editorial contents -...

No 6/2005, February

An innovative Magazine for Dentists from 3M Espe

Editorial Contents

Dear Readers,

“Challenge Interfaces” was the umbrella topic of

the international 3M ESPE Dental Innovation

Symposium, which recently took place in Munich.

About 150 experts from more than 30 different

countries discussed state-of-the-art and future

challenges on the interactions with dental materi-

als. You can read more about this meeting in this

magazine. In addition, a CD-ROM documenta-

tion picturing all the lectures given during this

international meeting will be published in 2005.

“Challenge interfaces” may also be the headline

when developing new products: the flow beha-

viour of impression materials on moist surfaces in

the oral cavity, the bonding of dental materials to

the tooth structure or the interaction of final re-

storations with the patients’ environment are

always raising the bar for developers. You can

also read in this edition how well they met these

challenges with our new fast setting Polyether im-

pression material. Not only when you introduce

such new products into your daily practice, you

have to deal with change management. You will

find more about that in the Dental Practice

Forum. Last but not least, we want to invite you

to visit us at the IDS in Cologne, the biggest den-

tal exhibition world wide.

Enjoy reading!

Gerhard Kultermann, Editor

3M ESPE, Seefeld, Germany

Editorial & Contents 1

Zen or the Art to Make an Impression 2

Facing Hypersensitive Teeth? Simply Seal It! 4

Host to the Scientific Elite of the European Dental World 5

How to Improve the Penta™ System? 6

Restoration of Anterior Teeth with Full Ceramic Crowns 8

Composite Core Build-Up on Adhesively Luted Metal Post 10

The “Express” and Easy Way to Impressions! 12

The Best Documentation for an Attractive Smile 14

How to Overcome: “That’s How We’ve always Done It”? 15

General Information 16

The art to make a dental impression ismuch diversified. People will develop withtime their very special technique, mixingwhat they learned at university, duringtheir work as a young dentist and whatthey found to be the best during years intheir own practice.

Recently I had the chance to interview anumber of dentists in Europe. It was amazingto see how many versions of the standardtechniques are used, sometimes with somesurprising and intelligent improvements.

Dental industry offers a number of very dif-ferent and very similar products for dentalimpressions. Main guideline for the industryare the three well-known techniques ormethods:

• Two-step putty/wash• Double mix technique• Monophase

There are of course indications which willfit to the one technique or to the other, but ingeneral dentists decide to use a methodwhich supplies reliable results with highprecision and well fitting final restorations.

As we all know already very small errorsand mistakes in the process can have a sig-nificant effect on the final result and jeopar-dize the whole process.

This is also linked to some financial risks ifa large prosthetic work, a bridge, does not fit.

For this reason, if a reliable process hasbeen found, hardly ever this process will beabandoned.

Personnel in this process are the patient, theassistant, the doctor and the dental technici-an.

Other factors are anesthesia, retraction,sometimes electrosurgery, the preparation,the situation in the mouth and the impres-sion material. If one component or one stepor one person is replaced or malfunctionsthe result of the process is put at risk.

For the patient, preparation work andimpression taking is a stressful situation.For the doctor too, let us think of retractionwith cords, the use of haemostatic agentsand keeping the area dry for the impression.

What maybe most dental workers are loo-king for is serenity or “peace of mind” whentaking an impression.

In technical terms for this would be reliabi-lity, reproducibility, and above all, preci-sion!

3M ESPE has got a long history in impres-sion materials.

In 2004 this history is continued with twonew and major products: Express PentaPutty and Ultra-Light Body, a new productcombination for the putty/wash method(launched in Europe in September 2004)and Impregum Penta Soft Quick (launch inEurope in April 2005) a new material forsmaller prosthetic restorations for themonophase and heavy-body/light-bodytechniques.

Express Penta Putty is a real, rigid, fast set-ting putty material mixed automatically bythe Pentamix™ Automatic Mixing Unit. Themixing is processed by pressing a button.The result is a void free impression mate-rial, mixed with a first-rate precision inmixing ratio therefore always providing thesame working and setting times.

Express Ultra-Light Body is the intelligentwash material (with a very high viscosity)which will stay where it should and flowaway from areas where it should not be.Impressive tear strength and an extraordina-ry hydrophilicity and wettability will sup-port superb results. New molecular structu-res and reinforced siloxane network crea-tion is the basis for these achievements.

