Saturday, November 27, 2010

Bruxzir™ and Emax™ the Highest Strength Metal Free Crown

One of the great dilemmas facing dentists is to create esthetic smiles for patients with severe wear, or destructive habits like habitual clenching and grinding (Bruxism)

severe wear

Historically, the material of choice for patients who have these conditions has been the use of cast metal. The metal used was usually gold alloy, semiprecious, or non precious alloy in  crowns and bridges. These metals gave restorations great strength and wear  resistance. Unfortunately, metal has horrible esthetics.

metal bridge

We still measure the longevity of all other restorative materials against metal alloy.  A gold crown can function  more than 50 years in the mouth.
In the early to mid 20th century, acrylic and porcelain were used to hide the metal and improve the esthetics of dental crowns and bridges. The problem with these esthetic restorations is the weaker porcelain can fracture off revealing the metal below. 

porcelain fractured off porcelain/metal bridge

 Since then not much has changed in the fabrication of restorations until the use of Dilithium Silicate marketed as Eris  and Zirconium marketed as Lava, and Procera® and others. These materials utilize the Dilithium Silicate or Zirconium as a base layer (core)  and overlay with porcelain. Dilithium Silicate is 3 times as strong as porcelain, while Zirconium is 10 times as strong as porcelain. These were the first strong  "Metal Free" restorations that were used for crowns and bridges. Since their introduction, fracturing of porcelain is still reported in bruxers as the porcelain is still weak, so we kept looking for stronger materials with good esthetics.

porcelain fracture off porcelain/zirconium bridge

 Through experimentation, newer shades of Dilithium Silicate and Zirconium have been developed which have acceptable esthetics.  These materials are E-Max and Bruxzir. Both of these materials can be milled out of a solid block of material. E-Maxcan be used with the CEREC™ in office milling system,which can be placed in a single visit for single crowns and onlays. Bruxzir™ must be made in a lab and will require 2 visits. Bruxzir has enough strength to be used in a full arch bridge.

 We have been placing E-Max crowns in one visit for over 2 years with no breakage. 
E-Max™ before
E-Max™ after

We  have been using the Lava system for several years for crowns and bridges and now will be able to offer the Bruxzir system as well for our more severe cases.

Bruxzir™ bridge before
Bruxzir™ bridge after
If you have any questions you can contact us at:

phone                   815 458 2202 

or Email us at

You comments are welcome


Friday, November 19, 2010

Is your dental work "Made in China"?

Many Dental Labs are outsourcing crowns partials and dentures to China in order to lower costs.

Dentists and Dental Labs are trying to control costs for patients. In the process, outsourcing lab work to foreign countries like China and Mexico is becoming more popular. It is important to know if your dentist uses a lab that outsources to foreign countries. These foreign labs may not be subject to quality control practices that prevent harmful impurities like Lead in their products.

We only use the highest quality lab products from U S Certified dental labs.

Your Comments are welcome.

Phillip c. Neal DDS
Crystal Lake Dental Associates
280 B Memorial Court
Crystal Lake,  IL 60014
815 459 2202

Friday, November 12, 2010

Why I recommend Sonicare™ toothbrushes.

One of the most common problems we see daily in dentistry among adults is gum recession and root notching from improper tooth brushing.  Why do we see this?
Let's look at the anatomy or an arch of teeth.

 Note how the teeth are curved arch, and also how the teeth are not flat.  The most common action of brushing is a front to back, and back to front motion across the side of the teeth. This rapid motion causes the brush bristles to attack the most prominent surfaces and miss the recessed areas. If effect we over-brush the most prominent surfaces and underbrush the others. Th result is tooth notching,  gum recession, sensitivity, and plaque left in the recessed areas between the teeth leading to more cavities.

Toothbrush notching

Enter the power rotary brushes and what do they do?

Oral B rotary brush

 The same thing as a manual brush only faster. why? Because the person operating the brush usually does not take the time to manipulate the brush properly to keep the bristles from over-brushing the same surfaces and under-brushing the recessed areas. In effect is more efficient in ruining your teeth  and gums.

 Now we have the Sonicare™.

The Sonicare™ is different in that the bristles are stimulated to vibrate and splay out into the recessed areas better.  In the mouth the vibrating motion breaks up Biofilm which is the community that the bacteria form and live in. The action of disturbing Biofilm takes place even at a distance from the bristles thus helping to remove bacteria that the brush physically does not touch. On top of this, the breakdown of Biofilm allows the fluoride in the toothpaste to penetrate the tooth better insuring lower decay again in places where the brush did not touch.

I have enclose links to 3 videos. The first is for the Oral B™ and the second is for the Rotadent™ , and the third is for the  Sonicare™.

