Diagnostics

The diagnostic wax-up is often the most important tool for case presentation, planning and for selling treatment based on patient acceptance. The dental lab creates a wax model of how the enhanced smile or repaired teeth will look. Once the patient and the dentist review the wax-up, changes are either initiated or the lab is given approval to proceed.

Creating a Beautiful Ivory Diagnostic Wax-up
Accurate pre-op models with good gingival capture and blemish free dentition produce accurate final results! The prescription is followed as to whether veneers or full crowns are desired. All pre-op models are duplicated for this process. Models are carefully prepared using conservative preps. We use our digital software to design the patient-specific diagnostic. Then mill the design in wax so that we can make final adjustments by hand to complete the wax up. Photos and a stick bite are necessary to aid in designing the ideal smile for each individual patient.

The completed diagnostic wax-up is then duplicated with green matrix material to produce a preparation guide. This matrix is used by the clinician as a guide to insure ample room was provided on each preparation for the lab technician to produce the proposed final restorations. A temporary matrix is also provided to aid the clinician in transferring the patient- approved diagnostic from the model to the mouth as temporary restorations need to be fabricated in the dental office after preparation and worn by the patient until the final restorations are completed by SCS.

In summary, begin with the end in mind. Planning turns even the most complicated case into a routine case. Effective treatment planning is envisioning the steps necessary to accomplish the desired end product. The diagnostic wax- up enables the dentist, patient, and laboratory technician to see the final outcome before any invasive steps have even been taken. Great communication is the best way to achieve superlative results!

DurusZ®

Full contour Zirconia

DurusZ® is a solid full contour Zirconia crown, bridge or inlay/onlay that is created from start to nish in our lab. This restoration provides a more natural looking alternative to a full cast crown, not to mention a more attractive cost resulting from the higher price of gold. DurusZ® is most suitable for posteriors due to its strength (1200-1400 Megapascals or MPA).

Indication:
The indications for an all zirconia restoration would be a patient who has a strong bite (a clincher or grinder) that would like something that looks more natural than a full cast gold restoration. For now, these restorations are recommended for the posterior region of the mouth.

Preparation:
We suggest the standard preparation for an all-ceramic restoration with a small 360-degree chamfer margin. The occlusal thickness should be at least .5mm – 1mm.

Cementation:
Cementation is recommended. Multilink by Ivoclar is a great choice; however, other equivalent products will work.

Adjustments:
Should occlusal adjustments be necessary, as with other restorations, do so with nesse using water, air and a ne diamond burr to prevent heat build up on the material (heat causes micro fractures). After adjusting, the unit(s) must be highly polished with any preferred polishing system. A high-polished finish is necessary to prevent excessive wear on the opposing dentition.

DurusZ®HT

  • 615 MPa
  • High translucent zirconia
  • Comparable to a PFM but with no metal fees
  • Quick turnaround time – 5 in-lab days
  • Cementable
  • Single units
  • 3 unit bridges

*If adjustments are necessary: adjust with finesse and copious amounts of water, air and a fine diamond burr to prevent heat buildup (Heat causes micro fractures). After adjusting the restoration must be highly polished with any preferred polishing system. A high polished finish is necessary to prevent excessive wear on the opposing dentition.

Please call our office with any questions. Our CDT’s are happy to help with any case planning.

What is IPS e.max?

Do you remember IPS Empress? It is one of the most esthetic all-ceramic restoration systems recognized among dental professionals. So, what is e.max? It is… Empress to the max!

E.max combines the esthetics of Empress with strength. At 400 MPa, versus IPS Empress at 160 MPa, you get unmatched beauty, strength and function with IPS e.max. The patented e.max material has more than 10 years of clinical evidence with a 98.2% success rate!

Suncoast Ceramic Studio proudly offers the IPS e.max Systems listed below:
IPS e.max Press
IPS e.max CAD
IPS e.max ZirCAD

IPS e.max Press (400 MPa Lithium disilicate ingot)
When creating an e.max Press restoration, each prep is created in a wax stage with full anatomy in place and then is pressed out of a lithium disilicate glass-ceramic ingot. At this point, the crown is meticulously finished and shaded to your patient’s desired color. This is called an e.max Press Full Contour Crown (or veneer).

Occasionally central and lateral anterior teeth require a little extra attention to attain that perfect shade by creating a more translucent incisal area. This process of cutting the incisal back and placing translucent ceramic (e.max Ceram) at the incisal area is called layering. This crown is an e.max Press Layered Crown (or veneer).

All-ceramic restorations do not have a metal core; therefore, light can shine through the restorations as it does through natural teeth. In the same way, the characterization of the prep itself can have a critical effect on the actual final shade of the seated restoration. This is the exact reason why we require a detailed prep (stump) shade whenever an all-ceramic crown is requested.

