Turkey new materials - Asbjorn Jokstad, Professor ... · PDF fileCoreShade Shofu GIC ... Cavex...

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NEW MATERIALS AND TECHNIQUES IN

PROSTHODONTICSAsbjørn Jokstad, Professor, Dr.Odont.

Department of Prosthodontics and Oral FunctionInstitute of Clinical Dentistry

University of Oslo, Norway

Turkish Dental Association, Istanbul, 24th June 2005

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Fixed Removable

Tooth

ImplantMucosa

Tooth + Mucosa


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New materials & methods

Dental implantsArticulatorsPrecision attachmentsRepairs (Ceram fracture, crown removal, post retrieval, etc.)

Denture fabrication: production, materials, lining & repairs

Laboratory: process & new materials

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New materials & methods–Fixed prostheses1. Rotating instrument

2. Root Post3. Gingival retraction

5. Bite & jaw registration4. Impression

6. Color shade7. Temporary construction

8. Restorative materials9. Production techniques

10. Cementation


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New materials & methods–Fixed prostheses

Axis• Acrylic Adjustment Kit• R.A.P.T.O.R. Resin Sculpting Set• R.A.P.T.O.R.

Brasseler• Acrylic Temporization Kit• Anterior Bur Box• Esthetic Inlay/Onlay• Nixon Inlay/Onlay II• Nixon Porcelain Veneer II Laminate

Veneer System• Ultra Denture Adjustment &

Polishing Kit

CosmedentTop Finisher System

Dentsply/CaulkEnhance Composite Finishing and Polishing System

Nobel BiocareProcera Preparation Kit

Preparation & finishing kits

Preparation & finishing kits


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New materials & methods–Fixed prosthesesRotating instrument

Root Post

1. Cast2. Prefabricated

– Metal– Non-metal

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1. Cast postsIndirect technique

• Impression

Direct technique: Post & resin• Wax• Resin

– Accuset– ExactaCast– Luminex– GC Pattern Resin


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2. Prefabricated posts1. Cast Posts

– Indirect– Direct: Post & resin

2. Prefabricated PostsAdditional core

Metal No YesNon-metal - Yes

> 30 products


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”Core”-materialsBis-core Bisco Dual co.Bisfil core Bisco Light co.Bisfil II Bisco Chem.CoBlue core Teledyne Chem.CoBuild-It! FR Jeneric Dual co.Ceracap Brasseler ceramicClearfil Core Kuraray Chem.Co“ “ PhotoCore Kuraray Light co.

Coradent Vivadent Chem.CoCore Paste Den-Mat Chem.Co

” ” Syringe Den-Mat Dual co.Core-Flo Bisco Chem.CoCoreRestore2 sds/Kerr Dual co.

” ” HDOC sds/Kerr Light co.CoreShade Shofu GIC

CuRay-support Sci-Pharm Dual co.Encore Centrix Chem.CoFluoroCore Dentsply Dual co.Fuji-II LC GC GIC-modif.HardCore Pulpdent Dual co.Infracore Temrex Dual co.Ketac silver 3M ESPE Ag-GICLight-Core Bisco Light co.LuxaCore Auto DMG Dual co.MagnaCore Bosworth Dual co.Microrest Core GC Chem.CoParapost Paracare Coltene Dual co.Rebilda VOCO Chem.CoTi-Core EDS Chem.CoVitremer 3M Espe GIC-modif.

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2. Prefabricated posts, metal

SteelTitanium-alloyTitanium

”Active” – ”Inactive”ConicalParallelSteps

ThreadedSmoothStructured

FlatConicalOvoid

Slots & grooves


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2. Prefabricated post, non-metalFive main groups

1. Ceramic, prefabricated

2. Ceramic, made in thedental laboratory


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Posts made in ceramics

Prefabricated

Biopost (Incermed), ZrOx, D, ~ 1990Cerapost (Brasseler), 1995Cosmopost (Ivoclar), 1998Laboratory

+ ”Cosmopuck” (Ivoclar), 1998 In-Ceram (VITA), 1994

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1. Ceramic, prefabricated

2. Ceramic, made in laboratory

3. ”Black post”, Carbonfibresdispersed in resin

4. ”White post”, Quartsfibresdispersed in resin

5. ”Translucent post”

