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Lab for Life. ™ Premise Indirect | Biomimetic nanotechnolgy
Premise Indirect / Biomimetics
Biomimetic refers to human-made processes, substances, devices or systems that imitate nature.
Burs on a dog’s coat led to the invention of Velcro.
Premise Indirect / Biomimetics
The art and science of deg and building biomimetic apparatus is called biomimetics.
Replicating the water repellant nature of certain leaves in the manufacturing of paint.
Premise Indirect / Nanotechnology
Nanotechnology involves the creation and manipulation of complex structures on the scale of nanometers – something organisms have done for about 3.8 billion years.
The ideal nanohybrid restorative that ages, feels, wears, functions and looks like a natural tooth.
Premise Indirect / Features
The result of science born from the success of Heruculite XRV™, belleGlass™NG and Premise™.
Premise Indirect™ utilizes the same optimized trimodal polymerization as belleGlass NG, the most respected indirect restorative of its kind.
Indications: Inlays, onlays, crowns, veneers, bridges, splints and ideal for implant restorations with proprioceptive tooth-like response.
Premise Indirect / Features
Natural look and wear. Closely matches natural dentition in wear characteristics, as well as an opalescent appearance that virtually replicates natural enamel like no other restorative material.
Performance. Trimodal curing (light, heat and pressure) achieves over 98% material conversion, as compared to 60 – 70% achieved with light-cure only materials.
Proven History. Twelve years of positive clinical history, and tens of thousands of successful restorations placed since 1996.
Premise Indirect / Research
Nanohybrid technology. The combination of large prepolymerized filler (PPF) particles, 0.4 micron structural filler and small silica nanoparticles allows higher filler loading, improved physical properties, optimal handling, higher surface gloss and reduced polymerization shrinkage.
Prepolymerized filler
Point 4 filler
Silica nanoparticles
Premise Indirect / Research SEM OF FILLER PARTICLES Fig: Field Emission Microscope photo 50,000X; Submicron Hybrid filler (67%), 50 nm Discrete Silica particles (33%)
Premise Indirect / Research
High gloss retention. The particle size of fillers in PPF particles is below the wavelength of visible light and light-scattering effects are minimal. Plucking of PPF particles is reduced because mechanical properties are more similar to the cured paste number rather than ceramic particles.
Cured traditional composites wear unevenly causing a loss of luster and gloss.
Premise Indirect PPF particles wear more uniformly, wear resistance is improved and surface remains smoother and glossier with time.
Premise Indirect / Research
In-vivo measurements of wear over a five year period shows an average of 1.2 microns a year – closer to the wear of natural teeth than any other material tested.
Premise Indirect / Research
Premise Indirect more closely matches the coefficient of thermal expansion (CTE) of natural dentin – resulting in a material that looks and acts virtually the same as natural tooth structure.
Premise Indirect / Research
Premise Indirect vs. belleGlass NG Increased chroma and opacity in the Facial Dentins, allowing for better shading when used with metal reinforced C&B restorations. belleGlass Translucent Dentins were highly translucent and created a darker shade due to the inability to completely mask the metal.
Premise Indirect / Research Q. How is Premise Indirect different from belleGlass? A.Premise Indirect provides increased chroma in the facial dentin shades to improve shading over metal, as well as new fillers. Q. Can Premise Indirect be used or repaired with Premise Indirect or flowable? A.Premise Indirect can be repaired intraorally with any Premise family direct composite. Premise direct or flowable should not be used in the preparation of the indirect restoration. Q. I have a belleGlass customer. Do they need to buy the new equipment to use Premise Indirect? A.No. Premise Indirect cures using the same methods of light, heat and pressure as belleGlass NG. Q. Does Premise Indirect work with belleGlass? A. Yes, While the shading is enhanced on Premise Indirect, the technique is the same.
Premise Indirect / Research
Q. Do I have to use the curing unit to cure Premise Indirect? R. Yes. As with belleGlass, polymerization of the metal is achieved by a tack cure with the light and then a final cure in the curing unit. Q. Are you discontinuing belleGlass? A. Yes, belleGlass will continue to be sold until supplies are exhausted. s of belleGlass refills can continue to use until the expiration date. Q. I have a customer who uses another brand of indirect material. Can they use their curing unit with our material? A. No. The customer will need to use our Curing Unit to ensure they are getting a proper cure, and complete conversion.
