(For Individual Attention Only) Not for distribution in the U. S. Scientific Compendium Xeno V 1
|
|
- Tyler Wells
- 5 years ago
- Views:
Transcription
1 (For Individual Attention nly) Not for distribution in the U. S. Scientific Compendium Xeno V 1
2 Table of contents 1 Introduction Storage conditions and shelf-life Xeno V Product Description New Chemistry Summary of new chemistry Components and functions In vitro Investigations Adhesion Bond Strength to Dentin and Enamel Micro Shear Fatigue Resistance (µsfr) to dentin Marginal Integrity Marginal Integrity of class V cavities Marginal Integrity of class II cavities Micro Morphology FESEM investigation of etching pattern in enamel and hybrid layer in dentin Clinical Investigations Clinical Class V Studies at the Medical University of Berlin and Bologna University Clinical Class II Study at Freiburg University Conclusion from the results of the clinical studies Directions for Use References Glossar and Abreviations List of Figures List of Tables Scientific Compendium Xeno V 2
3 1 Introduction Adhesive Dentistry has been gaining increasing importance for today s challenges in fulfilling patients needs, and is now used for most direct restorations in restorative dentistry. From the perspective of the patients, it means that in place of amalgam adhesively bonded compomer fillings are used in deciduous teeth, which are state-of-the-art today (Krämer et al., 2007). Furthermore, adhesive minimal invasive restorations are the treatment of choice in permanent dentition, in place of the cavity extension for prevention and the cavity extension needed for mechanical retention. Adhesive technology will also be the key approach for solving the increasing challenges in treatment of elderly patients, who are proud of having their own teeth and prefer direct restorations instead of replacement by indirect approaches. In contrast to traditional procedures such as amalgam fillings or cementation, adhesive technology is more complex and applications steps and techniques depend very much on the product used. Therefore, numerous efforts have been undertaken to reduce complexity and to increase the robustness of both the products and the application steps. ne principal step in reducing complexity is to use self-etching adhesives. Further reduction in complexity is gained by providing a one-component formulation. However, the robustness of these one-component self-etching adhesives with regard to storage conditions is very often neglected. The practitioner can see visible changes in the adhesive as a warning to discontinue use of the adhesive. Use of an adhesive with changes that are not immediately visible may lead to clinical failure. Therefore, a one-component self-etching adhesive that can be stored at room temperature is a major breakthrough in bringing adhesive dentistry one step further. Detailed information about the development of Xeno V can be found in the following chapters. 1.1 Storage conditions and shelf-life In general, polymerizable acrylate monomers are used in an aqueous, acidic solution as this is a requirement for one component self-etching dental adhesives. These monomers have to face two different potential degradation reactions: Scientific Compendium Xeno V 3
4 First, reactive solvent molecules can add at the polymerizable group, which results in the loss of its polymerizable function (Figure 1), although the overall monomer structure is not disrupted. (Figure 1). X R X + ethanol acid X R X Figure 1 Addition of solvent molecules (i.e. ethanol) to polymerizable groups (grey) results in loss of the polymerizable function (open circle) (X = for ester; X = NH for amide) Second, the reaction of water with a polymerizable group does not destroy its function, but separates the polymerizable group from the rest of the monomer by hydrolysis (Figure 2). a) ester linkage of polymerizable group R + H 2 acid H H R b) ester linkage of polymerizable group with phosphoric acid function R P H H + H 2 acid H H R P H H Figure 2 Separation of polymerizable groups (grey) by hydrolysis Both degradation mechanisms result in a reduced density of the polymer network. In the case of functionalized acidic monomers the hydrolysis may lead to acidic components that are no longer polymerized into the network (Figure 2 b). Thus, further etching by these mobile groups could occur at the interface. Formulations in which relevant components are separated by primary packaging with two compartments or in two separate bottles can be stored at room temperature over the respective shelf-life (Table 1). Scientific Compendium Xeno V 4
5 Two-components Storage condition Xeno III 2 24 C Adper Prompt L-Pop 25 C Table 1 Storage conditions of two-component self-etching adhesives However, one-component formulations based on acrylate ester chemistry and traditional solvents, as listed in Table 2, cannot be stored at room temperature for their entire shelf-life. ne-component Storage condition Remarks AdheSE ne 2 28 C Clearfil S3 BND 2 8 C If not in use. G-BND 1 28 C If not in use for a prolonged period of time, store in refrigerator! ibnd Gluma inside 8 C ibnd Self Etch 4 10 C Before first use. Then 23 C. ptibond All in ne 2 8 C Table 2 Storage conditions for one-component self-etching adhesives according to the respective manufacturer instructions To combine ease of use of one-component formulations, self-etching technology, and storage at room temperature for the entire shelf-life new monomers and formulations had to be invented. 2 Xeno V Product Description Xeno V is a one component self-etching dental adhesive designed to bond resin-based, lightcuring direct restorative materials to enamel and dentin. Xeno V does not need to be mixed. Although delivered as one component, it does not need to be stored in a refrigerator. Scientific Compendium Xeno V 5
6 2.1 New Chemistry The high tolerance of Xeno V towards storage conditions of up to 24 C is obtained by using new monomers acryl resins with amide groups instead of ester groups inverse functionalized phosphoric acid esters instead of ester functionalized phosphoric acid esters and the use of tertiary butanol instead of lower molecular weight alcohols, like ethanol, as a solvent The Xeno V components and their functions are given in more detail in Table 3. Their chemical structure is shown in Figure 3 and Figure 5. Component Bifunctional acryl resin with amide functions Acryloylamino alkylsulfonic acid inverse functionalized phosphoric acid ester Acrylic acid Camphorquinone, Coinitiator Butylated benzenediol Water Tert-butanol Function Crosslinker Etchant and wetting aid Etchant, adhesion promoter and wetting aid Wetting aid Photoinitiator system Stabilizes monomers during storage Solvent for the resins and etch promoter Solvent for the resins and mild stabilizer Table 3 Components of Xeno V and their function Scientific Compendium Xeno V 6
7 ethanol propanol n-butanol = = C = H iso-propanol tert-butanol Figure 3 Chemical structure of alcohols In Xeno V tert-butanol is used as the solvent. The alcohol group in tert-butanol is shielded by the surrounding methyl groups of the tertiary group (Figure 3). Therefore tert-butanol is not able to chemically react by addition at the acrylate resins in the same way ethanol and isopropanol do (Figure 4). For this reason formulations containing tert-butanol are chemically more stable than those containing ethanol or iso-propanol. acid R X X + tert-butanol Figure 4 Addition to polymerizable groups does not occur with tert-butanol (X = for ester; X = NH for amide) Scientific Compendium Xeno V 7
8 amides less prone to hydrolyses R' NH NH R NH R' inverse ester less prone to hydrolyses Patent Protection Figure 5 General chemical structures of the key monomers used in Xeno V. R P H highly acidic sulfonic acid group NH H R S H phosphoric acid ester group as known from PENTA H S P H H Xeno V comprises newly developed and patented monomers as schematically described in Figure 5. The novelty is due to the introduction of amide groups and inverse methacrylic ester functions instead of ester functions. Based on their molecular structure, amides are more stable in an aqueous, acidic solvent solution compared to ester. This protective effect is illustrated in Figure 6 and the resulting stability is demonstrated in Figure 7. amide monomer NH R NH + H 2 acid Figure 6 Protection of polymerizable function (grey) in acryl monomer with amide functions. monomer content [%] NH NH amide monomer ester monomer time [days] Figure 7 Stability of an ester monomer versus an amide monomer in an acidic water/tert-butanol solvent solution while stored at 50 C. Scientific Compendium Xeno V 8
9 In addition to amide monomers, inverse functionalized monomers are used in Xeno V. These monomers are characterized by the attachment of the polymerizable methacrylate function to the acidic phosphoric acid ester function by a more hydrolysis-stable ether bond instead of an ester bond (Figure 8) a) ester functionalized phosphoric acid ester R P H H b) "inverse" functionalized phosphoric acid ester R' R P H H Figure 8 Ester functionalization (a) compared to inverse functionalization (b) Hydrolysis of such monomers does not lead to the separation of the polymerizable group from the acidic monomer (Figure 9). "inverse" functionalized phosphoric acid ester R' + R P H H H 2 acid H R P H H Figure 9 Acidic monomers maintain the polymerizable group (grey) over the shelf-life Summary of new chemistry The use of tert-butanol as part of the solvent, combined with acryl resins with amide functions, and inverse functionalization guarantees that polymerizable functions remain Scientific Compendium Xeno V 9
