Ivoclar Vivadent IPS e.max Ceram User Manual

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Ceram

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I N S T R U C T I O N S F O R U S E

Table of contents

3 IPS e.max System – one system fo every indication

Ceram

PR OD UC T

IN FO RM ATI ON

4 Product Information

Material Usage Composition Firing behaviour and ﬁring process Scientiﬁc data

9 Practical Use

Shade determination Layering diagram Framework design Tips and tricks on layering

19 Processing on ZrO2Frameworks

Preparing the framework ZirLiner ﬁring 1stMargin ﬁring (optional) 2ndMargin ﬁring (optional) Wash ﬁring 1stDentin / incisal ﬁring 2ndDentin / incisal ﬁring Finishing and preparing for the Stains and Glaze ﬁring Stain and Glaze ﬁring Add-On ﬁring

35 Abutment Technique – Pressing on the Straumann®Anatomic IPS e.max®Abutment

Preparing the Straumann® Anatomic IPS e.max® Abutment Adaptation of the emergence proﬁle Direct ﬁring of IPS e.max Ceram

PR AC TI CA L USE

49 Gingiva Technique

Framework Design Criteria Framework Preparation and Application of IPS e.max Ceram ZirLiner Contouring Sprueing, Investing Veneering with IPS e.max Ceram

52 Veneers

54 One for 4

59 Seating and Follow-Up Care

Possibilities for Cementation Preparing for Cementation Care notes

TI ON

IN FO RM A

Ceram

62 General Information

Questions and Answers Combination tables Firing parameters

e.max

IPS

System –

A L L Y O U N E E D

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. IPS e.max delivers high-strength and highly esthetic materials for the Press and the CAD/CAM technologies. The system consists of innovative lithium disilicate glass-ceramics used mainly for singletooth restorations and high-strength zirconium oxide for large-span bridges.

Every patient situation presents its own requirements and objectives. IPS e.max meets these requirements, because due to the system components you obtain exactly what you need. – The components for 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-zirconium oxide technique.

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

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

– 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 System.

IPS e.max Ceram

The versatile layering ceramic is optimally coordinated with the materials of the IPS e.max System. Matching the shade when using different framework materials is clearly facilitated by the universal layering diagram and the precise shade coordination. After all, the veneering ceramic is the key to highly esthetic results within the IPS e.max System – both on lithium disilicate (LS2) and zirconium oxide (ZrO2). The unique combination of translucency, brightness and opalescence leads to natural light scattering and a balanced relationship between brightness and chroma. In addition to the traditional dentin and incisal materials in A–D, Chromascop and Bleach shades, there is a sophisticated range of additional materials (Impulse, Essence, Stains, etc.) for individual esthetics during internal and external characterization. With the Gingiva ceramic materials, true-to-nature gingival areas are designed, which are particularly important for implant-retained restorations.

e.max

IPS

Ceram

Product Information

Material

IPS e.max Ceram is a low-fusing nano-ﬂuorapatite glass-ceramic which permits the veneering and characterization of restorations fabricated using either the press technology and/or the CAD/CAM technology. This glass-ceramic, which contains nano-ﬂuorapatite crystals, demonstrates a crystal structure similar to that of vital teeth. The optical properties are controlled by the nanoﬂuorapatite crystals in the size range of 100–300 nm and microﬂuorapatite crystals with a length of 1–2 µm. The individual IPS e.max Ceram materials contain different concentrations of the apatite crystals, which then enable a unique and adjustable combination of translucency, brightness and opalescence, depending on the type of layering material. The IPS e.max ZirLiners are yet another innovation of this new material concept. They enable an exceptionally good bond with the zirconium oxide framework and demonstrate high light transmitting capability coupled with high ﬂuorescence. They thus make the white and not very translucent zirconium oxide frameworks look as if they have been shaded and permit the adjustment of the basic zirconium oxide shade of the framework to the shade of the IPS e.max Press and IPS e.max CAD glass-ceramics. In this way, the achieved layering concept permits the fabrication of highly esthetic restorations that demonstrate optimum stability of shape both on shaded/translucent glass-ceramic frameworks and on less translucent zirconium oxide frameworks. The uniform material composition and, consequently, homogeneous clinical properties, irrespective of the framework material used, underlines the comprehensive IPS e.max restorative concept.

IPS e.max Ceram is based on the tried-and-tested shade concept of other Ivoclar Vivadent veneering materials. In this way, a continuous concept covering composites, metal-ceramics and all-ceramics has been achieved. The easy application makes the time-consuming re-familiarization with the individual veneering materials a thing of the past.

CTE (100–400°C) [10-6/K] 9.5

Flexural resistance (biaxial) [MPa]* 90

Vickers hardness [MPa] 5400

Chemical solubility [µg/cm2]* 15

Firing temperature [°C/°F] 750/1382

*according to ISO 6872

Ivoclar Vivadent Shade Concept

Adoro

d.SIGN®/ InLine

IPS

e.max

IPS

Ceram

Usage

Composition

Indications

– Characterization and veneering of IPS e.max Press restorations – Characterization and veneering of IPS e.max ZirPress restorations – Characterization and veneering of IPS e.max CAD restorations – Characterization and veneering of IPS e.max ZirCAD frameworks – Characterizing and veneering Straumann®Anatomic IPS e.max

Abutments

– Characterization and veneering of frameworks, implant

abutments and implant superstructures made of – sintered zirconium oxide and/or HIP zirconium oxide, as well as – presintered zirconium oxide and demonstrating a CTE range of 10.5-11.0 x 10-6K

-1

[100-500 °C]. – Layered veneers on ﬁre-resistant investment materials – Creation of gingival portions on restorations made of IPS e.max

ZirCAD or IPS e.max ZirPress

Contraindications

– Patients with severely reduced residual dentitions – Patients suffering from bruxism – Any other use not listed in the indications

Important processing restrictions

If the following notes are not observed, successful work with IPS e.max Ceram cannot be ensured: – The necessary veneering layer thickness must be observed. – The required layer thickness relation between the framework and

the layering ceramic must be observed. – IPS e.max Ceram materials must not be mixed with other dental

ceramics – Zirconium oxide frameworks with a CTE different from the one

stipulated must not be veneered. – Veneering of zirconium oxide frameworks which were not con-

ditioned according to the stipulations for IPS e.max ZirCAD, e.g.

blasting with Al2O3. – Metal-frameworks must not be veneered. – Other pressed ceramics (e.g. IPS Empress®Esthetic) must not be

veneered. – Aluminium oxide frameworks (e.g. Procera Alumina,

Vita In-Ceram 200 Al Cubes) must not be veneered. – Slipped and CAD/CAM-fabricated Vita InCeram frameworks (e.g.

In-Ceram Classic Spinell, Alumina, Zirconia) must not be

veneered. – Cast and CAD/CAM-fabricated titanium oxide must not be

veneered. – IPS e.max Ceram ZirLiner and Margin materials should not be

used on IPS e.max Press and IPS e.max CAD. – Inlays, onlays without framework (CAD / ZrO2/ Press)

IPS e.max Ceram and the processing accessories consist of the following main components:

– IPS e.max Ceram

Components: SiO

Additional contents: Al2O3, ZnO2, Na2O, K2O, ZrO, CaO, P2O5, ﬂuoride and pigments

– IPS e.max Ceram Shades and Glaze Pastes

Components: oxides, glycerine, butandiol, poly(vinyl pyrrolidone)

– IPS e.max Ceram Glaze Spray

Components: Glazing powder, propellant, isobutane

– IPS e.max Ceram ZirLiner Build-Up Liquid (allround)

Components: Water, butandiol and chloride

– IPS e.max Ceram Margin Build-Up Liquids

(allround and carving)

Components: Water, zinc chloride and hydroxyl ethyl cellulose

– IPS e.max Ceram Build-Up Liquids (allround and soft)

Components: Water, propylene glyco, butandiol and chloride

– IPS e.max Ceram Stain and Glaze Liquids

(allround and longlife)

Components: Butandiol, pentandiol

– IPS Model Sealer

Components: Ethyl acetate, softener and nitrocellulose

– IPS Ceramic Separating Liquid

Components: Parafﬁn oil

– IPS Margin Sealer

Components: Wax dissolved in hexane

Warnings:

– Ethyl acetate is highly inﬂammable – keep it away from sources

of ignition. Do not inhale the vapours.

– Hexane is highly inﬂammable and detrimental to health. Avoid

contact with the skin and eyes. Do not inhale the vapours and keep the material away from sources of ignition.

– Do not inhale ceramic dust during ﬁnishing – use suction

equipment and a face-mask.

Side effects

If a patient is known to be allergic to any of the components of IPS e.max Ceram, the material should not be used.

Firing behaviour and firing process

Shade stability

IPS e.max Ceram is a low-fusing nano-ﬂuorapatite glass-ceramic. The new material generation contains nano-ﬂuorapatite crystals and demonstrates a crystal structure similar to that of vital teeth. Depending on the type of layering material, this permits a unique and adjustable combination of translucency, brightness and opalescence which is characterized by a high stability of shape and shade, even after several ﬁring procedures. The following images of ﬁred tabs show the shade stability of IPS e.max Ceram Dentin A3 after several ﬁring procedures. Even after ten ﬁrings, no obvious shade difference to the original tab is visible. After three ﬁrings, the shade of the tab already corresponds with that of the ﬁred restoration (2 Dentin/Incisal ﬁrings and 1 Glaze ﬁring).

1x 3x 5x 7x 10x 1x 3x 5x 7x 10x

Transmitted lightIncident light

The high shade stability is particularly important for the Opal materials (Opal Effect 1), which are predominantly used in the incisal area, in order not to obtain a lifeless, greyish incisal third, even after several ﬁring procedures. The following images show an Opal Effect 1 tab after 10 ﬁrings. There are no visible differences as regards the opalescence and brightness.

1x 3x 5x 7x 10x 1x 3x 5x 7x 10x

Transmitted lightIncident light

Burn-out behaviour

Given the low transformation point of low-fusing ceramic materials, the burn-out of the organic components in the buildup liquids occurs in a shorter time frame than that of high- and medium-fusing ceramics. If build-up liquids other than the IPS e.max Ceram Liquids are used, therefore, there is a risk of incomplete burn-out and thus discolouration of the restoration (e.g. cloudiness, greying). The following images show ﬁred IPS e.max Ceram clear tabs for which different build-up liquids were used. With certain liquids, the discolouration is clearly visible. Therefore, Ivoclar Vivadent recommends using only the liquids contained in the IPS e.max Ceram Kits. If silver dust is used to design the surface, make sure that it is completely removed during cleaning. If this is not done, discolouration (e.g. yellowish) may occur after glaze ﬁring.

