Composite Veneering. System. Step by Step

Transcription

1 Composite Veneering System Step by Step

2 PERFECTLY COORDINATED

3 CONTENT PAGE 1. Introduction 2 2. Properties 3 3. Indications 3 4. System components Compound combination table A-D shades 5. Framework construction Veneering (Simple layering) Framework conditioning 6.2. Applying Metal Primer 6.3. Applying Pre-Opaque 6.4. Applying Opaque 6.5. Applying Cervicall 6.6. Applying Dentin 6.7. Applying Enamel 7. Processing widths Dispersion layer Veneering (Individual layering) Individual layering with Dentin 9.2. Individual construction of the incisal area 10. Restoration without framework (inlay / onlay) Model preparation Inlay / onlay layering 11. Trimming and polishing Contouring with PRE-Form (PF 1-3) grinding tools Contouring and polishing with PRE-Polish (PP 1-2) and Polish (P 1-3) Pre-polishing and high-gloss polishing with POL and DiaPOL, PRE-Polish and Polish 12. Veneering on PEEK BioSolution Physical properties of and Peek BioSolution 13. Bonder I & Bonder II - Universal bonding agent Use 14. Technical data Polymerisation times Surface roughness Physical properties Physical properties of and PEEK Biosolution Polymerisation depth 15. Shade chart 21 YOUR PARTNER FOR DENTAL MATERIALS

4 1. - FROM PASSION TO PERFECTION For years, micro-filled, light-curing veneering materials have proven themselves in dentistry. Outstanding material properties, excellent aesthetics and easy handling make composites the standard material they are in dentistry today. With the - veneering system, Merz Dental offers a range of coordinated products, optimised workflows and efficient veneering techniques. The veneering material combines proven properties The -veneering material combines proven properties with new clinical challenges. The best physical properties in conjunction with natural shade reproduction ensures durable, aesthetically valuable anterior and posterior restorations to the greatest satisfaction of the patient, dentist and dental technician alike. Please read these processing instructions before using. Only then you ensure correct use of the system components. Convince yourself with the video, which illustrates the individual work steps. 2

5 2. PROPERTIES Excellent sculptability No sticking, easy-to-apply Natural shade reproduction Natural fluorescence and opalescence Excellent polishability Outstanding adhesion values High abrasion resistance Resistant against discoloration Very high plaque resistance 3. INdICATIONS indicated for intraoral and extraoral fabrication of temporary and permanent dental restorations. Veneers on metal-supported restorations Crowns and bridges in the anterior and posterior region Jacket crowns in the anterior and posterior region Veneers, inlays and onlays Implant superstructures Applications of combined dentures Covering model cast metal denture frameworks with Gum Opaque Individualisation of acrylic teeth in connection with Bonder I & II Contraindications In case of veneers in the molar region, the chewing forces have to be absorbed with metal stops. Occlusal dysfunctions and parafunctions, such as bruxism etc. 3

6 4. SYSTEM COMPONENTS Metal Primer secure and durable bond between composites and precious / non - precious metal, as well as PEEK BioSolution. The Metal Primer can be applied both intraorally or extraorally. Note: Take protective measures with intraoral application, e.g. the use of a rubber dam. Pre-Opaque light-curing, milky transparent universal priming opaquer for use with Opaque. Pre-Opaque flows effectively into all undercuts. Thanks to its considerable polymerisation depth, the product cures well and completely, which significantly raises bond strength values. Opaque (20 shades) light-curing, tooth-shade opaquer for covering the framework material. Opaque A-D 16 V-Classic shades IN Opaque (Incisal Opaque) Incisal opaquer for enhanced depth effect in the incisal / interproximal area. VR Opaque (Value Reduce Opaque) Opaquer for reducing the brightness value of the selected opaquer. VP Opaque (Value Plus Opaque) Opaquer for raising the brightness value of the selected opaquer. Gum Opaque gingiva-shade opaquer for colour coverage of the framework when using GUM compounds. Cervical (8 shades) cervical compounds serve to construct the cervical regions. 4 Opaque Dentin (10 shades) opaque dentin compounds match the V-Classic shades for reproduction of the dentin shade where space is tight.

