IPS Eris Training Program

1
Conventionally cemented unconventionally
beautiful.
2
IPSEmpress System New EquipmentEP-600 Combi
3
IPSEmpress System Options
IPSEmpress Staining
IPSEmpress Layering
IPSEris
4
IPSEmpress System New Features

• Universal Shade Pastes 24 Colors
• Universal Stain Pastes 14 Colors
• Universal Glaze
• IPSEris Layering Ceramic
• IPSConnectors
• IPSEmpress Low Fusing Add-On
• Conventional Cementation option with
  IPS Eris

5
IPSEmpress System New Equipment EP-600 Combi

• Fully Automated
• Opens Automatically
• PC Interface
• Auto Calibration
• Combi Capability

6
(No Transcript)
7
(No Transcript)
8
Universal Materials

• Same shading/staining/glazing material may now be
  used externally for all IPSEmpress and IPSEris
  materials
• Simplified approach
• Decreased inventory for labs
• Less confusion
• New options for internal shading of lithium
  disilicate frameworks
• Refer to Instructions for Use for proper firing
  parameters for all IPSEmpress and IPSEris
  materials

9
Universal Materials

• Universal Shade, Stains and Glaze may not be used
  for internal characterization of IPSEmpress
  (original) materials!
• IPSEmpress Add-On 770must be used if
  corrections are made to an IPSEmpress
  restoration where Universal Shade, Stains and
  Glaze were applied!

10
IPSEmpress Add-On 770 C
When Universal Shade, Stain and/or Glaze
materials are used with IPSEmpress restorations,
a lower fusing correction material (i.e. 770 C)
is necessary for post application corrections due
to the lower firing temperatures of the the new
Universal Materials.
11
(No Transcript)
12
(No Transcript)
13
IPSEris Layering Ceramic

• Lower Fusing Temperature (765 C)
• Broad Firing Tolerance (/- 15 C)
• Excellent Compatibility with Lithium Disilicate
  Pressed Ceramic Framework
• Outstanding Esthetics
• Conventional or Adhesive Cementation

14
IPSEris Indications

• Full Coverage Metal-free Crowns
• Three-Unit Full Coverage Bridges
• Distal abutment no further than 2nd premolar
• Maximum 9.0mm posterior pontic space
• Maximum 11.0mm anterior pontic space

15
IPSEris Restoration Features

• Lithium Disilicate Pressed Framework
• 3x stronger than original IPSEmpress
• 3x fracture toughness of original IPSEmpress
• Layered Fluorapatite Glass Ceramic
• with Dilithium Oxide Crystals
• Conventional Cementation
• Type I Glass Ionomers, Zinc Phosphate
• Optional Adhesive Placement

16
Physical Properties and Performance
17
IPSEmpress Leucite Reinforced Glass Ceramic
Crystal Structure Dispersion Comparisons
Leucite Crystal
Feldspathic Ceramic
18
IPSEmpress Physical Properties

• Mechanical
• Flexural Strength ? 120-220 MPa
• Fracture Toughness ? 1.3 MPam1/2
• Chemical
• Solubility lt 100mg/cm2
• Thermal
• CTE 15.0 x 10-6 K-1 m/m (Similar to Dentin)
• Crystalline Content
• By Volume 30-40
• Optical
• Light Dispersion Similar to Natural Dentition
• Translucency Similar to Natural Dentition

19
IPSEris Framework Composition
Lithium DiSilicate Si02 Li20
20
IPSEris Layering Ceramic Composition ...with
Dilithium Oxide Crystals
Fluorapatite (IPSEris) Ca10(P04)6F2
Hydroxyapatite (Human Tooth) Ca10(PO4)6(OH)2
21
IPSEris with Empress 2 Framework Physical
Properties

