02 learning module 1 gic complete 2013 pdf

9/3/2014

1

Saliva Testing Module 1 Glass Ionomer Cements

Advanced Learning Module 1


Topics

• Brief history of Glass Ionomer cement• Fuji IX Extra explained• Why use a Glass Ionomer cement?• Why use a Glass Ionomer liner?• Best placement techniques• Micro lamination - EQUIA technique


History of Glass Ionomer Cements

• The patent for the first Glass Ionomer Cement was published by Alan Wilson in 1972

• ASPA was released into the market in 1975• GC’s first Glass Ionomer Cement was first

released into the Australian market in 1977

9/3/2014

2


History of GC Glass Ionomers

Fuji VII EP 2011 Fuji IX Extra 2006 Fuji Lining Paste Pak2003

Fuji VII 2002Fuji II LC 1994 Fuji Bond LC 1998 Fuji VII 2002

Training Module 6Module 1 Glass Ionomer Cements

History of Fuji IX series

1994 1995

1995

1999

GC Fuji IXa

GC Fuji IXGP

GC Fuji IXGP FAST

More aesthetic

More Convenient

Faster

GC Fuji IXGP CAPSULE

EXTRA improvement

2006Fuji IX GP

EXTRA


GC Fuji IX GP EXTRA

9/3/2014

3


New generation glass filler is introduced inFuji IX GP EXTRAHigher reactivity

Faster setting

Higher fluoride release

Latest Technology

Unique optical property

Higher translucency


Class I cavity of resin teeth

1 hour after the mixing

Shade A2

Ketac Molar

Aplicap

Fuji IX GP

EXTRA

RIVA self cure

FAST

Fuji IX GP

FAST

EXTRA shade matching capability

Best shade matching


0

500

1000

1500

0 20 40 60 80 100

day

Fluo

ride

rel

ease

[ µ

g /

cm 2 ]

EXTRA high fluoride release

Fuji VII

Fuji IX GP EXTRA

Fuji II LC

Fuji IX GP FAST

9/3/2014

4


0

50

100

150

200

250

300

350

Enamel

Fuji IX ExtraFuji IX FastRiva S/C

Fluoride - Analysis of Cavity Walls in GIC Restorations

Flu

orin

e le

vel a

t 200

from

cav

ity m

argi

n

Journal of Dental Research Vol. 91 Special Issue B 2012 IADR 2012 Abstract 1158

Differences in Fluoride uptake into Enamel and Dentine can lead to differences in clinical performance


0

1000

2000

3000

4000

5000

6000

7000

Dentine

Fuji IX ExtraFuji IX FastRiva S/C

Fluoride - Analysis of Cavity Walls in GIC Restorations

Flu

orin

e le

vel a

t 200

fr

om c

avity

mar

gin

Journal of Dental Research Vol. 91 Special Issue B 2012 IADR 2012 Abstract 1158

Fuji IX Extra with its reactive glass particles delivers significantly more Fluoride into the enamel and dentine


0

10

20

30

40

50

60

Depth (microns)

Fuji IXRiva S/C

Wear of Glass Ionomer Restorative Materials

R. ROBLES, V.K. KALAVACHARLA, P. BECK, L. RAMP, D. CAKIR, and J. BURGESS AADR 2012, Abstract 865

Fuji IX had significantly less wear then Riva Self Cure

00.05

0.10.15

0.20.25

0.30.35

0.40.45

Volume (mm³)

Fuji IXRiva S/C

9/3/2014

5

Saliva Testing Glass Ionomer CementsModule 1

Applications

• Class I and II restorations in deciduous teeth.• Non-load bearing Class I and Class II restorations in

permanent teeth.• Intermediate restorative and base material for heavy stress

in Class I and Class II cavities using sandwich laminate technique.

• Class V and root surface restorations.• Core build-up as long as 50% of coronal tooth structure is

present


Why use a Self Cured Glass Ionomer Cement?

