Nothing is as constant as change!

It’s been two years since the merger of

3M Dental and ESPE Dental AG to form

3M ESPE and with this the first issue of our

new customer journal Espertise Magazine,

we would like to present to you a new face.

From now on three or four times a year this

magazine will inform you about our products,

give practical experience gathered by

colleagues, discuss concepts for a success-

ful dental practice and give news from your

region.

The success we enjoyed in meeting the chal-

lenges brought about by the merger is

reflected in our first joint projects – the

market launches of new products in recent

months. Of these, three are particular high-

lights, and we look at these in detail in this

issue. The universal composite Filtek™

Supreme is the first restorative material

which combines the high aesthetic require-

ments of anterior teeth with the mechanical

requirements of posterior teeth. For more

information on our “nanocluster” solution

see Page 2.

A luting cement which is simultaneously

self-adhesive, both light and chemically

curing, which meets high aesthetic

standards, is resistant to moisture and

permanently stable requires particular

chemical capabilities. You can find out on

Page 8 and 9 whether we achieved these

goals with the new Rely X™ Unicem™ Self-

Adhesive Universal Resin Cement.

The Dynamics of the technical progress in

microelectronics have enabled us to develop

the second generation of LED curing lights

with substantially increased capacity using

high-powered LEDs. To read more about

the new Elipar™ FreeLight 2 Curing Light,

turn to Page 6.

In addition, in this issue we report on Lava™

All-Ceramic System, our high-strength

zirconium oxide ceramic for metal-free

crowns and bridges, and consider the topic

of mentoring within the dental practice

team. I hope you enjoy reading your first

Espertise™ Magazine.

Gerhard Kultermann

3M ESPE, Seefeld, Germany

An Innovative Journal from 3M ESPE for Dentists

Contents

Editorial 1

Contents 1

Filtek™ Supreme Universal Restorative: 2

The New Nano-Composite from 3M ESPE

Lava™ All-Ceramic System: 4

Zirconia is “Breaking” New Ground for All-Ceramic Restorations

Elipar™ FreeLight 2 Curing Light: 6

Saving Time without Compromise

User Report: RelyX™ Unicem Cement: 8

The First Truely Universal Luting Material

Clinical Case Report: RelyX™ Unicem Cement: 9

The Beginning of a Revolution

User Report: Filtek™ Supreme Universal Restorative: 10

A Universal Genius with Brilliant Properties

The Dental Practice Page 11

Mentoring in the Practice

Calendar of Events 12

Editorial Information 12

March 2003No. 1 Year 1

3M ESPE MAGAZINE

Editorial

2

Product Information

Filtek™ Supreme Universal Resto-rative from 3M ESPE, which wasintroduced in October 2002, is a filling material for anterior andposterior teeth that combines ex-cellent mechanical properties andaesthetics. Nanotechnology used by3M ESPE for the first time in FiltekSupreme, unites the positive materi-al characteristics of conventionalcomposites:

• Aesthetics of a microfilled composite

• Mechanical stability of a hybrid composite

The ease of polishing and long lastingpolish of the restoration make FiltekSupreme an ideal material for anteriorteeth. High abrasion resistance andradiopacity mean that Filtek Supremeis perfect for restoring posterior teeth.

The quality of a restoration is largelydefined in terms of its durability. Highmechanical and abrasive resistanceare two of the key criteria for theassessment of an universal restorativematerial. In the following paragraphsyou will find a summary of the mostimportant scientific results for FiltekSupreme regarding wear resistanceand mechanical properties.

Filtek™ Supreme Universal Restorative: The New Universal Composite from 3M ESPE

A New Nano-Composite Combines the Aesthetics of a Microfilled Composite and the Mechanical Stability of a Hybrid CompositeAndreas Syrek, Roland Richter; 3M ESPE, Germany

Wear resistance of FiltekSupreme Universal Restorative

The most usual procedure for measur-ing contact-free area wear in-vitro isthe so-called ACTA method. Here asample wheel fitted with compositesrotates against a textured antagoniststainless steel wheel in a suspensionof millet seed. This produces an abra-sion trace on the composites; thedepth of this trace can be measuredprofilometrically, providing an indica-tor for abrasion resistance. The lesspronounced the abrasion trace in acomposite, the more resistant theproduct tested in this experiment willbe to abrasive influences.

