HIGH PERFORMANCE MATERIALS - ilovemysmile.com Ferrari.pdf · HIGH PERFORMANCE MATERIALS Welcome What better place to learn about the highest quality, best performing dental products

HIGH PERFORMANCE MATERIALS

Welcome

What better place to learn about the highest quality, best performing dental products than Ferrari, the global icon for performance and quality. During this program we will discuss the latest innovations in bonding, resin and curing

technology to help you create high quality direct posterior restorations as efficiently as possible

BOND FILL CURE FINISH


Robert Marcus D.M.D.

• UConn Dental 1993 • Poway (SD) office since 1997 • CEREC user since 2004 • CEREC Mentor and Trainer • Founder of Kick Your Apps, Inc.

Welcome


What matters?


People who understand

Venn Diagrams

People who don’t

understand Venn Diagrams

What matters?


Delicious Food

Gross Food

What matters?


Delicious Food

Gross Food

What matters?


The 3 C’s

What matters?


What matters?

Clinical Performance


ConvenienceWhat matters?


CostWhat matters?


C C CClinical

Performance Convenience Cost

What matters?


CCC

What matters?


BondFill

CureFinish


Bond


Clinical Performance BoBond: Clinical Performance


Bond: Clinical Performance

• High bond strength • Low post-op sensitivity • Low film thickness • Compatibility



0.0

10.0

20.0

30.0

40.0

50.0

Adhese® Universal

Scotchbond™ Universal

Prime & Bond® NT™

Optibond™Solo Plus

MP

a / 2

4h

R&D Ivoclar Vivadent, Schaan, FL

Shear Bond Strength on Dentin and Enamel with Tetric EvoCeram® Bulk Fill (Total-Etch)

Dentin Enamel


0.0

10.0

20.0

30.0

40.0

50.0

Adhese® Universal

Clearfil® SE™ Scotchbond™ Universal

Xeno® V+

MP

a / 2

4h

R&D Ivoclar Vivadent, Schaan, FL

Shear Bond Strength on Dentin and Enamel with Tetric EvoCeram® Bulk Fill (Self-Etch)

Dentin Enamel



0

10

20

30

40

50

Den+n Enamel Enamel

SELF-ETCH TOTAL-ETCH

MPa

/24h

Shearbondstrengthonhumanden+n/enamelwithTPHSpectraAdheseUniversal ScotchbondUniversal All-BondUniversal Prime&BondElect Op+bondXTR PeakUniversalBond

Third Party Evaluation: The Dental Advisor



0

10

20

30

40

Dentin Enamel Dentin Enamel

SELF-ETCH TOTAL-ETCH

MPa

/24h

Shearbondstrengthonhumanden5n/enamelwithZ-100Adhese Universal Scotchbond Universal All-Bond Universal Prime & Bond Elect Optibond XTR Peak Universal Bond

Third Party Evaluation: J. Burgess, U of Alabama





0.0

10.0

20.0

30.0

40.0

50.0

60.0

AdheseUniversal

PeakUniversalBond

All-BondUniversal

FuturabondU Prime&BondElect

Op=bondSolo

Mpa

/24h

MOIST DRY DESICCATED

Third Party Evaluation: D. E. Antonson, et el, University at Buffalo; 2015



53.7

23.7 24.1 20.3 6.1

50.2

8.5 0.8 0.5 32.6

0 10 20 30 40 50 60

Multilink Automix

Monobond Plus

RelyX Ultimate*

Scotchbond Universal*

NX 3* dual-curing

Optibond XTR*

DUO-LINK* All-Bond

Universal*

Panavia F2.0*

Ceramic Primer*

MP

a

Tensile bond strength to IPS e.max lithium disilicate glass-ceramics [MPa] - Application acc. to Instructions for Use

24 h

after 10,000 Thermo cycles

R&D Ivoclar Vivadent AG, Schaan, Liechtenstein, 2012 *These brands are not registered trademarks of Ivoclar Vivadent AG.

Achieving a Strong Bond



“No post-operative sensitivity.”



10μ film thickness won’t interfere with fit of restorations.



!  Direct-placed light-curing composite and compomer restorations !  Direct-placed core build-ups with light-, self- and dual-curing

composites !  Repair of fractured composite and compomer restorations !  Sealing of prepared tooth surfaces before temporary /

permanent cementation of indirect restorations !  Adhesive cementation of indirect restorations with light- and

dual-curing luting composites


When should I use this?



