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Cercon ht + Cercon ceram love Fully contoured or partially – completely veneered
al n o s r e p d an e saf
Cercon ht
n io t ra e n ge ia n o c ir z t x e n e h T
When light can partially pass through an object, this is called translucency. Re-creating the natural translucency of teeth is one of the most difficult challenges for developers of dental materials. Cercon ht combines 10 years of CerconŽ safety and reliability with contemporary expectations of a natural-looking translucent framework base – without compromise. Fully contoured restorations and restorations veneered with DeguDent veneering ceramics now both comprise complete treatment concepts for all indications. Kind regards, Your sirius team
Dental materials are called translucent when some light can pass through them without them being transparent. 2
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˅˅ All 16 Vita shades ˅˅ Shade transitions as in natural teeth (shade zones) ˅˅ Natural effect draws on the depth of the restoration, as the shade zones are part of the build-up ˅˅ Easier shade reproduction ˅˅ No liner required
Cercon ht is translucent but masks slightly discoloured tooth substance sufficiently and without “greying” (make-up effect).
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Influencing the shade of a Cercon ht restoration
Dentist
1
Standard preparation and procedure for all-ceramic restorations
The properties of the underlying structures
(Clinical Guidelines, DeguDent GmbH)
should be discussed with the dental technician (preserved vital tooth, non-vital and discoloured tooth, metal core, implant abutment).
˅˅ Take the shade prior to preparation, either in natural daylight or in a room with optimized artificial light ˅˅ Avoid makeup or lipstick
2
˅˅ The first impression is often the best impression ˅˅ Dried-out tooth substance may differ in brightness by up to two full brightness levels
If only very little tooth substance is available
˅˅ Photographs can be most helpful
matched carefully (shown here: cheek retrac-
Dental technician 3 ˅˅ CAD/CAM fabrication using the most recent technology ˅˅ Reduced tooth shapes for optimal support of the veneer ˅˅ Creating framework shade zones as per the suggested mixing recipe (cf. page 15) ˅˅ Multi-layer ceramic veneers optimize shape and function 4
or the background displays different shades, the shade of the bonder materials must be tor according to J. Freitag).
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Cercon ht Ë…Ë… Correct reproduction of the tooth shade according to the Vita Classical tooth guide or custom shade-matching aids
For more information:
www.sirius-ceramics.com
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The Cercon ht treatment concept
Each restoration is like a fingerprint. Each is unique. No two are the same. The excellent Cercon ht performance gives us the flexibility to meet the demand for uniqueness in nearly any situation.
˅˅ Fully contoured Cercon ht crowns (cf. sirius News, November 2011) ˅˅ Crowns and bridges on teeth or implants, multi-coloured or partially/completely veneered ˅˅ Double crown using the Weigl technique ˅˅ Two-piece abutments
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Fully contoured Cercon ht objects (unveneered)
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...one for all
The Cercon ht treatment concept is highly versatile and fulfils the dream of one material for all purposes. Familiar, reliable 10-year Cercon速 safety, supported by clinical studies throughout the world.
y it il t sa r e v d an y t Safe
even in the presence of high loads.
Fully contoured or partially/completely veneered.
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The Cercon ht treatment concept
The comprehensive anatomy library (3Shape) in connection with the top-of-the-line Cercon brain expert milling strategy delivers milling results that can be used directly without much finishing. The Cercon ht treatment concept is the most convincing concept for many indications.
Finishing unsintered frameworks is a very delicate task. Tools must be selected carefully to avoid damaging the framework. Minor imprecisions in contour can easily be corrected. Finishing should be performed at low speeds, avoiding pressure.
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t in r p r ge n fi a s a e u iq Un
Remove the framework from the blank
Use only approved tools for finishing
Perform all procedures with minimum
by sandblasting (50 Âľm, max. 1.2 bar).
unsintered frameworks.
vibration and without pressure. Use
Carefully grind flat any areas where
only approved milling instruments.
connectors were attached.
Important notes ! ! Never weaken pontic connectors. !! The minimum wall thickness is 0.4 mm for crowns and 0.5 mm for bridges. ! ! Keep cutters absolutely clean to preserve the material’s favourable physical properties. ! ! Make sure that the surface has some residual roughness (chalky surface) to allow the mixed stain to enter. ! ! While finishing, do not exert excessive pressure. The framework is very delicate and easily damaged. ! ! Use only Sirius Ceramics rubber cups. Other rubber cups may leave inclusions in the surface (black spots).