Clinical relevance

High resistance to abrasion is particu-larly important for posterior teeth as itcontributes to the strength of theocclusal and approximal contacts andprevents the formation of negativeledges between the tooth substanceand the restoration, which wouldencourage the accumulation of plaqueat the margin of the restoration.

10

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The diagram shows the depth of the above mentioned trace in µm after 200,000 abrasion cyclesin each case, measured at various times. The test specimens examined were stored in water during the specified periods. This was followed by the abrasion test. The smaller the value,the lower the wear and the greater the resistance to abrasion.

Results from the University of Amsterdam

1 day

4 days

1 week

1 month

2 months

TetricCeram

Charisma Z100 FiltekSupreme (Body)

FiltekSupreme (Translucent)

Trac

e D

epth

[µm

/200

,00r

ev.]

At sizes of 20 to 75 nm the nanomers containedin Filtek™ Supreme offer a high filler load andthus excellent mechanical properties.

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March 2003No. 1Year 1

3M ESPE MAGAZINE

Mechanical properties ofFiltek™ Supreme Universal

Restorative

As an universal composite, FiltekSupreme is indicated both for anteriorand posterior restorations. Beside lowlevels of wear, high material strengthis also required to withstand mastica-tory forces in the long term. Theresults for diametral tensile strengthand fracture resistance are shown inthe following figures.

Clinical relevance

The higher the values, the greater thediametral tensile strength and fractureresistance - and the less likely restora-tion fractures are to occur in the clini-cal situation.

Summary

Thanks to the innovative nanofillertechnology, Filtek Supreme is charac-terised by outstanding abrasion resist-ance and mechanical strength. The nanoparticles and nanoclustersutilised are only eroded through abra-sion layer by layer, i.e. nanoparticle bynanoparticle. In contrast, completefillers are broken out of the surface inthe case of hybrid composites. Thisresults in a "pothole effect" whichimpairs the abrasion resistance of therestorative material.

The excellent mechanical propertiesof Filtek Supreme allow it to be usedfor both anterior and posterior teeth,and with aesthetics that are at leastcomparable with microfiller compo-sites.

1,8

2,3

2,0

1,3

1,9

0,0

0,5

1,0

1,5

2,0

2,5

3,0

Z100 Z250 Tetric Heliomolarradiopaque

FiltekSupreme

K1C

[M

N/m

1.5 ]

33,5 33,130,6

25,1

41,8

0,0

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20,0

30,0

40,0

50,0

60,0

Z100 Z250 Tetric Heliomolarradiopaque

FiltekSupreme

DT

S [

MP

a]

With Filtek™ Supreme only particles of a size below the wavelength of visible light are abraded. This means improvedpolish retention.

The “pot-hole effect” observed inhybrids results from whole particles ‘splitting off‘ duringmastication. This causes a reduction in gloss.

Results from the University of Munich

Pothole-Effect

Diametral tensile strength

Fracture resistance

© 3M ESPE

4

Product Information

Lava™ All-Ceramic Zirconia Resto-rations combine biocompatibilityand perfect aesthetics with highstrength and long term stability.

In April 2002 the new Lava Systemwas introduced in Germany. Sincethen over 2000 restorations have beenplaced, and lab technicians, dentistsand patients alike are experiencing anew kind of all ceramic anterior orposterior restoration, with automatedmanufacturing excellent fit, aesthe-tics, strength and ease of placement.

All ceramic restorations in the anterior and posterior region are anincreasingly important area of dentalcare. This is because of the need anddesire to have a metal free alternativeto the established metal ceramic sys-tems e.g. PFM but also due to demo-graphic changes in society.

Ceramic materials exhibit a naturaltooth or “enamel like” appearance aswell as excellent biocompatibility.These qualities have been successfullydemonstrated with various all ceramicsystems over the last decade.

However all ceramic restorations havenot been able to achieve their fullpotential instead they have been limitedby aspects of their material properties,especially for indications with com-plex loading patterns and high loads.Nevertheless, high tech ceramics,which have the potential to satisfythese demands and have proven them-selves in other industrial areas, havemade their way into the dental indus-try. Furthermore, economic manufac-turing processes were not available,this hampered a wider usage of thesekind of materials, but a dramaticdevelopment has in the area ofCAD/CAM technologies, again learntfrom other industries, has opened upnew paths for economic processing ofcomplex geometries.

Ceramics - all the same ?

