For beautiful restorations that last: G-CEM LinkForce™ and GC Initial™ Lisi Press

Restorative dentistry has advanced at a great pace in the past decade, offering a myriad of new and updated materials that are stronger and more aesthetic than ever before. Dentists are now able to deliver more natural-looking and durable restorations, which continues to raise expectations for patients. In order to meet these aesthetic and functional requirements, dentists need a cost-effective material that isn’t technique sensitive for dental laboratories to deliver at a consistently high standard.  

 

At the forefront of dental materials research and development, GC America has created a formidable duo in G-CEM LinkForce and GC Initial LiSi Press that achieves not only beautiful but durable restorations. On the one side, G-CEM LinkForce is a dual-cure adhesive resin cement for dentists, which is aesthetic and stable with multiple indications. On the other side, dental technicians have the pleasure of working with GC Initial LiSi Press, a new high strength lithium disilicate ingot with High Density Micronization (HDM) technology which results in advanced physical properties and the most aesthetic pressed ceramic option on the market today.

 

When used together, studies have revealed exceptional tensile bond strength, in comparison to Ivoclar Vivadent’s IPS e.max Press and MultiLink Automix*. For dentists who want to create beautiful restorations that will last, using GC Initial LiSi Press together with G-CEM LinkForce will give you the desired outcome. Here is an overview of why you should use G-CEM LinkForce and GC Initial LiSi press for all your restorations.

 

G-CEM LinkForce is indicated for multiple applications

G-CEM LinkForce is a multi-purpose, dual-cured, radiopaque, universal adhesive resin cement system. One convenient kit is all you need for all restorative procedures, from lithium disilicate, ceramics and hybrid ceramics, as well as zirconia, PFMs and precious metals, glass fiber posts, and veneers.

 

Key features of G-CEM LinkForce include beautiful aesthetics, with good consistency of shades. Translucent, A2, Opaque and Bleach are the four shades available, with tooth-like fluorescence, convenient automix delivery and matching try-in pastes. The material offers ideal working times and good viscosity and uniformity of the mix. It is easy to use and to clean up. This system also includes a dual-cure activator, allowing the light-cured primer to be used in areas where a curing light may not have sufficient access.

 

G-CEM LinkForce offers secured adhesion in only one system, with three base elements:

*  G-Premio BOND™: bonding to preparations with no compromises 
Bonds to teeth, metal abutments and composite core build-ups

*  G-Multi Primer™: ensures a stable adhesion to restorations
  Stable chemical adhesion to surfaces, even on precious metals

*  G-CEM LinkForce: provides a strong bond in virtually all indications
Universal clinical use

 

G-CEM LinkForce is indicated for:

  • Cementation of all types of all ceramic, resin and metal-based inlays, onlays, crowns and bridges
  • Cementation of metal, ceramic, fiber posts, and cast post and cores
  • Cementation of all ceramic and composite veneers
  • Permanent cementation of crowns and bridges on implant abutments

 

G-CEM LinkForce is aesthetic and stable:

  • Four shades to match cementation needs, accompanied by their corresponding try-in pastes
  • Tooth–like fluorescence
  • Color stable over time

 

 

GC Initial LiSi Press is a revolutionary new high strength lithium disilicate ingot

GC America has recently introduced GC Initial LiSi Press, a new high strength lithium dislocate ingot with High Density Micronization (HDM). This proprietary technology provides advanced physical properties while obtaining the most aesthetic pressed ceramic open on the market today.

 

Improved aesthetics results in more vital-looking restorations, happier patients, and fewer remakes, saving time and money in the dental office.The physical properties of GC Initial LiSi Press offer high strength, better marginal integrity, and superior polishability. The material is robust and stable and it wears down the opposing dentition at a much lower rate, so it’s safer for the patient.