Premise Indirect / Research Dia. Tens. Str.Mpa (sd)
Comp. Str.Mpa(sd)
Flex Str. Mpa(sd)
Flex Mod. Mpa(sd)
Fracture Resist. MPam1/2(sd)
Resistance to Bulk Fracture
56 (4) 50 (10) 50 (10)
370 (28) 450 (60) 510 (10)
158 (11) 150 (30) 150 (10)
21,000 (1400) 11,100 (200) 10,900 (300)
1.48 (0.09) 1.1 (0.1) 1.1 (0.1)
Yes Yes Yes
48 (8)
395 (20)
136 (9) 126 (21)
12,700 (400) 10,500 (300)
1.13 (0.16)
Yes yes
Cristobal+ Opaceous Dentin Incisal
49 (6) 66 (10)
450 (38) 473 (19)
179 (11) 156 (20)
13,000 (400) 12,000 (200)
1.14 (0.27) 1.22 (0.09)
Yes Yes
Estenia Dentin Enamel
60 (9) 66 (4)
441 (60) > 500
155 (13) 136 (18)
16,129 (601) 17,980 (715)
1.27 (0.2) 1.19 (0.09)
Yes Yes
Sinfony Dentin Enamel
63 (3) 66 (4)
430 (18) 457 (43)
89 (8) 89 (3)
3,557 (338) 3,219 (228)
1.12 (0.05) 1.31 (0.08)
No No
Adoro Dentin
55 (2)
414 (20)
117 (19)
6,297 (808)
1.07 (0.09)
Gradia Dentin
57 (5)
403 (6)
103 (10)
5,995 (214)
1.21 (0.05)
Ceramage Dentin
57 (3)
321 (12)
143 (13)
9,407 (237)
1.39 (0.11)
Premise Indirect Primary Dentin Facial Dentin Incisal Sculpture+ Dentin Enamel
Premise Indirect / Research Rockwell 15 T Hard
CTE Ppm/Deg.C(sd)
Wt. % Filler (Vol. %)
Vol% Shrink.(sd)
Equilibrium Gloss 60°
High Clinical Gloss
89.1 (1.0) 84.0 (0.7) 87 (0.8)
13.1 (0.7) 28.6 (1.4) 33.9 (0.8)
87.1 (72.5) 78 (63) 77 (70)
0.94 (0.1) 2.3 (0.2) 2.3 (0.3)
14
No Yes Yes
78.7
24.0 (1.4)
78.7
2.62 (1.4)
Cristobal+ Opaceous Dentin Incisal
87.8 (0.2) 86.4 (1.0)
27.0 (1.0)
75.1 73
3.26 (0.3) 2.91 (0.10)
15
No No
Estenia Dentin Enamel
93 (0.4) 93.9 (0.2)
15.3 (2.8) 13.7 (1.1)
86.8 (72.4) 88.2
1.55 (0.15) 1.62 (0.07)
21
No No
Sinfony Dentin Enamel
51.5 (1.3) 56.6 (1.2)
62.6 (3.0) 68.6 (1.5)
44.7 44.7
4.53 (0.04) 4.62 (0.3)
44
Yes Yes
Premise Indirect Primary Dentin Facial Dentin Incisal Sculpture+ Dentin Enamel
No No
Adoro Dentin
73 (1.2)
2.41 (0.05)
47
Gradia Dentin
73 (0.6)
2.48 (0.09)
17
Ceramage Dentin
80 (1.2)
2.38 (0.26)
46
Premise Indirect / Research / Gloss Retention
Figure 1a: Surface gloss under 60º reflected light, BG Exp. vs. CB+ Inc.
Figure 1b: Surface gloss under 60º reflected light, BG Exp. vs. HM
Figure1c: Surface gloss under 60º reflected light, BG Exp. vs. E En.
Figure 1d: Surface gloss under 60º reflected light, BG Exp. vs. SF En.
Premise Indirect / Research / Gloss Retention PURPOSE: Compare the surface luster, after long-term tooth brushing, of an experimental small particle hybrid indirect composite resin versus several hybrid and microfill resins of known clinical luster. Gloss vs. Time BelleGlass Experimental
Estenia Enamel
Heliomolar
Sinfony Enamel
Cristobal + Incisal
100.00
Y = a + be-X (Y = 60 º Gloss (%), a = Equilibrium Gloss (%), b = constant) 90.00
G loss (P ercent)
80.00 70.00 60.00 50.00 40.00 30.00 20.00 10.00 0.00 0
2
4
6
8
10
12
14
16
Time (Hour)
CONCLUSION: The stable higher surface gloss of the B.G. Exp. After tooth- brushing suggests that a clinically stable gloss by a hybrid composite may be possible. V. Bui, A. Kobashigawa, and D. Tobia: “ Surface Luster of a New Indirect Composite Resin. “ J. Dent. Res. Special Issue Abst. # 621, March 2003
Premise Indirect / Research INTERNAL BONDING - SANDBLASTED AND HF ETCHED SURFACES
Vita Porcelain
Premise Indirect XRV
Premise Indirect / Systems
Intro System
Master System
Starter system offering everything needed for Inlays and Onlays.
Complete system offering everything needed for Inlays to full bridges.
Premise Indirect / Materials
Primary Dentins are used for foundation and coping layers and improve strength.
Facial Dentins cover all foundation and coping layers to produce a stable long lived polished surface.
Incisals are placed onto the incisal / cuspal area and are designed to match the vitality of tooth enamel.
Premise Indirect / Materials
Modeling Resin is an unfilled universal wetting agent used for sculpturing.
Opaques are applied after metal prep and block out any underlying metal color.
Cervicals simulate root and cervical color,
Rubber Sep is a removable latex release agent and spacer applied to all dies and areas creating a 20 micron space.
Silane Primer is applied to the fitting surface of any metal free restoration prior to bonding.
Kolor Plus is applied internally to add effect on occlusal and interproximal surfaces.
Premise Indirect / Materials Premise Indirect Gingival Shades The simulation of lost soft tissue on implant reconstructions. Two new gingival tissue shade kits, including a gingival and opaque in light and dark pink.