• Mechanical
• Flexural Strength ? 350-400 MPa
• Fracture Toughness ? 3.5 MPam 1/2
• Chemical
• Solubility lt 100mg / cm2
• Thermal
• CTE 10.6 x 10-6 K-1 m/m (Similar to Dentin)
• Crystalline Content
• By Volume gt60
• Optical
• Light Dispersion Similar to Natural Dentition
• Translucency Similar to Natural Dentition

22
Comparison of Properties

• IPSEmpress
• Mechanical
• Flexural Strength ? 120-220 MPa
• Fracture Toughness ? 1.3 MPam1/2
• Chemical
• Solubility lt 100mg/cm2
• Thermal
• CTE 15.0 x 10-6 K-1 m/m
• Crystalline Content
• By Volume 30-40
• Optical
• Light Dispersion Similar to Natural Dentition
• Translucency Similar to Natural Dentition

• IPSEris with Empress 2
• Mechanical
• Flexural Strength ? 350-400 MPa
• Fracture Toughness ? 3.5 MPam1/2
• Chemical
• Solubility lt 100mg/cm2
• Thermal
• CTE 10.6 x 10-6 K-1 m/m (Similar to Dentin)
• Crystalline Content
• By Volume gt60
• Optical
• Light Dispersion Similar to Natural Dentition
• Translucency Similar to Natural Dentition

23
Fracture Strength of All Ceramics Conventional vs
Adhesive Cementation
Newtons
LiSi2 Framework Glass Ionomer
LiSi2 Framework Variolink II
Procera Glass Ionomer
Fracture Strength of All-ceramic
Bridges, Pospiech, J Dent Res. Vol 72, 1999 1609
24
Marginal Fit of All-Ceramic Systems
microns
A Comparison of the Marginal Fit of In-Ceram, IPS
Empress and Procera Crowns Sulaiman F, Chai J,
Jameson LM, Wozniak WT. The International
Journal of Prosthodontics. Volume 10, Number 5,
1997.
25
Marginal Fit of All-Ceramic Systems
microns
Evaluation of the marginal accuracy of different
all-ceramic crown systems after simulation in the
artificial mouth. Beschnidt SM, Strub JR. J Oral
Rehabil Jul 26(7) 582-93
26
Fracture Toughness of Ceramic Materials
MPam0.5
Mechanical property evaluation of pressable
restorative ceramics. J.L. Drummond, T. J.
King, M.S. Bapna, R.D. Koperski. Journal of
Dental Materials, 16 (2000) 226-233.
27
Flexure Strength of Ceramic Materials
MPa
Mechanical property evaluation of pressable
restorative ceramics. J.L. Drummond, T. J.
King, M.S. Bapna, R.D. Koperski. Journal of
Dental Materials, 16 (2000) 226-233.
28
Wear of Opposing Enamel Samples
mm2
Three-Body in-Vitro Study of Enamel against
Dental Ceramics. Sorensen JA, Sultan E, Condon
JR, 1998 IADR
29
IPSEris Wear Equivalence to E2
Volume Loss (um3107)
100

• IPS Empress antagonist
• Flat samples
• 120,000 Cycles
• 50 N, 1.7 Hz
• 300 thermocycles (5ºC - 55 ºC)

80
60

40
20
0
Eris Dentin
Eris Incisal
Empress 2
Incisal
Internal Data, RD Ivoclar Vivadent, Schaan
Liechtenstein

30
Esthetics
31
IPSEris Esthetics
Opalescence
32
IPSEris Esthetics
Fluorescence
33
Tooth Preparation Guidelines
34
Anterior Crown Preparation
35
Anterior Bridge Preparation
36
Posterior Crown Preparation
37
Posterior Bridge Preparation
38
Cementation Preparation
39
FrameworkRequirements
40
Ratio of Framework to Layering Ceramic
i Note A supportive substructure is requirednot
only for strength, but also to meet individual
shade requirements
41
Ratio of Framework to Layering Ceramic
Framework Thickness _at_ 60
1.5mm Reduction
2.5mm Reduction
3.5mm Reduction
4.5mm Reduction
Layer Thickness _at_ 40
i Note 1.5mm Maximum layering material thickness
42
IPSConnectors

