At-a-Glance - Technique & Clinical Cases

1. At-a-Glance- Technique & Clinical Cases 80 YEARS OF SWEDISH QUALITY IN THE GLOBAL DENTAL SERVICE Twin Luscent Anchors Dentatus, known worldwide as a designer of systems and manufacturer of innovative dental products, produces a wide range of precision high tech dental products that are distributed worldwide.

2. Twin Luscent Anchors Light TranslucentEsthetic Posts for EndodonticallyTreatedTeeth • The Twin Luscent winning combination • Light transmission • Attractiveesthetics • Twice the retention

3. Twin Luscent Anchors PrimaryBenefits • Patient • Superior functional and esthetic restoration • Clinician • Time-saving procedure, superior end product

4. Twin Luscent Anchors PrimaryBenefits • Strong • Strengthens the restoration • Fast • One-stop procedure: simultaneously luting the anchor and building a monoblock core • Convenient • Compatible with brand name dual-cure adhesives/resins • Removable • Easily removed using Dentatus reamers

5. Twin Luscent Anchors Benefits • Esthetic • Twin Luscent Anchors eliminate shadows at • the gingival, root and crown interface as well as through thin composite restoration • Twin Luscent Anchors reflect the surrounding colors and hues compatible with natural esthetics

6. Twin Luscent Anchors Benefits • Light Transmitting • Twin Luscent Anchors effectively polymerize composite within the deep confines of canals • Including: • • Large canals weakened after endondontic treatment • • Extension of caries into the coronal portion and pulp chamber • • Developmental anomalies • • Trauma or over-preparation of root canal

7. Twin Luscent Anchors Benefits Monoblock Strength • Light or dual-cure composites bond to the fiberglass-reinforced anchors and the canal wall creating a cohesive and very strong foundation

8. Twin Luscent Anchors Benefits Reduced Incidence of Root Fractures • Twin Luscent Anchors absorb and dissipate sudden stresses Potential fracture location with fiberglass-reinforced composite posts FracturedPost and Crown FracturedPost and Crown Vector of Force Vector of Force Potential fracture location with metal posts Fracturedroot Fracturedroot Vector of Force Vector of Force

9. Twin Luscent Anchors Benefits Removable • Anchors are easily removed with either a large size NiTi rotary engine file or Dentatus Reamer Example Post fracture-post removal • Cut post flush to tooth • Create pilot in post with pin drill • Remove post with Gates Glidden #4 or Probos Pathfinder • Continue to remove post with largest nickel titanium rotary file

10. Twin Luscent Anchors Benefits Removable - Example (continued) • Probos Pathfinder or Gates Glidden down the center of the post • Large Nickel Titanium file in rotary handpiece to remove remaining post • After removal of post, resize canal with another post • Cement post or cast post and core • Restore with at least 1.5-2.0 mm ferrule

11. Original Luscent Anchor True taper Optimal choice for very narrow and small canals, from 0.8 mm to 1.2mm Anchor DesignTwin Luscent Anchor

12. Original Luscent Anchor True taper Optimal choice for very narrow and small canals, from 0.8 mm to 1.2mm Anchor DesignTwin Luscent Anchor

13. Twin Luscent Anchors Benefits • Shape Matches Root Form • • Twin Luscent and Luscent Anchors completely fit within the confines of natural teeth • Anchor design is tapered apically to match root form, minimizing unnecessary removal of dentin in the canal apicalseal CEJ Twin Luscent Luscent

14. Twin Luscent Anchors Benefits Benefits of the Physical Properties Longitudinal fiberglass rods in a bondable matrix resin with low modulus or elasticity closely resembling that of dentin, 20.1 Gpa. Finished Elements Manners (FEM) of the stress in the interface dentin-post Steel post maximum stress 7.51 Mpa Carbon post maximum stress 3.45 Mpa Glass post maximum stress 2.22 Mpa The results show the best behavior of glass fiber posts which are the most elastic. Source: Sandro Rengo. Atti del Ill SimposioInternazionaleOdontioiatriaAdesiva e Ricosruttiva. Al-Harbi FA, Nathanson D. Mechanical and retentive properties of new aesthetic posts. J Dent Tex 80 (AADR Abstracts) 2001, (Boston University, Boston Mass).

15. Twin Luscent Anchors Benefits • Benefits of the Physical Properties • High adhesion to composite materials. The glass fibers contain silica similar to filler materials. Source: Al-Harbi FA, Nathanson D. Mechanical and retentive properties of new aesthetic posts.J Dent Tex 80 (AADR Abstracts) 2001, (Boston University, Boston Mass).

16. Twin Luscent Anchors Benefits • Benefits of the Physical Properties • Flexural strength within the range of healthy teeth and outperforming metal posts, 579 Mpa. Source: Al-Harbi FA, Nathanson D. Mechanical and retentive properties of new aesthetic posts.J Dent Tex 80 (AADR Abstracts) 2001, (Boston University, Boston Mass).