Premise Indirect / Inlays & Onlays When layering note that maximum Facial Dentin thickness should not exceed 1.5 mm.
Primary
Facial
Incisal
Premise Indirect / Inlays & Onlays
If desired, duplicate the working die and articulate. Isolate adjacent tooth points and opposing dentition with Rubber Sep. Prepare the model and working die. Block out all undercuts.
Apply a thin layer of Primary Dentin into the floor and axial walls and adapt to the desired contour. Finish slightly short of the marginal periphery. Apply Kolor Plus to modify the occlusal color if needed. Light cure all aspects for 20 seconds.
Premise Indirect / Inlays & Onlays
Adapt Facial Dentin in small increments to desired contour. Continuously occlusal clearance. Work one cusp at a time. Apply Kolor Plus modifier to simulate occlusal staining. Light cure each increment for 10 seconds.
Finalize the occlusal scheme with Cuspal / Incisal to desired contour. Remove the die from the working model. Add areas if needed. Light cure all aspects for 20 seconds. Polymerize for 20 minutes in the curing unit. Remove the restoration from the die as soon as possible after full polymerization.
Premise Indirect / Inlays & Onlays
The completed restoration after polishing.
Premise Indirect / Crowns & Veneers When layering note that maximum Facial Dentin thickness should not exceed 1.5 mm.
Primary
Facial
Incisal
Premise Indirect / Crowns & Veneers
If desired, duplicate the working die and articulate. Isolate adjacent tooth points with Rubber Sep.
Prepare the model and working die.
Apply Primary Dentin and contour to the desired shape. Finish slightly short of the marginal periphery. Light cure each aspect for 20 seconds.
Premise Indirect / Crowns & Veneers
Adapt Facial Dentin onto the margin for precision fit.
Adapt Facial Dentin to the desired contour. Repeat on all aspects. Light cure at frequent intervals. Once final contour has been achieved, light cure all aspects for 20 seconds.
Premise Indirect / Crowns & Veneers
Adapt Incisal material in small increments. Light cure each increment for 10 seconds.
Finalize contour at the incisal edge. Create a restoration that is slightly longer than the tooth being replicated. (This allows for correct morphology after polishing procedures). Remove the die from the working model. Add areas. Light cure all aspects for 20 seconds.
Premise Indirect / Crowns & Veneers
Polymerize for 20 minutes in the curing unit. Remove the restoration from the die as soon as possible after full polymerization.
The completed restoration after polishing.
Premise Indirect / Metal Restorations
Premise Indirect can be incorporated onto any recommended dental alloy. Use of mechanical retention is recommended. Metal frameworks should incorporate smooth rounded edges especially for incisal and occlusal areas. Produce a framework thickness of 0.3 – 0.5 mm. For bridges, design the framework for correct placement of pontics and connectors. Ensure adequate space for veneering material.
Primary
Facial
Incisal
Metal
Opaque
Premise Indirect / Metal Restorations
Wax to full contour.
Assess available space.
Remove waxed crown.
Trim framework to desired shape.
Premise Indirect / Metal Restorations
Ideal margin space.
Trim and polish backings before applying material.
Rounded and smoothed.
Rounded and smoothed.
Premise Indirect / Metal Restorations
To achieve maximum bond strength, it is essential to ensure cleanliness of the metal.
Sandblast all veneering areas with 50 micron Aluminum Oxide at no more than 2 bar (30 PSI) pressure.
After cleaning, apply Metal Prep with an applicator brush or directly from the bottle.
Premise Indirect / Metal Restorations
All veneering areas are covered with Metal Prep. Allow to fully dry approximately 1 minute. Blast excess metal prep off with compressed air at 1 bar (15 PSI) pressure.
Apply Opaque to a final thickness of 0.1 – 0.2 mm. Ensure that there are no visible grey areas. This may require 2 – 3 applications. Light cure each opaque layer for 40 seconds per surface. Create a first wash Opaque. If desired, mix a small amount of Modeling Resin with Opaque.
Premise Indirect / Metal Restorations
If desired, modify Opaque shades with Kolor Plus.
Orange modifier is ideal for cervical areas or for producing a warmer color.
Premise Indirect / Metal Restorations
Wash application of Opaque with cervical area completed. Light cure each layer for 40 seconds.
Complete masking of the underlying metal framework. Note a slight surface shine.
Premise Indirect / Construct
Construct reinforcing braid is the ideal “building block”. It has a patented weave designed for more complete resin wetting. • Delivers superior strength and toughness • Made from polyethylene fiber • Cold gas plasma treated • Three widths available • Three times stronger than steel • Impregnated with Silane and Resin • Available in three shades, one neutral and two opaque shades designed to eliminate “shine through”.
Premise Indirect / Construct
Indications (Lab) • Single-unit posterior crowns • Posterior bridges • Anterior bridges • Selected anterior single crowns • Selected Inlays and Onlays
Guidelines • Assess all prescribed cases to ensure a successful outcome. • Always use the largest width of Construct fiber available. • Ensure complete wetting of the fiber with Construct Resin. • Keep the design of frameworks as simple as possible.
