CAD/CAM Product description and Instructions for Use Cercon® base, Cercon® base light, Cercon® base medium, Cercon® base colored (short: Cercon® base) and Cercon® ht, Cercon® ht light, Cercon® ht medium Cercon® base PMMA, Cercon® base cast, Cercon® wax for Cercon® brain and Cercon® brain expert Product description Cercon® base, Cercon® base light, Cercon® base medium, Cercon® base colored, (short: Cercon® base), Cercon® ht, Cercon® ht light, Cercon® ht medium (short Cercon® ht) Indications in the anterior and posterior segments: Cercon® base / Cercon® ht is indicated for • Crowns • Telescopicprimarycrowns • Multi-unitbridges(withnomorethantwoponticsbetween abutmentcrowns) • Abutments Cercon® base / Cercon®htcanbeusedasasubstructure (framework)whichisthenveneeredwithadentalveneeringceramic orcanbeusedforfull-contourapplication(withoutveneering)as well.InthecaseofTelescopicprimarycrownsandabutmentsthe substructureisnotveneered. Product description: Cercon® base / Cercon® ht blanks are made of yttria-stabilized zirconia (Y-TZP). They are used in fabricating frameworks for fixedprostheticrestorationsusingCercon® brain / Cercon® brain expert.Theyaremadeofanoxideceramicmaterialcharacterized byparticularlyhigh-strength. These blanks are available in white (Cercon® base) and three gradations of ivory (Cercon® base light, Cercon® base medium, Contraindications: •Inpatienthypersensitivitytozirconiaoroneoftheother ingredients,thismedicalproductmaynotbeusedatalloronly undertheparticularscrutinyofthedentistorphysicianincharge •Bruxismorrecalcitrantparafunctionalhabits(asusualforall ceramicallyveneeredframeworks) •Insufficientavailablespace •Inlaybridges Cercon®basecolored).Ahighlytranslucentvariant(Cercon®ht, •Endodonticposts Cercon® •Endosseousimplants ht light and Cercon® ht medium) offering particularly pro-nouncedlighttransmissioncompletesthisproductrange. Dependingontheframeworkdesign,Cercon® base / Cercon® ht frameworks can be ceramically veneered or inserted as fully anatomic restorations. Which blank is selected will depend on the shade to be reproduced and the space available for the veneer. Warnings: Known cross-reactions or interactions of this medical product withothermedicalproductsormaterialalreadypresentintheoral environment must be taken into consideration by the dentist in chargewhenselectingthismedicalproduct. Precautions: With fully anatomic restorations, no space is required for the Please note: • Keep product dust away from eyes • Avoid any ceramicveneer,whichmayallowthedentisttopreservemoreof contactwithmucosa•Afteruse,washyourhandsandapplya thetoothsubstanceduringpreparation. handcream•Whenusing,donoteatordrink,donotingest,do notinhaledustparticles•Uselocalsuctionandsuitablemouth/ Frameworkmaterial Temporarycementation Definitivecementation ZirconiaY-TZP •Adhesiveluting •Conventionalcementing UsingCercon® brain / Cercon®brainexpert,yourrestorations and frameworks are individually fabricated to your digital design specifications such as anatomic shape, framework wallthicknessandconnectordiameterorcementinggap. Always use the most current version of the design software, asthismayinfluencetheproductionofyourrestorations.–As per May 2011, the most current software version for Cercon®artisversion3.1.5. faceprotectionduringgrinding Possible Processing the material will result in the release of dust that may cause irritation of the eyes, skin or respiratory passages. Theoverallmaximumworkplaceconcentration(MAK)forzirconia underGermanoccupationalhealthregulationsis1mg/m³,which meansthatlocalsuctionmustbeensuredduringallprocessing. Thesafetyandwarningnoteslistedheredescribehowtouseour system components in a safe and risk-free manner. Notify the dentist in charge of all factors described above if you use this medical product for a custom design and make sure to comply with the Instructions for Use and the pertinent Material Safety DataSheets(MSDS). 