Ketac

MAGAZINE
March
2004
No. 4
Year 2
An Innovative Magazine for Dentists from 3M ESPE
Editorial
Dear Readers,
To enable the successful treatment of
patients in the long-term, many factors in
dentistry must come together: the patient’s
acceptance of responsibility and readiness
to comply; the dentist’s medical expertise,
empathy, diagnostic skill and willingness to
undertake further training. These must be
rounded off by a high degree of technical
understanding, dexterity and a sound
knowledge of materials on the part of the
dentist and – in prosthetics – the dental
technician. A further important success factor is high quality materials: materials that
are durable, reliable and safe – a challenge
for the manufacturer in the dental industry.
3M ESPE offers its customers a unique
range of top quality materials, and material
systems that complement each other, for the
entire spectrum of restorative and preventative dentistry.
The dentist can often choose from various
alternatives in this range depending upon
the preferred method of treatment: from
prep to crown, material systems for dental
professionals. You can find out more in the
coming issues of the Espertise magazine.
Enjoy reading!
Contents
Editorial & Contents
™
Ketac Molar Easymix Glass Ionomer Restorative
1
2
The Name Says it All
Lava™ Crowns and Bridges:
4
Zirconium Oxide Ceramic for Beautiful Crowns and Bridges
Elipar™ FreeLight 2 LED Curing Light:
6
LED Technology in the Focus of Science
Position™ Penta™ VPS Preliminary Impression Material:
8
Special Dental Care with 3M ESPE for a Hockey Team
Gerhard Kultermann, Editor
3M ESPE, Seefeld, Germany
Filtek™ Supreme Universal Composite:
9
Supreme Results in Reconstruction
From Prep to Crown:
10
Dental Materials in the Daily Practice
Lava™ Crowns and Bridges:
12
Summary of the International All-Ceramic Symposium 2003
Fostering Young Talent:
14
First European Dental Talent Award
Dental Practice Forum:
15
Put a Stop to the Flood of Paper …
General Information
16
Product Information
Ketac™ Molar Easymix Glass Ionomer Restorative
™
The Name Says it All – Ketac Molar Easymix
Sybille Frank, Andreas Syrek, Roland Richter; 3M ESPE, Germany
The beginning of 2004 will see the
arrival of the latest member of the
Ketac Molar family: Ketac Molar
Easymix. Ketac Molar Easymix
excels through its quick and
simple mixing characteristics. The
innovative powder technology that
makes this possible is drawn from
the findings made during the
development of Ketac Cem µ, where
the wettability of the powder by the
liquid has been significantly
enhanced. Ketac Molar Easymix is
the next logical technological step.
The product class known as “conventional glass ionomers” boasts a long
and impressive history at 3M ESPE.
As far back as the early 80s pioneering products like Ketac™ Cem and the
restorative material Ketac™ Fil were
introduced. The development of Ketac
Molar in the 90s marked the expansion of the scope of application of traditional 3M ESPE glass ionomers to
the molar region. Numerous studies
have verified the reliability of Ketac
Molar as a permanent restorative
material in Class I cavities. Ketac
Molar is tried and tested both in highly professional everyday work in western dental surgeries and also as a
restorative material in the so-called
A.R.T.
technique
(Atraumatic
Restorative Treatment). In a clinical
study in China excellent results were
recorded at the 5-year recall [1]. 294
ART restorations (small and large
Class I restorations) as well as 191
cases of fissure sealing with Ketac
Molar were examined. After 5 years
the survival rate for small Class I
restorations (restorations smaller than
50% of the occlusal surface) was
83%. (figure 1)
2
100
80
60
small Class I
40
20
0
1st year
3rd year
5th year
In order to obtain these “Easymix”
properties, the surface of the glass
ionomer powder is modified in a
process developed at 3M ESPE specifically for the purpose of processing the
primary fillers of the Ketac Molar
Easymix powder into granules. Figure
2 shows scanning electron microscope
images at 1000x magnification of such
a granule in contrast to conventional
powder.
Internal Data © 3M ESPE
Fi. 1: Survival/retention rate in %.
ART clinical trial in China
Building on this successful tradition,
Ketac Molar Easymix is following in
the footsteps of its predecessor, Ketac
Molar. In addition to the proven beneficial properties of products from the
Ketac Molar family, Ketac Molar
Easymix stands out because of its considerably improved mixing.
Fig. 2:
The granules consist of agglomerates of
individual fillers which are bonded to
each other using a granulating medium.
The special structure of the granules
used in Ketac Molar Easymix improved
the wettability of the powder by the
liquid. In the following images (Figure
3) this effect is shown clearly by the
different contact angles between the
powder and the drop of liquid; while a
drop of mixing liquid is repelled by the
conventional powder, it is almost com-
SEM photographs, 1.5kV, 1000x magnification.
Conventional GI powder (left), Ketac Molar Easymix powder (right)
MAGAZINE
(see Figure 5). This property is essential to ensure reliable and reproducible
dispensing of the powder.
