Anterior Zirconia Monolithic

[Brett Hansen CDT]

I was just wondering where you all are on anterior zirconia monolithic restorations. We recently started pre-sinter staining all our zirconia crowns. They really look nice. We are using Zenostar and MT0 zirconias. Obviously some cases need to be layered due to custom shades or esthetic demands. I feel like most anterior cases that are just a base vita shade could be done monolithically. What types of cases are you using zirconia monolithic on? What percentage of your anterior restorations are monolithic vs layered? Our lab's growth has always been somewhat stunted by layered anteriors because we have found it near impossible to hire anyone that can do them consistently other than my uncle.

 

[sidesh0wb0b]

it depends upon the client, and what we are trying to acheive as desired results. i have many cases that have proceeded through as FCZ anterior crowns, some with custom staining, and a handful that needed layering as well. with the right translucent fcz, proper staining, and the right client/patient....it is possible. even moreso possible the more teeth you are doing at once. i do far more fcz anteriors when i am making 7-10 or more. (usually single unit anterior are still emax)

 

[GarryB]

We have done a few cases with Argens Z Aesthetic anterior.

On the bench it doesn't look to far from e.max. In the mouth it is obviously more opaque than e.max but for run of the mill cases I am happy to do them.

 

[labtek]

The shading on these full zirconias is getting better every day. I am waiting for the day when one manufacturer or product gets to the point that they have a system that is easily duplicated when following the manufacturers instructions. Currently I can send a full contour crown to 3 different outsource labs with the same shade and all 3 of them are different, from the amount of saturation of color at the gingival, transition of light to dark, incisal coloring, etc. The FIt, Form and Function of FZ are spot on, now to solve the shading issue. Hey I am not complaining, this product has come so far from the days of PROCERA's light, medium and dark choices. For those in the trenches of R&D... keep on testing, because we are eagerly waiting for the "next" best thing to offer our patients.

 

[Brett Hansen CDT]

The shading on these full zirconias is getting better every day. I am waiting for the day when one manufacturer or product gets to the point that they have a system that is easily duplicated when following the manufacturers instructions. Currently I can send a full contour crown to 3 different outsource labs with the same shade and all 3 of them are different, from the amount of saturation of color at the gingival, transition of light to dark, incisal coloring, etc. The FIt, Form and Function of FZ are spot on, now to solve the shading issue. Hey I am not complaining, this product has come so far from the days of PROCERA's light, medium and dark choices. For those in the trenches of R&D... keep on testing, because we are eagerly waiting for the "next" best thing to offer our patients.

Totally agree Labtek. We finally got a mill at the beginning of the year. One of our techs threw herself into learning how to pre-sinter stain the FCZ. Having control over the staining process has improved things dramatically. In your situation, I would recommend using Zenostar's preshaded pucks and outsourcing your milling to Wieland. You will always get a consistent shade since no humans are involved in shading the crowns. Then you just need to be able to stain up what you get back to the final crown shade.

 

[Patrick Coon]

it depends upon the client, and what we are trying to acheive as desired results. i have many cases that have proceeded through as FCZ anterior crowns, some with custom staining, and a handful that needed layering as well. with the right translucent fcz, proper staining, and the right client/patient....it is possible. even moreso possible the more teeth you are doing at once. i do far more fcz anteriors when i am making 7-10 or more. (usually single unit anterior are still emax)

I totally agree! For the single tooth restoration, I am going to do a little layering on the facial only. If I'm doing 7-10, (or greater),than I have no problem doing Zenostar MT full contour on them all. This way I get consistent light reflection and on everything.

 

[Toothman19]

We've been using the Noritake Katana multi-layered zirconia and our clients have been loving that. I can mill one out for you to see if you'd like a sample

Sent from my SM-G920V using Tapatalk

 

[Sevan P]

We use Argen Z anterior. Look amazing! I compared it to the zenostar Mt and the argen anterior had more vitality just after sintering. And when blending next to an emax it looks perfect. Better then the HT zr monolithic. A lot of companies will give you a free sample disk. I know argen gave us a free 12mm disk and a sample coloring set to do the anterior zr.

Sent from my SM-G920V using Tapatalk

 

[Car 54]

We use Argen Z anterior. Look amazing! I compared it to the zenostar Mt and the argen anterior had more vitality just after sintering. And when blending next to an emax it looks perfect. Better then the HT zr monolithic. A lot of companies will give you a free sample disk. I know argen gave us a free 12mm disk and a sample coloring set to do the anterior zr.

Sent from my SM-G920V using Tapatalk

Sevan, had you had any issues yet with this zircona as far as chipping or cracking during seating, as maybe the case of some of the high trans, super high trans zirconias? Or does the ~765mpa strength make up for of any of those concerns?

Edit: I'm looking to send Argen a lower cuspid to cuspid case for a bruxer who is edentulous
on the lowers past the cuspids. We will be doing implants later in the year there. Would AgrenZ Anterior be strong enough for these lower anteriors?

 

[charles007]

Calling Car 54, Car 54 are you there ?

Been using mostly Imagine zirconia, 769MPa since last year and other Anterior zirconia's including Argens Anterior with no problems. Only time I use higher
strength zirconia is on thin restorations, dark stump cases, titanium implant abutments and bridges....Doctors love these materials.
As far as I know I've had 1 failure, crown split in half. This was a crown the doctor overly adjusted and the patient bite down and bam, split in 2 parts.
Central groove was easily 1.5 to 2mm.
Lower anteriors, no problem if you have the usual thickness and no dark stumps.........
Dark stump would be my only concern as you would be using emax.
Last year I was a little nervous using lower strength zirconia's but those fears are long gone.
As far as chipping, etc, I continue to use proper tools to adjust and thinning down margins without any problems.