 

GC Initial LiSi Press properties

 

  • Unsurpassed Flexural Strength (>450MPa) with HDM Technology
  • Unparalleled aesthetics
  • Rich, warm, and bright colors with excellent fluorescence
  • Virtually no reaction layer when divested which allows cleaner presses
  • Low abrasion
  • Optimized to be used with the proven GC Initial™ LiSi veneering ceramic and GC Initial™ Lustre Pastes NF
  • Seamless learning curve
  • Lower solubility than other leading brands
  • Material and color stability after repeated rings
  • Wear resistant

 

The game-changer: HDM Technology

GC Initial LiSi Press is unique thanks to the development of HDM technology. HDM utilizes equally dispersed lithium disilicate micro-crystals to fill the entire glass matrix rather than using traditional larger size crystals that do not take full advantage of the entire matrix structure. As result, GC Initial LiSi Press is the ultimate combination of strength and aesthetics making it suitable for all types of dental restorations. Most importantly, this technology allows the product to be extremely stable and strong, without distortion or a drop in value. GC Initial LiSi Press is also optimized to be used with the already proven GC Initial LiSi veneering ceramic to provide patients with the strongest, most aesthetic, and stable option available. What this means to you is a reduction in failures and remakes, and a more aesthetic and stronger option for your patient.

Endorsed by experts

 

Both G-CEM LinkForce and GC Initial LiSi Press have been rated highly in the dentist and dental technician communities for their superior properties and ease of use.

 

G-CEM LinkForce™ received a rating of ‘excellent’ by The Dental Advisor Editor’s Choice. The product was evaluated by 26 consultants who found it to be a complete and versatile system for multiple applications. It was lauded for aesthetic results in terms of consistency of shades, as well as good viscosity and low film thickness. It was further commended for its great consistency of mix, being easy to use and clean up, as well as having excellent laminated instructions for use.

Consultant comments included:

    • “G-CEM LinkForce is a superb multi-purpose cement.”
    • “Having everything in one kit is a plus, no more hunting around.”
    • “I liked the long working time and the ease of clean-up.”
    • “The etchant has a very good consistency, and the tips are helpful.”
    • “Try-in paste is always a plus.”
    • “I like the dual-cured option, and that can bond to any G-Premio Bond  material in any mode.”
    • “Very versatile, with multiple uses on different substructures.”

 

Best teamwork: GC Initial LiSi Press and G-CEM LinkForce

Clinicians who have trialled both products have praised the aesthetic and durable restorations they create. One team, consisting of Dr. Miles Cone, Prosthodontist and Certified Dental Technician and Lucas Lammott, Dental Lab Owner and Technician, recently delivered a webinar ‘Exploring New High-Strength Aesthetic Dental Ceramics’ in which they showcased the results of clinical cases where they have combined GC Initial LiSi Press with G-CEM LinkForce.  

 

This webinar is available to watch On Demand and free of charge, through the link below:

 

Game Changer: Exploring New High-Strength Aesthetic Dental Ceramics

Presenter: Dr. Miles Cone and Lucas Lammott

Free Self-Study

Duration: 1 hour

Earn 1 CE credit

 

About the webinar: The mandate on today’s dental clinicians to deliver predictable high-strength and highly aesthetic restorations is continually increasing. Lithium disilicate glass ceramic has been readily accepted as the standard restoration of choice by technicians for meeting the expectations of the dentists they work with and their patients. With the introduction of revolutionary new lithium disilicate systems, additional options to satisfy the demand for improved treatment outcomes are now available to the dental laboratory technician. This CE webinar will utilize several case studies to illustrate the range of indications and benefits that these new high-strength materials possesses and to demonstrate how they are positioned to change the game for this class of dental ceramics.

 

Upon completion of this CE webinar, the student will have

      • Reviewed the physical properties of newly introduced press ceramics that contribute to the improved strength and aesthetics of the material
      • Determined the chairside/benchtop protocols that will ensure the highest quality final product at delivery
      • Applied new concepts and techniques with the dental clinic and laboratory   

 

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http://www.gcatraining.com/member/classroom.asp?x_classID=3053

 

 

Ask your lab to start using this breakthrough new material, GC Initial LiSi Press, to give your patients the most life-like restorations that will last, thanks to the adhesive strength of G-CEM LinkForce.

 

 

*GCC R&D Data on file

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The new pressable ceramic endorsed by lab experts

GC Initial™ LiSi Press is a new high strength lithium disilicate ingot from GC America with HDM (High Density Micronization) Technology. This proprietary new technology provides unsurpassed physical properties and superior aesthetics.

GC America has released GC Initial LiSi Press, to offer dental laboratories a more aesthetic, stable and easy to use solution. With nearly 100 years of experience in dental materials, GC is known worldwide for its innovative technology, endorsed by clinicians and technicians alike.

