Notice to the Reader Publisher does not warrant or guarantee any of the products described herein or perform any independent analysis in connection with any of the product information contained herein. Publisher does not assume, and expressly disclaims, any obligation to obtain and include information other than that provided to it by the manufacturer. The reader is expressly warned to consider and adopt all safety precautions that might be indicated by the activities described herein and to avoid all potential hazards. By following the instructions contained herein, the reader willingly assumes all risks in connection with such instructions. The publisher makes no representations or warranties of any kind, including but not limited to, the warranties of fitness for particular purpose or merchantability, nor are any such representations implied with respect to the material set forth herein, and the publisher takes no responsibility with respect to such material. The publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or part, from the readers’ use of, or reliance upon, this material.
CDA, FADAA, M.Ed. Spokane Community College
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CDA, BA Spokane Community College
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Dental Materials Guide by Donna Phinney and Judy Halstead Vice President, Career and Professional Editorial Dave Garza Director of Learning Solutions Matthew Kane Senior Product Manager Darcy M. Scelsi Vice President, Career and Professional Marketing Jennifer McAvey Marketing Manager Lynn Henn Production Director Carolyn Miller Content Project Manager Kenneth McGrath Senior Art Director Jack Pendleton Printed in China 1 2 3 4 5 6 7 12 11 10 09 08
© 2009 Delmar, Cengage Learning ALL RIGHTS RESERVED. No part of this work covered by the copyright herein may be reproduced, transmitted, stored, or used in any form or by any means graphic, electronic, or mechanical, including but not limited to photocopying, recording, scanning, digitizing, taping, Web distribution, information networks, or information storage and retrieval systems, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without the prior written permission of the publisher. For product information and technology assistance, contact us at Professional & Career Group Customer Support, 1-800-648-7450 For permission to use material from this text or product, submit all requests online at www.cengage.com/permissions. Further permissions questions can be e-mailed to
[email protected]. Library of Congress Control Number: 2007943969 ISBN-13: 978-1-418-05199-0 ISBN-10: 1-4180-5199-3 Delmar Cengage Learning 5 Maxwell Drive Clifton Park, NY 12065-2919 USA Cengage Learning products are represented in Canada by Nelson Education, Ltd. For your lifelong learning solutions, visit delmar.cengage.com
CONTENTS
v
vi
CHAPTER 1
CHAPTER 7
Preliminary Restorative Dental Materials . . . . . . . . . . . . . . . . . . . . . . . . 1
Custom Trays and Provisionals . . . . 457
CHAPTER 8 CHAPTER 2 Dental Cements . . . . . . . . . . . . . . . . . 95
Fluorides, Pit and Fissure Sealants, and Tooth Whitening Agents. . . . . . 511
CHAPTER 3
CHAPTER 9
Restorative Dental Materials . . . . . . 181
Dental Sterilants and Disinfectants . . . 615
CHAPTER 4
CHAPTER 10
Dental Impression Materials . . . . . . 259
Speciality Materials . . . . . . . . . . . . . 679
CHAPTER 5
Index . . . . . . . . . . . . . . . . . . . . . . . . . 759
Dental Gypsum Materials . . . . . . . . 341
CHAPTER 6 Dental Waxes . . . . . . . . . . . . . . . . . . 389
PREFACE
vii
viii
PREFACE FOR DENTAL MATERIALS GUIDE There are so many different materials used in dentistry that the sheer number can be overwhelming when trying to learn the types of materials and where and when they are used. Dental materials are continually developing and changing as technology advances and different clinical needs arise. For example many dental materials now have fluoride added to their composition for fluoride strengthens the enamel. Another change has been occurring as more and more people want the “natural” look and from this trend a number of materials are being developed for esthetic/cosmetic dentistry.
The delivery methods of many materials are also advancing. They are being made easier to prepare, mix, and place for the dentist and the dental assistant. Instead of the materials coming in a powder/liquid composition form, many materials now come in cartridges or cannules for easy dispensing with a dispensing gun. Some come in automix forms with disposable mixing tips that mix the materials as they are being dispensed. There are also single dose packets available and capsules for quick mixing with little need for clean up. The dental assistant is responsible for knowing all of the materials used in a dental office. They order, stock, prepare and mix a large variety of materials. Some states also allow the assistant to place some of the materials in the oral cavity. There are many types of materials
used in the dental office; examples include materials used in dental hygiene, restorative materials or materials only used in the laboratory. Having a comprehensive grasp of the materials used is also beneficial for patient education and protection. The Dental Materials Pocket Guide is designed to give the dental assistant student the basic knowledge of a variety of dental materials in each category of materials used in a dental office. This pocket guide includes materials used in specialty offices, dental hygiene, and a few materials the patient uses at home. It allows the student to see how the materials are divided into uses and then gives examples of each type. There are too many different brands of each material to include in one text but we tried to
ix
include a variety of materials for the dental assistant to gain an understanding of the basics so they can use this information and apply it to any brand name. The materials are categorized in groupings that follow basic dental procedures in general and specialty dentistry. For example, one section covers the impression materials; another section covers all the dental cements. This allows students to easily study similar information. The pocket guide covers the use, composition, properties, OSHA properties, mixing and setting times, and directions for each material. We feel students will find this guide to be a very helpful tool in their learning process as an adjunct to their main textbook and clinic/laboratory experience.
x
ACKNOWLEDGEMENTS We want to thank those who have encouraged and motivated us to develop this dental materials guide. Thanks to our students for asking us to develop a guide similar to the instrument guide for dental materials. They want better ways to learn and remember all the materials used in dentistry. Each year, student quest for knowledge becomes more creative and inventive. The need for a quick reference is necessary in the busy lives of students. Our goal was a quick reference to meet their needs.
We would like to thank Thomson Delmar Learning which is now Cengage Learning and its staff whose assistance and encouragement are greatly appreciated. We would like especially to acknowledge Kalen Conerly and Maureen Rosener, Acquisitions Editors and Darcy Scelsi, Senior Product Manager, for her dedication and guidance with this project. As with our other projects we greatly would like to thank our husbands, Dwayne and Chuck, and our families, for their continued support through all of our endeavors.
Preliminary Restorative Dental Materials
1
CARIES DETECTORS/INDICATORS Caries detectors or caries indicators are special dyes used to detect caries by distinguishing between good, sound, hard dentin, and dentin that is infected with bacteria and is softened.
CARIES DETECTOR
Courtesy of Kuraray America, Inc.
MANUFACTURER: Kuraray America, Inc.
USE: • • •
Identification of carious dentin Aids in the removal of the carious dentin layer for a conservative preparation Minimizes removal of remineralizable, healthy dentin, thus protecting the pulp
COMPOSITION: •
Propane-1, 2-diol with D & C Red #30 dye
PROPERTIES: • • • • • • 5
Supplied in small bottles Comes in red dyes Must be rinsed off after a reaction time of 10 seconds Do not use after expiration date Do not store at temperature above 77 degrees F (25 degrees C) Avoid exposure to sunlight CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
6
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
OSHA PRECAUTIONS: • • • •
Eye and skin irritation possible Should not be ingested Product is flammable. Keep away from open flame. Avoid cross-contamination
MIXING AND SETTING TIME: No mixing. Apply for 10 seconds.
DIRECTIONS: 1. Place a couple of drops in a dappen dish. 2. Use a small applicator tip to dip into the dye. 3. Place the dye in the cavity preparation and let it set for about
10 seconds. 4. Rinse off the dye from the cavity preparation. 5. Burs and spoon excavators are used to remove the
stained dentin. 6. This process is repeated until no caries remain.
CARIES INDICATOR
Courtesy of Vista Dental Products
MANUFACTURER: Vista Dental Products
USE: • • •
Identification of carious dentin To preserve maximum amount of inner dentin while infected dentin is removed Assists in locating root canal orifices and calcified canals
COMPOSITION: • • •
Vista-Red Vista-Blue Vista-Green
Glycol based with 1% acid red 52 solution Methylene blue solution 1%, water Propylene glycol with FD&C green
PROPERTIES: • • •
9
Supplied in unit dose packages and prefilled syringes Must be rinsed off after reaction time of 10 seconds Do not use after expiration date
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
10
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
• •
Do not store at temperature above 77 degrees F (25 degrees C) Avoid exposure to sunlight
OSHA PRECAUTIONS: • • • • •
Eye and skin irritation possible Should not be ingested Product is flammable. Keep away from open flame. Avoid cross-contamination If ingested, may cause nausea and vomiting
MIXING AND SETTING TIME: No mixing. Apply for 10 seconds.
DIRECTIONS: 1. Dispense a small amount in a dappen dish. 2. Use a small applicator tip to dip into the dye. 3. Place the dye in the cavity preparation and let it set for about
10 seconds. 4. Rinse off the dye from the cavity preparation.
5. Burs and spoon excavators are used to remove the stained
dentin. 6. This process is repeated until no caries remain.
11
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
DESENSITIZERS Desensitizers are agents used to reduce or eliminate the sensitivity of the teeth. Sensitivity may be caused by exposed dentin from abrasion; caries; abfraction associated with bruxism; leaking restoration, scaling, and root planing; and some restorative materials. There are several categories of desensitizing agents including toothpastes, fluoride gel/varnish, inorganic salts, and resin agents. This chapter will cover the inorganic salts and resin agents. The toothpastes and fluorides will be covered in Chapter 8.
RELIEF GEL MANUFACTURER: Discus Dental
USE: • • •
Reduces sensitivity associated with thermal changes, tooth whitening, acid penetration, sweets, and/or direct contact Assists in preventing tooth decay by aiding in rebuilding enamel Improves luster of teeth
COMPOSITION: •
Potassium nitrate 5% and fluoride 0.240%
PROPERTIES: • •
Comes in a gel and is mint flavored Also comes in a syringe for easy application
OSHA PRECAUTIONS: • •
Eye and skin irritation possible Should not be ingested
MIXING AND SETTING TIMES: There is no mixing required.
DIRECTIONS: Patient may apply directly into whitening tray or apply with a soft toothbrush.
15
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
GLUMA DESENSITIZER
MANUFACTURER: Heraeus Kulzer
USE: • • • •
•
Prevents dentinal hypersensitivity Treats cervical sensitivity Prevents postoperative sensitivity Applied under amalgam restorations, with other bonding systems, under glass ionomers, under non-resin-bonded restorations, under resin-bonded veneers, inlays, onlays, and crowns Applied after root planing or periodontal treatment
COMPOSITION: • • •
17
5% glutaraldehyde 35% HEMA-hydroxyethyl, methacrylate, pentanedial Water
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
18
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
PROPERTIES: • • •
Refrigerate if not used for long time Place pulp protection before placing Gluma if cavity preparation is close to pulp Drying the tooth before placement is not necessary; tooth can be moist.
OSHA PRECAUTIONS: • • • •
Eye and skin irritation possible; if contact, rinse immediately Should not be ingested Product is flammable. Keep away from open flame. Avoid cross-contamination
MIXING AND SETTING TIME: No mixing. Apply for 30 seconds.
DIRECTIONS: 1. Use a small sterile cotton pellet, applicator tip, or single dose
applicator. 2. Apply material to the dentin of the tooth using a gentle but firm
rubbing motion for 30 seconds. 3. Dry thoroughly but do not rinse.
19
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
D/SENSE ® CRYSTAL
Courtesy of Centrix Dental
MANUFACTURER: Centrix Dental
USE: • • • •
Desensitizer and cavity liner Prevention of cervical erosion and gingival recession Applied under crowns and bridges, when standard cement is used Applied to exposed dentin, such as around the margins of a temporary crown Applied under restorations
•
COMPOSITION: • •
Solution of potassium binoxalate and nitric acid in water Free of HEMA, glutaraldehyde, and other toxic chemicals
PROPERTIES: • • 21
One-step, dual-action material Fast acting CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
22
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
• • • • •
Long-lasting results Reacts with the dentin to precipitate microcrystals of calcium oxalate and potassium nitrate Occludes dentinal tubules with calcium oxalate and potassium nitrate Time saving and less waste Gentle on soft tissues
OSHA PRECAUTIONS: • •
Eye and skin irritation possible If ingested. Give a solution of sodium bicarbonate or liquid antacid medication
MIXING AND SETTING TIME: No mixing required. Setting (drying) time is 30 seconds using a gentle air spray or 2 minutes without the air spray.
DIRECTIONS: 1. Remove the cap from the syringe and securely attach a Sofneedle
2. 3. 4. 5. 6.
23
foam tip or dispense a few drops of liquid from the syringe into a dappen dish and use a small applicator. To improve the comfort of the patient, warm the syringe to body temperature. Check the flow of the material from the syringe on a paper pad and then pass the syringe to the dentist for placement. The material is rubbed until the dentin is saturated for about 20 seconds. After the material is placed, gently air-dry for 30 seconds or let air-dry for 2 minutes. The material has a frosty white precipitate. Repeat if needed.
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
CAVITY LINERS AND LOW-STRENGTH BASES Cavity liners and low-strength bases are used in the cavity preparation where there is little or no dentin to cover the pulp. They have a variety of uses including protecting and soothing the pulp. Some stimulate the formation of secondary dentin and some contain fluoride to strengthen the tooth. Cavity liners and low-strength bases come in the following forms: powder/liquid, two paste systems, single tube, and syringes with disposable tips.
FUJI LINING LC MANUFACTURER: GC America, Inc.
USE: •
Permanent durable lining or low-strength base under all types of restorations
COMPOSITION: • •
Silicate glass powder: containing calcium, aluminum, and fluoride (calcium fluoroaluminosilicate glass) Liquid: aqueous solution of polyacrylic acid
PROPERTIES: • • • •
Light-cured material Releases fluoride Radiopaque material Biocompatible to reduce sensitivity
• •
Bonds mechanically and chemically to the tooth structure Also comes in paste form
OSHA PRECAUTIONS: •
Eye and skin irritation possible
MIXING AND SETTING TIME: •
•
Mixing time is 5 to 10 seconds for the first portion and 10 to 15 seconds for the second portion for a total not to exceed 20 seconds. Material is light-cured for approximately 30 seconds to set. (Time depends on strength of curing light.) Avoid long exposure to overhead light once the material is mixed.
•
DIRECTIONS: 1. Prepare materials. Powder and liquid, powder dispensing scoop
specific to this product (or paste cartridge and dispenser), paper pad, 2 ⫻ 2 gauze, and placement instrument. 2. Tooth should be isolated with rubber dam or cotton rolls. 27
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
28
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
3. Rinse and dry the cavity preparation. 4. Dispense one level scoop of powder (scoop comes with kit).
Replace the cap on the powder. 5. Divide the powder into two sections on the paper pad. Dispense
6. 7. 8. 9. 10.
11.
one drop of liquid holding the bottle vertically upside down. Replace the cap on the liquid. Incorporate the first portion into the liquid and mix for 5 to 10 seconds. Then bring the second portion and mix the whole for 10 to 15 seconds. Total mixing time should not exceed 20 seconds. Secure paste cartridge into the dispenser and dispense pastes onto the paper pad. Mix until smooth, uniform mix. Apply the mix into the cavity preparation with a small applicator or suitable lining instrument. Pass the instrument/applicator to the dentist and hold the paper pad and a gauze sponge close to the patient’s chin for easy access during placement of the lining cement. Once the material has been placed, light-cure for 30 seconds.
VITREBOND PLUS
MANUFACTURER: 3M ESPE
USE: • • • •
Permanent liner/base Prevention of microleakage Aids in reducing the effects of polymerization shrinkage of the restorative materials Seals dentin to reduce postoperative sensitivity
COMPOSITION: •
Resin-modified glass ionomer-paste and liquid form
PROPERTIES: • • • • • 31
Strong bond to dentin Has the “clicker” dispensing system for easy use Less mess than powder/liquid systems Releases fluoride Good consistency and quick set
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
32
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
OSHA PRECAUTIONS: •
Eye and skin irritation possible
MIXING AND SETTING TIME: Mix for 10 to 15 seconds. Light-cure for 20 seconds.
DIRECTIONS: 1. Prepare materials. Dual-barrel “clicker” dispensing gun, cement
spatula, paper pad, 2 ⫻ 2 gauze, and placement instrument. 2. Tooth should be isolated with rubber dam or cotton rolls. 3. Rinse and dry the cavity preparation. 4. On a paper pad dispense a small amount of material from the
dispenser until you hear the “click.” This should give you equal amounts of the paste and liquid. 5. Gather the material with the cement spatula and mix for 10 to 15 seconds until the mix is uniform in color. 6. Pass the placement instrument to the dentist and hold the paper pad close to the patient’s chin. 7. Once the material is in place, light-cure for 20 seconds.
DYCAL-TWO-PASTE SYSTEM
MANUFACTURER: Dentsply Caulk
USE: • •
A low-strength liner under any restoration, cements, and other base materials Applied with indirect or direct pulp capping procedures
COMPOSITION: • •
Base-Zinc oxide, 1, 3 butylene glycol disalicylate, calcium phosphate, calcium tungstate, and iron oxide pigments Catalyst-Calcium hydroxide, N-ethyl-o/p-toluene sulfonamide, zinc oxide, titanium dioxide, zinc stearate, and iron oxide pigments (dentin shade only)
PROPERTIES: • •
35
Rigid, self-setting material Radiopaque
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
36
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
• •
• •
Has a therapeutic effect on the pulp Alkaline pH between 9 and 11, which stimulates the formation of secondary dentin when the material is in direct contact with the pulp Has some thermal insulating properties Minimal strength to support the forces of condensation
OSHA PRECAUTIONS: • •
Some patients may be sensitive to calcium hydroxide cements. Eye contact—flush immediately with flowing water
MIXING AND SETTING TIME: • • •
Mix within 10 seconds Mixed material will set in 2 1/2 to 3 1/2 minutes Moisture and higher temperatures will decrease the working time and cause the material to set faster.
DIRECTIONS: 1. Prepare materials. Base and catalyst tubes, small paper pad, 2 ⫻ 2
gauze, and placement instrument (Dycal instrument or explorer). 2. Dispense equal amounts of the base and catalyst on the mixing
pad provided. 3. Stir the two pastes together using the Dycal instrument or an
explorer. 4. Mix for 10 seconds until a uniform color has been achieved. 5. Wipe the Dycal instrument off with a gauze sponge and pass to
the dentist. 6. Hold the small paper pad with the mixed material close to the
patient’s chin for easy reach of the dentist. 7. Have a gauze sponge ready to remove any excess material during
the application.
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CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
PRISMA VLC DYCAL
Courtesy of Dentsply Caulk
MANUFACTURER: Dentsply Caulk
USE: • •
A low-strength liner under any restoration, cements, and other base materials Applied with indirect or direct pulp capping procedures
COMPOSITION: •
Similar to two-paste calcium hydroxide with polymerizable monomers
PROPERTIES: • • • • •
39
Light-cured material Requires no mixing Must be refrigerated to prolong shelf life Radiopaque Material has a therapeutic effect on the pulp.
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
40
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
•
• • •
Alkaline pH between 9 and 11, which stimulates the formation of secondary dentin when the material is in direct contact with the pulp Has some thermal insulating properties Minimal strength to support the forces of condensation Very low water solubility compared to two-paste calcium hydroxide
OSHA PRECAUTIONS: • •
Some patients may be sensitive to calcium hydroxide cements. Eye contact—flush immediately with flowing water
MIXING AND SETTING TIME: No mixing required. Setting time depends on curing light, but a minimum of 20 seconds is required.
DIRECTIONS: 1. Dispense Prisma VLC Dycal on a small paper pad and cover to
2. 3. 4. 5.
41
avoid exposure to light. Allow the material to warm to room temperature. Rinse and dry the cavity preparation. Uncover the material, pass the Dycal instrument and hold the paper pad under the patient’s chin for easy reach of the dentist. Have a gauze sponge ready to remove any excess material during the application. Prepare the curing unit and then cure the material for a minimum of 20 seconds with the light source within 2 mm of the material. If the curing unit is between 2 mm and 5 mm from the surface, cure the material for 30 seconds.
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
B & T BASE AND TEMPORARY CEMENT
MANUFACTURER: Dentsply Caulk
USE: • •
Intermediate base Temporary filling
COMPOSITION: • • •
Zinc oxide eugenol material (ZOE) Powder-zinc oxide, resin, zinc acetate, and an accelerator Liquid-eugenol and other oils such as clove oil
PROPERTIES: • • • • •
Very soluble in the mouth Low strength Has a neutral pH of 7, so this material is very compatible with the tooth Sedative effect on the tooth Does not require a protective base or liner
43
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
44
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
• • •
Irritating to oral mucosa Has a strong odor May interfere with the polymerization process of composite materials
OSHA PRECAUTIONS: • •
May irritate the eyes, skin, and oral mucosa tissues Inhalation—this material has a strong odor.
MIXING AND SETTING TIME: • •
Mixing time—approximately 1 minute Setting time—2 1/2 to 3 1/2 minutes in the mouth
DIRECTIONS: 1. Prepare materials. Powder and liquid, paper pad, cement
spatula, 2 ⫻ 2 gauze, and plastic filling instrument. 2. Tooth should be isolated with rubber dam or cotton rolls. 3. Rinse and dry the cavity preparation.
4. Place 2 or more drops of liquid on a mixing pad depending on
the size of the cavity preparation. 5. Dispense sufficient powder and divide the powder into several
small increments. 6. Bring the first portion of powder into the liquid and mix;
continue to bring the rest of the powder into the mix for 1 minute. The mix should be a heavy nonsticky consistency that can be rolled into a ball. 7. Wipe off the spatula with gauze and pass a plastic filling instrument to the dentist. 8. During placement of the material, hold the paper pad with the mixed B & T near the patient’s chin with gauze to remove any excess material.
45
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
CAVITY VARNISH Cavity varnish is a material that is used as a protective barrier between the restoration and the prepared tooth. It seals the dentin tubules from irritating chemicals found in restorative materials and cements. Varnish sometimes comes with a solvent to thin the varnish when it becomes too thick for placement. Cavity varnish is used in some cavity preparations but many dentists prefer to use a bonding agent that has multiple functions.
COPALITE
Courtesy of Cooley & Cooley, Ltd.
MANUFACTURER: Cooley & Cooley, LTD
USE: • •
Seals the dentin tubules Acts as a protective barrier
COMPOSITION: • •
Natural resins Organic solvents (ether alcohol, acetone, or chloroform)
PROPERTIES: • • • • • •
49
Has a strong odor Does not exhibit any strength Does not provide any thermal insulation Insoluble in the oral fluids Reduces microleakage Prevents penetration of acids from cements and restorative materials CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
50
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
• •
Non-acidic and non-irritating Solvent in the varnish will evaporate so it is important to keep the bottle tightly capped when not in use.
OSHA PRECAUTIONS: • • • •
May irritate the eyes, skin, and oral mucosa tissues Inhalation—this material has a strong odor and may cause respiratory difficulties. Should not be ingested Product is flammable. Keep away from open flame.
MIXING AND SETTING TIME: •
No mixing required. Setting time: 5 to 10 seconds or just long enough for the layers to dry.
DIRECTIONS: 1. Clean and dry the cavity preparation. 2. Prepare two applicator brushes, cotton-tipped applicators, or
small cotton pellets. 50
3. Remove the cap from the varnish and dip the applicators into the
varnish until they are moistened. 4. Replace the cap on the varnish because of the strong odor and to
prevent evaporation of solvent. 5. Dab off the excess varnish on a gauze. 6. One layer of varnish is placed on dentin in the cavity preparation
and then allowed to dry. 7. Apply the second coat using the second applicator in the same
manor and allow it to dry.
51
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
COPAL CAVITY VARNISH
Courtesy of Sultan Healthcare
MANUFACTURER: Sultan Healthcare
USE: • •
Protects dentin from acids released by filling materials Provides chemical and slight thermal protection while eliminating air pockets
COMPOSITION: • •
Copal resins 75% dichloromethane
PROPERTIES: • • • •
53
Needs no thinner Does not exhibit any strength Insoluble in the oral fluids Reduces microleakage
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
54
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
• •
Prevents penetration of acids from cements and restorative materials Non-acidic and non-irritating
OSHA PRECAUTIONS: • • • •
May irritate the eyes, skin, and oral mucosa tissues Inhalation—this material has a strong odor. Should not be ingested Product is flammable. Keep away from open flame.
MIXING AND SETTING TIME: • •
Comes in single bottle—no mixing required Setting time: 5 to 10 seconds just long enough for the layers to dry
DIRECTIONS: 1. Clean and dry the cavity preparation. 2. Prepare two applicator brushes, cotton-tipped applicators, or
small cotton pellets.
3. Remove the cap from the varnish and dip the applicators into the
varnish until they are moistened. 4. Replace the cap on the varnish because of the strong odor. 5. Dab off the excess varnish on a gauze. 6. One layer of varnish is placed on dentin in the cavity preparation
and then allowed to dry. 7. Apply the second coat using the second applicator in the same
manor and allow it to dry.
55
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
CORE BUILDUP MATERIALS A core buildup is treatment performed on teeth that have very little crown structure left after the cavity preparation. The teeth are built up to support and provide retention for permanent restorations such as a porcelain crown.
MIRACLE MIX
MANUFACTURER: GC America, Inc.
USE: • •
Crown and core buildup Block-outs and repairs
COMPOSITION: • • •
100% fine silver alloy Glass ionomer cement Fluoride
PROPERTIES: • • • • • • 59
Long-lasting Strong direct bond Color contrast with tooth structure Has high fluoride release to reduce secondary decay Easy to mix and place Won’t stain or discolor surrounding teeth CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
60
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
• •
Shrinks and expands at the same rate as tooth structure Comes in a powder/liquid form and easy-to-use capsules
OSHA PRECAUTIONS: • •
Eye and skin irritation is possible. Some patients are allergic to glass ionomer cements.
MIXING AND SETTING TIME: • • •
Powder/Liquid—Mixing time is 35 to 40 seconds. Capsules—Preparation time is 10 to 15 seconds. Setting time is 4 to 5 minutes for both forms.
DIRECTIONS: Powder/Liquid 1. When using for the first time, pour the Miracle Mix alloy into the bottle of Miracle Mix powder and shake thoroughly. 2. Lightly tap the bottle for accurate dispensing of the powder. 3. Using the scoop that comes in the package, dispense 2 or 3 level scoops of powder on a paper pad.
4. Divide the powder into 2 equal parts. 5. Hold the liquid bottle vertically and squeeze to dispense 2 drops
of liquid. 6. Mix the first portion with all the liquid for 15 to 20 seconds. 7. Incorporate the second portion and mix thoroughly for
20 seconds. 8. Mix will be thick and putty-like. 9. Transfer the cement to the dentist using a syringe or plastic
filling instrument (PFI). Capsule: 1. Tap the capsule on a flat surface to fluff the powder. 2. To activate the capsule, press the button on the bottom of the capsule. 3. Place the capsule in a high-speed amalgamator and triturate for 10 seconds. 4. Remove the capsule from the amalgamator and place it into the applier for delivery.
61
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
LUXACORE DUAL SMARTMIX
Courtesy of Zenith/DMG
MANUFACTURER: Zenith/DMG
USE: •
One-step automix core buildup material
COMPOSITION: •
72% filled composite resin material
PROPERTIES: • • • • • •
Comes in a compact, self-contained syringe for a consistent mix every time No mixing, no air bubbles, and no wasted material Light-cured, self-cured, and dual-cured Strong resin material Releases fluoride to protect against secondary caries Syringe delivery for easy use and less chance of crosscontamination
63
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
64
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
•
• • •
Comes in three colors-natural A3 for optimal esthetics, blue for contrast with the tooth, and white for perfect balance of contrast and esthetics Increased work time Radiopaque on radiographs Composite viscosity to prevent material from slumping before cured
OSHA PRECAUTIONS: • • •
May cause skin and eye irritation Prolonged exposure may cause respiratory irritation. If ingested, rinse mouth out with water and contact a physician.
MIXING AND SETTING TIME: • •
No mixing required. Setting Time: Light-cure according to size of buildup—20 to 40 seconds
DIRECTIONS: 1. The tooth is prepared and then rinsed and dried. 2. Prepare the Smartmix handheld double-barreled syringe by
removing the storage cap. 3. Place on small core tip or an intraoral tip. 4. Dispense a small amount of material on a paper pad or gauze to
ensure material is mixed. 5. Pass the syringe to the dentist and have a PFI ready. 6. Once the material is placed, pass the curing light or light-cure
the material when the dentist indicates he/she is ready. Depending on the depth of the core material, the curing time will vary.
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CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
ENCORE CORE PASTE
Courtesy of Centrix Dental
MANUFACTURER: Centrix Dental
USE: •
Core buildup material
COMPOSITION: • •
Self-cured composite material Two-paste system that is used with a syringe for placement
PROPERTIES: • • • • • •
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High compressive strength Cuts like dentin to reduce ditching Comes with and without fluoride Radiopaque Comes in two shades: natural and white No slumping, therefore a matrix is not needed
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
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CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
OSHA PRECAUTIONS: • • •
May be irritating to the skin and eyes Should not be ingested Inhalation irritation—keep area well ventilated
MIXING AND SETTING TIME: • •
Mixing time is 10 to 15 seconds. Working time is 2 1/2 minutes. Setting time is 4 to 5 minutes.
DIRECTIONS: 1. Prepare the tooth and apply the bonding agents. 2. Using one end of the spatula, take a small portion of the base. 3. Using the other end of the spatula, take a small and equal
portion of the catalyst. Be sure not to cross-contaminate the two jars of material. 4. Mix the two materials together to a uniform mix. Working time at this point is 2 1/2 minutes.
5. Place the material into the Centrix C-R syringe tube. Fill half
full. 6. Place the plug in the end of the tube. 7. Place the syringe tube into the syringe barrel and dispense a
small amount of material to test the flow. 8. Pass the syringe to the dentist for placement.
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CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
BONDING AGENTS Bonding agents are used to attach restorative materials to the enamel or dentin of the tooth. There are many varieties of materials; they are self-curing, light-cured, or dual-cured. Most often they require a conditioning or etching prior to placement. Some are unidose meaning the etchant and the bonding agent are placed at the same time, whereas others require the etchant to be placed as a separate step.
ADPER PROMPT L-POP SELF-ETCH ADHESIVE
Courtesy of 3M ESPE
MANUFACTURER: 3M ESPE
USE: •
Adhesive for direct restorative procedures
COMPOSITION: • • • • •
Low-viscosity composite resin Di–hema phosphate Bisphone a diglycidyl ether dimethacrylate Ethyl 4 dimethyl aminobenzoate Dl camphoquinone
PROPERTIES: • • • • • 73
Improved properties for better bonding Higher viscosity for even application Easy application Etches, primes, and bonds in one step Aggressive etchant CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
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CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
• • •
Reduces postoperative sensitivity Easy-to-use technique Comes in a unit-dose or vial delivery system (Adper Prompt Self-Etch Adhesive 3M ESPE)
OSHA PRECAUTIONS: • • •
May be irritating to the skin and eyes Should not be ingested No inhalation irritation
MIXING AND SETTING TIME: • •
Mixing time is less than 5 seconds. (Refer to the directions.) Setting time is 10 seconds to light-cure.
DIRECTIONS: 1. Tooth is rinsed and lightly dried. 2. Press on the red chamber to move the contents into the yellow
chamber. 3. Fold the red chamber over the yellow chamber.
4. The yellow chamber will pop up to indicate the material has
flowed into this area. 5. Press again and the material will flow into the next chamber. 6. With the applicator, mix and churn the material to complete 7. 8. 9. 10.
75
the mix. Apply the material to the tooth by rubbing for 15 seconds. Reapply until the surface is smooth and glossy. The adhesive will appear a dull yellow. Light-cure for 10 seconds.
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
SCOTCHBOND MULTI-PURPOSE PLUS DENTAL ADHESIVE-ADPER 3M ESPE
Courtesy of 3M ESPE
MANUFACTURER: 3M ESPE
USE: • •
Dual-curing adhesive for bonding fresh amalgams, self-cured composites, and porcelains Bonding system for indirect restoration including crowns, inlays, and onlays
COMPOSITION: • •
Primer contains HEMA Catalyst contains HEMA and bis–GMA (low-viscosity composite resin)
PROPERTIES: • • •
77
Excellent bond strength to a variety of surfaces Fast and easy application Reduces microleakage and postoperative sensitivity
CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
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CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
OSHA PRECAUTIONS: • • •
May be irritating to the skin and eyes Should not be ingested No inhalation irritation
MIXING AND SETTING TIME: • •
There is no mixing required. Material is light-cured for 10 seconds.
DIRECTIONS: 1. Material works best if the tooth is isolated with a rubber dam. 2. Tooth is prepared, rinsed, and dried. 3. The etchant is applied to the enamel and dentin—wait
15 seconds. 4. Rinse thoroughly and then gently air-dry, leaving the tooth moist. 5. Apply Scotchbond Multi-Purpose Adhesive primer to the
enamel and dentin with an applicator brush.
6. Gently dry for 5 seconds—the surface should appear shiny. 7. Apply Scotchbond Multi-Purpose Adhesive to the enamel and
dentin with an applicator brush. 8. Light-cure for 10 seconds.
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CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
AMALGAMBOND PLUS ADHESIVE SYSTEM
Courtesy of Parkell, Inc.
MANUFACTURER: Parkell, Inc.
USE: • •
Bonding system for amalgams and composites to dentin, enamel, and existing amalgams Pulp capping
COMPOSITION: •
Low-viscosity composite resin
PROPERTIES: • • • • •
81
Provides a high-power bond Reduces the needs for pins Reduces sensitivity No need to place varnish or liners Reduces microleakage
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CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
OSHA PRECAUTIONS: • • •
May be irritating to the skin and eyes Should not be ingested May be inhalation irritation
MIXING AND SETTING TIME: • • • •
Mix the base and catalyst for 3 to 5 seconds. Allow the dentin activator to dry for 30 seconds. Allow the adhesive agent to dry for 30 seconds. Allow the base and catalyst to dry before placing composite material for 60 seconds.
DIRECTIONS: 1. Pumice the tooth, then rinse and dry completely. 2. Dispense 1 or 2 drops of dentin activator into the mixing well. 3. Brush the activator on the dentin for 10 seconds—to etch the
enamel leave on for 30 seconds. 4. Wash and dry the area. 5. Dispense 1 or 2 drops of adhesive agent into a clean mixing well.
82
6. Brush a thin layer of the adhesive onto the activated dentin
surface. 7. Air-dry the surface to achieve an even, thin layer of coverage. 8. Leave for 30 seconds. 9. Dispense 2 drops of base and 1 drop of catalyst into a clean
mixing well. 10. Mix thoroughly for 3 to 5 seconds. 11. Brush a thin, even layer onto the cavity preparation. 12. Place the amalgam immediately before the adhesive dries. If
placing a composite, allow the adhesive to dry about 60 seconds before placing the composite.
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CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
OPTIBOND SOLO PLUS SYSTEM MANUFACTURER: Kerr Corporation
USE: • • • •
Adhesive for direct and indirect bonding Different bonding applications—either unidose or self-curing bottle delivery Caries protection Pulp capping
COMPOSITION: •
Micron-filled composite resin with ethanol
PROPERTIES: • • •
High bond strength to a variety of surfaces Protects against sensitivity Prevents microleakage
• • • •
Caries protection Fluoride release Reduces shrinkage No need for liners or varnish
OSHA PRECAUTIONS: • • •
May be irritating to the skin and eyes Should not be ingested Inhalation irritation may occur
MIXING AND SETTING TIME: • •
If mixing is required, mix for 3 seconds. Material is light-cured for 20 seconds.
DIRECTIONS: OptiBond Solo in Unidose (capsule or rocket) delivery 1. Etch the enamel and dentin for 15 seconds. 2. Rinse thoroughly and lightly air-dry.
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CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
3. Grip the unidose capsule at the wings and twist each side in
opposite directions. 4. Discard the larger end. 5. Place one drop of OptiBond Solo Plus Activator into open end of
the capsule. 6. Dip an applicator tip into the opening and mix for 3 seconds. 7. Apply the OptiBond Solo Plus for 15 seconds. 8. Light-cure fore 20 seconds.
OptiBond Solo Plus in Bottles 1. Etch the enamel and dentin for 15 seconds. 2. Rinse thoroughly and lightly air-dry. 3. Place one drop of OptiBond Solo Plus and one drop of OptiBond Solo Plus Activator into the mixing well and mix for 3 seconds. 4. Apply for 15 seconds. 5. Air-dry gently for 3 seconds.
