The ability to closely replicate the natural translucency, color, and texture of natural teeth allowed dental professionals to deliver restorations that seamlessly blended with a patient’s smile. 1991 marked the beginning of the Esthetic Revolution in dentistry with the introduction of Ivoclar’s pressable Empress glass leucite ingot. More than 30 years later the esthetic revolution continues to transform patients’ lives and smiles with IPS e.max Press, a lithium disilicate glass ceramic, offering patients a renewed sense of confidence and self-esteem.
Robert Ganley, former Ivoclar CEO, is credited with launching the Esthetic Revolution. His vision and passion to Make People Smile shaped and defined the development of the innovative all-ceramic materials and technologies that better serve the needs of dentists, technicians and their patients. Today, Ivoclar continues its commitment to develop innovative biocomatible materials and integrated solutions that offer dentists and technicians restorative solutions that not only improve the lives and oral health of patients but also provide a financially lucrative alternative to metal-based restorations.
Today more than 100 million restorations have been placed in patients worldwide2. The success of pressable technology and materials rests not only on their highly esthetic nature but also on their strength and clinical longevity. Dr. Kenneth Malament, DDS, MSD clinical professor Prosthodontics at Tufts University School of Dental Medicine, Boston MA and private practitioner, has chronicled the clinical longevity of IPS e.max Press over the past two decades in the more than a thousand patients he has treated. His research reveals a remarkably low overall failure rate of 0.17% for complete or partial coverage restorations and suggests that regardless where the restoration is placed in the mouth, the sex or age of the patient, or whether the restoration is a full or partial coverage, its 96.49% survival rate at 16 or more years in the mouth is incredibly high.1 For dentists and technicians, working with a material that meets patient demands for a natural looking smile but won’t chip or break, is kind to opposing dentition, and provides long-term fit and function built unwavering trust in the material and the process
For dental laboratory owners like Mike Bellerino CDT, Trinident Dental Laboratory, Metarie,LA pressing technology and trust in the strength, biocompatibility, and the life-like esthetics3 of the IPS e.max family of materials was key to transforming his business from a metal-based to all-ceramic platform. Early in his career he had been involved in research focused on development of an all-ceramic material and bonding protocol that was needed for long-term clinical success. However, it wasn’t until the introduction of IPS Empress and later IPS e.max Press that he found a pressable material and processing system that produced a monolithic all-ceramic restoration that met his demands for exceptional strength, durability and life-like esthetics. In addition, all-ceramic restorations reduced patient risk of allergic reactions and adverse tissue responses in comparison to metal-based restorations, which is critical to dealing with the high-end anterior esthetic makeover cases he and his clients handle.
Press technology also streamlined the fabrication process by eliminating the labor-intensive metal-ceramic multi-layering process once performed by a master ceramist to achieve the illusion of life-like esthetics. With the introduction of pressing ingots of multiple opacities, shades, and translucencies, IPS.emax Press is now a staple of his business with most high-end anterior restorations receiving only a layer of ceramics on the facial or incisal third to achieve the life-like beauty of natural teeth4, leaving all functional aspects of the restoration untouched except for polishing to eliminate the chances of ceramic chipping and wear to opposing dentition.
The integration of press technology with digital work flows has added further efficiencies, time savings, and accuracy to the pressing process. Digital impressions, computer case design and 3D printed or milled wax-ups eliminate the time-consuming manual stages of the process and further enhance the precision, consistency and predictability of the final product from the digital impression to final placement of the restoration.
The two cases presented below by Mike Bellerino illustrate the versatility and highly esthetic outcomes that can be achieved with pressed ceramics to restore and bring to life the smiles of two young women in their 20s.
This young woman presented to the practice concerned about the wear exhibited on teeth #8 and #9 as well as the unnatural monochromatic nature of the composite bonding on both teeth (Figures 1 and 2). To minimize natural tooth reduction, two IPS e.max Press thin-pressed veneers were prescribed. However, once the teeth were prepped, a distinct difference in shade was apparent between the two preparations. In order to compensate for the shade differences, the veneer for tooth #8 was pressed using an IPS e.max Press HT BL3 ingot and #9 using IPS emax Press LT BL4. The veneers were designed with a cutback on the incisal third for ceramic layering to create a life-like appearance that would blend seamlessly with adjacent dentition (Figure 3). The patient was delighted with the outcome.
At a young age this patient’s damaged tooth #8 was restored with an all-ceramic crown. Due to aging and wear on natural tooth #9, the ceramic crown now appeared longer in length and darker in shade. Tissue recession and irritation were also present (Figures 1-4). A crown was prescribed to restore tooth #8 and a thin pressed veneer to minimize tooth reduction prescribed for tooth #9.
Press technology and the introduction of innovative all-ceramic materials such as IPS e.max Press continue to leave their indelible mark on the field of dentistry, redefining treatment approaches and patient experiences. From enhancing esthetics and functional fit to promoting minimally invasive dentistry, pressing technology continues its 30+ evolution and stands as a testament to the positive impact that technological advancements can achieve in terms of patient care and the advancement of dental science.
1 Kenneth A. Malament, Mariam Margvelashvili-Malament, Zuhair S. Natto, Van Thompson, Dianne Rekow, Wael Att. Comparison of 16.9-year survival of pressed acid etched e.max lithium disilicate glass-ceramic complete and partial coverage restorations in posterior teeth: Performance and outcomes as a function of tooth position, age, sex, and thickness of ceramic material. The Journal of Prosthetic Dentistry, Volume 126, Issue 4, 2021, pages 533-545.
2 Based on global sales figures.
3 At natural lighting conditions. The use of artificially generated UV or UV-like light may result in a different impression.
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