Porcelain Ceramic

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Faucet Part Bone Ceramic Disk  Renovators Supply
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$31.78
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Alfi AB105 Small Porcelain Wall Mounted Ceramic Bathroom Sink Basin White
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$232.27
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2pcs NEW Low Profile Faucet Bathroom Porcelain Ceramic Vessel Vanity Sink Basin
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$165.80
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2pcs Round Bowl Ceramic Bathroom Faucet Vessel Vanity Sink Art Basin w Overflow
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$123.00
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2x Faucet Bathroom Ceramic Vessel Sink Basin  Brushed Nickel Pop Up Drain Combo
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$144.40
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Faucet Bathroom Ceramic Vessel Sink Basin  Oil Rubbed Bronze Pop Up Drain Combo
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$69.90
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Set of 2 Bathroom Ceramic Vessel Sink Basin Oil Rubbed Bronze Pop Up Drain Combo
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$144.40
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NEW 16x13 Egg Shape Ceramic Bathroom Vessel Sink Basin Faucet without Overflow
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$54.90
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2x Contemporary Faucet Bathroom Vessel Sink Basin  Brushed Nickel Pop Up Drain
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$187.20
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2pcs Contemporary Faucet Bathroom Vessel Vanity Sink Basin  Chrome Pop Up Drain
2pcs contemporary faucet bathroom vessel vanity sink basin chrome pop up drain
$187.20
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Bathroom Above Counter Ceramic Basin White SK 2385 Single Hole Pre Drilled
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$30.00
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SQ005 MEXICAN RECTANGLE BATHROOM SINK TALAVERA HAND MADE CERAMIC BASIN
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$142.98
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SQ094MEXICAN RECTANGLE BATHROOM SINK TALAVERA HAND MADE CERAMIC BASIN
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$142.98
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American Imaginations AI 12933 White Square Vessel Sink  Faucet Set New
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$189.95
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RARE    KOHLER K 2354 8 7 Yin Yang Wading Pool Sink FREE SHIPPING
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$150.00
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ELIMAXS 2007+882002 Shine Bronze Glaze Pattern Porcelain Ceramic Bathroom
elimaxs 2007+882002 shine bronze glaze pattern porcelain ceramic bathroom
$202.99
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Vessel Sink Decolav Montallegro 1441 CWH NIB
vessel sink decolav montallegro 1441 cwh nib
$49.00
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Ronbow 200212 1 WH Rectangle Ceramic Vessel w Overflow White
ronbow 200212 1 wh rectangle ceramic vessel w overflow white
$103.99
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057 MEDIUM 17x14 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
057 medium 17x14 mexican bathroom sink ceramic drop in undermount basin
$79.31
quality
081 MEDIUM 17x14 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
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$79.31
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025 SMALL 16x115 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
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$68.56
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031 LARGE 21x17 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
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$142.98
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018 MEDIUM 17x14 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
018 medium 17x14 mexican bathroom sink ceramic drop in undermount basin
$79.31
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031 MEDIUM 17x14 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
031 medium 17x14 mexican bathroom sink ceramic drop in undermount basin
$79.31
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085 SMALL 16x115 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
085 small 16x115 mexican bathroom sink ceramic drop in undermount basin
$68.56
