Dr. David Hornbrook, the Clinical Director of Education Technology at Keating Dental Lab goes over solutions for materials when you are doing an anterior crown and bridge restoration in this whiteboard lecture addition to the replacement of anterior crowns with aesthetic zirconia video tutorial series in 4K.
After cutting off the older porcelain crowns in the anterior region, the decision was made to go with a solid zirconia product but with a high translucency like e.max or lithium disilicate.. The new exciting KDZ Bruxer® Aesthetic zirconia restoration material was the choice for this procedure and Dr. Hornbrook goes over the reasons for this choice as well as other restorative options for dental crowns and bridges. The fact that it’s KDZ Bruxer solid zirconia material means that it’s strong and has a flexural strength about 5X that of Empress and about three to four times that of e.max.
Be sure to watch the rest of these amazing 4K Dental Crown Restoration Videos with Dr. David Hornbrook:
Part 1 Removal of Anterior PFM Crowns:
Part 2. How to take a Stump Shade on Anterior Crown Restoration:
Part 3. Bruxer Aesthetic Anterior Crown Material Solutions (Whiteboard Lecture):
Part 4. Replacement of PFM Anterior Crowns with Aesthetic Zirconia:
Video Tutorial Series Transcript:
Hello Everyone, I’m Dr. David Hornbrook, the Clinical Director of Education Technology here at Keating Dental Lab in Irvine, California. I want to show you something we’re very excited about and that’s our new KDZ Bruxer Aesthetic. The fact that it’s KDZ Bruxer means that it’s strong, in fact the flexural strength is about five to six times that of Empress and about three to four times that of Emax. So it’s incredibly strong material [00:14:00]. Originally when the KDZ Bruxer or the monolithic zirconia crown came out the advantage was it was metal free, but it was very very opaque so we kind of limited it to the back of the mouth. And we know there’s a directly correlation between the vitality of a restoration and the amount of translucency. I’m going to show something very cool with this new aesthetic material.
This is a little box. It was originally designed from Sarah at Nobel Biocare. And the design was, it has these little LEDs as you can see. Little rubber tissue. And the goal was to put a porcelain-fused-to-metal crown where we see here, you can put it over that LED and then you can take a Procera and you’d stick it on top of that LED and when you lit it up you’d say “Wow, light comes through the Procera and out through the PFM. Well, we don’t use Procera anymore, but we are using zirconia. This is one of our new KDZ aesthetic material. I’m going to go ahead and put this on our LED, it’s the exact same thickness as the PFM, we’re going to go ahead and light it up, I mean, look at that. Here we have a porcelain-fused-to-metal crown, we’ve all seen it in our practice where light hits it and it just bounces back into that dark gingival third by the root. You can see no light as the LED penetrates through the metal. Look at the aesthetic material. Again, this material is two times stronger than Emax, three times stronger than Empress.
The porcelain on the edge, because this is monolithic it’s just been stained these incisal edge material, the material that’s going to go into stress and possibly fracture, is six to eight times stronger than the porcelain in the PFM. Very cool. It’s going to look better and it’s stronger. Very exccited about it. Now, let me show you something else that’s cool about this. Let’s say you have a dark tooth. Let’s say we have a tooth, this would be our final preparation, so this would be our preparation. Let’s say it was a C4, [00:16:00] a dark prep. This could be a root canal tooth, it could be a traumatized tooth, it could just be dark dentin. Typically, what we would do is we would either put metal on the inside, like I showed you that porcelain-fused-to-metal [inaudible 00:16:16] ceramic on top of it. The problem is, as we just saw, light does not penetrate through that metal so as light hits the surface, it just kind of dies and doesn’t bounce back. Our goal, is just like natural enamel. Natural enamel, light penetrates through the enamel [inaudible 00:16:31], hits the dentin and then reflects and refracts back through the enamel which gives it its vitality.
So we want this to be a translucent as possible. Our older zirconia materials, monolithic, was opaque all the way through, so light hit it and it just died. No vitality. So our new material, our aesthetic material has translucency all the way through. Now that’s great if you have a nice shade of prep. But a C5 is not a nice shade of prep. So, how do we cheat? It’s very cool. What we do here, is instead of making this opaque, we put actually a very thin- it’s negligible, like it’s not even as thick as a die spacer, we put a very thin layer of this white neutralizer on the inside of the zirconia. So, we’re able to neutralize the effect of the C4, very cool, and we’re able to get the full thickness, whether it be 1 to 2 millimeter, depending on what the crown prep is of this translucent enamel. So the tooth is alive and vital.
Hope you’re as excited about this new KDZ material as I am. Against the aesthetic material, it’s totally different than the zirconia you’ve ever seen of the past. New high translucency, [00:18:00] it’s strong, it’s beautiful. I hope you enjoyed this and I hope you’ll consider using a new aesthetic material in your next case