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Ivoclar Vivadent Technical Update

November 24, 2009

Advantages of Lithium Disilicate

• For anatomical single crowns, monolithic IPS e.max® lithium disilicate is more durable than
other veneered all-ceramic systems, including zirconia.

o A recent NYU Mouth Motion Fatigue and Durability Study shows that the veneering
ceramic of a zirconia system is much more susceptible to fracture from chewing and
other motions of the mouth compared to monolithic lithium disilicate.
o The result of the above test is similar to previous findings for other veneered zirconia
systems, including Lava™/Lava™ Ceram and Cercon®/Vita® Veneer.
o Lithium disilicate is a high strength ceramic material with a flexural strength at 360 to 400
MPa, while porcelain materials used in veneered zirconium crowns have a flexural
strength of 80 to 110 MPa.

• As with veneered zirconium oxide systems, conventional cementation can be used for lithium
disilicate due to its high strength.

o Previous monolithic glass-ceramic structures required adhesive bonding because they

did not have the structural strength of lithium disilicate.

• IPS e.max lithium disilicate provides outstanding esthetics while ensuring greater strength.

o Lithium disilicate achieves a very high translucency, and the material is available in four
translucencies.
o Traditional oxide ceramics that contain an oxide ceramic core material such as zirconia
present some esthetic challenges since the zirconia has an increased opacity. This is
not appropriate for i.e. inlays onlays, partial crowns or thin veneers

• Due to its strength and multiple translucencies, IPS e.max lithium disilicate can be used for a
wide range of indications, including:

o Anterior/posterior crowns.
o Inlays/onlays.
o Veneers.
o Thin veneers.
o Crowns on implants.
o Anterior three-unit bridgework up to the second premolar applying press technology.

• Competitive references have been made implying IPS e.max is Empress® 2. IPS e.max lithium
disilicate is not Empress 2. IPS e.max is a lithium disilicate glass ceramic, which is optimized in
translucency, durability and strength for full anatomical restorations.
IPS e.max and IPS Empress are registered trademarks of Ivoclar Vivadent, Inc.
Lava, Cercon and Vita are not registered trademarks of Ivoclar Vivadent, Inc.
 Frequently Asked Questions
New York University Mouth Motion Fatigue Study

Is the durability study an Ivoclar Vivadent study?

The NYU ceramic durability study was performed as part of a larger group of studies looking at many
different ceramic systems. The initial goal was to determine best practices for working with veneered
zirconia. Lithium disilicate was later added to the study because it had demonstrated significant clinical
success.

Does the zirconia substructure fail in this study?

Due to the high strength of zirconia, the substructure remains intact. The veneering ceramic failure
however has been shown to be quite substantial. The study reflects the challenges which have been
observed clinically with veneered zirconia restorations.

Was only IPS e.max ZirCAD evaluated in the study?

The first study evaluated Lava™/Lava™ Ceram and Cercon®/Vita® Veneer (Dent Mater. 2009
Sep;25(9):1122-7. The second study repeated the same test protocol with IPS e.max ZirCAD / IPS
e.max Ceram and monolithic anatomical crowns of IPS e.max CAD. The test results for all zirconia
based crowns were similar.

Were the zirconia restorations in this study created using proper support?

Specimen restorations were fabricated by authorized centers for each of the materials tested. The
zirconia substructures shown in the study used different support methods. Although, anatomical
support of the substructure improves the durability of the veneering ceramic, it does not eliminate the
chipping phenomenon.

Are there differences in quality of zirconia?

As a manufacturer of a zirconia restorative product, we believe that there are significant quality
differences between various brands of zirconia. However, the substructure of a zirconia restoration is
rarely at fault when a failure occurs. The issue is the dissimilar characteristics between zirconia and
the layering ceramic. A failure of the layering ceramic is a failure of the restoration.

Does lithium disilicate’s strength diminish in a wet environment?

The NYU methodology was conducted in a simulated wet environment and lithium disilicate still
performed far above the other all-ceramic materials tested and supports the excellent results of our
clinical trials.