Lava Crowns and Bridges

1
Lava? Crowns and Bridges A System for All-ceramic
Zirconia-based Crowns Bridges
2
Lava? Crowns and Bridges Strength and Beauty in
Ceramics
3
Lava? Crowns and Bridges Two-Stage System

• A high-strength CAD/CAM milled zirconia
  coping/framework for crowns and 3 4-unit
  bridges
• A highly esthetic finished restoration utilizing
  3M? ESPE? Lava? Ceram Veneering Ceramic

4
Lava? Crowns and Bridges Advantages

• High strength
• Excellent esthetics
• Longevity of restoration
• Versatility in cementation options
• Extremely low solubility and water absorption
• Outstanding marginal fit

5
Lava? Crowns and Bridges Long-term Stability

• To guarantee successful, long-term multi-unit
  bridge restorations, an initial strength of more
  than 400 N is required for anterior restorations
  and more than 600 N for posterior applications.
• Currently, values such as these (e.g. Lava unit
  bridges 1,500N) are achieved only with alumina
  or zirconia bridges.
• Lava frame zirconia demonstrates no measurable
  solubility or water absorption.

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Lava? Crowns and Bridges Long-term Stability
(cont.)

• Limitations of glass ceramics and infiltrated
  ceramics (sub-critical crack growth, fatigues,
  stress, corrosion) when subjected to masticatory
  forces in the mouth are problematic.
• Generally speaking, the long-term strength of
  ceramic systems containing glass cannot be
  classified as risk free.
• Glass ceramics have a higher subcritical crack
  growth velocity and in consequence they have a
  lower long term stability due to the effect of
  oral moisture and sub-critical crack propagation
  (decreases to gt50 of initial strength).

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Lava? Crowns and Bridges Zirconium Oxide Zr02

• Outstanding mechanical properties
• gt20 years of experience in various industrial
  and medical applications
• Extremely low solubility and water sorption
• Consistant raw material properties
• Good availability of raw materials
• Known processing parameters of raw materials

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Lava? Crowns and Bridges All Ceramic Dental
Materials
Infiltrated Ceramic (glass containing), e.g.
InCeram Zirconia (? ZrO2), InCeram Alumina ?B ?
500 MPa KIC lt 5 MPa m1/2
Glass Ceramic (glass containing), e.g. Empress
I/II ?B ? 400 MPa KIC 2 - 3 MPa m1/2
Polycrystalline Ceramic (glass free), e.g. Lava
ZrO2, Procera Al2O3 ?B 500 - 1500 MPa KIC
5 - 10 MPa m1/2
?B Flexural Strength, KIC Fracture Toughness
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Lava? Crowns and Bridges Transformation
Toughening of Zr02
DV/V0 (t ? m) 0.05
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Lava? Crowns and Bridges Fracture Mechanics -
Zr02 Longevity Flexural strength decreases
through defects, crack propagation and crack
corrosion (quicker with glass)
DIN 843 - 3
sinitial
s5 years
Material
MPa
MPa
Lava
1345
615
Empress II
289
82
Cerec
88
32
(Mark II)
InCerAl
666
125
Dr. Fischer/Prof. Marx, Aachen 3M ESPE
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Lava? Crowns and Bridges Strength Properties -
Zr02 ISO 6872 - Flexural Strength
3M ESPE Wagner et.al J. Prost. Dent. 76 2
1996
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Lava? Crowns and Bridges Precision and Fit
buccal
mesial
mesial
distal
distal
MO 50 µm Holmes et.al, J.Prosth.Dent 1989,
62 405-408
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Lava? Crowns and Bridges Optical Properties of
Ceramics Translucency comparison as a function of
wall (coping) thickness
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Lava? Crowns and Bridges Optical Properties of
Ceramics Versus Metal
Natural tooth Conventional crown with
metal-based framework
Natural tooth Lava? crown
Dr. D. Edelhoff, Aachen and MDT V. Weber
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Lava? Crowns and Bridges Effects of Moisture on
Ceramics
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Lava? Crowns and Bridges Esthetics
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Lava Crowns and Bridges Digital Wax Knife
Software
For "virtual" design and modification of copings
and frameworks prior to milling
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Lava Crowns and Bridges Digital Wax Knife
Software (continued)

• Adds proper structural support
• Allows virtual build-up or reduction to zirconia
  framework
• Optimized support of the veneering ceramic
• Especially useful for short preparations and
  restorations requiring interproximal augmention

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Lava Crowns and Bridges Digital Wax Knife
Software (continued)
Desired final contour
Wax knife addition
Original coping height
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Lava? Crowns and Bridges Geometry Preparation
Comparisons

