G-ænial Anterior & Posterior technic al manual
Table of Contents 1.0 Introduction 4 2.0 4 Product description 3.0 Indications for use 4.0 Composition 4.1 Fillers 4.2 Matrix 4.3 Interfaces 4.3 Initiators 5.0 Shades 5.1 Introduction 5.2 Shade system 5.3 Shade taking 5.4 Clinical hints 6.0 Physical properties 6.1 Modulus of elasticity and fracture toughness 6.2 Shrinkage 6.3 Three – body wear resistanc 6.4 Gloss rate 6.5 Radiopacity 6.6 Working time 6.
7.0 Field evaluation 7.1 Handling 7.2 Aesthetics 7.3 Overall evaluation 23 23 24 25 8.0 Literature 26 9.0 Instructions for use 27 10.
1.0 Introduction Since the introduction of Thermoresin LC in 1992 and GRADIA – micro ceramic composite in 2000, GC Corporation has demonstrated its expertise in composite technology. The experience gained in developing indirect composite resins that were aesthetically comparable to porcelain was the starting point of the research for a highly aesthetic direct composite material: Gradia Direct.
4.0 Composition G-ænial is classified as an MFR hybrid composite with a combination of 2 types of pre-polymerized resin fillers. It is composed of matrix, fillers, pigment and photo-initiators. Variations of monomer concentration, filler types and content between the Anterior and Posterior versions make the material ideally suited to its uses, with more radiopacity in G-ænial Posterior and softer handling in G-ænial Anterior.
Figure 2: Structural drawing of the filler system Prepolymerized Filler 17 µm 400 nm Strontium Glass 100 nm lanthanoid fluoride Prepolymerized Filler 16 µm 16 nm silica Inorganic Filler 850 nm Anterior : Silica glass Inorganic Filler 16 nm Fumed silica 4.2 Matrix The matrix consists of a mixture of urethane dimethacrylate (UDMA) and dimethacrylate co-monomers. G-ænial is bis-GMA free.
4.3 Interfaces To improve the bond between the silica and matrix resin, the silica surfaces are treated hydrophobically with dimethyl constituents rather than with silanol. This hydrophobic treatment improves the intimate contact between the silica and the matrix because both ingredients will attract each other.
5.0 Shades 5.1 Introduction One of the biggest challenges in prosthetic and restorative dentistry is to reproduce Mother Nature’s well balanced tooth colour harmony. Patients demand restorations that equal or surpass the aesthetics of nature and that are indiscernible from the tooth structure. One of the main objectives in developing G-ænial was to create a state-of-the-art composite that would offer predictable aesthetics in both simple and complex situations.
Light is scattered and reflected by internal tooth structures (e.g., enamel crystals, dentine-enamel junction and dentinal tubules). Certain wavelengths are absorbed, whereas the remaining light possessing information on tooth hue, chroma, value and translucency is diffusively reflected.
Figure 8: Diffuse reflection on natural tooth structure Figure 9: Diffuse reflection with G-ænial Reflection by enamel crystals Reflection by dentin enamel junction Reflection by peritubular dentin Reflection by dentinal tubules Enamel Pulp Light scattering on the different fillers of the material Dentin The scattering properties of G-ænial provide its unique blending abilities G-ænial Anterior exhibits the highest light scattering amongst the competitors tested.
5.2 Shade system G-ænial offers flexibility, enabling placement of aesthetically invisible single-shade restorations or aesthetic masterpieces with a multi-shade build-up.
Inside and Outside Special shades Although excellent aesthetics can be achieved for the majority of cases with just a single shade, there may be times when a multi-shade technique is preferred, such as when extensive restorations are required. G-ænial offers two additional types of shades to choose from, called Special Shades. Inside shades are placed underneath a Standard Shade, and are more opaque to block the transmission of light from the oral cavity.
Figure 16: Incisal (IE & P-IE) and Translucent (TE) Enamel shades IE & P-IE can be applied on the In elderly patients, TE can be incisal edge, occlusal third and applied on the occlusal third, incisal proximal surfaces in adult patients edge and proximal surfaces Additionally, the TE shade can be used to reproduce the transparent layer that can be observed at the enamodentinal junction (Figure 17). This will simulate a natural in-depth effect. Figure 17: Mesio-distal section of an incisor .
