Emax Press Abutmsolutions Va e 641315
Emax Press Abutmsolutions Va e 641315
Emax Press Abutmsolutions Va e 641315
Abutment Solutions
ic
eram
all c u need
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all y
Table of Contents
3
Product Information
Material
Uses
Composition
application procedure
6
Fabrication of Hybrid Abutments and Hybrid Abutment Crowns
Treatment/fabrication process
Shade tooth shade, preparation shade/abutment shade
Model preparation
Selecting a Ti base
Layer thicknesses of the ceramic components
Modeling
Sprueing
Investing
Preheating
Pressing
Divesting
Removing the reaction layer
Finishing
Stain and Characterization firing
Glaze firing
Crown on hybrid abutment
32
37 Permanent Cementation
Pre-treatment of the Ti base
Preparing the pressed object
Cementation with Multilink Hybrid Abutment
Sterilization
43
50
General Information
Frequently Asked Questions
Material Selection Table
Press and Firing Parameters
Clinical Cases
IPS
Product Information
Press ceramics have been synonymous with esthetics, accuracy of fit, shape and function for decades. The IPS e.max Press lithium disilicate
(LS2) glass-ceramic additionally offers an outstanding strength of 400 MPa. The already extensive indication range from thin veneers (0.3 mm)
and monolithic molar crowns to anterior and premolar bridges is now expanded to include hybrid abutment restorations.
With IPS e.max Press, you can fabricate such restorations in combination with a titanium base (Ti base). Two different approaches are available:
Hybrid abutment and separate crown
Hybrid abutment crown
Both solutions show outstanding function, efficiency and esthetics. The durable bond to the Ti base is achieved by means of the self-curing
Multilink Hybrid Abutment luting composite.
Hybrid abutment
The hybrid abutment is an individually pressed LS2 abutment which is luted to the Ti base. The shape,
emergence profile and esthetic properties of this abutment can be ideally adjusted to the clinical
situation.
Abutment
Base
Ti base
Ti base
Base
Individual esthetics
Given the lifelike appearance of LS2 glass-ceramics, the esthetic possibilities are virtually limitless,
particularly in the anterior region. Due to the individual characterization, a lifelike appearance is
achieved near the root and the transition area to the crown. With the preparation margin of the crown
located on the gingival level, the geometry of the hybrid abutments allows for an easy integration of
the restoration. Excess cementation material is therefore easily removed.
Hybrid abutment
Material
Uses
Press ceramic
IPS e.max Press are lithium disilicate glass-ceramic (LS2) ingots for
the press technology. The industrial
production process creates absolutely homogeneous ingots in different translucency levels. For IPS e.max Press Abutment Solutions,
ingots from the exisitng range of products are used.
The ingots feature a strength of 400 MPa and are thus the pressed
ceramic ingots with the highest strength. They are pressed in Ivoclar
Vivadent press furnaces to produce objects with outstanding accuracy
of fit. The pressed, tooth-coloured, highly esthetic restorations are
completed with IPS e.max Ceram.
Indications
Hybrid abutments for single-tooth restorations
Hybrid abutment crowns
Note: Pay attention to the released Ti bases, see page 8.
Contraindications
Use of Ti bases which do not fulfil the geometry requirements.
Failure to observe the requirements stipulated by the implant
manufacturer for using the selected implant type (diameter and
length of the implant must be approved for the respective position
in the jaw by the implant manufacturer).
Bruxism
Failure to observe the permissible maximum and minimum ceramic
wall thicknesses.
All uses not stated as indications are contraindicated.
Caution: Small diameter implants and angled abutments are not
recommended for the use in the posterior region in the mouth.
400
0.5
95
5800
915920
Side effects
If the patient is known to be allergic to any of the components,
IPS e.max Press Abutment Solutions should not be used.
Ti base
For IPS e.max Press Abutment Solutions, customary Ti bases made of
titanium or titanium alloys are used.
Please observe the instructions for use and processing of the manufacturer of the Ti bases used.
Composition
Warning
Do not inhale ceramic dust during finishing use exhaust air
discharge and mouth protection.
IPS Ceramic Etching Gel contains hydrofluoric acid. Contact with
skin, eyes and clothing must be prevented at all costs, since the
material is extremely toxic and corrosive. The etching gel is intended
for professional use only and must not be applied intraorally
(inside the mouth).
IPS
Treatment/Fabrication Process
Working steps
Ivoclar Vivadent
All the products
OptraGate, Virtual
Model fabrication,
selection of Ti base
Hybrid
abutment
Hybrid
abutment crown
Contouring
and Investing
Contouring
and investing
Pressing
Pressing
Characterization, glaze
Optional: Polishing
Characterization, glaze
Crown made of
IPS e.max Press
al
o
pti
Temporarily securing
pressed object Ti base
Clinical try-in
Hybrid
abutment
Hybrid
abutment crown
Cementing
pressed object Ti base
Cementing
pressed object Ti base
Preparing for
intraoral cementation
Preparing for
intraoral cementation
Cementation
IPS e.max Press crown
Sealing
the screw channel
Practice
Recall
Implant Care
Laboratory
6
Optimum integration in the oral cavity of the patient is the prerequisite for a true-to-nature all-ceramic restoration. To achieve this,
the following guidelines and notes must be observed.