• Lava
• Chamfer prep
• Wall thickness 0.5 mm
• In-Ceram
• Chamfer prep
• Wall thickness 0.8mm
• Empress
• Shoulder prep and overall reduction
• 1.0 mm
• Procera Alumina
• Prep
• Wall thickness 0.6 mm

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Lava? Crowns and Bridges Copings and
Frameworks It All Starts With Proper Tooth and
Model Preparation
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Lava? Crowns and Bridges Preparation Prerequisites

• Preparation Design
• Required for optimal margin detection during
  scanning
• Margins should be chamfered
• gt4 taper of axial walls
• Rounded angles on incisal, occlusal and shoulders

Chamfer
Shoulder with rounded internal angles
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Lava? Crowns and Bridges Prep/Die/Model
Preparation Requirements

• Nodules, stone-tags should be flicked, or scraped
  off.
• Block out undercuts, occlusal holes, and surface
  defects with resin material or light colored wax.
• Trough or gutter margins must be waxed or
  filled-in to an ideal level to be scanned.
• Feathered margins produce a slight over-contoured
  area for the porcelain buildup.

Avoid these types of defects
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Lava? Crowns and Bridges Cementation

• Due to high strength of the zirconium oxide
  copings and frameworks, the system provides for
  versatility in choice of cements Conventional
  and resin-based cements can be used.
• Mechanical retention.
• Pretreat with Rocatec? or conventional
  sandblasting.
• Due to higher translucency, shaded cements may be
  beneficial.

• Recommended Cement Systems
• 3M? ESPE? RelyX? Unicem Self-Adhesive Universal
  Resin Cement
• 3M? ESPE? RelyX? Luting Plus Cement
  (resin-modified glass ionomer)
• 3M? ESPE? Ketac? Cem Glass Ionomer Luting Cement

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Lava? Crowns and Bridges Profile of RelyX? Unicem

• Dual-curing chemistry ensures both light-curing
  and self-curing of the cement.
• Higher strength and mechanics compared to zinc
  phosphate, GIs, Compomers, and RMGIs.
• Esthetics and strength comparable to other
  composite resin cements.

• Low swelling and high dimensional stability.
• Fluoride release higher than composites, but
  lower than GIs.
• Excess removal easier than with other resins.
• Easy handling with capsule delivery.

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Lava? Crowns and Bridges Features of RelyX? Unicem

• Self-adhesive no conditioner or bonding agent
  required
• Significant reduction in sensitivity potential
• Reduced concern for film thickness build-up
• Reliable adhesion to dentin and enamel and
  sealing of the tooth.
• Less concern for moisture sensitivity

• Broad Indications for use
• Metal based (full metal or PFM)
• Metal-free, all-ceramic/
• composite restorations
• Strengthened core restorations (i.e. Procera)
• Fast application time
• Available Shades A1, A3 Opaque, A2
  Universal,White Opaque, Translucent

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Lava? Crowns and Bridges Clinical Experience EN
540 (Prof. Pospiech, Munich, Bad Homburg)

• Since 2000
• 38 posterior bridges
• 18 single crowns
• 3 telescoping crown dentures

No fractures of framework results after 3
years.1 case Small chipping of veneering
material
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Lava? Crowns and Bridges Clinical Experience
(continued)

• gt1500 cases, gt200 bridges (3-4 units, blocked
  crowns, many supported by implants)
• Tracked over 36 months

• EN 540 (Prof. Pospiech, Munich, Bad Homburg)
• External pre-marketing evaluation (three labs)
• USA (Raigrodski, Sorensen)
• Over 5,000 units U.S.

ZTM Jan Langner, Schwäbisch Gmünd
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Lava? Crowns and Bridges Clinical Photography
Single Units
Before
After
Dr. S. Reich, University of Erlangen, and
Hoffman CDT
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Lava? Crowns and Bridges Clinical Photography 3
Unit Anterior Bridge
After
Before
Dr. Bonatz
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Lava? Crowns and Bridges Clinical Photography 3
Unit Posterior Bridge
After
Before
Dr. Lynn Jones Matt Roberts, CDT
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Lava? Crowns and Bridges System Components
Lava Therm Sintering furnace
Lava Scan Optical 3D scanner
Lava Form Computer-aided milling machine
Lava Ceram Veneering ceramic
Lava Frame Zirconia framework
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Lava? Crowns and Bridges Processing Scheme
Die(s) Model
Scanning
Design
Milling
Sintering
Veneering
Removal Shading
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Lava? Crowns and Bridges Summary
The excellent properties of strength, longevity
and esthetics require Lava - zirconia as the
dental material of the future. CAD/CAM-technology
combined with milling of zirconia in a
presintered green state guarantees economical and
clinical success!