5.3 Shade taking It is advised to always select composite shade(s) after cleaning the tooth and before tooth preparation. It is also important to select the shade(s) prior to rubber dam placement, since desiccated teeth are lighter in value and if used for shade matching could result in the wrong shade being selected. Single-shade layering technique Worldwide, the VITAPAN Classical shade guide is the guide dentists use when selecting shades.
Figure 24: The Classical VitaPan Shade guide was reorganised according to the value of the shade tabs. A correspondence to the 3 main value shades from G-ænial (JE, AE and SE) can be observed. HIGH VALUE JE LOW VALUE AE SE Step 2: Choosing the hue The hue is the pure colour itself. It can be chosen from the 5 groups of the Standard shade (A, B, C, Cervical and Bleach). In order to best choose the hue, it is recommended to look at the colour of the dentin core, especially where enamel is thin, i.e.
5.4 Clinical hints In most cases, Standard shades alone will be used and will result in natural-looking aesthetic restorations. In some more aesthetically demanding cases, however, Inside and Outside shades will be required to bring life to the restoration. Table 3 provides possible shade combinations. Table 3: Possible shade combinations for large multi-layer anterior restorations A1 A2 A3 A3.5 A4 B1 B2 B3 C3 Inside special BW AO2 AO3 AO3 AO4 BW AO2 AO3 AO4 Standard A1 A A3 A3.
6.0 Physical properties 6.1 Modulus of elasticity and fracture toughness The modulus of elasticity (Young’s modulus) – a measure of the rigidity of the material – is defined by the initial slope of a stress-strain curve. A material with a high modulus is stiff and rigid, whereas a material with a low modulus is flexible. Ideally, a material should not have a too high modulus of elasticity as brittle materials are less able to buffer masticatory pressure.
6.2 Shrinkage Volumetric shrinkage (%) Pre- and post-curing composite resin densities were measured and the polymerization shrinkage calculated accordingly Figure 27: Volumetric shrinkage of various composites Source: GC Corporation The volumetric shrinkage was measured Volumetric shrinkage (%) following ISO Draft Date: 2007-07-10 G-ænial A (Dentistry - Polymerization shrinkage of G-ænial P filling materials) specifications.
Figure 29: Shrinkage stress of various composites Source: GC Corporation The volumetric shrinkage was measured Shrinkage Stress (N) following ISO Draft Date: 2007-07-10 G-ænial A (Dentistry - Polymerization shrinkage of G-ænial P filling materials) specifications. CeramX mono Venus This study demonstrated that the shrinkage stress generated by G-ænial is amongst the lowest of the tested composites.
To measure three-body wear resistance, composite specimens were prepared and moved up and down along a 5 cm path at a rate of 30 strokes per minute. They were held in indirect contact with an acrylic plate under a load of 350 gf load and, simultaneously, the sample holder slid horizontally along a 2 cm path at a rate of 30 strokes per minute. A mixture of PMMA and glycerol (1:1 vol%) was used as an intermediate abrasive.
6.5 Radiopacity Literature has reported that at 1 mm, dentin and enamel have radiopacities of 1.5 mm Al and 2.25 mm Al, respectively (Attar et al, 2003; ADA, 2006). Figure 33: Radiopacity of various composites Source: GC Corporation, test according to ISO 4049:2000 specifications G-ænial Anterior offers a clinically relevant radiopacity, without compromising on highly aesthetic results. Being more radiopaque, G-ænial Posterior fulfils the requirements for posterior restorations.
6.7 Depth of cure The depth of cure of G-ænial was determined with a scraping technique described in the ISO 4049:2000 specifications. Table 5: G-ænial Anterior: Irradiation time and effective depth of cure Irradiation time Plasma arc (2000 mW/cm²) 3 sec. GC G-Light (1200 mW/cm²) 10 sec. Halogen / LED (700 mW/cm²) 20 sec. 6 sec. 20 sec. 40 sec. Shade TE, IE, JE, SE, CVE 3.0 mm 3.5 mm A1, A2, B1, B2, XBW, BW, AE 2.5 mm 3.0 mm A3, B3 2.0 mm 3.0 mm A3.5, A4, C3, AO2, AO3, AO4, CV, CVD 1.5 mm 2.
7.0 Field evaluation Major objectives in the development of G-ænial Anterior and Posterior were to develop a material with easy handling properties, perfect shade matching with an easy shade selection, and radiopacity. Following in-vitro handling tests to determine the best viscosities, a large field study was conducted with 132 dentists in more than 20 European countries to test if these improvements were achieved. 7.
