Consultants’ Comments

• “Very esthetic.”
• “Restorations required no adjustment.”

Purpose:

IPS e.max CAD blocks are indicated for the fabrication of crowns, inlays and onlays. The material is lithium disilicate that is uniquely processed to provide both esthetics and strength. In block form, IPS e.max CAD is easy to mill and adjust with strength of 160 MPa. After sintering, the final restoration has strength of 360 MPa and excellent esthetic properties.

Clinical Evaluation Protocol:

Between June 2006 and August 2015, 1079 IPS e.max CAD restorations were placed (Figure 1), the majority during the five-year period between 2010 and 2015. Recall data were available for 758 restorations, of which there were 734 crowns, 15 inlays and 9 onlays (Figure 2).

Results at 5 years:

At the 5-year recall, the following clinically relevant attributes were measured on a scale of 1 to 5 (1=poor, 2=fair, 3=good, 4=very good, 5=excellent): esthetics, resistance to chipping/fracture, resistance to marginal discoloration, resistance to wear, and retention.

Esthetics

At recall, 96% of IPS e.max CAD restorations received an excellent rating for esthetics, and 6 of the remaining 7 restorations received a rating of very good (Figure 3).

Resistance to Chipping/Fracture

At recall, 95% of the IPS e.max CAD restorations received an excellent rating (Figure 3). Two percent of the restorations chipped but did not require replacement. Four crowns fractured and were replaced; one of these was in a patient who is a bruxer and was not using his splint.

Resistance to Marginal Discoloration

Among the recalled restorations, 96% had no visible marginal discoloration and were rated excellent (Figure 3). All other restorations receiving a rating were rated very good. For one restoration, the lower rating was associated with recurrent caries.

Wear Resistance

The wear resistance of IPS e.max CAD restorations was excellent at recall (Figure 3). There were no replacements due to wear.

Retention

Retention was excellent (Figure 3). Eleven restorations, all crowns, debonded and were recemented. This was not attributable to a particular cement.

Summary

IPS e.max CAD offers excellent esthetics and wear resistance, and was rated highly for resistance to chipping/fracture, and resistance to microleakage and staining. Retention was excellent and no wear was reported for any restoration. IPS e.max CAD received a clinical performance rating of 98% at five years.