Ivoclar Vivadent IPS e.max CAD-on User Manual

CAD-On

all ceramic

all you need

i n s t r u c t i o n s f o r u se

Table of Contents

3 IPS e.max system – one system for every indication

product

information

CAD-On

4 Product Information Description of the IPS e.max CAD-on Technique Materials for the IPS e.max CAD-on Technique Indications, Contraindications Composition Shade Concept Block Concept

13 Clinical Working Steps, Model Preparation Overview of the Fabrication Process Shade Determination – Tooth Shade, Shade of the Prepared Tooth Preparation Guidelines Model Preparation Layer Thicknesses

19 CAD/CAM Processing

CAD Process with Sirona inLab 3D Software

CAM Process with Sirona inLab MC XL

24 Finishing of the Framework and Veneering Structure

Completing the IPS e.max ZirCAD Framework

Completing the IPS e.max CAD Veneering Structure

notes on processing

practical

-

tion

informa

CAD-On

32 Glass-ceramic Fusion Process Preparation Fusion Process Cleaning, Checking

Fusion/Crystallization Firing

39 Glaze, Characterization Characterization/Glaze Firing

Optional – Adjustments with IPS e.max CAD Crystall./Add-On

43 Seating and Follow-Up Care Possibilities for Cementation Preparing for Cementation Care Notes

46 General Information

Frequently Asked Questions

Materials Combination Table Firing Parameters

2

®

IPS

e.max

System –

all you need

IPS e.max – one system for every indication

IPS e.max is an innovative all-ceramic system which covers the entire all-ceramic indication range – from thin veneers to 12-unit bridges.

The IPS e.max system delivers high-strength and highly esthetic materials for the Press and the CAD/CAM technologies. The system comprises lithium disilicate glass-ceramic used primarily for single-tooth restorations, high-strength zirconium oxide for long-span bridges and the veneering ceramic IPS e.max Ceram.

Every patient situation presents its own requirements and treatment objectives. IPS e.max meets these requirements, because due to the system components, you obtain exactly what you need in order to provide the optimum solution to every individual clinical case. – The components of the Press technology include the highly esthetic IPS e.max Press lithium disilicate

glass-ceramic ingots and the IPS e.max ZirPress fluorapatite glass-ceramic ingots for the fast and efficient press-on-zirconia technique.

– Depending on the case requirements, two types of materials are available for CAD/CAM techniques:

the innovative IPS e.max CAD lithium disilicate blocks and the high-strength zirconium oxide IPS e.max ZirCAD.

– The nano-fluorapatite layering ceramic IPS e.max Ceram, which is used to characterize/veneer all

IPS e.max components – glass or oxide ceramics –, completes the IPS e.max ystem.

IPS e.max CAD-on technique

The unique IPS e.max CAD lithium disilicate glass-ceramic (LS2) combines a high strength (360 MPa) and outstanding esthetic properties to provide durable all-ceramic restorations.

The CAD-on technique combines the advantages of IPS e.max CAD (LS2) with those of IPS e.max ZirCAD (ZrO2) in an innovative way and allows single crowns and up to 4-unit posterior bridges with outstanding strength to be fabricated. With its outstanding final strength (>900 MPa), IPS e.max ZirCAD is the material of choice for the fabrication of bridge frameworks. The monolithic IPS e.max CAD HT veneering structure provides the excellent esthetic properties and contributes to the high strength of the completed IPS e.max CAD-on restoration.

The homogeneous glass-ceramic bond between the ZrO2 framework and the LS2 veneering structure is achieved by means of an innovative fusion glass-ceramic: IPS e.max CAD Crystall./Connect. The optimally coordinated system allows a convenient fusion of the IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure.

3

®

IPS

e.max

CAD-on

Product Information

Description of the IPS e.max CAD-on technique

The IPS e.max CAD-on technique allows the lithium disilicate glassceramic (LS2) IPS e.max CAD to be used for the fabrication of highstrength zirconium oxide-based restorations. The CAD/CAM-based fabrication technique IPS e.max CAD-on is characterized by the combination of the two materials: IPS e.max CAD and IPS e.max ZirCAD (zirconium oxide). The LS2 glass-ceramic is already being very successfully used for single-tooth restorations, e.g. monolithic crowns, and serves as veneering structure in the IPS e.max CAD-on technique. The zirconium oxide material IPS e.max ZirCAD is used for the fabrication of a high-strength framework. Both components are designed in the software and milled to high precision in the milling unit. The IPS e.max ZirCAD framework is then sintered in the Programat® S1, for instance. The homogeneous allceramic fusion between the two separately milled parts is achieved with a specially developed innovative fusion glass-ceramic during the crystallization of the IPS e.max CAD material.

Increasing speed and efficiency

The IPS e.max CAD-on technique increases the efficiency and productivity in the fabrication of tooth- or implant-borne posterior restorations. With this technique, zirconium oxide-supported IPS e.max CAD restorations which are unmatched in terms of strength and esthetics can be fabricated with little manual work in one workday. The IPS e.max CAD-on technique can be applied as an alternative to the layering or press-on technique.

IPS e.max CAD veneering structure

IPS e.max CAD Crystall. /Connect fusion glass- ceramic

IPS e.max ZirCAD framework

Zirconium oxide (ZrO2)

Layering technique

Press-on

technique

CAD-on technique

4

Nano-fluorapatite

glass-ceramic

Fluorapatite

glass-ceramic

Lithium disilicate (LS

Glass-ceramic

)

2

Materials for the IPS e.max CAD-on technique

IPS e.max CAD

IPS e.max CAD is a lithium disilicate glass-ceramic block for the CAD/CAM technique. It is manufactured using an innovative process which provides an impressive homogeneity of the material. The block can be processed very easily in a CAD/ CAM unit in this crystalline intermediate stage (metasilicate). The typical and striking colour of IPS e.max CAD ranges from whitish to blue and bluish-grey. This shade is a result of the composition and the microstructure of the glass-ceramic. The strength of the material in this processable intermediate phase is 130–150 MPa. The crystallization takes places in a combined IPS e.max CAD-on Fusion/Crystallization firing in an Ivoclar Vivadent ceramic furnace (e.g. Programat® P700). This leads to a change in the microstructure in the IPS e.max CAD material, during of which lithium disilicate crystals grow. The final physical properties, such as the flexural strength of 360 MPa, and the desired optical properties are achieved through the transformation of the microstructure.

CTE (100-400°C) [10-6 /K] 10.2

CTE (100-500°C) [10-6 /K] 10.5

Flexural strength (biaxial) [MPa]* 360

Fracture toughness [MPa m

Modulus of elasticity [GPa] 95

Vickers hardness [MPa] 5800

Chem. solubility [µg/cm2]* 40

Crystallization temperature [°C] 840 – 850

*according to ISO 6872

0.5

] 2.25

IPS e.max ZirCAD

IPS e.max ZirCAD is a pre-sintered yttrium- stabilized zirconium oxide block for the CAD/CAM technique. The blocks are available both shaded and unshaded. IPS e.max ZirCAD can be processed very easily in a CAD/CAM unit in its partly sintered, "chalk-like" state. Milling is carried out with an enlargement of the framework of approximately 20–25%. Given the controlled manufacturing process of the blocks, combined with an coordinated sintering process in a high temperature furnace (e.g. Programat S1) the shrinkage of the enlarged milled frameworks can be controlled in such a way that excellent accuracy of fit can be achieved. During the sintering procedure, the final material-specific properties of IPS e.max ZirCAD are achieved. In the process, a structure that is densified to more than 99% is created, which features a high flexural strength (>900 MPa) combined with high fracture toughness (5.5 MPa m

0.5

and thus fully meets the clinical requirements presented by masticatory forces – particularly in the posterior region.

CTE (100-400°C) [10-6 /K] 10.8

CTE (100-500°C) [10-6 /K] 10.8

Flexural strength (biaxial) [MPa]* 900

Fracture toughness [MPa m

)

0.5

] 5.5

Vickers hardness [MPa] 13000

Chem. solubility [µg/cm2]* 1

Sinter temperature [°C] 1500

*according to ISO 6872

5

IPS e.max CAD Crystall./Connect

IPS e.max CAD Crystall./Connect is a specially developed fusion glass-ceramic which is used to create a homogeneous bond between the IPS e. max ZirCAD framework and the IPS e.max CAD veneering structure during the IPS e.max CAD-on Fusion/Crystallization firing.

The shades of the fusion glass-ceramic are adjusted in such a way that the IPS e.max ZirCAD shades MO 0 to MO 4 combined with the IPS e.max CAD shades correspond to the shades of the IPS e.max shade concept. By combining the brighter IPS e.max ZirCAD framework with the translucent IPS e.max CAD HT veneering structure and the harmonizing IPS e.max CAD Crystall./Connect material, restorations can be fabricated which exhibit outstanding esthetic properties.

IPS e.max CAD Crystall./Connect

CTE (100-400°C) [10-6 /K] 9.5

CTE (100-500°C) [10-6 /K] 9.2

Flexural strength (biaxial) [MPa]* 160

Chem. solubility [µg/cm2]* 10

Fusion temperature [°C] 840

*according to ISO 6872

1 µm

IPS e.max CAD Crystall./Connect is a pre-dosed, ready-to-use powder/liquid system available in single doses and nine shades. The precisely adjusted powder/liquid mixture of IPS e.max CAD Crystall./Connect turns liquid when vibrated (with the Ivomix). This allows the material to be mixed and the components to be joined on the Ivomix. Without mechanical influence (vibration) IPS e.max CAD Crystall./Connect turns stable again, which enables the joined restoration to be checked in the articulator. This special property is known as thixotropy.

6

10 µm

After the IPS e.max CAD-on Fusion/Crystallization firing at 840°C / 1544 °F the sintered material exhibits a high strength of 160 MPa and forms a homogeneous bond both to the IPS e.max ZirCAD freamework and the IPS e.max CAD veneering structure. This homogeneous bond is clearly visible on both material interfaces in SEM images. The sintering temperature of IPS e.max CAD Crystall./Connect has been adjusted to the crystallization temperature of IPS e.max CAD so that the fusion process and the crystallization of IPS e.max CAD can be conducted in one firing (Fusion/Crystallization firing).

IPS e.max CAD

IPS e.max CAD Crystall./Connect

IPS e.max ZirCAD

IPS e.max CAD-on fusion area

100 µm

10 µm

The IPS e.max CAD crystallization program was used as a basis for the IPS e.max CAD-on Fusion/ Crystallization firing. The pre-drying of the restoration including the fusion area is an important partial step of the firing process. As the even drying of the fusion glass-ceramic takes place through the fusion gap, the fused restoration must be pre- dried. The specific pre-drying takes place by means of a controlled process in a suitable ceramic furnace. An insufficient or too quick a drying might result in the veneering structure being completely or partially lifted off the framework. Furthermore, the heating rate and the holding time at 820 °C / 1508 °F have been adjusted so as to ensure an even heating of the entire restoration. At the end of the program cycle, the longterm cooling has been expanded to 600 °C / 1112 °F. Due to the complexity of the specially developed firing program, the ceramic furnace must meet strict requirements.

7

Uses

Indications

− Crowns

− Splinted crowns

− 3- to 4-unit bridges

− Implant superstructure crown

− Implant superstructure splinted crown

− Implant superstructure 3- to 4-unit bridges

Contraindications

− Restorations with more than two connected bridge pontics

− Two bridge pontics as extension units

− Very deep sub-gingival preparations

− Patients with severely reduced residual dentition

− Patients suffering from bruxism

− Any other use not listed in the indications.

