IPS Empress ® System – das Original FRC Postec ®¦ Glass fibre reinforced composite posts A...

IPSEmpress® System – das Original

FRC Postec ®¦ Glass fibre reinforced composite posts

A Presentation by

David A James SRDT LBIST AIMFT

of

Dentech



Relationships between Dentists and Dental Technicians

plus….



……. hoping to communicate to you the basic procedures used in the

construction of an

Pressed

Porcelain Veneer AND an introduction to the new

IPS e.max CAD/CAM system from Ivoclar

Empress® Esthetic LineIPS

IPS Empress EstheticShade selection /Adhesive preparation Adhesive technique

Step-by-stepIPS Empress Esthetic Veneer

Step-by-step IPS Empress Esthetic partial crown

Clinicallong-term studies CommunicationThe success story

4

Kommunikation

Many of you have probably have tried

‘all porcelain’ crowns and veneers

with varying degrees of success.

In the past, pressed porcelain had to be at least 1mm

thick at its thinnest section to be sure of adequate

strength, with a clearly visible rounded shoulder to

ensure an acceptable marginal fit and then cemented

according to the recommended procedure.





5

Kommunikation

I’m sure that most of you will recognise this smile





6

Kommunikation

More than 15 years ago,

IPS Empress revolutionized the all-ceramic

market and has since become its standard.

Lets take a look at the products and impressive

history





7

Kommunikation

Since 1991,

more than 25 million

restorations speak for

the successful method

offered by the

IPS Empress

System





8

Kommunikation

A tried-and-tested system

19911991

StartIPS Empress

CEM KitVariolink

19931993

New investment materialfor Staining and

Layering Technique

19951995

CosmoPost &Cosmo Ingot

19971997

A-D shadesSpeed

Investmentmaterial

19991999

New communicationtools, IPS Connector,

EP600

20012001

IPS EmpressEsthetic

20042004

T1 and T2Ingots

19921992

TC IngotImpulse & Dentin

Kit

19941994

TL Ingot

19961996

IPS Empress 2

19981998

IfU, TroubleShooting Guide

20002000

IPS Empress Universal

Shade/Stains/Glaze,EP600 Combi,IPS Eris for E2

20022002

Start ofclinicalstudies

19871987

IPS e.max

20052005





9

Kommunikation

Of what does the IPS Empress System

comprise?





10

138 ± 12 MPaFlexural strength

Leucite-reinforced glass-ceramics Type of ceramic

Veneers, Inlays,

Partial and Full Crowns

Indication

IPS Empress Staining and Layering Technique

Technique

IPS Empress (1991)

IPS Empress® 1 System – the original

Given the strength values,only single restorations can be fabricated.





11

350 ± 50 MPa Flexural strength

Framework material:lithium disilicate glass-ceramic

Layering ceramics:Apatite-containing glass-ceramics

Type of ceramic

Full crowns, 3-unit bridgesIndication

IPS Empress 2(framework & layering material)

Technique

IPS Empress 2(1998)

IPS Empress® II System

IPS Eris for E2 was launched in 2002

and is a further development of the IPS Empress 2 layering material.

IPS Empress 2 is suitable to fabricate bridge constructions in the anterior and premolar region.





12


Leucite-reinforced glass-ceramics Type of ceramic

Veneers, inlays, partial andfull crowns

Indication

IPS Empress Staining Technique and Layering Technique

Technique

IPS Empress EstheticLine (2004)

IPS Empress® Esthetic System





13


Leucite-reinforced glass-ceramics and Zirconium Oxide CAD Copings Type of ceramic

Veneers, Crowns, 3 and 4 unit Anterior, Pre-Molar and Molar

Bridges, Inlay Retained BridgesIndication

Staining, Layering and

CAD/CAM TechniqueTechnique

IPS e.max Line 2005

IPS e.max System





14

Thema2

Empress® Esthetic LineIPS

IPS Empress Esthetic is a further development of the proven IPS Empress Staining Technique.

Given the material composition, the results of the previous IPS Empress studies can also be extended to this material.

Due to the improved material properties and increased strength (from 138 ± 12 MPa to160 ± 8 MPa) equal or better clinical results can be expected with IPS Empress Esthetic.





15

Kommunikation

The new IPS Empress Esthetic Ingots are based on an extremely homogeneous leucite glass-ceramic and

are available in the 9 popular are available in the 9 popular IPS Empress IPS Empress

Staining Technique shStaining Technique shadesades.

The 2 new shades2 new shades (E TC0 and E OC1) have been developed particularly for the Veneer Technique and designed to complement a particularly bright tooth shade or after

bleaching.





16

Kommunikation

IPS Empress Esthetic Ingots are available in a wide range of Ivoclar Chromascope and Vita A-D shades

New New





17

Kommunikation

IPS Empress Staining Technique Ingots

IPS Empress EstheticIngots

Flexural strength 138 ± 12 MPa 160 ± 8 MPa

CTE (100-500°C) 18.0 ± 0.5 * 10-6/K 18.1 ± 0.5 * 10-6/K

Press temperature 1075°C 1075°C

Press procedure(depending on the press object)

10 – 15 min 20-25% shorter

What's the difference between the new and the old ingots?

