Step-By-Step: Zeo CE Light

What is the average time for a porcelain buildup? With all the studies and articles I have read throughout the years, I can honestly say “who knows.”

I developed my No Cut Back Technique more than 20 years ago and have taught this technique throughout the United States at various dental conventions. This technique is designed to increase production and at the same time allow the ceramist to produce a much more esthetic restoration.

I currently build on average a crown every 5-7 minutes in one bake. In the buildup process, I use seven different porcelain powders because natural dentition consists of more than just dentin and enamel-color comes from within a natural tooth. Having studied natural dentition as well as thousands of photographs throughout my career, understanding the layering of dentition is all part of my buildup technique. This technique can be used for any substructure regardless of the material. Having high-quality porcelain that you can control color and shrinkage makes it even better.

If we as an industry have the ability to produce the most esthetic crowns and bridges and save time, everyone is satisfied. Just a few years ago, we had to compete among ourselves. Now, with technology (e.g., CAD/CAM) and some of the work going to overseas markets, we must make a change for a more esthetic product. I am not trying to take away from the amazing technology that has come into our industry. I just believe a layered buildup is the most esthetic approach we can offer our clients.

Refer to the slideshow for figures.

01 Starting with an opaqued substructure, first analyze your working clearances (Fig. A). I am using black stone to enhance color of buildup technique for photography purposes.

02 Build buccal cusp tips with dentin. This buildup is shade A2 (blotting from facial) (Fig. B).

03 Apply lingual cusps with dentin while connecting porcelain to what was layered in Step 1, (blotting from facial) (Fig. C).

04 Apply dentin porcelain to buccal surface (Fig. D).

05 Apply dentin porcelain to lingual surface (Fig. E).

06 Apply occlusal ACCENT that corresponds to prescribed shade: Example: A1 would be a YELLOW OCHER and an A4 would be OCCLUSAL ORANGE (Fig. F).

07 Apply interproximal ACCENT T-BLUE for lighter shades going to T-GREY for darker shades (Fig. G).

08 Apply buccal mamalon lobe (ACCENT MAMALON VANILLA) (Fig. H).

09 Apply incisal porcelain (I prefer opalescent incisals OPAL E-2) following steps 01 through 04 (Figs. I and J).

10 Apply ACCENT WHITE at middle of crown to highlight contour of restoration (Fig. K).

11 Remove buildup from working model and add a slightly darker shade at the cervical 1/3 and apply a T-NATURAL to the marginal ridge area (Fig. L).

12 Build crowns in sequences of three to five, and fire at manufacturer’s recommendations.

13 Once fired, then start the finishing stage. Adjust contacts and occlusion, then begin contouring to your satisfaction.

14 Create detailed anatomy using a #34 FG bur. Create an ideal surface texture, and then you are ready to glaze (Fig. M). The buildup, grind-in and staining per crown is approximately 12 minutes (excluding firing time).

Fig. N shows the finished crown shade A2 next to a previously built crown shade A4 (Fig O).

By using this technique, the time you spend staining also is expedited. On posteriors, occlusal stains are required to produce a much more esthetic crown that will harmonize with the oral environment. All natural dentition regardless of shade has more color than what appears on a shade guide. I believe that if your goal is to increase your lab’s ability to create a more esthetic restoration, ask your clients for photos. Although not all dentists have photography equipment, you as a lab technician should do the research in understanding the importance of this technology. Whether you receive a printed photo or an e-mailed photo, this is the best tool we have to create a higher quality restoration.

Esthetics with added production

I realize learning a new technique can be difficult. These methods will increase your volume, and equally as important, you will produce a much more esthetic restoration. I use Zeo CE Light porcelain on our entire metal substructure restorations from Base Metal to High Noble. I have never had a tear or crack since our lab started using Zeo CE Light. I also recommend using wet trays for your buildup. I have wet trays for every different type of porcelain used in our laboratory. They are set up by shades (e.g., A tray for bleach shades as well as for my entire A, B, C and D shades). Pre-mixed porcelain saves time, and there is no wasted material.

Douglas J. Frye, CDT, owns Functional Esthetics Dental Laboratory, a cosmetically focused laboratory in Farmington, Mo. Doug was chosen by 3M to study under Yamamoto, one of the best technicians in the world. Doug has lectured on all phases of crown and bridge and dental ceramics throughout the country. He is the developer of the No Cut Back Technique™. Doug and his wife, Muffy, also have a sister company, Re-Creating Nature not just another crown™, which is focused on providing continuing education, NBC approved seminars. He has worked with some of the industry’s leading manufacturers in research and development of new products. For more information visit re-creatingnature.com or call 866-760-8821.