Achieving esthetic results with Cercon

July 19, 2017

 When zirconia was first introduced for dental restorations, it was mainly used for posteriors. Between its color and opacity, it just didn’t look right for applications in the front of the mouth. Over time, and as manufacturers have brought new versions to market, the esthetics have improved. And the latest version by Dentsply Sirona-Cercon xt-is an impressive step in the right direction.

When zirconia was first introduced for dental restorations, it was mainly used for posteriors. Between its color and opacity, it just didn’t look right for applications in the front of the mouth. Over time, and as manufacturers have brought new versions to market, the esthetics have improved. And the latest version by Dentsply Sirona-Cercon xt-is an impressive step in the right direction.

Formula

Cercon comes in two different varieties: Cercon ht and Cercon xt.

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“Cercon ht is high translucency zirconia,” says Thomas Blanchette, lab manager at B&R Dental Laboratory in San Antonio. “It’s commonly getting known as posterior zirconia. It has a flexural strength of 1,200 MPa and a translucency level of about 40 percent. This is comparable to all the other BruxZir-type products or full-contour zirconia out there. What’s valuable about this product is that it is specifically shaded, and it is the most accurate shaded system on the market today.

“Cercon xt is extra translucent,” Blanchette continues. “This material drops a little in strength; it drops to about 750 MPa. So, what happens is you have a drop in strength, but you have an increasing translucency. The translucency goes up to about 49 percent on this material, so, basically, what this is able to do is it lets us do all other indications in the mouth that you can prescribe for a zirconia crown. What we are doing in our lab today is we’re saying that for anything in the posteriors, prescribe Cercon ht. For anything anterior, prescribe Cercon xt, due to the fact that in the posteriors you have less esthetics and in the anterior more esthetic is desired.”

Blanchette has used Cercon for about six months and he says it proves to be a solid performer when compared to other formulations.

“Initially this was something we were pushing for,” Blanchette says. “Some other people released their own products on the market. Some had good products, some didn’t. It was very hit or miss when you just chose to go all in with the company. For instance, if we purged all our old products and just went with a new product, it was very hit or miss as to whether you have a consistent product. But since it came out, we’ve had zero issues. And once we had three months of good production with it, we completely adapted all of our production to it.”

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Handling

“Where Cercon xt and ht shine is, in the laboratory sense, the esthetics,” Blanchette says. “It is by far one of the best materials out there. It blows everything away. The Cercon xt is just as translucent as anything out there without any of the problems that come with any of the other brands, such as graying and no shade matching.

“What’s also nice about the Cercon xt versus any other product out there is the other products are required to be dipped or hand-painted,” Blanchette continues. “This leads to a lot of inconsistencies. This leads to a lot of wrong shades, wrong patterns and sometimes a lack of esthetics. Where Cercon xt comes in is it’s a milled product, it’s straightforward. It’s such a nice product that there’s no need to dip it, paint it or anything like that. It’s a great monolithic crown when it comes out of the oven.”

Cercon takes extra steps out of the workflow because it comes preshaded.

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“Everything is shaded,” Blanchette says. “Everything is specific to exactly what we need. So, if the doctor prescribes an A2, you get an A2. It takes a lot of the variables out. It takes a lot of the inconsistencies out. It’s a very consistent product, time and time over again.”

Sintering is also simplified since the two materials can be fired at the same temperature.

“When you sinter the material and you take it from a soft, millable state into its crystallization state, both discs are able to fire on the same sintering cycle,” Blanchette says. “What that enables us to do is high manufacturing. No longer do you need to run one cycle for one material and then another cycle for another material. What you can do is load up all the materials in one batch, fire it and go.”

In addition, Cercon xt is easier to fine-tune, thanks to its properties.

“Because it drops in strength, it is a lot easier to adjust,” Blanchette says. “One of the big complaints about BruxZir is that you have to grind it with a diamond, and there are a lot of adjustments that are very, very difficult to adjust. However, with these new materials, the adjustments take a lot less time and it’s a lot less difficult to adjust. There are very minimal adjustments and you can do them with rubber wheels. It’s not a very rugged product, it’s a very smooth product.”

What do doctors think?

Dr. Michael Zingalis, DDS, a general dentist in San Antonio and a client of Blanchette’s, says that he has had better quality crowns as a result of using Cercon.

“The Cercon material is great since it’s more lifelike with its translucency,” Dr. Zingalis says. “And there’s a faster turnaround time from the lab.”

Because of its esthetics and strength, Dr. Zingalis says he is able to use Cercon anywhere he chooses.
“All areas of the mouth, mainly posterior so far for me,” Dr. Zingalis says. “If the patient has a pretty standard shade, we’ll use it on anterior, but if the patient needs a custom shade, I actually still send the part to the lab for the custom shade.”

Dr. Zingalis doesn’t seem to be alone. According to Blanchette, there is plenty of demand for Cercon xt-and his business is benefiting from it.

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“The first month I adopted it, I had 10 percent growth,” Blanchette says. “The second month I adopted it, I had 23 percent growth, and after six months I am up 40 percent, due to the fact that all of the doctors are wanting my stuff now.

“The motto for our lab is: ‘Work quality and service make the difference,’” he continues. “We’re not really a price point lab, so when doctors do get the product, they know this is the best material on the market today.”

For Blanchette, Cercon xt seems to be the zirconia that covers all the bases.

“Cercon xt is pretty much the universal prescription,” Blanchette says. “It’s a great product. You can stack porcelain to it. You can use it for any indication, from a posterior crown to an anterior crown to an anterior esthetic crown, which has layered porcelain to it. And we’ve even taken it as far as to doing the All-on-4 zirconia products. They’re coming out absolutely phenomenal. Patients are ecstatic when they get an all-zirconia hybrid bridge. It’s indicated for almost any use possible."