Lava Ultimate · 2018. 3. 12. · 4 Background 3M ESPE utilizes nanotechnology, a science employed throughout multiple product lines at 3M, to develop the proprietary process used

Lava™ UltimateCAD/CAM Restorative

Technical Product Profile

2

Table of ContentsIntroduction ............................................................................................................................................... 3

Background .........................................................................................................................................4 – 5

Indications ................................................................................................................................................. 6

Preparation Guidelines ............................................................................................................................... 6

Step-by-Step Guide ................................................................................................................................... 7

Clinical Case .............................................................................................................................................. 8

Mechanical Performance ...................................................................................................................9 – 13

Flexural Strength and Flexural Modulus .....................................................................................9 – 10

Fracture Toughness ..................................................................................................................10 – 11

Flexural Fatigue Limit ..............................................................................................................11 – 12

Resiliency ......................................................................................................................................... 12

Compressive Strength ...................................................................................................................... 13

Wear Performance ...........................................................................................................................13 – 14

Two-Body Wear ................................................................................................................................ 13

Three-Body Wear ............................................................................................................................. 14

Restoration Fabrication and Placement ............................................................................................15 – 16

Millability ......................................................................................................................................... 15

Characterization, Adjustment, Intraoral Repair .................................................................................. 15

Cementation ..................................................................................................................................... 16

Esthetics ..........................................................................................................................................17 – 19

Polish and Polish Retention .............................................................................................................. 17

Plaque Resistance ............................................................................................................................ 18

Fluorescence .................................................................................................................................... 18

Stain Resistance .............................................................................................................................. 19

Customer Feedback .........................................................................................................................19 – 21

Technical Data Summary ......................................................................................................................... 22

References .............................................................................................................................................. 23

Bibliography ............................................................................................................................................ 23

3

IntroductionTechnical advances in hardware, software and materials provide dentists with new and improved options for indirect prosthetic treatments. CAD/CAM technologies are becoming more versatile, robust and offer more options to dentists and technicians for fabricating dental prosthetics. Fueling this trend are the development of intraoral scanning, faster and more accurate milling machines and stronger, tougher CAD/CAM materials. [1,2]

In recent years, perhaps the biggest driver in new material development is the desire to improve crown and bridge esthetics compared to the traditional porcelain-fused-to-metal or all-metal restorations. As such, zirconia, leucite-containing glass ceramics and lithium disilicate glass ceramics have become prominent in the dental practice. Each material type performs differently regarding strength, toughness, ease of machining and the final preparation of the material prior to placement. Location of production (e.g. chairside or at a dental laboratory) also determines material selection. For example, glass ceramics are typically weaker materials which limits its use to single-unit restorations; however mill times are relatively short, enabling chairside production. On the other hand, zirconia has a high fracture toughness which enables multi-unit restorations; however this material requires a long sintering procedure which excludes its use for fast chairside production.

3M™ ESPE™ Lava™ Ultimate CAD/CAM Restorative is a “new to the world” CAD/CAM product utilizing 3M’s revolutionary nanoceramic technology. This new material, called a Resin Nano Ceramic (RNC), is unique in durability and function. The material is not a resin or composite. It is also not a pure ceramic. The material is a mixture of both and primarily consists of ceramic. Like a composite, the material is not brittle and is fracture resistant. Like a glass ceramic, the material has excellent polish retention for lasting esthetics. These unique qualities enable the material to be named with the Lava™ brand, 3M ESPE’s premier brand for digital materials. This new material is highly heat cured through a controlled, proprietary manufacturing process, which eliminates the need for a firing step after milling. The material is easily machined chairside or in a dental lab, polishes quickly to an esthetic finish and if necessary, can be further adapted using light-cure restoratives.

Lava Ultimate CAD/CAM blocks perform similarly to or better than glass ceramic and composite materials. Lava Ultimate CAD/CAM restorative’s high fracture toughness, flexural strength and resiliency, assure that milled restorations will exhibit excellent durability. This enables 3M ESPE to offer an industry-leading 10-year warranty.