A variety of ceramics are described as“all-ceramic dental materials”, how-ever, it appears, that there is still someconfusion as to what are the main differences between different ceram-ics and what are their appropriateindications. This is true not only forthe physical (mechanical, optical,thermal) properties of the ceramicsthemselves but also for differences intheir composition or processing.

In glass ceramics the shape is formedfrom a viscous glass this is followedby a controlled crystallisation process.By contrast infiltrated ceramics use aporous framework of for example alu-mina which is infiltrated with a spe-cial glass. A third group, the so calledpolycrystalline ceramics like aluminaand zirconia are now established.

A material able to satisfy simultane-ously the clinical demands for anteriorand posterior applications (aesthetics,biocompatibility, initial high strengthand longevity, easy to prepare, excel-lent fit and ease of placement), is ZrO2

(zirconia), chosen as the ceramic ofthe future. Zirconia has a proven trackrecord going back over a decade withrespect to properties, raw materialsand processing procedures in themedico-surgical field of hip jointimplants and for over two decades inthe field of mechanical engineering.A track records thatlends credibility toour decision and will benefit our cus-tomers.

Lava™ All-Ceramic System from 3M ESPE

Zirconia is “Breaking” New Ground for All-Ceramic RestorationsDaniel Suttor; 3M ESPE, Germany

SEM micrograph of the zirconia microstructure

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March 2003No. 1Year 1

3M ESPE MAGAZINE

The manufacturing process

The CAD/CAM process, developedfor the manufacture of dental restora-tions, is based on the non tactile, opti-cal detection of prepared abutmentsurfaces of a saw cut model. The pro-cessing of the scanned data is fol-lowed by the computer aided design ofthe copings and bridge frameworksand the generation of machine read-able codes based on the CADdesigned frameworks. The shapingand milling of the enlarged contourfrom a so called pre sintered zirconiablank is followed by the sintering andveneering steps.

Property Profile

The initial and long-term stability ofzirconia used for Lava™ Frame is farsuperior to the qualities of conven-tional all-ceramic materials. With highflexural strength (3-pt. bend) of over1,300 MPa and characteristically highfracture toughness of over 5 MPa m1/2,zirconia guarantees superb long-termstability even with delicate shaping.This zirconia shows no measurablesolubility and is tissue-friendly. Noallergic reactions have been reported.It exhibits a much thermal conductivi-ty than metals making it comfortablefor the patient. Moreover, the materialdoes not exhibit involvement in gal-vanic processes.

A special feature of Lava Restorationsis that the frameworks can be dyed tothe desired tooth colour using ourpatented process. Hence, it is nolonger necessary to cover the frame-work with an opaquer. The highstrength of zirconia enables a subtledesign with a coping wall thickness ofonly 0.5 mm, giving a dentine-liketranslucency. Therefore, the patientwill receive restorations, which arehardly to distinguish from naturalteeth in the environment of the mouth.Due to the high quality of the blanksand precision of the entire process(blank homogeneity, scanning andmilling precision, sintering tech-nique), an excellent precise fit can beachieved with the Lava™ All-CeramicSystem. The average marginal gapwidth (MO) is only 50 µm. The advan-tage is a simple and time saving place-ment procedure for the dentist.

The Future - ParticipationPossibilities

The success of this new ceramic mate-rial from a lab, dentist and patientpoint of view will be equally deter-mined by the quality of the restorationobtained from the CAD/CAM systemas well as its availability to interestedparties. Clinical studies with the newzirconia mate-rials, not only with theLava System are approching the fiveyear bench-mark and look promisingso far. These studies are backed byextensive investigations of the materi-al at various universities.

The second important point, then, isthe question, who will have access tothis technique. A CAD/CAM systemwith the necessary performance willcost in the order of a 5 to 6 digit Euronumber, which would restrict theaccess to a small number of labs andhence dentists and patients.

A possible alternative are milling cen-tres, where every lab, independent ofsize and financial capability, will havethe opportunity to have access to thisnew technique with no financialinvestment or risk to themselves. Attheir own speed they can then marketthe technique both to and with theirdentists.

The concept and technical capabilityof the Lava™ System from 3M ESPEsupports both models. Milling centresand single systems are both alreadyestablished in the German market.

