Dental Asia November/December 2022

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BEHIND THE SCENES Figs. 13-16: Final result after the sintering process Figs. 17-20: First firing, only glaze and some chroma intensification Figs. 21-22: Second stain firing with predictable results Figs. 23-24: Applied stains in the monolithic areas and veneered gingiva before the firing of work. This system allows users to apply smaller amounts of material, saving on costs, reducing time and errors. FIRST STAIN FIRING For the first firing, I apply glaze as a base. At this stage, it is possible to take advantage of the great margin of fusion that these stains have and also to apply a little chroma (SD2) to the body of the teeth and to increase depth in the approximal spaces (Ivocolor E11 Mahogany). The first bake is the most important to prepare the surface for good aesthetic results, facilitating the application of the next layers, but also providing a good base for the adhesion of the ceramics used. To achieve high-aesthetic results, a lot of attention must be paid to the consistency of the glaze. Apply small amounts of stains in each application, maintaining a smooth and uniform colour. It is crucial to be careful with this detail for every firing. Keep in mind that in all firings, effects can be added and chroma can be improved. SECOND STAIN FIRING With the next stain firing, we have the opportunity to work very predictably. The anatomy, the shape and the function are done and now we can apply the necessary colours to make the work look as natural as possible. One of the great advantages of using only stains for monolithic restorations is the possibility of seeing the result of the firing before going to the furnace. The colours of the stains stay the same before and after the firing, so besides the form, we also achieve predictability in colours and effects (Figs. 21-22). The ceramic firing in this stage of the protocol, we add veneering ceramics to the surface of zirconia. Again, let’s take the advantage of all the firings to add more detail so that we can finish the job as quickly and simply as possible. Ideally, we will try to make just one our two ceramic firings. We apply the ceramic materials in the desired places and in the monolithic areas and, of course, we can also add effects and improve the chroma with stains. Thus, we reduce the thermal stress of the zirconia and ceramic, and we gain time. Remove the zirconia frames from the furnace when the temperature reaches 250ºC, too high temperatures can lead to thermal stress and fractures. FINALISATION In this case, I will not go into the surface treatment any further. That would go beyond the scope here and is also very individual from technician to technician and highly dependent on personal taste. Although I would still like to give a hint. Zirconia is characterised among other things by its high biocompatibility, which demonstrates very good behaviour on the contact points with the tissue if properly 46 DENTAL ASIA NOVEMBER / DECEMBER 2022
BEHIND THE SCENES processed. There are already numerous studies that prove this. When zirconia is high-gloss polished, the material shows an extremely smooth surface. This prevents the excessive colonisation of bacteria and significantly improves wearing comfort for the patient. So, when finishing the restoration, we have to make sure that all contact points with the gingiva are carefully polished. Figs. 25-26: Applied stains in the monolithic areas and some small cutback for the incisals before firing In addition, these areas should never be stained or veneered, as this in turn could lead to a deterioration of wearing comfort and to plaque adhesion. It is also essential to ensure a clean and gap-free connection between the titani-m base and the zirconia frame. A gap can lead to the colonisation of undesirable bacteria (Figs. 27-29). For monolithic zirconia restorations, the polishing of the occlusal contact points is also extremely important. Only a highgloss polished surface prevents abrasion of the antagonist. CONCLUSION With the arrival of CAD/CAM technologies, the doors for zirconia were opened. Nowadays, the great evolution of this material allows us to obtain highly aesthetic results in a predictable way, by using only small cut-backs or even full-contours. Mechanically, we reduce the possibility of fractures, and if we apply this protocol to any ceramic system, we should have a homogeneous restoration with predictable results. I believe that Zolid HT+ Preshade changed the game in a lasting way. This article is based on two cases, where we show a characterisation with a lot of effort and in the end, with a high-aesthetic result in a simple and fast way. This shows that for daily work it will be even easier to achieve the desired results. DA This article was first published in March 2019 issue of “BYT- Another Dental Magazine” by Amann Girrbach Figs. 27-29: mechanical polished contact areas Figs. 30-32: The final result — predictable aesthetics simple and fast ABOUT THE AUTHOR DT Luís Manuel Rocha Saraiva his debut as a speaker at several graduated from CESPU (Portugal) in conferences and as an instructor 2012 in dental prosthetics field. In of Amann Girrbach. In 2019, the same year, he began his career at he joined the team of August a laboratory in Matosinhos for fixed Bruguera in Barcelona, Spain. denture where he worked with his In 2020, he became one of the mentor: Domingos America. Saraiva founders of the ClarityLab, a also worked as the technical director laboratory and training centre, in of the Dental Solutions Lab and made Porto, Portugal. DENTAL ASIA NOVEMBER/ DECEMBER 2022 47
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