Premise Indirect / Construct
Common indications by Dentist • Splint loose teeth together • Connect teeth that have tissue / bone loss (usually lower anteriors) • Make single tooth temporaries with stock teeth for upper anteriors • Reinforce broken dentures (repairs) • Hold temporaries together while final restorations are being done in the lab
Premise Indirect / Construct Before / Splint
Before / Bridge
After
After
Premise Indirect / Construct PURPOSE: In this study, the apparent flexural strength (FS) and fracture toughness K 1C of a fiber reinforced composite resin laminate, Connect TMbelleGlassTM, was measured and compared to that of the unreinforced composite. RESULTS: The mean FS of unreinforced belleGlass was 126 (15) MPa and the apparent FS of the single ply Connect laminate was 335 (36) MPa. The mean K 1C of unreinforced belleGlass was 1.48 (0.09) MPa(m)1/2 and the apparent K1C of the single ply Connect laminate was 12.9 (1.0) MPa(m)1/2. ANOVA analysis of the means (p<0.05) indicate that the laminate substructures were significantly higher in FS and K1C than the unreinforced substructures. CONCLUSION: The data indicate that fiber reinforcement by Connect ribbon significantly improves strength and crack arresting properties of composite resin substructures.
A.I. Kobashigawa* and E. Shellard; “Crack Arresting Properties of a Fiber Reinforced Composite Resin Laminate.”; J. Dent. Res. V. 79 Special Issue Abst. # 289, Apr. 2000
Premise Indirect / Construct Fig. 1: Flexural Bar Connect Laminate. Note Deflection of Specimen Without Failure.
Fig. 2a: Fracture Toughness Bar Before Loading.
Fig. 2b: Fracture Toughness Bar in 3 Point Load. Note Complete Arrest of Crack by Single Ply of Connect.
Premise Indirect / Construct Effect Of Fiber Reinforcement On The Breaking Strength Of Crowns, C.A. MunozViveros, et al., Abst.#1177 J. Dent. Res. 77 Special Issue B, June, 1998). PURPOSE: This study evaluated the effect of fiber reinforcement on the breaking strength of two commercially available fiber reinforced systems: belleGlass TM (Kerr Corp.) and Targis/VectrisTM (Ivoclar Corp.). RESULTS: __________________________________________________________
Mean Kg. Group A 252 Group B 264 Group C 248
45 49 38
SD 4
Comp. Fract. 2
2 3
Tooth Fiber Fract. Interface 4
3 0
5 7_______
Group A: Belleglass/Connect (axial wall); Group B: Belleglass/ Connect (axial + occlusal wall); Group C: Targis/Vectris.
CONCLUSION: Within the design of this study and under the Conditions used, there was no difference in breaking strength for fiber Reinforced crowns made of belleGlass TM or Targis/VectrisTM.
Premise Indirect / Construct
Prepare the model and working die.
Asses size and area of the preparation. Forma a flat disc of Primary Dentin 0.5 – 0.6 mm thick.
Premise Indirect / Construct
Apply the disc to the occlusal surface and adapt excess material over the axial walls to form a coping. Finish short of the margin periphery. Light cure each aspect for 20 seconds. The ideal coping thickness is 0.2 mm.
Construct needs to be wrapped around the periphery of the preparation. Apply to the occlusal surface if space permits. Follow the preparations contour for optimal placement. Using Construct scissors, cut a length of fiber. Wet one end of the fiber with Construct Resin. Apply to the proximal axial walls into its desired position. After full adaptation and saturation, light cure for 3 – 5 seconds.
Premise Indirect / Construct
Apply Construct Resin in small increments 1 – 2 mm at a time. Wrap around the periphery. After each adaptation and saturation of the fiber, light cure for 3 – 5 seconds.
Wrap around the entire periphery. Light cure little and often.
Premise Indirect / Construct
After full adaptation overlay by 0.1 – 0.2 mm and cut the fiber. Light cure 3 – 5 seconds.
Measure a length of Construct for the occlusal surface.
Premise Indirect / Construct
Apply Construct as before and light cure 3 – 5 seconds. Once completed light cure all aspects for 20 seconds.
Continue layering of the crown to final completed restoration.
Premise Indirect
Continued improvements over the years with our indirect restorative line has resulted in superior handling characteristics as well as exceptional polishability.
Please refer to the complete Directions for Use for more information.
Visit www.kerrlab.com for more information.
Premise Indirect / Cases
Clinical and laboratory work © Pascal Magne, PHD, DMD
Premise Indirect / Cases
Clinical and laboratory work © Pascal Magne, PHD, DMD
Premise Indirect / Cases
Clinical and laboratory work © Pascal Magne, PHD, DMD
Premise Indirect / Cases
Clinical and laboratory work © Pascal Magne, PHD, DMD
Premise Indirect / Cases
Clinical and laboratory work © Pascal Magne, PHD, DMD
Premise Indirect / Cases
Clinical and laboratory work © Pascal Magne, PHD, DMD
Premise Indirect / Cases
Case by Gary Radz DDS
Premise Indirect / Cases
No Prep Veneers, using Premise Indirect and Nexus NX3 Laboratory work by Mizrachi Dental Lab
Premise Indirect / Cases
Laboratory work by David M. Zielinski CDT, FNBC
Premise Indirect / Biomimetics
Biomimetic refers to human-made processes, substances, devices or systems that imitate nature.
