Lava Plus High Translucency Zirconia

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A presentation on our new Lava Plus High Translucency Zirconia. Excellent esthetics ranging from all-zirconia to layered restorations

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  • There are Zirconias on the market that do not contain alumina to improve translucency. To fully maintain the aging stability 3M ESPE went a different path:Alumina content is reduced to 0.1 wt%Alumina distribution is improved to maintain the aging stability.Of course the Lava processing quality is maintained resulting in strength and precision on Lava™ level!
  • The result - a dense, homogenous Zirconia with no Alumina segregationNote irregular grain distribution with branded zirconia and no-name zirconia.
  • Lava(TM) Plus offers significantly higher translucency without compromising strength.Lava(TM) Plus offers equivalent strength as the clinically proven Lava™ Frame Zirconia.
  • A common method to compare translucency of dental materials is to determine the Contrast Ratio CR: The white light remission from a specimen placed over a standardized black (Yb) and white (Yw) background is determined. CR is calculated as CR= Yb/Yw. CR is ≤ 1, A CR value of 1 (or 100%) represents a completely opaque specimen. A low contrast ratio indicates a higher translucency, for easier readability this graph shows 1- CR. Lava(TM) Plus offers excellent translucency.Bottom of the bars shows the Alumina content in weight percent (%wt). Higher opacity materials have a higher Alumina content, the lower translucency materials differ in Alumina content between 0 to 0.1 wt%.
  • Lava Zirconia - excellent performance proven by abundant clinical evidence:- 10+ clinical studies completed or ongoing on Lava Zirconia crowns and bridges1800+ Lava Zirconia restorations were placed and observed for up to 7 yearsExcellent clinical success rate of the Lava Zirconia frameworks!1 Crisp RJ, Cowan AJ, Lamb J, Thompson O, Tulloch N, Burke FJT. A clinical evaluation of all-ceramic bridges placed in patients attending UK general dental practices: three-year results. Dent.Mater. In press2 Yu A, Raigrodski AJ, Chiche GJ, Hochstedler JL, Mohamed SE, Billiot S, Mercante DE. Clinical efficacy of Y-TZP-based posterior FPD - 5 year results.IADR 2009;# 16373 Nothdurft FP, Rountree PR, Pospiech PR. Clinical long-term behavior of zriconia-based bridges (Lava): Five year results. PEF 2006; # 03124,6 Clinical Study Report, 3M ESPE5 Perry R, Sharma S, Ferreira S, Kugel G, Orfanidis J. Two year clinical evaluation of zirconia bridges. AADR 2008 # 10857 Schmitt J, Holst S, Wichmann M, Reich S, Goellner M. Zirconia Posterior Fixed Partial Dentures: 5-Year Clinical Results, IADR 2011, #1459748 Raigrodski AJ, Zhang H, Dogan S. Clinical efficacy of zirconia-based anterior maxillary crowns with customized copings. IADR 2009; # 3749 Schmitt J, Wichmann M, Holst S, Reich S. Restoring Sev. Compr. Ant. Teeth with Zirconia Crowns and Feather-Edged Margin Preparations: A 3-Year Follow-up of a Prospective Clinical Trial. Int J Prosthodont 2010;23:107–10910 Reprint 06/10 of THE DENTAL ADVISOR™
  • A study booklet summarizing the clinical data is available on the web.
  • Lava™ Plus covers the the full Lava™ Zirconia indication range.The same limited warranty of 15 years applies.