Coloured bridge frameworks

Coloured coping for a crown 21 (Courtesy Christian Clauss, Munich)

Final restoration crown 21 (Courtesy Christian Clauss, Munich)

6

Product Information

With Elipar™ FreeLight 2 CuringLight, 3M ESPE can now present apolymerisation unit which catapultsLED technology into the “high-per-formance” class. Safe curing isachieved in half of the usuallyrequired curing time. This is madepossible by its high-intensity at 1000mW/cm2 combined with the efficacyof the LED lamp for curing light-curing restorative materials.

With the introduction of the firstElipar FreeLight, 3M ESPE set newstandards for light curing. Reliability,strong performance and simple han-dling aside, it is the unit’s cordlessoperation that many thousands of

users have come to appreciate as itsoutstanding feature. The Elipar

FreeLight has also led the way interms of hygiene as it doesn’t

require a fan and ventilationslits for cooling the hand

piece. The unit is not onlycompletely silent but

also easy to clean.However there was abasic wish many den-tists had that couldnot be fulfilled withElipar FreeLight. Itwas not possible to

reduce the curing time, inorder to ensure perfect curing,

the curing times used with conven-tional halogen lamps had to be kept.

Requirements for faster curing

The dramatic progress in blue light-emitting diode technology now pre-sents reduced curing times as an attrac-tive possibility. Besides the advantagesin handling mentioned previously, thelight generated by LEDs has greatpotential. In contrast to halogen units,which require filters for their selectionof wavelengths, the spectral range ofLEDs is set by the chemical composi-tion of the semi-conductors used.Unlike from halogen units the majorityof the light is in the high absorptionrange of the photoinitiator cam-phorquinone. In consequence, signifi-cantly lower intensities of an LED unitare sufficient to achieve the polymeri-sation performance of a halogen unit ofmuch higher intensity. Thus the EliparFreeLight with its 400 mW/cm2 corres-ponds to the performance level of standard halogen units with intensitiesof between 600 and 800 mW/cm2.

Fundamentally new concept

The high spectral efficiency of LEDlight now allows the development oflights with shorter curing times butwhich differs fundamentally from highperformance halogen units. If no com-promises are to be made regardingpolymerisation levels, then the intensi-ty of LED light must be doubled inorder to cut curing time by half.

Elipar™ FreeLight 2 Curing Light: From Zero to 1000 in LED Speed!

Saving Time without CompromiseMartin Hartung; 3M ESPE, Germany

Spectral distributionof various polymeri-sation units in com-parison with the ab-sorption spectrum(relevant range) ofthe photoinitiatorcamphorquinone.Wavelength rangesabove 490 nm are ineffect irrelevant forpolymerisation.(Source: internaldata, M. Hartung etal., 2002)

Elipar FreeLight 21000 mW/cm2

Elipar FreeLight 400 mW/cm2

Elipar TriLight700 mW/cm2

Optilux 5011500 mW/cm2

CamphorquinoneAbsorption

© 3M ESPE

7

March 2003No. 1Year 1

At 1000 mW/cm2 this demand is sur-passed by the new Elipar™ FreeLight 2Curing Light. This value is only slight-ly higher than the intensities used fortwice as long by conventional halogenunits. Thus, even in clinically difficultsituations there is sufficient reserveleft and there is no risk of thermalstress caused by exceedingly high lightintensities. Comprehensive studies, tobe published soon, show that, based onits technical data, the new EliparFreeLight 2 indeed delivers the 50%reduction in cure time expected theo-retically whilst maintaining polymeri-sation performance. As an example,the figure depicts the depth of cureachieved by Elipar FreeLight 2 with

different composites, tested accordingto ISO 4049. The curing times were allreduced to half of that recommendedby the composites’ manufacturerswhen curing with standard halogenlights. For comparison also includedare the values obtained by two stan-dard light units, the Elipar™ TriLightCuring Light and the Elipar FreeLight,using recommended curing times anda high-performance halogen unit, theOptilux 501 where the cure time wasalso reduced by half. The figure illus-trates that the Elipar FreeLight 2 candeliver a 50% reduction in cure times,with-out loss of cure depth. It evensurpasses the performance level of thehigh-performance halogen light.

3M ESPE MAGAZINE

The depth of cure achieved by the Elipar™ FreeLight 2 Curing Light is comparable to the valuesobtained by of the standard polymerisation units EliparTriLight Curing Light and EliparFreeLight Curing Light but in half of the time. The performance of the high-performance halo-gen unit Optilux 501, with turbo-tip and boost-mode, is slightly inferior to the Elipar Freelight 2Curing Light.