10 available to form a polymer network for the entire shelf-life even in a highly acidic aqueous one-component formulation. 2.2 Components and functions Besides their stability in an aqueous, acidic environment, each ingredient of Xeno V has to fulfil a specific function to guarantee the overall success of Xeno V. As crosslinkers, the bifunctional acryl resins with amide functions ensure the formation of a dense resin network upon light-curing. The inverse functionalized acidic monomer used in Xeno V comprises a phosphoric acid ester group (Figure 10). It has been demonstrated recently by µraman spectroscopy that such groups promote chemical interaction between the monomers and tooth substance (Latta, 2007a). R' R P H H Ca 2+ Ca 2+ Ca 2+ Figure 10 Possible interaction of phosphoric acid ester group with tooth substrate The second acidic monomer, the acryloylamino alkylsulfonic acid, was added to the formulation to increase the acidity of Xeno V and to ensure the formation of a well-defined etch pattern as described in the chapter Micro Morphology. Acrylic acid, although only a weak acid, plays an important role in the interaction of monomers. As a small polar, but also a polymerizable monomer, it promotes the penetration of the bigger crosslinker monomers into the tooth substrate. The use of a water/tert-butanol solvent solution provides the formulation with a well-balanced polarity. n one hand the polarity is high enough for the acidic monomers to be effective. n the other hand the polarity also allows less polar ingredients, like the initiators, to dissolve. In addition, the low volatility of the water/tert-butanol solvent solution makes it possible to use Xeno V from closed CliXdish for up to 30 min, making it more convenient in daily practice. Scientific Compendium Xeno V 10
11 3 In vitro Investigations Investigations under simulated conditions in vitro are necessary to verify the performance before new products can be evaluated in clinical studies. These investigations involve different aspects of variability including methods, operators, procedures and others, they can serve as a source of improvements in the application procedures so as to ensure reliable performance in everyday situations in the clinic. Investigations of bond strength, marginal quality, and micro morphology are described, below. 3.1 Adhesion ne of the most important features of Xeno V is that it can be stored at room temperature. But it was also very important to develop a product which can ensure balanced adhesion performance on both enamel and dentin Bond Strength to Dentin and Enamel Bond strength was tested at different sites by external experts and by DENTSPLY researchers under well established and standardized conditions Shear bond strength on enamel and dentin (Mark A. Latta, maha (NE), USA) ne experienced operator performed all samples for testing using a well described method (Barkmeier et al., 1999). Shear bond strength (SBS) was determined at a cross head speed of 5mm/min after 6000 thermo cycles (Figure 11), respectively. Scientific Compendium Xeno V 11
12 Shear Bond Strength [MPa] A a b Xeno V C a b ibond SE A b c B Ai a b AdheSE ne a Clearfil S3 c B B B B G Bond d ibond Gi A a b Clearfil SE Enamel Dentin ABC statistical grouping Figure 11 Shear bond strength after 6000 thermo cycles to dentin and enamel Xeno V showed high shear bond strength to both substrates dentin and enamel and was comparable to or better than Xeno III and other self-etching adhesive systems Shear bond strength after unintended pre-etching (DENTSPLY DeTrey, Konstanz, Germany) Xeno V is a self-etching adhesive. However, as for all other self-etching adhesives there is the limitation that bonding to unprepared enamel is not indicated. As the majority of practitioners prefer to use as few different adhesive products as possible, very often phosphoric etching gel is used in those indications to pre-etch unground enamel. When applying etch-gel to enamel margins (e.g. class IV cavities with extended bevelling) one may want to know whether unintended pre-etching of dentin together with the application of a self-etching adhesive leads to over etching of dentin and thus to decreased bond strength. Therefore, bond strength to dentin applying Xeno V in the intended self-etching mode was compared to situations in which unintended etching of dentin occurred. (Figure 12). In addition, either a QTH (Spectrum 800) or LED (SmartLite PS) curing light was used. Scientific Compendium Xeno V 12
13 Shear Bond Strength [MPa] Spectrum 800 SmartLite PS Figure 12 0 Self-Etch Etch&Rinse SBS on dentin after unintended pre-etching compared to self-etching mode Results support that Xeno V is compatible with halogen and LED curing lights and to unintentionally pre-etched dentin Micro Shear Fatigue Resistance (µsfr) to dentin (Marc Braem, Antwerp, Belgium) Achieving a long lasting bond between restoration and the tooth substance is the ultimate goal of adhesive dentistry. Besides chemical degradation, it might be expected that the adhesive degrades mechanically through fatigue. Therefore, a recently developed method (Braem, 2007) was used to investigate the fatigue behaviour of Xeno V and other adhesive systems. Tooth substance is placed and fixed in a brass mould (left picture of Figure 13). After the adhesive is applied and light cured, a Mylar strip with a hole 1 mm in diameter is centrically placed over this bonded surface (middle picture of Figure 13). Finally, another brass mould is fixed onto the first brass mould and composite is placed on top to bond through the 1 mm hole to the tooth surface (right picture of Figure 13). Figure 13 Specimen preparation (Braem, 2007) Scientific Compendium Xeno V 13
14 The assembled brass moulds are immediately placed into a test chamber under a constant temperature of 35 C where one brass mould is fixed and the other mould is loaded (Figure 14). Figure 14 Placement of the brass moulds in the fatigue machine. The lower part is fixed using compressed air (1). The piezo-electric force transducers (2) record the applied loads onto the upper part (Braem, 2007). Firstly, the quasi-static microshear strength is determined. The 50% value is then used as the starting level of the subsequent fatigue testing. Secondly, fatigue behaviour is tested in a staircase approach. The samples are loaded for up to 10,000 cycles to a specified limit with a frequency of 2 Hz. The load is increased by 8% of the initially determined microshear strength each time a specimen survives these 10,000 cycles, or decreased by 8% if the specimen fails prematurely. This staircase approach results in a set of data by which the mean fatigue resistance can be calculated. Scientific Compendium Xeno V 14
15 Figure 15 number of cycles sample µ-sfr Samples Exemplary data for number of cycles (bars) and respective load (dots) Applied stress [MPa] failed survived In Figure 15 exemplary data is used to illustrate the resulting set of data. The sample 001 was tested at a stress level of 20 MPa (right ordinate) and survived (green dot) 10,000 cylces (left ordinate). Therefore sample 002 was tested one step higher than sample 001 and survived as well. Sample 003 was stressed two steps higher compared to sample 001 but failed (red dot) after 500 cycles (bar). Sample 004 failed after 3700 cycles. Sample 005 was then tested at the same stress level as sample 001 and survived again. This method is followed until a sufficient amount of data for calculation of the mean Micro Shear Fatigue Resistance is available. Actual results are presented in Figure 16. µshear Fatigue Resistance [MPa] Xeno V Xeno III Clearfil SE ibond Gi 75% mean 25% Braem M (2006) Figure 16 Mean micro shear fatigue resistance to dentin and 25-75% quartiles Xeno V showed comparable or higher mean fatigue resistance compared to other selfetching adhesives. Distribution of data was significantly different for Xeno III compared to all other. Xeno V showed a comparable data distribution to the remaining adhesives tested with the 25% quartile being very close to the mean value. Scientific Compendium Xeno V 15