The HDM Technology found inside GC Initial LiSi Press utilizes equally dispersed lithium disilicate micro-crystals to fill the entire glass matrix rather than using traditional larger size crystals that do not take full advantage of the entire matrix structure. As result, GC Initial LiSi Press is a formidable combination of strength and aesthetics, making it suitable for all types of dental restorations. Most importantly, this technology allows the product to be stable and strong, without distortion or a drop in value. GC Initial LiSi Press is also perfectly optimized to be used with the already proven GC Initial LiSi veneering ceramic to provide your patients with the strongest, most aesthetic, and stable option available.

GC Initial LiSi Press properties

 

  • Unsurpassed Flexural Strength (>450MPa) with HDM Technology
  • Unparalleled aesthetics
  • Rich, warm, and bright colors with excellent fluorescence
  • Virtually no reaction layer when divested which allows cleaner presses
  • Low abrasion
  • Optimized to be used with the proven GC Initial™ LiSi veneering ceramic and GC Initial™ Lustre Pastes NF
  • Seamless learning curve
  • Lower solubility than other leading brands
  • Material and color stability after repeated rings
  • Wear resistant

 

In the back of the mouth, these restorations don’t look great, they look beautiful.

Dane Barlow, Dental Technician

 

  1. WATCH 

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In this brief and informative video, Dental Technician, Dane Barlow, reviews the GC Initial LiSi Press System and demonstrates investing and pressing as well as pressing parameters, while sharing some useful tips and recommendations for getting familiar with the material.

Duration: 7 minutes

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  1. LEARN ONLINE 

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Get a comprehensive overview of new aesthetic dental ceramics in this On Demand webinar presented by Dr. Miles Cone, Prosthodontist and Certified Dental Technician and Lucas Lammott, Dental Lab Owner and Technician.

Game Changer: Exploring New High-Strength Aesthetic Dental Ceramics

Presenters: Dr. Miles Cone and Lucas Lammott

Free Self-Study

Earn 1 CE credit

Duration: 1 hour

 

The mandate on today’s dental clinicians to deliver predictable high-strength and highly aesthetic restorations is continually increasing. Lithium disilicate glass ceramic has been readily accepted as the standard restoration of choice by technicians for meeting the expectations of the dentists they work with and their patients. With the introduction of revolutionary new lithium disilicate systems, additional options to satisfy the demand for improved treatment outcomes are now available to the dental laboratory technician. This CE webinar will utilize several case studies to illustrate the range of indications and benefits that these new high-strength materials possesses and to demonstrate how they are positioned to change the game for this class of dental ceramics.

 

Upon completion of this CE webinar, the student will have

  • Reviewed the physical properties of newly introduced press ceramics that contribute to the improved strength and aesthetics of the material
  • Determined the chairside/benchtop protocols that will ensure the highest quality final product at delivery
  • Applied new concepts and techniques with the dental clinic and laboratory   

 

Screen Shot 2017-03-03 at 09.56.12

http://www.gcatraining.com/member/classroom.asp?x_classID=3053

 

guide

 

G-CEM LinkForce™: one system, multiple indications

Restorative dentistry has advanced at a great pace in the past decade, offering a myriad of new and updated materials that are stronger and more aesthetic than ever before. Dentists are now able to deliver more natural-looking and durable restorations, which continues to raise expectations for patients. But even the most beautiful restorations won’t be of any use if they don’t last, which is why dentists need a reliable and easy-to-use cement.

 

In response to this market need, GC America launched, G-CEM LinkForce™, a multi-purpose, dual-cured, radiopaque, universal adhesive resin cement system. This one convenient kit is all you need for all restorative procedures, from lithium disilicate, ceramics and hybrid ceramics, as well as zirconia, PFMs and precious metals, glass fiber posts, and veneers.

 

G-CEM LinkForce offers secured adhesion in one system, with three base elements:

  1. G-Premio BOND™: bonding to preparations with no compromises

Bonds to teeth, metal abutments and composite core build-ups

  1. G-Multi Primer™: ensures a stable adhesion to restorations

Stable chemical adhesion to surfaces, even on precious metals

  1. G-CEM LinkForce: provides a strong bond in virtually all indications

Universal clinical use

 

Experts agree

 

Since its introduction to the market, clinicians have frequently endorsed G-CEM LinkForce. The product received a rating of ‘excellent’ by The Dental Advisor Editor’s Choice and was evaluated by 26 consultants who found it to be a complete and versatile system for multiple applications. It was lauded for aesthetic results in terms of consistency of shades, as well as good viscosity and low film thickness. It was further commended for its great consistency of mix, being easy to use and clean up, as well as having excellent laminated instructions for use.

