Dentaltown November 2013 - (Page 86)

continuing education feature continued from page 85 Some clinicians have built their practices on porcelain-fused- final impressions to be made in seconds. The NEVO camera to-metal (PFM) crowns, and these restorations have certainly attaches to a laptop computer through a high-speed connection, served well for our patients. Questions arise as to the durability which enables faster data transfer between the camera and the and strength of all-ceramic restorations, and whether they will computer. The tips are removable and can be easily disinfected last as long as PFM restorations. Millable ceramic technology has to allow for quick transfer from operatory to operatory. The tips advanced greatly in just a few years, and fortunately a lot of well- also contain a built-in heater element that prevents fogging on conducted research has been recently published. One material, the mirror element of the camera. The entire camera is solid lithium disilicate (IPS e.max), has really changed how we think state with no moveable elements except a small cooling fan. This about ceramic materials. After the restoration is milled and tried means that it is less likely to become out of calibration, and in, it is crystalized and characterized in a short 15-minute oven therefore is more consistently accurate. cycle. During this short cycle, the lithium metasilicate crystals While scanning, a real-time virtual model is created with are transformed into lithium disilicate crystals and the flexural color-coded feedback as to how the clinician is scanning (Fig. 1). strength significantly increases from around 160MPa to Additionally, the model orientation changes with the orienta360MPa. e.max was introduced to the market in 2006 and clin- tion of the camera to keep scanning simple, so as the clinician ical studies are just now being published. Gehrt and colleagues rotates the camera, the 3D model rotates as well (Fig. 2). Once followed 104 e.max crowns in 44 patients and found the corre- the model is generated, the Data Density View on the NEVO sponding survival rate for all restorations was 97.4 percent after highlights areas that have been missed in blue. The option to five years and 94.8 percent after eight years of clinical service view a high-contrast black and white photo of the digital model with location not significantly impacting survival rate.19 In a 10-year study Kern et al. Fig. 1 found three-unit fixed partial dentures (FPDs) made from monolithic lithium disilicate ceramic showed five- and 10-year survival and success rates that were similar to those of conventional metal-ceramic FPDs. They concluded that for the monolithic lithium disilicate FPDs the calculated survival rate was 100 percent after five years and dropped to 90.8 percent (when considering only catastrophic ceramic fractures) and 87.9 percent (when considering catastrophic ceramic fractures and biological failures) after 10 years.20 Fig. 1: Showing the color-coded scanning where green represents the sweet spot of the camera and Lastly, many clinicians are concerned orange and red indicate the clinician is drifting too far away from the teeth. about the perceived added time it takes to Fig. 2: Showing the intuitive scanning, the preview digital model on the left rotates with the camera, fabricate a single visit CAD/CAM restora- making scanning very easy. tion. E4D NEVO is E4D's natural evolution of digital dentistry and represents a Fig. 2 new level of precision, proficiency and productivity for CAD/CAM dentistry. Chairtime and workflow with this system have been optimized for speed without a compromise in quality. It is the first camera to feature Blaze blue laser technology for faster and more precise capture, allowing 19. 20. 86 Maren Gehr, Stefan Wolfart, Nicole Rafai, Sven Reich, Daniel Edelhoff Clinical results of lithium-disilicate crowns after up to 9 years of service. Clin Oral Invest, March 7, 2012. Kern M, Sasse M, Wolfart S.Ten-year outcome of three-unit fixed dental prostheses made from monolithic lithium disilicate ceramic. J Am Dent Assoc. 2012 Mar; 143(3):234-240. NOVEMBER 2013 » dentaltown.com http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown November 2013

Dentaltown.com Highlights
Howard Speaks: Not Getting it Done? Hire a Consultant
Professional Courtesy: Painful Advertising
Continuing Education Update
Second Opinion: The Role of Teamwork in the Third Era of Medicine
Deprogrammed Open Bite Can Help with Veneers
Bruxism Worse with Splint
Corporate Profile: Burbank Dental Laboratory
Product Profile: Eaglesoft 17
Debunking the Social Stigma of Stress
The Personal Side of Stress
In Your Face: Facing the Realities of Stress in Dentistry
When Tragedy Strikes: How to Prepare for and Recover from a Natural Disaster
The Latex Problem: It’s More Complicated Than You Think
Why Dentists Require Specific Exercise
How Much Money Can You Make When You’re Dead?
Denture Stabilizations with Small-diameter Implants
You Should Know: CrownMen
Product Profile: Synergy
Product Profile: NuSmiles ZR
Continuing Education: The New Evolution of Chariside CAD/CAM Technology
Ad Index
In This Issue: Dry Brush Inside Bottom Teeth First
Perio Reports
Dentally Incorrect
101 Ways to Reduce Stress
Achieving Goal Congruency

Dentaltown November 2013