Another nice feature of an all-ceramic restoration is that no dark metal edges will show at the gum line. The material is colorfast and wear resistant. Low heat conduction protects the dental nerve, which can be very sensitive to temperature changes.

Bonding is the preferred method to seat.

Suncoast Ceramic Studio offers e.max Press for highly-esthetic posterior and anterior crowns, veneers and 3-unit anterior and premolar bridges when an all-ceramic restoration is indicated.

IPS e.max CAD (360 MPa Lithium disilicate block)
Welcome to digital dentistry! e.max CAD is based on the same material technology as IPS e.max Press, but instead of an ingot being pressed the IPS e.max CAD block is milled using state of the art milling system.

Suncoast Ceramic Studio offers posterior crowns, inlays and onlays in this material.

IPS e.max ZirCAD (Zirconium framework (>900 MPa) milled using CAD/CAM technology then layered with e.max Ceram)
e.max ZirCAD combines the beauty you expect from e.max and the strength of Zirconia in the frame. This complementary duo produces highly-esthetic, extremely strong and durable crowns and bridges.

Once the framework is designed and milled, e.max Ceram (porcelain) is applied. e.max Ceram delivers vibrant color, translucency, opalescence and accurate shades. It is a Nano-Fluor Apatite Glass Ceramic that mimics optical effects of natural enamel, creating patient-pleasing esthetics.

As a high-strength, natural-looking alternative to a PFM, an e.max ZirCad crown’s versatility makes it ideal for anterior or posterior single units or multi-unit bridges.

Suncoast Ceramic Studio offers anterior or posterior single units or multi-unit bridges when high strength and esthetics are needed.

pfm-feature-1

PFM (Porcelain Fused To Metal)

Yes, we still do it! This is a tried and true process over many years with a very high success rate.

Semi-precious or high noble alloy are used to fabricate the metal coping. The metal coping is covered by a tooth-colored material that is painted on and fired in the furnace enough times to mask the gray metal color. The final porcelain is then layered on to the “opaqued” or “masked” coping to complete the final restoration.

Pre-Scheduling Procedures:

Our laboratory is different in many ways from most other laboratories. One of the biggest differences is that we pre-schedule our cases. Just as you schedule your patients to make the best use of your time, we have determined definite numbers that correlate with just how much high-quality, precision work we can produce at any given time. By determining how long each procedure takes and allowing for planned disruptions–such as vacations, holidays, and continuing education—our office staff arrives at a date your completed case can leave our premises. One important thing we ask is that you refrain from scheduling your patient to return on the exact date of delivery unless there is absolutely no other option. If you must do so, please advise us of the situation immediately. We make every effort to keep things on schedule but, unfortunately, some things cannot be anticipated or controlled—a crown fracturing during the final firing, UPS misrouting a package, a flat tire on the delivery truck, etc.

We try to make the pre-scheduling interaction as swift and painless as possible. The basic information we require is:

  1. What type of work is to be done—ie, Porcelain Fused To Metal, e.max® Press Monolithic or Layered, e.max® CAD, DurusZ®, Diagnostic Wax up, Metal Try-In, Implant Case, Full Cast Gold Crown;
  2. The date we are able to pick it up or you will ship it out to us;
  3. The patient’s name;
  4. How many teeth, including teeth numbers if at all possible.

If there are extenuating time constraints that need to be considered, we always do our best to coordinate and ensure these factors are addressed. Any pertinent historical information you have available to share is certainly appreciated. If we are aware of previous work, we will pull past records and make all this information available to the technician working on the case. As in most circumstances, it never hurts to have too much information; but, it can be extremely detrimental not to have enough data!

Implant Scheduling

Each implant case is unique and most are complicated (involving the ordering of parts or securing the abutments) so we prefer not to commit to a return date at initial contact. Once the case is received, model work is accomplished and the department supervisor evaluates the necessary steps to be taken and orders any parts required. Once everything is in line and the case is ready to move forward, we enter the information into our scheduling program and call you with a definitive date that the completed case will be back in your office and you can confidently appoint your patient for seating.

Adjustment Scheduling

When returning a case for an adjustment, we prefer to receive it before we establish a return date. This gives the supervisor of the affected department a chance to determine what actions are necessary and where that case can be “squeezed” into the probably-already-tight schedule. Once our office staff has that information, they will immediately call and advise you of the exact date the completed case will be sent back to you so you can contact your patient to schedule their seat date.

Our goal is to NOT make you change an appointment once it is set and this is the best way we have found to promote this goal.

As stated above, we are different from most other labs. We pride ourselves on delivering the highest quality restorations in the most efficient timeframe and are confident you and your patient will appreciate our efforts and we always appreciate yours!

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