The Cercon ht starter set was developed to match the requirements and specifics of Cercon ht. Highquality components offer the processing safety you are accustomed to. Cercon ht Starter-Set | sirius ceramics ART 40000
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Processing instructions
˅˅ Remove any contamination Thoroughly remove all contaminants such as dust or adhesives prior to staining, using appropriate liquids. Frameworks must not be steam-cleaned nor contaminated by e.g. sweat or grease from the fingers, as this may adversely affect the property of the materials and correct shade reproduction
˅˅ For staining, follow the mixing recipe on page 14 for Cercon ceram love or the mixing recipe in the November 2011 issue of sirius News for fully contoured Cercon ht Hold objects with disposable gloves or holding clasps. Use all staining liquids only once to prevent processing errors and keep the remaining content of the bottle viable.
˅˅ Avoid pooling Do not introduce “puddles” or staining liquid residue into the firing chamber to prevent serious damage and furnace contamination.
˅˅ Notes on the drying process Use infrared light with a power of approximately 150W at a distance of no more than 20 cm from the object to ensure complete evacuation of the liquid. Do not perform drying where there is a draft (e.g. near a window), as this may prevent the heat from reaching the object, resulting in incorrect drying times (see illustration). Acid storage cabinets or fume hoods can be used, provided they are run on “low”. Until the object has been sintered in the Cercon heat plus furnace, keep all metal tools, cutters, grinders and similar at a safe distance from the liquids to prevent flash rust and pro-
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cessing errors.
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...one for all
D RY I N G T I M E S Crowns, abutments, individual premolar-sized elements �
1 h
Molars and three-unit bridges
≥ 1,5 h
Wide-span bridges and superstructures
≥ 2 h 11
Staining techniques
n o si mer m I / e m o r ch Mono ˅˅ Immerse the framework in the desired staining liquid for 5 seconds (see mixing recipe on page 14) ˅˅ 16 Vita Classical shades ˅˅ The framework already has a basic colour ˅˅ No liner is required ˅˅ The framework shade is the colour foundation for the ceramic build-up ˅˅ Fully contoured elements and the more voluminous portions of frameworks (pontics) accept more liquid and exhibit a more intense shade
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e u iq n ch e t g in n ai st Cercon ht multi-colour The Cercon ht multi-colour staining mixing recipe (by sirius ceramics) is a unique staining concept. By applying the staining liquids in a controlled manner, you can create gradual colour transitions of varying intensity.
˅˅ 16 + 2 shades with transitions ˅˅ Up to five different shade zones per tooth ˅˅ Optimum shade base for veneering ˅˅ Due to the controlled application of the staining liquid, the framework gets the same uniform shade intensity in all areas
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The mixing recipe | 16 + 2
Carsten Fischer
MONOCHROM
M U LT I - C O L O R S TA I N I N G **
IMMERSION *
SHADE
14
MARGIN I
MARGIN II
CERVICAL
Bleach 1
5 seconds / A 1 P
–
2 x A 3 P
2 x A 2 P
Bleach 2
5 seconds / A 1 P
–
2 x A 3 P
2 x A 2 P
A 1
5 seconds / A 1 P
–
2 x A 3 P
2 x A 2 P
A 2
5 seconds / A 2 P
1 x A 3,5 C
2 x A 3,5 P
2 x A 3 P
A 3
5 seconds / A 3 P
2 x A 3,5 C
2 x A 3,5 P
2 x A 3 P
A 3.5
5 seconds / A 3.5 P
3 x A 3,5 C
2 x A 3,5 P
2 x A 3 P
A 4
5 seconds / A 3.5 P
3 x A 3,5 C
2 x A 3,5 P
2 x A 3 P
B 1
5 seconds / B 1 P
–
2 x B 3 P
2 x B 2 P
B 2
5 seconds / B 2 P
1 x B 4 C
2 x B 3 P
2 x B 3 P
B 3
5 seconds / B 3 P
2 x B 4 C
2 x B 4 P
2 x B 3 P
B 4
5 seconds / B 4 P
3 x B 4 C