“There are at least four clearly defined areas where we need a self cured Glass Ionomer cement with enhanced physical properties

1. Paediatric dentistry

2. Geriatric dentistry

3. Dentine adhesion for composite resin in the lamination technique

4. Long term temporary in the presence of rampant caries”

G.J. Mount


Why use a Self Cured Glass Ionomer cement?

• Zero shrinkage- No shrinkage stress- Bulk placement- No sensitivity

9/3/2014

6


Why use a Glass Ionomer Cement?

• Achieving predictable adhesion– Moisture tolerant during placement– Chemically fused seal– No sensitivity

Prof Hein Ngo


Why use a Glass Ionomer cement?

• Durable, long-term adhesion

– Stability with pulpal fluid movement– Stress-absorbing characteristics– Low coefficient of thermal expansion– Clinically proven to be the most

successful adhesive system


Clinical Effectiveness of contemporary adhesives: A systematic review

…..best clinical performance was recorded for Glass–Ionomers (GI)

….GI are the only category which fulfilled the ADA requirements

Effectiveness of the five adhesive categories

M.Peum

ans et al. Dent M

atr 2005, 21, 864-881

9/3/2014

7


Why use a Glass Ionomer cement?

• Glass Ionomer strengthens over time

– Pulpal fluid movement strengthens Glass Ionomer internally

– Uptake of minerals from healthy saliva strengthens external Glass Ionomer structure


0

20

40

60

80

100

120

1 10 100Immersed time / day

Vic

kers

har

dnes

s nu

mbe

r /

Hv

Maturation in Saliva

Saliva has the remarkable effect of increasing surface hardness of Fuji IXGP.

K. Okada, 1999 Dental Materials

Changes in surface hardness following storage in human saliva

Fuji IX GP EXTRA

Fuji IX GP FAST

Hybrid composite resin


GIC Adhesion - Video

Angela Pu

GIC go dry and brittle and opaque out of mouth- need to be kept in moisture filled environment.

9/3/2014

8



• Additional protection for the tooth– Fluoride release creates an external zone of

inhibition– Fluoride release has an antibacterial effect

H Ngo



• Low biological cost if/when it fails• Additional protection for the tooth• Minimally invasive cavity preparation• Internal remineralisation from Sr and F release


15 extracted permanent molars, restored with

Fuji IX 1-3 months previously , were sent to Adelaide from Fiji.

After sectioning chemical analysis is undertaken on the dentine beneath the Fuji IX restorations looking for evidence of remineralisation

H. Ngo

H. Ngo

9/3/2014

9


H. Ngo


Technique tips for Optimum Clinical results

• Ensure a clean, caries free DEJ• Asymptomatic tooth• “ This method minimises further trauma

to the pulp and enhances the biological integrity of the tooth” Professor Hien Ngo Dental Asia November/December 2004


Scholtanus & Huysmans, J Dent 2007;35:156-62

Dental Outlook, December 2006

The Open Sandwich

9/3/2014

10


Fuji LINING LC Paste Pak

The first radiopaque resin modified glass ionomer lining cement available

in a paste-paste presentation


Fuji LINING LC Paste Pak

Distinguishable colour pastes to ensure complete mixing

Easy to dispense

Only 10 seconds mixing


Fuji LINING LC Paste Pak: Handling

3M Vitrebond Fuji LINING LC PP

9/3/2014

11


Physical properties GC Fuji LINING LCPaste Pak

Vitrebond Powder/liquid

Type Resin Modified glass ionomer

Resin Modified glass ionomer

Colour B3 A3.5

Working Time (@23C) 2 min 15 secs 3 mins

Light Cure 20 secs 30 secs

Compressive strength (@24 hours)

194 MPa 73 MPa

Diametral tensile strength (@24 hours)

26 MPa 12 MPa

Flexural strength (@24 hours) 34 MPa 32 MPa

Tensile bond strength to dentin (@24 hours after 2000 TC)