 

Consultant comments included:

  • “G-CEM LinkForce is a superb multi-purpose
  • “Having everything in one kit is a plus, no more hunting around.”
  •  “I liked the long working time and the ease of clean-up.”
  •  “The etchant has a very good consistency, and the tips are helpful.”
  • “Try-in paste is always a plus.”
  • “I like the dual-cured option, and that G-Premio Bond can bond to any material in any mode.”
  •  “Very versatile, with multiple uses on different substructures.”

 

In addition, in a recent webinar recording entitled Game Changer: Exploring New High-Strength Aesthetic Dental Ceramics, co-presenter, Dr. Miles Cone, Prosthodontist and Dental Technician commented about the material: “This is a really strong, tenacious cement… One of the things that I like about this cement is that it comes with a complimentary try-in paste [in the complete kit]”.

 

G-CEM LinkForce is a dual-cure adhesive resin cement for cementation of all types of indirect restorations and is indicated for:

  • Cementation of all types of all ceramic, resin and metal-based inlays, onlays, crowns and bridges
  • Cementation of metal, ceramic, fiber posts, and cast post and cores
  • Cementation of all ceramic and composite veneers (up to 2 teeth)
  • Permanent cementation of crowns and bridges on implant abutments

 

G-CEM LinkForce is aesthetic and stable:

  • Four shades to match cementation needs, accompanied by their corresponding try-in pastes
  • Tooth–like fluorescence
  • Color stable over time

 

 

WATCH

For a detailed product overview with step by step technique instructions, watch this video clip (duration: 6:30 minutes)

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https://www.youtube.com/watch?v=JTwnnl-hWLM

 

G-CEM LinkForce is easy to use

 

G-CEM LinkForce is designed to be easy to use, making it a fuss-free way to gain a high aesthetic quality and color stability with tooth–like fluorescence and four shades to match all needs.

  • *High bond strength thanks to efficient light-curing
  • Incredibly thin film thickness not interfering with crown placement/li>
  • Self-cure mode
  • Particularly useful when cementing opaque or thick restorations/li>
  • Optimal light-curing of the resin cement
  • Ideal for the cementation of veneers/li>

 

Clinical Tips

  • Tack cure for no more than 5 seconds, it is difficult to remove excess once it has set.
  • Make sure to follow the instructions for use for the specific application.
  • Take a follow-up radiograph to check that all excess cement is removed.
  • Separate components into what normally gets used versus what rarely gets used.

 

 

Want to know more? Schedule a lunch and learn for your office

 

 

Schedule a lunch and learn with your local GC America representative at your office. Your entire team will benefit from this learning event, and we currently have an exclusive offer for all customers who book these sessions. Your local representative will visit when it’s most convenient for you and deliver a short training while you enjoy a free lunch!

With any lunch and learn scheduled, you will receive a same day offer to Buy 1 Get 1 Free G-CEM LinkForce (refills only)*

*Facebook promotion only.  Limited offer and certain restrictions apply.  Offer available in the US and Canada.  Please allow up 6-8 weeks delivery on the free goods.  Ask your local representative for further details.


Click here to schedule a Lunch and Learn

 

3 X CTA_3. Schedule Lunch&Learn for G-CEM LinkForce [lunch and learn icon]

Product tutorial: G-CEM LinkAce™

G-CEM_LinkAce

Offering significant benefits to the clinician, G-CEM™ LinkAce provides optimal self-curing properties for PFM and lithium disilicate restorations, high bond durability to Zirconia in one step, exceptional color stability, unsurpassed wear resistance and easy excess cement removal.

Available in four esthetic shades—A2 universal, AO3, BO1 and translucent—G-CEM™ LinkAce™ requires no refrigeration, so there is no delay waiting for the material to come to room temperature.

This short product tutorial talks through the steps of how to use

Watch the step-by-step tutorial below

 

To read the Dental Advisor report on G-CEM™ LinkAce™ click here

 

WATCH: Step by Step Breakdown of The Single Crown

Indirect restorations webinar

Duration: 1.04 h

Presenter: Dr Ron Kaminer

About the webinar:

A mainstay procedure in any dental office is the single crown. Yet despite our successes and failures many of us continue to do things the same way we have done for years. This CE webinar will break down the single crown and outline and modernize the steps and procedures needed to be ultimately successful.

