterials. 2004.
18. Syrek, A. Reich, G. Ranftl, D., Klein,
C. Cerny, B. Brodesser, J. (2010). Clinical evaluation of all-ceramic crowns
fabricated from intraoral digital impressions based on the principle of
active wavefront sampling. Journal
of Dentistry. 2010.
19. De Vico G, Ottria L, Bollero P, Bonino M, Cialone M, Barlattani A Jr. et al.
Aesthetic and functionality in fixed
prosthodontic: experimental and
clinical analysis of the CAD–CAM
systematic 3Shape. Oral Implantol.
2008; 1:104–115.
20. Gehrt, M. Wolfart, S. Rafai, N.,
Reich, S. Edelhoff, D. (2013). Clinical
results of lithium-disilicate crowns
after up to 9 years of service. Clinical
Oral Investigations. 17(1), 275–84.
21. Gupta TK, Bechtold JH, Kuznickie
RC, Cadoff LH, Rossing BR. Stabilization of tetragonal phase in polycrystalline zirconia. J Mater Sci
1978;13:1464.
22. Piconi C, Maccauro G. Zirconia as
a ceramic biomaterial. Biomaterials.
1999; 20:1–25.
This article was published in CAD/
CAM international magazine of digital dentistry No. 03/2016.
Dr Christian Brenes,
DDS.
Master in Prosthodontics. Clinical Assistant
Professor Dental College of Georgia at
Augusta
University. International speaker for Digital Dentistry Education and BlueSkybio
Academy on guided surgery, clinical digital protocols and dental aesthetics.
He can be contacted at:
christian@blueskybio.academy
Dr Ibrahim Duqum, DDS. MS. Clinical Assistant Professor. Department of Prosthodontics at the University of North Carolina at Chapel Hill.
Dr Gustavo Mendonza, DDS. MS. PhD.
Clinical Associate Professor. Department
of Biologic and Materials Sciences, Division of Prosthodontics, University of
Michigan School of Dentistry.
[4] =>
DTMEA_No.1. Vol.7_LT.indd
B4
LAB TRIBUNE
Dental Tribune Middle East & Africa Edition | 1/2017
New NPM sintered metal disk inCoris CCB for
the inLab MC X5 5-axis milling machine
By Dentsply Sirona
The extensive range of inCoris disks
from Dentsply Sirona CAD/CAM has
now been expanded to include the
new inCoris CCB disk made of cobaltchromium for the manufacturing of
NPM restorations with the inLab MC
X5 5-axis production unit.
LONDON, UK: Non-precious metal
restorations still play a key role in the
day-to-day life of a dental technician
– according to estimates from Dentsply Sirona CAD/CAM, they contribute to around 65 to 75 percent of all
work produced around the globe.
However, the conventional manufacturing process, the NPM cast, is a
more expensive and time-consuming production process that is more
susceptible to errors due to the number of steps necessary. Integration in
the digital workflow has provided
an alternative approach for cobaltchromium restorations that is faster,
cleaner and safer. In addition, it additionally offers better material homogeneity and stability compared
to cast work.
With the inCoris CCB disk, Dentsply
Sirona can now provide the dental
laboratory with a pre-sintered, nonprecious metal for the inLab MC X5
5-axis milling unit. The disk with a
standard size of Ø 98.5 mm is available in six different heights and can
be very easily managed via the inLab
MC X5’s own inLab CAM Software
16.0. As with all the other inCoris
disks from Dentsply Sirona, each inCoris CCB blank has a QR code that
can be conveniently scanned into
the CAM software with a webcam.
All material information such as disk
name, color, height, lot no., enlargement factor and other information
is thus automatically included in
the workpiece overview. Disks that
have been partially machined can be
found again later in the software via
the QR code. Users save valuable input time and always have an optimal
overview of their available inCoris
disk inventory.
Fig. 1: The inCoris CCB from Dentsply Sirona is available in
a standard size (Ø 98.5 mm) and in six different heights.
Fig. 2: The range of materials for the inLab MC X5 now
includes the NPM sintered metal disk inCoris CCB from
Dentsply Sirona.
inLab MC X5:
DENTAL LAB
FREEDOM OF CHOICE.
After the milling process, the NPM
restoration is sintered in a protected
argon atmosphere to achieve its final strength without any inclusions
or voids. The prerequisite for this is
the inFire HTC speed sintering furnace with the metal sintering option from Dentsply Sirona, which is
already equipped with an integrated
gas management system. All inCoris
materials can be quickly and directly
controlled via the preset programs.
Existing customers with an inFire
HTC speed without the metal sintering option can have this subsequently installed, depending on the serial
number of their sintering furnace.
The inCoris CCB is now available
from specialized dealers. More information at:
http://www.sirona.com/inlab
Experience new freedom in your lab processes breaking the chains of
former dependencies with inLab and the new 5 axis milling and grinding
unit inLab MC X5. Open for all restoration data, combining the largest
material range and the possibility to machine both wet and dry disks
and blocks – for no limitations to your production. Enjoy every day.
With Sirona.
INLABMCX5.COM
Dentsply Sirona
Sirona Straße 1
5071 Wals bei Salzburg, Austria
T +43 (0) 662 2450-0
F +43 (0) 662 2450-540
www.dentsplysirona.com
Fig. 3: Each inCoris CCB disk has a QR code that can be
conveniently scanned into the inLab MC X5’s inLab CAM
software with a webcam.
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