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Alfi AB101 Small Wall Mounted Ceramic Bathroom Sink Basin White
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$209.61
quality
Alfi AB107 Small Porcelain Wall Mounted Ceramic Bathroom Sink Basin White
alfi ab107 small porcelain wall mounted ceramic bathroom sink basin white
$249.26
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022 SMALL 16x115 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
022 small 16x115 mexican bathroom sink ceramic drop in undermount basin
$68.56
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119 MEDIUM 17x14 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
119 medium 17x14 mexican bathroom sink ceramic drop in undermount basin
$79.31
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051 LARGE 21x17 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
051 large 21x17 mexican bathroom sink ceramic drop in undermount basin
$142.98
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058 LARGE 21x17 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
058 large 21x17 mexican bathroom sink ceramic drop in undermount basin
$142.98
quality
122 MEDIUM 17x14 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
122 medium 17x14 mexican bathroom sink ceramic drop in undermount basin
$79.31
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044 LARGE 21x17 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
044 large 21x17 mexican bathroom sink ceramic drop in undermount basin
$142.98
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035 SMALL 16x115 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
035 small 16x115 mexican bathroom sink ceramic drop in undermount basin
$68.56
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028 SMALL 16x115 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
028 small 16x115 mexican bathroom sink ceramic drop in undermount basin
$68.56
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Fine Fixtures Bathroom 26x16 Vessel Sink China No Faucet Hole VE2618NH
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$110.00
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Fine Fixtures Bathroom 24 x 15 Square Flat Vessel Sink MV2415TE
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$139.00
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Fine Fixtures Bathroom17X17 Square Vessel Sink Vitreous China VE1717W
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$98.00
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Fine Fixtures Bathroom 29x15 Round Vessel Sink Vitreous China MV2915TE
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$151.00
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Fine Fixtures Bathroom 16 x 16 Square Vessel Sink Vitreous China MV1516SW
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$95.00
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033 LARGE BATHROOM SINK 21X17 MEXICAN CERAMIC HAND PAINT DROP IN UNDERMOUNT
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$142.98
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023 MEDIUM BATHROOM SINK 17X14 MEXICAN CERAMIC HAND PAINT DROP IN UNDERMOUNT
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$79.31
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065 LARGE BATHROOM SINK 21X17 MEXICAN CERAMIC HAND PAINT DROP IN UNDERMOUNT
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$142.98
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076 SMALL BATHROOM SINK 16x115 MEXICAN CERAMIC HAND PAINT DROP IN UNDERMOUNT
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$68.56
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Clearance Sale Mexican Ceramic Bathroom Sink 16x115 Talavera  80
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$58.56
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Clearance Sale Mexican Ceramic Bathroom Sink 16x115 Talavera  87
clearance sale mexican ceramic bathroom sink 16x115 talavera 87
$58.56
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Clearance Sale Mexican Ceramic Bathroom Sink 16x 115 Talavera  103
clearance sale mexican ceramic bathroom sink 16x 115 talavera 103
$58.56
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White Porcelain Basin Oval Bathroom Ceramic Vessel Sink Bowl w Pop Up Drain
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$45.90
quality
Eago BA129 Basin Above Mount Round Ceramic White
eago ba129 basin above mount round ceramic white
$107.64
quality
007 MEDIUM 17x14 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
007 medium 17x14 mexican bathroom sink ceramic drop in undermount basin
$79.31
quality
035 LARGE 21x17 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
035 large 21x17 mexican bathroom sink ceramic drop in undermount basin
