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Figure 50: Ironically, perhaps the worst thing you can do to clean out zirconia-based crowns after try-in is to use phosphoric acid to clean them. As you might imagine, phosphoric acid is full of phosphate groups, and in your attempt to clean the salivary phosphate groups still bonded to the zirconia, using phosphoric acid will flood the area with phosphates and occupy every receptor site on the zirconia. It is only by flooding the crowns with zirconia oxide that we can decontaminate the internal surfaces in preparation for cementation. Figure 51: Now that we have freed up the bonding sites on the zirconia with the Ivoclean, there is no better way to cement a BruxZir crown than with a cement that contains the same phosphate groups that bond to zirconia. That cement is Ceramir ® (Doxa Dental Inc.; Newport Beach, Calif.). Doxa Dental recently finished its clinical trials with the Dental Advisor to show that Ceramir does in fact bond to BruxZir. Here I am activating the Ceramir capsule in the activator by holding the handle down for three seconds. 50 Figure 52: It’s a good thing I didn’t get rid of my triturator! Next, I place the Ceramir capsule in the 3M ESPE RotoMix capsule mixer for 10 seconds to ensure a complete mix. I know this method of dispensing this cement seems a little 1980s compared to modern paste-paste cements, but I find it to be well worth the little bit of extra effort. Just the ease of cleanup alone makes Ceramir a no-brainer for me. Unlike most resin-modified glass ionomer cements, Ceramir has a “putty” stage that allows you peel it all off in one piece. In fact, my dental assistant never has to call me in anymore to dig out chunks interproximally that have set rock hard. 51 52 32 www.chairsidemagazine.com
Figure 53: I fill the BruxZir crowns with the Ceramir and seat them simultaneously on the preps. Because the Ceramir is so moisture tolerant, I no longer have to vigorously air-dry the preps prior to cementation. Instead, I often just place a few cotton rolls around the preps to remove any pools of moisture. Not having to blast the preps with air anymore, I find that I have to anesthetize far fewer patients for crown seats than before. We use pinewood sticks to ensure that the crowns stay in place while the cement sets, in case there is any soft tissue rebound. 53 Figure 54: Due to Ceramir’s tolerance to moisture, it is OK if the patient’s tongue or saliva hits the cement while it sets. Many BruxZir crown preps tend to be slightly shorter clinical crowns than the ones shown in this case, so having the Ceramir cement bond to the BruxZir crown is a good insurance policy without having to use a silane. As promised, you can see I am able to remove the entire facial surface of excess cement in one piece, followed by the lingual. I then run some Oral-B ® Superfloss ® (Procter & Gamble; Cincinnati, Ohio) interproximally to remove those pieces. 54 Figure 55: Here are the cemented final BruxZir crowns on tooth #8 and #9. Having an in-house technician makes it easier for me to match anterior BruxZir crowns, so I’m not suggesting that you switch to BruxZir for all of your anterior crowns. In fact, I’m going to suggest that you stick with IPS e.max for this type of situation unless you see that the patient has broken other restorations or shows higher-than-average wear. However, it’s becoming clear we are getting closer to having BruxZir Solid Zirconia become the go-to anterior crown & bridge material. CM 55 Photo Essay: The Pursuit of BruxZir Anterior Esthetics33
Page 1: Chairside® A Publication of Glidew
Page 4 and 5: Contents 49 Case Report: The Creati
Page 6 and 7: Letters to the Editor Dear Dr. DiTo
Page 8 and 9: Contributors Michael C. DiTolla, DD
Page 10 and 11: Numbers by the 2 26% Percentage of
Page 12 and 13: Dr. DiTolla’s CLINICAL TIPS PRODU
Page 14: Dr. DiTolla’s CLINICAL TIPS PRODU
Page 17 and 18: Photo Essay The Pursuit of BruxZir
Page 19 and 20: Figure 5: This is the shade taken f
Page 21 and 22: Figure 11: Because of the pressure
Page 23 and 24: Figure 17: On the lingual, I cut th
Page 25 and 26: Figure 23: I make my next depth cut
Page 27 and 28: Figure 29: Toward the end of the pr
Page 29 and 30: Figure 35: The next step of the Rev
Page 31 and 32: Figure 41: The bottom cord provides
Page 33: Figure 47: The BruxZir crowns fit w
Page 39 and 40: Interview with Dr. Dan Fischer - IN
Page 41 and 42: give you one-fourth to one-half tha
Page 43 and 44: ourselves darn hard, it’s still n
Page 45: one job I can think of in Western c
Page 48 and 49: In late 2010, Straumann introduced
Page 50 and 51: Our last step was to select Glidewe
Page 52 and 53: Strassler has written extensively o
Page 54: Dr. Len Boksman formerly was direct
Page 57 and 58: SPEED DENTISTRY Fast Is Better —
Page 59 and 60: apidly would lead to more mistakes
Page 61 and 62: 7. Move faster and have your staff
Page 63: There is no one method for speed de
Page 66 and 67: centrals at the current length or s
Page 68: Retraction cord was used to gently

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