Variolink II (Ivoclar Vivadent)

Variolink Veneer (Ivoclar Vivadent)

NX3 (Kerr)

RelyX Ultimate (3M ESPE)

Calibra (Dentsply)

Duo-Link (Bisco)

BiFix QM (Voco)

Light-cure only



Note:

Panavia (Kuraray)

Multilink Automix (Ivoclar Vivadent)

These self-curing luting composite systems must be used with their corresponding adhesive.



Self-Etch Minimum treatment time with reduced risk of post-op sensitivity

Dr.

A. P

esch

ke /

Liec

hten

stei

n

Selective Enamel-Etch Enhances adhesion to enamel and optimizes marginal integrity

Total-Etch (Etch & Rinse) Maximizes adhesion to both enamel and dentin with optimized marginal integrity

Whatever your preference:



No dual cure activator required:


Bond: Convenience


Bond: Convenience

•  Fresh material with every click •  Cost effective – virtually no waste •  Fast direct intra-oral application

VivaPen® Delivery


Bond: Convenience


Bond: Convenience

Only 35s

Click 2-3 times

Scrub 20 seconds

Disperse with air

Cure 10 seconds

No time for: dispense from bottle, bend brush, dip brush, etc.


Bond: Cost


Bond: Cost

Berndt & Partner: VivaPen Benchmarking Study, August 2013

•  Independent study analyzed the efficiency, waste and cost-effectiveness of the VivaPen compared to conventional bottle delivery forms using gravimetric weight analysis (0,0001g) after daily clinical application.

•  6 test products

VivaPen Benchmarking Study

VivaPen Minimizes Product Waste


Bond: Cost

$60.00 vs. Average of $29.85

Cost Per Application


Bond: Hands-on!


Fill

Tetric EvoCeram and EvoFlow Bulk Fill Composite


Clinical Performance Fill: Clinical Performance


What is Ivocerin?

Fill: Clinical Performance


Camphorquinone

Absorbs at 390 – 510 nm

PPD(phenylpropanedione)

LucirinTPO

Absorbs at 380 – 430 nm Composites Composites in bleach shades

300-420nm 390-500nm


Initiators


•  Tetric EvoFlow Bulk Fill contains Ivocerin, a patented light initiator that is more reactive to curing lights allowing increments up to 4mm to be cured in just 10 seconds.

• Other “bulk fill” flowable composites require up

to three curing cycles. Tetric EvoFlow Bulk Fill increases efficiency not only because you can place fewer layers of composite, but also because it can cure faster.

Ivocerin® light-initiator





So, we want:

A light that cures both spectrums…. many don’t. (More on this later in the lecture) —or— Composites with Ivocerin.

Or, better yet, both.



More about Tetric EvoCeram…



  Polymerization “Booster” ensures a complete 4mm depth of cure in just 10 seconds.

  Shrinkage Stress Reliever minimizes shrinkage stress during polymerization preserving superior marginal integrity.   Light Sensitivity Filter provides over 3 ½ minutes of working time for adequate placement and contouring.



It shrinks?



Tetric EvoCeram Bulk Fill offers lower shrinkage force compared to other “bulk fill” composite materials as a result of the shrinkage stress reliever.

Shrinkage Stress Reliever



0

20

40

60

80

100

120

Tetric EvoCeram

Bulk Fill

SDR – Flow Venus Bulk Fill

Quixx, Quix Fill

X-Tra Fil Sonic Fill

88.6 87.7

105.5 98

90

108

Shrinkage Force (N)



Tetric EvoCeram Bulk Fill offers lower shrinkage force compared to other “layered” composite materials placed in 2mm increments as a result of the shrinkage stress reliever.

Shrinkage Stress Reliever



0

20

40

60

80

100

120

140

160

Tetric EvoCeram Bulk Fill /

4mm

Estelite Sigma / 2mm

Tetric Ceram / 2mm

Filtek Z250 / 2mm

Sonic Fill / 2mm

Filtek Supreme

XTE / 2mm

110 124.7 125.2 128

138.7 151.7

R&D IVAG Schaan

Shrinkage Force (N)



Light Sensitivity Filter Tetric EvoCeram Bulk Fill offers the longest working time compared to other “bulk fill” composites.




•  Prevents premature polymerization and provides a working time of over three minutes under operatory light conditions

•  This additive acts as a shield surrounding the light-initiators delaying the effects of ambient light. However, the wavelength of dental curing lights is able to penetrate this shield allowing the material to cure 4 mm increments in just 10 seconds!

Light Sensitivity Filter


0 20 40 60 80

100 120 140 160 180 200

200

100 110

130

55 50

secs.

Wor

king

Tim

e (s

ec.)

Tetric EvoCeram

Bulk Fill

SDR Flow

Venus Bulk Fill

QuiXX x-tra fil SonicFill

R&D IVAG Schaan, light sensitivity according to ISO 4049



More about Tetric EvoFlow…



71%!