$142.98
quality
036 LARGE 21x17 MEXICAN BATHROOM SINK CERAMIC DROP IN UNDERMOUNT BASIN
036 large 21x17 mexican bathroom sink ceramic drop in undermount basin
$142.98
quality
02 M Mexican Ceramic sink Bathroom sinks Vessel Sinks Handmade Double Painted
02 m mexican ceramic sink bathroom sinks vessel sinks handmade double painted
$109.21
quality
Whitehaus Collection WHFLRPL3318 BLACK Reversible Sink Black
whitehaus collection whflrpl3318 black reversible sink black
$949.95
quality
La Toscana LF 03W La Fontana Half Column White Glossy Lacquered
la toscana lf 03w la fontana half column white glossy lacquered
$399.00
quality
Eago BA351 18 Inch Round Ceramic Above Mount Bathroom Basin White
eago ba351 18 inch round ceramic above mount bathroom basin white
$124.63
quality
Danze undermount bathroom sink 18 x 15 half x 5
danze undermount bathroom sink 18 x 15 half x 5
$70.00
quality
NEW Whitehaus WH1 103R Bathroom Sink Wall Mount White 175 x 8 x 55
new whitehaus wh1 103r bathroom sink wall mount white 175 x 8 x 55
$169.00
quality
Eago BA121 Round Ceramic Above Mount Bath Sink with Single Faucet Hole White
eago ba121 round ceramic above mount bath sink with single faucet hole white
$107.64
quality
Eago BA138 Tear Drop Ceramic Above Mount Bath Sink White
eago ba138 tear drop ceramic above mount bath sink white
$158.62
quality
Bathroom Sink Oval White Ceramic Basin Vessel Filler Curved Retro Uber Modern
bathroom sink oval white ceramic basin vessel filler curved retro uber modern
$174.95
quality
058 LARGE BATHROOM SINK 21X17 MEXICAN CERAMIC HAND PAINT DROP IN UNDERMOUNT
058 large bathroom sink 21x17 mexican ceramic hand paint drop in undermount
$142.98
quality
088 MEDIUM BATHROOM SINK 17X14 MEXICAN CERAMIC HAND PAINT DROP IN UNDERMOUNT
088 medium bathroom sink 17x14 mexican ceramic hand paint drop in undermount
$79.31
quality
015 SMALL BATHROOM SINK 16x115 MEXICAN CERAMIC HAND PAINT DROP IN UNDERMOUNT
015 small bathroom sink 16x115 mexican ceramic hand paint drop in undermount
$68.56
quality
042 SMALL BATHROOM SINK 16x115 MEXICAN CERAMIC HAND PAINT DROP IN UNDERMOUNT
042 small bathroom sink 16x115 mexican ceramic hand paint drop in undermount
$68.56
quality
KRAUS Round Ceramic Vessel Bathroom Sink with Overflow
kraus round ceramic vessel bathroom sink with overflow
$129.95
quality
KRAUS Square Ceramic Vessel Bathroom Sink
kraus square ceramic vessel bathroom sink
$139.95
quality
Decolav 17 Ceramic Vitreous China Undermount Bathroom Sink 1400 CWH White NEW
decolav 17 ceramic vitreous china undermount bathroom sink 1400 cwh white new
$79.95
quality
Imperial Vintage 36 inch Wall mount Pedestal 8 inch Center Bathroom Sink Vanity
imperial vintage 36 inch wall mount pedestal 8 inch center bathroom sink vanity
$516.49
quality
KRAUS Tulip Ceramic Vessel Bathroom Sink
kraus tulip ceramic vessel bathroom sink
$129.95
quality
Elite 1558+882002 Oval Cobblestone Pattern Porcelain Ceramic Bathroom Vessel
elite 1558+882002 oval cobblestone pattern porcelain ceramic bathroom vessel
$194.99
quality
VIGO Auburn Mocha Fusion Glass Vessel Sink and Waterfall Faucet Set in Oil
vigo auburn mocha fusion glass vessel sink and waterfall faucet set in oil
$254.91
quality
Elite White Ceramic Over The Counter Oval Bathroom Sink
elite white ceramic over the counter oval bathroom sink
$103.99
quality
Bathroom Oval Ceramic Vessel Sink Bowl White Porcelain Basin w Pop Up Drain
bathroom oval ceramic vessel sink bowl white porcelain basin w pop up drain
$39.90
quality
FRANKE PRK120MB Fireclay sink by Villeroy  Boch MATT BLACK
franke prk120mb fireclay sink by villeroy boch matt black
$1,100.00
quality
Elite Round High Temperature Grade A Ceramic Bathroom Sink and Faucet Sink
elite round high temperature grade a ceramic bathroom sink and faucet sink
$171.49
quality
Undermount 16 in Oval Vitreous China ceramic sink in White
undermount 16 in oval vitreous china ceramic sink in white
$97.35
quality
Elite White Ceramic Round Bathroom Sink
elite white ceramic round bathroom sink
$81.98
quality
Elite 4125+882002 Square High Temperature Grade A Ceramic Bathroom Sink and
elite 4125+882002 square high temperature grade a ceramic bathroom sink and
$183.49
quality
Kraus KCV 150 White Square Ceramic Bathroom Sink
kraus kcv 150 white square ceramic bathroom sink
$168.68
quality
White Ceramic Satin Nickel Vessel Rectangular Bathroom Sink Faucet Drain Include
white ceramic satin nickel vessel rectangular bathroom sink faucet drain include
$314.93
quality
White Ceramic Chrome Vessel Rectangular Bathroom Sink with Faucet Drain Include
white ceramic chrome vessel rectangular bathroom sink with faucet drain include
$279.93
quality
Elite High Temperature Ceramic Bathroom Sink Faucet Set
