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The overall esthetic result of an all-ceramic restoration is influenced by several factors: • the shade of the preparation • the shade of the restoration (ingot/block or layering material) • the shade of the cementation material Shade Determination of the Natural Tooth After tooth cleaning, the shade of the non-prepared tooth and/or the adjacent teeth is determined with the help of a shade guide. Individual characteristics should also be ips-emax-zahnarzt-zubehoer_1taken into consideration. During the fabrication of highly esthetic restorations, the influence of the preparation shade on the final result is a key factor. For that reason, the shade of the preparation should be carefully determined in order to select the suitable restorative material. This is of utmost importance when dealing with severely discolored preparations. Only if the dentist determines the shade of the preparation and subsequently communicates it to the laboratory ips-emax-zahnarzt-farbnahme_2fixmay the desired esthetics be achieved in a targeted fashion. Die Shade Selection In order to facilitate the proper reproduction of the desired tooth shade, the shade of the preparation should be determined with the help of an IPS Natural Die Material shade guide. This guide 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.

Recent research has shown that saliva contamination can hinder the bonding of solid zirconia and zirconia oxide copings. When a zirconia crown or bridge is tried in the patient’s mouth and comes in contact with saliva, the phosphate groups in the saliva bind to the zirconia oxide and cannot be rinsed out with water. Attempting to use phosphoric acid (which is full of phosphate groups) to “clean out” the saliva only makes the problem worse. BruxZir™ Solid Zirconia, BioZX2 Translucent Zirconia, and all PFZ (porcelain fused to zirconia) restorations are fabricated from solid zirconia oxide material, which exhibits a strong affinity for phosphate groups. We can take advantage of this fact with phosphate-containing primers such as Monobond Plus (Ivoclar Vivadent) and Z-Prime™ Plus (Bisco), or with cements such as Ceramir® Crown & Bridge (Doxa Dental) to increase our bond strengths to zirconia oxide. Unfortunately, saliva also contains phosphates in the form of phospholipids. Ivoclean To successfully remove saliva, it is now suggested that after try-in and before priming, the crown should be cleaned with Ivoclean, a zirconia oxide solution from Ivoclar Vivadent. This zirconia oxide solution is placed inside the restoration for 20 seconds and then rinsed out. Due to the large concentration of free zirconia oxide in the Ivoclean, it acts as a sponge and binds to the phosphate groups that were previously bonded to the restoration. The suggested protocol is: 1. Try in zirconia-based restoration 2. Rinse saliva out of restoration with water 3. Place Ivoclean in restoration for 20 seconds, rinse and dry 4. Apply primer and then cement with product of your choice ivoclean shots2 Once the Ivoclean is rinsed out, you will have a fresh bonding surface for the Monobond Plus, Z-Prime Plus or Ceramir to bond to. Cementation Resin reinforced glass ionomer cement (RelyX Luting Cement, 3M ESPE; GCFuji Plus, GC America) Resin cements for short or over-tapered preparations (RelyX, 3M ESPE, Panavia F2.0, Kuraray)

There are many reasons why I would advocate the use of the Mark 300 Series articulators in a dental practice and none of those reasons include ‘because I said so’. To begin, it’s important to know the difference between the Mark 310, Mark 320, Mark 330 and LabRelator. Why would you use one versus the other depends on what you want to accomplish… Mark 310 Perfect for anyone not taking any Lateral and/or Protrusive bite records. Fixed at anatomical averages (Condylar Inclination at 25°, Bennett at 15°). Mark 320 Great if you’re taking a Protrusive record. Adjustable Condylar Inclination 0-60°, Fixed Bennett at 15°. Mark 330 For the doc who’s taking Lateral and/or Protrusive records. Adjustable Condylar Inclination 0-60°, Adjustable Bennett 0-15 and Adjustable Immediate Side Shift 0-2mm. LabRelator For the office that mounts their own models. Fixed at anatomical averages, locked in centric, no moving parts help eliminate human error that occurs in the mounting process. Now that you know the differences between the instruments, you’ve probably mentally picked out which ones you want in your practice. But why this series? Why should you invest in one (or two) of these articulators? What sets them apart from others on the market? My number one reason is and always will be the accuracy in the interchangeability. The engineering of these instruments allows for cross-mountability within 20 microns or less. I don’t know when you last pulled out a ruler, but that measurement equates to near perfect accuracy. This will come in handy when transferring casts from one instrument to another with your laboratory. Sending only your casts back and forth will save you some shipping costs, your articulator wear and tear, plus you don’t have to wait for your articulator to return to begin a new case. Creative features make these articulators super user-friendly! Check out the magnetic system, which is built-in. This allows for easy removal and replacement of casts. Tilt the articulator back at 45° to look at casts as if the patient were there. Simple thumb knobs and centric latch allow you to make adjustments with ease and the built-in support rod allows you to keep the articulator open and stable throughout the mounting process. It’s pretty. Yes, I know this sounds vain, but so is dentistry. Patients want a straight and pretty smile. You want us to have good occlusion. Sometimes both of these wants can add up in the treatment plan. By presenting a case on a Mark 300 Series instrument to your patient, you’re ‘saying’ that you’ve invested in your practice and your ability to use such instrumentation so that our mouth receives the best care. Are you going to give your patient the Rolls Royce or Ford Pinto treatment plan?