Splinting 4 EMAX ?

[Toto]

Doc wants all 4 prepped teeth 22 to 12 to be splinted, made with emax press
- does Ivoclar recommend this?

 

[CatamountRob]

It's a contraindication for e.max.
I'd tell them that and if they insist on doing it anyway, ask them to sign something stating that both they and the patient have been informed and understand that, and want to proceed at their own risk.
Which 4 teeth are we talking about, I don't understand "22 to 12"?

 

[Toto]

It's a contraindication for e.max.
I'd tell them that and if they insist on doing it anyway, ask them to sign something stating that both they and the patient have been informed and understand that, and want to proceed at their own risk.
Which 4 teeth are we talking about, I don't understand "22 to 12"?

Thanks CatamountRob- it's 7,8,9,10 upper lateral to lateral centrals included - they are small teeth. I looked at Ivoclars Web site and am still not sure If It's ok to splint even two teeth -

 

[Gru]

Uhh, splinted units are really only a bridge with no pontics, yes? I've seen it done many times. Don't really know Ivoclar's official position, only that they limit the span to one pontic.
paging Patrick Coons!

 

[Hary]

Its contradiction to splint with Ivoclar... But I never understood when you can have a pontic as a first bicuspid and cant splint 2 lower centrals together.

 

[RileyS]

It's a contraindication for e.max.
I'd tell them that and if they insist on doing it anyway, ask them to sign something stating that both they and the patient have been informed and understand that, and want to proceed at their own risk.
Which 4 teeth are we talking about, I don't understand "22 to 12"?

Tricky avatar Roberto!

 

[AL1]

what you could try, is making two copings splinted together for your stabilization
and break it up how you want.
This way you can have multiple bridges tied together with splinted copings,
and if something goes wrong, you dont have the whole thing to fix.
We used to do this for cross arch stabilization and retrieveablity on full mouth cases
with pfc s.

 

[Smithwick0208]

Doc wants all 4 prepped teeth 22 to 12 to be splinted, made with emax press
- does Ivoclar recommend this?

We do quite a bit of 3 and 4 unit anterior bridges with Emax with minimal remakes. As long as the material is thick enough, you shouldn't have a problem.

 

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Doc wants all 4 prepped teeth 22 to 12 to be splinted, made with emax press
- does Ivoclar recommend this?

I have done this before on same teeth, worked just fine.

 

[Toto]

I have done this before on same teeth, worked just fine.

Bokke - good game last sat Keith !?- hope you are a fan

 

[Patrick Coon]

Uhh, splinted units are really only a bridge with no pontics, yes? I've seen it done many times. Don't really know Ivoclar's official position, only that they limit the span to one pontic.
paging Patrick Coons!

Slpinted crowns are contraindicated.

What makes this differernt than a bridge? With a bridge the abutments should be very stable or a bridge is not indicated even with PFM or Zirconia.

So why ldoes a doctor ask for two adjacent teeth to be splinted? Usually because one or both (or all four as in this request) are periodontally involved and need to be reinforced by the other teeth. This is not a problem with a PFM or Zirconia because these materials can withstand those forces. But with a glass ceramic material if there is any give or something moves in mastication then it can't withstand those forces and will crack.

Sidenote: the new Instructions for Use (IFU) for e.max Press is available on the website and some of the contraindications have been removed as well a couple new indications. In fact, splinted crowns on implants are now indicated, but again implants don't move (or shouldn't) so there is no chance for something to torque or flex.

Here is a link to the new IFU:

http://www.ivoclarvivadent.us/zoolu...nt/27100/IPS+e-max+Press+Monolithic+Solutions


Page Answered! BTW Gru, there's only one of me.

 

[rkm rdt]

Just press your emax over 4 splinted zir copings.

 

[Patrick Coon]

Just press your emax over 4 splinted zir copings.

e.max ZirPress would work like that, but NOT e.max Press. The CTEs of e.max Press and Zirconia are too close together and you will get cracking and debonding.

The difference is that e.max ZirPress is a Fluorapatite Glass Ceramic with a flexural strength of 110 mpa and e.max Press is a Lithium Dislicate glass ceramic with a flexural stregth of 400 mpa.

Basically I like to think of the ZirPress as the e.max Ceram Powders in a pressable ingot.

 

[rkm rdt]

Yes Patrick, I was too lazy to explain the difference , you are accurate.

I was thinking that the zirpress would satisfy the dentist's request for emax press without any contradiction of conventional emax and still supply strength and rigidity of a zir substructure.

I suck at zirpress so I'd probably layer and beg for forgiveness

 

[Patrick Coon]

Yes Patrick, I was too lazy to explain the difference , you are accurate.

I was thinking that the zirpress would satisfy the dentist's request for emax press without any contradiction of conventional emax and still supply strength and rigidity of a zir substructure.

I suck at zirpress so I'd probably layer and beg for forgiveness

I fully understand. I wasn't scolding you, not my style (mostly). I just wanted to clarify for some out there. I've taken several calls from technicians that thought they could press Lithium Disilicate over zirconia, or worse thought that ZirPress was pressable Zirconia (don't we wish).

 

[rkm rdt]

It's all good my friend, I didn't take it that way at all.
You are an expert because of your passion and I will always respect that.

We are privileged to have your contributions.

 

[Gru]

BTW Gru, there's only one of me.

But I bet some days a clone might be useful. (I'm really bad at typing on a touch screen!)

Thought you would be happy to clarify the official position and direct us to the IFU. Thanks.

 

[creationsdental]

I've only splinted 3 emax crowns together (11,21,22) and I've had no bad news for a few years. I use a renfert brilliant disc to work the embrasure form as doesn't score a fracture point in the emax. Here's a link ... http://www.usdentaldepot.com/Dental...--Separating/Dynex-Disc-20x025m(-)P023-562520

 

[[email protected]]

Bokke - good game last sat Keith !?- hope you are a fan

Hey Toto, for sure I watched the bokke!, was a game of note!