− Use of IPS e.max Ceram layering materials (layering technique, cut-back technique)

− Use of IPS e.max Ceram Glaze, Shades, Essences (staining technique)

Side effects

If patients are known to be allergic to any of the components in the materials, IPS e.max restorations should not be used.

Composition

– IPS e.max C AD blocks Components: SiO2

Additional components: Li2O, K2O, MgO, Al2O3, P2O5 and other oxides

– IPS e.max ZirCAD blocks Components: ZrO Additional components: HfO2, A2O3, Y2O3 and other oxides

– IPS e.max ZirCAD Colouring Liquid Components: Water, ethanol, colouring salts, additives

– IPS e.max CAD Crystall. /Connect Components: Oxides, water, butandiol and chloride

2

Important note:

The fabrication of IPS e.max CAD HT bridges which are not supported by a zirconium oxide structure is contraindicated.

Important processing restrictions

Failure to observe the following restrictions may result in failure and defective restorations:

− Milling of IPS e.max CAD and IPS e.max ZirCAD with non- compatible CAD/CAM systems.

− Failure to observe the necessary minimum connector and restoration thicknesses

− Sintering of IPS e.max ZirCAD in a non-compatible high-temperature furnace

− Conducting the Fusion/Crystallization firing or the Characterization/Glaze firing in a ceramic furnace which has not been approved and which is not recommended

− Conducting the Fusion/Crystallization firing or the Characterization/Glaze firing with deviating parameters

− Conducting the Fusion/Crystallization firing or the Characterization/Glaze firing in a non-calibrated ceramic furnace

− Conducting the Fusion/Crystallization firing or the Characterization/Glaze firing in a high-temperatur furnace (e.g. Programat S1)

− Mixing of IPS e.max CAD Crystall./Glaze, Shades and Stains with other ceramic materials (e.g. IPS e.max Ceram Glaze, Stains and Essences).

− Wetting or rewetting the IPS e.max CAD Crystall./Connect (fusion glass-ceramic)

− Mixing of IPS e.max CAD Crystall./Connect with other ceramic materials in general

− Using a vibrator other than Ivomix

– IPS e.max C AD Crystall. /Glaze, Shades and Stains Components: Oxide, glycols

– IPS e.max CAD Crystall. /Glaze Liquid Components: Butandiol

– IPS e.max C AD Crystall. /Add-On Incisal, Dentin, Connect Components: Oxides

– IPS e.max CAD Crystall. /Add-On Liquid allround

Components: Water, butandiol and chloride

– IPS e.max CAD Crystall. /Add-On Liquid longlife

Components: Water, butandiol and chloride

– IPS Object Fix Putty / Flow Components: Oxides, water, thickening agent

– IPS Contrast Spray Labside Components: Pigment suspension in ethanol, propellant:

Propane/butane mixture

Warning

– Do not inhale ceramic dust – use exhaust air discharge and mouth

protection.

– IPS Contrast Spray Labside must not be used intraorally.

8

Scientific Data

Further scientific data (i.e. strength, wear, biocompatibility) are contained in the “Scientific Documentaion IPS e.max CAD-on”. This Scientific Documentation can be obtained from Ivoclar Vivadent.

For further information about all-ceramics in general, please refer to the Ivoclar Vivadent Report No. 16 and 17.

Scientific Documentation

9

Shade Concept

In the CAD-on technique, the desired restoration shade is the result of the combination of:

− the shade of the framework (IPS e.max ZirCAD MO)

− the shade of the fusion glass-ceramic (IPS e.max CAD Crystall./Connect)

− the shade of the veneering structure (IPS e.max CAD HT)

− characterizations (IPS e.max CAD Crystall./Shades, Stains)

The desired esthetic properties can be specifically achieved if the correct materials which correspond to the tooth shade are selected. Note: If other combinations are selected (e.g. different zirconium oxide shades), the final shade may differ.

Desired tooth shade

BL1 BL2 BL3 BL4 A1 A2 A3 A3.5 A4 B1 B2 B3 B4 C1 C2 C3 C4 D2 D3 D4

IPS e.max ZirCAD

shaded

IPS e.max ZirCAD

non-shaded

+

optional

IPS e.max ZirCAD Colouring Liquid

IPS e.max CAD Crystall./Connect

IPS e.max CAD HT

IPS e.max CAD Crystall./Shade

*

BL11 BL2 BL31BL41A1 A2 A3 A3.5 A41B1 B2 B31B41C1 C2 C31C41D2 D31D4

MO 0 MO 1 MO 2 – MO 1 –

MO 0

1 2 3 4 5 6 9 3 4 7 8 9 8 9

SH 0 SH 1 SH 2 SH 3 SH 4

MO 0

+

CL 1

MO 0

CL 2

MO

MO 0

CL 4

0 +

CL 1

+

MO 0

CL 3

IPS e.max CAD Crystall./Shade

SH I1 SH I2 SH I1 SH I2

Incisal

IPS e.max CAD Crystall./Stains

*The range of available products may vary from country to country.

1

IPS e.max CAD HT B40 blocks are available in 10 shades. To create the desired tooth shade, select the closest block shade in the respective shade group and determine the final tooth shade by means of Stains.

white, creme, sunset, copper, olive, khaki, mahogany

MO

1

MO

CL 1

0 +

+

MO 0

+

CL 4

1

Note:

Do not use IPS e.max Ceram layering materials and Shades,

Essences or Glaze materials in conjunction with the IPS e.max CAD-on technique.

10

Block Concept

Block concept IPS e.max CAD

IPS e.max CAD is basically available in three levels of translucency (HT, LT, MO) and three block sizes (I12, C14, B40). Depending on the translucency level, different block sizes are available. For esthetic reasons, IPS e.max CAD HT blocks are used in the IPS e.max CAD-on technique.

Translucency level

High Translucency

Low Translucency

Medium Opacity

CR %

Processing technique

Staining

technique

Cut-back

technique

Layering

technique

CAD-on

technique

Thin

veneers

Indications

Veneers Inlays Onlays Partial

crowns

** IPS e.max CAD-on technique in conjunction with IPS e.max ZirCAD

Posterior

crowns

Splinted

3- to 4-unit

crowns

* up to the second premolar

posterior

bridges

IPS e.max CAD HT (High Translucency)

IPS e.max CAD HT (High Translucency) B40 blocks are available in 9 A–D shades and 1 Bleach BL shade. For the fabrication of IPS CAD-on bridge restorations, only B40 blocks are used. Due to their

translucency, IPS e.max CAD HT blocks are ideally suitable for the fabrication of IPS e.max CAD-on restorations in the staining technique. IPS e.max CAD-on restorations fabricated from HT blocks exhibit a lifelike brightness value and translucency. To characterize and glaze IPS e.max CAD-on restorations, only the IPS e.max CAD Crystall./Shades, Stains and Glaze are used.

The entire IPS e.max delivery program can be found at

www.ivoclarvivadent.com.

11

IPS e.max ZirCAD block concept

IPS e.max ZirCAD is currently supplied in 9 block sizes (see table) and 3 shades (MO 0, MO 1, MO 2). This provides utmost flexibility during block selection, with regard to both the shade and the block size.

The following IPS e.max ZirCAD blocks are available:

Block designation

Dimensions in mm (width x length x height)

IPS e.max ZirCAD for inLab

13.2 x 13.2 x 14.0

IPS e.max ZirCAD for inLab

14.5 x 15.5 x 18.5

IPS e.max ZirCAD for inLab

15.4 x 19.0 x 20.0

IPS e.max ZirCAD for inLab

14.2 x 15.5 x 40.0

IPS e.max ZirCAD for inLab

15.4 x 19.0 x 39.0

IPS e.max ZirCAD for inLab

15.5 x 19.0 x 55.0

IPS e.max ZirCAD for inLab

22.0 x 25.0 x 65.0

IPS e.max ZirCAD for inLab

17.0 x 40.0 x 65.0

Length

Width

Height

C 13

C 15

C 15 L

B 40

B 40L

B 55

B 65

B 65 L-17

MO 0 MO 1 MO 2

IPS e.max ZirCAD for inLab

22.0 x 40.0 x 85.0

The entire IPS e.max delivery program can be found at www.ivoclarvivadent.com.

B 85 L-22

12

®

IPS

e.max

CAD-on

Clinical Working Steps, Model Preparation

IPS e.max CAD-on technique

Preparation, shade determination,

CAM process

IPS e.max ZirCAD framework

Pre-shaded block

Shading with

Colouring Liquids

Drying

Sintering

Working steps

impression-taking

Model fabrication

Scan and design (CAD)

CAM process IPS e.max CAD veneering structure

Finishing/checking

fit of framework and

veneering structure

Ivoclar Vivadent Products

OptraGate

IPS® Natural Die Material

Shade Guide

®

IPS

Contrast Spray Labside

IPS e.max ZirCAD MO

IPS e.max ZirCAD Colouring Liquids

IPS e.max CAD HT

Programat

®

S1

Clinical Working Steps, Model Fabrication

*

Fusing framework and

veneering structure

Fusion/Crystallization firing

Characterization/Glaze firing

Preparing for cementation

Conditioning

Cementation

IPS e.max CAD Crystall./Connect

Ivomix

IPS e.max CAD Crystall./

Shades, Stains, Glaze, Add-On

IPS e.max CAD Crystallization

IPS Object Fix Putty and Flow

P300, P500, P700, EP 5000

Monobond

Multilink

Tray and Pins

Programat

®

Plus

®

Automix

SpeedCEM

Vivaglass® CEM

bluephase

®

Check of articulation / occlusion

+ polishing

(after intraoral adjustment)

Recall

®

OptraFine

Proxyt

13

*The range of available products may vary from country to country.

®

Shade Determination – Tooth Shade, Shade of the Prepared Tooth

Optimum integration in the oral cavity of the patient is the prerequisite for a true-to-nature all-ceramic restoration. To achieve this, the dentist must observe the following guidelines and notes. The overall esthetic result of an all-ceramic restoration is influenced by the following factors:

• Shade of prepared tooth (natural preparation, core build-up, abutment, implant)

• Shade of the restoration (framework shade, veneer, characterization)

• Shade of the cementation material

The optical effect of the preparation shade must not be underestimated during the fabrication of highly esthetic restorations. For that reason, the shade of the preparation should be determined together with the desired tooth shade in order to select the suitable block. Especially with severely discoloured preparations or non-tooth-shaded build-ups, this is of utmost importance. In order to achieve the desired esthetics, the shade of the prepared tooth must first be determined.

Preparation Shade

– Prepared natural tooth – Core build-up – Implant, abutment

Desired tooth shade

Cementation material

Responsibility of the Dental Office Responsibility of the Laboratory

Shade determination of the natural tooth

After tooth cleaning, the tooth shade of the non-prepared tooth and/or the adjacent teeth is determined with the help of a shade guide. Individual characteristics have to be considered when determining the tooth shade. If a crown preparation is planned, for example, the cervical shade should also be determined. In order to achieve the best possible true-to-nature results, shade determination should be carried out at daylight. Furthermore, the patient should not wear clothes of intensive colours and/or lipstick.

Restoration Shade

– Framework shade – Veneer – Characterization

Die shade selection

In order to facilitate the reproduction of the desired tooth shade, the shade of the preparation is determined with the help of the IPS Natural Die Material shade guide. This enables the technician to fabricate a model die similar to the preparation of the patient, on the basis of which the correct shade and brightness values of the all-ceramic restorations may be selected.

14

Preparation Guidelines

Basic preparation guidelines for all-ceramic restorations

– No angles or edges – The incisal edge of the preparation, particularly for anterior teeth, should be at least 1.0 mm (milling

tool geometry) in order to permit optimum milling during CAD/CAM processing.

1.0

The following notes should also be observed when using the IPS e.max CAD-on technique:

The zirconium oxide framework is designed in the software with a circumferential collar on abutment teeth / crown framework due to technical reasons. The height of this collar is mainly determined by the shape of preparation and the designed fully anatomical tooth shape. – A very pronounced shoulder/chamfer results in a thin zirconium oxide collar. – A minor shoulder/chamfer results in a wider zirconium oxide collar.

A very pronounced shoulder/chamfer results in a thin zirconium oxide collar.

A minor shoulder/chamfer results in a wider

zirconium oxide collar.

1.5

Clinical Working Steps, Model Fabrication

15

1.0

1.5

1.0

1.5

2.0

1.0

1.5

2.0

1.0

1.5

2.0

1.5

6°

1.0

1.5

1.5 1.5

1.0

1.5

1.5 1.5

1.0

1.5

1.0

1.5

6°

Singe Crowns to 3-Unit Bridges

Anterior Crown

− Reduce the anatomical shape and observe the stipulated minimum thickness. Prepare a circular shoulder with rounded inner edges or a chamfer at a degree of approximately 10°-30°. Width of the circular shoulder/ chamfer at least 1.0 mm.

− Reduce the incisal crown third by approx. 1.5 mm.

Reduce the vestibular and/or oral area by approx.

1.5 mm.

− For conventional and/or self-adhesive cementation, the preparation must demonstrate retentive surfaces.

Posterior Crown

− Reduce the anatomical shape and observe the stipulated minimum thickness. Prepare a circular shoulder with rounded inner edges or a chamfer at a degree of approximately 10°-30°. Width of the circular shoulder/ chamfer at least 1.0 mm.

− Reduce the incisal crown third by approx. 1.5 mm.

Reduce the vestibular and/or oral area by approx.

1.5 mm.

− For conventional and/or self-adhesive cementation, the preparation must demonstrate retentive surfaces.

4-Unit Bridges

− Evenly reduce the anatomical shape and observe the stipulated minimum thickness. Prepare a circular shoulder with rounded inner edges or a chamfer with a width of at least 1.0 mm.

− Reduce the incisal crown third – incisal and/or occlusal - by approx. 1.5 mm.

− For anterior crowns, the reduction in the labial and/or palatal/lingual area is at least 1.5 mm. The incisal edge of the preparation should be at least 1.0 mm (milling tool geometry) in order to permit optimum milling of the incisal area during CAD/CAM processing.

− For posterior crowns, the reduction in the buccal and/or palatal/lingual area is at least 1.5 mm.

− For conventional and/or self-adhesive cementation, the preparation must demonstrate retentive surfaces

16

Model Preparation

Please observe the instructions of the manufacturer of the CAD/CAM system for the selection of the model material.

Important for the fabrication of models:

− Check the radius of the incisal/occlusal edge on the prepared tooth (maxilla and mandible).

− The prepared incisal/occlusal edge should be at least as thick as the diameter of the bur used in the cavity during the CAD/CAM process.

− If the incisal/occlusal edge of the prepared die is thinner than the diameter of the bur, the edge has to be blocked out accordingly.

− The preparation margins must be clearly defined so that they are clearly recorded during scanning.

− Do not apply a die varnish or spacer.

− In clinical cases with a very thin alveolar ridge, the lingual/palatal side of the ridge must be supplemented with putty silicone or a similar material. This allows the dimensions of the bridge pontic to be correctly designed during the subsequent design of the restoration.

Clinical Working Steps, Model Fabrication

A stone model is used as a working model.

In clinical cases with a very thin alveolar ridge, the lingual/palatal side must be blocked out on the model.

17

Layer Thicknesses

The restoration design is key to the success of durable all-ceramic restorations. The more attention given to the design, the better the final results and the clinical success will turn out to be. The following basic guidelines have to be observed:

– The restoration design generated by the software may need to be individually adapted according to the clinical require-

ments using the design tools.

– In the case of bridges, a sufficient penetration of the individual bridge elements must be ensured in order to observe the

minimum connector dimensions in the IPS e.max CAD-on restoration.

– During the construction of an IPS e.max CAD-on restoration, the separation into IPS e.max ZirCAD frame-

work and the IPS e.max CAD veneering structure is carried out by the software after the design of an anatomical shape.

– If changes are made to the framework during construction in the milling preview, make sure that no undercuts are created.

Otherwise, the IPS e.max CAD veneering structure may not be placed on the framework.

– After the milling process, only the attachment point to the block may be smoothed out on the IPS e.max ZirCAD frame-

work. Further processing is not possible, as this would influence the size of the fusion joint.

The following minimum layer thicknesses are stored in the software and must be observed. Please refer to the indications (see page 8) for information on the possible restorations.

IPS e.max IPS e.max CAD veneering structure minimum layer thickness

IPS e.max ZirCAD framework minimum layer thickness

circular

occlusal

circular

occlusal

Connector dimensions

Crowns Splinted

crowns

3-unit posterior

bridges

4-unit posterior

(2 connected bridge pontics

0.7 0.7 0.7 0.7

0.5 0.5 0.5 0.5

0.5 0.5 0.5 0.7

— — 9 mm

2

bridges

at most)

12 mm

Dimensions in mm

2

18

®

IPS

e.max

CAD-on

CAD/CAM Processing

CAD process with Sirona inLab 3D Software

The inLab 3D software V3.81 or higher is necessary to fabricate IPS e.max CAD-on restorations with the Sirona inLab® system. The basic operation and function of this software is described in the respective "inLab 3D Operator's Manual".

In addition to the Manual, the following notes on the construction of IPS e.max CAD-on restorations must be observed. The description is not conclusive and does not include all required details; it is limited to the steps which are relevant in the context of the IPS e.max CAD-on technique.

In the New dialog, e.g. for the creation of a bridge restoration, make the following selection:

Restoration: Bridge

Design technique: Multilayer

CAD/CAM Processing

The "Multilayer" design technique is the software tool that is used to create IPS e.max CAD-on restorations.

After the model or prepared teeth have been scanned the restorative materials are selected. With this step, the material thicknesses that apply to the respective material are activated for the subsequent design.

Framework: Ivoclar Vivadent IPS e.max ZirCAD

Veneering structure: Ivoclar Vivadent IPS e.max CAD

Make the following individual settings for the framework in the Parameter dialog box:

– Oclusal contact strength: e.g. -50 µm –> influences the strength of the contact points

– Spacer: e.g. 0 µm –> individual setting according to the required fit

on the model

– Lingual open angle: 0° – 45° –> depends on the clinical case at hand or the

desired restoration geometry

19

Determination of the preparation margins and entering the base line of the bridge pontic in bridge restorations.

Note: The base line defines the dimensions of the bridge pontic rest in the design mode Multilayer and thus the dimensions of the framework.

Example: clinical case with thin alveolar ridge

The base line is entered on the "gingiva" and on the blocked-out part of the model (cf page 17 Model preparation) so that the desired bridge pontic rest can be achieved.

Example: clinical case with thin alveolar ridge

–> with no blocking-out of the thin alveolar ridge, the base line cannot be entered correctly.

Note on the optimum selection of the insertion axis: An inadequate insertion axis selection (see image: model is inclined too far to the buccal aspect) may result in a wide zirconium oxide collar on the framework. The insertion axis should therefore be determined in such a way to allow an optimum view of all preparation shoulders of the abutment teeth. In difficult cases, it is advisable to rather incline the model to the palatal/lingual side to achieve an optimum design of the restoration on the buccal side.

20

The automatically generated framework suggestion can be adjusted to the clinical situation using the design tools.

If bridges are fabricated, a sufficient penetration of the bridge pontics must be observed. The penetration defines the total surface of the connector cross section (framework and veneering structure).

An insufficient connector cross section area is indicated by a display highlighted with a red background (in the footer) The penetration of the bridge components must be increased with the Design tools.

The lingual open angle (0° -45°) can be changed in the Parameter dialog box. After the angle has been entered, the changes become effective by editing a small segment of the base line.

CAD/CAM Processing

When changing to the milling preview, the segmentation of the restoration into "Framework" and "Veneer structure" (transparent) takes place automatically.

If required, smooth out the occlusal surface (e.g. in case of protruding pontics) by means of the Design tools. Observe the minimum layer thicknesses!

The circular surfaces must not be edited with the Design tools, as this would compromise the fit of the veneering structure.

21

Load the veneering structure to the milling preview in the Design menu by clicking on Editing the veneering structure

Note: The milling procedure for the framework should start only now (see next image), as the milling preview of the veneering structure can otherwise not be loaded.

Select the Endo mode in the milling preview in order to ensure that an even joint gap is achieved between framework and veneering structure.

Select Ivoclar Vivadent IPS e.max ZirCAD in the block selection and the desired block size prior to the milling process for the framework. Then start the milling process.

Select Ivoclar Vivadent IPS e.max CAD in the block selection and the desired block size prior to the milling process for the veneering structure. Then start the milling process.

22

CAM process with Sirona inLab® MC XL

The milling process of the IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure takes place in a Sirona InLab MC XL milling unit. Please refer to Sirona's recommendations with regard to suitable milling tools.

For the milling process in a Sirona inLab MC XL unit, please observe the Ivoclar Vivadent recommendations with regard to the Dentatec milling additive.

CAD/CAM Processing

Milled IPS e.max ZirCAD framework Milled IPS e.max CAD veneering structure

23

®

VE R AR B EI T UN G SA N LE I T UN G

ZirCAD

all ceramic all you need

IPS

e.max

CAD-on

Finishing of the Framework and Veneering Structure

Completing the IPS e.max ZirCAD framework.

Note: For detailed information on the processing of IPS e.max ZirCAD please refer to the IPS e.max ZirCAD

Instructions for Use.

Finishing Drying Sintering Checking

Finishing

As a general rule, manual grinding of the IPS e.max ZirCAD framework should be limited in the IPS e.max CADon technique to smoothing out the attachment point to the block.

The circular collar at bridge pontics and crown frameworks generated by the software must not

be ground, as this might compromise the accuracy of fit between the IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure.

It is of critical importance to use the correct grinding instruments for adjustments of the attachment point on the IPS e.max ZirCAD framework. If unsuitable grinding instruments are used, e.g. chipping of the edges may occur (please observe the Ivoclar Vivadent Flow Chart "Recommended grinding tools for PS e.max zirconium oxide").

The following procedure is recommended for finishing IPS e.max ZirCAD frameworks: – The presintered zirconium oxide framework is prone to damages and fractures and must therefore be handled with

care.

– Rinse the milled IPS e.max ZirCAD framework under slightly running water directly after the milling process to remove

all milling residue. Subsequently, carefully blast with compressed air. – Carefully separate the milled IPS e.max ZirCAD framework from its holder using a diamond-coated separating disk. – Check the layer thickness next to the attachment point with calipers and reduce the IPS e.max ZirCAD

framework at the attachment point to precisely this layer thickness. Smooth out the attachment point

with suitable grinding instruments.

– Do not use fine rubber polishers for finishing IPS e.max ZirCAD frameworks to be shaded with an infiltration solution,

since this will seal the surface and result in uneven shading. – Rough tungsten carbide burs and burs with large diameters are not suitable, as the vibrations during finishing might

result in chipping. Therefore, only fine tungsten carbide burs and grinding instruments with small diameters should be

used. – Do not "post-separate" the bridge framework with separating disks. This may result in undesired predetermined

breaking points, which may cause the restoration to fracture. – After finishing, clean the IPS e.max ZirCAD framework with compressed air to remove grinding dust. If the framework

is still moist, additionally clean it under running water.