1,4
Ketac Molar Easymix powder
1,2
traditional GI powder
increase in mass [g]
1
0,8
0,6
0,4
0,2
0
0
10
20
30
40
50
60
70
80
90
100
time of absorption [s]
To sum up, glass ionomers are now
more relevant than ever before! Ketac
Molar Easymix combines simple and
quick mixing with the advantages of
the tried and tested Ketac Molar family:
• Long-term clinical
experience
Figure 4: Absorbency measurement with the
Krüss Processor Tensiometer K12
• Excellent mechanical
properties
• Fluoride release
Ketac Molar Easymix was globally • Self-adhesion to enamel and
tested and assessed by approx. 100
dentine
Internal Data © 3M ESPE
Figure 3: Wetting of the GI powder by a drop
of appropriate mixing liquid.
Conventional GI powder (upper), Ketac Molar
Easymix powder (lower)
pletely absorbed by the granulated
Ketac Molar Easymix powder.
The absorbency of the Ketac Molar
Easymix powder can even be measured
using a simple apparatus. To do so, the
powder is brought in contact with the
liquid in a controlled manner. The capacity of the powder to absorb liquid is
registered as an increase in mass. As can
be seen in Figure 4, Ketac Molar
Easymix powder stands out from conventional glass ionomer powder due to a
considerably higher absorbency. In practice, the increased absorbency of the
Ketac Easymix powder means the restorative material is much easier to mix.
dentists. For this, a total of 1809
restorations were carried out with
Ketac Molar Easymix over a period of
6 weeks. Almost 80% of the dentists
assessed the mixing properties of
Ketac Molar Easymix as better
(favourable) compared to their preferred restorative glass ionomer
(hand-mix version).
[1] C. Holmgren, E. Lo, D. Hu, H. Wan: ART
restorations and sealants in Chinese schoolchildren – five-year-results. IADR 2002
#0959)
Furthermore, it was determined that
the powder has a lower tendency to
produce dust due to granulation. This
means it is more hygiene in the dental
surgery. The powder is also distinguished by its excellent flowability
Figure 5: GI powder after dispensing. Conventional powder ( left) tends to compact,
Ketac Molar Easymix powder (right) forms a loose cone-shaped pile
3
March
2004
No. 4
Year 2
User Report
Lava™ Crowns and Bridges
Zirconium Oxide Ceramic for Beautiful Crowns and Bridges*
Andree Piwowarczyk, Peter Ottl, Timo Kuretzky, Hans-Christoph Lauer, Germany
Clinical procedure
Introduction
The Lava™ system enables the fabrication of crowns and bridges from
high-strength tetragonal, polycrystalline zirconium oxide ceramic (YTZP) which has been partially stabilised with yttrium oxide. This substance has been introduced with
great success into restorative dentistry over the last few years. The
Lava frameworks, which are processed in the green state and subsequently sintered until dense, offer
outstanding mechanical and optical
properties (good flexural strength,
good fracture toughness, subcritical
crack growth and good translucency) as well as a precision fit. What is
particularly special about the Lava
system is that the frameworks can
be coloured in several different
shades. Together with the veneer
(Lava™ Ceram) which has been specially developed for the zirconium
oxide framework ceramic (Lava™
Frame), highly aesthetic fixed
restorations can be created. This
article is a continuation of our first
contribution in the Espertise magazine in September 2003 and
describes the clinical procedure
with Lava on the basis of a second
case.
4
A patient whose tooth 35 had been
endodontically treated, underwent permanent restoration of the third quadrant after the obligatory waiting period. The prosthetic restoration was to
be carried out with an all-ceramic
posterior bridge from zirconium oxide
(Lava, 3M ESPE) on teeth 35 and 37
and a ceramic inlay (IPS Empress,
Ivoclar Vivadent) on tooth 34 (Fig.
14).
Fig. 15: Exact detail reproduction of the prepared teeth 34 and 35 following the one-step
tray wash technique (Impregum™ Duosoft,
3M ESPE)
Fig. 16: Basal view of the milled Lava bridge
framework made of zirconium oxide
Fig. 14: Initial situation with an insufficient
filling in tooth 34 and long-term temporary
work on the abutment teeth 35 and 37
On removal of the long-term temporary work, the preparation margins
were contoured in the form of a chamfer for the all-ceramic bridge, and the
preparation for the ceramic inlay was
carried out. Impressions were taken
with the one-step tray wash technique
using polyether materials (Fig. 15).
Fig. 17: Examination of the bridge framework
on the saw-cut model. On tooth 34 the preparation for the mounting of a three-surface
pressable ceramic restoration can be seen
MAGAZINE
(Part II)
Following arbitrary hinge axis transfer, the models of the lower and upper
jaw were mounted in a partially
adjustable articulator. After generation
of the Lava bridge framework with
connectors of 9 mm2 each (Fig. 16),
the passive fit of the framework and
marginal integrity on the master cast
(Fig. 17) and in the patient's mouth
were examined. The fit of the restoration was excellent. The veneering of
the zirconium oxide framework was
performed using the veneering ceramic Lava Ceram which was developed
for the framework ceramic Lava
Frame (Fig. 19).