• Six preformed connector shapes enable easy
  placement and optimal (16mm2) surface area

43
Pontic Design
Premolar and Canine - 9mm / Incisors - 11mm
i Note Maximum pontic span is measured prior to
tooth preparation
44
Bridge Connector Thickness 16mm2 Minimum
i Note To maximize strength, increase connector
dimension beyond 16mm2 whenever space permits
45
FabricationProcedures
46
IPSEris Framework Wax-up
If its not in the wax its not going to be
there !
47
The fabrication of a highly esthetic restoration
requires precise working models with easy-to-read
margins
i Note Maintain the integrity of the tissue
areas to optimize restorations final contour
i Note Clear, removable-type die spacer (e.g.
Rem-e-die ) is recommended to optimize
subsequent fit of the restoration and limit
internal die color influence
48
A full contour wax-up is recommended for proper
frame thickness and connector location
49
The fabrication of a Sil-Tech Putty index is
recommended to aid in wax cut-back
i Note Add wax where neccessary
i Note Wax cutback should allow for a maximum
of 1.5mm of layering ceramic
50
IPSConnectors aid in positioning and maintaining
proper pontic connections
i Note Retain holding tab throughout fabrication
process
51
IPSEris Sprue Placement
Critical Elements for Pressing Success
52
Correct sprue placement on the framework helps
establish subsequent flow of the pressed ceramic
3mm
i Note Place sprues along the long axis of the
tooth prep
5.5mm
i Note Sprues should be 3-8mm in length Do not
sprue to pontic i Note Maintain 3mm minimum
space between pontic and sprue i Note Keep wax
connections smooth
53
i Note Direct the flow of material along the
long axis of the preparations
54
i Note The maximum length of the sprue and
pattern is 15-16mm (Safe-Zone)
55
i Note Angle sprues to optimize the flow of
material into the mold
56
i Note Position the longest and/or thinnest
surface outward i Note Maintain proper flow of
the material
i Note Sprue attachments should be smooth and
rounded i Note Attach the sprues to the base at
a 45 - 60 angle
57
Correct sprue placement on the sprue former helps
establish the subsequent flow of the pressed
ceramic
i Note Keep wax connections smooth
i Note Follow all Safe-Zone location
requirements i Note Maintain clean bevelkeep
clear of sprue wax
58
Locating the Safe Zone
30x15
15x15
15x15
30x15
59
IPSEris Ring Size Selection

• 100gm ring
• One single crown
• Two veneers or inlays
• 200gm ring
• Multiple single units
• Bridges

i Note 100gm ring one small ingot only i Note
200gm ring one large or one small ingot
60
IPSEris InvestingBurnoutPressingDivesting
Maximizing the Framework Properties
61
IPSEris Ingot Selection

• Weigh the wax pattern with sprues attached
• 100gm ring
• 0.24 to 0.50gm wax weight requires 1 small ingot
• 200gm ring
• 0.24 to 0.50gm wax weight requires 1 small ingot
• 0.60 to 1.30gm wax weight requires 1 large ingot
• Use a phantom sprue when wax weight gt 0.24gm

62
IPSEris InvestingEvaluate Wax Pattern/Ring
Position
i Note Verify position of wax pattern position
to both base and ring i Note Verify paper ring
fit to sprue former base
63
Investing / Burnout Guide

• IPSEmpress2 Special Investment
• (Conventional Burnout)
• Mix for minimum of 1 minute
• Bench set for 1 hour
• Place in room temperature furnace
• Set rate of climb of 10 F (5 C) per minute
• Use 2 stage burnout
• 1st stage - 482 F (250 C)
• hold for 30 minutes
• 2nd stage - 1562 F (850 C)
• hold for 60 minutes