2. Prefabricated post, non-metalFive main groups:


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Non-metal, non-ceramic posts -many variants

Quarts compositeQuarts+Zirkonium ”resin”(Carbon) epoxiQuarts & Carbon polyester


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Root Post

Gingival retraction1. Cord• Impregnated• Non-impregnated

2. Gel/paste3. Cotton4. Electrosurgery5. (Cobber-tube)

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Retraction cords, impregnatedProduct Producer Active substance TypeAltrac VOCO AlCl3Biopak SDI AlCl3 twinnedCrown-Pak Gingi-Pak dl-Adrenalin (4-ply) twinnedGingi-Aid Gingi-Pak Fe2(SO4)3 wovenGingi-Pak Gingi-Pak dl-Adrenalin (2ply- Soft-twist) twinnedGingi-Tract Den-Mat AlSO4, 0.5 mg/i twinnedGingibraid VanR AlKSO4/adrenalin + Aluminium braidedHemalin VOCO AdrenalinHemodent HAWE Premier AlCl3 21% twinnedPascord Pascal AlSO4 twinnedRacestyptin Septodont AlCl3+lignocain braidedRacord Pascal dl-Adren HCl +Znfenolsulfonat 0.3% twinnedRetracto Roeko AlCl3Sil-Trax Pascal AlSO4/dl-adrHCl/dl-adr+Znfenolsulfonat braidedRetreat/II Henry Schein AlSO4/adrenalin twin/braidSulpak Sultan AlK N.F/adrenalin HCl 4% twin/braidTraco VOCO AlCl3 6%Ultrax Sultan AlK N.F/adrenalinHCl 4% /AlK+adr braidedUnibraid VanR Adrenalin-alum braidedZ-twist Gingi-Pak dl-Adrenalin/ AlCl3 woven


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Retraction cord, non-impregnatedAstringedent (Ultradent), First Stop (Stevenson), Gingi-Aid (Gingi-Pak), Gingiva liquid (Roeko), Hemodent (HAWE Premier), Hemo-gin-L (Van R Dent Prod.), Hemo-stat (Henry Schein), Ocu Clear (Health Care Prod), Orostat(Gingi-Pak), Rastringent (Pascal Comp), Racemistat (Pascal Comp), Stasis (Gingi-Pak), Styptin (Van R Dent. Prod), Ultradent Alum Chlor. (Ultradent), ViscoStat (Ultradent), Visine (Pfizer Inc), Wet Pack (Van R Dent. Prod.)


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Expasyl (Kerr /Pierre Roland)

15% Al-Chlorid + Caolin

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Gel-Cord (Pascal)

Retrac

Comprecap (Roeko)


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Gingival retraction

Impression

Root Post


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A perfect impression

1. Influence of theimpression material?

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Most commonly used materials in USA

Crowns Inlays

/bridges /onlays

Vinyl siloxane 81% 71%

Alginate 38% 20%

Polyeter 28% 22%

*Dental Products Report Survey, Nov 2000 n= 319 dentists.


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2. Influence of theimpression technique?


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Method 1 - Dual-archSYN: Dual-arch impression,

Double-arch impression, Triple tray technique, Closed-biteimpression, Double arch single mix impression, Double arch double mix impression

•Occlusion?

•Patientcomfort•Maximumintercuspid•Easy for laboratory•Time

Dual-arch

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SYN: One phase technique, Single phase impression, Medium viscosity technique, Single mix technique, Single mix single impression, Monophase technique

Materials – ex.Aquasil Monophase DentsplyExamix Monophase GCImprint II 3M EspeImpregum F 3M EspeProvil Novo Monophase KulzerPresident System 75 Coltene

Method 2-One polymerisation phase- one viscosity


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Method 3-One polymerisation phase- two viscosities

SYN: Double mix technique, Double mix single impression, Express technique, One step putty wash technique, Sandwich impression, Simultaneous one-step technique, Two phase technique/ impression, Wet/Wet impression