Burs on a dog’s coat led to the invention of Velcro.
Premise Indirect / Biomimetics
The art and science of deg and building biomimetic apparatus is called biomimetics.
Replicating the water repellant nature of certain leaves in the manufacturing of paint.
Premise Indirect / Nanotechnology
Nanotechnology involves the creation and manipulation of complex structures on the scale of nanometers – something organisms have done for about 3.8 billion years.
The ideal nanohybrid restorative that ages, feels, wears, functions and looks like a natural tooth.
Premise Indirect / Features
The result of science born from the success of Heruculite XRV™, belleGlass™NG and Premise™.
Premise Indirect™ utilizes the same optimized trimodal polymerization as belleGlass NG, the most respected indirect restorative of its kind.
Indications: Inlays, onlays, crowns, veneers, bridges, splints and ideal for implant restorations with proprioceptive tooth-like response.
Premise Indirect / Features
Natural look and wear. Closely matches natural dentition in wear characteristics, as well as an opalescent appearance that virtually replicates natural enamel like no other restorative material.
Performance. Trimodal curing (light, heat and pressure) achieves over 98% material conversion, as compared to 60 – 70% achieved with light-cure only materials.
Proven History. Twelve years of positive clinical history, and tens of thousands of successful restorations placed since 1996.
Premise Indirect / Research
Nanohybrid technology. The combination of large prepolymerized filler (PPF) particles, 0.4 micron structural filler and small silica nanoparticles allows higher filler loading, improved physical properties, optimal handling, higher surface gloss and reduced polymerization shrinkage.
Prepolymerized filler
Point 4 filler
Silica nanoparticles
Premise Indirect / Research SEM OF FILLER PARTICLES Fig: Field Emission Microscope photo 50,000X; Submicron Hybrid filler (67%), 50 nm Discrete Silica particles (33%)
Premise Indirect / Research
High gloss retention. The particle size of fillers in PPF particles is below the wavelength of visible light and light-scattering effects are minimal. Plucking of PPF particles is reduced because mechanical properties are more similar to the cured paste number rather than ceramic particles.
Cured traditional composites wear unevenly causing a loss of luster and gloss.
Premise Indirect PPF particles wear more uniformly, wear resistance is improved and surface remains smoother and glossier with time.
Premise Indirect / Research
In-vivo measurements of wear over a five year period shows an average of 1.2 microns a year – closer to the wear of natural teeth than any other material tested.
Premise Indirect / Research
Premise Indirect more closely matches the coefficient of thermal expansion (CTE) of natural dentin – resulting in a material that looks and acts virtually the same as natural tooth structure.
Premise Indirect / Research
Premise Indirect vs. belleGlass NG Increased chroma and opacity in the Facial Dentins, allowing for better shading when used with metal reinforced C&B restorations. belleGlass Translucent Dentins were highly translucent and created a darker shade due to the inability to completely mask the metal.
Premise Indirect / Research Q. How is Premise Indirect different from belleGlass? A.Premise Indirect provides increased chroma in the facial dentin shades to improve shading over metal, as well as new fillers. Q. Can Premise Indirect be used or repaired with Premise Indirect or flowable? A.Premise Indirect can be repaired intraorally with any Premise family direct composite. Premise direct or flowable should not be used in the preparation of the indirect restoration. Q. I have a belleGlass customer. Do they need to buy the new equipment to use Premise Indirect? A.No. Premise Indirect cures using the same methods of light, heat and pressure as belleGlass NG. Q. Does Premise Indirect work with belleGlass? A. Yes, While the shading is enhanced on Premise Indirect, the technique is the same.
Premise Indirect / Research
Q. Do I have to use the curing unit to cure Premise Indirect? R. Yes. As with belleGlass, polymerization of the metal is achieved by a tack cure with the light and then a final cure in the curing unit. Q. Are you discontinuing belleGlass? A. Yes, belleGlass will continue to be sold until supplies are exhausted. s of belleGlass refills can continue to use until the expiration date. Q. I have a customer who uses another brand of indirect material. Can they use their curing unit with our material? A. No. The customer will need to use our Curing Unit to ensure they are getting a proper cure, and complete conversion.