0

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Filtek Z250 A3 Tetric Ceram A3 Spectrum TPH A3

Elip

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High tech in every detail

The main part of the Elipar FreeLight2 Curing Light is a high-performanceLED. However the high efficacy ofthe light only becomes possible whenthe LED is used in combination with aspecial highly reflective mirror filmfrom 3M. This film is used to make areflector for shaping the light beam. Itmakes a high light intensity possiblewithin the slender, ergonomicallyoptimised hand piece. Consequentlywe were able to keep the attractiveappearance of the first EliparFreeLight while redesigning essentialparts of its interior. The battery hasbeen further optimised. Charge tech-nology ensures that the unit is alwaysready for use and its micro-processorcontrol maintains constant light inten-sity regardless of battery charge level.

Optimum handling and high-performance polymerisation

Thanks to its high polymerisation per-formance combined with optimumhandling, the lightweight, ergonomicElipar FreeLight 2 is a milestone indental light polymerisation technolo-gy. Previously quick polymerisationwas only achievable with noisy, barelyventilator-controlled halogen lampsrunning at the top of their capacities,or so-called plasma lamps, whosetechnology required huge amounts ofenergy and rigid light tubes, nowElipar FreeLight 2 has set new stan-dards. By these standards dentists willsave time without compromising qual-ity and efficiency of polymerisation orsimplicity of handling and familiarreliability. An attractive design andeveryday practicality makes the newElipar FreeLight 2 a light to be reck-oned with.

© 3M ESPE

8

User Report

Over the last few decades a numberof different cements have beendeveloped for the cementation ofindirect restorations. Today it couldbe said that there is a specialcement for absolutely every class ofmaterial and indication.

Manufacturers are striving to develop“universal cements” to simplify theluting procedure for the dentist. With RelyX™ Unicem Self-AdhesiveUniversal Resin Cement, 3M ESPEhas taken an important step in thisdirection. RelyX Unicem combinesthe benefits of conventional cementswith the advantages of modern com-posite cements. This does not onlyresult in a material with a range ofapplications but also in practicalhandling like a zinc phosphatecement, and also excellent aestheticsand mechanical properties similar tothose of composite cements. As withglass ionomer cements RelyX Unicemreleases fluoride ions into the toothsubstance. Due to its good self-adhe-sive bonding characteristics there isno need for costly and time-consum-ing conditioning of the tooth sub-stance with RelyX Unicem.

Experience with RelyX Unicem in combination withmetal-ceramic restorations

In the past classic cements (e.g. zincphosphate or glass ionomer cements)were used for this indication at ourdental practice. RelyX Unicem isoffered only in capsule form. Theadvantage of this over powder/liquidproducts is that no open jars/contain-ers have to be stocked. In comparisonwith composite cements, RelyXUnicem is not susceptible to moisture,which means that a rubberdam is notnecessary. The manufacturer does notrecommend conditioning of the toothsubstance (etching – priming – bond-ing) because the material is self etch-ing. This results in a noticeably fasterprocedure. The mixing capsules areactivated in approx. 2 sec and mixedfor 10 – 15 sec depending on the typeof mixing unit. The applicator allowsprecise and clean working . Automaticmixing also ensures a uniform mixand consistency of the material. Ifseveral crowns are being filled simul-taneously, it is advisable to first mix

RelyX™ Unicem Self-Adhesive Universal Resin Cement

The First Truely Universal Luting MaterialStefan Popp; Germany

RelyX™ Unicem Aplicap™. The universalcement is supplied in capsules to be activatedin commercial mixing devices and is availablein several shades.

up the contents of several capsules,and then to apply them one immedi-ately after the other. As RelyXUnicem is dual-curing, the treatmentlamp should not be pointed directly atthe restoration area, to prevent pre-mature curing of the cement. After fitting the restoration all theexcess material is light-cured forapprox. 3 sec. Afterwards it can belifted off with a probe or scaler. Withthis step the dentist no longer has towait for chemical curing of thecement while simultaneously stabi-lising the position of the restorationon the prepared teeth. All cementexcess should be quickly and com-pletely removed from the entirerestoration as RelyX Unicem alsooffers very good bond strengths tosmooth ceramic or metal surfaces.The range of shades offered ensuresthat optimum aesthetics are attainedfor the cemented restoration.All the above points underline theeconomy offered by this novel product, which allows the dentist tocover all major indications with oneproduct.

