Clinical Guide

All ceramic,
all you need.
 All ceramic,
all you need
An all-ceramic system for all applications
in fixed denture prosthetics

2
Table of contents

IPS e.max® – All ceramic, all you need  4

An all-ceramic system for all applications  5
Fields of application  6

Working steps for restorations made with IPS e.max® materials  7

Overview of working steps  7
Tooth shade determination  8
IPS e.max® Shade Navigation App (SNA) 9
General preparation guidelines for all-ceramics  10
Preparation guidelines for lithium disilicate glass-ceramics (LS2)  11
Preparation guidelines for zirconium oxide (ZrO2)  12
Guidelines for bridges made with lithium disilicate glass-ceramics (LS2) and zirconium oxide (ZrO2)13
Shade determination on the prepared tooth  14
Digital / analog impression  14
Temporary restoration  15
Try-in / Cleaning on the restoration  15
Preparing for cementation  16
Cementation Navigation System (CNS)  18
Adjustments and intraoral / extraoral polishing  19
Protection / Care  19

Clinical cases with IPS e.max® zirconium oxide (ZrO2)  20

Posterior crown cemented with Speedcem® Plus  20
Posterior bridge cemented with Speedcem® Plus  22

Clinical cases with IPS e.max® lithium disilicate (LS2)  24

Veneer cemented with Variolink Esthetic 
®
24
Onlay cemented with Variolink® Esthetic  26
Anterior crown cemented with Multilink® Automix  28
Anterior bridge cemented with Speedcem® Plus  30
Hybrid abutment and crown cemented with Speedcem® Plus  32
Screw-retained hybrid abutment crown  34

Documented clinical reliability  36

Scientific data and results from more than 10 years of research  37

IPS e.max® Patient Identifaction Card 38

IPS e.max® Guarantee  39

3
 IPS e.max – All ceramic, all you need | An all-ceramic system for all applications

Tex

IPS e.max –
HB
Pfad ISC

N
KLI
Text

all ceramic, all you need ISC

H BEWÄHR
10
ZrO

T
N
JAH

KLI
LS2
ZrO2 &

IE
10

NT
JAH RA
RE GA

N
CLI
IPS e.max is synonymous with exceptional esthetics
and dependability. It is the most widely used all-ceramic
ALL
Y PROV
IC E
system in the world (1). Since the system’s introduction 0

1
N
N
CLI
more than a decade ago, its innovative and reliable
components have thoroughly impressed scientists, & LS2
ZrO2

EE
dentists and patients alike.

NT
0
1
A YE
ARS GUAR

0 mm
über 3

Exceptional
esthetics
like the natural model

Maximum
flexibility
adhesive, self-adhesive or
conventional cementation

Complete Extensive
confidence application spectrum
96% survival rate (2) : an appropriate material
More than 10 years of for every situation
documented clinical success

1
 Based on sales figures
2
 IPS e.max Scientific Report, vol. 03 / 2001 – 2017, Ivoclar Vivadent AG, Schaan, Liechtenstein

4
 IPS e.max – All ceramic, all you need | An all-ceramic system for all applications

An all-ceramic system for all applications

The reliable IPS e.max materials offer suitable solutions for all types
of all-ceramic applications  –  from thin veneers to long-span bridges.

The system comprises two different types of materials: proven lithium disilicate glass-ceramic
and high-strength zirconium oxide. The materials ideally complement each other and open up
a wide range of possibilities to simplify and streamline restorative processes  –  from minimally
invasive preparation to conventional cementation.

Lithium disilicate glass-ceramic (LS2 )

Lithium disilicate glass-ceramic is ideally suited for the fabrication of
hybrid abutments and monolithic single crowns and can even be used
for 3-unit bridges in the premolar region. The patented glass-ceramics
IPS e.max® CAD and IPS e.max® Press have been clinically proven
a million times over since their introduction. They impress users
with their exceptional strength and high-end esthetics.

Zirconium oxide (ZrO2 )

High-strength zirconium oxide is one of the most efficient
all-ceramic materials for dental applications. IPS e.max® ZirCAD
zirconium oxide is characterized by its excellent biocompatibility
and low heat conductivity. It can be used to create single-tooth
restorations and long-span bridges. Zirconium oxide can be veneered
with IPS e.max® Ceram fluorapatite glass-ceramic.
IPS e.max® ZirCAD Prime is a material of the IPS e.max ZirCAD portfolio
which is distinguished by a unique combination of raw materials (3Y-TZP
and 5Y-TZP), together with Gradient Technology (GT), the new innovative
manufacturing technique. Among other things, this technology is responsible
for producing a continuous, seamless progression of the shade and translucency
within the material that results in exceptional esthetics comparable to
that of lithium disilicate glass-ceramics. As a result of its high strength,
IPS e.max ZirCAD Prime covers all applications  –  from single-tooth
crowns to long-span bridges.

Fluorapatite glass-ceramic
IPS e.max Ceram is the highly esthetic layering ceramic within the
IPS e.max system. All IPS e.max restorations veneered with IPS e.max Ceram
exhibit the same wear properties and surface gloss. Zirconium oxide frameworks
pressed over with IPS e.max® ZirPress, which are either stained or veneered,
present an alternative to conventionally veneered frameworks.