5.9 MPa 0.5 MPa

Radiopacity YES YES

Source: Internal data, GC Corporation


Source: Internal data, GC Corporation


HEMA Release from Light-cured Glass Ionomer and Compomer Cements

WR Hume et al. J Dent Res 76, Special Issue A (abst 2418) 1997

0

100

200

300

400

500

600

700

800

900

1000

Vitrebond 3M Fuji LINING LC

GC

Fuji BOND LC

GC

Dyract Dentsply

30 Day cumulative HEMA released (nmol/tooth)

9/3/2014

12


Lining, composite bonding & long term protection

• Durable• No sensitivity• Significant fluoride release• Strong and flexible• Stress absorbing• Unique glass ionomer technology

Fuji BOND LC


For Lining – 1 Powder 1 Liquid

• No slump handling• 20 second light cure• Radiopaque• Clinically insoluble – able to be exposed to the

oral environment

Fuji BOND LC


For Bonding – 1 Powder 2 Liquid

• Strong, stable chemical bonding• Fast application• Ideal for cervical and posterior composite bonding

including the sandwich technique• Proven clinical performance*

*Clinical evaluation of a resin-modified glass ionomer adhesive system: results at five years. MJ Tyas, MF Burrow. Operative Dentistry, 2002, 27,438-441

Fuji BOND LC

9/3/2014

13


Placement Techniques for GIC’s


Conditioners


Marcio Vivan Cardoso, Katleen I.M. Delme´, Atsushi Mine, Aline de Almeida Neves, Eduardo Coutinho,Roeland J.G. De Moor, Bart Van Meerbeek. Journal of Dentistry 38(2010)921-929

Conclusion: The use of the polyalkenoic-acid conditioner remains

crucial on bur-cut dentin. It excludes smear-layer interference,

enabling the RMGI to interact more intimately with the underlying

dentin surface.

Towards a better understanding of the adhesion mechanismof resin-modified glass-ionomers by bonding to differentlyprepared dentin

9/3/2014

14

9/3/2014

15


Placement Techniques

Do not over-dry or etch the tooth surface prior to placement of a Glass Ionomer


Shake and tap. Depress plungerShake and tap. Depress plunger


Insert on applier, click once to activateInsert on applier, click once to activate

9/3/2014

16


Mix for 10 sec.Mix for 10 sec.


Insert on Applier, Click twice to prime capsuleInsert on Applier, Click twice to prime capsule



Glass Ionomer Cement should be glossy on placement to ensure good adhesion

9/3/2014

17



•GIC’s are water based cements, any excess moisture will be displaced or incorporated into the material

Dr J Rutar


Finishing Glass Ionomer Cements

• Always wait until the material has gone through its initial setting phase before finishing (2 ½ minutes after start of mix for Fuji IX Extra)

• Always finish under water spray • Be careful not to dehydrate the surface


Dr Matteo Basso

9/3/2014

18


Dr Matteo Basso


Dr Matteo Basso


Dr Matteo Basso

9/3/2014

19


Dr Matteo Basso


Dr Matteo Basso


Why is it important to protect a Glass Ionomer Cement?

• Glass Ionomer Cement continues to mature after the initial placement

• To increase longevity • Smooth to patient’s tongue• Improves aesthetics

9/3/2014

20


Micro Lamination Technique (Equia)


What is the Micro Lamination (EQUIA)Restorative system?

•The new Glass Ionomer based restorative system for Long Term Restorations

EØEasy Bulk placement

QØQuick fillings in 3’25’’ only

IØIntelligent synergy effect with Coating

UØUnique features, cannot be replicated

AØAesthetic yet Economical


G-COAT PLUS

• A nano-filled self adhesive lamination material

• For use on Glass Ionomer, Composite and Temporary Restorations

• For improved aesthetics, increased strength, toughness and protection

G-COAT PLUS

9/3/2014

21


Single Dispersion Nano-Filled LaminateSingle Dispersion Nano –Filled Laminate


Wear Resistance – Micro Lamination

,

Wear Resistance – Micro Lamination

J. De Munck, Leuven BIOMAT Research Cluster, Catholic University Leuven, Belgium


G-COAT PLUS fills in surface porosity of Fuji IX GP EXTRA.

