Ceramic and Metal Free Solutions

Williams Dental Laboratory has been fortunate enough to have been involved with these systems from their inception into the dental industry. For years companies have consulted with us for feedback and suggestions aimed to increase the effectiveness of these materials for strength and esthetics.
CAD/CAM technology has been successfully adapted to the dental industry with 3D imaging and Virtual Visualization, which means many things to today’s clinician.

To summarize, there are three new types of milled products that have been developed. Leucite reinforced porcelain such as Empress Esthetic (yes we still proudly fabricate Empress Veneers, prepless veneers and crowns), requires bonding and can be used full contour or cut back and layered with translucent porcelains. We prefer the cutback method. Secondly, the stronger but still translucent lithium disilicate porcelain, such as e.max CAD, and e.max press. And finally, the highly tested Zirconia oxide stabilized with yttria such as e.max ZirCad, LAVA, Bruxzir, and Zirlux, colored monolithic solid zirconium. Milled e.max is very interesting because of the greater strength when compared to a waxed and pressed restoration.

The material choice that falls between, or has the hardness of Zirconia and translucency of leucite (Empress Esthetic) is the IPS e.max CAD.

Tough but translucent, e.max CAD can be full contour or layered with porcelain and can be either bonded or cemented. Zirconia (layered with e.max) is the answer to a high strength substitute for metal.
With all of these new materials allowing us in the dentistry profession to provide amazing results, comes a confusion that is mind boggling with too many choices.

e.max® Preparation Guide

Download the e.max® Preparation

Feldspathic (PREPLESS )

Using foil and/or Refractory Technique

We first began doing veneers with these techniques in the late 70’s.   A less invasive treatment (prepless or “almost” prepless is preferred by all patients nowadays. The use of feldspathic veneers is resurging. With this comes the desire for thinner veneers and preservation of natural tooth structure. Feldspathic techniques allow us to create thicknesses of less than 0.4 mm.  Today, many ceramists are not trained in the art of building  powder/liquid porcelains to form the highly esthetic feldspathic veneers, especially thin veneers  This creates a problem because the esthetic value exhibited in these restorations depends on the ceramist’s ability to build depth of color and translucency into the restoration.  Dentists and their ceramists must also know when it is appropriate to choose what materials to use in a given patients clinical situation..  We are here to help with these choices.

Stained and Glazed Zirconium versus Manually Polished Zirconium

The more inexpensive, solid monolithic zirconia restorations are generally stained  and glazed. This is the quickest way to produce them, but in our strong opinion, not the best restoration for your patient.   Many studies have shown glazed zirconia is abrasive and can can produce very high wear rates against opposing natural dentition.  The staining and glazing process increases the lack of translucency and vitality as well.  Our process starts with internally shaded zirconium discs.  Both our 1435 MPa and our 650 MPa High Translucent Zirconium are internally stained into the unsintered zirconia to achieve the final desired color, then after the sintering process, we diamond polish our zirconia to a mirror glaze. This not only looks much better than staining and glazing, it also produces highly favorable wear rates against opposing natural dentition. See graph below:

Material loss [μm]

Abrasion characteristics of different materials on the enamel; „Stawarczyk, B.; Özcan, M.; Abrasion Examinations with Different Dental Materials, Dental Materials Unit, University of Zurich, 2010 (in preparation) Based on 1.2 Million Chew Cycles

Zirconium dioxide polished
28 μm
Enamel
32 μm
CoCr polished
55 μm
Zirconium dioxide veneered
72 μm

Empress Esthetic

IPS Empress® has 20 years of highly proven clinical experience in bonded, esthetic metal-free restorations. With 30 million restorations placed worldwide, IPS Empress delivers amazingly consistent results whether we shade only, or cut back and layer.

Developed in 1991, IPS Empress has become an industry-recognized brand thanks to its esthetics and strength. When paired with our proprietary fabrication technique, every IPS Empress Esthetic restoration exhibits natural contours and vitality, while maintaining high-quality standards for an affordable price.

IPS Empress is highly recommended for anterior single crowns, inlays and onlays. PREPLESS and prepped veneers and can be used for anterior restorations to block out staining, close diastemas or to improve length and proportions.

e.max®

e.max® is a monolithic lithium disilicate ceramic and we call if the “miracle material e.max brings together outstanding esthetics and ultra-precision fit. An alternative to PFMs and zirconia-based restorations, e.max can be pressed or milled depending on the application

Prescribing e.max will ensure optimal esthetics, virtually perfect contacts and occlusion, and impressive strength. Its unique lithium disilicate ceramic provides flexural strength of 360-410 MPa, making it the ideal STRONG choice for single-unit anterior or posterior crowns, veneers, PREPLESS veneers, inlays, onlays, screw-retained implant crowns, 3-unit anterior bridges, posterior bridges in stable occlusions with tall connectors or restorations with minimum preparation.