16 3.2 Marginal Integrity Bond strength is only the first step in evaluating the potential of a newly developed adhesive. To simulate the more complex configuration and stresses found in a restoration, marginal integrity was tested in different cavity classes using different methods in order to evaluate the quality of the margin before and after stress was applied Marginal Integrity of class V cavities Class V restorations allow easy access and simultaneous evaluation of marginal quality in enamel and dentin. To quantify the quality, either dye penetration or quantitative SEM analysis were applied Dye penetration and dentin permeability in class V (Juan Ignacio Rosales-Leal, Granada, Spain) After restoring U-shaped class V cavities with the materials displayed in Figure 18, teeth were thermo cycled between 5 and 55 C and immersed in a 0.5 % water solution of basic fuchsine for 24 hours, embedded in acrylic resin and cut into bucco-lingual slices. The in-vitro micro leakage of the occlusal and gingival cavity walls was evaluated using an optical microscope. The extent of the dye penetration along the restoration was ranked (Figure 17) between 0 (hermetic seal) and 3 (massive micro leakage). Additionally, it was documented whether, in the presence of dye along the cavo-restorative margin, any dye penetrated into dentin. 2 cclusal Wall = Enamel 3 0 Micro-Leakage Permeability 1 Gingival Wall = Dentine Microleakage grades 0: hermetic seal 1: mild 2: moderate 3: massive Dentin permeability 0: negative, dentin tubules sealed 1: positive, absence of dentin tubules sealing. Figure 17 Scoring of micro leakage in class V restorations The teeth were either stored for 24 hours in water, or thermo cycled (TC) 4000 times before being immersed in dye. Results are summarized for the enamel margin (Figure 18) and dentin margin (Figure 19). Scientific Compendium Xeno V 16
17 24 TC 24 TC 24 TC 24 TC 24 TC Percentage per grade [%] a ab a a a b a a a a Enamel 24 hours TC Xeno V Ceram X mono Xeno III Ceram X mono Adper Prompt Filtek Supreme ibond Gi Venus Clearfil SE Clearfil APX adhesive restorative Figure 18 Microleakage grades in enamel margins All restorative systems involved in the test showed mild penetration. There was no significant difference between Xeno V and Xeno III. 24 TC 24 TC 24 TC 24 TC 24 TC Percentage per grade [%] a a b cd d e ef f b d Dentin 24 hours TC Xeno V Ceram X mono Xeno III Ceram X mono Adper Prompt Filtek Supreme ibond Gi Venus Clearfil SE Clearfil APX adhesive restorative Rosales-Leal JI (2006) grades Figure 19 Microleakage grades in dentin margins In contrast to the results in enamel, micro leakage grades in dentin showed huge variation among the tested restorative systems. Xeno V in combination with Ceram X mono showed tighter margins in dentin compared to all other systems. Sealing the dentin is one of the main advantages of self-etching adhesives. In this in vitro testing dye did not penetrate into dentin tubules despite dye penetration between the cavity and the restoration for all systems except one (Figure 20). Scientific Compendium Xeno V 17
18 24 TC 24 TC 24 TC 24 TC 24 TC Percentage per grade [%] Dentin 24 hours TC Xeno V Ceram X mono Xeno III Ceram X mono Adper Prompt Filtek Supreme ibond Gi Venus Clearfil SE Clearfil APX adhesive restorative Figure 20 Dentin permeability under class V restorations In summary, Xeno V proved to be as good as well established systems with longer clinical history at restoring class V lesions in regard to micro leakage Marginal Quality of class V under SEM (Uwe Blunck, Berlin, Germany) Marginal quality of class V restorations using SEM was quantified in teeth after storage for 3 weeks in water and 2000 thermo cycles following a well established protocol (Blunck et al., 2007). Percentage of marginal line fulfilling the following criteria was determined (Figure 21): Margin not or hardly visible No or slight marginal irregularities 1 No gap restoration dentin enamel 100 µm restoration 100 µm Figure 21 Example of continuous margins using Xeno V / Ceram X mono 1 The term "marginal irregularities" means porosities, marginal restoration fracture, bulge in the restoration Scientific Compendium Xeno V 18
19 Data were analyzed regarding statistical significance comparing Xeno V to the other adhesives. To exclude any effect by the restorative material Ceram X mono was used for all groups. Results are presented for enamel margins (Figure 22) and dentin margins (Figure 23), respectively. perfect margins [%] p = p = p = p = before TC after TC 2000 outlier statistical differences Xeno V Xeno III Cf SE ibond Gi Prompt Blunck U (2006, 2007) Figure 22 Percentage of continuous margin in enamel 2 perfect margins [%] p < before TC after TC 2000 outlier statistical differences Xeno V Xeno III Cf SE ibond Gi Prompt Blunck U (2006, 2007) Figure 23 Percentage of continuous margin in dentin 2 The performance of Xeno V was comparable to Xeno III and Clearfil SE Marginal Integrity of class II cavities Marginal quality in class II restorations was investigated under two similar study designs. In both studies micro leakage was investigated. In one of the studies replicas were used to investigate marginal integrity as well. Class II studies are useful to create clinically relevant stress during restoration by applying a simplified incremental layer technique and using chewing simulator to challenge the adhesive system by forces from chewing and temperature changes. 2 Note: rdinate begins at 60%; * = outliers Scientific Compendium Xeno V 19
20 Dye penetration in class II (Jürgen Manhart, Munich, Germany) There are numerous protocols as to how and where to place increments and light source in the restoration of class II cavities. As most practitioners tend to use simplified techniques, such a layering concept was applied for this investigation (Figure 24). Box in enamel Box in dentine cclusal part Manhart J (1999) Figure 24 Layering concept for class II cavities and directions of light source After restoration, the teeth were stressed in a chewing simulator by 2000 thermo cycles between 5 and 55 C, and 50,000 chewing cycles using an artificial antagonist loaded with 50N (Manhart et al., 1999). Dye penetration was evaluated separately for enamel margins in the approximal box limited to enamel (Figure 25) and dentin margins in the deeper approximal box (Figure 26). dye penetration score [%] a b a a b b b Microleakage scores for class II restorations limited within enamel Enamel Dentin 0 Xeno V Ceram X mono Xeno III Ceram X mono Clearfil SE Clearfil APX ibond Gi Venus Adper Prompt Filtek Supr. XT adhesive restorative Manhart J (2006) Figure 25 Microleakage scores in enamel margins of class II restorations. Scientific Compendium Xeno V 20
21 dye penetration score [%] a a a b b b c c Microleakage scores for class II restorations limited within dentin Dentin 0 Xeno V Ceram X mono Xeno III Ceram X mono Clearfil SE Clearfil APX ibond Gi Venus Adper Prompt Filtek Supr. XT adhesive restorative Manhart J (2006) Figure 26 Microleakage scores in dentin margins of class II restorations. In enamel restorations of Xeno V and Ceram X mono performed as good as all other restorative systems. In dentin Xeno V showed comparable leakage to all other systems except Clearfil SE / Clearfil APX which performed better Dye penetration and marginal integrity in class II (Roland Frankenberger, Erlangen, Germany) This investigation of marginal quality, following an almost identical protocol (Figure 27), combined SEM evaluation via replica with slicing and determination of dye penetration. Materials & Method - n = 8 mod (box in Dentin or enamel) Storage & Stressing - 24 hours at 37 C TC 5-55 C for 30 seconds - 100,000 cycles with 50 N Evaluation - dye penetration (32 slices) - SEM Frankenberger R (2007) Figure 27 Parameters for class II testing in chewing simulator. Scientific Compendium Xeno V 21
22 percenatage perfect margins [%] Xeno V Ceram X mono Xeno III Ceram X mono Enamel Before TML Dentin After TML Before TML After TML Frankenberger R (2007) Figure 28 Percentage of perfect margins before and after thermo mechanical loading (TML) Xeno V performed similar to Xeno III when determining the percentage of perfect margins either in enamel or in dentin and before or after thermo mechanical loading. After slicing the restorations for which marginal integrity data is shown in Figure 28 microleakage scores by means of dye penetration was determined as shown for enamel in Figure 29 and for dentin in Figure 30. dye penetration score [%] a b Microleakage scores for class II restorations limited within enamel Dentin 0 Xeno V Ceram X mono Xeno III Ceram X mono Enamel Frankenberger R (2007) Figure 29 Microleakage scores in enamel margins of class II. In enamel margins Xeno V performed better compared to Xeno III. Scientific Compendium Xeno V 22
23 dye penetration score [%] a a Microleakage scores for class II restorations limited within dentin Dentin 0 Xeno V Ceram X mono Xeno III Ceram X mono Figure 30 Microleakage scores in dentin margins of class II. In dentin margins both systems performed on the same level. In summary this investigation supports the hypothesis that Xeno V is at least comparable to Xeno III as regards performance. 3.3 Micro Morphology Investigations of micro morphology help to visualize the effects adhesives have on the respective substrate FESEM investigation of etching pattern in enamel and hybrid layer in dentin (Jorge Perdigão, Minneapolis (MN), USA) Enamel specimens were roughened with a course diamond bur and after application of Xeno V were immersed in acetone for 24 h in a rotator to dissolve the resin. The application of Xeno V resulted in very good intraprismatic penetration into enamel, however its interprismatic penetration was shallow, which is characteristic of self-etch adhesives. (Figure 31) Scientific Compendium Xeno V 23