Smooth surface with G-COAT PLUS

100um

G-COAT PLUS layer(approx. 30 um)

(x500))

G-COAT PLUS –Micro Lamination

G-COAT PLUS – Micro Lamination

Source: G

C R

&D

, Japan

9/3/2014

22


What does G-Coat do?

Fill porosities to increase physical properties of the restoration and offers a much smoother surface…

(SEM

im

ages

x1

00

0)

Source: GCC R&D

100um 100um

Some voids are observed A smooth surface is obtained

Fuji IX ExtraPolished by using silicon

carbide paper (#600)

Fuji IX Extra After coating

What does G-COAT PLUS do?


Mechanical Stress

Mechanical stress concentrate on surface voids and gaps. Then, cracks are formed.

Mechanical stress dispersed on the smooth and tough coating layer.


Mechanical Stress

Coating

GIC

GIC Restoration(Fuji IX GP EXTRA)

Protecting from cracking


Training Module 6Module 1 Glass Ionomer Cements 66

What does G-Coat do?

Source: G

C R

&D

, Japan

Unique synergic effect only possible with EQUIA

0

10

20

30

40

50

EQUIA (EQUIA Fil &EQUIA Coat)

SDI (Riva Self-CureFast & Riva Coat)

3M ESPE (Ketac Molar& Ketac Glaze)

VOCO (Ionofil MolarAC Quick & Easy

Glaze)

Fex

ural

str

engt

h/M

Pa

Without coating With coating

What does G-COAT PLUS do?

9/3/2014

23


Strengthening of Glass Ionomer Cements

G-COAT PLUS increases fracture toughness by reducing crack formation and growth.

0.000

0.010

0.020

0.030

0.040

0.050

0.060

Fuji IX GP Extra Fuji IX GP Extra + G-CoatPlus

Fracture Toughness, in MPa

After 1 day, 2.5 x 2.5 x 20 mm, Polished by using silicon carbide paper (#600)

Strengthening of Glass Ionomer Cements

Source: G

C R

&D

, Japan


Improved Acid ResistanceImproved Acid Resistance


Secondary maturation of Glass Ionomer

Improved physical properties of the restoration over time...

– After several months, uniform abrasion of EQUIA Coat– Material becomes harder through unique maturation effect of Saliva

Red: Coated until 80 days, soaked in saliva

At 80 days, coating was removed and soaked in saliva again. Maturation increased much more than when the material was uncoated. Afterwards surface hardness increases.

60

80

100

120

0 40 80 120 160Vic

ke

rs-h

ard

ne

ss

nu

mb

er

/ H

v

immersed time / day

Orange: Uncoated, soaked in Saliva

Surface hardness became saturated after 40 days.

Light blue: Coated until 80 days, soaked in distilled water

Diffrerent form red line, surface hardness did not change after coat was peeled off.

Blue: Uncoated, soaked in distilled water

IADR

2006,abstract 2076

Secondary maturation of Glass Ionomer Cements

9/3/2014

24


Permanent restorations with glass ionomer cements. Clinical evaluation on 319 cases

M. BASSO, M.A. HEISS, P. KHANDELWAL, M. DEL FABBRO. Abstract 594, IADR 2013.

Result: 380 restorations were placed with Equia Fil (GC, Japan), consisting of a high-viscosity glass ionomer cement coated with a light-curable coating agent. At 2 years, a general success rate of 96.55% and a general integrity rate of 90.91% were recorded. Highest number of failures were reported in class II (8) and Class V (6). No failures for Class I.

Conclusion: These results suggest that the restorative system used in this trial seems to be a reliable choice for permanent dental restorations, even in load bearing tooth surfaces of molars and premolars.