2 x B 4 P
2 x B 3 P
C 2
5 seconds / C 2 P
1 x C 3 C
2 x C 3 P
2 x C 2 P
C 3
5 seconds / C 3 P
2 x C 3 C
2x C 3 P
2 x C 3 P
C 4
5 seconds / C 4 P
2 x C 4 C
2 x C 4 P
2 x C 4 P
D 2
5 seconds / D 2 P
1 x D 3 C
2 x D 3 P
2 x D 2 P
D 3
5 seconds / D 3 P
2 x D 3 C
2 x D 3 P
2 x D 3 P
D 4
5 seconds / D 3 P
2 x D 3 C
2 x D 3 P
2 x D 3 P
* The entire framework has a uniform basic shade ** Gradual colour transitions similar to those of the natural tooth C see sirius News, November 2011 P see sirius News, November 2011
DENTIN/ ENAMEL
2 x A 2 P brush out
2 x A 2 P brush out
2 x A 2 P brush out
2 x A 2 P brush out
2 x A 2 P brush out
2 x A 3 P brush out
2 x A 3 P brush out
2 x B 2 P brush out
2 x B 2 P brush out
2 x B 2 P brush out
2 x B 2 P brush out
2 x C 2 P brush out
2 x C 2 P brush out
2 x C 3 P brush out
2 x D 2 P brush out
2 x D 2 P brush out
2 x D 2 P brush out
OCCLUSAL
2 x A 2 P 2 x A 2 P 2 x A 2 P 2 x A 2 P 2 x A 2 P 2 x A 2 P 2 x A 2 P 2 x B 2 P 2 x B 2 P 2 x B 2 P 2 x B 2 P 2 x C 2 P 2 x C 2 P 2 x C3 P 2 x D 2 P 2 x D 2 P 2 x D 2 P
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Occlusal
Cervical
Dentin/enamel
Margin II Margin I
1 Multi-colour staining of the vestibular surfaces
1a Staining of the vestibular areas
2 Staining of the basal aspects
1b Staining of the palatal surfaces
3 Staining of the proximal surfaces
4 Staining of the occlusal surfaces
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The right finishing tools
Finishing
Perform shape adjustments and all finishing using a water-cooled turbine and appropriate Bishop diamond burs.
80 µm gross cutters ˅˅ Good reduction action for more extensive finishing
40 µm finishing cutters ˅˅ Controlled, delicate reduction ˅˅ Final detailing prior to veneering ˅˅ Finer abrasive cutters are unsuitable
www.sirius-ceramics.com
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Limit all transition zones between the Cercon ht framework and the future veneer by a clean chamfer. This is the only way to ensure that the ceramic material achieves the desired compressive stress and provides adequate support for the ceramic veneer.
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Veneering preparations
Air-abrade the areas to be veneered with aluminium oxide (110 µm/max. 2 bar) and clean the object with a steam cleaner. ˅˅ Make sure to use only oil-free compressed air
s n io t a u t si al n io t p e c x e In There are situations in which a severely discoloured tooth or core must be masked to avoid shade discrepancies occurring in different areas of a single-thickness veneer despite a standardized technique. In these exceptional cases, use the Cercon ceram love liner as per the manufacturer’s instructions and cover the critical area locally.
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Cercon ht + Cercon ceram love
...one for all With its unique multi-colour formulation, Cercon ht is the best shade-defining base for ceramic veneering. It has never been so easy to match the 16 Vita Classical shades of the shade guide exactly.
? t n e r e f f di is t a h W w e What is n FRAMEWORK
veneer
˅˅ No liner required
˅˅ Cercon ht Custom Dentin mixing recipe (cf. page 21–23)
˅˅ Cercon ht (monochrome immersion), Cercon ht multi-colour with five shade zones already provides the basic shade
+
˅˅ 16 Vita and 2 bleach shades from only 3 components
=
Perfect shade reproduction even by novices
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new
Cercon ceram love/Custom Dentin
Apply the mixed Cercon ceram love Custom Dentin directly to the framework. This lets you either support the value of the desired shade or modify it as needed. Custom Dentin is a mixing recipe based on extensive experience at sirius ceramics; it is not a product sold on the market. For the appropriate mixing recipe, see page 23.
