Tetric N Ceram Dental Restorative Material

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Tetric N Ceram is the top of the line dental restorative material from Ivoclar Vivadent.

Tetric N Ceram Contents
  • Available as
    • Starter kit
      • 4 x 3.5 gm Tetric N Ceram
      • 1 x 2 gm Tetric N Flow
      • 1 x 3 gm Tetric N Bond
    • System kit
      • 8 x 3.5 gm Tetric N Ceram
      • 2 x 2 gm Tetric N Flow
      • 1 x 6 gm Tetric N Bond
    • Individual Syringes
Pros:
  • Available in a wide variety of shades
    • Enamel shades – A1, A2, A3, A3.5, A4, B1, B2, B3, C2, C3, D3
    • Dentin shades – A2 dentin, A3.5 dentin, B2 Dentin
    • High Transluscent insical shade – T
    • Bleach shades – Light (L), Incisal (I), Medium (M)
  • It can be cured in the wavelength of 400 – 500 nm.
Composition:
  • Dimethacrylates (19-20%)
  • Fillers – Barium Glass, Ytterbium trifluoride, mixed oxides, co polymers ( 80 – 81%)
  • Additives, initiators, stabilizers, pigments (<1%)
  • Inorganic fillers – 55-57%
  • Particle size of fillers is 40 – 3000 nm
Indications:
  • Class I to V restorations.
  • Deciduous teeth restorations.
  • Fissure sealant.
  • Direct veneers.
  • Splinting of mobile teeth.
  • Blocking of undercuts.
  • Repair of composite and ceramic veneer.
Contraindications:
  • Any situation where absolute isolation of working field cannot be achieved.
  • Patient is allergic to any of the ingredients.
Interactions:
  • Glass ionomer based liners may get dissolved by etchants.
  • Eugenol inhibits polymerization of composites and should not be used before use of composites.
  • Styptic agents ( to arrest the bleeding) should not be used just before or during the use of composite.
  • Fluorides should not be applied before use of composites.
  • Chlorhexidine mouthrinses etc can cause discolouration of composites and hence should be avoided.
  • Peroxide based bleaching agents or disinfectants cause inhibition of polymerization of the adhesives.
Direction for use:
Preparation of tooth:
  • Prepare cavity and isolate the tooth using suitable methods ( rubber dam etc)
  • Clean the cavity using water spray.
  • Air dry the cavity.
  • Apply calcium hydroxide sub base and Glass Ionomer liner/base, wherever required.
Etching:
  • Etch the enamel first, followed by dentin, for a total of 15 seconds and thoroughly wash the etchant away with water spray and dry with oil free air.
  • Avoid excessive drying of the dentin.
  • Etched enamel should have a chalky white appearance. If not, etch for a shorter time (10 sec). Similarly, if contamination of the site with saliva or blood occurs, etch for 10 seconds again.
  • In case of unprepared enamel, etch for 30-60 seconds. Enamel can be selectively etched for 15-30 seconds.
Application of Bonding agent:
  • Using a disposable applicator, apply a thick layer of Tetric N Bond over the enamel and dentin surfaces. Keep brushing the bond into dentin for 10 seconds.
  • Avoid insufficient coverage. Remove excess bond using gentle air to avoid pooling.
  • Light cure the bond for 10 seconds and observe a shiny tooth surface, which indicates a complete coverage of the bond.
Composite build up:
  • Apply Tetric N Flow to a maximum thickness of 2mm and light cure for 10-15 seconds
  • Subsequently, apply Tetric N Ceram Dental Restorative Material in layers of 2mm using a suitable instrument and polymerize each layer for 10-15 seconds.
  • Complete the restoration, finish and check for occlusion. Polish the restoration.
  • In case Tetric N Ceram is used to repair a fractured restoration or a previously polymerized composite restoration, the previous restoration should be roughened and wetted with Heliobond.
  • Always bring the composite to room temperature before use.

To read more about how to apply Tetric N-Flow, Click Here.

Storage:
  • Should be stored between 2-28° C.
  • Close the bottles and syringes tightly, immediately after use.
  • Prevent exposure to light, as it causes premature polymerization.

Review of Tetric N Ceram Dental Restorative Material

I have been using Tetric N Ceram for over 3 years now.

I look for a few things while choosing a composite for my esthetic restorations.

  • Shade matching – Tetric N Ceram is available in nearly every shade or in the combination thereof required to get a esthetic match for my patients.
  • Workability – One should be able to work with it, without it sticking to your instruments. If you use the best instruments money can buy, most of the composites with pass this test. Otherwise, Tetric N Ceram works with most good quality, even less expensive instruments.
  • Packability – Though a requirement for the posteriors, many modern day hybrid composites are difficult to pack. Tetric N Ceram is not the best either.
  • Storage – I should be able to store it without having to refrigerate it between consecutive appointments. With Tetric N Ceram having a good range of temperature for storage, you can even keep it out in the room, specially during the winters.
  • Availability – Refill composites should be easily available. Ivoclar Vivadent definitely checks this box.

I like to use a single brand for my composites and not a fan of mix and match. When the company has done the research and figured out the way to success, why go reinventing the wheel !!

Overall, Tetric N Ceram does the job it advertises for, that is to take care of your esthetic restorations with ease. Remember, the result depends on the skillset of the clinician too.

If you have any questions or comments, kindly use the comment box below.

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