PRIME & BOND NT DUAL CURE NANO-TECHNOLOGY DENTAL ADHESIVE
Courtesy of Dentsply Caulk
MANUFACTURER: Dentsply Caulk
USE: • • • • • • •
Universal self-priming dental adhesive Direct composites and compomers Veneers Indirect restorations, inlay, onlays, crowns, and bridges Repairs on composites, ceramics, and amalgams Endodontic post-cementation Adhesive bonding of direct amalgam bonding
COMPOSITION: • •
Dimethacrylate resin and acetone Highly filled nano-filled composite
PROPERTIES: • • 89
Superior bond Protection against microleakage CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
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CHAPTER 1 PRELIMINARY RESTORATIVE DENTAL MATERIALS
• •
Better surface coverage and penetration into dentin High bond strength
OSHA PRECAUTIONS: • • •
May be irritating to the skin and eyes Should not be ingested Inhalation irritation may occur
MIXING AND SETTING TIME: • •
No mixing is required. Light-cure to set material
DIRECTIONS: 1. Rinse and dry the cavity preparation or if no cavity preparation
is needed. Clean with a rubber cup and pumice or prophy paste and then rinse with water and air-dry. 2. Apply calcium hydroxide liner if necessary. 3. Condition/etch the tooth if required for 10 to 15 seconds and then rinse.
4. Gently air-dry-tooth can still be moist. 5. Dispense Prime and Bond NT adhesive directly on an applicator
brush or dispense 2 or 3 drops into a dispensing well. Replace the cap immediately. 6. Apply the adhesive on the tooth generously so the surface is wet. Additional application may be needed to keep the surface wet for 20 seconds. 7. Gently air-dry for 5 seconds; the surface should be glossy. If not, repeat the application of the adhesive. 8. Light-cure for 10 seconds and then place the restoration.
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PROCEDURE: MIXING CALCIUM HYDROXIDE LINING TWO-PASTE SYSTEM
This procedure is performed by the dental assistant at chairside after the dentist has completed the cavity preparation.
EQUIPMENT AND SUPPLIES: • • • • •
Calcium hydroxide two-paste system Small paper pad Small ball-ended instrument (often called the Dycal instrument) or an explorer 2 ⫻ 2 gauze sponge PPE worn by the dental assistant
DIRECTIONS: 1. After the dentist has completed the tooth preparation and the
dental assistant has rinsed and dried the tooth, the liner is prepared to be placed. 2. Dispense small and equal amounts of both the catalyst and base onto the paper pad. The amount is determined by the size of the tooth and the preparation. 3. Wipe off the ends of the tubes and replace the caps. 93
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4. Mix the two materials together using a circular motion. 5. Mix until the materials are a uniform color within the
10 to 15 second mixing time. 6. Wipe the excess material from the mixing instrument. 7. The dental assistant holds the paper pad, 2 ⫻ 2 gauze, and
placement instrument ready to pass to the dentist. 8. Pass the instrument to the dentist and hold the paper pad close
to the patient’s chin. 9. Wipe off the instrument with the gauze for the dentist between
applications. 10. Receive the instrument, wipe it off, tear and fold the top page of
the paper pad, and dispose of it.
Dental Cements
95
ZINC PHOSPHATE CEMENT-FLECK’S CEMENT
MANUFACTURER: Mizzy, Inc.
USE: • • •
Permanent cement for indirect restorations including inlays, onlays, crowns, and bridges Orthodontic cement High-strength base
COMPOSITION: • •
Powder—zinc oxide, magnesium oxide, and pigments Liquid—phosphoric acid and water
PROPERTIES: • • • •
97
High strength May be irritating to the pulp, so a liner is used first Has an exothermic reaction when mixed Specific guidelines for mixing to minimize the temperature rise and slow the reaction process and improve the strength CHAPTER 2 DENTAL CEMENTS
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OSHA PRECAUTIONS: • • •
Eye and skin irritation possible Should not be ingested Avoid cross-contamination
MIXING AND SETTING TIME: • • •
Mixing time is 2 minutes. Working time is 3 1/2 minutes. Setting time is 2 to 8 minutes.
DIRECTIONS: 1. Obtain a clean, cool, dry glass slab and flexible cement spatula. 2. Fluff the powder and dispense appropriate amount for
cementation. 3. Divide the powder in half, then into fourths, then divide one of
the fourths into two eighths, and then one of the eighths into two sixteenths. 4. Dispense the liquid (6 to 12 drops) holding the dropper vertical to the glass slab.
5. Incorporate one-sixteenth portion of powder into the liquid and
6. 7. 8.
9. 10. 11. 12.
99
mix for 15 seconds. Repeat by adding the second sixteenth and mix for 15 seconds. Add the eighth portion and mix the material using three quarters of the glass slab for 15 seconds. Add one of the quarters and spatulate for 20 seconds; follow by a second quarter, which is also spatulated for 20 seconds. Add enough of the last quarter of powder to achieve the consistency the dentist requires. Mix should be completed in 2 minutes. For cementation, the consistency is fluid and should follow the spatula up about an inch from the glass slab. Using the PFI, prepare to pass the cement to the dentist. Have the gauze ready to remove any excess cement from the spatula. Clean the glass slab and spatula immediately. For the base consistency, add more powder to the liquid until you reach a putty-like consistency and the cement can be rolled into a ball.
CHAPTER 2 DENTAL CEMENTS
ZINC PHOSPHATE CEMENT-HY-BOND™
MANUFACTURER: Shofu Dental Corporation
USE: • •
Permanent cement to bond metal crowns, bridges, inlays, and onlays Bonds orthodontic appliances
COMPOSITION: • •
Powder—zinc oxide, magnesium oxide, and pigments Liquid—phosphoric acid and water
PROPERTIES: • • • •
101
High compressive strength Contains tannin fluoride Radiopaque May be irritating to the pulp
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OSHA PRECAUTIONS: • • •
Eye and skin irritation possible Should not be ingested Avoid cross-contamination
MIXING AND SETTING TIME: • • •
Mixing time is within 60 seconds. Working time is 3 1/2 minutes. Setting time is 6 1/2 minutes from the end of the mix.
DIRECTIONS: 1. Obtain a clean, cool, dry glass slab and flexible cement spatula. 2. Fluff the powder and use the Shofu spoon to dispense one scoop
of powder. Use the straight edge of the semicircular hole in the stopper to level the powder. 3. Divide the powder into three equal portions. 4. Dispense four drops of liquid onto the glass slab. 5. Bring in the first portion and mix with short, quick strokes until the mix is homogeneous.
6. Repeat with the next two portions until all of the powder is
incorporated into a smooth homogeneous mix. 7. Prepare to pass the cement to the dentist, having the PFI and a
gauze pad ready.
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POLYCARBOXYLATE CEMENT-DURELON
Courtesy of 3M ESPE
MANUFACTURER: 3M ESPE
USE: • • •
Permanent cement for crowns, bridges, inlays, and onlays Orthodontic cementation High-strength base
COMPOSITION: • • • •
Powder is zinc oxide with small amounts of magnesium oxide. Stannous fluoride Liquid is polyacrylic acid copolymer in water. Liquid comes in a squeeze bottle or calibrated syringe.
PROPERTIES: • • •
105
High strength Does not exhibit exothermic heat Bonds chemically to the tooth structure and mechanically to the restoration CHAPTER 2 DENTAL CEMENTS
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CHAPTER 2 DENTAL CEMENTS
• • •
More viscous Less irritating Has a shelf life and should be discarded if the liquid discolors and becomes thick
OSHA PRECAUTIONS: • • •
Eye and skin irritation possible Should not be ingested Avoid cross-contamination
MIXING AND SETTING TIME: • • •
Mixing time is a minimum of 30 seconds. Working time is 2 minutes. Setting time is 5 to 10 minutes.
DIRECTIONS: Using powder and squeeze bottle 1. Gather the paper pad, cement spatula, powder, dosing rod, liquid, and gauze.
2. Fluff the powder and then, using the dosing rod, measure and
dispense one scoop of powder on the paper pad. Press the dosing rod into the powder and then, using the spatula, remove excess powder before placing on the paper pad. 3. Dispense the liquid by holding the squeeze bottle vertical and drop 2 drops onto the paper pad next to the powder. 4. Mix all the powder into the liquid in one move and mix until a uniform, homogeneous consistency is attained, approximately 30 seconds. 5. Gather the cement and prepare to pass to the dentist. Use wet gauze to remove excess material before it sets on the spatula and placement instrument. Using powder and calibrated syringe 1. Prepare the powder as described above. 2. Dispense the liquid from the syringe using the calibrations. For one scoop of powder use two scale units of liquid. 3. Mix all the powder into the liquid in one move until a uniform, homogeneous consistency is attained, approximately 30 seconds. 107
CHAPTER 2 DENTAL CEMENTS
GLASS IONOMER CEMENT-RELY X
MANUFACTURER: 3M ESPE
USE: • • • •
Cementing porcelain fused to metal crowns and bridges, amalgam composite, or glass ionomer core buildups Metal inlays, onlays, and crowns Prefabricated and cast post cementation Cementation of orthodontic appliances
COMPOSITION: • •
Powder is a radiopaque fluoroaluminosilicate glass. Liquid is an aqueous solution of modified polyalkenoic acid.
PROPERTIES: • • • • 109
High strength Chemically adheres to tooth structure and restoration Releases fluoride Low solubility CHAPTER 2 DENTAL CEMENTS
110
CHAPTER 2 DENTAL CEMENTS
• • •
Low viscosity, non-stringy, slump-resistant mix Non-irritating qualities Easy to mix and clean up
OSHA PRECAUTIONS: • • • •
Eye and skin irritation possible Should not be ingested May cause mild respiratory irritation Contains HEMA, which is a known allergen
MIXING AND SETTING TIME: • • •
Mixing time is 30 seconds. Working time is 2 1/2 minutes from the start of the mix at room temperature. Setting time is within 10 minutes.
DIRECTIONS: Comes in a powder/liquid system and a clicker dispenser system
Powder/Liquid System 1. Gather a paper pad, cement spatula, and gauze. 2. Keep the caps on the powder and liquid when not in use. 3. Fluff the powder. Using the specific scoop that is supplied with Rely X, dispense 3 scoops of powder on the paper pad. Three scoops of powder and 3 drops of liquid is adequate to seat one typical crown. Use an equal number of powder scoops and liquid drops. 4. Holding the squeeze bottle vertical, dispense 3 uniform-sized drops. 5. Bring all the powder into the liquid and mix in a small area to minimize water evaporation and maximize working time. Complete the mix in 30 seconds. 6. The mix should be smooth and uniform. 7. Prepare to pass the cement to the dentist. Use a gauze to wipe the excess from the spatula and PFI.
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Clicker Dispenser System 1. Dispense one portion to ensure that the dispenser is working correctly. 2. Dispose of the test material and on new paper squeeze the dispenser until you hear a clicking, continue to dispense one to three clicks depending on the restoration(s) to be cemented. 3. Mix the material into a homogeneous mix within 30 seconds. It is then ready for cementation.
FUJI-GLASS IONOMER LUTING CEMENT
MANUFACTURER: GC America
USE: • • •
For final cementation of crown and bridge restorations Metal inlays, onlays, posts Orthodontic appliances
COMPOSITION: • •
Powder is a radiopaque fluoroaluminosilicate glass. Liquid is polyacrylic acid and water.
PROPERTIES: • • • • •
115
Strong direct bond Marginal integrity for long-term restorations Minimizes microleakage Releases fluoride Does not require a dry field
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• •
Low film thickness and low solubility Easy to mix and clean up
OSHA PRECAUTIONS: • • •
Eye and skin irritation possible Should not be ingested May cause mild respiratory irritation
MIXING AND SETTING TIME: • •
Mixing time is 20 to 30 seconds depending on the size of the mix. Setting time is approximately 5 minutes.
DIRECTIONS: Powder/Liquid System 1. Gather the paper pad, cement spatula, and gauze. 2. Keep the caps on the powder and liquid when not in use.
3. Fluff the powder. Using the specific scoop that is supplied with
Fuji, dispense 1 scoop of powder on the paper pad. Divide the powder into two equal parts. 4. Holding the squeeze bottle vertical, dispense 2 uniform-sized drops. 5. Mix the first portion for 10 to 15 seconds with the liquid. Add the second portion and mix for 15 to 20 seconds. 6. Mix in a small area to minimize water evaporation and maximize working time. Complete the mix in 20 to 30 seconds. 7. The mix should be smooth and uniform. 8. Prepare to pass the cement to the dentist. Use a gauze to wipe the excess from the spatula and PFI. Premeasured Capsules 1. Tap the capsule on a flat surface to fluff the powder. 2. Depress the button on the bottom of the capsule to activate. 3. Place the capsule in a high-speed amalgamator and triturate for 10 seconds. 4. Place in designated dispenser. It is ready to use. 117
CHAPTER 2 DENTAL CEMENTS
KETAC-CEM RADIOPAQUE, KETAC-CEM APLICAP, AND KETAC-CEM MAXICAP
MANUFACTURER: 3M ESPE
USE: •
All of these materials are used for permanent cementation of inlays, crowns, bridges, and orthodontic bands/brackets.
COMPOSITION: • •
Powder is a calcium-aluminum-fluorosilicate glass. Liquid is polyacrylic acid and water.
PROPERTIES: • • • • • • • • 119
High compressive strength Adheres chemically to tooth structure Very low solubility Adheres to slightly moist tooth structure Minimal film thickness Releases fluoride ions to tooth structure Comes in various forms for easy use and cleanup Non-irritating to the pulp CHAPTER 2 DENTAL CEMENTS
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OSHA PRECAUTIONS: • • •
Eye and skin irritation possible Should not be ingested May cause mild respiratory irritation
MIXING AND SETTING TIME: • • •
Powder/Liquid mix—Mixing time is 60 seconds. Aplicap and MAXICAP—10 seconds Setting time for all is 7 minutes.
DIRECTIONS: Powder/Liquid Mix 1. Gather a paper pad, cement spatula, and gauze. 2. Keep the caps on the powder and liquid when not in use. 3. Fluff the powder. Using the specific scoop that is supplied with Ketac-Cem, dispense 1 scoop of powder on the paper pad. 4. Holding the squeeze bottle vertical, dispense 2 uniform-sized drops.
5. Mix the powder into the liquid in one portion. Mix for
60 seconds until the mix is smooth and has a glossy appearance. When the surface becomes dull, the setting reaction has started and the mix should be discarded. 6. Prepare to pass the cement to the dentist. Use a gauze to wipe the excess from the spatula and PFI. Aplicap and MAXICAP 1. Both of these systems are prepared in the same manner; the difference is in the amount of cement. The MAXICAP capsules contain a larger mix than the Aplicaps. 2. Shake the capsule to fluff the powder and then place in the designated activator to release the liquid into the powder in the capsule. 3. Place the capsule in the amalgamator and triturate for 10 seconds. 4. Remove the capsule from the amalgamator and place in the designated applier. 5. Materials are ready to dispense at this point.
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RESIN-IONOMER CEMENT-INFINITY
MANUFACTURER: Den-Mat Corporation
USE: • • • •
All-purpose cement for porcelain-metal, all ceramic, resin inlays, onlays, crowns, and bridges Maryland bridge cementation Endodontic post and core cementations Orthodontic band and bracket cementation
COMPOSITION: •
Resin-based fluoro-alumina silica glass
PROPERTIES: • • • • • 123
Self-adhesive and self-etching High-strength and long-lasting No bonding agent required in most cases Automixing syringe system Dual-curing CHAPTER 2 DENTAL CEMENTS
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CHAPTER 2 DENTAL CEMENTS
• • • • •
Easy placement and cleanup Reduces postoperative sensitivity Prevents microleakage Stress-resistant margins—fracture resistant Low film thickness
OSHA PRECAUTIONS: • • •
Eye and skin irritation possible Should not be ingested May cause mild respiratory irritation
MIXING AND SETTING TIME: • • •
Automix dispenser—no mix is required. Margins can be light-cured for easy removal of excess cement. Setting time is approximately 5 minutes.
DIRECTIONS: 1. Clean the tooth surface thoroughly. 2. Roughen a composite or metal surface with a micro-etcher or by
sandblasting before placing the cement. 3. Remove the cap from the syringe. Dispense a small amount of
4. 5. 6. 7.
125
Infinity on a mixing pad. Wipe the end of the syringe tips with a tissue. Align the automixing tip with the notch in the syringe and then turn the tip clockwise until it stops turning. Hand the syringe to the dentist for dispensing on the restoration and the tooth. When finished, remove the automixing tip and place the cap back on the syringe. Excess cement is removed and then the patient should bite on the restoration for another 5 minutes.
CHAPTER 2 DENTAL CEMENTS
RESIN CEMENT-CALIBRA
MANUFACTURER: Dentsply Caulk
USE: • • • • •
Resin cement for all indirect esthetic restorations including: ceramic, porcelain composite inlays/onlays, veneers, and crowns Cement for all metal crowns, bridges, and inlays/onlays Cement for PFM (porcelain fused to metal crowns and bridges) Cement for prefabricated and cast posts Adhesive cement for resin-bonded Maryland bridges
COMPOSITION: •
•
Barium boron fluoro alumino silicate glass, Bis-GMA, polymerizable dimethacrylic resin, hydrophobic amorphous silica, Benzoyl peroxide Shades: inorganic iron oxides and titanium dioxide
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CHAPTER 2 DENTAL CEMENTS
PROPERTIES: • • • • • • • • • •
High bond strength Virtually no sensitivity Long-term shade stability Variety of shades for excellent esthetics Low film thickness Light-cured and dual-cured Long-term retention Easy to handle and clean up Can be mixed to a variety of viscosities Do not use after expiration date
OSHA PRECAUTIONS: • • •
May cause irritation to the eyes and skin Do not breathe vapor Keep away from sources of ignition
MIXING AND SETTING TIME: •
Mixing time is 20 to 30 seconds.
• •
Working time is 2 minutes 30 seconds. Light-cured setting time is 20 seconds in each direction. Dual-cure is 6 minutes from the beginning of the mix.
DIRECTIONS: 1. Remove all temporary material from the tooth and polish with a
rubber cup and pumice or non-fluoride cleaning paste. Wash thoroughly and lightly air-dry. 2. The inside of the restoration is microetched and after the try-in is completed, it is cleaned to remove all debris. Rinse in an ultrasonic cleaner, then apply Caulks Tooth Conditioner (etchant) for 30 seconds, and then rinse the restoration thoroughly with water for 20 seconds. Air-dry. 3. Keep the area isolated. Apply Calibra Silane Coupling Agent with the syringe to etch the surface and allow to dry. 4. The tooth is prepared in the same maner as the restoration. First, rinse the preparation and then dry. Apply the Tooth Conditioner for at least 15 seconds and then rinse for 10 seconds and then blot-dry with a moist cotton pellet. Do not rub the surfaces. 129
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5. Dispense 1 to 2 drops of Prime & Bond NT into a mixing well;
add an equal number of drops of the Self-Cure Activator. Mix and then apply with a disposable brush (see Chapter 1 Preliminary Restorative Dental Material, under Bonding Agents) to the tooth for 20 seconds and then light-cure. Apply Prime & Bond NT to the restoration for 10 seconds and then air-dry for 5 seconds. 6. On a paper pad, dispense the selected shade of Calibra’s base and then an equal portion of the catalyst. Mix for 20 to 30 seconds. 7. After the cement is placed and the restoration is seated, lightcure for 20 seconds from each direction—buccal, lingual, and occlusal.
RESIN CEMENT-ADHERENCE ® DC
Courtesy of Septodont Inc.
MANUFACTURER: Septodont Inc.
USE: •
•
Final cementation of implant prostheses, bridges, crowns, inlay/onlays, Maryland bridges, and veneers. Including ceramic, metal, and metal to metal Cement for pins and posts
COMPOSITION: • •
Base: Quartz and silica Catalyst: Resin: Bis-GMA, polyethyleneglycal dimethacrylate, benzoyl peroxide
PROPERTIES: • • • • 133
Strong bonding Low film thickness Radiopaque Resistance to fracture CHAPTER 2 DENTAL CEMENTS
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• •
Low solubility Not acidic
OSHA PRECAUTIONS: • • •
May cause irritation to the eyes and skin Do not breathe vapor Avoid elevated temperatures
MIXING AND SETTING TIME: • • •
Mixing time is 20 seconds. No mixing time is required for automix. Initial set is 1 1/2 minutes and final set is 3 1/2 minutes.
DIRECTIONS: 1. As with the other resin cements, the tooth and the restoration
need to be prepared before mixing. Refer to Calibra for the steps of preparation. 2. Adherence DC does require a bonding system to be placed first. (Refer to Chapter 1, Bonding Agents.)
3. When ready, mix an equal amount of Adherence DC base and
catalyst for 20 seconds or dispense on a paper pad or directly on permanent restoration with automix material. 4. Pass to the dentist and have the PFI ready or the injection syringe system. 5. The cement is placed on the tooth and in the restoration. The restoration is seated and held in place for 1 1/2 minutes. 6. Remove excess cement at this point.
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RESIN CEMENT-LUTE-IT
Courtesy of Pentron Clinical Technologies, LLC
MANUFACTURER: Pentron Clinical Technologies, LLC
USE: • •
Cementing all composite and all ceramic indirect restorations including: veneers, inlays/onlays, crowns For intraoral porcelain repairs
COMPOSITION: •
BIS-GMA, UDMA, HDDMA, barium-borosilicate glass filler, inorganic fluoride, silica, Silane, photo initiator, amine, and inorganic pigments, benzoyl peroxide, and stabilizers
PROPERTIES: • • • •
Light-cured resin with dual-cure option Low cost Versatile shading with three levels of opacity. Shades are more natural in appearance. Unique formula provides excellent long-term marginal integrity.
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• •
Radiopaque Releases fluoride
OSHA PRECAUTIONS: • • •
Avoid contact on skin and in eyes. Some people may be allergic to the methacrylate resin. Avoid swallowing.
MIXING AND SETTING TIME: • • •
Mixing time is approximately 30 seconds. Dual-curing cement is 3 1/2 minutes working time. Setting time is about 4 minutes.
DIRECTIONS: 1. Choose the shade, reviewing the information concerning the
actions of Lute-It cement. 2. Tooth Preparation—Etch the tooth for 20 seconds and rinse
thoroughly. 3. A critical step is to keep the tooth moist. Either blot the tooth
gently or use the air for 1 to 2 seconds.
4. Place two coats of Bond 1-Primer/Adhesive to the tooth for
10 seconds. 5. A critical step is to remove the solvent by gently using the air for
at least 10 seconds. 6. Light-cure for 10 seconds. 7. Restoration Preparation—Apply Lute-It Silane to the inside of
8.
9. 10. 11. 12.
139
the restoration that has been etched, micro-etched, or sandblasted. Leave Silane on for 1 minute and then dry. Apply one coat of Bond 1-Primer/Adhesive to the inside of the restoration. Remove the solvent by gently using the air for at least 10 seconds. Do not light-cure. Cementation-Crowns, etc. Mix equal parts of the shade base and catalyst until the mix is uniform, approximately 30 seconds. Prepare to pass the cement and the PFI to the dentist for placement. Remove the excess once the cement has gelled. For veneers, place the Lute-It Cement base (light-cured) on the restoration, then place the veneer, and then light-cure for 10 seconds. Remove the excess and then light-cure for 40 seconds.
CHAPTER 2 DENTAL CEMENTS
RESIN CEMENTS-NX3, NEXUS THIRD GENERATION
MANUFACTURER: Kerr-Sybron
USE: • • • •
Cement for veneers Adhesive for ceramic, porcelain, metal, and resin crowns, inlays/onlays, and bridges Excellent adhesion to cad/cam block Can be used for core buildup
COMPOSITION: • •
Uncured methacrylate ester monomers Nonhazardous inert mineral fillers, stabilizers, activators, and radiopaque agent
PROPERTIES: • •
141
Simple delivery dual mix Unmatched esthetics, high translucency, and excellent color stability CHAPTER 2 DENTAL CEMENTS
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• • • • • • •
Versatility in light-cure and dual-cure Try in gels with both techniques Desirable non-slumping, easy control and cleanup Contains fluoride Highly radiopaque Nano-filled for easy placement and polishing Excellent bond strength
OSHA INFORMATION: • • •
May cause irritation to the eyes and skin May cause respiratory irritation Do not ingest
MIXING AND SETTING TIME: • • • •
Automix system Work time is 2 to 3 minutes. Cleanup time is 2 to 3 minutes. Finishing and polishing time for self-cure approximately 4 to 5 minutes.
DIRECTIONS: 1. The dentist will choose a shade by using the try-in gels to see
the optimum match. 2. The try-in gel is then rinsed off thoroughly and the tooth is
lightly air-dried. 3. The restoration is prepared by sandblasting or micro-etching,
then rinsed thoroughly, and dried. 4. Place the Silane to the internal surface of composite, ceramic, or
porcelain restorations and air-dry gently. If the restoration is metal, a bonding agent is used. 5. The tooth is cleaned and prepared with Optibond All-in-One bonding agent. The bonding agent is placed in a well and an applicator is used to place the material on the tooth. Scrub the first coat for 20 seconds. (Note various bonding agents could also be used.) 6. Apply a second coat and scrub for 20 seconds, dry the adhesive with air, and then light-cure for 10 seconds.
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7. Attach a new mixing tip to the dual-cured syringe and dispense
8. 9. 10. 11.
a small amount of cement on a paper pad. It is now ready to pass to the dentist. The cement is dispensed on the tooth or in the restoration. The restoration is then seated on the tooth. Allow the excess cement to flow away from the tooth and then remove. Light-cure all surfaces for 20 seconds each. Remove the disposable tip from the syringe and discard. Place the cap back on the syringe for storage. Finish and polish the restoration.
RESIN CEMENTS-VARIOLINK (VERY SIMILAR TO PANAVIA-KURARAY AMERICA AND NEXUS 2 AND NEXUS 2 DUAL-SYRINGE-KERR) MANUFACTURER: Ivoclar Vivadent
USE: •
•
Adhesive luting for indirect restorations including crowns, bridges, inlays/onlays, and veneers made from translucent ceramics and composites and FRC Core buildups
COMPOSITION: •
BIS-GMA, inorganic fillers, fluoride, initiators, stabilizers and pigments, and benzoyl peroxide
PROPERTIES: • • • • • •
High degree of strength Highest radiopacity Light- and dual-cured Six shades and three degrees of translucency for very good optical properties Two consistencies High abrasion resistance
OSHA PRECAUTIONS: • •
Irritating to the eyes and skin Irritating to the respiratory system
MIXING AND SETTING TIME: • • •
147
Mixing time is 10 seconds. Working time is 3 1/2 minutes. Material is light-cured to set.
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DIRECTIONS: 1. The Variolink II base may be used alone and light-cured to set
2. 3. 4.
5. 6.
7.
with some restoration such as veneers. Ceramic and composite restorations require the use of both the base and the catalyst for the self-curing and light-curing around the margins. Prepare the restoration according to manufacturer’s instructions. After the temporary has been removed and the dentist has tried in restoration, the tooth is rinsed and dried. An etchant is applied and then the tooth is rinsed thoroughly and gently dried. A bonding agent is placed according to manufacturer’s instructions. Dispense equal portions of the base and catalyst material on a paper pad and mix for 10 seconds until the mix is uniform and smooth. The mix is applied to the tooth with a brush or a spatula. The restoration is seated and the excess cement should be removed after tacking the margins by light-curing them for 10 to 20 seconds. Light-cure all segments of the seated restoration for 40 seconds each.
TEMPORARY ZINC OXIDE-EUGENOL CEMENTSTEMPBOND, TEMPBOND NE, AND TEMPBOND CLEAR
MANUFACTURER: Kerr
USE: • •
To cement temporary restorations Temporary cement for trial cementations
COMPOSITION: • • • • •
TempBond-Accelerator is eugenol and oil of cloves. Base is zinc oxide, mineral oil, and cornstarch. TempBond NE-Accelerator is resin, ortho ethocybenzoic acid, carnauba wax, and octanic acid. Base is zinc oxide, mineral oil, and cornstarch. TempBond Clear-Resin-based, uncured urethane diacrylate ester monomer, mineral fillers, activators, and fillers
PROPERTIES: • • 151
TempBond—Flows easily Strong enough for temporary cementation CHAPTER 2 DENTAL CEMENTS
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• • • • • •
• • •
Withstands mastication forces Seals the margins and prevents leakage Easy to mix and clean up Easy to remove Matches dentin color TempBond NE will not interfere with the polymerization of resin cements and acrylic temporaries. It has the same flow and retentive qualities. There are three delivery systems: two-paste, automix syringe, and unidose packets. Unidose packets are ideal to give patients who are traveling in case they lose their temporary. TempBond Clear has the same properties as the TempBond and is also a dual-cure material.
OSHA PRECAUTIONS: • • •
May be irritating to the eyes and skin Irritating to the respiratory system, remove the patient to fresh air If ingested, contact a physician
MIXING AND SETTING TIME: • • • •
Mixing time is 30 seconds. Working time is 1 1/2 minutes. Setting time is 7 minutes for TempBond and TempBond NE, and 5 1/2 minutes for TempBond Clear. Note: To accelerate the set with the TempBond Clear, light-cure all surfaces for 20 seconds.
DIRECTIONS: Tube or Paste 1. Dispense equal lengths of the base and accelerator on the mixing pad that is provided. Length and size is determined by the size of the temporary restoration. 2. Replace the caps tightly. 3. Mix for approximately 30 seconds until the mix is smooth, creamy, and uniform in color. 4. Wipe off the spatula and using a PFI, place TempBond cement on the tooth or temporary restoration. 153
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5. Firmly seat the restoration in the mouth and once the material is
set, remove the excess cement with a scaler. Unidose 1. Using scissors, cut along the dotted line. 2. Squeeze the material on a mixing pad. 3. Mix for 30 seconds. 4. Continue as described with the tube techniques. Syringe 1. Remove the cap from the syringe and dispense a small amount on a gauze or paper pad. 2. Place the automix tip on the syringe and turn until locked in place. 3. Material is ready to dispense directly into the temporary or on the tooth.
TEMPORARY ZINC OXIDE-EUGENOL CEMENTS-TEMPOCEM, TEMPOCEM NE, TEMPOCEM NE SMARTMIX
MANUFACTURER: Zenith/DMG
USE: •
Temporary cement for attaching all kinds of temporaries, such as crowns, bridges, inlays, and onlays
COMPOSITION: • •
TempoCem—Catalyst consists of natural resins, eugenol, and additives. TempoCem NE formulas—Catalyst consists of natural resins, fatty acids, and additives. Base for both materials is zinc oxide, paraffin, and additives. The non-eugenol materials are used with resin and resin-reinforced glass ionomer materials.
•
PROPERTIES: • • 157
Comes in eugenol and non-eugenol formulas Resists forces of mastication CHAPTER 2 DENTAL CEMENTS
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• • • • • • •
Securely retains the temporary restoration Easy to remove Resistant to saliva and protects the gingival tissues Radiopaque on X-rays Easy flow and no heat generated Protects against thermal sensitivity Comes in a variety of forms with automixing and direct dispensing
OSHA PRECAUTIONS: • • •
May be irritating to the eyes and skin Irritating to the respiratory system, remove patient to fresh air If ingested, contact a physician
MIXING AND SETTING TIME: • • •
No mixing is required. Working time is 1 minute. Setting time is from 1 to 3 minutes.
DIRECTIONS: Smartmix 1. Prepare the tooth and the temporary by rinsing thoroughly and air-drying. 2. Remove the cap from the Smartmix syringe and dispense a test amount on a paper pad or gauze. 3. Place a disposable syringe tip on the syringe and twist to secure. 4. Dispense the amount needed on the tooth or in the temporary restoration. 5. Place the temporary on the tooth and apply pressure until the material has set. 6. Remove any excess material from the margins. Cartridge 1. Prepare the tooth and temporary by rinsing thoroughly and airdrying. 2. Prepare the DMG Type 25 Applicator Gun by releasing the small lever in the back and make sure the slide is in position.
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3. Lift the top level and slide the cartridge into place. The notch on
the bottom of the cartridge aligns with the notch in the gun. Push down firmly to lock into place. 4. Remove the cap on the cartridge and dispense a small portion. Place the disposable cannula on the cartridge by lining up the notches. Twist it clockwise 90 degrees to lock into place. 5. Pull the trigger to dispense the material. 6. When finished, remove the cannula and replace the storage cap on the end of the capsule.
ZONE TEMPORARY CEMENT
MANUFACTURER: Dux Cadco Dental Products
USE: • •
Temporary cement for all provisionals Temporary cement for trial cementation of permanent restorations for evaluation purposes
COMPOSITION: •
Crystalline zinc oxide preparation
PROPERTIES: • • • • • • •
Smooth Rigid setting Consistent retention Easy removal and clean up Compatible with provisional materials Does not soften, craze, or discolor polycarbonate or acrylic crown forms Kind to the tooth
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• •
Available in tubes, unidose, and syringe Non-eugenol
OSHA PRECAUTIONS: • • •
May be irritating to the eyes and skin Irritating to the respiratory system, remove patient to fresh air If ingested, contact a physician
MIXING AND SETTING TIME: • • •
Mixing time is 30 seconds. Working time is approximately 1 1/2 minutes. Setting time is 5 to 7 minutes.
DIRECTIONS: Standard Two Tubes 1. Dispense equal lengths of the base and accelerator on the mixing pad that is provided. Length and size is determined by the size of the temporary restoration. 2. Replace the caps tightly.
3. Mix for approximately 30 seconds until the mix is smooth,
creamy, and uniform in color. 4. Wipe off spatula and using a PFI, place Zone cement on the tooth
or temporary restoration. 5. Firmly seat the restoration in the mouth and once the material is
set, remove the excess cement with a scaler. Unidose 1. Using scissors, cut along the dotted line. 2. Squeeze the material on a mixing pad. 3. Mix for 30 seconds. 4. Place in temporary restoration with a PFI. Seat the restoration in the mouth and hold in place until set. Remove excess cement. Automix Syringe and Auto-Aspirating Dual-Cartridge, SinglePlunger Syringe 1. Remove the cap from the syringe and dispense a small amount on a gauze or paper pad to be sure the materials are mixing evenly. 2. Place the automix tip on the syringe and turn until locked in place. 3. Material is ready to dispense directly into the temporary or on the tooth. 165
CHAPTER 2 DENTAL CEMENTS
TEMPORARY RESTORATIVE MATERIALS-IRM (INTERMEDIATE RESTORATIVE MATERIAL) AND IRM CAPS
MANUFACTURER: Dentsply Caulk
USE: • • •
Restoration of primary teeth if permanent teeth are within two years of eruption Restorative emergencies Caries management for Class I and II restorations lasting up to one year Public health care programs and dental school clinic application
•
COMPOSITION: • • •
Powder—polymer-reinforced zinc oxide Liquid—eugenol material and acetic acid Comes in a powder/liquid and capsules
PROPERTIES: • • 167
Fairly strong Low abrasion qualities CHAPTER 2 DENTAL CEMENTS
168
CHAPTER 2 DENTAL CEMENTS
• • • • •
Low solubility Prevents microleakage Fairly easy to mix and clean up Easy to place Material can be carved with a small round bur when hardened, if necessary.
OSHA PRECAUTIONS: • • •
May be irritating to the eyes and skin Irritating to the respiratory system, remove the patient to fresh air If ingested, contact a physician
MIXING AND SETTING TIME: • • •
Mixing time for the powder/liquid is 1 minute. Mixing time for the capsule is 8 to 30 seconds depending on the amalgamator. Mix at high speed. Setting time is 5 minutes from start to finish.
DIRECTIONS: IRM Powder/Liquid 1. Prepare the tooth by rinsing and drying completely. Place a liner if needed. 2. Powder/Liquid-Fluff the powder and using the scoop provided, measure 1 level scoop with the spatula and place on the paper pad. 3. Dispense 1 drop of liquid and replace the cap immediately to prevent evaporation. (When the liquid reaches the discard level marked on the bottle, it should be discarded.) 4. Bring 1/2 of the powder into the liquid and mix quickly and thoroughly. 5. Bring remaining powder into the mix in 2 or 3 increments and spatulate thoroughly. 6. Once all the powder is in the mix, continue mixing for 5 to 10 seconds. Mix will become smooth and adaptable. Completely mix in 1 minute. 7. IRM is now ready to place. 169
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IRM-Caps 1. To activate the IRM capsule, hold it vertical. Hold the bottom half and turn the top firmly until you feel a snap as the liquid is released. 2. Continue to tighten to be sure it is seated. 3. Place the capsule in an amalgamator and mix for a designated amount of time. 4. Once mixed, remove the bottom lid (called the press cap) and remove the mixed IRM. 5. It may be placed on a paper pad for dispensing or directly into the tooth.
TEMPORARY RESTORATIVE MATERIALS-CAVIT AND CAVIT G
MANUFACTURER: 3M ESPE
USE: •
Temporary filling material for Class I and II
COMPOSITION: • • • • •
Zinc oxide Calcium sulfate Barium sulfate and talc Ethylene BIS diacetate and zinc sulfate Poly(vinyl acetate)
PROPERTIES: • • • • • 173
High surface hardness Simple to apply Slight expansion seals margins Light-cured Comes in a tube or jar CHAPTER 2 DENTAL CEMENTS
174
CHAPTER 2 DENTAL CEMENTS
OSHA PRECAUTIONS: • • •
May be irritating to the eyes and skin Irritating to the respiratory system, remove patient to fresh air If ingested, contact a physician
MIXING AND SETTING TIME: • •
No mixing The hardening process begins within a few minutes and the patient should be advised to avoid chewing pressure for about 2 hours after application.