Lava Ultimate restorative is available as a block for chairside systems (eg. CEREC® and E4D) and as finished restorations from lab systems (Straumann® CARES®). 3M ESPE also plans to make the material available for Lava™ Milling Centers.

Benefits of Lava Ultimate restorative to the dentist and patient include:

• a faster procedure compared to other CAD/CAM materials: firing is not required and milling, polishing and adjustment are easier

• durability and shock absorption characteristics from a unique combination of mechanical properties

• intra-oral adjustability with light cured restoratives

introDuCtion

4

Background3M ESPE utilizes nanotechnology, a science employed throughout multiple product lines at 3M, to develop the proprietary process used to create the Resin Nano Ceramic. Lava™ Ultimate CAD/CAM Restorative is the direct result of this TRUE nanotechnology, which distinguishes itself by precise manipulation of the ceramic architecture at the nano scale (about 1-100 nm), yielding unique and controllable properties.[3] The nanotechnology in Lava Ultimate restorative is coupled with resin technology to achieve a combination of strength and esthetics beyond what current feldspathic ceramics or composite blocks offer.

Nanomer particles are monodisperse, nonaggregated, and nonagglomerated nanoparticles. Lava Ultimate restorative contains two types: silica nanomers of 20 nm diameter, and zirconia nanomers of 4 to 11 nm diameter. The engineered nanoparticles are treated with a silane coupling agent using a proprietary method. This functionalized silane bonds chemically to the nanoceramic surface and also bonds chemically to the resin matrix during manufacturing of the blocks.

Nanocluster particles consist of bound aggregates of engineered nanoparticles. Although structurally different from dense particles, these nanoclusters have structural integrity that allows a high proportion of ceramic filler to be incorporated into the blocks, which provides excellent strength, fracture and wear resistance properties. The zirconia-silica nanocluster particles in Lava Ultimate restorative are synthesized via a proprietary process from 20 nm silica particles and 4 to 11 nm zirconia particles; the nanoclusters are treated with the same silane coupling agent used with the nanomer particles. The average nanocluster particle size is 0.6 to 10 micrometers.

Lava Ultimate restorative was formulated using both nanomer and nanocluster fillers with a total nanoceramic material content by weight of approximately 80%. The addition of nanomer particles to formulations containing nanoclusters reduces the interstitial spacing of the filler particles, leading to higher nanoceramic content. The reinforced matrix (resin plus nanoparticles) is significantly harder and much more wear-resistant than resin alone. The resin has a unique chemical composition different from any light-cure or self-cure composite. Lava Ultimate restorative is processed multiple hours in a special heat treatment process. This unique formulation and processing results in a material that combines the high strength and wear resistance provided by nanoclusters with significantly improved polish retention and optical properties of the nanoparticles. (see Figure 1). The nanoceramic imparts excellent wear and polish retention properties. The new mill block technology is referred to as Resin Nano Ceramic (RNC).

Figure 1

5

BaCkgrounD

3M ESPE’s manufacturing process provides a final product that is highly cured and does not require firing in the dental lab or operatory. (Figure 2)

Lava™ Ultimate CAD/CAM Restorative is available in eight shades and two translucencies and are based on the VITAPAN® Classical Shade Guide. (figure 3, 4).

Figure 2

Figure 3Low Translucency (LT)A1-LT A2-LT A3-LT A3.5-LT B1-LT C2-LT D2-LT Bleach

High Translucency (HT)A1-HT A2-HT A3-HT B1-HT

Figure 4

• High speed polish in less than 4 minutes

• No firing step required

1

2 3

Photo shows shade range but is not meant for exact shade matching.

IndicationsPermanent, adhesive, single-tooth restorations including crowns, crowns over implants, inlays, onlays and veneers.

Preparation GuidelinesLava™ Ultimate CAD/CAM Restorations follow the same guidelines as all-ceramic restorations. Do not undercut. All internal edges and line angles should be rounded. Non-beveled shoulder finish lines are recommended.