– Make sure that all grinding residue (e.g. grinding dust) is removed. Adhering grinding dust may get fused to the

framework during sintering and result in inaccuracy of fit. – The IPS e.max ZirCAD framework must not be cleaned with ultrasound in a water bath or with a steam jet. – The IPS e.max ZirCAD framework must not be blasted with Al2O3 or glass polishing beads.

Optional

Shading

24

coated separating disk.

Do not grind the circular collar created by the software on the IPS e.max ZirCAD framework.Carefully separate the milled IPS e.max ZirCAD framework from its holder using a diamond-

Finishing of the Framework and Veneering Structure

Do not "post-separate" the bridge framework with a separating disk.

Check the layer thickness next to the attachment point and reduce the IPS e.max ZirCAD framework at the attachment point to this layer thickness.

Do not smooth out rough areas on the IPS e.max ZirCAD framework surface, as this

Smooth out the attachment point with suitable grinding instruments.

Observe the minimum layer thickness of the IPS e.max ZirCAD framework!

unnecessarily increases the size of the joint.

Comparison: Attachment point area before (left) and after (right) grinding.

Comparison: IPS e.max ZirCAD framework after CAM process (above)

and after correction of the attachment point (below).

25

Finishing Drying Sintering Checking

IN S T R U C T I O N S

FO R

US E

ZirCAD

all ceramic all you need

Finishing Drying Sintering Checking

Optional

Shading

Drying

In order to prevent damaging the IPS e.max ZirCAD framework during sintering, the IPS e.max ZirCAD framework must be completely dried. Moist IPS e.max ZirCAD frameworks must not be sintered.

Please observe the following notes for drying: – The IPS e.max ZirCAD framework must be free of dust and grinding residue. – The framework can be dried either in a drying cabinet or under an infrared lamp.

Place the IPS e.max ZirCAD framework on the occlusal surface for drying.

– Note: If infrared lamps (250 W) are used, the distance (5-20 cm) to the object decisively influences the

temperature that develops.

– The drying time depends on the temperature. For drying the frameworks, a temperature of

140 °C (284 °F) must not be exceeded. With lower temperatures, the drying times are prolonged.

– The drying time also varies with the size of the IPS e.max ZirCAD framework. The following table

contains the required drying times.

Temperature ~70 °C / 158°F Temperature ~140 °C / 284°F

Single-tooth frameworks

≥15 min

5 – 10 min

3-4-unit bridge frameworks

≥40 min

Finishing Drying Sintering Checking

≥25 min

Optional

Shading

Shading (optional)

For shading the IPS e.max ZirCAD MO 0 frameworks, four Colouring Liquids (CL1-CL4) are available*. With the shading, the framework shade is adjusted to the IPS e.max shade concept. The allocation to the desired tooth shade is listed in the combination table (page 50).

Note: For the detailed procedure regarding shading with IPS e.max ZirCAD Colouring Liquids, please refer to the IPS e.max ZirCAD Instructions for Use.

Comparison of shaded IPS e.max ZirCAD before and after sintering.

IPS e.max ZirCAD shaded before sintering

IPS e.max ZirCAD shaded after sintering

Note on the use of IPS e.max ZirCAD Colouring Liquids

The frameworks shaded with IPS e.max ZirCAD Colouring Liquids must be sufficiently pre-dried in a pre-drying furnace! Air drying is not sufficient and might result in the formation of cracks in the framework during the sintering process in the Programat S1.

*The range of available products may vary from country to country.

26

Finishing Drying Sintering Checking

Optional

Shading

Sintering

The high-temperature Programat S1 furnace is preferably used for sintering IPS e.max ZirCAD frameworks. The furnace's programs are optimally adjusted to IPS e.max CAD and the material's shrinkage during sintering and thus allow optimum results to be achieved.

Prior to sintering, allow the IPS e.max ZirCAD frameworks to dry for a sufficient amount of time according to the size (page 26). Please keep in mind that IPS e.max ZirCAD frameworks which are sintered while moist are damaged as a result to the high heating rate.

For the sintering process in the Programat S1, the following points should be observed: Positioning of dried IPS e.max ZirCAD frameworks on the sintering tray supplied with Programat S1:

– Do not use ZrO

sintering beads in the Programat S1.

2

– The sinter tray can be entirely filled with IPS e.max ZirCAD frameworks. Make sure that the frameworks do not

touch each other.

– Simultaneous sintering of single-tooth and bridge frameworks as well as frameworks with a sinter support

structure is possible. – Observe the program selection. – Provide even support for the IPS e.max ZirCAD frameworks. – Bridge frameworks should not exclusively be supported by the abutment crowns. The bridge pontic must

be supported. The abutment crowns do not absolutely have to come into contact with the sinter tray.

Observe the notes in the IPS e.max ZirCAD Instructions for Use!

– Arrange the IPS e.max ZirCAD frameworks in concentric circles on the sinter tray, particularly bridge frameworks.

Important: Do not place any frameworks over the separation in the sinter tray. – Place the loaded sinter tray in its intended position in the centre of the sintering chamber of the Programat S1 using the

sinter tray fork.

Finishing of the Framework and Veneering Structure

Arrange the frameworks in concentric circles on the sinter tray. This ensures even temperature distribution within the framework during heating and cooling.

Frameworks with or without sinter support structure may be sintered simultaneously.

Observe the program selection. The frameworks must not touch each other.

Do not place any frameworks over the separation in the sinter tray.

Select the sintering program in accordance with the materials used (e.g. use of IPS e.max ZirCAD Colouring Liquids) and the indications (single-tooth or bridge framework) and start the process.

Remove the sinter tray from the Programat S1 after the sintering process using the sinter tray fork. Always allow the hot IPS e.max ZirCAD frameworks to cool to room temperature before proceeding.

For details on the sintering process, please refer to the IPS e.max ZirCAD Instructions for Use and the Programat S1 Operating Instructions.

More information can be found at www.ivoclarvivadent.com.

27

Finishing Drying Sintering Checking

Optional

Shading

Checking on the model

Once the IPS e.max ZirCAD framework has cooled to room temperature, proceed with the following steps: – Remove the IPS e.max ZirCAD framework from the sinter tray and carefully place it on the model. – Check the fit of the IPS e.max ZirCAD framework on the model / the dies. – Do not grind the outer aspect of the IPS e.max ZirCAD framework, in order to prevent an inaccurate fit

between the IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure.

– Do not "post-separate" the bridge framework with separating disks after sintering, since this may result

in undesired predetermined breaking points, which may cause the restoration to break.

– If corrections by grinding are necessary to fit the framework on the model or the dies, use suitable grinding instruments.

For the selection of the grinding instruments, please refer to the "Recommended grinding tools for IPS e.max zirconium

oxide". – Use rotary instruments and low pressure for grinding. The instructions of the manufacturer of the grinding instruments

must be observed. – Make sure that the minimum layer thicknesses are observed. – Finally, clean the IPS e.max ZirCAD framework under running water or with a steam jet cleaner and dry. – The IPS e.max ZirCAD framework must not be blasted with Al2O3 or glass polishing beads, as this would damage the

ceramic surface and compromise the bond.

Do not grind the outer aspect of the IPS e.max ZirCAD framework, in order to prevent an inaccurate fit between the IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure.

Completely prepared IPS e.max ZirCAD framework on the model.

Do not "post-separate" bridge frameworks with separating disks, as this would create

predetermined breaking points.

28

Completing the IPS e.max CAD Veneering Structure

IN S T R U C T I O N S

FO R

US E

CAD

LAB SID E

all ceramic all you need

Note: For detailed information on the processing of IPS e.max CAD please refer to the IPS e.max CAD Instructions for Use.

Finishing

Fitting

to the framework

Checking

Occlusion, articulation,

contact points

Finishing, adjusting, checking

It is of critical importance to use suitable instruments for finishing IPS e.max CAD. If unsuitable grinding instruments are used, chipping of the edges and local overheating may occur (please observe the Ivoclar Vivadent Flow Chart "Recommended grinding tools for PS e.max glass-ceramics").

Carry out adjustments by grinding of IPS e.max CAD veneering structures while they are still in their pre-crystallized (blue)

state, if possible. – Only use suitable grinding instruments, low speed and light pressure to prevent delamination and chipping at the

margins in particular. – Overheating of the glass-ceramic must be avoided.

Observe the following procedure for finishing IPS e.max CAD veneering structures: – Carefully separate the IPS e.max CAD veneering structure from the block using a diamond-coated separating disk. – Place the IPS e.max CAD veneering structure on the sintered IPS e.max ZirCAD framework and check the fit. The

IPS e.max CAD veneering structure must touch the entire circular collar of the bridge abutment or the crown framework. – If corrections are required to adjust the IPS e.max CAD veneering structure to the IPS e.max ZirCAD framework, always

carry out the corrections on the IPS e.max CAD veneering structure.

− The IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure must touch each other only at the cervical collar, in order to ensure a correct subsequent fusion with the IPS e.max CAD Crystall./Connect fusion glassceramic.

− In the case of bridges, IPS e.max CAD veneering structure and the IPS e.max ZirCAD framework must not touch each other in the basal pontic area. Adjust by grinding, if necessary.

Completing the IPS e.max CAD Veneering structure

– Finish the outer aspects of the IPS e.max CAD veneering structure with rubber polishers. The veneering structure can be

placed on the IPS e.max ZirCAD framework in order to prevent excessive reduction.

– Do not separate the interdental space with separating disks. The interdental space can be adjusted with fine,

tapered diamond burs or diamond-coated rubber wheels. "V-shaped" cuts have to be avoided. – Carefully smooth out the attachment point on the restoration. Pay attention to the proximal contact. – Place the restoration (IPS e.max ZirCAD framework with IPS e.max CAD veneering structure in place) on the model.

Check occlusal contact points and articulation in the articulator. Carry out individual corrections, if required. – Surface-grind the entire occlusal surface of the IPS e.max CAD veneering structure with a fine diamond to smooth out

the surface structure created by the CAD/CAM procedure. – Make sure that the minimum layer thicknesses are observed. – Design surface textures. – Clean the IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure with ultrasound in a water bath or

blast with the steam jet before further processing. – Make sure to thoroughly clean the restoration before further processing and to remove any residue of the milling

additive of the CAD/CAM milling unit. Residue of the milling additive remaining on the surface may result in bonding

problems and discolouration. – Do not blast restorations with Al

or glass polishing beads!

2O3

29

Carefully separate the IPS e.max CAD veneering structure from the block using a diamond-coated separating disk.

Place the IPS e.max CAD veneering structure on the IPS e.max ZirCAD framework

and check the fit.

If corrections of the fit are required, always carry out the corrections on the IPS e.max CAD veneering structure.

In the case of bridges, the IPS e.max CAD veneering structure and the IPS e.max ZirCAD framework must not touch each other in the basal pontic area.

The contact area between the IPS e.max CAD veneering structure and the IPS e.max ZirCAD

Finish the margins of the IPS e.max CAD veneering structure with suitable instruments.

The veneering structure can be placed on the IPS e.max ZirCAD framework for this procedure.

framework is limited to the collar.

Do no t separate the interdental space with separating disks.

The interdental space can be adjusted with tapered diamond burs or diamond-coated rubber

wheels. "V-shaped" cuts have to be avoided.

30

Completely fitted IPS e.max CAD-on restoration prior to the fusion process.Smooth out the attachment point with suitable grinding instruments.

Check the occlusion and articulation as well as the proximal contact points on the model.

