The Trifecta Method

Published Date 03/21/2014

Complementary Materials, Technique

Find out why Dr. Mark Fleming believes the Trifecta Method is a simplified "system" for creating strong, predictable, esthetic indirect bonded restorations and provides chemical compatibility between materials for maximum beneficial properties.

I like the peace of mind and the consistent results I get by using materials, particularly bonding agents and luting cements, developed specifically to complement each other. And that is the philosophy behind 3M's Trifecta method.

Simply, the Trifecta method involves placing 3M Lava Ultimate Restorative indirect restorations using 3M Scotchbond Universal Adhesive and 3M  RelyX Ultimate Adhesive resin cement. Although each of these 3 products individually offers a variety of benefits, their clinical advantages increase significantly when they're used together.

The Restorative

Offered in blocks for CAD/CAM milling, Lava Ultimate restorative is a resin nano ceramic material formulated for exceptional esthetics and high strength. I regularly use it for all its indications: veneers, inlays, onlays, and crowns (including implant-supported crowns). Kinder to opposing dentition than glass ceramics, Lava Ultimate restorative has an elastic modulus similar to that of dentin, so it absorbs chewing forces to minimize stress. In addition, there is no need for a fi ring step, which speeds up the procedure and promotes productivity.

The Bond

Scotchbond Universal adhesive is a combined total-etch and selective-etch adhesive that I can use on zirconia, alumina, glass ceramics and metals. I've found it provides high bond strength (without a separate primer) and virtually no postoperative sensitivity. Other benefits are great marginal integrity, high esthetics, 1-step/1-coat application, and self- and dual-cure compatibility.

The Cement

3M's RelyX Ultimate Adhesive resin cement is a simple 2-component system—1 bottle, 1 syringe. It exhibits high wear resistance, natural fluorescence, and color stability. Like Scotchbond Universal adhesive, RelyX Ultimate Adhesive Resin cement provides high bond strength with total- and selective-etch techniques.

The Technique

While lab-fabricated Lava Ultimate restorations are delivered ready to seat, the process for preparing a chairside CAD/CAM Lava Ultimate restoration is fast and easy. The sprue is removed, the unit polished, and the internal surface sandblasted. The final step is an ultrasonic bath to remove all debris.

After try-in, the tooth prep and restoration are thoroughly cleaned. The tooth prep is etched and Scotchbond Universal adhesive is applied to both the tooth prep and inside the restoration, rubbing it in for 20 seconds and air thinning until the solvent no longer moves. Light cure the adhesive on the tooth prep for 10 seconds. Once complete, RelyX Ultimate Adhesive Resin cement is placed inside the restoration, which is gently seated on the prep. After 90 seconds, when the cement reaches the gel phase, excess can be removed from the margin (while holding the restoration firmly in place). All aspects are cured for 20 seconds each, margins are polished, and the procedure is finished.

The chemical compatibility between Scotchbond Universal adhesive with RelyX Ultimate Adhesive Resin cement offers optimal performance, leading to a simplified system of placing Lava Ultimate restorations.

RelyX Ultimate Adhesive Resin Cement
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