espertise magazine, june...

No 7/2005, June

An Innovative Magazine for Dentists from 3M ESPE

Editorial Contents

Dear Readers,

Recently, the IDS 2005 closed it’s doors after a very successful week in Cologne: 1550 exhibitors offered their products to more than 75.000 visitors from 141 different countries. Taking place every two years, the IDS is always a unique opportunity to take a look at the future of dentistry, to identify trends and look at new developments. This year, the use of the term “Nanotechnology” in product names was one of the lead-ing trends amongst exhibitors, highlighting the fact there are obviously some differ-ent understandings in the dental indus-try about what is understood by the term Nanotechnology. In this edition of Espertise Magazine you will find more details about the 3M ESPE meaning when using the term “Nanotechnology” in restorative dentistry.During the IDS it was apparent that more

and more manufacturers are entering into the field of automatic mixing of impression materials and to be the “gold standard” in impressioning. Also, the future in prosthetic dentistry seems very bright, the live dem-onstrations of milling and veneering Lava crowns and bridges found a great deal of interest at our exhibition desk. You can read more about both topics in the enclosed Magazine.

Enjoy reading!

Gerhard Kultermann, Editor

3M ESPE, Seefeld, Germany

Clinically relevant properties of 3M ESPE Polyethers, part one: Initial hydrophilicity 2

A Star in the World of Impression Taking 4

Impressive evaluation results from the field 5

Nanotechnology – more than tiny particles 6

From raw material to finished cartridge 8

Aesthetic reconstruction of the anterior maxillary region 10

Direct class IV restoration with composite 12

A building block for communication 13

The future is colourful 14

1022 Dentists Attended Dental Conference in Minsk 16

No 7/2005, June,

2

The exact reproduction of the intra-oral situation is the most impor-tant pre-requisite for a perfect fit of prosthetic work. State of the art precision impression materials are capable to reproduce the intra-oral situation quite well. However, in difficult clinical situations especially if saliva and/or blood is present, many of the commercial impression materials do not show the same performance than they would under ideal conditions. The result might be insufficient pre-cision and detail reproduction especially in critical areas such as the margins.

Polyether impression materials manufactured by 3M ESPE are well known for their very high reliability in all clinical situations. Mainly in moist environment – and there is always moisture present in the oral cavity – polyethers from 3M ESPE convince the dental prac-titioner as well as the specialist by their compelling results. There-fore, this particular class of impression materials is often refered to as forgiving. 3M ESPE has more than 40 years of experience in polyether development. The exceptionally high reliability of these materials has been proven over several millions of impressions that were taken with great success since their introduction to the marketplace in 1965. The very high degree of accuracy and detail reproduction has set the standard – a fact that is well respected in the dental community.

Continuous innovation has substantially simplified the handling and performance. Automatic mixing in the Pentamix™ System ensures

precise dosing of the base and catalyst paste, resulting in a void free impression material and a highly homogeneous mix.

Today 3M ESPE offers polyether impression materials for the one step, two viscosity technique as well as the monophase technique (one step one viscosity technique). The Impregum™ Penta™ Soft Polyether Impression Material product range launched in 2000 was designed to facilitate impression removal, even in difficult clinical settings such as severe undercuts, and provided fresh tasting pep-permint flavourings. The Impregum™ Penta™ Soft Quick Polyether Impression Material product range launched in 2004/2005 also answers the need of many dentists for a faster setting polyether with enough intra-oral working time. This is especially usefull when dealing with 1 or 2 prepared teeth. The Impregum™ Soft Polyether Impression Material product line is designed to be used successfully in a wide range of clinical applications.

But, what makes the difference between an ordinary impression material and the polyethers manufactured by 3M ESPE? Several requirements have to be met in order to accurately reproduce preparations in the moist environment of the mouth. Key material properties include:

• Pronounced hydrophilicity during intraoral working• Clinically relevant initial hydrophilicity prior to setting

Impregum™ Penta™ Polyether Impression Material

Clinically relevant properties of 3M ESPE Polyethers, Initial hydrophilicity (part one)Thomas Klettke, 3M ESPE, Seefeld, Germany

Product Information

Development of the 3M ESPE Polyether Product Range

1965 1974 1980 1987 1993 1994 1995 2000 2001 2004

Impregum™ Penta™Permadyne™ Penta™ L

Ramitec™ Penta™

Impregum™ Penta™ Soft QuickImpregum™ Penta™ H DuoSoft™ Quick

Impregum™ L DuoSoft™ QuickPermadyne™Impregum™

Ramitec™ Impregum™ F Impregum™ Penta™ SoftPermadyne™ Penta™ H

Permadyne™ Garant™ 2:1

Impregum™ Penta™ H DuoSoft™Impregum™ Penta™ L-/Garant™ L DuoSoft™

Penta™

Quick-

Soft-

No 7/2005, June,

3

• Excellent rheological properties (see part two of this article in Espertise No. 8)

• Favorable properties throughout the whole working time (snap set) (see part two of this article in Espertise No. 8)

Hydrophilicity is needed to precisely replicate a situation which is covered by moisture. Before the development of elastomeric impression materials, impressions were taken using a water based gypsum slurry. This very hydrophilic material captured dimensions and detail accurately but was hard to remove from the mouth once set. It was necessary to cut the cast carefully in the patient's mouth and put the pieces together following removal. Nowadays most of the materials available are labelled hydrophilic. But when is hydro-philicity really needed? It counts from the very moment when the material flows e.g. while syringing or when seating the tray. At this very moment, a new surface of the impression material is generated which is in contact with the moist oral environment. This is the point in time when hydrophilicity is really needed for clinical success. Polyether materials manufactured by 3M ESPE are hydrophilic by nature of their chemical make up. This ensures that from the time the polyether is mixed until when it sets, it is characterized by its tendency to favour moist surfaces, such as a preparation, and achieve precise reproductions. This is also known as intrinsic hydrophilicity.By contrast, silicone impression materials are intrisically hydropho-bic. Hydrophilicity can be gained by adding surface-active compo-nents called surfactants. When these materials have contact with moisture the surfactants “migrate” to the surface. This migration

needs time and prevents hydrophi-licity from fully developing at the first moment that contact is made with moisture – at the point of time when it really matters.

A frequently used method to deter-mine hydrophilicity is contact angle measurement.1,2,3 The lower the con-tact angle obtained the higher the hydrophilicity. Latest Results are illustrated in the diagram to the left of this paragraph.4 It is clear to see that initially at the first con-tact with water (at the time of 0 seconds) the polyethers manufactured by 3M ESPE show the high-est degree of hydrophilicity. This is also shown in other studies.3,5,6,7,8,9

The very high hydrophilicity of Polyethers from 3M ESPE ensures that when in contact with moisture, high-class impressions can be taken with extraordinary reliability.10,11

The initial hydrophilicity of the 3M ESPE Polyethers is one of the properties that enable the dentist to take a very precise impressi-on – the pre-requisite for a satisfying restoration.