1 2
3
1 Framework transitions can be masked without sharp edges.
Applying Cercon ceram love Custom Dentin is part of the shade reproduction process. The Custom Dentin and the multi-colour
2 Missing volume can be added without affecting the shade.
framework shade define the basic shade of the restoration. Cer-
3 Cercon ceram love Custom Dentin covers undesirable discontinuities by creating smooth transitions.
con ceram love Custom Dentin is fluorescent and supports the luminescence of the veneer. For the appropriate mixing recipe, see pages 23–25, top.
Cercon ceram love Custom Dentin is a mixing recipe brought to you by sirius ceramics.
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˅˅ 16 + 2 bleach shades ˅˅ Less space required per tooth ˅˅ Simple mixing recipe ˅˅ Shade-adaptive multi-color framework for more reliability ˅˅ Standard or custom implementation ˅˅ Safe veneering
The Cercon ht multi-color mixing recipes were tested by dental technicians for each individual shade and evaluated using actual ceramic buildups with Cercon ceram love.
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The Cercon ceram love concept is based on using a minimum of component shades. Any intermediate shades or transitions are first analysed against the comprehensive shade wheels and subsequently mixed at a 1 : 1 or 1 : 2 ratio following a simple mixing recipe.
This allows the Cercon ceram love shade system to produce excellent results with a manageable number of components. If you want, you can obtain any additional effects or details or even your own personal mixes by following the instructions and using the tools. For obtaining a precise dosage, we recommend an approach dispensing device (sirius ceramics/ART 70100). This device dispenses the correct amount of powder, ensuring reproducible results. Two different dosage tips can be used to accommodate different dosage needs.
Example
Sunset ˅˅ Red print: Available as a single component, no mixing required Sunset + S BY ˅˅ Black print: Mix 1 part of Sunset + 1 part of Standby Custom Dentin 22
˅˅ A2: 1 part of ID 0 + 1 part of ID 1 + 1 part of DE 2
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Cercon ceram love shade assignment table
CUSTOM DENTIN
DENTIN
INCISAL
ID 0 + DE 1
DE 1
WS
ID 0 + DE 1
DE 1 + DE 2
WS + TR
A1
ID 0 + ID 1
DE 2
E 1
A2
ID 0 + ID 1 + DE 2
DE 3
E 3
Body 2, 3
A3
ID 1 + ID 4 + DE 9
DE 9
E 3
Body 2, 3
A3.5
ID 1 + ID 4 + DE 16
DE 16
E 3
Body 3
Coping A3,5
ID 3 + ID 4 + DE 21
DE 21
E 3
Body 4
B1
ID 0 + DE 2
DE 2
E 1
Body 1, 4
B2
ID 0 + ID 4 + DE 4
DE 4
E 3
Body 1, 4
B3
ID 1 + ID 2 + DE 8
DE 8
E 3
Body 1, 4
ID 2 + ID 4 + DE 22
DE 22
E3 + Fog
Body 1, 4
ID 0 + ID 4 + DE 7
DE 7
E 1 + Fog
Body 6, 7
C2
ID 1 + ID 4 + DE 20
DE 20
E 3 + Fog 1:2
Body 6, 7
C3
ID 2 + ID 4 + DE 20
DE 20
E 3 + Fog
Body 6, 7
C4
ID 4
DE 22
E 3 + TC 2:1
Body 6, 7
D2
ID1 + ID4 + DE 13
DE 13
E 2 + Fog 1:1
Body 7, 9
D3
ID 3 + ID 4 + DE 15
DE 15
E 3
Body 7, 9
ID 3 + ID 4 + DE 17
DE 17
E 3 + Fog 1:1
Body 7, 9
SHADE
Bleach 1 Coping A1 Bleach 4 Coping A4
A4
B4 Coping B3 C1 Coping C2
D4 Coping D3
BODY I, II
Body 1, 2
The multi-coloured framework, ready for veneering.
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Cercon ceram love firing table
General firing
Pre-heating
Drying
Heating
Holding
Vacuum
program
°C
Min.