 

[Car 54]

Car 54 here Thank you Charles, I really appreciate your feedback, it gives me more peace of mind.

I did have Argen install the updated .dme file about 10mn ago, and now have the Anterior set for my order form.
Since I don't have a sintering furnace yet, I'm having to have them color it (A3 target shade). For speed and production sake, they only use 1 "version" of the Anterior for milling and sintering in house, but I think if you buy the discs to mill, you have 4 choices of value based discs?

Thanks again

 

[charles007]

Meant to say I use on almost 100% of my FCZ, both posteriors anteriors and cutback cases....

 

[sidesh0wb0b]

ive had only one fcz crown break...was near min thickness and the dr ground on it.
otherwise, anterior full contour and posterior full contour, high trans and high str....doesnt matter, statistically zero breakage

 

[Car 54]

Thank you for chiming in Bob, I appreciate it. I'll keep going with the Anterior Trans. game plan and getting this case sent into Argen today.

 

[Car 54]

Just a follow up question. While designing this case, I noticed in Operations and Parameters they have the default thickness at .45mm for FCZ I called tech support, and they said that is their default for all their zirconia
settings, and that if I wanted to change it, go ahead on this case change it on the fly in Ops and Params, and then later I can change it in Materials Settings.

Shouldn't I be around at least 1mm thick for restoring this lower anterior bruxer case using this ~765mpa zirconia? )

 

[charles007]

Just a follow up question. While designing this case, I noticed in Operations and Parameters they have the default thickness at .45mm for FCZ I called tech support, and they said that is their default for all their zirconia
settings, and that if I wanted to change it, go ahead on this case change it on the fly in Ops and Params, and then later I can change it in Materials Settings.

Shouldn't I be around at least 1mm thick for restoring this lower anterior bruxer case using this ~765mpa zirconia? )

My zirconia default setting on Minimum Thickness is .06 ........
It would be nice to have thinner milled crowns around the margin areas but I would prefer .06 over .45 on occlusals...

Anyone using .45mm setting and not having problems ?

 

[Car 54]

Thanks, Charles. I wasn't sure with this type of zirconia compared to the 900-1100mpa zirconias. So it sounds like if I wanted to feel safe on this case, I could at least probably go down to .75 without worries.

 

[JohnWilson]

Read the instructions that come with the disk, if you are outsourcing ask for them to send you the instructions for the material you are doing. DON'T TRUST, KNOW!

There is not a zirconia on this planet that is stating .45 that I have run across in HS. As for HT cubic style anterior it would be an even higher gamble.

Ever notice how some milling centers want you to use their DME for their materials. Ever notice how some material files have a much thicker margin line offset and cementa spacer?

The milling centers are in business to make money. The could care flipping less about your struggles with layering. They want it to fit and not come back. If they are stating something that will be problematic its silly for both parties as I see it.

My dimensions for EVERYTHING I do does not go inside of MFG recommendation.

Can I mill an absolute perfectly prepped rounded internal line angle prep and mill it to .45 and feel good about it in ZENO , yeah no problem but at that thickness I can not guarantee it will not have an issue down the line. I like to limit the things I can not control and if I am asked to do something inside spec I say no guarantee and document everything.

 

[Car 54]

Thanks John, good post...it really made me wonder why a 1100mpa and a 765mpa could be set at the same thickness, it didn't make sense.
I will ask Argen to send me the instructions, as I didn't realize it was like this until today's episode.

 

[Car 54]

Read the instructions that come with the disk, if you are outsourcing ask for them to send you the instructions for the material you are doing. DON'T TRUST, KNOW!

There is not a zirconia on this planet that is stating .45 that I have run across in HS. As for HT cubic style anterior it would be an even higher gamble.

Ever notice how some milling centers want you to use their DME for their materials. Ever notice how some material files have a much thicker margin line offset and cementa spacer?

The milling centers are in business to make money. The could care flipping less about your struggles with layering. They want it to fit and not come back. If they are stating something that will be problematic its silly for both parties as I see it.

My dimensions for EVERYTHING I do does not go inside of MFG recommendation.

Can I mill an absolute perfectly prepped rounded internal line angle prep and mill it to .45 and feel good about it in ZENO , yeah no problem but at that thickness I can not guarantee it will not have an issue down the line. I like to limit the things I can not control and if I am asked to do something inside spec I say no guarantee and document everything.

As far as the socks on a rooster fit of the .dme files settings, seems to be a setting we've had to change for a long time. Even when Lava was the gorilla on the block, I used to have to tell the milling center (B.S. "before scanner") to increase the fit tighter by 2 steps. When I saw the setting for the Z Anterior this morning, I forgot how thick the cement gaps were, as well as the low distance to margin number. It was, "oh well, here we go again", in making those changes, but when I saw the thickness at .45, that's what really got my attention.

I guess I wonder why they wouldn't at least try to make up for those numbers? I kinda understand the "lets make everything fit" issue we've been dealing with for years, but in having low wall thickness numbers on a lower strength zirconia, I would think they would want to preserve their name and reputation as far as breaking or fractures. To me, that's the one really doesn't make sense