Creative Dental Laboratory Scottsdale Arizona

Ivoclar IPS Empress

ipsempress

Creative Dental has nearly 15 years of experience creating Empress all-porcelain crowns, going back to when the processes and materials were first invented. During the past 15 years, Creative has upgraded our equipment and has adopted new materials and remains on the leading edge, including new stronger .

IPS Empress crowns are made of leucite ceramic which scatters light similar to natural tooth enamel and blends in well with other teeth. Restorations fabricated with the Empress have a lifelike translucent quality to them. These highly aesthetic all-ceramic single tooth restorations, such as inlays, onlays, crowns and veneers blend in seamlessly with the surrounding dentition.

Because of their lower fracture strength (160 MPa), Creative recommends Empress crowns only for un-stressed anterior teeth. For anterior bridges and for teeth that may experience higher level of wear, Creative recommends translucent zirconia copings.

Strengths:

  • Our AE (Advanced Esthetic) Teams of LVI trained cosmetic specialists have perfected unique layering techniques that make IPS Empress restorations come alive.
  • Indicated for inlays, onlays, veneers, anterior single crowns (where superior esthetics are a key consideration) and posterior single crowns (only in non-stressed teeth).
  • Leucite glass ceramic used clinically for over ten years.
  • All-ceramic system utilizes pre-shaded ceramic ingots and unique pressing technique.
  • Optimally co-ordinated degrees of translucency and slight shading.
  • Individually characterized ceramic core (in all Vita and ChromascopTM shades).
  • Improved and simplified shade selection with ChromascopTM and Dentin-stump guides (27 shades).
  • Pressure injected. High flexural strength values without metal. Tensile strength of 200 MPa.
  • Excellent marginal fit at approximately 70 microns reduces marginal leakage and breakage. Margins can be finished (or end) above the gingival margin or at the margin.
  • Wear nearly identical to enamel so not abrasive to opposing dentition.With the introduction of IPS ErisTM, Ivoclar North America has dramatically increased the range of all-ceramic restorations into the realm of three-unit anterior bridges. In combination with the original IPS Empress® (or "Empress 1" as some clinicians are calling it), dental practitioners can now create inlays, onlays, veneers, single anterior or posterior crowns and anterior bridges using the same comprehensive system and laboratory. All with the esthetics, accuracy and fit you've come to expect from IPS Empress® and Aurum Ceramic Dental Laboratories.

Unparalleled Beauty and Natural Vitality
The original IPS Empress® leucite glass-ceramic has been used clinically for over ten years. Optimally coordinated degrees of translucency and the slight shading give the leucite glass-ceramic material a chameleon effect. This ensures the restorations fit into the natural oral environment and are virtually indiscernible. Shade control is enhanced by patient-specific detail and characterization supplying you with virtually unlimited control over color, custom staining, form, surface detail and texture. Original IPS Empress® continues to be indicated, and recommended, for aesthetic inlays, onlays, veneers and single-unit anterior crowns. IPS Empress® is particularly well suited for conservative veneering as it allows the pressing of restorations less than 0.8 mm thick. This allows preparations that conserve natural tooth structure.

Enduring Strength Without Metal
Its leucite reinforced, pre-ceramed structure and pressure-injected fabrication offer you twice the strength of conventional ceramic materials. Resin bonding has also been demonstrated to significantly increase the overall strength of a restoration. The IPS Empress® system incorporates a full bonding system to ensure superior strength, less breakage and fewer repairs.

Chairside Preparation

Shade Selection
Recommended Shade Guides: Ivoclar Chromascop®.

General Considerations

  1. Ensure even reduction of the anatomic form.
  2. Avoid sharp internal edges, angles and undercuts. Create rounded internal line and point angles, particularly at the linguoincisal line angle.
  3. Create a shoulder preparation of 1.2 mm at a 90-110º angle. Maintain shoulder preparation with butt joint margins. Avoid tapered margins, feathered edges and bevelled margins.

Anterior Crown Preparation:

  • Reduce lingual surface 1.5 mm at the area of centric contact (not less than 1.0 mm) and 0.8 to 1.0 mm along the remaining lingual surface.
  • Incorporate taper of 8 to 10 degrees (never more than 12º)
  • Tooth preparation length should reflect a 1.5 to 2.0 mm occlusal (incisal) reduction.

Veneer Preparation:

Unform Facial Preparation: A medium grit, round-ended, diamond bur is used to remove a uniform thickness of facial enamel by joining the depth-cut grooves. Then join the depth grooves in three places by angling the diamond bur to the corresponding gingival, middle or incisal plane of the tooth.

Chamfer Margins: Correct preparation of the chamfer margins interproximally allows appropriate bulk of porcelain.

Interproximal Extension: Using the same round-ended diamond bur, the interproximal preparation is extended from the gingival chamfer margin into the proximal space. NOTE: Eliminate all discolored enamel in the interproximal.

