VISIONIST. A new generation of glass ceramics DENTAL How a high-performance material is setting new standards. A remarkable play of colors

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1 EURO 6,50. USD 8,20. 5,20 GBP DENTAL 2 13 VISIONIST A new generation of glass ceramics How a high-performance material is setting new standards. A remarkable play of colors We look at the integrated translucency, opalescence and fluorescence of VITA SUPRINITY. Dental technician Bastian Heinloth reports Esthetic anterior restoration: a clinical case study. Page 12 Page 14

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3 DENTAL VISIONIST 02/13 EDITORIAL 3 EDITORIAL "The next generation of glass ceramics unlocks new possibilities." As part of the generation of zirconia-reinforced glass ceramic VITA SUPRINITY represents a significant step forward in the development of CAD/CAM glass ceramics. Li 2O SiO 2 +ZrO 2 Test report: VITA SUPRINITY The properties that make the new glass ceramic so special. Page 4 Thanks to a special production process, it has been possible to increase the proportion of zirconia in VITA SUPRINITY in comparison with conventional lithium disilicate ceramic by approximately tenfold. The result is a new generation of ceramic materials for practice and laboratory use that offers exceptional mechanical properties. Initial studies have shown: thanks to the special composition of materials resulting in outstanding mechanical properties, the new material unlocks extraordinary possibilities particularly with regard to the wide range of indications, exceptional processing characteristics and natural play of colors. Simple, fast and reliable Users report on their experience with the new material. Page 10 In this issue of DENTAL VISIONIST, developers and researchers explain why the material is so unique, while practice and laboratory users report on their experience with VITA SUPRINITY, and proven experts offer useful tips on processing as well as on the particular benefits of the material. DENTAL VISIONIST wishes you an enjoyable read! Angeley Eckardt Managing Editor Exceptional esthetics More on integrated translucency, opalescence and fluorescence inside. Page 12 PUBLICATION DETAILS Publication/Editorial Production/Design/Layout: qu-int. marken medien kommunikation Waldkircher Strasse Freiburg Germany VITA Zahnfabrik H. Rauter GmbH & Co. KG Spitalgasse Bad Säckingen Germany Publication: three issues each year Copyright and publishing rights: Articles do not necessarily reflect the views of the editorial team. The product information published is accurate to the best of our knowledge. This does not, however, constitute a warranty. All rights reserved, in particular the right to reproduction (in any form), as well as the right to translation into foreign languages. PLEASE NOTE: The testimonials by dental surgeons and dental technicians published in this magazine are based on practical experience with VITA SUPRINITY gained during the course of pilot testing, and/or on manufacturer information based on the data provided in "Technical and scientific documentation" (VITA Zahnfabrik, Bad Säckingen, Germany). The testimonials from the dental surgeons and dental technicians named reflect the status as valid on The testimonials by developers or researchers published in this magazine are based on internal studies conducted by VITA R&D (Bad Säckingen, Germany) and/or the results of pilot testing.

4 4 IN CONVERSATION 02/13 DENTAL VISIONIST Test report: new glass ceramic "VITA SUPRINITY offers exceptional mechanical properties." Li 2 O +ZrO 2 SiO 2 VITA SUPRINITY features a particularly fine-grained and homogeneous structure.