Flowable Composites – Typical Indications

Liner or base material for posterior restorations

Block out material for undercuts

Restorative material for pit lesions

Fissure sealing material for deep fissures



Why Dentists Use Flowable as a Liner/Base

19% •  Better adaptation to the preparation

15% •  Better seal

14% •  Eliminates voids

12% •  Fills irregularities

11% •  Better coverage



Flowable Composite Selection Criteria

• Good flowability/handling #1

•  Low level of shrinkage #2

• Radiopacity #3

• Depth of Cure #4



What sets this apart from the others?

1. Self-adapting consistency 2. Opacifies upon polymerization 3. Cures up to 4 mm with Ivocerin™ 4. Shrinkage stress reliever 5. Light sensitivity filter 6. Radiopacity equal to EvoCeram



Self-adapting Formula

•  Tetric EvoFlow Bulk Fill adapts to preparation walls and margins providing an effective seal and a level base for placement of the final composite layer.

Tetric EvoFlow® Bulk Fill

Volume replacement Excellent adaptation to cavity walls.

Tetric EvoFlow® Small cavities, liner

(Thixotropic) Flows under pressure.



•  Tetric EvoFlow Bulk Fill includes a new patented technology allowing the material to achieve a translucency <10%, which simulates the opacity of natural dentin.

•  Most composites become MORE translucent after polymerization with a curing light.

•  Most “bulk fill” composites have a translucency level >20%, which is much higher than the translucency of dentin and enamel.

!  Dentin translucency: 8% - 10% !  Enamel translucency: 12% - 15%

Opacifying Technology



•  Easily distinguishable on radiographs

Pre-operative x-ray Post-operative x-ray. Notice the radiopacity of both Tetric EvoFlow Bulk Fill and Tetric EvoCeram Bulk Fill

©DrEduardoMahn,San/ago,Chile

Radiopacity Fill: Clinical Performance


Fill: Convenience


  Refractive Index Technology results in a heightened chameleon effect for a natural shade blend with surrounding dentition.

  The Universal Shade Concept covers a broad range of shades.

  Nano-Hybrid Fillers result in a smooth surface finish, high-gloss polish and lower wear.

Fill: Convenience

HIGH PERFORMANCE MATERIALS•  Three shades: IVA (universal “A”), IVB (universal “B”), IVW (bleach) •  Matches the shading system of Tetric EvoCeram® Bulk Fill

Simplified Shading System

Tetric EvoCeram and EvoFlow Shades

Fill: Convenience


A Shade (between A2-A3)

B Shade (between B1-B2)

W Shade (White for bleach shaded or pediatric teeth)

Fill: Convenience

Tetric EvoCeram and EvoFlow Shades


0

10

20

30

40

50

60

70

80

90

320 grit 10 s 20 s 30 s

Tetric EvoCeram Bulk Fill QuixFil

Venus Bulk Fill

SonicFill

SureFil SDR Flow

More than 70%: absolute gloss

Tetric EvoCeram and EvoFlow Polishing

Fill: Convenience


Fill: Cost


Material

3M Filtek Supreme Ultra 3M Filtek Supreme Bulk Fill Herculite XRV SonicFill Tetric EvoCeram Bulk Fill

Cost per 20X .2g

$105.95 $90.95 $119.95 $144.95 $97.50

Fill: Cost


Material

3M Filtek Bulk Fill Flow 3M Filtek Supreme Flow Herculite Flow Tetric EvoCeram Bulk Fill

Cost per 2g

$92.25 $96.95 $83.95 $83.00

Fill: Cost


Cure

Bluephase Style


Clinical Performance Cure


Cure: Clinical Performance

Remember the photo-initiators?


Cure: Clinical Performance


Cure: Convenience


Very light weight. Only two buttons.

Cure: Convenience


Can use the cord directly if the battery runs out.

Cure: Convenience


Charger base is inductive (like a Sonicare) so no contacts to clean.

Cure: Convenience


Cure: Cost


Light

3M Eliptar Deep Cure S Demi Ultra Bluephase Style

Cost

$1788.00 $1702.00 $1440.00

Cure: Cost


CCC

What matters?


CCC

What matters?


Thank you!

email: [email protected] lecture notes: www.ilovemysmile.com

mailto:[email protected]

http://www.ilovemysmile.com

Documents

HIGH PERFORMANCE MATERIALS - ilovemysmile.com Ferrari.pdf · HIGH PERFORMANCE MATERIALS Welcome What better place to learn about the highest quality, best performing dental products