I wouldn't be without it now
I was at first resistant to becoming zirconia enabled. I had convinced myself that I know how to prep and I didn't need it. I don't do that much zirconia yet, but I am doing one now on a lower left second molar. The thinnest area on the occlusal is 0.8 mm and I couldn't reduce any more because of pulp horn proximity. When I need it, I NEED it. I'm not getting into staining them and making them look like real teeth just yet but CEREC Zirconia C3 unstained and uncolored looks pretty good on this lower second molar I am doing. I am not sorry I pulled the trigger on the Trainer promotion Sirona offered at the end of last year.
I really think I need to get on the zirconia bandwagon. Emax has been very good to me but there are definitely times when I think zirconia would be a better option. And for someone like me, who once upon a time ALWAYS encouraged patients to opt for gold crowns on second molars before emax came along, I think the esthetics of a zirc crown are just fine in many cases. There are LOTS of patients walking around with huge, ugly amalgam fillings and they are still finding mates and living full lives, so I think an opaque crown on a second molar won't bother them much!
On 5/8/2017 at 12:58 pm, Charles LoGiudice said...I was at first resistant to becoming zirconia enabled. I had convinced myself that I know how to prep and I didn't need it. I don't do that much zirconia yet, but I am doing one now on a lower left second molar. The thinnest area on the occlusal is 0.8 mm and I couldn't reduce any more because of pulp horn proximity. When I need it, I NEED it. I'm not getting into staining them and making them look like real teeth just yet but CEREC Zirconia C3 unstained and uncolored looks pretty good on this lower second molar I am doing. I am not sorry I pulled the trigger on the Trainer promotion Sirona offered at the end of last year.
Great to have the choice when you want it. Thanks for sharing, Dr. Chuck!
I really love Zirconia. I never stain only polish and they look great D3 is a great blend in shade also for second molars Have to be sure prep smooth, especially if thin occlusal otherwise could fracture as I have found They fit great.
What I have not figured out yet Sam or Mark, why sometimes I get multiple sprues on single crowns but on bridges only a single sprue --- I have had a few fracture off late in milling process. Is there a way to set multiple sprues on a bridge for stabilization during milling?
I don't go crazy with the staining, just use the 3 Vita's colors that Dr Skramstad recommends ( was able to purchase separately thru Patterson, about $50 each) My suggestion is don't wait too long till you try it. Makes a good tool that much better.
Much respect to senior docs learning new stuff!! 
So many even younger docs just keep doing the same old thing.
I'm waiting for the Ivoclar CS4 to come out this summer and will make my decision then.
Jay
CS4 looks nice. I was just reading the manual and brochure it said it has a drying cycle before sintering. Does anybody know the time for drying and sintering together with this unit? Also is it going to be available in the summer and what is the cost?
Wet sintering vs dry sintering adds about 20-25 minutes onto the Speedfire I agree why wait move ahead now too
At my age I don't buy green bananas any more. I can't afford to wait for something coming out this summer. I fail to see the logic in waiting for an Ivoclar product when it is possible to start now. Anyone who has already pulled the trigger will confirm that there is a learning curve.
Takes a little more time in the oven, but I think you will like the results you get with infiltration. I totally agree that this is a nice option to have at our fingertips.
chuck, how difficult to remove a zirconia crown? If u say jump then I'll have to consider the leap.
Removal or even access for endo?
Just refer for endo instead?
I'm not anti, mind you. I want to know that someone has found a good way besides lots of water and fat yellow sparks and 5-10 minutes before I feel comfortable making the jump.
Thanks
God Bless
matt
On 5/9/2017 at 6:45 am, Charles LoGiudice said...At my age I don't buy green bananas any more. I can't afford to wait for something coming out this summer. I fail to see the logic in waiting for an Ivoclar product when it is possible to start now. Anyone who has already pulled the trigger will confirm that there is a learning curve.
All due respect and I understand the benefit of having the option now but I've had my ivoclar oven for almost 10 years now and have had 0 issues with it. If Ivoclar is coming out with a new oven that can sinter, most probably have a shorter cycle for both emax and zir, and I'll be able to stick with a company that I know I"ve had a great track record with, I think thats logic enough. Also I'm sure that Ivoclar is going to be coming out with their own Zir block. Is your Sirona oven going to be able to sinter it?
You're $14k away from being able to mill and sinter ziroconia in 15 min with your current scanner and mill. Just need the Speedfire. You can fire emax in 14.5 in the Programat you already have. What's the rationale behind a new Ivoclar mill and sintering furnace? It's going to cost 7-8 times as much as your present set up and it won't be faster.
