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Photo Essay: BruxZir® Solid Zirconia Anterior Esthetic Challenge

Michael DiTolla, DDS, FAGD

article by Michael C. DiTolla, DDS, FAGD

This photo essay illustrates our laboratory’s recent advancements in improving the esthetic properties of BruxZir® Solid Zirconia. Since the launch of the crown & bridge material in 2009, we have talked about BruxZir Solid Zirconia being “More Brawn Than Beauty.” As our R&D department refines our processes, improving the material’s translucency, the esthetics have continued to improve dramatically. What better esthetic challenge could there be for a material than using it to replace old crowns on teeth #8 and #9? BruxZir Solid Zirconia rises to the challenge in this case, but keep in mind, I have the advantage of in-house dental technicians, which always makes it easier to deliver great restorations. High-quality digital photographs can result in the same high-quality restorations almost as easily. After this case, we decided to upgrade the BruxZir Solid Zirconia motto to “More Brawn and Improving Beauty.” Continue reading to see if you agree!

With the margins now clearly exposed, I use an 856-025 bur (Axis Dental) with the water off and my KaVo ELECTROtorque handpiece set to 4000 rpm to slowly drop the margins to the new gingival level.

I use a Warm Air Tooth Dryer (A-dec; Newberg, Ore.) for 10 seconds after applying both coats of the G5. Meanwhile, my assistant places Z-PRIME™ Plus (Bisco; Schaumburg, Ill.) inside the BruxZir crowns, and then we air-thin that for 10 seconds. Z-PRIME Plus is a zirconia adhesive that helps strengthen the bond of the cement to the crown.

Figure 33: Here is an immediate, nonretracted shot of the BruxZir crowns on teeth #8 and #9 with the lips at rest. This is probably the easiest shot to take for crowns to look good because we are looking only at the incisal half, where reduction is nearly always adequate. The gingival third is where crown & bridge tends to look fake.

Figure 34: A retracted view of the BruxZir crowns on teeth #8 and #9. I used to always under-reduce in the gingival third before I started doing the Reverse Preparation Technique, which ensures 1 mm of reduction in this area. Thanks to this technique, these crowns look decent even in the retracted view.

Figures 35a–35c: Looking at this series of “after” pictures, the most amazing part is that there is not any porcelain on these BruxZir crowns; they are solid zirconia. This is why they have superior strength and are stronger than all other restorative materials, with the exception of cast gold. The other amazing thing I notice is the facial anatomy that you see on the crowns in the lateral views. That flat facial profile in three planes is what makes a tooth look real. Because that anatomy is built into the CAD/CAM database, we are able to deliver it every time — provided the doctor gives us enough reduction. The promise of CAD/CAM dentistry is being able to deliver predictable esthetics because the restoration contours are based on a library of ideal teeth, not on a technician’s skill level or whether he or she is having a good day. As BruxZir Solid Zirconia has become more translucent, I find myself more willing to use it for challenging esthetic cases like this one. While I’m not suggesting that you suddenly switch all of your anterior restorations to BruxZir crowns immediately, you may want to consider using it for patients with parafunctional habits, or patients with old PFMs like the ones in this case, where an esthetic improvement is essentially guaranteed.

The other amazing thing I notice is the facial anatomy that you see on the crowns in the lateral views. That flat facial profile in three planes is what makes a tooth look real. Because that anatomy is built into the CAD/CAM database, we are able to deliver it every time — provided the doctor gives us enough reduction.

Chairside Magazine: Volume 7, Issue 1

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