Focus on the individual needs of patients
The Inn-Keramik dental laboratory is located in the heart of the city of Innsbruck, Austria. There, three highly experienced dental technicians have been working together successfully for the past eleven years: they are Christoph Zobler, Max Wörishofer and Harald Gritsch, all dental technicians. In this second part of our interview with Christoph Zobler, he addresses the use of zirconium oxide and the press technique and the benefits of pressing a ceramic core on root posts.
Mr Zobler, what do you think of full-contour zirconium oxide restorations?
Christoph Zobler: Zirconium oxide is a great material for fabricating bridges, however, it is very hard. Therefore, particular attention must be paid to certain aspects. For instance, the jaw and the position of the teeth are not static. The situation changes over time. Consequently, a material needs to be used which is not too rigid. If this is not the case, long-term problems may arise which affect the teeth, the periodontal tissue or the temporomandibular joint. Therefore, we use zirconium oxide only as a framework material. As the veneering material we prefer to use an all-ceramic, for example IPS e.max ZirPress. It establishes a sound bond and it is etchable and fluorescent. In these areas, zirconium oxide shows certain limitations.
Could we have your opinion on the topic of chipping with regard to veneered zirconium oxide?
Christoph Zobler: No problems should arise, if your work is clean and accurate. In many cases, the blame for chipping is prematurely placed on the material or the bond. However, very different causes may be at the root of this problem. For example, the occlusion may not be in order. Alternatively, the dental technician may have modelled the inclination of the buccal cusps on the laterotrusion side too steeply. Whatever the case may be, the solution to preventing chipping should not be to use a harder material. As discussed, this approach would be completely inadequate. Instead, we should be tackling the causes of chipping altogether by seriously taking into account the patient’s individual chewing functions. Therefore, it is important for us to always focus on addressing the individual needs of our patients.
What about the press technique: Why are you so convinced of this classical method?
Christoph Zobler: We use the press technique, because it delivers high precision and quality and exceptional esthetics. Moreover, certain materials and products can only be used with this technique: for example, IPS e.max Press. In addition, the advanced Programat EP 5010 press furnace helps us to produce outstanding dental restorations. In other words, there are many reasons for liking this method.
You are known for your seamless margins and root posts with pressed-on ceramics.
Why do you use them?
Christoph Zobler: Yes, that‘s our speciality. We invented this technique. By pressing the ceramic material on the post, we can achieve a lifelike appearance in anterior restorations. We have the possibility of keeping the metal wedge very thin. Then we can control the light transmission, in other words, the brightness of the restoration, by means of the pressed-on ceramic. I don’t need an opaque metal or zirconium oxide framework, because I have a tooth-like pressed-on ceramic core on the metal post. As a result, I can continue my work with all-ceramics. I can etch the metal post with the pressed-on ceramic like I would IPS e.max. Consequently, I obtain optimum bonding results. The advantage of this technique is that several prepared front teeth in a row can be restored entirely with highly esthetic root posts and crowns made of the same all-ceramic material.
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©all pictures: Christoph Zobler, Innsbruck, Austria