2

No 6/2005, February,

Product Information

Zen or the Art to Make an ImpressionLaslo Faith, 3M ESPE, Germany

Express™ Penta™ Putty Vinyl Polysiloxane and Impregum™ Penta™ Quick Polyether Impression Materials

Figure 2: Introductory Kit of the new Express™

Penta™ Putty Vinyl Polysiloxane ImpressionMaterial

Figure 1: Homogeniously mixed material from the Pentamix™ Automatic Mixing Unit

Figure 3: Introductory Kit of the new Impregum™ Penta™ Soft Quick

Impregum™ Penta™ Soft Quick PolyetherImpression Material is the newest productof the Impregum family. This material is afast setting Polyether, offering a significant-ly shorter oral setting time. This saves timeand improves patient comfort. Stunninghydrophilicity (typical for polyethers) com-bined with top-of-the-line precision andremarkable flowability are characteristic ofthis material.

Impressive performance in the sulcus willsupply clear preparation edges on the model.

Archeologists who make copies of tiny bonesof million year old dinosaurs are impressedby the extraordinary detail reproduction ofmicro-structures when they use Impregum.

As we talk about an Impregum product, I donot even need to mention reliability and pre-cision of this material.

Both Express™ and Impregum™ products areused with the new Penta accessories, whichwill become standard for all 3M ESPE Pentaimpression materials in 2005: The improvedred mixing tip, the new reinforced cap foil-bags and the stainless steel Penta cartridges.

The main objective of this change is qualityimprovement: this system shall workalways, under any conditions and with all3M ESPE materials, with a first-rate reliabi-lity and with a robust performance. Thetechnical changes eliminate all potential fai-lure sources and impressively increase theperformance quality of the whole system.

The new system components offer impres-sive design changes regarding all their fea-tures: the system works with less pressure,reduces material fatigue and creates im-proved interfaces between the components.These system components upgrade thePenta system to a quality level which will be industry-standard for the future.

With these two new products and the impro-ved quality components the 3M ESPEimpression material portfolio is going tosupply the basis for relaxed work andexcellent results with no doubtsabout the outcome. So the dentalcommunity shall work inserenity and with success.

3


Product Information

Figure 5: The new steel reinforced cartridge is placed intothe Pentamix™ Automatic Mixing Unit�

Figure 6:Replace used mixing tips directly before eachmixing procedure ❿

What causes tooth hypersensitivity?

Tooth hypersensitivity is caused by fluidmovement in the dentinal tubules. Thismovement can be stimulated by drying,temperature shifts, as well as by compoundssuch as sugar [Brannstrom1) 1986]. Studiesindicate that hypersensitive root surfacescan have eight times as many open tubulesas non-sensitive dentine.

Since the reason for tooth hypersensitivityis the open dentinal tubules, a treatment thatoccludes the open tubules should be effecti-ve in reducing or even eliminating the sen-sitivity.

By scanning electron microscopy (SEM)Adper Prompt L-Pop has proven its abilityto seal dentinal tubules.

Clinical practice based study

The effect of Adper Prompt L-Pop´s sealingability on the reduction of cervical hyper-sensitivities was evaluated in a clinicalstudy that was run in general dental officesin five European countries.

Design of the study

108 patients treated by 22 general dentalpractitioners in five European countries(Germany, France, Italy, Spain, UK) partici-pated in this study. The dentists were askedto score the level of tooth sensitivity foreach patient after exposing the cervical areato tactile (dental probe) and air/water stimu-li. The results were recorded on a VisualAnalog Scale (VAS), ranging from level 1 =no pain to 4 = very painful. Immediatelyafter recording the baseline sensitivityAdper Prompt L-Pop was applied to the cer-vical tooth surface. Following light curingand removal of the oxygen inhibition zonethe sensitivity level was scored again.

Results of the study (Figure 3)

The application of Adper Prompt L-Popresulted in a significant reduction of sensiti-vity. This effect was more evident for theair/water stimuli, as these stimuli generatedalready higher pain scores at baseline.

Correlation with dentine permeability

The clinical results of this practice basedstudy are in line with a dentine permeabilitystudy2 conducted at the University ofRegensburg, Germany. In this study theability of Adper Prompt L-Pop to reducefluid flow in the dentinal tubules was com-pared to several commercial desensitizers.The teeth were subjected to three condi-tions. First, a dry surface with no waterpressure in the pulp chamber. Second, amoist tooth surface, but again no water pres-sure in the pulp chamber. Finally, a test con-dition where pressure was applied to thepulp chamber. Under any condition, AdperPrompt scored highest in its ability to re-duce permeability – and reduced perme-ability means less sensitivity.

