CDE0111

38 I I industry report _ CLEARFIL SA CEMENT cosmeticdentistry 1_2011 in situ. Cement not reached by the light will polymerise within five minutes. Owing to the thinness of the CLEARFIL SA CEMENT layer, the cement will not alter the natural colour of the ceramic restoration. In general, the Universal (A2) colour shade is used. White, which shows a better contrast with the gingiva when re- moving excess material, is used to shield against dark dentine colours or under metal restora- tions. _Clinical case A 65-year-old patient presented with pain in tooth #13. After examination and X-ray analy- sis, profound approximal caries and apical os- teitis were diagnosed. Furthermore, the existing cervical filling showed an insufficient marginal seal (Fig. 1). The neighbouring teeth #12, 11 and 22 had already been treated with ceramic crowns. Tooth #13 first received endodontic treat- ment in several sessions. After all signs of in- flammation had ceased, the root canal was per- manently filled and a provisional crown placed in order to ensure a non-irritated state of the root-canal filling before placing the permanent crown. Prior to definitive stump preparation, the provisional distal and cervical crown parts re- ceived adhesive build-up fillings. For the resto- ration,weusedtheuniversalcompositesCLEARFIL MAJESTY Esthetic and CLEARFIL MAJESTY Flow. Theself-etching,two-stepadhesiveCLEARFILSE BOND was used for the adhesive pre-treatment of the dentine. The preparation was completed and the colour of the crown defined using a VITA shade guide. The impression was taken as a one-step, putty-wash impression. Tooth #13 received a temporary crown until the ceramic crown was inserted.Thetemporarycrownontooth#13was removed and the core thoroughly cleaned di- rectly before the crown was inserted. A retrac- tion cord was used in order to ease the insertion of the crown, as well as for contamination con- trol purposes. The gingiva appeared to be free of any irrita- tion, the resin core was free of any clefts and the preparation margin was exactly and clearly defined (Fig. 2). An IPS e.max Press (Ivoclar Vivadent) crown was provided by the laboratory ready to use (Fig. 3). Try-in showed that the fit was good so that the crown could be inserted permanently.Thecrownwascleanedandtreated according to manufacturer’s instruction. The stump was cleaned with water and any excess water removed (Fig. 2). After fitting the mixing tip, CLEARFIL SA CEMENT in Universal (A2) was directly applied into the crown with the Automix syringe (Fig. 3). CLEARFIL SA CEMENT is supplied bubble free in the container. Ideally, the mixing tip of the Automix syringe should remain in the cement during application in order to avoid incorpo- rating any air bubbles. After application of the cement into the restoration, the dentist has one minute of working time in which to insert the restoration. When cementing inlays, onlays or Fig. 5_After two to five seconds of light-curing, the excess material becomes gel-like and can be easily removed in one piece without leaving any residue. Fig. 6_The approximal spaces are carefully cleaned with SuperFloss. The final light polymerisation phase takes 20 seconds. Fig. 7_Situation directly after insertion of restoration and removal of retraction cord. Fig. 6Fig. 5 Fig. 7