DIRECTIONS: 1. Remove the cap and use the sharp end to puncture the metal end
of the tube on the first time used. 2. Squeeze from the bottom of the tube to extrude a small amount
of material. Replace the cap immediately. Use a PFI to take the Cavit from the tube and place in the cavity. If additional material is required, use a clean instrument to remove what is needed.
3. Wipe the excess from the instrument with gauze and continue
filling the cavity. The cavity should be moist. Once the material is placed, have the patient bite down and then remove the excess material. 4. The hardening process begins a few minutes after placement. 5. Patient should avoid chewing pressure for about 2 hours after application. 6. Cavit G is applied following the same steps.
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PROCEDURE: PERMANENT CEMENTATION OF A PFM CROWN WITH PANAVIA F 2.0 DUAL-CURE DENTAL RESIN ADHESIVE
This procedure is performed by the dentist and the dental assistant at chairside.
EQUIPMENT AND SUPPLIES: • • • • • • • • • •
Basic setup Air/water syringe tip, HVE, and salvia ejector Cotton rolls and 2 ⫻ 2 gauze sponges Spoon excavator Cement spatula Plastic filling instrument (PFI) Sandblaster or microetcher Panavia F 2.0 Dental Adhesive System Curing light PPE worn by the dental assistant
DIRECTIONS: After the patient is seated, the temporary is removed and the crown is tried on for any adjustments before cementation. The crown and tooth are then prepared as follows before cementation: 177
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1. The internal surface of the crown is sandblasted or micro-etched,
then rinsed and dried. 2. Dispense 1 to 2 drops of alloy primer into the mixing well and
prepare a clean applicator for placement. Place the primer on the inside of the clean crown. 3. The dental assistant then dispenses equal amounts of the ED Primer II A & B (the ED Primer II initiates the set of the cement) into a mixing well, prepares a clean applicator, and mixes the material together. The dental assistant passes the applicator to the dentist and the primer is placed on the tooth. Wait for 30 seconds and then the assistant gently air-dries the tooth. 4. The assistant dispenses equal amounts of the paste A & B on a paper pad and mixes the material for 20 seconds and then passes the PFI to the dentist and holds the paper pad for the dentist to place the paste mixture into the crown. 5. The crown is firmly seated on the tooth and the excess cement is removed. In some cases the excess margins are light-cured for 2 to 3 seconds for easy cleanup.
6. After the excess cement is removed the margins are light-cured
for 5 to 20 seconds depending on the curing light or Oxyguard II is applied to the margins for self-curing in 3 minutes. 7. The dental assistant rinses and dries the area around the crown and dismisses the patient.
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Restorative Materials
181
DENTAL AMALGAM—DISPERSALLOY
MANUFACTURER: Dentsply Caulk
USE: •
Stress-bearing restorative material for posterior teeth (Class I and II)
COMPOSITION: •
•
Alloy powder contains silver, tin, copper, and zinc (Contains lathe-cut particles and silver/copper eutectic spheres that bond tin to copper) Mercury
PROPERTIES: • • • • • 183
Strong and durable material Corrosion resistant Reduced ditching Self-activating capsules Lustrous finish CHAPTER 3 RESTORATIVE MATERIALS
184
CHAPTER 3 RESTORATIVE MATERIALS
• • •
Strong margin integrity Comes in single, double, and triple spills Comes in regular and fast set
OSHA PRECAUTIONS: • • •
Material can cause irritation to the skin and eyes. Material may be irritating to respiratory system if powder is inhaled. If ingested, it may cause irritation, vomiting, and diarrhea.
MIXING AND SETTING TIME: •
•
Mixing time depends on type of amalgamator, regular set or fast set, and number of spills. Refer to manufacturer’s instructions (usually between 6 and 14 seconds). Setting time is 4 to 5 minutes for initial set and 24 hours before polishing.
DIRECTIONS: 1. The tooth is prepared and the necessary liners, bonding agents,
and matrix are placed. 2. The amalgam capsule is self-activating so it is simply placed in
the amalgamator. 3. The mixing and trituration speed is set according to
manufacturer’s instructions. 4. Follow the guidelines to achieve the proper amalgam mix
consistency. 5. The amalgam mix is removed from the capsule and placed into
an amalgam well, dappen dish, or squeeze cloth for loading into an amalgam carrier. 6. Load both ends of the carrier and pass to the dentist for placement and condensation. 7. Repeat loading the carrier as the dentist requires. 8. Place the amalgam scraps in well-sealed container. Regulations for disposal must be followed.
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DENTAL AMALGAM—PERMITE
MANUFACTURER: SDI
USE: •
Posterior restorations
COMPOSITION: • •
Non-gamma 2 admix alloy—high silver content, copper, and tin Mercury
PROPERTIES: • • • • • • •
187
High strength High polishability Excellent handling qualities Very low microleakage Capsule design releases consistent mixes Not as affected by moisture Less exposure to mercury vapor due to reduction in procedure time CHAPTER 3 RESTORATIVE MATERIALS
188
CHAPTER 3 RESTORATIVE MATERIALS
• •
Comes in five settings: slow, regular, fast, extra-carving time (ECT), and slow carving (SC) Comes in 1, 2, 3, and 5 spills
OSHA PRECAUTIONS: • • •
Material can cause irritation to the skin and eyes. Material may be irritating to respiratory system if powder is inhaled. If ingested, it may cause irritation, vomiting, and diarrhea.
MIXING AND SETTING TIME: • • •
Mixing time depends on type of amalgamator. Setting time is 2 1/2 to 6 minutes depending on type of mix. Carving time is 5 1/2 to 9 minutes depending on type of mix.
DIRECTIONS: 1. The tooth is prepared and the necessary liners, bonding agents
and matrix are placed.
2. The amalgam capsule is self-activating so it is simply placed
in the amalgamator. 3. The mixing and trituration speed is set according to the
manufacturer’s instructions. 4. Follow the guidelines to achieve the proper amalgam mix
consistency. 5. The amalgam mix is removed from the capsule and placed into
an amalgam well, dappen dish, or squeeze cloth for loading into an amalgam carrier. 6. Load both ends of the carrier and pass to the dentist for placement and condensation. 7. Repeat loading the carrier as the dentist requires. 8. Place the amalgam scraps in a well-sealed container. Regulations for disposal must be followed.
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DENTAL AMALGAM—TYTIN SPHERICAL ALLOY
MANUFACTURER: Kerr
USE: •
Posterior restorative material
COMPOSITION: • • •
Ternary alloy with high copper content Spherical particles of silver, tin, and copper Lower mercury content
PROPERTIES: • • • • •
Excellent clinical performance Higher in strength and lower in creep than other amalgams Very smooth surface Easy to place, carve and accepts immediate polishing 8 minutes in Class I restorations Comes in slow and regular set and single, double, and triple spill
191
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192
CHAPTER 3 RESTORATIVE MATERIALS
• • • • •
Each capsule is ensured to have the perfect ratio with pouched mercury. Reliable and consistent mixes Works with any amalgamator Self-activating Is color-coded
OSHA PRECAUTIONS: • • •
Material can cause irritation to the skin and eyes. Material may be irritating to respiratory system if powder is inhaled. If ingested, it may cause irritation, vomiting, and diarrhea.
MIXING AND SETTING TIME: • •
Mixing time—follow the manufacturer’s instructions (7 to 8 1/2 seconds) Setting time is 4 to 5 minutes for the initial set.
DIRECTIONS: 1. The tooth is prepared and the necessary liners, bonding agents,
and matrix are placed. 2. The amalgam capsule is self-activating so it is simply placed in
the amalgamator. 3. The mixing and trituration speed is set according to
manufacturer’s instructions. 4. Follow the guidelines to achieve the proper amalgam mix
consistency. 5. The amalgam mix is removed from the capsule and placed into
an amalgam well, dappen dish, or squeeze cloth for loading into an amalgam carrier. 6. Load both ends of the carrier and pass to the dentist for placement and condensation. 7. Repeat loading the carrier as the dentist requires. 8. Place the amalgam scraps in a well-sealed container. Regulations for disposal must be followed.
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DENTAL AMALGAM—VALIANT AMALGAM, VALIANT PH.D, VALIANT SNAP-SET
Courtesy of Ivoclar Vivadent
MANUFACTURER: Ivoclar Vivadent
USE: •
Posterior restorative material Class I and II
COMPOSITION: • •
Valiant and Valiant Snap-Set—Spherical amalgam alloy with high copper content and palladium added plus mercury Valiant Ph.D Amalgam—Phase-dispersed amalgam with palladium enriched and with lower mercury content
PROPERTIES: • • • • •
Higher early strengths Corrosion resistance Smooth carving and burnishing Specially designed capsules that are ultrasonically welded for increased safety and efficiency Valiant Snap-Set has a faster setting time.
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• •
Valiant Ph.D has a finer particle size for smoother carving, faster wetting, faster setting, and denser amalgam mass. All come in single, double, and triple spills.
OSHA PRECAUTIONS: • • •
Material can cause irritation to the skin and eyes. Material may be irritating to the respiratory system if powder is inhaled. If ingested, call a physician immediately.
MIXING AND SETTING TIME: • •
Mixing time—follow the manufacturer’s instructions (7 to 8 1/2 seconds). Setting time is 4 to 5 minutes for initial set.
DIRECTIONS: 1. The tooth is prepared and the necessary liners, bonding agents,
and matrix are placed.
2. The amalgam capsule is self-activating so it is simply placed in
the amalgamator. 3. The mixing and trituration speed is set according to manufacturer’s
instructions. 4. Follow the guidelines to achieve the proper amalgam mix
consistency. 5. The amalgam mix is removed from the capsule and placed into
an amalgam well, dappen dish, or squeeze cloth for loading into an amalgam carrier. 6. Load both ends of the carrier and pass to the dentist for placement and condensation. 7. Repeat loading the carrier as the dentist requires. 8. Place the amalgam scraps in a well-sealed container. Regulations for disposal must be followed.
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PRODIGY HYBRID—CONDENSABLE COMPOSITE
MANUFACTURER: Kerr
USE: • •
Primarily used for Class I and Class II posterior restorations Can be used for all classes of restorations
COMPOSITION: • •
Hybrid composite resin with uncured methacrylate ester monomers Mineral fillers, activators, and fillers
PROPERTIES: • • • • • 199
Packable application Low shrinkage High esthetic quality Margin integrity Easy to use with proven system
CHAPTER 3 RESTORATIVE MATERIALS
200
CHAPTER 3 RESTORATIVE MATERIALS
• •
Can be bulk cured Proven filler technology
OSHA PRECAUTIONS: • • • •
May be irritating to the skin with repeated and prolonged exposure Irritating to the eyes May be irritating if inhaled repeatedly Should not be ingested
MIXING AND SETTING TIME: • •
No mixing is required. The material comes in unidose tips. Material is light–cured.
DIRECTIONS: 1. 2. 3. 4.
Select the shade of the tooth under natural light. Tooth is prepared by the dentist. Place OptiBond Solo Plus following manufacturer’s instructions. Light-cure the bonding agent.
5. Place OptiGuard Surface Sealant according to manufacturer’s
instructions. 6. Place a new tip on the etchant syringe and place the etchant. 7. Leave the etchant in place for 10 to 15 seconds, then rinse
and air–dry. 8. Place the matrix. 9. Select the shade of material and place the unidose tip in the
unidose gun. 10. Apply the material directly into the cavity and condense; repeat
this procedure and light-cure each layer for 20 seconds. 11. After polymerization, remove the excess material and finish with
diamond burs, stones, and discs.
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COMPOSITES—FILTEK SUPREME PLUS— NANOCOMPOSITE UNIVERSAL RESTORATIVE
MANUFACTURER: 3M-ESPE
USE: • • • •
Designed for anterior and posterior restorations Core buildups Splinting Indirect restorations including inlays, onlays, and veneers
COMPOSITION: • • •
Nanocomposite Bis-GMA, UDMA, TEGDMA, and Bis-EMA resins Between 72.5% and 78.5% filler
PROPERTIES: • • • • 203
Highly regarded physical properties Excellent clinical properties Visible-light-activated material Comes in a variety of shades that blend easily
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• • • • •
Non-slumping and non-sticky Strong and dependable Wear comparable to enamel Also available as a flowable Filtek Supreme Plus Flowable Most shades are radiopaque.
OSHA PRECAUTIONS: • • •
May cause eye irritation May cause skin irritation May cause problems if ingested
MIXING AND SETTING TIME: • •
No mixing is required. Material is light–cured to set.
DIRECTIONS: 1. Before the tooth is prepared, select the shade under natural light. 2. The tooth is then prepared by the dentist. 3. A liner may be placed and then the matrix is positioned.
4. Follow manufacturer’s instructions regarding etching, priming
and adhesive application, and curing. 5. Dispense the composite as follows: Syringe—dispense necessary
amount of material from the syringe onto a pad. If the material is not used immediately, protect it from light until used. Material is placed with PFI in incremental layers. Single-dose capsules— Place capsule into 3M-ESPE Restorative Dispenser, remove the cap, and pass to the dentist for placement. 6. Composite is placed in layers and light-cured after each layer.
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POINT 4 OPTIMIZED PARTICLE HYBRID COMPOSITE SYSTEM—UNIVERSAL HYBRID COMPOSITE
MANUFACTURER: Kerr
USE: •
Suitable for all classes of cavity preparations
COMPOSITION: •
Composite resin with 77% inorganic filler
PROPERTIES: • • • • • • •
207
Sixteen body shades, eight opaque shades, and three translucent shades All shades are radiopaque. Polishes to a smooth, lustrous finish Hybrid strength Bridges the gap between the microfill and hybrid composites Quick and easy to use True chameleon effect and blends with adjacent teeth
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OSHA PRECAUTIONS: • • • •
May be irritating to the skin with repeated and prolonged exposure Irritating to the eyes May be irritating if inhaled repeatedly Should not be ingested
MIXING AND SETTING TIMES: • •
No mixing is required. Material is light-cured to set.
DIRECTIONS: 1. Prepare the etchant syringe and place the etchant in the cavity
preparation for 15 seconds. 2. Rinse and dry lightly. 3. Apply OptiBond Solo Plus on enamel and dentin for 15 seconds
using a light brushing motion. Lightly air-dry for 3 seconds and light-cure for 20 seconds.
4. Place the unidose base tip in the dispensing gun and pass to the
dentist. Light-cure each layer for 20 seconds. 5. Place the unidose translucency tip in the dispensing gun and
pass to the dentist. Light-cure after placement for 20 seconds.
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TETRIC FLOW—FLOWABLE MICRO HYBRID COMPOSITE RESTORATIONS
MANUFACTURER: Ivoclar Vivadent
USE: • • • • • •
Class V restorations (cervical caries, root erosion, wedge-shaped defects) Anterior restorations (Class III and IV) Small posterior restorations Extended fissure sealing in molars and premolars Blocking out of undercuts Adhesive cementation of ceramic and composite restorations
COMPOSITION: •
211
Monomer matrix of Bis-GMA, urethane, dimethacrylate, and triethylene glycol dimethacrylate, and 68% inorganic filler particles
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PROPERTIES: • • • • •
Low viscosity permits optimum wetting of the tooth. A variety of shades are available for outstanding esthetics. Has fluoride release Radiopaque Easy to use and variety of applications
OSHA PRECAUTIONS: • •
May be irritating to the skin Irritating to the eyes
MIXING AND SETTING TIMES: • •
Material comes in single-use cartridges and syringe form. Material is light-cured to set.
DIRECTIONS: 1. The tooth has been prepared and the pulp protection and
bonding agent are placed according to manufacturer’s instructions.
2. Tetric Flow Cavifil cartridges are placed in the dispensing gun or
Luer-lock applicator tips are placed on the Tetric Flow syringe. 3. The material is applied directly into the cavity preparation. 4. Light-cure each increment for 20 seconds.
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ESTHET X—MICRO MATRIX RESTORATIVE MATERIAL
Courtesy of Dentsply Caulk
MANUFACTURER: Dentsply Caulk
USE: • •
Esthetic restorative material for all cavity classes For primary and permanent dentition
COMPOSITION: • • •
Dimethacrylate resin (urethane modified Bis-GMA) Inorganic fillers (including silica, barium boron fluoro alumino silicate glass) Colorants
PROPERTIES: • • • • • 215
Outstanding physical properties Long working time High fracture toughness for strength and durability Radiopaque High wear resistance
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• • • • • • •
Adapts well to margins No patient sensitivity Low shrinkage Brilliant polish Optimum handling Comes with detailed shade guide Optimized 31 shades and 3 opacities
OSHA PRECAUTIONS: • • •
Can be irritating to eyes and skin No inhalation irritation Probably not harmful if ingested
MIXING AND SETTING TIMES: • •
No mixing is required. Materials come in single dose compules or easy-twist syringe. Materials are light-cured to set.
DIRECTIONS: 1. Easy-twist syringe—remove cap in a “snap-off” twist with lateral
force. 2. Dispense the necessary amount of Esthet X material from the
syringe on the paper pad by turning the handle clockwise. When finished dispensing the material, turn the handle counterclockwise and replace the cap. 3. Pre-dosed Esthet X compules—load by inserting the compule tips into the notched opening of the compule dispensing gun. Be sure the collar on the compules is inserted first. 4. Remove the tip cover; the material is now ready to be dispensed. 5. Light-cure each area of the restoration for 20 seconds. The restoration may be placed in increments and will need to be light-cured after each layer.
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PREMISE UNIVERSAL NANO-RESTORATIVE MATERIAL AND PREMISE FLOWABLE
MANUFACTURER: Kerr
USE: • •
Universal for all restoration on the anterior and posterior teeth Flowable is also used as pit and fissure sealants, repair of enamel defects, repair of porcelain restorations, minor occlusal buildups in nonstress areas, and incisal abrasions.
COMPOSITION: • •
Resin: ethoxylated Bis-GMA, triethylene glycol dimethacrylate, light-cured initators and stabilizers Three fillers: prepolymerizable filler, barium glass, silica nanoparticles (84% filler) Polymerizable organophosphate dispersant
•
219
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PROPERTIES: •
•
Universal material—ultra-low shrinkage • Universal application with strength for the posterior teeth and esthetics for anterior teeth • Three different fillers to improve this nano-restorative material • Unmatched handling • Comes in a variety of shades including body shades, translucent shades, and packable shades • High polish and gloss characteristics Flowable material flows easily but holds its shape, excellent mechanical strength, low shrinkage, high polishability and wearability
OSHA PRECAUTIONS: • •
Prolonged or repeated exposure may cause irritation to the skin. May cause irritation to the eyes
• •
Prolonged or excessive inhalation may cause irritation to the respiratory tract. May be harmful if swallowed
MIXING AND SETTING TIME: • •
There is no mixing time. The universal comes in unidose tips and the flowable comes in a syringe. Both materials are light-cured to set.
DIRECTIONS: Universal Premise 1. Apply self-etching bonding system following manufacturer’s instructions. 2. Place the unidose tip of the selected shade into the dispensing gun. 3. Pass to the dentist and prepare the curing light.
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4. Light-cure for 5 to 20 seconds depending on the curing light after
each increment is placed. 5. When finished, remove the unidose tip from the gun and dispose.
Flowable Premise 1. Apply self-etching bonding system following manufacturer’s instructions. 2. Place disposable tip on selected shade of Premise Flowable and secure. 3. Pass to the dentist and prepare the curing light. 4. The dentist will flow the material into the cavity preparation and place in layers. Light-cure for 5 to 20 seconds depending on the curing light. 5. Restoration is finished and polished.
HELIOMOLAR HB—PACKABLE MICROFILLED RESTORATIVE MATERIAL
Courtesy of Ivoclar Vivadent
MANUFACTURER: Ivoclar Vivadent
USE: • •
Microfill composite for the posterior region Restorations in primary teeth
COMPOSITION: • • • •
Monomer matrix of Bis-GMA, urethane dimethacrylate, decandiol dimeth acrylate Fillers include copolymer, silicone dioxide, yetterbium trifluoride Total amount of inorganic fillers is approximately 66%. Catalysts, stabilizers, and pigments
PROPERTIES: • • • 225
Highly viscous packable material Nine shades to choose from Highly radiopaque
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• •
Low wear value Polishes to a long-lasting high gloss
OSHA PRECAUTIONS: • • •
May be irritating to the eyes and the skin No problems anticipated if small amount of material is ingested If irritating when inhaled, move to fresh air.
MIXING AND SETTING TIME: • •
There is no mixing. Material comes in a syringe or a Cavifill. Material is light-cured for 20 seconds for each increment.
DIRECTIONS: 1. The tooth is conditioned and bonding agent is applied following
manufacturer’s instructions. 2. Prepare and coat the cavity with a layer of Heliomolar flow. 3. Heliomolar comes in either a syringe or a Cavifill. Prepare the
syringe by removing the cap and dispensing the selected shade on a pad.
4. Hold the pad and pass the plugger/condensing composite
instrument. 5. Cavifills—place the selected shade of Cavifill and place it into
the dispensing gun. 6. Secure the Cavifill and remove the tip. Pass to the dentist for
placement. 7. Heliomolar is placed in increments and each increment is light-
cured after placement for 20 seconds. 8. Several shades may be used to achieve the desired results.
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TETRIC—MICROHYBRID COMPOSITE RESTORATIVE MATERIAL MANUFACTURER: Ivoclar Vivadent
USE: • • • • •
All classes of restoration anterior and posterior (Class I, II, III, IV, and V) Veneering of discolored anterior teeth Preventive restoration in premolars and molars Splinting of mobile teeth Repairing ceramic and composite veneers
COMPOSITION: •
Monomer matrix of Bis-GMA, urethane dimethacrylate, triethylene glycol dimethacrylate
• •
Fillers of barium glass, yetterbium trifluoride, highly dispersed silicon dioxide, spherical mixed dioxide (81% fill) Cataylists, stabilizers, and pigments
PROPERTIES: • • • • • •
Good polishability Radiopacity is good. Continuous fluoride release High shade stability Easy handling Thirteen shades including one translucent and three opaque dentin shades
OSHA PRECAUTIONS: • • •
229
May be irritating to the eyes and the skin No problems anticipated if small amount of material is ingested If irritating when inhaled, move to fresh air.
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MIXING AND SETTING TIME: • •
There is no mixing. Material comes in a syringe or a Cavifill. Material is light-cured for 40 seconds for each increment.
DIRECTIONS: 1. Apply conditioner and bonding agent according to
2.
3. 4. 5.
manufacturer’s directions. Recommended to use product from the same manufacturer. Tetric comes in either a syringe or a Cavifill. Prepare the syringe by removing the cap and dispensing the selected shade on a pad. Hold the paper pad and pass the plugger/condensing composite instrument. Cavifill—place the selected shade of Tetric and place it into the dispensing gun. Secure the Cavifill in the dispensing gun and then remove the tip. Pass to the dentist for placement.
6. Tetric is placed in increments and each increment is light-cured
after placement for 40 seconds. 7. Several shades may be used to achieve the desired results of
matching the tooth coloring.
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GLACIER—MICROFILLED HYBRID COMPOSITE
MANUFACTURER: SDI
USE: • • • •
Anterior and posterior esthetic restorations (Class I, II, III, IV, and V) Veneers Inlays/onlays Core buildups
COMPOSITION: • •
Microfilled hybrid composite with strontium glass and amorphous silica Initiators, stabilizers, and pigments
PROPERTIES: • • • 233
High compressive strength Radiopaque Low shrinkage that reduces sensitivity and microleakage
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• • •
Wear resistant Non-stick and non-slump Polishes to a high luster
OSHA PRECAUTIONS: • • •
May be irritating to the eyes and the skin No problems anticipated if small amount of material is ingested If irritating when inhaled, move to fresh air.
MIXING AND SETTING TIMES: • •
Material comes in a syringe or Complets. There is no mixing. Glacier is light-cured to set.
DIRECTIONS: 1. Etch the tooth for 20 seconds with 37% phosphoric etchant. 2. Rinse the tooth thoroughly and then remove excess moisture
leaving the tooth moist. 3. Apply a bonding agent according to manufacturer’s instruction
and light-cure for 20 seconds.
4. Gently blow-dry for 2 seconds until glossy, then light-cure
20 seconds. 5. Prepare the syringe of the selected shade by removing the cap
and placing a dispensing tip on the end. If using the Complets (compules), place the Complets in the Complets applicator and snap to secure. Remove the end from the Complets. 6. Pass to the dentist for placement. Light-cure after each increment is placed for 20 seconds. 7. Restoration is ready to finish and polish.
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SIMILE NANO-HYBRID COMPOSITE MANUFACTURER: Pentron Clinical Technologies
USE: •
Esthetic restoration for both anterior and posterior teeth
COMPOSITION: •
A mixture of difunctional methacrylate of PCBis-GMA, Bis-GMA, UDMA, HDDMA, barium boron silicate glass, nano-particulated silica, zirconium silicate, photo initiator, accelerator, stabilizers, Silane, and pigments
PROPERTIES: • • • •
Sculptable handling that will not stick to instruments Superior surface for easy polishability and retention of shine Low wear rates for long-lasting restoration Familiar shades that are easy to use
OSHA PRECAUTIONS: • •
Irritating to the skin and eyes, rinse with plenty of water and contact medical attention If ingested, seek medical attention
MIXING AND SETTING TIME: • •
No mixing is required. Light-cured to set.
DIRECTIONS: 1. Apply bonding agent according to manufacturer’s instructions. 2. Select the syringe(s) of the desired shade and remove the tip. 3. Dispense material on paper pad and prepare for placement.
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DYRACT EXTRA UNIVERSAL COMPOMER
Courtesy of Dentsply Caulk
MANUFACTURER: Dentsply Caulk
USE: • •
Direct esthetic restoration indicated for all cavity classifications (Class I through V) Anterior and posterior teeth
COMPOSITION: •
• • •
239
Polymerizable dimethacrylate resin—urethane dimethacrylate resin, trimethacrylate resin, carboxylic acid modified dimethacrylate, triethyleneglycol dimethacrylate, camphorquinone, ethyl–4 dimethylaminobenzoate, butylated hydroxy toluene UV stabilizer Strontium alumino sodium fluoro-silicate glass Colorants are inorganic iron oxides.
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PROPERTIES: • • • • • • •
Improved physical properties—less sticky handling and increased working time Excellent wear resistant Fluoride release Shortened curing time Easier finishing and polishing to a high luster restoration Comes in a variety of shades Also comes in a flowable composition
OSHA PRECAUTIONS: • • •
May be irritating to the eyes May cause irritation to the skin Material is probably not harmful if swallowed.
MIXING AND SETTING TIME: • •
No mixing is required. Dyract comes in individual compule tips. Material is light-cured for 10 to 20 seconds.
DIRECTIONS: 1. Place 2 to 3 drops of self-etching adhesive into clean mixing
well. 2. Apply generous amount with small applicator and scrub for
15 seconds, then repeat. 3. Spread the adhesive and then gently spread with air until there
is no more flow of the material—about 5 seconds. 4. Light-cure at least 10 seconds and then immediately place the
restoration. 5. The selected shade of Dyract Xtra compule tip is placed in the
Compules Tips gun. Load by inserting the compules tips into the notched opening of the Compules Tips gun. Be sure the collar on the compules is inserted first. 6. The cap is removed and the material is ready for placement. 7. Dyract Xtra is placed in 2 mm increments and light-cured after each increment is placed for 10 to 20 seconds. This is repeated until restoration is completed. 8. Restoration is ready to finish and polish. 241
CHAPTER 3 RESTORATIVE MATERIALS
COMPOGLASS F—COMPOMER-BASED RESTORATIVE MATERIAL
Courtesy of Ivoclar Vivadent
MANUFACTURER: Ivoclar Vivadent
USE: • • • •
Restoration for deciduous teeth Class V (cervical caries, root erosion, and wedge-shaped defects) Class III restorations Intermediate Class I and II restorations
COMPOSITION: •
Monomer matrix of urethane dimethacrylate, tetraethylene glycol dimethacrylate, cycloatiphatic dicarboxylic acid dimethacrylate. Inorganic fillers—Ba-fluorosilicate glass, mixed oxides, yetterbium trifluoride (77% inorganic fillers). Catalysts, stabilizers, and pigments
PROPERTIES: • • 243
Advantages of glass ionomer cements and light-cured composites Radiopaque CHAPTER 3 RESTORATIVE MATERIALS
244
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• • • •
Polishable Higher fluoride release High abrasion resistance Excellent bonding to enamel and dentin
OSHA PRECAUTIONS: • • • •
Flush with water if material gets into the eyes May cause skin irritation—wash with water and soap No known problems if ingested Remove to fresh air if respiratory irritation
MIXING AND SETTING TIMES: • •
No mixing is required. Light-cure to set
DIRECTIONS: 1. It is recommended to use a bonding agent from Ivoclar Vivadent. 2. Apply primer to the cavity preparation using a small applicator
tip. Brush on for 30 seconds and then disperse excess liquid with strong stream of air until mobile liquid has disappeared.
3. Apply bonding agent with applicator tip. Using a gentle air
stream, disperse evenly and light-cure for 10 seconds. 4. Load the Cavifil capsule into the dispensing gun and secure.
Remove the cap. 5. Pass to the dentist for placement with a placement instrument
such as the PFI. Material will be placed in increments and light-cured for 40 seconds after each increment is placed. 6. Close the Cavifil capsule after placement. Restoration is ready to finish.
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GC FUJI IX GP-GLASS IONOMER RESTORATIVE MATERIAL MANUFACTURER: GC America
USE: • • • • •
Geriatric and pediatric restorations (Class I and II) Final restoration in non-stress areas Core-buildups Class V and root surface restorations Long-term temporaries
COMPOSITION: • • •
Glass Ionomer Liquid⫽polyacrylic acid Powder⫽polyacrylic acid and aluminosilicate glass
PROPERTIES: • •
Easy to handle and packable Chemically bonds to tooth structure
• • • • •
Cures extremely hard and is very wear resistant Fluoride release Non-sticky High compressive and flexural strength Placed and finished similar to amalgam
OSHA PRECAUTIONS: • • •
If ingested do not induce vomiting, give water and seek medical attention May be irritating to the eyes—flush with water for 15 minutes May be irritating to the skin—wash with soap and water
MIXING AND SETTING TIME: • •
Two minute working time Self-cures in 2.5 minutes (4.5 minutes from start)
DIRECTIONS: 1. Rinse the cavity preparation and air dry gently. 2. Shade the capsule or tap on a hard surface to loosen the powder.
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3. Push the plunger in until it is even with the capsule or
immediately place capsule in the GC metal capsule activator and compress handle until it clicks. This activates the capsule. 4. Immediately place the activated capsule into an amalgamator and triturate for 10 seconds ⫹/⫺ the designated amount of time depending on the amalgamator/mixer. 5. Immediately remove the capsule from the amalgamator and place in the GC applier. Compress the handle for two clicks to be sure the material is ready. Remove the tip and pass to the dentist for placement.
KETAC FIL PLUS APLICAP—GLASS IONOMER RESTORATIVE MATERIAL
Courtesy of 3M ESPE
MANUFACTURER: 3M-ESPE
USE: • • • • •
Ideal for pediatric and geriatric patients Class III and V restorations Cervical defects Small Class I Core build-ups
COMPOSITION: • • •
Glass ionomer Powder⫽glass powder Liquid⫽water, polyethylene, polycarbonic acid and tartaric acid
PROPERTIES: • • • 251
High compressive strength Minimal abrasion Excellent surface hardness
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• • • • • •
Fluoride release Bulk placement Chemical bonds to enamel and dentin Eight shades Tooth—like co-efficient of thermal expansion thus less shrinkage and microleakage Radiopaque
OSHA PRECAUTIONS: • • •
May be irritating to the skin and eyes Should not be ingested May cause upper respiratory irritation
MIXING AND SETTING TIME: • • • •
Activating the Aplicap–2 seconds Mix the Aplicap for 8 to 10 seconds in a rotary mixer or an amalgamator Processing from start of mix is 1:30 minutes Setting from start of mix is 7 minutes
DIRECTIONS: 1. Prepare tooth according to manufacturer’s instructions. 2. Rinse and gently dry the cavity preparation. Do not over dry. 3. Activate the Aplicap by placing it in the Aplicap Activator and
squeezing the handle. 4. Remove Aplicap and immediately place in rotary mixer or
amalgamator for 8 to 10 seconds. 5. Remove Aplicap and place in Applier. Raise the dispensing tip
and pass to the dentist for placement. Pass a placement instrument.
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COMPOSITE RESTORATION WITH TETRIC MICROHYBRID MATERIAL This procedure is performed by the dentist and the dental assistant at chairside.
EQUIPMENT AND SUPPLIES: • • • • • •
Basic set up Air/water syringe tip, HVE, and saliva ejector Cotton rolls and 2 ⫻ 2 gauze sponges, applicator tips Topical and local anesthetic setup Rubber dam setup High and low speed dental handpieces and assortment of diamond and cutting burs
• • • • • • • • •
Spoon excavator Shade guide Plastic filling instrument Celluloid matrix strip and wedges Etchant and bonding agent or all in one etchant and bonding agent Plastic filling instrument (PFI) Tetic Microhybrid Composite Restorative System Curing light Finishing burs/diamonds, discs, and stones
DIRECTIONS: 1. Select the shade under natural light before the procedure begins.
The tooth should be clean. 2. The anesthetic is given and the dental dam is placed for
isolation. 3. The dentist prepares the cavity to receive the restoration
material. 255
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4. The dental assistant places a liner if required. Check composite
5. 6.
7. 8.
instructions for type of material to select. Assistant mixes the material usually calcium hydroxide or glass ionomer liner and holds the pad, applicator, and a 2 ⫻ 2 gauze near the patients chin. After each application wipe the instrument. Light-cure if required. Place the matrix and the wedge. Place a dispensing tip on the etchant syringe and place the etchant for 10 to 20 seconds. Wash and rinse the tooth thoroughly for 20 to 30 seconds. Using the air, gently remove any excess moisture. Using a small application brush or cotton tipped applicator place the bonding agent, gently dry to remove any moisture and then light-cure approximately 10 seconds. Note: An all in one etchant/bonding agent may also be used. This material is placed in one step. Refer to Chapter 1 Preliminary Restorative Materials for more information.
9. Prepare the selected shades of Tetric (Tetric comes in either
Cavifils or the syringe. 10. Secure the Cavifils in the dispensing gun and then remove the
11. 12. 13. 14. 15. 16.
257
tip or remove the cap from the Tetric syringe and dispense some material onto a paper pad. Pass to the dentist for placement. Tetric is placed in increments and each increment is light-cured after placement for 40 seconds. Several shades may be used to achieve the desired results of matching the tooth coloring. Remove the wedge and matrix strip and pass an explorer to the dentist. Rubber dam may be removed here, depends on dentist’s preference. Prepare and pass high speed hand piece with fine diamond and/or finishing burs to remove the excess material. Pass finishing strip to finish the proximal surfaces.
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17. Pass articulating forceps/paper to the dentist to check the
occlusion. 18. Pass the low speed hand piece with silicone polishers,
polishing discs, and polishing strips. 19. Rinse and evacuate.
Impression Materials
259
JELTRATE ® ALGINATE
Courtesy of Dentsply Caulk
MANUFACTURER: Dentsply Caulk
USE: •
Making dental impressions used for the fabrication of casts for: • Study models • Orthodontic models • Opposing models • Removable splints • Removable retainers • Provisional restorations • Additional applications in the dental office
COMPOSITION: • • •
261
Crystaline Silica Amorphous Silica Calcium Sulfate
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262
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• • • • • •
Tetrasodium Pyrophosphate Potassium Alginate Magnesium Oxide Organic Glycol D & C Red #30 (Fast Set) Yellow Iron Oxide (Regular Set)
PROPERTIES: • • • •
Supplied in airtight pouches or can (canister), water measure, and a scoop Material is supplied with a scoop and measuring device Appears to be a creamy color when mixed Comes in regular and fast set
OSHA PRECAUTIONS: • • •
Always read the MSDS information on the product Eye contact Inhalation
• •
Ingestion Patients who have history of severe allergic reactions to components
MIXING AND SETTING TIME: Mixing time Total working time Initial setting time Setting time
Regular Set 1 minute 2:15 min/sec 2:30 min/sec 3:30 min/sec
Fast Set 45 seconds 1:30 min/sec 1:45 min/sec 2:30 min/sec
*The temperature of the water will vary the working and setting time. Cooler water increases time; warmer water decreases time.