Article will be continued in Espertise Magazine Nr. 8.: “Clinical relevant features of 3M ESPE Polyethers, part two: flow beha-viour – when it counts”.

Impregum™ Penta™ Polyether Impression Material

Product Information

Contact angle as a function of time in unset light body impression materials.

Detailed references available through your local 3M ESPE Dental Products office.

4

No 7/2005, June,

The 150,000th Pentamix Mixing Unit pro-duced by 3M ESPE AG provides impres-sive proof of the huge worldwide demand for our innovative all-rounder for mixing impression materials.

Since its successful trial launch on the Swiss market back in 1993, the Pentamix has taken the dental world by storm: it sets standards of impression quality, conveni-ence and hygiene that has made 3M ESPE a familiar name in tens of thousands of dental practices. From Germany to Korea – and

soon in India and China – the versatile automatic mixing system has established an impressive market presence in countless countries.

What was once a cautious question in the early years, “Is the Pentamix ushering in a new era in precision impression taking?” has long since been answered with a most definite “Yes”. But that‘s not all. In combi-nation with the growing range of automati-cally mixable Penta™ Impression Materials, the Pentamix quickly became the versatile system for all areas of impression taking.

In advertising campaigns it was soon por-trayed as a VIP (very important product), rather like a movie star for whom the red carpet is rolled out – and with good reason. Enlargement of the Penta product range triggered almost overwhelming demand, so that in the spring of 1996 production was virtually tripled in the space of just a few weeks. In 1999 things speeded up once again: the significantly faster Pentamix™ 2 Automatic Mixing Unit impressed users immediately by almost halving the time required to fill an impression tray. For many dental practices the Pentamix name was the most powerful reason for making a purchase, and they duly acquired the more powerful successor model as a back-up to their first Pentamix.

As from September 2000, user-friendliness was further enhanced with the PentaMatic™ Foil Bags, which are opened automatically inside the mixing unit. Almost every six months more automatically mixable Penta products become available – after all, den-tists have different preferences regarding impression techniques and materials. The emphasis on listening to customer require-ments led to another series of innovations, and today, new system components make the Pentamix 2 more efficient than ever. It is thus able to handle materials with a putty

consistency, which it had not previously been possible to mix in an automatic unit. A current international survey shows that 84 percent of Pentamix users are either “totally satisfied” or “very satisfied” with their mixing unit. 61 percent stated that if they had to replace their existing unit they would most certainly choose a Pentamix again, while another 29 percent said they would probably do so. These survey results are very positive, but not really surprising, because to date there is not a single com-petitor who offers a comparable service to the large and important market for dental impressions.

“The Pentamix hardware and Penta con-sumables complement each other symbioti-cally to create a highly innovative and ver-satile solution,” says Eva Geywitz, Global Brand Manager. “We shall continue to build on this competitive lead because it provides a strong foundation for our other innovati-ons in the field of prosthetic dentistry.”

A Star in the World of Impression TakingEva Geywitz, 3MESPE, Seefeld, Germany

The 150,000th Pentamix™ Automatic Mixing Unit leaves the factory

Product Information

Gertraut Benkert, one of the production staff who built the first-ever Pentamix™ Mixing Unit hands over the 150,000th Pentamix – in slightly different packaging than usual – to Eva Geywitz, Global Brand Manager.

Non-stop success story: the 150,000th Pentamix™ Automatic Mixing Unit is carefully assembled and checked. Its name reflects the mixing ratio of the pastes, namely 5:1 (Penta is the Greek word for five).

No 7/2005, June,

5

Impressive evaluation results from the field

The first putty from 3M ESPE to be specially developed for auto-matic mixing in the Pentamix™ 2 Automatic Mixing Unit has been very well received in the field. The excellent results of a large-scale user survey of more than 220 dentists in ten European countries have shown that Express Penta Putty Vinyl Polysiloxane Impression Material from 3M ESPE and the precision wash Express Ultra-Light Body Vinyl Polysiloxane Impression Material meet users’ needs consummately.

Automatic mixing at the push of a button: Express Penta Putty – Vinyl Polysiloxane Impression Material

With the new Express Vinyl Polysiloxane Impression Materials, dentists who prefer a real putty can now also benefit from the advantages of automatic mixing. At the push of a button the homo-geneous and void-free mix of Express Penta Putty flows out of the Pentamix 2 Mixing Unit directly into the impression tray. Once in the tray, it is ductile under the fingers, just like a classic putty. Express Penta Putty Vinyl Polysiloxane Impression Material and the wash Express Ultra-Light Body Vinyl Polysiloxane Impression Material are suitable for all precision impressions for crowns and bridges as well as inlays and onlays using the two-step putty wash technique or the one-step tray wash technique.

High level of convenience and hygiene in addition to classic putty properties

As part of a European user survey, more than 220 dentists took more than 3000 precision impressions. The excellent results of their comprehensive assessment of material and working characteristics speak for themselves. 94% of those who took part in the survey found automatic dispensing and mixing with the

Pentamix 2 Mixing Unit simple or very simple. Equally as convin-cing was the verdict on the hygiene aspect of automatic mixing of the putty material: 96% assessed the level of hygiene as better or much better than with their current hand-mixing. Not only that, around half of the dentists estimated the material saving as a result of automatic mixing at medium to high. 90% of users thought that the material could be formed well to very well in the tray using a finger. Just as many rated the consistency of Express Penta Putty Vinyl Polysiloxane Impression Material as very good or good. The carve was said by over 80% to be very easy or easy.

Exact detail reproduction and high tear strength set the precision wash material apart

The precision wash material Express Ultra-Light Body Vinyl Polysiloxane Impression Material also got top marks in the field: 82% of the participants said detail reproduction was excellent or good. Three out of four dentists gave the same assessment of the flow properties and the tear strength.

Dental technicians confirm the outstanding impression quality of both materials

The dentists’ good assessment of the impression precision was confirmed in the laboratory: 84% of dental technicians said the impression quality was good to excellent. The accuracy of fit of the fabricated restorations was rated by 84% of the dentists surveyed as excellent or good. Nine out of ten of those who took part in the survey found the working and setting times of both materials to be optimum for application.