IPS e.max Ceram Build-Up Liquid allround or soft

Competitive Liquid A Grey residue

Competitive Liquid B Grey residue

Competitive Liquid C Cloudiness

Competitive Liquid D Cloudiness

Firing of lithium disilicate-supported restorations

– Use the honey-combed ﬁring tray and the corresponding support pins to ﬁre the restorations. – Do not use ceramic pins, since they may stick to the restoration. – The processing temperatures must be observed. Increasing the ﬁring temperature will result in severe vitriﬁcation

between the framework and the veneering ceramic, which may lead to crack formation later on. Reducing the ﬁring

temperature results in the ceramic being underﬁred, rendering it very brittle, which may ultimately lead to delamination. – The parameters listed in the Instructions for Use apply to Ivoclar Vivadent furnaces (temperature tolerance ± 10 ºC/18 °F). – If furnaces other than those from Ivoclar Vivadent are used, temperature adjustments may be necessary.

Firing of zirconium oxide-supported restorations

In order to obtain optimum ﬁring results for IPS e.max Ceram, the following points have to be observed: – In order to ensure an even thickness of the veneer, the zirconium oxide framework must be designed in such a way that

it supports the cusps. Depending on the clinical situation, the results are different wall thicknesses and dimensions of

the framework. – Since ZrO2is a poor heat conductor compared to other framework materials, a low temperature increase rate tÀ is

required. This ensures even heat distribution in the bonding area between the framework and the veneer as well as the

outer surfaces of the restoration even with different framework thicknesses. In this way, an optimum bond as well as

even sintering of the layering materials is achieved. – During cooling of the restorations after firing, stress occurs as a result of the different cooling speeds at the outside and

within the material. With long-term cooling L for the "final firing cycle" this stress can be reduced and the risk of

delamination minimized, particularly in ZrO2-supported restorations.

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. – Do not blast or quench the objects.

Scientific Data

Further scientific data (i.e. strength, wear, biocompatibility) are contained in the “Scientific Documentation IPS e.max Ceram”. The Documentation also provides a set of studies that describe the clinical performance of IPS e.max Ceram. This Scientific Documentation can be obtained from Ivoclar Vivadent.

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

Scientiﬁc Documentation

e.max

IPS

Ceram

Practical Use

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 following guidelines and notes must be observed by both the dentist and the laboratory. The overall esthetic result of an all-ceramic restoration is influenced by the following factors:

• Shade of the preparation (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. Only if the dentist determines the shade of the preparation and its subsequent transmission to the laboratory may the desired esthetics be achieved in a targeted fashion.

Preparation Shade

– Prepared natural tooth

– Core build-up – Implant, abutment

Restoration Shade

Framework

–

– Veneer – Characterization

Practical Use

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.

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.

IPS e.max Ceram Material Shade Guides

For IPS e.max Ceram, the material shade guides are an integral part of the product concept. For reasons of light refraction, the dentin shade tabs have been given an anatomical shape and surface structure. All the other shade tabs demonstrate a slight wedge shape, in order to better illustrate the translucency of the individual materials. The shade tabs are ﬁred from the original ceramic materials. To facilitate the distinction from the existing material shade guides (e.g. IPS d.SIGN, IPS InLine, SR Adoro), the rods and holders of the IPS e.max Ceram material shade guides are light-grey.

Layering Diagram

The layering diagram of IPS e.max Ceram has been designed in such a way that easy and reliable shade reproduction is possible, irrespective of the framework material or framework shade. A proportional framework design that supports both shape and cusps represents the ideal basis.

Practical Use

Layering Diagram for Lithium Disilicate (LS2)

(IPS e.max Press and IPS e.max CAD)

Highly esthetic glass-ceramic framework

Wash (foundation) application

Layering Diagram for Zirconium Oxide (ZrO2)

(IPS e.max ZirCAD)

High-strength zirconium oxide framework

ZirLiner application

Dentin application

Completing the layering with Incisal material

Dentin application

Completing the layering with Incisal material

Framework Design

Failure to observe the stipulated framework design criteria and minimum thicknesses may result in clinical failure, such as cracks, delamination and ultimately to fracture of the restoration. The framework design must always support the shape of the restoration and the cusps in order to obtain an even layer thickness of the veneer with IPS e.max Ceram.

Framework Design Lithium Disilicate (LS2) Framework Design for Zirconium Oxide (ZrO

correct

incorrect

correct incorrect

correct

incorrect

)

correct

incorrect

correct

correct incorrect

incorrect

Tips and tricks on layering

Application of the Impulse materials

Increasing the brightness value

Practical Use

By applying Opal Effect 4 or Deep Dentin directly on the wash layer or ZirLiner, the in-depth brightness value in the dentin area can be enhanced. The corresponding areas are subsequently covered with Dentin materials.

Enhancing the in-depth effect – internal

To increase the brightness value in the incisal third, e.g. if space is limited, Inter Incisal white-blue can be used.

To enhance the in-depth effect in the incisal third, e.g. if space is limited, Special Incisal, e.g. SI grey, can be used.

Designing a true-to-nature incisal third

The Mamelon materials permit a true-to-nature interplay of shades in the incisal third. They are applied on the completed incisal area, e.g. MM light, MM salmon.

To complete and enhance the vitality in the incisal area, the shaded Transparent materials can be used, e.g. T brown-grey.

With the Opal Effect materials, a lifelike opalescent effect in the incisal third can be achieved. OE 2 can be applied on the individualized cut-back.

Opal Effect 1 is layered in the mesial and distal areas. Opal Effect 5 is excellently suitable to imitate secondary dentin.

Enhancing the in-depth effect – external

Halo effect

Practical Use

The Cervical Transparent materials with their slightly higher ﬂuorescence are used to complete the layering of the cervical third, e.g. CT orange-pink.

To achieve what is known as the halo effect, Incisal Edge is used and applied to prolong the incisal edge.

Result of an individual IPS e.max Ceram Impulse layering procedure

Applications for the Essence powders

Essence powders are intensively shaded and should, therefore, only be used in very small quantities.

Essence – mixing

Increasing the chroma or the shade saturation of layering materials, such as Deep Dentin and Dentin.

Dentin before

Transpa Incisal before

Dentin after

Enhancing the shade effect of Incisal materials, e.g. adjusting of warm and chromatic Incisal materials.

Transpa Incisal after

Shading of Transparent clear to create new individual Transpa materials.

Transpa neutral before

Transpa neutral after

Essence – internal

Internal characterizations should only be applied on thoroughly moist areas.

Practical Use

To design Mamelons, e.g. E 02 cream or E 10 terracotta are used.

To enhance the in-depth effect, E 15 profundo can be ﬂushed in.

The increase the brightness

value and to imitate incisal discolouration, E 01 white and

e.g. E 04 sunset can be ﬂushed in.

To design enamel cracks, E 02 cream or any mixture can be applied.

Essence – external

Superﬁcial deposits, such as the ones caused by coffee or tea, can be imitated using, e.g. E 13 espresso.

Staining

Completed crown

Natural tooth

Fissures and occlusal surfaces can be reproduced in a lifelike fashion using, e.g. E 05 copper, E 11 mahogany or E 14 terra.

Staining

Completed crown

Natural tooth

Enamel stains are imitated with e.g. E 01 white or E 02 cream.

Staining

Completed crown

Natural tooth

e.max

IPS

Ceram –

Processing on ZrO2Frameworks

Framework preparation

The stipulations of the manufacturer of the zirconium oxide regarding framework fabrication and preparation for veneering must be observed. When using IPS e.max ZirCAD, please observe the notes on ﬁnishing and regeneration ﬁring in the respective Instructions for Use. Place the sintered zirconium oxide framework on the model. Reduce the margins of the premolar for a fused-on ceramic shoulder down to the inner edge of the chamfer or shoulder preparation. Observe the following procedure: – Make sure that the minimum thicknesses are maintained even after minor adjustments. – Check marginal area and carry out slight adjustments, if necessary. – Do not 'post-separate' the bridge framework after sintering using separating disks, since this may result in undesired pre-

determined breaking points, which will subsequently compromise the stability of the all-ceramic restoration. – Before veneering, clean framework under running water or with the steam jet and dry. – The framework must not be blasted with Al2O3or polishing jet medium, since this would damage the

surfaces. – Before ZirLiner is applied, the framework must be free of dirt and grease. Prevent any contamination after cleaning.

Frameworks

Processing on ZrO

Reduce the margins of the premolar down to the inner edge of the chamfer or shoulder preparation for the fused-on ceramic shoulder.

Before veneering, clean framework under running water or with the steam jet and dry.The framework must not be blasted with Al2O3.

Finished and cleaned zirconium oxide framework

ZirLiner firing

Before ZirLiner is applied, the framework must be free of dirt and grease. Avoid any contamination after cleaning. Observe the following procedure. – The IPS e.max ZirLiners are only suitable for the application on IPS e.max ZirCAD and other zirconium oxide frameworks. – IPS e.max Ceram ZirLiner must always be applied prior to veneering in order to achieve a sound bond as well as an in-

depth shade effect and ﬂuorescence. – Direct layering on ZirCAD framework without using IPS e.max Ceram ZirLiner results in a poor bond and may lead to

delamination. – For unshaded frameworks, use the IPS e.max Ceram ZirLiners 1-4. If the frameworks are shaded, the

IPS e.max Ceram ZirLiner clear is applied. – Mix the IPS e.max Ceram ZirLiner in the corresponding shade with the respective liquid to a creamy consistency. – If a different consistency is desired, the IPS e.max Ceram Build-Up Liquids (allround or soft) and the Glaze and Stain

Liquids (allround or longlife) may be used. The liquids may also be mixed with each other at any mixing ratio. – Apply ZirLiner on the entire framework, pay special attention to the margins. If required, the restoration may be vibrated

until an even, greenish colour effect is achieved. If the colour appears too pale, the layer is too thin. – For more intensively shaded areas, 4 IPS e.max Ceram Intensive ZirLiners (yellow, orange, brown and incisal) are available. – After that, the applied ZirLiner is brieﬂy dried and ﬁred. – The IPS e.max Ceram ZirLiner should have a layer thickness of approximately 0.1 mm after ﬁring – If ZirLiner is to be individually characterized after the Margin ﬁring, IPS e.max Ceram Essence is suitable for this purpose.

Given the lower ﬁring temperature of Essence, characterization prior to Margin ﬁring is not possible.

Mix the corresponding IPS e.max Ceram ZirLiner with ZirLiner Liquid to a creamy consistency. Cover the entire framework with the mixed ZirLiner. Make sure that an even, greenish

Conduct the ZirLiner ﬁring on a honey-combed ﬁring tray using the stipulated ﬁring parameters.

colour effect is achieved.

Firing parameters for the ZirLiner ﬁring (note the temperature control)

IPS e.max Ceram on ZrO

ZirLiner ﬁring

B StÀ T H V1 V2

°C/°F min °C/°F/min °C /°F min °C/°F °C/°F

403/

757 72 1760 842 1758

4:00

40/ 960/

1:00

450/ 959/

Frameworks

Do not apply any layering materials on unﬁred ZirLiner, since this will lead to delamination of the layering ceramic. Before the actual layering is commenced, the ZirLiner must be ﬁred.