5 DENTAL VISIONIST 02/13 IN CONVERSATION 5 In terms of the life span of each restoration, VITA SUPRINITY offers outstanding reliability. DV: Mr. Gödiker, what were the goals during the development of VITA SUPRINITY and what is different about this material? Michael Gödiker (engineer and section manager at VITA R&D, Bad Säckingen, Germany) played a decisive role in the development of VITA SUPRINITY, the new zirconia-reinforced, lithium-silicate glass ceramic (ZLS). In this interview, he explains why the new CAD/CAM material is so special, describes its particular mechanical properties and reports on the results achieved during testing. Michael Gödiker: The goal was to create a reliable, esthetic, high-strength material that could be processed easily. The result is ZLS, a new class of lithium-silicate glass ceramic material with a fine crystalline structure and a glass phase enriched with zirconium dioxide. DV: What results were achieved by VITA SUPRINITY during testing, particularly in terms of mechanical strength and fracture load? Michael Gödiker: We began by specifying a 3-point flexural strength value of 420 MPa. This value describes the average strength as determined during the course of numerous batch tests with over 800 individual values and reduced preparation effort. With preparation in accordance with the ISO 6872 standard, higher average values in the range of 500 MPa were also achieved during 3 or 4-point flexural testing. In order to simulate clinical performance, we also carried out static and dynamic fracture load testing. A static fracture load value of approx newtons (N) was determined, which is significantly higher than the average maximum masticatory force of around 490 N. With a survival rate of 100% for adhesively-bonded VITA SUPRINITY crowns to which a force of 1200 N was applied for 1.2 million cycles, the result of dynamic load testing was also remarkable. Thanks to its reliability and high-strength properties, the zirconiareinforced glass ceramic is a material that users and patients can rely on. DV: What does the high load capacity determined signify for clinical use and what are the benefits as a result for users in practice and laboratory environments? Michael Gödiker: It means outstanding reliability in terms of the life span of each restoration, and in practical application, also enables a reduction in wall thickness in comparison with feldspar ceramic restorations.

6 6 IN CONVERSATION 02/13 DENTAL VISIONIST In terms of its esthetic properties, VITA SUPRINITY has proven to be very impressive. DV: VITA SUPRINITY has also been tested in clinical application for some time now. What sort of feedback have you received from dental practices and laboratories? Michael Gödiker: VITA SUPRINITY has generally received very positive feedback. The esthetic properties and outstanding milling and polishing results came in for particular praise. The corresponding veneering ceramic VITA VM11 also received excellent reviews with regard to processing and the resulting esthetics. DV: Looking ahead, where do you see the new generation of glass ceramics in a few years' time? Michael Gödiker: The new glass ceramic material has the potential to become the standard material in the fabrication of anterior and posterior crowns and bridge restorations. Blocks in fully crystallized form and a press-technology variant are in preparation for the near future. Ongoing development of the product characteristics and the resulting range is continuing in the long-term. "During clinical testing, the esthetic properties and outstanding milling and polishing results came in for particular praise." More information about the mechanical properties of the new glass ceramic is available at 3-point flexural strength after milling 600 Static fracture load point flexural strength [MPa] Fracture load [N] VITA SUPRINITY Lithium disilicate ceramic leucite-reinforced glass ceramic VITA SUPRINITY average masticatory force Fig.1: Average 3-point flexural strength of VITA SUPRINITY: MPa. Source: Internal study, VITA R&D, (1) Fig. 2: VITA SUPRINITY withstands loads of approx N. Source: Internal study, VITA R&D, (1)

7 DENTAL VISIONIST 02/13 THE EXPERT VIEW 7 THE EXPERT VIEW: FRAUNHOFER INSTITUTE FOR SILICATE RESEARCH (ISC) So what type of materials make up the new generation of glass ceramics? K. Dobberke for Fraunhofer ISC As project partners of VITA Zahnfabrik and DeguDent, Dr. Jörn Probst (Director, Health Division, Wurzburg, Germany; shown on the left) and Dr. Bernhard Durschang (research associate in the technical department for glass and mineral materials, Wurzburg, Germany; shown on the right) from the Fraunhofer Institute for Silicate Research (ISC) have played an active role in recent years in encouraging the development of new zirconia-reinforced, lithium-silicate glass ceramic (ZLS). In the following article, they report on the composition, structure and properties of these materials. zirconia-reinforced +ZrO 2 The building blocks for success Dr. Probst and Dr. Durschang explain: "Unlike previous commercially-available glass ceramics for dental applications, zirconiareinforced lithium-silicate glass ceramic (ZLS) contain an increased proportion of glass and zirconia (approx. 10 Wt% ZrO 2 ). Moreover, all the crystalline components are relatively small (approx. 0.5 µm) so that only a limited amount of light refraction is possible. The result is that zirconia-reinforced, lithium-silicate glass ceramic (ZLS) has a high level of translucency without any shade of their own." Making the difference In tests, zirconia-reinforced lithium-silicate glass ceramic (ZLS) demonstrate biaxial strength that is approx. 70 MPa* higher than that of lithium-disilicate glass ceramic, and offer superior processing characteristics as well as the possibility of directly verifying the material for visible faults. This is true both in the case of machine-based CAM processing (before and after crystallization) as well as in manual reworking and polishing. A positive outlook for the future Dr. Probst and Dr. Durschang are certain: "Further improvements to the material system and in fabrication techniques are making levels of flexural strength in the range of 500 MPa seem like an achievable possibility." VITA SUPRINITY components Wt% Li 2 O SiO2 ZrO 2 (zirconia) 8 12 SiO 2 (silicon dioxide) Li 2 O (lithium oxide) Various > 10 Fig. 1: Material components Source: Internal study, VITA R&D, (1) Fig. 2: VITA SUPRINITY, SEM image, 10,000x Source: Internal study, VITA R&D, (1) Fig. 3: Lithium disilicate, SEM image, 10,000x Source: Internal study, VITA R&D, (1) *) See laboratory studies on biaxial strength; Source: "Technical and scientific documentation"; VITA Zahnfabrik (1)