  • RelyX™ Unicem Self Adhesive Resin Cement Best combination of ease of use and performanceSimplified procedure for Zirconia compared to glass ceramic cementation:HF ecthing, silanization and bonding primer are obsoletePretreatment of Zirconia for RelyX™ Unicem Self Adhesive Resin Cement: Gentle sandblasting with 50 µm or less at 2 bars. Gentle sandblasting = Efficient surface roughening and maintained strength. Gentle sandblasting will not affect strength of Lava Zirconia – proven fact!**Stress-Induced Phase Transformation on Zirconia Surfaces, M. JAHNS, A. SCHMALZL, G. FOKAS, J. GEIS-GERSTORFER, G. SCHECHNER, Abstract 16, IADR 2009Fatigue behavior in water of Y-TZP zirconia ceramics after abrasion with 30 µm silica-coated alumina particles, Susanne Scherrerr et al, Dent Mater (2011): 27, e28-e42RelyX™ Ultimate Adhesive Resin Cement Ultimate bond strengthWorld-class esthetics with tooth-like fluorescenceYour choice of either total or self-etch procedureFewer components: Scotchbond Universal is Zirconia primer (MDP inside) and adhesive all in one bottle Pretreatment of Zirconia for RelyX™ Ultimate Adhesive Resin CementGentle sandblasting with 50 µm or less at 2 barsGentle sandblasting = Efficient surface roughening and maintained strength. Gentle sandblasting will not affect strength of Lava Zirconia – proven fact!*Scotchbond Universal*Stress-Induced Phase Transformation on Zirconia Surfaces, M. JAHNS, A. SCHMALZL, G. FOKAS, J. GEIS-GERSTORFER, G. SCHECHNER, Abstract 16, IADR 2009Fatigue behavior in water of Y-TZP zirconia ceramics after abrasion with 30 µm silica-coated alumina particles, Susanne Scherrerr et al, Dent Mater (2011): 27, e28-e42
  • RelyX Ultimate was used with Scotchbond Universal (left uncured), the other materials with their respective primers as indicated by manufacturer.LavaZ irconia was sandblasted (50µm, 2 bar) before priming, all cements light cured
  • IADR 2011, Abstract 2929Material Properties of Self-adhesive Resin Cements 
Saturday, March 19, 2011: 8 a.m. - 9:30 a.m. 
Location: Room 23C (San Diego Convention Center)
Presentation Type: Oral Session 
C. WIEDIG, R. GUGGENBERGER, M. LUDSTECK, H. RENNSCHMID, G. RAIA, and R. HECHT, 3M ESPE, Seefeld, GermanyObjectives: The purpose of this in vitro investigation was to compare different self-adhesive resin cements regarding the degree of neutralization and bond strength to enamel, dentin and zirconia to create a comprehensive performance overview.Materials and Methods: Materials tested were Maxcem™Elite (Kerr), SmartCem™2 (Dentsply), Clearfil™SA Cement (Kuraray), RelyX™ Unicem 2 Automix, RelyX™ Unicem Clicker™ and experimental handmix self-adhesive resin cement (all 3M ESPE).For shear bond strength (SBS) testing bovine teeth were ground, polished (320 grit sandpaper), water-rinsed and air-dried. In case of zirconia (Lava™, 3M ESPE), discs (15 x 3.5 mm) were pre-treated as recommended by manufacturers. Stainless steel rods were cemented under pressure (20 g/mm2) onto teeth and zirconia discs. After light-curing (lc) following the manufacturers' instructions, specimens were stored for 24h at 37°C and 100% relative humidity. SBS was measured using a universal testing machine (Zwick Z010, crosshead speed: 0.75 mm/min). The degree of neutralization was determined by measuring the increase of pH of the mixed cement within 24h (ΔpH) using pH indicator sticks (Fisherbrand).Data obtained were analyzed using Multiple Range Test (Fisher's LSD; p<0.05). Results: see table. Values in one column with different superscript characters are statistically different. Material SBS Enamel [MPa]SBS Dentin [MPa]SBS Zirconia [MPa]ΔpH    within 24hMaxcem Elite 26.3±11.1b   5.5±1.5c 24.3±12.2b1.0SmartCem 2 22.1±6.0b   5.0±1.6c 24.7±2.2b0.5Clearfil SA Cement 13.5±5.1c   6.5±4.5c 27.9±2.6b2.0RelyX Unicem Clicker 23.9±3.5b 13.0±3.8b 31.2±2.9a,b4.5RelyX Unicem 2 Automix 34.9±6.9a 21.9±3.1a 36.9±3.7a5.0Experimental Cement 34.6±5.7a 21.8±1.4a 36.8±4.1a5.0 Conclusion: RelyX Unicem 2 Automix and experimental handmix self-adhesive resin cement show the best performance profile with excellent results in all tested material properties compared to all other cements in this study. A high degree of neutralization as indicated by a high ΔpH-value contributes to the longevity of the cementation.        