7 4. SYSTEM COMPONENTS Dentin A-D (16 shades) Dentin compounds match the V-Classic shades for reproduction of the respective dentin shade. Enamel (3 shades) cutting compound for reproduction of the dental enamel. Translucent (4 shades) LVT (Low-Value Translucent) for reproduction of greyish translucent shades with lower brightness values. T (Translucent) for reproduction of especially translucent tooth shades. HVT (High-Value Translucent) for reproduction of of bluish translucent shades with higher brightness values. Enamel for reproduction of the dental enamel for 57 light dentin shades. Effect (4 shades) OC (OCCLUSAL) less translucent enamel compound for more dull effects in the enamel areas, such as occlusal surfaces of molars or approximal regions of anterior or posterior teeth. AM (AMBER) amber-coloured compound for additional effects in the enamel region. WE (White Enamel) white enamel compound for reproduction of cloudiness in the marginal or approximal areas of the anterior teeth. GUM gingival shade effect compound for reproduction and construction of pontics, papillae or gum region. Modelling Liquid Fluid to restore the inhibition layer on pre-polymerised material after processing with rotary instruments. 5

8 4. SYSTEM COMPONENTS Bonder I & II universal bonding agent for intraoral and extraoral use, durable connection of different materials. Repair and supplementation of restorations with light-cured composites. Permanent connection of cold-curing polymers with light-curing veneering resins. Joining different light-curing veneering resins with one another. Individualisation of prosthetic teeth with light-curing veneering materials. PRE-Form PF 1 PF 2 PF 3 PRE-Polish PP1 PP2 Polish P 1 P 2 P 3 Finishing Kit coordinated set of rotary instruments for systematic and effective processing of composite surfaces. PRE-Form trimming stones made of high-quality silicon carbide for fast, splinter-free shaping and trimming of ceramics and composites. PF 1-3 with black marking PRE-Polish pre-polishers for finishing and smoothing composites and ceramics Pre-polishing with PRE-Polish pre-polishers evenly pre-smooth the surface roughness of the ceramic particles while preserving the anatomical intricacies. PP 1-2 with blue marking. Polish high-gloss polishers for fast and efficient high-gloss polishing of composite and ceramic. The Polish high-gloss polishers contain ultrafine diamond particles to achieve a homogenous and smooth surface. P 1-3 with white or yellow marking POL & DiaPOL for pre-polishing microfilled hybrid composites, precious and non-precious metal, ceramic materials and prosthetic resins. 6

9 4.1. COMPOUNd COMBINATION CHART A-d SHAdES Name Pre-Opaque Opaque IN Opaque VP Opaque VR Opaque Gum Opaque Opaque dentin A1 A2 A3 A3.5 A4 B1 B2 B3 B4 C1 C2 C3 C4 d2 d3 d4 PreOpaque A1 A2 A3 A3.5 A4 B1 B2 B3 B4 C1 C2 C3 C4 D2 D3 D4 O O O O O O O O O O O O O O O O IN Opaque VP Opaque VR Opaque Gum Opaque A1 A2 A3 A3.5 A4 B1 B2 B3 B4 C1 C2 C3 C4 D2 D3 D4 OD OD OD OD OD OD OD OD OD OD OD OD OD OD OD OD Cervical AC1 AC2 BC1 BC2 CC1 CC2 DC1 DC2 dentin Enamel Translucent Effect A1B A2B A3B A3.5B A4B B1B B2B B3B B4B C1B C2B C3B C4B D2B D3B D4B LVT, T, HVT, Enamel 57 OC, AM, WE, GUM Shade chart see Page FRAMEWORK CONSTRUCTION The framework should generally reflect the reduced tooth shape. Attention should be paid to cusp-supporting modelling in the molar region. The layer thickness of the veneering surface should not exceed 0.6 mm in the vestibular region and 1.2 mm in the occlusal region. In case of veneers in the molar region, the chewing forces occurring have to be absorbed with metal stops. The wall thickness of the metal framework must not exceed 0.3 mm for individual crowns and 0.5 mm for bridge abutments. The edges in the labial region should be constructed in the form of a step or rounded. 0.3 mm 0.5 mm Enamel Dentin Cervical compound Opaque framework 7

10 5. FRAMEWORK CONSTRUCTION Labial surface with retention beads For an optimal bond of veneering compounds with the metal framework, additionally use retention beads of size 150 μm. In case of milled frameworks, undercuts have to be incorporated in the milling process. After casting, the retention beads can be reduced to half (equator). 150 µm undercut reduced retention beads Construction of the frameworks with optimal space conditions In case of partially veneered crowns, the back surface protection is reduced such that the incisal edge can be completely built up with the veneering material, the transition from veneer to metal lies outside the contact area. Approximal contact points can be constructed with compound. Parts of the restoration that are not veneered (e.g. palatinal or lingual areas / metal collars etc.) should be polished before framework conditioning. Enamel Polished palatinal surface Dentin cervical compound back surface protection 6. VENEERING (SIMPLE LAYERING) Blasting the framework 6.1. FRAMEWORK CONdITIONING Blast the veneer surface of the fully prepared metal framework with 50 to 110 μm aluminium oxide at 2-3 bar pressure. Then blow off the blasted surface with dry, oil-free compressed air. If a steam jet is used for cleaning, the surface then has to be dried thoroughly. 8