DIRECTIONS: After the tray is selected, PPE in place, and the patient is prepared for procedure: 1. Cut pouch and place into canister with tight-fitting lid 2. Fluff powder with lid in place 263
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3. Dispense material by dipping supplied scoop into powder
(do not pack) and tap it lightly against the rim to ensure that the scoop is filled. Use spatula by laying it level across the scoop to scrape excess material from the scoop. 4. Place scoops into dry mixing bowl (rubber bowl, disposable bowl, or into alginate mixer). Place additional scoops into bowl. Normally two scoops are needed for the mandibular and three scoops for the maxillary arch. 5. Add water from the water measuring device. Each line indicates enough water for one scoop. If three scoops are used, the entire water measuring device can be used. Water should be distilled and the water temperature should be approximately 73°F or 23°C. 6. Use a wide blade spatula to mix water and powder carefully at first to incorporate it together. Then spatulate against the bowl sides to reduce air incorporations. Do not whip the material. Rotate the bowl and gather the material and then spatulate again
against the sides of the bowl. Follow the mixing times for the material. 7. Once the material is mixed to a creamy texture without air bubbles, it can be gathered and loaded into the impression tray for insertion into the mouth.
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COE ALGINATE™
MANUFACTURER: GC America
USE: Making dental impressions used for the fabrication of casts for: • Study models • Orthodontic models • Opposing models • Removable splints • Removable retainers • Provisional restorations • Additional applications in the dental office
PROPERTIES: • • • • 267
Supplied in airtight Ziplock® pouches with a water measure and a scoop Use scoop and water measure that is supplied with the material Low flow minimizes gagging High compressive strength
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• •
High tear strength Comes in regular and fast set in both mint and cherry flavors
OSHA PRECAUTIONS: • • • • •
Always read the MSDS information on the product Eye contact Inhalation Ingestion Patients who have history of severe allergic reactions to components
MIXING AND SETTING TIME: Mixing time Total working time Initial setting time Setting time
Regular Set 45 seconds 2:35 min/sec 2:50 min/sec 3:45 min/sec
Fast Set 45 seconds 1:35 min/sec 1:50 min/sec 2:45 min/sec
*The temperature of the water will vary the working and setting time. Cooler water increases time; warmer water decreases time.
DIRECTIONS: After the tray is selected, PPE in place, and the patient is prepared for procedure: 1. Dispense material by dipping supplied scoop into powder and packing it into the scoop. Use spatula by laying it level across the scoop to further pack the material and scrape excess material from the scoop. 2. Place scoops into dry mixing bowl (rubber bowl, disposable bowl, or into alginate mixer). Place additional scoops into bowl. Normally two scoops are needed for the mandibular and three scoops for the maxillary arch. 3. Add water from the water measuring device. Each line indicates enough water for one scoop. If three scoops are used, the entire water measuring device can be used. Water should be distilled and at approx. 73°F or 23°C.
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4. Use a wide blade spatula to mix water and powder carefully at
first to incorporate it together. Then spatulate against the bowl sides to reduce air incorporations. Do not whip the material. Rotate the bowl and gather the material and then spatulate again against the sides of the bowl. Follow the mixing times for the material. 5. Once the material is mixed to a creamy texture without air bubbles, it can be gathered and loaded into the impression tray for insertion into the mouth.
KROMAFAZE ALGINATE
Courtesy of DUX Dental
MANUFACTURER: DUX Dental
USE: •
Making dental impressions used for the fabrication of casts for: • Study models • Orthodontic models • Opposing models • Removable splints • Removable retainers • Provisional restorations • Additional applications in the dental office
PROPERTIES: • •
Supplied in airtight pouches, with a water measure and a scoop Use scoop and water measure that is supplied with material
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• • • • • •
High compressive strength High tear strength Stone models can be separated after 30 minutes Dust free Color changing guide for consistency Comes in regular and fast set
OSHA PRECAUTIONS: • • • • •
Always read the MSDS information on the product Eye contact Inhalation Ingestion Patients who have history of severe allergic reactions to components
MIXING AND SETTING TIME: Visual color changing guide for consistency Mix Load Seat Set
Regular
Fast
Purple Pink White
Purple Pink White 30–45 seconds
*The temperature of the water will vary the working and setting time. Cooler water increases time; warmer water decreases time.
DIRECTIONS: After the tray is selected, PPE in place, and the patient is prepared for procedure: 1. Dispense material by dipping supplied scoop into powder and packing it into the scoop. Use spatula by laying it level across the scoop to further pack the material and scrape excess material from the scoop. 275
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2. Place scoops into dry mixing bowl (rubber bowl, disposable
bowl, or into alginate mixer). Place additional scoops into bowl. Normally two scoops are needed for the mandibular and three scoops for the maxillary arch. 3. Add water from the water measuring device. Each line indicates enough water for one scoop. If three scoops are used, the entire water measuring device can be used. 4. Use a wide blade spatula to mix water and powder carefully at first to incorporate it together. Then spatulate against the bowl sides to reduce air incorporations. Do not whip the material. Spatulate until the material turns to a pink color. Rotate the bowl and gather the material and then spatulate again against the sides of the bowl. Mix to a creamy consistency where all the powder is incorporated. Load the pink material into the tray. 5. When the material turns from pink to white, seat the tray into the patient’s mouth and wait until the material is firm to remove.
KROMOPAN ® 100 ALGINATE
MANUFACTURER: Kromopan USA, Inc.
USE: •
Making dental impressions used for the fabrication of casts for: • Study models • Orthodontic models • Opposing models • Removable splints • Removable retainers • Provisional restorations • When impression cannot be poured immediately • Additional applications in the dental office
PROPERTIES: • • • 279
Supplied in airtight pouches, with a water measure and a scoop Use scoop and water measure that is supplied with material Great elasticity
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• • •
High compression resistance Can be kept for up to 100 hours without distortion or shrinkage before pouring Color changing guide for consistency
OSHA PRECAUTIONS: • • • • •
Always read the MSDS information on the product Eye contact Inhalation Ingestion Patients who have history of severe allergic reactions to components
MIXING AND SETTING TIME: Visual color changing guide for consistency Spatulate Purple Load Tray Pink Insert into mouth White
Time from start to finish is just over 1 minute. *The temperature of the water will vary the working and setting time. Cooler water increases time; warmer water decreases time.
DIRECTIONS: After the tray is selected, PPE in place, and the patient is prepared for procedure: 1. Dispense material by dipping supplied scoop into powder and packing it into the scoop. Use spatula by laying it level across the scoop to further pack the material and scrape excess material from the scoop. 2. Place scoops into dry mixing bowl (rubber bowl, disposable bowl, or into alginate mixer). Place additional scoops into the bowl. Normally two scoops are needed for the mandibular and three scoops for the maxillary arch. 3. Add water from the water measuring device. Each line indicates enough water for one scoop. If three scoops are used, the entire water measuring device can be used. 281
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4. Use a wide blade spatula to mix water and powder carefully
at first to incorporate it together. Then spatulate against the bowl sides to reduce air incorporations. Do not whip the material. Spatulate until the material turns to a pink color. Rotate the bowl and gather the material and then spatulate again against the sides of the bowl. Mix to a creamy consistency where all the powder is incorporated. Load the pink material into the tray. 5. When the material turns from pink to white, seat the tray into the patient’s mouth and wait until the material is firm to remove. After removal the impression can be rinsed and enclosed in a plastic bag and kept without distortion for up to 100 hours.
ALGINATE FLAVORING
Courtesy of Ortho Technology, Inc.
MANUFACTURER: Ortho Technology, Inc.
USE: To add a pleasing flavor to alginate products
PROPERTIES: • • • •
285
Supplied in 2 oz. dropper bottles 10–14 sugar-free flavors Alginate Flavoring Carrier is available for use with 10 different flavors Flavors available: • Very Strawberry • Marvelous Mint • Chillin’Cherry • Groovy Grape • Wild Watermelon • Bubble Gum
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• • • • • • • •
Georgia Peach Cotton Candy French Vanilla Orange Dreamsicle Buttered Popcorn Jamaican Java Coffee New York Cheesecake Tropical Kiwi
OSHA PRECAUTIONS: •
Patients who have history of severe allergic reactions to components
DIRECTIONS: 1. Patients identify alginate flavoring preference 2. Plastic barrier is placed around dropper bottle 3. Operator adds 2 to 5 drops in water before mixing it with the
alginate powder
ALGINOT™
Courtesy of Kerr Corporation
MANUFACTURER: Kerr Corporation
USE: •
For impressions in preparation of: • Case study models • Orthodontic models • Opposing models • Simple removable dentures • Removable retainers and splints • Provisional crown and bridge
COMPOSITION: •
A silicone impression material intended as an alternative to traditional alginate materials
PROPERTIES: • • • 289
Extruder operation with mixing tip and cartridge—no hand mixing Impressions remain stable for months Tolerates disinfectants
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OSHA PRECAUTIONS: • • •
Skin, eyes: may cause mild irritation Inhalation: may cause mild irritation May be harmful if swallowed
MIXING AND SETTING TIME: Cartridge: Volume™
Minimum Working Time from Start of Mix 0:45 minute 1:00 minute
Removal Time 2:30 minutes 2:45 minutes
DIRECTIONS: After the tray is selected, PPE in place, and the patient is prepared for procedure: 1. Insert cartridge into the extruder. 2. Attach mixing tip to cartridge. 3. Squeeze trigger to mix and dispense material. 4. Material will stop flowing when trigger is released.
STATUSBLUE ® MIX STAR MATERIAL (ALGINATE SUBSTITUTE MATERIAL)
Courtesy of Zenith/DMG
MANUFACTURER: Zenith/DMG
USE: •
Making dental impressions used for the fabrication of casts for: • Study models • Orthodontic models • Opposing models • Impressions for temporaries • Model-cast dentures • Additional applications in the dental office
COMPOSITION: • • • • • 293
Addition curing polysiloxanes Silicon dioxide Food pigments Additives Platinum catalyst CHAPTER 4 IMPRESSION MATERIALS
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PROPERTIES: • • • • • • • • • • •
Designed at a high efficiency alternative to traditional alginates Supplied automix cartridges for use with a Zenith/DMG MixStar machine Automix Gun Tips are used with the automix cartridges StatusBlue® also supplied in 50 ml cartridges for automix guns and tips 100% dust-free Mixing takes place in the MixStar machine if using the MixStar cartridges Extremely flowable under pressure Low shore hardness Dimensionally stable Repourable and reusable StatusBlue is an additional curing silicone impression material
OSHA PRECAUTIONS: •
Always read the MSDS information on the product
•
•
On MSDS: under Hazards Identification it reads: “None if handled according to directions.” “No labeling of hazardous ingredients required.” Patients who have history of severe allergic reactions to components
MIXING AND SETTING TIME: Tray is loaded and inserted into mouth no later than Recommended Time in Mouth
1:15 after mixing 1:45 minutes
*Must wait a minimum of 30 minutes before pouring impression
DIRECTIONS: 1. Slide the locking mechanism into open position on the MixStar Cartridge. 2. Remove and discard the cap on the openings of the base and catalyst outlets on the MixStar Cartridge. 3. Seat the mixing tip completely into the open holes on the MixStar Cartridge. 295
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4. Secure the mixing tip by sliding the locking mechanism into
locked position over the mixing tip. 5. Insert the cartridge into the mixing unit. 6. Turn on the mixing unit and as the material is dispensed flow
the material into the tray keeping the tip in the material and not trapping air into the material. 7. Insert the tray into the patient’s mouth and hold for 1:45 minutes 8. Remove from the patient’s mouth, rinse, and disinfect. 9. Wait 30 minutes and pour the impression.
FINAL IMPRESSION MATERIALS ® COE-FLEX RUBBER BASE
MANUFACTURER: GC America
USE: •
For taking impressions for the following: • Full dentures • Partial dentures • Inlays • Onlays • Crowns • Bridges
PROPERTIES: • • • • • • 299
Lead-free High elasticity Excellent tear strength Blue-green color, mint flavor Available in 3 viscosities Three-year shelf life CHAPTER 4 IMPRESSION MATERIALS
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• •
Available in Regular Body, Injection Type (Light), Heavy Body, and Fast Set Unmixed catalyst or base may stain clothes
OSHA PRECAUTIONS: • • • • • •
Always read the MSDS information on the product MSDS indications refer to the accelerator Disposable vinyl gloves recommended Eye protection Respirator protection Ventilation
MIXING AND SETTING TIME: Material Type Mixing time Min. time in mouth
Lightbodied
Mediumbodied
Mediumbodied
Heavy bodied
Type 3 45 sec–1 min 8–10 min
Type 2 45 sec–1 min 8–10 min
Fast Set-Type 2 30 sec 4 min
Type 1 45 sec–1 min 8–10 min
*To speed up setting time, use more catalyst; to retard setting time, use less catalyst.
DIRECTIONS: After the tray is selected, PPE in place, and the patient is prepared for procedure: 1. Paint the entire surface of the tray with the tray adhesive. When dry, begin mixing the catalyst and base. 2. The catalyst and base are dispensed by using equal lengths. This is about one part catalyst to two parts base according to volume. The diameter of the dispensed material should be the same diameter as the orifice of the tubes. 3. Coat the spatula with the blue paste before incorporating the blue and white pastes together. Spatulate with broad strokes until it is free from streaks. 4. Fill an impression syringe with material (injection type—light) to inject onto and around the preparation. 5. Fill the impression tray that has been painted with adhesive with material (regular body or heavy body).
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6. Firmly place into the oral cavity. Do not apply pressure against
the tray while the material is setting. Do not remove impression prematurely. Hold in place for the minimum time indicated. With a blunt instrument, check material for setting prior to removal. 7. Break seal with lateral movement and remove impression with a straight pull. Rinse off and disinfect or sterilize. 8. Pour model no later than 8 hours.
PERMALASTIC ® POLYSULFIDE IMPRESSION MATERIAL
MANUFACTURER: Kerr Corporation
USE: • •
Regular is recommended for partial or full denture impressions. Light is for inlay and fixed bridge impressions.
PROPERTIES: • • • •
Has a high degree of flow Good tear strength Comes in Regular, Light-Bodied, and Heavy-Bodied An adhesive is available in a 2 oz. size.
OSHA PRECAUTIONS: • • • •
305
Always read the MSDS information on the product. Use safety glasses and gloves. Use protective clothing because this product may cause staining. This material may cause irritation to skin and eyes.
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• •
If ingested, this material may cause choking sensation. This product contains a lead compound.
MIXING AND SETTING TIME: Mixing time Tray loading Syringe filling Mouth removal
.75–1.0 minute 1.0 minute 10.0 min. from start of mix 6 min. in mouth
DIRECTIONS: After the tray is selected, PPE in place, and the patient is prepared for procedure: 1. Extrude appropriate amounts of base and catalyst pastes onto a mixing pad. Use equal lengths not equal amounts. 2. Using a laboratory spatula, mix materials into each other using a stirring motion. 3. Incorporate thoroughly until a streak-free mix is obtained. 4. Mixing should be completed within 45 seconds to 1 minute.
5. Immediately fill tray or syringe. 6. The material must stay in the mouth for a minimum of
6 minutes. 7. Remove and disinfect by immersion in a 2% solution of
gluteraldehyde. 8. Pouring should occur immediately or within 8 hours.
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COLTENE ® RAPID IMPRESSION MATERIAL
Courtesy of Coltene/Whaledent, Inc.
MANUFACTURER: Coltene/Whaledent, Inc.
USE: • •
For inlay and fixed bridge impressions Partial and full denture impressions
PROPERTIES: • • • • • •
309
Condensation silicone impression material Seven-day dimensional stability Material changes color during mixing for easy and reliable handling Surface-activated hydrophilic to enhance performance when in contact with moist oral tissue It is available in putty, liner with activators and applicator. Dosing spoon and dosing syringe are available as well.
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MIXING AND SETTING TIME: Mixing time Oral setting time
30 seconds 150 seconds
DIRECTIONS: After the tray is selected, PPE in place, and the patient is prepared for procedure: 1. Measure the required quantity of Rapid line base into the applicator. 2. Add red activator with the precision syringe. 3. Stir briefly. The material turns blue when it’s ready for use. 4. Rapid liner is applied from the applicator directly into the primary impression tray or into the syringe. 5. Place into the oral cavity and remove when set.
IMPREGUM™ PENTA™ POLYETHER IMPRESSION MATERIAL
Courtesy of 3M ESPE
MANUFACTURER: 3M ESPE
USE: • •
Impressions of inlay, onlay, veneer, crown, and bridge preparations Fixation and implant impressions
PROPERTIES: • •
Comes in tubes, Penta cartridges, syringe in medium and soft medium body Intrinsic pre-setting hydrophilicity helps capture and reproduce outstanding detail.
OSHA PRECAUTIONS: • • •
313
Face and eye protection Do not ingest. Avoid prolonged or repeated skin contact.
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MIXING AND SETTING TIME: Processing time from start of mixing Residence time in the mouth Setting time from start of mixing
1:00 minute max 3:00 minutes 4:00 minute max
DIRECTIONS: After the tray is selected, PPE in place, and the patient is prepared for procedure: 1. The dosing and mixing are done automatically in the Pentamix 2. 2. If using the tubes, dispense in equal lengths and mix until streak-free.
POLYJEL ® NF™ POLYETHER IMPRESSION MATERIAL
MANUFACTURER: Dentsply Caulk
USE: •
Reproduction for crown and bridge impressions
PROPERTIES: • • • •
Easy-to-release polyether-type elastomeric impression material Single viscosity that provides optimum performance Dimensional stability Fast set time
OSHA PRECAUTIONS: • • • • •
317
Always read the MSDS information on the product. Base paste and catalyst paste Avoid eye and skin contact and ingestion. Protective eyeglasses to be worn Protective rubber gloves to be worn
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• •
Rubber apron for protective clothing Do not eat, drink, or smoke when using.
MIXING AND SETTING TIME: Mix material Total working time
30–45 seconds 2.5 minutes
DIRECTIONS: After the tray is selected, PPE in place, and the patient is prepared for procedure: 1. Measure the required quantity of PolyJel base and catalyst onto mixing pad. 2. The material is dispensed in equal lengths not equal amounts within 45 seconds. 3. Spatulate with broad blade spatula and mix until streak–free. 4. Place into the oral cavity and remove when set. 5. Material must be poured within 2 weeks.
AQUASIL SMART WETTING ® VINYL POLYSILOXANE IMPRESSION MATERIAL
Courtesy of Dentsply Caulk
MANUFACTURER: Dentsply Caulk
USE: • •
Suitable for all impression techniques where high viscosity materials would be desired by the operator This material can be used for duplication of models.
COMPOSITION: •
Aquasil Putty Impression Material is a quadrafunctional hydrophilic addition reaction silicone.
PROPERTIES: • • • • •
Designed to minimize the problems of voids, bubbles, pulls, and drags Wetability High tear strength Available in broad range, many viscosities in regular and fast set Mint-flavored
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OSHA PRECAUTIONS: • • •
Always read the MSDS information on the product. Use safety glasses and gloves. Avoid eye and skin contact and ingestion.
MIXING AND SETTING TIME: Working time Setting time from start of mix
Regular 2:15–2:45 min 5:00 min
Fast Set 1:15–1:45 min 3:00 min
DIRECTIONS: After the tray is selected, PPE in place, and the patient is prepared for procedure: 1. Insert the cartridge into the extruder. 2. Attach the mixing tip to the cartridge. 3. Squeeze the trigger to mix and dispense material. 4. Material will stop flowing when the trigger is released.
EXTRUDE VINYL POLYSILOXANE IMPRESSION MATERIAL
MANUFACTURER: Kerr Corporation
USE: •
It is suitable for all crown and bridge, edentulous and implant impressions.
PROPERTIES: • • • • • • •
325
Thixotropic, non-slumping tray material Available in cartridge, putty (jars), and tube High flow and tear strength Putty has 3-year shelf life Dimensional stability Tasteless Odorless
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OSHA PRECAUTIONS: • • • •
May cause mild skin irritation May cause irritation to the eyes May be harmful if swallowed May cause mild irritation if inhaled
MIXING AND SETTING TIME: Total Working Time from start of mix Extrude Wash 3:00 min Extrude Medium 3:00 min Extrude Extra 3:00 min Extrude MPV 2:15 min Extrude Putty 2:00 min
Minimum Removal Time from start of mix 6:00 min 6:00 min 6:00 min 5:15 min 6:00 min
DIRECTIONS: After the tray is selected, PPE in place, and the patient is prepared for procedure: 1. Insert the cartridge into the extruder. 2. Attach the mixing tip to the cartridge. 3. Squeeze the trigger to mix and dispense material. 4. The material will stop flowing when the trigger is released.
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HONIGUM ® IMPRESSION MATERIAL
Courtesy of Zenith/DMG
MANUFACTURER: Zenith/DMG
USE: • • •
Crown and bridge impressions Inlay and onlay impressions All types of pickup impression, e.g., for implants
COMPOSITION: •
Addition curing polysiloxanes, silicone dioxide, food pigments, additives, and platinum catalyst
PROPERTIES: • • •
329
Patented microcrystalline wax matrix chemistry Pressure-sensitive variable viscosity Mild honey aroma for great patient acceptance
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OSHA PRECAUTIONS: • • •
Hand and skin protection: use rubber gloves. Eye protection: use goggles. Consult a physician in case of ingestion.
MIXING AND SETTING TIME: Working time Recommended time in mouth
Automix Heavy
Automix Heavy Fast
MixStar Heavy
MixStar Heavy Fast
2:00 min 3:15 min
1:15 min 2:00 min
2:15 min 3:15 min
1:15 min 2:00 min
DIRECTIONS: After the tray is selected, PPE in place, and the patient is prepared for procedure: 1. Slide the locking mechanism into open position on the MixStar cartridge. 2. Remove and discard the cap on the openings of the base and catalyst outlets on the MixStar cartridge.
3. Seat the mixing tip completely into the open holes on the
MixStar cartridge. 4. Secure the mixing tip by sliding the locking mechanism into
locked position over the mixing tip. 5. Insert the cartridge into the mixing unit. 6. Turn on the mixing unit and as the material is dispensed, flow
the material into the tray keeping the tip in the material and not trapping air into the material. 7. Insert the tray into the patient’s mouth and hold time noted according to material used. 8. Remove from patient’s mouth, rinse, and disinfect. 9. Wait 30 minutes and pour the impression.
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HYDROCOLLOID-REVERSIBLE HYDROCOLLOID IMPRESSION MATERIAL
(B)
(A) (C)
Courtesy of Van R
MANUFACTURER: Van R
USE: • •
Crown and bridge impressions Inlay and onlay impressions
COMPOSITION: •
Made from water and the ocean’s agar
PROPERTIES: • • • •
Wetness Small amounts of blood and saliva do not affect the accuracy of the impression. Available in syringe and tubes Must be used with a Hydrocolloid machine
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OSHA PRECAUTIONS: • •
Principal hazardous components—none No occupational control measures needed
MIXING AND SETTING TIME: Acculoid, Lavender, Extra Strength 5 minute temper at 110°F/43°C 7 minute cooling in the mouth with room temperature water Stores 5 days once liquefied AgarLoid, Blue, Fast Tempering 4 minute temper at 110°F/43°C 5 minute cooling in the mouth with room temperature water Stores 5 days once liquefied Slate, Gray, High Strength 5 minute temper at 110°F/43°C 5 minute cooling in the mouth with room temperature water Stores 4 days once liquefied
Qwik, Chocolate 3 minute temper at 110°F/43°C 3 minute cooling in the mouth with room temperature water Stores 3 days once liquefied
DIRECTIONS: After the tray is selected, PPE in place, and the patient is prepared for procedure: 1. Remove the tube from the storage compartment of the hydrocolloid conditioner. Fill the water-cooled tray and place in the tempering bath. 2. Set the timer to the correct time for tempering according to the material being used. 3. After the time has concluded, remove the syringe material that is in the cartiloid and place it into the syringe. Attach a hydrocolloid syringe tip to the cartiloid and apply pressure to the syringe to expel a small amount of material while taking to
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the operator to use. This ensures that the material does not set up in the tip. 4. Remove the impression from the tempering bath and place a 2 ⫻ 2 over the material to dry off the top surface. Attach the tubing to the impression and hand it to the operator to place into the mouth. 5. After the impression is seated in the mouth, attach the tubing to the water source and start the water flowing. Set the timer. 6. Remove from patient’s mouth, rinse and pour immediately.
POLYSILOXANE IMPRESSION MATERIAL
PROCEDURE: PREPARING A PRELIMINARY PUTTY IMPRESSION FROM A POLYSILOXANE IMPRESSION MATERIAL 1. Follow the manufacturer’s directions. 2. Wear vinyl gloves. 3. Either equal scoops of the putty are mixed together or putty
base and drops of catalyst are mixed together. The putty must be kneaded together until a homogeneous mixture is obtained within the manufacturer’s recommended time. Normally, this time is 30 seconds. The mixture must be one even color with no streaks. 4. After the material is mixed, pat it into a patty and load it into the prepared tray. With a finger, make a slight indentation where the teeth are located.
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5. Place the plastic spacer sheet over the material and insert it into
the patient’s mouth. The objective is to create 2 mm of space for the final syringeable viscous impression material. 6. The setting of the putty takes about 3 minutes. The tray is then removed from the patient’s mouth, the spacer is removed, and the putty is checked for accuracy and left to set further.
Gypsum Products
341
GENERAL INFORMATION RELATED TO GYPSUM MATERIALS
GENERAL INFORMATION RELATED TO GYPSUM MATERIALS: • • •
•
•
343
Setting of gypsum products is chemical and it gives off an exothermic reaction. The set can be determined when heat has dissipated the model. It is important to have the correct water/powder ratio. • Less water—the model can have greater setting expansion, increased strength, and hardness, but mix will become a dry and crumbly mass that will not flow properly. • Too much water—the model is weak, slow setting, and has a greater number of air spaces. Temperature of the water is important. • Hotter water—the more rapid the model sets (decreases setting time). • Cooler water—the longer the model takes to set (increases setting time). Incorporating the water • Over-spatulating will cause the breakdown of crystals and soft spots in the model. CHAPTER 5 GYPSUM PRODUCTS
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•
Setting time and enhancers • Retarders such as borax and sodium citrate can be added to the material to slow down the setting time. • Potassium sulfate can be added to the material to accelerate the setting time.
IMPRESSION PLASTER
Plaster
Plaster
Copyright 2009 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part.
USE: • •
Used to make impressions prior to newer materials being developed Mounting casts
COMPOSITION: The composition is produced by heating mineral gypsum in an open kettle at temperatures of 110 degrees to 120 degrees C. This produces crystals that are slender and porous and relatively soft.
PROPERTIES: • • • • • •
347
Beta-hemihydrate Reproduction detail poor Formatted for remounting casts Fast-setting plaster Requires more water to wet each surface Calcinated in an open kettle method
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• • • •
Takes more water to incorporate the mixture After the mixture dries, the areas where the water was now become air spaces. Weaker than stone or type II model or laboratory plaster. White in color
OSHA PRECAUTIONS: • • •
Eye and skin irritation possible Should not be ingested May cause respiratory tract irritation if inhaled
MIXING AND SETTING TIMES: • •
Ratio: 60 ml of water to 100 grams of powder Set in 4–5 minutes
DIRECTIONS: 1. Use a rubber bowl and a stiff spatula 2. Press against the bowl; don’t whip (causes more air to be
incorporated into mixture).
3. Mixing should take about 1 minute. 4. Over-spatulating will cause a breakdown of crystals and soft
spots in the model.
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TYPE II PLASTER
USE: • • • • •
Versatile formulation for multiple applications Study models Opposing models Repairing casts Mounting models and casts
COMPOSITION: The composition is produced by heating mineral gypsum in an open kettle at temperatures of 110 degrees to 120 degrees C. This produces crystals that are slender and porous and relatively soft.
PROPERTIES: • • • •
351
Beta-hemihydrate Requires more water to wet each surface Calcinated in an open kettle method Takes more water to incorporate the mixture
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• • •
After the mixture dries, the areas where the water was now become air spaces. Weaker than stone, stronger than type I model or laboratory plaster White in color
OSHA PRECAUTIONS: • • •
Eye and skin irritation is possible. Should not be ingested May cause respiratory tract irritation if inhaled
MIXING AND SETTING TIMES: • • • • •
Ratio: 50 ml of water to 100 grams of powder Working time 5–7 minutes Initial set loses glossiness and does not flow. Final set can no longer be penetrated. Set in 15–30 minutes for separation.
DIRECTIONS: 1. Use a rubber or disposable bowl and a stiff spatula. 2. Press against the bowl; don’t whip (causes more air to be
incorporated into mixture). 3. Place the mixture on a vibrator to allow the air bubbles to rise
to the top surface. 4. Mixing should take about 1 minute. 5. Consistency should be one where the spatula can cut through the
mixture and it stays to the sides without changing position. 6. It will appear like whipped cream with a smooth, creamy
texture. 7. Over-spatulating will cause a breakdown of crystals and soft
spots in the model.
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ORTHODONTIC PLASTER/STONE
USE: •
For making orthodontic casts (models)
COMPOSITION: Type II Plaster and Type III Laboratory Stone Mixed Together
PROPERTIES: • • • • • •
Mixture of type II plaster and type III stone Purchased as orthodontic stone-premixed Sets harder than models made from type II Denser than ordinary plasters Easy to trim White in color
OSHA PRECAUTIONS: • • •
355
Eye/face protection Skin protection to prevent drying or irritation of hands Respiratory protection—NIOSH-approved dust mask or filtering face-piece is recommended in poorly ventilated areas. CHAPTER 5 GYPSUM PRODUCTS
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MIXING AND SETTING TIMES: • • • • •
Ratio: 40 ml of water to 100 grams of powder Working time 5–7 minutes Initial set loses glossiness and does not flow. Final set can no longer be penetrated. Set in 15–30 minutes for separation
DIRECTIONS: 1. Use a rubber or disposable bowl and a stiff spatula. 2. Press against the bowl; don’t whip (causes more air to be
incorporated into mixture). 3. Place the mixture on a vibrator to allow the air bubbles to
rise to the top surface. 4. Mixing should take about 1 minute. 5. Consistency should be one where the spatula can cut
through the mixture and it stays to the sides without changing position.
6. It will appear like whipped cream with a smooth, creamy
texture. 7. Over-spatulating will cause a breakdown of crystals and soft
spots in the model.
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MAGIC WHITE MANUFACTURER: Dental Vencura Madespa
USE: •
Orthodontic models
COMPOSITION: Is produced by driving off water of crystallization under an elevated steam pressure at about 125 degrees C.
PROPERTIES: • • • •
Bright white Stronger than plaster Quick setting Comes in plastic bucket with closing lid
OSHA PRECAUTIONS: • • •
Skin contact: May cause dry skin, discomfort, and irritation Inhalation—breathing dust may be harmful—use mask Ingestion: Small quantities not known to be harmful but large amounts may cause an obstruction
MIXING AND SETTING TIMES: • • • •
Ratio: 26 ml of water to 100 grams of powder Working time—7 minutes Initial set—7 minutes Final set—7 1/2 minutes
DIRECTIONS: 1. Use a rubber or disposable bowl and a stiff spatula or a vacuum
mixing device. 2. Press against the bowl; don’t whip (causes more air to be
incorporated into mixture).
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3. Place the mixture on a vibrator to allow the air bubbles to rise to
the top surface. 4. Mixing should take about 1 minute. 5. Consistency should be one where the spatula can cut through the
mixture and it stays to the sides without changing position. 6. It will appear like whipped cream with a smooth, creamy
texture. 7. Over-spatulating will cause a breakdown of crystals and soft
spots in the model.
TYPE III LABORATORY STONE
USE: • • • • •
Diagnostic casts Working casts Models for partial and full dentures Articulating Flasking
COMPOSITION: Is produced by driving off water of crystallization under an elevated steam pressure at about 125 degrees C
PROPERTIES: • • • •
363
Calcinated by steam under pressure More strength than Type I and Type II Usually yellow, green, or blue in color Referred to as alpha-hemihydrate
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OSHA PRECAUTIONS: • • •
Skin contact: May cause dry skin, discomfort, and irritation Inhalation—breathing dust may be harmful—use mask Ingestion: Small quantities not known to be harmful but large amounts may cause an obstruction
MIXING AND SETTING TIMES: • • • • •
Ratio: 30 ml of water to 100 grams of powder Working time 5–7 minutes Initial set loses glossiness and does not flow. Final set—no longer can be penetrated Set in 15–30 minutes for separation
DIRECTIONS: 1. Use a rubber or disposable bowl and a stiff spatula or a vacuum
mixing device. 2. Press against the bowl; don’t whip (causes more air to be
incorporated into mixture).
3. Place the mixture on a vibrator to allow the air bubbles to rise to
the top surface. 4. Mixing should take about 1 minute. 5. Consistency should be one where the spatula can cut through the
mixture and it stays to the sides without changing position. 6. It will appear like whipped cream with a smooth, creamy
texture. 7. Over-spatulating will cause a breakdown of crystals and soft
spots in the model.
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TYPE IV DIE STONE
Courtesy of Whip Mix Corporation
USE: • •
For making dies (A die is a positive replica of the prepared tooth made from stone.) In making a cast or model where strength is important
COMPOSITION: Is commonly produced by dehydration in an autoclave in the presence of sodium succinate or in a kettle with a 30% calcium chloride solution.
PROPERTIES: • • • • • • • 367
Extra strong, extra hard High strength, low expansion Hard, smooth surfaces when poured Calcinated by autoclaving in the presence of calcium chloride. Modified alpha-hemihydrate that is referred to as die stone Stronger and more dense than Type I, II, and III Normally supplied in colors rose, peach, light blue, or light buff CHAPTER 5 GYPSUM PRODUCTS
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OSHA PRECAUTIONS: • • •
Skin contact: May cause dry skin, discomfort, and irritation Inhalation—breathing dust may be harmful—use mask Ingestion: Small quantities not known to be harmful but large amounts may cause an obstruction
MIXING AND SETTING TIMES: • • • • •
Ratio: 24 ml of water to 100 grams of powder (normally supplied in premeasured packets) Working time 5–7 minutes Initial set loses glossiness and does not flow. Final set—no longer can be penetrated Set in 15–30 minutes for separation
DIRECTIONS: 1. Use a rubber or disposable bowl and a stiff spatula or a vacuum
mixing device. 2. Press against the bowl; don’t whip (causes more air to be
incorporated into mixture).
3. Place the mixture on a vibrator to allow the air bubbles to rise
to the top surface. 4. Mixing should take about 1 minute. 5. Consistency should be one where the spatula can cut through the
mixture and it stays to the sides without changing position. 6. It will appear like whipped cream with a smooth, creamy
texture. 7. Over-spatulating will cause a breakdown of crystals and soft
spots in the model.
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TYPE IV STONE WHIP MIX ®
MANUFACTURER: Whip Mix Corporation
USE: • • • • •
Bleaching trays CAD-CAM restorations For making dies (A die is a positive replica of the prepared tooth made from stone.) In making a cast or model where strength is important Implants, porcelain, and inlay/only cases
COMPOSITION: Is commonly produced by dehydration in an autoclave in the presence of sodium succinate or in a kettle with a 30% calcium chloride solution
PROPERTIES: • • 371
Exceptionally fast setting Resin reinforced for maximum strength CHAPTER 5 GYPSUM PRODUCTS
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• • • • • • • •
Minimum expansion Thixotropic (liquid that flows easily under mechanical forces), yet highly stackable for easy sculpting Provides high definition, detailed models Tough, durable, nonbrittle Enhanced abrasion resistance Great stability over time No change or very little change in expansion Stronger and more dense than Type I, II, and III
OSHA PRECAUTIONS: • • •
Skin contact: May cause dry skin, discomfort, and irritation Inhalation—breathing dust may be harmful—use mask Ingestion: Small quantities not known to be harmful but large amounts may cause an obstruction
MIXING AND SETTING TIMES: •
Ratio: 23 ml of water to 100 grams of powder (normally supplied in pre-measured packets)
• •
Working time: 60–90 seconds Setting time: 2 minutes
DIRECTIONS: 1. Use a clean, flexible rubber, disposable or plastic bowl. 2. Use the proper ratio of water to powder. Measure room
temperature water into mixing bowl. 3. Add powder to liquid. 4. Use a clean, stiff spatula and spatulate at a rate of 120 RPM for
60 seconds until a smooth and uniform mix is achieved. If using a vacuum mixer, the recommended time is 15 seconds.
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TYPE V DIE STONE
MANUFACTURER: Modern Materials
USE: • •
Where a really strong die model is needed Implants, inlays, crown and bridge dies
COMPOSITION: Is commonly produced by dehydration in an autoclave in the presence of sodium succinate or in a kettle with a 30% or more calcium chloride solution. Additional refining and increased pressure of the powder by grinding results in a denser stone.