Resume

Adper Prompt L-Pop provides an effective,reliable and fast treatment for hypersensiti-ve teeth through a perfect seal of the denti-nal tubules. Patients appreciated that thepositive effect was immediately noticeableand that there was no need for local anaes-thetics. During application of Adper PromptL-Pop there is no reason for pain, as the pro-cedure does not require a seperate phospho-ric acid etching step.

4

Mean tactile before Mean tactile after Mean air/water before Mean air/water after0

0,5

1

1,5

2

2,5

3

3,5

4

ItalyFranceSpainGermanyUK

Pain Level


Product Information

Facing hypersensitive Teeth? Simply seal it!Andreas Syrek, 3M ESPE, Germany

Adper™ Prompt™ L-Pop™ Self-Etch Adhesive: Results of a European Practice Based Study

Figure 1: Open dentinal tubules, lateral view

Figure 2: Sealed dentinal tubules after Adper™

Prompt™ L-Pop™ application, lateral view.[Reference figure 2: UNC data on file]

Adper Prompt L-Pop Seal&Protect Gluma Desensitizer SuperSeal0

10

20

30

40

50

60

70

80

90

dry, no pressuremoist, no pressurepulp pressure simulation

% of dentin permeability reduction

Figure 3: Patients expressed tooth sensitivity of exposed cervical area

Figure 4: Dentine permeability study of University Regensburg, Germany (2) AADR 2003, Abstract 0632Detailed references available through your local

3M ESPE Dental Products office.

The list of participants at the internationalspecialist congress reads like a “Who’sWho” of the European dental world.

3M ESPE invited over 150 scientists andacademics from 32 different countries tothe International Dental Symposium from15th to 16th November in Munich. The focusof the event was the exchange of ideas andexperiences on developments and trends indental practice. A particular highlight wasthe insight given into the projects current-ly underway at the 3M ESPE developmentdepartment on the second day.

The motto of the symposium in Munich was“Challenge Interfaces” – a phrase whichrefers to one of 3M’s core competencies. In his opening presentation, Dr. AlphonsusV. Pocius, corporate scientist from St. Paul,introduced the assembled dental specialiststo the world of adhesive bonds beyond theirapplication in dentistry. Using many exam-ples, he impressively demonstrated the out-standing innovation shown by 3M as regardsthe adhesion of interfaces. For many partici-pants it became obvious that it is not a matter of coincidence that 3M ESPE plays aleading role in the development of new den-tal adhesive materials.

Following this, renowned experts from uni-versities and the 3M ESPE research anddevelopment department discussed, in briefpresentations, the challenges presented bydental interfaces.

A patented future

Some of the contributions dealt with a stillexperimental composite material for directtooth restorations. Thanks to a new chemi-cal – ring-opening silorane – which hasbeen patented by 3M ESPE, composites canbe produced with almost no undesirablevolume shrinkage. Shrinkage occurs withlight polymerisation and should ideally notexceed 1.0%. This goal has already beenachieved in the laboratory with this newmaterial. Clinical testing together with therespective adhesive material is now under-way. Nanotechnology, which is already inuse in the 3M ESPE development depart-ments, also presents great potential for thefuture. Bioactive materials, which, forexample, promote self-healing of the toothand minimally invasive treatment methodshave also been labelled as extremely promi-sing for the future. With a new enzyme solu-tion for selective caries removal without a drill which is still in the developmentstage, 3M ESPE is hot on the trail of thesedevelopments.

To sum up

The International Dental Innovation Sym-posium represents the only objective assess-ment of the state of the art of dental techno-logy of its kind. Once again this year renow-ned speakers from the academic world and3M ESPE presented exciting results and fin-dings. They also exchanged experiences andideas on the best course to take in the deve-lopment of new materials in order to ensurethe optimal well-being of the patient.

5


Scientific Activities in Europe

Host to the Scientific Elite of theEuropean Dental WorldGerhard Kultermann, 3M ESPE, Germany

International Dental Innovation Symposium in Munich:

View from behind into the lecture hall

3M ESPE European Business Director Andreas Dinges(left) with Global Director of Research and DevelopmentDr. Oswald Gasser (right) together with both chairmenProf. Dr. Reinhard Hickel, Munich (2. from left) andProf. Alan Boghosian (USA) (2. from right) are happyabout a successful meeting

Participants looking at a presentation using 3D glasses

Participants informing themselves about 3M ESPE products at the exhibition desk

The purpose of 3M ESPE’s Penta systemimprovement project is to achieve higherquality and reliability of the Penta systemto increase customer satisfaction with gre-ater reliability by offering a more robustmechanical design. This improvement isalso an enabling initiative for new pro-ducts such as Express™ Penta™ Putty, VPSImpression Material with its real puttycharacteristics, the first 3M ESPE automixputty, which was launched very successful-ly in September 2004 and for the new fastsetting Impregum™ Penta™ Soft Quick,Polyether Impression Material, which willbe launched in Europe in April 2005.

