3 IPS e.max system – one system for every indication
product
information
CAD-On
4Product InformationDescription of the IPS e.max CAD-on Technique Materials for the IPS e.max CAD-on Technique Indications, Contraindications Composition Shade Concept Block Concept
13Clinical Working Steps, Model Preparation Overview of the Fabrication Process Shade Determination – Tooth Shade, Shade of the Prepared Tooth Preparation Guidelines
Model Preparation Layer Thicknesses
19CAD/CAM Processing
CAD Process with Sirona inLab 3D Software
CAM Process with Sirona inLab MC XL
24Finishing of the Framework and Veneering Structure
Completing the IPS e.max ZirCAD Framework
Completing the IPS e.max CAD Veneering Structure
notesonprocessing
practical
-
tion
informa
CAD-On
32Glass-ceramic Fusion Process Preparation
Fusion Process Cleaning, Checking
Optional – Adjustments with IPS e.max CAD Crystall./Add-On
43Seating and Follow-Up CarePossibilities for Cementation
Preparing for Cementation
Care Notes
46General 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 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
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
– 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)
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.
*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.
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 InlaysOnlaysPartial
crowns
** IPS e.max CAD-on technique in conjunction with IPS e.max ZirCAD
Anterior
crowns
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 0MO 1MO 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 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.
Responsibility of the Dental OfficeResponsibility 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
1.0
1.5
2.0
1.5
6°
1.0
1.0
1.5
1.51.5
1.0
1.0
1.0
1.5
1.51.5
1.0
1.5
1.5
1.0
1.0
1.5
1.5
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
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