≥ 0.5

≥ 0.6

≥ 0.4

≥ 1.5

≥ 0.6

≥ 0.4

Veneer

Onlay

≥ 1.5

5–6°≥ 1.5

≥ 1.5

5–6°≥ 1.5 ≥ 1.5

Inlay

Full Crown

≥ 1.5

≥ 1.5

≥ 1.0

≥ 1.5

≥ 1.0

≥ 1.5≥ 1.5

5–6°

≥ 1.5

≥ 1.0≥ 1.0

≥ 1.5

≥ 1.5

6

7

StEP-By-StEP

Step-by-Step Guide

1. Prepare the tooth according to the preparation guidelines.

6. Sandblasting with aluminum oxide ≤50 μm is recommended. Clean with alcohol and dry with air.

2. After design, choose your block size, shade and translucency, and mill your restoration. 7. If required by the selected

adhesive or self-adhesive resin cement, apply silane primer (e.g. 3M™ ESPE™ RelyX™ Ceramic Primer) to the bonding surface of the restoration. Dry for 5 seconds.

3. Remove the sprue and finish the restoration.

4. Try in the restoration. Check the occlusion and adjust the contacts, if needed.

8. Use an adhesive or self-adhesive resin cement in accordance with the Instructions for Use.

Finishing and Polishing Bonding/CementationPreparation

Final Lava™ Ultimate CAD/CAM Restoration.

5. Smooth the restoration with a disc, e.g. Sof-Lex™ Discs. For final shine apply polishing compound with bristle brush.

Do not firE. With a Resin Nano Ceramic, esthetics are created with the polishing step.

8

Clinical Case

Initial situation: Fractured glass ceramic partial crown needs to be replaced.

Preparation according to the guidelines for CAD/CAM restorations.

Final restoration made with Lava™ Ultimate CAD/CAM Restorative.

9

MEChaniCaL PErforManCE

Mechanical PerformanceDetails specific to the test methods will be given in the subsequent individual testing sections. Statistical analysis was performed with Minitab 15 using Analysis of Variance (ANOVA) and two-sample t-tests with a 95% confidence level (p<0.05 confidence). Error bars on plots represent +/- one standard deviation.

Flexural Strength and Flexural ModulusFlexural strength is measured by applying a load to a material specimen that is supported at each end, which combines the forces found in compression and tension. Flexural modulus is a measure of a material’s stiffness; low modulus indicates a flexible material.

Flexural strength and modulus were measured according to ISO 6872, modified to accommodate bar sizes that could be sectioned from commercially available mill blocks. Bar-shaped specimens with dimensions 1mm x 4mm x ~12mm were cut from blocks, then polished. Testing was conducted using a test fixture with a 10mm span and a crosshead speed of 1mm/min.

0

50

100

150

200

Flex

ural

Stre

ngth

(MPa

)

IPS Empress®

CADVITABLOCS®

Mark IITetric

EvoCeram®

Paradigm™

MZ100Lava™ Ultimate

CAD/CAM Restorative

The flexural strength of Lava™ Ultimate CAD/CAM Restorative was statistically higher than that of Paradigm™ MZ100, Empress® CAD, VITABLOCS® Mark II and Tetric EvoCeram®.

Figure 5Source: 3M ESPE internal data

10

0.0

0.5

1.0

1.5

2.0

2.5

IPS Empress®

CADVITABLOCS®

Mark IIParadigm™


CAD/CAM Restorative

Frac

ture

Tou

ghne

ss K

1c (M

Pa m

0.5 )

The flexural modulus of Lava™ Ultimate CAD/CAM Restorative was statistically lower than that of Empress® CAD and VITABLOCS® Mark II, statistically not different from Paradigm™ MZ100, and statistically higher than Sinfony™. The flexural modulus of Lava Ultimate restorative is similar to the values reported for human dentine.

As postulated by Magne, et al,[4] a lower flexural modulus correlates to increased deformation under load, suggesting that Lava Ultimate restorative is more likely to absorb the stress than glass-ceramics. In addition, the combination of high strength with low modulus translates to greater resilience.

