Scientific Documentation TARGIS/VECTRIS Research and ...

Scientific Documentation TARGIS/VECTRIS Research and ...

TARGIS/VECTRIS Materials with very different physical properties are used in the conventional crown and bridge technique. The thermal and elastic properties are the most important ones to observe. Metal alloys are most often used for frameworks. These materials, however, cannot always be used, since they are biologically incompatible and they compromise the aesthetics of the restorations. In addition, metal veneered restorations are complex systems with a number of interfaces between a

variety of materials. These areas are the potentially weak points of the restoration and are often the cause of clinical failure. Tension in materials Materials expand when heated. When their are left to cool, they take on their original dimensions. The degree of this behaviour differs from one material to the other. It is represented by the particular coefficient of thermal expansion (CTE). The CTEs of conventional crown and bridge materials are listed in the table. The difference

between the CTEs of metals and resins is considerably greater than that between metals and ceramics. Metal-ceramics are exposed to high temperatures during the production procedure. Lightcuring veneering composites, however, are only exposed to then-nocycles when they come in contact with foods with different temperatures. Despite the use of special adhesive systems that produce a bond between metals and resins, chipping off of the material is often observed. Materials demonstrate different degrees of deformation when subjected to load. Their particular trend to

deformation is determined with the modulus of elasticity. Metals also clearly differ from popular veneering materials in this respect. As a result, tension is produced in the interface areas when load is applied. This tension can cause the bond to fail. In contrast to metal, the CTE and modulus of elasticity of the new Vectris framework material is coordinated with the new Targis complete veneer material. Furthermore, the properties of this material correspond to those of human dentin. As a result, tension is minimized in teeth

restored with this system Material Conventional veneering resins CTE (20-60-C) [ttm/(-*K)] Modulus of elasticity

[N/mm2] 40 2 - 20'000 Veneering ceramics 6 - 12

50 - 70'000 Dental alloys 10 - 14 200'000 Tarais (Dentin)

40 12'300 Vectris (Single) 24 2 l'000

Vectris (Pontic) 6 (Iangs)/51 ( quer) 36'000 Human Dentin 7-9

16 - 18'000 Aesthetics Special shoulder materials and opaquers considerably improve the aesthetic properties of metal restorations. However, there is no technique that can compensate for the opacity of these restorations. The new tooth-coloured, translucent, highly aesthetic Vectris framework material offers optimum prerequisites for true-to-nature

restorations. Vectris fibre-reinforced material Fibre-reinforced technology is being used in various industries (e.g. aeronautical and shipbuilding industries). The material is used in situations where permanent loads are applied and light weight is required. Vectris is a fibrereinforced material used to fabricate metal-free, translucent frameworks for crowns and bridges. The fibres and the matrix of the material have different basic physical properties. The fibres demonstrate high tensile strength, a

high tensile modulus, and low shear strength, while the matrix demonstrates a higher degree of toughness. An optimum composite material should combine the favourable properties of both components to form a material that is superior to the components themselves. This goal is achieved by optimizing the fibre-matrix bond. This bond is achieved chemically. The glass surface demonstrating silanol groups is conditioned with silane. In the processes of condensing on the glass surface, the silane

produces a covalent bond. In turn, the silane contains a functional methacrylate group which copolymerizes with the methacrylate of the matrix. Consequently, a chemical bond is achieved between the matrix and the fibres. F- lamination M> Vectris Pontic

PR> Vectris Single M> Vectris Frame Pressing and curing VS-1 Eg> Vectris Finished product M> Fibre reinforced composite

Veneering material Targis The veneering material is visible and comes in contact with adjacent and antagonist teeth. Therefore, the properties of the veneering material are decisive for the surface quality and the aesthetic effect of restorations, as well as for their interaction with the surrounding teeth and gingiva. Targis is a highly filled (up to 75-85% inorganic fillers) material. The high content of fillers provides aesthetic properties similar to those of ceramics, while the organic matrix assures the ease and accuracy of processing of resin materials. The matrix is formed upon polymerization of monomeres (chemical bond via free double bonds) and the filter particles are chemically linked via silane to

the matrix'. The wear resistance has been coordinated with that of natural enamel to protect antagonists. Furthermore, the Targis/Vectris Systems allows gentle preparation of teeth. Preparation margins may be supergingival. Furthermore, bridges anchored by inlays are possible. Tempering (final curing) Once restorations have been fabricated, they are tempered in the Targis Power. During this controlled process involving heat and light, the properties of the

materials are optimized (stability in mouth, colour stability, wear resistance, adhesion of plaque). Bond The followig materials are bonded in dentistry and dental technology: resin - resin metal - resin metal - ceramic

ceramic- resin resin - enamel and dentin Based on the content of organic molecules in Targis and Vectris resinresin bond is found. Due to the high content of inorganic part in Vectris (fiber) and Targis (filler) also the resinceramic and when Targis is used on metall the metal-resin bond must be considered. layers. This reaction is effectively utilized during the layering of the Targis material. During this procedure

intermediate curing is possible. The same is valid for the layering of direct composite restorations. This bonding mechanism also plays an important part in lightcuring Targis restorations (inlays, onlays and anterior crowns) and environment. Two issues, however, have not been solved:

1. After only a short time in the mouth, discolouration is visible between the metal and the resin. As a result, the aesthetic quality of the work is compromised. between metals and resins have been developed (Silicoaterl&, Rocatec, OVS, Spectra Link). All these systems involve the

conditioning of the substrate (metal) to produce bifunctional molecules that adhere to the metal surface (often silane) and that contain a polymerizable double bond. These molecules with the metal oxide, the layer is inert. The methacrylate group in the phosphoric acid reacts with

the monomer contained in the Targis Opaquer and forms a copolymer. As a result, a bond with the veneering material is assured. The hydrolytic stability (insensitivity towards moisture) is achieved, since Targis Link contains a monomer with Consequently, the finished

Vectris frameworks are silanized (Targis Wetting Agent). The silane condenses on the surface of the exposed fibres and bonds with the monomers of the Targis veneering material with the help of the methacrylate groups (resinceramic bond). The bond Vectris-Targis is therefore based developed specifically for dental

applications. As a result, there are no real competitors. Vectris can be used for the same indications as metal frameworks and the "core" materials from allceramic systems (In-Ceram, Dicor, Optec, IPS Empress). (Touati, 1996): -

Second-generation laboratory composites - Ceramic polymers - Polyglasses - Ceromers - highly filled (mineral fillers); - demonstrate improved

physical and mechanical properties; - mediate an excellent bond with metals. reduced susceptibility to fracture (resilience) - More freedom in preparation - Reduced risk of fracture during try-in

- Easy surface conditioning prior to cementation (sandblasting without hydrofluoric acid etching) 91000 Conquest (Jeneric Pentron) 79 155 8'500 Columbus (Cendres et Metaux)

77 160 12'000 Targis (Ivoclar) 80 150-160 10,000 BelleGlass HP (Belle de St. Claire) 74 150 9'655 Touati, 1996 - Composition

- Physical properties - Studies on the material (in vitro) - Clinical investigations (in vivo) - Toxicological data - Literature references Decandiol dimethacrylate 4.8

Urethane dimethacrylate 9.3 Bariumglassfiller, silanized 46.2 Mixed oxide, silanized 18.2 High dispersed silica 11.8 Catalysts and Stabilizers

Vickers hardness (HV 0.2/30) 640 + 60 MPa Water absorption 16.5 + 1.2 tig/mm' Water solubility 2.0 + 0.8 Ag/MM3 Depth of cure >- 2 mm Consistency (Penetrometer)

3 + 0.2 mm Date of issue / Reference: April 1997 - PO Ima TDENT-E.DOC Replaces version ofFebruary 1996 Bis-GMA 8.7 Decandiol dimethacrylate

4.6 Urethane dimethacrylate 9.0 Bariumglassfiller, silanized 72.0 High dispersed silica 5.0 640 + 30 MlPa Vickers hardness (HV

0.2/30) 700 + 60 MPa Water absorption 16.5 + 1.2 jig/nun3 Water solubility 2.0 + 0.8 pg/mm' Depth of cure >- 2 mm Consistency (Penetrometer) Date of issue / Reference:

April 1997 - PO Inia TSCHN-E.DOC Replaces version of: February 1996 Product: VECTRIS SINGLE, FRAME, PONTIC Type of material: Fibre reinforced metal-free frame work

material for the veneering technique Water absorption [mpg/mm'] 18.8 + 0.8 18.8 + 0.8 --Water solubility [mpg/mm'] 0.8 + 0.25 0.8 + 0.25 ---

In-house test, R&D Ivoclar Schaan Vectrisl Monobo.d S Phosphacap self-curing no adhesion Vectris 2 Monobond S Vivaglass Ce. self-curing no adhesion

Vectrisl, 4 Monobond S Variolink self-curing 23.3 _ 3 Targis Pover Program 1 2 sandblasted 4 5 min. saliva; r'@nse; 60 sec. Email Prepaatr

Scientif,c Documentation Tagis/ Vectris Pge 15 of3l 12.5 _ 3.2 In-house test, R&D Ivocla, Schaan Discussion: The Targis Link

40 -a-7.7 34.5 30 0 2 10 154 _ 19 9742 _ 480 1.9 _ 0.3 375 31 956 70

15 151 _ 24 9851 _ 699 1.8 _ 0.3 444 1-5 941 22 31 178 _ 33 10800_ 695 2.0 _ 0.5 412 45 685 37 Targis Base should be used in the area facing the cement. 5

0.5 [Annual equivalents] > 50 170 _ 20 200 _ 20 145 _ 15 Water absorption [pg/mm'] <3216.5 _ 1.2 16.5 _ 1.2

27.8 _ 0.9 Water solubility[@ig/mm'] < 5 2.0 _ 0.8 2.0 _ 0.8 < 5 Ta,gis LC 11 lc'.s.1 Denti.