Completing the IPS e.max CAD Veneering Structure

Surface-grind the occlusal surface, particularly functional areas of the restoration, with a fine diamond to smooth out the surface structure created by the CAD/CAM process. Pay attention to the contact points.

Design surface textures. Pay attention to the contact points.

Do not blast the IPS e.max ZirCAD framework with Al2O3 or glass polishing beads!Do not blast the IPS e.max CAD veneering structure with Al2O3 or glass polishing beads.

31

®

e.max

IPS

CAD-on

Glass-ceramic Fusion Process

The IPS e.max CAD Crystall./Connnect fusion glass-ceramic is used to fuse the IPS e.max CAD veneering structure to the IPS e.max ZirCAD framework. The Ivomix (vibrator unit) is used for the processing of the fusion glass-ceramic.

IPS e.max CAD Crystall. /Connect is already predosed and ready for use as Single Dose and must not be diluted. The addition of liquids results in a defective fusion of the restoration. The material's consistency is adjusted in such a way that optimum fusion is achieved.

Preparation

Preparation Fusion process

To prepare for the fusion process, please observe the following procedure: – Select the suitable IPS e.max CAD Crystall./Connect material on the basis of the desired tooth shade according to the

combination table (p. 50). – Press the Ivomix onto a smooth work surface and switch it on. Please refer to the respective Operating Instructions for

more details on the Ivomix. – To mix the material, lightly press the closed IPS e.max CAD Crystall./Connect capsule onto the vibrating plate of the

Ivomix for approx. 10 seconds and slightly agitate it. – Completely remove the sealing lid from the capsule. – Make sure that the material has been properly mixed and that it shows a homogeneous consistency. Use the IPS Spatula

for this purpose. If required, mix with the IPS Spatula while vibrating the capsule.

– Do not add any liquid.

Cleaning,

checking

Fusion/

Crystallization

firing

Firmly press the Ivomix onto a smooth work surface. If required, slightly moisten the suction cups beforehand.

Completely remove the sealing lid from the capsule.

Lightly press and agitate the close d capsule on the vibrating plate of the Ivomix

Make sure that the material has been properly mixed and that it shows a homogeneous

32

consistency. Use the IPS Spatula for this purpose.

for approx. 10 seconds.

Fusion/

Crystallization

firing

Fusion Process

Preparation Fusion process

Cleaning,

checking

The fusion process must be completed quickly in order to prevent a permature drying of the IPS e.max CAD Crystall. /Connect fusion glass-ceramic. The amount of IPS e.max CAD Crystall./Connect contained in one capsule is

sufficient for a 4-unit bridge. Please observe the following procedure for the fusion process: – Place the open capsule on the finger clip and put on the finger clip. – Place some IPS e.max CAD Crystall./Connect on the occlusal aspect of the IPS e.max ZirCAD framework in order to avoid

hollow spaces in the fusion area. Evenly distribute the IPS e.max CAD Crystall./Connect material by vibrating it for a

short time with the Ivomix. – Remove small amounts of IPS e.max CAD Crystall./Connect with the IPS Spatula and distribute it on all inner aspects of

the IPS e.max CAD veneering structure. – Hold occlusal surface of the IPS e.max CAD veneering structure against the vibrating plate of Ivomix for a short time so

that the IPS e.max CAD Crystall./Connect material is evenly distributed. – Insert the IPS e.max ZirCAD framework in the correct position into the IPS e.max CAD veneering structure. – Hold the occlusal surface of the restoration against the vibrating plate of the Ivomix. At the same time, apply slight

pressure against the IPS e.max ZirCAD framework, e.g. by means of the IPS Spatula, in order to evenly insert it into the

IPS e.max CAD veneering structure. – When joining the IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure, the IPS e.max

CAD Crystall. /Connect material must be evenly squeezed out of the entire circular fusion joint. If no fusion

glass- ceramic is being squeezed out in some places, an insufficient amount of material has been applied to

the IPS e.max CAD veneering structure, and the entire procedure must be repeated with a new capsule.

Separate and clean the IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure under run-

ning water before repeating the procedure.

– The IPS e.max CAD veneering structure is in the correct position when it sits flush on the collar of the IPS e.max ZirCAD

framework. – Important: Hold the restoration against the vibrating plate of the Ivomix only until the IPS e.max ZirCAD framework

and the IPS e.max CAD veneering structure are in the correct position to one another. A longer vibrating process may

result in too much IPS e.max CAD Crystall./Connect material escaping. – Switch off the Ivomix. – The IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure are in a firm position when the restoration

is no longer being vibrated.

Glass-ceramic Fusion Process

work and ...

Remove the IPS e.max CAD Crystall./Connect with the IPS Spatula from the capsule and distribute it on the inner aspect of the IPS e.max CAD veneering structure and ...

... evenly distribute the IPS e.max CAD Crystall./Connect material by means of the vibrator.Apply IPS e.max CAD Crystall./Connect on the occlusal aspect of the IPS e.max ZirCAD frame-

33

... evenly distribute the IPS e.max CAD Crystall./Connect material by means of the vibrator.

Insert the IPS e.max ZirCAD framework in the correct position into

the IPS e.max CAD veneering structure.

Hold the occlusal surface of the restoration against the vibrating plate of the Ivomix. At the same time, apply slight pressure against the IPS e.max ZirCAD framework in order to evenly insert it into the IPS e.max CAD veneering structure.

The IPS e.max CAD veneering structure is in the correct position when it sits evenly on the

Preparation Fusion process

ridge of the IPS e.max ZirCAD framework.

Cleaning,

checking

Fusion/

Crystallization

firing

Cleaning, Checking

After the fusion process, the restoration is cleaned and the fusion result is checked. To do so, observe the following procedure: – Before cleaning, allow the restoration to dry for a short time. – Carefully remove excess IPS e.max CAD Crystall./Connect material from the occlusal and proximal area as well as around

the restoration margins by means of the IPS Spatula. – Smooth out the IPS e.max CAD Crystall./Connect material at the fusion joint. – Carefully remove all residue of IPS e.max CAD Crystall./Connect material from the IPS e.max CAD veneering structure

(e.g. occlusal aspect) by means of the IPS Spatula or a dry short-haired brush. – Check the cavities of the IPS e.max ZirCAD framework, remove any residue of IPS e.max CAD Crystall./Connect material

with the IPS Spatula or a brush. – Checking in the articulator: Is the final occlusal position achieved? If not, the IPS e.max ZirCAD framework and the

IPS e.max CAD veneering structure have not been correctly joined. In this case, the fusion process has to be repeated.

Separate and clean the IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure under running water

before repeating the procedure.

– Do not re-use the Ivomix on the joined restoration.

34

Remove excess IPS e.max CAD Crystall./Connect material with the IPS Spatula.

Glass-ceramic Fusion Process

Remove residue of IPS e.max CAD Crystall./Connect material from the restoration with a dry short-haired brush.

Basal view: Joined, cleaned restoration. Note: Smooth out IPS e.max CAD Crystall./Connect material at the fusion joint.

Note: Smooth out IPS e.max CAD Crystall./Connect material at the fusion joint.

Another vibrating process is contraindicated,

as this would result in defects in the fusion area.

Joined, cleaned restoration.

Check in the articulator with foil at the adjacent teeth or the support pin. If the final occlusal position is achieved,

the IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure have been correctly joined.

35

Preparation Fusion process

Fusion/Crystallization Firing

Cleaning, checking

The glass-ceramic fusion of the IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure is first conducted without the application of IPS e.max CAD Crystall./Glaze, Shades or Stains. The characterizations (Shades, Stains) and the Glaze are applied to the tooth-coloured restoration and fired in a separate Characterization/Glaze firing.

Please observe the following procedure for the Fusion/Crystallization firing: – Keep the joined and cleaned restoration away from liquids and do not steam. – Only the IPS e.max CAD Crystallization Tray and the corresponding IPS e.max CAD Crystallization Pins must be used for

the Fusion/Crystallization firing. – Place the IPS e.max CAD-on restoration in the centre of the IPS e.max CAD Crystallization Tray. – For this purpose, place the IPS e.max CAD Crystallization Pins as close as possible to the centre of the IPS e.max CAD

Crystallization Tray. – The IPS e.max CAD-on restoration may be placed on the IPS e.max CAD Crystallization Pins by means of IPS Object Fix

Putty of Flow material. Apply a small amount of IPS Object Fix Putty or Flow into the cavity of the restoration and place it

on the pins. – A maximum of 6 units (e.g. 6 single crowns or two 3-unit bridges) may be placed on the IPS e.max CAD Crystallization

Tray. – Carry out the Fusion/Crystallization firing with the indicated parameters (p. 37). Observe the furnace type! – At the beginning of the firing procedure, open the furnace and wait for the acoustic signal. Subsequently, place the

firing tray with the objects in the centre of the firing table and start the program. – Remove restoration on the IPS e.max CAD Crystallization Tray from the furnace after completion of the firing cycle (wait

for the acoustic signal of the furnace). – Allow the restoration to cool to room temperature in a place protected from draft. – Do not touch the hot restoration with metal tongs.

Fusion/

Crystallization

firing

Note on the Fusion/Crystallization firing

A special firing program with pre-drying function has been developed for the Fusion/Crystallization firing in the IPS e.max CAD-on technique. The firing parameters have been precisely adjusted to the IPS e.max CAD Crystall./ Connect fusion glass-ceramic. This ensures optimum firing results.

The following ceramic furnaces can be used for this firing. – Programat P300 –> In order to offer all the required program functions the software version V5.1 or higher must be

installed on the ceramic furnace. – Programat P500, P700 and EP5000 –> The required firing parameters can be entered manually.

Apply some IPS Object Fix Putty or Flow material to the cavity of the restoration to place the restoration on the IPS e.max CAD Crystallization Pins.

Place the restoration on the positioned IPS e.max CAD Crystallization Pins

36

on the IPS e.max CAD Crystallization Tray.

Do not place the restoration at the periphery of the IPS e.max CAD Crystallization Tray.Place the restoration including the pins into the centre of the IPS e.max CAD Crystallization Tray.

Note:

– Select the firing parameters on the basis of the furnace. – A maximum of 6 units (e.g. 6 single crowns or two 3-unit bridges) may be fired simultaneously.

Programat P300 Firing parameters: IPS e.max CAD-on technique Fusion/Crystallization firing

Furnace

P300

Pre-

drying

(software 5.1

or higher)

B

[°C/°F]

403/757

S

[min]

02:00

t

1

[°C/°F/min]

30/54

T

1

[°C/°F]

820/1508

H

1

[min]

02:00

t

2

[°C/°F/min]

30/54

T

2

[°C/°F]

840/1544

H

2

[min]

07:00

V1

/V12

1

[°C/°F]

550/820

1022/1508

V2

/V22

1

[°C/°F]

820/840

1508/1544

L

[°C/°F]

600/1112

t

l

[°C/°F/min]

0

Glass-ceramic Fusion Process

Programat P500, P700, EP 5000 Firing parameters: IPS e.max CAD-on technique Fusion/Crystallization firing

Furnace

[°C/°F]

P500 P700 EP 5000

403/757

Use the pre-drying function for this firing cycle. For pre-drying, set the furnace head position to 100%.