3 Product description Adverse effects: Indoingso,however,makesurethatthereliefoftheocclusal We are not aware of any risks or adverse effects related to surfacesisnotmodifiedbydeepeningexistingfissures,asthis Cercon® base / Cercon® ht. If properly processed and used, mightcompromisethestabilityofthematerialduetonotching adverse effects of this medical product are highly unlikely. action. Note that a shallow occlusal relief will increase the life However, reactions of the immune system (such as allergies) or expectancyoffullyanatomicrestorations. localized paraesthesia (such as an irritating taste or irritation of the oral mucosa) cannot be completely ruled out as a matter When manually finishing the frameworks, never (!) segment of principle. Should you learn of any adverse effects – even them interdentally with cutting wheels or other rotary questionableones–youarerequestedtonotifyus. instruments, because this, too, might result in notching and reducedstability. Framework dimensions (anterior and posterior): Wallthickness-Singlecrowns Marginthickness-Singlecrowns Wallthickness-Bridges Marginthickness-Bridges 0,4mm 0,2mm 0,5mm 0,2mm Important note: Alwaysmakesurethattheminimumthicknessoftheframework intheocclusalareameetstheminimum-thicknessrequirements evenaftersubsequentocclusaladjustment. Additional dimensional requirements for the anterior region: Numberofpontics • Frameworkdesignforceramicveneering 2 Connector cross section 6mm2 Frameworks to be ceramically veneered must be designed to a reduced anatomical shape for the veneer to receive maximumsupportbytheframework. Additional dimensional requirements for the posterior region: Numberofpontics 2 Connector cross section Cantileverponticattoothposition (onlyonepontic,uptoone premolarwidth) The frameworks can be veneered using either the pressing techniqueorthebuilduptechnique. 9mm2 Upto secondpremolar Connector cross section forthiscantileverpontic Technical specifications: Typ II, Class 6 (according to DIN EN ISO 6872; 2009) 12mm2 •CTE:10.5(25–500°C)•Modulusofelasticity:210GPa General notes on framework design: Composition (in mass %): • Fullycontouredframeworkdesign • Zirconia • Yttria 5% • Hafnium oxide <2% resp. <3% Indicatedespeciallywherelittleocclusalspaceisavailable,where (Cerconht)•Aluminaandsilica<1%•(Total100%) the restoration will be inserted without prior veneering or where therestorationwillbeindividuallycharacterizedusingbodystains. Fully contoured framework designs will be given the most suitable surface shape and texture automatically, as the Cercon® brain / Cercon® brain expert milling strategy uses a particularly fine cutter. The framework surface thus attained canbeadditionallypolishedcarefully(!)beforesintering,using rotaryinstrumentssuchasfinecuttersorwheels. Finishing: • Processing with Cercon® brain: ProcessedinthesamemannerasallCercon® base / Cercon® ht shades. For detailed instructions, please refer to the Cercon®brainInstructionsforUse. • P rocessing with Cercon® brain expert: For processing the blanks, use Type 0 Cercon® brain expert cutters (ZrO2). For detailed instructions, please refer to the Cercon®brainexpertInstructionsforUse. 4 •Sintering with the Cercon® heat plus Cercon® base, Cercon® base light, Cercon® base medium, Cercon® base colored: Frameworksmadeofthesematerialsaresinteredat • 1.350°CintheCercon®heatfurnace or at • 1.350°Cbzw.1.450°CintheCercon®heatplusfurnace Sandblasting: -Program #2 for bridges of up to eight units, Thesandblastingaidfacilitatestheremovaloftheobjectfromthe blank.Ithelpspreventframeworkfractureorotherdamagetothe Tmax.=1.450°C Correctpositiononthesinteringtray. -Program #1 for bridges of up to eight units, Tmax.=1.350°C Sinteringtraywithsinteringblock. -Program #3 for bridges of nine units or more workpieces.Usealumina(50µm,max.1.5bar)tosandblastonthe labialandbuccalspruesoftheobjectandthe“tongue”connector, Tmax.=1.450°C** because the object must be sintered together with that “tongue”. Cercon® ht, Cercon® ht light, Cercon® FrameworksmadeofCercon® ht medium: ht are sintered at • 1.500°CintheCercon®heatplusfurnace - Program #4 for bridges of up to eight units, Bytrimmingexcessedgesatthebottomofthe“tongue”youcan give the object more stability on the sintering block. (The smaller objects nested inside the “tongue” are detached completely and sinteredseparately.) Tmax.=1.500°C - Program #5 for bridges of nine units or more, Tmax.=1.500°C •Special sintering notes applicable to large-span bridges (> 9-gliedrig) in Cercon® heat plus: Sandblastingaid. Sandblastingtheworkpieces. Nesting: Toensurehomogeneouscontraction,nestsmallerobjects(such assinglecopingsorthree-unitbridges)ontheinside(“tongue”)of largerworkpieces. Beforemilling: Completely remove the barcode label from the blank to avoid contaminationofthesinteringfurnace(Cercon®heatplus). Sintering: Only two wide-span bridges (> 8 units) can be sintered in the Cercon® heat plus at a time. Place the object on the sintering block, with due regard to the internal vertical clearance of the Cercon®heatplus(130mm)andtheneedtofacilitatecontraction without any mechanical constraints. The bridge must not touch thesinteringblockduringthesintering. Separation: The object is separated from the tongue using diamond cutters underirrigation. Manual finishing after sintering: • Sandblasttheinsideandoutsideoftheframeworkwithalumina (110–125µm,max.3–4bar,45°angle). • Eliminate premature contacts one by one until the framework hasreacheditsfinalpositiononthedie(s).Duringthetry-onand fittingoftheframework,keepthediesonthecastandtryon theframeworkasawhole. • Oncethetry-onandfittingworkhasbeencompleted,donot performanyadditionaladjustmentssuchasfinishingtheentire framework. 