New Zirconia Type: Cube X2

Cube X2 Zirconia next to an IPS Emax

Cube X2 is our newest zirconia on offer at the lab, its a high translucent zirconia for both PFZ (porcelain fused to zirconia) layered crown and bridgework and FC (full contour) monolithic crown and bridgework. Each Cube X2 restoration is made from the highest quality zirconia that features increased translucency for improved esthetics and and stregth when compared to IPS Emax. Designed and milled using state of the art CAD/CAM technology, Cube X2 crowns and bridges are incredibly strong and chip-proof in their construction. Available in all of the 16 Vita shades, Cube X2's glazed surface provides an amazing low abrasion behavior, smooth, biocompatible, and plaque resistant. Cube X2 is the new generation, high performance alternative to a PFM and gold crowns.

Indications

Cube X2 can be milled as a highly translucent zirconia framework for individual layered crowns with our premium Noritake porcelain. Available as single crowns throughout the arch or as multi-unit bridgework up to a full roundhouse, Cube X2 is are our recommended restoration for highly esthetic all-ceramic crowns for both conventional and implant applications.

Screw-Retained Cube X2

• A one-piece alternative to cemented implant restorations. This restoration combines the abutment and crown into one solid restoration.

Benefits for Your Patient

• Greater translucency for improved esthetics
• Chip-resistant, as it is made of full zirconia with no overlay porcelain
• Glazed to a smooth surface to reduce plaque accumulation

Cementation

•     Resin reinforced glass ionomer cement (RelyX Luting Cement, 3M ESPE; GCFuji Plus, GC America)
•     Resin cements for short or over-tapered preparations (RelyX Unicem, 3M ESPE; Panavia F2.0, Kuraray)

Cube X2 restorations are fabricated from solid zirconia oxide material, which has a strong affinity for phosphate groups. We can take advantage of this fact with phosphate-containing primers such as Monobond Plus (Ivoclar Vivadent) and Z-Prime™ Plus (Bisco), or with cements such as Ceramir® Crown & Bridge (Doxa Dental) to increase our bond strengths to zirconia oxide. Unfortunately, saliva also contains phosphates in the form of phospholipids. When a Cube X2 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 out” the saliva only makes the problem worse.

The only way to successfully remove these phosphate groups from the interior of a Cube X2 restoration is with the use of Ivoclean (Ivoclar Vivadent). This zirconia oxide solution is 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 bonded to the 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.

Preparation Guidelines

Cube X2 requires a gentle, minimally invasive preparation with less loss of tooth structure. Shoulder preparation not required, 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; however, 1.0 mm is ideal.

Carestream Partners with Exocad!

Carestream Dental has partnered with exocad, an OEM dental CAD/CAM software solutions provider, to offer systems integration with the CS Solutions product portfolio.

exocad design software is compatible with Carestream Dental’s CS 3500 intraoral scanner, which is said to allow practitioners to easily acquire true color, 2D and 3D images. Requiring no external heater or trolley system, the CS 3500 features high angulation scanning of up to 45 degrees and to a depth from -2 to +13mm. Additionally, the CS 3500 uses open-format STL files for easy sharing and can be plugged directly into a computer’s USB—reportedly making it a truly portable scanner option. The integration with exocad benefits practices that wish to incorporate digital impressions and easy collaboration with labs into their workflow.

Using exocad's cloud service “dentalshare,” clinicians and client labs reportedly can collaborate more rapidly. New workflows, such as lab-assisted chairside CAD/CAM, can now be created by any laboratory or clinician. The ability to transfer even large and complex cases in minimal time fosters new business opportunities and efficiencies for resellers, while allowing labs and clinicians to build their business by increasing productivity and strengthening personal relationships.

More from Carestream: Carestream Dental announces release of Logicon Caries Detector 5.1

"As Carestream Dental expands into the CAD/CAM market, the ability to integrate with other CAD/CAM software providers is critical," Joe Andrasko, regional product manager, CS Solutions, Carestream Dental said. “We are looking forward to working with exocad and we are excited to offer this solution to our customers.”

