TLZ-IB Bridge Update

PMMA Prototype

We continue to have great success with our full-arch zirconia restorations. Unlike many companies, ROE designs and fabricates all phases in-house for better design-control and improved turnaround time.

Base upon our experience with this prosthesis, we recommend utilizing a PMMA prototype.This milled provisional is used to finalize all functional and esthetic aspects of the prosthesis, and is kept in the mouth for no less than 6 to 8 months to allow adequate time for the tissue and bone maturation. Without this healing-adjustment period, it may be necessary to add to the intaglio surface with Gradia composite. Please visit our web site for additional details and processes.

TLZ-IB - Prettau Bridge

BruxZir BruxZir BruxZir

BruxZir crowns have been available from ROE for over a year. While we hear that BruxZir esthetics are average to poor from many labs, we receive very good feedback from our customers in all criteria. For esthetics, we us a special stain and glaze technique that brings life to the restoration. 

We charge just $99 and guarantee your satisfaction... and the restoration for 6 years.

Expanded Uses Of Zirconia

Due to its immense popularity and changing modalities, zirconia has been a frequent topic of discussion in our newsletters during the past few years. Another is progressive implant solutions. The first part of this section on zirconia will integrate the two topics, and the second will offer an alternative to metal-free bridges.

Part 1: Hybrid dentures have significantly increased in popularity. Although a wonderful option for the patient, they do present challenges, primarily with regard to strength and longevity. Fortunately, the technology with which they are produced continues to improve. Updates include virtually-designed milled bars, the use of special teeth, and required minimum vertical openings.

This year we are offering an exciting option to the traditional hybrid, a full-arch,

TLZ-IB

screw-retained, 100% zirconia bridge. This milled, monolithic bridge, which we call TLZ-IB, provides esthetics and durability with very little maintenance. The restoration is available for most implant systems and is attached to the implants via titanium interfaces that fit precisely into the bridge. As with all our implant-supported restorations, screws only contact titanium, and never zirconia.

Fabricating these cases differs slightly from traditional hybrids. The implant-level impression and bite registration are the same, but the try-in is unique. Once a set-up has been approved intra-orally, it is digitized and reproduced into a screw-retained, milled, acrylic prototype. This monochromatic appliance will be tried-in to confirm esthetics and function. The adjusted, patient-approved try-in is our blueprint for the final prosthesis that will require little-to-no adjustment.

Part 2: Monothltic zirconia, TLZ, is a great restorative option, and due to its superior strength has become many doctors’ “go-to material” for posterior crowns and bridges. In esthetically critical areas, PFZ restorations (porcelain-fused-to-zirconia) incorporate layered, veneering ceramics for a more vital appearance. Sometimes a case requires both the strength of monolithic zirconia and high esthetics. We can accomplish this with a hybrid restoration we call TLZ-cutback. We virtually design the monolithic material in functional areas, and digitally cut back labial material to make room for stacked porcelain to improve the vitality

TLZ-LL

of the case. If you have a patient that requires this combination, ask for a TLZ-cutback.

Zirconia Cementation Update

The generally accepted practice of conventionally cementing monolithic ceramic restorations is clinically effi cient and is the most popular method of placing our all-zirconia TLZ, BruxZir, and lithiumdisilicate eMax restorations. In a recent edition of Inside Dental Technology, however, Dr. Ed McLaren takes issue: “The problem is that these cements are much more soluble than resin-based cements. If, over time, the cement solubilizes and fails, exposing the glass cement to saliva, the restoration can undergo hydrolytic degradation which weakens the material.” He recommends bonding these restorations, particularly in situations where the preparation is non-retentive. Dr. Russell Giordano, Boston University Goldman School of Dental Medicine, an authority on dental materials agrees. It has been established that bonding almost doubles the load and increases resistance to failure. Low pressure, sandblasting the interior of the restoration at the laboratory with alumina, and the use of primers, such as AZ Primer (Shofu Dental Corporation),  Clearfi l™ Ceramic Primer (Kuraray), Metal/Zirconia Primer (Ivoclar Vivadent), and Z-Prime Plus® (BISCO), signifi cantly improve adhesion. Recently, The Dental Advisor gave Bisco’s Z-Prime Plus a 5-Star rating and claimed that it doubles zirconia bond-strength. Z-Prime is a priming agent that enhances the adhesion between zirconia and composite resin cements, in both self-cure and light-cure modes. Based on what we’ve recently learned about the effects of primers, therefore, we recommend their use on both full-contour zirconia and porcelain fused-to-metal restorations, particularly with minimally retentive preparations.