Fig. 19: Layered incisal material of the
veneering ceramic LavaCeram on the
frameworkFig. 4: Insertion of all-ceramic post
abutments and chamfering the former preparation margin
The finished veneered bridge (Fig.
20) was fixed in the conventional
manner using glass ionomer cement
(Ketac™ Cem; 3M ESPE, Seefeld).
Figure 21 shows the finished restoration cemented in the patient's mouth
and the outstanding aesthetics which
can be achieved with the Lava system.
Discussion and conclusions
Fig. 20: Completed work on the saw-cut model
The clinical experience described here
is proof that the Lava system, using
CAD/CAM technology, facilitates the
fabrication of individually produced,
high-strength posterior bridges from
densely sintered zirconium oxide partially stabilised with yttrium oxide.
The high strength of Lava zirconium
oxide ceramic permits the fabrication
of substructures with an average
coping thickness of only 0.5 mm and
therefore favours minimally invasive
preparations. Consequently, thanks to
the improved mechanics and aesthetics offered by Lava technology a
highly invasive procedure with significant substance abrasion is not necessary. At present the Lava system
enables restoration using highly aesthetic all-ceramic crowns and interlocked crowns as well as three- and
four-unit bridge restorations in the
anterior and posterior regions.
* Abridged reprint with kind authorization by Quintessenz Verlag.
Fig. 21: Lava bridge (3M ESPE, Seefeld) on
the abutment teeth 35 and 37 and IPS
Empress Inlay (Ivoclar Vivadent, Schaan,
Liechtenstein) on tooth 34 following permanent cementation
5
March
2004
No. 4
Year 2
Ask the Expert
Elipar™ FreeLight 2 LED Curing Light
LED Technology in the Focus of Science
Martin Hartung; 3M ESPE, Germany
High power LED
treatment intervals thanks to the high
thermal conductivity of the specially
finished aluminium housing. This
innovative thermal management of the
unit means that the Elipar Freelight 2
does not need a fan or ventilation slits.
What difference does light
from halogen and LED units
make in polymerization?
Heat sink
Efficient coupling optics
incorporating 3M visible
mirror film
What differentiates
Elipar FreeLight 2 from
other LED units?
Apart from the high standard of quality, the ease and convenience of handling and the attractive design, the
important innovation is its high irradiance of 1000 mW/cm2. This enables
curing times to be halved compared
with standard polymerization units
without compromising the result.
Crucial to the performance of the
Elipar FreeLight 2 is the efficiency of
its collecting optics and also the electronic control. The LED used in the
Elipar Freelight 2 is now also used as
a radiation source by other manufacturers. However this is not an automatic guarantee of high output. Only a
few units on the market come close to
the standard of the Elipar FreeLight 2
in this regard, but some have a considerably larger handpiece and a fan.
In the Elipar Freelight 2 the heat produced by the LED is absorbed by a
heat sink integrated into the handpiece. This stores the heat and then
releases it into the ambient air during
6
The general rule is that a certain light
dose is necessary to fully cure a layer
of restorative material of, let’s say,
2 mm. This dose is the intensity of the
polymerization lamp multiplied by the
curing time. If you double the intensity the curing time halves. This hypothesis has been proven by a large number of studies and is known as the
“Total Energy Concept”. To compare
halogen and LED units, however, the
spectral distribution, that is the wavelengths range at which the light is
radiated, must also be taken into con-
sideration, as is illustrated by the
graphs.
The “Total Energy Concept” is only
valid when it is correctly applied. That
is when the differing spectral efficiency of various units are also taken into
consideration. Even though these
latest scientific findings, backed up
by numerous investigations carried
out by leading universities, have not
been taken on board by all manufacturers, the potential of LED units to
deliver more effective polymerization
is receiving more and more acceptance.
Are there materials which
cannot be cured with
Elipar FreeLight 2?
The vast majority of commercially
available products contain camphorquinone and are compatible with
Elipar FreeLight 2. The few remaining
Internal Data © 3M ESPE
By overlaying the spectral distribution of a polymerization lamp (pale blue areas) with the
absorption of the camphorquinone photoinitiator (yellow), we can see the effective spectrum
(dark blue), which represents the proportion of light that can actually be used for polymerization. With LED units this is almost 90%; in the case of halogen units, in contrast, between 50
and 60%. Halogen units thus require significantly higher absolute light intensities than LED
units in order to achieve the same polymerization result.
MAGAZINE
Inside view of Elipar™ FreeLight 2 LED Curing Light
Thermomanagement through heat
sink and aluminium housing
High efficient
optical set-up
Control circuit
materials use other photoinitiators,
which are outside the narrow LED
spectrum between 430 and 480 nm.