1stMargin ﬁring (optional)

A ceramic shoulder is applied to the reduced premolar bridge abutment after the ZirLiner ﬁring. Observe the following procedure: – Before the ceramic shoulder is applied, cover the model die with IPS Margin Sealer and allow it to dry. After that, isolate

the shoulder areas using IPS Ceramic Separating Liquid. – Place the framework on the die and make sure it is correctly positioned. – Subsequently, mix IPS e.max Ceram Margin in the desired shade with the corresponding Margin Build-Up Liquid

(allround or carving) and apply in drop-shaped increments. – For more intensively shaded areas, 4 Intensive Margin materials (yellow, yellow-orange and orange-pink) are available. – Contour the Margin material as desired and dry. – Carefully remove the framework with the applied and dried shoulder material from the die, place it on a honey-combed

tray and ﬁre.

Processing on ZrO

Isolate the die and apply the Margin material on the entire shoulder preparation.

Do not apply the Margin material too thinly or with a concave shape.Apply the Margin material in drop-shaped increments.

Before ﬁring, carefully remove the framework with the applied and dried shoulder material from the die and ﬁre.

Ceramic shoulder after ﬁring. Compensate for the sinter shrinkage with the

Firing parameters for the 1stMargin ﬁring (note the temperature control)

Margin ﬁring.

IPS e.max Ceram on ZrO2 B StÀ T H V1 V2

°C/°F min °C/°F/min °C /°F min °C/°F °C/°F

1stMargin ﬁring

403/

757 72 1472 842 1470

4:00

40/ 800/

1:00

450/ 799/

Important: IPS e.max Ceram Margin materials are only suitable for the application on IPS e.max ZirCAD and other zirconium oxide frameworks and must not be used in conjunction with glass-ceramic materials.

2ndMargin ﬁring (optional)

After ﬁring, the shoulder may require minor adjustments by grinding. Observe the following procedure for the 2ndMargin ﬁring: – Isolate the die once again using IPS Ceramic Separating Liquid. – Complete the areas affected by shrinkage and any missing areas using the same Margin material that was used for the

1stﬁring. – Depending on the size of the gap, the shoulder material may be slightly vibrated. – Carefully remove the framework with the completed and dried shoulder from the die, position it on the ﬁring tray, and

ﬁre. – After the 2ndﬁring, the shoulder may require minor adjustments to achieve ideal accuracy of ﬁt.

Complete the areas affected by shrinkage and any missing areas using the same Margin material that was used for the 1stﬁring

Frameworks

Processing on ZrO

If necessary, slightly adjust the ﬁred shoulder by grinding to achieve very good accuracy of ﬁt.

Firing parameters for the 2ndMargin ﬁring (note the temperature control)

IPS e.max Ceram on ZrO

2ndMargin ﬁring

B StÀ T H V

°C/°F min °C/°F/min °C /°F min °C/°F °C/°F

403/

757 72 1472 842 1470

4:00

40/ 800/

1:00

450/ 799/

Important:

If the ﬁt of the shoulder is to be optimized during the subsequent Dentin and Incisal ﬁring, mix the corresponding Margin material with the Add-On Margin material in a 1:1 ratio and ﬁre using the ﬁring parameters for the Dentin / Incisal ﬁring.

Wash firing (Foundation)

Begin the veneering process by conducting a wash ﬁring of Dentin or Deep Dentin material. This procedure ensures controlled shrinkage of the veneering material in the direction of the substructure and ensures a homogeneous bond to the underlying ZirLiner material. In order to achieve this: – Mix the required IPS e.max Ceram layering materials (Dentin or Deep Dentin) with the Build-Up Liquids allround or soft. If

a more plastic consistency is desired, IPS e.max Ceram Glaze and Stain Liquids (allround or longlife) can be used to mix

with the Build-Up Liquids at any ratio. – Provide a thin even coverage of the Dentin or Deep Dentin material on the entire veneering surface. – After the surface is completely covered, position the restoration on the ﬁring tray and ﬁre according to the given

parameters.

Fire the Dentin or Deep Dentin materials according to the fring parameters

Firing parameters for Wash ﬁring (Foundation) (note the temperature control)

IPS e.max Ceram on ZrO

Wash ﬁring (Foundation)

B StÀ T H V

°C/°F min °C/°F/min °C /°F min °C/°F °C/°F

403/

757 72 1382 842 1380

4:00

40/ 750/

1:00

450/ 749/

1stDentin and Incisal ﬁring

In order to fabricate highly esthetic restorations, please observe the following procedure:

– Before layering, apply IPS Model Sealer on the model and allow it to dry. Then, isolate the corresponding areas using

IPS Ceramic Separating Liquid. – Place the framework on the die and make sure it is correctly positioned. – Mix the required IPS e.max Ceram layering materials with the Build-Up Liquids allround or soft. If a

different consistency of the ceramic is desired, the Liquids may also be mixed with each other at any ratio. – Use distilled water to rewet the layering materials on the mixing pad to avoid accumulation of organic components. – Underlay the pontic areas with Deep Dentin in the next lighter shade and make sure that a good rest is reached. After

that, layer these areas using Deep Dentin and Dentin materials. – The low thermal conductivity of zirconium oxide frameworks provides an insulating effect that in a small number of

cases such as restorations with an abnormally deep occlusal fossa or bulky molar pontics,

present challenges in achieving properly ﬁred veneering ceramic. To optimize the sintering result, control shrinkage and

ensure a well bonded veneer layer, two veneering options may be used:

– Option 1: Intermediate ﬁring

Use Deep Dentin, Dentin or Impulse materials for an intermediate ﬁring to minimize the bulk of veneering ceramic during the initial build-up. The layering has to cover the complete surface.

– Option 2: Fissure separation

Separate the central ﬁssure from mesial to distal including the marginal ridges with a thin scalpel. This allows optimal sintering behaviour and results in uniform shrinkage that is easily corrected during the 2ndDentin and Incisal ﬁring.

Frameworks

Processing on ZrO

1 mm

Normal occlusal surface Deep occlusal surface

Massive bridge pontic

– Subsequently, conduct the layering procedure according to the layering diagram. Observe the necessary layer thicknesses. – For individual characterizations, use e.g. Occlusal Dentin (see also pages 13–16). – Carefully remove the restorations from the model and supplement the contact points. – Do not apply excessive suction and prevent the restoration from drying out. – Before ﬁring, all the interdental areas must be separated down to the framework using a scalpel. – Position the restoration on the ﬁring tray and ﬁre using the stipulated ﬁring parameters.

Before layering, apply IPS Model Sealer and allow it to dry. Then, isolate the corresponding areas using IPS Ceramic Separating Liquid.

Underlay the pontic areas with Deep Dentin in the next lighter shade and make sure that a good rest is reached.

Observe the necessary layer thicknesses. Continue the layering with Dentin.

Layer the entire dentin core.

Apply Occlusal Dentin orange and complete the occlusal surface.

Carefully reduce the completed dentin layering and provide sufﬁcient space for the Incisal materials.

Individually supplement the restorations with Transparent and Impulse material and completely cover them with Incisal materials.

Frameworks

Processing on ZrO

Remove the completed layered restorations from the model, supplement the contact points and separate all interdental areas down to the framework.

Fired restorations after the 1stDentin / Incisal ﬁring.

Firing parameters for the 1stDentin/Incisal ﬁring (note the temperature control)

IPS e.max Ceram on ZrO

1stDentin / Incisal ﬁring

B StÀ T H V

°C/°F min °C/°F/min °C /°F min °C/°F °C/°F

403/

757 72 1382 842 1380

4:00

40/ 750/

1:00

450/ 749/

2ndDentin and Incisal ﬁring

Touch up the restoration and clean it completely. Cleaning is carried out with ultrasound in a water bath or the steam jet. Blasting the surface with Al2O3Type 50 at 1 bar (15 psi) pressure is only necessary if superﬁcial contamination is evident after cleaning. Thoroughly dry the restoration and complete any missing areas. Interdental areas and contact points should be given special attention. Use distilled water to rewet the layering materials on the mixing pad to avoid accumulation of organic components.

Thoroughly dry the restoration and complete any missing areas. Interdental areas and contact points should be given special attention.

Fired restorations after the 2ndDentin / Incisal ﬁring

Firing parameters for the 2

IPS e.max Ceram on ZrO2 B StÀ T H V1 V2

2ndDentin / Incisal ﬁring

dentin and incisal ﬁring (note the temperature control)

°C/°F min °C/°F/min °C /°F min °C/°F °C/°F

403/

757 72 1382 842 1380

4:00

40/ 750/

1:00

450/ 749/

Depending on the furnace type, the ﬁring temperature can be reduced by 5 °C to max. 10 °C (9 °F to max. 18 °F) for the

Dentin / Incisal ﬁring.

Finishing and preparation for the Stain and Glaze ﬁring

The restoration must be ﬁnished and polished as follows before the stain and glaze ﬁring:

– Use ﬁnishing diamonds to achieve a natural shape and surface structure of the restoration, such as growth lines,

convex/concave areas. – Areas that should demonstrate a stronger gloss after glaze ﬁring (e.g. pontic rests) can be smoothed and prepolished

using silicone wheels. – If gold or silver dust is used for the surface design, the restoration must be thoroughly cleaned with the steam jet. Make

sure that any gold or silver dust is entirely removed in order to prevent discolouration after ﬁring.

Create a natural shape and surface structure with ﬁnishing diamonds.

Frameworks

Processing on ZrO

Finished restoration ready for stain and glaze ﬁring.

Stain and Glaze firing

Stain ﬁring is conducted with Essence or Shade material, while Glaze ﬁring is carried out with Glaze powder. Depending on the situation, the ﬁrings may be conducted together or separately. The ﬁring parameters are identical. The restoration must be free of dirt and grease. Avoid any contamination of the restoration after cleaning with ultrasound in the water bath or with the steam jet. With this ﬁring, ﬁnal adjustments of the shoulder and contact points are also possible. Observe the following procedure:

– To promote wetting of the Stains and Glaze materials, IPS e.max Ceram Glaze and Stain Liquid can be lightly painted

onto the surface. – Mix the paste or powder with the IPS e.max Ceram Glaze and Stain Liquid (allround or longlife) until the desired

consistency is reached. – More intensive shades are achieved by repeated staining (1–3 ﬁrings), rather than by applying thicker layers. – Individually characterize cusps and ﬁssures using Essence materials. – If shade modiﬁcations are required, Shades can be used. – Use Glaze material in powder or paste form. – Apply Glaze material in an even layer on the entire restoration. – Make any adjustment of the shoulder using Add-On Margin. – Adjustments of contact points are carried out with a 1:1 mixture of e.g. Incisal and Add-On Incisal. – Polish the supplemented areas to a high gloss using silicone polishers.