Upon completion of this CE webinar, the student will have covered
1. Core build ups and post and cores: Current materials for optimal success
2. How to achieve a perfect impression every time
3. Material choice for single units
4. Clarifying cementation confusion

See below for a 2.5 minute excerpt of the webinar

 

Click here to view the full length on-demand webinar

 

About Dr Kaminer

RonKaminer

Dr Ron Kaminer is a 1990 graduate from SUNY at Buffalo School of Dental Medicine. He maintains two practices, one in Hewlett, NY and one in Oceanside, NY. Dr Kaminer is an international expert in the field of Dental lasers and has lectured on Lasers and minimally invasive Dentistry nationally and internationally. He is Director of the Masters of Laser training program in New York, and is a clinical consultant and lecturer for numerous companies, including, Ultradent, Lares, GC America, AMD Lasers , Camsight, Nu Calm and Smile Reminder. Dr. Kaminer maintains a teaching appointment at Peninsula General Hospital in Far Rockaway , NY. He is also a clinical instructor with the International College of Laser Education. He has authored numerous articles on Dental lasers and minimally invasive Dentistry. He is a member of the Academy of Laser Dentistry, Academy of General Dentistry, International College of Facial Esthetic, and American Dental Association. He lives in Hewlett, NY with is wife Jackie and three children, Josh, Erika and Matt.

WATCH: Updated Protocols for Provisional and Definitive Cementation of Indirect Dental Restorations

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Duration: 1:10 h

Presenter: Dr Robert Lowe

Most indirect dental restorations are luted to preparations using one of four types of dental cements:

1) Glass Ionomer Cements

2) Resin Modified Ionomer Cements

3) Resin Cements which require the use of total etch technique and dentin adhesives on the tooth structure prior to the luting process

4) Self Etching Resin Cements

Improved properties in this last category of cements including, improvements in self cure mode and bonding to zirconia, will be discussed. It is important to note that no cement will perform to its utmost clinically without an adequate preparation that includes good resistance and retention form.

In this CE webinar, Dr. Lowe will discuss clinical techniques and protocols for indirect cementation of both provisional and definitive restorations. Provisional cementation will be discussed as an integral part of the indirect delivery process for preparation protection and tissue management. The student will come away from this webinar with a more thorough understanding of the cementation process and which cements perform the best when coupled with the variety of restorative materials, both all ceramic and metal based, that are currently available.

GC America - Webinar - Button-02

Click here to watch the webinar free of charge

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About Dr Lowe

Robert Lowe

Dr. Robert A. Lowe graduated magna cum laude from Loyola University School of Dentistry in 1982 and was an Assistant Professor in Operative Dentistry until its closure in 1993. Since January of 2000, Dr. Lowe has been in private practice in Charlotte, North Carolina. Dr. Lowe lectures internationally and publishes in well-known dental journals on esthetic and restorative dentistry.

He is a clinical evaluator of materials and products with many prominent dental manufacturers. Dr. Lowe received fellowships in the AGD, ICD, ADI, ACD, and received the 2004 Gordon Christensen Outstanding Lecturers Award at the Chicago Midwinter Meeting. In 2005, he was awarded Diplomat status on the American Board of Aesthetic Dentistry.

 

Resin-modified glass ionomer cements versus resin-based materials as fissure sealants: a meta-analysis of clinical trials

GC America believes in the importance of informing dentists about the evidence available on Minimally Invasive Dentistry topics so they can make scientifically sound choices in the treatment of their patients. In the research-clinical application jigsaw puzzle, it is essential to make all the pieces fit in order to see the whole picture.

Systematic review with meta-analysis

AIM: To quantitatively appraise the current evidence regarding the caries-prevention effect of resin-modified glass ionomer cement (RM-GIC) fissure sealants in comparison to that of resin-based fissure sealants.

METHODS: 8 Anglophone databases and 2 Lusophone databases were searched until 15 April 2009, using a pre- determined search strategy. Clinical trials were considered for inclusion if their titles/abstracts were relevant to the topic, published in English, Portuguese or Spanish and had a two-arm longitudinal study design. The outcome measure of the caries-preventive effect was caries absence on sealed teeth. Two reviewers independently extracted data from the accepted articles in order to complete a 2×2 table for meta-analysis. The unit of interest was the tooth, and the number of caries-free teeth (n) at the end of each time interval (6, 12 and 24 months) was compared against the total number of evaluated teeth (N).