On 5/9/2017 at 8:47 am, Bob Conte said...You're $14k away from being able to mill and sinter ziroconia in 15 min with your current scanner and mill. Just need the Speedfire. You can fire emax in 14.5 in the Programat you already have. What's the rationale behind a new Ivoclar mill and sintering furnace? It's going to cost 7-8 times as much as your present set up and it won't be faster.
The furnace is not going to be available for purchase by itself?
I just realized that we went off the tracks with this. Props to you Dr Chuck for staying on the bleeding edge of technology. The zirconia workflow has made life pretty easy for us. I love being able to just stop prepping teeth when fighting for that magical 1.5 of reduction. The material is so forgiving and fits like crazy. I've done more zirconia in the last 9 months than I have done in the previous 10 years.
I agree with the above pro ZR sentiment. I am enjoying it when I need it, really enjoying a second mill.
With regards to the CS4: I am sure it will be a good oven. The times I saw at IDS for processing emax were LONGER than current time with CS2, probably because of the larger muffle. The processing time for ZR was longer as well. This oven would not be the go/no go decision on ZR for me. Maybe, they will open it up to more ZR, and that would be good, but knowing Ivoclar's passion for releasing safe, predictable solutions, they most likely will not release it for non-approved uses materials.
The new zirconia from Ivoclar will take 30 min to sinter and does not look drastically better
On 5/9/2017 at 8:17 am, Leo Rosenthal said... chuck, how difficult to remove a zirconia crown? If u say jump then I'll have to consider the leap.
I haven't had to remove a zirconia crown yet. I'm so naive I think my crowns aren't going anywhere once I bond/cement them in place. I have been told by the laser gurus I know that zirconia crowns can be removed with my Erbium laser and no cutting 9 out of 10 attempts. I haven't had to try that yet. All I know is that I used to think there wasn't a situation in which I couldn't make e.Max work. In my church, that is called the sin of pride. I have been humbled but I am thankful that I had the inspiration to get the Speedfire oven before I encountered some cases where I couldn't make e.Max work.
On 5/9/2017 at 7:39 pm, Mike Skramstad said... The new zirconia from Ivoclar will take 30 min to sinter and does not look drastically better
I talked to my Ivoclar rep today. I was a little surprised and disappointed to hear that it would take that long. He also told me that I would need to change my left motor out to mill zirconia. Never heard that before. Is that true? I bought my new mcx in 2015.
Leo, it is WAY easier to remove a cemented zirc than it is to remove an bonded emax with a hand piece. I don't have a hard tissue laser anymore so can't pop either one off.
On 5/9/2017 at 9:01 pm, Garo Adomian said...On 5/9/2017 at 7:39 pm, Mike Skramstad said... The new zirconia from Ivoclar will take 30 min to sinter and does not look drastically betterI talked to my Ivoclar rep today. I was a little surprised and disappointed to hear that it would take that long. He also told me that I would need to change my left motor out to mill zirconia. Never heard that before. Is that true? I bought my new mcx in 2015.
Don't trust your Ivoclar rep about that. I think your MCX, purchased in 2015 is good. Sometimes, sales reps are a source of incredible misinformation. I am lucky with my CEREC Specialist. She is the best. My Ivoclar rep is good, but I never see him.
I have been milling zirconia from day one I got the cerec. I was already doing zirconia crown prior to the cerec thru a local lab due to high patient pool with bruxism. Nice thing about the zirconia was as mentioned ability to prep conservatively as metal crown, hopefully reduction in post op sensitivity(?).
I bought the four motor milling or the milling with four burs, which is nice that I don't have to change the burs in between wet and dry. But dry milling makes some mess in the chamber, you got to vaccum up the dust and run a clean cycle, before wet milling. Now I wish I bought two separate milling with only two burs to dedicate one for dry and wet.. Just my 2cents.
It is not required to clean the chamber prior to wet milling, where did you get that information?. Just think of wet milling as an extended clean cycle that actually removes almost all the dust.
We do a lot of Zirconia and use the MCX for other crowns too. I have two machines so when doing multiple crowns same visit or multiple chairs let's us mill all quicker. For the MCX dry Mills we will occasional vacuum out the dust and large particles if built up a lot, but we never do or need a clean cycle. As Marc says that flushing is a clean cycle never an issue
On 5/9/2017 at 9:01 pm, Garo Adomian said...On 5/9/2017 at 7:39 pm, Mike Skramstad said... The new zirconia from Ivoclar will take 30 min to sinter and does not look drastically betterI talked to my Ivoclar rep today. I was a little surprised and disappointed to hear that it would take that long. He also told me that I would need to change my left motor out to mill zirconia. Never heard that before. Is that true? I bought my new mcx in 2015.