PROPERTIES: • • • •
375
High strength High expansion Recently approved by the American Dental Association (ADA) Optimum expansion for dies and crown and bridge work
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• •
Ultra fine Flows easily during vibration
OSHA PRECAUTIONS: • • •
Skin contact: May cause dry skin, discomfort, and irritation Inhalation—breathing dust may be harmful—use mask Ingestion: Small quantities not known to be harmful but large amounts may cause an obstruction
MIXING AND SETTING TIMES: • • •
Ratio: 21 ml of water to 100 grams of powder (normally supplied in premeasured packets) Initial set—10–13 minutes Final set—no longer can be penetrated
DIRECTIONS: 1. Use a clean, flexible rubber, disposable or plastic bowl. 2. Use the proper ratio of water to powder. Measure room
temperature water into mixing bowl.
3. Add powder to liquid. 4. Use a clean, stiff spatula and spatulate at a rate of 120 RPM for
60 seconds until a smooth and uniform mix is achieved. If using a vacuum mixer, the recommended time is 15 seconds.
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MODERN MATERIALS ® STATSTONE MANUFACTURER: Modern Materials/Heraeus Kulzer
USE: •
When speed and precision are needed for fabricating: • Custom trays • Mouth guards • Vacuum-formed splints • Denture repairs
COMPOSITION: Is commonly produced by dehydration in an autoclave in the presence of sodium succinate or in a kettle with a 30% or more calcium chloride solution. Additional refining and increased pressure of the powder by grinding results in a denser stone.
PROPERTIES: • • • • •
Fast and accurate High early compression strength Low expansion Well suited for bleaching application Available in light pink
OSHA PRECAUTIONS: • • •
Skin contact: May cause dry skin, discomfort, and irritation Inhalation—breathing dust may be harmful—use mask Ingestion: Small quantities not known to be harmful but large amounts may cause an obstruction
MIXING AND SETTING TIMES: • • •
Ratio: 23 ml of water to 100 grams of powder (normally supplied in premeasured packets) Initial set—2 minutes Ready for removal from the impression in just 5 minutes
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DIRECTIONS: 1. Use a clean, flexible rubber, disposable or plastic bowl. 2. Use the proper ratio of water to powder. Measure room
temperature water into mixing bowl. 3. Add powder to liquid. 4. Use a clean, stiff spatula and spatulate at a rate of 120 RPM for
60 seconds until a smooth and uniform mix is achieved. If using a vacuum mixer, the recommended time is 15 seconds.
PUMICE
Courtesy of Whip Mix Corporation
MANUFACTURER: Whip Mix Corporation
USE: •
Polishing dental appliances such as provisionals, dentures, partials, and bridges
COMPOSITION: Volcanic silica manufactured as a loose abrasive. Flour of pumice is extremely fine.
PROPERTIES: Available in grades: • Pumice, Flour • Pumice, Fine • Pumice, Medium • Pumice, Coarse • Pumice, X-Coarse Specially ground for fast cutting without scratching or grooving 383
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MIXING AND SETTING TIMES: • •
Used with water and a lathe to smooth the appliance No mixing required
DIRECTIONS: 1. Remove pumice from canister without contamination of other
pumice. Place about 1/3 cup into the slash pan of the lathe. Add water to the pumice to make a putty-like material. Wet the rag wheel and place it on the lathe. If the appliance has not been sterilized, the rag wheel and the splash pan will need to be sterilized/disinfected and the pumice discarded. The EPA issued guidelines for dental issues in 1999 for caring for dental pumice. 6. Place the pumice on the appliance in the area that requires smoothing. Using the rag wheel of the lathe, smooth the area. 7. The pumice needs to be fed into the area that needs polishing during the rotation of the rag wheel. 2. 3. 4. 5.
PROCEDURE: MIXING THE PLASTER FOR AN ALGINATE IMPRESSION
This procedure is performed by the dental assistant in the dental laboratory.
EQUIPMENT AND SUPPLIES: • • • • • • • • •
Spatula, metal with rounded end and stiff, straight sides Two flexible rubber mixing bowls Scale Type II plaster (100 grams) Gram measuring device Water measuring device Vibrator with paper or plastic cover on the platform Room temperature water Alginate impression (disinfected) PPE worn by assistant
DIRECTIONS: 1. Measure 50 ml of room temperature water into one of the
flexible mixing bowls. 2. Place the second flexible mixing bowl on the scale and set the
dial to zero. This allows the plaster powder to be weighed. 387
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3. Weigh out 100 grams of plaster in the second rubber bowl. 4. Add the powder from the second bowl to the water of the first
5.
6. 7. 8.
bowl. Placing the water in first allows for all the powder to become incorporated into the mixture. Allow several seconds for the powder to dissolve into the water. Use the spatula to slowly mix the particles together. The initial mixing should be completed in 20 seconds. The total mixing procedure should take about 1 minute. Turn on the vibrator to medium or low speed. Place the rubber bowl on the vibrator platform, pressing lightly. Rotate the bowl on the vibrator to allow the air bubbles to rise to the top surface. The mixing and vibrating should be completed within a couple of minutes. The mixture is ready if the spatula can cut through it and it stays to the sides without changing positions. It will appear like whipped cream with a smooth, creamy texture. Another way to check whether the powder/water is in correct ratio is to place a spoonful on the spatula and turn it upside down—if the material remains in place, the mixture is ready.
Dental Waxes
389
PATTERN WAX/INLAY WAX
USE: •
To make a wax pattern of the restoration (crown or bridge) to be made
COMPOSITION: • 40–60% paraffin wax • 10% gum dammar • 25% carnauba wax • 10% ceresin wax • 5% beeswax Note: Composition will vary from manufacturer to manufacturer.
PROPERTIES: • •
• 391
It is a hard wax used in crown and bridge construction. Comes in dark blue, green, or purple rods or sticks about 7.5 cm long and 6 mm in diameter (3 inches long and 1/4 inch in diameter). Used on a die to make a replica of the final restoration. CHAPTER 6 DENTAL WAXES
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• •
Type I is used for direct techniques (establishing the initial form of the tooth in the oral cavity) and it is a little softer. Type II, most often used in the dental laboratory, is used for indirect techniques where the wax pattern is carved on the die (stone model).
OSHA PRECAUTIONS: • • •
Nonhazardous at room temperature If exposed to melted wax, fumes may cause irritation. Direct contact with molten material may cause injury. Flush area with cold water.
DIRECTION: The wax is melted and applied to the die (a positive replica of the prepared tooth made of stone) layer by layer until the contacts, margins, anatomy, and occlusion are correct. It will resemble the final crown or bridge that is being made.
PATTERN WAX/BASEPLATE WAX
USE: •
Construction of the baseplate tray to establish the vertical dimension in the initial arch for a denture or partial
COMPOSITION: • 80% ceresin • 12% beeswax • 2.5% carnauba • 5% natural or synthetic resins Note: Composition will vary from manufacturer to manufacturer.
PROPERTIES: •
395
Available in three types: • Type I—a softer baseplate wax that is used for building contours and veneers • Type II—a medium wax used for patterns to be tried into the mouth in temperate climates (most commonly used) • Type III—a harder wax to be used in the mouth in tropical weather or when extra hardness is required CHAPTER 6 DENTAL WAXES
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• • • • • • •
Carves without chipping Boils out cleanly Pliable Shaded to resemble gum tissue (pink color) Unlimited shelf life Available in shapes that resemble the dental arches The Type II can be heated with warm water or a flame and used for taking a bite.
OSHA PRECAUTIONS: • • •
Nonhazardous at room temperature If exposed to melted wax, fumes may cause irritation. Direct contact with molten material may cause injury. Flush area with cold water.
DIRECTIONS: 1. Dental baseplate wax can be heated with a torch and adapted easily to a stone model of the edentulous arch.
2. It should be adapted closely and the excess trimmed with a wax spatula or blade. The softer wax is tough yet pliable all-purpose wax. 3. The margins of the wax should be made smooth to the touch due to the fact that it is going to be reinserted into the patient’s mouth.
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PATTERN WAX—OCCLUSAL RIMS OR BITE BLOCKS
Courtesy of Coltene/Whaledent, Inc., Mahwah, NJ
USE: •
It is a softer wax block that is attached to the baseplate wax that is used in the construction of the tray to establish the vertical dimension in the initial arch for a denture or partial.
COMPOSITION: • •
Hazardous components—none Less than 10% petroleum hydrocarbons and additives
PROPERTIES: • • • • • • • •
Can be shaped at room temperature Some types come with a recessed base to aid in adapting it to the baseplate. Can be adapted to fit any arch Can be easily heated to set the denture teeth into it U-shaped Pink in color Soft but not sticky Referred to as either occlusal rim or a bite block
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OSHA PRECAUTIONS: • •
Nonhazardous at room temperature Above its melting point, wax becomes liquid and flows more readily as its temperature increases. Use special handling with hot liquid wax.
DIRECTIONS: 1. Adapt the U-shaped wax arch to the baseplate on the stone model of the edentulous arch. 2. Heat the recessed base of the arch and stick it to the baseplate. 3. Ensure the two are adapted securely. 4. Smooth the area where the two waxes (baseplate and bite rim) come together.
PATTERN WAX/CASTING WAX
USE: •
It is used to fabricate the pattern for the metal framework for removable partial dentures and other similar structures.
COMPOSITION: •
The composition is the same as inlay waxes but contains reduced amounts of hard waxes and increased amounts of beeswax.
PROPERTIES: • • •
Easily trimmed with sharp knife Has a smooth, glossy surface after gently flaming Sold in: • Thin sheets • Preshaped like completed metal framework or clasps • Square sheets • Long thin strips
OSHA INFORMATION: • 403
Nonhazardous at room temperature CHAPTER 6 DENTAL WAXES
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•
Above its melting point, wax becomes liquid and flows more readily as its temperature increases. Use special handling with hot liquid wax.
DIRECTIONS: 1. Use the wax and place it on the stone model where the metal framework will be after fabrication. 2. Attach all wax on the model and secure it together. 3. Use a flame to smooth areas and obtain the glossy finish needed.
PROCESSING WAX/STICKY WAX
USE: •
It is used to adhere two materials together for fabrication or repairs. It has many uses.
COMPOSITION: • •
Hazardous components—none Less than 10% petroleum hydrocarbons and additives
PROPERTIES: • •
Brittle wax at room temperature but when melted with a flame it is sticky Adheres to a number of surfaces such as metal, stone, plaster, tooth structure, etc. Will fracture rather than flow if deformed Comes in a number of colors—usually orange or dark red Normally available in sticks Melting temperature 136 degrees F (58 degrees C)
• • • •
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OSHA PRECAUTIONS: • •
Nonhazardous at room temperature Above its melting point, wax becomes liquid and flows more readily as its temperature increases. Use special handling with hot liquid wax.
DIRECTIONS: 1. Place the two materials that need to be adhered together. 2. Heat the tip of the sticky wax stick with a flame. 3. Touch the end that has been heated to the items that need to be attached and the sticky wax will set up rapidly. 4. The wax will change to a milky color when set.
PROCESSING WAX/BOXING WAX
USE: •
It is used to form a wax box around an impression of an arch into which freshly mixed plaster or stone can be poured.
COMPOSITION: • •
Hazardous components—none Less than 10% petroleum hydrocarbons and additives
PROPERTIES: • • •
Comes in wide wax strips and ropes Wax strips are normally 1/16 inch thick, 1 1/2 inch wide, and 12 inches long. Wax strips can be purchased in extra thin, which is 0.40 inches thick. Withstands heat given off by gypsum products during setting Can be reused
• •
411
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OSHA PRECAUTIONS: •
Nonhazardous at room temperature
DIRECTIONS: 1. Take one strip and wrap it in a circle to the size of model that is to be poured up. 2. Attach it to itself in the circle pattern. 3. Place it on the counter in an upright position (like a fence around something). 4. The stone or plaster can be placed in this circle and into the model being poured. 5. The circle of wax can be removed easily after the poured model is set. It can be used again on another model if desired.
PROCESSION WAX/UTILITY WAX
USE: •
It is often used on hydrocolloid or alginate trays as beading wax on the periphery of the tray for a cushion or an extension.
COMPOSITION: • •
Hazardous components—none Less than 10% petroleum hydrocarbons and additives
PROPERTIES: • • • • •
Soft wax Easily workable and adhesive A flame is not necessary when working with utility wax. Often called periphery wax Comes in long ropes, sheets, or strips and in a number of colors
OSHA PRECAUTIONS: •
415
Nonhazardous at room temperature
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DIRECTIONS: 1. Take one rope of the utility wax and place it onto the impression tray. 2. Form the wax on the border of the tray. 3. Ensure that the wax is not above the height of the base of the tray. 4. Adjust the wax as necessary.
ORTHODONTIC WAX STICKS
USE: •
Orthodontic wax sticks are used much like utility wax strips. They are used for peripheral lining of trays, to increase the tray height, and across the back of the tray as a post dam for impression materials.
COMPOSITION: • •
Hazardous components—none Less than 10% petroleum hydrocarbons and additives
PROPERTIES: • • • • •
419
Soft and tacky Can be adapted to the tray without heating Comes in 6 inch sticks White in color Often are slightly scented
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OSHA PRECAUTIONS: •
Nonhazardous at room temperature
DIRECTIONS: 1. Take one stick of the orthodontic tray wax and place it onto the impression tray. 2. Form the wax on the border of the tray. 3. Form a post dam across the back of the tray. 4. Adjust the wax as necessary.
ORTHODONTIC WAX
USE: •
To mold around orthodontic brackets to help relieve irritation and discomfort
COMPOSITION: • •
Hazardous components—none Less than 10% petroleum hydrocarbons and additives
PROPERTIES: • • • •
Normally comes in a plastic carrying case for patient use Comes in mint or regular flavoring Soft and pliable Does not need to be heated to be adapted to brackets
OSHA PRECAUTIONS: •
Nonhazardous at room temperature
DIRECTIONS: 1. Plastic case can be opened easily. 2. Take a small amount from the sticks in the case. 423
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3. Adapt the wax around the brackets. 4. Rub it smooth to the touch. 5. Add more as necessary in areas where the brackets are causing irritation.
IMPRESSION WAX
Courtesy of Coltene/Whaledent, Inc., Mahwah, NJ
USE: •
To take an impression of a small area where great detail is not required and to take a bite
COMPOSITION: • • •
Most often made of pure, natural beeswax with no additives Hazardous components—none Less than 10% petroleum hydrocarbons and additives
PROPERTIES: • • • • • • •
Softens easily under hot water Very pliable Comes in sheets Often yellow in color Softens quickly Flows easily Sets hard when chilled
OSHA PRECAUTIONS: • 427
Nonhazardous at room temperature CHAPTER 6 DENTAL WAXES
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DIRECTIONS: 1. 2. 3. 4.
Take one sheet from the box. Heat the sheet with warm water. Adapt it to the area where the impression is needed. Let the wax cool and remove it from the area.
BITE WAFERS
USE: •
Used to check occlusal relationships, used to take bite registrations
COMPOSITION: • •
Hazardous components—none Less than 10% petroleum hydrocarbons and additives
PROPERTIES: • •
• •
Available in several colors: yellow, blue, and green Available in either nonlaminated or foil laminated. Foil is laminated between two layers of wax to decrease distortion and prevent the patient from biting through the wax bite. U-shaped wax Designed to adapt to the dental arch
OSHA PRECAUTIONS: •
431
Nonhazardous at room temperature
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DIRECTIONS: 1. Wax bite wafers are heated slightly in warm water. 2. Wafers are placed on the occlusal surface of the maxillary or mandibular arch. 3. The patient is instructed to bite together gently in their normal bite pattern. 4. After the patient has bitten into the wax and the wax has cooled, the wax is gently removed and used for check-bites or occlusal transfers.
COPRWAX ™ BITE WAFERS
USE: •
Used to obtain an occlusal registration
COMPOSITION: • • •
Hazardous components—none Less than 10% petroleum hydrocarbons and additives Copper particles
PROPERTIES: • • • • •
Has a thin foil layer between layers of wax Prevents patients from biting through the occlusal registration Has copper particles that provide uniform flow of heat and allow the wax to soften quickly Sets hard when chilled Made in the shape of an arch
OSHA PRECAUTIONS: •
435
Nonhazardous at room temperature
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DIRECTIONS: 1. Coprwax™ bite wafers are heated slightly in warm water. 2. Wafers are placed on the occlusal surface of the maxillary or mandibular arch. 3. The patient is instructed to bite together gently in their normal bite pattern. 4. After the patient has bitten into the wax and the wax has cooled, the wax is gently removed and used for check-bites or occlusal registration.
ALUWAX™
USE: •
Used for dental bite registration material
COMPOSITION: • •
Contains powdered aluminum Trade secret—paraffin and beeswax
PROPERTIES: • • • •
Comes in a number of shapes Contains powdered aluminum to increase the integrity of the compound and provide the heat retention properties Cut to shape for easy use Comes in denture forms, denture sheets, scored, and with waxed cloth forms as well as in the shape of an arch The waxed cloth forms contains coarse weave cloth at the center of the wax form to prevent going through the occlusal surface and prevent tooth skidding.
•
439
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OSHA PRECAUTIONS: •
Nonhazardous at room temperature
DIRECTIONS: 1. Aluwax™ bite wafers are heated slightly in warm water. 2. Wafers are placed on the occlusal surface of the maxillary or mandibular arch. 3. The patient is instructed to bite together gently in their normal bite pattern. 4. After the patient has bitten into the wax and the wax has cooled, the wax is gently removed and used for check-bites or occlusal registration.
STUDY WAX
USE: •
Used for students to carve teeth and develop skills in carving dental anatomy
COMPOSITION: •
Hazardous components—none
PROPERTIES: • • •
Available in blocks Firm wax Carves without chipping and flaking
OSHA PRECAUTIONS: •
Nonhazardous at room temperature
DIRECTIONS: 1. Books are available for the precise carving of each tooth. 2. Utilize a boley gauge and identify the width and length of each tooth. 443
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3. Carve the size and shape of the tooth accordingly. 4. Finalize the anatomy of the crown and root of the tooth. 5. Polish with a soft cloth when finished.
UNDERCUT WAX
USE: •
To place into undercuts in models prior to making the final restoration
COMPOSITION: •
Hazardous components—none
PROPERTIES: • • •
Hard wax Not sticky Available in a small metal container
OSHA PRECAUTIONS: • • •
447
Nonhazardous at room temperature If exposed to melted wax, fumes may cause irritation. Direct contact with molten material may cause injury. Flush area with cold water.
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DIRECTIONS: 1. Heat wax spatula under a flame. 2. Insert the hot spatula into the undercut wax. 3. The undercut wax will melt and then place it into the undercut on the model. 4. When the undercut is filled and the wax is cooled, remove any extra wax.
OCCLUSAL INDICATOR WAX
USE: •
To determine if the occlusal surface of the tooth is high and out of occlusion
COMPOSITION: •
Hazardous components—none
PROPERTIES: • • •
Available in a box with 180 strips and a pencil Strips can be separated easily for use. Green in color
OSHA PRECAUTIONS: •
Nonhazardous at room temperature
DIRECTIONS: 1. Use one wax strip for opposing quadrants. 2. Place on the occlusal surface of one quadrant. 3. Have the patient gently close into their normal bite pattern. 451
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4. 5. 6. 7.
Have the patient gently grind from side to side. The green wax will show the biting pattern. Adjust with a bur as necessary. Discard the used wax strip.
PROCEDURE: TAKING A WAX BITE REGISTRATION WITH A BITE WAFER
This procedure is performed by the dental assistant in the dental operatory.
EQUIPMENT AND SUPPLIES: • • • • •
Basic setup Wax wafer Laboratory knife Heat source (warm water, Bunsen burner, or torch) PPE worn by the dental assistant
DIRECTIONS: 1. Health and medical history is reviewed and the procedure is explained by the dental assistant to the patient. 2. The patient is informed that when the wax is placed into the mouth it will be warm and not to be alarmed. 3. The patient will practice opening and closing the mouth normally. The dental assistant will watch and take note of the correct occlusion positioning.
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4. The wax bite wafer is placed over the biting surfaces of the mandibular teeth. The wax bite wafer is checked for length. If the wax extends beyond the occlusal surface of the teeth, the laboratory knife can be used to remove the extra wax. 5. A heat source is used to warm and soften the wax bite wafer. Often the color will change to a more clear color when the wax is heated. 6. The wax bite wafer is placed on the occlusal surface and the patient is instructed to bite gently in a normal bite pattern. The patient closes and the dental assistant evaluates the position and ensures the patient is biting properly. 7. The wax is allowed to cool and it is removed from the mouth within a minute or two. 8. Carefully remove the wax bite registration to avoid any distortion. 9. The wax bite registration should be disinfected, rinsed, placed in with the impressions or casts related to this patient or labeled, and stored.
Custom Trays and Provisionals
457
COE ® TRAY PLASTIC MANUFACTURER: GC America
USE: •
Used to construct accurate fitting, individualized custom impression trays
COMPOSITION: • • • • •
2-methoxyethanol Tetraethoxysilane Ethanol Dibutyltin dilaurate Mineral oil
PROPERTIES: •
Trimming of tray is easy because tray plastic grinds away without clogging burs
• • • •
Will not warp or pull away from the cast during polymerization Powder and liquid mix in seconds and produce smooth dough. No additional equipment is needed. Tray adhesive available • Regular—15 minutes to set • Fast set—10 minutes to set
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Inhalation: May cause nose and throat irritation. May cause nervous system depression. Prolonged overexposure may cause brain and nervous system damage. May cause irritation or burning of mucous membranes. • Ingestion: May cause abnormal liver and kidney function. • Skin: May cause irritation or burning of skin. Repeated exposure may cause skin burns and allergic reactions. • Eyes: May cause irritation or burning of eyes.
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CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
DIRECTIONS: 1. Soak the cast in water for 10 minutes prior to making 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.
custom tray. Paint a thin film of Coe-Sep™ on cast to prevent sticking. With a pencil, outline the desired periphery of the tray. Adapt a sheet of base plate wax to the cast. Trim the wax to the pencil outline. Cut stops in the wax on areas that are not involved in the impression. Cover the wax spacer with a sheet of polyethylene. Mix 8 ml of liquid with a level scoop of powder. Spatulate together for 30–40 seconds. When it is not sticky or tacky, form the mixture into a patty and adapt it to the cast. Trim the excess material from the edges to the pencil outline while it is still soft.
12. Form a handle with the excess material and wet it with the
accelerator and adapt it to the custom tray. 13. Remove the custom tray from the model when set and finish
trimming with a bur. 14. Polish on a lathe if desired.
461
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
EXPRESS™ STD PUTTY
Courtesy of 3M ESPE
MANUFACTURER: 3M ESPE
USE: •
Used to construct accurate fitting, custom impression trays ready for the final impression material
COMPOSITION: • • • • •
Silane-treated quartz silica Vinyl polydimethylsiloxane White mineral oil Dimethyl methyl hydrogen silicone fluid Chromium oxide
PROPERTIES: •
463
Available for use with the Pentamix™ Mixing Unit • Homogeneous and void free mixing • Dispensing with just pressing the button • Filling of tray is straight from the Pentamix™ unit CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
464
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
• •
Available in hand-mixed putty system • 2 plastic jars of putty and 1 bag of spacers Final high rigidity provided by a special polymer combination
MIXING AND SETTING TIME: Regular set Fast set
Mixing Time: 1 min. 30 sec. working time 1 min. 30 sec. working time
Oral Setting Time: 5 min. intra-oral set time 23 degrees C 2 min. 30 sec. intra-oral set 23 degrees C
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines • Critical hazards—none
DIRECTIONS: 1. Dispense the material from the Pentamix™ unit into the
tray. 2. Shape the material into the tray with your gloved finger. 3. Place a spacer over the material and place it into the oral cavity
of the patient or onto the model to ensure that the correct space is available for the final impression material. 4. Remove the spacer and allow the material to set to the final set time.
465
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
TAK HYDROPLASTIC
Courtesy of Tak Systems
MANUFACTURER: TAK Systems
USE: •
Used in forming a custom tray or bleach tray
COMPOSITION: •
Hazardous ingredients—none
PROPERTIES: • • • • • • • • •
Nontoxic Hypoallergenic Softens in hot water Comes in 16 oz. jar of pellets Can be used with Model Bloc to block out undercuts, fill interproximals, and fabricate spacers No mixing No odor No chemical hazard Bench set in 5 minutes or immediately if placed in cold water
467
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
468
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines • No evidence of adverse effects from available information
DIRECTIONS: 1. Add a scoop of hydroplastic to hot water (155–180 degrees F). 2. After 1 minute, remove with an instrument and gather together. 3. The material should have turned from a milky color to a more
clear color. 4. Knead the material together. 5. Form it to the cast or model (it will not stick to the model). 6. Form a handle out of the material and it will adhere to the
material while in a soft stage. 7. Let it bench set for 5 minutes or place it into cold water for an
immediate set. 8. Remove the tray and trim if necessary with scissors or make
adjustments with a flame.
TAKE 1 ® RIGID TRAY MATERIAL
Courtesy of Kerr Corporation
MANUFACTURER: Kerr Corporation
USE: •
Used in forming a custom tray for use with a final impression material
COMPOSITION: • • • •
Contains no hazardous components as defined in the OSHA Hazard Communication Standard Polyvinyl siloxanes Platinum catalyst complex Fillers and colorants
PROPERTIES: • • • • 471
Fresh mint taste Enhanced marginal integrity Works when moisture is present Improved wettability CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
472
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
• • •
Available for use in automatic mixing machine Rigid tray material is purple in the cartridge syringe and tip system. Rigid tray is firm enough to use in the triple tray to keep the tray from flexing.
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Skin: May cause mild irritation • Eyes: May cause irritation • Inhalation: May cause mild irritation • Ingestion: May be harmful if swallowed
MIXING AND SETTING TIME: • • •
Working time Min. time in mouth Setting time
1:30 minutes 2:30 minutes 4:00 minutes
DIRECTIONS: 1. Dispense the tray material from the automatic mixing machine
or by using the cartridge, mixing tips, and gun. 2. Place it into the tray and shape the material into the tray with
your gloved finger. 3. Place a spacer over the material and place it into the oral cavity
of the patient or onto the model to ensure that the correct space is available for the final impression material. 4. Remove the spacer and allow the material to set to the final set time.
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CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
TRIAD ® TRUE TRAY™ VACUUM FORMING TRAY MATERIAL
MANUFACTURER: Dentsply
USE: •
Designed to fabricate the acrylic custom trays
COMPOSITION: •
Hazardous ingredients—none
PROPERTIES: • • • • • •
475
To be used with Triad 2000™ curing unit Very low shrinkage Does not contain methyl-methacrylate monomer Tray made extra oral only Store away from direct sunlight Refrigerate to extend shelf life
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
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CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
OSHA INFORMATION: Use appropriate PPE and follow all OSHA guidelines. • Nontoxic • Skin irritation is possible in sensitive individuals.
MIXING AND SETTING TIME: Curing Time • On the model initially • Final set off the model
2 minutes 2 minutes
DIRECTIONS: 1. Obtain a properly extended primary cast. 2. Place relief wax and “cutouts” for tray stops, as appropriate for
the situation. 3. Coat all surfaces that will contact TruTray custom tray material
with a thin layer of Triad Model Release Agent. 4. Remove the rayon film from the TruTray and carefully adapt the
material to the cast.
5. Trim the material with a scalpel, knife, or other sharp
instrument to the desired outline and remove excess material. 6. Attach a handle by molding excess material into shape and
7. 8.
9. 10.
477
blending edges into the TruTray material on the cast, with the Triad modeling tool. Cure the cast with its adapted tray in the Triad curing unit for 2 minutes. Remove the cast from the unit and carefully separate the partially cured tray from the cast. Remove any relief wax from the tray while it is still warm. Cover all surfaces of the custom tray with Triad Air Barrier Coating and return to the Triad curing unit for 2 minutes. Remove the custom tray when the cycle is complete. Scrub gently with warm water and trim if necessary.
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
PRESIDENT ® PUTTY
Courtesy of Coltene/Whaledent, Inc.
MANUFACTURER: Coltene/Whaledent, Inc.
USE: •
Used in forming a custom tray for use with a final impression material
COMPOSITION: •
Hazardous components: • Catalyst only • Dialkyltin dicarboxylate • Alkylsilicates
PROPERTIES • • • • • 479
Available for use in automatic mixing machine Available in the cartridge, gun, and tip system Available in 2 tubs (base and catalyst) Balanced thixotropy and flow “Drip-free” tray loading CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
480
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
• •
High tear strength High dimensional stability
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Provided that the product is used as directed, there are no known hazards. • May be harmful if swallowed.
MIXING AND SETTING TIME: Regular set Fast set
Mixing Time: 30 seconds 30 seconds
Oral Setting Time: 3 minutes 2 minutes
DIRECTIONS: 1. Measure out scoopfuls of base and catalyst. 2. Do not interchange the color-coded measuring scoops due
to risk of contamination of putty.
3. Take the base material and the catalyst with the fingertips and
start mixing. 4. Knead the material with the fingertips until the color is uniform. 5. Insert the material into the tray and press it into position.
481
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
ALIKE MANUFACTURER: GC America
USE: •
Used to make a provisional (temporary) restoration
COMPOSITION: •
•
Alike Liquid • Methyl methacrylate • Ethyl-2 cyano 3-3 diphenylacrylate • Methanol Alike Powder • Barium silicate glass • Benzoyl peroxide • Dibutyl phthalate
PROPERTIES: • • • •
Trimmed and polished easily without clogging burs High tensile strength 6 shades Flip-top bottles on powder
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. Alike Liquid • Inhalation: May cause nose and throat irritation, irritation of mucous membranes, and nervous system depression. Reports have associated repeated and prolonged overexposure to brain damage and nervous system damage. It may cause abnormal liver and kidney function. • Skin: May cause irritation or burning of skin. Repeated exposure may cause skin burns and allergic reactions. • Eyes: May cause irritation or burning of eyes, skin, and mucous membranes. 483
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
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CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
Alike Powder • Inhalation of dusts may be irritating to the upper respiratory tract.
MIXING AND SETTING TIME: Setting time • 1–2 minutes working time • 2 minutes intra oral time • 5–6 minutes total cure time
DIRECTIONS: Before preparing the teeth, take a full mouth impression. Rinse impression and remove excess water from the impression. Select the shade of Alike Powder desired. Place a small amount of Alike Liquid in all abutment teeth and pontic areas. 5. Add sufficient Alike Powder to absorb the liquid. 6. Abutment and pontic areas should be slightly over-filled. 1. 2. 3. 4.
7. Coat the prepared teeth and adjacent gingival tissues with a
thin film of Vaseline. 8. Wait approximately 30–60 seconds until the Alike mixture
reaches the desired flow. 9. Place the impression in the mouth with pressure. 10. Remove the impression from the mouth before the exothermic
heat begins, approximately 2 minutes. 11. Allow the Alike temporary to cure in the impression. 12. Remove the Alike bridge from the impression. 13. Trim and polish as necessary.
485
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
JET
MANUFACTURER: Lang Dental
USE: •
Used to make a provisional (temporary) restoration
COMPOSITION: •
Hazardous ingredient • Methyl methacrylate
PROPERTIES: • • •
Methyl methacrylate hardness Easy to polish and trim Available in a wide range of shades including dark and light incisal and clear
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. Jet Liquid • Highly flammable 487
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
488
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
•
It is irritating to eyes, respiratory system, and skin. It may cause sensitization by skin contact. High atmospheric concentrations may lead to irritation of the respiratory tract and anesthetic effects. Repeated and/or prolonged contact may cause dermatitis. Jet Powder • Primary routes of entry: Skin or eyes, inhalation of dusts • Avoid inhalation of dust. Keep dust out of eyes to prevent possible irritation.
MIXING AND SETTING TIME: Setting time • 1–2 minutes working time • 2 minutes intra oral time • 6–9 minutes total cure time
DIRECTIONS: 1. Before preparing the teeth, take a full mouth impression. 2. Rinse impression and remove excess water from the impression.
3. Select the shade of Jet Powder desired. 4. Place a small amount of Jet Liquid in all abutment teeth
and pontic areas. 5. Add sufficient Jet Powder to absorb the liquid. 6. Abutment and pontic areas should be slightly over-filled. 7. Coat the prepared teeth and adjacent gingival tissues with a
thin film of Vaseline. 8. Wait approximately 30–60 seconds until the Jet mixture reaches
the desired flow. 9. Place the impression in the mouth with pressure. 10. Remove the impression from the mouth before the exothermic 11. 12. 13. 14. 15.
489
heat begins, approximately 2 minutes. Place and remove the Jet temporary in the oral cavity. Allow the Jet temporary to cure. Remove the Jet crown or bridge from the impression. Place in the oral cavity to adjust bite. Trim and polish as necessary.
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
LUXATEMP
Courtesy of Zenith Dental
MANUFACTURER: Zenith Dental
USE: •
Used to make a provisional (temporary) restoration
COMPOSITION: • • •
Urethane dimethacrylate Aromatic dimethacrylate Glycol methacrylate
PROPERTIES: • • • • •
491
Excellent marginal adaptation Provisional is easily removable. No heat damage Does not contain liquid monomers Does not need to be removed and replaced multiple times during polymerization
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
492
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
• • • • • • • •
No hand mixing or reloading syringes No need for mixing pads, spatulas, application syringes Self-sealing mixing tips allow easy control of the material being used. Material available in cartridge gun and tip. Luxaglaze is available to provisional for high polish. Luzaflow, which is light–cured, is available to repair provisional. Luxatemp with Fluorescence is available to make temporaries look as good as final in all lighting conditions. Luxatemp Solar Plus is a light-cured format for temporization.
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • None, if handled according to directions • Irritating to eyes, respiratory system, and skin
MIXING AND SETTING TIME: Setting time: • 0–45 seconds • 2–3 minutes • 6–7 minutes
Insertion in the mouth Removal from the mouth End of setting
DIRECTIONS: 1. Take impression or make matrix prior to teeth being prepared. 2. Dry prepared teeth and lightly lubricate prepared teeth and
surrounding tissue with Vaseline or a similar separating medium. 3. Match shade and place appropriate Luxatemp cartridge into the application instrument. 4. Dispense Luxatemp into the impression or matrix, first on the occlusal surfaces and then bring it gingivally, overbuilding it slightly.
493
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
494
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
5. Insert the impression or matrix, filled with Luxatemp within
6.
7.
8. 9.
45 seconds with gentle pressure over the prepared teeth and hold firmly in place. Approximately 2–3 minutes from start of mix the provisional crown or bridge can easily be removed together with the impression from the prepared teeth. The crown or bridge may be contoured and polished after 4 additional minutes. Remove the soft, sticky inhibition layer on the surface of the Luxatemp restoration by wiping with ethyl alcohol. The temporary can be trimmed. Upon completion, the surface of the temporary can be glazed with Luxaglaze and light-cured.
PROTEMP™ CROWN TEMPORIZATION MATERIAL
Courtesy of 3M ESPE
MANUFACTURER: 3M ESPE
USE: •
Used to make short-term temporary restoration
COMPOSITION: • • •
Diacetate Glass powder Substituted pyrimidine
PROPERTIES: • • • • • • • 497
No impression or matrix Easier to obtain good occlusion Easier to obtain interproximal contact Very low oxygen inhibited layer No odor Low exothermic temperatures Light-cured on demand CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
498
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
• •
Has an anatomical shape similar to natural dentition that you can polish and customize Can be repaired using conventional composite or flowable materials
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Critical hazards—none
MIXING AND SETTING TIME: • • • • •
Set Time: Operator controlled due to light-curing Tack-cure buccal surface 2–3 seconds Tack-cure lingual surface 2–3 seconds Tack-cure occlusal surface 2–3 seconds Light-cure outside of the mouth for 60 seconds
DIRECTIONS: 1. Determine the mesial-distal width and temporary crown height
using the 3M ESPE crown size tool. Refer to size selection chart to select the appropriate size crown. 2. Remove the crown from sealed crown case.
3. Hold film between the thumb and finger. Carefully remove film
from Protemp Crown. 4. Measure the height of the adjacent teeth as a guide to the
amount of excess to be trimmed off the Protemp Crown. 5. Follow the gingival contour when trimming excess material
from Protemp crown. 6. Place crown on the prepared tooth and adapt, shape, and
7. 8. 9. 10. 11. 12.
499
establish interproximal contact for a snug fit onto the moist preparation. Gently close to adapt buccal surface and establish occlusion. Adapt buccal margin and adjust occlusion. While patient is in occlusion, check the buccal margin. Tack–cure the buccal surface for 2–3 seconds. Open the mouth for adaptation of the lingual surface. Apply finger pressure to the buccal surface to prevent dislodging of the temporary crown. Adapt the lingual margin. Tack–cure the lingual surface for 2–3 seconds. Tack–cure the occlusal surface for 2–3 seconds.
