Impulse case
I posted this case once before, but I took some new pictures with a different camera setup today. This will show what e.max Impulse looks like in the mouth. These are crowns on 8 and 9. I love this material and if there is any questions on strength, it's my go to for sure. Nice translucency and brilliance for e.max
Totally agree on the material and your case is incredible...completely indistinguishable from natural tooth structure.
Mike,
Do you (or your staff) mostly eyeball shades using a manual shade guide to come up with the initial block selection or do you use devices such as EasyShade?
Mike,
I have been talking with several ceramists in my area, and impulse or MT emax seems to be the go to material now for anterior cases. Now V1 gets to an A1 and V2 and V3 will get lighter. Soooo, my question is, how comfortable are you getting the V1 to an A2 or even an A3 shade from that block. And could you even get darker if you had to? Seems to be a significant amount of staining to get to that shade, and in those cases would you just select another block? Hope that makes sense.
Tom
On 8/3/2015 at 11:36 am, Gary Templeman said...Mike,
Do you (or your staff) mostly eyeball shades using a manual shade guide to come up with the initial block selection or do you use devices such as EasyShade?
I use Easy Shade for all anterior cases as a starting point. Then I rely on reduction and translucency of material to make my choice.
On 8/3/2015 at 11:48 am, Dr. Jay Wooster said...They look awesome - are they hand polished or glazed ?
Both... stained/glazed first, then polished
Awesome Case Mike! The stain and glaze and contours are outstanding.... As Always!
Thanks for sharing your work,
Justin
On 8/3/2015 at 11:50 am, Tom Monahan said...Mike,
I have been talking with several ceramists in my area, and impulse or MT emax seems to be the go to material now for anterior cases. Now V1 gets to an A1 and V2 and V3 will get lighter. Soooo, my question is, how comfortable are you getting the V1 to an A2 or even an A3 shade from that block. And could you even get darker if you had to? Seems to be a significant amount of staining to get to that shade, and in those cases would you just select another block? Hope that makes sense.
Tom
Not to get on too much of a rant here, but IMO we desperately need to get away from this antiquated (and random) A,B,C,D shade system and move toward a value-based system like Vita 3D (IMI, 2MI, etc.), which would require all the ceramic materials to move to that system, too. That will never happen, nor will the US move to the much more intuitive metric system, but we can always ask. Rant over...sorry!
On 8/3/2015 at 11:50 am, Tom Monahan said...Mike,
I have been talking with several ceramists in my area, and impulse or MT emax seems to be the go to material now for anterior cases. Now V1 gets to an A1 and V2 and V3 will get lighter. Soooo, my question is, how comfortable are you getting the V1 to an A2 or even an A3 shade from that block. And could you even get darker if you had to? Seems to be a significant amount of staining to get to that shade, and in those cases would you just select another block? Hope that makes sense.
Tom
I would select V1 and use Lustre Pastes to make the shade darker.
Luster Pastes really work well because it's a what you see is what you get. I am working on video and exact techniques for Lustre Pastes to achieve different effects. It will be ready by C30 and then obviously go into the courses and on here.
Here is another case i'm working on that needs more extentive effects... Lustre Pastes on e.max
On 8/3/2015 at 12:03 pm, Ross Enfinger said...On 8/3/2015 at 11:50 am, Tom Monahan said...Mike,
I have been talking with several ceramists in my area, and impulse or MT emax seems to be the go to material now for anterior cases. Now V1 gets to an A1 and V2 and V3 will get lighter. Soooo, my question is, how comfortable are you getting the V1 to an A2 or even an A3 shade from that block. And could you even get darker if you had to? Seems to be a significant amount of staining to get to that shade, and in those cases would you just select another block? Hope that makes sense.
Tom
Not to get on too much of a rant here, but IMO we desperately need to get away from this antiquated (and random) A,B,C,D shade system and move toward a value-based system like Vita 3D (IMI, 2MI, etc.), which would require all the ceramic materials to move to that system, too. That will never happen, nor will the US move to the much more intuitive metric system, but we can always ask. Rant over...sorry!
Ross,
I agree. I actually have a 3D shade guide on the way ;). I was kinda alluding to the fact of when if ever will there will be other value blocks available. From what I had heard there is just going to be an MT block soon. So, assuming the value system goes away and we get back to the A,B,C,D shade system you prefer 
. So then back to square 1 again. That's why i'm hoping the 3D guide will help us here in my office. RIght now, i have the classic guide set up on the value scale, which helps, but waiting for the 3D.