Keywords: Adhesion, Cements, Dentin, Enamel and Physical
  • Unique 3M ESPE shading technology from the inventor of dental zirconia shading.Widest selection of zirconia dyeing liquids in the market .Tailored to the micro structure of Lava Plus ZirconiaExcellent color match to VITAPAN® ClassicalWarm, natural colors
  • Lava Plus offers true colors: You get what you order!Lava™ Plus – True Colors: Excellent Color Match to VITAPAN® Classical.Lava Plus delivers a better color match to Vitapan Classical shade guide than leading zirconia brands, the precise color match to Vita classic is a clear differentiator of Lava Plus to competitor systems.Some systems do not offer a dedicated shading system at all – so by definition there is no shading system available that is tailored to the zirconia offered.Even when a shading solution is part of the system often a precise shading just by using the liquids and instructions provided by the manufacturer is not possible. A lot of trial and error is required to find ways to successfully match colors with theses systems.With Lava Plus the technician gets the right shade from the start to finish his masterpiece with ease.Compared to other Zirconia Lava Plus offers better esthetics due to ist unique combination of shading and translucency. Technicians can achieve a better result with less effort due to the warm, natural and MATCHING colors of Lava Plus restorations and frameworks.
  • Lava dyeing liquids are applied after milling e.g. by immersing the porous green-state restoration into the liquid.Dyeing liquids completely penetrates the restoration, guaranteeing color throughout.
  • The unique technology used in the Lava Plus Dyeing liquids helps to better maintain the translucency after shading.Lava Plus was rated to have the highest monolithic zirconia crown translucency among top competitors.156512 Contrast Ratios of Uncolored and Colored Zirconia Materials G. SCHECHNER, R. DITTMANN, A. FISCHER, and H. HAUPTMANN, 3M ESPE, Seefeld, Germany Objectives:  Translucency combined with high strength is a major advantage of zirconia restorations. Also the possibility to shade zirconia turned out to be an important feature for frameworks but particularly for full contour indications. Aim of this study is to characterize the translucency of colored and uncolored zirconia materials -all claimed to be highly translucent- by their contrast ratio (CR) respectively opacity. Methods: Fully sintered zirconia sample disks (thickness 1mm, diameter 14mm) were prepared according to manufacturer's instructions. N=5 for each group. Surfaces on both sides were finally polished with 3µm diamond suspension. Uncolored group: LP: Lava Plus zirconia (3M ESPE), HT: Crystal HT (Dental Laboratory Milling Supplies), WZ: Zenotec Bridge Translucent (Wieland), ZH: Translucent ICE (Zirkonzahn). Colored group: Zirconia materials as above with the following shading liquids:  LPA3: Lava Plus A3 (3M ESPE), HTA3: Prettau A3 (Zirkonzahn), WZA3: Zr A3 (Wieland), ZHA3: Color Liquid A3 (Zirkonzahn). CR was recorded on a photospectrometer Color i7 (X-Rite Corp.). D65 lamp. Measuring mode: Remission contrast ratio. Aperture: 10mm. Specula: excluded. UV irradiation: on. Results: CR of uncolored zirconia materials (Fig.1): LP 69.0% [0.4], HT 70.3% [1.9], WZ 70.0% [0.9], ZH 74.4% [1.3]. CR of ZH is significantly lower compared to the others. CR of colored materials (Fig. 2): LPA3 76.8% [0.2], HTA3 79.7% [1.14], WZA3 83.2% [0.2], ZHA3 88.0% [1.3]. CR values of all colored groups are significantly different to each other. Conclusion:  Within the uncolored zirconia materials differences in their translucency can be detected; as a trend between LP, HT and WZ, significantly between ZH and all others. However, since zirconia commonly is used in its colored form the detected significant differences between all colored materials are of particular relevance. So, this study gives a valuable guideline to the practitioner to select a colored zirconia material with a translucency of his choice.
