Entries by FGMUS

Combination of techniques for esthetic restorations

Authors: Dr. Leandro Martins, MSc. Verônica Abbud, Dr. Luciana Mendonça

CASE REPORT

22-year-old female patient presented dissatisfaction with color, stains and space between teeth. Good periodontal health was verified, but the upper anterior teeth had white spots, darkening and diastema between the central teeth.

 

TREATMENT

The treatment was planned to start with microabrasion to remove the stains and then external whitening. After 14 days of the external whitening session, the restoration was performed in order to avoid damage to the adhesion. To complete the esthetic rehabilitation, the closure of the diastema was performed with the composite Vittra APS (FGM) on the mesial of the central incisors through the “front wing” technique

 

STEP BY STEP

Initical aspect

Initical aspect

Initial clinical situation showing white spots on the cervical and incisal thirds and the diastema between the upper central incisors.

Microabrasion

The treatment started with microabrasion and shade taking of the central incisors and canines.

During whitening

Appearance after two microabrasion sessions and beginning of the in-office whitening with Wīt HP Maxx (hydrogen peroxide at 35%).

After whitening

Result after 14 days of the whitening session.

Total isolation

Acid etching

Restoration

After total isolation, the teeth were ecthed and the composite was applied to the vestibular face, giving it the desired shape and then completing the restoration.

Restoration

Restoration

Protection of the finished element and composite application to tooth 21 to complete the closing of the diastema.

Polishing

Polishing

Finishing with flexible sand disks, diamond polishing paste and flexible felt disks.

Initical aspect

Final aspect

Initial and final appearance of the case.

Increasing the predictability of ceramic veneers by using a resin cement with APS technology

Authors: Prof. Dr. Carlos Eduardo Francci, Dr. Alexander Cassandri Nishida, et. al.

CASE REPORT

32-year-old male patient presented dissatisfaction with his smile due to several interdental spaces in the upper anterior teeth. The presence of diastemata was noted in the region of the central, lateral and upper canines.

 

TREATMENT 
Due to the search for an immediate solution to the patient’s case and a good oral hygiene condition, ceramic veneers were chosen to improve the smile with: four veneers (12 to 22) and two ceramic fragments (13 and 23).

 

STEP BY STEP

Initial aspect

Initial aspect

Shade taking

Initial condition of the case after supragingival scraping followed by prophylaxis and shade taking.

Mock up

Silicon guide

Mock-up teeth were installed in order to provide the patient with a preview of the final esthetic result, with the possibility of minor adjustments and corrections. The preparations were carried out on the mock-up in position with the aid of silicone guides that allowed the precise and conservative wear necessary for the ceramics. These guides allow checking of the worn thickness in different regions, avoiding the unnecessary removal of healthy structure.

Veneers on plaster model

Veneers on plaster model

Dry proof of veneers

No-prep veneers and ceramic fragments on the plaster model, in vestibular and palatal view, followed by dry proof of pieces for adaptation check.

Etchin of veneer

Adhesive application

Etching teeth

After acid etching, the veneers received and application of silane and the teeth were also etched.

Colorless adhesive

Cement application

The dental adhesive Ambar APS, which is colorless and does not interfere in the final color of the veneers, was applied to the teeth. Then, the cement Allcem Veneer APS was applied to the inner surface of the veneers, which were carefully layed on the teeth. Excess cement was removed with a disposable microapplicator.

Light-curing

Excess removal

Cord removal

Allcem Veneer APS was cured for 40 seconds, then cement excesses and retraction cords were removed.

Initial aspect

Final aspect

Initial and final appearance of the case.

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DENTAL ADHESIVES: QUESTIONS ANSWERED

CONTEMPORARY PROTOCOLS FOR ACID AND DENTAL ADHESIVE APPLICATION

With the increasing number of studies on the preparation of the dental structure for better adhesion of dental materials, new protocols and applications are studied, modifying previous application methods, facilitating clinical steps and offering better results. Following those new trends is decisive for the best use of the modern dental materials and to achieve the best results. Here are the answers for the dentists’ main questions.

Did you know that the duration of the acid etching on the dentin has been decreasing?

Acid etching is believed to have a great demineralization potential, however, there is a lot of difficulty for the dental dental adhesive to penetrate the demineralized dentin. When acid etching is carried out on the dentin, there is also the release of enzymes that degrade collagen fibrils with time. For those reasons, acid etching of the dentin is being phased out. In case you use an dental dental adhesive that requires previous etching with phosphoric acid, we recommend the application on the dentin for a maximum of 5 seconds.