These cannot be cured with any of the
standard LED units. When purchasing
an LED unit it is vital that you check,
using the compatibility list accompanying the 3M ESPE LED units,
whether such materials are used in
your practice. In relation to this, however, a definite trend towards camphorquinone can be observed. More
and more manufacturers, in particular
when they themselves are developing
an LED unit or when they do not wish
to exclude their materials from this
forward-looking technology, are completely converting their light-cured
products to camphorquinone.
Is it true that there are some
LED units on the market
which cover a larger
wavelength range and can thus
cure materials which are not
compatible with the
Elipar FreeLight 2?
Despite claims by some manufacturers to the contrary this is mostly not
the case. The basis for such claims is
that the LEDs used have a certain distribution (typical of their electronic
components) in their peak emission
wavelength. This can be between 450
and 470 nm. However the entire spectrum, and not just the peak, contributes to polymerization. This effect
is insignificant for the activation of
NiMH battery
camphorquinone with its relatively
wide absorption band, but may not be
for the shorter-wave photoinitiators,
which are absorbed below 440 nm.
The individual LED used in the light
is now important, meaning that a
FreeLight 2 handpiece may be able to
cure a material which is actually categorised as incompatible, while a different unit cannot. We have therefore
decided, as a rule, only to designate
materials which can be cured with
each of the incorporated LEDs as
compatible.
light unit, namely short-term operation for a few minutes at high currents. This is not so, for example, with
mobile telephones, where energy is
continuously drawn off over hours and
days, but at much lower currents. Only
here lithium ion batteries are actually
superior.
Why is an NiMH battery still
used in Elipar FreeLight 2?
Is there no memory effect?
No, the nickel metal hydride (NiMH)
battery together with the patented
charging process is designed to assure
reliable operation for many years. The
feared memory effect, which leads to
the premature ageing of batteries if
they are not completely discharged
when placed in the recharger is a
characteristic of nickel cadmium
(NiCd) batteries. Other technologies,
especially those using lithium ions,
hold great potential for the future. At
the moment, however, the Elipar
FreeLight 2 battery concept is right up
with the state-of-the-art. This is mainly due to the specific demands of a
Dr. Martin Hartung
Born in 1966. Study of Physics at the
Technical University of Munich. PhD in semiConductor Physics 1997.
Since 1998 responsible for the development of
light curing devices at 3M ESPE.
7
March
2004
No. 4
Year 2
Clinical Case Report
Position™ Penta™ Vinyl Polysiloxane Preliminary Impression Material
Special Dental Care with 3M ESPE for a Hockey Team
Tim Meijer; Dentist, The Netherlands
This year we chose for a new concept;
the imprints were made with Position
Penta Quick VPS imprint material,
which was mixed with the Pentamix™ 2
automatic mixing unit. Also new this
year was the Position™ Tray, a disposable impression tray. All these materials were given to us by 3M ESPE.
Position gum shields for the
hockey players of A.M.H.C.
For many years gum shields are
made for the players of the
Alkmaarse hockey club. At the start
of each new season everybody can
get a custom-made gum shield. An
imprint is made of the maxilla
(upper jaw), which will be cast in a
mold at the lab. On this the shield
will be manufactured.
The dentists chose this procedure
because a lot of children, who bought
a common gum shield in the sport
store, put their gum shield in their
pocket instead of in their mouth. A
good fit, “position”, increases the
comfort and will decrease the chance
of dental trauma. The last couple of
years the imprints were made with
alginate, which left a huge mess in the
dressing room after more than 100
imprints.
8
Some big advantages were a good
constant mixing without air-bubbles
and Position is almost tasteless, which
leads to less drooling of the children
during hardening. The tray fitted perfectly in almost every mouth. This
year we made up to 150 impressions
within three hours, there were only
two dentists and one assistant. The
other years it took much longer and
we would leave the dressing room
exhausted and covered with alginate.
This year the atmosphere was
‘relaxed’. The gum shields where
given to us for only the costs of material, therefore an extra word of gratitude to 3M ESPE. I can recommend
everybody to use the combination of
these three 3M ESPE products in their
daily practice. I would like to end this
report with the one-liner:
Filling up to 150 within three hours with
Pentamix™ 2
“Better guard position with Position
Penta Quick”
No dust, no taste – Position™ Penta™ VPS
Clinical Case Report
MAGAZINE
Filtek™ Supreme Universal Composite
Supreme Results in Reconstruction
Karl-Heinz Kunzelmann; Germany
This is a case of so-called incisormolar hypomineralisation, in which
the first molars have also been
affected. The cause is unclear.
Fig. 3:
The dentine bonding agent is polymerised. Checking application of the
dentine bonding agent: the entire surface should have a shiny appearance.
Fig. 1: Initial view 13.
Fig. 2:
Individual shade determination is
achieved by applying and curing small
quantities of composite on the tooth
surface
The discoloration is localised in the
pores of the outer enamel layer.
