E-max Dental Crowns

Although both materials used to make these veneers were developed by the same manufacturer, their crystal structures determine their areas of application.

IPS Empress (Lithium Disilicate Glass Ceramic):

This material consists of lithium disilicate crystals embedded in a glass matrix. It has a flexural strength of approximately 160 MPa. Its light refraction and reflection properties are very close to those of natural tooth enamel.

Empress characteristics:

Natural appearance:

Its light transmission (translucency) is excellent. It mimics the optical properties closest to tooth enamel. Therefore, it provides a convincing and lifelike appearance, especially on front teeth. It does not appear artificial.

Production method:

It is generally produced using the casting technique. The veneer, shaped with wax, is obtained by casting it into a special mold. This offers the possibility of artistic detailing.

IPS Emax (Lithium disilicate glass ceramic):

It is a much stronger version of Empress technology. Thanks to the lithium disilicate crystals in its composition, its flexural strength reaches 360-400 MPa. This high durability allows Emax to be used safely not only on front teeth but also in the back regions where chewing pressure is high and even in short bridges.

Emax features:

Durability:

Its mechanical strength is almost twice that of Empress. This makes it a safe option not only for front teeth but also for crowns and bridges on back teeth.

Dual production options:

E.max CAD: For computer-aided design (CAD/CAM). After your tooth is scanned in 3D, the design is created on a computer and milled from a block in a single piece using a machine (CNC). It is a fast, precise, and modern method.

E.max Press: Manufactured using the traditional casting technique, just like Empress. Both methods offer the same quality material.

Superior aesthetics:

E.max is in no way inferior to Empress in terms of aesthetics. It offers a very wide range of colors and translucencies. Your dentist and dental technician can achieve the exact shade and light reflection that perfectly mimics your natural tooth.

Reliability:

Thanks to its high strength, the risk of cracks and fractures is minimal. This provides long-term peace of mind for both the dentist and the patient.

IPS Empress and IPS Emax porcelain laminate veneers are used to treat a wide range of dental problems with the aim of restoring the aesthetics and function of the teeth. These systems are preferred because they offer a minimally invasive approach (involving the least intervention in tooth tissue) that preserves the natural structure of the tooth. The main dental problems for which these veneers are used are as follows:

Colour and staining issues

These systems are the most effective solution in cases where teeth whitening (bleaching) methods are unsuccessful.

Severe discoloration:

Internal stains caused by the use of medications such as tetracycline or discoloration due to fluorosis.

Aging and dullness:

Teeth that darken with age or teeth that lose their vitality (devitalized) and change color due to reasons such as root canal treatment.

Existing restorations:

Aesthetic correction of old metal-ceramic or all-ceramic crowns with compromised color integrity.

Shape and size abnormalities

Used to alter the shape of teeth to meet the patient's expectations.

• Conoid (wedge-shaped) teeth: Correcting the shape of teeth that are structurally narrower or smaller than normal (peg lateral).
• Short teeth: Lengthening teeth that have become shortened due to wear or structural reasons and increasing their prominence.
• Structural abnormalities: Shape abnormalities and malformations in tooth enamel that are either genetically caused or acquired.

Alignment and spacing issues

It is applied as an alternative to orthodontic treatment or for aesthetic enhancement.

• Diastema (Tooth gaps): Closing unwanted gaps and black triangles between teeth.
• Mild misalignments: Correcting slight rotations or misalignments (malposition) in the position of the teeth.

Structural damage and wear

Repairs physical damage to tooth enamel.

• Cracks and fractures: Conceals cracks in the tooth enamel and aesthetically repairs small or large tooth fractures.
• Erosion and wear: Replaces enamel tissue lost due to acid erosion or mechanical wear.

Special application areas

Thin veneers: These ultra-thin veneers, with a thickness of 0.3 mm, are used to correct minor shape and size irregularities, particularly without touching the tooth enamel (no-prep) or with minimal intervention.

Table tops (occlusal veneers): Used to increase the vertical dimension (height) reduced due to wear on posterior teeth and restore functional loss.

Advantages:

• Natural aesthetics and color matching: Both materials provide excellent aesthetic results and match the color of the teeth perfectly. Thanks to the ‘chameleon effect’ in particular, they reflect the color of the surrounding tooth structure, offering a natural-looking integration.
• Superior light transmission: Their all-ceramic structure allows light to pass through as it does in natural teeth, creating a sense of depth; this feature is not possible with metal-supported porcelain.
• Biocompatibility: Ceramic materials are bioinert, meaning they are fully compatible with the body. They do not cause gum irritation or allergic reactions.
• High strength: IPS e.max, in particular, is one of the strongest materials among glass ceramics, with a flexural strength of around 360-400 MPa.
• Low plaque accumulation: Thanks to their smooth and non-porous surface structures, they are resistant to bacterial plaque accumulation and protect gum health.
• Chemical resistance and stability: They exhibit high resistance to oral fluids and acidic foods and are highly resistant to discoloration or wear.