Fig.1: Comparison of Unicem with the various material classes, in regards of typical character-istics of interest to the dentist.

RelyX Unicem

Inlays, onlays,bridges, crowns,pins and postsmade of metal,composite andceramic

Easy to mixClean applicationNo pretreatmentNo Rubberdamnecessary

Dual-curingHighly aestheticSelf-adhesiveFluoride releaseInsusceptibleto moisture

No long- termclinical experi-ence as it is anew material

Zinc PhosphateCements

Metal-basedrestorations

Easy to mixVariable consistencyQuite easy toremove

Over 100 yearsclinical experience

Occasional post-cementationsensitivityLow hardness,High solubility

PolycarboxylateCements

Metal-basedcrowns and smallbridges (exceptTitanium)

Easy to mixVariable consistencyVery easy toremove

25 years clinicalexperience Good pulp toleranceMolecular adhesion to tooth

Comparativelyhigh solubility,Low hardness

LutingComposites

Metal-based, fullceramic and indirect compositerestorations

Difficult to mix,Rubberdam nec-essary, specialpretreatment ofrestoration and forbonding procedure

Over 10 yearsclinical experience High bond strengthGood hardness Low solubility Highly aesthetic

Susceptible tomoistureOccasional post-cementation sensitivityExcess materialdifficult to remove

Glass IonomerCements

Metal- basedrestorations.Limited usage forhigh-strengthceramics

Easy to mix, mate-rial available incapsules,Variable consis-tencyDifficult to remove

20 years clinicalexperienceFluoride releaseMolecular adhesion to tooth

Occasional post-cementation sensitivitySusceptible towater andmechanical stressduring settingperiod

Material

Indications

Working,handling

Benefits

Disadvantages

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March 2003No. 1Year 1

3M ESPE MAGAZINE

RelyX™ Unicem Self-Adhesive Universal Resin Cement – A Clinical Case Report

The Beginning of a RevolutionAlex Demets; Belgium

Various manufacturers have beenoffering self-etching adhesives. Thequality of these products improvesrapidly, and it is not impossible toimagine that separate acid etchingwill soon becomes a thing of thepast. Completely eliminating theacid etching and the adhesive stepsfor bonding procedures seemed likea dream, but at least for indirectrestorations it is now a reality.

3M ESPE recently introduced a totallynew concept, a self-etching, dual cureresin cement called RelyX™ UnicemSelf-Adhesive Universal ResinCement. This created a revolution inthe placement of crowns, bridges,inlays, onlays and posts made ofmetal, ceramic, composite and fibres.In a clinical test in the authors prac-tice, the product soon became indis-pensable, as 86% of the other testersin Belgium confirmed. To illustratethis, let us look at the steps involved toconventionally bond a porcelaincrown:

This is history …

Isolation, removal of temporary,cleaning the preparation, fitting thecrown, silanising the porcelain, acidetching, rinsing, “controlled” drying,mixing the adhesive, applying theadhesive, mixing the luting com-posite, applying in the dried crown, airdrying the adhesive (in some caselight cure the adhesive), placing thecrown, removing the excess and lightcuring the margins.

With RelyX Unicem this becomesvery simplified; after the silanisation,mix the cement in the Aplicap™ cap-sule, apply into the crown directlyfrom the capsule, place, removeexcess and polymerise. It can’t geteasier than this! If possible an evenbigger benefit is shown in the place-

ment of carbon fibre posts. There areseveral products available for this, butthe author prefers the dual-curedoptions. The placement protocol withhis material of choice (non 3M ESPE)looked as follows:

This is a today’s standard …

Preparation of the root canal with cali-brated burs of the desired diameters(opening 2/3 of the canal length leav-ing 5 mm of gutta-percha), very care-ful rinsing and drying (when neces-sary several times with several solu-tions and drying tools), mixing andapplying the self-etching, dual-curingprimer and thoroughly applying to theroot canal, leaving it for the recom-mended time period, dabbing withpaper points, mixing the luting com-posite and applying it into the rootcanal with a Lentulo needle, quicklyplacing the post and extruding theresin for the core build-up.