5 Product description Note: Zirconia crown or bridge abutments should fit passively, Build-up technique withoutfriction.Therationaleforrequiringapassivefitliesinthe ItisrecommendedtouseCercon® ceramkiss/Cercon® ceram physical properties of the material itself: Ceramics will tolerate press / Cercon® ceram love (ceramic veneering materials) for compressive stress but not tensile stress. In crowns that veneeringzirconiaframeworks.Makesuretofollowtheapplicable exhibitafrictionfit,thisfrictionisgeneratedbycertain“bearing” InstructionsforUse. partsoftheframework,asthecrownitselfneverrestscompletely onthedieduetoprocessing-relatedsurfaceroughness(thesame Annealing: actuallyholdsforcast-metalframeworks).Itisonlythepeaksof Based on the results of our scientific testing of zirconia frame- the surface roughness (the named “bearing” parts) that are in works, we consider a separate annealing (“healing”) step both contact with the die surface. This converts the compressive unnecessaryandinappropriate. forces generated by masticatory pressure into tensile forces, whichmaywelldamagethecrown. In-laboratorypolishing: Unveneeredzirconiaframeworksshouldnotbeinsertedwithout • Adapt the framework margins exactly to the preparation margins. polishingthemtoahighlusterorsealingthemwithaglazeinordertoprotecttheantagonistsfromabrasion.Inaddition,polishing or glazing the restoration supports patients in their efforts at Note: Zirconia should be finished using diamond instruments oralhygiene. underproperirrigationonly.Keepthepressureontheframework materialtoaminimumandworkonlyinonedirection. In-office polishing: Comprehensive DeguDent-initiated studies have demonstrated • Sandblast the finished areas once again with alumina (110–125µm,max.3–4bar,45°angle). • Finally,cleantheframeworkusingasteamcleaner. the abrasive effect of Cercon® base / Cercon® ht on the antagonistnottoexceedthatofcommerciallyavailableceramic veneers or lithium disilicate ceramics – not even after adjusting onpolishing. Veneering / shading: You may need to adapt your usual build-up procedure to the Strictly for prevention purposes we recommend, following final respectiveCercon®baseshade.Pleasereadinstructionsforuse intraoral occlusal adjustment of the restoration, polishing any oftheusedveneeringceramic. adjusted surfaces to a high lustre or sealing them with glaze beforetemporaryordefinitivecementing.Thisisveryimportantas NotethatCercon®htexhibitshighlevelsoflighttransmissiondue it protects the antagonists from possible abrasion. In addition, toitspronouncedtranslucency. polishing or glazing the restoration supports patients in their effortsatoralhygiene. General Notably, reproduction of the custom shade is potentially Shadesfinalizedbystainingmayresultinbrightspotswherethe influencedby: stainwasremovedduringocclusaladjustment. • Dieshade • Colourofthematerialusedfortemporary/definitivecementing Transport and storage: • Wallthicknessoftheframework Therearenospecialterms. • Useofliner Staining technique For tooth-coloured staining of fully anatomic Cercon® base / Cercon® ht restorations, we recommend our Cercon® ceram bodystains. 6 Product description Cercon® base PMMA Product description: Indications in the anterior and posterior segments: Cercon® base PMMA are made of polymethylmethacrylate. They are used in fabricating provisionals for crown and bridge •Crowns frameworksforfixedprostheticrestorations. •Multi-unitbridges(withoneponticbetweenabutmentcrowns) Frameworkmaterial Polymethylmethacrylat Temporarycementation Yes Definitivecementation – Using Cercon® brain/Cercon® brain expert, your restorations and frameworks are individually fabricated to your digital Cantilevered-ponticbridgesarefabricatedattheordering laboratory’srisk. Allprovisionalsshouldnotbewornforlongerthansixmonths. Contraindications: •Inpatienthypersensitivitytopolymethylmethacrylateor oneoftheotheringredients,thismedicinalproductmay notbeusedatall. design specifications such as anatomic shape, framework wallthicknessandconnectordiameterorcementinggap. Warnings: Known cross-reactions or interactions of this medical product Always use the most current version of the design software, withothermedicalproductsormaterialalreadypresentintheoral asthismayinfluencetheproductionofyourrestorations.