Ivodent Online blog

IVOblog was 'in the chair' with Dr Ridhwaan Haffajee (Matrix Dental) chatting about the “real beauty of e.max…”

Posted by Ivodent on March 23, 2022

Tell us about your favourite case using e.max?  

It's difficult to speak about one, I am working on so many at the moment and each one of them has such different indicators. Some are tabletop, some simple single inlays, some onlays and single crowns, and a full case of veneers. Actually that pretty much sums up the versatility of e.max. I won’t call it multi-purpose though, as this can perhaps minimise its amazing, focused, capabilities. I feel you only appreciate the real beauty of e.max once you learn to understand the material, and how it is able to perform optimally in a multitude of scenarios. So I think that's pretty much my simple take home from it.

How long have you been using e.max?

From about 2015, when I initially became aware of e.max. Many dentists out there like to talk about ‘recreating nature’ and say how ‘good it is for the body and the health and all of that’, but for me, from a clinical perspective, it's really only the scientist in you that will appreciate e.max in itself. Patients are usually unaware of what's going into their mouths – whether we cement or bond a crown.

We want it to be aesthetically pleasing, but a patient is never aware of the tensile strength, or the coefficient of thermal expansion and all of those amazing things that e.max brings with it. In terms of my experience on a clinical level, I've been incredibly happy with it and for the options it offers. Especially when it comes to anterior work, you're looking at a multitude of different scenarios that need the right material to perform different functions to create the ideal aesthetics, from blocking out, translucency and colour enhancing and matching etc., and from that aspect, I think e.max is amazing!

But the real beauty for me in e.max, and why I choose it, is because it comes with a good track record, is scientifically backed, and for all the biomimetic aspects that it offers… and that is the e.max message that I would like to emphasise from an education standpoint, to patients as well as other clinicians.

It’s crazy that there are labs out there that will use a cheaper block, knowing that it won’t last like e.max does, but it’s cheaper so they choose that for their practice.  In some cases that I have seen, a lab will display the e.max sticker, say it’s e.max, but it’s most definitely NOT e.max!

Patients (and their dentists) should not buy into consumerism and expect a crown to last five years (like an iron or microwave does). Only when you critically appraise your work on patients over long periods of time - 10 years, 15 years, 20 years, do you see the importance of using a product that you can trust to stand the test of time like e.max does!

With e.max, for me the beauty is not just in the colour, but in the material science behind it. I would like to share this with other dentists and make them aware of what some labs do; they shouldn’t just accept what they get from their labs – labs should be governed by what we dictate to them! A lab slip should be like a prescription, and stuck to, with no derivative offered or considered! Too many clinicians are being duped into believing they're using e.max. They need to be aware - they owe it to the consumer too! I would like to think that Ivodent could somehow involve the council and get on top of this unethical marketing practise. It’s a big problem, because in essence, the product is being marketed, but not delivered.

Don’t get me started on how I feel about how many poor quality dentists out there are making more money than the really good ones, purely because they move the goalposts and think about the bottom line before longevity in their work. Maybe you need to do more lectures based on material – yes it's not the best lecture, it's a boring topic to talk on, but we need to find an exciting way of getting this message out there.

I also think we're speaking implants too often, but we're not speaking about what's happening in between. And I see the same thing with digital dentistry. There are so many guys talking about digital dentistry and how cool it is and the wonderful offering it is. But when you actually sit down with those guys and ask them, ‘so what are you doing?’ Their response is unsatisfactory.  They're simply sending a scan to the laboratory and the laboratory gives them 3D printed models. They have no concept of the process, quality, or expected longevity of the product that they are supplying their patient and which is unquestioningly accepted by the patient.

It's exactly the same with e.max and I think more engagement needs to happen in some sort of a fun, but a relatable way.

Have consumers become more aware and more demanding of quality product materials?

Sure they expect and demand the best long lasting product from you, but they are not really aware how long things should actually last! A crown breaking after 2years - yes they get angry, but after 3yrs they accept it, when they should expect 10years!

I have only been in private practice for two years, so fortunately, I haven't had any of those issues. But I am seeing and fixing patients presenting with other dentists’ issues - I've seen patients come to me who had rehabs done five years ago, and they sit in the chair and they know they're going to pay for it again. And in my head I'm thinking, this is legally not right – but they accept it. I think I would like to see at least 50 percent of my patients being more educated about what they are paying for and what they should expect. It's like they just want a wide smile. Patients are coming to me wanting veneers and crowns done, and I have to educate them that doing less is more. Patients need to be told when doing nothing is better than doing something. They are ill-advised that doing veneers is the best option for protecting their teeth, because even such ‘minimal’ treatment is still invasive and attaches a certain longevity to the tooth. They should be made aware of options available so they can make informed decisions. But yeah, I think we need to educate on the material itself, and it doesn't help to do this when they come to the practice, because I'd like to believe that patients who come to my practice are already the converted and the informed. They come because they have confidence that they will receive quality treatment, or will soon realise, once they are engaged and included in decision-making. I want patients to ask me about material quality and ask ‘what is e.max’. Ask me ‘why do I need a crown over a veneer’, or ‘why do I need a veneer or a crown?’ ‘Or can I have this instead’, etc? Those are good conversations. Yes, I'm seeing more and more patients asking things like that because patients are Googling crowns and veneers, which is incredible, and I love it. But I think we need to get them asking material questions from an implant perspective. The market for implants is smaller, so it's easier to get information out there.

So yes, patients are definitely more aware of what they're putting inside their bodies. I do enjoy educating the patient in my chair so that if they have a family member or a friend who needs the same experience, at least they can speak knowledgeably.

I do love that every step of the way, e.max eliminates stress for me. There's no guessing. I don't think there's any other system in the market that allows us that much predictability from a clinical perspective, predictability both short term and long term. But again, all of this, you guys know already!

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