11 6. VENEERING (SIMPLE LAYERING) 6.2. APPLYING Metal Primer Place 1 to 2 drops in a mixing tray and then apply on the veneer surface with a small brush. Allow the surface to dry for 10 seconds, then apply Pre-Opaque quickly to achieve the optimal adhesion value. Note: Metal Primer contains volatile substances, therefore close bottle tightly immediately after use. Use the fluid dispensed immediately. Clean the brush with ethanol after applying the Metal Primer. Application of Metal Primer 6.3. APPLYING Pre-Opaque Apply Pre-Opaque with a brush and light-cure*. Ensure here that Pre-Opaque flows into the undercuts of the retention beads. * The polymerisation times are device-dependent. Please find the relevant device types and curing times in the polymerisation table on page 19. Application of Pre-Opaque 6.4. APPLYING Opaque Remove the required amount of ready-to-use opaquer from the syringe and mix through with a spatula on the mixing block. Then apply the opaquer on the veneer surface with a firm short-haired brush and cure according to the polymerisation table. Repeat this process two or three times until the framework is fully covered. First layer of opaquer Opaque retention bead Pre-Opaque Metal Primer metal Framework fully covered with Opaque and IN Opaque 9

12 6. VENEERING (SIMPLE LAYERING) Crescent-shape layered cervical compound 6.5. APPLYING Cervical Apply Cervical in a crescent shape. Model the compound and taper it thinly towards the middle of the crown (fig.), then perform intermediate polymerisation. Note: The curing depth and the maximum layer thickness of the individual compounds always have to be observed during layering. In confined spaces or with individual layers, may be coloured in the incisal area by IN Opaque in order to achieve more depth effect APPLYING dentin In the case of restricted space conditions, the framework can firstly be covered with Opaque Dentin and then coated with Dentin. Layering the dentin compound Enamel Enamel Dentin Cervical compound Opaque Dentin Opaque- Dentin back surface protection tooth stump Enamel Dentin Cervical compound Opaque-Dentin Applications for Opaque dentin 10

13 6. VENEERING (SIMPLE LAYERING) Cut off the Dentin compound expelled from the syringe with an instrument forming a disc shape. Preform the Dentin on the modelling block to the required shape and thickness. Then apply the Dentin with a spatula and model it according to the layering protocol and perform intermediate polymerisation. Note: To avoid air pockets, avoid mixing through with a spatula. Applying the Modelling Liquid The sculptability of the composite compounds can be improved by warming with a hot air dryer. After curing the Dentin, correct the shape as necessary, using suitable grinding tools, e.g. PRE-Form. Note: Following shape correction by grinding and before applying further compound, the dispersion layer has to be renewed by thinly applying Modelling Liquid (see fig.). Polymerisation of the liquid is not necessary. Before applying, brush off the grinding dust with a brush or blow off with oil-free compressed air. Do not clean with a steam jet! Standard layering 6.7. APPLYING Enamel The final tooth shape is attained by applying the strong opalescent incisal compounds. Shape the incisal compound then apply and adapt in the enamel region. Final polymerisation is then performed according to the polymerisation table. Should shape correction be necessary after polymerisation, it is recommended to use Translucent (T). 11

14 7. PROCESSING WIdTHS The processing width depends on the layer thickness, the transparency of the material and the prevailing light conditions. Polymerisation takes place in a light range of nm. Please find information on the light range of the light polymerisation device used in the manufacturer's specifications (data sheet). Brightly illuminated workplaces can lead to shorter processing times. 8. dispersion LAYER In case of light-curing composites, a dispersion layer is produced on polymerisation due to the effect of oxygen. It provides for the chemical bond between the individual compounds to be applied. For, this layer is so thin that after intermediate polymerisation that further layering can be performed without postprocessing. Always avoid touching the intermediate polymerised layers. Should the dispersion layer be damaged by touching nevertheless, Modelling Liquid can be applied thinly for renewal before further processing. oxygen diffusion dispersion layer polymerised composite 12