With IPS e.max Press Abutment Solutions, you can imitate not only the clinical crown of a natural tooth, but also a part of the
root. This allows you to achieve highly esthetic implant-supported restorations which retain their lifelike appearance also in the
case of gingiva recession.
For IPS e.max Press hybrid abutment and the separate crown, the desired tooth shade results from
the shade of the IPS e.max Press hybrid abutment (IPS e.max Press MO ceramic structure, Multilink Hybrid Abutment)
the shade of the luting material for intraoral cementation of the crown on the IPS e.max Press hybrid abutment
(e.g. SpeedCEM)
the shade of the IPS e.max Press crown.
Shade
Multilink Hybrid
Abutment
(extraoral cementation)
Shade
IPS e.max Press
hybrid abutment
Shade
luting material
(intraoral cementation)
Shade
IPS e.max Press
crown
Desired
tooth shade
Ti base
For the IPS e.max Press hybrid abutment crown, the desired tooth shade results from
the shade of the IPS e.max Press ceramic structure
the shade of Multilink Hybrid Abutment.
Hybrid abutment crown
Ti base
Shade
IPS e.max Press
ceramic structure
Shade
Multilink
Hybrid Abutment
Shade
hybrid abutment crown
Desired
tooth shade
(extraoral cementation)
Please refer to the table on page 52 for the selection of the suitable IPS e.max Press ingot.
Model preparation
For the fabrication of an IPS e.max Press Abutment Solutions restoration, a model with gingiva mask is fabricated.
Select the suitable model analog according to the implant system used.
Fabricate a model with gingiva mask.
Selecting a Ti base
The following paragraphs outline the selection criteria for a suitable Ti base. As a general rule, the instructions of the
respective manufacturer regarding the use of the Ti base have to be observed.
Only bases consisting of Ti or Ti alloys must be used.
Select a Ti base with a size that matches the clinical situation and the chosen implant system. The geometry
requirements must be observed.
The rotation lock must be designed in such a way that stress concentrations on the pressed object are avoided.
Ti bases with undercuts, e.g. retention grooves, are suitable to some extent.
Check the available space for the pressed object taking the geometry of the Ti base into account on the model (e.g.
silicone key).
Observe the instructions of the manufacturer when modifying the Ti base.
Height HTi
(bonding
surface)
Minimum dimensions
Shoulder width STi
Height HTi
(bonding surface)
Ti base
Marginal shoulder
width STi
Observing the geometry requirements of the pressed objects made of IPS e.max Press material is the key to success for a
durable restoration. The more attention given to the design, the better the final results and the clinical success will turn out
to be.
Warning
Do not design or modify the ceramic components outside the geometry requirements.
Hybrid abutment
Height HAK
Height HA
Wall thickness WA
Marginal
shoulder width SA
Marginal
shoulder width SA
Modeling
Fabrication of a resin coping
To prepare the wax-up, a resin coping is prepared if both hybrid abutments and hybrid abutment crowns
are fabricated. Please observe the following procedure:
Check the implant position and inclination with regard to the position of the screw channel.
Screw the Ti base onto the model analog with the corresponding screw.
Tip: Make sure that an additional model analog is available as this will facilitate some steps.
Clean the Ti base with a steam cleaner.
Insert a pin with the same diameter as the screw channel to "seal" and "extend" the screw channel.
Do not apply die spacer.
Isolate the Ti base and the pin with a thin application of separator. If too much separator is used, this
might result in uneven areas on the inner aspect of the pressed object.
In order to achieve a sound fit and to facilitate the subsequent wax-up, a coping is first fabricated on
the Ti base with modelling resin. Design the coping in such a way that it can subsequently be completely covered with modelling wax. Please observe the instructions of the manufacturer regarding the
processing of modelling resin.
Remove the Ti base from the model.
Eliminate possible over-contoured areas of the resin coping at the transition area to the Ti base by
means of rubber polishers. Do not damage the Ti base.
Remove the resin coping together with the pin from the Ti base.
Loosen and remove the pin by rotating the resin coping.
Screw the Ti base onto the model analog again.
Place the resin coping back on the Ti base and check the fit and dimension (e.g. silicone key). If
necessary, adjust the coping by means of rotary instruments.
Screw the Ti base onto the model analog with the corresponding screw.
Insert a pin with the same diameter as the screw channel to "seal" and "extend"
the screw channel.
10
Remove the resin coping together with the pin from the Ti base.
Eliminate possible over-contoured areas of the resin coping at the transition area to
the Ti base by means of rubber polishers.
Place the resin coping back on the Ti base and check the fit and dimension (e.g. silicone key). If necessary, adjust the coping by means of rotary instruments.
Design the coping in such a way that it can subsequently be covered with modelling wax.
11
Isolate the Ti base and the pin with a thin application of separator.
Wax-up
Please observe the following notes with regard to modelling:
Observe the stipulated layer thicknesses.
Create an accurate model of the restoration, particularly at the transition area to the Ti base.
Do not over-contour the margins, since this would require time-consuming and risky fitting procedures after pressing.
Use an organic wax for modelling to ensure that it burns out without leaving residue in the investment ring.
Procedure for hybrid abutments
Before creating the wax object, re-insert the isolated pin into the screw channel.