Worth personally recommending, say 79% of the den-tists

Besides the great advantages that automatic mixing has, the material properties alone of both viscosities are evidently reason enough to change over: 60% of the dentists said Express Penta Putty Vinyl Polysiloxane Impression Material was better than their current material for the impression tray. Well over half of all dentists survey-ed in Europe found Express Ultra-Light Body Vinyl Polysiloxane Impression Material superior to their current precision wash mate-rial. So it was no surprise to find out that an impressive 79% of all participants would even personally recommend both new Express viscosities to their colleagues.

Express™ Penta™ Putty/Ultra Light Body Vinyl Polysiloxane Impression Material

Impressive evaluation results from the fieldElke Kopp, 3M ESPE, Seefeld, Germany

Product Information

6

No 7/2005, June,

Nanotechnology – more than tiny particlesSumita Mitra, 3M ESPE, St. Paul, USA

Filtek™ Supreme Universal Restorative

It seems that the word nanotechnology has become a rather popular word of marketers of all branches. But what is nanotechno-logy? The US National Nanotechnology Initiative defines three criteria1:

• at least one of the dimensions of the buil-ding block must be in the range of 1 to 100 nanometers

• it must create and use structures and devices and systems that have novel pro-perties and functions because of their small size

• the ability to control and manipulate mate-rials on an atomic and molecular scale.

Thus the term nanotechnology should imply a high level of control and planning. Heretofore resin and filler technology had limited our ability to deliver a composi-te with both excellent esthetics and high mechanical strength suitable for universal application. Could nanotechnology be the technical platform to create a new composi-te with the following properties?

• good handling properties, e.g. easy to adapt to preparation and non-stickyness

• microfill-like polish characteristics - both initially and long-term,

• excellent strength and wear resistance like a hybrid

• a wide range of shades and opacities sui-table for a single-shade or a multi-shade technique.

Microfills – Are they nanofills?…. No!

The overuse of the term nanotechnology has led to much confusion. So, it is useful to take a closer look at the conventional dental filling materials and examine the difference between these and true nanocomposites. Microfills are well-known for their excel-lent esthetics but the fumed silica fillers used to make these materials cause some

inherent mechanical problems. The pyro-genic process used to make fumed silica produce strings of silica particles which are aggregated into fibrous, low-density chain like structures. Even though an individual particle can be as small 40nm most of these particles never exist as discrete entities. The fibrous structures of microfills limit the loading of fillers in the resin. The viscosi-ty increases rapidly when fumed silica is incorporated into a resin yielding a rather tacky paste as the filler content is increased. In contrast truly nanomeric fillers can be loaded to a high concentration in a resin and still yield materials with practical viscosity2. To overcome the viscosity problem com-mercial microfills generally prepolymerize the tacky mixture of fumed silica and resin to create a pre-polymerized organic filler. This is then added to more resin and fumed silica to create the paste. In consequence microfills have low filler content and poor binding between the prepolymerized fil-ler and resin matrix resulting in inferior mechanical strength so that they cannot be recommended for stress-bearing areas3. A comparative flexural strength study4 shows the flexural strength of microfills to be infe-rior while that of Filtek Supreme is compa-rable to hybrids and microhybrids. Similar results for diametral tensile strength were reported by Lopez et.al5. These properties make microfills unacceptable for universal composites in spite of their excellent optical characteristics.

Designed Nanomers

In order to fulfil our original objective at 3M ESPE we have developed novel types of nanofillers and used these to design Filtek Supreme. The first of these are discrete nanomeric particles which are either 20nm or 75nm in size. Nanoparticles of a sol are are treated with a polymerizable silane and dried in a proprietary process to provide discrete nanomers without any agglomera-

tion. The interfacial stabilization process allowed us to overcome the entropic factor normally responsible for particle agglome-ration.

Concept of Nanoclusters: quite diffe-rent from hybrid fillers

The other type of nanofiller we designed is called nanocluster. These fillers are prepa-red by lightly sintering nanomers to form clusters, which are then subdivided into nanoclusters of controlled particle size dis-tribution. The nanoclusters are subsequently treated with polymerizable silanes so as to provide good binding with the matrix resin and thus provide optimal mechanical strength and toughness. Unlike dense hybrid filler particles these nanoclusters are porous and allow the resin matrix of the composite to fill the spaces within and between the clusters.

The “grape effect”

The TEM (Fig. 1) of a section of Filtek™ Supreme clearly shows the presence of the nanomers and nanoclusters. It is useful to draw an analogy of nanoclusters to a bunch of grapes. In the absence of an external force the individual particles of a nanocluster stay together just as would a bunch of grapes. As such the nanoclusters behave like large particles with a broad particle size distri-

Ask the Experts

Figure 1

Nanocluster

Nanomer

7

No 7/2005, June,

Nanotechnology – more than tiny particlesSumita Mitra, 3M ESPE, St. Paul, USA

Filtek™ Supreme Universal Restorative

bution to provide good handling properties in the composite. However, under abrasive forces encountered in the oral environment individual nanoparticles of the cluster break off akin to individual grapes in a bunch. The resultant surface after abrasion still appears smooth and comparable to microfills as evident from the SEMs. In contrast hybrid or microhybrid particles cannot be further subdivided so that upon abrasion these large particles are exposed and plucked off leaving a rough and dull surface. The atomic force micrograph images (AFM) of a representative microhybrid EsthetX and a microfill Filtek A110 before and after 2000 cycles of tooth-brush abrasion is compared with those of Filtek Supreme nanocompo-site containing nanoclusters and nanomers (Fig. 2). After brushing the Filtek Supreme sample preserved its smoothness as well as that of the microfill studied while the microhybrid surface became quite rough. Gloss retention studies after extended too-thbrushing for 2000 cycles of abrasion also confirmed the above findings (Fig. 3).

At a clinical study conducted at University of Leuven it has been shown that at one year Supreme is showing a wear rate comparable

to human enamel6. Kunzelmann et.al. found that the in vitro wear of the nanofilled composite Filtek Supreme was superior to all other materials that he had in his study7. Clinical studies indicate that Filtek Supreme even appears to have self-polish characteri-stics. The shine is better after a year than after initial placement and it continues to look good after two years8.

Thus, through careful design, deliberate control and manipulation of nanosized par-ticles 3M ESPE has created a material with novel properties: easy handling, excellent optical characteristics and high mechanical properties: Filtek Supreme - a real nano-composite.