Resellers of exocad software are said to be able to offer a unique and innovative workflow solution to their customers by pairing the CS 3500 with exocad’s new dentalshare software feature. Due to the integration, validation and certification of Carestream Dental’s clinical solutions, the implementation risk to resellers reportedly is low. Installation, training and support for the CS 3500 are provided by Carestream Dental, which is said to allow resellers to continue to focus on providing exocad software support and service.

"We immediately found development synergy with Carestream Dental’s CS 3500 intraoral scanner and our new dentalshare real time lab collaboration,” Larry Bodony, president, exocad America said. “The ability for our technologies to combine is extremely beneficial to a clinician’s workflow and we are excited to work with Carestream Dental in this partnership moving forward.”

Why invest in an Intra Oral Scanner

Intra oral scanners were seen as something for the future. They are thought of as always being a great idea in theory, but when it came time to actually putting them in your practice, most doctors hesitate. New technology is scary, plain and simple, but it is also exciting. There is way too much information out there that it will make your head explode and there are a variety of different scanners on the market that it’s hard to choose which one will best fit your practice. Before we get into the whats, the hows, and the costs, we must first talk about the whys.

            So why does your practice need an intra oral scanner and why should you invest in one? Today’s world revolves around convenience, ease of use, and how fast can I get something. A scanner allows for all of those to happen. What is the first thing you think of when you think about buying a scanner? The answer is, “I wouldn’t have to take impressions anymore,” but it’s not just never having to take an impression again, its all the other things you get to eliminate from having to take an impression. No more impression materials, you don’t have to keep them in stock and you don’t have to waste you or anyone else’s time ordering them. No more mixing tips, you don’t have to worry about how long the impressing has set in the patients mouth or how long until you can pour it. You would never have to pour an impression again and no more plaster mess in the office. The most important aspect for you and your patient would be not having to take a second impression. You can see on the screen instantly what your preps and margins look like. No more bad impressions and having to call your patient back in. All of these things are nuisances that can being taken care of by using an intra oral scanner.

            Accuracy is probably the most important aspect of the debate between to scan or not to scan. Intra oral scanner range between the 10-30 micron range for accuracy consistently. Consistently is a key word here, every time you use your scanner it is going to work the same way. You scan the prep and adjacent teeth, then you scan the opposing, and finally you scan the bite. There are not many variables when using a scanner, what you see is what you get. Taking a traditional impression is a different story. They are many different variables to consider.

            Impression materials are not an exact science. The temperature in the office will cause the impression to expand more or less, faster or slower when it is hardening. This changes the accuracy right when you begin. Set time in the patients mouth needs to be precise but often times is taken out to early leaving behind distortion. After taking an impression it needs to be disinfected, when this happens the liquid can get inside this impression through porous sections where it was not mixed correctly. Finally we get to pouring the impression and the model stone needs to be weighed and measured precisely again. This again has a dramatic effect on the expansion rate of the stone. After it hardens it needs to be trimmed and by grinding on a wet model grinder could cause more expansion. All of the above information shows how many variables go into creating a crown out of a traditional impression. If one thing goes wrong, the case will not be accurate and the patient will have to come back to the office after taking more time off of work and take a new impression. Most people say happy wife, happy life. Well I say happy patient, happy life. (don’t tell my wife I said that)

            Intra oral scanning is already here, its time to take the bull by the horns and bring this exciting technology into your office. In the next blog, we will discuss which scanner is best for your office. Stay tuned

Using Zirconia for UCLA Abutments

UCLA Abutments

Why should you choose Zirconia?

          Technology is racing ahead faster then anyone could have predicted. If you get caught in the slow lane, it’s only a matter of time before you won’t be able to catch up. New materials are coming out every day it seems and new techniques must be used to fully integrate these materials to get the best of a particular product. PFM’s have been around for decades, they are tried and true, but there is a new material creeping into the market that has had a surprising success in today’s practices.

