A new day has dawned upon us… did you notice it?

A few years ago Ivoclar introduced a revolution in dentistry and radically improved our ability to correctly treat our patients.  Even though the ADA no longer defines our profession as the ‘Art and Science’ of dentistry, what Ivoclar has done is allow us to continue that approach under the new definition of Dentistry!

This is interesting and important to what we are doing in our practices because it specifically guides us to provide treatment and consider the impact of that treatment on our patients.  In the world of fixed restorative, one of the major frustrations has been to find a solution for significant destruction of the tooth that would not create additional destruction – or more simply, to create a fix that doesn’t cause more problems.  The new material e.Max does exactly that!  Combine the wear characteristics of e.Max being in the same range as natural tooth structure with the advanced protocols that can eliminate bruxism, and we are now talking about treating the disease and considering their impact on the human body!

e.Max has wear rates over two years that are within the range of enamel!  So many of our choices cannot claim this and we were forced to accept progressive deterioration of the mouth because the materials did not function as natural tooth structure.  The e.Max is also significantly stronger than pressed ceramics – some 250% stronger when bonded in place.  It is strong enough that you can actually conventionally cement it though I am hard pressed to understand why you would.  The advantages of adhesively places restorations are too numerous to not become expertly proficient at using adhesively retained restorations as your primary, or perhaps sole, treatment.  The ideal combination of the restorative material e.Max and the bonding resin Variolink II and the power of the bluephase light and there is little that can’t be accomplished!

Although it is not widely appreciated or understood yet, the emerging approach of Neuromuscular dentistry cannot be ignored.  It offers the benefits of conventional occlusal perspectives and has the additional advantage that we can create physiologic muscle harmony by intent.  Finally we have the ability to objectively measure where the muscles are comfortable and design a functional envelop for the patient that allows muscle harmony along with joint balance and proper articulation of the teeth.  Astonishingly, when this occurs the parafunctional habit of bruxism can be totally eliminated!  If bruxism is eliminated, and the patient is given the benefit of a material like e.Max with ideal wear characteristics, it is finally possible to offer our patients conservative restorations that will replace and restore the broken, missing, or diseased tooth while maintaining the healthy and strong natural tooth structure – and perhaps keep that restoration for life!

It is painfully apparent that we are enjoying one of the most rapidly advancing times in the history of dentistry.  In the arena of materials, we now enjoy beautiful esthetics with great bondability and strength characteristics that don’t create their own problems.  Predictable and tooth conserving adhesive dentistry is truly an option!  There is diagnostic equipment that allows us to see and understand so much more in our patients!  From 3D imaging technology to objective measurement tools to allow us to evolve into the next level as a profession; we are in a time of unparalleled change and growth.  In the world of occlusion we once thought the teeth were the only important structure – then evolved out thinking to include the bones and proper alignment of the joints.  The next evolution in understanding simply incorporates the muscle and soft tissue in the diagnosis, and when that is included, we can maximize the properties of materials like e.Max.

What a great time to be a dentist! Check it out at!

If you have any questions contact your local Oklahoma Ivoclar Vivadent representative, Nate Smith.

Best in Business,

Dr. Mark Duncan DDS, FAGD, DICOI, LVIF

In 2007 Dr. Duncan was invited to join the full time faculty at the Las Vegas Institute and has moved to Las Vegas where he teaches with the Institute and maintains a faculty practice. Together with the faculty at the Las Vegas Institute, he is involved in teaching advanced esthetic and occlusal concepts along with practice management concepts to students from around the world.

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