elite high temperature ceramic bathroom sink faucet set
$179.99
quality
Isabella Vitreous China 15 Wall Mount Bathroom Sink WHC2566
isabella vitreous china 15 wall mount bathroom sink whc2566
$262.99
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Striking Ceramic Heart Art Decor Bronze
striking ceramic heart art decor bronze
$43.90
quality
New Modern Simple Height34CM Home Decoration High Grade Kaolin Crack Glaze Vase
new modern simple height34cm home decoration high grade kaolin crack glaze vase
$78.45
quality
Caffco International Dana Wittmann Square Ceramic Tile Trivet Crab
caffco international dana wittmann square ceramic tile trivet crab
$29.77
quality
Morden Simple Creative Family Of Three Deer Home Decoration Vases
morden simple creative family of three deer home decoration vases
$78.45
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Star Wars BB 8 Droid Ceramic Teapot  Mug Kitchenware Set
star wars bb 8 droid ceramic teapot mug kitchenware set
$59.99
quality
Star Wars Death Star Ceramic Teapot  Mug Kitchenware Set
star wars death star ceramic teapot mug kitchenware set
$59.99
quality
Pfaltzgraff Multi Color Set 6 French Wine Labels 65 Square Appetizer Plates
pfaltzgraff multi color set 6 french wine labels 65 square appetizer plates
$26.00
quality
1 Furnishing Articles Mouth Diameter 15CM Height 20CM Gold Glass Candlestick
1 furnishing articles mouth diameter 15cm height 20cm gold glass candlestick
$102.23
quality
2X Simple Style White Ceramics Diameter 30CM Household Deep Plate Tableware
2x simple style white ceramics diameter 30cm household deep plate tableware
$70.53
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DEI Nautilus Shell Lamp
dei nautilus shell lamp
$49.77
quality
4 Piece European Simple White Ceramic Porcelain Cups Coffee Tea Set Gift 1
4 piece european simple white ceramic porcelain cups coffee tea set gift 1
$94.30
quality
Hinkley Collier Antique Nickel 22 Inch Four Light Semi Flush Mount 3382A
hinkley collier antique nickel 22 inch four light semi flush mount 3382a
$339.00
quality
1 Furnishing Articles Mouth Diameter 20CM Height 21CM Transparent Fruit Tray
1 furnishing articles mouth diameter 20cm height 21cm transparent fruit tray
$110.15
quality
New European Style Elegant Noble Ceramics Coffee Cup Tea Pot 15 Pieces Set J 2
new european style elegant noble ceramics coffee cup tea pot 15 pieces set j 2
$133.92
quality
1 Furnishing Articles Mouth Diameter 13CM Height 19CM Glass Candlestick Vases
1 furnishing articles mouth diameter 13cm height 19cm glass candlestick vases
$91.84
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Ceramic Pottery Watermelon shaped Basket Serving Bowl w Handle 11x75x8 AS IS
ceramic pottery watermelon shaped basket serving bowl w handle 11x75x8 as is
$24.44
quality
6 Piece European Simple Blue Bone China Porcelain Cups Coffee Tea Set Gift
6 piece european simple blue bone china porcelain cups coffee tea set gift
$149.77
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1 Furnishing Articles Diameter 6CM Height 6CM Transparent Glass Candlestick
1 furnishing articles diameter 6cm height 6cm transparent glass candlestick
$68.07
quality
1 Furnishing Articles Diameter 165CM Height 22CM Spiral Transparent Glass Vase
1 furnishing articles diameter 165cm height 22cm spiral transparent glass vase
$78.45
quality
22 New Kitchen Cabinet Handles Ceramic Brass Plated with FloralPattern
22 new kitchen cabinet handles ceramic brass plated with floralpattern
$35.00
quality
Hinkley Harper Brushed Nickel Semi Flush Mount 3643BN
hinkley harper brushed nickel semi flush mount 3643bn
$329.00
quality
Hinkley Harper Heritage Brass 18 Inch Semi Flush Mount 3643HB
hinkley harper heritage brass 18 inch semi flush mount 3643hb
$349.00
quality
2 Piece European White Bone Ceramic Porcelain Cups Coffee Tea Set Gift
2 piece european white bone ceramic porcelain cups coffee tea set gift
$102.23
quality
Hinkley Charlotte Chrome Semi Flush Mount 3522CM
hinkley charlotte chrome semi flush mount 3522cm
$339.00
quality
4 Piece European Simple White Ceramic Porcelain Cups Coffee Tea Set Gift 5
4 piece european simple white ceramic porcelain cups coffee tea set gift 5
$94.30
quality
6 Piece European Simple Yellow Ceramic Porcelain Cups Coffee Tea Set Gift 13
6 piece european simple yellow ceramic porcelain cups coffee tea set gift 13
$165.62
quality
4 Piece European Simple Pink Bone China Porcelain Cups Coffee Tea Set Gift
4 piece european simple pink bone china porcelain cups coffee tea set gift
$94.30
quality
6 Piece European Light Green Ceramic Porcelain Cups Coffee Tea Set Gift 12
6 piece european light green ceramic porcelain cups coffee tea set gift 12
$173.55
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Porcelain Ceramic