15 9. VENEERING (INdIVIdUAL LAYERING) The framework can also be constructed for individual layering. Apply Metal Primer and Pre-Opaquer as described INdIVIdUAL LAYERING with dentin Apply the Dentin and model such that the mamelons are clearly contoured. Individually constructed framework 9.2. INdIVIdUAL CONSTRUCTION OF THE CUTTING REGION Apply an intermediate layer in the incisal area with the transparent compounds (LVT, T, HVT, Enamel 57) to enhance the effect of the mamelon structure. If necessary, use Effect Amber AM (amber effect) or White Enamel WE to undertake additional individualisation in the cutting area. Following an intermediate polymerisation, complete the tooth shape using incisal compounds. Individually constructed framework with cervical compound Translucent Opaque Enamel dentin structure individually layered with mamelon shape Dentin Opaque Dentin back surface protection tooth stump Enamel Translucent framework Individualisation with Translucent Dentin Cervical Opaque Individually layered veneering 13

16 10. RESTORATIONS WITHOUT FRAMEWORK (INLAY / ONLAY) MOdEL PREPARATION Block out undercuts with wax, apply placeholder if necessary. Use alginate isolation (e.g. PremEco Line alginate isolation / Merz Dental). Prepared stump min 1.2 mm min 1.0 mm Cavity floor covered with Cervical Minimum thicknesses Inlay / Onlay LAYERING In the case of restricted space conditions, the cavity can firstly be covered with Opaque Dentin and then coated with Dentin. Cavity with dentin Fully layered inlay Build up marginal ridges and cusps with Dentin, making sure that the individual layers do not exceed 1 mm and sufficient space remains for incisal and effect compounds. Following a second polymerisation, complete the restoration with incisal and effect compounds ( Effect Occlusal) and perform final polymerisation. Contour, finish and polish the inlay / onlay according to the specifications in Chapter Finished trimmed inlay

17 11. TRIMMING ANd POLISHING The high proportion of ceramic filler in composite ensures the extraordinary wear resistance and excellent physical properties. Subsequent discolourations and plaque adhesion on composites is often attributable to incorrect processing of the polymerised surfaces. Therefore, it is extremely important that the composite surfaces are given systematic shape correction, contouring and polishing with coordinated rotary instruments. Trimming with mills or rough diamonds should be avoided. With the Finishing Kit, the POL and DiaPOL polishing pastes, you systematically obtain an optimal ceramic-like surface gloss with proven low surface roughness. PRE-Form PF 2 Finishing Kit PRE-Form PRE-Polish Polish PF 1 PF 2 PF 3 PP 1 PP 2 P 1 P 2 P 3 PRE-Form PF CONTOURING WITH PRE-Form grinding tools (PF 1-3) Contour the composite with the three forms of PRE-Form grinding tools made of highquality silicon carbide at a speed of rpm and shape the anatomical details. Take care that the composite is not overheated. The PRE-Form grinding tools remove the material abrasively, but without splintering and thus smoothen the ceramic fillers. With the PRE-Form grinding tools you obtain an extraordinarily goods grinding results and homogenous surfaces. PRE-Form PF 1 15

18 11. TRIMMING ANd POLISHING PRE-Polish PP1 PRE-Polish PP CONTOURING ANd POLISHING WITH PRE-Polish (PP 1-2) The PRE-Polish polishers were specially developed for finishing, polishing and smoothing composites. Depending on the contact pressure, the surfaces that are still rough are smoothened and contoured in a single step. Polish (P 1-3) polishers are diamond-coated silicon polishers with which the surface is smoothened and pre-polished. A speed of rpm is recommended, whereby the composite must not overheat. Polish P PRE-POLISHING ANd HIGH-GLOSS POLISHING WITH POL & diapol Pre-polishing is performed with POL and a wheel brush (goat hair or bison bristles) at approx rpm and low contact pressure. On account of its distribution and density of abrasive, the polishing paste filled with aluminium oxide particles is the best choice for pre-polishing composites. Final result Finally, the high-gloss polish is performed with DiaPOL, a wheel brush and a wool or leather buffing wheel. The polishing paste containing ultra-fine diamond particles achieves a long-lasting high gloss and durable composite surfaces within a very short time. 16