• IPSEmpress2 Speed Investment
• (Rapid Burnout)
• Mix for minimum of 2-3 minutes
• Bench set for 3060 minutes
• Place in furnace preheated to 1562 F (850 C)
• When furnace returns to temperature hold for
• 45 minutes (100gm ring)
• 60 minutes (200gm ring)
• Add 15 minutes when preheating more than 1 ring

i Note Mixing times are based on an approximate
450rpm mixing speed i Note All temperatures are
based on accurately calibrated equipment
64
IPSEris InvestingMixing
i Note Mixing times are based on approximate
mixing speed of 450rpm
i Note Select investment for either the
Conventional or Rapid Technique
i Note Mix appropriate Special Liquid with
distilled water according to expansion required
i Note Always add powder to liquid
i Note Hand mix (approx. 30 sec) / Mechanically
mix according to investment type
65
IPSEris InvestingFilling the Ring
i Note Work efficiently to prevent investment
from setting prematurely i Note Watch for
trapped air bubbles in/around the restoration! i
Note Be sure ring gauge is properly positioned i
Note Follow recommended setting times precisely
66
IPSEris Burnout
i Note Place Alox Plunger(s) into room
temperature oven i Note Do not preheat the
IPSEmpress2 ingot material
67
IPSEris PressingEP-600 Combi
i Note All press parameters for IPSEmpress
products are preset in the EP600
68
IPSEris Pressing EP-500 (with V2.9 upgrade)
i Note Be sure the EP500 has received the V2.9
upgrade i Note IPSEmpress2 ingots should be
pressed on program number 11 or 12 i Note
Program 11 Large Ring 20 min hold due to larger
ring size i Note Program 12 Small Ring 15 min
hold due to smaller ring size
69
IPSEris DivestingRemoving the Alox Plunger
70
IPSEris Divesting
i Note Do not use aluminum oxide for divesting
i Note Never blast at a 90 angle to the axial
walls
71
IPSEris Divesting
i Note Remember the framework position in the
ring
i Note Rough divesting is accomplished using
glass beads at 4 bar pressure (58psi) i Note
For fine divesting, reduce air pressure to 2 bar
(29psi)
72
IPSEris Removing the Reaction Layer
i Note Submerge pressing in Invex Liquid in an
ultrasonic cleaner for 20 minutes to weaken and
identify the reaction layer i Note Rinse with
water and thoroughly dry to identify reaction
layer i Note Blast thoroughly with 100 micron
aluminum oxide at 2 bar pressure (29psi) i Note
Repeat above steps after finishing and skinning
(10 minutes Invex)
73
IPSEris Seating the FrameworkInternal Inspection
i Note Evaluate internal aspects for nodules or
remaining reaction layer
i Note Carefully trial fit the restoration on
the working dies and evaluate
74
IPSEris Seating the FrameworkInternal Relief
i Note Apply a thin coat of Control Paste on
working dies and carefully seat
i Note Adjust heavy markings with fine diamonds
at slow speed (no high-speed!)
i Note Carefully trial fit the restoration
onto the working dies and evaluate
75
IPSEris Fabricating a Tooth-Shaded Die
i Note Apply separator to all aspects of
framework that will contact the material i Note
Contour material into the internal aspects of
framework (watch for trapped air!) i Note Adapt
prescribed Die Material onto die holder i Note
Light cure and finish with rubber wheel as
necessary
76
IPSEris Removing the SprueFinishing the
Framework
i Note Use water throughout the entire finishing
process to keep framework cool i Note Maintain
slow speed and avoid excessive heat buildup i
Note Carefully cut through the sprues with a
diamond disk i Note Use appropriate abrasives
for sprue reduction
77
IPSEris Finishing the FrameworkSurface Finishing
i Note Framework reduction should of be kept at
a minimum i Note Maintain framework thickness
requirements (0.8mm minimum) i Note Use
appropriate stones and/or fine diamonds for
minor adjustments i Note Maintain slow speed
and keep it cool!
78
IPSEris Finishing the FrameworkSurface Skinning
i Note Use silicon carbide stones for surface
skinning and minor adjustments i Note Maintain
slow speed and keep it cool! i Note Maintain
framework thickness and design requirements
79
IPSEris Ceramic Application
Simple Esthetic Control
80
IPSEris Pre-Ceramic EvaluationFramework
Preparation
i Note Re-evaluate framework design
requirements i Note Repeat Invex and aluminum
oxide blasting procedure if necessary
81
Programat P100

