Lava. Secure Your. Future. Precision Solutions. Inside: Is all zirconia really the same? How can zirconia be different?

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1 Lava Precision Solutions Secure Your Future Inside: Is all zirconia really the same? How can zirconia be different? History Lesson: Medical zirconia hip implants What qualities do labs need from a manufacturer? How does the future of digital impressioning affect dental labs? What can labs do today? Sponsored by: What is 3M ESPE s vision of a digital workflow?

2 A brand you can trust. Is all zirconia really the same? Zirconia is not zirconia. Gordon Christensen Dental Economics, Sept A recent article in Dental Economics by Gordon Christensen confirms what many manufacturers have been saying about zirconia. Christensen continues, The scientists from each company have developed their own desired characteristics of their zirconium oxide materials...some labs are telling dentists that any zirconia is adequate. I would be wary of this statement. If your Doctors are wary or confused, remind them that while all zirconia can be chemically similar the processing methods that created the final zirconia product can be very different. Suppliers of zirconia often guard their composition and processing of their zirconia much like a chef who carefully guards the receipe to his secret sauce. Why are they different? Processing methods for pre-sintered zirconia affect performance attributes. Process Step Processing Methods Attributes Impacted Powder CO-Precipitated (most powders) Mixed Oxide Process (cheaper) Longevity Grain Size ( µm) Hydrolytic Stability Spray Drying & Organic Additives Sinter Behavior Pressing Pre-sintering Machining Coloring Final sintering Axial Compacting Isostatic Compacting Pressure (800 3,000 bar) Clean Room (no imperfections by airborne impurities) Temperature Time Pigments (part of the powder processing) Liquids Temperature (1,360 C 1,530 C) Time Marginal Fit Marginal Fit Machinability Marginal Fit Longevity Longevity Hydrolytic Stability Know the facts. How can The fact remains all zirconias are not the same, therefore performance attributes of each zirconia will also not be the same. In order to better understand these performance attributes, there are some very simple but important questions you should be asking your zirconia supplier: Is there solid scientific and clinical data behind their product? Do they have In-Vivo (in the mouth) clinical studies? Very few manufacturers have these studies. Once dental professionals understand the differences in zirconia materials, choosing the right material becomes clear. The Lava Zirconia Espertise Scientific Facts booklet includes fiveyear clinical results for Lava Crowns and Bridges and compiles data on the material s milling and fabrication process, marginal fit, translucency and esthetics. Use the information to help you choose the right product and ensure you get the exact properties you specified unit posterior bridges, P. Pospeich, University of Homburg, Homburg (Start 2000) In-Vitro Vertical Marginal Gap Comparison of CAD/CAM Zirconium Copings, A.J.T. Shannon, F. Qian, P. Tan, and D. Gratton, University of Iowa, Iowa City, USA (2007). 3. 3M ESPE Lava showed the lowest marginal and absolute marginal gap in comparison to Cercon and DCS, A. Piwowarczyk, H.-C. Lauer, Determining the marginal fit of CAD/CAM bridge frameworks, Pan European Federation Conference (PEF; CED) #0254 (2006). 4. Lava 3-unit bridges showed smallest Marginal gap v. Etkon, Cercon brain, Cerec Inlab, F. Beuer, T. Fischer, K.-J. ERdelt, H.-U. Aggstaller, K. Spiegl, W. Gernet; (2005) IADR #1336 and In-vitro Study Marginal fit of Lava restorations; F. Beuer, T. Fischer, K.-J. ERdelt, H.-U. Aggstaller, K. Spiegl, W. Gernet, industrial report (2006). 5. Translucency of different zirconia materials, Prof. R. Scotti, Prof. P. Baldissara, Dr. A. Llukacej, Dr. L. F. Valandro and Prof. M. A. Bottino, Academy of Dental Materials Conference, [Abstract 103]. 6. Zirconia ceramics or By Night, all Caats are Grey, A. Dambreville, M. Phillipe, A. Ray.