The combinations listed below represent suggestions:

IPS e.max Ceram Shade

Shade Incisal 1

Shade Incisal 2

Shade 0

Shade 1

Shade 2

Shade 3

Shade 4

Chromascop

110–140, 210, 220, 310, 320

230, 240, 330, 340, 410–440, 510–540

110–140, 210–240

310–330

410–440

340, 510–540

A–D

A1, A2, A3, B1, B2, B3, B4

A3.5, A4, C1, C2, C3, C4, D2, D3, D4

A1, A2, A3, A3.5

B1, B2, B3, B4, D4

C1, C2, C3, C4

A4, D2, D3

Bleach BL

BL1, BL2, BL3, BL4

Apply Glaze material in an even layer on the entire restoration. Basal area and the pontic should be given particular attention.

Frameworks

Processing on ZrO

Characterize the ﬁssures with Essence and supplement the contact points with a 1:1 mixture.

Completely stained, glazed and adjusted restoration ready to be ﬁred.

Polish the supplemented areas to a high gloss using silicone polishers.

Firing parameters for the Stain and Glaze ﬁring – note the slow cooling!

IPS e.max Ceram on ZrO

Stain ﬁring 403/757 6:00 60/108 725/1337 1:00 450/842 724/1335 450/842

B StÀ T H V1 V2 L

°C/°F min °C/°F/min °C/°F min °C/°F °C/°F °C/°F

Glaze ﬁring 403/757 6:00 60/108 725/1337 1:00 450/842 724/1335 450/842

Optional

Stain and Glaze ﬁring with IPS e.max Ceram Glaze Spray

As an alternative to IPS e.max Ceram Glaze Paste and Powder, IPS e.max Ceram Glaze Spray can be used. Please observe the following procedure: – Prepare the IPS e.max restoration for Stain and Glaze ﬁring as usual (surface texture, shape, etc.). – Clean the restoration with ultrasound in a water bath and/or with a steam jet. – If you wish to characterize the restoration using Essence and Shade material, apply a small portion of Glaze and Stain

Liquid on the surface before in order to promote wetting of the Stains materials.

– Hold the IPS e.max restoration with tweezers or secure it with a small amount of IPS Object Fix Putty or Flow on a ﬁring

pin.

– The cavities of bridges can be ﬁlled with IPS Object Fix Putty or Flow in order to avoid application of the spray on the

inner aspects of the anchor crowns.

– Shake the spray can well immediately before use until the mixing ball in the container is moving freely (approximately

20 seconds). – Observe a distance of 10 cm between the nozzle and the surface to be sprayed. – Spray the restoration from all sides with short bursts to coat the (characterized) restoration with an even layer. Shake the

spray can well between individual bursts. – Hold the spray can as upright as possible during spraying. – Wait brieﬂy until the glaze layer is dry and has assumed a whitish colour. If required, apply Glaze Spray again. – If IPS e.max Ceram Glaze Spray accidentally reaches the inner aspects of the restoration, remove it with a dry brush. – Place the IPS e.max restoration on a honey-combed ﬁring tray for the (Stain and) Glaze ﬁring and ﬁre according to the

ﬁring parameters for Stain and Glaze ﬁring. – Should renewed application of the spray be necessary after ﬁring, spray the restoration in the same manner again.

10 cm

Observe a distance of 10 cm when applying the IPS e.max Ceram Glaze Spray. Spray IPS e.max Ceram Glaze Spray with short bursts directly on the unﬁred Essence

Shake the spray can well between individual bursts.

Restoration with evenly applied IPS e.max Ceram Glaze Spray before Stain and Glaze ﬁring.

materials and/or Shades from different directions.

Firing parameters for the Stain and Glaze ﬁring – note the slow cooling!

IPS e.max Ceram on ZrO

Stain ﬁring 403/757 6:00 60/108 725/1337 1:00 450/842 724/1335 450/842

B StÀ T H V

°C/°F min °C/°F/min °C/°F min °C/°F °C/°F °C/°F

Glaze ﬁring 403/757 6:00 60/108 725/1337 1:00 450/842 724/1335 450/842

Add-On ﬁring

There are 3 IPS e.max Ceram Add-On materials available for adjustments. Depending on the individual application, the materials are processed differently.

Option 1 – Add-On with Glaze ﬁring

This method is used if minor adjustments are made together with the Glaze ﬁring. If you use this method, proceed as follows: – If IPS e.max Ceram Glaze Spray is used for glazing, spray it once the Add-On

materials have been applied.

– If necessary, optimize the accuracy of ﬁt of the shoulder using IPS e.max Ceram

Add-On Margin (alone).

– Mix IPS e.max Ceram Add-On Dentin and Incisal in a 1:1 ratio and then mix it with

Dentin and Transparent Incisal material. Apply the mixture on the corresponding areas and ﬁre.

– Polish the adjusted areas to a high gloss after ﬁring.

Firing parameters for Add-On with Glaze ﬁring – note the slow cooling!

Frameworks

Processing on ZrO

IPS e.max Ceram on ZrO

Add-On with Glaze ﬁring 403/757 6:00 60/108 725/1337 1:00 450/842 724/1335 450/842

B StÀ T H V1 V2 L

°C/°F min °C/°F/min °C/°F min °C/°F °C/°F °C/°F

Option 2 – Add-On after Glaze ﬁring

Additional corrections may be required once the restoration has been completed and tried in with the patient (e.g. pontic rest, contact points). In such cases, proceed as follows:

– Apply IPS e.max Ceram Add-On Dentin and Incisal (alone) to the corresponding

areas and ﬁre. – Polish the adjusted areas to a high gloss after ﬁring.

Firing parameters for Add-On after Glaze ﬁring – note the slow cooling!

IPS e.max Ceram on ZrO

Add-On after Glaze ﬁring 403/757 6:00 50/90 700/1292 1:00 450/842 699/1290 450/842

B StÀ T H V1 V2 L

°C/°F min °C/°F/min °C/°F min °C/°F °C/°F °C/°F

Completed IPS e.max Ceram restoration

Homogeneous, true-to-nature surface and gloss

High-gloss basal area of the pontics for optimum cleaning

Jürgen Seger, Ivoclar Vivadent, Schaan/Liechtenstein

The dental lab work was carried out by

e.max

IPS

Ceram

Abutment Technique

Overview of the processing possibilities of the Straumann®Anatomic IPS e.max®Abutment

Straumann Anatomic IPS e.max Abutment

Indirect method

Cement-retained crowns and bridges

Optional

Adaption Emergence profile with IPS e.max Ceram

Abutment Technique

IPS e.max Press

IPS e.max CAD

IPS e.max ZirCAD/ Ceram

IPS e.max ZirCAD/ ZirPress

Direct method

Screw-retained crowns

Definition "Indirect / Direct Method"

Indirect method – Cement-retained crowns and bridges

– Straumann Anatomic IPS e.max Abutment screwed onto the implant – (Laboratory) Fabrication of the IPS e.max restoration same as on natural preparations – IPS e.max restoration incorporated using a cementation material

Veneering with IPS e.max Ceram

Pressing over with IPS e.max ZirPress

Direct method – Screw-retained crown

– Direct veneering of the Straumann Anatomic IPS e.max Abutment with IPS e.max

Ceram or direct pressing on of IPS e.max ZirPress

– Screwing down of the veneered and/or pressed-over Straumann Anatomic IPS e.max

Abutment on the implant

Preparing the Straumann®Anatomic IPS e.max®Abutment

The Straumann Anatomic IPS e.max Abutment is prepared according to the step-by-step instructions. For the selection of the grinding instruments, please refer to the Ivoclar Vivadent Flow Chart “Recommended grinding tools for IPS e.max zirconium oxide”. Conduct a Regeneration ﬁring after preparing the abutment.

Individualized Straumann®Anatomic IPS e.max®Abutment on the model

Please observe the following procedure for conducting the Regeneration ﬁring: – Clean and dry the individualized abutment with the steam jet. – Position the abutment on a metal pin on a honey-combed tray. – Conduct the Regeneration firing in a ceramic furnace (e.g. Programat P700) using the respective parameters. – Do not adjust the abutment by grinding after the Regeneration firing. – Do not blast the framework with Al2O3or glass polishing beads before veneering, since this may cause lasting damage

to the surface.

– Before veneering, clean the abutment with running water or the steam jet.

Firing parameters for the Regeneration ﬁring

Furnace

°C/°F

min

P300 P500 P700

EP 3000

403 757

0:18

EP 5000

P80 P100 P200

EP 600

PX1

403 757

0:18

0:30

°C/°F/min

117

°C/°F

1050 1922

min

15:00

°C/°F

750

1382

750

1382

750

1382

°C/°F/min

25 45

––

12 min

Adaptation of the emergence profile

If there is a gap between the "gingiva" (gingiva mask) and the abutment on the model with the abutment screwed down, it can be closed by adding and ﬁring IPS e.max Ceram. The emergence proﬁle can be adapted using tooth-shaded or gingiva-shaded materials as necessary.

When adapting the emergence proﬁle, the maximum layer thickness of 1.0 mm of IPS e.max Ceram must not be exceeded.

Screwed-down abutment on the model with individualized incisal adaptation. The gap between the abutment and the "gingiva" requires adaptation of the emergence proﬁle.

Abutment Technique

Application of IPS e.max Ceram ZirLiner

IPS e.max Ceram ZirLiner must always be applied before the application of the IPS e.max Ceram layering materials to achieve an optimum bond. Direct layering onto the abutment without ZirLiner may result in cracks and delamination.

– Remove the Straumann Anatomic IPS e.max Abutment from the model for the application of the IPS e.max Ceram ZirLiner. – Do not blast the Straumann Anatomic IPS e.max Abutment with Al

, since this may damage the surface.

2O3

– Clean the abutment with the steam jet before the application of the IPS e.max Ceram ZirLiner. – Mix the IPS e.max Ceram ZirLiner in the desired shade or gingiva shade with the respective IPS e.max Ceram ZirLiner Build-

Up Liquid to a creamy consistency. – For shaded abutments, use IPS e.max ZirLiner clear. – If a different consistency is desired, IPS e.max Ceram Build-Up Liquid (allround or soft) as well as the IPS e.max Ceram Glaze

and Stain Liquids (allround or longlife) may be used. The liquids may also be mixed with each other at any mixing ratio. – Cover the areas to be adapted with ZirLiner. If necessary, brieﬂy vibrate until an even, greenish colour effect is achieved. If

the colour appears too pale, the layer is too thin. – For more intensively shaded areas, four IPS e.max Ceram Intensive ZirLiners (yellow, orange, brown, incisal) are available. – It is important that no ZirLiner reaches the contact surface between the abutment and the implant. – Conduct the ZirLiner ﬁring on a honey-combed ﬁring tray. – After ﬁring, the IPS e.max Ceram ZirLiner should exhibit a layer thickness of approx. 0.1 mm. – Remove the restoration from the furnace after completion of the ﬁring cycle (wait for the acoustic signal of the furnace). – Allow the objects to cool to room temperature in a place protected from draft. – Do not touch the hot objects with metal tongs.