Look closely at the entire  Oral B™ and Rotadent™ video and see for yourself if the positioning movements needed to clean the entire surface of each tooth look easy.

Look at how the Sonicare stirs up the liquid and think about whether you want a device that helps you ruin your teeth or one that really gets your mouth healthy.

As  you can tell I am a real fan of the Sonicare™ and my patients improved oral health is all of the proof I need. A list of studies on the Sonicare™ and its effectiveness are included on the link below.

Our entire staff and uses the Sonicare™ exclusively.

A list of studies on the Sonicare™ and its effectiveness are included on the link below.

Your Comments are welcome.


Friday, November 5, 2010

Advances in Dentistry part 3

Advances to make your visit more comfortable, quicker, and with a better result.

Isolite® is a "tooth pillow" that also protects the cheek and lip while removing fluids and saliva. It can also illuminate the mouth for excellent vision.


Improvements in dental anesthetics.
Citanest®,  Articaine®, Marcaine® and other  advanced anesthetics allow for more comfortable injection and more profound numbing.

The Wand® is a major leap forward in comfort is delivering dental anesthetic. The slow computer metered delivery prevents pain form the manual delivery from a traditional dental syringe. Dr. Neal uses this method routinely on all patients.
The Wand®

Dental lasers can be used to treat gum problems, diagnose decay, and is some cases prepare cavities.
we have 3 lasers:

DIAGNOdent® is used to detect decay under the enamel surface. It is much more accurate than x-rays or the traditional explorer.
The Navigator® is used to sterilize gum pockets and for minor gum treatment procedures. It is compact ,versatile and a favorite of the team. The laser is quite comfortable to use and creates a bloodless field with rapid comfortable healing.

The Periolase® is revolutionizing periodontal treatment. It can replace the traditional cut and sew surgical method commonly used to treat gum disease. Healing is rapid and extremely comfortable. Gum levels are usually unchanged and tooth sensitivity is uncommon.


Relax in the dental chair as you can utilize oral premedication, Nitrous oxide ( Laughing gas), watch cable TV, listen to headphones, have a warm hand waxing, soft pillows and blankets... followed by a a warm cleanup cloth.

Now advanced oral cancer screening can be done easily with the Velscope®, or Vizilite® systems. We use the Vizilite plus® system.

Vizilite plus®

Composite "tooth colored fillings can be cured much more rapidly with the use of lasers, PAC lights or the new high intensity LED lights.


Dental treatment is now moving into the realm of microdentistry and microsurgery with the use of High powered dental loupes powerful lighting systems and dental microscopes.
Dental Loupe and light

Drill free dentistry can be experienced for certain procedures utilizing lasers and air abrasion techniques. These procedures also offer the possibility of not requiring anesthetic.

Air Abrasion  

Root canal therapy has advanced with rotary instruments that can speed up the procedure and improve the outcome and comfort. advanced x-ray imaging and electronic apex locators along with high powered magnification, and  ultrasonic diamond points can aid the dentist is visualizing and shaping the root canal space.

Root Canal

 Advances in fluoride, and enamel rebuilding pastes allow us to remineralize enamel,  reduce tooth sensitivity and drastically reduce tooth decay.
Some of the products that we are currently using include Fluoridex®  gel for reducing decay and sensitivity.
MI Paste® is used to reduce sensitivity and remineralize teeth. 
MI Paste®

 SootheRx® is used to reduce sensitively in teeth.

New technology allows us to make more accurate mouth-guards , biteplanes, TMJ appliances,  splints and clear orthodontic appliances and retainers right in the office.

                         Drufomat®                                                    Biteplane/mouthguard

Advances in design and materials have allowed us to make great improvements in precision attachments for dentures and partials to make them more secure.

Locator® Precision Attachments

Dental implants continue to evolve with new shapes and coatings resulting in better  and faster integration and reduced bone loss over time.

Dental Implants

Advances in techniques brings us synthetic polymers, xenograft and allograft materials to replace missing or damaged bone and gum areas in the mouth for greater esthetics, health and function. These new methods and materials do not require donor sites form other parts of the body resulting in with much greater comfort and quicker healing.

Grafting before

Grafting after

These advancements are available right now at Crystal Lake Dental Associates and through our trusted partners.

Dentistry has come a long way from a 40watt light bulb and a barber chair. As we move forward, the advances in dentistry will continue to revolutionize our ability improve oral healthcare. I am eager to see the next improvements dentistry will have to offer our patients. As always I will embracing every improvement in dentistry.

Your comments are welcome


About Me

My photo
Born in the Midwest. Married with 6 children and 3 grandchildren. Attended Maine West High School, Harper Jr College, Northern Illinois University, the University of Illinois College of Dentistry. Practice in Crystal Lake, Illinois.