Premise Indirect / Research Dia. Tens. Str.Mpa (sd)
Comp. Str.Mpa(sd)
Flex Str. Mpa(sd)
Flex Mod. Mpa(sd)
Fracture Resist. MPam1/2(sd)
Resistance to Bulk Fracture
56 (4) 50 (10) 50 (10)
370 (28) 450 (60) 510 (10)
158 (11) 150 (30) 150 (10)
21,000 (1400) 11,100 (200) 10,900 (300)
1.48 (0.09) 1.1 (0.1) 1.1 (0.1)
Yes Yes Yes
48 (8)
395 (20)
136 (9) 126 (21)
12,700 (400) 10,500 (300)
1.13 (0.16)
Yes yes
Cristobal+ Opaceous Dentin Incisal
49 (6) 66 (10)
450 (38) 473 (19)
179 (11) 156 (20)
13,000 (400) 12,000 (200)
1.14 (0.27) 1.22 (0.09)
Yes Yes
Estenia Dentin Enamel
60 (9) 66 (4)
441 (60) > 500
155 (13) 136 (18)
16,129 (601) 17,980 (715)
1.27 (0.2) 1.19 (0.09)
Yes Yes
Sinfony Dentin Enamel
63 (3) 66 (4)
430 (18) 457 (43)
89 (8) 89 (3)
3,557 (338) 3,219 (228)
1.12 (0.05) 1.31 (0.08)
No No
Adoro Dentin
55 (2)
414 (20)
117 (19)
6,297 (808)
1.07 (0.09)
Gradia Dentin
57 (5)
403 (6)
103 (10)
5,995 (214)
1.21 (0.05)
Ceramage Dentin
57 (3)
321 (12)
143 (13)
9,407 (237)
1.39 (0.11)
Premise Indirect Primary Dentin Facial Dentin Incisal Sculpture+ Dentin Enamel
Premise Indirect / Research Rockwell 15 T Hard
CTE Ppm/Deg.C(sd)
Wt. % Filler (Vol. %)
Vol% Shrink.(sd)
Equilibrium Gloss 60°
High Clinical Gloss
89.1 (1.0) 84.0 (0.7) 87 (0.8)
13.1 (0.7) 28.6 (1.4) 33.9 (0.8)
87.1 (72.5) 78 (63) 77 (70)
0.94 (0.1) 2.3 (0.2) 2.3 (0.3)
14
No Yes Yes
78.7
24.0 (1.4)
78.7
2.62 (1.4)
Cristobal+ Opaceous Dentin Incisal
87.8 (0.2) 86.4 (1.0)
27.0 (1.0)
75.1 73
3.26 (0.3) 2.91 (0.10)
15
No No
Estenia Dentin Enamel
93 (0.4) 93.9 (0.2)
15.3 (2.8) 13.7 (1.1)
86.8 (72.4) 88.2
1.55 (0.15) 1.62 (0.07)
21
No No
Sinfony Dentin Enamel
51.5 (1.3) 56.6 (1.2)
62.6 (3.0) 68.6 (1.5)
44.7 44.7
4.53 (0.04) 4.62 (0.3)
44
Yes Yes
Premise Indirect Primary Dentin Facial Dentin Incisal Sculpture+ Dentin Enamel
No No
Adoro Dentin
73 (1.2)
2.41 (0.05)
47
Gradia Dentin
73 (0.6)
2.48 (0.09)
17
Ceramage Dentin
80 (1.2)
2.38 (0.26)
46
Premise Indirect / Research / Gloss Retention
Figure 1a: Surface gloss under 60º reflected light, BG Exp. vs. CB+ Inc.
Figure 1b: Surface gloss under 60º reflected light, BG Exp. vs. HM
Figure1c: Surface gloss under 60º reflected light, BG Exp. vs. E En.
Figure 1d: Surface gloss under 60º reflected light, BG Exp. vs. SF En.
Premise Indirect / Research / Gloss Retention PURPOSE: Compare the surface luster, after long-term tooth brushing, of an experimental small particle hybrid indirect composite resin versus several hybrid and microfill resins of known clinical luster. Gloss vs. Time BelleGlass Experimental
Estenia Enamel
Heliomolar
Sinfony Enamel
Cristobal + Incisal
100.00
Y = a + be-X (Y = 60 º Gloss (%), a = Equilibrium Gloss (%), b = constant) 90.00
G loss (P ercent)
80.00 70.00 60.00 50.00 40.00 30.00 20.00 10.00 0.00 0
2
4
6
8
10
12
14
16
Time (Hour)
CONCLUSION: The stable higher surface gloss of the B.G. Exp. After tooth- brushing suggests that a clinically stable gloss by a hybrid composite may be possible. V. Bui, A. Kobashigawa, and D. Tobia: “ Surface Luster of a New Indirect Composite Resin. “ J. Dent. Res. Special Issue Abst. # 621, March 2003
Premise Indirect / Research INTERNAL BONDING - SANDBLASTED AND HF ETCHED SURFACES
Vita Porcelain
Premise Indirect XRV
Premise Indirect / Systems
Intro System
Master System
Starter system offering everything needed for Inlays and Onlays.
Complete system offering everything needed for Inlays to full bridges.
Premise Indirect / Materials
Primary Dentins are used for foundation and coping layers and improve strength.
Facial Dentins cover all foundation and coping layers to produce a stable long lived polished surface.
Incisals are placed onto the incisal / cuspal area and are designed to match the vitality of tooth enamel.
Premise Indirect / Materials
Modeling Resin is an unfilled universal wetting agent used for sculpturing.
Opaques are applied after metal prep and block out any underlying metal color.
Cervicals simulate root and cervical color,
Rubber Sep is a removable latex release agent and spacer applied to all dies and areas creating a 20 micron space.
Silane Primer is applied to the fitting surface of any metal free restoration prior to bonding.
Kolor Plus is applied internally to add effect on occlusal and interproximal surfaces.
Premise Indirect / Materials Premise Indirect Gingival Shades The simulation of lost soft tissue on implant reconstructions. Two new gingival tissue shade kits, including a gingival and opaque in light and dark pink.
