Dr. Michael McMahon and Greg Nash, CDT have worked together for more than 20 years to deliver the highest quality of care and esthetics to patients. Both are self-professed perfectionists when it comes to their mutual commitment to provide the highest level of oral health care and to working with restorative materials that deliver the life-like restorations the patients’ demand.
In the early years, esthetics were defined by the skilled time-intensive multi-layering of porcelain materials to metal. Porcelain-fused-to-metal achieved the esthetics strived for by the technician while the metal substructure provided the strength and durability the clinician desired.
That changed in the mid-2000s with the skyrocketing price of gold and the introduction of CAD/CAM milled zirconia. Although zirconia demonstrated the strength and durability of PFMs that clinicians wanted, achieving life-like esthetics from the monolithic material was much more difficult. The esthetic issue as addressed by the development of new iterations of the material, resulting in zirconia that exhibited higher translucency levels and multi-layered zirconia materials that attempted to achieve the subtle dentin to enamel transition. However, each of these new zirconia materials came with a compromise either in strength or esthetics or both. And all still required labor-intensive layering to achieve a highly esthetic outcome.
“I have a very critical eye and all these different zirconia materials resulted in restorations that just didn’t look right, even with layering, staining and glazing,” said Dr. McMahon, “even though my patients seemed happy with the results, to my eye the restorations lacked that true life-like quality we were hoping to achieve. The word that comes to mind is ‘blah’.” For Greg and Dr. McMahon, one of the biggest issues with these zirconia iterations was the compromise in material strength for minor esthetics and labor-saving value.
Then Greg discovered IPS e.max® Prime and introduced the material to Dr. McMahon. “Finally, we now have a zirconia material that combines the premium esthetics, comparable to glass ceramics with the exceptional 1200 MPa strength of monolithic zirconia,” said Greg. For Dr. McMahon, Prime™ has become a single material solution that he prescribes for 90% of the indirect cases he treats. “Ever since Greg introduced me to Prime™ I have not used any other brand of zirconia for most of the cases I do whether it’s a single crown, bridge, or implant case,” said Dr. McMahon. He believes the life-life esthetics achieved by the material is far superior to anything he has experienced in the past. “Now when I place a Prime™ crown next to a PFM crown, the Prime™ crown is so natural looking that it simply disappears in the mouth and the PFM becomes so obviously a less-than-natural crown.”
For Greg, Prime has become his high-tier go-to material for any case where esthetics is an issue. Whether fabricating a monolithic crown, multi-unit full-contour bridge or bridge framework with up to two pontics, Prime™ provides the flexibility to simply stain, glaze or cut-back and layer to achieve the final level of esthetics needed for the case.
“We can see the difference and so can our clients,” says Greg
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