Fracture ToughnessThe values reported for fracture toughness (K1c) are related to the energy required to propagate a crack. In this test, a defined notch is cut into the bar of material. The bar is placed on a fixture that supports either end and the stylus is positioned above the notch in a 3-point bend configuration similar to that used for flexural strength. A high fracture toughness reflects a high ability of a material to hinder crack propagation.

Fracture toughness was measured according to ISO 6872, modified to accommodate bar sizes that could be sectioned from commercially available mill blocks. A notch was cut using the V-notch option in bar-shaped specimens with dimensions 3mm x 4mm x 14mm. Testing was conducted on a test fixture with a 10mm span and a crosshead speed of 0.5mm/min. K1c was calculated from the failure load, notch depth, and specimen dimensions.

The fracture toughness of Lava Ultimate restorative was statistically higher than that of Paradigm™ MZ100, Empress CAD, and VITABLOCS Mark II.



Fixture

Sample Notch

Anvil

Instron Fixture

0

10,000

20,000

40,000

30,000

60,000

50,000

Flex

ural

Mod

ulus

(MPa

)

IPS Empress®

CADVITABLOCS®

Mark IISinfony™ Paradigm™


CAD/CAM Restorative

11

MEChaniCaL PErforManCE

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

100 150 200 250

Frac

ture

Tou

ghne

s K1

C (M

Pa m

^1/

2)

Flexural Strength (MPa)

Lava™ Ultimate CAD/CAM Restorative

Paradigm™ MZ100

Typical Glass Ceramics

Figure 8, shows a schematic of material fracture toughness (K1c) vs. flexural strength for various material classes. Fracture toughness range for glass ceramic materials was determined from literature values (see orange area in Figure 8). Paradigm™ MZ100 provides greatly enhanced mechanical properties compared to glass ceramics. The Lava™ Ultimate CAD/CAM Restorative provides further improvement over Paradigm MZ100 and provides substantially greater resilience compared to brittle glass ceramic materials.

Flexural Fatigue LimitThe initial flexural strength of dry samples is the parameter most used to compare materials regarding strength. However, clinical use introduces a moist and functional environment. This investigation looks at the difference between the initial strength under dry and wet conditions and at the flexural fatigue limit of Lava Ultimate restorative as compared to a acrylic CAD composite, a feldspathic glass ceramic and a lithium disilicate glass ceramic material.

Initial strength of Lava Ultimate restorative, VITA CAD-Temp®, IPS Empress® CAD and IPS e.max® CAD was determined according to ISO 6872 in a 3-point-bending geometry. Both dry and wet conditions were investigated. Flexural fatigue limit was determined according to the staircase method for 10,000 cycles at 10 Hz. A sinusoidal load was applied under water using the same 3-point-bending geometry as for the initial strength tests.


Figure 8 Fracture Toughness vs. Fluexural StrengthSource: 3M ESPE internal data

0.1 1 10 100 1,000 10,000 100,000 1,000,000 10,000,000

Stre

ss L

oad

(MPa

)

Number of cycles

Lithium Disilicate

Resin Nano Ceramic

-222 MPa

-59 MPa

0

100

200

300

400

500

600

Initial Strength (Dry Conditions)

Fatigue Strength (Wet Conditions)

12

Lava™ Ultimate CAD/CAM Restorative was the only material investigated that maintained its initial strength when changing from dry to wet conditions. Initial strength of Lava Ultimate restorative was higher than the feldspathic glass ceramic and the CAD acrylic composite and lower than lithium disilicate. All materials show a decrease in strength upon cycling fatigue in water. The flexural fatigue limit (FFL) of Lava Ultimate restorative is at 74% of its initial dry strength whereas the lithium disilicate material can only maintain 50%. FFL of feldspathic glass ceramic and CAD acrylic composite was at 64% of the initial dry strength.

Based on its high flexural strength and high fatigue resistance, the material is ideal for challenging cases like implant crowns. 3M ESPE provides an industry-leading 10-year warranty for the material.

