Comprehensive Guide to Cementation of E.Max Restorations

This guide provides a comprehensive overview of the steps and best practices for adjustment and cementation of eMax restorations.

Adjustment Recommendations

Instruct the patient to bite on carbon paper lightly for initial modifications. After the first adjustment, ask the patient to bite firmly and follow a complete excursion movement pattern, then proceed with the final adjustments.

  • Tools for Shaping:
    • A fine-grit diamond
    • Football-shaped bur for occlusal and lingual surfaces, especially anterior teeth.
    • Tapered bur for buccal and lingual surfaces.
  • High-Speed Handpiece: Use a high-speed handpiece with minimal pressure, employing water and air spray to maintain temperature and prevent micro-fractures.

Note: Air-only handpiece adjustments are not recommended.

eMax Cementation Options

Versatile cementation choices are available with e.max restorations. Crowns and bridges can be cemented using adhesive, self-adhesive, or conventional methods. Inlays, onlays, and veneers are typically cemented adhesively. Ivoclar offers a comprehensive selection of cementation materials, including:

  • Variolink Esthetic: This light- and dual-curing luting composite excels in esthetics and user-friendliness. Its effect shade concept allows subtle adjustments to the restoration's brightness or darkness.
  • Multilink Automix: A universal luting composite, Multilink Automix is known for its wide range of applications, strong bonding, and durable bond. It ensures sealed dentin and good marginal adaptation, especially with primers A and B.
  • Multilink Hybrid Abutment: Specially designed for cementing lithium disilicate glass-ceramic to titanium bases, this self-curing product is ideal for IPS e.max hybrid abutments and crowns.
  • Speedcem Plus: This luting composite, self-adhesive and dual-curing, offers a user-friendly alternative to traditional cement. It provides the added advantages of a composite, including enhanced bond strength, increased translucency, and lower water solubility.
  • Vivaglass CEM: A classic self-curing glass ionomer cement suitable for cementing high-strength ceramics like IPS e.max. It includes a transparent glass filler to enhance esthetics.

Preparation Procedures

  • Etching: Before placement, lithium disilicate restorations necessitate etching. The IPS Ceramic Etching Gel is designed to prepare ceramic restorations for insertion by forming surfaces conducive to strong bonding. Dandy ensures that all E.Max restorations are etched before dispatching the case. It is important to re-etch the case for each attempt at cementation.
  • Silanizing: For adhesive and self-adhesive cementation of IPS E.Max, Monobond Plus is used to silanize restorations. Monobond Plus acts as a universal bonding agent for various restorative materials.
  • Monobond Etch & Prime: An all-in-one ceramic primer that eliminates the need for hydrofluoric acid by enabling glass-ceramic surfaces to be simultaneously etched and silanated in a single, easy step.
    • Note: The preparation steps must be repeated if a try-in process compromises the restoration’s etch and bonding.

Conclusion

Adhering to these cementation and adjustment guidelines will ensure optimal bonding and durability of your e.max restorations.

  • Note: Always consult the manufacturer’s instructions for specific details.
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