[min]

6:00

B

[°C/°F]

403/757

S

[min]

02:00

t

1

[°C/°F/min]

30/54

T

1

[°C/°F]

820/1508

°F

[min]

02:00

t

2

[°C/°F/min]

30/54

T

2

[°C/°F]

840/1544

H

2

[min]

07:00

V1

/V12

1

[°C/°F]

550/820

1022/1508

V2

/V22

1

[°C/°F]

820/840

1508/1544

600/1112

Notes on cooling after completion of the firing program

In order to ensure "smooth" cooling of the restoration after firing, please observe the following notes: – Wait for the acoustic signal or optical indication of the furnace at the end of the firing cycle before the firing tray with

the fired objects is removed. – Do not touch the hot objects with metal tongs. – Allow the objects to cool to room temperature in a place protected from draft.

L

[°C/°F]

t

l

[°C/°F/min]

0

37

Once the IPS e.max CAD-on restoration has cooled to room temperature, proceed with the following steps: – Remove the restoration from the IPS e.max CAD Crystallization Tray. – Remove adhering IPS Object Fix Putty or Flow residue with ultrasound in a water bath

and/or with steam. – Do not blast IPS Object Fix Putty or Flow residue with Al2O3 or glass polishing beads. – Check the fit on the model and in the articulator. For bridges, pay particular attention to the fit of the bridge pontic on

the "gingiva". – If adjustments by grinding are required, use suitable grinding instruments. Observe the recommendations regarding the

selection of suitable grinding tools. – Smooth out possible IPS e.max CAD Crystall./Connect excess with a fine diamond. – Check the fusion area for defects. If corrections are necessary, please observe the notes on page 42.

Do not remove IPS Object Fix Putty or Flow residues with Al2O3 or glass polishing beads.

attention to the fit of the bridge pontic on the "gingiva".

Remove adhering IPS Object Fix Putty or Flow residues with ultrasound in a water bath

Smooth out possible IPS e.max CAD Crystall./Connect excess with a fine diamond.Check the fit of the restoration on the model and in the articulator. For bridges, pay particular

and/or with steam.

38

®

IPS

e.max

CAD-on

Glaze, Characterization

Characterization/Glaze firing

After the Fusion/Crystallization firing, the Characterization/Glaze firing is carried out as a second step. The characterizations are applied to the tooth-coloured restoration with IPS e.max CAD Crystall./Shades and Stains. This enables a very precise shade reproduction.

IPS e.max CAD Crystall./Shades are ready-to-use "Dentin" and "Enamel" stains in syringes. IPS e.max CAD Crystall./Stains are ready-to-use intensive stains in syringes. IPS e.max CAD Crystall./Glaze Paste is a ready-to-use glazing paste in syringes.

Glaze, Characterization

For the application of the glaze and characterizations, observe the following procedure: – Before starting the characterization and glazing procedure, make sure that the outside of the restoration is free from

contamination. – Hold the restoration in place with diamond-coated tweezers. – Extrude the glaze material from the syringe and mix thoroughly. – If a slight thinning is desired, the ready-to-use glaze may be mixed with a small amount of IPS e.max CAD Crystall./Glaze

Liquid. However, the consistency should still remain pasty. – Apply the glazing material on the entire outer aspect of the restoration. Avoid to apply too thick a glaze layer. Avoid

"pooling", especially on the occlusal surface. – Too thin a glaze layer may lead to an unsatisfactory gloss. – In the case of bridges, apply the glaze also to the IPS e.max ZirCAD framework at the basal side of the bridge pontic. – If characterizations are desired, they can be applied with IPS e.max CAD Crystall./Shades and/or IPS e.max CAD Crystall./

Stains. – Extrude Shades and Stains from the syringe and mix thoroughly. – The Shades and Stains may be slightly thinned using IPS e.max CAD Crystall./Glaze Liquid. However, the consistency

should still remain pasty. – Apply mixed Shades and Stains directly into the unfired glaze layer using a fine brush. The margin of the IPS e.max

ZirCAD framework may also be characterized. – Only the IPS e.max CAD Crystallization Tray and the corresponding IPS e.max CAD Crystallization Pins must be used for

the Characterization/Glaze firing. – Place the IPS e.max CAD-on restoration in the centre of the IPS e.max CAD Crystallization Tray. – For this purpose, place the IPS e.max CAD Crystallization Pins as close as possible to the centre of the IPS e.max CAD

Crystallization Tray. – The IPS e.max CAD-on restoration may be placed on the IPS e.max CAD Crystallization Pins by means of IPS Object Fix

Putty of Flow material. Apply a small amount of IPS Object Fix Putty or Flow into the cavity of the restoration and place it

on the pins. – Carry out the Characterization/Glaze firing with the indicated parameters (see p. 41). – Remove restoration on the IPS e.max CAD Crystallization Tray from the furnace after completion of the firing cycle (wait

for the acoustic signal of the furnace). – Do not touch the hot restoration with metal tongs. – Allow the restoration to cool to room temperature in a place protected from draft. – If required, an additional Characteraization/Glaze firing can be conducted. In total, a maximum of 3 Characterization/

Glaze firings may be conducted.

Note:

Do not use IPS e.max Ceram layering materials and Shades, Essences or Glaze materials in conjunction with the IPS e.max CAD-on technique.

39

Hold the restoration in place ... ... and apply IPS e.max CAD Crystall./Glaze Paste evenly on the entire outer surface and the

basal side of the bridge pontic.

Characterizations with IPS e.max CAD Crystall./Shades and Stains can be applied to the unfired glaze.

Apply some IPS Object Fix Putty or Flow material to the cavity of the restoration to place the restoration on the IPS e.max CAD Crystallization Pins.

In the case of bridges, the basal rest area can be characterized with IPS e.max CAD Crystall./

Place the restoration on the positioned IPS e.max CAD Crystallization Pins

Shades and/or Stains, if required.

on the IPS e.max CAD Crystallization Tray.

Place the restoration including the pins in the centre of the IPS e.max CAD Crystallization Tray. Do not place the restoration at the periphery of the IPS e.max CAD Crystallization Tray.

40

Firing parameters: IPS e.max CAD-on technique Characterization/Glaze firing

Furnace

P300 P500 P700 EP 5000

B

[°C/°F]

403/757

S

[min]

6:00

t

1

[°C/°F/min]

60/108

T

1

[°C/°F]

820/1508

H

1

[min]

00:10

t

2

[°C/°F/min]

30/54

T

2

[°C/°F]

840/1544

H

2

[min]

03:00

V1

/V1

1

2

[°C/°F]

550/820

1022/1508

V2

/V2

1

[°C/°F]

820/840

1508/1544

2

600/1112

L

[°C/°F]

Once the IPS e.max CAD-on restoration has cooled to room temperature, proceed with the following steps: – Remove the restoration from the IPS e.max CAD Crystallization Tray. – Remove adhering IPS Object Fix Putty or Flow residue with ultrasound in a water bath and/or with steam. – Do not blast IPS Object Fix Putty or Flow residue with Al

or glass polishing beads.

2O3

– Check the fit on the model and in the articulator. For bridges, pay particular attention to the fit of the bridge pontic on

the "gingiva". – If adjustments by grinding are required, use suitable grinding instruments. Observe the recommendations regarding the

selection of suitable grinding tools.

t

l

[°C/°F/min]

0

Glaze, Characterization

Do not remove IPS Object Fix Putty or Flow residues with Al2O3 or glass polishing beads. Check the shade with the Shade Guide.

Completed IPS e.max CAD-on restoration on the model.

41

Optional – Adjustments with IPS e.max CAD Crystall./Add-On

If adjustments of the shade or shape or corrections at the fusion joint of IPS e.max CAD-on restorations are necessary, three IPS e.max Crystall./Add-On materials are available.

Mix IPS e.max CAD

... Connect

... Incisal

... Dentin

Crystall./Add-On ....

... for adjustments

... in the fusion area

... in the incisal area

... in the dentin area or the

basal area of the pontic

... with IPS e.max CAD Crystall./...

... Add-On Liquid

longlife

... Add-On Liquid

allround

... Add-On Liquid

allround

Application on the

fused, crystallized

restoration

Correction at the fusion joint with vibration with Ivomix

Correction of proximal contact

Circular or basal correction

Procedure for the application of the IPS e.max CAD Crystall./Add-On materials on the fused, crystallized IPS e.max CAD restoration

– Mix IPS e.max CAD Crystall/Add- On Connect with IPS e.max CAD Crystall/Add-On Liquid longlife to obtain a

creamy consistency which tur ns flowable when vibrated.

– Apply the IPS e.max CAD Crystall./Add-On Connect material to the area of the fusion joint of the crystallized restora-

tion to be corrected while using the vibrator (Ivomix).

– To mix the IPS e.max CAD Crystall./Add-On Incisal and Dentin, the IPS e.max CAD Crystall./Add-On Liquid all-

round is used. A material which offers a stable consistency and which can be layered is thus obtained. Apply the mixed Add-On materials to the area to be corrected.

– If required, additionally apply IPS e.max CAD Crystall./Glaze, Shades and Stains to the crystallized restoration.

Characterizations can also be applied on the IPS e.max CAD Crystall./Add-On Connect material.

– Conduct the corrective firing on the IPS e.max CAD Crystallization Tray.

For the IPS e.max CAD-on Corrective firing, the firing parameters of the "IPS e.max CAD-on technique Characterization/Glaze firing" (p. 41 and 51) must be used.

42

®

IPS

e.max

CAD-on

Seating and Follow-Up Care

Possibilities for Cementation

Possibilities for esthetic cementation are decisive for the harmonious shade effect of an all-ceramic restoration. Depending of the indication, IPS e.max CAD-on restorations can be seated using either adhesive, self-adhesive or conventional cementation.

– For the adhesive cementation of IPS e.max CAD-on restorations, Multilink® Automix is ideally suitable. – SpeedCEM is available for the self-adhesive cementation of IPS e.max CAD-on restorations. – The glass ionomer cement Vivaglass® CEM is recommended for the conventional cementation of IPS e.max CAD-on

restorations.

Definition

• Adhesive cementation

With adhesive cementation, the bond is also created by static friction, but primarily by the chemical and/or micro-

mechanical bond between the luting material and the restoration, as well as between the luting material and the

preparation. Given the chemical and/or micromechanical bond, retentive preparation is not required. Irrespective of the

cementation material, special adhesive systems are used on the preparation to generate the micromechanical bond with

the dentin and/or enamel. Adhesive cementation results in enhanced fracture strength of the seated all-ceramic restoration.

• Self-adhesive cementation

The cementation material features self-conditioning properties to the tooth, which is why no additional special pre-

treatment of the tooth surface is necessary. Hence, the adhesion of the restoration is partially achieved by a micro-

mechanical and/or chemical bond. In order to achieve sufficient bonding strength values, retentive preparation is

recommended. Self-adhesive cementation does not result in a significant improvement of the fracture strength of the

all-ceramic restoration.

• Conventional cementation

With conventional cementation, the bond is almost entirely created by static friction between the luting material and the

restoration, as well as between the luting material and the preparation. To achieve the necessary static friction, retentive

preparation with a preparation angle of up to 6° is required. Conventional cementation does not result in an improvement

of the fracture strength of the all-ceramic restoration.

*

Seating and Follow-Up Care

Cementation possibilities for the different indications

cementation

Crowns

IPS e.max CAD-on

Bridges

Adhesive

Self-adhesive

cementation

Conventional

cementation

*The range of available products may vary from country to country.

43

Preparing for Cementation

Conditioning of the restoration and preparation depends on the cementation method used, as well as the cementation material. The following paragraphs describe the basic working steps to prepare for cementation. Please refer to the Instructions for Use of the corresponding cementation material regarding the detailed processing procedure.

Conditioning of the restoration

Conditioning of the ceramic surface in preparation for cementation is decisive for generating a sound bond between the cementation material and the all-ceramic restoration.

