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Dynamics Sep 08 20/8/08 09:02 Page 11RestorativesChemFil ® Molar CapsTemporary Cavity Restorationduring Root Canal Treatment– Current MethodsAn endodontic specialist is able to choose among several alternative methods to restore the cavityfollowing root canal treatment temporarily or permanently. DENTSPLY spoke to Dr. Claudia Barthel,senior physician at the Outpatients' Department for Restorative Dentistry at the Heinrich-HeineUniversity in Düsseldorf, about currently available materials for temporary cavity restoration, duringand after root canal treatment.Which dental materials can be principally used for coronal restorationsduring endodontic treatment, and what are their benefits and disadvantages?For temporary coronal restorations we have, for example, Cavit ® which can beapplied very easily. However, after only a few days - according to our research- it tends to become permeable. The same aspect applies to intermediaterestorative materials, so-called IRM, which also can be used only for a few days.Glass Ionomer cements exhibit a significantly longer durability and excellentimpermeability, although the higher price might be seen as a disadvantage.Capsule systems, in particular, permit a rapid and safe procedure with a highdegree of impermeability - the best solution in the case of temporary coronalrestorations of less than four weeks.For a permanent or long-term temporary coronal restoration, composite systemsare the material of choice with regard to sealing properties. However, processingis more complex and expensive due to the adhesive bonding procedure.What circumstances necessitate a temporary coronal restoration of a toothduring root canal treatment?A temporary coronal restoration is always needed, either during single-sessionroot canal treatments or during multi-visit treatments which require a root canaldressing. You also need to restore endodontically treated teeth prior to postinsertion, and prior to placement of definitive restorations when a tooth remainsunder observation.What are the decisive criteria for temporary filling materials?Temporary filling materials must exhibit maximum impermeability to ensure thesuccess of an endodontic treatment procedure. Any amount of bacterial leakageduring or following treatment can cause reinfection. It would be unjustifiable totake complex steps to avoid bacterial infiltration during root canal treatment, onlyto allow re-infection when placing the temporary coronal restoration. In additionto impermeability, the functional and, especially in the case of anterior teeth,aesthetic aspects must be considered. The selection of a compatible restorativematerial is further determined by the defined period of time it will remain in situ.What is your personal choice of temporary restorative material?Numerous studies on the quality of restorative materials are available, includinga number of our own diverse published studies. I routinely use glass ionomercement during endodontic treatment, because the overall composition of thismaterial provides the best compromise of high safety and durability of temporaryrestorations together with an acceptable cost factor.In the case of extended planning intervals, bonded composite systems are alsoa valid option - for permanent restorations or for observation periods until healingof the tooth is completed.What durability do you anticipate from glass ionomer cement restorations,for example the new DENTSPLY capsule system ChemFil Molar Caps?In general, I use glass ionomer cement for approximately four to a maximumof six weeks, for reasons of impermeability, which, according to our studies,can no longer be guaranteed after this period of time. It should be noted thatthe permeability is not necessarily determined by innate material properties,but rather due to other factors. For example, the soft medical dressing materialin the root canal or cavity can cause dysfunction. In any case, there are numerousparameters, which, in varying degrees of influence, limit the durability of atemporary restorative material. Duration of application of four weeks should besafe for glass ionomer cement restorations.IRM may indeed be less costly, but offer reliable sealing properties for only alimited period of time. Added to this, the patient themselves presents an unknownfactor if, based on unforeseen circumstances. They delay attending for furthertreatment more than a few daysCavit ® is not a registered trademark of DENTSPLY International Inc.Prof. Dr. Claudia BarthelScientific Associate at the Dental Clinic of the Charitè, Berlin.One year Visiting Professor in the Dept. Of Endodonticsin Chapel Hill, USA.Currently, Senior Clinician at the Polyclinic for RestorativeDentistry at the Heinrich-Heine University in Düsseldorf.My use of Glass Ionomersin a Private PracticeBeing purely private, I am trying to get away from placing amalgams as a treatment of choice forchildren. But also I am uncomfortable using composites in youngsters whose caries status is in aconstant flux depending on their dietary habits and fads, which seem to change at the drop of a hat!My treatment of choice for early class I cavities is glass ionomers. Cavities can be prepared minimally,they adhere very well, the fluoride release seems to give some protection against secondary caries,and moisture control isn’t as vital as for conventional composites (very useful in the very young).The treatment plan after providing a glass ionomer is to monitor the tooth at futurecheck-ups, and to restore with composite when the child is older. Often though, allof the ionomer does not need removing. Just enough thickness to put a compositeover the top, later on.ChemFil ® Molar is the new glass ionomer from DENTSPLY. It is presented incapsules, in individually wrapped foil packs. The capsules are transparent, whichis useful for seeing how much material is within them. It is activated by the same‘press’ tool familiar to users of 3M ESPE glass ionomer materials, and dispensedwith the same trigger action gun that now mercifully seems to fit all GC,DENTSPLY and 3M ESPE products .The material mixes to a nice consistency, flows well into cavities and packsnicely