It isn’t unusual for clinicians to regularly see patients who have clinical failures or complications related to poor occlusion. Complications can cause pain, compromise masticatory function and affect patients’ phonetics and appearance.

Increasingly, patients are demanding dental restorations that provide excellent aesthetics and functionality. Most ceramic restorations can meet these needs, and there are many different types on the market. Achieving a successful restoration depends on the clinician’s ability to select the appropriate material and follow the right preparation and cementation protocols. Selection should be based on the ceramic’s physical properties, which include fracture resistance, strength, wear resistance, and long-term durability. One of the most popular materials is zirconia. Modern zirconia is very different from its original bone-white incarnation.

The name zirconium is derived from the Arabic word “Zargun,” or golden in color, which is further derived from the Persian words “zar” for gold and “gun” for color. Zirconium is a naturally occurring element with an atomic number of 40 and is a transitional metal found in nature as the mineral Zircon. It is purified to Zirconium, a silver-colored metal that is corrosion-resistant and has properties like titanium. When combined with oxygen, it forms zirconia, a strong and highly biocompatible ceramic. Zirconium was initially discovered in the 18th century.

Shade matching is subjective and influenced by many different factors. An inaccurate shade is a common cause of remakes, as even the slightest difference between an actual shade and its perceived color makes a huge difference in the mouth and is unacceptable to the patient and clinician. Being aware of issues that can affect your perception of color, and knowing how to reduce their influence, allows you to take more accurate shades.

For many clinicians, the monthly bill from the dental lab is their second largest expense. Building an excellent working relationship with a dental lab is essential to running your dental office smoothly and efficiently. Poor communication results in numerous remakes, increased chairside, avoidable expenses and dissatisfied patients.

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 required the Department of Health and Human Services in the United States to develop regulations protecting the security and privity of specific health information. To meet these requirements, the Department published what is known as the HIPAA Security Rule and the Privacy Rule. Ensuring that the standards outlined by the Security Rule are met protects the health information covered under the Privacy Rule.

Screw-retained and cement-retained restorations each have specific qualities. Your choice of which restoration will best suit the patient depends on several factors.

There is nothing quite like the satisfaction of seating a case successfully without the need for time-consuming adjustments. Conversely, it can be very frustrating for the clinician and the patient when things don’t go smoothly. Perhaps a restoration fails to seat correctly or needs such significant adjustments that it must be returned to the lab for refinishing or entirely remaking. Poor impressions and incorrect shades are two of the most common failures resulting in remakes and adjustments, and there are many others.

The introduction of stronger and more durable ceramics over the past few years has greatly increased the clinician’s choice of materials when fabricating an all-ceramic three unit bridge. The latest generation of zirconia is suitable for three unit bridges and can restore teeth anywhere in the mouth, and IPS e.max is suitable for anterior teeth.