            Zirconia was at first, just used as frameworks, but now with the advancements in technology we are able to provide a highly aesthetic full contour zirconia crown. This was never thought possible even 5 years ago. There are no more gray circles on the occlusal table, no more paying for 4 pennyweights of gold on a molar, and there is no need to order parts.

            Customer satisfaction is our number one priority at the lab. By prescribing a UCLA Zirconia Crown you are offering the patient the best of both worlds, high aesthetics, lower cost, and a faster turnaround time. When prescribing a UCLA PFM the patient will end up with a grey circle where the screw channel is and if there is any chipping down the road even more grey will show through. With a UCLA Zirconia crown there will be no grey circle for the access channel because the only gray material is the interface where the crown engages the implant. Our cost to the patient is much lower because the is no need to order a part to cast in gold. The turnaround time is faster because no one has to wait on any parts to arrive and hope they aren’t back ordered or ordered the wrong part.

            In the table below is a price comparison between a Zirconia and PFM UCLA crown:

Zirconia                      PFM

Crown                                            $450                          $179

Implant Chg                                   $120                           $120

Gold                                               N/A                            $200

Parts                                              N/A                             $265

Total                                             $570                            $764

Zirconia – 5 day Turn around

PFM – 10 day Turn around

Introduction to Zirconia

Full contour Zirconia

About

     For years there has been a dedicated search to find an alternative to gold crowns that are both biocompatible and esthetically pleasing for your patient. The advantages of gold crowns have been well demonstrated through millions of case studies, but its biggest disadvantage is its lack of natural tooth coloring and the fluctuations of the gold market. Many patients are now resisting gold crowns because they want a higher esthetic looking crown. They no longer want any of their teeth to be showing gold. Many of the all ceramic restorations available today lack the strength for first and second molars and will often chip or fracture resulting in a remake and wasting everybody’s time.

What is Zirconia

      Zirconia is a relatively new material in the dental market when compared to a gold crown. It is made of 90-95% ZrO2, 4.5-6% Y2O3, <5% HIO2, and <0.5% AI2O3. It is FDA approved as Yttrium Zirconia. Full Contour Zirconia restorations offer flexural strength ranging up to 1200MPa and achieves excellent biocompatibility. These characteristics make Zirconia a great option for a full contour restoration. Current studies conclude the material shows clinically tolerable wear with natural tooth structure.

Types of Zirconia Restorations

      Today there are numerous types of Zirconia restorations and more are coming out each day. They range in translucency and strength, they can be dipped in liquid or colored with a brush. To get the best results you must find what works best for you. The most popular Zirconia crown at the moment is the BruxZir crown. It has a very high flexural strength but not quite the esthetics of the new Prettau Anterior Zirconia crowns. Prettau’s crowns have a 600MPa flexural strength but the have the same translucency as an IPS Emax Crown. There is not one end all be all option for every Zirconia restoration but if you have the right information you can make an informed choice. Since BruxZir crowns range at 1200MPa they are able to span an entire arch without the risk of fracture while the 600MPa rated Prettau crowns are only able to span 3-4 units.

If there are any questions on how to make the most out of using Zirconia for your practice you can comment below and send an email to Toothman19@sbcglobal.net

Getting Started

Today is a big day for Rutherford Dental Lab. We have officially gone online with our very own website. With this website we hope to broaden our relationships with the dental world and make it a more informative and successful process with the patients and the clinics. We will be doing monthly blogs on this website that will cover a wide range of topics involved in the dental community.

The lab will go over all the new technologies that have come out and will continue to come out. We will go over any new materials that go onto the dental market as well as give an unbiased review to help you make the right choice. The lab will take a look at all the new scanning technology and help find the one that best suits your needs.

The dental community has a vast ocean of knowledge, but sometimes it can be hard to find. Our goal is to be able to find what your looking for here. If you cant find it on our blog, we will do our best to point you in the right direction. So buckle up and enjoy the ride.

I hope to see you in the comment section below where we can continue to discuss the blog's topic. Also make sure to subscribe so you can get an email whenever we create our new blogs