Design the emergence profile by flooding the area between the gingiva mask and the resin coping with wax.
Contour the hybrid abutment to a reduced tooth shape. The hybrid abutment should be designed in such a way that the
required layer thicknesses are met in the crown that is fabricated. Check by means of the silicone key and in relation to
the opposing dentition.
Determine the crown margins in relation to the gingiva level.
Design a chamfer on which the crown is subsequently seated.
Remove the object together with the Ti base from the model and check the emergence profile. If necessary, make
adjustments.
Check the transition to the Ti base and remove excess wax.
Check the required minimum thicknesses (page 9) prior to attaching the sprue.
Design the emergence profile by flooding the area between the gingiva mask and the
resin coping with wax.
Check the dimensions by means of the silicone key and in relation to the opposing
dentition.
Design the hybrid abutment with a reduced tooth shape and determine the crown
margin in relation to the gingiva level.
Remove the object together with the Ti base from the model and check the emergence
profile. If necessary, make adjustments. Check the transition to the Ti base and
thoroughly remove excess wax.
12
Design the emergence profile by flooding the area between the gingiva mask and the
resin coping with wax. If necessary, re-insert the pin prior to modelling.
Design the abutment crown to full contour according to functional and esthetic
criteria. Check the object in relation to the opposing dentition.
13
Sprueing
Please observe the following notes when attaching the sprues to the abutment or the abutment crown:
Depending on the number and size of the objects to be invested, either the 100 g or 200 g IPS Investment Ring System
is selected. Before sprueing, weigh the ring base and record the weight (seal the opening of the ring base with wax).
Please note that the mixing ratio of the investment material is different for the various restoration types (e.g. inlays,
crowns, abutments).
Use a 2.5 mm wax wire for sprueing.
For abutments, the sprue is attached to an axial surface.
For abutment crowns, the sprue is attached to a cusp.
Align the wax wire as parallel as possible to the screw channel in order to prevent the investment material
from fracturing in the screw channel.
The maximum length (object + sprue) of 16 mm must not be exceeded.
Place the object on the investment ring base in such a way that the screw channel is parallel to the outer wall of the
investment ring. As a result, the investment material can subsequently be filled evenly and in a controlled manner. The
objects could be placed in a tilted position on the investment ring base, but this may lead to difficulties during investing
(e.g. bubbles in the screw channel).
Observe a distance of at least 10 mm between the object and the silicone ring.
If only one object is invested and pressed in an EP500 furnace, a second short (blind) sprue must be placed. This ensures
that the switch-off function of the furnace works properly at the end of the pressing procedure.
2.5 mm
Attach the sprue to a circular area of the abutment model and as parallel as possible
to the screw channel. Use a 2.5 mm wax wire.
2.5 mm
Attach the sprue to an oral cusp of the abutment crown and as parallel as possible to
the screw channel. Use a 2.5 mm wax wire.
Place the object on the investment ring base in such a way that the screw channel is parallel to the outer wall of the investment ring.
As a result, the investment material can subsequently be filled evenly and in a controlled manner.
Furthermore, this reduces the risk of the investment material breaking in the screw channel while the ceramic material is pressed.
14
Investing is carried out with either IPS PressVEST or IPS PressVEST Speed. The corresponding IPS Silicone Ring with the
matching ring gauge is used for investment.
Determine the weight of the object before investing.
Position the wax objects on the ring base and attach them with wax and weigh.
The difference between the empty and the loaded ring base is the definitive wax weight.
Small Ingot
Wax weight
up to max. 0.75 g
up to max. 2 g
only 200 g
Please refer to the Instructions for Use of the corresponding investment material regarding the detailed processing
parameters. The following basic procedure is recommended:
Do not use a debubblizer on the wax objects.
Carefully place the IPS Silicone Ring on the ring base without damaging the objects. The silicone ring must sit flush on
the ring base.
The processing temperature of the investment material is 18 max. 23 C / 64 F max. 73 F. Higher or lower
processing temperatures substantially affect the setting behaviour.
Mix the investment material. Note: The investment material contains quartz powder. Therefore, avoid the inhalation of
dust.
Important: Pour the investment material slowly into the investment ring, so that the material continuously
fills the screw channel. If the material does not sufficiently fill the screw channel, use an instrument to
carefully apply additional investment material to the screw channel from the top.
Carefully fill the investment ring with investment material up to the marking on the silicone ring and position the ring
gauge with a hinged movement.
Allow the investment ring to set without manipulating it.
To prevent crystallization of the IPS PressVEST investment material, the invested ring must be processed within 24 hours.
If IPS PressVest Speed is used, make sure that the investment ring is placed in the preheating furnace after a setting time
of at least 30 and maximum 45 minutes.
Investment material: Liquid concentration and quantity
IPSPressVEST
Indication
IPSPressVEST Speed
16 ml : 6 ml
32 ml : 12 ml
20 ml : 7 ml
40 ml : 14 ml
IPSe.max Press
Hybrid abutment
Hybrid abutment crown
Mixing time
(under vacuum at approx. 350 rpm)
2.5 minutes
60 seconds
Liquid concentration: The data contained in the table are approximative values. Depending on the geometry of the Ti
base and the materials used for the wax-up, these values may be individually changed. However, the concentrated Liquid
content must not be lower than 50% in relation to distilled water.