1: Stape THS, Wik P, Mutluay MM, Al-Ani AAS, Tezvergil-Mutluay A. Selective dentin etching: A potential method to improve bonding effectiveness of universal dental adhesives. J Mech Behav Biomed Mater. 2018 Oct;86:14-22. 2: Takamizawa T, Barkmeier WW, Tsujimoto A, Berry TP, Watanabe H, Erickson RL, Latta MA, Miyazaki M. Influence of different etching modes on bond strength and fatigue strength to dentin using universal dental adhesive systems. Dent Mater. 2016 Feb;32(2):e9-21.

Why are these new adhesives called “universal”?

The name comes from the fact that, since those materials have MDP in their composition, it is suggested that they may be used not only as dental adhesive systems for direct restorations but also as ceramic/metallic primer under the piece in indirect restorations. The MDP group bonds with metallic ions available on the surface of metallic and ceramic pieces and achieves a long-lasting adhesion. Nevertheless, it does not mean that the universal dental adhesive has “silane”. There are universal dental adhesives that do, but, in this case, due to their acid pH, there is an inactivation of the silane. In short: universal dental adhesives that contain silane cannot be relied on for this function! FGM’s dental adhesive line does not contain silane in its formula.

1: Perdigão J, Loguercio AD. Universal or Multi-mode Dental adhesives: Why and How? J Adhes Dent. 2014 Apr;16(2):193-4. 2: Yoshihara K, Nagaoka N, Sonoda A, Maruo Y, Makita Y, Okihara T, Irie M, Yoshida Y, Van Meerbeek B. Effectiveness and stability of silane coupling agent incorporated in ‘universal’ dental adhesives. Dent Mater. 2016 Oct;32(10):1218-1225.

How do universal dental adhesives function with dentin that has been affected by cavities or erosion?

Dentin that has been eroded by a tooth decay or frequent ingestion of erosive fluids is always more difficult to be adhered to. However, recent studies have shown that, as this dentin has already been “attacked” and therefore is more porous, phosphoric acid is not necessary. The application of a universal dental adhesive with MDP in the self-etching mode is the best way to achieve adhesion.

1: Hass V, Cardenas A, Siqueira F, Pacheco RR, Zago P, Silva DO, Bandeca MC, Loguercio AD. Bonding Performance of Universal Dental adhesive Systems Applied in Etch-and-Rinse and Self-Etch Strategies on Natural Dentin Caries. Oper Dent. 2019 Sep/Oct;44(5):510520. 2: Siqueira FSF, Cardenas AM, Ocampo JB, Hass V, Bandeca MC, Gomes JC, Reis A, Loguercio AD. Bonding Performance of Universal Dental adhesives to Eroded Dentin. J Adhes Dent. 2018;20(2):121-132.

What would be an alternative for not using phosphoric acid on the dentin?

Use a self-etching dental adhesive, or, a more recent product, a universal dental adhesive. Universal dental adhesives contain acid monomers which make a superficial modification in the smear layer and dentin, forming a hybrid layer that is thinner, but very resistant, which is the same as happens with self-etching dental adhesives. Since a part of those acid monomers (MDP) chemically bond with the calcium in the dentin (MDP phosphate group), it is no longer necessary to etch the dentin. Unfortunately, not many dental adhesives contain MDP. The whole line of FGM dental adhesive does, and that is why it is a great choice!

1: Hass V, Cardenas A, Siqueira F, Pacheco RR, Zago P, Silva DO, Bandeca MC, Loguercio AD. Bonding Performance of Universal Dental adhesive Systems Applied in Etch-and-Rinse and Self-Etch Strategies on Natural Dentin Caries. Oper Dent. 2019 Sep/Oct;44(5):510-520. 2: Siqueira FSF, Cardenas AM, Ocampo JB, Hass V, Bandeca MC, Gomes JC, Reis A, Loguercio AD. Bonding Performance of Universal Dental adhesives to Eroded Dentin. J Adhes Dent. 2018;20(2):121-132. 3: Loguercio AD, Muñoz MA, Luque-Martinez I, Hass V, Reis A, Perdigão J. Does active application of universal dental adhesives to enamel in self-etch mode improve their performance? J Dent. 2015 Sep;43(9):1060-1070. 4: Muñoz MA, Luque-Martinez I, Malaquias P, Hass V, Reis A, Campanha NH, Loguercio AD. In vitro longevity of bonding properties of universal dental adhesives to dentin. Oper Dent. 2015 May-Jun;40(3):282-92.