Ask the Experts

Dr. Sumita B. Mitra, PhD,St.Paul, MN, USAPresent position: Corporate Scientist, 3M ESPE Dental products Division. Further Information: Dr. Mitra is the creator of many new materials technologies and the developer of several new product segments for the dental market. Examples are resin-modified glass ionomers, nanocomposites and adhesives for the dental and orthodontic market. Recipient of 50 US patents (and OUS equivalents); autho-red numerous publications (>80) and book chapters in the areas of polymer science and dental materials. Internationally recognized lecturer on these topics and has lectured in 42 countries. Received numerous honors and awards, both inside and outside 3M. Inducted into 3M’s prestigious Carlton Society (1998) and received the 2004 American Chemical Society Regional Industrial Innovation Award for application of Nanotechnology.

Figure 3

Polished Blocks Brushed 2000 times

Figure 2

Detailed references available through your local 3M ESPE Dental Products office.

No 7/2005, June,

8

For over 50 years now, local anesthetics have been part of the 3M™ ESPE™ product range, and are trusted by dentists in more than 66 countries around the world. A high level of expertise and the use of state-of-the-art technology are essential aspects of the complex manufacturing process, which we would like to present here, taking the example of Ubistesin™.

Large tanks, a labyrinth of pipes and a variety of gauges and dials confront you when you visit the plant where the chemical synthe-sis is carried out. Here, the chemists not only produce the active ingredient, articaine, but also the basic materials for Impregum™, Express™, Ketac™ Molar and Adper™ Prompt™ L-Pop™. A multi-stage synthesis, lasting around a week and comprising more than twelve individual steps, such as chemical synthesis, extraction and crystallisation, is required to produce articaine, the active ingredient of Ubistesin.

Continuing on from this synthesis, the active ingredient is processed in a separate production unit where the staff work on a three-shift basis exclusively for the production of 3M ESPE local anesthetics. In special clean rooms, some 65 million cartridges of local anaes-thetic are manufactured each year for our customers.

The in-house water-treatment plant purifies and distills the water that forms the basis of the injection solution. Complex processes are used to demineralise and sterilise the water, while continuous tes-ting ensures consistently high quality. The raw materials are added according to the specified formulation. In the case of Ubistesin, the active ingredient articaine and the vasoconstrictor adrenaline are dissolved in the water. Chloride concentration, pH and the concen-tration of the active ingredient are all measured prior to the solution being filtered to remove minute particles (< 0,2µm).

In the meantime, the empty glass cartridges are carefully washed and then rinsed with a silicone oil emulsion. The thin film that

remains on the inside walls of the body of the cartridge is burned into the glass by means of four heating stages at temperatures of around 300°C for 2 hours. This leaves a siliconised surface which ensures easy, controlled and smooth injection when the cartridge is used by the dentist.

Filling of the cartridges with the solution takes place in the B zone, which is a Class A clean room subject to extremely strict rules of use and can only be entered via three safety air locks. Rather like the production facilities for computer chips, the B zone is continuously monitored for airborne particles. The staff who work in these clean rooms have to wear special shoes, sterile gloves special overalls with a full hood covering their entire face except for the eyes. Before filling begins, the oxygen in the empty cartridges is driven out with nitrogen to prevent tiny air bubbles from becoming trapped in the solution. A machine then fills the cartridges two-thirds full, allo-wing the solution to settle before being topped up and immediately sealed with an aluminium cap.

With the filling process complete, the next step is for the Ubistesin cartridges to be sterilised at 121°C and then subjected to internal and external analytical and sterility tests. These tests involve che-mists and microbiologists checking the local anaesthetic solution principally for the identity and concentration of the active ingre-dient and vasoconstrictor, and also the pH value. In addition, they test the stopper for smooth movement. To ensure that the solution is free of all microorganisms, samples taken from every batch are sent to external laboratories, where they are incubated and tested for 14 days.

Only when the solution has passed all these tests does each individu-al cartridge undergo optoelectronic testing, in which the cartridges are rotated and then abruptly stopped, allowing highly sensitive optical sensors to detect the tiniest particles, such as minute glass splinters, which are invisible to the human eye. These are identified due to their different degrees of inertia.

Only 100 percent perfect cartridges are allowed through to the conveyor belts for labelling. The transparent labels provide the dentist with the product name, expiry date and batch number, which guarantees complete traceability of the product right back to manuf-acture of the raw materials. The label also serves another important purpose: the special safety foil, similar to the laminated safety glass used for car windscreens, protects the cartridge against splintering. This is particularly important for intraligamentary anaesthesia because of the high injection pressure required.

Ubistesin™ and Ubistesin™ forte Solution for Injection

From 3M ESPE raw material to finished cartridgeMaria Bauer, 3M ESPE, Seefeld, Germany

Product Information

No 7/2005, June,

9

Each of these labelled cartridges must now pass an electronic sen-sor, which checks the printed information. Then specially trained staff pack the Ubistesin cartridges in metal cans (50 cartridges per can) with foam padding for protection against damage during transport. In the next production step, a machine seals the cans, and prints the batch number and expiry date on the base. Another elec-tronic sensor checks all the information once again, and only then does the can receive the green light to continue its journey along the conveyor belt, where instructions for use and a plastic lid are added. At the next station, a label indicating the name and composition of the anaesthetic and important storage instructions is attached.

Finally, our staff check the tins once again to ensure that they are complete and free of visual damage, before packing them in boxes of 10. From here, the 3M ESPE local anesthetics are dispatched to our customers around the world.

This combination of decades of experience, state-of-the-art pro-duction facilities, qualified staff, great attention to detail and con-tinuous inspection throughout the entire production process – from chemical synthesis through to the finished product – is the reason why dentists all over the world trust 3M ESPE local anesthetics.

Ubistesin™ and Ubistesin™ forte Solution for Injection

Ubistesin™

1/200 000 · Ubistesin™

1/100 000 – solution for injection. COMPOSITION: Active substance:

Ubistesin 1/200 000: 1 ml solution for injection contains: Active substances: Articaine hydrochloride 40 mg,

Adrenaline hydrochloride 0.006 mg (corresponding to 5 µg adrenaline (epinephrine)). Excipients: Sodium

sulphite max. 0.6 mg (equivalent to max. 0.31 mg SO2), Sodium chloride, Water for injections, Hydrochloric

acid and sodiumhydroxide solution for adjusting the ph-value. Ubistesin 1/100 000: 1 ml solution for injection

contains: Active substances: Articaine hydrochloride 40 mg, Adrenaline hydrochloride 0.012 mg, (corresponding

to 10 µg adrenaline (epinephrine)). Excipients: Sodium sulphite max. 0.6 mg (equivalent to max. 0.31 mg SO2),

Sodium chloride, Water for injections, Hydrochloric acid and sodiumhydroxide solution for adjusting the ph-value.

