IN DEPTH WITH
Occlusal instability: Hybrid ceramic VITA ENAMIC in the virtual articulator
The “virtual patient” has long been a utopian dream in dentistry, providing a precise, purely virtual working basis for the planning, design and manufacture of restorations that is available at all times. Dental technicians Lukas Wichnalek and Arbnor Saraci share how they treated an occlusally unstable patient on a purely virtual working basis with the polychromatic CAD/CAM hybrid ceramic VITA ENAMIC multiColor.
From left: Arbnor Saraci and Lucas Wichnalek of HIGHFIELD DESIGN (Zahntechnik Wichnalek)
Today, commercial laboratories are already working completely virtually as models are disappearing from everyday work life, opening up entirely new restorative options. This is because digitalisation not only means the further development of hardware and software, but also the possibility of using new materials in CAD/CAM-supported production. These innovative materials offer a great opportunity to treat patients faster, more economically and appropriately for the indication. For Wichnalek and Saraci of the HIGHFIELD DESIGN (Zahntechnik Wichnalek) dental lab in Augsburg, Germany, the differences in VITA ENAMIC and other ceramics and composites starts from its structure.
is already tooth-coloured is sintered porous in block form during the production of the hybrid ceramic and then infiltrated with a transparent polymer under pressure and heat. As a result, the ceramic dominates the material structure,” said Wichnalek. Saraci highlighted that this structure is the precise difference with composite blocks, which are also often incorrectly referred to as hybrid ceramic. “Composite blocks consist of a polymer in which finely ground fillers made of glass, quartz or ceramic are embedded. The whole thing is then polymerised in the form of the blank. In contrast to this, with the hybrid ceramic VITA ENAMIC, a dual interlocking ceramic- resin network is created, with clear material advantages,” said Saraci.
material´s ability to be ground easily and reliably at any time, but could also be built up.
“The hybrid ceramic VITA ENAMIC is very robust when grinded. If this causes microcracks in the ceramic, these are stopped by the time they reach the adjacent polymer. Cracks do not spread, preventing any major damage from occurring. Afterwards, polishing is fast and simple,” said Wichnalek. Furthermore, additions or corrections with composite are also possible at any time. Saraci explained that ceramic dominates on the surface, which is why the hybrid ceramic can also be conditioned in the same way. “After final integration, such restorations can be roughened in the mouth at any time, silanised and then adhesively supplemented with filling composite. This leeway gave the dentist more security with the occlusally unstable patient,” he said.
“All-ceramic by itself is more or less brittle. To counteract this, a fine-structure ceramic that
The advantages with regard to the occlusally unstable patient in the case was the
50 DENTAL ASIA SEPTEMBER / OCTOBER 2024
Made with FlippingBook Online document maker