  • Lava™ Plus Custom Shading allows to achieve any shade and any shade gradient from inside the Lava Plus Zirconia.The general custom shading procedure comprises the following 4 steps:Custom shading outside with Lava Plus High Translucency Zirconia Dyeing Liquid.Custom shading inside with Lava Plus High Translucency Zirconia Dyeing Liquid.Characterization with Lava Plus High Translucency Zirconia Effect Shades.Sintering at 1.450°C
  • Lava Plus High Translucency Zirconia

    1. 1. Lava ™High Translucency Zirconia PlusExcellent esthetics ranging from all-zirconia to layered restorations.
    2. 2. Lava™ Plus High Translucency Zirconia The esthetics of a layered restoration from all-zirconia.  Provides unprecedented beauty and significantly higher translucency compared to other zirconia dental materials without compromising strength  Patented shading system enables highly esthetic all-zirconia or traditionally layered restorations  Excellent color match to the VITA® Classical Shade Guide and VITA SYSTEM 3D-MASTER® Shades  High strength allows tooth-preserving ≤0.5 mm minimum wall thickness— requiring 3X less occlusal preparation than lithium disilicate glass ceramic because of its 3X greater strength© 3M 2012
    3. 3. Lava™ Plus All-Zirconia Restorations —Key Benefits Require only minimal preparation (0.3 mm anterior, 0.5 mmm posterior) No Layering = Resists chipping – Ideal for Bruxers/Clenchers Cost effective tooth-colored, biocompatible alternative to metal Lava™ Plus All-Zirconia Restorations
    4. 4. Lava™ Plus High Translucency Zirconia –Unique Material Based on Special Chemistryand Processing. Reduced Alumina Content of 0.1 wt% ─ Greatly improved translucency Improved Alumina Distribution ─ Maintained aging stability Lava™ processing quality ─ Lava™ Strength and Precision Lava™ Plus Zirconia Dental Material© 3M 2012
    5. 5. Lava™ Plus High Translucency Zirconia –Unique Material Based on Special Chemistryand Processing. Segregated Al2O3 grains Irregular grain sizes PoresBranded Zirconia, Impuritiessegregated Alumina No-Name Lava™ Plus Zirconia High Translucency Zirconia3M ESPE Internal Data© 3M 2012
    6. 6. Lava™ Plus High Translucency Zirconia – Higher Translucency, Same Strength. Flexural Strength (MPa) 1200 1000 800 600 400 200 0 Lava™ Frame Lava™ Plus 3M ESPE Internal Data© 3M 2012
    7. 7. Lava™ Plus High Translucency Zirconia – Excellent Translucency 1- Contrast Ratio CR (%), Alumina Content (wt%) 30 25 20 15 10 5 <0.05% <0.05% <0.1% 0% <0.1% <0.05% 0% < 0.25% < 0.25% < 0.25% < 0.25% < 0.1% 0 Crysta™ ZENOSTAR Zr Cercon HT BruxZir® ZENOTEC ZR Crysta™ Prettau Crysta™ ICE Zirconia Lava™ Frame ZENOTEC ZR Lava™ Plus "Diamond" Translucent (Degudent) (Glidewell) Bridge Zirconia HT Zirconia Zirconia HS Translucent (3M ESPE) Bridge (3M ESPE) Zirconia Pure (Wieland) Translucent (DLMS) (Zirkonzahn) (DLMS) (Zirkonzahn) (Wieland) (DLMS) (Wieland) 3M ESPE Internal Data© 3M 2012