STATISTICS: Datasets were assessed for their clinical and methodological heterogeneity, following Cochrane guidelines, and only homogeneous datasets were combined for meta-analysis, using a random effects model (RevMan 4.2). Differences in the caries-preventive effect were computed on the basis of the combined Relative Risk (RR) with 95% confidence interval (CI).

RESULTS: Of the 212 articles identified, only 6 trials were included. From these, 19 separate datasets were extracted. For the pooled data, equivalent caries-preventive effects were observed at 6 months (RR= 0.98, 95% CI 0.95- 1.00; p = 0.08); 12 months (RR=1.00, 95% CI 0.96-1.04, p = 0.99) and 24 months (RR=1.01, 95% CI 0.84-1.21, p = 0.91). The 36-month data (not pooled) favored resin-based sealants (RR 0.93, 95% CI 0.88-0.97, p = 0.002).

CONCLUSIONS: This meta-analysis found no conclusive evidence that either material was superior to the other in preventing dental caries.
European Archives of Paediatric Dentistry, official journal of the European Academy of Paediatric Dentistry (2010) Volume: 11, Issue: 1, Pages: 18-25

The academic perspective: Dr Steffen Mickenautsch, University of the Witwatersrand, South Africa

What were the main reasons for reviewing this particular area of dental materials?
Steffen Mickenautsch: Resin is still considered to be the material of choice, worldwide, to caries-protect pits and fissures. This begs the question: Why? Is this so because we have overwhelming scientific evidence for its preference? Or overwhelming evidence in the sense that it sweeps any other possible materials asunder? Or is it just because of tradition, because we do not know the merits of other materials, or finally simply: because we have been told so in dental school? It is always interesting (and beneficial to the heart and mind) to find out the truth of things and that is why we embarked on an intensive systematic review programme that also included the comparison of the caries preventive effect between resin-based and resin-modified glass ionomer cement (RM-GIC) based fissure sealants.

What criteria did the articles you selected meet and why is this important?
Steffen Mickenautsch: We aimed to identify all evidence to this topic from all different sources, corners of the world and from as many languages as possible. We did that in a systematic format and from what we found we selected studies that were relevant, i.e. compared the two types of material with each other. Then these studies needed to have been randomized in some way. Randomization assures that patients whose teeth were sealed with either resin or RM-GIC do not substantially differ, thus are comparable. Studies who do not use randomization, cannot tell whether any observed results, e.g. that one material performed better than the other, were due to the material and not due to other factors (like one group of patients may simply had better oral hygiene or used fluoride and thus had less caries activity than the other, regardless what materials was used).

What should the general dental practitioner understand about this particular review?
Steffen Mickenautsch: The general dentist in her/his daily dental practice should have the knowledge that there is simply no scientific evidence that says that resin protects pits and fissures better against caries than RM-GIC.

How should general dentists apply the conclusion of this review to their daily practise of dentistry?
Steffen Mickenautsch: The application of this knowledge would be that if a dentist finds resin not to be a favorable choice to use as fissure sealant, perhaps for reasons of moisture control, material handling, material availability, costs, a personal reason, or reason stated by the patient etc., then RM-GIC can provide a good alternative.

How does this review contribute to the body of evidence on this topic in dentistry?
Steffen Mickenautsch: This is the very first quantitative systematic review and thus offers the best source of current scientific evidence to this topic. It’s the best, simply because: it first and foremost employed a comprehensive systematic sweep through all possible scientific and non-scientific sources of evidence available to answer a particular question. From everything that we found, we selected the best evidence in line with commonly accepted criteria and then we quantified this evidence, using meta-analysis, in order to provide a precise and well weighted answer to whether resin is better than RM-GIC in preventing caries or not. The result showed that it’s not.

Is more evidence needed on this topic? If so, what gaps are there in the research that has been done thus far on it?

Steffen Mickenautsch: From an academic point of view there is always need for more evidence – even just for the purpose to confirm the current state of evidence. It is recommended that future studies to this topic should report in much more detail on their randomization methods, which would remove any last academic shred of doubt. Our team is committed to continuously update current systematic review evidence – to this topic perhaps in about 2-3 years’ time. For now the current evidence from our systematic review is as good as it can get.

