Our clinic’s indirect restorative treatment concepts

1. Full ceramic inlays, onlays, crowns, partial crowns and bridges
Inlays/onlays, partial crowns and crowns replace parts of destroyed dental substance. If the stability of a tooth cannot be guaranteed with a composite resin filling placed directly in the mouth or a tooth’s root canal is being treated, we then recommend having a partial crown (inlay/onlay) or crown prepared to enclose the tooth and prevent further tooth fractures.

Inlays/onlays, partial crowns and crowns can be prepared nowadays from glass ceramic (leucite-reinforced or feldspar) such as EMax, aluminium oxide (such as Inceram) or high-performance pressed porcelain (such as Empress) or zirconium oxide. They can also be made by dental laboratories from pre-shrunk composite resin.

2. Empress – Good things take time
Empress (pressed ceramic) inlays, onlays and partial crowns are pressed to one thousandth of a millimetre accuracy and then fired by dental technicians using a special tissue-friendly high-performance ceramic. The restorations are unparalleled in terms of aesthetic properties and have almost the same hardness as natural enamel. This means that they are gentle to the opposing tooth.

Using 3D laser scanners (CAD/CAM) or a conventional impression, the information needed to prepare the restoration is sent to the dental technician. This information is used to create a model. The high-performance ceramic is pressed onto this model in the correct shape. Empress inlays, onlays and partial crowns can be adapted to all the idiosyncrasies of the dentition and the adjacent teeth. This gives an almost undetectable result. The aesthetic solution!

The restoration is now carefully checked by us and only then do we attach the ceramic restoration to the tooth using a special cement. The whole process is completed within a week. We provide our patients with a very aesthetic temporary restoration during this time.

 

Computer-milled inlays, onlays, partial crowns and crowns (CAD/CAM)

Nowadays glass ceramics (EMax), aluminium oxide (AlO2) or zirconium oxide systems (ZrO2) are used for milled inlays/onlays, partial crowns and crowns. Those based on glass ceramics or AlO2 (including the highly publicised Cerec and E4D systems) allow the dentist to prepare a full ceramic restoration by electronically scanning the patient’s tooth and milling the inlay/onlay, partial crown or crown out of a block of glass ceramic or AlO2 in the clinic using a small ceramic milling robot.

Because these blocks have a single uniform colour or are polychromatic at most, the specific characteristics of the tooth must be painted onto the surface by hand using shading pastes. From an aesthetic point of view this cannot be compared with pressed ceramic which has the colours and translucency created from within.

The dentist then attaches the restoration to the tooth of the patient using a special adhesive. There are, however, concerns about long-term resistance to breakage and reparability, particularly for systems based on AlO2.

The patient can have a ready-to-insert inlay/only or a partial crown in 2.5 hours. In our clinic we have decided not to use AlO2 because we have concerns about the resistance to breakage over the long term. We recommend and work with zirconium oxide, the ideal, biocompatible material.

We provide a 10-year guarantee for the resistance to breakage of our zirconium oxide crowns, bridges, inlays and onlays.

 

Zirconium-based systems – The wait is worth it

Zirconium is one of the most fracture-resistant materials in modern dentistry. It is absolutely biocompatible and is even used as a tooth implant material directly in the body (bones).

Unfortunately, it is not technically possible to make a ceramic milling machine for zirconium oxide small enough to be used in a normal dental clinic. This means we cannot prepare a restoration in 2.5 hours as was possible with the previous AlO2 systems, Cerec or E4D.

After gentle anaesthesia and subsequent grinding of the tooth to the ideal shape, the tooth is recorded using 3D laser scanning or a conventional impression. We then work together with internationally renowned partners such as NOBEL BIOCARE (Procera) and Lava to obtain absolute precision and top quality from their milling centres. In these milling centres pure zirconium inlays/onlays and crowns are prepared to an accuracy of only a few thousandths of a millimetre as well as zirconium oxide frameworks for highly aesthetic situations.

For this highly demanding work high-performance porcelain (from the dental technician) is fired in layers onto the zirconium oxide framework until the shape and colour matches the other teeth. We provide a 10-year guarantee for the resistance to breakage of our zirconium oxide crowns, bridges, inlays and onlays.

Replacement of visually unattractive metal fillings

As a replacement for visually unattractive old metal fillings such as amalgam and gold or to make specific aesthetic corrections of teeth, we offer full ceramic crowns, inlays/onlays and bridges.

For this we use Empress (pressed ceramic), pure zirconium or zirconium oxide covered with highly aesthetic special porcelain.

Several international studies have shown that dental restorations made from zirconium oxide are one of the most adaptable and break-resistant materials there is. They far surpass aluminium oxide systems such as Cerec and 2d4. We agree that zirconium oxide is an ideal filling material and for this reason we provide a 10-year guarantee against fractures.