    8. 8. Lava™ Zirconia – Clinically Proven Performance Investigator Type of Restoration Years Restorations Framework placed/recalled success rate Burke et al.1 anterior & posterior 3- and 4-unit bridges 3 42 / 34 100% Raigrodski et al.2 posterior 3-unit bridges 5 20 / 19 100% Pospiech et al.3 posterior 3-unit bridges 5 31 / 21 100% Sorensen et al.4 posterior 3- and 4-unit bridges 3 55 / 45 100% Perry et al.5 anterior & posterior 3- and 4-unit bridges 2 16 / 16 100% Edelhoff et al.6 anterior & posterior crowns and bridges 1,75 91 / 83 100% Reich et al.7 posterior 3- and 4-unit bridges 5 30 / 23 96% Raigrodski et al.8 0.3 mm anterior crowns 2 20 / 20 100% Schmitt et al.9 0.3 mm anterior crowns, feather edge 3 19 / 17 100% THE DENTAL ADVISOR™10 anterior & posterior crowns and bridges 7 1500 / 574 100%© 3M 2012
    9. 9. Lava™ Zirconia Clinical Studies Booklet  To read more, visit 3MESPE.com/Lava© 3M 2012
    10. 10. Lava™ Plus Zirconia – All Current Indications Crown Primary Crowns Splinted Crowns Cantilever Bridges Inlay & Onlay Bridges Anterior Adhesive Bridges 3-unit Bridges 4-unit Bridges 5-unit Bridges 6-unit Bridge Curved and long-span Bridges Build Up for 2-Piece Abutment All Zirconia Crown and Bridge© 3M 2012
    11. 11. 3M ESPE Dental Cementation Recommendations For ultimate bond strength coupled with ease of use Simplicity powered by performance OR RelyX™ Ultimate Adhesive Resin Cement with Scotchbond™ Universal Adhesive RelyX™ Unicem 2 Self Adhesive Resin Cement© 3M 2012
    12. 12. Lava™ Zirconia + RelyX™ Ultimate = Excellent Bond Strength Shear Bond Strength (MPa) to Lava Zirconia 24 h 60 24h + 5,000 TC 40 20 0 RelyX Ultimate Panavia F2.0 Multilink Automix Clearfil Esthetic Scotchbond Universal -- Monobond Cement Plus Clearfil Cer. Primer 3M ESPE Internal Data© 3M 2012
    13. 13. RelyX™ Unicem 2 Automix Self-Adhesive ResinCement - High bond strength to Lava™ Zirconia Burgess et al, Material Proprerties of self-adhesive resin cements, IADR 2011, Abstract 2929
    14. 14. Lava™ Plus Dyeing Liquids  Patented technology — from the inventors of dental zirconia shading  Widest selection of dyeing liquids  18 colors, plus two bleach shades ─ Excellent color match to VITA® Classical A1-D4 shades ─ Direct conversion to most common VITA SYSTEM 3D-MASTER® Shades.© 3M 2012
    15. 15. Lava™ Plus – True Colors, Excellent Color Match to VITAPAN® Classical Competitor 1 Competitor 2 Lava™ Plus VITAPAN classical Shade Guide A4 A4 A4© 3M 2012
    16. 16. Lava™ Zirconia Shading – How does it work? Sinter Apply Lava™ Zirconia dyeing liquid© 3M 2012
    17. 17. Lava™ Plus – More Translucent When Shaded 1- Contrast Ratio CR (%) 30% unshaded unshaded unshaded unshaded unshaded unshaded 25% unshaded A3 20% A3 A3 A3 15% A3 A3 10% A3 5% 0% Crysta™ Zirconia HT Cercon HT Crysta™ "Diamond" ZENOTEC ZR Bridge ZENOSTAR Zr ICE Zirconia Lava™ Plus (DLMS)* (Degudent)* Zirconia (DLMS)* Translucent (Wieland) Translucent Pure Translucent (3M ESPE) (Wieland) (Zirkonzahn) * No dedicated shading solution - shaded with Zirkonzahn Prettau Color Liquid A3 3M ESPE Internal Data ,G. Schechner et al, Contrast Ratios of Uncolored and Colored Zirconia Materials, AADR 2012, Abstract 156512© 3M 2012
