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Laboratory Services

Crown & bridge
restorations, reimagined

Turner & Goldrich offers crown and bridge restorations in both traditional metal based construction techniques and a range of all ceramic options that will meet all our clients' requirements. With CAD/CAM being the future of dentistry it has become a large part of our laboratory.

For our aesthetically challenging cases, we encourage patients to attend the lab for a personal consultation by one of our highly skilled technicians to ascertain the exact shade (colour) required for the restoration. Other aspects that form part of this appointment would be to establish patient preferences, smile-line assessment, facial measurements and a photographic record. The patient may need to return to the lab after the dentist does the try-in of the crown or bridge, if necessary, for a final colourisation.

PFM

Porcelain Bonded to Metal

Porcelain bonded to metal has been the main-stay of dental technology and the first choice of dentistry as a treatment option for the past forty years. It has longevity, is stable and requires little to basic equipment to produce. In comparison PFM today cannot match all porcelain alternatives in most indications. They are growing in popularity providing, far superior aesthetic results. In many cases PFM will remain a reasonable option for some time to come.

Indications

All restorative procedures — a material offering lower cost
Excellent where devitalized teeth are present
Where partial dentures need to be retained
Where precision attachments are required — still the first choice
Very suited where paranormal function exists
Excellent solution for excessive heavy bite history or TMJ joint issues
Can be compromised aesthetically owing to the metal base
May lack vitality when there is lack of room
IPS e.max

IPS e.max Lithium Disilicate

IPS e.max is offered in both single unit veneers and as bridges. The material offers a superior aesthetic solution to both anteriors and posteriors applications with a strength of 400 MPa where preparations are cut with shoulders.

All IPS e.max restorations are etched with 9.5% hydrofluoric acid before leaving the laboratory.

Guidelines for Crowns & Bridges

Almost all restorative procedures including implants can be constructed using IPS e.max porcelain on Lithium Disilicate or Zirconia
Preparations should be cut with classic shoulder design for vertical support for optimal transition of light into the tissue
IPS e.max requires adequate room palatally, lingually, occlusally with 2mm clearance for occlusal strength
Bridges are ideally restricted to three unit spans
A requirement for bridges is to allow sufficient clinical height for adequate connectors — approximately 3mm to 4mm in height
IPS e.max offers superior aesthetics over conventional porcelain bonded restorations, although sometimes the strength can be compromised
Use IPS e.max on Zirconia for long span bridgework as an alternative to porcelain bonded bridgework
In conjunction with Zirconia abutments, IPS e.max offers superior restorations for implant applications

Guidelines for Full Contour or Facial Veneers

Can be used as full contour stained where space is at a minimum, or fully layered where space is available
Where a form change is required, "open or clear the inter-proximal areas" so the IPS e.max veneer can re-contour inter-dental areas
If no form change is required leave inter-dental contacts intact to maintain tooth enamel for bonding

Guidelines for Inlays

IPS e.max inlays, onlays, one, two or three surface either clear glazed or stained offers excellent aesthetic results
Avoid cutting internal sharp corners within internal boxes as this may create pressure points or increased friction on cementing
For internal box cutting use a round nosed diamond or tungsten cutter, not a square tipped
Avoid long bevels as these may distort while firing the ceramic — cut bevels at thirty degrees and 1mm in length maximum
Zirconia

Zirconia

Zirconia has changed the face of dentistry in a way that years past was only a dream. This material can be fabricated into a variety of dental solutions that brings aesthetics and tremendous strength that challenges metal based solutions. Manufactured by technology that delivers unquestionable fit, the latest developments have solved many of the earlier issues related to translucency, colour and light reaction.

In its present development Zirconia offers outstanding quality restorations for a wide range of dental procedures, complete reconstructions and implant configurations that are virtually impossible to create by traditional methods.

IPS e.max in our opinion is the softest and most aesthetic solution when using Zirconia for your patient's treatments. IPS e.max overlaying ceramic has a low firing temperature which pays dividends in reducing stress and brittleness usually associated with the Zirconia higher fusing alternatives. It simply creates superb quality in all respects of its use.

Overview

Milled Zirconia offers strength values between 900 to 1100 MPa
Extremely strong but more expensive as a restorative option
Can be prescribed for cases with little vertical dimension
Zirconia is abrasive in its natural form — always cover with layered ceramic where possible
When exposed to opposing dentition ensure it is completely polished after adjustment using diamond polishing pastes or wheels
Zirconia as a material is guaranteed for ten years against breakage by the manufacturers
Five axis scanning allows tremendous design possibilities and milling options
Try and avoid undercuts near margins when preparing

Guidelines for Crowns & Bridges

Ideal material for all crown indications anterior to posterior
More expensive than porcelain fused to metal or IPS e.max
Where aesthetics and very close colour matching is required, preps need to accommodate an allowance for 0.3mm for the Zirconia coping on all surfaces
A good selection of shoulder porcelains are available to colour match marginal transition to facial tooth surfaces when required
For anterior bridge work where bite and leverage issues are concentrated, consider connectors being thicker than metal to increase strength
The IPS e.max overlaying ceramic is easy to correct and polish in situ — available in all commercial shades

Guidelines for Large Reconstructions

The software allows for pre-diagnosis waxing to be scanned and copied into the design phase
The software allows for complete internal design if preferred
Can be milled in one piece up to twelve unit spans, cement retained or implant supported

Guidelines for Implants

Excellent in the design phase to evaluate implant bed contouring and custom abutment design
Design issues can be communicated to the dental office for evaluation, approval or discussion
Excellent fit to all types of clinical implants
Two part implant solutions are possible on difficult case designs
Excellent material to fabricate primary telescopes for removable dentures
Complete fabrication of fixed or removable Zirconia bars are possible for fixed or removable prosthetics
Complete Prettau (ZirconZahn) one piece reconstructions are possible from pre-set-up templates