Summary
Zirconnet Lab followed polyetheretherketone (PEEK) early on, growing a brand new line of metal-free dental prosthetics. We experimented with more than a few zirconia generations on PEEK buildings. Our function was once to provide aesthetic, easy-to-maintain, and repairable answers.
This newsletter compares conventional porcelain-fused-to-metal (PFM) bridges with hybrid PEEK buildings. PFM bridges have top fracture dangers and service demanding situations. Complete-arch monolithic zirconia is heavy and rigid, resulting in doable jaw problems and non-repairability.
Hybrid answers with PEEK and zirconia crowns are optimum. PEEK supplies elasticity and lightweight weight, whilst zirconia gives sturdiness. We used Zolid Bion zirconia (1100 MPa) from Amann Girrbach for its awesome aesthetics and energy.
A case find out about is gifted: a 65-year-old affected person with chipped PFM bridges wanted substitute. We selected a hybrid PEEK and zirconia answer. The method concerned virtual impressions, prototype printing, framework milling, and ultimate crown placement.
Our effects confirmed stepped forward aesthetics, capability, and affected person delight. Combining PEEK with Zolid Bion zirconia proved efficient in huge implant circumstances
Advent
At Zirconnet lab, we had been early adopters of the polyetheretherketone (PEEK) subject matter and advertised it to our clientele, growing a brand new line in dentistry in our area. Over time we experimented with a number of zirconia generations on PEEK construction. Our purpose in adopting this carrier is to create a classy metallic unfastened line, this is smooth to keep and smooth to fix and repair at any time. This newsletter discusses using PEEK buildings in huge implant circumstances, using multilayer zirconia Zolid Bion (1100 MPa) of Amann Girrbach.
Massive implant circumstances: from conventional previous PFM to PEEK construction
- The previous porcelain fused to metallic (PFM) means gifts headaches, like a top fracture possibility, particularly after a number of firings of porcelain. It’s additionally tricky to fix in case of any breakage.
- Using full-arch monolithic zirconia ends up in a heavy prosthetic that can transmit the occlusal stresses to the bones, which would possibly result in bones resorption. The loss of elasticity of full-arch monolithic zirconia inhibits the mandibular deformation all through chewing, inflicting the temporomandibular joints (TMJ) drawback. In case of fractures it’s unimaginable to fix.
- Hybrid answers of PEEK construction crowned with zirconia crowns, and nanocomposite gum is an optimum answer, given the pliancy and lightweight weight of the PEEK, and its surprise absorption feature between occlusal stresses and the jaw bones. This system lets in us to crown the thimble with lithium disilicate or zirconia and the gingiva with nanocomposite.
Subject material of selection: Zolid Bion
Other sorts of zirconia generations had their very own benefits and drawbacks in moderation selected to be maximum appropriate and highest for the case in use.
- 5Y-TZP Multilayer Zirconia (600–700 MPa): Tremendous translucent, polychromatic, and aesthetically matching 16-color coloration guides. Certainly one of its drawbacks is its low flexural energy.
- 4Y-TZP Multilayer Zirconia (> 1000 MPa): Extremely translucent, polychromatic, much less problematic than its prior iteration, however with decreased aesthetic enchantment, it calls for further ceramic layering. This ends up in higher effort and time all through the recovery procedure and bigger complexity for any doable crown replacements afterward.
- 4Y-/ 5Y-TZP Multilayer Zirconia Zolid Bion (1100 MPa): From Amann Girrbach is the most recent technology of zirconia, used within the case described underneath. In our enjoy, this product combines the most efficient of earlier zirconia generations and it supplies higher aesthetic high quality because of its higher translucency on the incisal edge for a herbal 3-D impact.
Case presentation using Zolid Bion:
A 65-year-old affected person offered with two fullarch porcelain fused to metallic (PFM) bridges that had sustained substantial chipping. The affected person and physician determined to switch it for classy and purposeful functions. Dr. Ovidiu Tudor at Clinica Identiq in Bucharest to begin with aimed for a substitute of the PFM bridges. On the other hand, he identified that the former surgeon didn’t preferably position the implants.. Subsequently, after discussing the case we opted for the hybrid prosthetic answer for a greater and more secure consequence. Underneath is the entire procedure, illustrated with pictures.
Chipped PFM to begin with observed through the physician
The primary footage display that the occlusal aircraft and profile of the affected person are smartly positioned. The interpupillary line is parallel to the occlusal aircraft. We will superpose the pictures in a second smile author tool with a purpose to test the occlusal aircraft we’re operating on along with the facebow registration and occlusal desk despatched through the dentist (with a purpose to position the prosthetic paintings on an Artex articulator) . Minor VDO changes and lateral actions had been had to keep away from the porcelain chipping. (Drawback this is published in Determine 2 and three)
2. Preparation for virtual affect and facebow registration
Determine 6, 7: Placement of the scanbodies of the Megagen implant, in each decrease and higher arch, making ready for IntraOral scanner for virtual affect.
Figures 8, 8a: Virtual information–affect won from the dentist.
3. Designing and printing prototypes
Revealed temp for prototypes the use of A.G. Ceramil NextDent 5100 printer with NextDent C&B MFH (Mirco stuffed hybrid) Liquid shade N1,5. Coloured gum the use of GC Optiglase.
Determine 09: Designing the prototype relaying on pre-opp registration (preliminary scenario of the affected person) and occlusal relation supplied through the dentist. Determine 10: Printing the prototype the use of A.G. NextDent 5100 printer with temp liquid NextDent C&B MFH (Mirco stuffed hybrid) shade N1,5 with a purpose to test and keep an eye on the entire given knowledge.
Figure11, 12: Sand blasting the TiBase with 110um AL2O3 at 2 bars …and the interior floor of the bridges to arrange for cementation, the use of VisioLink for Pmma and MKZ Primer fro TiBase and DTK resine cement to mend the TiBase to the bridge.