Important: The total quantity of liquid (Liquid + dist. water) must not be altered.
15
Investing
Correctly sprued abutment (left) and abutment crown (right). The screw channel is in a
vertical position and parallel with the wall of the investment ring.
Pour the investment material slowly into the investment ring, so that the material can
continuously fill the screw channel.
Continue to carefully fill the investment ring up to the marking and position the ring gauge with a hinged movement.
16
After the stipulated setting time of the respective investment material (IPS PressVEST or IPS PressVEST Speed), the investment ring is prepared for preheating as follows:
Remove the ring gauge with a turning movement.
Carefully push the investment ring out of the IPS Silicone Ring.
Remove the ring base with a turning movement.
Remove rough spots on the bottom surface of the investment ring with a plaster knife. Check the 90 angle. Investment
material residue must not enter the sprues. Blow into the sprues if necessary.
If several investment rings are preheated together, mark them accordingly.
IPS PressVEST
Room temperature
850 C / 1562 F
850 C / 1562 F
min. 60 min
no preheating
no preheating
no preheating
no preheating
Setting time
Important
Towards the rear wall, tipped with the opening facing down
Do not preheat the IPS e.max Press ingot and Alox Plunger.
In order to ensure smooth working procedures in the laboratory on a daily basis, impeccable functioning of the infrastructure, particularly the preheating furnaces, is essential. This includes their maintenance, cleaning with a vacuum cleaner in a
cool state as well as regular checks of the temperature controls and heating elements, etc., by the manufacturer.
17
Preheating
Pressing
Carry out the following preparatory steps for pressing before the preheating cycle for the investment ring has been
completed:
Provide a cold IPSAlox Plunger and a cold IPS e.max Press ingot in the desired shade (please refer to the material
selection table on page 52).
Dip the cold IPS Alox Plunger into the opening of the IPS Alox Plunger Separator and keep it ready for use.
Turn on the press furnace (e.g. Programat EP 5000) in time so that the self-test and preheating phase are completed.
Select the press program for IPS e.max Press and the desired investment ring size.
Remove the investment ring from the preheating furnace immediately after completion of the preheating cycle. This step
may take max. 30 seconds to prevent the investment ring from cooling down too much.
Place the cold IPS e.max Press ingot into the hot investment ring.
Insert the ingots in the investment ring with the non-imprinted side facing down. The imprinted side faces up to check
the ingot shade.
Place the side of the cold IPS Alox Plunger which has been coated with Separator into the hot investment ring.
Use the investment ring tongs to place the loaded investment ring in the centre of the hot press furnace.
The selected press program is started by pressing START.
After the end of the press cycle (optical and/or acoustic signal) proceed as follows:
Remove the investment ring from the press furnace using the investment ring tongs immediately after pressing.
Place the investment ring on a cooling grid to cool in a place protected from draft.
Do not speed up cooling, e.g. by blasting with compressed air.
1 small ingot
1 small ingot
or
1 large ingot
cold ingot
cold ingot
cold plunger
cold plunger
Ingots: select one large or one small ingot according to the determined wax weight!
Provide a cold isolated IPS Alox Plunger and a cold IPS e.max Press ingot in the
desired shade.
Place the cold IPS e.max Press ingot into the hot investment ring with the imprinted
side facing up.
18
Place the hot and loaded investment ring in the centre of the hot press furnace using
the IPS Investment Ring Tongs.
Once the press program is completed, place the hot investment ring on the cooling
grid using the Investment Ring Tongs and allow it to cool to room temperature.
Programat EP 3000
Select the press program in accordance with the selected ingot to be pressed
and the investment ring size used.
Programat EP 5000
Select the press program in accordance with the selected ingot to be pressed
and the investment ring size used.
The press parameters for HO, MO, LT and HT are integrated starting
with software V 6.1.
19
Then, place the side of the IPS Alox Plunger which has been coated with Separator
into the hot investment ring.
Divesting
After cooling to room temperature (approximately 60 minutes), the investment ring may show cracks, which developed
during the cooling phase (immediately around the Alox plunger). This is the result of the different CTEs of the various
materials (Alox Plunger, investment material and press ingot) and does not compromise the press results.
Divest the investment ring as follows:
Mark the length of the Alox Plunger on the cooled investment ring.
Separate the investment ring using a separating disc. This predetermined breaking
point enables reliable separation of the Alox Plunger and the ceramic material.
Break the investment ring at the predetermined breaking point using a plaster knife.
Always use polishing beads to divest the pressed objects (rough and fine divestment).
Do not use Al2O3.
Rough divestment is carried out with polishing beads at 4 bar (58 psi) pressure.
Fine divestment is carried out with polishing beads at 2 bar (29 psi) pressure.
Observe the blasting direction and distance to prevent damage to the object margins
during divestment.
Same as the outer surfaces, thoroughly blast the screw channel with polishing beads
at 2 bar (29 psi) pressure.
Remove possible ceramic residue from the Alox Plunger with type 100 Al2O3.
Mark the length of the Alox Plunger.
Separate the investment ring using a separating disc and break it at the predetermined breaking point.
Tip
Pull out the plunger with pliers from the separated segment using a rotating movement.
This also removes any possible ceramic residue from the Alox plunger.
