blocs PROCESSING INSTRUCTIONS disc

blocs PROCESSING INSTRUCTIONS disc

Content 1. Material basis... 3 1.1. Measurements... 4 1.2. Properties... 10 2. Technical data / dimensions... 13 3. Indications... 14 4. Shade selection... 15 5. Milling parameters... 16 6. Post-processing... 17 7. Adhesive luting... 18 8. Accessories... 19 8.1. Dimanto... 19 8.2. Ceramic Bond... 19 8.3. Futurabond U... 20 8.4. Bifix QM... 20 9. Advantages at a glance... 21 10. Presentation Grandio blocs / Grandio disc... 21 11. Further support... 22 2

PROCESSING INSTRUCTIONS 1. Material basis Grandio blocs and Grandio disc are based on nanohybrid composite technology. The basis for the expertise in the development of this material originated in the German Federal Ministry of Education and Research (BMBF) Biocompatible materials based on monomer-free nanocomposites for dental restoratives and prosthetics project. The trailblazing findings of this research project resulted in the development of the thoroughly successful nanohybrid composites Grandio and GrandioSO. Material characteristics similar to those of natural tooth substance, such as the dentine-like modulus of elasticity, together with a very high filler content and low shrinkage that s what places Grandio and GrandioSO among the premium composites available on the market. It is exactly these properties which are ideal as a foundation for the development of CAD / CAM materials. The aim of the development was to develop a CAD / CAM material which not only offers outstanding physical properties, but also leaves nothing to be desired by the user in terms of processing. CAD / CAM ceramic restorations are usually the material of choice when it comes to producing high-strength restorations, but ceramic is not always easy to process. A combination of the strength offered by ceramics and the processability of composites would be ideal. And that is exactly what Grandio blocs and Grandio disc offer. Source: Department of Materials for Medical Technology, University of Rostock, 2016 3D tomography visualisation of the homogeneous distribution of fillers in Grandio blocs. 50-nm sections were prepared using the dual beam technique, viewed under a microscope and combined to create a 3D image. The light blue and dark blue regions represent the glass fillers in 3D. They are surrounded by resin and nanoparticles. One of the 50-nm sections is shown here in grey. 2 3

1.1. Measurements Strongest in their class Overall, the study results presented here demonstrate that Grandio blocs / Grandio disc is no ordinary composite this material is also the strongest in its class. At 86 % by weight, our CAD / CAM material boasts the highest filler content among the composite-based blocks and discs. This is achieved through nanotechnology and guarantees outstanding strength and stability. Filler content [% w/w] 100 90 80 70 86 80 71 70,1 60 50 40 30 20 10 0 Grandio blocs / Grandio disc Lava Ultimate Cerasmart Ambarino High Class Source: Manufacturer s specifications Ambarino High Class, Cerasmart and Lava Ultimate are not registered trademarks of VOCO GmbH. 4

PROCESSING INSTRUCTIONS Extraordinary strength In a study conducted by the University of Tübingen into biaxial flexural strength, a value of 333 MPa was recorded for Grandio blocs. This result was far superior to the other composites. With this extraordinary strength and the highest filler content, at 86 % by weight, Grandio blocs is a guarantee for durable restorations. Biaxial flexural strength [MPa] 500 450 400 350 300 250 200 150 100 50 0 Grandio blocs Lava Ultimate Cerasmart Ambarino High Class VITA Enamic IPS e.max CAD Composite Hybrid ceramic Lithium disilicate Source: Two-body Wear Behavior of Nano-hybrid Technology Produced CAD / CAM Composite-resin Blocks C. Lyu, J. Geis-Gerstorfer et al, J Dent Res Vol 96 Spec Iss A: 1002, 2017 Ambarino High Class, Cerasmart, VITA Enamic, IPS e.max CAD and Lava Ultimate are not registered trademarks of VOCO GmbH. 4 5

Antagonist-friendly The two-body wear test shows that Grandio blocs demonstrates similarly low abrasion to lithium disilicate and, in addition, is antagonist-friendly. Two-body wear [μm] 350 300 Abrasion of specimen Abrasion of antagonist Abrasion overall 250 200 150 100 50 0 Grandio blocs Lava Ultimate Cerasmart Ambarino High Class VITA Enamic IPS e.max CAD Composite Hybrid ceramic Lithium disilicate Source: Two-body Wear Behavior of Nano-hybrid Technology Produced CAD / CAM Composite-resin Blocks C. Lyu, J. Geis-Gerstorfer et al, J Dent Res Vol 96 Spec Iss A: 1002, 2017 Ambarino High Class, Cerasmart, VITA Enamic, IPS e.max CAD and Lava Ultimate are not registered trademarks of VOCO GmbH. 6