Is it true that all universal dental adhesives are less susceptible to moisture variations?

It is not true. For the MDP to remain ionized, it is crucial that those materials contain water in their composition. That may lead one to imagine that, if you dry the dentin, the water from the universal dental adhesive would re-moisturize the dentin. On the other hand, if the dentist leaves the cavity too moist and applies an dental adhesive that contains water, there may be excess moist, which would be detrimental for the obtainment of a resistant hybrid layer. That problem may be compensated through different strategies. One of them is in the FGM dental adhesive line: the APS technology. It has already been demonstrated that, with the use of APS dental adhesives, which contain more hydrophilic photoinitiators, higher conversion rates are reached, even when there is a very moist substrate, such as the apical region during the cementation of a fiberglass post. That is an important advantage of the Ambar APS and Ambar Universal APS.

What are the other advantages of the APS technology?

Besides improving polymerization of the Ambar APS and Ambar Universal APS dental adhesives, the APS technology has allowed for the production of a transparent dental adhesive due to the very low concentration of camphorquinone. This is important in esthetic restorations such as veneers and no-prep veneers in which the piece is very thin. The use of a “yellowish” dental adhesive could interfere in the final shade of the restoration. The choice of a transparent dental adhesive such as Ambar APS and Ambar Universal APS facilitates the achievement of excellent esthetic results

1: Oliveira OF Jr, Kunz PVM, Baratto Filho F, Correr GM, Cunha LFD, Gonzaga CC. Influence of PreCuring Different Dental adhesives on the Color Stability of Cemented Thin Ceramic Veneers. Braz Dent J. 2019 Jun;30(3):259-265.

Author: Alessandro Dourado Loguercio

FGM’s whitener gel wins Dental Advisor quality award

Dental Advisor has granted the “preferred product” seal of 2019 to the at- home-whitening gel Wīt Essential (a.k.a. Whiteness Perfect), sales leader of the company.

The rigid process that supports Dental Advisor’s ranking involved 31 consultants who analyzed the product after 242 applications in patients. The Brazilian whitener stood out for items such as its viscosity, whitening speed, easy application and patient’s satisfaction with minimum dental sensitivity. The consultants were also impressed by the good presentation of the kit “with a lot of material and everything you need”, and “excellent results”.

Dental Advisor is known as a “reliable specialist for dental professionals all over the world, with concise, precise and objective information”, combining clinical experience with laboratorial data and reporting the performance of materials in the long term. The publication aims at supplying professionals with information based on evidences and that are clinically relevant about dental restorative products, infection control products and dental equipment.

With 30% of its sales concentrated in exports, present in more than 100 countries, FGM has already been granted other credentials that certify the quality of its products. It is the case of the Obelis seal and the CPNP certificates (Cosmetic Product Notification Portal) and RP (Responsible Person), for European countries, besides the CE – which indicates conformity with medical requirements, according to European directives -, ISO 13.485 (health products Quality Management System), and of the Brazilian Anvisa Certification of Good Manufacture Practices (CBPF).

About FGM

FGM is a reference on the international dental market, manufacturing over 300 items such as dental whiteners, composites, cements, fiber glass posts, implants, biomaterials, restoration finishing and polishing materials, CAD/CAM blocks, etc.

FGM products have transformed millions of smiles in over 100 countries in America, Africa, Asia, Oceania and in the European Community. To broaden its presence, the company is constantly investing in Research and Development, maintaining a close relationship with renowned universities and excellence national and international research centers.

FGM Produtos Odontologicos Press Advisory Office

How to attract more patients to your private office.

Today we are going to talk about “how to attract more patients to your private office”. That is the most frequent question faced by any professional that decides to open a private office. Some professionals search for sales-specialist “gurus” who promise to teach them the miraculous formula that will make their appointment book overflow with […]

Periodontics Specialist clarifies doubts.

In an interview with the Brazilian Odontology Association (ABO) the periodontics specialist José Peixoto Ferrão Jr. talked about diagnosis and treatment. Below are excerpts of that interview: What are periodontal diseases? The periodontal disease is infectious and inflammatory with a chronic character and its origin is bacterial. The disease attacks the gingival tissues and the […]