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Material Choice Matters in Digital Restorative Dentistry


Case Presentation: Visalys Core 

We often encounter case studies that highlight the latest innovations in digital dentistry, and rightfully so because today’s technologies are exciting.

It’s important to remember that behind every successful digital restoration are temporary and restorative materials that the clinician chose for specific reasons and that helped him or her successfully execute the treatment plan.  

Take, for instance, a case presentation by Marty Jablow, DMD, which was published earlier this year. The case study centered on the fabrication of a 3-unit zirconia bridge using digital technologies. However, Kettenbach temporary restorative materials played a prominent role in treatment. Dental Product Shopper followed up with Dr. Jablow for more insight on why he chose Kettenbach materials in this case.

First, here’s some background:

A 65-year-old patient presented to Dr. Jablow’s practice with the primary complaint that she had “a lot of problems.” One of the problems was a failing 3-unit porcelain-fused-to-metal bridge from the maxillary right canine to the central incisor. The patient was scheduled to have knee-replacement surgery in a month and requested that she undergo dental treatment as quickly as possible so it would be completed prior to the surgery. After obtaining radiographs, the treatment was discussed, and the patient was scheduled.

patient awaiting a temporary dental bridgeDr. Jablow began by anesthetizing the patient and removing the bridge. He performed endodontic therapy on the maxillary right canine and once completed, Visalys Core buildup material (Kettenbach) was bonded to the remaining tooth structure.

“Visalys Core was chosen for the core build-up because it is easy to express, dual cures, and cuts very similar to dentin,” said Dr. Jablow. “This makes preparation much easier than using conventional composites.”

Visalys Core was introduced in 2015 as Kettenbach’s first core build-up material and represented a new generation of core materials. The material has innovative Active-Connect-Technology, which enables the material to bond actively with all common light-curing and dual-curing, single-step, and multi-step adhesives, without an additional activator. The advantage for users is that it allows them to use the bonding agent they are used to, no matter whether it is light-curing or dual-curing or a single- or multi-bottle system.

In this case, the material was light-cured and the teeth prepared using an electric handpiece.

Dr. Jablow then took an intraoral scan of the preparation and marked the margins of the crown. A temporary bridge was fabricated from a preoperative impression of the failing bridge using Silginat (Kettenbach), which Dr. Jablow described in the case study as “a medium-viscosity, addition-curing impression material with alginate-like consistency.”

intraoral digital imaging shot Asked to elaborate on this material choice, Dr. Jablow added, “Silginat was chosen because it handles similar to alginate and can become dimensionally stable over time. Should the patient fracture the bridge, it is much simpler to fabricate a new one prior to the insertion of the final prosthesis.”

According to Kettenbach, Silginat has a low tear resistance to avoid dislodging restorations or orthodontic appliances inadvertently.

The material also has a high dimensional stability, so model impressions can be kept for weeks and poured multiple times. It’s highly thixotropic and flows properly under pressure.

The impression was sent to a laboratory and the permanent bridge was tried in with no adjustments necessary. The bridge was cemented, and the excess cement removed. 

“The patient was very happy with the result,” Dr. Jablow concluded.   

The Takeaway

Dr. Jablow has been using Kettenbach materials for more than 10 years, and has found that they can be used for analog dentistry and in conjunction with digital technologies when necessary. 

Another go-to product for Dr. Jablow, which wasn’t used in this particular case, is Futar, Kettenbach’s bite registration material formulated to achieve proper occlusal registration and minimize any adjustments. Again, versatility is key in material preference. 

“I have used Futar as both my bulk-impression material (along with a wash using the hydraulic-and-hydrophobic impression technique) prior to going digital, as well as for bite registration,” Dr. Jablow added. “Why stock two materials?”

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