20
Fine divestment of the abutment crown is carried out with polishing beads at 2 bar
(29 psi) pressure.
21
Rough divesting with polishing beads at 4 bar (58 psi) pressure until the object
becomes visible.
To remove the reaction layer, immerse the pressed objects in IPS e.max Press Invex ...
... and place in an ultrasonic cleaner for at least 10 and at most 30 minutes.
Using Al2O3 and a pressure of at most 12 bar (1529 psi) pressure, carefully remove
the reaction layer from the outer side ...
Warning
Disposal
It is of critical importance to use the correct grinding instruments for finishing and adjusting high-strength glass-ceramics
(please refer to the Ivoclar Vivadent Flow Chart "Recommended grinding instruments for glass-ceramics"). If unsuitable
grinding instruments are used, chipping of the edges and local overheating may occur.
Observe the following procedure for finishing IPS e.max Press restorations:
Adjustment by grinding of pressed IPS e.max Press restorations should be kept to a minimum.
Overheating of the ceramic must be avoided. Low speed and light pressure is recommended.
Make sure that the minimum thicknesses are maintained even after the minor adjustments.
Fitting to the Ti base
The fit of the abutment or abutment crown is checked on the Ti base before the sprue is separated.
Before the object is fitted, the inner aspect of the object (screw channel) is checked for bubbles in the ceramic. If
required, the bubbles are removed with suitable instruments.
Carefully position the abutment or abutment crown on the Ti base. Note: Apply only light pressure to secure the pressed
object on the Ti base in order to prevent chipping of the ceramic. Observe the position of the rotation lock.
Possible rough spots interfering with the fit of the pressed object on the Ti base cause greyish-black markings on the
screw channel. Carefully remove such markings with suitable grinding instruments. The diameter of the grinding
instrument must be smaller than that of the screw channel. As an alternative to marking the rough spots, an occlusion
spray can also be used.
Carefully remove possible rough spots until an optimum fit between the Ti base and the pressed object is achieved.
Repeat the procedure, if required.
Possible rough spots interfering with the fit on the Ti Base cause stains on the screw
channel of the pressed object, ...
23
Finishing
After possible rough spots have been removed, an optimum fit between the hybrid
abutment ...
Finishing
Once an optimum fit between the abutment or the abutment crown and the Ti base has been achieved, please proceed as
follows for the finishing steps:
Separate the sprue using a separating disc. Avoid overheating.
Smooth out the attachment point of the sprue. Make sure that the minimum thicknesses are maintained.
Check the emergence profile and the fit on the model.
In the case of abutment crowns, additionally check the occlusion and articulation. Adjust by grinding, if necessary, and
create surface textures.
To clean the abutment crown, briefly blast the outer side with Al2O3 at 1 bar (15 psi) pressure and clean with the steam
cleaner. Some blasting devices may require different pressure settings to accomplish this procedure.
24
The following paragraphs will explain the steps of optional staining and characterizing with IPS e.max Ceram Shades and
Essences. On abutments, only the emergence profile is characterized for the individual patient. This characterization may
also take place at a later stage, i.e. when the crown is characterized.
If abutments are fabricated, only the area of the emergence profile is characterized
with IPS e.max Ceram Shades and Essences.
If abutment crowns are fabricated, the entire outer surface may be individually
characterized.
The Stains and Characterization firing is conducted with IPS e.max Ceram Shades and Essences. For further
information, please refer to the IPS e.max Ceram Instructions for Use.
IPS e.max Ceram Shades are ready-to-use stains in syringes.
IPS e.max Ceram Essences are intensively shaded powdered stains, which are
mixed with IPS e.max Ceram Glaze and Stain Liquid.
The following steps must be observed:
Clean the pressed object with a steam cleaner to remove any contaminations and grease residue. Any contamination after cleaning must be prevented.
Tip: For the characterization, place the abutment or the abutment crown on the Ti base using a little IPS e.max Ceram
Glaze and Stain Liquid. This allows you to assess the effect of the Ti base on the shade.
For better wetting of the stains, a small quantity of IPS e.max Ceram Glaze and Stain Liquid may be slightly rubbed into
the area that needs to be characterized.
Mix the pastes or powders with the IPS e.max Ceram Glaze and Stain Liquids (allround or longlife) until the desired
consistency is achieved.
More intensive shades are achieved by several staining procedures and repeated firing, not by applying thicker layers.
To imitate the incisal area and translucency of the abutment crown in the incisal and occlusal third, IPS e.max Ceram
Shade Incisal may be used.
The cusps and fissures can be individualized using Essences.
If abutments are fabricated, only the area of the emergence profile is characterized with IPS e.max Ceram Shades and
Essences. Do not apply materials to the bonding surface to the crown, as this might compromise the fit and the bond.
Important: Make sure that absolutely no materials are applied to the screw channel and the interface to the Ti base in
order not to compromise the fit and bond.
Conduct the Stain and Characterization firing on a honey-comb firing tray using the stipulated firing parameters. Please
observe the special firing parameters.
Remove restoration from the furnace after completion of the firing cycle (wait for the acoustic signal of the furnace).
Allow the objects to cool to room temperature in a place protected from draft.
Do not touch the hot objects with metal tongs.
25
Apply IPS e.max Ceram Shade Incisal to imitate the incisal area.