PROCESSING INSTRUCTIONS Similar to natural tooth substance The modulus of elasticity is a measure of the resistance that a material exerts against its deformation. In the best case scenario, it should be the same as that of natural tooth substance. Grandio blocs also achieves this with ease, and thus offers not only extremely high strength, but also the similarity to natural tooth substance desired by practitioners. Modulus of elasticity [GPa] 30 25 20 15 10 5 0 Grandio blocs Lava Ultimate Cerasmart Ambarino High Class Brilliant Crios VITA Enamic Composite Lithium disilicate Source: Spintzyk, S.; Geis-Gerstorfer, J. et al, 4th EuroBioMat, Weimar, 2017 Ambarino High Class, Cerasmart, Coltene Brilliant Crios, VITA Enamic, IPS e.max CAD and Lava Ultimate are not registered trademarks of VOCO GmbH. 6 7

Like most materials, composites expand when heated and contract when they cool again. This behaviour is also true of human teeth. Teeth and restoratives expand when we consume hot food and drinks. If the expansion of the restoration (crown) is greater than that of the tooth itself, a tensile force develops at the adhesive bond. The study conducted by Wolter et al. revealed that Grandio blocs comes closer than any other composite to the values recorded for natural tooth substance (cf. Xu et al., 1989). Coefficient of thermal expansion [10-6 /K] 40 35 Enamel Dentine 30 25 20 15 10 5 0 Grandio blocs Lava Ultimate Cerasmart Ambarino High Class VITA Enamic Composite Hybrid ceramic Source: H. Wolter et al., Fraunhofer ISC Würzburg, report to VOCO, 2016 Ambarino High Class, Cerasmart, VITA Enamic and Lava Ultimate are not registered trademarks of VOCO GmbH. 8

PROCESSING INSTRUCTIONS Compared to other CAD / CAM materials Grandio blocs has an extremely low water absorption, which stands for a higher quality of the restoration and as well for an increased longevity. The water absorption represents an important indicator for the later attachment of a material. The higher it is, the greater the risk of decementation. Water absorption [µg/mm 3 ] 40 35 30 25 20 15 10 5 0 Grandio blocs Lava Ultimate Cerasmart VITA Enamic Brilliant Crios Ambarino High Class Source: as per ISO 4049, VOCO, 2017 8 9

1.2. Properties Alongside its outstanding physical values, Grandio blocs and Grandio disc also offer a whole range of additional advantages, which makes these materials the genuine alternative to ceramics: The use of composite materials makes it possible to mill even thinly tapering edges precisely and without the risk of chipping or breakages. This means precision-fit restorations that are also easy to polish inside the mouth or outside. Grandio blocs and Grandio disc come in monolithic shades and can be customised just like ceramics. For this, the low-viscosity material GrandioSO Flow and the high-viscosity material GrandioSO Heavy Flow or GrandioSO composite are particularly suitable, as they permit exact shade matching. FinalTouch can then be used to add particular accents such as fissures and white spots as well as other effects found in natural teeth. Lava Ultimate VITA Enamic IPS e.max CAD Grandio blocs GrandioSO shade spectrum Source: Internal pictures, veneer 0.6 mm Yet another advantage is that there is no need for the firing process required when using ceramics. As Grandio blocs / Grandio disc is a completely polymerised composite, it can be further processed immediately after the milling procedure. This time saving enables you to offer your patients a complete restoration in just one session. FinalTouch shade spectrum Source: Dr. Maurício Watanabe, Brazil VITA Enamic, IPS e.max CAD and Lava Ultimate are not registered trademarks of VOCO GmbH. 10

PROCESSING INSTRUCTIONS Whilst chips in ceramic restorations require extensive treatment, any defects in composite restorations can be repaired quickly and easily. This is done by roughening the surface of the defect, applying the bonding agent and then correcting the situation with a composite. Roughening of the defect Application of bonding agent Light-curing Application of flowable composite Light-curing Result Clinical case 1 Initial clinical situation Core preparation Crown directly after milling Finally prepared restorations Inserted restorations Final result Source: Dr. Felipe Moura, Brazil 10 11

Clinical case 2 Initial situation teeth 36 and 37 Tooth 37 showing core preparation, tooth 36 with cavity awaiting inlay Blocks in clamp Restoration after completion of milling Luted restorations FinalTouch is used to individualise the fissures Source: Dr. Jongki Hadi, Indonesia Clinical case 3 Initial situation tooth 26 Individualized crown on model Fixed crown Final result Source: Alvaro Ferrando, Visiting professor master aesthetic dentistry and minimally invasive rehabilitation, University Valencia, Spain Clinical case 4 Initial situation tooth 16 Occlusal view of the individualized overlay Buccal view Overlay on model Final result Source: Alvaro Ferrando, Visiting professor master aesthetic dentistry and minimally invasive rehabilitation, Manuel Minguez, dental technician, University Valencia, Spain 12