–As environment must be taken into consideration by the dentist in per May 2011, the most current software version for chargewhenselectingthismedicalproduct. Cercon®artisversion3.1.5. ProcessingCercon®basePMMAdiskwillresultintherelease of dust that may cause irritation of the eyes, skin or respiratory passages. The legal threshold limit value (TLV) for methylmethacrylateinGermanyis210mg/m³.Toensuresafeandsustainable compliance, the measured value must not exceed 25% of the TLV. This in turn requires that the room in which the Cercon® brain expert is used to process this material (max. 2 disksper8hours)musthaveavolumeofatleast28m³.Inrooms withasmallervolume,theairexchangeratemustbeincreasedby asuitableHVACinstallation. Precautions: Please note: • Keep product dust away from eyes • Avoid any contactwithmucosa•Afteruse,washyourhandsandapplya handcream•Whenusing,donoteatordrink•Donotswallow •Donotinhaledustparticlesduringgrinding•Uselocalsuction andsuitablemouth/faceprotectionduringgrinding. Wear protective gloves when replacing or disposing of dustfilterbags. 7 Product description The safety and warning notes listed here describe how to use our system components in a safe and risk-free manner. Notify the dentist in charge of all factors described above if you use this medical product for a custom design and make sure to comply with the Instructions for Use and the pertinent Material Technical specifications: • Density: 1.19 g/cm³ • Solubility: ≤ 7.5 µg/mm³ • Flexural strength:≥65MPa•Watersorption:≤40µg/mm³•Flexural modulus:≥2,000MPa SafetyDataSheets(MSDS). Composition (in mass-%): Adverse effects: of methacrylic acid > 99% • Pigments (predominantly We are not aware of any risks or adverse effects related to ironoxidepigmentsandbenzoylperoxide)<1%•Polymethyl • Polymethyl methacrylate and cross-linked copolymers Cercon® base PMMA. If properly processed and used, adverse effects of this medical product are highly unlikely. However, methacrylatemaycontainuptoapprox.1%residualmonomer •(Total100%) reactions of the immune system (such as allergies) or localized paraesthesia (such as an irritating taste or irritation of the oral Manual finishing: mucosa)cannotbecompletelyruledoutasamatterofprinciple. To remove a framework from the blank and to finish the Shouldyoulearnofanyadverseeffects–evenquestionableones framework,cross-cuttungsten-carbidecutterssuitableforcutting –youarerequestedtonotifyus. resinorappropriateseparatingdisksmustbeused.Toavoidan imprecise fit of the completed framework, subsequent to Framework dimensions (anterior and posterior): Wallthickness,singlecrowns 1,0mm Marginthickness-Singlecrowns 0,2mm Wallthickness-Bridges 1,0mm Marginthickness-Bridges 0,2mm Connector cross section Veneering: Notapplicable. Transport and storage: Additional dimensional requirements for the anterior region: Numberofpontics frameworkavoidexcessiveheatduringfinishingandpolishing. Storedry. 1 9mm2 Reuse: As each restoration or frameworks is a custom product for a specific patient and case, the product is not reusable in any Additional dimensional requirements for the posterior region: Numberofpontics Connector cross section Cantileverponticattoothposition (onlyonepontic,uptoone premolarwidth) Connector cross section forthiscantileverpontic 8 dental rehabilitation setting other than that for which it has beenprescribed.Inaddition,theframeworkcannotbereusedfor 1 9mm2 Kontraindiziert – refabricationoranyothersubsequenttherapeuticpurpose. Product description Cercon® base cast , Cercon® wax Product description Cercon® base cast: Indications in the anterior and posterior segments: Cercon®basecastblanksaremadeofpolyurethane,whichisa castingresinthatleavesnoresidue.Theyareusedinfabricating •DependingonthepropertiesoftheCAD/CAMsystemandthe castingalloyused. frameworksfortheconventionalcastingtechnique. Frameworkmaterial Polyurethan Temporarycementation No Definitivecementation – Contraindications: •Cercon® base cast and Cercon®waxhavenotbeenapprovedfor intraoraluse. Warnings: Known cross-reactions or interactions of this medical product Product description Cercon® wax: Cercon®waxblanksareblanksmadeofamillingwaxthatleaves no residue after firing. Shey are used in fabricating frameworks