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
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CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
13. Gently remove the Protemp Crown from the preparation.
Light-cure outside the mouth for 60 seconds. 14. Trial fit cured crown and adjust occlusion, trim margin, and
contour if necessary. Finish using a fine carbide bur and 3M ESPE Sof-Lex™. 15. Polish the ProTemp Crown using a dry muslin rag wheel or polishing brush.
TRIM II
Courtesy of Bosworth Company
MANUFACTURER: Bosworth Company
USE: •
Used to make a provisional (temporary) restoration
COMPOSITION: Hazardous Components: • Polyfunctional acrylates • Methacrylates • Unsaturated esters • Malonyl urea derivatives
PROPERTIES: • • • • • 503
Automixed system with cartridge, gun, and tips Available in powder and liquid system Free of any harsh monomers Free from offensive odors Minimal shrinkage CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
504
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
• • • • • •
Sets in the mouth in approximately 2 minutes Completely cures in 5 minutes Color stable Good polish ability and translucency Glaze™ and Masque™ available for use with Ultra Trim™ Available in 3 shades
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Cadmium pigments are listed as a suspected human carcinogen by IARC and NPT. All other materials are not listed as carcinogens. • Eye—Prolonged exposure may irritate or burn eyes. • Skin—Prolonged exposure may irritate skin, allergic reaction to methacrylates by chronic exposure possible. • Inhalation (Breathing)—Can cause nausea, headaches, drowsiness, breathing difficulties, and unconsciousness
MIXING AND SETTING TIME: Setting time: • Cures in the mouth in 2 minutes • Completely cures in 5 minutes
DIRECTIONS: 1. Take an alginate impression of tooth/teeth prior to final
preparation. 2. Load EZ Squeeze with Ultra Trim cartridge in shade choice. 3. Extrude Ultra Trim directly into the impression. 4. Reseat the impression in the patient’s mouth. Seat onto prepared
areas of the teeth. 5. Leave 2–3 minutes in mouth or until the material shows
a hardened yet still elastic state. 6. Remove the temporary from the impression and trim/finish.
505
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
UNIFAST
MANUFACTURER: GC America
USE: •
Used to make a provisional (temporary) restoration
COMPOSITION: Hazardous Ingredients • Methyl methacrylate
PROPERTIES: • • • • • •
507
5 shades and translucent Dense, nonporous Light-cured Operator has control over working time. Partial cure possible Glaze available
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
508
CHAPTER 7 CUSTOM TRAYS AND PROVISIONALS
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Inhalation may cause nose and throat irritation. It may cause nervous system depression. Reports have associated repeated and prolonged overexposure to brain damage and nervous system damage. It may cause irritation or burning of eyes, skin, and mucous membranes. Repeated exposure may cause skin burns and allergic reaction. It may cause abnormal liver and kidney function.
DIRECTIONS: 1. 2. 3. 4. 5.
Take an impression prior to cutting the preparation. Mix powder and liquid quickly for 10–15 seconds. Pour Unifast LC mixture into the impression. Seat the impression back into its original position. Hold the impression in place for 2 minutes.
6. Remove the impression from the mouth. Carefully remove the
rubber-like Unifast from the impression, trim off the extra, and replace it into the mouth. 7. Partially cure the resin while having the patient bite in occlusion. 8. Remove the partially cured material from the mouth and cure any area that may have been unexposed to the curing light. 9. Adjust occlusion and shape and final trim.
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Fluorides, Pit and Fissure Sealants, and Tooth Whitening Agents
511
ALL-SOLUTIONS FLUORIDE FOAM
Courtesy of Dentsply Caulk
MANUFACTURER: Dentsply Caulk
USE: •
Topical fluoride application
COMPOSITION: •
1.23 acidulated phosphate gel (APF) or 2% neutral sodium fluoride (NaF)
PROPERTIES: • • • • •
513
Clinical convenience of a gel and tray delivery Great fluoride protection Five flavors to choose from Easy to dispense Neutral sodium fluoride is non-acid and safe for patients with composite or porcelain restorations and sealants
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
514
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
OSHA PRECAUTIONS: • •
May be irritating to the eyes and skin Should not be ingested
MIXING AND SETTING TIME: • •
No mixing required Fluoride is left in the mouth for 4 minutes.
DIRECTIONS: 1. Examine the patient’s mouth and estimate the size of tray needed
for complete coverage. 2. Ask the patient which flavor is preferable. 3. Remove the cap of the fluoride and squeeze the top of the bottle
to dispense an even amount throughout the tray—about a third full. 4. The teeth are dried and the tray is placed in the patient’s mouth for 1–4 minutes. 5. Remove the tray and evacuate the patient’s mouth thoroughly.
MINUTE-FOAM
MANUFACTURER: Oral B
USE: • •
Fluoride therapy for children and adults Protects against dental caries
COMPOSITION: •
Sodium fluoride, hydrofluoric acid (equivalent to 1.23% ww F ion)
PROPERTIES: • • • • •
Pleasant flavor with no after taste Six creative flavors Fast and effective fluoride uptake—provides 12,000 ppm in just 1 minute Low pH—3.5 Excellent coverage including the interproximal areas
517
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
518
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
• • •
Reduces gagging and ingestion because the material stays in the tray Light airy consistency Foam clears easily from mouth and will not clog suction
OSHA PRECAUTIONS: •
Ingestion may cause abdominal pain, vomiting, diarrhea, and weakness.
MIXING AND SETTING TIME: •
Setting time is 1–4 minutes exposure.
DIRECTIONS: 1. On the initial time you dispense from a new bottle, gently lift
upward on the nozzle to break the protective shipping tab. 2. Shake the bottle vigorously for 3–4 seconds prior to filling
each tray. 3. Invert the bottle 180 degrees with nozzle pointing downward.
4. Place the nozzle tip close to the bottom of the tray at one end
of the arch. Slowly press down on trigger. 5. Dispense the foam into the fluoride tray. Move from one end
of the tray to the other in one motion to evenly fill about a third of the tray. 6. Place the tray in the patient’s mouth and have the patient bite down lightly for 1 minute (or up to 4 minutes). 7. Instruct the patient not to eat, drink, or rinse for at least 30 minutes.
519
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
TOPEX NEUTRAL FOAM
Courtesy of Sultan Healthcare
MANUFACTURER: Sultan Healthcare
USE: • • •
Fluoride protection Used for patients with cosmetic restoration Used with patients with intolerance to acidic fluoride
COMPOSITION: •
2% sodium fluoride (0.9% fluoride ion)
PROPERTIES: • •
• • •
Several flavors Clearly strawberry has no dyes, so it is ideal to use after whitening procedures or for patients who are sensitive to acidic fluoride Will not harm cosmetic restorations Effective caries prevention Excellent interproximal coverage
521
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
522
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
OSHA PRECAUTIONS: •
Primary routes of entry: No hazardous health hazards (acute or chronic)
MIXING AND SETTING TIME: • •
No mixing time Up to 4 minute application time
DIRECTIONS: 1. After initial use, shade for 10 seconds before use. 2. Turn can completely upside down to dispense. 3. Point can downward toward fluoride tray and press the nozzle 4. 5. 6. 7. 8.
to fill the tray. Use one press per arch, as foam will expand slightly to fill the tray. Dry the teeth and insert the tray. Have the patient bite down for 4 minutes. Remove the trays and have the patient expectorate excess. Instruct patient not to eat, drink, or rinse for 30 minutes.
PERFECT CHOICE ONE MINUTE APF GEL
Courtesy of Biotrol
MANUFACTURER: Biotrol
USE: •
Fluoride treatment to prevent dental caries
COMPOSITION: • •
1.23% acidulated phosphate fluoride Dyes and flavorings
PROPERTIES: • • • •
Great tasting 80% effective at 1 minute and 100% effective at 4 minutes Assorted flavors Effect fluoride application
OSHA PRECAUTIONS: •
525
May be irritating to the eyes
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
526
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
• •
May be irritating to the skin if prolonged contact May cause nausea and vomiting if ingested
MIXING AND SETTING TIME: • •
No mixing time Setting time is 1–4 minutes
DIRECTIONS: 1. After prophylaxis, flip the top open and place gel in fluoride
tray (not more than a third full). 2. Thoroughly air-dry the teeth and insert trays in the mouth. 3. Gel may also be applied with a cotton tipped swab. 4. Instruct the patient to bite down slightly but firmly for 1 minute
to 4 minutes. 5. A slight chewing motion enhances coverage interproximally. 6. Remove trays and have the patient expectorate excess gel. 7. Instruct the patient not to eat, drink, or rinse for 30 minutes.
60 SECOND TASTE FLUORIDE GEL
Courtesy of Pascal Company, Inc.
MANUFACTURER: Pascal Company, Inc.
USE: •
Fluoride treatments to reduce dental decay
COMPOSITION: •
Acidulated phosphate fluoride—1.23% fluoride ion at pH 3.5
PROPERTIES: • • • •
Unique flow-set characteristics—flows easily into the tray and then thickens during treatment Smooth and creamy texture Effective strength to protect against dental caries Available in eight flavors
OSHA PRECAUTIONS: •
529
Prolonged exposure may cause skin irritation.
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
530
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
• •
May be irritating to the eyes Ingestion may cause nausea, vomiting, diarrhea, and abdominal discomfort.
MIXING AND SETTING TIME: • •
No mixing required Setting time is 60 seconds application time.
DIRECTIONS: 1. After the teeth have been polished, select the fluoride tray. 2. Open the flip-top on the 60 Second Taste fluoride bottle of the
flavor the patient has selected and turn the bottle upside down to fill the tray. 3. Starting at one end of the arch squeeze enough to fill the bottom of the tray in one sweeping motion. About a third of the tray should be filled. 4. Dry the teeth and insert the tray into the patient’s mouth. Have the patient bite down to seat the tray. 5. Trays are in place for 60 seconds and then removed.
6. Have the patient expectorate excess gel. 7. Instruct the patient not to eat, drink, or rinse for 30 minutes
following treatment.
531
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
TOPEX 2 PART IN-OFFICE FLUORIDE RINSE
Courtesy of Sultan Healthcare
MANUFACTURER: Sultan Healthcare
USE: • •
In office fluoride rinse to reduce dental caries Safe for use with crown, bridges, and composite restorations
COMPOSITION: • •
0.31% acidulated phosphate fluoride 1.64% stannous fluoride
PROPERTIES: • • • •
Combines the benefits of acidulated phosphate fluoride and stannous fluoride Easy-to-use metered pump Clinically proven Comes in three flavors
533
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
534
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
OSHA PRECAUTIONS: • • •
May be irritating to the eyes, flush with water for 15 minutes May be irritating to the skin If ingested, may cause nausea, vomiting, and abdominal discomfort
MIXING AND SETTING TIMES: • •
No mixing required Rinse for a total of 1 minute
DIRECTIONS: 1. When first using Topex 2 Part Fluoride Rinse, remove the caps
from both Part A and Part B and replace caps with dispensing pumps. 2. After polishing the patient’s teeth, dispense one full pump of fluoride from the Part A bottle and one full pump of fluoride from the Part B bottle into the mixing vial.
3. Pour the solution from the mixing vial into a disposable cup that
is provided. 4. Have the patient rinse for 60 seconds and then expectorate
solution. 5. Instruct the patient not to eat, drink, or rinse for 30 minutes.
535
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
ALL-SOLUTIONS 2% NEUTRAL RINSE
Courtesy of Dentsply Professional
MANUFACTURER: Dentsply Professional
USE: •
Topical fluoride rinse to reduce dental caries
COMPOSITION: •
2% neutral sodium fluoride
PROPERTIES: • • • • • • • •
In-office one part ready-to-use mix Great fluoride protection Does not require mixing Good fluoride uptake No need for fluoride trays Non-acidic fluoride so safe for patients with porcelain or composite restorations and sealants Short treatment time Four flavors
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
OSHA PRECAUTIONS: • • •
May be irritating to the eyes, flush with water for 15 minutes May be irritating to the skin If ingested, may cause nausea, vomiting, and abdominal discomfort
MIXING AND SETTING TIMES: • •
No mixing required Rinse for a total of 1 minute
DIRECTIONS: 1. For first time use of All-Solutions Rinse, remove the cap and
insert pump. 2. After the patient’s teeth have been polished, prepare the fluoride 3. 4. 5. 6.
rinse. Dispense premeasured amount of 15 ml into the provided cup. Have the patient rinse (swish) for 30 seconds and expectorate. Repeat. Instruct the patient not to eat, drink, or rinse for 30 minutes.
DURAFLOR CAVITY VARNISH
MANUFACTURER: Medicom
USE: • • •
Relief of hypersensitivity for up to 6 months Reduce postoperative sensitivity Dental caries protection
COMPOSITION: • •
5% sodium fluoride Nonmedical ingredients: denatured ethyl alcohol, flavor, purified water, rosin, sucralose, xylitol, yellow beeswax
PROPERTIES: • • • •
541
Strong desensitizing action when applied to the teeth Water-tolerant Adheres well to the tooth surface Slight tint for easy visual control and placement verification
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
• •
Proven effective up to 6 months May be placed on a moist tooth surface
OSHA PRECAUTIONS: • • •
May cause irritation to the skin May cause irritation to the eyes May cause nausea with extensive application
MIXING AND SETTING TIME: • •
No mixing required Hardens rapidly when in contact with saliva
DIRECTIONS: 1. Wash and dry the tooth surface. 2. Remove the top of the container. 3. Apply Duraflor with the supplied brush over the surfaces of the
teeth. 4. Gently thin the excess varnish in the surfaces of the tooth until
the varnish surface is dry.
5. Duraflor covers even moist teeth with a coating of varnish film
for several hours, which occludes the openings of the dentinal tubules. 6. Duraflor hardens on contact with saliva and the patient may leave immediately following the application. 7. Instruct the patient to eat only soft foods for 2 hours following treatment. 8. Clean instruments with alcohol before sterilizing.
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
DURASHIELD 5% SODIUM FLUORIDE VARNISH
Courtesy of Sultan Healthcare
MANUFACTURER: Sultan Healthcare
USE: • • •
Dental caries protection for both primary and permanent teeth Cavity varnish and desensitizing agent Reduces hypersensitivity for high-risk caries patients with root caries or xerostomia where dentin and cementum are exposed
COMPOSITION: • • •
Sodium fluoride 5% Colophony resin, synthetic inert polymer, alcohol, silica, and flavoring Sweetened with xylitol and contains no dyes
PROPERTIES: • • • 545
Effective in reduction of caries and sensitivity Fast to apply and a wide range of applications No need to prophy before application CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
• • • • •
Sets on contact with salvia and releases fluoride for 6 to 8 hours after application Can be used with small children (infants and toddlers), disabled patients, and patients with active gag reflex Light amber color for visual where applied Comes in single use hygienically sealed doses; aids in asepsis and cross contamination Cleanup is easy and fast.
OSHA PRECAUTIONS: •
• •
Inhalation—may be irritating to the throat; may cause headaches, drowsiness, lassitude, loss of appetite, and inability to concentrate May be irritating to the eyes and skin—seek medical attention Ingestion—may cause nausea, diarrhea, vomiting, and depression to the central nervous system
MIXING AND SETTING TIME: • •
No mixing Hardens rapidly when in contact with saliva
DIRECTIONS: 1. Remove any calculus or plaque. 2. Remove any excess saliva or moisture to area where varnish is
going to be applied. 3. Remove the Ultra Brush 2.0 from the sealed packet. 4. Use the brush to mix the contents of the packet and then bend
the applicator brush to desired angle needed for application. 5. Uniformly brush the varnish over the entire surface to be
covered, reinserting the brush into the packet as needed. 6. Allow the area to become wet by rinsing or saliva contact. 7. Instruct the patient to eat soft foods for the remainder of the day;
avoid rinses containing fluoride or alcohol; avoid brushing and flossing treated area for 4 to 6 hours after application.
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
FLUOR PROTECTOR ASSORTMENT FLUORIDE VARNISH MANUFACTURER: Ivoclar Vivadent
USE: • • • • •
Professional protection against dental caries Prevents hypersensitivity Protective varnish and dentin sealant Remineralization of incipient caries Used on children, adolescents, and adults
COMPOSITION: • •
Fluoride Ethyl acetate, isoamylpropioniate, polisocyanate, and fluorsilane
PROPERTIES: • • • • • • • •
Excellent seal of enamel Reduces microleakage Hydrogen fluoride varnish penetrating the enamel Simple unit-dose delivery Low fluoride concentration Colorless and fast setting 1 ampoule sufficient for 2 to 3 sets of teeth Single dose sufficient for 1 set of teeth
OSHA PRECAUTIONS: • • •
May be irritating to the eyes—rinse thoroughly May be irritating to the skin—wash with soap and water No hazards indicated from swallowing small amount
MIXING AND SETTING TIME: • • 549
No mixing required Apply varnish and wait for 1 minute CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
DIRECTIONS: 1. 2. 3. 4. 5. 6. 7. 8. 9.
Thoroughly clean the tooth. Dry the tooth with air and isolate area with cotton rolls. Place the bottle or ampoule in the plastic base. Ampoule opens with enclosed breaker. Apply a thin layer using the enclosed brush (for single use). Use dental floss to apply the material to the proximal surface. Evenly disperse the varnish and then air-dry. Keep the area isolated with cotton rolls for 1 minute. Ask the patient not to rinse, eat, or brush for 45 minutes after the placement of the fluoride varnish.
TOPEX TAKE HOME CARE 0.4% STANNOUS FLUORIDE GEL
Courtesy of Sultan Healthcare
MANUFACTURER: Sultan Healthcare
USE: • •
Reduces sensitivity and plaque biofilm Inhibits cariogenic microbial process
COMPOSITION: • •
Glycerin, cellulous derivative, and 0.4% stannous fluoride Inorganic halide, saccharide, and polylo
PROPERTIES: • • • • •
553
Thick, clear gel Easy to apply to toothbrush or tray No food or drink restrictions after treatment Alcohol-free with no color additives Reduced allergenic reactions
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
OSHA PRECAUTIONS: • • •
Effects of overexposure: Inhalation of vapors may cause breathing difficulty and coughing. Contact with skin or eyes may cause dermatitis. Ingestion may cause headache, nausea, vomiting, gastrointestinal irritation, convulsions, and unconsciousness.
MIXING AND SETTING TIME: No mixing is required, but the fluoride gel should be in contact with the teeth for 1 minute.
DIRECTIONS: 1. Adults and children 6 years or older use once a day at bedtime. 2. Brush and floss and then remove excess water from toothbrush. 3. Liberally cover bristles of toothbrush with Topex Take Home
Care Gel 0.4% Stannous Fluoride. 4. Brush on to all tooth surfaces for 1 minute. 5. Push gel in between the tooth surfaces with the tongue and
cheek muscles for 1 minute and then spit gel out.
6. Do not swallow any material and do not rinse. 7. Adults: Expectorate thoroughly, do not rinse, eat, or drink
for 30 minutes. 8. Children 6 years and older: Expectorate and rinse thoroughly.
555
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
NEUTRAGARD ADVANCED 1.1% NEUTRAL SODIUM FLUORIDE GEL
Courtesy of Pascal Company, Inc.
MANUFACTURER: Pascal Company, Inc.
USE: • • •
Indicated for adults and children over 6 years of age For patients with recurrent decay around restorations and for those at risk for root caries Good for xerostomia-induced caries, orthodontic decalcification, and hypersensitivity
COMPOSITION: • •
1.1% sodium fluoride Sodium saccharin
PROPERTIES: • • • • 557
Safe for porcelain crowns, bridges, or composite restorations Can be used in place of toothpaste Mild dentifrice cleaning that removes plaque Leaves mouth feeling fresh CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
558
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
• • • •
Highest level of fluoride allowed for take-home fluoride products Easy dispensing Nonallergenic and nonstaining Sodium benzoate free
OSHA PRECAUTIONS: • • •
May cause irritation to the eyes—flush for 15 minutes May cause irritation to the skin—wash for 15 minutes Ingestion: may cause nausea, vomiting, diarrhea, abdominal distress, and weakness—seek medical assistance if more than used for brushing is swallowed
MIXING AND SETTING TIME: • •
No mixing required Leave gel on teeth for 1 minute
DIRECTIONS: 1. Adults and children 6 years or older use once a day at bedtime.
2. Brush and floss and then remove excess water from the
toothbrush. 3. Liberally cover bristles of toothbrush with NeutraGard
Advanced 1.1% Neutral Sodium Fluoride Gel. 4. Brush on to all tooth surfaces for 1 minute. 5. Do not swallow any material and do not rinse. 6. Expectorate thoroughly; do not rinse, eat, or drink for
30 minutes. 7. Children 6 years and older: Expectorate and rinse thoroughly.
559
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
CLINPRO SEALANT
Courtesy of 3M ESPE Dental Products
MANUFACTURER: 3M-ESPE Dental Products
USE: •
Sealing the enamel pits and fissures to protect against dental caries
COMPOSITION: • • • •
Triethylene glycol dimethacrylate Bisphenol A diglycidyl ether dimethacrylate Tetrabutylammonium, tetrafluoroborate Silane-treated silica
PROPERTIES: • • • •
561
Low viscosity Bonds to enamel Fluoride releasing Flows easily into pits and fissures
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
• •
Comes with ultra fine tips for easy placement Color change technology
OSHA PRECAUTIONS: • • • •
May cause mild eye irritation May cause allergy to skin or moderate skin irritation Prolonged or repeated exposure may cause upper respiratory irritation May cause gastrointestinal irritation
MIXING AND SETTING TIME: • •
No mixing required Sealant is light-cured for 20 seconds to set.
DIRECTIONS: 1. Prepare delivery system. Remove cap from the syringe and save. 2. Twist disposable cap onto the syringe until secure. 3. Dispense a small amount of material on a paper pad to ensure
the tip is not clogged.
4. Etch each tooth according to the manufacturer’s directions, then
5. 6. 7.
8. 9. 10.
563
rinse thoroughly and air-dry. The tooth should be a matte frosty white color on the etched area. Do not allow the etched surface to be contaminated. Using the syringe tip, slowly introduce the pit and fissure sealant to the etched surface of the tooth. Stirring the sealant during and after placement with the syringe tip or an explorer will help to eliminate air bubbles and enhance the flow of the sealant into the pits and fissures. Hold the tip of the curing light close to the surface and cure for 20 seconds. When set, the sealant forms a hard, opaque film that is light yellow in color with a slight inhibition. Repeat this on each etched tooth.
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
DELTON SEAL-N-GLO LIGHT CURE PIT & FISSURE SEALANT
Courtesy of Dentsply Professional
MANUFACTURER: Dentsply Professional
USE: •
Preventive sealing of pits and fissures in the primary and secondary dentition in combination with the acid-etch techniques
COMPOSITION: •
Low viscosity monomers, triethylene glycol dimethacrylate, BisGMA, barium alumino fluroboro silicate glass, titanium dioxide, silicon dioxide, sodium fluoride, initiators, stabilizers, fluorescent dye—38% filled
PROPERTIES: • •
Provides visual verification of sealant margins at time of placement Easy way to verify retention and integrity of margins at recall appointments
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
• • • •
Contains fluoride Effective sealing properties Illuminating dye does not color or change the look of the opaque sealant Easy to place
OSHA PRECAUTIONS: • • • •
May cause eye irritation Individuals sensitive to acrylics may develop an allergic response. Possible nausea on prolonged exposure Possible irritation to the skin
MIXING AND SETTING TIME: • •
No mixing required Setting: Light-cure to set
DIRECTIONS: 1. Tooth must be cleaned with an air polishing device or
prophylaxis treatment.
2. Rinse well with water and isolate the teeth to be sealed. 3. Air-dry each tooth with air free of oil or water contamination. 4. Etch the pits and fissures of the teeth to be sealed for
15–60 seconds according to the manufacturer’s directions. 5. Rinse thoroughly for at least 30 seconds, then dry area. 6. Teeth will have a dull frosty white appearance; if they do not
look like this, re-etch for another 20 seconds. 7. Remove cap from the Delton Seal-N-Glo syringe. Attach a
8. 9. 10.
11.
567
disposable applicator tip to end of the syringe. Turn the tip clockwise to secure the applicator tip to the end of the syringe. Express a small amount onto a pad to assure free flow of material. Apply the sealant into the pits and fissures. Cure each surface for at least 20 seconds, keeping the curing light tip as close to the tooth surface without actually touching the tooth as possible. Remove the soft (oxygen-inhibited) surface layer after lightcuring with cotton pellets or cotton rolls.
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
Image not available due to copyright restrictions
MANUFACTURER: Dentsply Caulk
USE: • •
Preventive sealing in pits and fissures in primary and secondary dentition to protect against dental caries Fluoride release that is intended to act as a fluoride supplement
COMPOSITION: • • • • • • • • • 569
Urethane-modified Bis-GMA dimethacrylate Barium alumino fluroboro silicate glass Polymerizable dimethacrylate resins Bis-GMA Sodium fluoride Photoiniator Photoaccelerator Silicon dioxide 50% inorganic filler CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
570
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
PROPERTIES: • • • • •
Visible light-cured pit and fissure sealant Releasable fluoride that is intended to act as a fluoride supplement Decreases the chance of microleakage Bonds chemically and mechanically to the enamel Low water absorption increases resistance to washout
OSHA PRECAUTIONS: • • •
Material may cause irritation to the eyes. Material may be an irritant. Material is probably not harmful if swallowed.
MIXING AND SETTING TIME: • •
No mixing is required. Material is light-cured for 20 seconds per surface.
DIRECTIONS: 1. Prophy the pits and fissures of the teeth to be sealed then rinse
thoroughly and air–dry.
2. Isolate the teeth with cotton rolls or a rubber dam. 3. Apply Caulk 50% Tooth Conditioner Liquid with the cotton tip
4. 5. 6. 7.
571
applicator for 60 seconds to permanent teeth and 90 seconds for primary teeth then rinse thoroughly and air–dry. Tooth should look frosty. Remove the cap and place FluoroShield material on a paper pad. Cover to protect from the overhead light. Pick up a liberal amount of material using the disposable brush and place on the tooth into the pits and fissures. Light-cure all surfaces keeping the tip of the light about 1–2 mm away from the surface for 20 seconds (curing time depends on the light source).
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
HELIOSEAL SEALANT
MANUFACTURER: Ivoclar Vivadent
USE: •
Provides excellent long-term cavity protection in occlusal areas
COMPOSITION: •
Mixture of Bis-GMA, dimethacrylate, titanium dioxide, initiators, and stabilizers
PROPERTIES: • • • •
573
Long-term caries protection Fast and easy to apply Has a white opaque shade Also available in three other formulas: A transparent sealer— Helioseal Clear; a transparent sealer with reversible color changes using a halogen polymerization light—Helioseal Clear Chroma; and a white-shaded sealant with additional fluoride release—Helioseal F CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
OSHA PRECAUTIONS: • • • •
May be irritating to the eyes—flush with water Skin contact—wash thoroughly with soap and water Inhalation—move to fresh air No hazards anticipated with swallowing a small amount of material with normal handling
MIXING AND SETTING TIME: • •
No mixing required 35 second total including waiting time and light-curing
DIRECTIONS: 1. Thoroughly clean the tooth to be sealed. 2. Isolate the area preferably with a rubber dam. 3. Place the disposable tip on Syringe Total Etch and apply the
etching gel for 30–60 seconds, then thoroughly rinse and dry with oil-free air. Tooth should have a mat appearance. 4. Shake the Helioseal bottle well and open immediately before use to prevent any premature polymerization by light.
5. Remove the cap and place a cannula on the bottle to apply
directly or place Helioseal in well, on paper pad, or directly dispense from bottle and apply with the brush handle and tip supplied in the kit. 6. Wait for 15 seconds and then light-cure with a suitable light source for 20 seconds. 7. Check seal and occlusion.
575
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
ORAL-B WHITENING STRIPS
MANUFACTURER: Rembrandt
USE: • •
To whiten teeth To restore the original brightness of professional whitening
COMPOSITION: •
PVP, PEG8, water, acrylate copolymer, hydrogen peroxide, disodium pyrophosphate, sodium stannate, disodium EDTA
PROPERTIES: • • • • • •
Noticeably whiter teeth in 5 days Only apply once a day compared to twice-daily with other systems Form fit strips Economical yet effective whitening Quick results and easy application Adheres well to the tooth
577
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
OSHA PRECAUTIONS: • • •
May cause irritation to the eyes May cause skin irritation and blanching If swallowed, contact your doctor immediately or the Poison Control Center.
MIXING AND SETTING TIMES: •
No mixing required
DIRECTIONS: 1. Rinse mouth with water for 15 seconds to moisten the teeth. 2. Remove the upper strip from the blister pack. 3. Apply the upper strip by aligning the straight edge with the gum
line and pressing down to fit the curves of the teeth. 4. Press the tabs behind the front teeth to secure strip. 5. Remove the lower strip from the blister pack and repeat the
same process on the lower teeth. 6. Wear the strips for 30 minutes and avoid eating, drinking,
or smoking.
7. After 30 minutes, rinse mouth with water for 15 seconds. 8. Remove the strips from the upper and lower teeth. Discard the
used strips. 9. If whiter teeth are desired, continue using the strips for 7 days.
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
OPALESCENCE TOOTH WHITENING SYSTEMS
Courtesy of Ultradent Products, Inc.
MANUFACTURER: Ultradent Products, Inc.
USE: • • •
Whiten the teeth Removing the colors present on teeth from the time of tooth eruption and/or the stains of aging Success with varying degrees of tetracycline and brown fluorosis discoloration Used on nonvital teeth for intracoronal bleaching
•
COMPOSITION: • • •
Carbamide peroxide Potassium nitrate Fluoride ion
PROPERTIES: • • 581
Very effective bleaching agent Comes in unit dose syringes and is flavored CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
582
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
• • • • •
Available in different percentages of carbamide peroxide Has sustained release Adhesive properties Custom designed application tray High-viscosity and sticky
OSHA PRECAUTIONS: • • • •
Eyes—immediately flush eyes for 15 minutes Skin—wash with soap and water thoroughly Ingestion—if swallowed, give the patient a glass of water or milk and call a physician. Inhalation—not defined
MIXING AND SETTING TIMES: • •
No mixing is required. Application time varies depending on the patient’s needs, level of sensitivity, and day-to-day activities.
DIRECTIONS: 1. Fabricate the tray according to the manufacturer’s instructions. 2. Instruct the patient on the bleaching procedure. 3. Patient should load gel into their custom tray. Use 1/2 to 1 full
syringe of material to fill the tray. 4. Brush the teeth, and then insert the tray. Adapt tray sides to the
teeth. 5. Remove excess gel with a clean finger or soft toothbrush. Rinse
twice; do not swallow rinses. 6. The dentist will instruct the patient when and how long to
bleach. Opalescence carbamide peroxide gel will bleach 8–10 hours during the night or 4–6 hours during the day. In some treatment sequences the bleaching procedure is completed by the patient for 30 minutes several times a day. 7. Patient is evaluated every 3 to 5 days of treatment or as needed.
583
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
CONTRASTPM WHITENING SYSTEMS
Courtesy of Spectrum Dental
MANUFACTURER: Spectrum Dental
USE: •
Tooth whitening system
COMPOSITION: •
Propylene glycol, hydroxlpropyl, glycerin, spearmint oil, fumed silica, tetra potassium, pyrophosphate, carbamide peroxide, emulating wax, and hydrogen peroxide
PROPERTIES: • • • • • •
Neutral pH Mild spearmint flavor Fast, effective whitening Cream texture, viscous gel material Offers extended contact and prolonged carbamide peroxide release Comes in different percentages
585
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
OSHA PRECAUTIONS: • • •
Eyes—immediately flush eyes for 15 minutes Skin—wash with soap and water thoroughly Ingestion—if ingested, may cause irritation; contact physician
MIXING AND SETTING TIMES: • •
No mixing required Contact time depends on strength of solution and patient’s level of sensitivity
DIRECTIONS: 1. Place a drop of ContrastPM whitening gel in the center of each
tooth compartment of the custom fit tray. 2. Place the tray in the mouth and compress the gel against the
tooth, dispersing the material across the surface. 3. Do not over-fill the trays, as the overflow may irritate the
gingival tissues. Remove any excess with your finger or a dry toothbrush. 4. You may rinse gently for 5 seconds, if needed.
5. Follow the dentist’s instruction, carefully regarding the
treatment plan. 6. The 10% and 15% whitening gels can be worn in the trays
overnight or during the day for up to 4 hours. 7. The 20% whitening gels can be worn for 1 hour and up
to 2 hours if no sensitivity exists. 8. After the trays are removed, rinse and brush excess gel from the
teeth. Rinse the trays with cold water using a toothbrush to remove any gel. Store trays in the case in a cool, dry place.
587
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
NU RADIANCE DUET TOOTH WHITENING SYSTEM
Courtesy of Nu Radiance, Inc.
MANUFACTURER: Nu Radiance
USE: •
To whiten teeth without sensitivity
COMPOSITION: •
Stabilized carbamide peroxide gel mixed with an accelerator and hydrating agent
PROPERTIES: • • • •
Easy, comfortable, and effective whitening system Takes less time Comes in different percentages Hydrates the teeth so it does not cause sensitivity
OSHA PRECAUTIONS: •
589
May cause irritation to the eyes—flush with copious amount of water CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
590
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
• • •
May cause skin irritation—wash with soap and water If swallowed, drink large amounts of water and contact your doctor immediately No harm anticipated if inhaled in the amount of commercially packaged material
MIXING AND SETTING TIMES: • •
No mixing is required. Application times vary with the percentage of solution.
DIRECTIONS: 1. Remove the tip guard and place a mixing tip securely on the
syringe. 2. Do not pull back on the syringe as this may activate the gel. 3. Pat the teeth dry before treatment. 4. Place a small line of gel on the front of the tray, using the
material sparingly. 5. As the gels are released from the syringe, they will be blended in
the mixing tip and activate.
6. Place the tray into the mouth and press the gel against the teeth;
remove any excess with a tissue. 7. After 30–60 minutes, remove the tray and rinse. 8. Complete the whitening treatment once a day or as directed by
the dentist. 9. Do not eat, drink, or smoke while whitening or for 30 minutes
after the treatment.
591
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
NIVEOUS IN-OFFICE TOOTH WHITENING
MANUFACTURER: Shofu
USE: • • •
Chair-side tooth whitening system For bleaching vital and nonvital teeth and intracoronal bleaching Bleaching intrinsic stains such as tetracycline stains
COMPOSITION: • • •
25% hydrogen peroxide Approved FDA orange pigment Stabilizer
PROPERTIES: • • • •
Proven to whiten teeth quickly Booster brushes have proprietary enhancer to optimize the whitening effect Convenient single-arch ampules Easy to use
593
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
594
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
• • • •
Long-lasting whitening effect Premixed gel Heat-activated system “Booster brushes” provided in the system are treated with a special oxidizing mechanism. When the booster brush is introduced to the Niveous gel, a “boosted” bleaching effect is created on the tooth.
OSHA PRECAUTIONS: • •
May cause severe irritation to skin and eyes—flush with large amounts of water for 15 minutes Ingestion—drink lots of water and seek medical assistance
MIXING AND SETTING TIMES: • •
Mixing time is 15 seconds. Application time is 15 minutes for each application.
DIRECTIONS: 1. Patient should have a prophylaxis treatment prior to the
bleaching appointment.
2. Select and record the patient’s pre-bleaching shade. 3. Remove plastic droplets and brushes from the refrigerator
4. 5.
6. 7. 8. 9.
595
15 minutes prior to the bleaching treatment to bring them to room temperature. Remove the resin dam material from the refrigerator and use immediately. Remove the syringe cap and place the syringe tip on the resin dam. Carefully place the dam on the gingival tissues to isolate the teeth being treated. Cut the tip of the plastic droplet and dispense the gel into dappen dish or directly on the tooth. Agitate the gel using the booster brush for 15 seconds in the well, and then apply to the tooth or directly on the tooth. Small bubbles will appear indicating the oxidation process has begun. Two applications at 15-minute periods are recommended when using a curing light that gives off heat. Use a new booster brush for each application of six teeth.
CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
10. Using a halogen light apply to each tooth for a minimum
of 2 minutes (making two passes of 1 minute each). 11. If using a high intensity laser or plasma arc light, expose each
tooth for 3–5 seconds. 12. A third 15-minute application may be needed if a light source
is not used with the Niveous gel. 13. Remove the bleaching gel with cotton rolls and HVE after each
application followed by rinsing with water. 14. After the bleaching procedure is completed, remove the
bleaching gel with cotton rolls and high-volume evacuation and then rinsing with water thoroughly. 15. Remove the resin dam material using a hand instrument. Floss may be used to remove the dam from the interproximal area.
POLAOFFICE BLEACHING AGENT
Courtesy of SDI (North America) Inc.
MANUFACTURER: SDI (North America) Inc.