EQUIA


36-Months Clinical Performance of a Glass-IonomerRestorative System

S. GURGAN, F. YALCIN CAKIR, E. FIRAT, Z.B. KUTUK, and S.S. OZTAS Abstract 2933, IADR 2013

Methods: A total of 60 moderate size Class II lesions were randomly restored either with a glass-ionomer restorative system (EQUIA/ GC) or with a composite (Gradia Direct/ GC) with a self-etch adhesive (G-Bond/ GC) by two calibrated operators according to the manufacturers' instructions (n=30).

Conclusions: Both materials exhibited a similar and clinically acceptable performance on moderate Class II cavities after 36-months

EQUIA


G-Coat PLUS IndicationsG-COAT PLUS Indications

Dr J. Lucas

9/3/2014

25



Dr J. Sugisaki



Dr G. Milicich



Dr J. Sugisaki

Before

After

9/3/2014

26


Application of G-Coat PLUS

• Dispense immediately prior to placement• Apply single coat only• No etching required (except on uncut enamel)

• Do not air dry• Must only be placed on set material• Light cure for 20 seconds

Application of G-COAT PLUS

Effect of no air inhibition layer

Applied surface

G-Coat Plus

O2O2

O2 O2

O2

Vapor layer of volatile monomer (MMA)

MMA MMA

MMA MMAMMA

Less wear ⇒long lasting gloss

G-Coat PLUS

Evaporating layers of monomer (MMA) shut out the oxygen (O2), enabling the glossy and smooth coating surface with no air inhibition layer.

Effect of no Air Inhibition Layer


Science behind

EQUIA

9/3/2014

27


Scientific evidence for EQUIA•Numerous Clinical studies that are ongoing worldwide for EQUIA:

– A 2 year retrospective study (approx 150 restorations) in Germany concluded that EQUIA may be used as a permanent restoration material for any sized Class I and in smaller Class II cavities

*2 year Retrospective study by K.H. Friedl et al. Abstract 3240, IADR San Diego, March 2011.

– A Clinical evaluation in about 245 patients over a period of 2 years concluded that EQUIA system seems to be a reliable choice for long-term dental restorations, even in load bearing teeth surfaces

*18 months clinical evaluation results. M. Basso et al. Dental Cadmos 2010, Giugno; 78(6)

*2 years clinical evaluation of EQUIA by M. Basso et al. Abstract 2494, IADR San Diego, March 2011

– Results indicate that EQUIA shows an excellent initial colour match *Clinical Evaluation Of New Glass Ionomer-Coating Combination Systems For 18-months, L.S. Turkun et al, Abstract 402 -IADR July 2010, Barcelona, Spain.

– Clinical performance of EQUIA is similar to a micro-filled composite resin system*12-Month Clinical Performance of a New Glass-Ionomer Restorative System, S. Gurgan et al, Abstract 3246 - IADR San Diego, March 2011


Evidence from Systemic review•SR compares the longevity of GIC restorations compared to Amalgam

– Systematic review by Mickenautsch et al. Clin Oral Investig 2010; 14: 233-40

•Its meta-analysis combines the data of the 7 randomized control trials that are currently known to this topic:••Honkala E, Behbehani J, Ibricevic H, Kerosuo E, Al-Jame G (2003) The atraumatic restorative treatment (ART) approach to restoring primary teeth in a standard dental clinic. Int J Paediat Dent 13:172-179••Frencken JE, Taifour D, van't Hof MA (2006) Survival of ART and amalgam restorations in permanent teeth of children after 6.3 years. J Dent Res 85:622-626••Frencken JE, van't Hof MA, Taifour D, Al-Zaher I (2007) Effectiveness of ART and traditional amalgam approach in restoring single-surface cavities in posterior teeth of permanent dentitions in school children after 6.3 years. Community Dent Oral Epidemiology 35:207-214••Gao W, Peng D, Smales RJ, Yip KH (2003) Comparison of atraumatic restorative treatment and conventional restorative procedures in a hospital clinic: evaluation after 30 months. Quintessence Int 34:31-37••Taifour D, Frencken JE, Beiruti N, van 't Hof MA, Truin GJ (2002) Effectiveness of glass-ionomer (ART) and amalgam restorations in the deciduous dentition: results after 3 years. Caries Res 36:437-444••Yip KH, Smales RJ, Gao W, Peng D (2002) The effects of two cavity preparation methods on the longevity of glass ionomer cement restorations: an evaluation after 12 months. J Am Dent Assoc 133:744-751••Yu C, Gao XJ, Deng DM, Yip HK, Smales RJ (2004) Survival of glass ionomer restorations placed in primary molars using atraumatic restorative treatment (ART) and conventional cavity preparations: 2-year results. Int Dent J 54:42-66