Clinician comments: Dr Geoff Knight, private dentist based in Australia

For how long have you been using glass ionomer cements in practice – and what motivated your decision to use them in the first place?
Geoff Knight: I met Dr Jurgen Eberlein at a dental seminar in Melbourne in the late 1970s. He was then with ESPE and gave me some samples of Ketac Fill to use in my practice. I was concerned about the recurrent caries I was seeing with composite resin and was impressed with the anti caries properties, low interface stress and ease of handling and I found myself using it for more and more clinical applications.

What is your preferred protocol for fissure sealing and what materials do you prefer to use for this?
Geoff Knight: I fissure seal with auto-cure glass ionomer cement because the material has relatively good wear resistance, releases abundant fluoride to convert carbonated apatite into fluorapatite and is a semi permeable to enable phosphate and calcium ions in towards the enamel and hydrogen ions to move outwards. Furthermore when the GIC is placed on the enamel surface it has a low pH that dissolves the outer surface of carbonated apatite enamel crystals so as to enable the formation of fluorapatite crystals after the GIC sets and the pH returns to neutral.

I am unaware of any tooth that I sealed with auto-cure glass ionomer cement ever developing a carious lesion beneath the seal. My current gem is Colgate Neutra fluor 5000 plus tooth paste. When patients brush without rinsing twice daily it prevents caries and significantly improves periodontal health.

Before reading the meta-analysis, what was your opinion of resin-modified glass ionomer cements versus resin-based materials as fissure sealants?
Geoff Knight: Resin fissure sealants prevent carbonated apatite from maturing into fluorapatite and have no place in MID. Resin modified glass ionomer cements enable the transfer of carbonated apatite into fluorapatite but do not wear as well as auto-cure GICs.

As a busy clinician, how do you keep yourself updated on developments in clinical evidence in dentistry, particularly in MID?
Geoff Knight: Read the literature, use Google and look at focused resources such as Dental Outlook here in Australia.

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Glass-Ionomer Cement Technology Advances into 21st Century Dentistry

Systematic reviews reveal the continued evolution of dental materials

Results from a recent systematic review suggest high-viscosity glass-ionomer cement (GIC) as safe and economical long-term tooth restorative system in conventional stress bearing Class I and in non-stress bearing Class II and Class V situation. High-viscosity GIC may also be acceptable in Class II stress bearing situations, as long as the isthmus is less than half of the intercuspal distance as stated in the manufacturer’s instruction of use.

Systematic reviews, often including meta-analysis as statistical method, provide the highest form of clinical knowledge in terms of achieving internal validity of results. One systematic review appraised the current clinical evidence regarding the use of high-viscosity GIC for longterm Class I, II and V tooth restorations placed in permanent teeth (1). This systematic review included 14 clinical studies, providing a total of 27 separate study results and concluded as follows:

  • Most of the 27 results show no significant statistical difference between the success rate of high viscosity GIC restoration and amalgam for treatment of the same clinical indications
  • One of the 27 results show that high-viscosity GIC restorations in posterior class V cavities of permanent teeth had a 28% higher chance to be more successful than amalgam after 6.3 years
  • Two of the 27 results indicate that high-viscosity GIC restorations in posterior class I cavities of permanent teeth have a 6% higher chance after 2.3 years and a 9% higher chance after 4.3 years of being more successful than amalgam
  • One of the 27 results show that high-viscosity GIC restorations in posterior class II cavities of permanent teeth have a 61% higher chance of being rated more successful than amalgam (this result requires further confirmation)
  • None of the 27 results indicate high-viscosity GICs being inferior to amalgam in clinic

These results show that high-viscosity GIC is not inferior in comparison to traditional amalgam restorations under similar clinical conditions. In addition, two further systematic reviews revealed the following evidence:

* Tooth margins of single-surface GIC restorations in permanent teeth had significantly less carious lesions after 6 years than on amalgam restorations (2)

* A significantly higher fluoride release (p<0.05) of GIC than from compomers (3)

Further advances have revealed that a resin coating over a GIC restoration may increase its fracture toughness (4) and reduce microleakage (5). This resin layer may also not completely hinder the fluoride release activated by the GIC and thus its external anti-cariogenic effects within the oral cavity (6).