Individual characterization of the emergence profile with IPS e.max Ceram Essences.
min
V2
C/min
V1
min
403
6:00
60
770
01:00
450
769
500
Additional Stain and Characterization firing cycles can be conducted with the same firing parameters.
Note:
If the layer thickness is less than 2 mm on the entire pressed object, long-term cooling (L) is not required to
produce a tension-free condition.
26
Glaze firing is conducted with powder or paste glaze. On abutments, only the emergence profile is glazed.
Glaze firing may also take place at a later stage, i.e. when the crown is glazed. On abutment crowns, glaze
is applied to the entire outer surface.
The following procedure is recommended:
Mix the glazing material (IPS e.max Ceram Glaze Paste or Powder) with the IPS e.max Ceram Glaze and Stain Liquids
allround or longlife to the desired consistency.
Apply an even layer of glazing material covering all areas that are to be glazed.
If required, the fluorescence may be increased by applying a fluorescing glazing materal (paste or powder).
Important: Make sure that absolutely no materials are applied to the screw channel and the interface to the Ti base in
order not to compromise the fit.
Make sure that no glaze material is present on the interface of abutments and abutment crowns prior to the firing cycle.
If necessary, carefully remove the glaze material.
Conduct the Glaze firing on a honey-comb firing tray using the stipulated firing parameters. Please observe the special
firing parameters.
Remove restoration from the furnace after completion of the firing cycle (wait for the acoustic signal of the furnace).
Allow the objects to cool to room temperature in a place protected from draft.
Do not touch the hot objects with metal tongs.
If adjustments are required after Glaze firing (e.g. contact points), they may be applied using IPS e.max Ceram Add-on
(see page 28).
Apply an even layer of glaze material to the emergence profile of the abutment. Make
sure that no glaze material enters the screw channel.
Make sure that no glaze material is present on the interface of abutments and
abutment crowns prior to the firing cycle. If necessary, carefully remove the glaze
material.
Apply the glazing material evenly on the outer surface of the abutment crown. Make
sure that no glaze material enters the screw channel.
Conduct the Glaze firing on a honey-comb firing tray with the corresponding
parameters.
27
Glaze firing
min
V2
C/min
V1
min
403
6:00
60
770
1:00
2:00
450
769
500
If the gloss is unsatisfactory after the first Glaze firing, further Glaze firing procedures may be conducted
using the same firing parameters.
Note:
If the layer thickness is less than 2 mm on the entire pressed object, long-term cooling (L) is not required to
produce a tension-free condition.
Glaze firing
min
V2
C/min
V1
min.
403
6:00
50
700
01:00
450
699
500
28
29
30
31
IPS
Please observe the following procedure to temporarily secure the components in place:
Clean the non-pre-treated Ti base and the pressed object (abutment or abutment crown) with steam and blow dry.
Place the pressed object on the Ti base (which is screwed to the model analog) and mark the relative position of the
components. This facilitates the achievement of the correct position when the parts are subsequently temporarily
assembled.
Seal the screw channel with a foam pellet.
Insert the Virtual cartridge into the dispenser and remove the protective cap.
Screw on the mixing tip and attach the Oral Tip to the mixing tip.
Apply Virtual Extra Light Body Fast Set both to the Ti base and directly into the pressed object.
Insert the Ti base into the pressed object. Observe the relative position of the objects (rotation lock/marking).
Hold the parts in the correct relative position for 2:30 minutes until the Virtual Extra Light Body Fast Set has set.
Carefully remove protruding excess material with a suitable instrument, e.g. a scalpel.
Place the abutment or abutment crown onto the Ti base and mark the relative position.
Insert the Virtual cartridge into the dispenser, screw on the mixing tip and attach the
Oral Tip.
32
Insert the Ti base into the pressed object. In doing so, observe the relative position of
the two components (rotation lock/marking). Hold the components in place for
approx. 2:30 minutes until the Virtual Extra Light Body Fast Set material has set.
Carefully remove protruding excess material with a suitable instrument, e.g. a scalpel.
Remove excess Virtual Extra Light Body Fast Set material from the screw channel with
an instrument.
33
Clinical try-in
Hybrid abutment
Important note: Any intraoral checking of the occlusion/articulation and possible adjustments by grinding may only be
performed if the objects have been attached to one another by means of Virtual Extra Light Body Fast Set. During try-in,
the Virtual material acts as a buffer, particularly if grinding is necessary, and prevents chipping in the transition area
between the hybrid abutment and the crown.
Please observe the following procedure for the clinical try-in:
Have the clean prepared hybrid abutment (temporarily secured) and the matching clean crown ready at hand.
Remove the temporary restoration.
Manually screw in the hybrid abutment with the matching screw.
Check the geometry of the hybrid abutment (e.g. fit, gingival anaemia) with regard to the gingival margin.
If required, seal the screw channel on the hybrid abutment with a foam pellet.
Tip: Isolate the inner aspect of the crown with glycerin gel, e.g. Try-in paste, Liquid Strip
Place the crown intraorally onto the hybrid abutment to check and adjust the proximal contacts, if necessary.
Note: No occlusal functional checks must be performed at this stage.
For the functional check, the crown has to be secured on the hybrid abutment with Virtual Extra Light Body
Fast Set. Do not use Try-in paste for this purpose, as this material is not sufficiently resistant against the
compressive forces.
