While waiting to board my plane from Las Vegas after CEREC 27aah, I thought I would share some of the things I heard at this fantastic meeting. These are items that offer some food for thought and I have not yet spent enough time formulating my own opinions. Just wanted to share.

Gordon Christensen's organization did some work regarding e.max and full-contour Zirconium crowns. He commented that these products are sucking the last bit of breath out of the PFM. Also, full-contour Zirconium crowns are replacing gold crowns and can be placed effectively on preps resembling the full gold prep we learned in dental school.

Because of this huge uptick in these types of crowns, he had some suggestions regarding some problems that may present themselves, such as how do you remove them if that becomes necessary? His suggestions were to do buildups on all cases that need them to keep the crowns the ideal thickness and not really thick in some areas, which will make them harder to cut off. He also advocated cementing – not bonding – many of these crowns. Of course, only the ones with adequate retention, so that they can be removed easier as well. He further suggested to use NeoDiamond burs for removal as they performed better than any other burs, even burs manufactured and marketed for this specific application. In addition, they cost less than two bucks.

Gordon’s wife Rella showed that the biggest problem – which may not even be clinically significant – is something she called Glaze Fracture. She showed e.max and BruxZir cases where the glaze was fracturing and coming off on occlusal surfaces at a pretty fast rate. This affected occlusal surfaces only and smooth surfaces were doing well. It is too soon to tell if this is really a problem. I would have liked to have had a comparison to a longstanding PFM, to see if this is a problem we have been dealing with for a long time or if this is new and unique to these materials. Just keep this on your radar and we will see what the future holds.

Rella also mentioned that it is critical to use a polishing system on these crowns after occlusal adjustment. These consist of fine diamonds and a series of rubber points and cones. They are made and sold in kits from all of the major bur manufacturers. The unpolished surfaces that she showed looked really bad blown up on the big screen. Again, the long-term implications are unclear, but we should strive to do better.

So, as I said, just some things I picked up and wanted to share. I have paraphrased and believe I am accurate in my comments. Keep in mind however I was in Vegas for the last four days. In addition, I have not formulated my own opinions on some of these topics. So no suggestions, just information. On my way back to reality.