EMax: etch in lab or leave to the dr?

[BruceQuality]

We were discussing our EMax cases recently and were wondering how many labs etch them prior to delivering to the doctor?

Do your doctor's know that they are supposed to etch them prior to seat? Have you communicated this step to your doctor's and if so, how did you communicate?

Thank you!

 

[TheLabGuy]

Etching and salinating are two different things with different materials. YOU must etch in the lab all of your cases. Our etch in the lab is much stronger than what they use chairside. Our etch in the lab is to etch the porcelain. The acid they use to salinate chairside with is to remove any organic matter (saliva, last weeks lunch, etc..) from trying the restoration in before bonding/cementing the restoration in permanently. Hope that helps Bruce

 

[EJADA]

I etch all emax before they leave my lab. For me it's insuance.

 

[patmo141]

Some doc's etch with HF chair-side. But I've never seen it with a restoration that came from a lab....if ya know what I mean.

 

[doug]

I etch nothing. Once you etch and they try-in the crown it never, ever gets cleaned properly so the etch is a waste of time. They need to try-in the case, clean the crown, etch it,(their etching gel is as good if they know what they're doing) silanate and go.
I don't want to have to accept any responsibility for the crown coming out after it's cemented.

 

[paulg100]

heres what i do,

etch in the lab for 20 secs(LS2),clean with water, run though ultrasonic for 5mins in water and bicorbonate of soda(to neautralize the acid) then steam clean.

without neautalizing the acid, any remenants just carry on working, are they going to do this in the surgery? i doubt it.

that is what i regard as thorough etching.

Once the doc tries the units it, they DO NOT re-etch to clean, as this will over etch the unit. All thats required for them is to clean up with phosphoric acid, then silinate.

I think its important to etch in the lab so that it is done thououghly, otherwise the bond is just as likely to fail as if its not cleaned after try in.

 

[Tooth Geek]

I'm with Doug, we do not etch for the above reasons (and i believe as per the manual). We have been using emax since its infantcy and as we have transitioned our dentists from PFMs we have been thorough in providing all the manufacturers working instructions not too mention reiterating verbally.

 

[AL1]

I etch, neutralize and steam clean. Each emax that leaves the lab is marked as etched, if the Dr. with his or her degree doesnt read and handle it properly thats their fault.
They have been told how to handle it.

 

[subrisi]

You have to etch in the lab. We use hydrofluoric acid to etch. After the try in, the doctor suppose to etch with phosphoric acid. Total different material. It is crucial that we etch cases before they go out since phosphoric acid is not as strong. It is just good enough to "Clean up" the prevoiusly ethced surface.
So again:
Strong etch = in the lab
try in and then
phosphoric acid = in the office
silane treatment = in the office

this order has to be maintained for bonding and is explained everywhere in appropriate literature

 

[CatamountRob]

I etch, 20 seconds with IPS ceramic etching gel, if they screw it up it's there problem, I did my part.

 

[DMC]

Anyone tried Naval Jelly?

Phosphoric Acid at a very cheap price. Good consistancy as well to stay put. Not too runny.

I know many Dentists that etch the tooth with this stuff.

Medical use......Phosphoric acid is used in dentistry and orthodontics as an etching solution, to clean and roughen the surfaces of teeth where dental appliances or fillings will be placed. Phosphoric acid is also an ingredient in over-the-counter anti-nausea medications that also contain high levels of sugar (glucose and fructose). This acid is also used in many teeth whiteners to eliminate plaque that may be on the teeth before application.

 

[subrisi]

Anyone tried Naval Jelly?
Phosphoric Acid at a very cheap price. Good consistancy as well to stay put. Not too runny.

I know many Dentists that etch the tooth with this stuff.


*** You still didn't read any of the previous posts???!!!

 

[shearl06]

I DEF ETCH ALL MY EMAX CASES BEFORE THEY LEAVE OUR LAB!

 

[Scuff75]

This is an interesting discussion and I can definitely see both sides (from the doctor and lab) of the argument.

I think a big part of this answer depends on what type of relationship you have with your clients and the level of communication you have.

As has been mentioned, I doubt many Doc's have HF in their office and would not have the ability to adaquately etch the porcelain as per the Ivoclar instructions.

Many times when doing my own lab work, I will just wait and complete the etching/silane/bonding procedure all at time of delivery. Especially if I think there will be any chance I may do any on the spot characterization/color adjustments which includes another firing cycle.

Since I do and always will have access to a lab in close proximity to my operatory, by doing it chair-side I don't have to second guess if the lab technician completed the etching procedures.

If as a lab you have a good working relationship with your Doc's I don't see any reason why they shouldn't be alright with you completing the HF application process if you communicate that you are in fact doing it.

As a Doc myself, we are all human and have an off day. Personally I would much rather complete the process myself in the off event one of my restorations/cases slipped through the cracks and was not etched at the lab. If I delivered the case assuming that it was, at the end of the day it's my reputation and lost clinic time for the repair.

 

[patmo141]

(their etching gel is as good if they know what they're doing)

Hey Doug, are you referring to the HF gel that you can get chairside? It's my understanding that the Phosphoric acid "etch" is not an etch at all(on porcelain),it just cleans the saliva and crud out of the micro roughness created by the HF which was clogged up when it was tried in.

No HF = no micro roughness

 

[zvac]

I include note that the case is not etched. I agree with Doug that after tryin is the time to etch.

 

[TheLabGuy]

Lets revist this for a second
HF (HydroFlouric) Acid = etches the porcelain
H3PO4 (Phosphoric) Acid = removes organic debris after tryin

It's clearly stated in the ivoclar manual that the e.max must be etched with HF before bonding/cementing in the restoration. Now unless you're an overachiever (like Scuff up there) then your Doc isn't going to have HF chairside. They are use to using Phosphoric Acid at the Dental offices and will have that chairside. However, the Phosphoric isn't strong enough to etch the porcelain. The porcelain must be etched because it adds mechanical retention to the intaglio surface of the crowns. Under an electron microscope it looks like relatively flat surface before etching, and afterwards it appears like a field of tiny mushrooms (that's your mechanical retention).