    18. 18. Lava™ Plus Custom Shading – Any Shade, Any Gradient from Inside 1 2 1. Custom shading outside with Lava Plus High Translucency Zirconia Dyeing Liquid. 2. Custom shading inside with Lava Plus High Translucency Zirconia Dyeing Liquid. 3 4 3. Characterization with Lava Plus High Translucency Zirconia Effect Shades. 4. Sintering at 1.450 C© 3M 2012
    19. 19. Lava™ Plus Color MarkersPredictable Custom Shading
    20. 20. Lava™ Plus Effect ShadesFor unprecedented lab customization
    21. 21. Lava™ Plus Fluorescent Effect Shade Relative Intensity (a.u.) 1.000 Lava™ Plus UV-Light High Translucency Zirconia 800 600 400 200 0 Unshaded Fluorescent Effect Shade -200 380 420 460 500 540 580 620 660 700 740 780 Wavelength (nm)
    22. 22. Lava™ Plus: Excellent Esthetics — Layered toAll-Zirconia Restorations Lava™ Plus Veneered Lava™ Plus All-Zirconia Lava™ Plus All-Zirconia with Vita® VM9 Custom Shaded + Vita Custom Shaded + Akzent Stains, Glazed Effect shades, Glazed
    23. 23. Strength of Zirconia and Lithium Disilicate 1800 1600 a a a a •―Lava Plus High Translucency 1400 showed improved translucencyBiaxial Flexural Strength (MPa) 1200 without compromising its mechanical properties‖ 1000 800 • 3X stronger than IPS e.max CAD* 600 b 400 c 200 0 Zenotec Bridge Lava Frame Lava Frame Lava Plus IPS e.max IPS e.max CAD Translucent FS3 Press MO1 LT A2Takahashi et al, Translucency and Biaxial Flexural Strength of Dental Ceramics, AADR 2012, Abstract 156649
    24. 24. Strength of All-Ceramic Restorations After Fatigue Fracture Force (N) 3000 1.5 mm 2500 0.6 mm 2000 1500 1000 500 0 1,2 mm 1,5 mm 1,5 mm 1,2 mm 0,6 mm IPS e. max CAD monolithic IPS e. max CAD Lava Zirconia Lava All-Zirconia cut-back VeneeredBurgess et al, Fracture Strength of All-Ceramic Restorations After Fatigue Loading, AADR 2012, Abstract 158346
    25. 25. Lava™ Plus Zirconia Strength EnablesTranslucency Similar to Glass Ceramics1- Contrast Ratio CR (%)40353025201510 5 0 IPS e.max CAD LT A3 Lava Plus A3 IPS e.max CAD LT A3 Lava Plus A3 1,5 mm 0,5 mm 1 mm thickness Mimimum occlusal thickness posterior crowns
    26. 26. Lava™ All-Zirconia – 2-Body Wear Test on Enamel Volumetric Enamel Wear @ 200K cycles(mm 3) 0,6 0,5 0,4 0,3 0,2 0,1 c b a a 0 Veneering Enamel Aged Polished Porcelain Lava™ Zirconia Lava™ ZirconiaBurgess et al, Wear of enamel opposing aged zirconia, AADR 2012, Abstract 156478
    27. 27. Lava™ Plus — Low Antagonist Wear Steatite Antagonist Loss (mm³) 0,18 0,16 0,14 0,12 0,10 0,08 0,06 0,04 0,02 0,00 Veneering initial aged - 5 h aged - 30 h Porcelain Lava™ Plus, PolishedR. DITTMANN et al, Wear Behavior of a New Zirconia after Hydrothermal Accelerated Aging , AADR 2012, Abstract 158142
    28. 28. Lava™ All-Zirconia Restorations —Easy to Adjust and Polish
    29. 29. Lava™ Plus Restorations —All-Zirconia Beauty
    30. 30. For additional questions, please visit ourwebsite www.3mespe.com or contact ourCustomer Care Center at 1-800-634-2249

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