Minimal preparation produces a clear
improvement in colour, and at the
same time the enamel surface is made
more reactive to the dentine adhesive.
As a canine is subject to high mechanical forces, and also because the
degree of mineralisation of the tooth
is unclear, conventional etching with
phosphoric acid is performed for 30
seconds.
Fig. 5:
The restoration is then completed
with body shade. Enamel shade is not
used as the contralateral canine does
not display any pronounced translucency effects. The restoration is contoured using finishing diamonds. The
incisal shape is formed after removal
of the rubber dam, checking both
occlusion and articulation.
Fig. 4:
The palatal wall is built up with a dentine shade whose high degree of
opacity is designed to prevent the
restoration from appearing grey
against the background of the dark
oral cavity.
To mask the dark dentine sections, an
additional layer of dentine shade is
placed in the shell of the dentine composite and cured.
Fig. 6 and 7:
Final result after removal of the rubber dam. The teeth are lighter because
they have dried out, and the rubber
dam margins are recognisable. The
tooth becomes darker after water
absorption.
9
March
2004
No. 4
Year 2
Clinical Case Report
Wide range of products from 3M ESPE
From Prep to Crown – Dental Materials in Daily Practice
Gabriele Enderle, Martin Groten; Germany
Case Description
General: Female patient, approx. 43
years of age; treatment began in
October 2003.
Treatment Plan: Fabrication of temporary restorations in the laboratory
with Protemp™ 3 Garant™ before final
treatment with 3 four-unit Lava™
bridges 13-16, 23-26 and 12-22
Indication: Prosthetic rehabilitation
of the maxilla for functional reconstruction and occlusal harmonisation
after orthodontic treatment of the
mandible; the laboratory-made temporary restorations represent an
attempt to reconstruct the new occlusion and proportioning for trial wearing.
Documentation
Fig. 1: Pre-operative situation
Fig. 2: Maxilla before taking the impression
Fig. 3: Precision impression with Impregum™
Penta™ H DuoSoft Polyether Impression
Material
Fig. 4: Protemp™ 3 Garant Composite for
Temporary Restorationsbeing dispensed into
the preliminary impression
Fig. 5: Preliminray impression with
Composite replaced onto the cast
Fig. 6: Elastic phase of Protemp™ 3 Garant
Composite for Temporary Restorations
Fig. 3: Result of the preparation impression of the maxilla using the one-step
tray wash technique with a stock tray
(Rimlock type) and Impregum™ Penta™
H DuoSoft from 3M ESPE.
impression. The slide shows the composite temporary material Protemp™ 3
Garant (3M ESPE) being dispensed
into the impression for producing the
temporary bridge 12-22.
Fig. 4: A preliminary impression of the
maxilla was taken using Position™
Penta™ Quick in a single-use Position™
Tray (3M ESPE). It was modified and
carved for use as the key for fabricating
temporary restorations (initially directly
at chairside). It was reused to produce
laboratory temporary restorations on a
second casting of the preparation
Fig. 5: First of all, Protemp 3 Garant
was syringed around the preparations
on the model to ensure compete reproduction of all details in the area of the
preparation margins. Then a duplicate
of the preparation model isolated with
vaseline was inserted into the impression, which had been filled with
Protemp 3 Garant.
Fig. 1: Initial situation of the patient’s
anterior teeth, showing old resin
veneer bridges fitted over 10 years
ago.
Fig. 2: The state of the maxilla in
occlusal overview following preparation: after removal of the old bridges,
the abutments had to be extensively
pre-treated [removal of caries; direct
insertion of post abutments at 16 and
26] with Cosmopost (IvoclarVivadent) and RelyX™ Unicem (3M
ESPE) for the adhesive bonding of the
posts and the core build-ups; the existing metal post abutments at 12, 13, 22
and 23 were coated intraorally with
Cojet™ from 3M ESPE and veneered
with Composite]. The slide shows the
measures taken in preparation for the
impression using the double cord
technique.
10
MAGAZINE
Fig. 7: Trimming the temporary
Fig. 9: Light curing of added composite
Fig. 8: Individualization of the temporary
Fig. 10: Finally polished temporaries
March
2004
No. 4
Year 2
Fig. 8: The modelling build-up for functional and aesthetic shaping was performed with Sinfony™ light curing
veneering composite from 3M ESPE in
the appropriate colour shades. Before
applying Sinfony, the surfaces of the
temporary restoration were freshened up
with a carbide finishing bur to ensure
complete bonding to the Protemp™ 3
composite.
Fig. 9: In the same way, the facial and
occlusal surfaces were individually built
up. Short light polymerisation (approx.
10 to 15 seconds) was performed
between the individual work steps.
Fig. 10: The polished laboratory temporary restorations 12-22, 13-16 and 23-26:
After the final light polymerisation for at
least 60 seconds, final grinding corrections were made with the finishing abrasives.
