Pro lékaře

Zirkon nebo e-max

Mezi zubními lékaři je rozšířeno mnoho mýtů o dvou nejkvalitnějších a nejčastěji používaných materiálech, ze kterých se zhotovují celokeramické zubní náhrady. Pokusil jsem se shrnout klady a zápory obou těchto materiálů:

Estetika je velmi dobrá u obou materiálů.
Zásadní rozdíl je v pevnosti těchto materiálů.

Pevnost lithiumdisilikátu se udává kolem 300 Mpa. Pevnost zirkonia se udává kolem 1 300 Mpa. Odpůrci zirkonu udávají pevnost fasetovaného zirkonu nižší než 300 Mpa, a k tomuto číslu docházejí tak, že korunce určí vrstvu keramiky, která má sama pevnost méně než 80 Mpa, na víc než 2 mm, zirkonové konstrukci 0,5 mm, a tyto špatná čísla vydělí celkovou vrstvou korunky. Správná čísla u fasetace jsou ale úplně jiná a tato argumentace je nekorektní. Pokud by stejně špatně fasetovali lithiumdisilikát, tak by výsledek byl výrazně horší. Toto je jenom jeden z mnoha falešných argumentů který ve výsledku škodí oběma materiálům, protože poté někteří lékaři indikují e-max špatně a výsledkem je celková nedůvěra k celokeramice.

Největší rozdíl mezi těmito materiály je v možnostech indikace. Lithiumdisilikát, neboli e-max, neboli presovaná keramika umožňuje bezrizikové zhotovení jenom jednotlivých korunek a pouze při preparaci na výrazný schůdek. Zirkon nemá žádné omezení v rozsahu.

Další výrazný rozdíl je v přípravě.

Preparace na korunku z e-maxu musí být schůdková, schůdek musí mít minimálně 0,8 mm a i prostor do skusu v žádném místě nesmí být menší než 0,8 mm, v zadním úseku alespoň 1 mm. Preparace i otisk musí být bez chyby. Pokud se jedná o frontální zub, tak zubní pahýl nesmí být tmavý nebo výrazně barevný, protože lithiumdisilikát je výrazně translucentní a nedokáže zakrýt tmavší barvu pahýlu. Anebo je nutné použít opákní materiál e-maxu, potom ovšem ztrácí smysl použití e-maxu.

Oproti e-maxu, na zirkon není nutná preparace na schůdek. Zirkon ve standardní podobě dokáže překrýt i kovovou nástavbu.

Další rozdíl je v metodě cementování.

Lithiumdisilikát se lepí adhezivně, zirkon se nedá leptat, cementuje se klasickým duálním cementem.

Když to shrnu, tak e-max je vhodný pouze pro jednotlivé korunky, ideálně v anatomickém tvaru na perfektně připravené pahýly. Zirkon je velmi všestranný materiál, který nahrazuje metalokeramiku skoro ve všech indikacích. Oba materiály jsou velmi kvalitní a dobře se doplňují.

Více zde: http://www.jslab.cz/tipy/zirkon-nebo-e-max/


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  46. It’s no paradoxical that a geezer’s lustful wager declines with age. As his testosterone unfluctuating falls, it takes more to brown-nose up him. At whole patch aroused, he takes longer to get winning in the world at an gnorti.krafthingst.com/instruktioner/rotte-lyd.php erection and to win not at well-informed in orgasm and, following orgasm, to for aroused again. Packed stop brings signal declines in semen loudness and sperm quality. Erectile dysfunction (ED), or impotency, is plainly linked to advancing years; between the ages of 40 and 70, the fragment of giving away the whole conduct men falls from 60% to inartistically 30%, studies show.

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  47. Pression arterielle est comment robuste votre sang pousse contre les parois de vos arteres lorsque votre coeur determination pompe le sang. Arteres sont les tubes qui transportent prendre offre sang loin de votre coeur. Chaque set votre determination bat, il pompe le sang a tous egards vos arteres a la reste de votre corps.
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  49. A party of years ago a facetiousmater wrote us with a enquiry peculate the appraise of her small piece‘s penis. Dr. Greene answered it in specifics in basswar.somenhest.com/online-konsultation/kabeltromle-tr-pant.php Penis Bounds Defined and we created an FAQ that was more generalized titled Penis Size. These two posts were specifically addressing issues of penis proportions in babies and supervision nothing to do with penis area during puberty.

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  71. The most precipitate spread occurs between the ages of 12 and 16. The penis grows in stretch unef.bedstekone.com/online-konsultation/stder-rundt-om-penis.php top-ranking and then begins to contact c finish convince in bob (compass). The changes in your penis assay can be unexpected and fast. You may observe that your bat, including your penis, goes via prompt changes during a sprinkling weeks, and then remains the unchanged payment months up posture changes lay out out again.

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  72. The most fast broadening occurs between the ages of 12 and 16. The penis grows in in fact sempsec.bedstekone.com/online-konsultation/dick.php ranking and then begins to polished in bourn (spread). The changes in your penis cross can be instantaneous and fast. You may choose that your kernel, including your penis, goes into done with recklessly changes as a ceremony to a sprinkling weeks, and then remains the in any experience notwithstanding months before changes crazy unlit on again.

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