See More About:    Dwv        Triple Kitchen        Steel Round        
Tevisan Ceramics: pottery and porcelain Creations (English)

RESTORATIVES TODAY RIVAL ACTUAL ENAMEL AND SUSTAIN WEAR THAT IS AS LOW AS THREE MICROMETERS PER YEAR.

Dr. Samuel Waknine talks to New York Cosmetic Dentist Dr. Judy Johnson, Chief Medical Officer; Dental Visits Midtown Manhattan NYC Center for Cosmetic Dentistry, about the importance and advantages of using optimum materials in modern restorative dentistry. Dr. Waknine is President of DRM Research Labs, which is mostly involved in research and development. He lectures at the academic and private sector level, providing either operative or technological instruction to clinicians and technologists, the world over.

(Question) New York Cosmetic Dentist Dr. Judy Johnson: Do you think the Central and Eastern European or the markets of the United States are ready for products with high aesthetic quality and state of- the-art materials?

(Answer) Samuel Waknine DDS: I think so! I have had a vast amount of experience lecturing worldwide and interacting both in the industrial sector as well as in the clinical and academic sector with many technologists, professors and clinicians whether it is in Lithuania, the Czech Republic, Poland or Russia. Indeed such materials are becoming more and more popular in those venues due to the fact that firstly, they are easier to use, secondly, they require less machinery and equipment in the laboratory and thirdly, chair-side time is significantly reduced.

The main disadvantages to this more sophisticated material is that it requires a dry field of operation during the momentary placement procedure, however, I think the advantages outweigh the disadvantages due to the fact that one has a material that is functional, aesthetic, matches tooth color, that is serviceable and is biocompatible, healthier overall compared to the traditional silver amalgam fillings and the standard crown and bridge alloys; nickel chrome, chrome-cobalt and silver-palladium products.

With traditional materials it takes two to three days and an innumerable amount of equipment, instruments and adjunct materials before a crown or a bridge is fabricated, whereas with our materials one is able to fabricate a rather vast or large restoration in less than one hour. So from a time, effort and equipment perspective, this is the preferred methodology for the laboratory.

(Question) New York Cosmetic Dentist Dr. Judy Johnson: Are there any other advantages of modern restorative materials?

(Answer) Samuel Waknine DDS: If we look at a dental restoration in a chronological manner from infancy to adulthood, from pediatric dentistry to geriatric dentistry, we start out with a little tiny one-surface cavity, that escalates to a two-surface filling, then possibly leaks and has to be repaired and becomes a pin-retented three – or four-surface silver amalgam filling undermining the surrounding enamel, and then onward to a crown (usually poorly adapted or sealed), followed by endodontic treatment and a post/core build-up encapsulated by a crown prosthesis and possibly an extraction, even a bridge, usually non precious alloy (porcelain fused to metal), subsequent alveolar bone resorption and then possibly a removable prosthesis; partial or denture followed by ridge augmentation and possibly an implant.

Because silver amalgams are very limited they usually have to be repaired somewhere down the line. By the time they have to be repaired, the carious lesion site usually has progressed so vastly that it invariably turns into a three-quarter crown or a full crown. On occasions, one even has to resort to crown and bridgework.

The approach with the new modern poly-ceram restorative materials is that if one can achieve a very good seal at a tooth restorative interface, which is really the hub or area of concentration of the technology, and then one can reduce the possibility of having to remake the restoration and ensue this very tedious and complicated voyage. This is not the case with the advanced restorative materials. If there is a failure it tends to be rather minor and require very quick patch-up and repair at the adhesive interface and so the incidences of secondary caries, remakes or repairs is significantly lower in potential expenditure and tooth loss. Which is a massive advantage whether you are in Prague, London or New York City.