Premise Indirect / Inlays & Onlays When layering note that maximum Facial Dentin thickness should not exceed 1.5 mm.
Primary
Facial
Incisal
Premise Indirect / Inlays & Onlays
If desired, duplicate the working die and articulate. Isolate adjacent tooth points and opposing dentition with Rubber Sep. Prepare the model and working die. Block out all undercuts.
Apply a thin layer of Primary Dentin into the floor and axial walls and adapt to the desired contour. Finish slightly short of the marginal periphery. Apply Kolor Plus to modify the occlusal color if needed. Light cure all aspects for 20 seconds.
Premise Indirect / Inlays & Onlays
Adapt Facial Dentin in small increments to desired contour. Continuously occlusal clearance. Work one cusp at a time. Apply Kolor Plus modifier to simulate occlusal staining. Light cure each increment for 10 seconds.
Finalize the occlusal scheme with Cuspal / Incisal to desired contour. Remove the die from the working model. Add areas if needed. Light cure all aspects for 20 seconds. Polymerize for 20 minutes in the curing unit. Remove the restoration from the die as soon as possible after full polymerization.
Premise Indirect / Inlays & Onlays
The completed restoration after polishing.
Premise Indirect / Crowns & Veneers When layering note that maximum Facial Dentin thickness should not exceed 1.5 mm.
Primary
Facial
Incisal
Premise Indirect / Crowns & Veneers
If desired, duplicate the working die and articulate. Isolate adjacent tooth points with Rubber Sep.
Prepare the model and working die.
Apply Primary Dentin and contour to the desired shape. Finish slightly short of the marginal periphery. Light cure each aspect for 20 seconds.
Premise Indirect / Crowns & Veneers
Adapt Facial Dentin onto the margin for precision fit.
Adapt Facial Dentin to the desired contour. Repeat on all aspects. Light cure at frequent intervals. Once final contour has been achieved, light cure all aspects for 20 seconds.
Premise Indirect / Crowns & Veneers
Adapt Incisal material in small increments. Light cure each increment for 10 seconds.
Finalize contour at the incisal edge. Create a restoration that is slightly longer than the tooth being replicated. (This allows for correct morphology after polishing procedures). Remove the die from the working model. Add areas. Light cure all aspects for 20 seconds.
Premise Indirect / Crowns & Veneers
Polymerize for 20 minutes in the curing unit. Remove the restoration from the die as soon as possible after full polymerization.
The completed restoration after polishing.
Premise Indirect / Metal Restorations
Premise Indirect can be incorporated onto any recommended dental alloy. Use of mechanical retention is recommended. Metal frameworks should incorporate smooth rounded edges especially for incisal and occlusal areas. Produce a framework thickness of 0.3 – 0.5 mm. For bridges, design the framework for correct placement of pontics and connectors. Ensure adequate space for veneering material.
Primary
Facial
Incisal
Metal
Opaque
Premise Indirect / Metal Restorations
Wax to full contour.
Assess available space.
Remove waxed crown.
Trim framework to desired shape.
Premise Indirect / Metal Restorations
Ideal margin space.
Trim and polish backings before applying material.
Rounded and smoothed.
Rounded and smoothed.
Premise Indirect / Metal Restorations
To achieve maximum bond strength, it is essential to ensure cleanliness of the metal.
Sandblast all veneering areas with 50 micron Aluminum Oxide at no more than 2 bar (30 PSI) pressure.
After cleaning, apply Metal Prep with an applicator brush or directly from the bottle.
Premise Indirect / Metal Restorations
All veneering areas are covered with Metal Prep. Allow to fully dry approximately 1 minute. Blast excess metal prep off with compressed air at 1 bar (15 PSI) pressure.
Apply Opaque to a final thickness of 0.1 – 0.2 mm. Ensure that there are no visible grey areas. This may require 2 – 3 applications. Light cure each opaque layer for 40 seconds per surface. Create a first wash Opaque. If desired, mix a small amount of Modeling Resin with Opaque.
Premise Indirect / Metal Restorations
If desired, modify Opaque shades with Kolor Plus.
Orange modifier is ideal for cervical areas or for producing a warmer color.
Premise Indirect / Metal Restorations
Wash application of Opaque with cervical area completed. Light cure each layer for 40 seconds.
Complete masking of the underlying metal framework. Note a slight surface shine.
Premise Indirect / Construct
Construct reinforcing braid is the ideal “building block”. It has a patented weave designed for more complete resin wetting. • Delivers superior strength and toughness • Made from polyethylene fiber • Cold gas plasma treated • Three widths available • Three times stronger than steel • Impregnated with Silane and Resin • Available in three shades, one neutral and two opaque shades designed to eliminate “shine through”.
Premise Indirect / Construct
Indications (Lab) • Single-unit posterior crowns • Posterior bridges • Anterior bridges • Selected anterior single crowns • Selected Inlays and Onlays
Guidelines • Assess all prescribed cases to ensure a successful outcome. • Always use the largest width of Construct fiber available. • Ensure complete wetting of the fiber with Construct Resin. • Keep the design of frameworks as simple as possible.
