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IPS e.max HT in the esthetic zone

Thomas Monahan Daniel Wilson
6 years ago

I know there is a lot of discussion about what materials to use in the anterior zone. I don't think there is necessarily a universal answer but what I've learned over the years is to understand the properties of these materials and their strengths and weaknesses.  

In general, I'm trying to use Feldspathic porcelain (VITABLOCS typically for me Mark II or TriLuxe) or Leucite Re-inforced Glass Ceramics (IPS Empress) in the anterior region.  I feel like they have more vitality, given the right case, you can just mill polish and cement and get a really nice result.  This is a case with VITA TriLuxe 1M2 polish only

I know the go-to block when using e.max in the anterior region is e.max MT. I really like the block and use it quite often as well.  My point for this discussion is that a lot of doctors will shy away from e.max HT.  There is the big fear of the dreaded "grey" crown or a crown that has "low" value.  It is a real concern.  I've had it happen to me and if you aren't careful, it can happen quite easily.  This was my first case I posted on CEREC doctors and at the time I thought it was quite good. Now I would have approached it differently because of the "low" value of #8,9.

This case I did about a year ago.  It's not perfect but it is a vast improvement over what she started with.  She is quite happy, but I always evaluate my photos and have other CEREC doctors look at them and give me their feedback.  Dr. Tom Monahan and I share cases back and forth, and aren't afraid to pick apart our cases.  It makes us better and I would encourage you to do the same.

So I chose HT for this case because I felt like I did see some C-tones in this case.  I felt like MT would be too bright or high in value for this and I didn't feel great about using Feldspathic on this case because of limited space on the lingual. So I used A1 HT.  I compensated about 2 shades in order to offset the drop in value.  I wish I would have taken a pre-op pic with a shade tab but she was closer to A3.

There are a lot of ways to approach these anterior cases, but I felt like e.max HT was the best solution and what I saw for the case in my eyes.

 

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