With RelyX Unicem this becomesmuch easier. The preparation of theroot canal is the same until the dryingstep. Then the Aplicap is activated,mixed and syringed into the root canaland onto the post. The post is placedand the build-up composite syringedon top. After curing the preparation isfinished.

Will it bond enough? Research inLouvain under Prof. Van Meerbeekshowed adhesion values of 20 MPa,surely enough for these applications.Besides the product offers goodmechanical properties, does not needpre-treatment of the tooth and theremoval of excess material afterplacement is very easy. Now all weare waiting for is a restorative materialwith similar characteristics! Can a dentist ever be fully satisfied?

Preparation of the root canal

The post is placed

The build-up composite is syringed on top

After curing and preparation

Clinical Case Report

10

Filtek™ Supreme Universal Restorative – A Clinical Case Report

A Universal Composite with Supreme Properties?Pascal Magne; Switzerland

4: Body Shade applied and fissures sculpted

3: First layer of Dentine Shadeapplied

5: Resin tints applied to fissures 6: Last increments of EnamelShade applied

7: Final view after rehydration.

1: Pre-operative situation and shade selection 2: View after preparation, etchingand bonding

Examination of this patient showed a defective amal-gam restoration. A radiograph confirmed the need forreplacement. Since aesthetics were the primary concernof the patient, new Filtek™ Supreme UniversalRestorative was chosen.

The correct shade of the tooth was evaluated before remov-ing the old restoration. If this had been done later the toothcould seem brighter because of dehydration, and a colourmismatch could then occur upon rehydration (1). After removal of the old amalgam the occlusal margins ofthe cavity were beveled. A fourth generation adhesive wasused to bond and seal the restoration (2). Then a first increment of Filtek Supreme Dentine Shade,the most opaque variety of the composite, was placed. Thisdentine shade nicely masked the dark occlusal floor of thecavity (3).Then the dentine portion of the restoration was completedwith increments of Filtek Supreme Body Shade. Beforelight curing the last body increment, fissures were sculptedinto the material. An additional benefit of Filtek Supremeis the lack of slumping, which makes this sculpting fairlyeasy to accomplish (4). The fissures were then highlighted with dark resin tints, tosimulate as closely as possible the natural appearance ofthe neighbouring teeth (5). The restoration was then finished with increments of FiltekSupreme Enamel Shade (6). The composite system alsooffers translucent shades, especially required for anteriorteeth.After finishing and polishing the patient was very satisfiedwith the final aesthetic appearance of the restoration (7).

Dental Practice Forum

11

Knowledge alone is not enough. Theoptimum effectiveness of a mentoris based on the pillars of humannature and specialist knowedge:He/she recognises qualities in people, encourages them and putsthem to use according to theirnature.

We are familiar with Mentor fromGreek mythology as the tutor andcounsellor of Telemachus, the son ofOdysseus. Telemachus was only aninfant when Odysseus set out for Troy.So Odysseus entrusted the upbringingand education of his son and care ofhis possessions to Mentor. Since then“Mentor” has been used as a term fortutor and counsellor. In the sciences orbusiness mentoring means that anexperienced and respected expertpasses on his/her know-how withinthe framework of project work andteamwork.

Priorities in processesJust as controlling reveals economicviability, which should perhaps beimproved, mentoring is a means ofbringing and keeping the practice asyour enterprise on course. To achievethis, specialist experience such associal and communication skills arerequired.

If we regard the practice team as adynamic system*, then having anobjective external yardstick is impor-tant in order to avoid a blinkered atti-tude to one’s work. This entails theformulation of the goals from time totime and checking whether the know-ledge in the team is still sufficient toachieve these goals. New employeesare integrated and training carried out.The continual development of instru-ments, materials and informationtechnology requires constant training.Various dynamic processes happensimultaneously. The speed of thedevelopments and their preferencesmust be included in the decision-making process.

Analysis of the teamIn order to utilise the team optimally,each member should be deployed anddeveloped according to his/her indi-vidual strengths. To assess each teammember, Margerison-McCann’s“Team Management Profil®” is atried and tested Aid worldwide.Rapidly and precisely it outlines in itsassessment, the strengths of an indi-vidual and his/her role in the team:How he/she communicates with otherpeople, obtains information, makesdecisions and organizes his/herwork.Are all team roles in the practicefilled? Is there a sense of the mutualesteem essential to encourage bestpossible performance and forming thebasis for a win-win situation: bestpossible allocation of duties, maxi-mum success?