EXTRACT from the Systemic Review:

[1] Most of the 27 results show no significant statistical difference between the successrate of high-viscosity GIC restoration and amalgam for treatment of the same clinicalindications [page3/right column/paragraph3/line8]

[2] Four individual results show higher success rate for high-viscosity GIC restorations incomparison with conventional amalgam restorations [page4/left column/paragraph1/line1]

[3] One of the 27 results show for high-viscosity GIC restorations in posterior class V cavities ofpermanent teeth a 28% higher chance to be successful than amalgam after 6.3 years [page4/leftcolumn/paragraph1/line3]

[4] Two of the 27 results indicate that high-viscosity GIC restorations in posterior class I cavities ofpermanent teeth have a 6% higher chance after 2.3 years and a 9% higher chance after 4.3 yearsof being more successful than amalgam[page4/left column/paragraph1/line8]

[5] One of the 27 results show that high-viscosity GIC restorations in posterior class II cavities ofpermanent teeth have a 61% higher chance of being rated more successful than amalgam [page4/leftcolumn/paragraph1/line14]


Evidence from Systemic review•SR compares the absence of caries on margins of GIC restorations with Amalgam

– Systematic review by Mickenautsch et al. Eur J Paediatr Dent 2009; 10: 41-6.

•Its meta-analysis combines the data of the 8 randomized control trials that are currently known to this topic:••Frencken JE, van't Hof MA,Taifour D, Al-Zaher I. Effectiveness of ART and traditional amalgam approach in restoring single-surface cavities in posterior teeth of permanent dentitions in school children after 6.3 years. Community Dent Oral Epidemiol 2007; 35: 207-214.

•Mandari GJ, Frencken JE, van't Hof MA. Six-year success rates of occlusal amalgam and glass-ionomer restorations placed using three minimal intervention approaches. Caries Res 2003; 37: 246-253.

•Taifour D, Frencken JE, Beiruti N, van't Hof MA, Truin GJ. Effectiveness of glass-ionomer (ART) and amalgam restorations in the deciduous dentition - results after 3 years. Caries Res 2002; 36: 437-444.

•Taifour D, Frencken JE, Beiruti N, van't Hof MA, Truin GJ, van Palenstein Helderman WH. Comparison between restorations in the permanent dentition produced by hand and rotary instrumentation--survival after 3 years. Community Dent Oral Epidemiol 2003; 31: 122-128.

•Östlund J, Möller K, Koch G. Amalgam, composite resin and glass ionomer cement in Class II restorations in primary molars - a three year clinical evaluation. Swed Dent J 1992; 16: 81-86.

•Welbury RR, Walls AW, Murray JJ, McCabe JF. The 5-year results of a clinical trial comparing a glass polyalkenoate (ionomer) cement restoration with an amalgam restoration. Br Dent J 1991; 170: 177-181.

•Qvist V, Qvist J, Mjör IA. Placement and longevity of tooth-colored restorations in Denmark. Acta Odontol Scand 1990; 48: 305-311.

•Qvist V, Laurberg L, Poulsen A, Teglers PT. Eight-year study on conventional glass ionomer and amalgam restorations in primary teeth. Acta Odontol Scand 2004; 62: 37-45.

