2. Advanced Cementation Update Webinar

3. Clinical Mastery (www.clinicalmastery.com)
Over-the-shoulder Prepless veneer courses
Full mouth rehabilitation courses
Hands-on Occlusion Courses
Webinars
Phoenix, Arizona

4. Webinar October 14th The Why, Where, & When of bite relationships
John Nosti, DMD

6. Cementation Adhesion Semi-adhesion Non-adhesion
“total-etch”, resin cement
Semi-adhesion
Self-etching resin cement
Non-adhesion
Glass Ionomer, resinionomer, zinc phosphate, polycarboxylate

7. Cement Requirements Lack of post-operative sensitivity
Strong bond and good seal
-to the tooth and to the restorative material
Easy placement and clean-up
Esthetics compatible with the restorative material
Minimal film thickness
Radiopaque (posterior)

8. Powder liquid ceramic or Pressed ceramic restorations
“Total-etch” with Resin Cement
Powder liquid ceramic or
Pressed ceramic restorations

9. “Tack & Wave” Cementation
Veneers and anterior crowns

10. Emprethin evaluation

11. Be Careful!!!
0.2 mm glass is fragile!

12. OptraGate (Ivoclar)

14. Hydrogen Peroxide in Ultradent Syringe

15. Metal strip removes any interproximal Luxatemp and freshens the enamel

16. Try in independently DRY

17. Occlude Spray Powder (Pascal)

18. Try-in collectively DRY!
Check complete seating
Proximal contacts

19. Mesial Surface
Dry Erase Marker

21. Distal
Surface

24. Variolink Veneer (Ivoclar/Vivadent)
Value based
+1, +2, +3
-1, -2, -3
Microfill

27. +2

30. Clean and acidify with 35% Phosphoric acid

31. Silane Coupling Agent (Relyx Ceramic primer) placed for 1 minute

32. Place bonding agent (All Bond 3) inside dry restoration

33. Load restoration with resin cement

34. Vivapad (Ivoclar)

35. Etch with 35% phosphoric acid for 15 seconds per tooth

36. Apply Systemp desensitizer for 15 seconds

37. Effect of Remoistening
Water vs. Desensitizer/Rewetting Agent
Product
Dentinal Bond
Water-blotted dry
Water- wet
Gluma Desensitizer
HurriSeal
Vivadent Desensitizer
MicroPrime
Aqua-Prep

38. “suction” away excess; do not desiccate

39. Apply 2 coats of All Bond 3 A & B Primer mix

41. Adec Warm Air Tooth Dryer

42. Seat all restorations at one time; do not remove
excess resin cement

43. Polymerize “dead center” each restoration for 1 second using a 2
Polymerize “dead center” each restoration for 1 second using a 2.0 mm light guide (Ivoclar)

44. Hold light guide 1 inch from restorations
and light cure 3-5 seconds on facial and lingual

45. General Guidelines
+2: 5 seconds
0: 3 seconds
-3: 5 seconds +

46. “Pick" away excess using Bard Parker or scaler

47. Floss through contacts using a Brasseler Serrated Saw

48. Floss through contacts using waxed dental floss

49. Place DeOx (Ultradent) on all margins

50. Light polymerize for at least 60 seconds
per tooth from both buccal and lingual

51. Curing Lights Photoinitiators Camphoroquinone- 470-490 nm
PhenylDipropandione nm

52. PDP 430 nm
CQ 488 nm
Wavelength (nm)

53. Emits light with wavelength
OptiLux 501
(Demetron)
Emits light with wavelength nm

54. PDP 430 nm
CQ 488 nm
Wavelength (nm)

55. -Wavelength output 450-500 nm
LED Light i.e.. Freelight (3M), LEDemetron (Kerr),,BluPhase (Ivoclar), DEMI (Kerr)…
-No bulb degradation
-Portable
-Wavelength output nm

56. PDP 430 nm
CQ 468 nm
Wavelength (nm)

57. Emits light with wavelengthnm
BluePhase G2
(Ivoclar)

58. Fusion

59. Remove excess resin cement with Scaler, #12 & #15 Bard-parker Blades

60. Run Serrated Saw through contacts

61. 1954N Strip (3M)

62. Epitex Strips (GC)

63. 15 micron finishing diamond (Brasseler))

64. 15 micron football-shaped diamond on lingual

66. OptraFine Porcelain polishing system (Ivoclar)

67. DiaShine ( V & H )

72. Solid Model Contacts

73. Adhesion to the restoration
Ceramist etches in lab
Clinician cleans internal surfaces with phosphoric acid
Rinse and dry thoroughly
Apply Silane coupling agent
Apply dual-cure adhesive resin to internal of restoration

