e.max. All you need

IPS e.max delivers the ultimate in metal free aesthetics and strength utilising both pressable and CAD/CAM technologies.

IPS e.max


e.max

With the use of e.max we have been able to create beautiful natural looking smiles which we are confident will last.

IPS e.max delivers the ultimate in metal free aesthetics and strength utilising both pressable and CAD/CAM technologies.

Ivoclar Vivadent’s patented lithium disilicate material is truly a revolution for the dental industry. Using e.max it is now possible to combine high strength, high esthetics and ease of use into one product.

IPS e.max is a lithium disilicate glass ceramic that has optimized translucency, durability and strength for full anatomical restorations. Due to the use of new technologies and optimized processing parameters, IPS e.max lithium disilicate has evolved beyond previously available lithium disilicate ceramics. 

IPS e.max lithium disilicate restorations exhibit superior durability featuring 360-400 MPa of flexural strength. When fabricated to full-contour, the monolithic structure is the most robust ceramic system tested to date. 

The opalescence, translucency and light diffusion properties of IPS e.max lithium disilicate were all designed to replicate natural tooth structure for beauty and undetectable restorations.

Spot the veneers

e.max veneers

There's a little game we like to play with some of our clients who ask about the aesthetics of e.max, it's called spot the veneer.

So far nobody has got it right (although in fairness we never say how many veneers have been made, just to keep it interesting)

The picture above perfectly illustrates the exceptional aesthetics that can be achieved using the e.max system, but as will all our restorations it's a team effort which starts from the information coming in.

e.max lateral veneers

 

The perfect results achieved with attention to P S C


P = Preparation

A clean marginal design with a circular shoulder or a chamfer preparation with rounded inner edges is important. Avoid sharp transitions and feather edges. There are 2 images below for anterior and posterior



Rather than straining your eyes, both prep sheets below are available for you to download and keep in the surgery by clicking here


Anterior
emax_prep
Posterior
emax_prep_2
Rather than straining your eyes, both these sheets are available for you to download and keep in the surgery by clicking here


S = Shade

eMax shade


The overall lifelike, aesthetic result of an all-ceramic restoration is influenced by the following factors: 

shade of the preparation
shade of the restoration (ingot/block, layering material) 
shade of the cementation material 

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 also taking individual characteristics into consideration. 

Unlike traditional bonded ceramics, the influence of the preparation shade on the final result is a decisive aspect and must be taken into consideration, especially if it is heavily discoloured.

eMax stump shade

For that reason, the shade of the preparation should be determined in order to select the suitable restorative material, especially with severely discoloured preparations. 

Only if the dentist determines the shade of the preparation and subsequently transmits it to the laboratory may the desired esthetics be achieved in a targeted fashion. 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 (even a standard Vita shade of the preperation always helps)

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 restoration may be selected.

C = Cementation

The multiple cementation options for IPS e.max restorations allow for flexibility of cementation, since the crowns and bridges can be cemented adhesively, self-adhesively or conventionally. Inlays, onlays and veneers are adhesively cemented as usual. 
 
e.max cementation

Depending on the indications, you may choose from the comprehensive range of Ivoclar Vivadent cementation materials: 


Variolink II / Variolink Veneer The dual-curing, highly esthetic luting composite Variolink II has provided excellent clinical results for more than 10 years. For the cementation of veneers, the light-curing Variolink Veneer is used, which permits a brightening or darkening of the ceramic restoration with its special shade concept. 

Multilink Automix The universal luting composite Multilink Automix offers a broad range of indications. It provides high bonding strength and an excellent durable bond. Together with the primer A/B, the dentin is sealed and good marginal adaptation is achieved. 


SpeedCEM The self-adhesive, dual-curing luting composite is even easier to use than a conventional cement. At the same time, it offers the additional advantages of a composite, such as higher bond strength and translucency, as well as lower water solubility. 