Institute for dental material science and technology (Institut fur zahnarztliche Werkstoffkunde 20 _ Atglass Conq.est Sol'@de. Tbe,[email protected] locro. PE T,,rgis LC H Incisal IM Dentin

fur zahnarztliche Werkstoffkunde und Technologie), University of Mainz science and technology (Institut fur zahnartliche Wekstoffkunde und Technologie), University of Mainz

- who require 1-3 restorations in premolars or molars are examined. Experimental:Following preparation, impressions are taken of the teeth (no liners/bases are placed). The lab-fabricated onlays are inserted with the

Experimental: Lab-fabricated crowns are seated on the prepared teeth (no linersibases are placed) with Syntac ("total etch technique") and an experimental luting composite (Vivadent). After 12 and 24 months, the restorations are examined. Abrasion (OCA/CFA), marginal quality

- Patients whose lost tooth structure cannot be restored withcomposites - Patients who do not wish to have orthodontic treatment Experimental: Once the patients

were temporarily provided with 36 Vectris bridges (veneers of Chromasit/Spectrasit (Ivoclar). The wearing time up until the examination lasted an average 7.7 weeks. Results:The results were highly satisfactory. Consequently,

the premolar and molar region. Twenty-six of these bridges have two pontics and three have three pontics. The anterior bridges are divided into three bridges with one incisal and three with two incisals. One bridge has three Region 0-100 pm "excellent" 100-200 Jim "Satisfactory" 200

pm- "unsatisfactory" [%] margin 65% 7% 28% 0.0 0.0 Cleaning 1

1 84.8 0.0 0.0 15.5 none little average a lot

occlusion were given priority during fabrication, no aesthetic defects were observed l The occlusion and masticatory functions can be effectively restored with VECTRISbridges. 20 TargisNectris Bridges

were available, the low rate of failure has been most impressive. Results: Year No. of crowns FailuresComments 1989 9 4

after I year A CRA clinical study on TargisNectris crowns (Dr. G. Christensen, Provo, Utah, USA) will begin in December 1996. must also be used for the

biological testing of dental materials. The release of soluble substances presents possible risks. According to ISO 10993 and ISO/ DIS 7405, the following biological effects should be Cytoxicity, the inhibition of cell

proliferation, and other effects of the medical device on cells are determined with cell cultures. These tests provide an initial evaluation of the biocompatibility of the material. A direct cell contact test with Targis [3, 6] determined that this contact sensitizing potential of

medical devices. In a maximization test on guinea pigs [4], Targis was demonstrated to be non-sensitizing. An irritant effect can also be ruled out on the basis of the test used. in the chromosome structure, or gene defects in cell cultures. The Ames Test is always used as the

screening test. In this type of back mutation test [5], Targis Dentin and Incisal demonstrated no mutagenic changes. biologically inert. Direct exposure to the material in the event of the veneering material chipping off and related mechanical irritation can be

practically excluded. Based on this information, may cause irritation or an allergy or sensitization to dimethacrylates in hypersensitive people. This type of reaction can be avoided to a large extent if clean working conditions are

assured and the uncured materials are not brought in contact with the skin. The working technique for these materials is state-of-the- though the size of the dust particles produced during the finishing of Vectris frameworks is not within the international values given as presenting a high

risk [12, 13, 14], the use of protective equipment (dust mask and vacuum extraction equipment, generally required when working with fine dust) is recommended in the Instructions [3] In Vitro Cytotoxicity Test: Evaluation of materials for medical devices (Direct cell

contact assay) CCR Project 534701 [7] Primary eye irritation study with Helloseal in Rabbits RCC Project 034604 [81 Salmonella Typhimurium Reverse Mutation Assay with Helioseal F (Ames-Test)

[14] Gutachterliche Stellungnahme betreffend das gesundheiliche, Inhalative Risiko beim Verarbeiten vom GerilstwerkstoffVectris der Firma Ivoclar RCC Projekt 620280

Zahntechnik und Zahnmedizin Dental Labor 40 (1992) 615-628 Krejci I, Reich T, Lutz F, Albertoni M In-vitro-Testverfahren zitr Einwirkung aufden Oberfachenzustand von Dentallegierungen (I)

Quintessenz 10, (1985) 19271934 Le concept Targis/Vectris, 2eme partie Proth Dent 124, (1997) 27-31 Clunet-Coste B Targis/Vectris Proth Dent 124, (1997) 33-37 Johnke G, K6rber K-H, K6rber S Die Glasfuserverstirkte Briicke

Faserverbund-Briicken TargisVectris ZWR 105, (1996) 693-702 Korber S, Korber KH Glasfaser-Briicken-Zahnersatz Zahnarzt Magazin 3, (1996) 3242 Touati B The evolution of aesthetic

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