Zirconia and Porcelain Polishing & Adjusting

Zirconia and Porcelain Polishing & Adjusting Due to the incredible popularity of ROE’s monolithic zirconia restorations (TLZ) we are frequently asked to recommend products to adjust and polish zirconia. Komet USA developed ZR Polishers a special line of burs specifically designed for hard materials like zirconia and lithium disilicate (emax). They incorporate interspersed diamonds for a “consistently, outstanding sheen in just two steps”. They are identified by blue for pre-polishing and light-gray for high-shine final polishing. Both are available in three shapes: point, flame, and cone. 

ROE now offers a special kit for intraoral adjustment of full-contour zirconia and lithium disilicate restorations. The new, diamondinterspersed, ZR Flash Polishers are designed to re-glaze hi-strength ceramics simply, once seating adjustments are complete. These  slowspeed points and cups complement Komet’s excellent long-lasting adjustment burs.
Call our customer service team to place an order. The kit comes in a sleek stainless steel block and is available for $95.

New Zirconia Wear Studies

Zirconia is one of the most studied materials in dentistry, especially since the development of the monolithic option. Manufacturers insist that wear to opposing dentition is similar to enamel, provided that restorations are highly-polished. Furthermore, many dentists contend that individual crowned teeth in balanced occlusion should not spontaneously supererupt because of wear to the opposing teeth. Rella Christiansan’s TRAC Research group has released preliminary results of a 7-year full-contour zirconia wear study which supports both of these claims. The study seeks to measure the amount of wear zirconia and other monolithic restorations exhibit invivo. After one year, the “very promising” results show that zirconia “mimics” natural dentition.

Zirconia & Phosphates Don’t Mix

Don’t let phosphates contaminate your zirconia. Phosphates, in the form of phosphilipids, are found in saliva. They are attracted to zirconium oxide and create a reaction that affects ‘bonding’. Phosphilipids cannot be rinsed with water or phosphoric acid, which is actually full of phosphates. Therefore, following a tryin of a zirconia restoration that has contacted saliva, it is recommended that you use a zirconia oxide solution called Ivoclean from Ivoclar. This 20-second process optimizes adhesion by drawing the phosphate groups away from the oxides and leaving a fresh bonding surface for priming and/or cementing.

Zirconia Restorations - 200% jump

The number of Zirconia-based restorations produced at ROE has jumped 200% in the last year. To put this in perspective, metal-free restorations account for 30% of the fixed work produced by all dental laboratories in the USA, while at ROE we are above 50%, and at least half of these restorations involve zirconia. Due to the frequently asked questions, we thought we would share some facts about zirconia. 

What is zirconia? Dental and medical zirconia is labeled as a bioceramic, which means it is biocompatible. It is primarily composed of zirconium, an extremely hard, low reactive, inorganic metal-oxide with a high melting point. It is also considered the oldest mineral on earth. Conversely, zirconia-based restorations in dental are coded by insurance providers as allceramic. We consider zirconia a breakthrough material and a magnifi cent substitute for traditional metal-based restorations. 

How is it designed for dental? 