Before the application of the ZirLiner, clean the abutment with the steam jet. Do not blast with Al2O3or glass polishing beads.

Cover the entire abutment with the tooth-shaded or gingiva-shaded ZirLiner Place the abutment on a honey-combed ﬁring tray for ZirLiner ﬁring. Before ﬁring, make sure

that the contact surface between the abutment and the implant is free from contamination.

Firing parameter for the ZirLiner ﬁring

IPS e.max Ceram ZirLiner on Straumann Anatomic IPS e.max

Abutment °C/°F min °C/°F/min °C/°F min °C/°F °C/°F °C/°F

ZirLiner ﬁring 403/ 757 4:00 40/72 960/1760 1:00 450/842 959/1758

B StÀ T HV1V

Dentin firing

For the application of the layering materials on the ﬁred ZirLiner, observe the following procedure:

– Secure the Straumann®Anatomic IPS e.max®Abutment with the ﬁred Liner on the model. – Mix the required IPS e.max Ceram layering materials Deep Dentin or Gingiva with the Build-Up Liquids allround or soft. If a

different consistency of the ceramic is desired, the liquids may also be mixed with each other at any mixing ratio. – Subsequently, layer the emergence proﬁle. Observe the necessary layer thicknesses. – Loosen the screw and carefully remove the abutment from the model. – Before ﬁring, the contact surface between the abutment and the implant must be checked. It must be

absolutely free of layering material so that the accuracy of ﬁt is not compromised.

– Position the restoration on a honey-combed tray and ﬁre it according to the stipulated ﬁring parameters. – Remove the restoration from the furnace after completion of the ﬁring cycle (wait for the acoustic signal of the furnace). – Allow the objects to cool to room temperature in a place protected from draft. – Do not touch the hot objects with metal tongs.

Abutment Technique

Layer the emergence proﬁle using Deep Dentin and/or Gingiva. Place the abutment on a honey-combed ﬁring tray for the Dentin ﬁring.

Firing parameters for the Dentin ﬁring

IPS e.max Ceram on Straumann Anatomic IPS e.max

Dentin ﬁring 403/757 4:00 40/72 750/1382 1:00 450/842 749/1380

Abutment °C/°F min °C/°F/min °C/°F min °C/°F °C/°F °C/°F

B StÀ T HV1 V2 L

Finishing and preparing for the Stain and Glaze firing

Before the Stain and Glaze ﬁring, the abutment has to be ﬁnished as follows:

– Check the restoration on the model. The ﬁred emergence proﬁle must be designed in such a way that it rests ﬂush

against the "gingiva" without exerting pressure. – It is important that the contact surface between the abutment and the implant is not ﬁnished in any way. The polishing

aid can be used for ﬁnishing. – If necessary, the emergence proﬁle can be ﬁnished using ﬁne-grain diamonds and rubber polishers. – Prepolish tapered areas with a rubber polisher so that a very smooth transition to the abutment is achieved.

Check of the restoration on the model. The ﬁred emergence proﬁle must rest ﬂush against the gingiva.

ﬁnishing the layered areas with ﬁne-grain diamonds and rubber polishers.

Glaze firing

The abutment must be free of dirt and grease prior to the Glaze ﬁring. Any contamination after cleaning must be prevented.

The following steps must be observed: – Mix the paste or powder with the IPS e.max Ceram Glaze and Stain Liquids allround or longlife to the desired consistency. – The shade of the emergence proﬁle can be individually designed using IPS e.max Ceram Essence and Shade materials. – Apply the Glaze and Stains layer thinly using a brush. – Before ﬁring, the contact surface between the abutment and the implant must be checked. It must be

absolutely free of Glaze and Stains so that the accuracy of ﬁt is not compromised.

– Position the restoration on a honey-combed tray and ﬁre it according to the stipulated parameters for the Glaze ﬁring. – Remove the restoration from the furnace after completion of the ﬁring cycle (wait for the acoustic signal of the furnace). – Allow the objects to cool to room temperature in a place protected from draft. – Do not touch the hot objects with metal tongs.

Apply Glaze and/or Stains on the ﬁred areas. Conduct the Glaze ﬁring on a honey-combed tray with the stipulated ﬁring parameters.

Before ﬁring, make sure that the contact surface between the abutment and the implant is

4040

free from contamination.

Firing parameters for the Glaze ﬁring – note the slow cooling!

IPS e.max Ceram on Straumann Anatomic IPS e.max

B StÀ T HV1 V2 L

Abutment °C/°F min °C/°F/min °C/°F min °C/°F °C/°F °C/°F

Glaze ﬁring 403/757 6:00 60/108 725/1337 1:00 450/842 724/1335 450/842

Straumann®Anatomic IPS e.max®Abutment with individually adapted emergence proﬁle. Straumann®Anatomic IPS e.max®Abutment with individually adapted emergence proﬁle.

Abutment Technique

Comparison: Abutment before and after the adaption of the emergence proﬁle

4141

Direct firing of IPS e.max Ceram

max. 2mm

IPS e.max Ceram offers the possibility to directly veneer the Straumann®Anatomic IPS e.max®Abutment. The veneered abutment is intraorally screwed down with the abutment and the screw cavity sealed with composite.

When ﬁring IPS e.max Ceram on the Straumann®Anatomic IPS e.max®Abutment, the following maximum layering thicknesses must not be exceeded.

Anterior region Premolar region

Application of IPS e.max Ceram ZirLiner

IPS e.max Ceram ZirLiner must always be applied before the application of the IPS e.max Ceram layering materials to achieve an optimum bond as well as a true-to-nature shade effect and in-depth translucency. Direct layering onto the abutment without ZirLiner may result in cracks and delamination.

– Remove the Straumann Anatomic IPS e.max Abutment from the model for the application of the IPS e.max Ceram ZirLiner. – Do not blast the Straumann Anatomic IPS e.max Abutment with Al2O3, since this may damage the surface. – Clean the abutment with the steam jet before the application of the IPS e.max Ceram ZirLiner. – Mix the IPS e.max Ceram ZirLiner in the desired shade with the respective IPS e.max Ceram ZirLiner Build-Up Liquid to a

creamy consistency. – For shaded abutments, use IPS e.max ZirLiner clear. – If a different consistency is desired, IPS e.max Ceram Build-Up Liquid (allround or soft), as well as the IPS e.max Ceram Glaze

and Stain Liquids (allround or longlife) may be used. The liquids may also be mixed with each other at any mixing ratio. – Cover the areas to be veneered with ZirLiner. If necessary, brieﬂy vibrate until an even, greenish colour effect is achieved. If

Before the application of the ZirLiner, clean the abutment with the steam jet. Do not blast with Al2O3or glass polishing beads.

Abutment Technique

Cover the entire abutment with ZirLiner. Place the abutment for ZirLiner ﬁring on a honey-combed ﬁring tray. Before ﬁring, make sure

The ﬁred ZirLiner shows a homogeneous, silky-mat surface.

that the contact surface between the abutment and the implant is free from contamination.

Firing parameters for the ZirLiner ﬁring

IPS e.max Ceram ZirLiner on Straumann Anatomic IPS e.max

Abutment °C/°F min °C/°F/min °C/°F min °C/°F °C/°F °C/°F

ZirLiner ﬁring 403/757 4:00 40/72 960/1760 1:00 450/842 959/1758

B StÀ T HV1 V2 L

Wash Firing

The low heat conductivity of zirconium oxide requires a Wash ﬁring. The Wash ﬁring ensures controlled sintering of the ceramic onto the framework surface and enables a homogeneous bond to the ﬁred ZirLiner. In order to achieve this, please proceed as follows:

– Before the application of the Wash layer, clean the abutment with the steam jet. – Mix the required IPS e.max Ceram Dentin or Deep Dentin material with the IPS e.max Ceram Build-Up Liquids allround or

soft. If a different consistency of the ceramic is desired, the liquids may also be mixed with each other at any mixing ratio. – Apply the wash in a thin coat on the entire ﬁred ZirLiner. – It is important that no layering material reaches the contact surface between the abutment and the implant. – Position the abutment on a homey-combed tray for the Wash ﬁring. – Remove the restoration from the furnace after completion of the ﬁring cycle (wait for the acoustic signal of the furnace). – Allow the objects to cool to room temperature in a place protected from draft. – Do not touch the hot objects with metal tongs.

Apply the wash in a thin coat on the entire ﬁred ZirLiner. Secure the abutment on the polishing aid for the application of the Wash.

Remove the abutment from the polishing aid and place it on a honey-combed tray for the

Wash ﬁring. Before ﬁring, make sure that the contact surface between the abutment

and the implant is free from contamination.

Firing parameters for the Wash ﬁring

IPS e.max Ceram on Straumann Anatomic IPS e.max

Wash Firing 403/757 4:00 40/72 750/1382 1:00 450/842 749/1380

Abutment °C/°F min °C/°F/min °C/°F min °C/°F °C/°F °C/°F

B StÀ T HV1 V2 L

1st/2ndDentin and Incisal firing

For the application of the layering materials on the ﬁred Wash, observe the following procedure:

– Secure the Straumann®Anatomic IPS e.max®Abutment with the ﬁred Liner on the model using the screw. – Mix the required IPS e.max Ceram layering materials, i.e. Dentin, Incisal and Effect, with the Build-Up Liquids allround or

soft. If a different consistency of the ceramic is desired, the liquids may also be mixed with each other at any mixing ratio. – Seal the screw cavity before layering so that no material may enter. – Subsequently, layer the IPS e.max Ceram layering materials. Observe the maximum layer thicknesses. – Loosen the screw after layering and carefully remove the abutment from the model. – Before ﬁring, the contact surface between the abutment and the implant as well as the screw cavity must be

checked. They must be absolutely free of layering material so that the accuracy of ﬁt is not compromised.

– Position the restoration on honey-combed tray and ﬁre it according to the stipulated ﬁring parameters. – Remove the restoration from the furnace after completion of the ﬁring cycle (wait for the acoustic signal of the furnace). – Allow the objects to cool to room temperature in a place protected from draft. – Do not touch the hot objects with metal tongs. – If a second ﬁring is required, it can be conducted using the same parameters.

Abutment Technique

Layer the IPS e.max Ceram layering materials.

Before ﬁring, make sure that the contact surface between the abutment and the implant and the screw cavity are free from contamination.