3 Sponsored by 3M ESPE zirconia be different? Marginal fit. Lava zirconia has excellent fit relative to leading competition. 2,3,4 Strength and longevity proven with clinical results. Lava Zirconia has a 100% survival rate in 5+ years of clinical studies. 1 Crowns 3-unit bridges 3-and 4-unit bridges Comparison PFM and Lava all ceramic crown N. Lasser, E. Pieslinger, University of Vienna, Vienna Start 2004 Lava all ceramic anterior crowns with reduced wall thickness (0,3 mm) D. Edelhoff, H. Spiekermann, University of Aachen; Start 2004 A. Raigrodski, University of Washington, Seattle Start % 3-unit posterior bridges P. Pospiech, University of Homburg, Homburg Start 2000 A. Raigrodski, G. Chiche, LSU, New Orleans Start 2001 One center study (general practitioner/university) J. Sorensen, Portland Start 2003 R. Perry, G. Kugel, Tufts University, Boston Start 2004 G. Laborde, P. Lacroix, Privatpraxis, Marseille Start 2005 (Post Market Surveillance) survival Multi center study at universities R. Scotti, Bologna; D. Re, Mailand; F. Zarone, Neapel Start 2003 Multi center study at general practitioners T. Burke, University of Birmingham, Birmingham Start 2004 Translucency and restoration esthetics. Lava zirconia shows a significantly higher translucency relative to the competition shown. 5 history lesson Medical zirconia hip implants What happened? Many manufactures entered the market as zirconia increased in popularity in the late 1980s Failures resulted from unexpected chemical phase transformation of zirconia hip implants In 2001, major FDA recall of selected vendors hip implants Manufacturers dropped out of market with five remaining major players worldwide Zirconia hips are still very successful ,000 placed annually in the US 6% of hip implant market Lessons learned. Zirconia is not all the same Depending on the quality of manufacturing, the properties of zirconia obviously vary as do the results observed: there is zirconia and zirconia 6 Quality depends on purity, density, porosity, particle size, crystalline structure (content of tetragonal and monoclinic phases) 6 Slight variances during the various manufacturing processes, compacting, sintering, HIP could have given rise to the defects...a few degrees during heating could reduce cohesion of particles...manufacturing secrets 6 Clinical studies are invaluable in confirming lab test results In the absence of rigorous scientific clarification, information on bio-materials is frequently a source of confusion and misleading generalizations worrying to orthopedic surgeons 6 What is 3M ESPE doing to authenticate their zirconia? 3M ESPE is implementing an authentication system to help Doctors know if they are getting authentic Lava Zirconia Doctors ask lab for Lava zirconia by filling out the Lava Post-it Note prescription pad and marking the Accept No Substitute box on the form Authorized Lava labs include the Lava Sticker with restoration Doctors look for the Lava Sticker with their case

4 A partner you can rely on. What qualities do labs need from a manufacturer? You ve done your homework, studied pros and cons and finally made a decision to purchase a piece of equipment. What happens next is what defines a partnership versus just another sale. The best way to understand if it s a partnership or just a sale is to talk to existing customers. How does the training process work? How will you promote your new product or purchase? What kind of network is in place for service and support? Do you have a clear understanding of the manufacturer s capabilities and future digital vision? As you can see, quite often the real work begins after the purchase. Consistency 3M has 100+ years manufacturing excellence Doctors ask for the Lava Brand by name Precision CAD/CAM system Security Last year, 3M spent $1.5 billion in research and development, creating practical and ingenious solutions to help its customers succeed 3M ESPE has a history of innovative products that are rigorously tested before being introduced to the market Strong commitment to digital dentistry highlighted by the purchase of Brontes Technologies in 2006 Support 3M R&D Related Expenditures* 3M ESPE supports your business with technical service and educational resources 2006 $1.522 billion Total for last 5 years 3M ESPE helps grow your business with business planning, marketing and sales support 3M ESPE has a nationwide sales force more than 130 strong calling on dentists and labs daily $6.390 billion 3M ESPE believes there is more to a partnership than just selling equipment. It is about consistency, security and support. *Amounts have been revised to reflect 3M s election to restate prior periods upon adoption of an accounting standard that required 3M to expense stock-based compensation effective Jan. 1, What is 3M ESPE s vision of The future begins with commitment and 3M ESPE is committed to being a leader in the transformation of dentistry from conventional processes to digital processes. How is that transformation achieved? Through a vision of a complete digitally enabled workflow an end to end solution. And what makes the digital workflow vision a reality? It all begins with a digital file that can come from a digital impression or by scanning a model, and it is all made possible by an integration of technologies and partnerships. That digital file enables digital design, digital manufacturing and will enable digital finishing. The tremendous success of Lava Crowns and Bridges has enabled the introduction of Lava Precision Solutions and the promise of a technology platform is to lead this transformation of dentistry. Digital Conversion Digital impressioning Scanning of model