Fig. 11: Occlusal overview
Fig. 12: After insertion of the temporary
Fig. 6: After reaching the elastic state
during self-curing, the model was lifted off the impression and repositioned
several times. The fully cured temporary restoration was removed from the
impression and the bulk of the excess
was removed using scissors. Then the
entire surface was rubbed down with
paper and cotton wool to remove the
oxygen inhibition layer (smear layer).
This provided better vision for finishing the temporary restoration with
rotary grinding instruments, as otherwise the grinding dust would have
clogged the surface details.
Fig. 7: Finishing was performed with
cross-cut carbide burs without water
cooling. The slide shows the modification of detailed structures with a
suitably pointed abrasive to complete
the basic finishing and shaping.
Fig. 11: Occlusal overview of the maxilla
after placing the laboratory temporary
restorations with temporary cement
(RelyX™ Temp NE from 3M ESPE).
Fig. 12: Anterior view after inserting the
laboratory temporary restorations. In
contrast to the state with the old bridges,
the static and dynamic occlusal relations
are now balanced after reconstruction
with incisal/canine guidance.
11
Sientific Activities in Europe
Lava™ Crowns and Bridges: Summary of the All-Ceramic Symposium 2003
™
International Espertise All-Ceramic Symposium
Daniel Suttor, Laurence Settekorn; 3M ESPE, Germany
The international AllCeramic Symposium,
which took place from
September 21st to
23rd 2003 in Stresa,
Italy, gave 125 experts
from the clinical,
research and dental
technology fields with
a unique forum entitled "Exploring the
Future
for
AllCeramic
Restorations". The scientific
contributions by internationally renowned
speakers from Europe
and the USA were
proof that Lava has
Grand Hotel in Stresa, Italy
opened up a new clinical and technological dimension in
all-ceramics. Renowned clinicians
and researchers with extensive
experience of Lava™ crowns and
bridges based on zirconia frameworks were extremely positive about
this product. Indeed one top speaker was quoted as saying "[Lava represents] a quantum leap!" during a
round-table discussion at the end of
the first day.
In his welcoming speech Andreas
Dinges, Business Unit Director
Europe, EU and MENA and Member
of the Executive Board of 3M ESPE,
invited all Espertise™ Symposium
participants to actively use this information platform for both research and
practice-oriented purposes, and to
share their personal expectations and
experiences. Access to this new technology is key, so Andreas Dinges.
With the concept of Lava™ milling
centres, laboratories of all sizes can
benefit from the latest CAD/CAM
technology, without increased fixed
costs or the purchase of new systems
or system components. With five Lava
milling centres in Germany and four
in the USA, Lava has already successfully entered the market. Moreover, it
is planned to launch Lava in Italy and
other European countries in the near
future.
In order to get that fare, first-class
research was absolutely essential research which, as the 3M ESPE
Member of the Executive Board
Dr. Oswald Gasser explained, took
time. 3M and ESPE independently
invested many years of research into
ceramics and the necessary hardware
components. It goes without saying
that the merged company 3M ESPE
and its customers are now able to benefit from the know-how acquired during this research phase.
Focus on the new generation of
all-ceramics
In his opening speech chairman
Professor John Sorensen emphazised
the material properties of zirconia
which have not only given all-ceramic
restorations a whole new dimension in
quality but have also significantly
pushed forward the development of
CAD/CAM systems for the automatic
production of frameworks.
Come together in the evening of the first day
12
It was not a surprise that questions
concerning materials proved to be of
particular importance, even in small
discussion groups because two
decades of all-ceramics have also
been two decades of wishes and
expectations. Acceptable clinical
results have been achieved in the anterior region in particular with regard to
single-tooth restorations, but to date
dynamic advances in the posterior
region have been kept within certain
clear (indication) limits as a result of
material strength.
Zirconia - outstanding
mechanical properties
Strength data shows, that Lava crowns
and bridges made from zirconia are in a
league of its own. Strength values are
five times higher than glass ceramics.
The zirconia's fracture resistance far
exceeds the load spectrum in the oral
cavity, even after simulated ageing with
thermocycles and load mastication.
This is due, on the one hand, to the
extremely fine microstructure and, on
the other hand, to the material’s inher-
MAGAZINE
ent "airbag effect" - the so-called transformation toughening. The appearance
of a defect causes a transformation in
the material structure at the crack tip,
retarding its progression and effectively
clamping the crack. In contrast to glass
containing ceramics, which can suffer
reductions in strength in moist conditions, Lava zirconia retains its strength
even when used in a moist environment.
"A quantum leap"
from a clinical perspective
The scientific presentations with extensive case studies clearly demonstrated
the great extent to which Lava had
impressed and convinced internationally renowned researchers and clinicians
in clinical applications. In addition to
the extremely positive material- and
system assessment, several speakers
highlighted the fact that Lava dovetails
perfectly into the essential goals of
modern prosthetics: Patients should be
provided with a dental solution which is
designed so that as little tooth substance
as possible has to be removed.