PROCESSING INSTRUCTIONS 2. Technical data / dimensions Grandio blocs / disc Biaxial flexural strength 333 MPa University of Tübingen Vickers hardness [HV] 154.6 University of Tübingen Two-body wear (specimen) 59.9 µm University of Tübingen Two-body wear (antagonist) 98.1 µm University of Tübingen Filler content 86 % w/w DIN 51081 Coefficient of thermal expansion 16.0 10-6 K -1 ISC Würzburg Compressive strength 530 MPa As per ISO 9917 Modulus of elasticity 18.28 GPa Water absorption 13.6 µg/mm 3 As per ISO 4049 Water solubility < 0.1 µg/mm 3 As per ISO 4049 Radiopacity 308 %Al As per ISO 4049 Grandio blocs is available in two sizes Grandio disc 12 for small restorations such as inlays 10.5 mm 12.5 mm 98.4 mm 94 mm 16 mm 10 mm 15 mm 10.4 mm 12.4 mm 14L for larger restorations such as crowns 14.8 mm 18 mm 14.5 mm 14.5 mm 12 13

3. Indications Crowns, inlays, onlays, veneers Implant-retained crowns Minimum wall thickness for restorations Inlay Veneer 4-6 1,5 1,5 0,4 0,4 0,5 0,5 0,5 1,5 Onlay 4-6 Cement space: 70 μm (± 10 μm) 1,5 1,5 1,5 Crown 1,5 1,5 0,8 0,8 0,8 4-6 1,5 14

PROCESSING INSTRUCTIONS 4. Shade selection Use the VITA shade system (e.g., GrandioSO shade guide) to determine the shade against the cleaned but unprepared tooth prior to anaesthesia and preferably in daylight conditions. Two grades of translucency for optimal aesthetics LT ideal for the anterior region in the shades A1, A2, A3, A3.5, B1, C2, BL (available as disc) by applying, for example, GrandioSO Flow in the adhesive technique. Grandio blocs, with its range of available shades and resulting possibilities for individual solutions, is ideal for chairside use, offering the user maximum simplicity regarding shade selection HT ideal for the posterior region in the shades A1, A2, A3, A3.5 (available as disc) 11 shades ensure that your patient always receives the restoration which suits him or her best. LT HT As a general rule of thumb, the choice of colour tone for the final result, i.e., the luted restorations, depends on a number of factors: Colour of the core Layer thickness of the restoration Colour and translucency of the restorative Colour of the luting material Special shades or effects for composite blocks are easy to create using a flowable material. After milling, parts of the restoration are abraded with a grinding tool, then rebuilt 14 15

5. Milling parameters Select the correct block size for the planned restoration as well as the milling parameters for Grandio blocs / Grandio disc or for composites. When doing so, pay attention to the software settings of the respective CAD / CAM systems. If the block sizes and milling parameters are not already available in the CAD / CAM systems software settings, they will need to be added before you proceed. Please contact the CAD / CAM system provider for assistance. The operating instructions from the manufacturers must be observed and followed. For the processing of Grandio blocs / Grandio disc the use of diamond tools is recommended. Grandio blocs is equipped with a universal pin, which can be processed with all conventionally available milling units. Grandio disc has a diameter of 98,4 mm and is suitable for universal disc holder. Examples of compatible systems for Grandio blocs / Grandio disc 16

PROCESSING INSTRUCTIONS 6. Post-processing CAD / CAM Grandio blocs / Grandio disc is an already completely cured composite and must not be fired. For an optimal bond, blast the luting surface of the restoration with aluminium oxide (25 μm - 50 μm) at 1.5 bar - 2 bar. Use a suction device to prevent the accumulation of dust. Note: Do not etch with hydrofluoric acid or phosphoric acid! Clean the pretreated restoration using an ultrasonic bath or steam cleaner and then dry with oil-free air. Final disinfection with medical alcohol is possible. 16 17

7. Adhesive luting Treat the luting surface of the restoration with a silane coupling agent such as Ceramic Bond. Apply Ceramic Bond to the inside of the work and allow it to work for 60 seconds. Then dry for 5 seconds with oil-free air. In this case, the light output of the curing light used must not be lower than 1,000 mw/cm 2, as the polymerisation must penetrate the entire wall thickness of the restoration. 60 sec. 5 sec. 150-210 sec. 5 sec. 180 sec. Grandio blocs / Grandio disc must be luted with a composite-based, adhesive luting agent. VOCO recommends the dual-curing luting system Bifix QM in combination with the silane Ceramic Bond for an optimal bond to the restoration and a suitable dentine-enamel bond (Futurabond U) for the dental hard tissue. Alternatively, it is also possible to use a purely light-cured, flowable composite / ORMOCER (e.g., GrandioSO Flow or Admira Fusion Flow) if the restoration has thin walls ( 2 mm). 18