7.2 Aesthetics Aesthetics of G-ænial Anterior Aesthetics of G-ænial Anterior 100% 80% 81% 83% 85% 87% Adaptability to tooth colour Aesthetic end result 81% 60% 40% 20% 0% Colour Change after LC Ease of polishing Poor / Not Good Gloss after polishing Average Good/ Excellent With G-ænial, only one shade is necessary for restoration of most cavities. Therefore, the test was performed with a choice of A2 or A3 only in order to check the blending ability of the material.
7.3 Overall evaluation Approximately 85% of dentists judged G-ænial as good to excellent. Both the Anterior and Posterior version received excellent ratings.
8.0 Literature Light diffusion property of newly developed composite resin “G-ænial” K. HIRANO, F. FUSEJIMA, T. KUMAGAI, and T. SAKUMA, GC Corporation, Tokyo, Japan Abstract 3019, Genera session IADR 2010, Barcelona Objectives: Human teeth have unique light diffusion property which creates special colour property. Light diffusion property of composite resin is important to provide excellent aesthetic result on direct composite resin restorations.
9.0 Instruction for use LIGHT-CURED COMPOSITE RESTORATIVE For use only by a dental professional in the recommended indications. RECOMMENDED INDICATIONS A. G-ænial ANTERIOR 1. Direct restorative for Class III, IV, V cavities. 2. Direct restorative for wedge-shaped defects and root surface cavities. 3. Direct restorative for veneers and diastema closure. B. G-ænial POSTERIOR 1. Direct restorative for Class I and II cavities. CONTRAINDICATIONS 1. Pulp capping. 2.
Clinical Hints 1. Anterior cavities a. In the case of small cavities Restore using a one shade layering technique. In most cases the use of one Standard shade alone will be sufficient. In cases where a higher degree of translucency is needed, one of the Outside special shades can be selected. See also Examples of Clinical applications. b. In the case of large cavities In most cases a multi shade layering technique will give the best aesthetic results.
Table 7: G-ænial Anterior: Irradiation time and effective depth of cure Irradiation time Plasma arc (2000 mW/cm²) 3 sec. GC G-Light (1200 mW/cm²) 10 sec. Halogen / LED (700 mW/cm²) 20 sec. 6 sec. 20 sec. 40 sec. Shade TE, IE, JE, SE, CVE 3.0 mm 3.5 mm A1, A2, B1, B2, XBW, BW, AE 2.5 mm 3.0 mm A3, B3 2.0 mm 3.0 mm A3.5, A4, C3, AO2, AO3, AO4, CV, CVD 1.5 mm 2.5 mm Table 8: G-ænial Posterior: Irradiation time and effective depth of cure Irradiation time Plasma arc (2000 mW/cm²) 3 sec.
10.0 Packaging Shades 1. 22 shades for anteriors Standard shades: XBW (Extra Bleaching White), BW (Bleaching White), A1, A2, A3, A3.5, A4, B1, B2, B3, C3, CV (Cervical), CVD (Cervical Dark) Inside special shades : AO2, AO3, AO4 Outside special shades: JE (Junior), AE (Adult), SE (Senior), TE (Translucent), IE (Incisal), CVE (Cervical) *1 TE shade is not radiopaque. 2. 6 shades for posteriors Standard shades: P-A1, P-A2, P-A3, P-A3.
Notes G-ænial Anterior & Posterior Technical Manual 31
G-ænial Anterior & Posterior Technical Manual
G-ænial Anterior & Posterior Technical Manual 33
G-ænial Anterior & Posterior Technical Manual
G-ænial Anterior & Posterior Technical Manual 35
GC EUROPE N.V. Head Office Researchpark HaasrodeLeuven 1240 Interleuvenlaan 33 B - 3001 Leuven Tel. +32.16.74.10.00 Fax. +32.16.40.48.32 http://www.gceurope.com GC AMERICA INC. 3737 West 127th USA - Alsip, Illinois 60803 Tel. +1.800.323.7063 Fax.+1.708.371.5103 http://www.gcamerica.com GC ASIA DENTAL PTE. LTD. 19 Loyang Way #06-27 Singapore 508724 Tel. +65.6546.7588 Fax. +65.6546.7577 http://www.gcasia.info z O MA EN 8 68 04/12 GC CORPORATION 76-1, HasumumaChoItabashi-ku JP -Tokyo 174-8585 Tel. +81.339.