Firing parameters for the Dentin ﬁring

IPS e.max Ceram on Straumann Anatomic IPS e.max

Dentin ﬁring 403/757 4:00 40/72 750/1382 1:00 450/842 749/1380

Abutment °C/°F min °C/°F/min °C/°F min °C/°F °C/°F °C/°F

B StÀ T HV1 V2 L

Finishing and preparing for the Stain and Glaze firing

Before the Stain and Glaze ﬁring, the abutment has to be ﬁnished as follows:

– Check the restoration on the model. Check the proximal and occlusal contact points. – Secure the abutment on the polishing aid for ﬁnishing. – Finish the veneered abutments with ﬁne-grain diamonds and rubber polishers to obtain a true-to-nature shape and

surface structure, such as growth lines and convex/concave areas. – Areas which should exhibit a higher gloss after Glaze ﬁring can be smoothed out and prepolished using silicone disks. – Prepolish the transition area between the veneer and the abutment rubber polishers so that a very smooth transition is

achieved. – If gold and/or silver dust was used to design the surface texture, the restoration has to be thoroughly cleaned with

steam. Make sure to remove all gold or silver dust in order to avoid any discolouration after ﬁring.

Check the restoration on the model. The ﬁred emergence proﬁle must rest ﬂush against the "gingiva" without exerting pressure.

Finish the layered areas with ﬁne-grain diamonds and rubber polishers.

Glaze firing

Stain ﬁring is conducted with Essence and/or Shades, while glaze powder or paste is used for Glaze ﬁring. Depending on the situation, the Stain and Glaze ﬁrings may be conducted together or separately one after the other. The ﬁring parameters are identical.

The restoration must be free of dirt and grease. Avoid any contamination after cleaning the restoration with ultrasound in a water bath or steam jet. With this ﬁring, ﬁnal adjustments of contact points are also possible. The following steps must be observed:

– For better wetting of the Stains and Glaze, a small amount of Glaze and Stain Liquid can be applied on the surface. – Mix the Glaze paste or powder with the IPS e.max Ceram Glaze and Stain Liquids allround or longlife to the desired con-

sistency. – If more intensive shades are desired, they are achieved by several staining procedures, not by applying thicker layers. – The cusps and ﬁssures can be individualized using Essence. – If shade adjustments are required, Shade materials can be used. – Apply the glazing material in an even layer on the entire restoration. – For the adjustment of the contact points, mix e.g. IPS e.max Ceram Incisal and Add-On Incisal in a 1:1 ratio. Polish the

adjusted areas to a high gloss after ﬁring using silicone polishers. – Before ﬁring, the contact surfaces between the abutments and the implant must be checked. It must be

absolutely free of Glaze and Stains so that the accuracy of ﬁt is not compromised.

Abutment Technique

Apply the Glaze in an even layer. Apply characterizations using Shades and Essence

Supplement the contact points using a 1:1 mixture. Conduct the Glaze ﬁring on a honey-combed tray with the stipulated ﬁring parameters.

Before ﬁring, make sure that the contact surface between the abutment and the implant is

free from contamination.

Firing parameters for the Glaze ﬁring – note the slow cooling!

IPS e.max Ceram on Straumann Anatomic IPS e.max

Stain ﬁring 403/757 6:00 60/108 725/1337 1:00 450/842 724/1335 450/842

Glaze ﬁring 403/757 6:00 60/108 725/1337 1:00 450/842 724/1335 450/842

B StÀ T HV1 V2 L

Abutment °C/°F min °C/°F/min °C/°F min °C/°F °C/°F °C/°F

If the gloss is unsatisfactory after the ﬁrst Glaze ﬁring, further Glaze ﬁring procedures may be conducted using the same ﬁring parameters.

IPS e.max Ceram on Straumann®Anatomic IPS e.max®Abutment – fabricated in the staining technique.

e.max

IPS

Ceram

Gingiva

IPS e.max Ceram Gingiva layering materials can be used to create a lifelike gingiva, particularly for implant superstructures. The materials are applied together with the Dentin and Incisal materials and ﬁred.

A total of 13 ceramic materials are available for fabricating the gingival portions. For determining the gingival characteristics a shade guide which shows the different Gingiva materials after ﬁring is available.

Gingiva Technique

Gingiva ZirLiner

Note: As with the tooth-shaded layering materials, gingival portions made of IPS e.max Ceram have to be adequately supported by a respective zirconium oxide framework.

Please observe the following procedure: – Before layering, apply IPS Model Sealer on the model and allow it to dry. After that, isolate the corresponding areas

using IPS Ceramic Separating Liquid.

– For frameworks made of zirconium oxide, the IPS e.max Ceram ZirLiner Gingiva or a tooth-shaded ZirLiner has to be

ﬁred on the gingival areas (application of ZirLiner see page 20/observe the ﬁring parameters). – The ZirLiner Gingiva is applied together with the tooth-shaded ZirLiner and ﬁred. – Mix the required IPS e.max Ceram layering materials (e.g. Dentin, Deep Dentin, Incisal, Gingiva) with the Build-Up

Liquids allround or soft. If another consistency is desired, the liquids may also be mixed with each other at any mixing

ratio. – Use distilled water to rewet the layering materials on the mixing pad to avoid accumulation of organic components. – Underlay the pontic areas of bridges with Deep Dentin in the next lighter shade. – Place the framework on the model and make sure it is correctly positioned. – Layer tooth-shaded areas of the restoration according to the layering diagram. – Depending on the restoration size and extension of the gingival portions, the Gingiva materials can be applied with the

ﬁrst or second Dentin/Incisal ﬁring. – Use the Gingiva materials to create the basal rest of the restoration on the “natural” gums. In order to ensure proper

oral hygiene of the inserted restorations, observe a homogeneous basal area free of pores and a correct shape. – Apply the vestibular and oral portions of the gingiva. – Do not apply excessive suction and prevent the restoration from drying out. – Before ﬁring, all the interdental areas must be separated down to the framework using a scalpel. – Position the restoration on the ﬁring tray and ﬁre it according to the ﬁring parameters for Dentin/Incisal ﬁring. – If required, an additional Dentin/Incisal ﬁring can be conducted. Moreover, the gingival portions can be adjusted.

G2 G3 G4 G5 IG1 IG2 IG3 IG4 E20

rose

Gingiva Intensive Gingiva Essence

E21

berry

E22

aubergine

Apply the Gingiva materials according to the clinical situation.

Gingiva G1 Gingiva G2 Essence E22 Gingiva G3 Gingiva G5

Complete the tooth-shaded portions of the restoration using Incisal and Impulse materials for the second Dentin/Incisal ﬁring.

Firing parameters for IPS e.max Ceram Gingiva

IPS e.max Ceram B StÀ T H V1 V2 Cut-Back and layering technique °C/°F min °C/°F/min °C/°F min °C/°F °C/°F

ZirLiner ﬁring

Dentin/Incisal ﬁring

403/

757 72 1760 842 1758

403/

757 72 1382 842 1380

403/

757 72 1382 842 1380

4:00

40/ 960/

40/ 750

40/ 750/

1:00

450/ 959/

450/ 749/

Stain and Glaze ﬁring

The gingival portions are characterized and glazed together with the tooth-shaded areas of the restoration. Stain ﬁring is conducted with IPS e.max Ceram Essence and Shades, while Glaze ﬁring is carried out with Glaze powder or paste. Depending on the situation, the ﬁring cycles may be conducted together or separately. The ﬁring parameters are identical.

Please observe the following procedure: – Finish the restoration with diamonds and provide a true-to-nature shape and surface structure, e.g. stippling. – Areas which should exhibit a higher gloss after Glaze ﬁring (e.g. pontic rests) can be smoothed out and prepolished

using silicone wheels. – In order to improve the wetting properties of the surface, rub the restoration with moist ceramic or pumice. – The restoration must be free of dirt and grease. Avoid any contamination after cleaning the restoration with ultrasound

in a water bath or with a steam jet. – Mix the pastes or powder with the IPS e.max Ceram Glaze and Stain Liquids (allround or longlife) until the desired

consistency is achieved. – If shade adjustments on the gingival portions are required, the Gingiva Essence materials can be used. – Evenly apply the glazing material to the entire surface of the restoration. Do not use any IPS e.max Ceram Glaze FLUO

on the gingival portions, since natural gingiva does not exhibit any ﬂuorescence. – Conduct Stain and Glaze ﬁring according to the ﬁring parameters. – IPS e.max Ceram Add-On materials can be used for further adjustments (page 33).

Firing parameters for IPS e.max Ceram Gingiva – note the slow cooling!

Gingiva Technique

IPS e.max Ceram B StÀ T H V Cut-Back and layering technique °C/°F min °C/°F/min °C/°F min °C/°F °C/°F

Stain ﬁring

Glaze ﬁring

403/

757 108 1337 842 1335

403/

757 108 1337 842 1335

6:00

60/ 725/

1:00

450/ 724/

Completed restoration after Glaze ﬁring

The dental lab work was carried out by

MDT Thorsten Michel, Schorndorf/Germany

e.max

IPS

Ceram

Veneers

The following chart shows the step-by-step layering of IPS e.max Ceram veneers on refractory dies. Important: Prior to each working step, the refactory model has to be immersed in distilled water for about 5–10 minutes.

TIP:

For the fabrication of veneers, smaller working steps and several intermediate ﬁring cycles are recommended.

Fabricating the model

Fabricate a duplicate model and subsequently cast it with commercially available refractory die material, e.g. BegoForm®from Bego or Cosmotech VEST, G-CERATMVest from GC (observe the instructions of the manufacturer). Die materials that feature an even, light colour after ﬁring are particularly suitable.

Fabricate the model as small as possible in order to minimize the effects on ﬁring!

Prepare dies made of refractory die material for the veneer fabrication

Wash ﬁring

Conduct the Wash ﬁring using Add-On, Dentin or Transpa clear materials. Apply the layering materials in a thin layer.

Cervical ﬁring

For the wash ﬁring, IPS e.max Ceram Add-On is preferably applied. However, IPS e.max Ceram Dentin or Transpa clear can also be used. Mix the materials with Build-up Liquid, apply in a thin layer on the refractory model, and ﬁre at the respective temperature.

Wash ﬁring with IPS e.max Ceram Add-On

°C/°F

720/

1328

°C/°F

403/

757

min

8:00

tÀ

°C/°F/min

50/

min

1:00

°C/°F

450/

842

°C/°F

719/

1326

Wash ﬁring with IPS e.max Ceram Dentin/Transpa clear

°C/°F

780/

1436

°C/°F

403/

757

min

8:00

tÀ

°C/°F/min

50/

min

1:00

°C/°F

450/

842

°C/°F

779/

1434

Build up the marginal areas using IPS e.max Ceram Dentin.

Build up the marginal areas using Deep Dentin.

°C/°F

770/

1418

°C/°F

403/

757

min

8:00

tÀ

°C/°F/min

50/

min

1:00

°C/°F

450/

842

°C/°F

769/

1416

1stDentin/Impulse/Incisal ﬁring

Layer the restoration according to the clinical requirements using IPS e.max Ceram Dentin and IPS e.max Ceram Incisal.

