E-max Porcelain Crown

1- Metal Supported Porcelain Crowns

  • Ceramic restorations are associated with aesthetics in dentistry.  However, their resistance to stress causes them to be supported by a metal substructure.
  • Metal supported ceramic restorations are still used, but metal substructure and opaque ceramic prevent light transmittance.
  • However, due to the disadvantages of metal from the gum rim, such as reflection and corrosion, the search has begun and interest in full ceramics has increased.

2-IPS e.Max Porcelain Crowns (Full Ceramic Porcelain, Laminate Veneers, Inlay, Onlay, Overlay, Endocrowns)

  • Since IPS e.max restorations have the ability to transmit and reflect light, they provide closer appearance to natural tooth tissue, excellent aesthetics and color depth compared to metal-supported restorations.
  • It has thermal expansion coefficient and thermal conductivity similar to natural tooth tissue.
  • They have high resistance against compression forces.
  • They are biocompatible.
  • They do not cause a change in taste in the mouth and the majority allow radiographic caries diagnosis.
  • They are used for making crowns, bridges, inlays, onlays and laminate veneers.  Due to these superior features, they have recently become an indispensable option in fixed prosthetic applications.

Clinical success of full ceramic systems

  • Substance properties may change depending on factors such as preparation, edge fit, cementation, bonding, color and aesthetics.  These factors are also important for the clinical life of the restoration.
  • In recent years, various full ceramic applications are included depending on their content and construction method.
  • Substance selection should be done very carefully for the full ceramic restoration to be produced.  Durability or aesthetic requirement is effective in this choice.
  • Although the glass ratio of the preferred aesthetic materials in the front tooth crowns is high, their durability is less.
  • With the addition of some crystals to the content of the ceramic, restorations with a more durable yet opaque appearance can be achieved.  These full ceramic varieties are obtained by different production methods. Computer-aided design and computer-aided manufacturing (BDT / BDU) methods known as casting, heat pressing, slip-casting and CAD / CAM are examples of these.  It is aimed to increase success especially with the use of BDT / BDÜ systems. 
  • The substance to be used and the method of construction must be selected and applied very carefully.
  • In addition to the substance and method to be used, important factors such as preparation, impression phase, edge compliance, cementation, early contacts, parafunctional habits of the patient and oral hygiene of the patient should be evaluated very carefully.

Dental Aesthetics

  • It is one of the most important issues for both the patient and the physician.
  • Natural tooth color is formed by the reflection of light directly from the tooth surface and the reflection of the light entering through the dentin and enamel layer.
  • While the natural tooth allows light to be transmitted back, metal-backed ceramic restorations allow only reflection of light.
  • The color of the restoration is affected by the surface structure, the gum tissue surrounding the restoration and the light of the environment.
  • Dental restorations should be able to imitate natural teeth in terms of color depth and light transmittance.
  • Since all ceramic restorations allow light transmission, a compatible aesthetic can be provided with neighboring teeth.
  • Due to its superior properties such as aesthetics, biocompatibility and durability, interest in all-ceramic systems has increased considerably in recent years.

Advantages of Full Ceramic Porcelain

  1. They are biocompatible with tissues.
  2. They do not cause irritation or coloration in the gums.
  3. They are aesthetic.  Because they have the ability to transmit light, they are closer to the natural tooth structure.
  4. They have thermal expansion coefficient and thermal conductivity similar to natural tooth tissue.
  5. Heat conduction is less than metal-supported ceramic restorations and they do not create pulpal sensitivity.
  6. They are stable in color and size.
  7. They are resistant to abrasion.
  8. They are very resistant to compression forces.
  9. They are reliable in terms of ion release and electrolytic corrosion.
  10. Due to the very low accumulation of plaque and bacteria, healthy subgingival areas (such as over implant restorations) are available.
  11. They do not have an allergic effect.
  12. They do not cause a change in taste in the mouth.
  13. When prepared as laminated veneers, a good aesthetics result can be obtained by removing the tooth tissue very little.
  14. Most of them allow radiographic caries diagnosis.

Disadvantages of Full Ceramic Porcelain

  1. It is not resistant to breakage. Therefore, it must fully adapted to the mouth.
  2. They are not economical and require special materials and tools to make.
  3. Their resistance to tensile forces is low.
  4. Care is required in all stages such as dental preparation, impression taking, restoration preparation and cementation. It also takes a long time.
  5. It is not suitable for long bridge construction on the back teeth. 

In which cases can full ceramics be applied

  1. Teeth broken due to trauma or caries
  2. Situations with tooth coloring
  3. Worn teeth as a result of abrasion, attrition and erosion
  4. Diastema cases
  5. Teeth with impaired placement
  6. Teeth with deformity
  7. Congenital or acquired tooth deficiencies
  8. Endodontically treated teeth with excessive damage
  9. Patients with metal allergies
  10. All front teeth where aesthetics gain importance

In which cases cannot full ceramics be applied

  1. Teeth with short clinical crowns
  2. In individuals with deep bite
  3. In excessively crooked teeth
  4. Cases of bruxism
  5. Crowns with excessive contraction towards the cervix
  6. Teeth with periodontal disease, whose clinical crowns are too long for proper preparation
  7. Areas with high chewing pressure and cases where closing is not appropriate
  8. Cases where the interocluzal gap after the preparation will be less than 1‐2 mm
  9. People engaged in traumatic sports
  10. It is not indicated in patients who cannot be motivated in terms of oral hygiene.

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