forthecastingtechnique. withothermedicalproductsormaterialalreadypresentintheoral environment must be taken into consideration by the dentist in chargewhenselectingthismedicalproduct. Processing Cercon® base cast / Cercon® base cast disk / Cercon®waxwillresultinthereleaseofdustandchipsthatmay Frameworkmaterial Wax Temporarycementation No Definitivecementation – causeirritationoftheeyes,skinorrespiratorypassages.Provide a sufficient local workspace vacuum throughout. For safety requirements while burning out the material, please consult the pertinent information in the Cercon® base cast Instructions for Use. When burning out Cercon® wax from the casting mould, observe the same safety precautions as for conventional wax Using Cercon® brain/Cercon® brain expert, your restorations and frameworks are individually fabricated to your digital design specifications such as anatomic shape, framework wallthicknessandconnectordiameterorcementinggap. castingmolds(removingwaxfumesbyvacuum). Precautions: Please note: • Keep product dust away from eyes • Avoid any contactwithmucosa•Afteruse,washyourhandsandapplya Always use the most current version of the design software, asthismayinfluencetheproductionofyourrestorations.–As per May 2011, the most current software version for handcream•Whenusing,donoteatordrink•Donotswallow •Donotinhaledustparticlesduringgrinding•Uselocalsuction andsuitablemouth/faceprotectionduringgrinding Cercon®artisversion3.1.5. Thesafetyandwarningnoteslistedheredescribehowtouseour system components in a safe and risk-free manner. Notify the dentist in charge of all factors described above if you use this medical product for a custom design and make sure to comply with the Instructions for Use and the pertinent Material Safety DataSheets(MSDS). 9 Product description Adverse effects: We are not aware of any risks or adverse effects related to Cercon® base cast / Cercon® wax. If properly processed and Technical specifications: – used, adverse effects of this product are highly unlikely. Should Composition Cercon® base cast: youlearnofanyadverseeffects–evenquestionableones–you •Polyurethan arerequestedtonotifyus. Composition Cercon® wax: Framework dimensions (anterior and posterior): Wallthickness,singlecrowns Marginthickness,singlecrowns Wallthickness,bridges Marginthickness,bridges 0.4mmorasdirectedbythe pertinentrecommendations forthecastingalloyused 0.2mmorasdirectedbythe pertinentrecommendations forthecastingalloyused 0.5mmorasdirectedbythe pertinentrecommendations forthecastingalloyused 0.2mmorasdirectedbythe pertinentrecommendations forthecastingalloyused Connector cross section • LD polyetylene homopol • Esters of hydrated colophon •Additives. Processing with Cercon® brain expert: For processing Cercon® base cast disk or Cercon® wax disk, use Type 2 Cercon® brain expert cutters (PMMA). For detailed instructions,pleaserefertotheCercon®brainexpertInstructions forUse. Manual processing: Additional dimensional requirements for the anterior region: Numberofpontics Microwax•Resins•Paraffins•Pigments•Polyethylenewax Cercon® wax can be processed using a high-speed procedure, 2 9mm2orasdirectedbythe pertinentrecommendations forthecastingalloyused asthematerialcanbeburned-outwithoutincreasinginvolume. To remove a framework from the blank and to finish the framework, cross-cut tungsten-carbide cutters suitable for cutting resin or appropriate separating disks must be used. Additional dimensional requirements for the posterior region: Numberofpontics Connector cross section Cantileverponticattooth position(onlyonepontic,upto onepremolarwidth) Connector cross section forthiscantileverpontic Toavoidanimprecisefitofthecompletedframework,subsequent toframeworkavoidexcessiveheatduringfinishingandpolishing. 2 12mm2orasdirectedbythe pertinentrecommendations forthecastingalloyused Upto secondpremolar 16mm2orasdirectedbythe pertinentrecommendations forthecastingalloyused Veneer Cercon® base cast / Cercon® wax: Notapplicable. Transport and storage: Nospecialterms. Reuse: As each restoration or frameworks is a custom product for a specific patient and case, the product is not reusable in any dental rehabilitation setting other than that for which it has beenprescribed.Inaddition,theframeworkcannotbereusedfor refabricationoranyothersubsequenttherapeuticpurpose. 10 11 Fascination GB 28239/1112/DB Last revision: 12/2011 Prosthetics DeguDent GmbH Rodenbacher Chaussee 4 63457 Hanau-Wolfgang Germany www.degudent.com
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