Moreover, solutions should be highly
aesthetic, ensure good biocompatibility
and offer long-term stability. The specific translucency of the Lava frameworks offers natural-looking aesthetics
as well as enabling implant superstructures or discoloured teeth stumps to be
concealed. The accuracy of fit which
can be achieved, was also judged as
very positive; it corresponds to values
achieved with PFM.
A new standard in veneering
Dr. Domenico Massironi and Romeo
Pascetta, dental technician, impressed
all those at the symposium with their
brilliant vision of first-class aesthetics
and perfect supragingival marginal
integrity in Lava restorations. It is not
only the spirit of Lava zirconia crowns
and bridges which has taken off in the
host country of Italy - two Lava milling
centres will be launched in Italy this
year.
3M ESPE have a long experience in
developing, producing and distributing innovative products for dentistry
and dental technology. 3M ESPE
Dental is a division of the diversified
technology company, 3M, and is one
of the most innovative dental suppliers
in the world. With more than 2,000
products, the portfolio includes all the
important fields of the dental market:
from prophylaxis, restorative dentistry, prosthetics and local anaesthesia to the avoidance of cross-infection
and dental technology.
3M's commitment to research and
development has been the key to this
success. The foundation of the knowhow consists of more than 100 technologies from 3M in a variety of areas
such as abrasives, adhesives and
ceramic products, which are extremely important sources of new product
ideas.
With a portfolio of more than 50,000
products the 3M diversified technology company that is over 100 years old
and has its headquarters in St. Paul,
USA, is today amongst the world's
leading manufacturers. In 2002 a
turnover of more than 18 billion US
dollars was reached with approximately 70,000 employees worldwide.
Examples of well-known products are
Scotch™ tape, Post-it® notes,
Scotchgard™
fabric
protector,
Scotch-Brite™ household products
and Scotchlite™ reflective material.
3M is one of 30 companies in the
Dow Jones Industrial Average
13
March
2004
No. 4
Year 2
Scientific Activities in Europe
Fostering Young Talent
First European Dental Talent Award
Gerhard Kultermann; 3M ESPE, Germany
Eight young scientists from
Belgium, France and India,
Lebanon and the Netherlands,
Poland, Turkey und Belarussia participated in the first European
Dental Talent Award competition
held by 3M ESPE AG in Seefeld,
each contributing a short presentation in English.
The subject of the presentation was
the results of scientific research in
conjunction with 3M ESPE products.
In his welcoming speech, Dr. Gerhard
Kultermann, the initiator of the award
scheme and head of the 3M ESPE AG
Information Centre, explained the
idea behind the event: 3M ESPE’s aim
in holding this competition is to discover talented young scientists at an
early stage in their career and give
them support; this in turn will help
promote an international exchange of
ideas. The winner will receive a scholarship enabling him or her to study at
a foreign university for three months.
On this occasion the jury, in which the
universities were also represented by
Professor Reinhard Hickel from
Participants preparing their presentations
14
Prof Dr Reinhard Hickel, München (Jury)
Krzysztof Gonczowsky, Poland, Winner of the 3M ESPE Dental Talent Award
Dr Gerhard Kultermann, 3M ESPE
Prof Dr Hans-Christoph Lauer, Frankfurt (Jury)
Munich and Professor HansChristoph Lauer from Frankfurt,
chose Krzystof Gonczowski from
Poland. He can now look forward to studying at Munich
University next year. The participants were enthusiastic
about this completely new
opportunity for a scientific
exchange of experience with
industry, and they also
enjoyed conversing with
their fellow scientists. In
two years’ time the next
European Talent Award
will be held in Seefeld –
Dr. G. Kultermann gave
his word on that.
TALENT
AWARD
3M ES
PE
Talent
Award
Europ
e 2003
Krzyszto
f Gonczo
wsky
First P
lace W
inner
of the S
peaker
’s Con
test
Seefeld
, Oc
tober 14
, 2003
Dr. Gerh
ard
Kulterm
ann
Dental Practice Forum
MAGAZINE
Creating good working conditions
Put a stop to the flood of paper –
create order in your dental practice
• Optimize your filing system by
means of colour coding, labelling,
dividers and numbering.
• Mark on the calendar which cupboards and filing cabinets are to be
organized by whom and when. This
will mean that surgery assistants
take turns in being responsible for
medicines, patient cards and stocks
of materials.
• Tidy up the hard disk of the surgery
computer: delete unnecessary programs or files and save them on
disks or CD-ROM, if need be.
The quantity of available information doubles every three to
four years. This data revolution has
of course had its effect on dental
practice. Filing and storage systems
in dental practices can scarcely cope
with all the correspondence, patient
records and X-rays. Growing piles
of books, journals and brochures
ask to be read. This deluge of paper
seems to require more time than the
dental surgery’s everyday routine
can afford. Even the storage space
on the hard disk is becoming seriously low.
The surgery team is faced with a
mountain of work. Fear of throwing
something important away leads to
much that is unnecessary being stored,
but in time the mountains of paper and
records impede efficient and timeeffective work.