5
 IPS e.max – All ceramic, all you need | Fields of application

Fields of application

Lithium disilicate Zirconium oxide

glass-ceramic (LS2) ( ZrO2 )

Thin veneers 

Veneers 

Inlays 

Onlays
(e.g. occlusal veneers,
partial crowns)


Crowns  

3-unit bridges  (1) 

4- to multi-unit
bridges 

Hybrid abutments 

Hybrid
abutment
crowns

1
Up to the second premolar

Limitations of use:
– V ery deep subgingival preparations – P rovisional insertion or trial wearing
– Patients with substantially reduced residual dentition – Any other uses that are not included
– Parafunctions, e.g. bruxism in the range of applications

6
 Working steps for restorations made with IPS e.max materials | Overview of working steps

Working steps
for restorations made with IPS e.max materials

Working steps Ivoclar Vivadent products

Preparation

IPS e.max® A–D Shade Guide

Tooth shade determination
IPS e.max® Shade Navigation App (SNA)

Preparation OptraGate®

Die shade selection IPS® Natural Die Material

OptraGate®
Digital / analog impression
Virtual

Production

Lithium disilicate Zirconium oxide IPS e.max® CAD

IPS e.max® ZirCAD
( LS2 ) ( ZrO2 ) IPS e.max® Press

Cementation

Cleaning Monobond Etch & Prime®

Etching with Al2O3 at a maximum –
pressure of 1 bar (15 psi). IPS® Ceramic Etching Gel

Variolink® Esthetic or Multilink® Automix Try-In

Try-in
Liquid Strip

Cleaning after try-in Ivoclean®

Conditioning – Monobond® Plus –

Cementation Cementation Variolink® Esthetic Speedcem® Plus

adhesive self-adhesive / conventional Multilink® Automix Vivaglass® CEM

Care

Protection and care Proxyt®

7
 Working steps for restorations made with IPS e.max materials | Tooth shade determination

Tooth shade determination

Optimum shade and shape matching in the oral cavity of the patient is the
prerequisite for a true-to-nature restoration. Shade differences between the
restoration and the natural residual dentition in particular, detrimentally affect
the overall esthetic appearance.

To achieve optimum shade matching, the following guidelines and notes must be observed.

The overall esthetic appearance of a restoration is influenced by the following factors:

– The shade of the prepared tooth (natural tooth structure, core build-up, abutment, implant)
– The shade, translucency and thickness of the restoration,
– The shade of the cementation material.

Factors influencing the overall shade effect

Layer thickness Translucency Shade Shade of the

Preparation Desired
of the of the of the cementation
shade tooth shade
restoration restoration restoration material

Tips on shade determination:

– T he tooth shade is determined on the
non-prepared tooth or adjacent teeth
after cleaning.
– Individual characteristics need to be
taken into account.
– The shade should be determined
by daylight.
– The patient should not wear clothes
and / or lipstick of intensive colour.
– It is recommended to additionally take
a digital photo of the starting situation.

8
 IPS e.max ®

Shade
Shade selection Navigation
App
made easy

The free IPS e.max

Shade Navigation App
makes it easier for you
and your dental lab
to find the suitable material
in the correct shade
and translucency level.

The intelligent Shade Navigation

App takes all important factors into
account and provides support in
selecting the optimal material and
the correct shade. It represents an
ideal basis for your communication
with the lab.
A few entries suffice, and your dental
technician will be presented with a
suggestion for the optimal ingot or
the suitable disc in five easy steps.

Your lab merely requires

the following information:
– Tooth shade – S hade of the
– Application preparation
– Material – Layer thickness

For easy
WATCH THE
ANIMATION
NOW:
communication of shades
www.ivoclarvivadent.com / SNA to your laboratory
9
 Working steps for restorations made with IPS e.max materials | General preparation guidelines

General preparation guidelines

for all-ceramics

Successful results with IPS e.max can only be achieved if the preparation guidelines
and minimum layer thicknesses are strictly observed.

In general, the following rules apply for all-ceramic restorations:

– Do not prepare any angles or edges.
– T he ideal preparation is a shoulder with rounded inner angles
or a chamfer preparation.
– Evenly reduce the anatomical shape while observing
the stipulated minimum wall thicknesses.

For CAD/CAM-fabricated restorations, the incisal edge of the preparation should be

at least 1 mm (milling tool geometry) in order to allow optimum milling of the incisal portion
during CAM processing.

The dimensions indicated on the following pages reflect

the minimum thicknesses for IPS e.max restorations.

Shoulder preparation

1.0 10 –30°

Chamfer preparation 1.5

10
 Working steps for restorations made with IPS e.max materials | Preparation guidelines for LS2

Preparation guidelines
for lithium disilicate glass-ceramics ( LS2 )
The availability of sufficient space represent an important basis for achieving
successful results with the material selected. The minimum layer thicknesses
for IPS e.max CAD and IPS e.max Press restorations indicated below must be
observed when preparing the tooth.

IPS e.max® CAD IPS e.max® Press

0.4 0.3
veneer
Thin

0.5 0.3

0.5 0.4

0.6 0.6
Veneer

0.6 0.6

0.7 0.7

1.0 6° 1.0 6°

1.0 1.0
Inlay

100°-120°

6° 6°
1.0 1.0
1.0 1.0
Onlay

1.0 1.0 1.0 1.0

1.0 1.0
Minimally

1.0 1.0
invasive

1.0 1.0 1.0 1.0

crown

1.0 1.0

1.0 1.0 1.0 1.0

1.0 1.0
1.0 1.0
1.0
1.0 1.0

1.5 1.5 1.5 1.5

1.5 1.5
1.0 1.0
Crown /

1.5 1.5
bridge

1.0 1.5 1.0 1.5

1.0 1.0 1.0 1.0

1.2 1.2
1.2 1.2
1.0 6° 6°

1.5 1.5

Failure to observe the stipulated framework design criteria and minimum thicknesses
may result in clinical failures, such as cracks, delamination or fracture of the restoration.
In combination with adhesive cementation, IPS e.max lithium disilicate crowns (500 MPa)1
should have a minimum wall thickness of at least 1 millimetre.