17. Twin Luscent Anchors Benefits In Vitro Post-Tooth Retention • Benefits of the Physical Properties • All posts inserted to same length (9mm) • All posts cemented with resin cement (Bisco) except “ParaPost (ZOP” that were cemented with zinc phosphate cement (as a control) • All ParaPosts are titanium Source: Al-Harbi FA, Nathanson D. BU, 2001

18. Twin Luscent Anchors Benefits - summary • Light transmitting • True root canal shape (tapered end) • Mechanical retention • Elimination of trapped air • Longitudinal glass fibers (post reinforcement) • Conserves sound radicular and coronal structure • Translucent • Anti-rotational • Easy removal • 3 diameters of posts • Bondable, resin-based

19. Twin Luscent Anchors Procedure – Simple Technique 1 PATHFINDER Reamer PROBOS II

20. Twin Luscent Anchors Procedure – Simple Technique 2 OR Diamond Alcohol Air dry

21. Twin Luscent Anchors Procedure – Simple Technique 3 Etch H20 Air Dry

22. Twin Luscent Anchors Procedure – Simple Technique 4 Bonding Agent Dual-Cure Resin*

23. Twin Luscent Anchors Procedure – Simple Technique 5 6 Insert LightCure Core Build up Core Preparation

24. Twin Luscent Anchors Procedure – Simple Technique Review 1 2 3 4 5 6

25. Twin Luscent Anchors Case Study Restoring the Endodontically Treated Tooth with Fiber Reinforced Resin Posts Howard E. Strassler, DMD, FADM, FAGD Department of Restorative Dentistry Dental School University of Maryland

26. Twin Luscent Anchors Case Study • Indications for fiber posts • Need for esthetic translucency • Need for root reinforcement, sealing and strengthening • At least 1.5 mm ferrule in the tooth preparation • Provide for a monoblock system of core bonded to post bonded to tooth • Create a failsafe design that if traumatized the tooth crown and post would fracture leaving the root intact

27. Twin Luscent Anchors Case Study • Important points for post selection • Posts must transmit light to eliminate gingival and tooth shadowing • Post should be tapered following the true shape of theroot canal and leaving more radicular dentin • Post should not transmit forces down the root during trauma; the post should dissipate forces and fracture before the tooth and root • If broken, the post be easily removed • Post comes in multiple sizes to accommodatedifferent root canal diameters

28. Twin Luscent Anchors Case Study • Preoperative View • Endodontically treated maxillary lateral incisor with defective Class 3 restorations and an endodontic access opening Twin Luscent Anchor • Decision to restore with adhesive composite resin supported by a bondable Twin Luscent Anchor

29. Twin Luscent Anchors Case Study • Post Space • The length of the canal was determined with a radiograph • Sized reamers determined the Twin Luscent size to be used • Post space (length) was created by removing the guttapercha with a Pathfinder then a Luscent Reamer

30. Twin Luscent Anchors Case Study • Anchor Placement • Twin Luscent Anchor was tried into the canal and length verified • Canal was etched for 15 seconds

31. Twin Luscent Anchors Case Study • Rinsing and drying the canal • Canal was rinsed using an endodontic irrigation syringe with water • Canal was dried with a large paper point

32. Twin Luscent Anchors Case Study • Adhesive application • A 4th-generation adhesive was used with a separate primer and adhesive resin in the root canal • The adhesive must be either a dual cure or self-cure adhesive compatible with a self-cure or dual-cure composite resin cement

33. Twin Luscent Anchors Case Study • Cementation of Twin Luscent • Twin Luscent Anchor painted with adhesive • Dual-cure composite resin cement syringe into the canal with a Needle Tube

34. Twin Luscent Anchors Case Study • Anchor Placement • Twin Luscent Anchor seated into the root canal and cemented. Note, twirling motion used in seating the anchor. • Light cure for 60 seconds

35. Twin Luscent Anchors Case Study • Preparation for all-ceramic crown • The Twin Luscent Anchor was cut down to the level of the access with a diamond on a high speed handpiece • Restoration of the access and Class 3s with composite resin. Note, no discoloration of gingiva with Twin Luscent Anchor. • Preparation for an all-ceramic crown

36. Twin Luscent Anchors Case Study • All ceramic crown cementation • Preparation etched for 15 seconds, rinsed and dried • Dentin primer painted on preparation

37. Twin Luscent Anchors Case Study • All ceramic crown cementation • Dual cure adhesive painted on preparation • All-ceramic crown cemented with dual-cure composite resin cement

38. Twin Luscent Anchors Case Study • Final all-ceramic crown • Excess cement removed; crown light cured for 30 seconds on facial surface, 30 seconds on lingual surface • The final restoration, highly esthetic and translucent

39. Twin Luscent Anchors Kits LUT-K1, Twin Luscent Starter Kit 15 anchors (assorted s, m, l) with all accessories LUC-K3, Luscent Starter Kit 15 anchors (assorted s,m,l) with all accessories Refill Kits 5 or 15 anchors (individual size only) Light transmitting Forms-to-Fit