CLINICAL PARTICULARS: Therapeutic indications: Ubistesin 1/200 000: Local anaesthesia (infiltration

and nerve-block anaesthesia) in dentistry during minor procedures. Ubistesin 1/100 000: Local anaesthesia

(infiltration and nerve-block anaesthesia) in dentistry. Ubistesin 1/100 000 is especially indicated for complicated

procedures requiring prolonged anaesthesia. Contraindications: The use in children under 4 years of age is

contraindicated. Ubistesin 1/200 000 / Ubistesin 1/100 000 is contraindicated in case of hypersensitivity to any

of the components. Due to the local anaesthetic ingredient articaine, Ubistesin 1/200 000 / Ubistesin 1/100 000

is not allowed to be used in the event of: known allergy or hypersensitivity to local anaesthetics of the amide

type, severe impairment of the impulse initiation and conduction system of the heart (e.g. grade II and III AV

block, pronounced bradycardia), acutely decompensated cardiac insufficiency, severe hypotension, patients

who are known to have a deficiency in plasma cholinesterase activity, haemorrhagic diatheses – particularly

with nerve-block anaesthesia, injection into an inflamed area. Due to the content of adrenaline (epinephrine)

as a vasoconstrictor admixture, Ubistesin 1/200 000 / Ubistesin 1/100 000 is not allowed to be used in the

event of: Heart diseases such as unstable angina pectoris, recent myocardial infarction, recent coronary artery

bypass surgery, refractory arrhythmias and paroxysmal tachycardia or high-frequency, continuous arrhythmia,

untreated or uncontrolled severe hypertension, untreated or uncontrolled congestive heart failure. Concomitant

treatment with monoamine oxidase (MAO) inhibitors or tricyclic antidepressants. Due to the content of sulphite

as excipient, Ubistesin 1/200 000 / Ubistesin 1/100 000 is not allowed to be used in the event of: allergy or

hypersensitivity to sulphite, severe bronchial asthma. Ubistesin 1/200 000 / Ubistesin 1/100 000 can provoke

acute allergic reactions with anaphylactic symptoms (e.g. bronchospasm). Pregnancy and lactation: No

clinical experience of the use in pregnant and lactating women is available. Safe use of local anaesthetics during

pregnancy has not been established with respect to adverse effects on fetal development. This medicine should

only be used in pregnancy when the benefits are considered to outweigh the risks. The excretion of articaine

and its metabolites in human milk is unknown. However, preclinical safety data suggest that the concentration

of articaine in breast milk does not reach clinically relevant concentrations. Therefore, nursing mothers should

milk and discard the first mother’s milk following anaesthesia with articaine. Effects on the ability to drive

and use machines: Although test patients have shown no impairment of their normal reactions when driving a

vehicle, the dentist has to assess in each case the possible impairment of safety when operating a motor vehicle

or machinery. The patient should not leave the dental office earlier than at least 30 minutes after the injection.

Undesirable effects: Due to the local anaesthetic ingredient articaine, the following adverse effects can occur:

Cardiovascular disorders: Rare (≥ 0.01%): Decrease in heart rate, hypotension. Drop in blood pressure, car-

diac impulse conduction disorders, bradycardia, asystolia, cardiovascular arrest. Nervous system disorders:

Rare (≥ 0.01%): Metallic taste, tinnitus, dizziness, nausea, vomiting, restlessness, anxiety, yawning, shaking,

nervousness, nystagmus, logorrhoea, headache, increase in respiratory rate. Paresthesias (loss of sensation,

burning, tingling) of the lip, tongue, or both. When these signs appear are required rapid corrective measures

to prevent possible worsening. Drowsiness, confusion, tremor, muscle twitching, tonic-clonic seizures, coma

and respiratory paralysis. Respiratory disorders: Rare (≥ 0.01%): Tachypnea, then bradypnea, which could

lead to apnoea. Allergic reactions: Very rare (< 0.01%): One may observe manifestation of hypersensitivity to

articaine as rash, pruritus edema, pruritus, and erythema as well as nausea, diarrhea, wheezing or anaphylaxis.

Cross-reactivity to articaine has been reported in a patient with delayed hypersensitivity to prilocaine. In general,

patients with demonstrated hypersensitivity to articaine or other amides should receive an ester-group local

anaesthetic for subsequent procedures. The administration of large doses of articaine may produce methaemo-

globinemia in patients with subclinical methaemoglobinemia. Due to the content of adrenaline (epinephrine) as

a vasoconstrictor admixture, the following undesirable effects can occur: Cardiovascular disorders: Rare (≥

0.01%): Heat sensation, sweating, heart racing, migrainelike headache, blood pressure increase, angina pectoris

disorders, tachycardias, tachyarrhythmias and cardiovascular arrest as well as acute oedematous thyroid swelling

cannot be ruled out. Due to the content of sulphite as excipient, the following undesirable effects can occur in

very rare cases: Allergic reactions or hypersensitivity reactions, particularly in bronchial asthmatics, which are

manifested as vomiting, diarrhea, wheezing, acute asthma attack, clouding of consciousness or shock. Due to

the content of both articaine and adrenaline (epinephrine), the following undesirable effects can occur: Nervous

system disorders: 2 weeks delayed onset of facial nerve paralysis has been described with articaine/adrena-

line (epinephrine), the event still occurs 6 months later. Interferences in the clinical picture can result from the

simultaneous occurrence of various complications and side effects. Prescription. Information shortened. For

further details please refer to the Instructions for Use. Date of revision of the text: August 2002. 3M

ESPE AG · ESPE Platz · D-82229 Seefeld, Germany

Product Information

10

No 7/2005, June,

Clinical Case Report

Aesthetic rehabilitation of the anterior teeth is generally a very demanding treat-ment which needs a lot of experience. The learning objective of this article is to pre-sent several practical clinical observations that will assist the practitioner in attaining predictable aesthetic results with full cera-mic restorations.

Figure 1:

Using a situation model mounted on an arti-culator, the extent of reconstruction and the associated space requirement was determi-ned in a wax-up. From this it was apparent that minimally invasive preparations were indicated for veneers (3) and veneer crowns (1 and 2) with minimal preparation depth in the labio-incisal third of the teeth, incorpo-rating existing composite restorations.

Figure 2:

The preparation margins were defined and finished circularly with a slight chamfer (approx. 0.5 mm) using a fine-grit round head diamond bur. Tooth 21 has a somewhat darker colour due to a root canal filling.

The preparations are largely limited to the enamel. 22 has been prepared mesio-labi-ally down to the dentine for reconstructive positional correction.