ResiliencyResiliency is the capability of the material to absorb energy when it is deformed elastically and then to recover its size and shape upon unloading. In other words, it is the maximum energy per unit volume that can be elastically stored. It is represented by the area (integral) under the curve in the elastic region (the initial, linear portion) of the stress-strain curve; the units are of pressure (MPa).

The modulus of resilience of Lava Ultimate restorative is statistically significantly higher than VITABLOCS® Mark II, Empress® CAD, IPS e.max® CAD and Paradigm™ MZ100. This means that Lava Ultimate restorative can absorb significantly more stress than these materials without suffering permanent deformation or failure.



0

100

200

400

300

600

500

IPS e.max® CAD IPS Empress® CAD VITA CAD - Temp® Lava™ Ultimate CAD/CAM Restorative

Initial Strength dry (MPa)Initial Strength in water (MPa)Flexural Fatigue Limit at 10Hz, 10k cycles in water (MPa)

0.0

0.5

1.0

2.0

1.5

2.5

VITABLOCS®

Mark IIIPS Empress®

CADIPS e.max®

CADParadigm™


CAD/CAM Restorative

Mod

ulus

of R

esili

ency

(MPa

)

13

wEar PErforManCE

Wear Performance

Two-Body WearTwo-body wear of human enamel on the test materials was measured at the Minnesota Dental Research Center for Biomechanics and Biomaterials (MDRCBB) at the University of Minnesota. In this test developed by DeLong[5] and coworkers, a human third molar palatal cusp abrades the test material in a computer-controlled motion that mimics natural chewing. The surface topography of the enamel and test material is profiled before and after abrasion with a contact digitizer, allowing volume loss of both the test material and the antagonist cusp.

The wear of Lava Ultimate restorative material is statistically not different from that of IPS Empress® CAD and IPS e.max® CAD.

Compressive StrengthCompressive strength is of particular importance because of chewing forces. Rods are made of the material and simultaneous forces are applied to the opposite ends of the sample length. The sample failure is a result of shear and tensile forces.

Figure 13Source: University of Minnesota

0.00

0.04

0.02

0.08

0.06

0.14

0.16

0.12

0.10

0.18

IPS e.max® CAD IPS Empress® CAD

Mat

eria

l Vol

ume

Loss

(mm

3 )


0

50

100

150

200

250

300

350

400

Com

pres

sive

Stre

ngth

, MPa

IPS Empress® CAD Lava™ UltimateCAD/CAM Restorative

Paradigm™

MZ100 BlockVITABLOCS® Mark IIIPS e.max CAD

Lava™ Ultimate CAD/CAM Restorative has similar or higher compressive strength than leading chairside materials.


14

Three-Body WearThree-body-wear of Lava Ultimate restorative, IPS e.max® CAD, IPS Empress® CAD, VITABLOCS® Mark II, Esthet-X®, Paradigm™ MZ100, and Tetric EvoCeram® was determined with an ACTA Wear Machine (ACTA, Amsterdam, NL). The material loss in μm was measured after 200,000 cycles with a profilometer.

The three-body wear rate of Lava Ultimate restorative material is significantly lower than that of the composites investigated. The glass ceramic materials showed nearly no wear in this test. For human enamel three-body-wear values in the range of 10 μm to 60 μm were reported (ACTA method, 200k cycles, Spiegl et al, #1288 IADR 03, #0175 CED 07). The resin nano ceramic material was found to be much more wear resistant than composite and closer to the lower values reported for enamel than glass ceramic materials.

Lava Ultimate restorative offers a balanced wear resistance — it exhibits a significantly higher wear resistance than composites and is better able to “give way” as compared to glass ceramic materials.


0

10

5

20

15

30

25

35

IPS e.max® CAD

IPS Empress®

CADVITABLOCKS®

Mark IIEsthet-X® Paradigm™

MZ100

Mat

eria

l Los

s at

200

k Cy

cles

(µm

)

TetricEvoCeram®


Lava™ Ultimate CAD/CAM Restorative wear on enamel is statistically significantly lower than that of IPS Empress CAD, and IPS e.max CAD. Lava Ultimate restorative is gentle to opposing enamel.