1
 Mean biaxial flexural strength over a period of 10 years (IPS e.max CAD 530 MPa, IPS e.max Press 470 MPa),
R&D Ivoclar Vivadent AG, Schaan, Liechtenstein
11
 Working steps for restorations made with IPS e.max materials | Preparation guidelines for ZrO2

Preparation guidelines for zirconium oxide ( ZrO2 )

In addition to the general preparation guidelines, the guidelines

and minimum wall thicknesses indicated below must be observed
for IPS e.max ZirCAD zirconium oxide.

– F or conventional and/or self-adhesive cementation, retentive surfaces

must be created (preparation height at least 4 mm).
– T he indicated dimensions reflect the minimum thicknesses
for IPS e.max ZirCAD restorations.

Minimum
preparation depth for Anterior Anterior bridge Posterior crowns
monolithic restorations: crowns abutments and bridges

1.0 1.0
ZirCAD  MT Multi

1.0
ZirCAD  Prime
Polychromatic

IPS e.max®

IPS e.max®

0.8 1.0
1.0 1.0
0.8 1.0

1.0 1.0
0.8 0.8 1.0 1.0
6°
0.8 1.0

1.0 1.0
1.0
ZirCAD  MT
IPS e.max®

0.8 1.0 1.0 1.0

0.8 1.0

1.0 1.0
Monochromatic

0.8 0.8 1.0 1.0 6°

0.8 1.0

0.6 0.6 0.7 0.7

0.6 0.7
IPS e.max®
ZirCAD  LT

0.4 0.6 0.6 0.6 0.7 0.7

0.4 0.6
0.6 0.6 0.7 0.7
6° 6°
0.4 0.4 0.6 0.6

0.4 0.6

The required minimum wall thicknesses vary depending on the material used. The respective
preparation guidelines need to be observed in this context. If necessary, ask your dental lab.
When using the cut-back technique, care must be taken to further reduce the dental hard tissue
by another millimetre in the area of the veneer.

Minimum
preparation depth for Anterior Anterior bridge Posterior Posterior bridge
veneered restorations: crown coping abutment framework crown coping framework

1.6 1.6 2.0 2.0

1.6 2.0
ZirCAD  Prime
Polychromatic

IPS e.max®

1.0 1.0
1.6 1.6 2.0 2.0
1.0 1.0

1.0 1.0 1.0 1.0

1.4 1.4 1.6 1.6
6° 6°
1.4 1.6

1.6 1.6 1.7 1.7

Monochromatic

1.6 1.7
ZirCAD  MO
IPS e.max®

IPS e.max®

1.0 1.0
ZirCAD  LT

1.0 1.0 1.6 1.6 1.7 1.7

1.0 1.0 1.0 1.0

1.4 1.4 1.6 1.6
6° 6°
1.4 1.6

12
Working steps for restorations made with IPS e.max materials | Guidelines for bridges made with LS2 and ZrO2

Guidelines for bridges

made with lithium disilicate glass-ceramics ( LS2 )
and zirconium oxide ( ZrO2 )

The availability of sufficient space represents an important basis for achieving successful results
with the material selected and thus for producing long-lasting restorations. In this context, it is
important to observe the material-specific occlusal minimum layer thicknesses and connector
dimensions.

Aim for the largest possible dimensions when designing the connectors:
– T he height of the connector is more important for the stability than its width. Doubling the width
only results in double the stability, while doubling the height results in up to four times the stability.
– T he greater the distance between the abutment teeth, the higher the mechanical stress on the construction
and the exerted masticatory forces are going to be.
Therefore, no bridge restorations with more than one pontic may be constructed with IPS e.max CAD
(flexural strength of 530 MPa(1) ), IPS e.max Press (flexural strength of 470 MPa(1) ) and
IPS e.max ZirCAD MT / MT Multi (flexural strength of 850 Mpa(1) ),
and no bridge restorations with more than two pontics may be constructed with
IPS e.max ZirCAD Prime / LT / MO (flexural strength of 1200 MPa(2).

Note on lithium disilicate glass-ceramic (LS2 ) bridges:

Given the different masticatory forces, the maximum acceptable pontic width
is different in the anterior and premolar region.

Occlusal force

9 mm 11 mm

Premolar region
to canine Anterior region

The pontic width is determined on the unprepared tooth:

– In the anterior region, the pontic width should not exceed 11 mm.
– In the premolar region (canine to the 2nd premolar), the pontic width should not exceed 9 mm.

1
 Mean biaxial flexural strength over a period of 10 years, R&D Ivoclar Vivadent, Schaan, Liechtenstein
2
 Typical mean value of biaxial strength (MO and LT) or typical of biaxial flexural strength in the dentin region (Prime),
R&D Ivoclar Vivadent AG, Schaan, Liechtenstein

13
 Working steps for restorations made with IPS e.max materials | Shade determination and digital / analog impression

Shade determination on the prepared tooth

In order to facilitate the reproduction of the

desired tooth shade, the shade of the preparation
is determined in the most heavily discoloured
area with the help of the IPS Natural Die Material
shade guide.
This enables the dental lab technician to fabricate
a model similar to the prepared tooth of the patient,
on the basis of which the correct shade and
brightness values of the all-ceramic restorations
may be selected.

The example below shows which influence the various shades of the preparation / natural tooth structure have on the
final result when the same restoration is used. The restoration (veneer made of LS2 , 0.5 mm) remains unchanged.

ND 1 ND 2 ND 3 ND 4 ND 5 ND 6 ND 7 ND 8 ND 9

Restoration: Cementation material: Preparation shade:

Veneer (0.5 mm, IPS e.max CAD HT B1) Variolink Esthetic neutral IPS Natural Die Material, ND 1 – ND 9

Digital / analog impression

Impressions and intraoral scans are an important link between the dental practice and the dental lab.
They form the basis for successful restorations.