Individual layering with the Impulse and Transpa materials enables mamelons, opalescent and translucent effects to be achieved.

Individual layering with Dentin, Impulse and Incisal materials

2ndDentin/Corrective ﬁring

Compensate for the anatomical shape using Transpa and Incisal materials.

Stains and Glaze ﬁring

°C/°F

770/

1418

°C/°F

403/

757

min

8:00

tÀ

°C/°F/min

50/

min

1:00

°C/°F

450/ 842

°C/°F

769/

1416

The anatomical form is adjusted and supplemented using Incisal and Transpa materials. Several corrective ﬁring cycles can be conducted using the same ﬁring parameters.

°C/°F

770/

1418

°C/°F

403/

757

min

8:00

tÀ

°C/°F/min

50/

min

1:00

°C/°F

450/ 842

°C/°F

769/

1416

Evenly apply glaze paste to the surface of the veneers. If desired, Essence material and/or Shades can be used to apply characterizations.

Conduct the Stain and Glaze ﬁring with Essence, Shades and Glaze materials.

Divesting of veneers

Divest the veneers with polishing jet medium at max. 1 bar (15 psi) pressure.

°C/°F

740/

1364

°C/°F

403/

757

min

8:00

tÀ

°C/°F/min

50/

min

1:00

°C/°F

450/ 842

Remove large amounts of die material using a grinding disk. Subsequently, clean the inner aspects of the veneers with polishing jet medium at approx. 1 bar pressure.

Conditioning the veneers for adhesive luting

Before the veneers are placed, the inner aspects have to be etched with IPS Ceramic Etching Gel for 20 seconds and subsequently silanized with Monobond-S.

Important:

IPS e.max Ceram veneers have to be adhesively cemented.

°C/°F

739/

1362

e.max

IPS

Versatility and simplicity of IPS e.max Ceram on the various IPS e.max framework materials

Ceram – One for 4

Press ZirPress

Glass-ceramic framework prepared for the wash application

Wash application

Zirconium oxide framework prepared for the ZirLiner application

ZirLiner application

Fired wash

Building up the tooth shape using Dentin materials

Fired ZirLiner

Pressing over the tooth shape

ZirCAD

CAD

Framework prepared for the ZirLiner application

ZirLiner application

Framework prepared for the wash application

Wash application

Fired ZirLiner

Conducting the Wash ﬁring and building-up the tooth shape using Dentin materials

Fired wash

Building-up the tooth shape using Dentin materials

Press ZirPress

Reducing the tooth shape to the dentin core

Completing the layering with Incisal materials

Labial view of the completed restoration after glaze ﬁring

Palatal view of the completed restoration after glaze ﬁring

ZirCAD

Reducing the tooth shape to the dentin core

CAD

Completing the layering with Incisal materials

Labial view of the completed restoration after glaze ﬁring

Palatal view of the completed restoration after glaze ﬁring

e.max

IPS

Uniform esthetic appearance irrespective of the framework material

Maximum efﬁciency and performance through one layering ceramic

Ceram – All you need

Uniform layering diagram

The crowns were fabricated by Thorsten Michel, M.D.T., Schorndorf/Germany

e.max

IPS

Ceram

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 on the indication, IPS e.max ZirPress restorations can be seated using either adhesive, self-adhesive or conventional cementation.

– For the adhesive cementation of IPS e.max ZirPress restorations, Variolink®II, Variolink®Veneer or Multilink®Automix are

the ideal composites. – SpeedCEM is available for the self-adhesive cementation of IPS e.max ZirPress. – We recommend using the glass ionomer cement Vivaglass®CEM* for the conventional cementation of IPS e.max ZirPress.

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

Short definition of the different cementation methods

• 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 ”(overall) strength” of the seated all-ceramic restoration.

• Self-Adhesive Cementation

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

the tooth surface is necessary. Hence, the adhesion of the restoration is partially achieved by a micromechanical and/or

chemical bond. In order to achieve sufﬁcient bonding strength values, retentive preparation is recommended. Self-

adhesive cementation does not result in enhanced ”(overall) strength” of the seated all-ceramic restoration.

• Conventional Cementation

With conventional cementation, the bond 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 approximately 4-6° is required. Conventional cementation does not result in

enhanced ”(overall) strength” of the seated all-ceramic restoration.

Seating and Follow-Up Care

Cementation possibilities for the different indications

Cementation

IPS e.max Ceram

on ZrO

Veneers

Anterior and

Posterior Crowns

Bridges with/without

ceramic shoulder

Adhesive



Self-Adhesive

Cementation

––



Conventional

Cementation

––



Preparing for Cementation

IPS e.max Ceram

Veneers

adhesive

––

Variolink®Veneer,

Variolin

Nano-fluorapatite

glass-ceramic

20 sec with

IPS Ceramic Etching Gel

Material

Indication

Cementation method

Blasting

Etching

Conditining/Silanization

Cementation system

Cleaning with Al2O3at max. 1 bar (15 psi)

Multilink

Automix

––

Crowns and Bridges

adhesive

self-adhesive /

conventional

IPS e.max ZirCAD / IPS e.max Ceram

Zirconium oxide /

Nano-fluorapatite glass-ceramic

60 sec with

Monobond Plus

60 sec with

Monobond Plus

SpeedCEM

Vivaglass

CEM

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.

a. 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 zirconium oxide-supported restorations: – The surface of zirconium oxide-supported restorations may be cleaned with max. 1 bar (15 psi) pressure before cemen-

tation.

– High-strength zirconium oxide ceramics are generally not etched with hydrofluoric acid gel (IPS Ceramic Etching Gel),

since no etching pattern is produced. In pressed-over inlay-retained bridges – with contact of the glass-ceramic and the

tooth structure – the pressed-on glass-ceramic must be etched with hydrofluoric acid (IPS Ceramic Etching Gel). – Thoroughly clean the restoration with water and blow dry. – For adhesive cementation, condition the bonding surface of the restoration using Monobond Plus.

For veneers made of IPS e.max Ceram, observe the following procedure: – Do not blast the veneer with Al2O3before incorporation. – Generally etch the bonding surface with 5% hydrofluoric acid gel (IPS Ceramic Etching Gel). – Condition the bonding surface of the veneer with Monobond Plus.

Please observe the corresponding Instructions for Use.

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

b. 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 are required, the restoration may be polished extraorally in these areas before final incorporation. 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 ZirPress 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 of 7 (Relative Dentin Abrasion) is a reliable confirmation to use a cleaning paste that is only a little abrasive. Scientific investigations and long-term clinical experience have proved the gentle effect compared with other pastes.

Seating and Follow-Up Care

e.max

IPS

Ceram

General Information | Questions and Answers

Is IPS e.max Ceram also suitable to veneer frameworks made of other glass-ceramic materials?

IPS e.max Ceram is not suitable to veneer and characterize glassceramic frameworks made of materials other than IPS e.max Press, IPS e.max ZirPress, and IPS e.max CAD. On the one hand, the CTE of other glass-ceramic materials is not compatible and, on the other hand, the shade coordination between framework and veneering ceramics is not ensured.

Is IPS e.max Ceram (besides IPS e.max ZirCAD) also suitable to veneer frameworks made of other zirconium oxide materials?

IPS e.max Ceram can be used to veneer frameworks made of sintered zirconium oxide, HIP zirconium oxide as well as presintered zirconium oxide with a CTE range of 10.5-11.0 x 10-6K (100–500 °C). The following zirconium oxide materials have been tested: – KaVo Everest – Bio ZS (coloured and uncoloured) and Bio ZH

Blanks – Nobel Biocare – Procera Zirconia – DeguDent – Cercon Base – 3M/Espe – Lava Frame (coloured and uncoloured) – DCS – DC-Zirkon – Cad.esthetics – Denzir – Vita – In-Ceram 2000 YZ Cubes (coloured and uncoloured) – Diatomic – Diadem/Diazir (coloured and uncoloured) – Wieland – Zeno Zr Disc – etkon – Zerion – Sirona – inCoris – AmannGirrbach – Ceramill Zi

-1

What is the purpose of the IPS e.max Ceram ZirLiner?

IPS e.max Ceram ZirLiners are translucent. Their three major purposes are as follows:

1. They enable a strong, homogeneous bond with the zirconium oxide framework.

2. They provide the white, non-coloured zirconium oxide frameworks with chroma, an in-depth effect, and a shaded character without increasing their opacity.

3. They also provide the non-ﬂuorescent zirconium oxide framework with a natural ﬂuorescence, thus enabling the fabrication of lifelike restorations.

Which type of IPS e.max Ceram ZirLiner should be used on shaded zirconium oxide frameworks?

The clear IPS e.max Ceram ZirLiner should be used on shaded zirconium oxide frameworks. The transparent character of the IPS e.max Ceram ZirLiner does not affect the framework shade. An outstanding bond as well as natural-looking ﬂuorescence is achieved. If shaded frameworks from other manufacturers are used, the colour compatibility of the IPS e.max Ceram and that of the framework must be ensured.

Can zirconium oxide frameworks also be veneered without IPS e.max Ceram ZirLiner, or with a wash ﬁring of dentin material, respectively?

An IPS e.max Ceram ZirLiner in the corresponding shade must always be applied prior to veneering. A wash ﬁring, e.g. with dentin, as it is done for glass-ceramics, is not sufﬁcient.

Is IPS e.max Ceram also suitable to individualize and veneer implant abutments?

Yes. IPS e.max Ceram is suitable to individualize and veneer zirconium oxide abutments, e.g. the Straumann®Anatomic IPS e.max®Abutment, with a CTE in the range of 10.5–11.0 x 10-6K (100–500 °C). Both an adaption of the emergence proﬁle and a full direct veneer maybe carried out. It must be made sure that the abutment is not designed too small in order to ensure adequate support of the tooth shape and cusps. The instructions of the respective manufacturers must be observed.

Is IPS e.max Ceram also suitable for the fabrication of veneers?

IPS e.max Ceram is suitable to fabricate veneers on ﬁre resistant investment material dies. The material meets the required strength values (ISO standard: at least 50 MPa). The physical properties, such as the setting expansion, must be taken into consideration when selecting the corresponding investment material.

-1

Why is the IPS e.max Ceram ZirLiner powder green and how should it be applied?

Since zirconium oxide is white and, therefore, shows a poor contrast to tooth-coloured and/or white powders, the IPS e.max ZirLiner was given an identiﬁcation colour to render its application more simple and efﬁcient. The IPS e.max Ceram ZirLiner consists of a very ﬁne powder and appears somewhat thick due to the dense packing of the grains. Make sure that the material is applied in an even, greenish coat. If the shade is too pale, the layer is too thin. After ﬁring, however, the ZirLiner demonstrates a layer thickness of approximately 0.1 mm.

How are the IPS e.max Ceram Add-On materials correctly used?

What liquid should be used to rewet IPS e.max Ceram layering materials?