without sticking to the instrument. Setting is quite rapid and the instructionsrecommend polishing after only four minutes. At the time I was road-testing thematerial though, the surgery was warm, and it seemed very solid after 2-3minutes.Personally, I am quite a fan of this type of glass ionomer material.I haven’t been using ChemFil Molar long enough to comment on its long-termwear, but in general, I have been placing restorations like this for about ten yearsnow, and have been very impressed with the wear rates, so long as the filling isnot too large.I also use the material for replacing fractured cusps in non-visible areas ofpremolar or molar teeth. The sort of fracture where a bit of cusp comes away froman MO, DO or MOD amalgam. Sometimes, it seems overly dramatic to crown orinlay such a tooth when it’s only a small piece missing, and the old restoration isfirmly in place. Just repairing the missing cusp can often be a good long lastingrepair and put off crowning an otherwise healthy tooth for many years.In summary then, I feel that ChemFil Molar Caps are a good, user-friendlypresentation of a very useful material. Setting time and wear resistance for suchmaterial has come on tremendously over the past few years and they haveestablished themselves as a material with a very important place in a preventativepractice, operating in a minimally-invasive way.Andy Bates, GDPSkipton, North Yorkshire10 DENTSPLY Dynamics | September - December 2008www.dentsply.co.uk11
Dynamics Sep 08 20/8/08 09:02 Page 13COMING SOONLasting TouchOffers are valid from 1st September 2008 to 31st December 2008, through participating dealersPaint-on-polishLasting Touch nano-technology liquid polish is new from DENTSPLY, andavailable to order from Henry Schein Minerva. As its name implies; it is acoating that can create a smooth and shiny surface on temporary andpermanent restorations or natural teeth, by being applied directly tofinished surfaces. The liquid polish can enhance the final polish achievedwith conventional finishing techniques. Liquid polishers are especiallybeneficial for temporary crowns or bridges, where prolonged polishing timeis not justified.Outshines the restAesthetic needs make stain resistance one of the critical requirements for a liquid polish. Compared with its closestcompetitor, Lasting Touch provides longer lasting resistance to food and beverage stains, and is proven to stay in place,without flaking or chipping. Stain testing of liquid polishes was performed by immersing the coating into a mustard pasteor coffee for 24 hours. Figures 1 and 2 show Lasting Touch and Brand B after the coffee stain test. Lasting Touch hasexcellent stain resistance to both mustard and coffee staining agents.New Surgery Set-Up OfferNot only will we supply you with a DENTSPLYSales Specialist to advise the best set up ofinstruments and materials, you will also get freegoods to the value of 10%, 15% or 20% on a newsurgeryset-up of DENTSPLY Ash Instruments.Spend £1000 and get 10% FREE goods*Spend £3000 and get 15% FREE goods*Spend £5000 and get 20% FREE goods**To the value of 10% , 15% or 20% RRP on orders over £1000 (excluding VAT)**First £1000 (RRP) must be spent on Ash InstrumentsCeram.XSystemStarter KitWhile stocks lastBuy a Ceram.X Mono Starter kit and a Ceram.X Duo Starter kitand get a Ceram.X Mono Starter Kit Free.Available for syringes. Order on code 60701401 or compules 60701339* SDM DataGroup 1 - Special Price (Equivalent to 20 Hi-Di ® Diamond Burs plus 10 Hi-Di ® Diamond Burs FREE)Figure 1.Coating of Lasting Touch after 24 hours in coffeeFigure 2Coating of Brand B after 24 hours in coffeeHi-Di No. 541 542 543 525 526 527 537ISO 108-010 109-014 109-18 237-010 237-012 237-016 019-012Product Code 60703541 60703542 60703543 60703525 60703526 60703527 60703537Medium Medium Medium Medium Medium Medium MediumSeals for longer lasting beautyAdhesion to substrate is an essential requirement for a liquid polisher. No matter how high the wear and stain resistanceof a coating, it will not maintain a smooth surface or protect margins if the coating layer de-bonds from the substrate.Most competitive products have good adhesion to composites and compomer, but none have good adhesion to enamel.Lasting Touch contains the same adhesion promoters used in Prime&Bond ® NT to enhance adhesion to enamel.These adhesion promoters, combined with specially synthesized resin, provides excellent adhesion to enamel.A Lasting Touch coating resin-reinforced polish seals the margins and any microscopic cracks or fissures, ensuring minimumpatient post-operative sensitivity.Nano-Technology for high wear resistanceThe main drawback of current liquid polishers on the market is poor wear resistance. Generally, wear resistance can beimproved by adding fillers; however, this could change the opacity and thereby change the shade of the underlying substrate.Using nano filler can solve the opacity issue, but can also increase the viscosity, which will limit the filler loading level.To address this issue, Lasting Touch uses proprietary nano filler which has a minimum impact on viscosity. It is a clearformulation with a high filler loading level, ensuring high wear resistance.If you would like further information on Lasting Touch please contact DENTSPLY +44 (0) 800 072 3313or Henry Schein Minerva +44 (0) 8700 1020 43.Hi-Di No. 520 521 522 534 535 561 742ISO 001-010 001-012 001-016 225-014 225-016 247-016 160-009Product Code 60703520 60703521 60703522 60703534 60703535 60703561 60703742Medium Medium Medium Medium Medium Medium MediumGroup 2 - Special Price (Equivalent to 10 Hi-Di ® Diamond Burs plus 10 Hi-Di ® Diamond Burs FREE)Hi-Di No. 554 555 556 557 622 630 564ISO 171-014 172-014 173-016 173-013 171-016 174-022 243-022Product Code 60703554 60703555 60703556 60703557 60703622 60703630 60703564Medium Medium Medium Medium Medium Medium MediumHi-Di No. 501 635 753 566 672 546 544ISO 197-016 197-018 160-014 233-012 238-016 110-014 138-010Product Code 60703501 60703635 60703753 60703566 60703672 60703546 60703544Medium Medium Medium Medium Medium Medium Medium12 DENTSPLY Dynamics | September - December 2008www.dentsply.co.uk13
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