What will change technically andwhat will be the improvements?What were the challenges in thisengineering process?

The initiative covers the Penta accessoriesfor use in all Pentamix Mixing Unit.

The improved accessories are:

• A new low force red mixing tip• Coloured foil bag caps and• A stainless steel reinforced cartridge.

The mechanical design of the red mixing tipis completely new with a focus on reductionof application forces in the Pentamix. Thebenefits of this design are a higher perfor-mance level in power and speed of mixing.

The power of a Pentamix is theoreticallysufficent to lift a car.

The new reinforced foil bag caps providesafe and fully reliable use of the system.

Another innovation is the new stainlesssteel tube used as a core of the new Pentacartridge.

This steel tube will deliver better shelf life

and stability for the cartridge.

The biggest challenge was to reduce the for-ces in the Penta system by up to 50%without changing the outer dimensions ofsystem components and without changingthe handling characteristics for the user. Wesuccessfully managed to overcome theseissues supported by a 3D CAD-CAMsystem and of course the knowledge andexperience of our engineers. You may beinterested to know that the new innovativemixing geometry is protected by patents.

How to find out the wishes andneeds of users?

We used the Design for Six Sigma philoso-phy to find out, in our words, the “Voice ofthe Customer”. We conducted interviewswith consultant dentists and did comprehen-sive market research with general practitio-ners.

What are the benefits to the users?

We put a focus on e.g. user friendliness,because of the special design of componentsit is impossible to use them incorrectly – thenew Penta™ Mixing Tip Red will only fit onto the new foil bag caps. So the new redmixing tips fit to the new coloured foil bagcaps and the current white mixing tips to thewhite foil bag caps.

6


Ask the Expert

How to improve the Penta System?Interview with Ingo Wagner, 3M ESPE, Germany

Pentamix™ Automatic Mixing Unit and Penta™ System

Figure 2: The new stee reinforced Penta™

cartridge

Figure 1: Penta™ System product range

The new system supplies highest reliabilityand robustness.

What is the philosophy behind theresearch and development work in3M ESPE?

Our philosophy is to create and developinnovative products and systems for dentalprofessionals with a focus on easy handlingand robust design. We want to support ourcustomers in their daily work in the bestway possible.

How can you make sure that thisconversion will run smoothly andwithout any problems?

Here we also used the Six Sigma process to create comprehensive communication packages and supporting tools for dentistsand dental distributors.

The switch date will be April 1st 2005 inEurope. From that date we will only ship thenew foil bags and steel cartridges.

In order to make the conversion as smoothas possible in the foil bag refills there willbe two new red mixing tips and a Step-by-step information card.

During the conversion period both whiteand red mixing tips will be available in suf-ficient quantities.

The most important message is: If you havea new coloured foil-bag cap, you need anew red mixing tip and only the red oneswill fit.

As long as you have foil bags with whitecaps you need to use the old white mixingtips and only those will fit. It is impossibleto interchange mixing tips or to use them inthe wrong way.

White mixing tips will be available for aslong as necessary.

For existing Penta™ materials the plastic car-tridges can still be used and an immediatereplacement is not necessary. The use of thesteel cartridges is only mandatory for thenew products Express™ Penta™ Putty andImpregum™ Penta™ Soft Quick.

When you order a cartridge as a replace-ment some time after April 1st you willreceive an improved steel cartridge.

7


Ask the Expert

Ingo WagnerMasters degree in mechanical engineering from the University of Karlsruhe/Germany.Joined the company in 1996 starting as an R&D engineer. Inventor of 14 independent dental patents. In charge of the Penta-Pro-grams such as Pentamix 2 and Pentamatic.Current position: Manager of the MechanicalDesign Department, Research and DevelopmentDivision of 3M ESPE. At the moment alsoresponsible for managing the “Penta-SystemImprovement” project.

Figure 3: New Penta™ Red Mixing Tip

Figure 4: Insertion of the Red Penta™ MixingTip into the Pentamix™ Automatic Mixing Unit


Clinical Case Report

Restoration of Anterior Teeth with Full Ceramic CrownsVolker Bonatz; Germany

Lava™ Crowns and Bridges

A young female patient came to my practice as she was unhappywith the appearance of her anterior teeth. The aesthetic findingsclearly show deficits on teeth 11 and 21 (Fig. 1, 2, 3). At the patient’srequest, an improvement in appearance is to be strived for usingonly prosthetic materials. Consequently, correction of the “redwhite aesthetics” will not be carried out. In order to ensure a deli-cate framework design as well as translucent and opalescent pro-perties which are similar to that of teeth, the use of all-ceramicindividual crowns made of zirconium oxide (Lava™) is suggested.