Materials – ex.Aquasil Putty + Reprosil HF Light DentsplyExamix Putty + Examix Regular eller Inject GCExpress Putty + Express Medium 3M EspeImpregum F + Permadyne 3M EspeOptosil Comfort P Plus + Xantopren KulzerPresident Heavy + President (Jet) Light Coltene


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Method 4 –Two polymerisation phases-two viscosities

SYN: Correction impression, Double impression, Double mix double impression, Overlay impression, Putty-wash technique / impression, Two-step putty-wash technique, Wash technique, Wet/Dry impression

Materials – ex.Coltoflax + Coltex Xtrafine ColtenePanasil Heavy + Panasil Regular KettenbachPresident Putty Soft + President (Jet) Light ColteneExamix Putty + Examix Regular GCExpress Putty + Express Medium 3M EspeAquasil Putty + Reprosil HF Light Dentsply

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•Techniquesensitive•Hydraulic•Replacement

•Putty : washhardnesscompatibility?

•Occlusion?

•Hydraulic•Hydraulic•Fast•Patientcomfort•Maximumintercuspid•Easy for laboratory•Time

Two-phase -two stage

Two-phaseSingle-phase

Dual-arch


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Alternative method 5 -”Hydraulic principle”

For upper anterior abutments with fragile gingiva


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Alternativ method 6 -”Laminar” principle(Ref: G Schoenrock (1989)

For lower posterior abutments with dry work field problems

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Alternative method 7 – Tube-section

The safest techniquewhen abutments areperiodontally unstable


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1. Dual-arch1. Metall2. Plastic

2. Other1. Metall2. Plastic3. Individual


3. Influence of theimpression tray?


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Trays – Dual-arch• Bite Relator (Temrex)• Bite Tray (Kerr)• Exacta• First Bite• Quad-Tray• Tri-Bite (Tri-Bite)• Triple Tray (Premier)

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Trays - metal

Platinated brassSteelTitaniumAluminium

PerforatedUperforated


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Trays – metal


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Trays – metal, for implant prosthodontics

KohlerMedizintechnik

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Trays - plastic


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Most used in USA

Percent used for impressionsCrowns Inlays

/bridges /onlaysVinyl siloxane 81% 71%Alginate 38% 20%Polyeter 28% 22%

Do you ever use individual tray? Yes 73% No 24%



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Tray - individualCandulor C-plast Candulor Dental ChemicalCavex Shellac Cavex HeatCitotray Bayer AG LightComtray Schütz Dental LightEasy Tray Kerr HeatErkolen Erkodent Heat/VacuumExtoral Pro-Den LightFastray H Bosworth ChemicalFormatray Kerr ChemicalHygon Premier ChemicalIndivido/Lux VOCO Chemical/LightOstron 100 G-C Dental ChemicalPalatray/LC Hereaus Kulzer Chemical/LightPekatray Bayer ChemicalSpectra-Tray Ivoclar LightSR-Ivolen Ivoclar ChemicalT-LUX Scheu Dental LightTrayAcryl Schütz Dental ChemicalTriad Dentsply Light

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Root PostGingival retraction

Bite & jaw registrationImpression


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Bite & jaw registration

Symmetry FacialPlane Relator

JAWS 3D


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Color shade

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• Dental Color Analyser (clearlight.com/~aei)

• Metalor-ikam system (metalor-ikam.com)

• Pocketspec(Pocketspec.com)

• ShadeVision /ShadeRite(X-Rite.com)

• Shadescan(Cynovad.com)

• Spectroshade(mhtint.com)

• ShadeEye NCC (Shofu.com)

• Dental Color Analyser (clearlight.com/~aei)

• Metalor-ikam system (metalor-ikam.com)

• Pocketspec(Pocketspec.com)

• ShadeVision /ShadeRite(X-Rite.com)

• Shadescan(Cynovad.com)

• Spectroshade(mhtint.com)

• ShadeEye NCC (Shofu.com)

Digital Shade SystemsDigital Shade Systems


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Hue

Chroma

Value


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Bite & jaw registration

Impression

Color shade

Temporary construction

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Bis-Acrylic composite Polymethyl metacrylatePolyethyl methylacrylate

Microfill light cured UDMA composite


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• ……. …………..

