Not too Ugly...CEREC Zirconia Bridge
Fortunately our chairside options for bridge blocks is growing. With Ivoclar Vivadent coming out with some blocks, 3M and Katana Noritake will be releasing there STML bridge block later too. Originally I used to push the limits with IPS e.max bridges with the B32 block. I had one failure with connectors that were adequate 18mm2 but they were short. Now I tend to only do IPS e.max bridges if I am doing an anterior case or a premolar pontic.
So here is a case that I just did with CEREC Zirconia A3 in the medi S block. The challenge with CEREC Zirconia in my opinion is the opaqueness and the high value. For me, I'm always trying to tone that brightness down and give the restoration more depth of color. What has worked well for me is infiltration stains from VITA and then stain and glaze to follow. Here is a lower posterior bridge that I just delivered. After design in the software, I used my infiltration stains and then did 45 minutes drying and sintering cycle.
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I bought the Zig Detailer Brushes on Amazon for like $5/each.
After the sintering cycle, I fired the case on P4 with Empress Stain and Glaze. I used a bit of Mahogany in the grooves and for the embrasures. A little bit of A shade stain for the gingival aspect. Added very little Incisal 1 (Blue) for the translucency for the cusp tips. And then white to create accents and highlight the other colors. 
Overall this case isn't perfect, but I think it is a good option for us chairside. As an aside, I did this case in two appointments. Milled the provisional bridge with 2M2 Vita CAD Temp.
Dan, that looks very nice! What Pontic design did you use? (Ovate modified ridge lap, etc).
Thanks
Kevin
When people dismiss Cerec Zirconia quickly I always remind them a little infiltration staining goes a long way and with a little practice can look great.
Great bridge Dan!
On 6/5/2019 at 2:07 pm, Daniel Wilson said... Thanks Kevin, This was a modified ridge lap. I tend to do this for my posterior Bridges
Great work Dan.
I just have a little concern with the pontic design from a periodontal perspective. I see this a lot coming from my referrals as well but can't quite understand the rational behind this design. A pontic area like that in a site with minimal-no keratinized gingiva will be hard for the patient to keep clean....unless of course it is wide open on the lingual but even then it comes down quite a bit on the buccal.
Farhad
Farhad, It is more open on the lingual aspect, but I see what you are saying. Are you a fan more of the hygienic pontic when there is a lack of keratinized tissue or would you prefer to have this 2-3mm less apical?
