The initial research for Vident’s VITA Enamic began years ago at Boston University, and Dr. Russell Giordano was there from the beginning.
Here, he takes us behind the scenes of this product’s development and outlines the benefits of VITA Enamic, a new category of CAD/CAM material and the first hybrid dental ceramic with a dual-network structure that combines the best properties of ceramic and composite materials.
Q: What was the idea behind VITA Enamic?
A: It’s a completely new material with a combination of a ceramic sponge matrix with a small amount of polymer. That created a whole different set of challenges, to make sure we had the proper network with bonding materials that were stiff enough but not too stiff to be used for natural teeth.
One of the issues we wanted to avoid was the problems of composite resins. We also wanted to make sure the material wasn’t as stiff or as brittle as a conventional ceramic. It took a number of years to figure out the proper networks with wear properties, with machinability, materials that were stiff enough but not too stiff. There were a lot of properties that had to be examined and a lot of steps.
Q: What advantage does VITA Enamic offer over a conventional composite resin?
A: A conventional composite resin has individual filler particles. With Enamic, we essentially have a ceramic backbone or a ceramic sponge network. All that ceramic is connected like a sponge and then the pores are filled with polymer. That type of interconnected network is unique. That small amount of polymer gives the material some flexibility, which improves the machinability and decreases milling time. You don’t go through as many burs when you are milling these blocks because they do not gum up the bur. A typical crown mills out in about four minutes; it is usually double for a conventional ceramic. You also don’t have the chipping you see with conventional ceramic materials.
Q: What was the biggest challenge?
A: Figuring out the proper network so we would have the right connection between the ceramic and the amount of polymer in the final material. The whole processing step had never really been done before. You have to compensate for a number of different things that are going on during the curing process, and it took a lot of time to figure out how to do that properly.
Q: What feedback have you received?
A: So far all the news has been excellent. It has about 6 years worth of clinical trials. The edges are very sharp, so you don’t see all the chipping. The surface finish is smoother and you can get away with less tooth reduction, so you can use this material for a lot more cases. And the machining properties are well beyond what we ever imagined when we were making this material.
Q: How can labs best incorporate VITA Enamic?
It’s something they can jump into. In the area of single units, it’s pressing versus milling, which is more cost efficient. At this point, with the milling speed you can get with this material, it’s more cost efficient to mill things than to press them out. You don’t have to do any investment. You no longer wax up and you burn out. You just stick the block in, and four minutes later, you have your restoration. In the area of fabricating veneers, you can mill this to 3/10th of a mm and then finish it down to 2/10th in cases where you have minimal preps for veneers. So you also shift your fabrication procedures from conventional, whether it’s platinum foil or refractory or pressing, to milling for a veneer in only a few minutes. It is extremely quick and very easy to do.
Q: How do you see this product changing the industry?
The initial offering is really a small corner of all the possibilities for the different types of ceramics and polymer combinations. There are a lot of applications for this material, including implant abutments, crowns on top of implants, dentures and frameworks. A whole slew of materials can be made based on this structure by slightly changing some of the variables. There has been some independent testing on different Enamic variations that show you can go even thinner and start to approach 0.5 mm, the same minimum thickness some manufacturers claim for zirconia crowns. There is going to be a shift to materials that contain some sort of polymer because of the resilience and the improved machinability versus conventional ceramics or conventional composite resin.