Cerpress SL (5 yr)

Consultants’ Comments

• “The most reliable ceramic system I have used.”
• “Inlays are undetectable.”
• “Crowns still look like new after 4 years!”

Description

Cerpress SL is a low-fusing, leucite-reinforced ceramic system indicated for anterior and posterior crowns, inlays/onlays and veneers. Restorations may be completely made of Cerpress SL or a Cerpress SL core may be overlaid with Sensation SL low-fusing porcelain and stains. Both contain leucite particles of 2-4 microns, dispersed in a glass matrix. Cerpress SL pressable ingots are available to the
laboratory in a variety of shades and translucencies, allowing the treatment of a wide range of clinical conditions.
> Highly Translucent – used with a light preparation color or with inlays/onlays to reflect the inner tooth color.
> Medium Translucent – designed for lighter shades, including the “Hollywood” shades; indicated for veneers and masking dark preparations.
> High Opacity – developed to mask very dark preparations, posts and tetracycline stain.
Shades available include all Vita shades plus translucent shades and “Hollywood” shades (A0, A00, B0 and B00) that are lighter than Vita B1. Cerpress SL received a 98% clinical rating.

Clinical Evaluation Protocol

• A total of 545 Cerpress SL restorations were placed
  in 151 patients and evaluated at insertion.
• Restorations included crowns, inlays/onlays, and veneers on 91 molars, 80 premolars and 374 anterior teeth.
• All restorations were seated with adhesive resin cements.
  415 restorations were recalled for evaluation, ranging from 1 to 5 years in service (Figure 1).
• Restorations were evaluated on a 1-5 rating scale:
  1=poor, 2=fair, 3=good, 4=very good, 5=excellent.

Categories evaluated at insertion:
• Overall laboratory product
• Shade match
• Vitality
• Fit of restoration
• Margin integrity
• Ease of adjustment/polish

Categories evaluated at recall:
• Resistance to fracture/chipping
• Shade match/esthetics
• Vitality
• Lack of marginal discoloration
• Wear resistance
• Patient satisfaction

Clinical Observations

Insertion

Ratings at insertion were very high, with 94% or more of the restorations receiving excellent ratings in each category (Figure 2). No ratings below 4 were noted. Cerpress SL produced excellent, life-like appearance with shades true to those requested. Over 99% of the restorations exhibited excellent fit and margins upon seating. Only minimal adjustments were required, and the ability to regain a high polish rated excellent in all cases.

Recall

Resistance to Fracture/Chipping
> After 5 years, over 98% of Cerpress SL restorations were fully intact (Figure 3). During the evaluation period, 8 restorations required replacement due to complete fracture: 4 anterior crowns at 1 year, 1 molar crown at 2 years, and 2 veneers plus 1 molar crown at 3 years.

Shade Match/Esthetics and Vitality
> Restorations maintained their esthetic appearance with no loss of gloss, shade change or staining (Figure 3).

Lack of Marginal Discoloration
> Restorations rated excellent for absence of marginal staining in 89% of cases (Figure 3). Eleven percent of the restorations showed slight microleakage, noted as black/gray stain visible at the ceramic margins. The majority of these were in anterior restorations, one of which was replaced due to marginal staining.

Wear Resistance
> One hundred percent of restorations rated excellent for wear resistance upon visual inspection (Figure 3).

Patient Satisfaction
> High patient satisfaction reflects the excellent ratings received in the other categories evaluated (Figure 3). Ninety-six percent of Cerpress SL restorations rated excellent for comfort and appearance, based on patient response.

Summary

Cerpress SL is an excellent pressable ceramic system for single-unit, metal-free restorations.

Clinical Tips

• Communication with the laboratory technician regarding desired appearance is critical to a successful case.
• A description of the preparation or “stump” shade will help the technician choose the proper translucency of material.