EXTRACT from the Systemic Review:

- Margins of single-surface GIC restorations in permanent teeth had significantly less carious lesions after 6 years (than on amalgam restorations placed after drilling) [page43/right column/paragraph3/line3]

9/3/2014

28


Dental Update 585 November 2011


What if the restoration is too large for Micro Lamination (EQUIA) ?

Small – medium cavities, high caries risk patients

• EQUIA: real bulk-fil including occlusal surface in 1 material

Large cavities – Class I & II

• Sandwich technique – GIC

• everX Posterior + composite: reinforcement, avoid tooth & cusp fracture

Large cavities: 1 or 2 missing cusps, after endo

treatment

• everX Posterior + composite

9/3/2014

29


New technology for direct restoration of

large posterior cavities


• Alternative to large amalgam restorations• An economic alternative to an inlay/onlay• Restoration following endodontic treatment• Tooth conservation where a large “bonded”

restoration is desirable• Transitional restorations as part of rehabilitation

Why a need to place larger posterior composite restorations?


Fibres are key to strengthening polymers

9/3/2014

30


everX Posterior

A revolutionary fibre-reinforced composite substrucutre for dentine replacement in large restorations


Dr Anthony Mak


Filler:• 1-2mm 17µm Ø silanated e-glass fibres• barium glass• Loading - 76% wt, 57% vol.

Resin:• Bis-GMA, PMMA, TEGDMA

Radiopacity:• 290% Al

everX Posterior – designed for strength

9/3/2014

31


everX Posterior - the toughest composite substructure for large posterior restorations


everX Posterior – bilayered restorations with increased load bearing capabilities

Exp-CC: everX Posterior & Z250 (3M.ESPE). CC: Z250 (3M.ESPE)


• Crack initiated at tooth surface can be stopped & redirected away from tooth structure6

• everX Posterior significantly reinforces composite crowns in endo treated molars resulting in more easy to restore fractures

Composite Z250 crown

everX Posterior structure

Z250 substructure

Fracture line within the composite

REPAIR POSSIBLE

Fracture line within the composite AND Tooth structure

EXTRACTION ??

Crack propagation under load Predominant fracture types3 (favorable/unfavorable)

Fibres change fracture patterns of endotreated teeth

9/3/2014

32


everX Posterior – Reinforcement of large restorations • Cavities where inlays or onlays would also be indicated

2. Cavity preparation 3 Build-up o f missing walls with G-aenial Posterior

5. Final restoration after final layer of G-aenial Posterior

4. Application of everX Posterior

1 Defective composite restoration

Cou

rtes

yD

r Y.

Mar

inov

a, B

ulga

ria


everX Posterior –replacing old amalgam with missing cusp(s)

2. Cavity preparation

3 Build-up o f missing walls with composite

5. Final restoration after final layer of composite

4 Application of everX Posterior

1. Defective amalgam restoration

Cou

rtes

yPr

of M

. Pe

uman

s, L

euve

n, B

elgi

um


everX Posterior – restoration after endo treatment

Prepare cavity and apply bonding Build the external walls with composite

Apply everX Posterior in 4 mm layer Light-cure & apply outer composite layer

Cou

rtes

yD

r J.

Sab

bagh

, Bel

gium

Check Occlusion & polish

9/3/2014

33


In Conclusion

• Self Cure Glass Ionomer Cement – the original bulk fill material. Ensuring a durable adhesion to dentine and zero shrinkage

• Micro Lamination technique –getting the best out of your Fuji IX Extra

• Fibre reinforced composite gives you options for teeth that would normally require indirect restorations


MI Dentistry is the Future...

02 learning module 1 gic complete 2013 pdf

Documents

glass ionomer cementsclass

glass ionomer liner

glass ionomer cementsgc

gpextratraining module

dentinesaliva testing

reactive glass particles

fuji bond lc

fuji lining paste pak2003fuji