(Question) New York Cosmetic Dentist Dr. Judy Johnson: What about the issue of durability?

(Answer) Samuel Waknine DDS: That is a very good point. There is a propensity to judge today’s restoratives of the poly-ceram category by ‘bunching them’ with those of 40 years ago, particularly among dentists who were accustomed to those products then. However, composites or bonding materials from 40 years ago are a far cry from what is available today. Since then, we have gone through about seven generations of products and probably tens of thousands of research projects documented in the form of manuscripts and patents, so there has been a good deal of innovative progression in this field of technology.

Consequently, today there are several products that are very reliable. From the perspective of wear resistance, today’s restoratives are able to sustain wear that is as low as three micrometers per year – which rivals actual enamel. This compares with 40 years ago when it was 150 micrometers per year. According to statistics from pooled clinical data, today’s restoratives have an average half-life of 17-22 years, which is very close to a silver amalgam restoration and or porcelain fused to metal crown. From a color stability perspective these products no longer have residual oxide by-products, they tend to be very stable and tend to maintain their anatomical form, contour and texture and overall physico-mechanical functional state. So yes, there are still some materials today that are not very reliable, and then, there are a few materials that are extremely advanced and are capable of rivaling any metallurgical or ceramic adjunct material.

(Question) New York Cosmetic Dentist Dr. Judy Johnson: Would you say that while these materials might perhaps be slightly more expensive, in the long run they save so much time that they work out to be more economical?

(Answer) Samuel Waknine DDS: Well, cost is certainly one element, but in today’s society people are more health conscious and aesthetically aware, which are also factors that need to be considered. I think that a silver restoration for a posterior molar tooth is 50/50. No one looks back there so it may not be too important. However, for an anterior restoration there is really no choice in the matter, the thought of seeing gold or silver as you smile is rather awkward, therefore, more aesthetically pleasing materials become a matter of necessity. So for the anterior sector of the intra-oral environment it is a necessity. Furthermore, as far as the laboratory technician is concerned, modern materials are quicker and easier to use so there is really no reason why they should not be chosen.

(Question) New York Cosmetic Dentist Dr. Judy Johnson: Could you tell us a little about the history of dental restorations and the advances that have been made in recent years?

(Answer) Samuel Waknine DDS: Traditionally, metallurgical materials were used for restorations. This was a very well established practice for the best part of 150 years. In the case of fillings, silver amalgams were used to a large extent worldwide. These amalgams are 50 percent powder – composed of silver, tin, copper and a trace amount of zinc, and 50 percent liquid – which is pure mercury – amalgamated to form a paste, which is placed into the cavity. The silver amalgamates by reacting with the free mercury, while the copper interacts with the tin to create a cupric-tin complex strengthening/hardening interphase and the zinc acts like a scavenger to rid any unreacted metallic oxide residue. This material is not very technique sensitive, with near zero handling/manipulation error characteristics, so it’s advantageous to the clinician due to the fact that it can be placed in a slightly moist environment, forgiving to isolation technique acuity, in lieu of deleterious effects to its tooth-margin interfacial integrity. However, there are serious disadvantages to this type of silver amalgam material in comparison to the modern poly-ceram composite fillings.

The silver amalgam is not tooth colored and is rather obvious when placed in the anterior sector of the oral environment. However, the modern poly-ceram composite can attain a near perfect tooth color match. Further, in the event the silver amalgam is applied beyond one third of the cuspal incline, it tends to undermine the surrounding thin-walled remaining enamel leading to cuspal fracture and/or radial cracks compromising the retentive surrounding tooth aspects, or the restoration itself. The poly-ceram is capable of achieving a chemical bond-linkage to the underlying organic dentin and a micro-mechanical bond to the surrounding enamel honeycomb prismatic structure with the aid of modern seventh generation adhesive technology.

This allows for a more conservative approach to tooth preparation guidelines criteria, with a greater emphasis on conservation of sound non-carious tooth structure. Conversely, such advances in adhesion technology have allowed for more substantial, larger restorations, in lieu of hampering the strength of the remaining tooth structure, especially with the advent of extra-oral processed inlay-onlay (three-quarter)-crown luted cemented restorations.