• Automatic
• Accurate
• Self Monitoring
• PC Connectivity
• Easy Operation

82
Foundation layering may be accomplished by either
of the following techniques

• Technique A
• Used whenever sufficient space is available or if
  custom shading of the framework is not required
• May be accomplished with any dentin, incisal or
  impulse powder except KM
• Powder may be mixed using either IPSEris
  Modeling Liquid or IPSEmpress Universal
  Glaze/Stain Liquid
• Apply a thin, uniform layer on entire veneering
  surface
• Fire according to the Instructions for Use

83
Foundation layering may be accomplished by either
of the following techniques

• Technique B
• Used when space is limited or to increase the
  in-depth chroma of the restoration
• Mix the IPSEmpress Universal Shade Paste and/or
  IPSEmpress Universal Stain with the Universal
  Glaze/Stain Liquid to the proper working
  consistency
• Apply a thin, uniform layer on entire veneering
  surface
• Fire according to the Instructions for Use

84
IPSEris Ceramic ApplicationFoundation Staining
i Note Apply stain liquid to the die surface to
eliminate air (influences shade) i Note Apply a
thin amount of stain liquid to the framework with
a small thin brush i Note Select appropriate
Universal Shade/ Stain and mix according
to the instructions i Note Apply and fire
according to the Instructions for Use
85
IPSEris Ceramic ApplicationFoundation Staining
i Note Observe the degree of color influence i
Note Multiple applications may be necessary
i Note Determine chroma level by comparing to
shade tab
i Note Framework ready for ceramic powder
applications
86
IPSEris Ceramic ApplicationDentin Layering
i Note Select prescribed dentin shade i Note
Apply for dentinal shape, maintaining
approximately 0.5mm room for enamel i Note
Maintain moisture throughout the buildup
procedure
87
IPSEris Ceramic ApplicationEnamel Layering
i Note Select prescribed enamel shade i Note
Apply enamel, overbuilding slightly to compensate
for firing shrinkage i Note Maintain moisture
throughout application
88
IPSEris Ceramic ApplicationFiring
i Note Observe the translucency and color i
Note Note texture and luster of properly fired
ceramic i Note Minor finishing/contouring can be
accomplished prior to
corrective buildup
89
IPSEris Ceramic ApplicationCorrective Buildup
i Note Clean the restoration thoroughly before
making corrections i Note Build corrections as
necessary for shape and color effect
90
IPSEris Ceramic ApplicationCorrective Firing
i Note Final contour can be made using fine
diamonds and aluminum oxide stones i Note Clean
thoroughly prior to glazing
91
IPSEris Ceramic ApplicationApplied Glaze
i Note Clean thoroughly prior to staining or
glazing i Note Stains and Shade pastes can be
applied for external characterization i Note
Universal Glaze Paste must be applied over fired
external characterization i Note Universal Glaze
Paste must be thoroughly mixed prior to
application i Note Any exposed framework
material must be either mechanically polished or
glazed with the Universal Glaze Paste
92
IPSErisCeramic ApplicationNatural Glaze
i Note To achieve a natural glaze, fire the
restoration at the last dentin firing
temperature with a 3060 second hold time. i
Note Altered surface texture can be achieved
using pumice.
93
IPSEris The Completed Restoration
! !
94
IPSEris Add-On Material

