E.Max on Ti implant bridge

[aqdental]

Dear forum
i'm in the process of fabricating a full upper implant bridge using a cad-cam Ti frame with 12 preps which are going to be fitted with individual crowns .
The original plan was for pfm's but i was thinking of using monolitics ( ie: e.max LT as Ivoclar recommends for their monolitic hybrid abutments).
Could anyone share some thoughts to help me plan this case ie: ingot selection, thickness of crowns (min and max),choice of ingot,luting cement etc .Could i use a more translucent ingot like HT or Value if i opaque the frame?
I would appreciate any ideas.
Thanks

 

[BobCDT]

Opaquing the frame can not be accomplished using a porcelain opaquing system. The high heat from the porcelain furnace will resut in a heavy oxide layer of the titanium interfaces and have a negative effect the fit of the frame.

 

[TheLabGuy]

Opaquing the frame can not be accomplished using a porcelain opaquing system. The high heat from the porcelain furnace will resut in a heavy oxide layer of the titanium interfaces and have a negative effect the fit of the frame.

I opaque and build porcelain on stock titanium abutments all the time so I'm curious if what your suggesting Bob is because it's a full arch of titanium (versus my single units) that will flex??? To the original poster, why not zirconia?

 

[JohnWilson]

I would not run up a round house cad cam bar to use porc opaque on it. I would sandblast, use GC metal primer, and light cure opaque if you need some masking.

 

[k2 Ceramic Studio]

Bond the Ti frame onto links or temp abutments, after you have opaqued the frame. Then do a full design in cad and mill in wax or pmma or just wax the units up by hand, what ever floats your boat. Once milled/waxed, make any changes you feel are needed, then we do an incisal cut back and press in LT. We then reduce the face down by hand making sure the opaqued Ti frame does not start to show through. Once happy, we then use a fan type marix to layer the face. Not everyone's cup of tea, very challenging cases, but for me I love the challenge, anyone can knock out a pfm bridge Lol. Or just design the bridge out of Zr with a 1mm incisal/facial reduction and bond that to links. We have one of these in the lab at the mo, just done a pmma try-in last week and now need to increase the incisal height and go through to milling. Will try and post some pics if I get the chance.

 

[martintay]

Sorry for being stupid , but could you explain links? and why temp abutments ?

 

[k2 Ceramic Studio]

Links were developed by Neoss a good few years ago, its an abutment that has been milled down so you can bond a Zr abutment onto it, they are used by loads of implant companies now, temp abutments because not every system has a link (only the well known ones) but most systems use Ti temp abutmens that are the same as a link (just longer) you cut the length down depending on the bite and now you have a link that you can bond a Ti frame to or a Zr one. Or just bond an emax to it. Pete

 

[rkm rdt]

They are also reffered to as Titanium bases.

K2, are the titanium temp bases the same titanium as the stock abutment titanium? More importantly, are the screws used for the temp abutment bases the same grade as the final screws and are they tightened to the same Newtons?

 

[martintay]

Thankyou !!

 

[k2 Ceramic Studio]

They are also reffered to as Titanium bases.

K2, are the titanium temp bases the same titanium as the stock abutment titanium? More importantly, are the screws used for the temp abutment bases the same grade as the final screws and are they tightened to the same Newtons?

Yeh thanks for that one RMK Lol. It all depends on what system you use and who you talk to, We always buy the correct screw for that system and use it with there temp abutment, the Temps are milled from the same medical grade Ti as the long term abutments, We know labs that use the screws provided with the temp abutments.Some screws are identical to the ones sold with the abutments but some have a reduced length. And have asked (milling companies)if it is the same grade material and have been told Yes, as the implant manufacturers can only use medical grade to place in the mouth and it would be dangerous to use sub standard material, we also questioned the torque issue as most temp abutments state you only go to 15, We were told the reason for this is that 15 is more than adequate to maintain the restoration for a temp basis, and that it was unnecessary to torque it to 30 when it would be removed after a short period of time putting undue stress on the implant, the same as a healing cap is not placed at 30 its just excessive. But like I said the correct screws are cheap enough so we use those when we have to use temp abutments.

 

[martintay]

well explained i understand now ! Martin

 

[aqdental]

Hi
thanks for your reply. I forgot to mention that i was thinking of LC opaque after metal primer (not ceramic). Today i've spoken to one of ivoclar's tech. adviser and he recommernds not to use opaque , it will reduce bond strenght and their luting cement is opaque enough to mask the titanium. Should i prep to have 1.5 mm of e.max (don't want too thick to compromise aesthetic)?\
BTW we are using Titanium because requested .
Thank you for your help.
Regards
AQ

 

[rkm rdt]

Thanks K2,good info.

 

[PCDL]

I have done a number of these cases, and I have found that just using a ZR core with emax pressed on top will give you excellent results without the mess of opaquing and priming and whatnot. Also, look into Ceramage (Shofu, I think..) for the gingival portion of the restoration. Here is a case that I did and posted in the presentation section (This one happened to be Pressed to metal per the Dr.'s request, but I prefer them in ZR now.)

 

[Ryan Gottlieb]

Dental Lab Products - March 2011 - 31

here is a link to a similar case that i did a few years ago. hope it helps.
Ryan

 

[k2 Ceramic Studio]

Dental Lab Products - March 2011 - 31

here is a link to a similar case that i did a few years ago. hope it helps.
Ryan

That looks fantastic Ryan, I don't like composite but that looks really nice.