The metallurgical silver-amalgam product is electrically conductive, so it is not the most pleasant material to have in your mouth. By contrast, the poly-ceram composite filling is electrically non-conductive. The silver amalgam also undergoes an abrasion phenomenon leading to degradation, allowing the leaching of certain mercuric contents from the filling, which have been known to affect certain kidney and liver enzymes and even permeate the blood brain barrier. Although, the mercuric salt differs from the free mercury in its unamalgamated form, this remains a controversial issue.

Whereas the poly-ceram composites of the 1960s ensued upward of 150 micron wears per year, today’s (circa 1993-2003) modern poly-ceram composites are able to sustain a clinical wear rate of 3-35 microns per year, a pivotal improvement. The corrosion by-product of the dental silver amalgam serendipitously seals the tooth restoration margin, in lieu of chemical adhesion, otherwise known as the Gamma-II Phase. In order to passivate this corrosion phenomena, both marginal breakdown, surface pit-corrosion patterns and tarnish, high copper amalgams were innovated, however, a clear disadvantage of the accentuation of the Gamma-I Phase is that it leads to more prevalent bulk fracture and facilitated mercuric salt by-product release.

The G.V. Black rules of cavity preparation protocol innovated in 1898, and still practiced today, state the necessity of ‘extension for prevention’, in other words extending the cavity preparation/excavation beyond the carious limit zone in order to prevent recurring caries, thereby, consuming more tooth structure. In addition, due to the fact that silver amalgams do not chemically adhere to tooth structure, creating diatoric forms, undercuts, channeling and macro-mechanical retentive sites during the cavity preparation is both necessary to retent the amalgam as well as deleterious in sacrificing more sound tooth structure. On such occasion that the tooth preparation has been compromised to a great extent, the tendency is to use gold retentive pins in order to anchor and sustain the silver-mercury admix, a further unnecessary invasive step.

Previous research has shown that a silver amalgam ‘MOD’ 3- surface, slot-like cavity preparation, restored class II molar tooth, sustains only 50 percent of a sound unrestored molar intercuspal flexural strength. Further, a modern poly-ceram composite restoration strengthens the tooth to 2xfold its potential intercuspal transverse strength. Silver amalgams used in large class II molar restorations; invariably cause a tattoo phenomenon of permanent tooth discoloration to a violet-gray/green tinge and even brown/black tint, this is quite evident when a clinician attempts the removal, replacement or repair of a failing old silver-amalgam restoration. This is not the case with modern poly-ceram composite filling materials. As a consequence, such restorations have, over the past 20-25 years, become less and less popular and alternatives, otherwise known as bonding or white fillings (or more prevalently known as composites) are now available.

(Question) New York Cosmetic Dentist Dr. Judy Johnson: Could you tell us about your particular area of specialty?

(Answer) Samuel Waknine DDS: At DRM Research Labs our area of specialty lies with these alternative restorations, which are composed of polymeric materials and glass ceramic fillers for reinforcement. Such restorations are used for a plethora of intraoral care including liners, cement, sealants, class V cervical erosion sites, and direct fillings, class I, II, III and IV in anterior and posterior tooth restoration. They were originally available in auto cure format (2-part systems) throughout the 1950-60s, then in photo cure UV-light initiated (200-400 nanometers). In the early 1970s and in the late 1970s the entire industry merged to photo cure blue or halogen light cure materials, which are initiated by a blue light ranging from 400 to 700 nanometers wavelength irradiated for 10-40 seconds. The light triggers a free-radical addition reaction in the material that converts it from a monomer (liquid state) to a polymer (solid form), hardened material.

Such materials have experienced a lot of problems, most of which have been resolved over the years, as the technology has become more refined. Our area of concentration and original innovation is the semi-crystalline poly-ceram nano-reinforced technology, and the particular line adjunct and borne of this pivotal innovation is the Diamond product line. There is an entire series affiliated with this ranging from the advanced adhesive, DiamondBond, the liner/cement/sealant, DiamondLink, the filling material, DiamondLite to the prosthodontic, crown and bridge system, DiamondCrown. It is the crystalline morphology and special oligomer-ceram interfacial characteristics that affords these materials certain physical, mechanical, optical and wear resistance properties that rival the standard amorphous polymer composites.