74. Adhesion to the restoration
Ceramist etches in lab
Clinician cleans internal surfaces with phosphoric acid
Rinse and dry thoroughly
Apply Silane coupling agent
Apply dual-cure adhesive resin to internal of restoration

78. Blot Dry dentin

79. Apply primer

80. Air dry primer

81. Light polymerize for 10 seconds

82. Posterior
RelyX ARC (3M)

84. Hold passively for 3 minutes

85. Remove excess with
scaler or explorer

86. Floss through contacts

87. oxygen-inhibiting medium
Cover margins with
oxygen-inhibiting medium

88. Light polymerize for
at least 60 seconds

89. Use scaler and/or
#12 Bard Parker

93. Core-reinforced Restorations Lithium disilicate (e.Max)
Zirconia
Alumina
Metal
Lithium disilicate (e.Max)

94. “Core” reinforced ceramic
(Metal, zirconium, lithium disilicate, alumina oxide)
Pressed Ceramic/
Powder-liquid ceramics
High technique sensitivity
Conventional cements
No etch Adhesive cements
“Total-etch” resin cements

95. Lithium disilicate pressed
e.Max Pressed
Lithium disilicate pressed

96. “Core” reinforced ceramic
(Metal, zirconium, lithium disilicate, alumina oxide)
Conventional cements
(Zinc phosphate, polycarboxylate,
Glass ionomer)
No etch Adhesive cements
(Resin-ionomers, self-adhesive resin cements)

97. “Core” reinforced ceramic
(Metal, zirconium, lithium disilicate, alumina oxide)
No etch adhesive cements
Resin Modified glass ionomers
(FujiCem, FujiPlus, RelyX Luting)
Self-adhesive resin cements
(Unicem, MaxCem, Multilink Automix, Panavia FL)

98. “Self-adhesive” resin cements
(the benefits of resin without the technique sensitivity)
Single component Self-Adhesive
(Unicem, MaxCem, others)
Assisted Self-adhesive resin cements
(Multilink Automix, Panavia FL)

99. “Single Component Self-adhesive “ cements
Unicem (3M)
MaxCem Elite (Kerr)
Embrace Wetbond ( Pulpdent)
G-Cem (GC)
BisCem (Bisco)
Embrace

100. “Single Component Self-adhesive “ cements
BisCem (Bisco)
Embrace

101. “Single Component Self-adhesive “ cements Bond strengths (Reality)
Dentin
Enamel
MaxCem
Embrace
Unicem
BisCem
“Total-etch”
Relyx

102. Good physical properties Some adhesive properties
Advantages of
“Single Component self-adhesive” cements
Good physical properties
Some adhesive properties
Very, very easy to use

103. Mediocre bonds to dentin and enamel
Disadvantages of
“Single Component self-adhesive” cements
Mediocre bonds to dentin and enamel
Questionable long term enamel bonds
Questionable bonds to restorative substrate

104. Assisted “Self-etch” resin cements
Panavia FL2.0
(Kuraray)
Bistite II DC
(J. Morita)
Multilink Automix
(Ivoclar)

105. Good physical properties
Advantages of
Assisted “Self-adhesive” cements
Good physical properties
Good adhesive properties
Easier to use than “Total-etch” cements

106. Assisted “Self adhesive” cements Bond strengths (Reality)
Dentin
Enamel
Panavia F
Embrace
Bistite II
Multilink
“Total-etch”
Relyx

107. Involves an adhesive step
Disadvantages of
Assisted “Self-adhesive” cements
Involves an adhesive step
Bonds not as strong as “Total-etch”

108. Can we “etch “with phosphoric acid with self-etch cements?
Enamel Bonds
Total-etch
Self-etch
Panavia F
Unicem
Multilink
BisCem
Decreased bond strengths to dentin

109. When do I use what? Non-core supported ceramic: Core-supported Ceramic
“Total etch”
Core-supported Ceramic
Minimal retention and resistance form?
“Total-etch” with dual cure resin cement
Adequate retention and resistance?
“self-adhesive” resin cements

110. Hornbrook 2009 Updates – Full Day Events
Topics include:
2009 Materials Update
My top 10 failures and how YOU can avoid them!
Treatment Planning the Full Mouth Rehabilitation
Winning Case Presentation Techniques for a Tough Economy
Prepless Veneers: Necessary Addition to Your Restorative Arsenal
And much more!
November 6th – Albuquerque, NM
November 13th – Boston, MA at Tufts University