• Use only IPSEris Add-On Material
• Fire according to the Instructions for Use

95
Firing Parameters - Benchmarking
Under-fired
Over-fired
Properly Fired
Firing parameters listed in the Instructions for
Use are valid for Ivoclar Vivadent Programat
furnaces. To benchmark firing parameters for
furnaces from other manufacturers, adjust the
high temperature until a medium high gloss is
attained. Once a desired result is achieved, add
or subtract the difference in temperature for all
other IPSEris programs.
96
(No Transcript)
97
Etching the Restoration

• IPSEris restorations must be etched regardless
  of the cementation technique
• All internal aspects of the restoration must be
  clean and free of contaminants
• Etch for 20 seconds with IPSCeramic Etching Gel
• A properly etched surface will have a frosty
  white appearance

98
IPSEmpress2 IPS Ceramic Etching Gel (lt 5 HF
Acid) _at_ 2000X
20sec Etch
40sec Etch
60sec Etch
Over-etching results in the dissolving of the
glassy matrix causing a loss of retention and
weakening of the ceramic restoration
Preferred Etch Pattern for optimal strength and
adhesion
99
Cementation

• IPSEris restorations may be cemented either
  conventionally using Type I glass ionomer cement
  (i.e. Vivaglass CemTM) or adhesively (i.e.
  Variolink II)
• Hybrid resin cements with high expansion rates
  must not be used!

100
Clinical Applications

• Vivaglass Cem
• Conventional Cementation
• Pre-encapsulated Type I Glass Ionomer
• Mix, Place, Set

101
Clinical Applications

• Retentive Preparation Guidelines
• Essential Shade Communications

Laboratory and Clinical work courtesy of
Christopher Ramsey, DMD and Lee Culp, CDT
102
Technical Applications

• Pressed Lithium Disilicate Frameworks
• IPSEris Powders Layered
• Restorations finished and glazed

Laboratory and Clinical work courtesy of
Christopher Ramsey, DMD and Lee Culp, CDT
103
Technical Applications

• Final restorations etched internally with
  IPSCeramic Etch
• Exceptional results!

Laboratory and Clinical work courtesy of
Christopher Ramsey, DMD and Lee Culp, CDT
104
Clinical Applications

• Seat
• Set
• Remove Excess

Laboratory and Clinical work courtesy of
Christopher Ramsey, DMD and Lee Culp, CDT
105
Clinical Applications

• Finish

Laboratory and Clinical work courtesy of
Christopher Ramsey, DMD and Lee Culp, CDT
106
Adhesive Placement

• Excite! Dental Adhesive
• Monobond-S Silane Coupler
• VariolinkII Resin Cementation System

107
IPSEris Quick Tips

• Do
• Do thoroughly air abrade with 100 micron
  aluminum oxide at 1 bar pressure prior to
  building ceramic
• Do shade the framework if desired
• Do apply substantial thickness of layering
  porcelain for foundation bake
• Do observe proper firing parameters
• Do use appropriate liquids to dilute powders or
  staining/glazing materials
• Do regularly calibrate the EP500/EP600 pressing
  furnace

• Dont
• Dont apply layering ceramic directly to reaction
  layer
• Dont apply layering ceramic over unfired stain
• Dont apply foundation as a thin slurry (powder
  technique)
• Dont apply layering ceramic thicker than 1.5mm
• Dont contaminate honeycomb trays by firing PFM
  crowns

Always

• Always observe 0.8mm minimum frame thickness
• Always refer to the tooth reduction chart for
  proper frame to layering ratio
• Always use the honeycomb firing tray with rounded
  pins
• Always maximize the substructure and minimize the
  layering ceramic

• Always use a layer of IPSEmpress Universal Glaze
  to protect IPSEmpress Universal Stains
• Always use Invex liquid to weaken and identify
  reaction layer

108
Thank You!