Full Press...LT or HT

[dhdc]

would like to get an idea on what you are all using for your full press mono Emax.I am pressing everything in Lt,but read on the site that alot are Ht.Shade selection is obviously an issue,but just for those jobs where the straight A3 is prescribed.Would love to hear pros and cons,Thanks Dean

 

[2thm8kr]

For 90% of my mono posteriors I'm using HT
For Shades: A3,A3.5,A4,B3,B4,C3,C4,D3,D4 = HT A2
For Shades: A1,A2,B1,B2,C1,C2,D2 = HT B1

Depending on the thickness of the crown those two shades will
cover most everything. And give a nice incisal area with a little more brightness.
HT BL1 is also an option, but the incisal area can end up a little too bright.
Started playing with V1 a little. Used it for B shades and D2
I'm thinking it could be used for lighter A shades as well.
Titanium abuts and ND9 are tricky, but if it's thick enough the HT material
will mask it.

 

[Al.]

For 90% of my mono posteriors I'm using HT
For Shades: A3,A3.5,A4,B3,B4,C3,C4,D3,D4 = HT A2
For Shades: A1,A2,B1,B2,C1,C2,D2 = HT B1

Depending on the thickness of the crown those two shades will
cover most everything. And give a nice incisal area with a little more brightness.
HT BL1 is also an option, but the incisal area can end up a little too bright.
Started playing with V1 a little. Used it for B shades and D2
I'm thinking it could be used for lighter A shades as well.
Titanium abuts and ND9 are tricky, but if it's thick enough the HT material
will mask it.

2th thanks for posting that. Have you seen any of them in the mouth or gotten any feed back?
Just wondering, I've been using A1 for most everything (press and stain posteriors) execpt B1 for B1. I haven't seen any of them or asked for feed back so I have no idea the shades or the value of them.

 

[2thm8kr]

2th thanks for posting that. Have you seen any of them in the mouth or gotten any feed back?
Just wondering, I've been using A1 for most everything (press and stain posteriors) execpt B1 for B1. I haven't seen any of them or asked for feed back so I have no idea the shades or the value of them.

Seen several in the mouth. They match well, some alot better than others.
The Docs I work with are real sticklers for value match more so than shade
being dead on.
When I first started using e.Max I was really struggling with value in the
incisal areas and the LTs just weren't helping me out.
I talked to a friend that has tons of experience with Empress and alot
more time with e.Max than me. He has really helped me out with the
value issues.
I still don't have a strategy for anteriors yet, but I did a case this month
22 e.max monolithic crowns, patients ND shade in the anterior region was ND2insisal 1/3 with ND8 gingival 2/3. I used V1 and shaded down with a mix of 2/3shade 4 and 1/3 Khaki/ essence 08 for a final shade of D2. The Value 1 covered the ND8 at .6 -.5 mm and kept the grey effect out of the incisal. If I get final photos back I'll post.

 

[2thm8kr]

Working n a case right now #'s 30,31,&14 patient selected B1.
ND shade for #30 is ND8, #31 ND4, #14 ND3
Used HT B1 for all. I can't see a difference in them on the
natural die material. Thinnest area is on the lingual of #30 at .7mm
I think this one is due Tues Morn. I will probably see the patient for this.
If it's a failure I'll report back.

 

[EJADA]

I use the the HT-BL3&4 for most of my lighter shades & HT-C1 for D2&D3 & HT-C2 for lower value shade ie...C3&4,D4. I use these to control the value. I have seen many in the mouth and they blend well. I find the HT-BL1&2are to bright for most people. They can help when matching an opaquey light pfm.

 

[2thm8kr]

I use the the HT-BL3&4 for most of my lighter shades & HT-C1 for D2&D3 & HT-C2 for lower value shade ie...C3&4,D4. I use these to control the value. I have seen many in the mouth and they blend well. I find the HT-BL1&2are to bright for most people. They can help when matching an opaquey light pfm.

I have been using the LT for matching really old or ugly PFMs.

What are you doing in the incisal areas for BL1&2 when matching
PFMs. I find that these shades end up being really bright incisally
and I end up using alot of I2 to cut the value.