Figure 14Source: University of Minnesota

0.00

0.04

0.02

0.08

0.06

0.14

0.16

0.12

0.10

0.18

IPS e.max® CAD IPS Empress® CAD

Enam

el A

ntag

onis

t Vol

ume

Loss

(mm

3 )


rEStoration faBriCation

Restoration Fabrication and Placement

MillabilityThe ability to mill materials was qualitatively assessed by examining the margins on MOD Inlays milled on a chairside mill in “Fast Milling” mode. Milled samples were examined under scanning electron microscopy (SEM).

The images in Figure 16 show that the excellent millability of Lava™ Ultimate CAD/CAM Restorative provides better marginal quality than glass ceramics. The low brittleness of Lava Ultimate restorative results in excellent machinability, ease of adjustment and cutting, and suggesting less fragility at try-in.

Characterization, Adjustment, Intraoral RepairLava Ultimate restorative offers the dentist a high degree of versatility in characterization, adjustment, and repair/service. Light-cured composites and stains can be bonded directly to Lava Ultimate restorations with a simple procedure (Figure 17) that can be done intra- or extra-orally. This sets Resin Nano Ceramic material apart from glass ceramics.

The material is especially suited for use as a crown over an implant; in this case, it is possible to obtain access to the retention mechanism through the crown, and reliably re-seal with light cured restorative materials to maintain the original crown esthetics.

Figure 17


Lava™ Ultimate CAD/CAM Restorative

Lithium disilicateFeldspathic glass ceramic

15

16

CementationShear bond strength of steel cylinders bonded to disks of the test materials was measured after 24 hours water storage and 5000 thermocycles. RelyX™ Unicem 2 Automix Self-Adhesive Resin Cement was used for all groups. For all glass ceramics, the manufacturers’ instructions were followed: hydrofluoric acid etch, rinse, silane priming, bonding. Lava™ Ultimate CAD/CAM Restorative specimens were prepared by sandblasting.

All materials showed high bond strength to RelyX Unicem 2 Automix cement. However, the bonding procedure with Lava Ultimate restorative is significantly easier — no HF etch, no silanation and no bonding (when using RelyX Unicem cement).


0

10

20

50

40

30

70

60

IPS e.max® CAD IPS Empress® CAD VITABLOCS® Mark II Lava™ UltimateCAD/CAM Restorative

SandblastHF Acid Etch, Silane, Monobond Plus

24 hours5,000 Thermocycles

Shea

r Bon

d St

reng

th (M

Pa)

17

ESthEtiCS

Esthetics

Polish and Polish RetentionThe polish retention property of Lava™ Ultimate CAD/CAM Restorative is similar to glass ceramics and better than composite blocks.

Tiles of 2mm thickness were cut from blocks. The surfaces were polished wet using a variable-speed grinder-polisher to ensure a uniform surface. They were stored in water at 37ºC for 24 hours. The samples were brushed with toothpaste and a toothbrush that was mounted on an Automatic Toothbrush Machine. Gloss measurements were taken after 6,000 toothbrush strokes.

Lava Ultimate restorative has statistically higher polish retention than Paradigm™ MZ100, Esthet-X®, and Tetric EvoCeram®, and statistically not different polish retention from IPS e.max® CAD, IPS Empress® CAD, and VITABLOCS® Mark II after 6000 toothbrush cycles. Lava Ultimate restorative displays outstanding polish retention, which far exceeds typical composites and is comparable to glass ceramics.


0

10

20

30

40

50

60

70

80

90

100

IPS e.max® CAD

IPS Empress®

CADVITABLOCS®

Mark IIEsthet-X® Paradigm™

MZ100Tetric

EvoCeram®Lava™ Ultimate

CAD/CAMRestorative

Glos

s (%

)

18

FluorescenceThe fluorescence of Lava Ultimate restorative was designed to match natural dentition. In a study by Monteiro, fluorescence match was determined visually using UV lighting; photographic images were collected with a digital camera (Figure 21).