Observe the following procedure for IPS e.max CAD-on restorations: – The inner aspects of IPS e.max CAD-on restorations may be cleaned with Al2O3 at a maximum pressure of 1 bar (15 psi)

before cementation. – Thoroughly clean the IPS e.max CAD-on restoration with water and blow dry. – For adhesive cementation, condition the bonding surface using Monobond® Plus. Apply Monobond Plus to the inner

aspect, let it react for 60 seconds and subsequently blow dry. – High-strength zirconium oxide ceramics (inner aspect of the IPS e.max CAD-on restoration) are generally not etched

with a hydrofluoric acid gel (IPS Ceramic Etching Gel), as no etching patter n is created.

The inner aspects may be cleaned with Al2O3 at a maximum pressure of 1 bar (15 psi).

For adhesive cementation, condition the bonding

surface using Monobond Plus.

Material

Indication

Cementation method

Blasting

Cleaning with Al

adhesive

Etching

Conditioning *

Cementation system

* The conditioning procedure is not necessary for self-adhesive or conventional cementation

IPS e.max CAD-on

Lithium disilicate on zirconium oxide

Crowns and bridges

adhesive

at a maximum pressure of 1 bar (15psi).

2O3

—

60 seconds

with Monobond

Multilink

®

Automix

Plus

self-adhesive/

conventional

SpeedCEM

Vivaglass

—

®

CEM

Please observe the corresponding Instructions for Use.

44

Conditioning of the preparation

Thoroughly clean the preparation once the temporary has been removed. Before it is conditioned, the restoration is tried-in and the occlusion and articulation checked. If adjustments of the restoration are required, the restoration must be polished extraorally in these areas before final seating. Conditioning of the restoration and preparation depends on the cementation method used and is carried out according to the respective Instructions for Use.

Care Notes

Same as natural teeth, high-quality IPS e.max CAD-on restorations require regular professional care. This is beneficial for both the health of the gingiva and teeth, as well as the overall appearance. The pumice-free Proxyt pink polishing paste is used to care for the surfaces without causing any wear. The low RDA* value = 7 (*Relative Dentin Abrasion) is a reliable confirmation that a low-abrasion cleaning paste is used. Scientific investigations and long-term clinical experience have proved the gentle effect compared to other pastes.

Seating and Follow-Up Care

Using Proxyt

45

®

IPS

e.max

CAD-on

General information

Frequently Asked Questions

What are the preparation requirements for IPS e.max CAD-on restorations?

The mandatory Ivoclar Vivadent preparation guidelines for all-ceramic restorations apply also to the IPS e.max CAD-on technique. Sharp edges on the preparation are to be avoided in order to ensure exact milling in the CAD /CAM system. In addition, the width of the circular margin on the framework can be reduced by designing a pronounced chamfer.

Can the IPS e.max CAD-on technique also be used to fabricate anterior restorations?

Which are the software and hardware requirements for the IPS e.max CAD-on Technique?

The Sirona inLab and a Sirona inLab MC XL milling unit are necessary to fabricate IPS e.max CAD-on restorations. The restoration is designed using the "Multilayer" mode.

Is it possible to modify the suggested design of the CAD-on framework with the design tools?

®

3D software V3.81 or higher

The fabrication of anterior restorations is supported by the software. However, the esthetic properties may be compromised depending on the clinical situation.

Which materials determine the esthetics of IPS e.max CAD-on restorations?

The desired restoration shade is the result of the combination of the IPS e.max ZirCAD framework, the IPS e.max CAD veneering structure and the shade of the fusion glass-ceramic. If, for instance, another framework shade is selected, the final shade may differ.

Is it possible to use an IPS e.max CAD LT block instead of an HT block for the fabrication of IPS e.max CAD-on crowns?

Generally, an IPS e.max CAD LT block could be

used. However, the esthetic properties of the resulting restoration might be compromised.

How is it possible to fabricate an IPS e.max ZirCAD framework in the shades MO 3 or MO 4?

This can be achieved by shading IPS e.max ZirCAD MO 0 blocks with IPS e.max ZirCAD Colouring LIquids*.

It is possible to modify the occlusal area (e.g. protruding connectors). However, the circular surfaces must not be edited, as this would compromise the fit of the IPS e.max CAD veneering structure.

Is it possible to manually grind the IPS e.max ZirCAD frameworks with rotary instruments?

Grinding of the presintered IPS e.max ZirCAD framework is restricted to smoothing out the attachment point to the block. The sintered framework is only fitted to the model, if required. Any further processing is contraindicated, as it might negatively influence the fit to the IPS e.max CAD veneering structure.

How do IPS e.max ZirCAD frameworks need to be prepared for sintering?

IPS e.max ZirCAD frameworks must be cleaned and dried. IPS e.max ZirCAD frameworks must not be cleaned with ultrasound in a water bath or with a steam jet or blasted.

*The range of available products may vary from country to country.

46

Can moist IPS e.max ZirCAD frameworks be sintered?

IPS e.max ZirCAD frameworks must be dry prior to the sintering procedure. Moist IPS e.max ZirCAD frameworks must not be sintered. The drying time depends on the framework size and temperature (70–140 °C / 158–284 °F). If moist IPS e.max ZirCAD frameworks were sintered, the risk of cracking would be considerably increased.

What is particular when sintering IPS e.max ZirCAD frameworks in the Programat S1?

The IPS e.max ZirCAD frameworks must be placed in circles on the sinter tray. In the case of bridges, a sufficient support of the bridge pontic must be ensured in order to prevent distortion.

Is it possible to manually grind the IPS e.max CAD veneering structures with rotary instruments?

Modifications of the IPS e.max CAD veneering structure should be carried out on the "blue", partially crystallized IPS e.max CAD veneering structure whenever possible. Make sure to use suitable grinding tools. If adjustments are necessary to achieve an optimum fit between the IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure, the adjustments should be made on the IPS e.max CAD veneering structure.

Does the IPS e.max CAD veneering structure require occlusal adjustment after the CAD/ CAM process?

Can furnaces from other manufacturers also be used to sinter IPS e.max ZirCAD restorations?

The Programat® S1 and Sintramat sintering furnaces have been tested with and adjusted to the IPS e.max ZirCAD material. Other hightemperature furnaces are thus suitable for sintering only to a limited extent.

Is a Regeneration firing for the IPS e.max ZirCAD framework necessary prior to the fusion process?

No. Any processing of the IPS e.max ZirCAD framework is not admissible, in order not to compromise the fit between the IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure. A Regeneration firing is therefoer not required.

Yes. Surface-grind the outer surface, particularly functional areas with antagonist contact, with a fine diamond to smooth out the surface structure created by the CAD/ CAM process.

Is it permissible to blast the IPS e.max ZirCAD framework or the IPS e.max CAD veneering structure prior to the fusion process?

No. The IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure must only be cleaned under running water or with a steam jet prior to the fusion process. Blasting is not permissible, as this would result in damages to the ceramic surface.

Is it necessary to apply IPS e.max Ceram ZirLiner to the IPS e.max ZirCAD framework in the IPS e.max CAD-on technique?

No. In the IPS e.max CAD-on technique, the homogeneous bond and the shade are achieved by means of the fusion glass-ceramic IPS e.max CAD Crystall./Connect.

47

Is it possible to dilute the IPS e.max CAD Crystall./Connect fusion glass-ceramic with a liquid?

Is it possible to characterize the fused, "blue" IPS e.max CAD-on restoration prior to the Fusion/Crystallization firing?

No. The fusion glass-ceramic, which is predosed and ready for use in the Single Dose, must not be diluted. The addition of liquid results in a defective fusion. The consistency of the fusion glass ceramic is adjusted in such a way that optimum flow properties with vibration (Ivomix) and a high stability without vibration are achieved.

Is it possible to mix and use (non-used) leftover IPS e.max CAD Crystall./Connect fusion glass-ceramic again?

No. The very specific powder/liquid ratio in the predosed mixture ensures an optimum fusion. If leftover materials are mixed, the mixture is changed and no longer meets the specifications.

Is it possible to use other vibrators than Ivomix?

The vibration (freqency, amplitude) of Ivomix has been optimally adjusted to the flow propeties of the fusion glass-ceramic IPS e.max CAD Crystall./Connect. Other vibrators are not suitable.

If required, only the occlusal third can be characterized with IPS e.max CAD Crystall./Shades and Stains. Important: Do not apply IPS e.max

CAD Crystall. /Shades, Stains or Glaze on or near the fusion gap.

Is it possible to apply IPS e.max Ceram layering materials or Shades, Essences and Glaze to IPS e.max CAD-on restorations?

No. In the IPS e.max CAD-on technique, only IPS e.max CAD Crystall./ Shades, Stains, Glaze and Add-On may be used.

Is it necessary to use the auxiliary firing paste IPS Object FIx Putty or Flow for the Fusion/ Crystallization firing?

IPS Object Fix Putty or Flow is not required for IPS e.max CAD-on restorations, as the IPS e.max ZirCAD framework provides sufficient support for the IPS e.max CAD veneering structure. A small amount of IPS Object Fix Putty or Flow material can be used to facilitate the placement of the restoration on the IPS e.max CAD Crystallization Pins.

How is the IPS e.max CAD-on restoration cleaned after the fusion process?

The IPS e.max C AD Crystall./Connect fusion glassceramic is allowed to dry for a short time. Subsequently, remove excess with the IPS Spatula and fine residue with a short-haired brush. Make sure that no IPS e.max CAD Crystall./Connect material is removed from the fusion gap.

How can the correct position of the IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure be checked after fusing and prior to firing?

The fused IPS e.max CAD-on restoration can carefully be checked on the model in the articulator. If the fusion is not correct, the restoration must not be vibrated again. In such a case, the fusion process has to be repeated with fresh material.

Which furnaces can be used for the Fusion/ Crystallization firing of IPS e.max CAD-on restorations?

Only recommended furnaces which are equipped with a pre-drying mode can be used for the Fustion/Crystallization firing. Please refer to the notes on ceramic furnaces (see p. 36).

Why is the predrying function so important for the Fusion/Crystallization firing in the IPS e.max CAD-on technique?

The controlled predrying of the IPS e.max CAD-on restoration allows the liquid contained in the fusion glass-ceramic to escape through the very thin gap between the IPS e.max ZirCAD framework and the IPS e.max CAD veneering structure. This controlled drying is a prerequisite for a homogeneous bond. If no controlled predrying is employed, there is the risk that the IPS e.max CAD veneering structure is lifted off the IPS e.max ZirCAD framework, which renders the restoration useless.

48

Can firing trays other than the IPS e.max CAD Crystallization Tray be used for the firing of IPS e.max CAD-on restorations?

Which materials should be used if additional shade adjustments are necessary after Characterization/Glaze firing?

No other firing trays should be used. The IPS e.max CAD Crystallization Tray contained in the assortment stores the heat necessary for slow and above all tension-free cooling of the restoration. Other firing trays, e.g. honey-combed trays, are therefore not suitable.

What must be considered after the firing of IPS e.max CAD-on restorations?

In order to prevent tension within the ceramic, remove the restoration from the furnace only after the firing cycles have been completed (wait for the acoustic signal of the ceramic furnace). Allow the objects to cool to room temperature in a place protected from draft and do not touch them with metal tongs during that time. Do not blast or quench the objects.

Which stains and glaze are used to characterize/glaze IPS e.max CAD-on restorations?

Only the IPS e.max CAD Crystall./Shades, Stains and Glaze materials may be used. A maximum of 3 Characterization/Glaze firings may be conducted.

How can IPS e.CAD-on restorations be cemented?