Digital impression
In order to obtain an adequate and clear view of the treatment field,
we recommend using a latex-free lip and cheek retractor
(e.g. OptraGate).

Analog impression
An efficient, reliable impression material is required to produce highly
precise models and consequently highly precise permanent restorations.
The impression is taken using
– silicone (e.g. Virtual )
– polyether

For detailed information on the scan process and the CAD/CAM processing procedure,
please refer to the corresponding instructions for use / operating manual of the respective
CAD/CAM system. The directions of the manufacturer need to be observed.

14
 Working steps for restorations made with IPS e.max materials | Temporary restoration

Temporary restoration

Temporary restorations enable the function,

phonetics and esthetics to be determined in
advance and to adjust them at a later stage,
if necessary.
The Telio product system is designed for dentists
(Telio CS) and dental technicians working with
CAD/CAM systems (Telio CAD). All the materials
are ideal for the manufacture of conventional and
implant-supported temporaries. The materials are
fully compatible and their shades are optimally
coordinated.

Temporary restorations are cemented with a provisional, eugenol-free cement

such as the dual-curing Telio CS Link.

Try-in / Cleaning of the restoration

Shade simulation with the help of try-in pastes (e.g.

Varliolink Esthetic or Multilink Automix try-in pastes)
must always be carried out before the working field
is isolated or the teeth are dried, since drying
temporarily lightens the tooth structure.
The glycerine-containing pastes are
water soluble and can be rinsed off
easily under running tap water or
removed with an ultrasonic cleaner.

For the try-in of the permanent restoration glycerine gel

(e.g. Liquid Strip) can be used. The gel is also suitable for preventing
an oxygen-inhibited layer on composite resin and for protecting
the etch pattern on lab-fabricated all-ceramic restorations.

The universal cleaning paste Ivoclean is used for the

extraoral cleaning of pretreated ceramic restoration surfaces
that have become contaminated during intraoral try-in procedures.

15
 Working steps for restorations made with IPS e.max materials | Preparing for cementation

Preparing for cementation

Enjoy complete flexibility when cementing IPS e.max restorations.

Depending on the area of application, you can use adhesive, self-adhesive
or conventional cementation. Choosing the right cement is essential
to achieving long-lasting restorations.

IPS e.max Press | IPS e.max CAD

Material Lithium disilicate (LS2 )

Thin veneers, veneers,

occlusal veneers, inlays, Crowns,
Crown on hybrid Hybrid abutment
Applications onlays, partial crowns, 3-unit bridges up to Hybrid abutment
abutment crown
minimally invasive the 2nd premolar
crowns

Cementation Self-adhesive /
Adhesive Screw-retained Self-adhesive Screw-retained
method conventional(1)

Steam sterilization Steam sterilization

Sterilization – – 132 °C / 270 °F (3 min)
– 132 °C / 270 °F (3 min)

Etching / Option 1 Option 2

Conditioning of Apply Monobond Etch & Prime for 20 seconds Etching: 20 seconds with IPS Ceramic Etching Gel
bonding or screw and allow it to react for another 40 seconds. Conditioning: 60 seconds with Monobond Plus ( 2 )
channel surfaces

Application of the bonding Application of the bonding

Sealing of the agent and sealing of the agent and sealing of the
screw channel – – screw channel with – screw channel with
(intraoral) temporary composite resin composite resin
(e.g. Telio Inlay) (e.g. Tetric Evo Ceram)

Luting Variolink Esthetic, Speedcem Plus,

system
– Speedcem Plus –
Multilink Automix ( 3 ) Vivaglass CEM

Variolink Esthetic
Esthetic, light- and dual-curing luting composite offering exceptional esthetics
and user-friendly processing. Adhesive luting of
– glass-ceramics
– lithium disilicate glass-ceramics
– composite resin restorations
(inlays, onlays, partial crowns,
crowns, bridges)

16
 Working steps for restorations made with IPS e.max materials | Preparing for cementation

Please read the corresponding Instructions for Use.

IPS e.max ZirCAD

Material Zirconium oxide ( ZrO2 )

Applications Crowns and bridges

Cementation
Adhesive Self-adhesive / conventional
method

With Al2O3  ( 25 –70 µm ) at a maximum pressure of 1 bar (15 psi)
Cleaning
Cleaning with Ivoclean after try-in

The range of available products may vary from country to country.

Conventional cementation does not involve a conditioning step.
Conditioning 60 seconds with Monobond Plus –
 Wall thickness of crowns min. 1.5 mm

 Not recommended for veneers

Luting Speedcem Plus

Multilink Automix
system Vivaglass CEM
1

Speedcem Plus
Self-adhesive, self-curing resin cement with optional light-curing
for the self-adhesive, self-curing cementation of
– high-strength all-ceramics
(zirconium oxide / lithium disilicate)
– r estorations on
implant abutments
– metal or metal-supported
restorations

17
 Cementation
Navigation
System
Proper
cementation

The Cementation Navigation

System, the popular multimedia
application, offers practical
orientation and guidance for
cementation cases.

The app helps you to find the most

suitable luting material for almost
any cementation task, irrespective
of the substrate: tooth structure or
implant abutments.
The app is easy to use and contains
detailed 3D animations. Step-by-step
instructions guide you through the
application procedure.