Tom
On 8/3/2015 at 12:45 pm, Tom Monahan said...On 8/3/2015 at 12:03 pm, Ross Enfinger said...On 8/3/2015 at 11:50 am, Tom Monahan said...Mike,
I have been talking with several ceramists in my area, and impulse or MT emax seems to be the go to material now for anterior cases. Now V1 gets to an A1 and V2 and V3 will get lighter. Soooo, my question is, how comfortable are you getting the V1 to an A2 or even an A3 shade from that block. And could you even get darker if you had to? Seems to be a significant amount of staining to get to that shade, and in those cases would you just select another block? Hope that makes sense.
Tom
Not to get on too much of a rant here, but IMO we desperately need to get away from this antiquated (and random) A,B,C,D shade system and move toward a value-based system like Vita 3D (IMI, 2MI, etc.), which would require all the ceramic materials to move to that system, too. That will never happen, nor will the US move to the much more intuitive metric system, but we can always ask. Rant over...sorry!
Ross,
I agree. I actually have a 3D shade guide on the way ;). I was kinda alluding to the fact of when if ever will there will be other value blocks available. From what I had heard there is just going to be an MT block soon. So, assuming the value system goes away and we get back to the A,B,C,D shade system you prefer
Tom
Good to hear, Tom. The reason I got on the rant is because V1, V2, V3 actually makes a lot of sense (except Ivoclar should've made V1 the highest value, like in the Vita 3D Master guide), so I dislike that they are likely changing that. The problem is that almost no one thinks in increments of value, even though they should
and only Vita makes materials with that nomenclature. As for the 3D guide, I use it for anteriors because choosing your block based on value is the most critical, yet most often missed, part of nailing the shade. If you don't think a restoration matches, chances are the value is wrong. I start by selecting value with the 3D guide and then I might dust off the Ivoclar shade tabs to decide on hue and chroma. But then you have to translate between the different shade guides and the material.
Anyway, I digress. Great case, Mike! But if I'm being picky...haha.
Value is all that matters... period.
You can change chroma with stains and Hue means nothing.
You determine the correct value based on the thickness of the restorative material. The reason Ross knows this so well is that he has listened to Dr. Winter of Spear talk about it endlessly. Prep is critical.
On 8/3/2015 at 1:09 pm, Mike Skramstad (Faculty) said...Value is all that matters... period.
You can change chroma with stains and Hue means nothing.
You determine the correct value based on the thickness of the restorative material. The reason Ross knows this so well is that he has listened to Dr. Winter of Spear talk about it endlessly. Prep is critical.
Mike, this is true...however, you deserve a ton of credit because I'm not sure there's anyone other than you who so comprehensively combines prep design, ceramic selection, stain/glaze/polish techniques, and cement influence. Bob Winter has had a huge influence on me, but what you do and how you teach it is a rarity and I don't think there's anything else out there like it. I'm looking forward to the new stuff you'll be showing us at C30.
I must have missed something. When did Impulse become available? Is it comparable in strength to regular E-max? What are the advantages/disadvantages of this vs. the LT and HT blocks? Is it just a different shading system?
Impulse has been available since before CEREC 27.5. It is regular e.Max. There is no loss of strength. Advantage of e.Max over Vita and Empress is strength. It is a value based shade system, not a hue based system. It is being taught in Scottsdale. There is a learning curve with it, but the results are incredible.
On 8/3/2015 at 1:42 pm, Ross Enfinger said...On 8/3/2015 at 1:09 pm, Mike Skramstad (Faculty) said...Value is all that matters... period.
You can change chroma with stains and Hue means nothing.
You determine the correct value based on the thickness of the restorative material. The reason Ross knows this so well is that he has listened to Dr. Winter of Spear talk about it endlessly. Prep is critical.
Mike, this is true...however, you deserve a ton of credit because I'm not sure there's anyone other than you who so comprehensively combines prep design, ceramic selection, stain/glaze/polish techniques, and cement influence. Bob Winter has had a huge influence on me, but what you do and how you teach it is a rarity and I don't think there's anything else out there like it. I'm looking forward to the new stuff you'll be showing us at C30.
You couldn't have said it any better Ross... Again thanks for everything you do MIke!
JG
Any plans for EMAX to come up with a shade guide including the LT/MT/HT and impulse blocks..again as a starting reference?? and then with that as a start, taking thickness of material and underlying tooth structure into consideration before selecting shade??
Wow! Let me know when your assistants start teaching assistants or get tired of those Minn winters. Houston is nice and balmy now but nicer during the winter .
Beautiful Case Mike!
I am really looking forward to your videos in the application of the lustre pastes. I recently got the kit and find there is a bit of a learning curve with the viscosity . I could use some tips with it for sure !
