14 exhibitors Chicago Midwinter — February 24, 2018 Internal characterization of a transitional restoration milled from hybrid-ceramic material using HC Block/Disc and LiteArt Stain System By Abel Fernandez, MDT, CDT n In a dental laboratory, planning a successful clinical case involves a multifaceted collaboration between a clinician and a dental laboratory tech- nician. This process includes discuss- ing an overall treatment plan, and it incorporates studying the clinical photographs and digital and die stone models, preparing the diagnostic wax-ups and provisional restorations (mockups), and designing the func- tion and esthetics of a restoration. The ability to provide a long-term temporization for an individualized, full-mouth restoration is an impor- tant phase of a successful treatment plan. This step gives both the dentist and the patient confidence that a final restoration will meet the require- ments of functionality and esthet- ics. Furthermore, when fabricating a multiple-unit case, specifically for the anterior region, patients concerned with the quality and esthetics of a temporary restoration may not accept a monochromatic solution. Therefore, choosing an appropriate transitional material and a shade adjustment sys- tem is an important part of a success- ful treatment plan. Laboratory procedure A new-generation CAD/CAM mate- rial, HC Block/Disk (Shofu Dental) in a shade A2-LT/M (low translu- cency / block size medium), meets all the criteria of an effective long-term provizionalization. Comprised of 61-percent zirconium silicate embedded in a high-tempera- ture/high-pressure polymer matrix, a densely-packed nanofiller of HC Block/Disk forms a skeleton which uniformly absorbs masticatory forces and promotes resistance to break- down phenomena. The high flexural strength of 191 MPa and Vickers hard- ness of 66 Hv0.2 make HC Block/Disk a good candidate for a vast spectrum of indications, including long-term tran- sitional restorations and permanent anterior/posterior restorations for inlays/onlays, full-contour crowns, and implant-supported cases. With a total milling time of 11 min- utes and 30 seconds, with Cerec inLab MC XL (Dentsply Sirona), under wet conditions, HC Block/Disk showed excellent machinability in terms of damage tolerance, wear of CAD/CAM instruments and the ability to be milled in a very low thickness. Fig. 1 Here in Chicago For more information about Shofu products, visit the company at booth No. 2807. terization effects of natural dentition, the stains were diluted with LiteArt Clear Liquid (Fig. 1). Solidilite V light- curing unit (Shofu Dental) was used to polymerize the restoration for one minute. An overlay of an indirect flow- able composite, Ceramage F-59, was applied with a small, flat brush to enhance the translucency, to create the depth and space and to shield the restoration from damages (Fig. 2). The final curing was carried out for three minutes with the Solidilite V appliance. Minor surface contouring accen- tuating the morphology and texture was created with a Dura-Green Stone and a diamond bur. CompoMaster (Shofu Dental), a two-step, diamond-filled abrasive sys- tem, was used to finish and pre-polish the restoration without impeding its complex anatomical details. The final restoration was polished with a bristle brush and Dura-Polish Polishing Paste (Shofu Dental). To obtain the wet, glossy sheen the unit was super-polished with a felt wheel and Dura-Polish Dia Polishing Paste (Shofu Dental). The achieved transitional restora- tion was fully functional and visually appealing (Fig. 3). Conclusion Transitional restorations offer an excellent means of a treatment. Whether prescribed as a short-term or a long-term modality, this restorative option offers an efficient and inexpen- sive interim solution to a variety of patients, including those undergoing a periodontal therapy, the geriatric population, the dental-implant users and as a phase antecedent to an indi- rect esthetic restoration. In a very short time, HC Block/ Disk, Ceramage and the LiteArt Stains can create a successful transitional restoration that is both functional and highly esthetic. About the author Abel Fernandez, MDT, CDT, is the owner of Master’s Touch Dental Laboratory in San Marcos, Calif. 5 (Photos/Provided by Abel Fernandez, MDT, CDT) Fig. 2 Fig. 3 The evidence also supports that fabricated with HC restorations Block/Disk achieve ideal marginal integrity and fit. As a composite-based ceramic restorative, HC Block/Disk is highly compatible with other resin-based materials, allowing dental laboratory technicians to create highly individu- alized customizations with a stain system, such as the LiteArt (Shofu Dental), and to repair or modify with a direct or indirect restorative mate- rial, such as Ceramage (Shofu Dental). After milling, the sprue was removed, and contacts and occlu- sion were minimally adjusted with a Dura-Green Stone (Shofu Dental). To create adequate canvas for internal characterization with the LiteArt and final layering with Ceramage F-59, the unit was cut labially. In order to provide reliable mechan- ical retention, first the surface of the milled restoration was roughened by sandblasting with aluminium oxide particles (ca. 50—100 mm), at 2-3 bar pressure, for 10 seconds. Then neatened with a clean brush without the presence of water. The cleaning process can also be conducted with oil-free compressed air. Strong and durable chemical reten- tion for the successive staining was obtained with CeraResin Bond Adhe- sive System (Shofu Dental). Initially, and CeraResin Bond 1 was applied to prime the surface. After 10 seconds, CeraResin Bond 2 was added, left undisturbed for 10 seconds and sub- sequently light-cured for 20 seconds. The restoration was naturalized with LiteArt Stain System, which incorporates novel multifunctional monomers photo-initiators, responsible for emulating the natu- ral dentition’s optical properties of light diffusion and anisotropy. The proprietary chemical composition of the LiteArt also supports a failsafe adhesion to a variety of substrates including direct and indirect com- posites, PMMA and other resin-based materials. The high-viscosity nature of LiteArt Stains allows for a precise application and prevents product’s wasting. The color spectrum utilized for internal staining of the restoration included: • White (W) — to create decalcifica- tion spots, crack lines, white bands, to bring out the marginal ridges, and to enhance the tips of the cusps • Khaki (K) — to emphasized cervi- cal and palatal areas, and the develop- mental grooves • Cyan (C) — to highlight and inten- sify translucent areas • Orange (O) — to mirror the char- acteristic of inter proximal contacts To achieve the nuances and charac-