CNS

Finding your way out

of the cements maze TRY NOW:
www.cementation-navigation.com

18
Working steps for restorations made with IPS e.max materials | Adjustments, polishing and protection / care

Adjustments and intraoral / extraoral polishing

Monolithic Veneered

Lithium disilicate
Lithium disilicate Zirconium oxide
glass-ceramic ( LS2 ) and
glass-ceramic (LS2) ( ZrO2 )
zirconium oxide ( ZrO2 )

Fine diamonds (2, 3) Fine diamonds (2, 3) Extrafine diamonds  (2, 3)

Extensive
adjustments

Extrafine diamonds  (2, 3) Fine diamonds (2, 3) Extrafine diamonds  (2, 3)

Small
adjustments

Polishing in two steps Polishing in two steps Polishing in two steps

using OptraGloss (1) using OptraGloss (1) using OptraGloss (1)
Polishing

General notes: 1
 Maximum rotation speed 10 000 rpm
2
 Intraoral:  Maximum rotation speed 15 000 rpm
– P erform wet processing intraorally 3
 Extraoral: Maximum rotation speed 20 000 rpm
and dry processing extraorally
– T he directions of the grinding tool manufacturer regarding
the correct use (e.g. low rotation speed) need to be observed.
– Use low pressure to avoid overheating.

Protection / Care
Systematic professional cleaning and polishing of the teeth,
restorations and implants is essential in the prevention of caries,
periodontal and peri-implant disease.
Professional oral care using suitable products (e.g. Proxyt)
not only promotes oral health, but also pink-white esthetics.
Gentle care for IPS e.max Press
restorations

Optimum pink-white esthetics

19
 Clinical cases with IPS e.max zirconium oxide | Posterior crown cemented with Speedcem Plus

Clinical cases
with IPS e.max zirconium oxide ( ZrO2 )

Posterior crown
made with IPS e.max zirconium oxide Dr Lukas Enggist, 
cemented with Speedcem Plus Ivoclar Vivadent, Liechtenstein

Starting situation with temporary Remove the temporary restoration Prepared tooth, exposed and cleaned
restoration (e.g. Telio CS C&B). from tooth 25.

Try-in of the zirconium oxide restoration Clean the bonding surface after try-in Thoroughly clean the prepared tooth
using try-in paste (e.g. Varliolink Esthetic using Ivoclean cleaning paste. Then using a polishing brush and oil- and
Try-In Paste) thoroughly rinse with water. fluoride-free prophy paste (e.g.
Proxyt). Thoroughly rinse with water
spray.

Dispense the desired amount of Seat the restoration and pre-cure any Any excess can be easily removed
Speedcem Plus directly into the cement excess for approx. 2 seconds with a suitable instrument.
restoration. using a curing light (e.g. Bluephase
PowerCure in the PreCure mode).

20
 Clinical cases with IPS e.max zirconium oxide | Posterior crown cemented with Speedcem Plus

Apply glycerine gel / airblock Cure the restoration from 4 different Polish the cement line under water
(e.g. Liquid Strip) to the cement line aspects for 20 seconds each and from cooling using a suitable polisher
to avoid the formation of an the occlusal aspect for 10 seconds (e.g. OptraGloss).
oxygen-inhibited layer. using a curing light (e.g. Bluephase
PowerCure).

Buccal view of the seated premolar Final restoration in situ

crown made from zirconium oxide at the recall examination

21
 Clinical cases with IPS e.max zirconium oxide | Posterior bridge cemented with Speedcem Plus

Posterior bridge
made with IPS e.max zirconium oxide Dr Lukas Enggist,
cemented with Speedcem Plus Ivoclar Vivadent, Liechtenstein

Starting situation: Situation after the removal Preparation with build-up

old metal-ceramic bridge of the bridge

Monolithic 3-unit zirconium oxide Blast the bonding surfaces using Clean the restoration with Ivoclean
bridge aluminium oxide (AI2O3) at a pressure after try-in. Then rinse thoroughly
of maximum 1 bar (15 psi). with water.

Apply Speedcem Plus directly Subsequently, seat the restoration Pre-cure any cement excess at a
to the bonding surface. and retain it in place exerting uniform distance of maximum 10 mm for two
pressure. seconds per quarter surface using a
curing light (e.g. Bluephase PowerCure
in the PreCure mode). Retain the
restoration in place during the process.

22
 Clinical cases with IPS e.max zirconium oxide| Posterior bridge cemented with Speedcem Plus

Remove pre-cured excess Polish the cement line under water As a final step, check the occlusion
using a suitable instrument. cooling using suitable polishers of the restoration.
(e.g. OptraGloss).

Apply a thin, uniform layer of Final 3-unit, monolithic bridge

Fluor Protector S fluoride varnish made from IPS e.max ZirCAD LT
in the cervical area. Dry the varnish after insertion
with the air syringe.

23
 Clinical cases with IPS e.max lithium disilicate | Veneer cemented with Variolink Esthetic

Clinical cases
with IPS e.max lithium disilicate (LS2 )

Veneer
made with IPS e.max lithium disilicate Dr Arnd Peschke  /  DT Dieter Grübel, 
cemented with Variolink Esthetic Ivoclar Vivadent, Liechtenstein

Starting situation: Fabricate a mock-up using a self-curing Try in the veneer on tooth 11 using
Retruded tooth 11 with a crack temporary crown and bridge material Variolink Esthetic Try-In Paste neutral.
on the vestibular enamel surface (e.g. Telio CS C&B). Then carefully rinse off the try-in paste
with water.

Clean the preparation with fluoride-free Etch the inner surfaces of the ceramic Apply the bonding agent / primer (e.g.
prophy paste (fluoride-free Proxyt). restoration using etching gel Monobond Plus) to the inner surfaces
(e.g. IPS Ceramic Etching Gel). of the restoration.

Etch the enamel with 37% phosphoric After phosphoric acid etching, the Scrub the single-component adhesive
acid gel (e.g. Total Etch). Then enamel surface appears chalky white Adhese Universal into the prepared
thoroughly rinse with water. (acid-etch pattern). tooth surface for at least 20 seconds.
Subsequently, disperse the adhesive
with air and light-cure it.

