Let’s Grow Tooth 2016 Jack D Griffin Jr DMD 1 Jack D Griffin Jr DMD Master Academy of General Dentistry Accredited American Academy of Cosmetic Dentistry Diplomat American Board of Aesthetic Dentistry Let’s Grow Tooth Excellence with bioactive/regenerative materials Let’s Grow Tooth: 1. Bioactive –vs- Regenerative 2. Direct restoratives 3. Indirect restorations 4. Cementation to heal margins 5. Regenerative Aesthetics New burs Water Isolation Effective decay removal Bioactive/ regenerative materials Selective etch Thorough rise Moist surface Universal DBA Evaporate solvent Shrinkage management Effect curing Proper adjustment Let’s Grow Some Tooth… Bioactive [bi″o-ak´,v] having an effect on or elici,ng a response from living ,ssue. Regenerative To provide an environment that promotes tissue repair Let’s Grow Some Tooth… Regenerative To provide an environment that promotes tissue repair Optimal pH Bacteria inhibition Void free Moisture tolerant Bio-friendly Well sealed Tooth-like physicality “regenerative” materials: TheraCal LC (Bisco) – a liner Activa (Pulpdent) – a base/restorative Ceramir (Doxa) – a cement Giomers (Shofu) – a class of restorative materials
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Let’s Grow Tooth 2016
Jack D Griffin Jr DMD 1
Jack D Griffin Jr DMD Master Academy of General Dentistry
Accredited American Academy of Cosmetic Dentistry Diplomat American Board of Aesthetic Dentistry
Let’s Grow Tooth Excellence with bioactive/regenerative materials
TheraCal LC (Bisco) – a liner!Activa (Pulpdent) – a base/restorative!Ceramir (Doxa) – a cement!Giomers (Shofu) – a class of
"restorative materials!
Let’s Grow Tooth 2016
Jack D Griffin Jr DMD 2
TheraCal LC (Bisco)
What it is!A Resin Modified Calcium Silicate (RMCS) Stimulates apatite formation and 20 dentin MTA (Mineral Trioxide Aggregate) chemistry Early high alkalinity (high pH = 11) Neutralizes over weeks Self-sealing minor bond to dentin Anti-microbial
Clinical use!Liner to protect pulp Place on moist dentin prior to DBA Keep 1mm deep or less Opacity prevents deep cure Direct pulp cap possible Keep 1mm from enamel May show through less opaque composite
Giomer Shofu !
A class of restorative materials!
Giomer ion release by S-PRG:
A stable glass ionomer which allows ion release and recharge. The surface layer is protected giving great physical properties. The glass core is protected from moisture.
GI plus calcium aluminate… Bioactive cement – apatite formation Easiest clean up ever!Least sensitivity of any cement tested NO RESIN!Alkaline pH Hydrophilic!No silane, no primer, no bonding agents Awesome for metal, zirconia, implants!No bad taste!
Compare margin sealing:!!Rely X Luting!Rely X Unicem!Fuji GI!!Ceramir!ProRoot MTA!!
Cement Bond
Retention Material
Aesthetics
Zr adjsutments Fine diamond High speed Light pressure Concentric turbine Rubber polishers Polish paste?
Ceramaster !Shofu!
Prep not ideal… Zr primer! Z-Prime Plus Bisco Self adhesive resin ! BeautiCem Shofu
Monolithic lithium disilicate…
J Very durable, versatile
J 1.5-2.0 mm clearance
J Monolithic esthetics good for 95% of posterior restorations
J Cementation good if prepped well
J Adhesive cementation may result in higher ceramic strength
J Slightly better esthetics than zirconia, more translucency
Probe to !sulcus depth…!!Margins 2.5-3.0mm from bone crest to prevent biologic width violation
“Sounding” the bone
Plan…!1. Get pt a tooth brush 2. Perio Protect 3. Records 4. Wax up 5. Extraction #19 6. Length determination 7. Long term mock up 8. Establish bite 9. Restore lower posterior 10. Restore the rest