Vivaglass CEM The classical self-curing glass ionomer cement is suitable for the cementation of high-strength ceramic materials, such as IPS e.max, among others. It contains a particularly transparent glass filler for achieving esthetic results. 

Etching and silanization Lithium disilicate (LS2) restorations are generally etched before incorporation! IPS Ceramic Etching Gel (20 s) is used to generate retentive bonding surfaces on all-ceramic restorations in preparation for incorporation. It enhances the bonding effect between the luting composite and the ceramic bonding surface. 

With adhesive and self-adhesive cementation of IPS e.max lithium disilicate (LS2) restorations, as well as the adhesive cementation of zirconium oxide (ZrO2), Monobond Plus (60 s) is used for silanization. Silanization is not required for the self-adhesive cementation of ZrO2. This also applies to conventional cementation. Monobond Plus is a primer mediating an adhesive bond between the luting composite (particularly the Variolink and Multilink product lines) and all indirect restorative materials (glass and oxide ceramics, metals, composites, fibre-reinforced composites). 

A pdf on cementation for you to download and keep in the surgery is available by clicking here

Ivoclar also have a great Cementation selection portal which guides you through the many cementation options. You can get to the portal by clicking on the image below

Ivoclar e.max Cementation Portal

Prepless veneers

We prefer to do ‘no-prep’ veneers in e.max as it has consistency of colour throughout irrespective of thickness and we can easily copy a pre-approved provisional model as there is virtually no shrinkage with the wax/press technique. Also attached is some information on the ‘new’ e.max impulse range, which has been specifically designed for very thin veneers i.e. 0.3mm

It consists of three ‘Value’ shades and two opal shades, the value shades are dentine and designed for altering discoloured teeth and increasing their brightness, the opal shades are really just enamel and are designed for re-contouring existing teeth where the patients shade is acceptable, say after a bleaching and can be made as full coverage or partial veneers.

Ivoclar Vivadent’s IPS e.max Press ingots are now also available as Impulse ingots. They are offered in three different brightness values and two opalescent shades.

The IPS e.max Press Impulse ingots in Value shades allow different brightness effects to be reproduced. They are used in the fabrication of partial crowns, single crowns as well as bridges. No matter whether a specific tooth shade needs to be created based on a defined brightness value, or consistent brightness needs to be established throughout restorations with different core shades, the Value shades enable restorations to be fabricated that blend in seamlessly with the remaining dentition. The desired tooth shade is finally attained by means of the staining or cut-back technique.

Lifelike opalescent effect In the fabrication of veneers, particularly thin veneers, translucency and opalescence play a role that is equally important to that of the tooth shade in order to attain the desired optical effects. With the two new IPS e.max Press Impulse Opal ingots, the opalescent effect of natural teeth can be reliably mimicked, which is particularly desirable when fabricating anterior veneers.

Lithium disilicate-based Like the time-tested IPS e.max Press ingots, which are offered in the levels of translucency HT, LT, MO and HO, the new IPS e.max Press Impulse ingots consist of lithium disilicate glass-ceramic material which features a flexural strength of 400 MPa.

IPS e.max Press Impulse Value 1, 2 and 3 as well as Opal 1 and 2 will be available from September 2010 onwards.


 For the full pdf on e.max impulse ingots click here



Professional care and aftercare 


emax_aftercare


Same as natural teeth, high-quality all-ceramic restorations require regular professional care. This is beneficial for both the health of the gingiva and teeth, as well as the overall appearance. With the pumice-free polishing paste Proxyt pink, high-quality surfaces are gently treated and maintained without abrasion.  

 

Need More Information?

Give us a call at the lab on 01765 607347 and we'll be happy to discuss any cases you're looking at restoring using the e.max all ceramic system. Or download our lab cards and postage labels to send a case today!

or


There's a whole library of PDF's covering everything to do with the IPS e.max system. These are provided by Ivoclar Vivadent and available for for you to download and keep by clicking here

 

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