Disadvantages:

Although they possess superior characteristics, these systems have certain application difficulties and limitations.

• Fragility: The materials are quite fragile in the stages prior to being bonded to the tooth and must be handled with great care.
• Technical precision: Both the preparation of the tooth and the bonding of the veneers require a high level of clinical skill.
• Repair difficulty: Once the cementation (bonding) process is complete, repairing or modifying a veneer that has cracked or broken is extremely difficult.
• Cost: These systems are more expensive than alternative restorations such as amalgam or composite. They also require specialized and costly laboratory equipment (press furnaces or CAD/CAM devices) for production.
• Irreversibility: Once the tooth enamel has been abraded, the process is irreversible; even if the veneers are removed, some intervention in the natural structure of the tooth will have occurred.
• Risk of bruxism (teeth grinding): Ceramic veneers are generally contraindicated (not suitable) for patients with severe teeth grinding habits, as they carry a risk of fracture under excessive pressure.

The application process for IPS Empress and IPS Emax veneers (lamina) is a precise, multi-stage procedure that combines the scientific and technological advances offered by modern dentistry. This process is based on a conservative (minimally invasive) approach that aims to change the shape, size, and color of the teeth in order to meet the patient's aesthetic expectations.

The application process generally consists of the following stages:

Diagnosis, planning and design

The first step for a successful result is to evaluate the overall structure of the face, the smile line and the gum line.

• Color determination: The dentist determines the target color using standard color scales such as A-D or Chromascop to ensure harmony with natural teeth.
• Smile design: Computer-assisted imaging or composite mock-up studies performed inside the mouth show the patient how the smile will look after treatment.

Tooth preparation

Veneer applications aim to preserve as much tooth structure as possible.

• Minimal abrasion: Typically, only a thin layer of approximately 0.5 mm is removed from the tooth enamel.
• Preparation techniques: Depending on the condition of the tooth, different preparation designs can be applied, such as ‘window,’ ‘butt-joint,’ or ‘incisal-lapping,’ where the cutting edge of the tooth is wrapped from above.
• Margin: A clear chamfer is created at the gum line to ensure the porcelain fits the tooth perfectly.

Impression taking and temporary restorations

Elastomeric impression materials (such as PVS) or digital intraoral scanners are used to make a precise copy of the prepared teeth. Temporary veneers are prepared to protect the teeth and maintain aesthetics until the permanent veneers are ready and are lightly fixed to the tooth using a method called ‘spot-etch.’

Laboratory production stage

Two main technologies are used for veneer production, depending on the selected material:

PRESS technology (heat pressing):

The traditional ‘lost-wax’ technique is used. The restoration is first modeled in wax, then pressed into a ceramic mold (Empress or Emax Press) at high temperature.

CAD/CAM technology (computer-aided manufacturing):

The restoration is designed in a computer environment and milled from ready-made ceramic blocks (such as Emax CAD) using a milling machine. Emax CAD blocks are fired after milling to achieve their final strength and color (crystallization).

Try-in and bonding (Cementation)

When permanent veneers reach the dentist, they are first checked for fit and color in the mouth. Try-in pastes that mimic the cement color can be used at this stage. If everything is suitable, the bonding process begins:

Preparing the Veneer Surface:

The inner surface of the porcelain is roughened with hydrofluoric acid (approximately 20 seconds), and then a silane agent (such as Monobond-S) is applied to provide a chemical bond.

Preparation of the tooth surface:

The tooth enamel is etched with phosphoric acid, rinsed, and a suitable primer/adhesive is applied.

Bonding:

Veneers are fixed to the tooth using special resin cements such as Variolink or Multilink Automix and light-cured.

Finishing and control

After bonding, any excess cement is removed and the edges of the veneer are smoothed. Finally, the patient's biting and chewing movements are checked, and fine occlusion adjustments are made. Recommendations for oral hygiene and protective care are given to the patient to ensure long-term use.

Which teeth will be treated?

If you are only having veneers done on your front 6-8 teeth and you do not have a teeth-grinding habit, Empress may be a good option due to its aesthetic performance. If you have more teeth (front and back) or a habit of clenching your teeth, Emax is definitely the preferred choice due to its durability.

What is your priority?