24
 Clinical cases with IPS e.max lithium disilicate | Veneer cemented with Variolink Esthetic

Apply Variolink Esthetic to the inner Remove any excess by running a To prevent the formation of an
surfaces of the restoration. Position the brush transversely to the cement line oxygen-inhibited layer, cover the
restoration on the tooth and retain it (wiping technique). cement line with glycerine gel / airblock
in place with OptraSclup Pad. (e.g. Liquid Strip).

Finally, cure for 10 seconds per mm Esthetic result ten days after the
ceramic and segment using a curing successful seating of the veneer
light with a light intensity of at least
1000 mW / cm2 (e.g. Bluephase
PowerCure).

25
 Clinical cases with IPS e.max lithium disilicate | Onlay cemented with Variolink Esthetic

Onlay
made with IPS e.max lithium disilicate Dr Stephanie Huth, 
cemented with Variolink Esthetic Ivoclar Vivadent, Liechtenstein (2014)

Starting situation: Prepare the tooth for the IPS e.max CAD After try-in, use water spray to
Tooth 36 with defective onlay according to the guidelines for thoroughly wash the try-in paste
composite resin filling all-ceramic restorations. In order to off the restoration and dry the
achieve optimum esthetic results, you restoration with oil- and
can check the shade with the help of a moisture-free air.
try-in paste (e.g. Variolink Esthetic Try-In).

Place a rubber dam and clean the Apply the self-etching Monobond Then thoroughly rinse off Monobond
preparation with fluoride-free Proxyt. Etch & Prime to the bonding surface Etch & Prime with water and dry the
using a microbrush and scrub it into restoration with a strong jet of water-
the surface for 20 seconds. Allow to and oil-free air for approximately
react for another 40 seconds. 10 seconds.

Etch the cavity surfaces with 37% Apply Adhese Universal to the bonding Apply Variolink Esthetic luting composite
phosphoric acid using the total-etch surfaces for 20 seconds. Then disperse directly to the restoration and seat
technique. the adhesive with the air syringe and the restoration in the cavity using
polymerize it for 10 seconds. OptraStick.

26
 Clinical cases with IPS e.max lithium disilicate | Onlay cemented with Variolink Esthetic

Pre-cure any cement excess at a distance Remove any excess with a scaler. Apply a glycerine gel / airblock
of maximum 10 mm for two seconds Make sure to continue exerting pressure (e.g. Liquid Strip) to the cement line
per quarter surface using a curing light on the restoration until final light-curing. to prevent the formation of an
(e.g. Bluephase PowerCure in the oxygen-inhibited layer.
PreCure mode).

Finally, cure for 10 sec. per mm ceramic Situation after seating the restoration Finish and polish the restoration
and segment using a curing light and checking the occlusion margins and the cement line using
with a light intensity of at least suitable polishers (e.g. OptraGloss).
1000 mW / cm2.

Apply a fluoride-containing protective Final result one week after cementation

varnish (e.g. Fluor Protector S) to all
tooth surfaces.

27
 Clinical cases with IPS e.max lithium disilicate | Anterior crown cemented with Multilink Automix

Anterior crown
made with IPS e.max lithium disilicate Dr Ronny Watzke  /  DT Franz Perkon, 
cemented with Multilink Automix Ivoclar Vivadent, Liechtenstein

Remove the temporary restoration. Use Try in the permanent restoration. To check Etch the inner restoration surfaces with
a polishing brush and oil- and fluoride- the esthetic appearance, use Multilink 5% hydrofluoric acid (e.g. IPS Ceramic
free prophy paste (e.g. fluoride-free Automix Try-In Paste if necessary. After Etching Gel) for 20 seconds.
Proxyt) to clean the preparation and try-in, use water spray to thoroughly rinse Subsequently, rinse thoroughly
the try-in paste off the restoration and
then rinse with water spray. Dry with with water and dry with oil-free air.
dry the restoration with oil- and moisture-
oil-free air. free air.

Apply Monobond Plus bonding agent / Clean the preparation again according Apply the mixed Multilink Primer A / B
primer to the pretreated restoration to the procedure described. to the entire bonding surface with a
surfaces and leave it to react for Subsequently, dry with oil-free air. microbrush (starting from the enamel)
60 seconds. Subequently, disperse Avoid overdrying! and scrub it in for 30 seconds.
it thoroughly with air.

Disperse Multilink Primer excess with Extrude Multilink Automix luting Seat the restoration and retain it
the air syringe until the mobile liquid composite from the automix syringe in place exerting uniform pressure.
film is no longer visible. and apply it directly onto the restoration.

28
 Clinical cases with IPS e.max lithium disilicate | Anterior crown cemented with Multilink Automix

Pre-cure any cement excess at a distance Any excess can be easily removed To prevent the formation of an oxygen-
of maximum 10 mm for two seconds with a scaler. inhibited layer, cover the restoration
per quarter surface using a curing light margins with glycerine gel / airblock
(e.g. Bluephase PowerCure in the (e.g. Liquid Strip) immediately after
PreCure mode). excess removal.

Subsequently, light-cure all cement lines Final situation after having finished the
again for 20 seconds (at approx. 1200 proximal areas with finishing and polishing
mW / cm2 ). If a non-translucent, opaque strips and after having checked the
restorative material is used, wait for the occlusion and functional movements
self-curing mechanism to take effect. and polished the restoration margins
Subsequently, rinse off Liquid Strip. with suitable polishers (e.g. OptraGloss)

29
 Clinical cases with IPS e.max lithium disilicate | Anterior bridge cemented with Speedcem Plus

Anterior bridge
made with IPS e.max lithium disilicate Dr Ronny Watzke  /  DT Franz Perkon, 
cemented with Speedcem Plus Ivoclar Vivadent, Liechtenstein

Remove the temporary restoration. Try in the permanent restoration. Etch the inner surfaces of the restoration
Clean the preparation with a polishing Next, check the shade, fit and occlusion with 5% hydrofluoric acid (e.g.
brush and an oil- and fluoride-free of the restoration. IPS Ceramic Etching Gel) for 20 seconds.
cleaning paste (e.g. fluoride-free Proxyt). Subsequently, rinse thoroughly with
Rinse with water spray and subsequently water spray and dry with oil-free air.
dry with oil-free air.