In-operatory adjustment of zirconia:

Recommended Bur Kits for Adjusting Zirconia:

Wear to opposing:

read more

TLZ Crowns Climb Mt. Hood, Jefferson, & Rainier

 

TLZ Crowns were wired to crampons and travelled 19,000 vertical feet. The trek included lava fields, ice climbing, rock climbing, trail hiking and very bad weather. The crowns survived and proved to us that our restorations are indeed nearly indestructible and warrant their Guarantee for Life!

YOUTUBE Video: http://youtu.be/QB9AzHEeYDg 

TLZ gaining popularity

We purchased another industrial milling machine last month to keep up with demand of our TLZ restorations. If you have not tried TLZ, it is time. We guarantee if for life, and it is more esthetic than other monolithic restorations on the market.

TLZ Crown is tested in a Carver Lab Press

We visited Dr. Anne Clouser's office in Chardon OH to test a TLZ molar in her Carver Lab Press. The lab press drove a TLZ crown into a 2x4 under 1200 Psi. You can hear the wood splitting during the test. This is one of many tests performed on one single test crown. This crown has been thrown from a building, run over with a car and a forklift and beaten with a hammer for months, without fracture.

http://www.youtube.com/watch?v=947L1qEkdMU

Unheard of among dental materials, TLZ is designed to last a lifetime! Tested at a flexural strength of 850 MPa, our High-Translucency, monolithic formula zirconia is stronger than nearly all other restorations on the market. TLZ is appropriate for posterior restorations, is completed in just 6 laboratory days and is guaranteed to satisfy.

Choose your weapon - ODA Booth 2010

This year's theme at the ODA was 'Choose your weapon'. Our booth had a 3 foot 2x4, 3 hammers and several TLZ crowns to choose from. Dentists were asked to drive a crown into the wood with the hammer to experience the strength of a TLZ crown. It took a single hand sledge hammer to finally break a crown. This crown was abused for a month before finally succumbing to our punishment.

The TLZ crown is tough, yet esthetic, adjustable, and polishable chairside. TLZ crowns are appropriate for nearly all posterior cases.

TLZ compared to pfm

This is a demonstration that was conducted at our laboratory comparing the fracture toughness of conventional porcelain fused to metal crowns and bridges to the TLZ crown. Below is the result of driving crowns into a wood plank with a hammer. The TLZ crown exhibited no change while the pfm restorations were destroyed.

TLZ Indestructable Crown Video

TLZ crowns are practically indestructible. This fun video will demonstrate a series of tests we conducted at our facility in Cleveland, OH. The crown we tested has been put through tests for many weeks, primarily driving it into solid wood with the force of a hammer. This crown has been hammered by technicians and dentist for weeks without any signs of chipping or breakage.

http://www.youtube.com/watch?v=R-DsAWY8hV8

TLZ - There are competitors, but no contenders

Crystal Translithic TLZ all-zirconia crowns and bridges are the ideal restoration for posterior crowns and bridges. We have completed hundreds of cases with very satisfied clients and patients. Because these crowns and bridges are monolithic, not porcelain fused or layered or pressed, to a substructure, there are not weak spots, and resistance to fracturing, sheering, chipping, breaking, and wearing are maximized.

There is a genuine reluctance to try an all zirconia crown for two reasons. Wear against opposing and adjustability. This was a major criteria for ROE Dental Laboratory when choosing an all-zirconia product. TLZ is a yttria stabilized zirconia with three other trace elements. This compound consists of extremely tiny particles, much smaller than a glass matrix, especially a feldspathic type porcelain. Due to this fine particle attribute, kindness to opposing, adjustability and polishability are a benefit, not a contraindication. Due to the popularity of TLZ and other full contour materials, test are being conducted and these conclusions are being published. Our TLZ is in the middle of such a study and the findings will be shared soon.

In the mean time. TLZ is ideal for bicuspids with standard shades, and molars. Our staining and firing technique make TLZ and esthetic restoration. The industrial milling technology makes TLZ extremely precise. And, the strength of material makes TLZ clinically indestructible.