Dentsply Sirona CEREC Zirconia meso User manual

New as of:
02.2018
CEREC Zirconia meso
Zirconium oxide ceramic blocks for Sirona CAD/CAM
systems
Processing instructions: Manufacture of individually
designed directly screw-retained crowns on Sirona TiBase
English

Table of contents Dentsply Sirona
Processing instructions CEREC Zirconia meso
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Table of contents
1Introduction ............................................................................................................. 4
1.1 Dear Customer,............................................................................................ 4
1.2 Contact information...................................................................................... 4
1.3 Copyright...................................................................................................... 4
2General data ........................................................................................................... 5
2.1 Certification .................................................................................................. 5
2.2 Structure of the document............................................................................ 5
2.2.1 Identification of the danger levels .................................................. 5
2.2.2 Formats and symbols used............................................................ 5
2.3 Other relevant documents............................................................................ 6
3Scope of supply ...................................................................................................... 7
4Material ................................................................................................................... 8
5Chemical composition............................................................................................. 9
6Technical data ........................................................................................................ 10
7Intended use, indications and contraindications, and important processing
restrictions............................................................................................................... 11
7.1 Intended use ................................................................................................ 11
7.2 Indications.................................................................................................... 11
7.3 Contraindications ......................................................................................... 11
7.4 Important processing restrictions ................................................................. 12
8Creating the restoration .......................................................................................... 13
8.1 Scanning, designing and milling/grinding..................................................... 13
8.2 Design information ....................................................................................... 14
8.3 Rework of the grounded/milled restoration .................................................. 15
8.4 Drying before sintering................................................................................. 15
8.5 Sintering....................................................................................................... 16
8.6 Additional notes: procedure after sintering .................................................. 18
8.7 Rework......................................................................................................... 18
8.8 Veneer ......................................................................................................... 19
8.9 Polishing ...................................................................................................... 19
8.10 Painting and coating .................................................................................... 19
9Recommended tools and materials ........................................................................ 21

Dentsply Sirona
Processing instructions CEREC Zirconia meso
Table of contents
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10 Glue the directly screw-retained crown onto the titanium base .............................. 22
11 Seal the screw channel........................................................................................... 23
12 Information for the dentist ....................................................................................... 24
12.1 Sterilization .................................................................................................. 24
12.2 Application in the mouth............................................................................... 24

1 Introduction
1.1 Dear Customer,
Dentsply Sirona
Processing instructions CEREC Zirconia meso
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1Introduction
1.1 Dear Customer,
Thank you for purchasing the Dentsply Sirona product CEREC Zirconia
meso.
CEREC Zirconia meso blocks are intended for use in manufacturing
individually designed, directly screw-retained crowns and partially
reduced, directly screw-retained crowns, which are glued to a fitting
titanium base after milling/grinding and sintering.
Improper use and handling can create hazards and cause damage.
Please therefore read and follow these operating instructions carefully.
Always keep them within easy reach.
Also pay attention to the safety instructions in this document to prevent
personal injury and material damage.
Please also observe the instructions provided by the manufacturer of
the titanium base or the implant.
Your
CEREC Consumables Team
1.2 Contact information
Manufacturer's address Sirona Dental Systems GmbH
Fabrikstrasse 31
64625 Bensheim
Germany
Tel.: +49(0) 6251/16-0
Fax: +49(0) 6251/16-2591
e-Mail: [email protected]
www.dentsplysirona.com
1.3 Copyright
© Sirona Dental Systems GmbH. All rights reserved.

Dentsply Sirona
Processing instructions CEREC Zirconia meso
2 General data
2.1 Certification
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2General data
Please read this document completely and follow the instructions
exactly. You should always keep it within reach.
Original language of the present document: German.
2.1 Certification
CE mark
0123
The CEREC Zirconia meso product bears the CE mark in accordance
with the provisions of Council Directive 93/42/EEC of June 14, 1993
concerning medical devices.
For the USA only
CAUTION: Federal law (USA) restricts sale of this device to or on the
order of a physician, dentist, or licensed practitioner.
2.2 Structure of the document
2.2.1 Identification of the danger levels
To prevent personal injury and material damage, please observe the
warning and safety information provided in these operating instructions.
Such information is highlighted as follows:
DANGER
An imminent danger that could result in serious bodily injury or death.
WARNING
A possibly dangerous situation that could result in serious bodily
injury or death.
CAUTION
A possibly dangerous situation that could result in slight bodily injury.
NOTICE
A possibly harmful situation which could lead to damage of the
product or an object in its environment.
IMPORTANT
Application instructions and other important information.
Tip: Information for simplifying work.
2.2.2 Formats and symbols used
The formats and symbols used in this document have the following
meaning:

2 General data
2.3 Other relevant documents
Dentsply Sirona
Processing instructions CEREC Zirconia meso
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Prerequisite
1. First action step
2. Second action step
or
➢ Alternative action
Result
➢ Individual action step
Prompts you to do something.
See “Formats and symbols
used [→5]”
Identifies a reference to another text
passage and specifies its page num-
ber.
● List Designates a list.
“Command / menu item” Indicates commands, menu items or
quotations.
2.3 Other relevant documents
● Operating instructions for titanium bases and implants,
● Operating instructions for the consumables used during application,
● User manual for the software used (e.g. CERECSW,
CERECPremiumSW, inLabSW),
● Operating instructions for the sintering furnace used (e.g. CEREC
SpeedFire, inFireHTC and inFireHTC speed).

Dentsply Sirona
Processing instructions CEREC Zirconia meso
3 Scope of supply
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3Scope of supply
CEREC Zirconia meso blocks are each available in four different classic
colors (A1, A2, A3, and A3.5) and in two different sizes for connecting to
the titanium base (S and L):
CEREC Zirconia meso S
Product REF Product name
6623016 CEREC Zirconia meso S A1
6582428 CEREC Zirconia meso S A2
6582436 CEREC Zirconia meso S A3
6582444 CEREC Zirconia meso S A3.5
CEREC Zirconia meso L
Product REF Product name
6623024 CEREC Zirconia meso L A1
6582451 CEREC Zirconia meso L A2
6582469 CEREC Zirconia meso L A3
6582477 CEREC Zirconia meso L A3.5
The blocks feature identical dimensions of 24 mm x 23 mm x 21.5 mm
(L x W x H).

4 Material Dentsply Sirona
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4Material
CEREC Zirconia meso ceramics constitute blocks comprised of
translucent zirconium oxide.
The blocks are initially delivered partially sintered; they are then
enlarged with the Sirona CAD/CAM systems for processing as
individual restorations before being densely sintered. In the final step,
the restorations attain their final size and geometry through shrinkage.
The aesthetic features of CEREC Zirconia meso enable application as
implant-supported fully anatomical crowns.
The advantages of CEREC Zirconia meso include:
● High strength,
● Resistance to corrosion,
● Good biological compatibility of the product,
● Translucency,
● Coloration of the blocks to match classic tooth colors A1 - A3.5.

Dentsply Sirona
Processing instructions CEREC Zirconia meso
5 Chemical composition
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5Chemical composition
The chemical composition of the zirconium oxide ceramics of CEREC
Zirconia meso is described in the following table:
Component CEREC Zirconia meso
ZrO2+HfO2+Y2O3≥ 99.0%
Y2O3> 4.5% - ≤ 6.0%
HfO2≤ 5 %
Al2O3≤ 0.07%
Other oxides ≤ 1.1%

6 Technical data Dentsply Sirona
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6Technical data
The following specifications apply to material that is densely sintered in
a CEREC SpeedFire, inFire HTC, or inFire HTC speed sintering
furnace.
Density: 6.08 ± 0.2 g cm-3
Fracture toughness KIC 7.1 MPa m1/2
Thermal expansion coefficient (20 - 500 °C): 10.5·10-6 K-1
Bending strength: > 900 MPa
Grain size ≤ 0.4 µm
Chemical solubility < 25 µg/cm2
Colors:
The blocks are available in four different classic colors:
● A1
● A2
● A3
● A3.5

Dentsply Sirona
Processing instructions CEREC Zirconia meso
7 Intended use, indications and contraindications, and important processing restrictions
7.1 Intended use
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7Intended use, indications and
contraindications, and important
processing restrictions
7.1 Intended use
Manufacture of individually designed dental restorations from CEREC
Zirconia meso blocks using Sirona CAD/CAM systems.
CEREC Zirconia meso blocks are intended for use in manufacturing
individually designed directly screw-retained crowns, which are glued to
a fitting titanium base after milling/grinding and sintering.
7.2 Indications
Indications in dentistry areas:
●Directly screw-retained crown: A fully anatomical crown for the front
and lateral tooth area produced via the CAD/CAM process that
already has a drill hole in the block. This crown is glued to a fitting
titanium base after milling/grinding and sintering and then fixed into
the patient's mouth with a screw on an implant.
●Partially reduced directly screw-retained crown: Like a directly
screw-retained crown, but with reduced wall thickness. The partially
reduced crown is veneered with veneering ceramics. The screw
channel for fixing onto the implant is not sealed with veneering
ceramics.
In both versions the screw channel is only sealed in the patient's mouth
using a composite.
Sintering in inFire HTC speed and inFire HTC
Sintering must take place with the pre-programmed Speed and Classic
programs in inCoris TZI / ZI in inFire HTC speed and inFire HTC.
Sintering in CEREC SpeedFire
Sintering must take place with the programs for CEREC Zirconia meso
in the CEREC SpeedFire.
7.3 Contraindications
Contraindications in areas of dentistry:
● Insufficient oral hygiene
● For restorations with angulation correction of more than 20° to the
implant axis
● For individual tooth restorations with free end saddle
● Insufficient space available
● For restorations with a length to implant length ratio of more than
1:1.25

7 Intended use, indications and contraindications, and important processing restrictions
7.4 Important processing restrictions
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7.4 Important processing restrictions
Working successfully with CEREC Zirconia meso cannot be guaranteed
by Dentsply Sirona in the event of a failure to comply with the following
instructions:
● With a directly screw-retained crown the outlet for the screw channel
must not be in the area around the contact points or be on functional
masticatory surfaces. A frame and separate crown is preferred if this
is not possible.
● Failure to observe the manufacturer's instructions for processing
titanium bases and implants.
● No extension links, i.e. exclusively individual tooth supply.

Dentsply Sirona
Processing instructions CEREC Zirconia meso
8 Creating the restoration
8.1 Scanning, designing and milling/grinding
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8Creating the restoration
8.1 Scanning, designing and milling/grinding
Further details on the manufacturing processes for the restorations can
be found in the user manuals for the following software products:
● CEREC SW
● CEREC Premium SW
● inLab SW
1. When working on the model: Plug a titanium base onto the lab
implant of the master model. Plug a scanbody onto this until it
comes to rest on the shoulder of the implant without any gaps. The
scanbody is scannable without powder or scan spray.
For intraoral working: Plug a ScanPost directly onto the implant.
Plug a scanbody onto this until it comes to rest on the shoulder of
the implant without any gaps. The scanbody is scannable without
powder or scan spray.
2. Scan the situation with a scanner, e.g. inEos Blue, inEos X5 or an
acquisition unit.
3. Design the individual shape of the directly screw-retained crown
with one of the software products CEREC SW, CEREC Premium
SW or inLab SW and mill/grind the shape from a CEREC Zirconia
meso block (see user manual). The following information must be
observed when designing, reworking and sintering zirconium oxide.
IMPORTANT
The manual trim function should be used for optimum results with
CEREC Zirconia meso during the restoration design process using
one of the aforementioned software products. The design proposals
must be reviewed with particular care if the
"Auto Trim" function is
used. In some cases the thickness of the approximal contacts cannot
be displayed correctly.

8 Creating the restoration
8.2 Design information
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8.2 Design information
AScrew channel
BTitanium base
● Maintain a minimum wall thickness of 0.5 mm circularly around the
screw channel.
● The outlet point for the screw channel should not be in the area
around the contact points to the antagonist wherever possible.
● If the crown is to be reduced and then veneered immediately, make
sure that this does not narrow the screw channel. The connection
point to the adhesive base and the screw channel must not be
changed.
● Make sure that no sharp edges or corners are produced.
● The incisal/occlusal wall thickness of the ceramic above the titanium
base should be at least 1 mm.
● The circular wall thickness above the titanium base should be at
least 1 mm.

Dentsply Sirona
Processing instructions CEREC Zirconia meso
8 Creating the restoration
8.3 Rework of the grounded/milled restoration
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8.3 Rework of the grounded/milled restoration
After the grinding/milling process and prior to sintering, the restoration
must be separated using a carbide milling machine (Dentsply Sirona
recommends: HM489FC 023 from Meissinger).
To prevent milling residues from remaining in the fissures, the
restoration can be briefly steamed off or cleaned with water and a soft
toothbrush.
In the case of dry-milled restorations we recommend that these are
freed from dust using a ceramic brush or compressed air.
Make sure you do not inhale abrasive dusts. Use a vacuum system and
wear a mask.
Block remains and the block holder do not need to be disposed of
separately. They can be disposed of as normal household waste. This
also applies to trepanated restorations.
8.4 Drying before sintering
No drying is required for dry-milled restorations (with no water cooling).
The CEREC software makes a drying program available for the CEREC
SpeedFire furnace for drying restorations.
NOTICE
Prior to sintering in the inFire HTC or inFire HTC speed, restorations
processed with water cooling (wet milling/wet grinding) must be dried
for 10 minutes at 150°C (302°F) in the drying cabinet. Residual
moisture in the material can cause the restorations to burst.
NOTICE
In the case of high humidity
In an environment with a high level of humidity, the restorations can
absorb moisture after drying. For this reason, sintering must take
place within a maximum of one hour after drying.

8 Creating the restoration
8.5 Sintering
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8.5 Sintering
Restorations made from CEREC Zirconia meso have to be sintered in
dry conditions.
The Sirona inFire HTC, inFire HTC speed and CEREC SpeedFire
sintering furnaces offer programs with a pre-drying function.
In addition the restorations processed with water cooling (wet milling/
wet grinding) must be pre-dried beforehand for 10 minutes at 150°C
(302°F) in the drying cabinet for sintering in the inFire HTC and inFire
HTC speed furnaces.
The sintering process should preferably be performed in a Sirona
sintering furnace.
When sintering in the inFire HTC/HTC speed, use the pre-programmed
inCoris TZI / ZI program.
When sintering in the CEREC SpeedFire, the CEREC software
automatically selects the program. Observe the information in the
operating instructions for the furnace.
The classic program for sintering with CEREC Zirconia meso is the
same as for inCoris TZI / ZI. The sintering result from furnaces other
than those specified here cannot be guaranteed by Dentsply Sirona.
As an alternative, the sintering process can be carried out in the
compatible VITA Zyrcomat or Ivoclar Vivadent Sintramat high
temperature furnaces. Use the following zirconium oxide program for
this.
Sintering program for other furnaces
Heating rate
°C/min
Holding temperature
°C
Holding time
min
25 800 0
15 1510 120
30 200 0
In any case, the details in the manuals for the respective furnaces are to
be adhered to.
Sintering in CEREC SpeedFire
When sintering in the CEREC SpeedFire furnace, place the restorations
with the occlusal surface directly on the top door insulation.
NOTICE
Maximum Observe restoration size
Observe the maximum Furnace chamber size when loading the
furnace.
- Diameter: 38 mm
- Height: 20 mm
The restoration must be placed on the labial surface when sintering if
the restoration exceeds 20 mm (block height 22 mm).

Dentsply Sirona
Processing instructions CEREC Zirconia meso
8 Creating the restoration
8.5 Sintering
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Sintering in inFire HTC or inFire HTC speed
When using an inFire HTC or inFire HTC speed, place the restorations
in the sintering tray with the occlusal surface on the sintering beads.
If several restorations are sintered at the same time, these must not
touch the edge of the sintering tray or each other.
Notes on sintering in an inFire HTC speed from serial numbers 5000
to 5699
NOTICE
Reprogramming heat curves
As a result of a modified component in inFire HTC speed from serial
numbers 5000 to 5699, depending on the local power grid your
furnace may show signs of an increased heating rate. Please
program the following heat curves for CEREC Zirconia meso and use
this or the "classic" program for sintering.
For speed sintering "speed":
On program stations 20 to 26:
Heating speed
°C/min
Holding tempera-
ture
°C
Holding time
min
S4 99 750 0
S3 99 1100 0
S2 50 1510 30
S1 99 800 5
For speed sintering with pre-drying "speed + dry":
On program station 27 or 28:
Heating speed
°C/min
Holding tempera-
ture
°C
Holding time
min
S4 99 750 0
S3 50 1510 30
S2 99 800 5
S1 15 80 30
For speed sintering "speed + air":
On program station 29 or 30:
Heating speed
°C/min
Holding tempera-
ture
°C
Holding time
min
S4 99 750 0
S3 99 1100 0
S2 50 1510 30
S1 99 500 0

8 Creating the restoration
8.6 Additional notes: procedure after sintering
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8.6 Additional notes: procedure after sintering
In the case of yellow staining of CEREC Zirconia meso restorations
after the sintering process, the high-temperature furnace should be
cleansed by performing an empty run. The details in the manuals for the
respective furnaces are to be adhered to in this case.
This is not necessary for CEREC SpeedFire due to the different heating
concept.
Sintering beads that adhere are to be removed carefully.
After the sintering process, the restorations from CEREC Zirconia meso
blocks must be cooled down to room temperature before further
processing.
8.7 Rework
The surface condition of ceramic materials is decisive for their bending
strength. Reworking sintered restorations with milling tools, especially in
the connector region, must be avoided at all costs.
Corrections to the grounded restoration should be completed if possible
before sintering.
One of the following tools should be used if rework is required in
sintered state:
● Wet grinding turbines (approx. 2.5 bar - 3 bar),
● Rubber polisher (low speed),
● With primary telescopes, a milling device with water cooling and low
grinding pressure,
● Soft diamond rubber polisher (Dentsply Sirona recommends: EVE
DIASYNT PLUS / DIACERA).
Follow the manufacturer's instructions for the tools.
The sintered restorations should also be polished prior to applying the
enamel coating in order to prevent abrasion to the antagonist following
potential loss of shine.
CEREC Zirconia meso can be polished with all standard polishing
agents for zirconia ceramics (Dentsply Sirona recommends: EVE
DIASYNT PLUS / DIACERA). Subsequent heat treatment
(depressurization fire) is not necessary.
NOTICE
Observe usage information
Etching with hydrofluoric acid does not produce a retentive surface.
Silanization is not required
Please observe the information on use of the fastening materials of
the corresponding manufacturers.

Dentsply Sirona
Processing instructions CEREC Zirconia meso
8 Creating the restoration
8.8 Veneer
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8.8 Veneer
The areas of the reduced crowns to be veneered that are made of
CEREC Zirconia meso may not be sandblasted or reworked.
Sandblasting could lead to an undesirable phase transformation of the
zirconium dioxide.
For the veneer, this would cause complex diffusions of stress along the
interface which might lead to cracks or late cracks in the veneer after
the restoration is inserted.
Make sure that the screw channel is not narrowed when the veneering
ceramics is applied. The connection point to the adhesive base and the
screw channel must not be changed.
Reduced crowns made of CEREC Zirconia meso can be veneered with
veneering ceramics for zirconium oxide ceramics (Dentsply Sirona
recommends: Cercon® Ceram Kiss from Dentsply Sirona).
In this case the manufacturer's processing instructions must be
observed without fail.
8.9 Polishing
The sintered restorations should also be polished prior to applying the
enamel coating in order to prevent abrasion to the antagonist following
potential loss of shine.
Restorations made from CEREC Zirconia meso can be polished with
rubber polisher (Dentsply Sirona recommends: EVE DIASYNT PLUS /
DIACERA) for processing zirconium oxide. Subsequent heat treatment
(depressurization fire) is not necessary.
8.10 Painting and coating
Restorations made from CEREC Zirconia meso can be finalized using
paints for zirconium oxide ceramics. Celtra Universal Stain from
Dentsply Sirona is suitable for this purpose. In this case the processing
instructions for the relevant product must be observed without fail.
Restorations made from CEREC Zirconia meso blocks can be finalized
using glazes for zirconium oxide ceramics. CEREC SpeedGlaze from
Sirona and Celtra Universal Stain & Glaze from Dentsply Sirona are
suitable for this purpose.
NOTICE
No glaze on/in the adhesive area/screw channel
No glaze must under any circumstances get onto the adhesive area
for the restoration to the titanium base or into the screw channel as
this impairs the fit.

8 Creating the restoration
8.10 Painting and coating
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Processing instructions CEREC Zirconia meso
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The following step-by-step instructions illustrate the glazing process
using the CEREC SpeedFire furnace as an example.
1. Always use a slim restoration holder wherever possible for glazing
restorations which does not touch the inner surfaces when glazing.
Use the "Glasur Support Single Unit" restoration holder from Sirona.
2. Use the CEREC SpeedPaste from Sirona for fastening onto the
restoration holder and for closing the screw channel.
3. Press the thinnest tapered pin into the screw channel filled with
CEREC SpeedPaste.
4. Spread/model the CEREC SpeedPaste in such a way that the
screw channel is sealed and the adhesive surface to the TiBase is
covered and no glaze/spray can get onto these surfaces.