BruxZir® Solid Zirconia is indicated for crowns, bridges, veneers, inlays and onlays, screw retained crowns and full-arch implant prostheses. It is an esthetic alternative to PFM metal occlusal/lingual or full-cast restorations and ideal for restorations requiring extra durability such as crowns under partials or screw-retained implant crowns. The chip-proof durability of BruxZir restorations also makes them ideal for bruxers who have broken natural teeth or previous PFM restorations. BruxZir restorations are also ideal for patients lacking the preparation space for a PFM.
Preparation Requirements for BruxZir Crowns & Bridges
Shoulder preparation not needed, feather edge is OK. It is a conservative preparation similar to full-cast gold, so any preparation with at least 0.5 mm of occlusal space is accepted.
Minimum occlusal reduction of 0.5 mm; 1 mm is ideal.
For BruxZir Anterior restorations, a minimum occlusal reduction of 0.8 mm; 1.25 mm is ideal.
Ceramir Crown & Bridge or a resin-reinforced glass ionomer cement such as RelyX™ Luting Cement (3M ESPE; St. Paul, Minn.) or GC Fuji Plus™ (GC America; Alsip; Ill.)
For short or over-tapered preparations, use a resin cement such as RelyX™ Unicem (3M ESPE) or Panavia™ F2.0 (Kuraray; New York, N.Y.)
Instructions for Seating BruxZir and Other Zirconia-Based Crowns & Bridges
BruxZir restorations are fabricated from solid zirconia oxide material, much like the zirconia oxide coping found in restorations such as Prismatik Clinical Zirconia™, Lava™ Zirconia (3M ESPE; St. Paul, Minn.), and NobelProcera™ (Nobel Biocare; Yorba Linda, Calif.). Like most metals, zirconia exhibits a strong affinity for phosphate groups, and zirconia oxide is no different. We can take advantage of this fact with phosphate-containing primers, such as Monobond Plus (Ivoclar Vivadent; Amherst, N.Y.) and Z-Prime™Plus (Bisco; Schaumburg, Ill.), or cements such as Ceramir® Crown & Bridge (Doxa Dental; Newport Beach, Calif.). Unfortunately, saliva also contains phosphates in the form of phospholipids, so when a BruxZir crown or bridge is tried in the patient’s mouth and comes in contact with saliva, the phosphate groups in the saliva bind to the zirconia oxide and cannot be rinsed out with water. Attempting to use phosphoric acid (which is full of phosphate groups) to “clean” the saliva out only makes the problem worse.
The only way we have found to successfully remove these phosphate groups from the interior of a BruxZir restoration is with the use of Ivoclean™ (Ivoclar Vivadent). This is a zirconia oxide solution placed inside the restoration for 20 seconds and then rinsed out. Due to the large concentration of free zirconia oxide in the Ivoclean, it acts as a sponge and binds to the phosphate groups that were previously bound to the BruxZir restoration. Once the Ivoclean is rinsed out, you will have a fresh bonding surface for the Monobond Plus, Z-Prime Plus or Ceramir to bond to.
The BruxZir crowns fit well, and the patient has approved them, so it is time to start the cementation procedure. Since zirconia crowns are susceptible to salivary contamination from phospholipids when they are tried in the mouth, if you simply rinse them out with water, as I am doing here, you remove the visible saliva, but the phosphate groups remain bonded to the zirconia surface. The good news is that once we remove these salivary phosphate groups, we are going to take advantage of this fact when we cement or bond these crowns.
Instructions for Adjusting and Polishing BruxZir Crowns & Bridges
Because BruxZir restorations are made from solid zirconia, you may find them harder to adjust with conventional bur kits. To easily adjust, polish or remove these restorations, we have developed specially designed burs and polishers. The diamond burs and polishers in the new BruxZir™ Adjustment & Polishing Kit are ideal for adjusting and polishing zirconia, and the diamonds also work extremely well if you ever need to cut off or provide access for a root canal through a zirconia crown. Always use light pressure with water and air spray when adjusting ceramic restorations to avoid micro-fractures.
Finally, use the white cup with light to medium pressure to achieve a “wet” high shine.
Procedure to Sterilize Aluminum Bur Block
1. Sterilizers (Dry Heat, Autoclave and Chemiclave)
Operate sterilizer unit at 121°C high-pressure saturated steam for 15–20 minutes.
2. Ultrasonic Cleaning
Do not use ultrasonic solutions containing alkali products such as sodium hydroxide, potassium hydroxide, or hydroxides.
Always mix solutions according to instructions.
A five-minute cycle time is recommended.
Remove the burs from ultrasonic and rinse well with water.
Dry the bur block thoroughly before placing in sterilization pouches.