The cerec technology allows us to take a monolithic block of porcelain and create an exact a perfectly fitting restoration. The entire thing takes only  about an hour from start  to  finish. The Cerec Blocks of porcelain that we use and place into the machine to be ground down into crowns come in several types of materiel.

Types Of Cerec Blocks

Feldspathic Porcelain

Cerec Blocks fall into 3 main categories and each has it’s own uses. The original blocks were standard dental porcelain. These blocks have been around for many years. The are strong, very wear resistant and very esthetically pleasing. The advantage of this porcelain is that it has expansion and contraction characteristics similar to tooth making it comfortable with very few post op sensitivities. It can be stained and glazed to individualize each crown. The disadvantage is strength measure in mega pascals. These Cerec Blocks are among the weakest and can fracture if under extreme stress. Usually though they  are fine and I have found them fracture only under very unusual circumstances and even then only on second molars.

E-max

Next is E-max or lithium disilicate blocks. These blocks are the strongest options around, they are very esthetic and have the smallest chance of fracturing. In fact it is quite rare that that ever happens. The only downside is that these Cerec Blocks must be fired in an oven in order to make them have their final strength. That means they need an extra 1/2 hour of time in order to finish the procedure.

Hybrid

Finally there are hybrid blocks which are made up of composite material with porcelain components. The advantages of these blocks is that have a certain microscopic flexibility making them useful in high stress situations.

No matter which if these Cerec Blocks we use, today we have a wide range of different options allowing us to give our patients one visit crowns in an hour that are esthetic, strong and comfortable

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Emax cad porcelain is a new materiel being used to make dental crowns. It has numerous advantages over standard porcelain. The Cad in Emax cad porcelain stands for  computer aided design , being used by the CEREC SYSTEM that allows for the manufacture of a CEREC crown in the dental office in  an hour.

Emax cad porcelain is a material called  lithium disilicate. It is exceptionally natural in its appearance and is hard to differentiate from natural teeth. But the greatness of this porcelain material is not in its beautiful esthetics, but rather in its strength.

Porcelain strength

In general, dental porcelain is a strong materiel. It has great strength under compression. Imagine putting a piece of glass on a perfectly flat surface with 1 drop of water under it. Drive a car over it and it won’t break but put one grain of sand under and it will. It has poor resistance to lateral forces or flexural strength. Porcelain strength is measured in  MPaS or megapascals. Regular porcelain has something like 150 MPa’s but Emax cad porcelain is in the order of 400MPA’s. More than 2 times as strong as a regular porcelain crown with esthetic advantages.

When we make a CEREC  Emax cad porcelain crown, it comes in a block that is not fully formed and once the crown is manufactured, it needs to be fired in a porcelain oven to be completed and brought to strength. It is quite fascinating as the materiel has a blue color until it is removed from the oven when it takes it’s final beautiful shape and hue.

Depending on the situation, we use this material for many of our crown solutions.The  translucency,opalescence, and light diffusion properties of IPS e.max lithium disilicate were all designed to copy natural tooth for beauty and quality restorations.

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Zirconia Crowns In A day is one of the great breakthroughs in digital dentistry. The are only a handful of dentists in the country who employ CEREC technology, Dr. Ari Greenspan being the first. Let’s discuss Zirconia Crowns In A day.

Zirconia Crowns

Zirconia is a new form of dental material that allows us to mill it into a crown using CAD-Cam technology. We take a three dimensional image of the teeth, design that crown or bridge and then mill it on the spot. Zirconia oxide is a synthesized material that is exceptionally hard and has optical qualities similar to tooth. It has many advantages over standard porcelain fused to metal crowns, namely: esthetics, durability, strength and hardness as well as high biologic compatibility. Because it is milled and not cast in metal from a wax mold, there are virtually no discrepancies in fit. Until recently, the only way to get such a material for a crowns was through the traditionall’impression method. Another complication is that the zirconia is milled in an unfinished relatively soft states. It must then be finished and required hours and hours in an oven for a process known as sintering. The sintering requires special equipment that dentists don’t have.

Except in our office. We have recently started being one of  just a handful of dentists in the entire country with the ability and equipment to produce Zirconia Crowns In A day using new and advanced technologies that reduce the sintering time.

The  Inlab dental laboratory system is not really used by dentists because of the complexity. We wanted the ability to control every aspect of our lab work to ensure perfection. As a result, we now own a 5 axis sophisticated milling unit and the special ovens necessary to make Zirconia Crowns In A day.

If you have any questions please do not hesitate to contact us.

Click Here To See Before and After Pictures

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The new era of dental materials is flourishing and much has to do with the advantages and disadvantages of Zirconia Crowns. Zirconia is an extremely strong and hard materiel, close to 1200 Mpa, compared to  a traditional full porcelain crown at 250mpa. We measure in MPA’s or mega pascals. It is white and relatively opaque. So it is a great replacement for the previous metal that was used as a base underneath PFM’s, or porcelain fused to metal crowns. PFMs, were the standard of esthetic dentistry for the last 60 years or so.

Advantages and disadvantages of Zirconia Crowns

We are all familiar with the white crowns, that were relatively opaque, sometimes you saw a little metal sticking out at the gum line, causing a dark area at the neck of the tooth. These teeth were also often opaque and not terribly natural. This was because the  metal had to be hidden by an opaque white color, so as not to see greyish in the crown.One problem was that the porcelain can chip off of the outside of the crown revealing an ugly grey color.

Zirconia crowns have overcome these problems. The zirconia comes either in small blocks that can be milled in a CEREC machine, or, as one of the few dentists in Israel with a Sirona Inlab system in my office, I can mill large restorations  out of a puck of zirconia. Zirconia in its raw form is chalky. We mill it dry, and it needs to be put into an oven for 12 hours to sinter, or become hard. But once hard it is strong, tough and very exact in terms of its fit. One of advantages and disadvantages of Zirconia Crowns is that they are brittle. So we must be careful when adjusting the so as not to cause microscopic cracks which can lead to failure. All in all it is an amazing material and the  advantages and disadvantages of Zirconia Crowns  are far outweighed by the advantages.

Click Here For Before And After Pictures

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3D printing is a fascinating advance in computer technology. Dentistry is often an early adopter of technological break throughs and 3d printing in dentistry is no different.So what is 3d printing in dentistry and how does it relate to Digital dentures ?

Dentistry is a unique combination of 3-dimensional medical treatment requiring exact placement of materials and as well as placement of forces on teeth. Designing appliances like Digital dentures to make this easier is an ideal usage for 3d printing in dentistry.

Digital Dentures

The construction of a denture for a patient has traditionally been a long arduous process. Many different appointments were needed to measure both how the dentures fit in the mouth as well as how the 2 jaws and teeth fit together. The denture was ultimate prepared in wax, with teeth placed. They were tried in the mouth, adjusted and then sent to the dental laboratory. A complicated and inexact process of pouring stone around the wax try in teeth and then melting the wax out in order to inject plastic or porcelain into the hollow ensued.

3D printing is changing all of this. Now a digital impression of the entire soft tissue of the mouth is taken. It is a 3d scan and the ensuing file has a standard .stl format. This .stl file is easy to manipulate digitally and as a result we can utilize it to manufacture the appliance. We scan both jaws and capture the 3d relationship of how the upper and lower jaws fit together.Then it is a matter of designing the denture digitally.

We print the base in a material that is pink like gums. We then print the teeth and glue the two together. We are left with a perfectly fitting denture.

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