Figure 1:

Initial situation: On examining the anterior teeth situation, in whichthe gingival margin is concealed, the unattractive Class IV mesialcomposite restoration on tooth 11 and the unfavourable colouring ofthe veneer crown on 21 stand out.

Figure 2:

… In the terminal hinge position, the lateral view after exposure ofthe gingival margin clearly shows the overmodelling of the crown.The dark metal framework which shows through the gingiva and thelacking translucency of the prosthetic restoration compared with theadjacent teeth are particularly noticeable.

Figure 3:

In the mirror image from palatal, the way in which the dark metalbase shows through and the lack of transparency are particularlyconspicuous. Due to the level of damage to both teeth, restorationwith two individual crowns is being aimed for.

8

Figure 3 Figure 4

Figure 1

Figure 2



Figure 4:

Conclusion of the preparation: Tooth 21 is devitalised, and, compa-red to 11, has a dark discolouration. Both teeth are prepared with achamfer: the chamfer preparation on tooth 21 follows the contour ofthe margin of the previous crown and thus is significantly subgingi-val.

Figure 5:

Impression with Impregum™ Penta™ H DuoSoft™/L Duosoft™ Poly-ether Impression Material: detail of the impression.

Figure 6:

Trial insertion of the Lava™ frameworks. The frameworks are sub-sequently fixed using an overimpression and veneered in the labo-ratory with Lava™ Ceram veneering ceramic.

Figure 7:

State immediately after cementation with RelyX™ Unicem Self-Adhesive Universal Resin Cement. The natural aesthetic appearanceof the Lava crowns compared with the initial findings stands out inparticular.

Figure 8:

… and 8 weeks after the conclusion of treatment.

9

Figure 8

Figure 7

Figure 6Figure 5

General:

Female patient, approx. 75 years old, treat-ment in March 1999

Treatment:

Core build-up on non-removable metalroot post with an almost round transversesection in tooth 11 with composite, follow-ing adhesive conditioning with Cojet.

Indication:

Restoration of tooth 11 and functioningthereof as a prosthetic abutment

10



Composite Core Build-Up on Adhesively Luted Metal PostMartin Groten, Germany

Cojet ™ Adhesive Repair and Pretreatment Prior to Cementation

Figure 1

Figure 4

Figure 7

Figure 10

Figure 2

Figure 5

Figure 8

Figure 3

Figure 6

Figure 9

Documentation (12 figures):

Figure 1:

Initial situation of the patient’s centralmaxillary incisors. The patient’s oral hygie-ne is good. The crown on tooth 11 is to beremoved and replaced mainly for aestheticreasons; on account of the recession of themarginal gingiva and the extreme discolou-ring of the dentine. A PFM crown was plan-ned as a replacement.

Figure 2:

The post cemented in tooth 11, whichunderwent root treatment, could not be re-moved. Due to its almost round transversesection and its small diameter, it was, howe-ver, not suitable for the application of acrown either. However, when removing thecaries, tooth 11 proved to be suitable as anabutment.

Figure 3:

After the caries had been completely remo-ved, a rubber dam was inserted from tooth13 to 23 to ensure total moisture control. Atthe adjacent teeth 12 and 21, the rubber damwas additionally secured with a light-curedliquid rubber dam (Paint-On Dental Dam,Den-Mat Corporation, Santa Maria, USA).

Figure 4:

The metal surface of the post was complete-ly sandblasted with Cojet™ Sand (3M ESPE,Seefeld, Germany), and thus not only roug-hened, but also silicated. The matt appea-rance, not only of the neighbouring dentine,but also of the rubber dam, indicates thatunintentional sandblasting or at least cove-ring of dust of the neighbouring structures isunavoidable. Blowing away the dust fromthe neighbouring structures should be avoi-ded where possible, as it cannot be guaran-teed that the compressed air applied is freeof water/moisture. Moisture prevents thesuccessful adhesive conditioning of themetal surface.

Figure 5:

The silicated post surface was then selec-tively conditioned using a silane bondingagent (ESPE Sil). The solvent evaporatesvery quickly. The spraying of air should alsobe dispensed with. The silane was applied inseveral thin layers with great care, since thedentine surfaces should remain untouched.They were selectively conditioned at a laterstage.