8 8 IN DEPTH 02/13 DENTAL VISIONIST Long-term clinical performance in focus Committed to reliability In the following article, Dr. Norbert Thiel, VITA R&D division director (Bad Säckingen, Germany) and Michael Gödiker, engineer and VITA R&D section manager (Bad Säckingen, Germany) report on their material reliability studies aimed at simulating / evaluating the long-term clinical performance of VITA SUPRINITY. Outstanding dynamic load capacity Of the consistently positive technical properties provided by VITA SUPRINITY, the dynamic load capacity (fracture load test) is of particular note. The engineer Michael Gödiker explains: "While testing adhesivelybonded molar crowns, for example, we increased the load to 1200 newtons (N) over 1.2 million cycles (= intraoral load over approx. 5 years), without causing a single crown to fall out. This suggests that long-term clinical performance can be expected." A high level of material quality and reliability VITA Zahnfabrik is committed to the quality of its material. In order to make statements regarding material quality and reliability, parameters including the Weibull modulus are determined. The Weibull modulus is informed by a theory that is based on the concept of failure of the weakest link. If the distribution parameters are known, a clear correlation can be drawn between the load and the probability of a fracture, in other words, a high Weibull modulus is indicative of consistent material quality. Together with the high load capacity values, it is an indicator of the reliability of a material. Dr. Thiel reports: "In a series of tests with various glass ceramics, VITA SUPRINITY demonstrated the highest Weibull modulus (m) of 8.9. In this study, a Weibull modulus of 5.0 was determined for lithium disilicate." Exceptional long-term stability expected In addition to laboratory studies, the new material has also been clinically tested and feedback from consultant testers in practice and laboratory settings has been outstanding. The combined feedback and available data material suggest that exceptional long-term stability can be expected. "While a series of tests on various glass ceramics showed a Weibull modulus for lithium disilicate of 5.0, VITA SUPRINITY achieved the highest Weibull modulus value at 8.9." The foundation for excellent results As both scientists explain: "The excellent mechanical properties that we have achieved with VITA SUPRINITY are primarily due to the increased proportion of zirconia. This results in a fine crystalline structure, high strength due to enrichment of the glass phase, excellent mechanical processing and superior esthetics. This last aspect is possible thanks to crystallite sizes that provide for natural opalescence by interacting with the visible light". More test results for VITA SUPRINITY are available at: Dynamic load test Weibull modulus Survival rate [%] VITA SUPRINITY Lithium disilicate ceramic Fig. 1: Success rate for VITA SUPRINITY crowns in this test: 100%. Source: Internal study, VITA R&D, (1) Weibull modulus [m] VITA SUPRINITY Lithium disilicate ceramic Fig. 2: VITA SUPRINITY achieved a high Weibull modulus value. Source: Internal study, VITA R&D, (1)