Apply Monobond Plus bonding agent / Clean the preparation(s) again using a Extrude Speedcem Plus resin cement
primer to the pretreated surfaces, polishing brush and oil- and fluoride- from the automix syringe and apply
leave to react for 60 seconds and then free cleaning paste (e.g. fluoride-free the desired quantity directly onto the
thoroughly disperse with a stream of air. Proxyt) and rinse with water spray. bonding surface of the restoration.
Subsequenlty, dry with water- and
oil-free air. Avoid overdrying!

Seat the restoration and retain it in Pre-cure any cement excess at a distance The gel-like excess can be easily
place exerting uniform pressure. of maximum 10 mm for 2 seconds per removed with a scaler.
quarter surface using a curing light
(e.g. Bluephase PowerCure in the
PreCure mode).

30
 Clinical cases with IPS e.max lithium disilicate | Anterior bridge cemented with Speedcem Plus

To prevent the formation of an oxygen- Subsequently, light-cure all cement lines Subsequently, rinse off Liquid Strip.
inhibited layer, cover the restoration again for 20 seconds (at approx. 1200
margins with glycerine gel / airblock mW / cm2). If non-translucent, opaque
(e.g. Liquid Strip) immediately after restoration material is used, wait for the
excess removal. self-curing mechanism to take effect.

Apply finishing and polishing strips Apply a thin layer of fluoride varnish
in the proximal regions. Check the (e.g. Fluor Protector S). Evenly disperse
occlusion and functional movements. and dry the varnish with an air syringe.
Polish the restoration margins with
suitable polishers (e.g. OptraGloss).

31
 Clinical cases with IPS e.max lithium disilicate | Hybrid abutment and crown cemented with Speedcem Plus

Hybrid abutment and crown

made with IPS e.max lithium disilicate Dr Ronny Watzke  /  DT Jürgen Seger, 
cemented with Speedcem Plus Ivoclar Vivadent, Liechtenstein

The abutment has been screwed in. Try in the permanent restoration. Clean the abutment using a polishing
Check the shade effect, accuracy brush and oil- and fluoride-free cleaning
of fit and occlusion. paste (e.g. Proxyt) and rinse with water
spray. Dry with oil-free air.

Apply a thin layer of Monobond Plus Etch the inner surfaces of the restora- Apply Monobond Plus to the pretreated
bonding agent / primer to the abutment tion with 5% hydrofluoric acid (e.g. surfaces, leave it to react for 60 seconds
and leave it to react for 60 seconds. IPS Ceramic Etching Gel) for 20 seconds. and then thoroughly disperse with
Subsequently, dry with water- and Subsequently, rinse thoroughly with blown air.
oil-free air. water spray and dry with oil-free air.

Dispense Speedcem Plus resin cement Seat the restoration and retain it in Pre-cure any cement excess at a distance
from the automix syringe and apply place exerting uniform pressure. of maximum 10 mm for 2 seconds per
the desired quantity directly onto the quarter surface using a curing light
restoration. (e.g. Bluephase PowerCure in the
PreCure mode).

32
 Clinical cases with IPS e.max lithium disilicate | Hybrid abutment and crown cemented with Speedcem Plus

The gel-like excess can be easily removed Subsequently, light-cure all cement lines Subsequently, rinse off Liquid Strip.
with a scaler. To prevent the formation again for 20 seconds (at approx. 1200
of an oxygen-inhibited layer, cover the mW / cm2). If non-translucent, opaque
margins with glycerine gel / airblock restoration material is used, wait for the
(e.g. Liquid Strip) immediately after self-curing mechanism to take effect.
excess removal.

Apply finishing and polishing strips Apply a thin coat of a protective varnish
in the proximal regions. Check the containing chlorhexidine (e.g. Cervitec
occlusion and functional movements Plus). Let the varnish dry or dry it with
and make adjustments if necessary. a stream of air.
Polish the restoration margins with
suitable polishers (e.g. OptraGloss).

33
 Clinical cases with IPS e.max lithium disilicate | Screw-retained hybrid abutment

Screw-retained
hybrid abutment crown Dr Ronny Watzke  /  DT Franz Perkon, 
made with IPS e.max lithium disilicate Ivoclar Vivadent, Liechtenstein

Remove the temporary restoration. Manually screw in the hybrid abutment Then cautiously remove the hybrid
crown using the matching screw in abutment crown in order to clean it
order to try in the permanent restora- extraorally. Clean the hybrid abutment
tion. Check the shade effect, accuracy crown, rinse with water spray and dry
of fit and occlusion. with oil-free air.

Etch the screw channel from the Subsequently rinse thoroughly with Insert the hybrid abutment crown
occlusal side with 5% hydrofluoric acid water spray and dry with oil-free air. intraorally into the implant, screw it in
gel (e.g. IPS Ceramic Etching Gel) for with the matching implant screw and
20 seconds. tighten the screw using a torque wrench
(observe the manufacturer's directions).

34
 Clinical cases with IPS e.max lithium disilicate | Screw-retained hybrid abutment

Apply Monobond Plus bonding agent / Next, insert a cotton or foam pellet into Seal the screw channel with a composite
primer to the pretreated surfaces, the screw channel and apply the bond- resin material (e.g. Tetric EvoCeram) in
leave it to react for 60 seconds and ing agent (e.g. Heliobond). the appropriate shade.
subsequently thoroughly disperse it
with a stream of air.