Figure 6 and 7:

Next, opaquer (Sinfony™ System, 3M ESPE)was applied to the metal and then light poly-merized. Given that the new PFM crown

will be completely opaque, one could havedispensed with the opaquer, and insteadapplied and light cured a resin bonder (e.g.Visio™ Form, 3M ESPE). Prior to the corebuild-up with composite restorative materi-al, the dentine was adhesively prepared inselected areas of the preparation shoulderwith dentine conditioner (Syntac Classic™,Ivoclar-Vivadent, Schaan, Liechtenstein).

Figure 8:

The core build-up was modelled with com-posite restorative material (Tetric™ Ceram,Ivoclar-Vivadent) around the post, at thebase, and into the dentine, and then comple-tely polymerized. Build-up and light poly-merisation occur successively in severalsteps.

Figure 9:

State of the build-up and prepared tooth 11before the restoration will be fitted.

Figure 10:

The finished restoration (single-tooth PFMcrown) on the master cast.

Figure 11:

State of tooth 11 following the fitting of thePFM crown approx. three months after thebuild-up of the abutment tooth with Cojetand Composite restorative material.

Figure 12:

Situation of the central anterior teeth morethan four years after the conclusion of treat-ment. The vestibular recession of the margi-nal periodontium at tooth 11 may be signifi-cant, but does not seem to be due to acuteinflammation of the anterior marginal peri-odontium. As before, the patient’s oralhygiene gives a good impression.

11



Figure 11 Figure 12


User Report

The “Express” and Easy Way to Impressions!Edgar Trübenbach, Germany

Express™ Penta™ Putty and Ultra-Light Body Vinyl Polysiloxane – An Empirical Report –

It's heavy! – this is the first thing that springs to mind once you’veused all your strength hand kneading a putty material. However: for the true putty user, “impression” begins with the almost artisticprocess of kneading so far. As a “die-hard advocate of the two-stepputty wash technique”, I was curious at 3M ESPE’s promise of akneadable material without the kneading. Can a machine mixedimpression material offer all those handling properties being soimportant for us putty users? For example that the material can beinserted into the tray in a ductile form, that doesn’t run, and, can bewell adapted to individual jaw dimensions? Apart from the fact thatthe tray can be “customised”, another critical factor for every puttyuser is that there should be a certain amount of resistance wheninserted.

I would like to report on our practice team’s experiences with thenew Express-Penta Putty and Ultra-Light Body VPS impressionmaterials.

Material and method

We tested the advantages and disadvantages of this automixed VPSfrom the Pentamix™2 Automatic Mixing Unit over a period of fourmonths. As stipulated, the material was processed using the metalreinforced and therefore more pressure-resistant cartridges and thenew Red Penta™ Mixing Tips in the Pentamix 2. We only used rigidtrays with VPS tray adhesive by wearing vinyl gloves. The manu-facturer is declining a working time for both the Express Penta Puttyand Ultra Light Body wash material of 1 min 30 sec from the startof mixing, and a setting time in the mouth of approx. 2 min 30 sec.

These recommended times are based on a temperature of 23 °Celsius. Under warmer conditions these times may decrease,under colder conditions increase. Once taken, the impression mustrest for at least another two hours before being casted with a commercially available special stone plaster.

Results

At last, the practice team were able to fully benefit from the advan-tages of virtually stress-free, automatic mixing, and, not without acertain amount of pride, could present the boss with a perfectlymixed result:

Throughout the impression preparation process there was

• No laborious preparation of the impression material, in fact thefoil bag was ready for use straight away

• No measuring errors with base and catalyst components

• No more removal from containers which are difficult to open, nomore unsightly tubes or blocked dropper bottles

• Totally hygienic format at all times, without potential cross-conta-mination from previous procedures

The mixing procedure of the putty material was as easy as ever, asit is for all other materials mixed with the Pentamix, and did notrequire a long training period.

For loading of the tray, especially under warmer conditions, werecommend to apply Express Penta Putty in the tray in u-shapedmovements. This way, it can be ensured that the application pressureis even. The surface profile soon is smooth and even, and subsequentshaping or contouring of the material is seldom necessary. Thereforeworking time was sufficient to load even Maxi trays reliably.

Assuming you follow the aforementioned rules, while intraoralpositioning of Express Penta Putty an even degree of resistance canbe easily felt, like with most hand mix putties. On account of thegreat pressure exerted, the putty flowed well around the preparedteeth, and gave very good primary impression results, especially inthe sulcal area.