9 DENTAL VISIONIST 02/13 PROCESSING TIPS 9 Five processing tips Dental technician Andreas Buchheimer (Bad Säckingen, Germany) answers five questions on processing VITA SUPRINITY. 1. What are the hardware and software requirements for processing the new zirconia-reinforced glass ceramic VITA SUPRINITY? Processing can be carried out using the CEREC/inLab MC XL milling system from software version 4.2. Otherwise, lithium disilicate should be selected from the materials menu. It is planned that by the time VITA SUPRINITY is launched on the market, processing using other CAD/CAM systems will have been tested and cleared (e.g. systems manufactured by AmannGirrbach and KaVo). 2. How should VITA SUPRINITY restorations be polished, and what polishing tools should be used? Reworking should only be performed using fine-grained diamond-coated milling tools (4 µm) and special polishing tools (for pre-polishing: diamond finishing bur / 8 µm) at low pressure. For optimum polishing, a 2-phase polishing range for extraoral and intraoral use has been specially developed, which allows a natural highgloss finish to be achieved quickly and easily using the VITA SUPRINITY Polishing Set technical and clinical. 5. What is of particular importance when customizing VITA SUPRINITY restorations? What needs to be taken into consideration during processing? With the cut-back technique, incisal or occlusal reduction is performed to allow for layering using the VITA VM 11 materials that have been optimally adapted for this purpose. Thanks to the outstanding surface wettability, layering can be applied directly without liner firing or washbake. The minimized application of ceramic materials adapted in terms of shade facilitates highly-esthetic restorations in just a few steps. Detailed working instructions are available here for download: 3. What firing units are required for thermal firing and what must practice offices and laboratories observe in this regard? The restorations can be crystallized in any vacuum furnace that supports slow cooling. Honeycomb firing trays with platinum pins are the most suitable for firing. No particular aids are required, and as a result of the superior firing stability of the base material, firing paste is not required either; it can, however, be used additionally in the fabrication of a custom firing tray. 4. What stains can be used to characterize VITA SUPRINITY restorations and what is the exact procedure in this case? VITA AKZENT Plus stains, available as POWDER, PASTE or SPRAY, and glaze material, are applied to the restorations after full anatomical milling has been completed. Characterization using Effect Stains and Body Stains and glaze material can be performed either in combination with or following crystallization firing. VITA SUPRINITY offers numerous advantages both in terms of processing and process reliability.

10 10 IN CONVERSATION 02/13 DENTAL VISIONIST Benefits during processing "VITA SUPRINITY: simple, fast and reliable!" DV: How would both of you assess machine processing of the material using CEREC/inLab, particularly in comparison with lithium disilicate ceramic? Dr. Ernst Kolb (Eggelsberg, Austria) and master dental technician Thomas Absmanner (Eggelsberg, Austria) were among the very first users to test VITA SUPRINITY. In the following report, they describe their experience of processing the new zirconia-reinforced glass ceramic. Dr. Ernst Kolb: The new material lends itself extremely well to machine processing. In this respect, the high edge stability of VITA SUPRINITY is particularly convenient. The restoration margins are noticeably more stable than in the case of lithium disilicate with the positive effect that there is less chipping at the edges. Thomas Absmanner (master dental technician) : Generally speaking, I did not observe any particular differences in terms of processing with CEREC with one notable exception. I also noticed the improvement in edge stability at the margins in comparison with other similar materials. And this allows greater accuracy in terms of the fit. Li 2 O +ZrO 2 SiO 2 approx. 163 µm VITA SUPRINITY, SEM image, 200x approx. 276 µm Lithium disilicate ceramic, SEM image, 200 x Fig. 1: In laboratory tests, VITA SUPRINITY demonstrates edge stability superior to that of conventional lithium disilicate materials. Source: Internal study, VITA R&D, (1)

