Don’t get me wrong- I think the Vita blocks can be extremely esthetic when properly used.  Vita Mark II blocks are fabricated from feldspathic porcelain.  They are on the weaker side in terms of strength so I don’t use them in the back of the mouth as we have other better options for those situations. However, the Mark II blocks are an excellent material that can be used very successfully in the anterior regions of the mouth.  Their small particle size allows them to be highly polished which leads to a nice smooth surface texture and it means that you get great esthetics.  The Vita Real Life blocks are just a variation of the Mark II blocks. Same particle size, same surface but the block has a dentin core surrounded by lighter, more translucent porcelain that allows the users to adjust the restoration shade by changing the position of the restoration in the block.

What then could be the problem with these blocks if all the characteristics give the potential to be so esthetic?  Essentially the problem with the Real Life blocks isn’t when you are doing a single restoration. The problem with the blocks is when you are doing multiple restorations.  With single restorations, you adjust the position of the restoration in the block and by varying the amount of dentin porcelain and enamel porcelain, you can adjust the shade.

Take however the example below.  This patient presented to the office with trauma to the two front teeth.  Endodontic therapy was completed and the teeth prepared to receive CEREC restorations.  

Now we can talk about the preparation design at a future date but imagine if you will that you have to restore these two teeth, which we will use the Real Life blocks for.  With the current software, how are you going to guarantee that on both blocks, on both restorations, that you will have the exact same amount of dentin and enamel showing?  If you had more dentin porcelain on the left central incisor for example, then the tooth would appear darker and vice versa.

So in a situation like this, I personally don’t like and recommend the Real Life Blocks until we can get the software to position the blocks exactly.  This is what the Sirona C In blocks do and we will discuss them in a future blog.  Bottom line, Real Life blocks- great esthetics, great potential, but very difficult to get the esthetics to match on multiple unit cases.