24 Perdigão J (2006) Figure 31 SEM of enamel treated with Xeno V The investigator compared these findings to previous results from other self-etching adhesives and stipulated that Xeno V resulted in more defined enamel etching pattern than self-etch adhesives with ph 1.8. The interaction of Xeno V with dentin and the resulting hybridisation is described as follows: hybrid layer thickness 0.2 μm to 0.5 μm adhesive layer thickness 3.4 μm to 4.8 μm resin tags were observed 120 μm below the interface no debonding was observed the hybrid layer showed the typical reticular aspect In summary the micro morphology data show the well defined interaction of Xeno V with both substrates enamel and dentin. It complements the favourable performance found in other kind of investigations. Scientific Compendium Xeno V 24
25 4 Clinical Investigations Despite the significance of the above in-vitro investigations, conducted both internally and externally, clinical investigations are the only method of providing absolute certainty concerning the efficacy of new restorative technologies. Therefore three clinical investigations on Xeno V have recently been initiated in different cavity classes. Some brief information is provided below on the design and status of these studies. 4.1 Clinical Class V Studies at the Medical University of Berlin and Bologna University Due to their non-retentive nature and their special stress pattern, the follow up of Class V restorations is most helpful in revealing potential weaknesses of adhesives. Therefore data on clinical success of Class V s is essential. Dr. Uwe Blunck from the Medical University of Berlin, Germany, and Professor Giovanni Dondi dall rologio from Bologna University, Italy, are running two randomized longitudinal clinical investigations on restoration of caries free cervical lesions. At each site, 40 Xeno V plus 40 controls (40 Xeno III or 40 Clearfil SE restorations, respectively) have been placed in 40 patients. Ceram X duo, DENTSPLY, is used as restorative material. The restoration margins are primarily in dentin. Both studies are identical in design in order to enable pooling of the results for Xeno V. RYGE criteria are applied. perator calibration was conducted at both sites prior to commencement of trials. The investigations were designed according to the revised guidelines of the American Dental Association (ADA, 2001a) for dentin and enamel adhesive materials; details are provided in Table 4. Scientific Compendium Xeno V 25
26 Number of patients per site Number of restorations per site Test adhesive Control materials Restorative Method of evaluation Recall periods Blinding 40 to be included, each receiving one test and one control restoration 40 test and 40 control restorations Xeno V Xeno III (Berlin) and Clearfil SE (Bologna) Ceram X duo Clinical examination (RYGE criteria) Baseline, 3, 6, 18 and 48 months Patient and operator blinding Table 4 Design details on Class V investigations at Berlin and Bologna University The results recorded over the 18-month period from Bologna University are available and are provided in Table 5 and Table 6. Criteria Xeno V / Ceram X [n] Clearfil SE / Ceram X [n] alpha bravo charl. delta alpha bravo charl. delta Retention n/a 0 n/a n/a 0 n/a Marginal discolouration n/a n/a Marginal integrity Secondary caries n/a n/a n/a n/a Restoration contour n/a n/a Table 5 18 month results in Class V, Bologna University (Dondi dall'rologio, 2008) Post-op. sensitivities total no yes mean SD total no yes mean SD n/a n/a n/a n/a Table 6 Post-operative sensitivities at 18 months, University of Bologna. Mean value and standard deviation. 1 = lowest sensitivity. 10 = highest sensitivity. (Dondi dall'rologio, 2008) 18 patients and 36 teeth were sensitive to stimuli (score 2 or 3 in a category of 0 to 4) before treatment and rated score 0 (no sensitivity) at baseline control. This was evaluated between 3 and 7 days after placement. After 18 months, the success rates achieved at Bologna University amounted to 100% for Xeno V and 100% for Clearfil SE. No adverse events occurred. The results recorded over the 18-month period from The Medical University Berlin (Charité) are available as well and displayed below in Table 7 and Table 8. Scientific Compendium Xeno V 26
27 Criteria Xeno V / Ceram X duo [n] Xeno III / Ceram X duo [n] alpha bravo charl. delta alpha bravo charl. delta Retention n/a 2 n/a n/a 6 n/a Marginal discolouration n/a n/a Marginal integrity Secondary caries n/a n/a n/a n/a Restoration contour n/a n/a Table 7 18 month results in Class V, University of Berlin (Blunck, 2008) Post-op. sensitivities total no yes mean SD total no yes mean SD n/a n/a n/a n/a Table 8 Post-operative sensitivities at 18 months, University of Berlin. Mean value and standard deviation. 1 = lowest sensitivity. 10 = highest sensitivity. (Blunck, 2008) The overall success rate amounts to 92.3% for Xeno V and 78.1% for Xeno III. No adverse events or other clinical problems occurred. Principal Clinical Investigator Uwe Blunck concluded that the use of Xeno V was both safe and efficient. 4.2 Clinical Class II Study at Freiburg University The clinical behaviour of Xeno V in Class II cavities is of particular interest because it is one of the major indications of modern adhesive materials. Accordingly, a randomized controlled longitudinal Class II investigation is underway at the University of Freiburg, Germany, under the auspices of Professor Elmar Hellwig. 40 Xeno V restorations plus an according number of control restorations (Syntac Classic) have been placed in 40 patients. Ceram X mono, DENTSPLY, is used as restorative material. RYGE criteria are applied. The investigation was designed according to the revised guidelines of the American Dental Association (ADA, 2001b) for posterior restorations, details are provided in Table 9. Scientific Compendium Xeno V 27
28 Number of patients Number of restorations Test adhesive Control adhesive Restorative Method of evaluation Recall periods Blinding 40 to be included, each receiving one test and one control restoration 40 test and 40 control restorations Xeno V Syntac Classic Ceram X mono Clinical examination (RYGE criteria) Baseline, 3, 6 and 18 months Patient and operator blinding Table 9 Design details on Class II investigation at Freiburg University The 6 months results on 32 patients have been received from the University of Freiburg and are displayed below (Table 10 and Table 11). Criteria of evaluated restorations Xeno V / Ceram X mono [n] Syntac Classic / Ceram X mono [n] total alpha bravo charl. delta total alpha bravo charl. delta Retention n/a 0 n/a n/a 1 n/a Marginal discolouration n/a n/a Marginal integrity Secondary caries n/a n/a n/a n/a Prox. contact/ cont. (d) n/a n/a Prox. contact/ cont. (m) n/a n/a Vitality test Fracture Table 10 6 months results in Class II, University of Freiburg (Hellwig, 2008) Post-op. sensitivities total no yes mean SD total no yes mean SD spontaneous n/a n/a n/a n/a triggered by chewing n/a n/a n/a n/a triggered by other noxa n/a n/a ( ) n/a n/a Table 11 Post-operative sensitivities at 6 months, University of Freiburg. Mean value and standard deviation. 1 = lowest sensitivity. 10 = highest sensitivity. (Hellwig, 2008) Scientific Compendium Xeno V 28
29 Principal Clinical Investigator Elmar Hellwig concludes that presently no clinically relevant differences between the two experimental groups neither in occurrence nor in the severity of post-operative sensitivity can be stated. 4.3 Conclusion from the results of the clinical studies The success rate of Xeno V in class V amounts to 98,7% after 6 months. In class II, the observed results indicate no clinical difference between the used adhesive systems. Adverse events were not observed in any study. Scientific Compendium Xeno V 29
30 5 Directions for Use The up-to-date directions for use can be found in all European official languages on the Internet at Scientific Compendium Xeno V 30
31 6 References ADA (2001a). American Dental Association Council on Scientific Affairs: Guidelines for Acceptance of Enamel and Dentin Adhesive Materials. American Dental Association, Chicago, May ADA (2001b). American Dental Association Council on Scientific Affairs: Resin Based Composites for Posterior Restorations. American Dental Association, Chicago, May Barkmeier WW, Hamesfahr PD, Latta MA (1999). Bond Strength of Composite to Enamel and Dentin Using Prime and Bond 2.1. perative Dentistry 24:1, Blunck U, Zaslansky P (2007). Effectiveness of All-in-one Adhesive Systems Tested by Thermocycling Following Short and Long-term Water Storage. J Adhes Dent 2007; 9: Blunck U (2006). Final Report Data on file. Blunck U (2007). Final Report Data on file. Blunck U (2008). 18-month report Data on file. Braem M (2006). Final Report Data on file. Braem M (2007). Microshear Fatigue Testing of Tooth/AdhesiveInterfaces. J Adhes Dent 2007; 9: Dondi dall'rologio G (2008). 18-month report Data on file. Frankenberger R (2007). Final Report Data on file. Hellwig E (2008). 6-month report Data on file. Krämer N, Frankenberger R (2007). Compomers in restorative therapy of children: a literature review. Int J Paed Dent 17:2-9. Latta MA (2007a). Shear Bond Strength and Physicochemical Interactions of XP BND. J Adhes Dent 2007; 9: Latta MA (2008). Bond Strength of Composite to Dentin and Enamel Using Self-Etching Adhesive Systems. General Dentistry. Accepted for publication. Manhart J, Hollwich B, Mehl A, Kunzelmann K-H, Hickel R (1999). Randqualität von rmocer- und Kompositfüllungen in Klasse-II-Kavitäten nach künstlicher Alterung. Dtsch Zahnärztl Z; 54:89-95 Manhart J (2006). Final Report Data on file. Perdigão J (2006). Final Report Data on file. Rosales-Leal JI (2006). Final Report Data on file. Scientific Compendium Xeno V 31