11 DENTAL VISIONIST 02/13 IN CONVERSATION 11 DV: The new material also requires crystallization firing. What is of particular importance here? In your opinion, does the new material offer any procedural advantages in this regard? Step 1 Dr. Ernst Kolb: The material is transparent until crystallization firing is performed. Although this makes esthetic shape verification during patient try-in a little more difficult from my personal point of view, this is compensated by the fact that the thickness of the restoration wall, for example, is clearly visible thanks to the transparent appearance. VITA SUPRINITY Surfaces following grinding with a diamond bur... Lithium disilicate Thomas Absmanner (master dental technician): The fact that patient try-in is possible following raw firing is of additional benefit. Corrections are particularly easy to carry out as full strength has not yet been reached and diamond burs can be easily used to work the material. It is also worth mentioning that firing paste is not required for crystallization and that characterization can also be carried out during crystallization firing. Step 2 VITA SUPRINITY Lithium disilicate "It is worth mentioning that firing paste is not required for crystallization, and that characterization can also be carried out during crystallization firing." Step 3... surfaces following grinding with a diamond bur and additional coarse polishing and... DV: In your opinion, is the new glass ceramic an improvement in comparison with lithium disilicate with regard to manual reworking, such as milling and polishing? Dr. Ernst Kolb: In general, VITA SUPRINITY can be considered an improvement. Now I finally have an alternative when it comes to chairside fabrication of crowns that can be expected to offer durability. In terms of polishing results, I would refer to the SEM images provided by the manufacturer. VITA SUPRINITY You can find the views of practice and laboratory users here: Lithium disilicate... surfaces following grinding with a diamond bur and additional coarse and fine polishing. The manual processing time for each step was 30 seconds. Source: Internal study, VITA R&D, (1) Thomas Absmanner (master dental technician): I also find VITA SUPRINITY to be an improvement. The zirconia-reinforced lithium silicate is impressive to use not only because of its superior edge stability in comparison with conventional glass ceramics, but also because manual reworking is easier. Bibliography: 1. Internal studies, VITA R&D: published in "Technical and scientific documentation" VITA Zahnfabrik H. Rauter GmbH & Co. KG Research and Development Inorganic Chemistry Spitalgasse Bad Säckingen Germany Michael Gödiker, engineer, R&D section manager (Inorganic Chemistry), Bad Säckingen, Germany Prof. Jens Fischer, R&D division director (Inorganic Chemistry), Bad Säckingen, Germany

12 12 IN CONVERSATION 02/13 DENTAL VISIONIST Translucency, opalescence and fluorescence are already integrated "A natural play of colors." DV: Mr. Zahno, how would you assess VITA SUPRINITY in terms of its esthetic properties, particularly with regard to translucency, opalescence and fluorescence? Xavier Zahno, a dental technician from Montreux, Switzerland, is an expert in the area of highly esthetic reconstructions, and has collaborated for a number of years with renowned Swiss dental clinics. In this interview, he reports on his experience with VITA SUPRINITY. Xavier Zahno: The material is beautifully translucent. The integrated fluorescence and opalescence, which are highly effective in scattering light, also offer a significant advantage. For natural results that are also sufficiently reliable for the anterior area, staining can easily be applied to the material. In particular, I can highly recommend the new VITA AKZENT Plus stains. They are tailored to ceramic applications, easy to use and extremely versatile. "VITA AKZENT Plus stains are tailored to ceramic applications, easy to use and extremely versatile."

13 DENTAL VISIONIST 02/13 IN CONVERSATION 13 CUT-BACK TECHNIQUE WITH VITA VM 11 Individualization of VITA SUPRINITY is demonstrated in the following step-bystep example. 1 2 DV: What esthetic possibilities does this material offer in combination with the new veneering ceramic VITA VM11? Xavier Zahno: For custom patient restorations with natural light and shade effects, complete layering is not required and dentin materials are generally not necessary. Instead, fully anatomical milling is performed followed by reduction only in the incisal third using the cut-back technique a fast and efficient approach of this kind is what I prefer. Another positive aspect is that VITA VM11 offers a very compact selection of materials. And despite this, I have always been able to fully implement all my creative ideas thus far. Incidentally, both materials also support highly effective polishing. Fig. 1: Crown before crystallization 3 Fig. 2: Veneering following crystallization 4 "Existing expertise can be applied 1:1 so that work can begin directly." DV: In your experience, how should VITA VM11 be processed and what are the benefits in your view? Fig. 3: Veneered crown on a firing tray Fig. 4: Polishing with the polishing set 5 6 Xavier Zahno: As highly esthetic restorations are my specialty area, I work a great deal with VITA VM11. It can be used in the same way as the materials from the VM system and also offers the same superb processing characteristics resistance, minimum shrinkage, high edge stability, etc. Existing expertise can be applied 1:1 so that work can begin directly. Fig. 5: Finishing with polishing paste Fig. 6: Model of the final result More information is available at: PRACTICE REPORT VITA SUPRINITY and clinical use As a consultant tester, Dr. Gerhard Werling (Bellheim, Germany) has already gained clinical experience in processing the new glass ceramic. Preparation and restoration design Dr. Werling explains: "The same rules apply for VITA SUPRINITY as those generally observed for all-ceramics. Preparation appropriate to ceramic materials is required that converts tensile stress to compressive stress; in other words, round shapes and edges are required, with a wall thickness in the occlusal area of 1.5 to 1.0 mm." Bonding recommendation The expert also advises: "We always use adhesive bonding for all-ceramics. This ensures optimum bonding between the stump, luting agent and restoration. Although bonding using self-adhesive and glass ionomer cements is possible in the case of high-strength ceramics, their ease of use is mitigated by limited adhesion." Note on reworking Dr. Werling's views on reworking are as follows: "Theoretically, all conventional milling and polishing tools found in the practice environment such as red fine-grained diamonds, SOF-LEX polishing discs, etc. can be used. However, a polishing set is also available that has been adapted specifically for use with VITA SUPRINITY, and using the same system is recommended in such cases."