Garo check your serial number on your mill. If the number is higher than 231 001, you're good to go to mill with carbides. If you bought it new vs a training center unit I'm sure your serial number is much higher than that number.
On 5/10/2017 at 4:32 am, Joseph Kim said...I have been milling zirconia from day one I got the cerec. I was already doing zirconia crown prior to the cerec thru a local lab due to high patient pool with bruxism. Nice thing about the zirconia was as mentioned ability to prep conservatively as metal crown, hopefully reduction in post op sensitivity(?).
I bought the four motor milling or the milling with four burs, which is nice that I don't have to change the burs in between wet and dry. But dry milling makes some mess in the chamber, you got to vaccum up the dust and run a clean cycle, before wet milling. Now I wish I bought two separate milling with only two burs to dedicate one for dry and wet.. Just my 2cents.
I have yet to clean my chamber out between either kind of milling and switch back and forth all day. You are making life too hard for yourself.
I just had to cut my first one off....it was my fault for not closing the gingival embrasures well enough and the patient was packing food. It took me about the same amount of time to cut off a pfm. I went through two diamond burs though. The crown was cemented with rmgi. If it was cemented with something stronger, I'm sure it would have taken more time to cut off.
On 5/10/2017 at 4:18 am, Charles LoGiudice said...On 5/9/2017 at 9:01 pm, Garo Adomian said...On 5/9/2017 at 7:39 pm, Mike Skramstad said... The new zirconia from Ivoclar will take 30 min to sinter and does not look drastically betterI talked to my Ivoclar rep today. I was a little surprised and disappointed to hear that it would take that long. He also told me that I would need to change my left motor out to mill zirconia. Never heard that before. Is that true? I bought my new mcx in 2015.
Don't trust your Ivoclar rep about that. I think your MCX, purchased in 2015 is good. Sometimes, sales reps are a source of incredible misinformation. I am lucky with my CEREC Specialist. She is the best. My Ivoclar rep is good, but I never see him.
Ok thanks Charles. I'll look into it
On 5/8/2017 at 12:58 pm, Charles LoGiudice said...I was at first resistant to becoming zirconia enabled. I had convinced myself that I know how to prep and I didn't need it. I don't do that much zirconia yet, but I am doing one now on a lower left second molar. The thinnest area on the occlusal is 0.8 mm and I couldn't reduce any more because of pulp horn proximity. When I need it, I NEED it. I'm not getting into staining them and making them look like real teeth just yet but CEREC Zirconia C3 unstained and uncolored looks pretty good on this lower second molar I am doing. I am not sorry I pulled the trigger on the Trainer promotion Sirona offered at the end of last year.
I'm glad I finally bit the bullet late last year too. I am also finding myself placing a lot more Zirconia than ever before. Getting that showed me an alternative to e.max (which had become, for the most part, my one trick pony). Since I found that additional materials could be integrated at my office, I also took a closer look at Celtra Duo. I'd have to say that those two materials now make up a bulk of my CEREC restorations.
Thomas you have found what I have doing for year plus now. Molars are all Celtra Duo(mostly polished) or Zirconia. Love the Zirconia addition I made over a year ago. D3 for all is a decent looking one too. 13 or 17 minutes to sinter is plenty not 30 minutes for Ivoclar. Changes the whole single visit time concept to me. See my separate post on a 4 unit Zirconia bridge we did today one visit.
On 5/11/2017 at 8:34 pm, Dave Rossen said...Thomas you have found what I have doing for year plus now. Molars are all Celtra Duo(mostly polished) or Zirconia. Love the Zirconia addition I made over a year ago. D3 for all is a decent looking one too. 13 or 17 minutes to sinter is plenty not 30 minutes for Ivoclar. Changes the whole single visit time concept to me. See my separate post on a 4 unit Zirconia bridge we did today one visit.
I saw that post! How long was the finished bridge? It sure looked liked you squeezed every last bit out of that block!
Tom
I just saw the video on the Ivoclar Zircad and they recommend 0.6 mm of thickness so that is 0.8mm on the monitor. Are they stronger than inCoris or Sirona Zirconium?
Ray
Sameer: Dentsply rep is telling me Celtra Duo is stronger than emax. I am hearing differently from my peers. What is your opinion? Tell me when you want the best meal in Boston. My cc is ready.
Best,
Jim Nager