Development in the team

The development of individual teammembers should be initiated andchecked. The trends are sometimesmore important than the status quo.Current knowledge must be perma-

March 2003No. 1Year 1

Mentoring in the Practice

Everyone play a part

3M ESPE MAGAZINE

nently integrated and the trendschecked to establish if they corre-spond to the joint goal and the targetgroup. Who can perform this task?Ideally a mentor, who tracks the prac-tice in regular team meetings.

• • • • • • >

Knowledge and experience of older colleagues coupled with the carefree enthusiasm of youngermembers creates innovative potential, image gains and a strong team.

Mentoring in the practice

We have just illustrated some ofthe aspects of mentoring. Valuablesuggestions, however, come fromreal-life experience in your prac-tice. How do you practise “mentor-ing in the practice”? How do youimplement further training andmaintain a healthy team?

We would be delighted to publishyour experiences and will rewardfive entries drawn from the hatwith a conference folder.

You can contact us per E-mail:

Laurence.Settekorn@mmm.com

General Information

Calendar of EventsMarch to July 2003

DENTA, Bucarest March 06 – 09, 2003

BelarusDent, Minsk March 04 – 07, 2003

SEOC, Barcelona March 06 – 08, 2003

Scandefa, Copenhagen March, 13 – 15, 2003

IDS – International Dental Show, Cologne March 25 – 29, 2003

Collegio dei Decenti, Rome April 09 – 12, 2003

Dentexpo, Warsaw April 10 – 12, 2003

AEEDC, Dubai April 23 – 26, 2003

Dental Salon, Moscow April 23 – 26, 2003

BDA Conference, Manchester April 24 – 26, 2003

Amici di Brugg, Rimini May 15 – 17, 2003

EAED – Intl Congress: Esthetics reflections, Venice May 27 – 25, 2003

ConsEuro, Munich June 05 – 07, 2003

World Aesthetic Congress, London June 06 – 07, 2003

Dental Informa, Hannover June 20 – 21, 2003

IADR Meeting, Goteborg June 25 – 28, 2003

ORCA 50th Anniversary Congress, Konstanz July 02 – 06, 2003

3M ESPE AG

ESPE Platz, 82229 SeefeldTelephone: +49 (0) 81 52 / 7 00-0 • Telefax: +49 (0) 81 52 / 7 00-15 86E-Mail: info3mespe@mmm.com • Internet: http://www.3mespe.com

EDITORIALINFORMATIONS

Published by: 3M ESPE AG ESPE Platz82229 Seefeld GermanyTelephone: +49 (0) 8152 / 7 00-0Telefax: +49 (0) 8152 / 7 00-1586E-Mail: info3mespe@mmm.comInternet: http://www.3mespe.com

Editor:Gerhard Kultermann

Editorial team:Keith R. Haig, Roland Richter,Markus Roepke, LaurenceSettekorn, Al Waning

Coordination:Laurence Settekorn

Final editing and production: Markus Roepke

Circulation: 5.000

We accept no liability forunsolicited manuscripts orphotographs.

© 3M ESPE AGSeefeld, 2003

3M ESPE MAGAZINE

Communication – external and internal

The practice sells itself through itsoutward communication, with patientsand representatives: An atmosphere isdeveloped by means of the manner inwhich telephone calls are made andthe way people treat each other. Thisestablishes the reputation in parallel tothe medical performance and causespeople to come again.

How is communication within thepractice? Is it characterised by envy,boasting and mobbing or are all colleagues mutually supportive and sharing goals?

As a supervisor, the mentor can exertinfluence and intervene in an interme-diary role with regard to communica-tion and dealings with one another.

The role of the mentorAbstract

Knowledge alone is not enough. Odysseus entrusted Mentor with his infant andhis possessions. He invested in him the faith that he withheld from his wife. Theoptimum degree of effectiveness of a mentor is based on the pillars of upbring-ing, education and specialist knowledge. He/she recognises and encourageshuman qualities, puts them into effect according to their nature, completesknowledge where there are gaps and communicates in a manner appropriate tothe target group.

*Literature:Dörner, Dietrich: Die Logik des Mißlingens. Strategisches Denken in komplexen Situationen, (The Logic of Failure. Strategic Thought in Complex Situations)Reinbeck nr. Hamburg, rororo, 15th edition 2002

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