The particularly high ultimate hardness makes this impressionmaterial easy to carve without ragged edges.

12

Having a real putty material from the Pentamix™2 Automatic Mixing Unit is a new experience


The impressions were trimmed more economicallythan usual: only those tags which were undercut or whichtapered off very thinly were removed. This economical trimming ofthe putty impression is possible due to the high performance of thenew Express™ Ultra-Light Body wash material, which even in verythin layers is flowing very smoothly. The wash is dispensed from agun, making application on to the preparation and impression veryeasy and quick. Due to the hydrophilic nature of the material onmoist dentine surface of the abutment, a good material stability anda high tear resistance after setting, even finest tissue structures couldbe visualized very well.

Due to the strong colour contrast between the putty and light-bodywash material, the layer thickness of the wash material was easilyvisible. Also potential distortions while repositioning the firstimpression could be identified.

Discussion and conclusion

Our conclusion after the testing phase:

The Pentamix™ Mixing Unit can be mastered easily even bytrainees following a short period of training

The product combination Express™ Penta™ Putty andExpress™ Ultra-Light Body takes into consideration therequirements for quality management procedures inpractices. The automated delivery systems havemade significant improvement to working

procedures that have resulted in an improvement in the structure andprocess quality of the treatment we offer. With this in mind it hasbeen possible to achieve:

• A constantly homogeneous and completely void-free mixedimpression material of a high quality which can be reproduced inthe portioning you need

• Compared to hand mixing a greatly reduced overall time require-ment for preparation, mixing, disposal of single-use items and

reassembly of the cartridge for reuse, as well as timespent to ensure compliance with hygiene standards

• Less rubbish; thus conserves resources and is kindto the environment

• Material input

Now that testing has been completed, as a “die-hardadvocate of the two-step putty wash technique”, it is my

great pleasure to say that: The Express Penta Putty and ExpressUltra-Light Body product combination will become a permanentfeature in our practice.

13

User Report

The homogenious machine mixed material is easy to carve

Patient profile:

10 years old, male

Diagnosis:

Traumatic fracture in the crown region ofteeth 11 and 12. X-ray examination showedno root fractures. The tooth had a mobilityof 2 on a scale of 0 to 3.

Treatment:

Because treatment was not possible on thefirst session, a plaster impression was made,a cast fabricated and the missing tooth frag-ment was reconstructed with white wax.Then a silicone matrix was fabricated on thebasis of a complete wax-up to make it easyto shape the tooth.

The tooth shades were applied with layersof the Filtek Supreme body shades A1B,A2B and A3B and enamel shades A2E andA3E with multicolour layer technique.

The highest opacity level of the filling mate-rial for the dentine shade (A2D) was selec-ted to reconstruct the dentine core. Shade Gfrom Filtek Supreme was applied over theincisal edges under the layer of enamelshade.

14



The Best Documentation for an Attractive SmileDr. Tomasz Smigiel, Poland

Filtek™ Supreme Universal Restorative

Initial situation

Silicone matrix in situWax-up with silicone matrix

Restoration after two weeks


Change Management in the Dental Surgery

15

The Dental Practice Forum

How to Overcome: “That’s How We’ve always Done It”? Dorothee Heckhausen, Germany

When dentists want to make changes in their surgeries, there is fre-quently a lack of willingness amongst the surgery staff to participa-te actively. There are several reasons for this phenomenon. Timeand again, surgery staff see the management's desire to optimise sur-gery procedures as a criticism of their current work, or they feel, forexample, controlled and patronised by work studies and standards.Even if the surgery team recognises that changes in the work placeare necessary, they are reluctant to give up their favourite, well-esta-blished working methods, which give them a sense of security.

Surgery staff fear that changes to the surgery procedures are notreally an improvement, but lead to more work and a higher errorrate. Perhaps they also feel that they are not equipped professional-ly and personally to meet the new requirements. The surgery teamhas often had negative experiences with previous plans for changesbecause they were imposed without being discussed beforehand.Maybe the surgery staff's concerns were not heeded or takenseriously, or the dental surgery assistants invested a lot of time inplanning an improvement, which was not implemented. A strained,unsupportive and competitive working atmosphere likewise reducesthe staff's willingness to actively participate in implementing chan-ges.

If surgery staff have such concerns, they become defensive, whichmanifests itself, for example, as disinterest or a lack of commitment.The surgery staff do not participate in the development of sensibleplans for changes and do not make any suggestions themselves.Plans for changes are delayed, for example, by constantly findingreasons why they cannot be implemented. Old working proceduresare overrated with the attitude “that’s how we’ve always done it”.

