70
|
CERECDOCTORS.COM
|
QUARTER 2
|
2014
| | |
D I S C U S S I O N F O R U M
water shield and provokes bleeding if not applied under a
rubber dam. Best is Velopex Aquacut Quattro. e.max has
to be sandblasted very shortly with low pressure, if at all.
I usually use OptiBond FL and polymerise both (tooth
and crown); takes some time.
Quicker with RelyX Ultimate and Scotch Universal (no
etch, no silane, but polymerizing both surfaces again). One
debond only (Lava Ultimate).
My guess is the Vaseline, too.
Gary Templeman | Corvallis, Ore.
Vaseline is the big red flag for me, and yes, you
must etch ceramics if you are bonding and not
cementing. Just remember it is generally 60 seconds for the
feldspathic materials, and only 20 seconds for e.max.
Even though it is not recommended, I do air abrade
lightly to remove the object fix and, since I have only had
one de-bond and one fracture in almost four years, I am
not overly concerned about what the lab studies say in
that regard. But, since you are having issues, I would use
a steam cleaner to remove any oil and object fix in the
crown and then etch. However, since the debond is at the
tooth and not the crown interface, I strongly suspect the
Vaseline.
Aaron Tinkle | Portland
Sam, if you are reading this, I think this thread
should be shown at all Accept events. It shows
how awesome this community is. Marc must have spent
20 minutes of his busy day to help someone he probably
has never met. Every person who replied to the original
post took it upon themselves to help a frustrated colleague.
They were all positive comments and none were conde-
scending. I love this community and am so proud to be a
part of it!
Sameer Puri (cerecdoctors.com Founder)
Scottsdale, Ariz.
I’m reading it. I try to read everything. :)
I’m very proud of the CEREC community and how
willing everyone is to help our fellow clinicians. We have
all been in the trenches and not everything always works
out perfect, and it’s nice to know that like-minded individ-
uals are around the corner to help out in times of trouble.
Mustafa Shah-Khan | Charlotte, N.C.
I agree with what everyone has said. Don’t mix
Vaseline with your cement. You will have a lot of
trouble getting it off. If you are having retention issues with
your temps that are leading you to use Durelon, then I would
focus on prep design; that is probably a contributing factor.
Studies will show that even temp bond with Eugenol doesn’t
affect cementation if you have it in place for twoweeks.
Think about extending your crown times so that you
have enough time to deliver on the same day — that is the
beauty of CEREC.
With fractured e.max on second molars, if not a severe
bruxer, you should probably analyze prep design again.
Focus on clearance and not having any sharp angles, as
well as making sure you don’t have significant transitions
from a thin axial wall to a thick spot on the occlusal.
Studies do show that you should not sandblast e.max.
If possible, you may want to take the Spear
Restorative
Design
workshop. It helped me tremendously in under-
standing what is truly necessary in prep design as well as
covering how to cement and bond.
Ernie Johnson | Phoenix
Marc beat me to the punch and said things
extremely well (as always). As I was reading
your posts, so many red flags were going off in my head,
glad he touched on them all.
He is absolutely right; get back to basics and each one of
his paragraphs has a pearl in it.
Doug Sakurai | Santa Ana, Calif.
(In response to Sandra Cove)
Just to be sure, you are mixing A and B and
then applying, and not placing A and then B separately?
Robert Hoffmann | München, Germany
There are a number of “prep toilets”, cleansing
agents. Chemically, those who clean the best
contain acetone. This liquid does not leave any residue and
eliminates fats and oils. (There are many studies related to
bonding brackets after cleaning with acetone.)
I do sandblast and etch to achieve maximum bond with
classical composite cements (not RelyXUnicemof course).
But sandblasting is amess when usedwith devices without