 

[EJADA]

I only use these where the PFM is already very bright and opaquey. I often try not to match really old and ugly PFMs to perfect as they will probably be getting replaced. Especially when the patient sees the new crowns. It is a challenging balancing act we play.

I find I can usually lower the value down on these with the smallest amount of chroma/shade. It doesn't take much.

If you have you ever done a shade adjustment with the crown in the patients mouth it is amazing how little shading is needed to make them blend. I am always amazed.

 

[sixonice]

Seen several in the mouth. They match well, some alot better than others.
The Docs I work with are real sticklers for value match more so than shade
being dead on.
When I first started using e.Max I was really struggling with value in the
incisal areas and the LTs just weren't helping me out.
I talked to a friend that has tons of experience with Empress and alot
more time with e.Max than me. He has really helped me out with the
value issues.
I still don't have a strategy for anteriors yet, but I did a case this month
22 e.max monolithic crowns, patients ND shade in the anterior region was ND2insisal 1/3 with ND8 gingival 2/3. I used V1 and shaded down with a mix of 2/3shade 4 and 1/3 Khaki/ essence 08 for a final shade of D2. The Value 1 covered the ND8 at .6 -.5 mm and kept the grey effect out of the incisal. If I get final photos back I'll post.

you mentioned that ypur docs are sticklers for matching the value correctly. if you have not used them (yet),i would strongly recommend you trying the e.max Impulse ingots. these are the same lithium disilicate we are all using, but these are unique in the fact they feature value more than chroma. they have (3) impulse Value ingots (V1, V2 & V3). these are great for full contour stuff. there is also (2) opal ingots which are very translucent and used for veneer work or where the doctor prepper just enamel. check them out, i think you will like the results.
I grabbed this off the website:
Impulse ingots (Value, Opal)
The new Impulse ingots are available in 3 Value (Value 1, 2, 3) and 2 Opal shades (Opal 1, 2). They are mainly used for the fabrication of thin veneers, veneers, table tops, partial and single crowns.

Depending on the favoured processing technique (staining, cut-back or layering technique) and the respective patient situation, a suitable ingot can be found. Individual characterization or veneering is carried out using the coordinated stains and layering materials of the IPS e.max Ceram veneering ceramic. For processing of IPS e.max Press in the EP3000 and EP5000 press furnaces, the two investment materials IPS PressVEST and IPS PressVEST Speed are available.

Advantages
•High strength (400 MPa) and high esthetics
•Minimally invasive, accurately fitting restorations
•Four levels of translucency and additional Impulse ingots for maximum flexibility
•Lifelike esthetics, irrespective of the shade of the preparation
•Adhesive, self-adhesive or conventional cementation depending on the indication
Indications
•(Thin) veneers
•Minimally invasive inlays/onlays (1 mm)
•Partial crowns and crowns
•Bridges in the anterior and premolar region
•implant superstructures

 

[subrisi]

The value ingots are between HT and LT in the translucency range.
I use HT B1 for A1, C1 and D2 shades, HT A1 for A 2,3,B2,3. HT D2 for C2,3, D3,4.
I never have C4 shades. HT A2 for A3.5,4, B4.
I do not use HT C colors because they are already too low in value and I think the ingots are too grey.
Some of the crowns I saw in the mouth still have a slight too low value.
It is very hard to control value and I started to use value ingots more often now. Unfortunately the darkest color you should use it for is A2.
For premolars and Anteriors I use LT ingots. To keep as much strength as possible, I press full contour Anteriors. Once the crown is fit and icisal edge adjusted, I draw a line on the facial and ligual edge of the icisal edge. I cut the facial back close to the lingual line and hollow out the Incisal third. I stain characterizations into the hollowed out area up to the Incisal edge and set fire it. Then I overlay it with OE1, 3 or 4 and Ti's. I don't believe anyone should do Anteriors in stain and glaze technique. It is just flat looking and lacks depth. It looks terrible in photographs.