If there is resistance, dentists mostly try to persuade the surgery staffto accept the changes more or less assertively. This dominant beha-viour, which is frequently regarded as pompous, leads to an increa-se in the resistance of the surgery staff to the coming improvements.

It is a good idea to, first of all, create general acceptance of the chan-ges. The owner of the surgery encourages the surgery staff toexpress any concerns or doubts they have regarding the changes anddiscusses the changes openly and seriously with them. This approach strengthens the dentist’s position, increases team spirit,makes everyone think about the necessary changes and highlightspotential difficulties concerning their implementation in good time.

When the aims of the surgery and the necessary measures are plan-ned, agreed and carried out as a team, the surgery staff become acti-ve participants in the process of change. The team compiles a realis-tic schedule and must not take on too much at once. Exact plans ofaction, including the responsibilities that go with them, are develo-ped. Conflicts, concerns and discontent - a normal part of any pro-cess of change – are dealt with promptly and are brought up at regu-lar team meetings.

The achievements of the team are highlighted again and again andthen areas are addressed where further endeavours are necessary.This resource-orientated approach raises the team's self-confidenceand motivates the members to make more effort. It must be ensuredthat the surgery staff are professionally, personally and practicallyequipped to implement plans for change, for example by means offurther training.

Change management – a matter of survival for the dragon fly


General Information

Calendar of Events 2005Datum Event Ort Website / Veranstalter

03.03.2005 www.targi.krakow.pl05.03.2005 KRAKDENT 2005 Krakow Targi Krakow

09.03.2005 www.iadr.com12.03.2005 IADR/AADR General Session Baltimore IADR/AADR

10.03.2005 www.bellacenter.dk12.03.2005 Scandefa Kopenhagen Bella Center S/A

17.03.2005 www.saldent.mtp.pl19.03.2005 saldent Poznan Internationale Messe Poznan GmbH

05.04.2005 Stomatology Uzbekistan 2005 www.itesa-osiyo.uz07.04.2005 and 1st Tashkent Tashkent ITE Uzbekistan

International Dental Forum

12.04.2005 www.ids-cologne.de16.04.2005 IDS - Internationale Dental-Schau Köln VDDI

19.05.2005 WID Wiener Internationale www.wid-dental.at21.05.2005 Dentalausstellung Wien Österreichischer Dentalverband

19.05.2005 British Dental Conference www.bda-events.org21.05.2005 & Exhibition Glasgow British Dental Dental Association

01.06.2005 www.messe.ch03.06.2005 Swiss International Basel Prodonta SA

Editorial Information

Published by:3M ESPE AGESPE Platz82229 SeefeldGermanyTelephone:+49 (0)8152/700-0Telefax:+49 (0)8152/700-1586E-Mail: [email protected]:http://www.3mespe.com

Editor:Gerhard Kultermann

Editorial team:Keith R. Haig, Dieter Klasmeier, Annika Meyer, Markus Roepke, Laurence Settekorn, Inge Schwientek

Coordination:Laurence Settekorn

Final editing and production:Markus Roepke

Design and typesetting:Attila SirmanDigital Consulting, Munich

Global circulation:100,000

We accept no liability for unsolicitedmanuscripts or photographs.Court of Jurisdiction: Munich

© 3M ESPE AG, Seefeld, 2005

Your Partner for Dental Professionals

You can find following 3M ESPE Boothsat the IDS 2005 in Cologne:

3M ESPE Dentist’s World:Hall 14.2 – Aisle N/OBooth Number 10/11

3M ESPE Dental Technician’s World:Hall 14.2 – Aisle L/MBooth Number 50/51

3M ESPE AG

ESPE Platz, 82229 Seefeld, GermanyTelephone: +49(0)8152/700-0 • Telefax: +49(0)8152/700-1586E-Mail: [email protected] • Internet: http://www.3mespe.com

3M, ESPE, Espertise, Express, Impregum, DouSoft,Pentamix, Penta, Adper, Prompt, L-Pop, Lava, RelyX,CoJet, Sinfony, Visio, Filtek, are trademarks of 3M or 3M ESPE AG.

Tetric and Syntac Classic are trademarks of Ivoclar-Vivadent, Schaan, Liechtenstein.

Seal & Protect is a trademark of Dentsply De Tray,Konstanz, Germany.

Gluma Desensitizer is a trademark of Heraeus-Kulzer,Hanau, Germany.

SuperSeal is not a trademark of 3M or 3M ESPE AG.

editorial contents -...

Documents