Incisal Preparation: The diamond bur is angled to bevel back the incisal edge.

Lingual Reduction to Increase Length: The diamond bur is angled to eliminate undercuts and establish a deep chamfer on the lingual aspect of the preparation to ensure a passive fit. The incisal edge should be rounded. Avoid all sharp angles.

Posterior Crown Preparation:

INLAYS/ONLAYS

Inlay Preparation:

  • Avoid sharp internal line angles and undercuts.
  • Smooth prep walls and trim excess lining material with finishing diamond or bur
  • Do not include undercuts
  • Create a 5º to 15º divergence in the proximal walls from the floor to the occlusal margin of the preparation.
  • Ensure all walls end in a butt margin.

Onlay Preparation:

  • Avoid sharp internal line angles and undercuts.
  • With onlays, cuspal reduction of a minimum of 1.5 mm is required.
  • Smooth prep walls and trim excess lining material with finishing diamond or bur.
  • Do not include undercuts.
  • Create a 5º to 15º divergence in the proximal walls from the floor to the occlusal margin of the preparation.
  • Ensure all walls end in a butt margin.

Cementation:

As traditional luting agents have little or no chemical bond to porcelain or dentin structure, bonding is preferred to cementation. Composite resin cement achieves both a chemical and a micromechanical lock, enabling it to achieve superior retention.

Example Bonding Instructions Based on Inlay Restoration:

Other Tips for Getting teh Most Out of IP Empress:

  • Good preparations are essential. Adequately reduce the tooth, providing rounded shoulders and no sharp line angles. Use a fine diamond bur along the margins to insure smooth finish lines.
  • Before final impressions, verify that preparations are smooth. Make sure to avoid sharp internal line angles.
  • Use a buffalo mirror to verify arch form reduction; one prep can be your limiting factor.
  • Try to make all preparation shades a uniform color.
  • Handling Empress veneers and inlays with adhesive holders like Vivasticks®
    greatly facilitates handling during cementation.
  • When cementing Empress veneers, apply pressure incisally and gingivally while the assistant tacks the center of the veneer with a 2 mm diameter curing tip. Expose to the overhead light then clean and floss before final curing.
  • When color is being improved (brightened) with veneers, the amount of reduction required is directly proportional to the amount of shade change desired. Small color shifts may be made with conservative preparation. More aggressive color changes require more aggressive preparation.
  • Severe discoloration should be handled with direct bonding to the prepared tooth. Always make sure the incisal of the prepared tooth is not too close to the surface of the restoration where it causes a chromatic headlight or a horizontal line of translucency demarcation.
  • Always do a try in and observe the restorations in varying light sources.
  • For marketing, great close ups allow the patient to really appreciate
    the beauty of the restoration.
  • Perfect your provisionals.
  • If you are restoring 6 or 8 maxillary teeth instead of a full arch or full mouth, ask the lab to make a "custom shade tab" when they fabricate the 6 or 8 veneers. It is a little chip of porcelain that exactly matches the veneers. Store it in the patient's record and then if they decide at a later date to do 2 or 4 more veneers to widen the buccal corridor, you already have the shade matched exactly. Otherwise, adding a few veneers to an existing case can be trial and error to get the exact value and shade used previously. This makes it easy.
  • Natural esthetics within the smile will occur with proper incisal characteristics expertly placed by your ceramists. Use of blues, ambers, hypo-calcifications, halos, clears, and randomness can all add to the beauty of a smile.
  • Use magnification when preparing, temporizing, and seating Empress restorations. If you can't see it you can't treat it. To provide the best for your patients you must be able to properly visualize.
  • Insist that your lab use Empress products throughout the fabrication of the restoration. Non-certified materials can compromise the long term results of the restoration.
  • Provide complete shading information including a custom shade tab and a photograph of the shade tab next to the treated area. Supply the preparation shade to the lab.
  • Adjust the occlusion after cementation. Use high speed finishing diamond followed by slow speed porcelain polishers to leave a smooth surface.
  • Use Variolink Veneer cement to bond Empress laminates. The unique value-ordered try-in pastes simplifies shade matching.
  • Desensitizing the tooth following preparation mimimizes patient discomfort
    especially if the temporary would inadvertently come loose.
  • Lab communication is crucial. A lab can use the Empress System to give you
    the life-like restorations you want, but communicating the final shape, color and characterization is a must. Your patients don't see the preparations, but they do see the final restorative results.

Additional materials from the Ivoclar available for download:

cover_empress_prep_guide

Empress Prep Guide

cover_cementation

Cementation Guide

cover_empress_esthetic

Esthetic Brochure

cover_empress_esthetic_se

Empress - Lee Culp

cover_empress_esthetic_matt_roberts_se

Empress - Matt Roberts
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