USE: To remove the following • Superficial stains • Absorbed and penetrating stains • Age-related stains • Conservative treatment to improve appearance • Stains due to pulpal trauma and necrosis • Stains from tetracycline and dental fluorosis • Natural occurring yellow stains, chromogenic food stains, and tobacco stains
COMPOSITION: • • • 599
35% hydrogen peroxide Nonhazardous balanced ingredient Silicone dioxide powder CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
• •
Catalyst Potassium nitrate
PROPERTIES: • • • • • •
Simple to use Quick and requires minimal chair time Unique desensitizing properties Effective whitening Self-curing and light-curing Includes a gingival protectant
OSHA PRECAUTIONS: • •
•
May be irritating to the eyes—flush immediately for 15 minutes; seek medical attention May be irritating to the skin—remove contaminated clothing, wash skin with soap and water; area may appear temporarily bleached white May cause gastrointestinal problems—do not induce vomiting drink lots of water or milk; seek medical attention
•
Inhalation—remove to fresh air; if respiratory difficulties occur seek medical attention
MIXING AND SETTING TIME: • •
Mixing time is 10 seconds. Activation time is 8 minutes for each application.
DIRECTIONS: Determine and record the preoperative shade of teeth. Clean the teeth with flour-based pumice. Place cheek retractors and place Vaseline on lips. Remove the cap from the Gingival Barrier syringe and place and secure a disposable syringe tip. Dry the teeth. 5. Using the syringe, place Gingival Barrier on both arches slightly overlapping the enamel and interproximal spaces. 6. Light-cure for 20 to 30 seconds using a fanning motion until the material is set. 7. Open the powder pot. Take one syringe of the PolaOffice, remove the cap, and place securely a disposable dispensing tip. 1. 2. 3. 4.
601
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
8. Pull back on the syringe plunger to release pressure. 9. Place the contents of the syringe into the pot and
10. 11. 12. 13. 14. 15. 16.
immediately mix with the brush applicator until the gel is a homogeneous mix. Using the brush applicator, apply a thick layer of gel to all teeth being treated. Leave the gel on the teeth for 8 minutes or you can light-cure following the manufacturer’s directions. Evacuate the material off the teeth using a surgical evacuating tip. Repeat the application three times. A second mix needs to be completed for the third application. After the last application, suction off the gel and then wash and suction the entire area thoroughly. Remove the Gingival Barrier with cotton pliers by lifting it from one end. Give the patient the postoperative instructions.
LUMA WHITE BLEACHING PASTE
Courtesy of Lumalite
MANUFACTURER: Lumalite
USE: • •
To whiten and brighten teeth Remove stains
COMPOSITION: • •
35% hydrogen peroxide Non-crystalline silica, ethanol, and proprietary trace elements
PROPERTIES: • • • • • •
605
Achieves the best results in the least amount of time Convenient to use Everything needed is provided for in the kit. Low cost No guessing or mixing Protectant for gingival tissues provided
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
OSHA PRECAUTIONS: • • • • •
Corrosive to mucous membranes of the skin and eyes Eyes—may cause severe damage Skin—may cause irritation and burns Inhalation—slight nose and throat irritation Ingestion—corrosive to GI tract, may cause irritation, burning
MIXING AND SETTING TIME: • •
Mixing time is 10 seconds. Activation time is 8 minutes for each of the three applications.
DIRECTIONS: 1. Determine the existing shade with the teeth moist and no 2. 3. 4. 5.
overhead lighting. Use flour of pumice to clean the teeth. Insert cheek retractors provided in the kit. For badly stained teeth apply a 5 second acid etch to the teeth. Insert cotton rolls on either side of the frenum on the maxillary and mandible.
6. Thoroughly dry the teeth and the gingiva. Apply Luma Block
7. 8.
9. 10. 11. 12.
607
paint on, light-curable rubber dam two teeth at a time. Lightcure the material in a slow flowing motion over the teeth. Material should be rubbery and cover all the gingival tissues. Dry teeth and apply Vaseline around any exposed tissue near retractors. Prepare Luma White bleach by opening the top on a catalyst jar; open one of the hydrogen peroxide premeasured ampoules by cutting the top off close to the flattened area of the tip. Dispense the material into the catalyst jar. Carefully and slowly mix the material with the applicator brush for at least 10 seconds. Apply the mixture to the teeth covering the cervical and incisal areas completely. Insert a saliva ejector into the patient’s mouth and raise the chair so the patient is sitting in an upright position. Position the Full Smile Illuminator (head of the Luma whitening light) as close as possible to both arches to fully cover the area.
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
13. Activate the light to begin the 8 minute cycle (which can be
changed if necessary). 14. When the time is completed, the light will automatically
shut off. 15. Evacuate the bleaching paste from the teeth with a surgical tip
16. 17. 18.
19.
on the HVE, being careful not to disturb the protective dam material. Do not rinse the teeth but wipe the excess paste using a gauze pad. Repeat the application of the bleaching paste two more times. Mix the bleach for each application separately. After the last application, remove the bleach paste with the high-volume suction and then thoroughly rinse teeth with water and suction. Remove the protective dam and cotton rolls with the explorer. Then remove the retractors.
PROCEDURE FOR PLACING PIT AND FISSURE SEALANTS
This procedure is performed by the dentist and/or the dental assistant at chairside.
EQUIPMENT AND SUPPLIES: • • • • • • • • •
611
Basic setup Air/water syringe tip, HVE, and saliva ejector Cotton rolls and 2 ⫻ 2 gauze sponges, applicator tips Rubber cup or brush Dri-angles Rubber dam setup, cotton rolls, or Garmer cotton roll holders and short and long cotton rolls Low-speed dental handpiece with right angle (prophy angle) attachment Flour of pumice or prophy paste without fluoride, or air polisher, or dry toothbrush or fissurotomy burs Applicators (microbrush, small cotton-tipped applicator, or syringe for etchant)
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
• • • • • •
Etchant and bonding agent or all-in-one etchant and bonding agent Pit & Fissure Sealant material Curing light Articulating paper and forceps Assorted burs, discs, and stones for reducing high spots PPE worn by the dental assistant
DIRECTIONS: 1. Check tooth or teeth with explorer. Polish the occlusal surface
of the teeth to receive sealants. The dentist may want x-rays of the teeth to be sealed before beginning the procedure. 2. Polish the teeth using flour of pumice or a nonfluoride prophy paste with a rubber cup to clean the occlusal surfaces. (Some sealants can be used with fluoride prophy materials, check with the manufacturer before using.) An air polisher, dry toothbrush, or fissurotomy burs may also be used.
3. Once the teeth are polished, rinse and dry the teeth thoroughly.
4. 5. 6.
7. 8. 9.
10.
613
If the pits and fissures are deep, check them with an explorer and then rinse and dry again. Place the chosen method of isolation—may be the dental dam, cotton rolls, or Garmer clamps. Place a Dri-Angle on buccal mucosa and dry the tooth. Apply the etchant using an applicator or syringe with a disposable tip to the occlusal surface, into the pits and fissures and two-thirds up the cuspid incline. Etch for 15–60 seconds according to the manufacturer’s directions. Rinse the tooth with water, and use the evacuator tip to remove the remaining etchant and water. Dry the tooth; it should have a dull chalky white appearance. If the tooth does not have this appearance, re-etch for 15–30 seconds. Follow the manufacturer’s directions to prepare and apply the sealant material.
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CHAPTER 8 FLUORIDES, PIT AND FISSURE SEALANTS, AND TOOTH WHITENING AGENTS
11. With applicator selected, place the sealant so that it flows into
the pits and fissures. 12. Light-cure the sealants, holding the curing light 2 mm directly
13. 14. 15. 16. 17. 18. 19.
above the occlusal surface and expose for 20 seconds on each surface. Evaluate sealant with an explorer to check for voids and irregularities; repeat the process if necessary. After the sealant has set, rinse, or wipe the surface with a moist cotton roll to remove the air-inhibited layer. Remove the dental dam or cotton rolls. Dry the teeth and place articulating paper in articulating forceps to check the bite. Reduce any high spots with slow speed handpiece and burs or discs. Apply fluoride to the sealed teeth. Record procedure on the patient’s chart.
Dental Sterilants and Disinfectants
615
BANICIDE PLUS ®
Courtesy of Pascal
MANUFACTURER: Pascal
USE: •
It is used for sterilization and high-level disinfection.
COMPOSITION: •
Active ingredient: 2.65% acidic, potentiated glutaraldehyde
PROPERTIES: • • • • • • • • • 617
Requires the addition of an activator prior to use Additional additives guard against corrosion. Effective in disinfecting impression materials and dental stone Mint scent May be used as a sterilant/high-level disinfectant for up to 28 days from initial use 24 degrees C Can be deactivated with glycide for disposal down drains Sterilant: 10 hours High-Level Disinfectant: at least 90 minutes CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
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CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Ingestion: It may cause irritation and possibly chemical burns of the mouth, throat, stomach, and esophagus. • Eyes: It may cause damage to the eyes, including severe corneal injury, which may cause permanent impairment of vision. Vapors may cause stinging sensation in the eye. • Skin: Direct solution contact may cause skin irritation or aggravation of an existing dermatitis. Skin may also turn a harmless yellow or brown color. • Inhalation: Vapor is irritating to the respiratory tract. • Ventilation and skin and eye protection should be used.
DIRECTIONS: 1. Open the screw lid on the gallon container and the activator. 2. Pour the activator into the plastic gallon container.
3. Place the lid back on the gallon container and move it to
incorporate the activation into the entire solution. 4. Make a notation of the date that the activator was placed in the
container either on the bottle or another notation close by. It is advisable to make this notation on any sterilizing or disinfecting tray that is being used. 5. The solution is ready for use for 28 days.
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BIOCIDE G30™
Courtesy of Biotrol
MANUFACTURER: Biotrol
USE: •
Used for a 30-day reusable sterilization and disinfecting solution
COMPOSITION: •
Active ingredient: 2.65% acidic glutaraldehyde
PROPERTIES: • • • • • • •
621
Ready to use Requires no activation Contains a rust inhibitor Active for 30 days Lemon scent Sterilizes in 10 hours Disinfects in 45 minutes
CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
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CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Ingestion: Solution contact may cause irritation and possibly chemical burns. • Eyes: Solution contact may cause damage, including severe corneal injury, which could permanently impair vision. Vapors may cause a stinging sensation in the eye. • Skin: Direct solution contact may cause skin irritation or aggravation of an existing dermatitis. It may also cause skin to turn a harmless yellow or brown color. • Inhalation: Vapor is irritating to the respiratory track. • Ventilation and skin and eye protection should be used.
DIRECTIONS: 1. The solution is ready to use. 2. Pour the solution into the disinfecting/sterilizing tray directly
from the gallon container.
3. Place notation on the container when the solution was first
used. Also make a notation on the disinfecting/sterilizing tray to indicate when the solution was first used. 4. Solution is active for 30 days.
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CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
BIREX™ SE
Courtesy of Biotrol
MANUFACTURER: Biotrol
USE: •
Intermediate-level disinfectant, deodorizer, and cleaner for hard surfaces
COMPOSITION: • •
Phenylphenol Phosphoric acid
PROPERTIES: • • • • • •
Meets 2003 CDC guidelines for hospital disinfectants (intermediate level) 14-day shelf life (after mixing) Available in twenty-four 1/8 oz. packets and spray bottle Easy to store 10-minute disinfecting contact time Biodegradable
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CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Acute: Concentrate is corrosive to tissues. • Dilution is slightly irritating to eyes. • Concentrate is severely irritating to skin and eyes. • It will cause an upset stomach. • Chemical is listed as a carcinogen or potential carcinogen.
DIRECTIONS: 1. Fill water to the correct level in the quart spray bottle that comes 2. 3. 4. 5.
with Birex. Dispense one 1/8 oz packet into the water. Label the spray bottle with the activation date. Shake bottle slightly to evenly dispense the packet into the water. It is ready to spray on hard surfaces for disinfecting in 10 minutes.
CAVIWIPES XL™
Courtesy of Metrex
MANUFACTURER: Metrex
USE: •
Surface disinfectant and cleaner
COMPOSITION: • •
Isopropanol Ethylene glycol monobutyl ether
PROPERTIES: • • • • • • •
Disposable towelettes Presaturated with Cavicide Surface Disinfectant Cleaner Available in individually wrapped towelettes, XL (3 times larger), or a dispensing canister Nonwoven, nonabrasive towels Recommended for all nonporous surfaces A wall mount for the canister is available. 5-minute disinfectant
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CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Skin: Not considered an irritant • Eyes: Contact with eyes can cause reversible damage. • Inhalation: May cause low or mild irritation
DIRECTIONS: 1. Pop-up center-hinged plastic lid 2. Towelettes can be dispensed as a single sheet by tearing the
perforated line or taking as many as needed before tearing the perforated line. 3. Wipe the nonporous surface for a 5-minute disinfectant.
CETYLCIDE II
MANUFACTURER: Cetylite Industries, Inc.
USE: •
Used as a surface disinfectant and cleaner
COMPOSITION: • • • •
Dual quaternary ammonium compound Sodium carbonate Tergitol NP-10 Ethylenediaminetetraacetic acid
PROPERTIES: • • • • •
EPA-registered broad-spectrum disinfectant Meet CDC guidelines for cleaning environmental surfaces in patient care areas Environmentally safe/biodegradable Lemon scent Tip and pour bottle for easy mixing
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CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
• • •
Each quart yields 16 gallons of solution Biodegradable detergent with cleaning properties No alcohol, bleach, iodophor, phenol, or glutaraldehyde
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Eye: Corrosive and irritant. Prolonged contact may cause corneal burns. • Skin Contact: Corrosive and irritant • Ingestion: May be fatal. Burning pain, swelling in digestive tract, paralysis, circulatory shock • Inhalation: Will cause irritation of mucous membranes, coughing, and shortness of breath • Systemic and other effects: None reported
DIRECTIONS: 1. Fill tip and pour bottle to 1/2 oz of concentrate for one quart
or 2 oz of concentrate for 1 gallon.
2. Dispense into sanitizer spray bottle that comes with the solution
or obtained separately. 3. Fill the rest of the solution with water. 4. One step cleaning and disinfecting
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CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
CIDEX PLUS ®
MANUFACTURER: Advanced Sterilization Products, a Johnson & Johnson Company, division of ETHICON, Inc.
USE: •
Used for high-level disinfection
COMPOSITION: •
3.4% alkaline glutaraldehyde solution
PROPERTIES: • • • •
Fast-acting 28-day solution delivers a high level of disinfection in just 20 minutes at 25 degrees C. Packaged with an activating chemical Noncorrosive to instruments Destroys 100% of resistant Mycobacterium tuberculosis in 20 minutes at 25 degrees C. Effective in the presence of 2% organic soil Increased wetting and rinsing properties
• • 637
CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
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CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
• • •
Easily discarded down office drains in accordance with state and local regulations Available in quart or gallon size Test strips available to measure the minimum effective concentration (MEC)
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Oral: Can irritate the tissues of the mouth, esophagus, and other tissues of the digestive system • Eye contact: Severe irritant/corrosive to the eye • Skin Contact: May cause skin irritation. May aggravate preexisting dermatitis • Ingestion: This material may cause oral thrush, nausea, vomiting, epigastric distress, diarrhea, headache, fatigue, dizziness, insomnia, mental confusion, and impairment.
• •
Inhalation: Mist or vapors may be severely irritating to the nose, throat, and lungs. Ventilation and skin and eye protection should be used.
DIRECTIONS: 1. Open the container top on both the activator and the solution. 2. Pour the activator into the solution. 3. Place the top on the solution and mix slightly to incorporate the
activator thoroughly. 4. Write on the bottle the date of activation and/or on the
disinfecting tray to note the active date of 28 days at 25 degrees C.
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CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
COECIDE™ XL AND COECIDE™ XL PLUS
MANUFACTURER: GC America
USE: •
Used for sterilization, high-level disinfection, and intermediatelevel disinfection
COMPOSITION: • •
Coecide™ XL Coecide™ XL Plus
2.5% alkaline glutaraldehyde 3.4% alkaline glutaraldehyde
PROPERTIES: • • • • • • • 641
Corrosion inhibitor Activator included EPA is registered for use and reuse up to 28 days after activation. Can activate one quart at a time for economy Sterilization: 10 hours at 25 degrees C High-Level Disinfection: 90 minutes at 25 degrees C Intermediate-Level Disinfection: 10 minutes at 25 degrees C CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
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CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Acute and Chronic: Avoid skin contact. Repeated contact with skin may cause sensitization in some people, resulting in allergic contact dermatitis. Moderate to severe irritation to skin, eyes, and mucous membranes. Low to mild irritation by inhalation. Toxic by ingestion. • Ventilation and skin and eye protection should be used.
DIRECTIONS: 1. Open the container top on both the activator and the solution. 2. Pour the activator into the solution. 3. Place the top on the solution and mix slightly to incorporate the
activator thoroughly. 4. Write on the bottle the date of activation and/or on the
disinfecting tray to note the active date of 28 days at 25 degrees C.
COMPLIANCE™
MANUFACTURER: Metrex
USE: •
It is used for high-level disinfection and sterilization.
COMPOSITION: •
Non-glutaraldehyde
PROPERTIES: • • • •
Requires no activation No test strip required 14 day reuse High-level disinfectant:
•
Sterilant:
15 minutes at room temperature (20 degrees C) 3 hours at room temperature (20 degrees C)
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. 645
CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
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CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
• • • •
Skin: Mild to moderate irritation Eyes: May cause irreversible tissue damage Inhalation: Low or mild irritation of the nose, throat, and lungs Ingestion: May irritate or burn mucosa membrane
DIRECTIONS: 1. Place solution in the sterilizing/disinfecting tray. 2. Instruments must be immersed into the solution. 3. Write down the date of usage on the disinfecting tray to note
the active date of 14 days at 20 degrees C.
COEFOAM™ II
MANUFACTURER: GC America
USE: •
Foaming germicidal cleaner, surface deodorant, surface disinfectant
COMPOSITION: • •
Dimethyl benzyl ammonium chlorides Ethylbenzyl ammonium chlorides
PROPERTIES: • • •
Aerosol foam Disinfect for 10 minutes and wipe off with a clean damp cloth. Store away from heat or flame
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Causes eye and skin irritation • Harmful if swallowed 649
CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
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CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
• •
Product may be absorbed through intact skin May cause irritation to throat and gastrointestinal tract
DIRECTIONS: 1. Remove the cap, shake, spray evenly over the surface, and wipe
clean. 2. For heavily soiled surfaces, allow the foam to remain for
a minute before wiping. 3. To disinfect, clean as noted above and then spray a thin coat of
foam over the entire surface to be disinfected. 4. Allow it to remain for at least 10 minutes and then wipe off
with a clean damp cloth.
PROCIDE D ® AND PROCIDE D ® PLUS
MANUFACTURER: Metrex
USE: •
High-level disinfectant or sterilant on immersible instruments
COMPOSITION: • •
Procide D® has 2.5% buffered glutaraldehyde. Procide D® Plus has 3.4% buffered glutaraldehyde.
PROPERTIES: • • • •
Attains an alkaline pH of between 7.5 and 8.5 Active up to 28 days at temperature of 25 degrees C Sterilization: 10 hours at 25 degrees C Disinfection: 90 minutes at 25 degrees C
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines.
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CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
• • • •
Skin: Mild to moderate irritation Eye: Direct contact with eyes can cause irritation Ingestion: Toxic Inhalation: Low or mild irritation
DIRECTIONS: 1. Place solution in the sterilizing/disinfecting tray. 2. Instruments must be immersed into the solution. 3. Write down the date of usage on the disinfecting tray to note the
active date of 28 days at room temperature (25 degrees C).
PROSPRAY™ C-60
Courtesy of Certol International, LLC.
MANUFACTURER: Certol International, LLC.
USE: •
Surface disinfectant
COMPOSITION: •
Active ingredients: o-phenylphenol and o-benzylp-chlorophenol
PROPERTIES: • • • • • • •
1/2 oz unit-dose tubes for mixing Does not stain or bleach hard surfaces Lemon scent Spray bottle has nozzle with 3 adjustable settings (off, spray, and stream) Meets all CDC guidelines for surface disinfection Approved for 60-day use Available in wipes
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OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. Effect of overexposure: • Swallowing: Irritation of the mouth, throat, and digestive tract • Skin contact: May cause mild irritation • Inhalation: May cause mild irritation • Eye contact: May cause irritation
DIRECTIONS: 1. Fill 16 oz ProSpray C-60 bottle with room temperature water
to the fill line. 2. Add 1/2 oz of ProSpray C-60 to filled spray bottle using unit
dose or measuring cup. 3. This is when the 60-day shelf life begins. Note this on the
container. 4. Disinfect and clean surfaces using spray nozzle or optional
squirt cap
SODIUM HYPOCHLORITE (BLEACH)
USE: •
Intermediate-level surface disinfection
COMPOSITION: •
5.25% sodium hypochlorite “household bleach”
PROPERTIES: • • • •
Works within 10 minutes Unstable; must be mixed daily Corrosive to metals Harmful to clothing
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Irritation or damage to skin and eyes may occur. • Use in a well-ventilated room. Avoid inhalation.
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• •
Do not mix with other chemicals. If swallowed, mucosal and gastric damage will occur; call a physician.
DIRECTIONS: 1. Mix 1 cup of sodium hypochlorite with one gallon of water. 2. Place the solution into a spray bottle or onto a sponge. 3. Allow it to remain for at least 10 minutes and then wipe off with
a clean damp cloth. 4. Take extra care not to get solution on clothing. 5. Solution should be disposed of at the end of each day.
SPOROX II
Courtesy of Sultan Healthcare
MANUFACTURER: Sultan Healthcare
USE: •
Sterilizing and high-level disinfecting solution
COMPOSITION: •
Active ingredient: hydrogen peroxide 7.5%
PROPERTIES: • • • • • • •
665
Ready to use; no mixing or activation required No noxious odors Oxidizes away dental debris and contaminants High-level disinfecting 30 minutes (20 degrees C/68 degrees F) Sterilization 6 hours (20 degrees C/68 degrees F) May be reused up to 28 days Test vials available
CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
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CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Corrosive to eyes • May be harmful or fatal if swallowed • Do not get in eyes, on skin, or on clothing • Use safety glasses and gloves.
DIRECTIONS: 1. Place the solution in sterilizing/disinfecting tray. No activation
is required. 2. Instruments must be immersed into the solution for 6 hours. 3. Write down the date of usage on the disinfecting/sterilizing tray
to note the active date of 21 days at room temperature (20 degrees C/68 degrees F).
STERALL ® AND STERALL ® PLUS
MANUFACTURER: Colgate
USE: •
Sterilizing and high-level disinfectant
COMPOSITION: • • •
Active ingredient Sterall® Plus Sterall®
Glutaraldehyde 3.4% 2.65% potentiated glutaraldehyde
PROPERTIES: •
669
Sterall® • One-year shelf life • Contains corrosion inhibitor • Lemon scent • No activator needed • 30-day reuse life • Used for sterilization and high-level disinfection
CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
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CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
•
Sterall® Plus • Light mint scent • Corrosion inhibitor • 28-day reuse life • Activator required for sterilization solution
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Acute and Chronic: Avoid skin contact. Repeated contact with skin may cause sensitization in some people, resulting in allergic contact dermatitis. Moderate to severe irritation to skin, eyes, and mucous membranes. Low to mild irritation by inhalation. Toxic by ingestion. • Ventilation and skin and eye protection should be used.
DIRECTIONS: 1. Spray bottle is ready for use as a disinfectant/decontaminate
cleaner. 2. Spray on inanimate surfaces and operatory equipment. 3. Allow it to remain for at least 10 minutes and then wipe off with
a clean damp cloth.
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SURFLETS DISINFECTANT TABLETS
Courtesy of Sultan Healthcare
MANUFACTURER: Sultan Healthcare
USE: • •
Intermediate-level disinfectant Disinfectant for impression materials
COMPOSITION: • •
Sodium dichloroisocyanurate, dihydrate Sodium bisulfate
PROPERTIES: • • • • • • • 673
Sixteen tablets in blister packaging Neutral pH, bromine-based formula Not corrosive Effective for 7 days No mixing—add 2 tablets to 32 oz of water Saves storage space Mild lemon fragrance CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
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CHAPTER 9 DENTAL STERILANTS AND DISINFECTANTS
OSHA PRECAUTIONS: Use appropriate PPE and follow all OSHA guidelines. • Eye Contact: Slightly irritating, avoid contact with eyes. • Skin Contact: Slightly irritating, avoid contact with skin. • Inhalation: No data available • Ingestion: No data available
DIRECTIONS: 1. Place 2 tablets into spray bottle with 32 oz of water. 2. This solution is effective for 7 days so it can be made weekly; if
not, the day the water and tablets were combined should be noted on the spray container. 3. Spray nonporous surfaces and/or impression materials. 4. Allow it to remain for at least 5 minutes and then wipe off with a clean damp cloth or rinse off the impression materials.
PROCEDURE: DISINFECTING SURFACES IN THE DENTAL OPERATORY This procedure is performed by the dental assistant in the dental operatory.
EQUIPMENT AND SUPPLIES: • • • •
Disinfecting solution in spray bottle is mixed and ready. 4 ⴛ 4 gauze Wiping cloth Small utility carry tote to hold or transport items if desired
DIRECTIONS: 1. 2. 3. 4. 5.
Review MSDS sheet for the solution. Wear appropriate PPE. Wash hands and pull on utility gloves. Bring the equipment and supplies to the operatory. Have a routine procedure established for disinfection to ensure that nothing is missed. All surfaces need to be sprayed and
cleaned first, then wiped to remove debris. The surfaces are then sprayed a second time and the solution is left on surfaces for a designed time according to the manufacturer’s directions. 6. Spray on the disinfectant and leave it for the correct time to accomplish disinfection. 7. Rewipe all surfaces after the time has lapsed.
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Speciality Materials
679
APEXIT ENDODONTIC SEALER/CEMENT MANUFACTURER: Ivoclar Vivadent
USE: •
Permanent obturation of root canals
COMPOSITION: •
Base and Activator: Calcium hydroxide, calcium oxide, inorganic fillers, colophony, disalicylate
PROPERTIES: • • • • • •
High bio-compatibility Low water solubility Mixes easily High radiopaque Non-shrinking material Can be used with all obturating systems
• •
Flows easily into canals and adapts to the walls of the root canals Comes in automix syringes for easy handling
OSHA PRECAUTIONS: • • • •
Eye irritation: Flush with water for 10 to 15 minutes Skin irritation: Wash with soap and water Ingestion: No hazards anticipated from swallowing small amount during incidental or normal handling Inhalation: Remove to fresh air
MIXING AND SETTING TIME: • •
Automix syringes requiring no mixing Working time is approximately 3 hours.
DIRECTIONS: 1. Remove the cap from the automix syringe by turning it a 1/4 turn counterclockwise.
681
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682
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2. Insert the mixing tip by pushing down until the notch of the tip is aligned with the double-push syringe. 3. Secure the mixing tip in place by gripping the colored base and turning a 1/4 turn clockwise. 4. The double-push syringe contains predosed amounts of Apexit Plus activator and base, which are automatically mixed and dispensed when the two materials are extruded. 5. The material is placed into the canal with a Lentulo spiral or an Intra Oral Root Canal tip.
NOGENOL ROOT CANAL SEALER
MANUFACTURER: GC America
USE: •
Root canal sealer
COMPOSITION: • •
Base: salicylic acid Catalyst: zinc oxide, vegetable oil, barium sulfate, and bismuth oxychloride
PROPERTIES: • • • • • • • 685
Biocompatible No eugenol Radiopaque Sets quickly in the mouth Two-paste system that is easy to mix and use Long-working time Allows time for placement and manipulation of material
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686
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• • •
Adheres to dry surface Seals and adapts to the tooth surface well Low solubility
OSHA PRECAUTIONS: • •
•
Eye and skin irritation possible with prolonged exposure Ingested: • Base—induce vomiting and seek medical attention • Catalyst—drink several glasses of water Inhalation: remove to fresh air and seek medical attention
MIXING AND SETTING TIME: • •
Mixing time is 10 to 15 seconds Setting time is 7 minutes in the mouth
DIRECTIONS: 1. The dentist prepares the root canal according to routine root canal treatment. 2. Prepare and pass paper points to dry the canal.
3. Extrude equal lengths of each paste on a paper pad. Approximately 3/4 of an inch of each paste. 4. Spatulate for 10 to 15 seconds until mix is uniform in color and consistency. 5. Nogenol Root Canal Sealer has a long working time on the paper pad, but once placed in the mouth it will set in about 7 minutes. 6. Prepare a spreader or other endodontic instrument to place the sealer. 7. Prepare the gutta percha points or silver points to be coated with the sealer.
687
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SEALAPEX XPRESS NON-EUGENOL ROOT CANAL SEALER
Courtesy of Ormco Corporation, on behalf of its SybronEndo division
MANUFACTURER: SybronEndo
USE: •
Seal the root canal after the root canal treatment
COMPOSITION: • •
Isobutyl salicylate, silicone dioxide, bismuth trioxide, titanium dioxide pigment Base: N-ethyl toluene, sulfonamide resin, silicone dioxide, zinc oxide, and calcium hydroxide
PROPERTIES: • • • • •
689
Non-eugenol Non-irritating No manual mixing required Stimulates hard tissue formation One to one syringe ratio
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690
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OSHA PRECAUTIONS: • • •
May be irritating to the eyes and skin. Inhalation may cause drowsiness. Remove to the fresh air. If ingested, consult a physician.
MIXING AND SETTING TIME: •
No mixing required
DIRECTIONS: 1. Remove the cap from the automix syringe by turning it a 1/4 turn counterclockwise. 2. Insert the mixing tip by pushing down until the notch of the tip is aligned with the double-push syringe. 3. Secure the mixing tip in place by gripping the colored base and turning a 1/4 turn clockwise.
4. The automix syringe contains pre-dosed amounts of Sealapex Xpress catalyst and base, which are automatically mixed and dispensed with the two materials extruded. 5. The material is placed into the canal with a Lentulo spiral or an Intra Oral Root Canal tip.
691
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ROOT CANAL SEALER MANUFACTURER: Pulpdent
USE: • •
Permanent root canal filling material Used to seal root canals in both primary and permanent dentition
COMPOSITION: • •
Liquid: eugenol Powder: zinc oxide
PROPERTIES: • • • • •
Tissue compatible Bacteriostatic Radiopaque Used with all permanent filling techniques Expands slightly upon setting to assure a positive seal
• • • •
Resorbs with roots of primary teeth Insoluble Flows through 30 gauge needles for root apex placement Slight overfills resorb in 10 to 12 months
OSHA PRECAUTIONS: • •
Eye and skin irritation possible Should not be ingested
MIXING AND SETTING TIME: • •
Mixing time is approximately 15 to 30 seconds Setting time is approximately 5 to 10 minutes
DIRECTIONS: 1. After the root canal has been opened, enlarged, and cleaned by the dentist, a Pulpdent Pressure syringe tip is selected. 2. Measure the powder and liquid to maintain a 1:1 ratio.
693
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3. Fluff the powder bottle before using and then with the designated scoop, dispense 3 scoops of powder on to the pad. Be sure to level the scoop of powder. 4. Drop 3 drops of liquid on the pad and mix until a uniform, putty-like consistency. 5. Material will be pliable enough to form a homogeneous mass. 6. Fill the hub of the syringe with the Pulpdent Root Canal Sealer thick mix to prepare the syringe for use.
TEMPIT MOISTURE-ACTIVATED TEMPORARY FILLING AND SEALING MATERIAL
Courtesy of Centrix Dental
MANUFACTURER: Centrix
USE: •
For sealing access cavities during root canal treatment appointments
COMPOSITION: •
Calcium sulfate and zinc oxide, glycol, ethyl methacrylate polymer, barium sulfate, and silica
PROPERTIES: • • • •
697
No mixing and no mess Sets in minutes Easy to remove Non-eugenol formula
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698
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OSHA PRECAUTIONS: • • • •
Eyes: Flush with copious amounts of water and seek medical attention Skin irritation possible: Wash with soap and water Ingested: N/A Inhalation: N/A
MIXING AND SETTING TIME: • •
There is no mixing Setting time: 5 minutes or less
DIRECTIONS: 1. Remove the cap from the syringe. 2. Place the tip securely on the end of the syringe. 3. Squeeze the syringe with slow steady pressure to ensure the syringe is functional. 4. Dispense a small amount on the pad then inject into the moist canal.
5. Tamp down with a moist instrument and dismiss the patient. 6. On the patient’s return appointment, use an explorer to remove Tempit material.
699
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T.E.R.M. TEMPORARY RESTORATIVE MATERIAL
MANUFACTURER: Dentsply/Mailefer
USE: •
Temporary restorative material in the root canal access orifice
COMPOSITION: •
Aluminum oxide, silica amorphous, silica crystalline, urethane dimethacrylate resin
PROPERTIES: • • • • • •
701
Light-cured material Firm restoration Easy-to-place Compule tips Superior moisture-free seal Quick to remove with bur or hand instrument Creamy paste
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702
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OSHA PRECAUTIONS: • • • • •
May cause skin irritations Persons susceptible to methacrylates, acrylics, and urethanes may develop allergic response. Dermal redness or irritation may occur, and several allergic responses may cause difficulty in breathing. Should not be ingested May cause mild respiratory irritation
MIXING AND SETTING TIME: • •
No mixing required Light-cure to set
DIRECTIONS: 1. Select a Compule tip and Compule syringe. 2. Snap the Compule tip into the syringe making sure it is secure.
3. Remove the cap and squeeze the handle until T.E.R.M. Temporary Restorative Material starts to flow. 4. Place the material into the access orifice, compact the material, and then light-cure for 20 seconds.
703
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BUCKLEY FORMO CRESOL MANUFACTURER: Sultan Healthcare
USE: •
Devitalize and sterilize infected pulp chambers and canals
COMPOSITION: • • •
35% Cresol 19% Formaldehyde 17.5% Glycerin
PROPERTIES: • •
Slightly less irritating to periapical tissues Lower content of formaldehyde
OSHA PRECAUTIONS: •
Eye contact—flush with plenty of running water
• • •
Skin irritation possible—wash with soap and water and remove contaminated clothing Ingestion—quickly give 3 or more glasses of milk or water Inhalation—remove to fresh air and have qualified person restore and/or support breathing with oxygen
MIXING AND SETTING TIME: •
No mixing is required
DIRECTIONS: 1. Clean the tooth and root canal. 2. Use a cotton tip applicator or cotton pellets to apply the Formo Cresol. 3. Place the applicator in the Formo Cresol, remove excess liquid, and place in the canal.
705
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C.L. CANAL LUBRICANT
Courtesy of Roydent Dental
MANUFACTURER: Roydent Dental
USE: • • •
Chelates root canal walls Aids in enlarging the root canals Assists in instrumentation by lubricating the canals
COMPOSITION: •
17% ethylenediaminetetraacetic acid in aqueous gel
PROPERTIES: • •
Lubricates the canal Softens calcifications in the root canals
OSHA PRECAUTIONS: • •
707
Inhalation: none Eyes: may cause transient irritation
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708
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• •
Skin: nonirritating Ingestion: none expected with this product with normal conditions of use
MIXING AND SETTING TIME: • •
There is no mixing. There is no setting time.
DIRECTIONS: 1. C.L. Canal Lubricant comes in pipettes for easy dispensing. 2. With the material in pipettes it can be placed directly in the canal or a reamer or file can be used to place the lubricant into the canal. 3. Holding the pipette, cut the tip off. The pipette is then squeezed for dispensing.
RC-PREP ROOT CANAL PREPARATION CREAM
MANUFACTURER: Premier
USE: •
Chemo-mechanical preparation for root canals
COMPOSITION: •
Glycol, urea peroxide, and EDTA in special water soluble
PROPERTIES: • • • • • • •
711
Removes calcifications from the root canal Lubricates the canal for efficient instrumentation Used with apex locators for reliable readings Allows for efficient use of reamers and files Prevents instruments from binding Easy to use Also come in a microdose form
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712
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OSHA PRECAUTIONS: • •
•
•
Skin: There may be irritation and redness. Remove contaminated clothing and wash with soap and water. Eyes: There may be pain and redness and eyes may water. Vision may blur. Rinse with water for 15 minutes and seek medical assistance. Ingestion: There may be soreness and redness in the mouth and throat. Nausea and stomach pain may occur. Wash out mouth with water, give water to drink, and seek medical assistance. Inhalation: There may be irritation in the throat and a feeling of tightness in the chest. Remove from exposed area.
MIXING AND SETTING TIME: •
There is no mixing.
DIRECTIONS: 1. RC-Prep comes in jars, pumps, or syringes. 2. With the material in the jars and pumps, a reamer, file, or root canal filler is used to place the RC-Prep into the canal. Dispense
a small amount of the RC-Prep on a pad and then coat the reamer, file, or root canal filler with the material. 3. With the syringe, the material is placed directly into the canal with the tip of the syringe. 4. When the material reacts with the sodium hypochloride, it lifts the debris from the canal.