Pure, natural-looking aesthetics: Empress has a legendary reputation in this regard. Durability and aesthetics: Emax offers both at the highest level.

How should the production process be?

If you want a traditional, labor-intensive process, choose Empress Press or Emax Press. If you want a digital, single-session (completed on the same day) treatment, the Emax CAD method is suitable.

How much money do you have?

Emax is usually a little more expensive, but it's worth the money because it lasts longer and comes with a long-term guarantee.

What does your dentist say?

A dentist that has been doing this for a long time will look at your mouth, your bite force, your gum health, and what you want to choose the best material for you. The best decision is based on their clinical observation and advice.

Follow these rules to keep your new smile for a long time:

• Cleanliness: You should clean your teeth at least twice a day with a gentle brush and use dental floss often.
• Bad habits: Chewing ice, biting your nails, or biting pencils might break the porcelain.
• Protection: If you grind your teeth at night (bruxism), you might need to wear a sleep guard.

Is the procedure painful?

No, local anesthesia is used throughout the surgery; therefore, there is no pain. You might feel sensitive, a little tight, or sore after the treatment. This is normal and will go away in a few days. Painkillers can help with this.

Does Empress look more natural?

Empress is known for its excellent light transmission and gives everything a very natural look. But because of Emax's advanced color and translucency settings, its level of naturalness is now on par with Empress. An expert technician can make both look very natural.

Which material is more durable?

E.max is definitely stronger. It is about twice as strong as Empress when it comes to mechanics. This means there is less chance of cracks and breaks, which is a good thing, especially for people who grind their teeth or work on back teeth.

I grind my teeth (bruxism). Which one is suitable for me?

Emax is fine. It is more resistant to the extra stresses induced by bruxism since it is quite durable. But if you grind your teeth, your dentist has to make you a night guard. No matter what material you used for your restorations, this protection will make them last longer.

Is there a price difference?

E.max usually costs a little more. This is because the material and the way it is made are both quite advanced. The price, on the other hand, may change based on where the clinic is, how much expertise the dentist has, and how much the lab costs. It's crucial to think about long-term durability instead of just price.

How long do Empress Emax dental veneers last?

If you take care of it and have regular checkups, it should last 10 to 15 years or more. Because Empress is not as durable as Emax, it may not last as long. But this time is directly determined by things like how well the person takes care of their teeth, what they eat, and whether or not they grind their teeth.

Do Empress Emax dental veneers stain?

No, none of them leave stains. The ceramic material has a glazed surface that looks like porcelain and doesn't let water through. This surface is not affected by coffee, tea, cigarettes, or food colorings. The cement (adhesive) that holds them to the teeth or your natural tooth, on the other hand, may still discolor. So, it's important to clean regularly.

How much of my tooth needs to be removed when applying Empress Emax dental veneers?

Not much. It is a process that doesn't hurt too much. Usually, only a layer that is between 0.3 mm and 0.7 mm thick, or as thin as a coat of nail polish, is taken off. A "prep-free" (no cutting) veneer can also be put on sometimes, especially if your teeth aren't extremely noticeable. Your dentist will have to make a clinical judgment about this.

How many sessions does the Empress Emax dental veneer application take?

The classic approach (press technique) normally takes 2–3 sessions: preparation, impression, trial fitting, and bonding. Using the CAD/CAM (digital) method, you may do all of the preparation, design, production, and bonding in one session on the same day.

Can Empress Emax dental veneers be applied to back teeth?

Yes, they can be used with Emax in particular. It can withstand chewing forces since it is very strong. People usually prescribe Empress for front teeth. If you need crowns or veneers for your back teeth, your dentist will probably suggest Emax.

Will they be very white? Will they look natural?

No, they will not have a ‘photographic whiteness.’ The color of the veneers is selected from a natural shade scale that you desire and your dentist recommends. A color that matches your neighboring teeth and suits your age and skin tone is determined.

Can I have Empress Emax dental veneers done while pregnant?

The general recommendation for all elective (non-urgent) dental treatments is to wait until the second trimester of pregnancy (4th-6th months) or to postpone until after delivery. Be sure to consult with your obstetrician and dentist about this.

What happens if Empress Emax dental veneers fall out or break?

This is rare, especially with Emax. If it does happen, the veneer usually comes out intact and can be reattached. If it breaks, a new one will need to be made. In an emergency, you should see your dentist immediately.

What should be the most important criterion when making a decision?

Your dentist's recommendation and clinical experience are important. The decision made after evaluating your mouth structure, bite force, gum health, and expectations will be the most appropriate. The dentist's skill in applying the material is more important than the brand of the material.