Case Report of All-on-X with using LayZir

Case Report of All-on-X with using LayZir

Crafting great dental restoration is as much an art as a science. But until recently, even the most talented artists in the field were limited by the materials available to them. Jungo Endo, RDT, a dental technician who has specialized in the fabrication of highly esthetic implant-supported restorations using ceramics and has been working in this field for nearly 30 years, will present a case study.

Mr. Endo opened his dental laboratory in Santa Monica, California in 2012, at which time 95% of his restorations were PFM (porcelain-fused-to-metal). At the time, this material was the industry standard, and while it allowed for strong restorations, it doubled down on the esthetic dilemma. When we first started using zirconia material, it was very opaque and came in only one shade, Endo said, “describing it as an unsightly chalky white”. Materials have since evolved, and most of the restorations produced in Endo's studio are now made of Zr. In particular, he states that LayZir has become his “go-to” material for highly esthetic restorations. According to Endo, LayZir allows him to fully express his own artistry. The difference, Endo says, lies in the value management of the material, or “brightness. I've used Zr Discs from other manufacturers before, and the results were less than ideal.” Endo says, “Most of the products have good transparency. Most products are good and transparent, but LayZir was the only one that could achieve a color tone closest to that of natural teeth.”

LayZir, which can be fabricated in a choice of 12 colors, uses a triple gradation technology that seamlessly transitions between 3Y and 5Y Zr in terms of “strength,” “translucency,” and “shade” in 5 layers. This optimizes the strength of the restoration while at the same time providing excellent esthetics. The cervical layer of this material boasts an industry-leading flexural strength of 1,450 MPa, providing ideal brightness, while the enamel layer is 44% translucency, combining natural transparency with a flexural strength of an astounding1,030 MPa, making this material ideal for veneers, inlays and bridge restorations from molars to anterior teeth, as well as full-mouth LayZir is a “One Disc Solution” that can be applied to all cases with a single material, from molar to anterior veneers, inlays, and bridge restorations to full-mouth All-on-X restorations.

In addition, because LayZir offers an excellent balance of esthetic and aesthetic properties, Dr. Endo uses it for all types of restorations, from single crowns to full jaw restorations.

In this article, he will present a case study in which LayZir was used for a fixed full-arch implant-supported restoration.

Dr. Endo is a member of Oral Design and specializes in the fabrication of highly esthetic implant-supported type restorations and is an internationally renowned speaker in this field.

In this case, a 48-year-old patient with severe masticatory function loss due to severe periodontal disease was restored with All-on-X (fixed full-arch implant-supported restoration) using Zr as upper and lower full-arch prosthetic treatment to restore function and esthetics.

Chairside (1)

  1. Before
    Preoperative findings: Severe periodontal disease resulted in severe swaying and loss of masticatory function.



  2. Implant placement after tooth extraction
    Remaining teeth were extracted from severe periodontal disease and implants were placed.



  3. Provisional stracture attached.
    A PMMA disc and light-cured composite materials, SHOFU LiteArt and CeramageUP, were used to create the provisional, then placed it to the patient.



Lab Side

  1. Zr Disk LayZir Milling
    All-on-X restorations were performed using LayZir, an All Indication Zr material with high esthetic and scientific properties. All mandibular anterior teeth and molars were fully anatomically stained, and only maxillary anterior teeth were micro-cut back.



  2. Zr full arch after sintering
    The A1 shade was selected for this case. When the upper and lower jaws were mounted on the model after sintering, LayZir showed minimal distortion and required almost no occlusal adjustment. In addition, an ideal transition of brightness and coloration from the cervical area to the incisal area can be seen.






  3. Firing of ceramic on Zr frame
    Gum porcelain is built up and fired on the gingival area. Next, crown porcelain was built up and fired on the micro-cutback area of the crown. After the morphological modification, staining and creasing were performed using Vintage Art Universal and Yamamoto Liquid.



【Chairside(2)

Placement of final prosthesis in the mouth
The Zr disc LayZir used in this project has a high level of patient satisfaction due to its high esthetic and scientific characteristics.





This time, a patient who had lost masticatory function and esthetics due to severe periodontal disease underwent a full jaw restoration using implants and Zr. The Zr material used this time was LayZir, which is marketed by SHOFU Lab USA/Smart Dentistry Solutions, a Japanese dental material manufacturer. Both esthetic and physical properties of the material were high, and the patient was highly satisfied with the material, so we were able to use it with confidence.

 

CV of Clinical Case Presentation

Jungo Endo (RDT/Oral Design Hermosa Beach)

1995 Graduated from Yamagata Dental Technology College
Completed Master's Course in Ceramics at Osaka Ceramic Training Center
Received the Shigeo Kataoka Award in 1999
Worked in Los Angeles private dental laboratory for 6 years
2005 UCLA Master Ceramist, UCLA Advanced Prosthodontic Laboratory Training Co-Instructor
2012 Opened Jungo Endo Dental Studio/Santa Monica
2018 Oral Design Hermosa/Hermosa Beach relocation

Dr. Tasuku Teruya (DDS/Gussuri Dental Clinic Fukushima)

2011 Graduated from Ohu University School of Dentistry
2013 Director of Kira Kira Dental Clinic
2017 Director, Gussuri Dental Clinic