Premise Indirect / Construct
Common indications by Dentist • Splint loose teeth together • Connect teeth that have tissue / bone loss (usually lower anteriors) • Make single tooth temporaries with stock teeth for upper anteriors • Reinforce broken dentures (repairs) • Hold temporaries together while final restorations are being done in the lab
Premise Indirect / Construct Before / Splint
Before / Bridge
After
After
Premise Indirect / Construct PURPOSE: In this study, the apparent flexural strength (FS) and fracture toughness K 1C of a fiber reinforced composite resin laminate, Connect TMbelleGlassTM, was measured and compared to that of the unreinforced composite. RESULTS: The mean FS of unreinforced belleGlass was 126 (15) MPa and the apparent FS of the single ply Connect laminate was 335 (36) MPa. The mean K 1C of unreinforced belleGlass was 1.48 (0.09) MPa(m)1/2 and the apparent K1C of the single ply Connect laminate was 12.9 (1.0) MPa(m)1/2. ANOVA analysis of the means (p<0.05) indicate that the laminate substructures were significantly higher in FS and K1C than the unreinforced substructures. CONCLUSION: The data indicate that fiber reinforcement by Connect ribbon significantly improves strength and crack arresting properties of composite resin substructures.
A.I. Kobashigawa* and E. Shellard; “Crack Arresting Properties of a Fiber Reinforced Composite Resin Laminate.”; J. Dent. Res. V. 79 Special Issue Abst. # 289, Apr. 2000
Premise Indirect / Construct Fig. 1: Flexural Bar Connect Laminate. Note Deflection of Specimen Without Failure.
Fig. 2a: Fracture Toughness Bar Before Loading.
Fig. 2b: Fracture Toughness Bar in 3 Point Load. Note Complete Arrest of Crack by Single Ply of Connect.
Premise Indirect / Construct Effect Of Fiber Reinforcement On The Breaking Strength Of Crowns, C.A. MunozViveros, et al., Abst.#1177 J. Dent. Res. 77 Special Issue B, June, 1998). PURPOSE: This study evaluated the effect of fiber reinforcement on the breaking strength of two commercially available fiber reinforced systems: belleGlass TM (Kerr Corp.) and Targis/VectrisTM (Ivoclar Corp.). RESULTS: __________________________________________________________
Mean Kg. Group A 252 Group B 264 Group C 248
45 49 38
SD 4
Comp. Fract. 2
2 3
Tooth Fiber Fract. Interface 4
3 0
5 7_______
Group A: Belleglass/Connect (axial wall); Group B: Belleglass/ Connect (axial + occlusal wall); Group C: Targis/Vectris.
CONCLUSION: Within the design of this study and under the Conditions used, there was no difference in breaking strength for fiber Reinforced crowns made of belleGlass TM or Targis/VectrisTM.
Premise Indirect / Construct
Prepare the model and working die.
Asses size and area of the preparation. Forma a flat disc of Primary Dentin 0.5 – 0.6 mm thick.
Premise Indirect / Construct
Apply the disc to the occlusal surface and adapt excess material over the axial walls to form a coping. Finish short of the margin periphery. Light cure each aspect for 20 seconds. The ideal coping thickness is 0.2 mm.
Construct needs to be wrapped around the periphery of the preparation. Apply to the occlusal surface if space permits. Follow the preparations contour for optimal placement. Using Construct scissors, cut a length of fiber. Wet one end of the fiber with Construct Resin. Apply to the proximal axial walls into its desired position. After full adaptation and saturation, light cure for 3 – 5 seconds.
Premise Indirect / Construct
Apply Construct Resin in small increments 1 – 2 mm at a time. Wrap around the periphery. After each adaptation and saturation of the fiber, light cure for 3 – 5 seconds.
Wrap around the entire periphery. Light cure little and often.
Premise Indirect / Construct
After full adaptation overlay by 0.1 – 0.2 mm and cut the fiber. Light cure 3 – 5 seconds.
Measure a length of Construct for the occlusal surface.
Premise Indirect / Construct
Apply Construct as before and light cure 3 – 5 seconds. Once completed light cure all aspects for 20 seconds.
Continue layering of the crown to final completed restoration.
Premise Indirect
Continued improvements over the years with our indirect restorative line has resulted in superior handling characteristics as well as exceptional polishability.
Please refer to the complete Directions for Use for more information.
Visit www.kerrlab.com for more information.
Premise Indirect / Cases
Clinical and laboratory work © Pascal Magne, PHD, DMD
Premise Indirect / Cases
Clinical and laboratory work © Pascal Magne, PHD, DMD
Premise Indirect / Cases
Clinical and laboratory work © Pascal Magne, PHD, DMD
Premise Indirect / Cases
Clinical and laboratory work © Pascal Magne, PHD, DMD
Premise Indirect / Cases
Clinical and laboratory work © Pascal Magne, PHD, DMD
Premise Indirect / Cases
Clinical and laboratory work © Pascal Magne, PHD, DMD
Premise Indirect / Cases
Case by Gary Radz DDS
Premise Indirect / Cases
No Prep Veneers, using Premise Indirect and Nexus NX3 Laboratory work by Mizrachi Dental Lab
Premise Indirect / Cases
Laboratory work by David M. Zielinski CDT, FNBC
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