Here are some hints for
remedying this situation:
• Dispose of journals, brochures and
books together with old stationery,
out-of-date samples of medicines
and other dust collectors (such as
post-cards, gifts, packaging and
any other unused items).
• Do not put off dealing with paperwork, but select and categorize it as
soon as you have read it: waste
paper basket, professional association, patient record, items to be followed up like special offers from
your dealer or preferred manufacturer.
• Your desk should only have on it
what is essential for the work you
are doing at the moment.
It is always difficult to make a start. A
joint clearing up action day has proved
its worth in avoiding being overwhelmed by mountains of paper. This
should take place at least once a year.
Of course, all of these measures call
for a certain amount of courage and
decisiveness. Clear-cut arrangements
made between dentist and DSA make
this tidying up easier and will avoid
anyone being made a scapegoat.
You have to notice the statutory storage periods for important records. In
Germany for example, X-ray films
must remain on file for 30 years, Xray reports, laboratory printouts and
medical records ten years, but prescriptions for anaesthetics for only
three years. Privacy legislation mandates special disposal methods for
patient records.
Now there is nothing standing in the
way of your “spring cleaning”. You
will be surprised how much easier
work becomes after it.
15
March
2004
No. 4
Year 2
General Information
MAGAZINE
Pentamix™ 2 Automatic Mixing Unit
10 Years Pentamix Anniversary –
Makes a good Impression!
The production of dental prostheses, such as crowns and bridges,
demands accuracy to within hundredths of millimetres in order to
prevent the luting cement from
being washed out and bacteria from
penetrating beneath the crown.
Impressions are taken with polyether
and silicone materials, but manual
mixing of these products leads to the
inclusion of air bubbles and voids,
which in turn reduces the quality of
the finished crown or bridge. Ten
years ago, 3M ESPE AG developed an
automatic mixing technique which
solves this problem. The latest genera-
tion of mixing units, Pentamix™ 2, not
only offers numerous advantages for
the user, but also helps to ensure that
the patient receives perfectly fitting
crowns. Pentamix’s tenth anniversary
was the occasion for a Europe-wide
advertising campaign during the first
half of the 2003, in which dentists
from Germany, Denmark, Great
Britain, Italy, Norway, Austria,
Switzerland and Spain took part in a
prize draw. First prize for each country was a luxury weekend for two in
Milan, including a visit to the Grand
Prix in Monza. Over 3,000 dentists
participated in the competition, much
to the delight of Laslo Faith, European
Calendar of Events
March to July 2004
IADR/AADR General Session, Honolulu
www.iadr.com
Expodental, Madrid
www.ifema.es
Saldent, Poznan
SCANDEFA, Copenhagen
www.bellacenter.dk
Dental Expo 2004, Utrecht
www.promotionprojects.com
IDEM, Singapore
www.idem2004.com
WID, Vienna
www.wid-dental.at
EXPODENTAL, Istanbul
www.istanbul2004.com
STOMATOLOGY, St Petersburg
www.ite-exbibitions.com
EAED/IFED Joint Meeting, Venice
www.eaed.org
26th Asia pacific Dental Congress
www.hkda.org
March 10 – 13, 2004
March 11 – 13, 2004
March 18 - 20, 2004
March 25 – 27, 2004
April 1 – 3, 2004
April 2 – 4, 2004
May 13 – 15, 2004
The lucky winners in Monza
Marketing Manager, Prosthodontics
Business Segment: “This campaign
centering on Formula 1 racing,
brought us an exceptionally high level
of response”.
EDITORIAL
INFORMATIONS
Published by:
3M ESPE AG
ESPE Platz
82229 Seefeld
Germany
Telephone:
+49 (0) 8152 / 7 00-0
Telefax:
+49 (0) 8152 / 7 00-1586
E-Mail: [email protected]
Internet:
http://www.3mespe.com
Editor:
Gerhard Kultermann
Editorial team:
Keith R. Haig, Dieter Klasmeier,
Roland Richter, Markus Roepke,
Laurence Settekorn
May 20 – 22, 2004
May 26 – 29, 2004
May 27 – 29, 2004
Coordination:
Laurence Settekorn
Final editing and production:
Markus Roepke
May 28 – June 1, 2004
3M ESPE AG
ESPE Platz, 82229 Seefeld
Telephone: +49 (0) 81 52 / 7 00-0 • Telefax: +49 (0) 81 52 / 7 00-15 86
E-Mail: [email protected] • Internet: http://www.3mespe.com
3M, ESPE, Adper, Espertise, Filtek, Garant, Impregum, L-Pop, Penta, Pentamix, Position, Prompt, Protemp,
Scotchbond, Sof-Lex are trademarks of 3M or 3M ESPE.
All rights reserved. © 3M ESPE 2004.
Global circulation:
80.000
We accept no liability for
unsolicited manuscripts or
photographs.
Court of Jurisdiction: Munich
©
3M ESPE AG, Seefeld, 2004