Pressing posterior bridges (ZirPress) etc...

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Clear Precision Dental

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I am loving my EP5000 for pressing eMax crowns and anterior 3 unit bridges. I am ready to go to another level and offer posterior metal free bridges and anterior bridges that fall outside the protocol for eMax Press. ie., I want to start using ZirPress.

Give me some protocols for pressing these other restorations. Is it straight forward or is it better to outsource for LAVA, etc? Al mentioned using ZirPress (and I love everything of his I have seen!). I am still casting copings and stacking dSIGN for posteriors and I want to enjoy not finishing down metal in the near future.
I've seen x-rays of LAVA copings and they look identical PFM castings. Are they supposed to be more mushroom shaped to support the porcelain on the marginal ridges and/or interproximals?
Can you press implant abutments using ZirPress using castable patterns similar to metal? [I usually cast UCLA type (implant level) in gold using "GoldAdapt" or similar "cast-to" abutments... or send to Atlantis].

Call me an idiot, if you would like, but I'd love the input from my family at DLN! Set me straight! How do I jump in?
 
JohnWilson

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We have done plenty of Zir press and honestly there are some clinicals that say that there is less chipping compared to conventionally stacked restorations.

Substructure design is no difference all substructures should follow a protocol to support the glass in all critical areas. Minimizing unsupported porc is even more critical in ZI and there has been plenty of reports of failures when thimble designed copings are produced. When pressing/stacking to Zi I like to extend the inter-proximal contacts in Zi it has eliminated all marginal ridge fractures and really is easy to design in CAD.

As for pressed glass ceramic abutments pressed to UCLA type of interface ONLY I would not consider this. I have made some with full cast substructures that I have either baked porc to or pressed Ivoclars POM ingots to. It allows the margin to be etched and the client can bond directly to it. Its completely and utterly overkill but its another bullet we can put in the clip.

I wish I had taken some pictures of a case I did earlier this year that had a major defect to the buc plate and we pressed pink Zir press to a Procera Zi abutment to fill in the defect and create the papilla for the cement retained crown. It turned out great and was much easier to create a nice shoulder than stacking/grinding it in.
 
TheLabGuy

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First of all, I wouldn't do e.max bridges of any type. The 5-year clinical studies on those aren't looking good at all >50% failure rate. I've done some zir-press but the only way I see this being a viable way is if you can do it cad/cam, because taking the time to wax it seems tedious when you can pick your brush up and stack that porcelain faster than you can wax it. Just my opinion.
 
doug

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I did one zir-press bridge two years ago. It was 7-10, 8-9 pontics. More trouble than it was worth but it's still in and serves the patient well. I'm sure I violated the rules on units, but the span was not that big as the patient has a small mouth.
 
sixonice

sixonice

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I am loving my EP5000 for pressing eMax crowns and anterior 3 unit bridges. I am ready to go to another level and offer posterior metal free bridges and anterior bridges that fall outside the protocol for eMax Press. ie., I want to start using ZirPress.

Give me some protocols for pressing these other restorations. Is it straight forward or is it better to outsource for LAVA, etc? Al mentioned using ZirPress (and I love everything of his I have seen!). I am still casting copings and stacking dSIGN for posteriors and I want to enjoy not finishing down metal in the near future.
I've seen x-rays of LAVA copings and they look identical PFM castings. Are they supposed to be more mushroom shaped to support the porcelain on the marginal ridges and/or interproximals?
Can you press implant abutments using ZirPress using castable patterns similar to metal? [I usually cast UCLA type (implant level) in gold using "GoldAdapt" or similar "cast-to" abutments... or send to Atlantis].

Call me an idiot, if you would like, but I'd love the input from my family at DLN! Set me straight! How do I jump in?

the zirpress technique works great if your in a "pressing state of mind". make sure you have the demand for posterior all-ceramic bridges. have you crunched the numbers on your profit margins doing an outsourced zirconia frame versus having to purchase alloy? like another member mentioned would the extra waxing be alright with you? you could certainly use preformed wax patterns over the zirconia then sprue, invest & press. the zirpress ingot is basically e.max ceram compressed and made into an ingot. they have 3 different translucencys- MO, LT & HT. i thing the HT ingots work the best and are the easiest to use because it is all full contour. next time you order supplies from ivoclar have them send you the zirpress instructions for use manual so you can get a real good idea of the technique.
 
Clear Precision Dental

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I have enjoyed the efficiency of not having to metal finish, followed by three layers of opaque . I am always slow to offer something outside of " old school". I wanted to use my investment to its fullest capabilities. I do not have CAD/CAM ability at this time. I thank you all for your input.
 
Al.

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First of all, I wouldn't do e.max bridges of any type. The 5-year clinical studies on those aren't looking good at all >50% failure rate. I've done some zir-press but the only way I see this being a viable way is if you can do it cad/cam, because taking the time to wax it seems tedious when you can pick your brush up and stack that porcelain faster than you can wax it. Just my opinion.

I havnt had problems with anterior bridges and bis as long as I really beef up the connections and keep the layering to the facial only and the connections 100% full contour.
For me that means waxing full contor and selectively cutting back, and often that means a unnaturally bulky bridge on the lingual.

For posteriors I prefer pfm over zir or emax.
Anyway pfms are alot harder or impossible for robots to produce, so I dont want them to die.
 
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