Figure 3:

Under the influence of moisture control, a so-called pulpal haematoma (diffuse red region) has formed in this area. The marginal periodonteum has been drawn back from the preparation margins using retraction cords (Ultrapak, Ultradent, South Jordan, USA) with a styptic (Racestyptine, Septodent, Saint-Maur-des-Fossées Cedex, France). At the same time, the cords absorb sulcal fluid, and therefore assist moisture control during impression-taking. The situation shows the thin cords (size 0), which were laid first. In the two-cord technique employed here, these thin cords remain in place in the sul-cus while the impression is being taken.

Aesthetic reconstruction of the anterior maxillary regionMartin Groten, Germany

Impregum™ Penta™ DuoSoft™ Polyether Impression Material

Figure 4

Figure 2

Figure 3

Figure 1

11

No 7/2005, June,


Aesthetic reconstruction of the anterior maxillary regionMartin Groten, Germany

Impregum™ Penta™ DuoSoft™ Polyether Impression Material

Second retraction cords (Ultrapak, size 1, with Racestyptine) were left in the sulcus for at least 5 minutes before the preparation impression was taken. Only after they had been removed from the sulcus did mixing of the impression material commence. With this procedure, the sulcus remains open (retracted) for several minutes. The impres-sion was taken with Impregum™ Penta™ DuoSoft™ H & L (3M ESPE, Seefeld, Ger-many) in a stock tray (Rimlock type) using the one-step tray wash technique. The light-bodied phase (DuoSoft™ L) was applied around the prepared teeth from the Garant cartridge and then applied over the occlusal surfaces of the posterior teeth.

Figure 4:

Result of the preparation impression taken with Impregum DuoSoft from 13 to 23: The preparation surfaces are reproduced free of voids, and the circularly fully formed sulcus tags clearly define the preparation margins.

Figure 5:

Quality of the master model following removal from the impression in the area of the preparations.

Figure 6:

The prepared teeth have been temporarily restored with composite. The temporary restorations were fabricated by the direct technique (chairside) with Protemp™ 3 Garant™ (3M ESPE) and a deep-drawn film, which had been fabricated on the basis of the morphology of the wax-up. They were not highly polished but finished with a rub-ber disc at the chairside. The slide shows the condition after a wearing period of approx. 2 weeks, following reinsertion subsequent to the first try-in of the veneer crowns. They were originally fabricated in a single piece from 13 to 23 (for better retention), but after 2 weeks a crack appeared between the number 1 teeth. This did not pose a pro-blem for use of the temporary work. They were cemented with a eugenol-free cement (RelyX™ Temp NE, 3M ESPE), this time in two parts (13-11 and 21-23).

Figure 7

State of the restoration at the half-year follow-up. All the teeth are vital and free of symptoms; periodontal integration is optimal. The pulpal haematoma at 22 (see Fig. 3) has evidently receded without any clinical consequences.

Figure 5Figure 4

Figure 6

Figure 7

12

No 7/2005, June,


A 25 year old patient presented herself at the dental practice expressing a wish to improve a class IV restoration on the upper left central incisor (21) (Fig. 1).On the basis of the patient’s clinical history and diagnosis, we decided on a conservative treatment plan: reconstructing the tooth with a composite. The material Filtek™ Supreme was chosen on the basis of the physical (wear resis-tance) and optical properties (optimum poli-shing and polish retention) offered by the material’s nanotechnology.Once the restoration had been removed a stainless steel pin could be seen (previously diagnosed by radiography). This pin was one of the factors causing the restoration’s dark colour.

The tooth was prepared with a bevel on the vestibular side and a chamfer on the palatal side. After this, the bonding procedure was started (Fig. 2).

We began by using a 35% acid etchant (Scotchbond™ Etchant) for 30 seconds on the enamel and 15 seconds on the dentine.

Next a Scotchbond™ 1 adhesive was used and the layering process begun.

WE (white enamel) was used to imitate the palatal enamel. This gave the restora-tion luminosity and made the buccal floor opaque. (Fig. 3).

A2D dentine was used to conceal the frac-ture line and to contour the mamelons (not sure about this either!). The incisal trans-lucency has a slightly yellow tone so the material YT was chosen. Finally, the enamel was applied, using A2B in the central area and A2E in the incisal area. This enabled us to obtain the translucency needed to maintain carved anatomical and chromatic characteristics (Fig. 4 and 5).

Each increment was light cured for 10 seconds. A final 40 second light cure was performed with the help of an oxalate gel for the purpose of oxygen inhibition.

Polishing was carried out with 3M Sof Lex XT discs, and diamond and aluminium oxide pastes (Fig. 6). Immediate postoperative

results showed slight signs of bleaching of the adjacent teeth due to dehydration during the restoration and polishing process. This increased the quality of the restoration.

The results are satisfactory four weeks after the procedure (Fig. 7 and 8).

Direct class IV restoration with compositeCarlos Fernandez Villares, Spain

Filtek™ Supreme Universal Composite

Figure 5

Figure 1 Figure 3

Figure 7

Figure 2

Figure 4 Figure 6

Figure 8

13

No 7/2005, June,

Digital dental photography enables den-tists and technicians to produce pictures more efficiently and thus save valuable time. The number of sessions the patient is required to visit the laboratory or that the technician has to go to the dental surgery, can be reduced. The following article out-lines some suggestions regarding the suc-cessful use of digital photography. All the photographs in this article were taken with an SLR (single-lens reflex) camera, which permits faster and more flexible working than any compact digital camera, no mat-ter how professional it may look.

Fig. 1 with the anterior teeth in termi-nal hinge position shows how symmetri-cal camera alignment ensures an aesthetic image. Furthermore, the selected section of the image focuses on what is essential. A small aperture („22“ or „32“) was used to give maximum depth of focus. At the same time, a powerful professional lateral flash was used to illuminate the subject brightly and uniformly.

Fig. 2 demonstrates the need to inform the dental technician about the initial cli-nical situation - e.g. completely different abutment coloration – by means of a com-

puter file, and to assist him in the choice of promising ceramic materials. The pho-tograph of a quadrant which fills the entire frame (Fig. 3) is the acid test of a good dental photography kit. Here, the horizontal alignment ensures clarity and comparability. Images of master casts not only serve as documentation, but also provide motivation when it comes to consultation in relevant cases (Fig. 4). Just as for taking a portrait picture of a patient, the camera‘s flash is switched off, and daylight, room lighting or large-area studio flash lighting is used instead.

Figure 1

Figure 4Figure 3

Figure 2

The Dental Practice Forum

Digital dental photography

A building block for communicationVolker Bonatz, Germany

No 7/2005, June,

14

As one of the younger generation of dental technicians, Jan-Holger Bellmann, Jever, puts high-tech processing and economy on an equal footing with aesthetics and human creativity. In his view, these are factors which will play an increasingly important part in the dentistry of the future and in the job description of the dental technician. From this perspective, new technologies can be seen as a strong basis on which traditional ideals in dentistry, and the extremely high standards that the art of veneering is expected to fulfil, can be realised even more effectively.