°C/Min
Min.
hPA
Cooling
Dentin I
450
6:00
55
900
1:30
no
Dentin II
450
6:00
55
890
1:30
no
Glaze correction
450
6:00
55
880
1:00
yes
Final Love correction
450
6:00
55
750
1:00
yes
Cercon Body stains
450
3:00
55
800
1:00
yes
* The values listed here are intended for orientation only and should be regarded only as guidelines. Your firing results may differ. All firing results depend on the performance of the furnace used, which in turn depends on the make, model and age of the furnace. Therefore, the guideline values will have to be adapted individually for each firing. We recommend running a test firing cycle to evaluate the performance of the furnace used. We have compiled and checked all values and other data with great care. However, we cannot be liable for your results under any circumstances. For all firing tables: The firing temperature must be adjusted to the number of units fired. Five to ten units require an increase by 5°C to 10°C; more than ten units require an increase by 10°C to 20°C.
Applying Cercon ceram love Custom Dentin to define
Applying dentin according to the mixing recipe. A re-
the value and/or compensate for volume differences.
duced anatomic shape is required. Cercon ceram love exhibits approximately one-third less contraction than comparable veneering ceramics.
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Completed Cercon ht bridge according to shade guide
Applying enamels and completing the shape prior to the first and second firings
25
Cercon ht + Cercon ceram love Standard posterior restorations
live
Baseline situation: Insufficient posterior restorations, no function, no shade design
The prepared teeth 14 and 15 differ greatly in shade. Cercon ht will be able to eliminate these differences almost completely
while preserving the natural
translucency. A two-shade build-up is sufficient to match the shade as determined by the shade guide.
Cercon ht is used to mask the darker tooth, yet the translucency is still close to that of the adjacent
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natural tooth.
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Cercon HT treatment concept as clinical routine 17, 16, 27, 26 Cercon ht, fully contoured 14, 15, 24, 25 Cercon ht, fully contoured In our actual daily work, many full-arch restorations are cemented temporarily using Tempbond (DENTSPLY DeTrey, Constance, Germany) to identify and eliminate residual high-risk areas prior to definitive cementing. 27
Cercon body stains/glaze
Individual options
Cercon body stains are highly versatile. They can be applied directly to the framework, prior to veneering, or employed in the final staining process as customary.
˅˅ Make sure the stains have a creamy consistency to prevent “islands” from forming on the surface. ˅˅ Finish the shade according to the table on pages 23–25.
Cercon body stains and Cercon glaze were reformulated in 2011 to adapt them even better to Cercon ht and Cercon ceram love.
28
˅˅ Glaze firing is a necessary step for fully contoured units: the glaze is required to “seal” the surface. ˅˅ For firing recommendations, see page 25.
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Examples of custom applications
Bluish incisal zone obtained by using Opal Sky, Opal Ocean + Fog
The value of the incisal third can be achieved by applying Flu I, Flu II (even in situations with minimal available space)
1
1 Semi-transparent zone between reddish-brown and sunny. Sunset–Sunrise
2
or 50 : 50 using Standby 2 Age-adjusted in-depth translucency using, e.g., opal incisal Fog
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live
Cercon ht + Cercon ceram love Anterior restorations
Baseline situation: “Liveless� anterior situation. Teeth 12, 11, 21, 22 to be restored with Cercon ht.
A
B
C
D
A The virtual wax-up, drawing on comprehensive library
B Completed Cercon ht copings with multi-colour shade.
data, forms the basis of correctly reduced anatomical contours of the Cercon ht frameworks. C Correct application of Cercon ceram love Custom Dentin.
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D Applying different ceramics, full-body view.
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Finishing and delivery of the completed Cercon ceram love crowns
The ability of Cercon ht to conduct light results in a natural appearance of the red and white aspects, especially in the aesthetically demanding anterior area 31
Special thanks go to Lilli Schermer, Tanja Wagner, Jan Stiller and Dr Rafaela Jenatschke for their unbelievable performance as the mixing recipes were developed and realized. No such collection of mixing recipes can ever be compiled without diligent teamwork! All restorations shown are actual, non-retouched restorations delivered to patients of Dr Rafaela Jenatschke of Frankfurt in the course of our daily work.
Kind regards Your sirius team
sirius ceramics | Carsten Fischer Lyoner StraĂ&#x;e 44 – 48 60528 Frankfurt Germany E-Mail info@sirius-ceramics.com Web www.sirius-ceramics.com www.sirius-ceramicsshop.com Phone
+49 69 66366910
Fax
+49 69 66366911