There are 3 Add-On materials available for ﬁnal adjustments. AddOn Margin with a ﬁring temperature of 725 °C (1337 °F) is used for shoulder adjustments with the dentin / incisal ﬁrings as well as with the ﬁnal glaze ﬁring. Depending on the application, the Add-On Margin material is mixed 1:1 with the correspondingly shaded Margin material (adjustment with the dentin/incisal ﬁring) or used alone (adjustment with the glaze ﬁring). Add-On Dentin and AddOn Incisal with a ﬁring temperature of 700 °C (1292 °F) are used to supplement missing areas (e.g. contact points) with the ﬁnal glaze ﬁring or a separate add-on ﬁring after glaze ﬁring. Depending on the application Add-On Dentin and Add-On Incisal are mixed 1:1 with the Dentin and Incisal material in the corresponding shade (supplements with the glaze ﬁring) or used alone (supplements after glaze ﬁring) (see also page 33).

How should completely layered IPS e.max Ceram restorations be prepared for ﬁring?

Separate the completely layered IPS e.max Ceram restorations in the interdental area down to the framework and only blot them dry with a cloth. Excessive vibration of the restorations by drawing another instrument over the grooves of the forceps grip and using suction equipment or excessive drying with blown air should not be done.

If a layering material has to be rewetted on the mixing pad, distilled water has to be used for that purpose. No Build-Up Liquids must be used, since this would result in an accumulation of organic components, which may lead to gray discolouration of the veneer as they fail to ﬁre without leaving residue.

How can the wetting properties of the restoration be improved before the Stain and Glaze ﬁring?

The wetting properties of the surface can either be improved by slight blasting with Al2O3(Type 100 µm/ max. 1 bar/15 psi) or by rubbing with moist ceramic powder or pumice. Good wetting properties are important for a homogeneous application of the Shades, Essence and Glaze materials.

How can the shrinkage be compensated for deep occlusal preparations or very concave areas?

With deep occlusal surfaces and/or steep cusp inclinations and particularly with massive zirconium oxide pontics and abutments, it is favourable to separate the central ﬁssure with a scalpel down to the framework before the ﬁrst ﬁring (with the ZirLiner layer already ﬁred). In this way, the ceramic may sinter to the framework surface in a controlled fashion. During the subsequent 2ndDentin and Incisal ﬁring, the central ﬁssure and occlusal surface are then closed.

How can the shrinkage of the ceramic be reduced, especially in large bridges and implant superstructures?

If enough space is available, a special Deep Dentin or intermediate Dentin ﬁring is recommended, to distribute the overall shrinkage to two ﬁring procedures. In this way, especially the position of the Impulse materials after the second ﬁring can be ensured.

e.max

IPS

Ceram – Combination Table

A–D

e.max

IPS

Ceram – Combination Table

Chromascop

e.max

IPS

Ceram

Firing parameters

Firing of lithium disilicate glass-ceramic (LS2)-supported restorations

between the framework and the veneering ceramic, which may lead to crack formation later on. Reducing the ﬁring

temperature results in the ceramic being underﬁred rendering it very brittle, which may ultimately lead to delamination. – The parameters in the Instructions for Use apply to Ivoclar Vivadent furnaces (tolerance: +/- 10 °C/18 °F) – If furnaces other than those from Ivoclar Vivadent are used, temperature adjustments may be necessary. – At the beginning, open the furnace and wait for the acoustic signal. Subsequently, place the ﬁring tray with the objects

in the center of the ﬁring table and start the program. – Remove IPS e.max objects from the furnace after completion of the ﬁring cycle (wait for the acoustic signal of the

furnace). – Allow the objects to cool to room temperature in a place protected from draft. – Do not touch the hot objects with metal tongs. – Do not blast or quench the objects.

IPS e.max Ceram on IPS e.max Press or IPS e.max CAD (Staining technique)

IPS e.max Ceram on B StÀ T H V1 V2

IPS e.max Press or IPS e.max CAD °C/°F min °C/°F/min °C/°F min °C/°F °C/°F

Staining technique

Stain and characterization ﬁring

Glaze ﬁring

Add-On after Glaze ﬁring

IPS e.max Ceram on IPS e.max Press or IPS e.max CAD (Cut-back and Layering technique)

IPS e.max Ceram on B StÀ T H V1 V2

IPS e.max Press or IPS e.max CAD °C/°F min °C/°F/min °C/°F min °C/°F °C/°F

Cut-back and layering technique

Wash ﬁring (foundation)

Wash ﬁring (foundation) characterization

Dentin/Incisal ﬁring

Stain ﬁring

Glaze ﬁring

Add-On with Glaze ﬁring

Add-On after Glaze ﬁring

403/ 6:00 60/ 770/ 1:00 450/ 769/

757 6:00 108 1418 1:00 842 1416

403/ 6:00 60/ 770/ 1:00 450/ 769/

757 6:00 108 1418 1:00 842 1416

403/ 6:00 50/ 700/ 1:00 450/ 699/

757 6:00 90 1292 1:00 842 1290

403/ 4:00 50/ 750/ 1:00 450/ 749/

757 4:00 90 1382 1:00 842 1380

403/ 4:00 50/ 750/ 1:00 450/ 749/

757 4:00 90 1382 1:00 842 1380

403/ 4:00 50/ 750/ 1:00 450/ 749/

757 4:00 90 1382 1:00 842 1380

403/ 4:00 50/ 750/ 1:00 450/ 749/

757 4:00 90 1382 1:00 842 1380

403/ 6:00 60/ 725/ 1:00 450/ 724/

757 6:00 108 1337 1:00 842 1335

403/ 6:00 60/ 725/ 1:00 450/ 724/

757 6:00 108 1337 1:00 842 1335

403/ 6:00 60/ 725/ 1:00 450/ 724/

757 6:00 108 1337 1:00 842 1335

403/ 6:00 50/ 700/ 1:00 450/ 699/

757 6:00 90 1292 1:00 842 1290

Depending on the furnace type, the ﬁring temperature can be reduced by 5 °C to max. 10 °C (9 °F to max. 18 °F) for the 2ndDentin / Incisal ﬁring.

Firing of zirconium oxide (ZrO

)--supported restorations

– Several units (e.g. multi-unit bridges with bulky pontics) in the furnace impede even and thorough heating of the

individual units. – Heat penetration in the ﬁring chamber depends on the type of furnace and the size of the ﬁring chamber. – The parameters listed in the Instructions for Use apply to Ivoclar Vivadent furnaces (temperature tolerance ± 10 ºC/18 °F). – If furnaces other than those from Ivoclar Vivadent are used, temperature adjustments may be necessary. – At the beginning, open the furnace and wait for the acoustic signal. Subsequently, place the ﬁring tray with the objects

in the center of the ﬁring table and start the program. – Remove IPS e.max objects from the furnace after completion of the ﬁring cycle (wait for the acoustic signal of the

furnace). – Allow the objects to cool to room temperature in a place protected from draft. – Do not touch the hot objects with metal tongs. – Do not blast or quench the objects.

IPS e.max Ceram on IPS e.max ZirPress (Staining technique)

IPS e.max Ceram on IPS e.max ZirPress B StÀ T H V

Staining Technique °C/°F min °C/°F//min °C/°F min °C/°F °C/°F °C/°F

ZirLiner ﬁring – before wax-up and pressing 403/757 4:00 40/72 960/1760 1:00 450/842 959/1758

Stain and characterization ﬁring 403/757 6:00 60/108 770/1418 1:00-2:00 450/842 769 450/842

Glaze ﬁring 403/757 6:00 60/108 770/1418 1:00-2:00 450/842 769 450/842

Add-On after Glaze ﬁring 403/757 6:00 50/90 700/1292 1:00 450/842 699 450/842

IPS e.max Ceram on IPS e.max ZirPress (Cut-back and Layering technique)

IPS e.max Ceram on IPS e.max ZirPress B StÀ T H V

Cut-back and Layering technique °C/°F min °C/°F/min °C/°F min °C/°F °C/°F °C/°F

ZirLiner ﬁrng – before wax-up and pressing 403/757 4:00 40/72 960/1760 1:00 450/842 959/1758

Wash ﬁring (Foundation) 403/757 4:00 40/72 750/1382 1:00 450/842 749/1380

Wash ﬁring (Foundation) characterization 403/757 4:00 40/72 750/1382 1:00 450/842 749/1380

1stDentin/Incisal ﬁring 403/757 4:00 40/72 750/1382 1:00 450/842 749/1380

2ndDentin/Incisal ﬁring 403/757 4:00 40/72 750/1382 1:00 450/842 749/1380

Stain ﬁring 403/757 6:00 60/108 725/1337 1:00 450/842 724/1335 450/842

Glaze ﬁring 403/757 6:00 60/108 725/1337 1:00 450/842 724/1335 450/842

Add-On with Glaze ﬁring 403/757 6:00 60/108 725/1337 1:00 450/842 724/1335 450/842

Add-On after Glaze ﬁring 403/757 6:00 50/90 700/1292 1:00 450/842 699/1290 450/842

Depending on the furnace type, the ﬁring temperature can be reduced by 5 °C to max. 10 °C (9 °F to max. 18 °F) for the 2ndDentin / Incisal ﬁring.

IPS e.max Ceram on IPS e.max ZirCAD (Layering technique)

IPS e.max Ceram on IPS e.max ZirCAD B StÀ T H V

Layering technique °C min °C/min °C min °C °C °C

ZirLiner ﬁring 403/757 4:00 40/72 960/1760 1:00 450/842 959/1758

1stMargin ﬁring 403/757 4:00 40/72 800/1472 1:00 450/842 799/1470

2ndMargin ﬁring 403/757 4:00 40/72 800/1472 1:00 450/842 799/1470

Wash ﬁring (Foundation) 403/757 4:00 40/72 750/1382 1:00 450/842 749/1380

Dentin/Incisal ﬁring 403/757 4:00 40/72 750/1382 1:00 450/842 749/1380

2ndDentin/Incisal ﬁring 403/757 4:00 40/72 750/1382 1:00 450/842 749/1380

Stain ﬁring 403/757 6:00 60/108 725/1337 1:00 450/842 724/1335 450/842

Glaze ﬁring 403/757 6:00 60/108 725/1337 1:00 450/842 724/1335 450/842

Add-On with Glace ﬁring 403/757 6:00 60/108 725/1337 1:00 450/842 724/1335 450/842

Add-On after Glaze ﬁring 403/757 6:00 50/90 700/1292 1:00 450/842 699/1290 450/842

Depending on the furnace type, the ﬁring temperature can be reduced by 5 °C to max. 10 °C (9 °F to max. 18 °F) for the

Dentin / Incisal ﬁring.

IPS e.max Ceram on Straumann®Anatomic IPS e.max®Abutment

IPS e.max Ceram on Straumann

Anatomic IPS e.max®Abutment °C min °C/min °C min °C °C °C