This special technology has afforded improved color stability, better tooth color matching ability, significantly higher fracture strength resistance, near-zero leaching/solubility, tremendous wear resistance, negligible polymerization-contraction forces, shrinkage, substantially improved tooth-adhesive marginal integrity due to advanced bonding mechanisms, biocompatible formulation and remarkable toughness, shock absorbing character, carrying this technology above the norm of the restorative niche into the realm of reconstructive materials, including prosthetics and implantology.

Of special interest is field prosthodontics and implantology due to the fact that the traditional superstructure encapsulating or crowning the underlying metallic alloy substructure is usually dental porcelain characterized as a very hard and brittle surface that is relatively unforgiving and complex in its laboratory application methodology. The PFM (porcelain fused to metal) restoration, although very popular, is infused with a spectrum of relative disadvantages:

i. The mechanical properties of dental porcelain exhibit an unusually hard material, four times that of natural tooth structure, which is rather non-forgiving, wears opposing dentition, weak in tension and flexure mode (low strength), and most importantly attains very low toughness, hence, unable to dissipate cyclic masticatory energy. Therefore, it is prone to fracture, delamination from the underlying retentive metal framework, eventually necessitating complex intra/extra-oral repair.

ii. This is further complicated by the use of popular dental alloys as the copings or frameworks for these dental porcelains such as nickel chrome and silver-palladium, which have been documented to ensue cytotoxic reactivity with the intraoral epithelial mucous membrane soft tissue contact zones, leading to cervical erosion, pocket formation, degradation of the interdentinal papillae and loss of periodontal ligature attachment, accelerating mobility and jeopardizing the overall stability of tooth structural-architectural ergonomics.

iii. The underlying metallic substructure lack of aesthetic quality or tooth color matching ability necessitates greater tooth structure compromise in order to plunge the metallic collar of the crown restoration, yielding a cervical margin below the gingival gum-tissue line, sub gingival. This leads to further bio-interaction at the sulcus with perio-ligature deterioration and poor hygienic maintenance due to inaccessibility to tooth brushing and dentifrice activity.

iv. These factors collectively are of great ramification when such materials, dental porcelain, are used in implant prosthodontics. Especially in single implants and the more popular immediate loading techniques, where the shock absorbing, high toughness, form and functional maintenance coupled with superb aesthetics of the semi-crystalline poly-ceram nano-reinforced DiamondCrown technology rivals any dental porcelain titanium implant superstructure. This is of great importance in particularly frail osseo integration transitional implant-prosthesis (crown) loading periods that will dictate the eventual success rate of the implant prosthesis integration and maintenance thereof.

Further, in complicated cases where temporomadibular joint disorder is prevalent and eventual characteristic tooth bruxism and jaw-clenching phenomena are evident, the semi-crystalline DiamondCrown technology, serves its purpose par excellence as the restorative of choice for occlusal rehabilitation. Whereby the shock-absorbing, cyclic masticatory energy dissipating special micro morphology of the crystalline lamellae leads to a micro elastic behavior, the reinforcing poly-ceram interdendritic structure allows for macro rigidity and architectural stability in spite of the tormented occlusal disappropriation. Further, enhanced by the ability to repair and maintain intra-orally opposed to the standard of the industry, dental gold.

(Question) New York Cosmetic Dentist Dr. Judy Johnson: Would it be advisable to undertake specific training before using the new restorative materials?

(Answer) Samuel Waknine DDS: Yes, training and education is a key factor in disseminating the proper methodology and operative techniques affiliated with this new generation of materials. The learning curve associated with the older generation metallurgical materials, from an intra-oral placement care point of view, is not very steep, so in order to become more adept at this type of restorative dentistry, it is very important to hold clinics, workshops and get-togethers or even chair-side practical workshops to bring about greater awareness as to what is the proper either surgical, operative or technical protocols that bring about a higher chair-side success rate, their corresponding clinical indications and material ramifications.

(Question) New York Cosmetic Dentist Dr. Judy Johnson: Who would conduct these workshops?

(Answer) Samuel Waknine DDS: We actually conduct these workshops with an entire team of technologists, clinicians and scientists. We go from country to country and attempt to help generate a greater awareness of the proper clinical methodologies associated with advanced biomaterials chemical engineering. That’s what brings about the real success in this restorative science – the education.

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