Conventionally cement using resin ionomer cements or bond for maximum retention on nonretentive preparations. E.max ceramic is highly biocompatible and provides more than double the flexural strength of Empress® Esthetic and feldspathic.

  • Outstanding esthetics blending combinations of Veneers, bridges and implants
  • Conventional cementation with Multilink
  • Choice of high strength materials, Zirconium and glass ceramic
  • Pressed and/or CAD/CAM fabrication for both fit and strength
  • Single overlay veneering ceramic, delivering one smile chemistry

Lab Processed Composite Restoration

At Williams Dental lab we take pride in using the latest and most durable materials that are on the market. Cristobal, Premise, and Sinfony composite have made our top three selections when considering lab processed indirect restorations. Your indirect onlays and inlays are fabricated to provide a strong, lower-cost option for conservative metal-free dentistry. All of our composites are carefully internally layered with shading, staining, dentin, enamel and incisal translucencies to blend in seamlessly with surrounding tooth structure. The physical properties of a lab processed inlay or onlay are enhanced with additional heat. And vacuum treatment to increase wear and stain-resistance. We will provide ideal marginal fit, full polymerization and lifelike esthetics, all under 20x microscopes.

Williams Dental Lab not only uses processed composite for inlays and onlays but also in addition we use them for metal-free bridges up to four units, full crowns and many orthodontic applications as you sequentially erupt and move adjacent natural teeth. Williams Dental Lab recommends that lab processed composite be used in occlusion with itself, natural enamel or dentin and composites and resin denture teeth.

Zirconia Restoration

We have 5 different zirconium restoration types we provide…. each has their own advantages.

Bruxzir, Emax zirc, Lava, Noritake press, and Zenostar

BruxZir® and Zenostar are Solid Monolithic Zirconia, a monolithic zirconia crown, bridge, screw-retained implant crown, inlay or onlay with no porcelain overlay. These provide a durable, more esthetic alternative to posterior metal occlusal PFMs or cast gold restorations for demanding situations like bruxers, implant restorations and areas with limited occlusal space, and long span bridges. Now, thanks to the new BruxZir™ Shaded formulation, BruxZir restorations exhibit improved translucency and color similar to natural dentition, making them a restorative option in the anterior as well. Complete color penetration all the way through the restorations ensures greater shade consistency and prevents any shade changes after occlusal adjustment.

Designed and milled using CAD/CAM technology, (they fit as well as any restoration we have ever seen), all of these Zirconia can be cutback and layered in the aesthetic zone or shaded for strength.

Miami Cosmetic Dentist Raul Garcia

Williams Dental Lab
http://www.miamidesignersmiles.com
“Williams Dental Lab is a class act. If you are looking for excellent esthetics, quality and customer service this is the lab for you.  Bob and Frank are your partners in ensuring your success.  They are excellent for the experienced doctor and also have the patience to help the doctor that is developing and expanding.  I personally feel that they are partnered with me on my journey as I grow my practice and they along with excellent continuing education are the secret to the growth we are experiencing in our practice.  Thanks Bob and Frank!!”

Ivoclar E.Max

MaterialIvoclar E.Max
Impression TechniqueTraditional or Digital
IndicationsAnterior crown & bridge, posterior crown
Recommended UseCrowns, inlays/onlays, veneers, prepless veneers, Full mouth, (cutback and layered)
PreparationChamfer, or Shoulder, Modified shoulder
CementationAdhesive bonding recommended
Turnaround Time3 to 5 Days
Method of ManufactureDigitally designed, milled or waxed and pressed

Lab Processed Composite

MaterialLab Processed Composite
Impression TechniqueTraditional or Digital (we print 3D model)
IndicationsSingle unit crowns, multi-unit bridges, inlays , onlays
Recommended UseConservative or large partial tooth replacement
PreparationChamfer or shoulder
CementationAdhesive bonding
Turnaround Time2 or less lab days
Method of ManufactureTraditionally hand built by LVI trained technician

Prepless Veneers, Emax or feldspathic

MaterialPrepless Veneers, Emax or feldspathic
Impression TechniqueTraditional or Digital
IndicationsAesthetic Enhancement
Recommended UseVeneers
Preparation0.3mm reduction
CementationAdhesive bonding
Turnaround Time1 to 3 Lab Days
Method of ManufactureTraditionally fabricated via feldspathic build up or waxed and pressed by an LVI trained technician