Figure13: Verifing the occlusion and lateral actions on Artex previous to sending the published temps to the sanatorium
Figure14, 14a: Making an attempt the prototype permit the dentist to keep an eye on minor changes and sending the brand new knowledge again to the lab.
Figure15 to 18: Artex Face bow registration very important for articulator mounting later on the Lab. Ultimate chew registration with changes and lateral actions keep an eye on are despatched again to the Lab
4. Construction design and BioHpp milling:
Design with Ceramill Thoughts tool. Milled on Ceramill Movement 2 DNA.
Determine 19: Those changes are presented inside the information to be adjusted, as soon as accomplished we commence designing the Peek framework.
Determine 20, 21: The framework is being milled with BioHpp (By way of Bredent) on A.G. Ceramill Movement 2 milling device.
Determine 22: Identical steps and protocol for cementing Pmma on TiBase is used to cement BioHpp on TiBase. (Figures 11, 12 steps)
Determine 23, 24: Sandblasting BioHpp with AL2O3, 110 microns at 2 bars force. Then making use of Visolink at the interior floor to be cemented – VisionLink is cured the use of Bredent gentle curing unit for 90s.
Figure25, 26: MKZ Primer on handled floor of the TiBase, sandblasted with AL2O3, 110 microns at 2 bars force
Figure27, 28: Making use of DTK (Bredent) resin composite to cement TiBase on construction, then remedy it in Bredent curing Unit for 360s
Figure29: Controlling the passive are compatible of the cemented construction at the revealed type.
5. Crown design: A.G. Zolid Bion milling on Ceramill Movement 2 DNA technology.
Figure30: Designing indivudual Bion crowns at the construction, relaying at the ultimate revealed type adjustements used as a 3d verification key.
Figure31, 32: Zolid Bion discs despatched to us from Amann Girrbach to check the fabric and reach the specified recovery case.
Figure33, 34: Crowns are beeing milled on Ceramill Movement 2 DNA.
6. Sintering Zolid Bion on Ceramill Therm 3:
Figure35, 36 and 37 to 40: Crowns are beiing sintered in Ceramil Therm 3 the use of particular program for Zolid Bion. Period 8 hours and optimal temrature of 1500 oC for two hours
7. Minimum characterization of 12–22 upon request:
Figure41 to 43: The dentist requested for characterisation of the anterior enamel (12- 22), so we desinged those crowns with a minimal cutback with a purpose to follow a skinny layers of translucent and opal ceramics the use of GC ceramic for zircon.
Figure44, 45, 46: The crowns are positioned at the buildings to keep an eye on the chew registration on Artex and lateral actions as desired.
Figure47: previous to ultimate cementation, another trial within the affected person mouth to ensure the entirety.
Figure48: sandblasting the thimbles with 110 μm AL2O3 and appying a layer of Visiolink cured in Bredent curing unit for 90s
Figure49: Making use of MKZ primer at the interior floor of the Bion crowns sandblasted with AL2O3 50 micron at 2 bars force.
Figure50: Crowns are being cemented with DTK Bredent, cured for 360s in Bredent curing unit. F.
Figures 51, 52, and 53 display the appliance of Visiolink on Peek within the gum house to bond. Crealign Gum on buildings with AL2O3 makes use of 110 microns at 2 bars force. Robotically polish the nano composite to finish the task.
8. Gum paintings accomplished with Bredent Crea.lign nanocomposite and exceptional consequence:
Figure58: Higher and decrease recovery positioned once more on Artex to make certain that the precise required effects had been accomplished (no DVO adjustments all through the method).
Ultimate pictures59 to 63: The task is completed and brought to the sanatorium. Satisfied affected person and project achieved.
Merchandise Applied:
Epilogue:
Particular because of Dr. Ovidiu Tudor at Clinica Identiq – Strada Popasului 12, Bucharest, Romania who collaborated with the Zirconnet workforce in this case. Dr. Ovidiu Constantin Tudor For greater than 20 years, Dr. Ovidiu Tudor has practiced in Bucharest, Romania focusing solely on combos of smile design, aesthetic dentistry, oral surgical procedure and prosthetic rehabilitation. He graduated from the Carol Davila College of Medication and Pharmacy in Bucharest, and specialised as a GP following a three-year residency. Since 2014, he has been a lecturer for MegaGen’s R2Gate guided surgical procedure device (oneday implant thought). Dr. Tudor has taken section in numerous grasp categories, initiatives and seminars in Romania and the USA. Touch Knowledge: Dr. Ovidiu Constantin Tudor Identiq Dental Hospital 12 Popasului Side road, Bucharest Telephone: +40 21 210 30 77 Cell: +40 722 456 918 Email: dr.ovidiu_tudor@yahoo.com www.fb.com/TudMedical www.identiq.ro
Zirconnet M.A.S. Lab The paintings mentioned on this article was once performed at Zirconnet M.A.S. Romania in collaboration with Zirconnet Lebanon. MDT Marwan Khoury coordinated Zirconnet workforce effort to understand this mission. In its 30+ years of striving for excellence, Zirconnet has remained a essential dental lab within the Jap Mediterranean in the case of measurement and high quality. It followed virtual applied sciences in 2009 and has been the one AG Reside Lab within the Heart East and North Africa since 2014. Touch Knowledge: Zirconnet MAS Romania, Bucharest, sector1, calea floreasca 91-111, bloc f1, tronson 3, ap28 E-mail: zirconnetmas@gmail.com Telephone: +40731351611 Zirconnet, Lebanon Zalka, Amaret Chalhoub Telephone: +96171661165 Zirconnet.com E-mail: zirconnetdentallab@hotmail.com