In a nutshell, the new ingots are much stronger, quicker to press and offer greater

aesthetic flexibility during the manufacturing process.





18

Step by Step Step by Step Fabrication of Fabrication of

an an IPS Empress IPS Empress

Esthetic VeneerEsthetic Veneer





19

d.SIGN® IPS

The Preferred veneer preparation





20

d.SIGN® IPS

The fully anatomical and contoured veneers are waxed up and sprued

The sprued veneers are attached to the investment ring base

The correct shade of ingot is selected





21

d.SIGN® IPS

After setting and pre-heating, the ingot and plunger are positioned and the mould is placed in the pre-programmed

pressing oven. The pressing cycle takes around 20 minutes, after which the mould is removed and slowly

cooled.

The special investment is then mixed under vacuum and carefully poured into the mould former.





22

d.SIGN® IPS

The sand blasted veneers after pressing

After fitting onto the model, the incisal third is then

„cut-back“ and reduced to a dentine-mamelon structure.

Any internal characterization is applied with Wash Pastes

The incisal third is then reconstructed using conventional porcelain crown build-up techniques





23

d.SIGN® IPS

Any other (known) Individual characterizations are applied using IPS Empress Universal Stains and subsequently fired in a conventional porcelain furnace

The completed veneers are then seated back onto the model and admired by all, prior to sending back to you for fitting.

Result – a very happy patient (and dentist), both with a confident smile





24

Just a quick look at the Micro-Structure comparison

IPS Empress Staining Technique Ingots IPS Empress Esthetic Ingots

- Homogeneous distribution of leucite crystals- Small leucite grain sizes - Increased precipitation of crystal density of leucite

IPS Empress Esthetic





25

Shade selection Shade selection and preparationand preparation





26

Shade selection /Adhesive preparation

• The Chromascop shade guide is an invaluable help for exact shade determination.

The proper shade is the basis for true-to-nature restorations.





27

Shade selection / Adhesive preparation

• It is important for the dental technician to know

the shade of the prepared tooth.

• The main selection criteria for choosing the ingot are the shade of the die as well as the desired tooth shade.





28

• The correct brightness value of the final shade is exclusively determined by the ingot material.

• Masking of a dark die is usually achieved by using an ingot that exhibits both a high degree of opacity and a low colour intensity.

• The correct final shade of the veneer is a combination of thedie shade, the ingot material, the layering material as

well as the staining procedure and the used

cementation material.






29

The IPS Empress Die Material closely resembles the natural dentine shade

Some Colour examples: ST9 ST3 ST2





30

IPS Empress Die

Material Shades: ST9 ST3 ST2

Examples of how an

IPS Empress Esthetic Veneer

appears using different die shades

(could this be important?)





31

• Careful preparation is decisive for the durability and accuracy of fit of the restoration.

• It is important to properly design the margin with a circular shoulder or chamfer preparation and rounded inner aspects.

• Transitions with sharp angles and feather edge margins should be always be avoided where possible.

• In order to achieve a stable restoration, the minimum wall thicknesses have to be observed.






32

Partial Crowns (Note the rounded internal surfaces)

Specifications in mm





33

Full crowns






34

Inlays






35

Indications: anterior crowns

Aesthetic layerings on pressed anterior crowns

in the incisal region

Minimum thickness of pressed objectsafter the corresponding reduction = 0.5 mm

Limited layering area Labial, incisal thirdLayering thickness = 0.5 - 1 mm





36

Indications: anterior veneers

Aesthetic layerings on pressed anterior veneers

in the incisal region

Minimum thickness of pressed objectsafter the corresponding reduction = 0.5 mm

Limited layering area: Labial, incisal thirdLayering thickness = 0.5 - 1 mm





37

Step-by-stepStep-by-step

IPS Empress IPS Empress Esthetic VeneerEsthetic Veneer

Adhesive TechniqueAdhesive Technique





38

Cementation

Adhesive technique

IPS Empress Esthetic restorations require adhesive require adhesive cementationcementation.

Ivoclar recommend using Variolink II or Multilink resin cements for the adhesive cementation of inlays, partial crowns and full

crowns.

For IPS Empress Esthetic Veneers, Variolink II is

exclusively recommended.

Variolink II EstheticCementation System

Variolink IIProfessional Set

Multilink





39

Used in more than 20 million restorations, it is the market leader world-wide in the field of dual-curing luting composites.

Variolink II has twice been awarded a five-star rating in the category of Dual-Cure Resin Cements by the trade magazine 'Reality'.

Variolink IIIts success speaks for itself…

Adhesive technique





40

Light and dual-curing luting composite in

6 shades

3 consistencies

3 degrees of translucency

Ideal shade simulation with the water-soluble Variolink II Try-In pastes

Double Push Syringe: The Variolink II Universal shade is now also available in the new double push syringe.