32 7 Glossar and Abreviations FESEM LED µsfl QTH SBS SEM TC TML Field Emission Scanning Electron Microscopy Light Emitting Diode Micro Shear Fatigue Limit Quartz Tungsten Halogen Shear Bond Strength Scanning Electron Microscope Thermo Cycles Thermo Mechanical Loading Scientific Compendium Xeno V 32
33 8 List of Figures Figure 1 Addition of solvent molecules (i.e. ethanol) to polymerizable groups (grey) results in loss of the polymerizable function (open circle) (X = for ester; X = NH for amide)...4 Figure 2 Separation of polymerizable groups (grey) by hydrolysis...4 Figure 3 Chemical structure of alcohols...7 Figure 4 Addition to polymerizable groups does not occur with tert-butanol (X = for ester; X = NH for amide)...7 Figure 5 General chemical structures of the key monomers used in Xeno V....8 Figure 6 Protection of polymerizable function (grey) in acryl monomer with amide Figure 7 functions....8 Stability of an ester monomer versus an amide monomer in an acidic water/tertbutanol solvent solution while stored at 50 C....8 Figure 8 Ester functionalization (a) compared to inverse functionalization (b)...9 Figure 9 Acidic monomers maintain the polymerizable group (grey) over the shelf-life...9 Figure 10 Possible interaction of phosphoric acid ester group with tooth substrate...10 Figure 11 Shear bond strength after 6000 thermo cycles to dentin and enamel...12 Figure 12 SBS on dentin after unintended pre-etching compared to self-etching mode...13 Figure 13 Specimen preparation (Braem, 2007)...13 Figure 14 Placement of the brass moulds in the fatigue machine. The lower part is fixed using compressed air (1). The piezo-electric force transducers (2) record the applied loads onto the upper part (Braem, 2007) Figure 15 Exemplary data for number of cycles (bars) and respective load (dots)...15 Figure 16 Mean micro shear fatigue resistance to dentin and 25-75% quartiles...15 Figure 17 Scoring of micro leakage in class V restorations...16 Figure 18 Microleakage grades in enamel margins...17 Figure 19 Microleakage grades in dentin margins...17 Figure 20 Dentin permeability under class V restorations...18 Figure 21 Example of continuous margins using Xeno V / Ceram X mono...18 Figure 22 Percentage of continuous margin in enamel...19 Figure 23 Percentage of continuous margin in dentin Figure 24 Layering concept for class II cavities and directions of light source...20 Figure 25 Microleakage scores in enamel margins of class II restorations Figure 26 Microleakage scores in dentin margins of class II restorations Figure 27 Parameters for class II testing in chewing simulator Figure 28 Percentage of perfect margins before and after thermo mechanical loading (TML)...22 Figure 29 Microleakage scores in enamel margins of class II Figure 30 Microleakage scores in dentin margins of class II Figure 31 SEM of enamel treated with Xeno V...24 Scientific Compendium Xeno V 33
34 9 List of Tables Table 1 Storage conditions of two-component self-etching adhesives...5 Table 2 Storage conditions for one-component self-etching adhesives according to the respective manufacturer instructions...5 Table 3 Components of Xeno V and their function...6 Table 4 Design details on Class V investigations at Berlin and Bologna University...26 Table 5 18 month results in Class V, Bologna University (Dondi dall'rologio, 2008)...26 Table 6 Post-operative sensitivities at 18 months, University of Bologna. Mean value and standard deviation. 1 = lowest sensitivity. 10 = highest sensitivity. (Dondi dall'rologio, 2008)...26 Table 7 18 month results in Class V, University of Berlin (Blunck, 2008)...27 Table 8 Post-operative sensitivities at 18 months, University of Berlin. Mean value and standard deviation. 1 = lowest sensitivity. 10 = highest sensitivity. (Blunck, 2008)...27 Table 9 Design details on Class II investigation at Freiburg University...28 Table 10 6 months results in Class II, University of Freiburg (Hellwig, 2008)...28 Table 11 Post-operative sensitivities at 6 months, University of Freiburg. Mean value and standard deviation. 1 = lowest sensitivity. 10 = highest sensitivity. (Hellwig, 2008)...28 Scientific Compendium Xeno V 34
35 The following materials are not trademarks of DENTSPLY International but of the respective manufacturer. Abreviation AdheSE ne Adper Prompt CfSE Cf APX Clearfil S3 FSupXT G Bond ibond Gi ibond SE B Ai Z250 Brand (Manufacturer) AdheSE ne (Ivoclar Vivadent) Adper Prompt L-Pop (3M Espe) Clearfil SE Bond (Kuraray) Clearfil APX (Kuraray) Clearfil S 3 Bond (Kuraray) Filtek Supreme XT (3M Espe) G Bond (GC) ibond Gluma inside (Heraeus Kulzer) ibond Self Etch (Heraeus Kulzer) ptibond All in ne (Kerr) Filtek Z250 (3M Espe) Scientific Compendium Xeno V 35
Forgives Nothing. Forgives Almost Anything. Science Update
Forgives Nothing Forgives Almost Anything Science Update Shear bond strength on wet and dry dentin (Ultradent) Latta M, Omaha Since etching of dentin with phosphoric acid was introduced, one focus of research
More information1 Introduction Product Description Prime&Bond XP In vitro Investigations... 8
Table of contents 1 Introduction... 4 2 Product Description Prime&Bond XP... 4 2.1 Prime&Bond XP: Components and Function... 4 3 In vitro Investigations... 8 3.1 Adhesion... 9 3.1.1 Bond Strength to Dentin
More informationAdper Easy Bond. Self-Etch Adhesive. Technical Product Profile
Adper Easy Bond Self-Etch Adhesive Technical Product Profile Table of Contents Table of Contents Introduction... 4 Product Description... 4 Composition...5-8 Background... 5 Mechanism of Adhesion to Enamel
More informationG-Premio BOND. One component light cured universal adhesive. BOND with the BEST
One component light cured universal adhesive BOND with the BEST The world s most clinically successful adhesive is now even better! Introducing. G-BOND has proven to be the world s most clinically successful
More informationAdhesive Solutions. Scotchbond Universal Adhesive. SEM pictures of Scotchbond Universal Adhesive. One bottle for all cases! Total-Etch and Self-Etch
Adhesive Solutions Adhesive SEM pictures of. One bottle for all cases! Total-Etch and Self-Etch One adhesive for Total-Etch and Self-Etch Discover the Universal Bonding Solution. Unleash the power of the
More informationAdhese Universal. The universal adhesive. Direct Indirect Total-Etch Selective-Etch Self-Etch Wet & Dry. All in. one click
Adhese Universal The universal adhesive Direct Indirect Total-Etch Selective-Etch Self-Etch Wet & Dry All in one click 1 Universal Adhesion with advanced delivery Adhese Universal is a singlecomponent,
More informationThe App to seal! Endo-Resto System. Sealed Safe Certified. For Immediate Post-Endodontic Restorative Treatment. For better dentistry
The App to seal! Root Canal Seal Cleaning Coronal Seal Endo-Resto System For Immediate Post-Endodontic Restorative Treatment Sealed Safe Certified For better dentistry Endo The Immediate Post-Endodontic
More informationG-Premio BOND. Introducing a premium bonding experience
Introducing a premium bonding experience The world s most clinically successful adhesive is now even better! Introducing G-Premio BOND. G-BOND has proven to be the world s most clinically successful adhesive
More information< 1% shrinkage! * new record: Low Shrink Posterior Restorative. volumetric. The fi rst direct posterior composite to achieve less than 1 % shrinkage.
Filtek Silorane Low Shrink Posterior Restorative The new record: volumetric < 1% shrinkage! * * < 1 % volumetric shrinkage tested by bonded disc method. The fi rst direct posterior composite to achieve
More informationceram.x one Scientific Compendium
For Individual Attention nly 2014-06-19 Draft Version 06 ceram.x one Scientific Compendium 1 Table of contents 1 Introduction... 3 2 Composite Technology... 3 2.1 Traditional Composites... 4 2.2 Nano-Ceramic
More informationBonding to dentine: How it works. The future of restorative dentistry
Bonding to dentine: How it works The future of restorative dentistry There are 82 adhesive systems on the market today! Are dentists confused about bonding? Michael Buonocore Buonocore MG. A simple method
More informationAdper Scotchbond SE. Self-Etch Adhesive. Self-etch technology that s visibly better
Adper Scotchbond SE Self-Etch Adhesive Self-etch technology that s visibly better Radiopacity: be confident in your future diagnosis. One confidence-inspiring feature of Adper Scotchbond SE Self-Etch Adhesive
More informationProduct Information. ibond Self Etch & ibond Total Etch Bonding with confidence. Giving a hand to oral health.
