Cementation of Esthetic Inlays/Onlays - PDF

Cementation of esthetic inlays/onlays Semmelweis University Department of Restorative Dentistry and Endodontics Version: 02.2023 Steps of ce...

Cementation of esthetic inlays/onlays Semmelweis University Department of Restorative Dentistry and Endodontics Version: 02.2023 Steps of cementation (composite / Additional information ceramic material) DID 1 Check the onlay on the articulator Check the marginal seal, occlusion, contact points and the (In case it is not a cad/cam restoration) anatomical shape 2 Remove temporary filling with a probe No drilling, the prepared cavity should not be damaged 2 3 Clean the cavity With benzine or fluoride free-polishing paste (fluoride inhibits adhesive bonding) 4 Check the onlay in the prepared cavity The onlay can be placed on an instrument for insertion (with first without a rubber dam. Make adhesive or wax). Check the marginal seal and integrity with a corrections if necessary. probe, contact points with floss. If the onlay does not fit due to tight contact points they can be adjusted with a polishing disk or diamond finishing bur. No occlusal control (fracture risk!) 5 Absolute isolation (rubber dam) The neighbouring teeth should be included. (Avoid placing the 9,15am Newone clamp on the prepared tooth if possible). 6 Matrix+ wedge or teflon tape Polyester strips + plastic wedges. If using teflon tape, no wedge is needed and in this case, the of p.TTtstiptatsectteeth adhesive cement excess has to be cleaned with superfloss from the plasticwerge bigwoodsmaller interproximal areas before light curing! Fillingter incisors 7 Re-inserting the onlay (with rubber dam) Make sure that the rubberdam, polyester strips, wedges or teflon don’t hinder the insertion 8 Pre-treatment of inner surface of the Always follow the manufacturer’s instructions for the material. onlay  concentration ofacid Press-ceramic e.g. Ivoclar e.max: 5% hydrofluoric acid for 20 seconds, and silanization. We rinse the acid over a cup, far from the patient. Always wear goggles, because the fluoric acid is highly corrosive. Composite: sandblasting. Nohydroflavi and Gaitjihagen 0 The particle size is: 25-100 microns. Pressure: 1-2.5 bar. shareBlasting for 10 seconds, 1 cm away from the onlay. Silane is O applied. Dry with air syringe or warm air (wait at least 1-2 mins till fully dry). The treated surface should not be touched after this point. 9 Pre-treatment of the prepared cavity Again, always follow the manufacturer’s instructions. The pre- treatment of the cavity depends on the type of the adhesive cement. If the solvent is acetone, wet-bond technique is used (dentin should not be dried completely because it impairs the adhesive bond quality) tooth surface defendsthe material selective etching theme wingtiitis remove theexcess  O Dual curing resin cement Self-adhesive dual curing resin cement Etch and rinse Self-etch 1. 35-37% phosphoric acid 1. Primer + bond application (1 or 2 1. Selective enamel etching (dentin: 15-20 sec, steps, depending on the system for 15 sec. enamel: 30-40 sec) used). Bond activator or light 2. Application of self- 2. Primer + bond (1 or 2 curing (LC). (No additional adhesive dual curing steps, depending on the etching is needed!) adhesive cement. (No system used). Sometimes 2. Application of dual-curing resin additional etching is an activator is added to cement needed!) the bond- in these cases we do not light cure (LC) E.g.: OptiBond All-in-one (LC) + For this technique it is forbidden to it. Nexus 3 adhesive resin cement (wet use a separate bonding material 3. Application of dual curing bonding) because it would hinder the self- resin cement. etching process! 4. E.g.: OptiBond Solo (LC)+ Nexus 3 adhesive cement This type of cement is used in the (wet bonding) student practice 10 f Insert the onlay into the E.g.: MaxCem Elite, Speed Cem 2 Make sure that it’s firmly in place but without excessive pressure prepared cavity 11 Remove excess cement Once the cement has entered the gel phase (1-2 min), the probe is used to remove the excess. For self-etch or self-adhesive dual curing cement, wait until the self-etching process is finished. If teflon tape is used instead of polyesther strips, you can use superfloss to remove the excess from the proximal spaces. The onlay must be held in place at all times, don’t move it! 12 Polymerisation Only light cure after the excess cement has been removed! Should be light cured from each direction for at least 40 seconds. In case of vital teeth, make sure you don’t overheat the pulp (take breaks, cool the tooth with air). Prior to light curing you can use glycerol gel along the marginal seals to prevent oxygen inhibition. 13 Rubberdam removal, checking And also check articulation movements! Corrections can be done with yellow occlusion, correction if needed or red diamond burs 14 Finishing, polishing Finishing: yellow / red diamond, Arkansas stone, Soflex discs. Polishing: rubber (specific rubber polisher for ceramic)