Variolink IIAesthetics at its best

Variolink Ultra Variolink II Variolink II

highly viscous viscous low viscosity(placed with ultrasound)

Adhesive technique





41

The Variolink II Try-In pastes feature the same optical properties as the subsequently used luting composite Variolink II.

Thus, the aesthetic effect of the luting composite on the restoration can be checked prior to adhesive cementation.

Shade simulation withVariolink II Try-In

Adhesive technique





42

Multilink ...

… is a self-etching and self-curing paste-paste luting composite system

for universal cementation of indirect restorations.

Adhesive technique





43

The Multilink System consists of ...

Multilink paste-paste luting composite

Multilink-Primer A/B

Adhesive technique





44

Multilink - especially for clinical situations …

with limited or no light access

where high bond strengths are needed

dentine sealing is required

and minimal postoperative sensitivity are priorities

Adhesive technique





45

Multilink

3 shades (Opaque, Yellow, Transparent)

base & catalyst (mix 1:1)

available in double syringes only

filler matrix based on Variolink II

Adhesive technique





46

Kommunikation

Long-term studies Long-term studies

The Experts agreeThe Experts agree





47

A tried-and-tested system

Clinical long-term studies

Ivoclar Vivadent has 15 years of clinical experience with the IPS Empress Staining Technique.

Given the material composition, the results of the previous IPS Empress studies can also be extended to this material.

The improved material properties and in-vitro results compared to those of IPS Empress indicate that equal or even better clinical results can be expected with IPS Empress Esthetic.





48

The IPS Empress success rate will convince you and your patients alike


10-year clinical performance10-year clinical performance

IPS Empress restorations received high patient and dentist acceptance for resistance to fracture and wear and for excellent aesthetics.

The Dental Advisor continues to highly recommend IPS Empressafter 10 years in service.

The Dental Advisor (2004); 21(3):6





49


Clinical evaluation of leucite reinforcedClinical evaluation of leucite reinforcedglass-ceramic crowns over 11 yearsglass-ceramic crowns over 11 years

Survival rate after 11 years: 95.2%

M. Fradeani, M. Redemagni, Quintessenz (2003); 54:379-386





50


Leucite-reinforced glass ceramic inlays and onlaysLeucite-reinforced glass ceramic inlays and onlaysafter eight years in vivoafter eight years in vivo

Survival rate after 8 years: 92%

N. Krämer, A. Petschelt, R. Frankenberger, J Dent Res Spec Iss (2002); 81:Abstr. #1696:A-224





51


Four-year survival rate study of IPS EmpressFour-year survival rate study of IPS Empressrestorationsrestorations

The postoperative sensitivity with Syntac/Variolink IIand Syntac/Dual Cement is less than 1%

L. Pröbster, HJ. Ulmer, E. Engel, Ann. Conf. DGZPW (1996); Abstr. #70:59





52


Six-year follow-upSix-year follow-upwith IPS Empress veneerswith IPS Empress veneers

Survival rate after 6 years: 98.8%

M. Fradeani, Int J Periodont Rest Dent (1998); 18:217-225



Some ‘Before and After’

Examples





54

Images: Dr. John Roberts / USA

Case 1Preoperative view





55Completed restorations






56Case 2

Preoperative view












58

Images: Dr. Michael Miyasaki / USA

Case 1Preoperative view





59Postoperative view






60Case 2

Preoperative view






61Post Operative Maxillary veneers for teeth 14-25












63Case 3

Preoperative view






64Maxillary veneers for teeth 16-25






65

Images: Dr. Arnd Peschke / Liechtenstein

Preoperative view





66

Images: Dr. Arnd Peschke / Liechtenstein

Completed restorations





67

Kommunikation

Just going back to Communication for a Just going back to Communication for a moment, moment,

Ivoclar Vivodent have a wide variety of Ivoclar Vivodent have a wide variety of literature and demonstration aids literature and demonstration aids

available.available.

Kindly direct any enquiries to Etienne or Kindly direct any enquiries to Etienne or his staff at Bart Enterprises Ltd.his staff at Bart Enterprises Ltd.





68

Communication tools for dentists

Brochure

Flow Chart

CD-ROM

590 268

Clinical Guide Patient Information

Communication

FAQ

G: 592 521E: 592 522

G: 562 752E: 562 753

G: 593 423E: 593 424

PosterClinical Guide

G: 593 985E: 593 986





69

Kommunikation

And finally,And finally, but probably the most but probably the most

important...important...

A complete ceramic system A complete ceramic system that will solve almost ALL that will solve almost ALL

of your of your (Crown & Bridge) (Crown & Bridge)

situationssituations















75





76

Kommunikation

Thank you

for your kind attention.

Should you have any technical questions

(only simple ones that I know

the answers to please)

feel free to ask.

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