19 12. VENEERING ON PEEK BioSolution Framework conditioning with PEEK BioSolution Blast the surface of the PEEK framework to be veneered with 50 to 110 μm aluminium dioxide at 2-3 bar pressure. Blow off the blasted surface with dry, oil-free compressed air. Place 1 to 2 drops of Metal Primer in a mixing tray and then apply on the veneer surface with a small brush and allow to dry for 10 seconds, then immediately apply Pre-Opaque and light-cure. The subsequent veneering of PEEK BioSolution with composite is performed analogously to the method described under item 6 in the processing instructions PHYSICAL PROPERTIES ANd PEEK BioSolution Universal Opaque/ Metal Primer Shear bond strength on PEEK BioSolution [MPa] 19 PEEK BioSolution White A2/B2 PEEK BioSolution GUM Vickers hardness [HV0.2] acc. to ISO Flexural strength [MPa] acc. to ISO Elastic modulus [MPa]* *in-house test 17

20 13. Bonder I & II - UNIVERSAL BONdING AGENT Bonder I & II is a universal bonding agent to durably join various materials together intraorally and extraorally. Ceramic restorations can also be quickly supplemented with light-curing materials using Sun- Cera Bonder I & II. Bonder bonds cold-curing polymers with light-curing veneering resins, as well as reliably bonding various light-curing veneering composites with one another. Therefore, there are no longer any limits in individualisation of prosthetic teeth with light-curing veneering materials. Apply Bonder I / allow to take effect for 10 sec. APPLICATION OF Bonder I & II Preparing surfaces Roughen the surface to be treated with grinding instruments (diamond tips etc.), clean or blow off and dry thoroughly. Treat ceramic with phosphoric acid as etching agent, as necessary, and rinse with water and dry. Condition exposed metal parts with a metal primer (e.g. Metal Primer) and then apply opaquer. Apply Bonder II / allow to take effect for 10 sec. Application and drying Apply Bonder I with a MicroBrush over the entire surface to be repaired and allow to take effect for 10 sec. Apply Bonder II with a MicroBrush over the entire surface to be repaired and allow to take effect for 10 sec. Light-curing (polymerisation) Light-cure the surface with a dental polymerisation lamp according to the polymerisation table. Then apply the composite material (e.g. ) and light-cure. Cure with a polymerisation lamp for 20 sec. / ready for composite application Note: Bonder I & II contains volatile substances; close bottle tightly immediately after use. 18

21 14. TECHNICAL data POLYMERISATION TIMES Solidilite (Shofu) Solidilite EX (Shofu) Heraflash (Kulzer) UniXS (Kulzer) dentacolor XS (Kulzer) Eclipse Junior VLC Curing Unit (dentsply) Specifications in minutes [min] LicuLite (dentsply detrey), POLYLUX-HdS 400 (dreve-dentamid) Labolight LV ƖƖ Labolight LV ƖƖƖ (GC) Pre-Opaque Opaque IN Opaque VP Opaque VR Opaque Gum Opaque Opaque dentin Cervical dentin Enamel Translucent Effect Pontic Final SURFACE ROUGHNESS after polishing with PRE-Form PRE-Polish Polish POL diapol Surface roughness average roughness value Ra [μm]* Test conditions Pressure: 1 N Speed: rpm Time: 30 sec. *in-house test PHYSICAL PROPERTIES Vickers hardness [HV0.2] acc. to ISO Flexural strength [MPa] acc. to ISO Flexural elasticity [GPa] acc. to ISO Compressive strength [MPa] acc. to ISO Indirect tensile strength [MPa]* Shrinkage [Vol.-%]* Tooth brush wear [Vol.-%]* Elastic modulus [MPa]* Filler loading (inorganic) [Gew.-%]* *in-house test

22 14. TECHNICAL data PHYSICAL PROPERTIES Universal Opaque / Metal Primer Shear bond strength on metal [MPa]* 26.1 *in-house test POLYMERISATION depth Curing depths in mm* PreOpaque max Opaque max IN Opaque max VP Opaque max VR Opaque max Gum Opaque max Opaque dentin at least 1 Cervical at least 1 dentin at least 2 Enamel at least 2 Translucent at least 2 Effect at least 2 *in-house test 20

23 15. SHAdE CHART Opaque Cervical Opaque Translucent Enamel Effect BASE SHADES EFFECT SHADES Enamel 57 Shade chart available separately REF Opaque dentin dentin Incisal 21

24 Merz Dental GmbH Eetzweg Lütjenburg, Germany Tel +49 (0) 4381 / Fax +49 (0) 4381 / Merz Dental is certified in accordance with EN ISO and offers the assurance and advantages of a pioneering quality management system. All errors and misprints reserved / , en