Product Information & Total Etch Bonding with confidence. Giving a hand to oral health. Bonding with confidence. All-round, everyday adhesives. They need to be fast, and must be stable for life. This is
More informationshrink less than 1 %
Filtek Silorane Low Shrink Posterior Restorative System The first composite to shrink less than 1 % Filtek Silorane The first posterior composite to shrink less than 1% 1 Any time you restore a patient
More informationNew Nano-Hybrid Technology for your everyday Use
New Nano-Hybrid Technology for your everyday Use NEW New NANO-HYBRID TECHNOLOGY For Your every Day USE You need a composite that allows you to easily achieve high quality restorations? Polofil NHT, the
More informationetching systems with mixing self-etching Etch & Rinse systems 3-year Water-storage Class-V Dentin Margin Integrity of Adhesives
3-year Water-storage Class-V Dentin Margin Integrity of Adhesives Introduction U. BLUNCK Charité - Universitätsmedizin Berlin Dental School Dept. of Operative Dentistry and Periodontology P. ZASLANSKY
More information***Handout*** Adhesive Dentistry Harald O. Heymann, DDS MEd Dentin Bonding Rewetting/Desensitization
***Handout*** Adhesive Dentistry Harald O. Heymann, DDS MEd Dentin Bonding * Regardless of the type dentinal adhesive used, the primary mechanism for dentin adhesion is still establishment of the hybrid
More informationMarketed in US as: Individual Attention Only
Marketed in US as: Individual Attention Only 2010-03-03 With the compliments of DENTSPLY DETREY GmbH De-Trey-Str. 1 78467 Konstanz GERMANY T +49-7531-583-0 F +49-7531-583-104 www.dentsply.eu Table of contents
More informationshrink less than 1 %
Filtek Silorane Low Shrink Posterior Restorative System The first composite to shrink less than 1 % Filtek Silorane The first posterior composite to shrink less than 1% 1 Any time you restore a patient
More informationSDR has proven reliability in high C-factor cavities 2
R R SDR has proven reliability in high C-factor cavities 2 SDR was introduced by DENTSPLY DETREY, Konstanz, Germany in 200 and has since been used in over 20 million restorations across the globe. SDR
More informationXP BOND IN SELF-CURE MODE USED FOR LUTING PORCELAIN RESTORATIONS:
XP BOND IN SELF-CURE MODE USED FOR LUTING PORCELAIN RESTORATIONS: 2-YEAR RECALL MARCO FERRARI, IVANOVIC CONIGLIO 2, ELISA MAGNI 2, MARIA CRYSANTI CAGIDIACO Abstract Purpose: The aim of this clinical study
More informationA real leader takes you further.
A real leader takes you further. The unmatched SDR bulk fill technology In 2009, SureFil SDR flow material with SDR technology was the first product that allowed 4mm bulk placement in flowable consistency.
More informationXP Bond in Self-Cure Mode Used for Luting Porcelain Restorations: 4-year Recall
RESEARCH ARTICLE XP Bond in Self-Cure Mode Used for Luting Porcelain Restorations: 4-year Recall 1 Marco Ferrari, 2 Maria Crysanti Cagidiaco, 3 Cecilia Goracci, 4 Antonella Polimeni 1 Professor and Chair,
More informationProduct Information. ibond Universal All-purpose convenience. Giving a hand to oral health.
Product Information All-purpose convenience. Giving a hand to oral health. Bonding with confidence. What would you expect from a universal bonding? Durable, reliable bond strength. Convenient and safe
More informationUNIVERSAL ADHESIVE SYSTEM. PEAK UNIVERSAL BOND Light-Cured Adhesive with Chlorhexidine
UNIVERSAL ADHESIVE SYSTEM PEAK UNIVERSAL BOND Light-Cured Adhesive with Chlorhexidine 1 TOTAL-ETCH PEAK UNIVERSAL BOND SELF-ETCH UNIVERSAL BONDING The Peak Universal Adhesive System features a universal
More informationProduct Information. Charisma Diamond Discover the next dimension of natural beauty. Giving a hand to oral health.
Product Information Charisma Diamond Discover the next dimension of natural beauty. Giving a hand to oral health. The new Charisma Diamond Welcome to the next dimension of natural beauty. We commit our
More informationHeraeus Dental Science. ibond Self Etch ibond Total Etch Scientific Compendium. Experts in dialogue.
Heraeus Dental Science ibond Self Etch ibond Total Etch Scientific Compendium Experts in dialogue. Preface Content For more than 25 years, Heraeus Kulzer has been developing and marketing bonding systems:
More informationibond Self Etch Scientific Information
ibond Self Etch 3 25 2 15 1 5 Scientific Information 31956_iBOND_SelfEtch_Scientific.Inform_GB.indd 1 23.2.29 13:49:57 Uhr Preface For more than 25 years, Heraeus Kulzer has been developing and marketing
More informationS CIENTIFIC C OMPENDIUM
S CIENTIFIC C OMPENDIUM (For Individual Attention Only) 2016-09-13 With the compliments of DENTSPLY CAULK 38 West Clarke Avenue Milford, DE 19963 USA Phone +1 302 422 4511 www.caulk.com DENTSPLY DETREY
More informationBulk Fill PERFECTION STRESS DEPTH STATES: The New Esthetics
STRESS REDUCTION DEPTH PERFECTION Venus is the low stress base liner to bulk solution for efficient esthetic posterior restorations. Venus delivers: Self-adaptive handling eliminates steps and provides
More informationProduct Information. GLUMA Desensitizer & GLUMA Desensitizer PowerGel More gain, less pain. Giving a hand to oral health.
Product Information GLUMA Desensitizer & GLUMA Desensitizer PowerGel More gain, less pain. Giving a hand to oral health. GLUMA Desensitizer / GLUMA Desensitizer PowerGel The success story continues. More
More informationScotchbond Universal Adhesive. Technical Product Profi le
Adhesive Technical Product Profi le Table of Contents Product Description... 3 Indications... 4 Composition... 5 6 DCA Dual Cure Activator... 7 Etchant... 7 Summary of Adhesive Unique Chemistry Powered
More informationAdper Scotchbond SE Self-Etch Adhesive. technical product profile. Adper
Adper Scotchbond SE Self-Etch Adhesive technical product profile Adper 2 Table of Contents Introduction................................................................5 Product Description.......................................................5
More informationAdhese Universal The universal adhesive
NEW Adhese The universal adhesive All in one click... Up to 19 times. Self-Etch Selective-Etch Total-Etch Direct Indirect adhesion with advanced delivery Adhese is a single-component, light-cured universal
More informationA real leader takes you further.
A real leader takes you further. 2017 Dentsply Sirona. All rights reserved. The unmatched SDR bulk fill technology In 2009, SureFil SDR flow with SDR technology was the first product that allowed 4mm bulk
More informationSPEED. DURABILITY. PLEASURE. THE WHOLE-IN-ONE POSTERIOR RESTORATIVE
SPEED. DURABILITY. PLEASURE. THE WHOLE-IN-ONE POSTERIOR RESTORATIVE WITHOUT HANDICAP: QUIXFIL CAN YOU FULFIL YOUR PATIENT S EXPECTATIONS? Patients nowadays expect more than a simple restoration, even for
More informationAdperTM FiltekTM EliparTMSof-LexTM
AdperTM FiltekTM EliparTMSof-LexTM 3M ESPE Composite-Navigator An orientation aid for our composite filling therapy 3M ESPE Composite-Navigator To find the right Solution for your Requirement As one of
More informationPress Release. Press Contact. The concept for Class II restoration Delicate preparation, rapid procedure and reliable results
Press Release The concept for Class II restoration Delicate preparation, rapid procedure and reliable results by Dr. Arzu Tuna and Dr. Umut Baysal, Attendorn, Germany Composite restorations have always
More informationCalibra. Cements. The Simple Choice for Easy Cleanup
Calibra Cements The Simple Choice for Easy Cleanup www.calibracement.com The Calibra family of definitive cements was designed to make it easier than ever to achieve consistent, successful results in your
More information3M Scotchbond Universal Adhesive. Technical Product Profile
3M Scotchbond Universal Adhesive 2 3M Scotchbond Universal Adhesive Table of Contents Product Description.... 3 Indications... 4 Composition....5 6 3M Scotchbond Universal DCA Dual Cure Activator....7
More informationDirect composite restorations for large posterior cavities extended range of applications for high-performance materials
Direct composite restorations for large posterior cavities extended range of applications for high-performance materials A case study by Ann-Christin Meier, Dr. med. dent., Stapelfeld, Germany When large
More informationDeveloped to make a difference... every step of the way. CEREC CAD/CAM solutions
CEREC CAD/CAM solutions Developed to make a difference... every step of the way Essential restorative products designed to complement one another to provide a seamless CEREC workflow resulting in optimal
More informationTechnical Product Profile
Adhesive www.3mespe.com Technical Product Profile 3M Deutschland GmbH Location Seefeld 3M ESPE ESPE Platz 82229 Seefeld Germany info3mespe@mmm.com www.3mespe.com 3M, ESPE, Adper, Aplicap, Clinpro, CoJet,
More informationPrime&Bond elect Universal Dental Adhesive. The universal adhesive that s more than strong. NEW! FLIP TOP BOTTLE
Universal Dental Adhesive The universal adhesive that s more than strong. NEW! FLIP TOP BOTTLE NEW! FLIP TOP BOTTLE There s more in this little drop than muscles. A good adhesive is not measured by bond
More informationAvaDent Bonding Procedure Results: The AvaDent bond exceeds ADA requirements.
