zirconia maryland bridge

[CoolHandLuke]

ZR has a chemical bond you say?? ruh ro...

here we go again....

ZR has no oxidation, therefore no chemical bond. hence, why soo many doctors are seeing them come out of the mouth after cementation. also why ....oye.. please refer to my thread regarding the crappiness of this product. mechanical retention is NOT enough.

some day Zirconium will go away..just like belle glass, Just like Eris 2, just like..........ect. ect. ect.

the only times i've seen them come out of the mouth were on two occasions: when the doc doesnt understand how to cement them in place, and when the patient is ready for a full bridge due to the rest of the teeth requiring such preparation).

never seen porcelain delaminate from zirconia since 2009, which puts my count at over 10 000 units.

 

[Marcusthegladiator CDT]

I did this successfully my first try.
I designed my wings as copings.
Drew my margin at the edges of the wings.
Minimized my margin settings.
And then made the wings very thick only to deliminate them manually after cutting. It kept them strong while cutting.
And Sum3d made it easy as well as far as building a "Nice and Easy" strategy since these Zirc Marylands can be fragile.

 

[Affinity]

"hence, why soo many doctors are seeing them come out of the mouth after cementation. "

Really? Please elaborate.

Yes please do elaborate.. ive never had one 'come out' .. but some chipping sure.. The dr prescribes it, not me!

 

[DMC]

They come out.

Young patients have more tooth movement.

In my area, we have many youth born without a lateral.

Some Genetic thing from Europe that usually skips every other generation.

My Son is missing a lateral, gene was passed down from grandmother, on his mother's side of family.

This senerio is hard to keep a winged bridge in place. There is also less exposed tooth due to ginviva not receeding yet much when young in life.

Easy to makes these work for people over 30yrs.

 

[SiKBOY]

From personal experience. I have had 2 zirco Maryland bridges in m mouth. He first one was a single wing with a lower central. Second one was double wing. Both failed.

I now have an emax double wing and its been there for 5 years so far.

 

[Affinity]

im doing one right now.. but Im doing a zirpress over it, then etch the zirpress.. but now im thinking I should just do a full emax.. its for a 20 year old girl, only has to last 6-8 years so the insurance will cover an implant.. I would never do a full zr winged maryland bridge.

I was trying to get disturbed to elaborate on why soo many zr crowns 'come off' not necessarily maryland bridges..

 

[disturbed]

Nothing sticks to zr for very long. Not cement,not porcelain, not zr liner.NOTHING. Cant etch it, no chemical bond to porcelain, mechanical retention only. Compare it to glueing glass to wood. It May hold for a while but eventually it will FAIL. Pressing a monolithic over the entire thing with highwater margins is the only way i will try it..betting even that fails in five or less years.

 

[rkm rdt]

I feel a drinking game coming on.

 

[Affinity]

Nothing sticks to zr for very long. Not cement,not porcelain, not zr liner.NOTHING. Cant etch it, no chemical bond to porcelain, mechanical retention only. Compare it to glueing glass to wood. It May hold for a while but eventually it will FAIL. Pressing a monolithic over the entire thing with highwater margins is the only way i will try it..betting even that fails in five or less years.

So then why are you using zirpress? Youre contradicting yourself.. Shame on you for providing eminent failure to these patients!!!

 

[CoolHandLuke]

I feel a drinking game coming on.

tomorrow is already looking like it will be a hard day. time for a booze-up.

if you don't hear from me until thursday, you'll know what happened.

 

[SlowWater]

I have made a few of these bridges, but I have never looked at them as a failure and I knowing the fact, that there is no bonding such as oxidation.

Because they were made in a situacion, were other options would be less good - like destroying really nice healty teeth.

So in my mind with these cases I just say if it fails I'll do it again. I still haven't done any harm to the teeth. I guess I live on a wrong planet, because I don't look at this in an economical maner.

But if we don't do it, we also don't know how long it will hold. We have to take the risks and move forward. In my opinion metal is way behind Zr. and it's not perfect. So do not understand me wrong. Zr. is also behind Press - estetically



No place for implants and no bone level from CT readings.



Right after bonding





and after almost 2 years you can see the gum build and the hygene has droped, because pacient has finally a free mind - not good, but ok



So when it fails we need to look at the problem of the failure and desing it in a new beter way.
In the mean time I am just buying time for better materials and bondings to come to the market and preserving the beautiful natural teeth, because we all now we make just cheap replikas.