Do we really need all-ceramic?

After all, the porcelain fused to metal technique has been very successful in the day-to-day work of the dental laboratory. If an all-ceramic system is to be a real alternative to the PFM technique, it must be better than, or at least equally as good as metal, as regards the following points.

Biocompatibility and aesthetics: With regard to biocompatibili-ty, all-ceramic materials are far superior to precious metal alloys. Similarly, in terms of aesthetics there is, I believe, no discussion about whether more attractive results are achieved with all-ceramic or metal ceramics. There are, however, major differences between the various all-ceramic systems, and particularly the zirconium oxides. (Fig.1).

Durability: When it comes to durability, there is almost no alter-native to zirconia, at least for the posterior teeth, if you choose the all-ceramic option. But here too, the strength values of zirconias range from 900 Mpa to 1,500 Mpa. At above 1,100 Mpa, Lava is

four times stronger than the maximum masticatory load to which posterior teeth are subjected (Fig 2). Due to their high strength, we are already able to use zirconias for bridge spans up to four units without any problem.

Accuracy of fit: With respect to accuracy of fit, you have to look rather carefully at the results obtained with CAD/CAM systems, as there are enormous differences. Of the manufacturers of such sys-tems that I know, only two have really managed to convince me up to now: Procera and Lava. In the meantime we work almost exclu-sively with Lava because the range of indications for this system includes both individual crowns and bridges for the entire anterior and posterior regions. This enables our dentists to offer their patients aesthetically homogeneous restorations with uniform materials. What‘s more, for Lava the laboratory does not have to purchase an expensive scanner.

Handling and cost-efficiency: At the end of the day every labora-tory proprietor is faced with the decision on whether to invest in a new technology like CAD/CAM, and consequently to take on board the task of learning new work processes. At the dental practice of Peter W. Hirschfeld in Jever, we decided to have this work done by a milling centre (P. Hanning, Detmold) and to concentrate ourselves on the subsequent finishing of the frameworks. In this way we have eli-minated virtually all investment risk. The veneering ceramic for the Lava System, the Lava Ceram Master Set, is certainly affordable.

The future is colourfulJan-Holger Bellmann, Germany

Lava™ Crowns and Bridges

User Report

Fig.1: Excellent translucency of the coloured zirconium oxide frameworks

Fig. 2: Lava anterior bridge in situ. It withstands mas-ticatory forces up to 1,100 Mpa.

Fig. 3: Vital appearance of anterior crowns veneered with Lava Ceram

No 7/2005, June,

15

Casting technique on the decline

In my view, CAD/CAM technology and zirconia are going to have a decisive influence on the future of dentistry. It may only be a few years before they replace casting altogether. At our laboratory, for example, we now use hardly any metals at all, which saves us the typical problems associated with the casting technique (stresses, porosity, batches of investment materials etc.).

Veneering

I quickly became familiar with the Lava Ceram range of ceramics. Once you adopt a creative approach, you soon get a feel for the design potential offered by these materials. Furthermore, with the modified enamel porcelains E1 to E4 even a standard build-up pro-duces very pleasing results (Fig. 4 and 5).

All in all, Lava Ceram is a decidedly user-friendly ceramic material: it does not crack and is very resilient. The good selection of trans-parent and effect materials is sufficient even for complex build-ups. Compared to the PFM technique, or indeed other zirconia systems, oxide, opaquer and liner firings are not required with Lava, which saves a considerable amount of time.

Advantages for the dentist

The coloured zirconia frameworks mean that Lava provides, as it were, a built-in ceramic shoulder made of zirconium. Conventional or temporary cementation presents no problem. For permanent cementation, the self-adhesive universal cement RelyX™ Unicem

from 3M Espe is recommended. The inside surfaces of the frame-work do not require any pre-treatment prior to cementing, nor does the enamel or dentin of the tooth. As you can see here too, Lava performs at least as well as the PFM technique, but surpasses many other all-ceramic systems, such as pressable ceramics, which can only be adhesively bonded.

Conclusion

We now have come to value the Lava System and have treated a large number of patients with Lava crowns and bridges. Of course, any new system takes some getting used to for the dental technician and dentist, but things are looking bright for us thanks to the pro-gress we have made with zirconia and CAD/CAM technology. With Lava it is possible to offer a high-tech product without having to make a major investment.

But if you ask me whether, in future, teeth will only be made by computer; my reply would be that I do not think so. Rather, the high-quality craftsmanship of the dental technician will play a greater role in his day-to-day work than ever before.

Human skill and a feel for colour and shape, aesthetics and artistic ability are central to our work. The future is colourful.

The future is colourfulJan-Holger Bellmann, Germany

Lava™ Crowns and Bridges

User Report

Fig. 4: Aesthetic result with relatively simple Lava Ceram build-up

Fig. 5: Build-up design using the enamel porcelains. Only the selective combination of the small number of enamel and transparent porcelains creates contrast. Here whitish and yellowish enamel porcelains are deli-berately placed next to each other.

Fig. 6: Quadrant restoration with Lava

No 7/2005, June,

1022 Dentists Attended Dental Conference in MinskSvetlana Mazepa , 3M ESPE, Belarus

Espertise™ Expert Education

Taking place at Minsk Medical University on 19th November 2004, the conference included presentations from Roland Frankenberger (Germany), Andrey Peshko (Ukraine) and Nikolay Polonejchik (Belarus). Covering topics including aesthetic restoration, adhe-sive systems and impression materials, the conference attracted 1022 dentists from all regions of Belarus.Roland Frankenberger, Associate Professor at the dental school in Erlangen-Nürnberg (Germany) in his brilliant presentation, combined perfectly both the theoretical background and the practical outcome of modern dental materials and techniques. “Adhesives – State of the Art 2004” and

“Direct resin composite restorations – pos-sibilities and challenges” were the titles of his two lectures. Andrey Peshko, General Dental Practitioner and 3M ESPE Professional Support Representative (Ukraine) performed a lec-ture titled “Composite restorations with the use of a silicon matrix” attracted the atten-tion of the audience by combining great professional knowledge with a high level of practical skills. From the side of Minsk Medical University, Professor Nikolay Poloneichik, Dean of the Dental faculty performed a lecture entitled, “Preventing typical mistakes during impres-sion taking”.