Tests Summary: AvaDent Bonding Procedure Results: The AvaDent bond exceeds ADA requirements. AvaDent Color Stability Results: AvaDent is more color stable than conventional dentures. AvaDent Acrylic Porosity
More informationClinical relevance of tests on bond strength, microleakage and marginal adaptation
d e n t a l m a t e r i a l s 2 9 ( 2 0 1 3 ) 59 84 Available online at www.sciencedirect.com jo u rn al hom epa ge : www.intl.elsevierhealth.com/journals/dema Clinical relevance of tests on bond strength,
More informationHIGH DEMANDS AND POWER PANAVIA TM F 2.0
HIGH DEMANDS AND POWER PANAVIA TM F 2.0 THE UNIQUE ANAEROBIC-CURING RESIN CEMENT The PANAVIA brand looks upon a scientific and clinical track record of more than 30 years. Being recommended as the universal
More informationvalues is of great interest.
User Report Dr. Ralph Schönemann, May 21, 2008 There are numerous self-etchbonding systems on the market that sometimes differ very much from one another with regards to their chemical composition. It
More informationUniversal light-curing dental adhesive. All the power you need in one drop.
Universal light-curing dental adhesive All the power you need in one drop. ONE COAT BOND: Super Concentrated. One Component. One Step. That s what s so unique about the bond: 100% bond, 0% acetone, 0%
More informationKetac Universal Aplicap
Ketac Universal Aplicap Technical Data Sheet 2 Introduction Ketac Universal Aplicap is the latest development in a long history of proven glass ionomer technology from 3M. It s designed to save steps for
More informationIntroduction to Layering with Filtek Supreme Plus Universal Restorative. Filtek. Supreme Plus Universal Restorative
Introduction to Layering with Filtek Supreme Plus Universal Restorative Filtek Supreme Plus Universal Restorative Introduction to Layering with Filtek Supreme Plus Universal Restorative TM. Multishade
More informationResults:Mean microleakage score of group G1, G2 and G3 was 2.86 ± 1.43, 1.86 ± 1.65 and 2.46 ± 1.50 respectively.
Journal of Oral Health & Community Dentistry original article Comparative Evaluation of Microleakage in Class 2 Cavities Restored with A Nanohybrid Composite Using Three Different Increment Techniques-
More information1. Introduction Technical data In-vitro investigations with Systemp.link Clinical assessment Biocompatibility...
Scientific Documentation Systemp.link Page 2 of 9 Table of Contents 1. Introduction...3 1.1 Temporary restorations... 3 1.2. Temporary luting materials... 3 1.3. Systemp.link... 3 2. Technical data...4
More informationExciTE F L I G H T - C U R I N G T O T A L - E T C H A D H E S I V E. ExciTE F DSC D U A L - C U R I N G T O T A L - E T C H A D H E S I V E
ExciTE F L I G H T - C U R I N G T O T A L - E T C H A D H E S I V E ExciTE F DSC D U A L - C U R I N G T O T A L - E T C H A D H E S I V E Now bonding takes place with light and without light! A strong
More informationAdhesive Solutions. Adper Easy One Self-Etch Adhesive. One for all.
Adhesive Solutions Adper Easy One Self-Etch Adhesive One for all 21 Preferred Products www.dentaladvisor.com One component multiple advantages Adper Easy One Self-Etch Adhesive is a simple one component,
More informationOne solution for all. cavity classes. Tetric Evo product line. Tetric EvoCeram. Tetric EvoFlow. Tetric EvoCeram Bulk Fill Tetric EvoFlow Bulk Fill
One solution for all cavity classes Tetric Evo product line Tetric EvoCeram Tetric EvoFlow Tetric EvoCeram Bulk Fill Tetric EvoFlow Bulk Fill One solution for all cavity classes Posterior region: Class
More informationAdheSE One F Click & Bond with
AdheSE One F Click & Bond with the VivaPen Economical and convenient to use AdheSE Click & Bond High level of convenience AdheSE One F is a self-etching, light-curing, fluoride-releasing, single-component
More informationSummary of in-vivo studies. RelyX. Unicem. Self-Adhesive Universal Resin Cement. Clinical studies
Summary of in-vivo studies RelyX TM Unicem Clinical studies 2003 2006 Table of contents Restorations after 4 years in-vivo................................. 4 Full ceramic inlays and onlays after 12 months
More informationThe Sof-Lex Finishing and Polishing System 3ESPE
The Sof-Lex Finishing and Polishing System 3ESPE 3M ESPE is a recognized leader in dental innovation. Introduced in the mid-1970s, the Sof-Lex Finishing and Polishing System was a revolutionary breakthrough
More informationBehaviour of general dental practitioners in Germany regarding posterior restorations with flowable composites
O R I G I N A L A R T I C L E International Dental Journal 2011; 61: 252 256 doi: 10.1111/j.1875-595X.2011.00068.x Behaviour of general dental practitioners in Germany regarding posterior restorations
More informationnew Variolink Esthetic The esthetic luting composite Amazingly simple esthetics!
new Variolink Esthetic The esthetic luting composite Amazingly simple esthetics! Variolink Esthetic EXCEPTIONAL ESTHETICS Variolink Esthetic is an esthetic light- and dual-curing luting composite for the
More informationUNIVERSAL COMPOMER RESTORATIVE
UNIVERSAL COMPOMER RESTORATIVE 2003-06-16 (Individual Attention Only) With the compliments of Dentsply DeTrey GmbH Clinical Research De-Trey-Str.1 D-78467 Konstanz Phone +49-7531-583-0 Fax +49-7531-583-104
More informationClinical use of Filtek Silorane. Low Shrink Posterior Restorative
Clinical use of Filtek Silorane Low Shrink Posterior Restorative In collaboration with Dr. Gabriel Krastl Department of Periodontology, Endodontics and Cariology at the University of Basel Dental Hospital
More informationPrinciple Investigators: Overview of Study Methods: Dr. John Burgess Dr. Carlos Muñoz
Principle Investigators: Dr. John Burgess Dr. Carlos Muñoz Overview of Study Methods: Subjects in need of Class I and/or Class II restorations were enrolled in two clinical trials conducted in US dental
More informationCERASMART. The new leader in hybrid ceramic blocks
The new leader in hybrid ceramic blocks Introducing, a new force absorbing hybrid ceramic block 20 µm Contains high density of ultra fine homogeneously-dispersed fillers in a highly cross-linked resin
More informationXBW BW A1 A2 A3 A3.5 A4 B1 B2 B3 C3 CV CVD. Outside Translucent Shades DT CT GT NT WT CVT. GRADIA DIRECT Flo & LoFlo - 7 Shades (radiopaque) Standard
GRADIA DIRECT Anterior - No Barium or FAS fillers for ultimate aesthetics and handling (radiolucent) Standard XBW BW A1 A2 A3 A3.5 A4 B1 B2 B3 C3 CV CVD 002275 002050 001988 001989 001990 001991 002042
More informationFiltek. Bulk Fill. Posterior Restorative. One. and done.
Filtek Bulk Fill Posterior Restorative One and done. Introducing Fast and easy One increment up to 5 mm. Excellent handling and sculptability. No expensive dispensing devices or time-consuming layers.
More informationJBR Journal of Interdisciplinary Medicine and Dental Science
ISSN: 2376-032X JBR Journal of Interdisciplinary Medicine and Dental Science Yashpal and Monika, 2014, 2:1 DOI: 104172/2376-032X1000111 JBR Journal of Interdisciplinary Medicine and Dental Science Research
More informationG-COAT PLUS G-COAT PLUS GET THE BEST OF BOTH WORLDS WITH THE STROKE OF A BRUSH
G-COAT PLUS BEAUTY BRAWN GET THE BEST OF BOTH WORLDS WITH THE STROKE OF A BRUSH 1 Introducing a Revolutionary new Coating G-COAT PLUS gives your restorations the Best of Both Worlds: A beautiful new finish
More informationEASY TO REMOVE HARD TO FORGET! PANAVIA SA Cement Plus Automix
EASY TO REMOVE HARD TO FORGET! PANAVIA SA Cement Plus Automix the SMartESt WaY to EnJoY PanaVIa LonGEVItY Easy storage. Easy application. Easy removal of excess cement. The all-new PANAVIA SA Cement Plus
More informationScientific Research Result
Scientific Research Result Introduction Recently an additional breakthrough adhesive has been introduced to the market. As compared to other systems, Tokuyama Bond Force is a 7 th generation single component,
More informationMultilink Automix The adhesive cementation system
Multilink Automix The adhesive cementation system A strong bond, proven performance. Recommended for Multilink Aut Strong hold A wide variety of restorative materials are available today. Due to their
More informationhow to technique How to treat a cracked, but still inact, cusp. Disadvantages. 1 Issue Full coverage crown. >>
Issue 37 2013 How to treat a cracked, but still inact, cusp. 1 Full coverage crown. >> Advantages. A full crown can splint all sections of the tooth together. 1 Disadvantages. 1 Encircles crown and acts
More informationIndividual Attention Only Not for distribution in the U.S (Date of Version)
Individual Attention Only Not for distribution in the U.S. 2015-07-27 (Date of Version) Table of contents 1 Introduction... 4 1.1 Classification of ceram.x... 4 1.2 SphereTEC... 6 1.3 Rheology of ceram.x...