These results show that Lava™ Ultimate CAD/CAM Restorative demonstrates plaque resistance equivalent to glass ceramics, and demonstrates greater plaque resistance than enamel itself. Toothbrushing abrasion did not affect the plaque resistance of Lava Ultimate restorative.

Plaque ResistanceTwo groups of disks were prepared for each material: polished, and polished followed by toothbrush abrasion. Bovine enamel disks served as a control. Plaque was grown on the material disks and on bovine enamel using original human saliva from a volunteer; all specimens were sterilized via ethanol prior to incubation. Plaque was collected and freeze-dried to determine plaque biomass.

Figure 20 Dried biomass in mg/cm2 (grown in human saliva for 26 hours)Source: 3M ESPE internal data

Figure 21

Photo courtesy of Paulo Monteiro DMD, MSC, Assistant Professor

0.0

0.5

1.0

1.5

2.5

3.5

2.0

3.0Polished

Toothbrushed

IPS Empress®

CADIPS e.max®

CADEnamelControl


Drie

d Bi

omas

s (m

g/cm

2 )

19

fiELD EvaLuation

Lava™ Ultimate CAD/CAM Restorative shows stain resistance that is superior to composite materials, and similar to some glass-ceramic materials. The excellent stain resistance of Lava Ultimate restorative helps provide long-term color stability.

Customer FeedbackA total of 195 restorations (including inlays, onlays, crowns, crowns on implant abutments and veneers) were completed by 44 evaluators selected by an independent agency. 98% of evaluators indicated the overall esthetics of a restoration made with Lava Ultimate restorative were acceptable for use in the posterior.

Stain ResistanceOne millimeter thick tiles of each material were immersed in red wine for 7 days at 37°C. CIELAB color was measured on a spectrophotometer before and after immersion.

Figure 22Delta E color change after 7 days storage in red wine at 37°CSource: 3M ESPE internal data


0

5

10

15

20

25

30

35

40

45

IPS e.max® CAD

IPS Empress®

CADVITABLOCS®

Mark IIQuixx®Tetric

EvoCeram®Lava™ Ultimate

CAD/CAM Restorative

Acceptable98%

20

Figure 24

Source: 3M ESPE internal data

On average, it took evaluators 3.7 minutes to polish a crown made of Lava™ Ultimate CAD/CAM Restorative.

Figure 25


1

3

2

5

4

Time to Mill

Very Satisfied

Satisfied

Dissatisfied

Very Dissatisfied

Neutral

Ability to Achieve Desired Anatomy

Ability to Achieve Desired Marginal Edge

Evaluators were satisfied with the milling characteristics for all types of restorations.

Figure 26

Source: 3M ESPE internal dataShade of the Restoration In Vivo

Effort Required to Achieve Desired Polish

Overall Polish, Gloss and Smoothness of the Finished Restoration

Blending of the Restoration with the Surrounding Dentition

Time Required to Achieve Desired Polish

0% 20%

% of Respondents

40% 60% 80% 100%

86%59% 27%

59% 23% 82%

50% 32% 82%

48% 32% 80%

Satisfied (Rated 4) Very Satisfied (Rated 5)

84%50% 34%

Over 80% of evaluators were satisfied with the features related to polish and esthetics.

3.7 Minutes

21

fiELD EvaLuation

Figure 27


Ease of Polish

Time to Polish

Milling Time

Time after Milling Until Seating

Blending with Neighboring Dentition

Esthetics of Final Posterior Restoration

Cementation

Shade Selection

0% 10% 30% 50% 70% 90%20%% of Respondents

40% 60% 80% 100%

Lava Ultimate is

SameBetterMuch Better

33% 39% 19%

60% 20%

54%

72%

17%

3 3 37% 43% 14%

6% 51% 31% 9%

66% 20% 11%

86% 11% 3

3

We asked evaluators to tell one thing they liked best about Lava™ Ultimate CAD/CAM Restorative.

