Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy...

45
Tiny Tweaks Make Big Differences: How Sphere Technology May Revolutionize Composite Dentistry Timothy M. Bizga, DDS, FAGD

Transcript of Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy...

Page 1: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Tiny Tweaks Make Big Differences:How Sphere Technology May Revolutionize Composite

Dentistry

Timothy M. Bizga, DDS, FAGD

Page 2: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

www.2thLectures.com

Page 3: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

ABOUT ME

Page 4: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of
Page 5: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

What matters?

Page 6: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Composite Resins

• Composed of a resin matrix and fillers

• Fillers (glass, quartz, silica, pre-polymerized resin) help to reduce shrinkage

• Fillers influence material based on size, shape, surface quality, optical index

Page 7: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

1. Excellent handling

2. Durable restorations

3. Fast and easy polishing

4. Simplified shading

Development objectives

Page 8: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

The “Filler” Problem

The smaller the filler…

+ the better the gloss

the lower the filler load (due to increased surface) the weaker the material

the lower the wear resistance (in occlusal contact areas)

Page 9: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

How to overcome these contradictions?

– Make large fillers out of small primary particles

Page 10: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Filler technology - overview

Ivoclar-Vivadent

Pre-polymerized

Page 11: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Combination of pre-polymerized macrofiller and submicron glass filler

resin

submicron

glass filler

silanized

submicron-

filler

irregularly

shaped pre-

polymerized

macro-filler

(10-100 µm)

milling resin

resin matrix

curing

Filler Technologies: Tetric EvoCeram(Ivoclar)

Page 12: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Surface after generalized wear (2500x)

Latta MA (2015)

Tetric EvoCeram

30 µm

Page 13: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Filler technology - overview

3M Espe Ivoclar-Vivadent

Nanocluster Pre-polymerized

Page 14: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

FS combines “Nanoclusters” with nanofillers

zirconia- and

siliciumdioxide

nanoparticles

(10- 20 nm)

irregularly shaped

„Nanocluster“

(1 - 20 µm)

1. spray-drying

2. calcination

3. milling

Filler Technologies: Filtek SupremeUltra (3M ESPE)

Page 15: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

FS combines “Nanoclusters” with nanofillers .

zirconia- and

siliciumdioxide

nanoparticles

(10- 20 nm)

irregularly shaped

„Nanocluster“

(1 - 20 µm)

1. spray-drying

2. calcination

3. milling

Filler Technologies: Filtek SupremeUltra (3M ESPE)

4. silane

5. resin

+ nanofiller

resin matrix

Page 16: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Surface after generalized wear (2500x)

Latta MA (2015)

30 µm

Filtek Supreme Ultra

Page 17: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Filler technology - overview

*patent applied

Dentsply Sirona 3M Espe Ivoclar-Vivadent

Nanocluster Pre-polymerized*

Page 18: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Submicron Glass Filler (SEM)

SphereTECTM – Spherical pre-polymerized granulated filler

Matthias Hagner

Nanostructure Laboratory

Univ. Konstanz

Page 19: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Filler Technology –

milling balls

agglomerated glass

resin mixture in

solvent

Page 20: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Filler Technology –

Page 21: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Filler Technology –

glass particles coated

with resin

solvent

Page 22: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Filler Technology –

Page 23: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Filler Technology

raw materials dispersion atomization evaporation curing

Page 24: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Filler Morphology

Page 25: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Micro-mechanical interlocking

Page 26: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Bizga!

Page 27: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

The role of composites in procedure success

What matters: Handling that enables efficient placement with confidence

74% of dentists complain about handling

properties of composites such as

adaptability and stickiness.

74%

Page 28: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Low Compule Extrusion Force due to ”Ball-Bearing“-Effect

* out of standardized compule

Composite Extrusion Force*

TPH Spectra ST (HV) 71 N

Filtek Supreme Ultra 76 N

Tetric EvoCeram 148 N

Venus Diamond 175 N

Page 29: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Handling characteristics

• Easy Extrusion

• Low stick

• Exceptional adaptation and handling

• Uncompromised Strength

Page 30: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Leinfelder – Generalized Wear (2500x)

Latta MA (2017)

TPH Spectra ST

Tetric EvoCeram

30 µm

Filtek Supreme Ultra

TPH Spectra

Page 31: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Dr Manuel Pinon & Dr Walter Dias

Indirect onlays on molars

Preparation Indirect onlays Post-operative view

Page 32: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Common Class II Clinical Considerations

14% of total Class II chair time is spent

finishing and polishing14%

What matters: The finishing system produces a smooth surface efficiently

More than 80% of dentists are satisfied

with the final surface generated by

Enhance in posterior restorations80%

Page 33: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Polishing – composite with large filler particles

Resin matrix

Primary barium

glass particles

Page 34: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

filler particles

Resin matrix

Primary barium

glass particles

Polishing –

Page 35: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Finishing and Polishing

da Costa J, Ferracane JL (2017)

0

10

20

30

40

50

60

70

80

F 20 40 60 80 100 120

Glo

ss

Unit [

GU

]

TPH Spectra ST

+ Enhance + Pogo

Filtek Supreme Ultra

+ Sof-Lex (medium-superfine)

polishing time [sec]

Polishing (comparing systems)

0

5

10

15

20

25

30

0 20 40 60 80 100

Glo

ss

Unit [

GU

]

finishing time [sec]

TPH Spectra ST

Filtek Supreme Ultra

Tetric Evo Ceram

TPH Spectra

Finishing with Enhance

Page 36: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Amazing gloss

After contouring

After finishing

After polishing

Page 37: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of
Page 38: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

The role of composites in procedure success

Dentists spend up to 28% of Class II chair

time on shade selection and finishing and

polishing

80% of patients are reportedly aware

of color differences between restored

and adjacent natural teeth.

28%

80%

What matters: Simple, accurate shade selection & fast, effective finishing

Page 39: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Simplified shading

VITA®

– Cloud shades

Page 40: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Chameleon effect

Page 41: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of
Page 42: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of
Page 43: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of
Page 44: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Review of TodayEfficient

Esthetic

Built to

Last

Page 45: Timothy M. Bizga, DDS, FAGDd1ue90e5sp4tcv.cloudfront.net/3178/images/Asset308133_v1.pdf · Timothy M. Bizga, DDS, FAGD . . ABOUT ME. What matters? Composite Resins •Composed of

Contact Info

• Dr. Tim Bizga• Like Dr. Tim Bizga on Facebook

• @DrTimBizga

• 2thLectures.com

• Email: [email protected]

45