14 14 PRACTICE REPORT: CASE STUDY 02/13 DENTAL VISIONIST Due to its considerable esthetic qualities, VITA SUPRINITY is also suitable for anterior restorations. In clinical use, the new generation of glass ceramics has certainly proven its worth.

15 DENTAL VISIONIST 02/13 PRACTICE REPORT: CASE STUDY 15 PRACTICE REPORT Using zirconia-reinforced, lithium silicate ceramic (ZLS) Esthetic anterior restoration with VITA SUPRINITY: a clinical case study 1 10 Fig. 1 BEFORE Fig. 10 AFTER 1. INITIAL SITUATION Findings and material selection Bastian Heinloth is a dental technician and certified CEREC Trainer in Munich, with several years' of experience using CEREC and inlab. His specialty area is all-ceramic reconstructions. The patient presented in the practice with a situation in region 21 that was unsatisfactory from an esthetic point of view (Fig. 1). The existing lithium disilicate crown showed a significant difference in shade in comparison with adjacent dentition. The adjacent tooth, which is particularly opaque, was the reason for this situation. Revision of the existing root filling followed by post and core therapy resulted in a stable initial situation for prosthetic restoration. In addition, gingival scarring was resolved through a minor surgical procedure so that the same height could be achieved at the gingival margin. Different conventional glass ceramics were then tested. Only the new generation of glass ceramics from VITA achieved the required result.

16 16 PRACTICE REPORT: CASE STUDY 02/13 DENTAL VISIONIST 2 4 Fig. 2: Preparation Fig. 4: Model proposed by the software 3 5 Modeling should ideally be performed using CEREC/inLab software from version 4.2. Fig. 3: Adding the copy line 2. PREPARATION Fig. 5: Editing the occlusal contacts 3. MODELING Preparation and taking digital impressions Dr. Martin Butz from Munich, Germany, was the dentist treating the patient. Using Apollo DI from Sirona, he took a digital impression of abutment tooth 21 (Fig. 2), which had undergone significant sub-gingival preparation, and transferred the virtual model to the "Cera-Technik" dental laboratory in Munich where the patient also had an appointment due to the difficult nature of the shade situation. In the inlab Software version 4.2 from Sirona, the material selected was VITA SUPRINITY. Restoration design and milling This was followed by definition of the preparation margin and insertion axis. Tooth 11 was then specified as a reference and the copy line drawn (Fig. 3). This was used by the software as a basis for generating a proposed model for region 21 (Fig. 4). Once the occlusal contacts were adapted (Fig. 5), final verification was performed in the milling preview and the crown was milled from the lithium-silicate glass ceramic blank using the inlab MC XL system. The new glass ceramic can be easily integrated into practice or laboratory routine.