5 A platform you can build upon. Sponsored by 3M ESPE How does the future of digital impressioning affect dental labs? Digital impressioning is coming and will have a great impact on how dental labs conduct their business. It is a very exciting time to be involved in the transformation from conventional to digital dentistry. There are many intangibles that promise to improve lab productivity but some very tangible steps that will go away with digital impressioning include: shipping of impression from dentist to lab, disinfection of impression, pouring impressions, base and pin model, die cutting, trimming and articulation. As you can see, a very real and different manufacturing process is coming to dental labs. It is this process that will take you out of the stone age and into a future with infinite possibilities. Digital Impression The Lava C.O.S. will offer dentists the ability to capture high speed and precise digital impressions to feed a wide range of digital production technologies. Conventional Crown and Bridge Processes The lab will receive a digital impression file, mark the margins and receive a model for producing PFM, Gold, Glass Ceramic, etc. using conventional processes. CAD/CAM Processes including Lava Crowns and Bridges Laboratories will design, mill and finish restoration based on digital impression file. Digital Design Laboratory Processes Utilizing digital impressioning along with digital design technologies to enable automated manufacture of final anatomy. a digital workflow? Digital Design Multiple substructures Full anatomy Coming Soon... The Lava Chairside Oral Scanner C.O.S. will support conventional and CAD/CAM processes. With the Lava C.O.S.*, Doctors and labs will be uniquely positioned for the future of digital dentistry. By leveraging our expertise in impressioning, scanning technology, and systems integration, we will enable digital workflows with numerous possibilities. Digital Production Milling Wax printing Stereolithography * not yet available for sale Digital Finishing Wax printing Full anatomy automation What can labs do today? Don t panic. Have a plan. Outsourcing is an effective and proven way to maintain your business. You should not feel pressure to buy a piece of equipment. However, as your business grows and you look towards the future be certain that you partner with a manufacturer that has the flexibility and ingenuity to integrate future technologies. What can 3M ESPE offer? 1. Outsourcing made easy... It s easy for your lab to keep your existing dentists happy and attract new ones by outsourcing. You simply send the design and milling of the coping or framework to an Authorized Lava Milling Center (ALMC). You ll receive the best canvas possible for your porcelain artistry a coping or framework in a natural dentin shade. Secure your artistry with Lava Ceram, the only porcelain designed specifically for Lava Zirconia. As part of the Lava CAD/CAM System, Lava ceram has five years of clinical history. 2. Authorized Lava Design Center (ALDC) As your Lava Restorations business grows, you have the option to do more work in-house. With the Lava Scan ST Scanner, you can design your own copings and frameworks for milling by your preferred ALMC. The scanner also gives you the ability to provide design services for other labs an additional source of revenue. 3. Authorized Lava Milling Center (ALMC) Yes, you can even grow your lab to the point where you become an ALMC. This means you control every aspect of creating genuine Lava restorations from initial design, to milling, shading and sintering the framework, down to the porcelain artistry.

6 Control Your Design. Control Your Future. The Lava Scan ST Design Center will help you manage the transition to digital. With digital impressioning coming soon, now is the time to partner with a company that will lead you through the transition from traditional to digital dentistry. A brand that you can trust + The brand doctors ask for by name + Differentiated zirconia + 5 years of proven clinical results + Excellent fit A partner you can rely on + Technical service and educational resources that support your business + Business planning, marketing and sales resources that help grow your business A platform you can build upon + Coming soon: digital impressioning and integrated digital workflow See the difference for yourself. Provide your doctors with Lava Crowns and Bridges from 3M ESPE. Or, to learn more, visit us at 3Mespe.com/lava. Coming Soon! Lava Design Software 4.0 Improved productivity New Indications Implant abutments Maryland and Inlay/onlay bridges Lava Scan ST Design Center 3M ESPE All rights reserved. 3M, ESPE, Espertise and Lava are trademarks of 3M or 3M ESPE AG. Post-it is a trademark of 3M. Cercon, CEREC, Control Cast, DC Zirkon, Digizon, E.Max, Everest, Procera and Wieland are not trademarks of 3M.