713
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SLICKGEL ES ROOT CANAL LUBRICATING AGENT
Courtesy of Ormco Corporation, on behalf of its SybronEndo division
MANUFACTURER: SybronEndo
USE: •
Aids in the negotiation of root canals
COMPOSITION: •
Ethylenediamine, tetraacetic acid, urea peroxide, proplyene glycol, and polyethylene glycol
PROPERTIES: • • • • • • •
715
High effervescent action that produces vigorous bubbling Chemically removes the smear layer Helps prevent blockage during shaping and cleaning Lubricates the canal that aids in negotiation of the root canals Aids in softening calcifications in the root canal Easy to use Comes in Micro Dose Polytubes that do not require disinfection after each use, reducing cross-contamination
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716
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•
Smooth solution not grainy
OSHA PRECAUTIONS: • • •
Eyes: Flush with water for 15 minutes. Skin: Wash with soap and water thoroughly. Swallowing: Drink two glasses of water and seek medical attention.
MIXING AND SETTING TIME: •
There is no mixing or setting time.
DIRECTIONS: 1. SlickGel comes in Micro Dose Polytubes. 2. When the dentist is ready, the assistant cuts the end of a unidose polytube and passes it to the dentist. 3. The dentist places the tip of the polytube into the root canal and squeezes. 4. At the end of the procedure the polytube is thrown away.
ENDO-ICE
Courtesy of Coltene/Whaledent Inc.
MANUFACTURER: Coltene/Whaledent
USE: •
To test pulp vitality
COMPOSITION: •
Tetrafluoroethane
PROPERTIES: • • • •
Fast and easy method for testing pulp vitality Much colder than ice or ethyl chloride Spearmint scent Directional spray extension
OSHA PRECAUTIONS: • • • 719
After inhalation: Get fresh air. After skin contact: Wash with water for 15 minutes. After eye contact: Flush with water for 15 minutes.
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720
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• •
After swallowing: Drink water to dilute. Do not induce vomiting. If irritation persists, contact a physician with all of the above.
MIXING AND SETTING TIME: •
No mixing or setting times
DIRECTIONS: 1. Place spray extension into the cap securely. 2. Have cotton tip applicator or cotton pellet ready. 3. Spray the applicator or pellet and hand to the dentist to apply to the tooth.
FUJI ORTHO LC CEMENT
MANUFACTURER: GC America
USE: •
Orthodontic light-cured adhesive that bonds to metal and porcelain brackets and metal bands
COMPOSITION: • •
Liquid: Polyacrylic acid, hydroxyethyl methacrylate Powder: Alumino-silicate glass
PROPERTIES: • • • • • • • 723
Low sensitivity to moisture Use with or without etching Significant fluoride release and recharge Available in both powder/liquid and capsules Prevents caries—no decalcification High success rate Easy to use and clean up
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724
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OSHA PRECAUTIONS: • • • • •
Eyes: May be irritating to the eyes, rinse for 15 minutes Skin: May be irritating to the skin, wash for 15 minutes Ingestion: Do not induce vomiting. Drink large volumes of water. Inhalation: Powder—Remove to fresh air. Drink water to clear throat and blow nose to remove dust particles. If irritation develops, seek medical attention with all of the above.
MIXING AND SETTING TIME: • •
Total mixing time is 20 to 25 seconds. Working time is 3 minutes from start of mix.
DIRECTIONS: 1. Clean the surface with nonfluoridated prophy paste and water. 2. Rinse thoroughly with water.
3. Dispense a few drops of GC Fuji Ortho Conditioner into a well. Dip a gauze or sponge into the conditioner and apply to the bonding surfaces of the teeth for 20 seconds. Rinse. 4. Enamel bonding surfaces must be moist. 5. Tap the powder and then dispense one level scoop with designated scoop onto a paper pad. 6. Holding liquid vertical, gently squeeze to dispense 2 drops onto the paper pad. 7. Divide the powder into two parts. Bring one part of powder into all the liquid and mix for 10 seconds. Bring the second portion of powder into the mix and mix for 10 to 15 seconds until smooth, creamy, and uniform. 8. Fuji Ortho cement is ready to use.
725
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HELIOSIT ORTHODONTIC MANUFACTURER: Ivoclar Vivadent
USE: •
Permanently cementing orthodontic brackets—metal or ceramic
COMPOSITION: •
Paste of dimethacrylate, bis-GMA, silicone dioxide, catalyst, and stabilizers
PROPERTIES: • • • •
Light-curing material Highly translucent No dosing or mixing required High strength bond
OSHA PRECAUTIONS: • • • • •
May be irritating to the eyes. Flush with water. May be irritating to the skin. Wash with soap and water. Ingestion: No hazard anticipated from swallowing small amounts incidental to normal handling Inhalation: Remove to fresh air. If irritation develops, seek medical attention with all of the above.
MIXING AND SETTING TIMES: • •
No mixing required Light-cured for a total of 40 seconds
DIRECTIONS: 1. Clean the surface thoroughly. 2. Isolate with cotton rolls and blown air. 3. Apply etchant to the tooth according to manufacturer’s instructions. Usually etchant is applied for 30 to 60 seconds. 727
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728
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4. Rinse and dry the area thoroughly. The tooth surface should look chalky. 5. Remove the cap from the Heliosit Orthodontic cement and place a small amount on the bracket according to the bracket manufacturer’s instructions. The cement may also be placed on a paper pad and using an instrument placed on the bracket. 6. Replace the cap. 7. Light-cure the bracket once placed for 20 seconds from the cervical and 20 seconds from the incisal.
PERFECT CHOICE PROPHY GEMS PROPHY PASTE
MANUFACTURER: Biotrol
USE: •
Cleaning paste to remove deposits and stains from the teeth
COMPOSITION: • •
Blend of cleaning and polishing agents Sodium fluoride and sodium saccharine
PROPERTIES: • • • • • • •
731
Removes tough stains Low splatter paste Variety of grits Contains fluoride Rinses easily Variety of flavors Rings are color-coded by flavor.
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732
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• •
Lip for thumb hold ring in place Ring is comfortable and secure on finger.
OSHA PRECAUTIONS: • • •
Eyes: Direct contact will cause irritation. Skin: Prolonged contact will cause irritation. Ingestion: Contains sodium fluoride, do not swallow.
MIXING AND SETTING TIMES: •
None
DIRECTIONS: 1. Determine the grit to use by evaluating the amount of hard and soft deposits a patient has. 2. Select the grit and flavor. 3. Remove the foil seal from the Prophy Gems. 4. Remove the prophy paste with a prophy angle and cup to begin the polish.
NUPRO PROPHY PASTE CUPS VARIETY PAK WITH FLUORIDE
MANUFACTURER: Dentsply Professional
USE: •
Prophy paste to remove soft and hard deposits from the teeth
COMPOSITION: • •
Blend of polishing and cleaning agents 1.23% fluoride ion
PROPERTIES: • • • • • • • 735
Excellent stain removing and polishing Variety of grits and flavors Spatter-free formula Rinses easily and completely Always consistent Comes in unidose cups, jars, and variety paks With and without fluoride
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736
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OSHA PRECAUTIONS: • • • •
Skin: not applicable Eyes: Flush with water. If irritation persists, contact a physician. Ingestion: Give copious amounts of water or milk and call a physician. Inhalation: not applicable
MIXING AND SETTING TIMES: •
Does not apply
DIRECTIONS: 1. 2. 3. 4. 5.
Each cup contains enough prophy paste to complete one patient. Remove foil from prophy cup. If finger grip is used, place prophy cup in finger grip and secure. Attach rubber cup to prophy angle. Place the rubber cup into the prophy paste while running the angle at low speeds. 6. To avoid overheating the tooth, always keep enough prophy paste in the rubber cup to be used on the teeth.
COE-PAK AUTOMIX NDS PERIODONTAL DRESSING
MANUFACTURER: GC America
USE: •
Non-eugenol surgical and periodontal dressing
COMPOSITION: •
Vegetable oil, zinc oxide, mineral oil, magnesium oxide, chlorodimethyl phenol ethanol, methanol, and petrolatum
PROPERTIES: • • • • • • •
739
No burning sensation No unpleasant taste No strong odor Protection to tissues Promotes cleanliness and healing Resilient hardness to resist fracture or breakage Smooth cohesive mix
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740
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• •
Automix or two-paste system Material won’t stick to gloves.
OSHA PRECAUTIONS: • • • • •
Eyes: May be irritating to the eyes. Flush for 15 minutes. Skin: May be irritating to the skin. Wash for 15 minutes with soap and water. Ingestion: Drink several glasses of water. Inhalation: Remove to fresh air. Drink water to clear throat and blow nose to remove dust particles. If irritation develops, seek medical attention with all of the above.
MIXING AND SETTING TIME: • •
Ready to use in 3 minutes Hard and fast set ready in 1 minute
DIRECTIONS: 1. Place an automix cartridge into a GC cartridge dispenser II. 2. Remove the cap from the cartridge and place a mixing tip.
3. Dispense the required amount of material on a paper pad. 4. Using a spatula, form the material into a cylindrical shape. 5. Lightly lubricate your fingers with Vaseline, lanolin, cold cream, or water to test the mix for thickness. 6. Automix material will lose its tackiness in about 30 seconds, whereas the two-paste mix should lose its tackiness in 2 to 3 minutes. 7. Automix will be workable for 8 minutes; two-paste mix can be worked for 10 minutes. 8. Form into ropes. Material is extremely cohesive. Place in patient’s mouth.
741
CHAPTER 10 SPECIALITY MATERIALS
BARRICAID VLC SURGICAL PERIODONTAL DRESSING
MANUFACTURER: Dentsply Caulk
USE: • •
Light-cured surgical periodontal dressing Protection for periodontal surgical sites during the healing process
COMPOSITION: •
Dimethacrylate resins
PROPERTIES: • • • • • •
743
Control over the setting time of the material Light-cured Designed for direct and indirect placement Material forms a nonbrittle, elastic protective cover. Is tasteless Tinted pink with translucent qualities
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744
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OSHA PRECAUTIONS: • • • •
Eyes: Rinse with open eyes for several minutes under running water. May be irritating to the skin: Immediately wash with soap and water and rinse thoroughly. Ingestion: If symptoms persist, contact a physician. Inhalation: Remove to fresh air.
MIXING AND SETTING TIME: • •
No mixing is required. Light-cured for 10 seconds per tooth on both buccal and lingual sides
DIRECTIONS: Barricaid Periodontal Dressing can be applied directly or indirectly. 1. Direct Technique: Using sterile gauze, dry the buccal or lingual surfaces adjacent to the surgical site.
2. Remove the cap from the syringe and begin dispensing the material at the juncture of the cervical 1/3 of the teeth and the margin of the surgical site. 3. Indirect Technique: Using sterile gauze, dry the buccal or lingual surfaces adjacent to the surgical site. 4. Place a thin layer of lubricant on a paper pad. Remove the cap from the syringe and dispense the amount needed. 5. Place a light layer of lubricant on your gloved hand and roll the material off the pad ready to be placed. 6. Once placement is completed, light-cure for 10 seconds the buccal and lingual of each tooth 7. Check for uncured material with a blunt instrument or explorer.
745
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DRY SOCKET PASTE
MANUFACTURER: Sultan Healthcare
USE: •
To treat Alveolitis (dry socket)
COMPOSITION: •
Gualacol, balsum peru, eugenol, 1.6% chlorobutanol
PROPERTIES: • • • •
Easy to use Instant pain relief Effective treatment Only one treatment needed
OSHA PRECAUTIONS: • • 747
May be irritating to the eyes: Lifting eyelid, flush with large amounts of running water for 15 minutes. May be irritating to the skin: Remove contaminated clothing and wash area with soap and water.
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748
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• •
Irritating to the respiratory system: Remove patient to fresh air. If ingested, contact a physician.
MIXING AND SETTING TIME: • •
No mixing Material remains in the socket for 3 to 5 days.
DIRECTIONS: 1. 2. 3. 4.
Socket is prepared. Remove the lid from the paste. Remove the amount necessary to fill the socket. Place material into the socket with a flat-bladed instrument and pack into place. 5. Tamp down to cover exposed bone. 6. Material remains in the socket for 3 to 5 days. 7. Paste washes out gradually as the socket heals.
ALVOGYL
Courtesy of Septodont
MANUFACTURER: Septodont
USE: • •
Dry socket treatment Post-extraction dressing
COMPOSITION: •
Eugenol, butamben, and iodoform
PROPERTIES: • • • • • • •
751
One-step dressing Rapidly alleviates pain Soothing effect throughout healing process Fibrous consistency for good adherence during healing Analgesic action Anesthetic action Anti-microbial action
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752
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OSHA PRECAUTIONS: • • •
May be irritating to the eyes and skin Irritating to the respiratory system: Remove to fresh air. If ingested, contact a physician.
MIXING AND SETTING TIME: •
No mixing required
DIRECTIONS: 1. 2. 3. 4.
Socket or surgical site is prepared. Remove the lid from the paste. Remove the amount necessary to fill the socket. Place material into the socket with a flat-bladed instrument and pack into place. 5. Tamp down to cover the exposed bone. 6. Material remains in the socket as the socket heals.
PROCEDURE: PREPARATION AND PLACEMENT OF NON-EUGENOL PERIODONTAL DRESSING
This procedure is performed by the dentist and/or the dental assistant at chairside.
EQUIPMENT AND SUPPLIES: • • • • • • • • •
Basic setup Air/water syringe tip, HVE, and salvia ejector Cotton rolls and 2 ⫻ 2 gauze sponges Periodontal dressing catalyst and base tubes Paper pad—large Large spatula or tongue depressor Lubricant (Vaseline, lanolin, cold cream, water) Instrument to contour dressing (spoon excavator) PPE worn by the dental assistant
DIRECTIONS: After the hemorrhaging is controlled, the patient’s lips are coated lightly with a lubricant. The dental assistant prepares the periodontal dressing for application as follows before placement: 755
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756
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1. Extrude equal lengths of paste from the catalyst and base tubes onto the paper pad. 2. Spatulate for 30 to 45 seconds until the mix is of uniform color. 3. Using the spatula, form the paste into a cylindrical shape. 4. Lightly lubricate gloved fingers with Vaseline, cold crème, lanolin, or water to test the mixed paste for tackiness. It should be ready in 2 to 3 minutes. 5. After 2 to 3 minutes the dressing paste can be handled. Remove the cylindrical shape from the paper pad and mold into the diameter and length needed to place over surgical site. 6. The dressing paste can be worked for 10 to 15 minutes. This gives the dentist or dental assistant enough time to place and secure the dressing on the buccal and lingual surfaces of the surgical site. 7. The dressing is secured around the most posterior tooth and then pressed interproximally on the buccal surfaces. This procedure is repeated on the lingual surfaces.
8. Once the dressing is placed, it is evaluated for effectiveness and comfort for the patient. Adjustments are completed. 9. Give home care instructions to the patient and dismiss.
757
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INDEX
759
60 Second Taste Fluoride Gel, 528–31 Adherence DC, 132–35 Adhesives. See Bonding agents Adper Prompt L-Pop SelfEtch Adhesive, 72–75 Alginate Alginot, 288–90 Coe, 266–70 Jeltrate, 260–65 Kromafaze, 272–76 Kromopan 100, 278–82 Alginate flavoring, 284–86 Alginate substitute material (StatusBlue mix star material), 292–96 Alginot, 288–90 Alike, 482–85 All Solutions 2% Neutral Rinse, 536–38
All Solutions Fluoride Foam, 512–14 Aluwax bite wafers, 438–40 Alvogyl, 750–52 Amalgam. See Dental amalgam Amalgambond Plus adhesive system, 80–83 Apexit endodontic sealer/cement, 680–82 Aquasil Smart Wetting vinyl polysiloxane impression material, 320–22 B & T base and temporary cement, 42–45 Banicide Plus, 616–19 Barricaid VLC surgical periodontal dressing, 742–45
Baseplate wax, 394–97 Bases, low-strength, 24 B & T base and temporary cement, 42–45 Dycal-Two-Paste System, 34–37 Fuji Lining LC, 26–28 Prisma VLC Dycal, 38–41 Vitrebond Plus, 30–32 Biocide G30, 620–23 Birex SE, 624–26 Bite blocks, 398–400 Bite wafers, 430–32 Aluwax, 438–40 Coprawax, 434–36 wax bite registration with, 454–56 Bleach, 660–62 Bonding agents, 70 Adper Prompt L-Pop Self-Etch Adhesive, 72–75
Amalgambond Plus adhesive system, 80–83 calcium hydroxide lining two-paste system mixing procedure, 92–94 OptiBond Solo Plus System, 84–86 Prime & Bond NT Dual Cure Nano-Technology Dental Adhesive, 88–91 Scotchbond multi-purpose plus dental adhesive, 76–79 Boxing wax, 410–12 Buckley Formo Cresol, 704–5 Buildup materials. See Core buildup materials Calcium hydroxide lining twopaste system mixing procedure, 92–94
761
INDEX
Calibra, 126–30 Caries detectors, 2, 4–6 Caries indicators, 2, 8–11 Casting wax, 402–4 Cavit, 172–75 Cavit G, 172–75 Cavity liners, 24 B & T base and temporary cement, 42–45 Dycal-Two-Paste System, 34–37 Fuji Lining LC, 26–28 Prisma VLC Dycal, 38–41 Vitrebond Plus, 30–32 Cavity varnish, 46 Copal Cavity Varnish, 52–55 Copalite, 48–51 Duraflor, 540–43 Durashield 5% Sodium Fluoride Varnish, 544–47
Fluor Protectant Assortment Fluoride Varnish, 548–50 CaviWipes XL, 628–30 Cements. See Dental cements Cetylcide II, 632–35 Cidex Plus, 636–39 C.L. Canal Lubricant, 706–8 Clinpro Sealant, 560–63 Coe Alginate, 266–70 Coecide XL, 640–42 Coecide XL Plus, 640–42 Coe-Flex rubber base (final impression materials), 298–302 CoeFoam II, 648–50 Coe-Pak Automix NDS periodontal dressing, 738–41 Coe tray plastic, 458–61 Coltene rapid impression material, 308–10
Compliance, 644–46 Compoglass F (compomerbased restorative material), 242–45 Composites. See Restorative materials ContrastPM, 584–87 Copal Cavity Varnish, 52–55 Copalite, 48–51 Coprawax bite wafers, 434–36 Core buildup materials, 56 Encore core paste, 66–69 LuxaCore Smartmix Dual, 62–65 Miracle Mix, 58–61 Crown. See PFM crown Crown temporization material (ProTemp), 496–500 Custom trays and provisionals, 457 Alike, 482–85
Coe tray plastic, 458–61 Express STD putty, 462–64 Jet, 486–89 Luxatemp, 490–94 President putty, 478–81 ProTemp Crown temporization material, 496–500 Take 1 rigid tray material, 470–73 Tak Hydroplatic, 466–68 Triad True Tray vacuum forming tray material, 474–77 Trim II, 502–5 Unifast, 506–9 Delton Seal-N-Glo Light Cure Pit & Fissure Sealant, 564–67
Dental adhesives. See Bonding agents Dental amalgam Dispersalloy, 182–85 Permite, 186–89 Tytin speherical alloy, 190–93 Valiant Amalgam, Valiant Ph.D, and Valiant Snap-Set, 194–97 Dental cements, 95 Adherence DC, 132–35 Calibra, 126–30 Cavit and Cavit G, 172–75 glass ionomer cements, 108–17 IRM and IRM Caps, 166–70 Ketac-Cem radiopaque, Ketac-Cem aplicap, and Ketac-Cem maxicap, 118–21
Lute-It, 136–39 NX3, 140–44 permanent cementation procedure, 176–79 polycarboxylate cement, 104–7 resin cements, 126–48 resin-ionomer cement, 122–25 TempBond, TempBond NE, TempBond Clear, 150–54 TempoCem, TempoCem NE, TempoCem NE Smartmix, 156–60 temporary restorative materials, 166–75 temporary zinc oxide-eugenol cements, 150–65 Variolink, 146–48
763
INDEX
zinc phosphate cements, 96–103 Zone temporary cement, 162–65 Dental operatory, surface disinfecting procedure in, 676–77 Dental sterilants and disinfectants, 615 Banicide Plus, 616–19 Biocide G30, 620–23 Birex SE, 624–26 CaviWipes XL, 628–30 Cetylcide II, 632–35 Cidex Plus, 636–39 Coecide XL and Coecide XL Plus, 640–42 CoeFoam II, 648–50 Compliance, 644–46 Procide D and Procide D Plus, 652–54 ProSpray C-60, 656–58
sodium hypochlorite (bleach), 660–62 Sporox II, 664–66 Sterall and Sterall Plus, 668–71 surface disinfecting procedure in dental operatory, 676–77 Surflets disinfectant tablets, 672–74 Dental waxes, 389 Aluwax bite wafers, 438–40 bite wafers, 430–40 Coprawax bite wafers, 434–36 impression wax, 426–28 occlusal indicator wax, 450–52 orthodontic wax, 422–24 orthodontic wax sticks, 418–20
Dental Waxes continued pattern wax/baseplate wax, 394–97 pattern wax/casting wax, 402–4 pattern wax/inlay wax, 390–92 pattern wax/occlusal rims or bite blocks, 398–400 processing wax/boxing wax, 410–12 processing wax/sticky wax, 406–8 procession wax/utility wax, 414–16 study wax, 442–44 undercut wax, 446–48 wax bite registration with bite wafers, 454–56
Desensitizers, 12 D/Sense Crystal, 20–23 gluma desensitizer, 16–19 relief gel, 14–15 Die stones. See Gypsum products Disinfectants. See Dental sterilants and disinfectants Dispersalloy, 182–85 Dry Socket Paste, 746–48 D/Sense Crystal, 20–23 Duraflor Cavity Varnish, 540–43 Duralon, 104–7 Durashield 5% Sodium Fluoride Varnish, 544–47 Dycal-Two-Paste System, 34–37 Dyract extra universal compomer, 238–41
Encore core paste, 66–69 Endodontic sealer/cement (Apexit), 680–82 Endo-Ice, 718–20 Esthet X micro matrix restorative material, 214–17 Express STD putty, 462–64 Extra universal compomer (Dyract), 238–41 Extrude vinyl polysiloxane impression material, 324–27 Filtek Supreme Plus, 202–5 Final impression materials (Coe-Flex rubber base), 298–302 Fissure sealants. See Pit and fissure sealants Fleck’s cement, 96–99
Flowable micro hybrid composite restorations (Tetric Flow), 210–13 Fluorides, 511 60 Second Taste Fluoride Gel, 528–31 All Solutions 2% Neutral Rinse, 536–38 All Solutions fluoride foam, 512–14 Duraflor Cavity Varnish, 540–43 Durashield 5% Sodium Fluoride Varnish, 544–47 Fluor Protectant Assortment Fluoride Varnish, 548–50 Minute-Foam, 516–19 Neutragard Advanced 1.1% Neutral Sodium Fluoride Gel, 556–59
765
INDEX
Perfect Choice One Minute APF Gel, 524–26 Topex 2 Part In-Office Fluoride Rinse, 532–35 Topex Neutral Foam, 520–22 Topex Take Home Care 0.4% Stannous Fluoride Gel, 552–55 Fluor Protectant Assortment Fluoride Varnish, 548–50 FluroShield VLC Pit & Fissure Sealant, 568–71 Fuji-glass ionomer luting cement, 114–17 Fuji Lining LC, 26–28 Fuji Ortho LC, 722–25 Glacier microfilled hybrid composite, 232–35
Glass ionomer cements Fuji-glass ionomer luting cement, 114–17 Rely X, 108–12 Glass ionomer restorative material, 246–53 Gluma desensitizer, 16–19 Gypsum products, 341 general information related to, 342–44 impression plaster, 346–49 Magic White, 358–60 Modern Materials Milestone (type IV stone), 370–73 Modern Materials Statstone, 378–80 orthodontic plaster/stone, 354–57 plaster mixing for alginate impressions, 386–88
Gypsum products continued pumice, 382–84 type II plaster, 350–53 type III laboratory stone, 362–65 type IV die stone, 366–69 type V die stone, 374–77 Heliomolar HB packable microfilled resorative material, 224–27 Helioseal, 572–75 Heliosit Orthodontic, 726–28 Honigum impression material, 328–31 Hy-Bond, 100–103 Hybrid composites Point 4, 206–9 Prodigy, 198–201 Tetric Flow, 210–13
Hydrocolloid-reversible hydrocolloid impression material, 332–36 Hydroplastic (Tak), 466–68 Impregnum Penta polyether impression material, 312–14 Impression materials, 259 alginate flavoring, 284–86 Alginot, 288–90 Aquasil Smart Wetting vinyl polysiloxane impression material, 320–22 Coe Alginate, 266–70 Coe-Flex rubber base (final impression materials), 298–302 Coltene rapid impression material, 308–10
Extrude vinyl polysiloxane impression material, 324–27 Honigum impression material, 328–31 hydrocolloid-reversible hydrocolloid impression material, 332–36 Impregnum Penta polyether impression material, 312–14 Jeltrate alginate, 260–65 Kromafaze Alginate, 272–76 Kromopan 100 Alginate, 278–82 Permalastic polysulfide, 304–7 Polyjel NF polyether impression material, 316–18
polysiloxane impression material, 338–40 StatusBlue mix star material (alginate substitute material), 292–96 Impression plaster, 346–49 Impression wax, 426–28 Infinity resin-ionomer cement, 122–25 Inlay wax, 390–92 Intermediate restorative material. See IRM IRM (intermediate restorative material), 166–70 IRM Caps, 166–70 Jeltrate alginate, 260–65 Jet, 486–89 Ketac-Cem aplicap, 118–21 Ketac-Cem maxicap, 118–21 Ketac-Cem radiopaque, 118–21
767
INDEX
Ketac Fil Plus Aplicap glass ionomer restorative material, 250–53 Kromafaze Alginate, 272–76 Kromopan 100 Alginate, 278–82 Laboratory stone. See Gypsum products Low-strength bases. See Bases, low-strength Luma White Bleaching Paste, 604–8 Lute-It, 136–39 LuxaCore Smartmix Dual, 62–65 Luxatemp, 490–94 Magic White, 358–60 Microfilled resorative materials Glacier, 232–35 Heliomolar HB, 224–27
Microhybrid composite restorative materials Tetric, 228–31 Tetric Flow, 210–13 Micro matrix restorative material (Esthet X), 214–17 Milestone (type IV die stone), 370–73 Minute-Foam, 516–19 Miracle Mix, 58–61 Modern Materials Milestone, 370–73 Modern Materials Statstone, 378–80 Nano-hybrid composite (Simile), 236–37 Nano-restorative material (Premise), 218–22
Neutragard Advanced 1.1% Neutral Sodium Fluoride Gel, 556–59 Niveous In-Office Tooth Whitening, 592–96 Nogenol Root Canal Sealer, 684–87 Non-eugenol periodontal dressing preparation and placement procedure, 754–57 Non-eugenol root canal sealer (Sealapex Xpress), 688–91 Nupro Prophy Paste Cups Variety Pak With Fluoride, 734–36 Nu Radiance Duet, 588–91 NX3, 140–44
Occlusal indicator wax, 450–52 Occlusal rims, 398–400 Opalescence Tooth Whitening Systems, 580–83 OptiBond Solo Plus System, 84–86 Optimized particle hybrid composite system (Point 4), 206–9 Oral-B Whitening Strips, 576–79 Orthodontic plaster/stone, 354–57. See also Gypsum products Orthodontic wax, 422–24 Orthodontic wax sticks, 418–20 Packable microfilled resorative material (Heliomolar HB), 224–27
Panavia F 2.0 Dual Cure Dental Resin Adhesive, 176–79 Pattern waxes baseplate wax, 394–97 casting wax, 402–4 inlay wax, 390–92 occlusal rims or bite blocks, 398–400 Perfect Choice One Minute APF Gel, 524–26 Perfect Choice Prophy Gems, 730–32 Periodontal dressing Barricaid VLC, 742–45 Coe-Pak Automix NDS, 738–41 preparation and placement procedure, 754–57 Permalastic polysulfide, 304–7 Permanent cementation procedure, 176–79
Permite, 186–89 PFM crown, permanent cementation of, 176–79 Pit and fissure sealants, 511 Clinpro Sealant, 560–63 Delton Seal-N-Glo Light Cure Pit & Fissure Sealant, 564–67 FluroShield VLC Pit & Fissure Sealant, 568–71 Helioseal, 572–75 placing procedure for, 610–14 Plaster mixing, for alginate impressions, 386–88 Plasters. See Gypsum products Point 4 optimized particle hybrid composite system, 206–9
769
INDEX
PolaOffice, 598–602 Polycarboxylate cement, 104–7 Polyether impression materials Impregnum Penta, 312–14 Polyjel NF, 316–18 Polyjel NF polyether impression material, 316–18 Polysiloxane impression material, 338–40. See also Vinyl polysiloxane impression materials Polysulfide (Permalastic), 304–7 Preliminary restorative dental materials, 1 Adper Prompt L-Pop SelfEtch Adhesive, 72–75
Amalgambond Plus adhesive system, 80–83 B & T base and temporary cement, 42–45 bonding agents, 70–94 calcium hydroxide lining two-paste system mixing procedure, 92–94 caries detectors, 2, 4–6 caries indicators, 2, 8–11 cavity liners and lowstrength bases, 24–45 cavity varnish, 46–55 Copal Cavity Varnish, 52–55 Copalite, 48–51 core buildup materials, 56–69 desensitizers, 12–24 D/Sense Crystal, 20–23
Preliminary restorative dental materials continued Dycal-Two-Paste System, 34–37 Encore core paste, 66–69 Fuji Lining LC, 26–28 gluma desensitizer, 16–19 LuxaCore Smartmix Dual, 62–65 Miracle Mix, 58–61 OptiBond Solo Plus System, 84–86 Prime & Bond NT Dual Cure Nano-Technology Dental Adhesive, 88–91 Prisma VLC Dycal, 38–41 relief gel, 14–15 Scotchbond multi-purpose plus dental adhesive, 76–79 Vitrebond Plus, 30–32
Premise Flowable, 218–22 Premise universal nanorestorative material, 218–22 President putty, 478–81 Prime & Bond NT Dual Cure Nano-Technology Dental Adhesive, 88–91 Prisma VLC Dycal, 38–41 Processing waxes boxing wax, 410–12 sticky wax, 406–8 Procession wax, 414–16 Procide D, 652–54 Procide D Plus, 652–54 Prodigy hybrid condensable composite, 198–201 ProSpray C-60, 656–58 ProTemp Crown temporization material, 496–500
Provisionals. See Custom trays and provisionals Pulpdent Root Canal Sealer, 692–94 Pumice, 382–84 Putty Express STD, 462–64 President, 478–81 Rapid impression material (Coltene), 308–10 RC-Prep, 710–13 Relief gel, 14–15 Rely X, 108–12 Resin cements Adherence DC, 132–35 Calibra, 126–30 Lute-It, 136–39 NX3, 140–44 Variolink, 146–48 Resin-ionomer cement, 122–25 Restorative materials, 181
Compoglass F— compomer-based restorative material, 242–45 dental amalgam, 182–97 Dispersalloy, 182–85 Dyract extra universal compomer, 238–41 Esthet X micro matrix restorative material, 214–17 Filtek Supreme Plus, 202–5 Glacier microfilled hybrid composite, 232–35 glass ionomer restorative material, 246–48 Heliomolar HB packable microfilled resorative material, 224–27 Ketac Fil Plus Aplicap glass ionomer restorative material, 250–53
771
INDEX
Permite, 186–89 Point 4 optimized particle hybrid composite system, 206–9 Premise universal nano-restorative material and Premise Flowable, 218–22 Prodigy hybrid condensable composite, 198–201 Simile nano-hybrid composite, 236–37 Tetric Flow flowable micro hybrid composite restorations, 210–13 Tetric Microhybrid Composite Restorative System, 228–31, 254–58 Tytin speherical alloy, 190–93
Valiant Amalgam, Valiant Ph.D, and Valiant Snap-Set, 194–97 See also Preliminary restorative dental materials; Temporary restorative materials Rigid tray material (Take 1), 470–73 Root canal sealers Apexit, 680–82 Nogenol Root Canal Sealer, 684–87 Pulpdent Root Canal Sealer, 692–94 Sealapex Xpress noneugenol root canal sealer, 688–91 Scotchbond multi-purpose plus dental adhesive, 76–79
Sealants. See Pit and fissure sealants Sealapex Xpress noneugenol root canal sealer, 688–91 Sealers. See Root canal sealers Simile nano-hybrid composite, 236–37 SlickGel ES, 714–16 Sodium hypochlorite (bleach), 660–62 Specialty materials, 679 Alvogyl, 750–52 Apexit endodontic sealer/cement, 680–82 Barricaid VLC surgical periodontal dressing, 742–45 Buckley Formo Cresol, 704–5 C.L. Canal Lubricant, 706–8
Coe-Pak Automix NDS periodontal dressing, 738–41 Dry Socket Paste, 746–48 Endo-Ice, 718–20 Fuji Ortho LC, 722–25 Heliosit Orthodontic, 726–28 Nogenol Root Canal Sealer, 684–87 non-eugenol periodontal dressing preparation and placement procedure, 754–57 Nupro Prophy Paste Cups Variety Pak With Fluoride, 734–36 Perfect Choice Prophy Gems, 730–32 Pulpdent Root Canal Sealer, 692–94 RC-Prep, 710–13
Sealapex Xpress non-eugenol root canal sealer, 688–91 SlickGel ES, 714–16 Tempit moisture-activated temporary filling and sealing material, 696–99 T.E.R.M. Temporary Restorative Material, 700–703 Sporox II, 664–66 Statstone, 378–80 StatusBlue mix star material (alginate substitute material), 292–96 Sterall, 668–71 Sterall Plus, 668–71 Sterilants. See Dental sterilants and disinfectants Sticky wax, 406–8 Stones. See Gypsum products
Study wax, 442–44 Surface disinfecting procedure, in dental operatory, 676–77 Surflets disinfectant tablets, 672–74 Surgical periodontal dressing (Barricaid VLC), 742–45 Take 1 rigid tray material, 470–73 Tak Hydroplatic, 466–68 TempBond, 150–54 TempBond Clear, 150–54 TempBond NE, 150–54 Tempit moisture-activated temporary filling and sealing material, 696–99 TempoCem, 156–60 TempoCem NE, 156–60
773
INDEX
TempoCem NE Smartmix, 156–60 Temporary restorative materials Cavit and Cavit G, 172–75 IRM and IRM Caps, 166–70 Tempit, 696–99 T.E.R.M. Temporary Restorative Material, 700–703 Temporary zinc oxideeugenol cements TempBond, TempBond NE, TempBond Clear, 150–54 TempoCem, TempoCem NE, TempoCem NE Smartmix, 156–60 Zone temporary cement, 162–65
T.E.R.M. Temporary Restorative Material, 700–703 Tetric Flow flowable micro hybrid composite restorations, 210–13 Tetric Microhybrid Composite Restorative System, 228–31, 254–58 Tooth whitening agents, 511 ContrastPM, 584–87 Luma White Bleaching Paste, 604–8 Niveous In-Office Tooth Whitening, 592–96 Nu Radiance Duet, 588–91 Opalescence Tooth Whitening Systems, 580–83 Oral-B Whitening Strips, 576–79 PolaOffice, 598–602
Topex 2 Part In-Office Fluoride Rinse, 532–35 Topex Neutral Foam, 520–22 Topex Take Home Care 0.4% Stannous Fluoride Gel, 552–55 Trays. See Custom trays and provisionals Triad True Tray vacuum forming tray material, 474–77 Trim II, 502–5 True Tray vacuum forming tray material, 474–77 Type II plaster, 350–53 Type III laboratory stone, 362–65 Type IV die stone, 366–73 Type V die stone, 374–77 Tytin speherical alloy, 190–93
Undercut wax, 446–48 Unifast, 506–9 Universal nano-restorative material (Premise), 218–22 Utility wax, 414–16 Vacuum forming tray material (Triad True Tray), 474–77 Valiant Amalgam, 194–97 Valiant Ph.D, 194–97 Valiant Snap-Set, 194–97 Variolink, 146–48 Varnish. See Cavity varnish Vinyl polysiloxane impression materials Aquasil Smart Wetting, 320–22 Extrude, 324–27 Vitrebond Plus, 30–32
Wax bite registration, with bite wafers, 454–56 Waxes. See Dental waxes Whitening agents. See Tooth whitening agents Zinc oxide-eugenol cements. See Temporary zinc oxide-eugenol cements Zinc phosphate cements Fleck’s cement, 96–99 Hy-Bond, 100–103 Zone temporary cement, 162–65