PROCESSING INSTRUCTIONS 8. Accessories 8.1. Dimanto One-step diamond polisher for pre- and high-gloss polishing of composites Presentation REF 2380 REF 2381 REF 2382 REF 2383 REF 2384 REF 2385 Set 5 pcs. mixed (one each of small point, large point, small cup, large cup, lens) Small point, 10 pcs. Large point, 10 pcs. Small cup, 10 pcs. Large cup, 10 pcs. Lens, 10 pcs. 8.2. Ceramic Bond Silane bonding agent for optimal chemical bond. Surface silanisation of restorations creates optimal conditions for a permanent bond between the restoration and luting material. Presentation REF 1106 Bottle 5 ml 18 19

8.3. Futurabond U The universal adhesive for all cases Applied in one layer total working time of just 35 seconds Self-etch, selective-etch or total-etch free choice for the practitioner Outstanding adhesion compared to other universal, self or total-etch adhesives Outstanding versatility of application for direct or indirect restorations fully compatible with all light-curing, dual-curing or self-curing methacrylate-based composites without additional activator for dual-curing secure adhesion to various materials such as metal, zirconium dioxide or aluminium oxide as well as silicate ceramics without additional primer treatment of hypersensitive tooth necks protective varnish for glass ionomer cement fillings, etc. Moisture-tolerant Refrigeration not necessary Presentation REF 1571 REF 1572 REF 1574 SingleDose 50 pcs., accessories SingleDose 200 pcs., accessories SingleDose trial pack (SingleDose 20 pcs., Vococid gel syringe 2 ml, accessories) 8.4. Bifix QM Dual-curing, universal composite-based luting system Presentation Suitable for all materials (metals, composite inlays and ceramics, even zirconium dioxide) Bubble-free perfect mixing Direct application Excellent adhesion to dentine, enamel and metal REF 1217 REF 1218 REF 1219 REF 1759 Set QuickMix syringe 10 g U (universal), Futurabond DC bottle 4 ml each of liquid 1 and 2, Ceramic Bond bottle 5 ml, accessories QuickMix syringe 10 g universal, accessories QuickMix syringe 10 g transparent, accessories QuickMix syringe 10 g white-opaque, accessories Radiopacity Available in three shades 20

PROCESSING INSTRUCTIONS 9. Advantages at a glance Highest filler content (86 % w/w) Can be processed using any conventional milling unit Resembles natural teeth perfectly Can be polished and repaired optimally Excellent physical values for flexural strength and abrasion Ideal for milling even in cases with thin edges No firing required Based on the nano-hybrid technology 10. Presentation Grandio blocs / Grandio disc Presentation Grandio blocs REF 6000 Set blocks 2 No. 12 (A2 LT, A3 HT), 3 No. 14L (A3 LT, A3 HT, A3.5 LT), Bifix QM QuickMix syringe 10 g universal, Futurabond U SingleDose 5 pcs., Ceramic Bond bottle 5 ml, Dimanto set, accessories Low translucent (LT) 5 No. 12 5 No. 14L A1 LT REF 6003 REF 6018 A2 LT REF 6004 REF 6019 A3 LT REF 6005 REF 6020 A3.5 LT REF 6006 REF 6021 B1 LT REF 6007 REF 6022 C2 LT REF 6008 REF 6023 BL LT REF 6009 REF 6024 High translucent (HT) 5 No. 12 5 No. 14L A1 HT REF 6012 REF 6027 A2 HT REF 6013 REF 6028 A3 HT REF 6014 REF 6029 A3.5 HT REF 6015 REF 6030 Shade 5 No. 12 5 No. 14L Mixed* REF 6033 REF 6034 *(1 each of A1 LT, B1 LT, C2 LT, BL LT, A1 HT) Presentation Grandio disc Low translucent (LT) A1 LT A2 LT A3 LT A3.5 LT High translucent (HT) A1 HT A2 HT A3 HT A3.5 HT 1 15 mm, ø 98.4 mm REF 6050 REF 6051 REF 6052 REF 6053 1 15 mm, ø 98.4 mm REF 6057 REF 6058 REF 6059 REF 6060 20 21

10. Further support Should you have any further questions on the composite CAD / CAM materials, please do not hesitate to contact your local VOCO dental consultant or our customer service department on Freecall: 00 800 44 444 555 22

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VOCO GmbH Anton-Flettner-Straße 1-3 27472 Cuxhaven Germany Freecall: 00 800 44 444 555 Fax: +49 (0) 4721-719-140 info@voco.com www.voco.dental VC 84 006003 GB 0518 V