More informationHeraeus Kulzer Adhesives. Adhesive Guide
Heraeus Kulzer Adhesives Adhesive Guide Contents Principles of adhesion Enamel Preparation and conditioning Dentin Conditioning Wettability and surface tension Classification of adhesive systems Classification
More informationesthetics efficiently produced
Natural-looking esthetics efficiently produced Tetric Evo Composites Bulk Fill Bulk Fill 2005 Conventional composites 2007 2011 PATENTED LIG H T Ivocerin INITIAT O R Bulk Fill Bulk-fi ll composites 2015
More information1 Introduction Composite Technology Traditional Composites Nano-Ceramic Technology Material properties...
1 Table of contents 1 Introduction...3 2 Composite Technology...3 2.1 Traditional Composites...4 2.2 Nano-Ceramic Technology...6 3 Material properties...9 3.1 Biocompatibility...9 3.1.1 Cytotoxicity...9
More informationEvaluation the Effect of Different Surface Treatment on Shear Bond Strength between Composite Increments (An in vitro study)
International Journal of Scientific and Research Publications, Volume 7, Issue 11, November 2017 676 Evaluation the Effect of Different Surface Treatment on Shear Bond Strength between Composite Increments
More informationBulk Fill REDUCTION PERFECTION. Bulk Fill Flowable posterior bulk fill composite. Bulk Fill Flowable posterior bulk fill composite STRESS DEPTH
BulkFillBrochure_Sell Sheet 7//1 3: PM Page 1 able posterior bulk fill composite provides dentists with a filling method alternative that saves time and money and allows for easier and more efficient placement,
More informationMetal-Free Restorations PROCEDURES FOR POSTERIOR DIRECT & SEMI-DIRECT COMPOSITE RESTORATIONS D I D I E R D I E T S C H I. For.
PROCEDURES FOR POSTERIOR DIRECT & SEMI-DIRECT COMPOSITE RESTORATIONS Metal-Free Restorations D I D I E R D I E T S C H I The Geneva Smile Center D.M.D, PhD, Privat-Docent 2, Quai Gustave Ador 1207 Geneva
More informationGLUMA Comfort + Desensitizer
GLUMA Comfort + Desensitizer Bond Gebrauchsanweisung... 3 Instructions for use... 11 Mode d emploi... 19 Instrucciones de uso... 27 Istruzioni per l uso... 35 Instruções de uso... 43 Gebruiksaanwijzing...
More informationA Collection of Scientific Results. Adper. Scotchbond 1 XT. Total-Etch-Adhesive
A Collection of Scientific Results Adper Total-Etch-Adhesive Introduction Welcome to Adper! Dear Dental Professional, Adper represents the culmination of years of experience in the area of dental adhesives.
More informationG-CEM LinkAce. The new strength in self-adhesive cement
The new strength in self-adhesive cement is stronger Now offering comparative physical properties to current adhesive resin cements, is the next evolution in easy-to-use, versatile, self-adhesive. Designed
More informationFiltek LS. Low Shrink Posterior Restorative System. Techniques and Results. Clinical Cases
Filtek LS Low Shrink Posterior Restorative System Techniques and Results Clinical Cases What a composite that shrinks less than 1% 1 can mean to your practice. When restoring a tooth, a dentist takes great
More informationFiltek. Any place. Any class. Supreme XTE. It s the one that can do it all. Universal Restorative. Class III. Class IV. Class II. Class I.
Class III Class IV Class II Class I Class V Any place. Any class. It s the one that can do it all. Designed to be versatile. If you re still using one composite for strong posterior fillings, and another
More informationNovember Copyright DENTSPLY International
November 2015 Copyright DENTSPLY International Table of Contents Page 1. Introduction 3 1.1. Background of Dental Restorative Composite 3 1.2. Flowable Resin Composites 3 1.3. Polymerization Shrinkage
More informationAnisotropy of Tensile Strengths of Bovine Dentin Regarding Dentinal Tubule Orientation and Location
Original paper Dental Materials Journal 21 (1): 32-43, 2002 Anisotropy of Tensile Strengths of Bovine Dentin Regarding Dentinal Tubule Orientation and Location Toshiko INOUE, Hidekazu TAKAHASHI and Fumio
More informationClinical report. Drs Paul and Alexandre MIARA and F. CONNOLLY COMPOSITE POSTERIOR FILLINGS. How to control. layering? 8 - Dentoscope n 124
COMPOSITE POSTERIOR FILLINGS How to control layering? 8 - Dentoscope n 124 CV FLASH Dr Paul MIARA Dental surgeon Dr Alexandre MIARA Dental surgeon Dr F. CONNOLLY Dental surgeon Thanks to continuous improvements
More informationAmaris. You want outstanding esthetic restorations with the WOW-EFFECT
The Composite For Simplified Esthetics The Simplified Esthetic Concept You want outstanding esthetic restorations with the WOW-EFFECT You do not have the time to work on a patient for hours You do not
More informationUNIVERSAL DUO-SHADE NANO COMPOSITE BRILLIANT NG. simply natural MADE IN SWITZERLAND
UNIVERSAL DUO-SHADE NANO COMPOSITE BRILLIANT NG simply natural MADE IN SWITZERLAND BRILLIANT NG simply natural Excellent Aesthetics Simple Technique BRILLIANT NG is a universal composite aimed at simplifying
More informationTHE FUTURE DEMANDS THE RIGHT EQUIPMENT CLEARFIL SE BOND 2
THE FUTURE DEMANDS THE RIGHT EQUIPMENT CLEARFIL SE BOND THE GOLD STANDARD MADE FUTURE PROOF It's now a two-step self-etch universal adhesive. NEW! With the new and stronger CLEARFIL SE BOND you can bond
More informationTetric Evo Line. A composite for every indication.
Tetric Evo Line A composite for every indication. The Tetric Evo Line of Composites Efficient, reliable, esthetic A composite for every indication. Uniquely formulated to be used in any combination, the
More informationSyntac. Scientific Documentation
Syntac Scientific Documentation Scientific Documentation Syntac Page 2 of 35 Table of contents 1. Introduction 3 1.1 Mechanics of dental adhesion 3 2. A brief history of adhesives 5 3. Classification of
More informationBond strengths between composite resin and auto cure glass ionomer cement using the co-cure technique
SCIENTIFIC ARTICLE Australian Dental Journal 2006;51:(2):175-179 Bond strengths between composite resin and auto cure glass ionomer cement using the co-cure technique GM Knight,* JM McIntyre,* Mulyani*
More informationPulpal Protection: bases, liners, sealers, caries control Module A: Basic Concepts
Readings: Fundamentals of Operative Dentistry, 3 nd Edition; Summitt, et al Chapters 5, 6 and 8 Pulpal Protection: bases, liners, sealers, caries control Module A: Basic Concepts REST 528A Operative #3A
More informationCementation Solutions. RelyX Ultimate Adhesive Resin Cement. Glass ceramic
Cementation Solutions Resin Cement Glass ceramic Ultimate strength for glass ceramics is an innovative dual cure, adhesive resin cement from 3M ESPE. The cement was developed with the specific needs of
More informationImmediate Dentin Sealing and Cerec How to avoid sensivities 100 pc and how to have lots of practical advantages
Immediate Dentin Sealing and Cerec How to avoid sensivities 100 pc and how to have lots of practical advantages Some abbreviations in this ppt. IDS: Immediate dentin sealing means the application of the
More informationStudy and case compilation
SDR flow+ Bulk Fill Flowable Study and case compilation The SDR bulk-fill technology SDR flow+ is the improved next generation of the leading and still unmatched flowable bulk-fill resin composite SDR.
More informationTHE ONE AND ONLY. CLEARFIL Universal Bond
THE ONE AND ONLY THIS ADHESIVE LETS YOU BOND ALMOST ALL DENTAL MATERIALS Universal. Easy. Reliable. NEW! With the new you can bond various dental materials and select the etch mode of your choice. You
More information