• The ability to shape and contour Intraorally

• The way that Lava Ultimate restorative shades blend with the natural teeth

• Easy to polish

• Great shine

• It’s great to be able to add-on or build up intraorally if necessary

• Fit and margins

• Fast, no firing

• Ease of milling

• Smooth finish right out of milling unit

• The ease of adjusting the occlusion

• It’s easy to add to. I didn’t realize that we had exposed dentin on part of the occlusal surface and it was easy to do a mini cavity prep which solved the problem.

• Shade compatibility

• The potential of really making a crown from start to finish, prep to seating, within one morning or one afternoon.

• Because it is so fast to finish, Lava Ultimate may accelerate the process by a critical 30 minutes.

For a CROWN, evaluators rated 5 out of 8 attributes better compared to their current product (average rating > 3.0).

22

Lava™ Ultimate CAD/CAM Restorative Technical Data Summary

Lava™ ultimate CaD/CaM

restorative

Fracture ToughnessK1c 2.02

StDev 0.15

Flexural StrengthMPa 204.00

StDev 19.00

Flexural ModulusMPa 12.80

StDev 1.00

Modulus of Elasticity (GPa) MPa 12.77

StDev 0.99

3-Body ACTA Wear Material Loss at 200k Cycles (μm) um los 6.3

StDev 0.4

Compressive Strength MPa 383

StDev 32

23

rEfErEnCES

References[1] Christensen GJ. “In-office CAD/CAM milling of restorations. The future?” J Amer Dent Assoc 2008;

139: 83-85.

[2] Poticny DJ, Klim J. “CAD/CAM in-office technology.” J Amer Dent Assoc 2010; 141: 5S-9S.

[3] “US Nanotechnology Initiative.” <http://www.nano.gov/>.

[4] Magne P, Paranhos MP, Burnett LH Jr, Magne M, Belser UC. “Fatigue resistance and failure mode of novel-design anterior single-tooth implant restorations: influence of material selection for type III veneers bonded to zirconia abutments.” Clin Oral Impl Res. 2011 Feb; 22 (2): 195-200. 157 (University of Southern California)

[5] DeLong R, Douglas WH. “Development of an artificial oral environment for the testing of dental restoratives: bi-axial force and movement control.” J Dent Res. 1983 Jan; 62 (1): 32-6.

BibliographyFasbinder DJ, Dennison JB, Heys D, Lampe K. “Clinical Evaluation of CAD/CAM-Generated Polymer Ceramic Inlays.” J. Dent. Res. 80 (AADR Abstracts #1882), 2001. (University of Michigan)

Dental Products

3M CenterBuilding 275-2SE-03St. Paul, MN 55144-1000U.S.A.1-800-634-2249

3M Canada

Post Office Box 5757London, Ontario N6A 4T1Canada1-888-363-3685

3M, ESPE, Filtek, Lava, Paradigm, RelyX, Sinfony and Sof-Lex are registered trademarks of 3M or 3M Deutschland GmbH. Used under license in Canada. © 3M 2011. All rights reserved.

Straumann® and/or other trademarks and logos from Straumann® that are mentioned herein are the trademarks or registered trademarks of Straumann Holding AG and/or its affiliates. All rights reserved. CARES® is a registered trademark of Straumann Holding AG. E4D is a registered trademark of D4D Technologies. IPS Empress, IPS e.max and EvoCeram are registered trademarks of Ivoclar Vivadent AG, Schaan, Liechtenstein. CEREC is a registered trademark of Sirona Dental Systems. VITABLOCS, VITAPAN and CAD-Temp are registeredf trademarks of Vita Zahnfabrik H. Rauter GmbH & Co. KG, Bad Säckingen, Germany. Esthet-X and Quixx are registered trademarks of Dentsply International Inc.

Please recycle. Printed in U.S.A. 70-2009-0500-3

Customer Care Center: 1-800-634-2249 www.3MESPE.com/Lava

Documents

Lava Ultimate · 2018. 3. 12. · 4 Background 3M ESPE utilizes nanotechnology, a science employed throughout multiple product lines at 3M, to develop the proprietary process used