Hydraulic and Hydrophobic Impressions
(Continued)After the final impression was made, the preparations were coated with a water soluble lubricant. The pre-operative impression in 30-Second Blue Velvet was loaded with Photocore (J. Morita), a highly filled hybrid resin-composite used for building cores. The loaded pre-operative impression was inserted over the prepared teeth and light cured through the walls of the Blue Velvet impression. After being light cured, the provisional bridge was easily removed, finished, polished and cemented provisionally with Durelon (ESPE/ Premier), a polycarboxylate cement. The aesthetics during the interim were excellent and the patient was comfortable (Figure 19).
 Figure 19 |
When the patient returned for cementation of the permanent Sculpture/FibreKor bridge, no injection of local anesthesia was needed. The Liner Bond 2V applied at the prior visit scaled the dentinal tubules and protected the pulp from adverse stimuli. The ATD Bridge Remover was used to gently tap out the provisional Photocore bridge. The inlay preparations were debrided of Durelon cement and were pumiced clean.
The bridge was cemented with Panavia 21 (J. Morita), a filled resin-composite cement. The undersurface of the pontic was coated with a water soluble lubricant to make it easier to remove excess cement without damaging the undersurface after cementation. E&D conditioning liquid was applied to the inlay cavity preparations and blown dry after one minute. The intaglio surfaces of the inlay portion of the bridge were sandblasted with 50 micron aluminum oxide particles, then washed and dried. The intaglio surfaces of the inlays were etched for 10 seconds with Etching Agent V (37% phosphoric acid) and then washed and dried. One drop of Porcelain Activator was mixed with one drop each of the Liner Bond 2V base and catalyst and then applied to the intaglio surfaces of the inlays.
The Panavia 21 cement was applied to the intaglio surfaces of the inlays and the bridge was seated and held in place for one minute with finger pressure. Excess cement was removed with a stiff brush and explorer. A floss threader was inserted under the pontic to remove excess around and under the pontic. The margins of the inlays were covered with Oxyguard to eliminate the air inhibited layer and to ensure complete polymerization. After three minutes, the Oxyguard was washed off.
After the bridge had been cemented, excess set cement was removed with a scaler or twelve-fluted, 7406 finishing bur. The occlusion was checked and required minimal adjustment. Occlusion should not be checked until the bridge has been permanently cemented when all margins are bonded to the enamel and supported by cement. A finishing cup (Enhance, L.D. Caulk) was used for the final polish (Figure 20 and 21). The aesthetics were great. And needless to say, the patient loved it!
 Figure 20 |
 Figure 21 |
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