Insert the Virtual cartridge into the dispenser and remove the protective cap.
Screw on the mixing tip and attach the Oral Tip to the mixing tip.
Apply Virtual Extra Light Body Fast Set to the inner aspect of the crown.
Use your finger to press the crown to the hybrid abutment until the final position has been achieved. Hold the crown in
the final position until the Virtual material has set.
Remove excess Virtual material.
Check the occlusion/articulation and make required adjustments with suitable grinding instruments (see separate
IPS e.max Recommended grinding instruments for ceramics use in the dental practice). If adjustments have been made
by grinding, conduct another polishing cycle or glaze firing.
Carefully remove the crown from the hybrid abutment and the hybrid abutment (including Ti base).
Insert the temporary restoration.
Manually screw in the hybrid abutment with the matching screw. Check the geometry
of the hybrid abutment (e.g. fit, gingival anaemia) with regard to the gingival margin.
If required, seal the screw channel of the hybrid abutment with a foam pellet.
34
Apply Virtual Extra Light Body Fast Set to the inner aspect of the crown.
Place the crown intraorally onto the hybrid abutment to check and adjust the proximal
contacts, if necessary. Note: No occlusal functional checks must be performed
at this stage.
Use your finger to press the crown to the hybrid abutment until the final position has
been achieved. Hold the crown in the final position until the Virtual material has set.
Carefully remove the crown from the hybrid abutment and remove the
Virtual Extra Light Body Fast Set material.
35
Place the hybrid abutment crown intraorally onto the implant to check and possibly
adjust the proximal contacts. Note: No occlusal functional checks must be
performed at this stage.
Manually screw in the hybrid abutment crown with the matching screw.
Check the geometry of the hybrid abutment crown (e.g. fit, gingival anaemia) with
regard to the gingiva.
36
Permanent Cementation
Careful preparation of the bonding surface is a prerequisite for an optimum adhesive cementation of the Ti base and the
pressed object. The following paragraphs outline the required procedures. The procedure is the same for hybrid abutments
and hybrid abutment crowns.
Etching
Abutment,
abutment crown
Ti base
Conditioning/silanating
Adhesive cementation
Curing
Polishing the cementation joint
7-minute curing
Customary polishers for ceramic/resin materials
37
IPS
Screw Ti base onto a model analog. Mark the relative position to the
pressed object.
Apply wax to protect the emergence profile. In addition, seal also the screw
channel with wax.
Carefully blast the bonding area with Al2O3 (50100 m) at low pressure until an even
mat surface has been achieved.
Clean with an instrument and steam cleaner. Make sure that any
wax residue is carefully removed.
38
39
Keep the cleaned and conditioned components that are to be luted at hand.
Attach a new mixing tip to the Multilink Hybrid Abutment syringe prior to each use.
40
Apply Multilink Hybrid Abutment directly from the mixing tip in a thin layer on the
bonding surface of the ceramic structure.
5s
The ceramic structure is placed on the Ti base in such a way that the position markings
are aligned. The components are joined using even and light pressure and the relative
position of the components is checked (transition base/ceramic structure).
23 min
Carefully remove excess in the screw cavity, e.g. with a Microbrush or a brush, using a
rotary movement.
7 min
Apply a glycerine gel (e.g. Liquid Strip) to the cementation joint to prevent the
formation of a inhibition layer.
41
After the completion of auto-polymerization, the glycerine gel is rinsed off with water
or with the steam jet.
Any remaining cement residue in the screw channel is removed with suitable rotating
instruments. The Ti base must no be damaged.
IPS e.max Press hybrid abutment and IPS e.max Press hybrid abutment crown
after cementation.
Sterilization
The hybrid abutments or hybrid abutment crowns must be sterilized prior to insertion.
Furthermore, the locally applicable legal regulations and the hygiene standards
applicable for a dental practice must be observed.
Steam sterilization can be performed with the 3 x fractionated pre-vacuum with the
following parameters: Sterilization time 3 min; steam temperature 132 C/270 F;
resulting in a half-cycle exposure time of 1.5 min. The abutment is for immediate use.
No storage after sterilization!
The responsibility for the sterility of the hybrid abutment or hybrid abutment crown lies with the user. It must be ensured
that only suitable devices, materials and product-specifically validated methods are used to perform sterilization.
The equipment and devices must be properly maintained and serviced at regular intervals. The fabricator (dental technician)
of the IPS e.max Press Abutment Solution must inform the dentist of the need to sterilize the abutment before inserting it
in the patients mouth!
42
43
IPS
Tighten the implant screw with a torque wrench (observe the instructions of the
manufacturer).
Seal the screw channel, for instance with a cotton or foam pellet
and a temporary composite material.
44
Place the crown onto the hybrid abutment and secure in place.
Cover the restoration margin with glycerine gel (e.g. Liquid Strip).
45
Polish restoration margins and the cementation joint with polishers (e.g. Astropol,
OptraFine).
46
47
Tighten the implant screw with a torque wrench (observe the instructions of the
manufacturer).
Seal the screw channel with a composite material (e.g. Tetric EvoCeram) in
the appropriate shade.
After polymerization, check the occlusion/articulation and correct possible rough spots
with suitable finishers (e.g. Astropol F) or fine diamonds.
