CDE0211

36 I I industry report _ compobonds sion making or restoration fabrication. Unwanted sharp line angles or deficiencies, such as voids, can readily be blocked and sealed with the easily adapt- able flowable composites for both intra- and extra- coronal tooth preparations. Inthefollowingcase,alargeamalgamrestoration with underlying profound decay was scheduled for an indirect ceramic inlay. After isolation with a rubber dam,theamalgamfillingfromthemaxillarymolarwas removed, revealing gross carious dentine (Fig. 49). All soft, carious dentine was exacted, leaving blatant undercuts (Fig. 50). Due diligence was exercised not to remove all the hard, deeper decayed dentine to avoid possible pulpal exposure. In this instance, Vertise Flow has a dual function: firstly, to block un- dercuts; and, secondly, to act as a stress-absorbing linerforthesubsequentindirectceramicinlay(Fig.51). Repair Lastly, Vertise Flow can be used for minor repairs, foreitherchairsideorlaboratory-made,acrylicbased temporary restorations such as crowns with air blowsorchipsorfracturesafteraperiodofuseinthe mouth. Once again, the repair protocol is simplified and predictable, involving a single step, with the addedbenefitoftheSEbondingagentwithinVertise Flow. Another form of repair involves the increasingly problematic fractures associated with ceramic pros- theses, such as crowns or inlays. Since these types of all-ceramic indirect restorations are increasingly popular, the number of fractures is also becoming progressively more common, and replacement is costly. Traditionally, ceramic fracture repair involved several stages, that is etching with hydrofluoric acid, silanation and repairing with conventional resin- based composites, either a flowable or non-flowable variety. As previously mentioned, Vertise Flow incorpo- rates an acidic phosphate monomer, which links chemicallytomanyceramicsubstrates,suchassilica, alumina and zirconia. Therefore, after roughening thefracture“lesion”withadiamondbur,onlyasingle step is necessary with Vertise Flow, which combines both chemical bonding and a repairing composite to “heal” the fracture. Thefollowingcaseillustratesrepairofafractured, alumina core crown, veneered with silica (felds- pathic) porcelain. The patient presented with a distal fracture of the all-ceramic crown on the maxillary left central incisor (Fig. 52). A shade analysis was performed with the Vita Classic shade guide (VITA). VertiseFlowA2waschosenforthebodyofthecrown, and the Translucent shade for the incisal edge translucency (Fig. 53). Initial cleansing was carried out with a slurry of pumice to remove the plaque biofilm (Fig. 54). To increase the surface area for bonding, the frac- tured porcelain requires pre-treatment roughening, which can be achieved either mechanically or chem- ically. The choice is mainly empirical, depending on the clinician’s personal experience and penchant for either technique. Mechanical roughening involves using a rotary instrument followed by cleansing the sitewithphosphoricacid(Fig.55),whichdoesnotetch porcelain, but removes any remaining debris (Fig. 56). Fig. 51_Vertise Flow is used to block the undercuts and acts as a stress-relieving lining. Fig. 52_Pre-op view showing a distal fracture of the all-ceramic crown on the maxillary left central incisor. Fig. 53_Shade analysis to ascertain colour of existing crown. Vertise Flow A2 and Translucent shades were selected to repair the fractured porcelain. Fig. 54_Pumice is used to cleanse the crown and remove any plaque biofilm. Fig. 55_The porcelain surface is mechanically roughened with a diamond bur and then cleansed with phosphoric acid. Fig. 56_Prepared porcelain site. cosmeticdentistry 2_2011 Fig. 52 Fig. 53Fig. 51 Fig. 55 Fig. 56Fig. 54