Scientific journal articles for further reading:

1. Systematic review of clinical trials by Mickenautsch et al., Clinical Oral Investigation 2010; v14:pp233-240.

2. Systematic review of clinical trials by Mickenautsch et al., European Journal of Paediatric Dentistry 2009; v10: pp41-46.

3. Systematic review of trials by Oliveira et al., Journal of Minimum Intervention in Dentistry 2010; v3: p23 – abstract 023.

4. Investigation of dental materials by Bagheri et al., American Journal of Dentistry 2010; v23: pp142-146.

5. Investigation of dental materials by Magni et al., Journal of Dentistry 2008; v36: pp885-891.

6. Investigation of dental materials by Mazzaoui et al., Dental Materials 2000; v16: pp166-171.

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WATCH: A guide to bonding and cementation

FujiCEM2

Duration: 58 minutes

Presenter: Dr Lee Ann Brady

This CE webinar will look at the current options for bonding and cementation of indirect restorations. With so many choices today it can be confusing. Simple decision points will be presented to know when to use conventional cementation or a true bonding protocol. We will also look at the current choices in materials and which clinical situations they are best for.

View a short excerpt of the tutorial here or click the image below to watch the full tutorial free of charge!
video-screen shot

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About Dr Brady

LeeAnnBrady

Dr. Brady earned her D.M.D. degree from the University Of Florida College Of Dentistry. She has worked in a variety of practice models from small fee-for-service offices to large insurance-dependent practices, as an associate and as a practice owner.

She was invited to join the Pankey Institute in 2005 as their first female resident faculty member and was promoted to Clinical Director within a year, and held this position until November of 2008. She was asked by Dr. Frank Spear in September of 2008 to join him in the formation of Spear Education and the expansion of his curriculum. As the Executive VP of Clinical Education at Spear Education, she managed the development and delivery of all programs in addition to her teaching responsibilities until June of 2011. In 2010 she was recognized by Dental Products Reportas one of the “Top 25 Women Dentists in the U.S.” in the category of dental educators. She is on the editorial board of Inside Dentistry, DentalTown magazine and The Journal of Cosmetic Dentistry. Dr. Brady is a Guest Presenter at The Pankey Institute and teaches Continuing Education for the University of Florida College of Dentistry and University of Minnesota.

She has published articles in General Dentistry, Dentistry Today, Seattle Study Club Journal, Oral Health Journal (Canada), DentistryIQ, Women Dentist Journal, Inside Dentistry, DentalTown Magazine, Journal of Cosmetic Dentistry Dental Practice Report, Private Dentistry (UK), Journal of Dental Technology, and other print and web publications. Dr. Brady is a frequent presenter at local, state, national and international dental meetings such as the ADA Annual Session, AACD Annual Meeting, Thomas P. Hinman Dental Meeting, Chicago Midwinter Meeting, Yankee Dental Congress and Florida National Dental Congress.

Being a lifelong learner, Dr. Brady dedicates countless hours to studying and understanding occlusion, restorative dentistry and dental materials performance. She enjoys researching and teaching these clinical disciplines as well as patient communications, case acceptance and team development. She is passionate about solving complex cases, understanding the needs and concerns of her patients, facilitating the success of colleagues, and helping dentists find balance in their lives.

 

Free product tutorial: GC FujiCEM 2

FujiCEM2

Luting cements play an important role in the long-term success of indirect restorations.

This module will introduce you to new GC FujiCem™ 2 Automix, and show how it delivers remarkable strength, fracture toughness, and the versatility of a resin-reinforced glass ionomer—while giving you the confidence of an exact mix for the best possible physical properties.

 

FujiCEM2 1

Here is an overview of GC FujiCem™ 2 Automix properties:

  • Strong Retention

Optimal chemical balance for maximum adhesion to tooth structure. The early, high compressive and flexural strength provides the best possible support for your indirect restorations.

  • Sealing Ability and Marginal Integrity

Superior chemical bonding to tooth structure maintains the marginal seal, minimizing the risk of microleakage and secondary caries.

  • Sustained Fluoride Release

Utilizes glass ionomer technology for a sustained release of desirable fluoride.

  • No Post-Operative Sensitivity

Poses no risk of post-op sensitivity for patients because it is non-irritating to tooth structure and surrounding soft tissue.

  • Extremely Thin Film Thickness

The creamy consistency and low film thickness allows for stressfree seating of restorations

 

To access the free product tutorial with a detailed guide for users, click here

FuijCEM2 tutorial

 

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