Courtesy of Inside Dentistry:
With respect to emerging technologies and current materials available today, clinicians look for three main attributes in a restorative material: durability, versatility, and esthetics. For the past 4 years, I have chosen lithium disilicate (IPS e.max®) nearly exclusively in my practice for my indirect restorative solutions, because of the way it measures up to each of these three desirable characteristics.
Durability and Strength
Lithium disilicate has a flexural strength many times stronger than other pressed or stacked porcelains commonly used to restore teeth. Clinicians using this material for restorations in the anterior or the posterior can do so with the peace of mind knowing that, when properly used and designed, this material has a higher probability of holding up and serving the patient well over an extended period of time, resulting in higher patient satisfaction and fewer remakes.
Furthermore, as a result of lithium disilicate's strength, restorations can be made as thin as 0.3 mm thick when bonded to enamel. This not only makes it easier for a clinician to achieve a predictable color match because of the material's enamel-like translucency, but allows more conservative preparations- and where we have more enamel, we tend to have longer-lasting restorations.
For the past 4 years, I have chosen lithium disilicate nearly exclusively in my practice for my indirect restorative solutions." Dr. Marshall Hanson (Arizona)
Versatility and Handling
Clinicians who strive for simplicity and predictability can find both in the versatility of lithium disilicate. This one material can offer appropriate restorative solutions for both anterior and posterior teeth, both full-coverage and partial-coverage restorations, bonded or cemented, implant-born or tooth-born. It is a material that can have a place in most situations. Additionally, there are enough ingots available to allow a clinician to just as predictably block out a dark tooth or titanium implant abutment as intentionally permit the underlying tooth structure to show through to create a natural look.
The properties of lithium disilicate allow the material to be adjusted by a high-speed hand piece with less risk of fracture propagation when compared with other types of porcelain. It can be easily hand-polished within seconds, even with a single rubber wheel, back to a flawless glossy shine as if it had never been touched. The versatility and handling properties of this material make our desired restorative goals simpler and more predictable to achieve.
Esthetics: The Material's Ability to Mimic Nature
Most of my current restorative work is accomplished using in-office CAD/CAM to create my own partial-and full-coverage crowns for my patients. In my efforts to create natural-looking restorations that can blend in with the surrounding dentition, I have yet to find an indirect material that appears more enamel-like (both macro and microscopically) (Figure 5 and Figure 6) than lithium disilicate. Simply because of the material's properties, I have found there is often little to no need for even cutbacks and layering to get the restoration into the zone of "realistic." In my opinion, lithium disilicate is one of the most promising esthetic, enduring and versatile indirect materials available to clinicians today.
In fact, Ivoclar Vivadent believes so strongly in this product that they have created a consumer website: www.smiletothemax.com It's a great resource for patients.