Modus Operandi Part 1: Etching

I decided to post up some artsy in-proccess shots I've been hiding. Here is a couple photos that many in dentistry will recognize. Mark is performing the final touch to a Lithium disilicate restoration, IPS e.max Press by Ivoclar. At McTech we etch every e.max crown before delivery. We use the IPS Ceramic Etching Gel and follow Ivoclar's instructions.

However, in online dental lab forums there is actually some debate surrounding this practice. Some labs do not want the "specter of liability over their heads" if a doctor fails to properly clean the restoration after a try in, which can result in a severely lower bonding strength. And to that Argument the etching instructions that come with the etching gel contain a "note" which states, "Preferably etch the reconstruction immediately before incorporation of the restoration. This prevents contamination during transport or try-in." However this is communicated as a recomendation, and not a requirement. In fact, Ivoclar even provides another product called Ivoclean, specifically designed to clean the etched surface of an e.max restoration after intra-oral try-in procedures. The following is taken from the Ivoclean scientific documents available for download at ivoclar.com .

"Very frequently, however, the restorations are pre-treated in the laboratory. Not all dental practices have the equipment required to carry out etching and sandblasting procedures. In such cases, the pre-treated restorations are tried in in the mouth of the patient, which leaves them contaminated with try-in paste, blood and saliva."" The intaglio surface is coated with Ivoclean for 20 seconds, rinsed thoroughly with water, and dried with oil-free air."

Another counter argument is that some practices may not have Ivoclean or similar products. However many labs, and as shown even the manufacturer, make the same argument that not all of practices have the etching gel.

At McTech collaboration is our defining mantra. When evaluating why we do what we do, we rely on a blend of the latest best science available, our nearly 30 years of experience, and the communication we work hard to maintain with our Doctors and their staff. We find that the practices in our community have come to expect the e.max crowns they receive from us to be already etched. We have been using IPS e.max since it's inception and in all that time have never had a doctor or staff member request that we not etch the crown before delivery. Nor have we experienced an epidemic of e.max crown retention failures.

So while the debate drudges on you know what to expect from McTech Dental Lab.