17 DENTAL VISIONIST 02/13 PRACTICE REPORT: CASE STUDY 17 PRACTICE REPORT 6 8 Fig. 6: Try-in of the crown following raw fi ring Fig. 8: Veneering with VITA VM Fig. 7: Cut-back technique Fig. 9: Completed VITA SUPRINITY crown 4. REWORKING 5. THE RESULT Cut-back technique and veneering Figure 6 shows the try-in following raw firing here, the crown has a slightly grey appearance. However, the opalgrey areas were transparent in natura; the contributory shade effect as a result of the luting agent was missing. Using the cut-back technique, the restoration was reduced and built up again in layers using the fine-structure veneering ceramic VITA VM11 (Fig. 7 to 9). As lithium-silicate glass ceramic materials (ZLS) are distinguished by a beautiful opal appearance, as well as by a unique shade effect, particularly in conjunction with VITA veneering ceramics, an enormous esthetic advantage can be obtained when combined with a custom surface texture. Stunningly, beautiful, natural esthetics The restoration was seated in the dental practice using adhesive bonding. The final outcome of treatment is a set of stunningly beautiful teeth that offer consistently natural esthetics. A successful outcome was enabled in the case of this patient only by selecting the right material. VITA SUPRINITY is both a highly esthetic and stable material. It is also particularly easy and quick to process. The VITA SUPRINITY Polishing Set, VITA AKZENT Plus stains and VITA VM11 are the perfect accessories for the new generation of glass ceramics. Together with VITA VM 11, VITA SUPRINITY enabled a successful outcome for this patient case. 10

18 18 PRACTICE REPORT 02/13 DENTAL VISIONIST PRACTICE REPORT What dentists and patients have to say about VITA SUPRINITY! Dr. Alessandro Devigus (Bülach, Switzerland) has been using CEREC for more than 20 years and was one of the first users in a practice setting to test VITA SUPRINITY as part of daily clinical routine. In this article, he reports on his experience. DV: Dr. Devigus, in your personal opinion, what makes VITA SUPRINITY so special? Dr. Devigus: Thanks to the combination of proven materials, a new class of material has been created that merges the benefits of the individual groups. This has created a product that offers both attractive esthetics and superior strength. DV: What are the specific benefits of this new generation of glass ceramics in clinical application? Dr. Devigus: In general, industrially prefabricated, homogenous, high-strength materials that can be processed using CAD/CAM technologies, stand for optimum reliability and efficiency. Of particular benefit, when adding VITA SUPRINITY to your range of practice services, is that no new processing methods must be learned. As a result, it is immediately very easy and efficient to use. DV: What sort of feedback have you received from your patients regarding their restorations made from the new material? Dr. Devigus: My patients are confident in the fact that, as their attending dentist, I will recommend the right material for their needs, and they trust my judgment. Feedback so far in this regard has been consistently positive. DV: What do you see as the primary field of application for VITA SUPRINITY now and in the future? Dr. Devigus: The material is ideally suited to implant-based restorations and for all demanding indications. Fig. 1: VITA SUPRINITY block on the MC XL system Fig. 2: Model of the crystallized crown

19 DENTAL VISIONIST 02/13 LOOKING AHEAD 19 What is the potential of VITA SUPRINITY? Looking to the future! In the following interview, collaborators on the development of VITA SUPRINITY, Dr. Norbert Thiel, VITA R&D division director (Bad Säckingen, Germany) and Michael Gödiker, engineer and VITA R&D section manager (Bad Säckingen, Germany) report on the potential of VITA SUPRINITY for the future. DV: Mr. Gödiker, does this material have the potential for use in monolithic, tooth-colored bridge restorations? Michael Gödiker: The technical properties suggest that suitability for use in anterior and premolar bridge restorations can be expected. Clearance will follow once corresponding clinical tests have been carried out. In a second phase and following further studies, it will be possible to consider broadening the current range of indications even further based on the exceptional mechanical and optical properties. DV: Will VITA SUPRINITY blocks for CAD/CAM fabrication of implant abutments also be available in the future, and if so, in what form? DV: Dr. Thiel, in what forms of material will VITA provide the new material in the future? Dr. Norbert Thiel: VITA SUPRINITY blocks will soon be available not just in a pre-crystallized state, but also in fully crystallized form. The shades 0M1, A1, A2, A3, A3.5, B2, C2 and D2 will be available, with the various block shades each provided in two levels of translucency. As well as CAD/CAM variants, we are also preparing a press-technology variant. More information is available at: Michael Gödiker: Initial studies have already begun in this area, with I might add positive results so far. However, details on sizing and other specifications cannot be provided at this time. VITA SUPRINITY FC, final crystallized variant (left) VITA SUPRINITY, pre-crystallized variant (right)

20 Now available to read online! The CAD/CAM material of the future Videos, images, scientific documentation, links and downloads on the topics covered in the current issue as well as all previous issues are available from DENTAL VISIONIST online at E (X.)S - Version (01)