 

[desertfox384]

Very interesting.. I never thought about using one ingot shade for so many of the prescribed shades. I generally go 1 or 2 shades lighter than the prescribed shade but I also dont see many in the mouth and have had no complaints.

One question for you all... Why dont you go by the book? If you are getting stump shades (which i never do ) the ivoclar book has a nice guide for ingot selection, or are you finding that does not produce good shades?

 

[2thm8kr]

I think that the guide is more for anteriors where the final restoration will not be as thick as in the posterior region.
When I first started I used the guide and had a lot of trouble with value. With some advice from some of the users here I started using a shade or two lighter than suggested by the guide and started having better results with value in the incisal area.
I only use HTB1 and HTA2 for posteriors.

 

[2thm8kr]

you mentioned that ypur docs are sticklers for matching the value correctly. if you have not used them (yet),i would strongly recommend you trying the e.max Impulse ingots. these are the same lithium disilicate we are all using, but these are unique in the fact they feature value more than chroma. they have (3) impulse Value ingots (V1, V2 & V3). these are great for full contour stuff. there is also (2) opal ingots which are very translucent and used for veneer work or where the doctor prepper just enamel. check them out, i think you will like the results.

I just recently started playing with V1. In the one case I have done (monolithic) I found that the value in the incisal area to be similar to the HT BL 1-4s and not quite as translucent.

I have a veneer case that the patient is not sure what shade of 'white' they want so I did some mock venners for 8 and 9 before the are preped in shades LTB1, LTBL1, HTB1, HTBL1, Opal1, Opal2, V1. The patient gets to select what they want and I get to see how these compare in the mouth.

 

[NicelyMKV]

I missed the whole empress value ingot thing. I was using opc at the time and made the switch to Emax later. The value ingots sound like a good way to go for monolithic posteriors. Middle of the road translucency and correct value?, right? I heard in between HT and LT? I'm just wondering how much staining would be involved?

 

[2thm8kr]

I missed the whole empress value ingot thing. I was using opc at the time and made the switch to Emax later. The value ingots sound like a good way to go for monolithic posteriors. Middle of the road translucency and correct value?, right? I heard in between HT and LT? I'm just wondering how much staining would be involved?

Info I picked up from one of the techs at Ivoclar.

V1= B1'ish' value no chroma shade tab
V2= BLD3/BLD4 in between
V3= Middle 3rd of B1 shade tab

I know it's kind of vague, but it's something.

 

[EJADA]

Info I picked up from one of the techs at Ivoclar.

V1= B1'ish' value no chroma shade tab
V2= BLD3/BLD4 in between
V3= Middle 3rd of B1 shade tab

I know it's kind of vague, but it's something.

I see much value to this approach. Seems Ivoclar hasn't really given much guidance to these. I really like a better starting point from a manufacturer than what they have given. Maybe I missed it.

 

[ccdental]

I have been using the value ingots for all posterior monolithics since they came out. V1 works great for A1,A2,B1,B2,C1,C2 and D2 as long as stump is not to dark. Can do as dark as A3 just takes a liitle more stain. Was using Ht ingots for these shades but kept hearing value was a little low.

 

[subrisi]

This is what I got from my Ivoclar rep:
Value 1 = A2,A3,B3,C1,D2
Value 2 = A1,B1
Value 3 = Bleach 3,4

 

[labwoman]

How about for the 3d vita shade guide any imput on these.

 

[Crownu2]

For 90% of my mono posteriors I'm using HT
For Shades: A3,A3.5,A4,B3,B4,C3,C4,D3,D4 = HT A2
For Shades: A1,A2,B1,B2,C1,C2,D2 = HT B1

Depending on the thickness of the crown those two shades will
cover most everything. And give a nice incisal area with a little more brightness.
HT BL1 is also an option, but the incisal area can end up a little too bright.
Started playing with V1 a little. Used it for B shades and D2
I'm thinking it could be used for lighter A shades as well.
Titanium abuts and ND9 are tricky, but if it's thick enough the HT material
will mask it.

So were do you use any LT ingots at and can you give us your break down for the Lt ingots shade ..Thank you