Wednesday, January 22, 2014

Zirconia or Emax, Monolithic or Layered – Decisions, Decisions

Based upon our experience, and reinforced by gurus in our industry, we’d like to make a recommendation of restorative materials and how they relate to location in the arch. The basic selection process for dental materials has not changed over the years - the stronger the restoration the less esthetic, and vice-versa. In the mouth, this directly correlates to stronger in the posterior, esthetic in the anterior. Fortunately, due to material improvements over recent years, the range between the two ends of the spectrum is narrowing. But a combination of treatment around an arch often presents a conundrum.

ROE’s standard recommendation for material-selection is as follows: in the molar area we suggest full-cast gold restorations or full-contour zirconia (TLZ, BruxZir) as the most predictable and reliable. With centrals and laterals, when occlusion is stable, we suggest our very esthetic, layered eMax. Our choice for bicuspids and cuspids varies depending upon a number of factors, such as occlusion, guidance, opposing surfaces, translucency, final shade, and stump shade. For example, if strength is the primary concern, full-contour zirconia might be the best choice; conversely, if a younger patient presents with translucency requirements and a stable occlusion, layered eMax or even monolithic eMax might be well-suited. If the patient has a dark preparation-shade, PFZ, full-contour zirconia, or monolithic eMax is the best choice to mask the discoloration.

In more extensive restorations, it may seem prudent to use the same material to maintain continuity within the smile. However, the patient’s particular needs, and the spectrum of materials available, may complicate the choice of material. In these situations, feel free to gather information and discuss treatment-options with your ROE Technical Consultant. They are experienced and trained to help dentists decide the best material for the situation.

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