THE ADVANTAGES OF E4D RESTORATION

• E4D ceramic restorations offer a number of technical advantages. As the crown is fabricated and fitted in a single appointment, a larger, healthier portion of the tooth can be retained. In fact, the bond between the tooth and the ceramic is known to be stronger in the healthy enamel, allowing the preservation of certain walls that would have to be removed if the restoration were made in two visits. According to scientific studies, E4D ceramic restoration restores 98% of the strength of a natural, untouched tooth. This makes it more durable than white composite fillings;
• As this technology enables the patient to receive the restoration in a single visit, only one anesthetic is required. What’s more, there’s no need for a temporary restoration – a definite advantage, since temporary restorations tend to be brittle, peel off and can cause temporary pain on contact with cold. What’s more, in the case of temporary inlays, the temporary restoration is only held in place with temporary cement, so the remaining tooth is not yet as strong and is more at risk of breaking;
• E4D technology also uses a digital or video camera, depending on the generation used by the dentist. This camera creates a 3D model from which the ceramic part is designed. This eliminates the need to take impressions with standard materials, which can be difficult to tolerate or make some people gag.

THE BENEFITS OF CERAMICS

• Dental ceramics is the material that most closely resembles tooth enamel in terms of rigidity, texture and the way it reacts to temperature variations when eaten;
• In addition to being biocompatible, dental ceramic restores strength to damaged teeth;
• Ceramic provides chewing comfort, and its wear is comparable to that of natural teeth.

• E4D ceramic restorations are more expensive than amalgam (grey filling) or composite (white filling) restorations;
• A minimum thickness and width of natural tooth substance is required to achieve good strength;
• Finally, we need to take into account the time required to manufacture restorations (design, machining and firing). For the majority of cases involving more than 4 units, it is preferable to place the restorations in the mouth during a second visit. In this case, an impression is taken (either with a viscoelastic material, or with the E4D device and sent to the laboratory electronically). If 2 visits are necessary, the dentist prepares temporary restorations. Permanent restorations will be fabricated either by an external dental laboratory or by a team member using E4D technology. When restorations are fabricated in the clinic, the fabrication time is often shorter than when cases are sent to an external laboratory.

• Tooth fracture;
• Root canal treatment may be required if the fracture goes into the vital part of the tooth;
• Tooth loss if fracture too deep.

• The first step in designing an E4D ceramic restoration is to capture images of the preparation made by the dentist using a digital or video camera, depending on the generation of the device used;
• The restoration is then created virtually using a specialized computer program. The dentist can then analyze the preparation, define the contours and draw the restoration in 3D using several virtual tools. This is akin to technical drawing, used in many fields of technology. These are often referred to as CAD-CAM technologies (Computer Assisted Design-Computer Assisted Manufacturing). The drawing is then sent to a machining chamber;
• The dentist chooses the color and size of the ceramic block to be cut. A wide selection of aesthetically pleasing shades is available, as well as blocks with a color gradient to offer the patient a restoration that blends perfectly with the natural shade of his or her teeth. Some ceramics are also more resistant to fracture (E-MAXtm), and are indicated for reinforcing a short tooth that has lost height over the years through wear (attrition), or a fragile tooth in a patient who clenches or grinds their teeth (bruxism). There is also a category of pressed composite blocks (a family of polymers such as white fillings) which can be used in the same cases as those mentioned above. The size of the block is determined by the computer software according to the size of the restoration to be made;
• The next step is to insert the selected ceramic block into the machining chamber. This unit is equipped with two 5-axis rotating instruments, which cut the block and reproduce the 3D design created by the computer. A jet of water and oil is used to control temperature and reduce friction, so that the ceramic block is cut with the utmost precision. Machining takes between 5 and 20 minutes, depending on the type of restoration, block and machining equipment used;
• Some blocks require firing to reach their full strength. This is the case with E-Max ceramics and Zircon. Other ceramics can be glazed and kiln-fired to improve strength or to color them for superior aesthetics. This step is more time-consuming, which is why this type of restoration is slightly more expensive.
• The piece is then bonded with resin or glass ionomer cement in or on the patient’s tooth. The restoration is polished, and there is no delay before eating.

The cost of E4D crowns is similar to or lower than that of laboratory-made crowns, depending on the type of block or material used. However, since only one appointment is required, you save both time and money.