48
Implant Care comprises a range of coordinated products for the professional care of patients during the various phases of
implant treatment and lifelong aftercare. Products for professional tooth cleaning and bacterial control contribute to the
long-term quality assurance of implant-supported restorations. Structural elements, peri-implant tissue, natural teeth, dental
restorations, gingiva and the mucosa are treated in an optimum way with regard to function and esthetics.
49
IPS
General Information
Frequently Asked Questions
In addition to the desired tooth shade, why
should the root shade also be defined/
determined upon shade determination?
IPS e.max Press Abutment Solutions allow you to
fabricate restorations with a lifelike appearance
both in the visible area and the area below the
gingiva (root). By defining the root shade, a highly
esthetic outcome can be achieved especially
receding gingiva.
50
51
52
LT
BL1
BL1
BL3
LT
BL2
LT
BL3
MO 0
BL2
LT
BL4
BL4
LT
A1
A1
MO 1
LT
A2
A2
LT
A3
A3
B2
Ti base
B1
B3
MO 3
MO 1
MO 3
A4
B4
LT
A3,5
LT
A4
LT
B1
LT
B2
LT
B3
LT
B4
MO 2
A3,5
LT
C1
C1
MO 1
LT
C2
C2
LT
C3
C3
LT
C4
MO 4
C4
LT
D2
D2
Extraoral cementation
IPS e.max Press abutment
crown / T base
LT
BL1
BL1
LT
BL2
BL2
LT
BL3
BL3
LT
BL4
BL4
LT
A1
A1
LT
A2
A2
LT
A3
A3
LT
A3,5
A3,5
B2
Ti base
B1
B3
LT
A4
LT
B1
LT
B2
LT
B3
A4
LT
B4
B4
LT
C1
C1
LT
C2
C2
LT
C3
C3
LT
C4
C4
LT
D2
D2
Intraoral cementation
Crown on
hybrid abutment
Extraorale Verklebung
IPS e.max Press abutment /
Ti base
MO 3
LT
D3
D3
LT
D3
D3
Material combination
to achieve the tooth shade
(Material-) Kombination
z um Erreichen der
Zahnfarbe
LT
D4
D4
LT
D4
D4
IPS Investment
Ring System
Programat EP 3000
min
V1
V2
700
60
930
25
500
930
Program 11-20
Software 2.9
100 g
700
60
920
15
500
920
Program 11-20
Software 2.9
200 g
700
60
925
25
500
925
Program 11-20
Software 2.9
IPS Investment
Ring System
C/min
min
200 g
700
60
920
25
300 m/min
100 g
700
60
910
15
300 m/min
200 g
HO, MO, LT
HT
200 g
100 g
EP 600
Combi
C/min
HT
Press furnace
100 g
HO, MO, LT
EP 500
Select the press program in accordance with the selected ingot to be pressed
and the investment ring size used.
The press parameters for HO, MO, LT and HT are integrated starting
with software V 6.1.
Programat EP 5000
Select the press program in accordance with the selected ingot to be pressed
and the investment ring size used.
The press parameters for HO, MO, LT and HT are integrated starting
with software V 6.1.
The firing parameters listed represent standard values and apply to the Ivoclar Vivadent furnaces P300, P500, P700,
EP 3000 and EP 5000. The temperatures indicated also apply to furnaces of older generations. However, the temperature
in the firing chamber may deviate by approx. 10 C/18 F, depending on the age of the heating muffle.
If a non-Ivoclar Vivadent furnace is used, temperature corrections may be necessary.
Regional differences in the power supply or the operation of several electronic devices by means of the same circuit
may also render adjustments of the temperatures necessary.
53
min
V2
C/min
V1
min
403
6:00
60
770
01:00
450
769
500
Glaze firing
403
6:00
60
770
1:00
2:00
450
769
500
403
6:00
50
700
01:00
450
699
500
54
Clinical cases
IPS e.max Press hybrid abutment / IPS e.max Press crown (area 36), IPS e.max Press crown (area 37).
Dr R. Watzke / ZT J. Seger, Liechtenstein
IPS e.max Press hybrid abutment (36) and IPS e.max Press crown,
IPS e.max Press single crown
Final image, buccal view: IPS e.max Press crown cemented onto an
IPS e.max Press hybrid abutment
Final image, occlusal view: IPS e.max Press crown cemented onto an
IPS e.max Press hybrid abutment
55
Manufacturer:
Ivoclar Vivadent AG, 9494 Schaan/Liechtenstein
www.ivoclarvivadent.com
Rx only
Date information prepared: 2013-04-23/Rev. 0
Some products and/or indications may not be regulatory cleared/released in all markets. Please contact the local
Ivoclar Vivadent sales office for the current national status.
These materials have been developed solely for use in dentistry. Processing should be carried out strictly
according to the Instructions for Use. Liability cannot be accepted for damages resulting from failure to
observe the Instructions or the stipulated area of application. The user is responsible for testing the products
for their suitability and use for any purpose not explicitly stated in the Instructions. Descriptions and data constitute no warranty of attributes and are not binding. These regulations also apply if the materials are used in
conjunction with products of other manufacturers.
Printed in Liechtenstein
Ivoclar Vivadent AG, Schaan / Liechtenstein
662737/de