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What does the IPS e.max® Layered clinical workflow look like across the two appointments?

IPS e.max Layered is a lab-fabricated, two-visit crown. The first visit creates a clean preparation and complete records; the second verifies fit and esthetics and seats the crown. The decisive judgment calls happen at the first visit (reduction, margin quality, moisture control, and shade) because the lab cannot fix those later.

First appointment: preparation and records

  1. Remove decay and damaged structure; shape the tooth to accept the crown, and build up core material if needed.
  2. Establish retention form, verify occlusal clearance, and pack retraction cord. Keep margins clean and dry, because blood or fluid during scanning produces inaccurate impressions and open or short margins in the final crown.
  3. Capture the impression (digital or traditional) plus bite registration. Verify correct bite position; full-arch records give the best occlusal accuracy.
  4. Select shade and capture photographs with shade tabs and stump shade references.
  5. Place a temporary crown to protect the prep.
  6. Send records to ROE and complete the Rx.

Second appointment: try-in and seating

  1. Remove the temporary and thoroughly clean residual cement from the prep.
  2. Immerse the crown in 0.12% chlorhexidine gluconate for 2 minutes to sanitize before placement.
  3. Trial-fit: evaluate margins, contacts, occlusion, embrasure form, and esthetics; adjust as needed. Have the patient bite firmly to confirm full seating.
  4. Capture a post-operative radiograph to confirm margins are fully sealed; confirm proximal fit tactilely with an explorer where vision is limited.
  5. Clean the inside of the crown with cleaning solution and cement (see the cementation article).
  6. Remove excess cement while rubbery, then re-check and adjust contacts, emergence profile, and occlusion in centric and excursive movements; polish all adjusted surfaces.

Don't skip the radiograph at step 4. Improperly adjusted contacts can hold a crown off its margin, and an incompletely seated anterior crown invites micro-leakage and recurrent decay. Confirming complete seating before final cementation is the cheapest insurance in the procedure.

 

Additional Resources

For more information concerning the IPS e.max Layered:

Contact Information

For help with a Locator Fixed solution for your next case, contact ROE Dental Laboratory: