IPS

InLine PoM

Press-on-Metal Ceramic

Edition
LOVE FOR DETAIL ESTHETICS AND MORPHOLOGY

Dieter Grbel

The joy of being a dental

pletely translated into a

technician and love for

restoration by pressing

detail are important factors

ceramic material to metal,

for a constant personal

the morphology becomes

development.

the most important aspect

of my work again.

I have been trying for years

to perfect my imitations of

I would like to point out

the natural shape and anat-

that all the items presented

omy of the tooth. However,

in this report are not clinical

as a result of each tooths

cases, but merely case

individual structure, in

simulations. These studies

particular when planning

help to illustrate the

the shrinkage during the

numerous application

individual firing cycles, the

options offered by IPS InLine

focus is lost. Because an

PoM.

anatomical wax-up is com2

Love for Detail

Todays patients strive for

requirement, but it is quite a

is to meet all criteria in

row of teeth. The morphol-

perfect harmony and

task for the dental technician.

terms of naturalness and

ogy is the key to a

natural-looking esthetics.

The most difficult challenge

function when fabricating a

harmonious result in the

This may seem a simple

dental technicians are facing

tooth or replacing an entire

patients mouth.

Esthetics and Morphology

The (tooth) shade is not the

tion. Other factors, such as

tongue, lips and cheeks ,

anatomical wax-up are

sole factor for the success of

masticatory function

are also crucial. The IPS

reproduced in the

a restoration. Rather, the

(static/dynamic occlusion),

InLine PoM (Press-on-Metal)

pressed ceramic object.

morphology allows an

phonetics and the absence

ceramic is perfectly suited

My focus is the lifelike

esthetic and harmonious

of irritations of the anato-

for creating the restoration.

design of the teeth.

integration of the restora-

mical structures i.e. gingiva,

All details of the fully

Individuality is Key

When it comes to metal-

individual solution which

I therefore have the

required, which is my pro-

ceramics, the alloy has to be

suits the patient. IPS InLine

possibility to use a wide

cedure of choice with regard

chosen keeping the esthetic

PoM can be pressed to

variety of alloys in an

to the esthetics of anterior

possibilities in mind.

alloys with a CTE value in

individual manner. In addi-

teeth, particularly when

IPS InLine PoM allows dental

the range of 13.8 to 14.5

tion, metal-free shoulders

base-metal alloys are used.

professionals to provide an

(25500 C / 77932 F).

can also be fabricated if

The Creation of
Tooth Shades

The final tooth shade is

made up of the opaque
Press ingot, Shades and
Stains. Only if the various
materials are applied in the
correct ratio, the dental
technician may achieve the
desired tooth shade. Shades
are required to approximate
the perfect tooth shade,
while Stains are used to
imitate the individual
characteristics of the teeth
(chroma, translucency
effects, brightness, etc.).

IPS InLine Stains

the staining technique. The

work with an optimum

Tip: The IPS InLine Shades

The 14 different, very finely

pre-mixed IPS InLine Stains

paste consistency. The

and Stains feature a lifelike

ground Stains (particle size:

in paste form render the

particle size of the IPS InLine

fluorescence. For this

6-9 m) offer the possibility

mixing step unnecessary.

Stains allows an even

reason, they do not

to achieve highly esthetic

The dental technician thus

application, which results in

influence the esthetics in a

results easily by using only

saves time and can always

perfectly stained surfaces.

negative fashion.

THE CREATION OF TOOTH SHADES

The main advantage for the

The ceramic ingot is already

opaquer is more clearly

teeth. The dental

dental technician is the fact

equipped with a very high

visible if the layer is too thin.

technicians job is to imitate

that the IPS InLine PoM

level of shade fidelity due to

This influences the tooth

these properties.

ingots are coordinated with

its properties.

shade.

the three shade systems

The shade effect fully

Chromascop, Bleach and

develops if the indicated

Highly translucent incisal

tion of the Shades and

AD (Vita). The dental

minimum layer thicknesses

edges, incisal halos, whitish

Stains are the topic of this

technician is thus flexible to

are observed. Due to the

seams, absorption and

report.

meet any requirements of

adjusted translucency of the

reflection are only a few of

his or her customer.

ingot, the colour of the

the properties of natural

The use and correct applica-

Step by Step

The correct processing of

Framework design

the material is certainly the

Opaquer

basic prerequisite for the

Wax-up

success of a restoration.

Predictability of the

I would therefore like to

point out the aspects that
need to be considered in the
next few chapters.

result
Press technology / press
result
Morphology
Surface texture of teeth

Framework Design

ALLOY CRITERIA
IPS InLine PoM can be used

feature a CTE value in the

shaped framework to

wise choice, since this often

together with alloys which

mid-range between 14.1

support the ceramic material

results in fractures of the

have a CTE value in the

and 14.3.

is indispensable.

veneering ceramic.

range between 13.8 and

For the long-term clinical

Compromises for esthetic

14.5. I prefer alloys which

success, an anatomically

considerations are not a

PREPARATION GUIDELINES

Depending on the esthetic

can be fabricated with or

preparation (approx. 1 mm

framework is ensured with a

requirements of the patient

without a metal shoulder. If

wide) is the ideal design.

minimum layer thickness of

and the indication,

a metal-free shoulder is

Sufficient stability of the

0.3 mm.

IPS InLine PoM restorations

fabricated, a chamfer

cervical edge of the metal

Opaquer

OXIDE FIRING
After the correct finishing

the oxide layer has a major

that the alloy is free of

indicator to check whether

of the alloy surface with

influence on the bond

contamination prior to the

the framework is clean. The

suitable rotary instruments

between metal and ceramic.

application of the opaquer

processing parameters for

and blasting with a

For this reason, the oxide

by conducting an oxide

the alloy are listed in the

disposable jet medium

firing should be carried out

firing. An even colour of the

respective instructions for

(Al2O3), the oxide firing is

very carefully. It is therefore

oxide on the alloy after the

use.

conducted. It is known that

recommended to make sure

oxide firing is a good optical

The opaquer is applied in

to achieve better bonding

Tip: Special attention must

completely covered with

two layers, with the first

values and allows the alloy

be paid to the cervical

opaquer.

layer (wash firing) always

to degas, if required. The

margin, particularly with

being very thin. This layer

second opaquer layer

metal-free shoulders. In

ensures an improved

completely masks the

order to prevent a dark

wetting of the alloy surface

metal framework.

colour effect, the margin is

OPAQUER

Die fertige Arbeit

Wax-Up

SURFACE
The preparations for an optimum

are trapped in the pressed object.

press result begin with the design of

Simultaneously, much time other-

the wax surface. A smooth surface

wise required for surface finishing

gives users the confidence that no

after pressing can be saved.

particles of the investment material

WAX DIMENSIONS
For the ideal reproduction of the

If the layer thickness falls below

shade in the final restoration, a

0.8 mm, the influence of the

layer thickness of no less than

opaquer on the shade increases and

0.8 mm and no more than 1.5 mm

the shade design becomes more

should be observed in the wax-up.

challenging.

1.5 mm
1.5 mm

1.5 mm
0.8 mm

0.8 mm

10

0.8 mm

Predictable Result

PROXIMAL
CONTACT POINTS

MORPHOLOGY

EMERGENCE PROFILE
CERAMIC SHOULDER

A fully anatomical wax-up

LIGHT REFLECTION AT THE MARGINAL RIDGE

offers the possibility to easily

focus on important details

The objective is to perfectly copy the sur-

of the restoration. This

rounding teeth in terms of shape and

makes the results

morphology. This can be checked already at

predictable.

this stage by means of the light reflection at

the marginal ridge.

EMERGENCE PROFILE

MORPHOLOGY

PERFECT
MARGINAL SEAL

Die fertige Arbeit

11

Press Technology

SPRUES

METAL RETENTIONS

INVESTMENT
MATERIAL

When designing the sprues,

The retentions attached to

Smooth press results showing

it is advisable to always

the framework are used to

a high level of detail repro-

place the sprue with a

hold the object to be

duction are achieved because

diameter of 3 mm at the

pressed in place inside the

the investment material and

thickest part of the object

investment ring. This

IPS InLine PoM are ideally

to be pressed. The cervical

prevents the framework

coordinated. Surfaces and

edges of the restoration

from being displaced during

critical areas, such as cervical

should always be placed

the press procedure.

margins and occlusal

towards the edge of the

patterns, are perfectly repro-

investment ring.

duced with press ceramic

from the wax structure.

12

Press Result
The detailed reproduction of the wax-up with IPS InLine PoM
press ceramic avoids a great deal of work required for
adjustments and at the same time imparts an even more
natural-looking appearance to the restoration.

WAX-UP

PRESS RESULT

WAX-UP

PRESS RESULT

13

Morphology
Morphology (Greek: morph

important elements of

technician needs deep

be rendered visible.

= shape, appearance, and

dental esthetics; they are

knowledge of the anatomy

I recommend this to every

logos = word, study) is

also the centrepiece of

and a skilled eye to detect

dental technician, because

the study of shapes and

function.

the morphological details.

routine, security and

structures.

With simple tools, such as a

efficiency can only be

The tooth shape and surface

As a basis for the fabrication

colour pencil or silver dust,

achieved through systematic

structure are not only

of a restoration, the dental

the shape and structure can

work.

MACROSTRUCTURE: MARGINAL RIDGES

The marginal ridges

observation of natural teeth.

By highlighting the ridges

doing so, it is important that

determine the visually

The natural tooth shape

on the natural tooth and the

the margins start at the

perceived shape, width and

must be exactly copied, and

restoration, the dental

incisal edge and extend to

axis of the tooth. Therefore,

the marginal ridges are the

technician has the possibility

the cervical edge without

the dental technician should

starting point.

to copy the contours of the

interruptions.

focus on his or her own

14

margins very precisely. In

Surface Texture of Teeth

MACROSTRUCTURE
The central and lateral

should be taken into

the process of ageing and

should be included in the

incisors and the canines

account. The macrostructure

the wear due to intensive

design and fabrication of a

exhibit different

on the vestibular aspect is

tooth cleaning, these bulges

restoration.

characteristics in their

clearly visible with the

are abraded. The age-

macrostructure. This

vertical linear bulges. With

related characteristics

Such structural

and macrostructures reflect

surface structure therefore

This procedure allows

characteristics directly

the incandescent light and

significantly contributes to

restorations to be fabricated

influence the overall

thus create a surface that

the esthetics and determines

that blend in with the

appearance of the restora-

appears vital and exhibits

reflection and opacity,

surrounding dentition and

tion. Both microstructures

light reflection effects. The

absorption and translucency.

are virtually indiscernible.

15

MICROSTRUCTURES
Microstructures create a

After grinding the macro-

surface. A natural surface

Youthful teeth often show a

pattern of light refraction

structure, the surface is first

texture is decisive for the

rough surface texture with a

and light reflection on the

smoothed out and pre-

overall impression of all

low level of in-depth effect,

tooth surface. This makes

polished with a diamond

restorations, as they have a

while older teeth show a

natural teeth look vital. The

rubber polisher.

major influence on the in-

very high level of in-depth

microstructure is made up

Microstructures are designed

depth effect of the material.

effect due to attrition.

of horizontal growth lines

as the last step before the

Internal structures are more

(perikymata) and vertical

glaze firing. With a tungsten

visible through smooth

grooves as well as natural

carbide bur, very delicate

surfaces than through rough

pits and pores. These pat-

growth lines (perikymata)

surfaces.

terns disappear in time (due

can be ground into the

to attrition), which causes a

smoothening of the tooth
surface and a decrease in
reflectivity.

16

Polishing

For me, polishing prior to

polishers and silicone

porous surfaces, the stains

staining is an essential step

instruments. Only a homo-

only fill up the cavities,

to achieve a perfect surface

geneous surface can be

which results in an in-

texture. The ceramic surface

evenly stained and thus

homogeneous appearance.

is treated with various

show a lifelike appearance.

rotary diamond rubber

On very uneven or even

HOMOGENEOUS SHADE DISTRIBUTION ON SMOOTH SURFACES

INHOMOGENEOUS SHADE DISTRIBUTION ON ROUGH SURFACES

17

Surface Cleaning

After polishing with

SANDBLASTING

rotary diamond rubber

polishers and silicone

By gently blasting the resto-

important to note, however,

instruments, a surface

ration with Al2O3 (100 m)

that the surface is abraded

layer that makes direct

at 1 bar (15 psi) pressure, an

and thus destroyed if the

staining impossible has

optimum surface on which

pressure used is too high or

been created.

the IPS InLine Stains can be

the jet medium too coarse.

applied in a controlled
manner is achieved. It is

ALUMINIUM OXIDE, 100 m, 1 BAR (15 PSI)

CERAMIC POWDER
The ceramic surface is

surface is degreased and

rubbed with IPS InLine

slightly roughened. Pumice

ceramic powder in order to

may also be used for this.

clean it. In this way the

18

One Single Working step

FOR TOOTH SHADE,
INCISAL CHARACTERIZATION AND
INDIVIDUALIZED ESTHETICS

There are some rules that

a more intensive shade in

integration into the

gradation must be

must be followed if a life-

the cervical area than in

gingiva. In the incisal

copied. The tooth shade

like shade appearance of

the central part, as the

area, however, the

is created in three

the anterior teeth is

enamel layer is thinner.

translucency is higher,

working steps and a

desired. Every tooth is

This shade gradation

because there is no or

concluding glaze firing.

slightly darker and shows

ensures a harmonious

practically no dentin. This

PRIOR TO STAINING

AFTER STAINING

1. SHADE AND CHROMA

By applying the Shades in an

different shades. This is

If the chroma or shade is

Tip: If too much shade is

even and thin layer, the life-

most apparent in the canine,

insufficient after the first

applied for the first firing,

like basic shade can be

which is often two shade

firing, the desired result can

the resulting shade looks

achieved quickly and easily.

levels darker than the

be obtained by applying

unnatural.

The individual teeth in a

incisors (e.g. incisor: shade

another layer of IPS InLine

natural dentition show

A1, canine: shade A3.5).

Shades.

PRIOR TO STAINING

AFTER STAINING

19

2. INCISAL CHARACTERIZATION
Apart from these general

even chalky spots.

working step for chroma

shade categories, the lifelike

Mamelons, opalescence,

and shade, the above-

appearance of a restoration

translucency and the halo

mentioned characterizations

and 2 and IPS InLine Stains

is further enhanced by

effect are natural

are applied in a second step.

basic blue.

special effects such as

occurrences which we try

To do so, I use various basic

mamelons, a halo margin or

to copy. After the first

shades of the IPS InLine

Shades, e.g. 1, 2, 3 and

IPS InLine Shade Incisal 1

3. INDIVIDUAL CHARACTERISTICS
In the third step, the

large variety of small or

yellowish-brown) are

important issue today. For

individual characteristics of

even large individual

observed on abraded incisal

this purpose, IPS InLine

the tooth are created with

characterizations. These

edges, while white dis-

Stains basic red is available

the various colours from the

characterizations may have

colorations are frequently

to achieve a smooth transi-

IPS InLine Stains product

various causes. Very often,

caused by fluorosis. The

tion from the gingiva to the

range.

small or large discoloured

esthetics of the cervical

restoration in an easy way.

Natural teeth may show a

areas (in most cases

area, however, is also an

After these 3 working steps, all esthetic characteristics are completed by staining the surface. The first Shade and Stains firing
is conducted at 800 C (1472 F) with a holding time of 1 minute and activated vacuum function in the range of 450 to
799 C (842 to 1470 F).
20

The right lustre

If minor shade adjustments

can only be achieved with a

and the holding time

glaze liquid, because the

are required, the glaze paste

glaze paste. The firing

2 minutes.

glaze would be too weak

can be mixed with Shades

temperature for the glaze

Tip: Do not excessively dilute

and porosities may occur.

or Stains. A lifelike lustre

firing is 800 C (1742 F)

the glaze paste with the

21

The Art of Colours

COLOUR MANAGEMENT

It is easy to learn how to

tion. Individual shades can

the various materials, which

match the characteristics of

use the entire range of

also be created by mixing

allows users to perfectly

the natural tooth.

IPS InLine Shades and Stains,

because the IPS InLine
Impulse Shade Guide serves
as a reference. It is therefore
easy to match the individual
shade to the required indica-

OPALESCENCE AND TRANSLUCENCY

To achieve an opal effect,

enhances the translucency

Small highly translucent

Stains basic blue can increase

the IPS InLine Shade Incisal 1

effect is thus achieved.

spots applied with IPS InLine

the contrasting effect.

(blue-transpa) is applied
below the incisal edge in a
defined manner. A contrast
with the incisal edge which

WHITISH INCISAL EDGE (HALO EFFECT)

I determine the colour of

yellow-orange mamelon,

salmon-shaded mamelon. I

whitish seam of the incisal

the mamelons with the

vanilla and basic red a

use Stains vanilla for the

edge.

IPS InLine Impulse Shade

Guide and compare them
with the colours of the
IPS InLine Stains materials.
Orange and yellow can be
mixed to create a perfect

ABSORPTION AND REFLECTION

I use IPS InLine Shade Incisal

small or larger discoloured

light reflection, I use

vanilla, depending on the

2 (grey-transpa) as the basic

areas with a high level of

IPS InLine Stains white or

tooth type.

component and mix it with

the IPS InLine Stains. The
result is a material with
chroma, translucency, shade
and in-depth effect. For
individual effects, such as

22

Anterior Case 1
IPS INLINE PoM RESTORATION ON THE HIGH-GOLD ALLOY BRITE GOLD XH
WITHOUT CERAMIC SHOULDER

In this tooth type, the high

It is always important to

into account when selecting

brightness value of the tooth

select a shade which is

the appropriate ingot. As a

to be matched is very striking.

slightly brighter than the

basic rule, it can be said that

That means that the

actual shade, because the

the less space is available,

appropriate basic shade

restoration can quickly

the more the restoration will

must be determined to

appear darker, due to the

lose its lustre, shade and

choose the tooth and ingot

subtractive light situation in

brightness.

shade. What criteria are

the mouth.

crucial for the shade selection

The available space for the

of the appropriate ingot?

ceramic must also be taken

The framework was covered with opaquer B1, and an ingot 1 was pressed onto it.

FULLY ANATOMICAL WAX-UP

BRITE GOLD XH FRAMEWORK

PRESSED IPS INLINE PoM RESTORATION

23

ANTERIOR CASE 1
IPS InLine PoM restoration on the high-gold alloy Brite Gold XH without ceramic shoulder

Application of the shade, chroma and translucency using IPS InLine PoM Stains yellow and Shade Incisal 2 50% applied in each working step. I use this mixture particularly
for the shade B1.

Opalescence and translucency in the incisal area are easily created using IPS InLine/IPS InLine PoM Shade Incisal 1 and IPS InLine/IPS InLine PoM Stains basic blue.

The individual esthetic characteristics result in a natural appearance. IPS InLine Stains vanilla are suitable for the effect of the whitish seam, IPS InLine Stains basic red
ensure a perfect transition to the gingiva.

24

Anterior Case 2
IPS INLINE PoM RESTORATION ON THE BASE METAL ALLOY 4ALL
WITH CERAMIC SHOULDER

This is an interesting case:

translucency as well as

absorption. In this case,

This tooth type presents a

individual characteristics.

opaquer A2 and an ingot 2

challenge due to the

The dental technician must

were used.

combination of shade,

be able to control the

chroma, brightness and

interplay of reflection and

FULLY ANATOMICAL WAX-UP

4ALL FRAMEWORK

PRESSED IPS INLINE PoM RESTORATION

25

ANTERIOR CASE 2
IPS InLine PoM restoration on the base metal alloy 4all with ceramic shoulder

Shade: I first use IPS InLine Shade 2 (A2) for the basic shade. It is applied in a very thin layer.

Opalescence and translucency: For this purpose, IPS InLine Shade Incisal 1 is perfectly suitable. For the contrast, I apply small spots of Stains basic blue.

Individual esthetics: Absorption material orange for the incisal third. Shade Incisal 2 and Stains orange are mixed to achieve this effect.
Whitish seam: For the halo effect, I use Stains crackliner directly on the incisal edge.

Individual esthetics: The white pigmentation in the incisal third is characteristic for the individual appearance of this tooth. This can be imitated by using IPS InLine Stains
white. Pink and white esthetics: The transition from the gingiva to the restorations is perfected by applying Stains red.

26

ANTERIOR CASE 1
IPS InLine PoM restoration on the high-gold alloy Brite Gold XH without ceramic shoulder

ANTERIOR CASE 2
IPS InLine PoM restoration on the base metal alloy 4all with ceramic shoulder

Considering the effect of todays increased requirements on

the routine in the laboratory, I was quickly convinced of the
advantages of IPS InLine PoM. My expectations regarding
function and esthetics are met by the fully anatomical waxup, and the ease of use gives me the possibility to provide
the patient with an optimum, individualized solution.
Dieter Grbel
27

632944/1109/e/RDV