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Cool Temp ColteneIntegrity DentsplyLuxatemp Automix DMGProtemp 3 Garant 3M ESPEStructur 2 VOCO GmbHTempofit DetaxTrim II H Bosworth


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Eugenol -containing E.g.Temp-Bond og IRM

Non-eugenol-containingE.g. Nogenol og Dycal

Light & chemical curedE.g. Provilink


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Color shadeTemporary construction

Restorative materials

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Restorative

In-Ceram

LFC-Hi-Au

Procera

Galvano/AGC

Empress

Metal-ceram


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Most used in USA – full ceramics

1. Pressed 63%

(e.g., Empress, OPC)

2. Aluminium-oxide 46%

(e.g., Procera)

3. Lithium disilicate 36%

(e.g., Empress 2)



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Fibre-reinforced CompositeLaboratory• FibreKor & Sculpture• Vectris & TargisClinic• Connect & BelleGlass• Fiber-splint• FibreSpan NSI & Nulite• GlasSpan• Ribbond & Revolution• Ribbond Triaxial & Revolution• Splint-it! & Flow-It! & Protect-It!• Stick / Sticknet / Everstick

Glass

Kevlar

Polyethylene

Mesh

Parallel

Twinned

Pre-Impregnated

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Restorative materials

Production techniques


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Production techniques-CAD-CAM (CADCAD--CAM)CAM)


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BEGO Medifacturing BEGO Medical (D)CAD/CAM System etkon (D) CELAY Mikrona Technologie (CH)Cercon® Dentsply/Degudent/Degussa Dental (D)CEREC3/CEREC Inlab Sirona Dental Systems (D)CICERO® Cicero Dental Systems (NL)DCS Precident DCS Dental (CH)DECIM DECIM (S)DENT. CAD/CAM GN-1 GC Corporation (J)digiDENT® Girrbach Dental (D)Everest KaVo Elektrotechnisches (D)Lava® 3M ESPE Dental (D)PRO 50 CYNOVADSM (Can)Procera® Nobel Biocare (S)WOL-CERAM WDT-Wolz-Dental-Technik (D)Xawex Arnold Wohlend (D)

Production techniques- CAD-CAM

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1. Development of materials, e.g Ceramics

0

200

400

600

800

1000

1200

1400

Carrara Core Optec OPC Empress Empress2Vitadur Alfa Carrara Dentin Vintage

Synspar VMK95 Duceram LFCCreation LF InCeram Alum InCeram ZirconiaInCeram Spinell Cerec Mark 2 ZiOxideLava 3M

(Tensile strength, Mpa)


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2. Development of software

CEREC 1 CEREC 2

Time - precision


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3. Development of production units

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Restorative materialsProduction techniques

Cementation


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Water-based - conventional

Zinc-phosphatePolycarboxyla


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Water-based:Glassionomer

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Resinmodified GIC & polyacrylate modified resin


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Light-Cured/Dual-Cure1. Insure/Insure Lite

Cosmedent2. Variolink II

Ivoclar Vivadent3a. Nexus2

sds/Kerr3b. RelyX Veneer Cement

3M ESPE4a. Choice

Bisco4b. Illusion

Bisco5. Calibra

Dentsply/Caulk

Resin CementsResin CementsDual-Cure-Only1. Panavia F

Kuraray2. RelyX ARC

3M ESPE3. Bistite II DC

Tokuyama Soda/J. Morita USA

4. Duo-LinkBisco

5a. Cement-It! Universal C & BPentron

5b. PermaFlo DC Indirect Luting/Restorative ResinUltradent

Self-Cure1. Panavia 21

Kuraray2. Post Cement HI-X

Bisco3a. C & B Metabond

Parkell3b. M-Bond

Tokuyama Soda/J. Morita USA

4. C&B Cement Luting CompositeBisco


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1. Clean surface with H2O2, wash, dry 2. Mix powder and liquid3. Apply cement in crown4. Place crown on prepared tooth5. Wait6. Remove surplus with probe7. Inspect crown margin

Zinkphosphate cement

Thank you for yourkind attention

Turkey new materials - Asbjorn Jokstad, Professor ... · PDF fileCoreShade Shofu GIC ... Cavex...

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