Following the event, the local 3M ESPE team received plenty of thanks and positive comments from the participants admitting that the conference is now the main annual event for the whole dental community in Belarus. Dentists mentioned among the reasons of this phenomenon that 3M ESPE always demonstrates the highest level of organization and the real understanding of dentists’ actual needs in gaining the latest information. The open-minded exchange with foreign colleagues during the con-ference helps to improve the professional level of dentistry in Belarus and speakers invited by 3M ESPE always provide a strong professional input for the daily work of a practitioner.

Date Event Location Website

01.06.2005 03.06.2005

Swiss International Baselwww.messe.ch Prodonta SA

04.06.2005 06.06.2005

SIDEX 2005 Seoulwww.sidex.or.kr Seoul Dental Association

06.06.2005 09.06.2005

Sino Dental PekingInternational Health Exchange Centre

23.06.2005 25.06.2005

International Dental Congress and Expodental 2005

Istanbulwww.ido.org.tr TDB Chamber of Dentists of Istanbul

24.08.2005 27.08.2005

93nd FDI World Dental Congress Montrealwww.fdiworldental.org FDI

02.09.2005 04.09.2005

KDX 2005 3rd Korea International DentalExhibition & Conference

Seoulwww.kdx.xo.kr Korea Dental Trade Association

08.09.2005 10.09.2005

Cede Lodz www.exactus.pl

20.09.2005 23.09.2005

Dental Expo Moskauwww.dental-expo.ru RDA/JSC Dental-Expo

Calendar of Events 2005

3M ESPE AG

ESPE Platz, 82229 Seefeld, GermanyTelephone: +49(0)8152/700-0 • Telefax: +49(0)8152/700-1586E-Mail: [email protected] • Internet: http://www.3mespe.com

3M, ESPE, Espertise, Adper, DuoSoft, Express, Filtek, Impregum, Ketac, Lava, L-Pop, Pentamix, Penta, Prompt, Protemp, RelyX, Scotchbond, Sof-Lex, Ubistesin are trademarks of 3M or 3M ESPE AG.

Aquasil is a trademark of Dentsply, Exafast is a trademark of GC, Afinis is a trademark of Coltene, Honigum is a trademark of DMG, Ultrapak is a trademark of Ultradent, Racestyptine is a trademark of Septodent.

More than 1000 conference attendees followed the presentations in the completely filled lecture hall

Published by:3M ESPE AG

Editor:Gerhard Kultermann

Editorial team:Dieter Klasmeier, Annika Meyer, Markus Roepke, Christin Schack, Inge Schwientek, Laurence Settekorn

Coordination:Laurence Settekorn

Final editing and production:Markus Roepke

Design and typesetting:Attila SirmanDigital Consulting, Munich

Global circulation:120,000

We accept no liability for unsolicited manuscripts or photographs.Court of Jurisdiction: Munich

© 3M ESPE AG, Seefeld, 2005

Editorial Information

General Information

References

Nanotechnology – more than tiny particles Sumita Mitra, 3M ESPE, St. Paul, USA

1. http://www.nano.gov/html/facts/whatIsNano.html

2. Roscher C, “Tiny particles, huge effect”, Paint and Coating Industry Magazine, 2003; 19(10), 46-52.

3. Ferracane JL, Condon JR, “In vitro evaluation of the marginal degradation of dental composites under simulated occlusal loa-ding”, 1999; Dent Mat 15, 262-7.

4. Mitra SB, Wu D, Holmes BN, “An application of nanotechnology in advanced dental materials”, 2003; JADA 134, 1382-1390.

5. Lopez GC, Zucco J, De Lucca C, Bratieri L, Vieira L, “Diametral tensile strength of microhybrid composite resins”, 2004; 82nd IADR General Session, abstract 0585, Honolulu, Hawaii, USA.

6. Bharadwaj D, Lambrechts P, De Munck J, Matter D, van Meerbeek B, „Clinical wear performance of Filtek Supreme and Z100 in posterior teeth“, 2005;IADR/AADR/CADR 83rd General Session, abstract 0576, Baltimore, Maryland, USA.

7. Kunzelmann KH, unpublished data on file at 3M ESPE (2002).

8. Dunn J, Munoz C, Wilson A, Druan M, Randall R, “Two-year cli-nical evaliuationof Filtek Supreme”, 2005; IADR/AADR/CADR 83rd General Session, abstract 0578, Baltimore, Maryland, USA.

Clinical relevant properties of 3M Espe Polyethers, Initial hydrophilicity (part one) Thomas Klettke, 3M ESPE, Seefeld, Germany

1. Mondon M., Ziegler C., Reusch B.:Surface wettability during the curing process of impression materials. AADR 2001 #618.

2. Geis-Gerstorfer J., Lee H. R., Axmann D., Rupp F.: Initial hydro-philicity of 15 type 3 impression materials during setting. IADR 2004 #1385.

3. Rupp F., Axmann D., Jacobi A., Groten M., Geis-Gerstorfer J.: Hydrophilicity of elastomeric non-aqueous materials during set-ting. Dental Materials in press, on-line version available (2005).

4. Klettke T., Kuppermann B., Führer C., Richter B.: Hydrophilicity of precision impression materials during working time. CED/NOF/IADR 2004 #141. 3M ESPE internal data.

5. Ragain J. C., Grosko M. L., Raj M., Ryan T. N., Johnston W. M.: Detail reproduction, contact angles, and die hardness of elasto-meric impressions and gypsum die material combinations. Int J of Prosth 13/3, 214-220 (2000).

6. Mondon M. C., Ziegler C.: Changes in Water Contact Angles During the First Phase of Setting of Dental Impression Materials. Int J of Prosthodontics 16/1, 49-53 (2003).

7. Lepe X., Johnson G. H., Berg J. C., Aw T. C., Stroh G. S.: Wettability, imibition, and mass change of disinfected low-visco-sity impression materials. Prosht Dent 88/3, 268-276 (2002).

8. Goldberg J., Benchimol J., Perry R., Kugel G.: Comparison of Hydrophilic Measurements of Impression Material During Working Time. IADR 2005 #3048.

9. Rupp F., Jacobi A., Groten M., Geis-Gerstorfer J.: Hydrophilic Changes Characterizing The Working Time Of Different Elastomeric Impression Materials. IADR 2005 #1204.

10. Johnson G. H., Lepe X., Aw T. C.: The effect of surface moisture on detail reproduction of elastomeric impressions. J Prosht Dent 90/4, 354-364 (2003).

11. Walker M. P., Petrie C., Haj-Ali R.., Dumas C., Williams K.: Moisture effect on polyether and vinylpolysiloxane accuracy and detail reproduction. IADR 2004 #0431.

References:

No 7/2005, June

espertise magazine, june...

Documents