Light-cure using a curing light After polymerization, check the occlusion / Apply a thin layer of protective varnish
(e.g. Bluephase PowerCure ). articulation and remove any rough spots (e.g. Cervitec Plus). Let the varnish dry
with suitable fine-grit diamonds or dry it with a stream of air.
if necessary. Polish the restoration to
a high gloss using suitable polishers
(e.g. OptraGloss).

35
 Documented
clinical
reliability

96 %
survival rate  (1) IPS e.max
all-ceramic
restorations

150 million
provide an
excellent
highly esthetic
restorations  (2) alternative to
metal ceramics

98 %
for various
indications
and provide
similarly positive
customer satisfaction  (3) survival rates.(4)

1
 IPS e.max Scientific Report, vol. 03 / 2001–2017, Ivoclar Vivadent AG, Schaan, Liechtenstein
2
 Based on sales figures
3
 Corporate Market Insight, Ivoclar Vivadent AG, Schaan, Liechtenstein
4
 IPS e.max Scientific Report, vol. 03 / 2001–2017, Ivoclar Vivadent AG, Schaan, Liechtenstein
(Pjetursson et al. 2007, Schley et al. 2010, Kern et al. 2012, Sailer et al. 2015)
36
 Documented clinical reliability | Scientific data and results

Scientific data and results

from more than 10 years of research

For many years, dentists and dental technicians around the world have shown
their trust in Ivoclar Vivadent products. The reasons for this are manifold.
The clinical reliability of the innovative Ivoclar Vivadent products and systems
is what makes them particularly attractive to customers.

Since the beginning of its development, the IPS e.max system has been monitored by the scientific
community. Many renowned experts have contributed to an excellent data base with their studies.
The worldwide success story, the ever growing demand, as well as over 150 million fabricated
restorations are testament to the excellent track record and the reliability of the system. More than
20 clinical in-vivo studies to date and even more in-vitro studies, as well as the continuously increasing
number of clinical studies throughout the world show the long-term success of the IPS e.max system
in the oral cavity of the patients.
The most important study results are compiled in the IPS e.max Scientific Report vol. 3.
Further scientific data (i.e. on strength, wear, biocompatibility) are listed in the
Scientific Documentations for the individual IPS e.max products. They can be obtained
from Ivoclar Vivadent. 
Additional information about the topic of all-ceramics and IPS e.max can be found in the
Ivoclar Vivadent Reports Nos. 16 and 17, as well as in the IPS e.max ZirCAD Scientific Documentation.
More detailed information on the luting composite Variolink Esthetic is provided in the
Ivoclar Vivadent Report No. 22 and the Variolink Esthetic Scientific Documentation,
while details on Multilink Automix are contained in the Multilink Automix Scientific Report 2/2016.

SCIENTIFIC
REPORT
Vol. 03 / 2001 – 2017
English

amic
all cer need
all you

37
 IPS e.max Patient Identification Card

IPS e.max
Patient Identification Card

If you use IPS e.max in your dental practice, you can take advantage
of the new IPS e.max Patient Identification Card to prove to your patients
that you use only authentic materials.

You will receive the Patient Identification Card from your dental laboratory.
It contains all the important details about the materials used
as well as the type of restoration manufactured.

All you have to do is add your practice stamp and hand the card over
to your patient. This simple yet effective measure allows you to assure
your patient of the high quality of the dental restoration
you have placed.

Ask your dental laboratory for

IPS e.max Patient Identification Cards
or order free copies from
Ivoclar Vivadent directly.

38
 IPS e.max Guarantee

IPS e.max
Guarantee 10 Years

E
TE
UA

G
RAN

Trust builds confidence:  10-year guarantee

More than 150 million restorations (1), over 96% survival rate (2), more than 15 years of experience.
The 10-year IPS e.max Guarantee is as promising as the material itself.

Your trust; our promise.

By choosing IPS e.max materials you are making the right choice, because these materials have proven
their long-lasting clinical performance on a daily basis. (3) Our promise to you, the dentist and the
dental technician, is backed up by our guarantee. The laboratory will receive a once-off reimbursement
or a replacement for the product, while the practitioner will be reimbursed for the replacement or
repair of work previously accomplished.
The guarantee covers the following IPS e.max products: zirconium oxide (IPS e.max ZirCAD),
lithium disilicate (IPS e.max Press and IPS e.max CAD) and layering ceramic (IPS e.max Ceram).
We offer you a 10-year guarantee on newly placed restorations. It also applies retroactively
for restorations that were permanently seated during the past 5 years.

Getting the most out of your IPS e.max restoration

High-quality restorations made of IPS e.max materials deserve special care and protection in order
to maintain their proper function and esthetic appearance for a long time. The Proxyt prophy pastes
gently clean dental hard tissue and restorations. The Cervitec line comprises chlorhexidine-containing
products for professional teeth cleaning and germ control.

MORE
INFORMATION:
guarantee.ipsemax.com
 Ivoclar Vivadent, Scientific Report IPS e.max_Vol.3, 2018 
 Fasbinder D J. et.al, Study Report, 2017
1
 Based on sales figures
2

39
 ipsemax.com
Rx ONLY

Manufacturer:
Ivoclar Vivadent AG, 9494 Schaan, Liechtenstein
www.ivoclarvivadent.com

Ivoclar Vivadent AG
Bendererstr. 2
9494 Schaan
Liechtenstein
Tel. +423 235 35 35
Fax +423 235 33 60
40www.ivoclarvivadent.com 665082 / en / 2020-07