IPS e.max CAD-on restorations can be cemented adhesively or conventionally. For conventional cementation however, a retentive preparation design must be observed. If this is not possible, adhesive luting should be preferred, e.g. with Multilink Automix. Vivaglass CEM is available for conventional cementation. SpeedCEM is recommended for self-adhesive cementaion. We advise against the use of conventional phosphate cements, since they negatively influence the light transmission through the allceramic.

Only the IPS e.max CAD Crystall./ Shades, Stains and Glaze materials may be used.

Is it possible to modify the shade of the circular collar of the IPS e.max ZirCAD and the basal rest of bridges?

The IPS e.max ZirCAD collar can also be individualized using IPS e.max CAD Crystall./Shades and Stains after the Fusion/Crystallization firing. In the case of bridges, the basal rest of the bridge pontic can also be characterized and glazed.

The range of available products may vary from country to country.

49

Combination Tables

1

D4

1

D2 D3

+

CL 4

MO 0

1

C4

1

Desired tooth shade

1

MO

0

+

MO

CL 1

C1 C2 C3

1

B4

+

CL 3

MO 0

+

CL 1

MO 0

1

B1 B2 B3

0

+

MO

CL 4

+

CL 2

MO 0

+

CL 1

MO 0

1

white, creme, sunset, copper, olive, khaki, mahogany

A1 A2 A3 A3.5 A4

1

BL4

1

SH I1 SH I2 SH I1 SH I2

BL3

SH 0 SH 1 SH 2 SH 3 SH 4

MO 0 MO 1 MO 2 – MO 1 –

MO 0

BL1 BL2 BL3 BL4 A1 A2 A3 A3.5 A4 B1 B2 B3 B4 C1 C2 C3 C4 D2 D3 D4

IPS e.max CAD-on technique

IPS e.max ZirCAD

shaded

IPS e.max ZirCAD

non-shaded + IPS e.max ZirCAD

optional

*

Colouring Liquid

BL2

1

1 2 3 4 5 6 9 3 4 7 8 9 8 9

BL1

IPS e.max CAD

Crystall./Connect

50

IPS e.max CAD HT

IPS e.max CAD

Crystall./Shade

IPS e.max CAD

Crystall./Shade

Incisal

IPS e.max CAD

Crystall./Stains

IPS e.max CAD HT B40 blocks are available in 10 shades. To create the desired tooth shade, select the closest block shade in the respective shade group and determine the final tooth shade by means of Stains.

*The range of available products may vary from country to country.

1

Firing Parameters

Compatible ceramic furnaces for the IPS e.max CAD-on technique

A special firing program with pre-drying function has been developed for the Fusion/Crystallization firing in the IPS e.max CAD-on technique. The firing parameters – particularly the pre-drying time and the pre-drying temperature – have been precisely adjusted to the IPS e.max CAD Crystall./Connect fusion glass-ceramic. This ensures optimum firing results. Due to the required functions of the ceramic furnace, only the following ceramic furnaces may be used:

Programat P300

Note: In order to offer all the required program functions (pre-drying function), the software version

V5.1 or higher must be installed on the ceramic furnace.

Programat P500, P700 and EP 5000

The firing parameters can be manually programmed on a free programmable slot or loaded

to the furnace by means of a software update (available in spring 2011).

Programat P300 Firing parameters: IPS e.max CAD-on technique Fusion/Crystallization firing

Pre-

drying

(software 5.1

or higher)

403/757

B

[°C/°F]

S

[min]

02:00

t

1

[°C/°F/min]

30/54

T

1

[°C/°F]

820/1508

H

1

[min]

02:00

t

2

[°C/°F/min]

30/54

T

2

[°C/°F]

840/1544

H

2

[min]

07:00

V1

/V12

1

[°C/°F]

550/820

1022/1508

Furnace

P300

Programat P500, P700, EP 5000 Firing parameters: IPS e.max CAD-on technique Fusion/Crystallization firing

Furnace

[°C/°F]

P500 P700 EP 5000

403/757

Use the pre-drying function for this firing cycle. For pre-drying, set the furnace head position to 100%.

[min]

6:00

B

[°C/°F]

403/757

S

[min]

02:00

t

1

[°C/°F/min]

30/54

T

1

[°C/°F]

820/1508

H

1

[min]

02:00

t

2

[°C/°F/min]

30/54

T

2

[°C/°F]

840/1544

H

2

[min]

07:00

V1

/V12

1

[°C/°F]

550/820

1022/1508

Firing parameters: IPS e.max CAD-on technique Characterization/Glaze firing

Furnace

P300 P500 P700 EP 5000

B

[°C/°F]

403/757

S

[min]

6:00

t

1

[°C/°F/min]

60/108

T

1

[°C/°F]

820/1508

H

1

[min]

00:10

t

2

[°C/°F/min]

30/54

T

2

[°C/°F]

840/1544

H

2

[min]

03:00

V1

/V1

1

2

[°C/°F]

550/820

1022/1508

1508/1544

V2

/V22

1

[°C/°F]

820/840

1508/1544

V2

[°C/°F]

820/840

1508/1544

V2

/V2

1

[°C/°F]

820/840

/V22

1

2

L

[°C/°F]

600/1112

L

[°C/°F]

600/1112

L

[°C/°F]

600/1112

t

l

[°C/°F/min]

0

t

l

[°C/°F/min]

0

t

l

[°C/°F/min]

0

B = Stand-by temperature S = Closing time t1 = Heating rate 1 T1 = Firing temperature 1

H1 = Holding time t2 = Heating rate 2 T2 = Firing temperature 2 H2 = Holding time 2

V1/V2 = Vacuum 1/2 L = Long-term cooling tl = Cooling rate

5151

Ivoclar Vivadent – worldwide

Ivoclar Vivadent AG

Bendererstrasse 2 FL-9494 Schaan Liechtenstein Tel. +423 235 35 35 Fax +423 235 33 60 www.ivoclarvivadent.com

Ivoclar Vivadent Pty. Ltd.

1 – 5 Overseas Drive P.O. Box 367 Noble Park, Vic. 3174 Australia Tel. +61 3 979 595 99 Fax +61 3 979 596 45 www.ivoclarvivadent.com.au

Ivoclar Vivadent GmbH

Bremschlstr. 16 Postfach 223 6706 Bürs Austria Tel. +43 5552 624 49 Fax +43 5552 675 15 www.ivoclarvivadent.com

Ivoclar Vivadent Ltda.

Rua Geraldo Flausino Gomes, 78 – 6.º andar Cjs. 61/62 Bairro: Brooklin Novo CEP: 04575-060 São Paulo – SP Brazil Tel. +55 11 3466 0800 Fax +55 11 3466 0840 www.ivoclarvivadent.com.br

Ivoclar Vivadent Inc.

2785 Skymark Avenue, Unit 1 Mississauga Ontario L4W 4Y3 Canada Tel. +1 905 238 5700 Fax +1 905 238 5711 www.ivoclarvivadent.com

Ivoclar Vivadent Marketing Ltd.

Rm 603 Kuen Yang International Business Plaza No. 798 Zhao Jia Bang Road Shanghai 200030 China Tel. +86 21 5456 0776 Fax +86 21 6445 1561 www.ivoclarvivadent.com

Ivoclar Vivadent Marketing Ltd.

Calle 134 No. 7-B-83, Of. 520 Bogotá Colombia Tel. +57 1 627 33 99 Fax +57 1 633 16 63 www.ivoclarvivadent.com

Ivoclar Vivadent SAS

B.P. 118 F-74410 Saint-Jorioz France Tel. +33 450 88 64 00 Fax +33 450 68 91 52 www.ivoclarvivadent.fr

Ivoclar Vivadent GmbH

Dr. Adolf-Schneider-Str. 2 73479 Ellwangen, Jagst Germany Tel. +49 (0) 79 61 / 8 89-0 Fax +49 (0) 79 61 / 63 26 www.ivoclarvivadent.de

Ivoclar Vivadent Marketing Ltd. (Liaison Office)

503/504 Raheja Plaza 15 B Shah Industrial Estate Veera Desai Road, Andheri( West) Mumbai, 400 053 India Tel. +91 (22) 2673 0302 Fax +91 (22) 2673 0301 www.ivoclarvivadent.com

Ivoclar Vivadent s.r.l. & C. s.a.s

Via Gustav Flora, 32 39025 Naturno (BZ) Italy Tel. +39 0473 67 01 11 Fax +39 0473 66 77 80 www.ivoclarvivadent.it

Ivoclar Vivadent K.K.

1-28-24-4F Hongo Bunkyo-ku Tokyo 113-0033 Japan Tel. +81 3 6903 3535 Fax +81 3 5844 3657 www.ivoclarvivadent.jp

Ivoclar Vivadent S.A. de C.V.

Av. Mazatlán No. 61, Piso 2 Col. Condesa 06170 México, D.F. Mexico Tel. +52 (55) 5062-1000 Fax +52 (55) 5062-1029 www.ivoclarvivadent.com.mx

Ivoclar Vivadent Ltd.

12 Omega St, Albany PO Box 5243 Wellesley St Auckland, New Zealand Tel. +64 9 914 9999 Fax +64 9 814 9990 www.ivoclarvivadent.co.nz

Ivoclar Vivadent Polska Sp. z.o.o.

Al. Jana Pawla II 78 00-175 Warszawa Poland Tel. +48 22 635 54 96 Fax +48 22 635 54 69 www.ivoclarvivadent.pl

Ivoclar Vivadent Marketing Ltd.

Derbenevskaja Nabereshnaya 11, Geb. W 115114 Moscow Russia Tel. +7 495 913 66 19 Fax +7 495 913 66 15 www.ivoclarvivadent.ru

Ivoclar Vivadent Marketing Ltd.

171 Chin Swee Road #02-01 San Centre Singapore 169877 Tel. +65 6535 6775 Fax +65 6535 4991 www.ivoclarvivadent.com

Ivoclar Vivadent S.L.U.

c/ Emilio Muñoz Nº 15 Entrada c/ Albarracin E-28037 Madrid Spain Tel. + 34 91 375 78 20 Fax + 34 91 375 78 38 www.ivoclarvivadent.es

Ivoclar Vivadent AB

Dalvägen 14 S-169 56 Solna Sweden Tel. +46 (0) 8 514 93 930 Fax +46 (0) 8 514 93 940 www.ivoclarvivadent.se

Ivoclar Vivadent Liaison Office

Ahi Evran Caddesi No 1 Polaris Is Merkezi Kat: 7 80670 Maslak Istanbul Turkey Tel. +90 212 346 04 04 Fax +90 212 346 04 24 www.ivoclarvivadent.com

Ivoclar Vivadent Limited

Ground Floor Compass Building Feldspar Close Warrens Business Park Enderby Leicester LE19 4SE United Kingdom Tel. +44 116 284 78 80 Fax +44 116 284 78 81 www.ivoclarvivadent.com

Ivoclar Vivadent, Inc.

175 Pineview Drive Amherst, N.Y. 14228 USA Tel. +1 800 533 6825 Fax +1 716 691 2285 www.ivoclarvivadent.com

Date information prepared: 09/2010 Rev. 0

These materials have been developed solely for use in dentistry. Processing should be carried out strictly according to the Instructions for Use. Liability cannot be accepted for damages resulting from failure to observe the Instructions or the stipulated area of application. The user is responsible for testing the material for its suitability and use for any purpose not explicitly stated in the Instructions. Descriptions and data constitute no warranty of attributes. These regulations also apply if the materials are used in conjunction with products of other manufacturers.

Ivoclar Vivadent IPS e.max CAD-on User Manual

Specifications and Main Features

Frequently Asked Questions

User Manual