 

[Affinity]

WOW great case! I think anyone would be happy with that.. maybe I missed it but is this complete zr wings? or zirpress? what porcelain?

 

[Drizzt]

I have made a few of these bridges, but I have never looked at them as a failure and I knowing the fact, that there is no bonding such as oxidation.

Because they were made in a situacion, were other options would be less good - like destroying really nice healty teeth.

So in my mind with these cases I just say if it fails I'll do it again. I still haven't done any harm to the teeth. I guess I live on a wrong planet, because I don't look at this in an economical maner.

But if we don't do it, we also don't know how long it will hold. We have to take the risks and move forward. In my opinion metal is way behind Zr. and it's not perfect. So do not understand me wrong. Zr. is also behind Press - estetically



No place for implants and no bone level from CT readings.



Right after bonding





and after almost 2 years you can see the gum build and the hygene has droped, because pacient has finally a free mind - not good, but ok



So when it fails we need to look at the problem of the failure and desing it in a new beter way.
In the mean time I am just buying time for better materials and bondings to come to the market and preserving the beautiful natural teeth, because we all now we make just cheap replikas.

It looks stunning , so natural ! I agree with your thinking . I have a similar case , were two absolutely healthy lateral incisors were extracted from a 20 years old boy , because he didn't want to have orthodontic treatment . Unfortunately there is very little space , and I don't know if I can make two maryland bridges . I also has a question . There is the whole debate about etching . Can we etch metal ? All these years , maryland bridges are made of metal . What is the advantage that metal has over zirconia for these kind of restorations ? I don't have much experience with maryland bridges , so please don't laugh at my question if it is something obvious !

 

[SiKBOY]

There is a product called rocatec that you can use to treat the metal on the fitting surface.

 

[Drizzt]

This product rocatec , is something like '' etching '' the metal ?

 

[Affinity]

Yes hydrofluoric acid etches metal, but it is generally ONLY non-precious metal.. at least how I was taught.

 

[rkm rdt]

Metal is not esthetic period!

Zirconia requires the same surface area for retention as metal. ie; wings

Lithium Disilicate is the best material to use but it requires a completely different prep design and will bond with less surface area.

 

[SiKBOY]

Yes hydrofluoric acid etches metal, but it is generally ONLY non-precious metal.. at least how I was taught.

I have had a few Maryland bridges in my mouth. Non precious, the grey just comes out through the teeth and they look dead. I now have a emax Maryland with very minimal prepping on the linguals and they have been the most successful to date.

 

[SlowWater]

I have a CAD/CAM and manual Mill (MAD/MAM) from Steger - Zirkonzahn. I also use the ICE ceramic from Steger.

I usually combine these two sistems together, so I am not stucked with some software problems (my mind and the computer) - that appears sometimes

I also like to design these cases manually, because I can correct them very easly in the try in and construction phase in the pacient mouth.

I have some problems with milled PMMA - very difficult to make quick corrections like adding material when needed - I have received a new bonding, but I need to try it out, because edges are falling of on the manual mill.

I also go for the old type of burning porcelain to the Zr. and not using zirpress (because it needs to be thicker on the wings, other wise no porcelain there - in this case no room)

We have to make a tight bonding on the Zr. and porcelain - I burn it 100 degrees celzius higher, so the surface is like glass (this is the bonding).
Then I make a refractory die model - from VITA vitadurvest and then burn porcelain were the wings are with porcelain under the wings and pontics.
The I make the rest of porcelain build and glaze. I don't take the bridge from the refractory die till the end.

Then you just make classical etching and Variolink II from Ivoclar.

Why not using gold or other metal - I like to move forward and the result will get better if we all move in that direction.
We need to push the industries to make better materials otherwise they will be pushing us. But that won't be a push that we like, more of a push out of a buissines. We have to make natural looking teeth and they won't be replacing us.

Also metal is changing the light beam path of healty teeth, so your outcome won't look so close to the nature. Also it can change into grey, teeth look dead. I have seen bridges that changed young teeth in such a way, that the Doctor decided to make fillings on the facetes and destroyed everything. I didn't took over the case after that nonsense situacion. Maryland bridge suppose to save teeth not oposite.

But this is just my opinion and some of the answers I was asked (Affinity and Drizzt). I can only tell, that I am working for 8 years on Zr. and the results are satisfied. I have just around 2% of metal structures. For me maryland is made out of Zr. ZirPress or Press - depends on the situacion.

Everyone needs to decide for himself. I know in a case of a failure I'll do it again

 

[JohnWilson]

Beautiful case, true talent to make that look so natural.