Unidentified Woman: Blending the effortless removal and true versatility of NX3 resin cement with the adhesive superiority of OptiBond XTR Kerr creates the new standard for the permanent cementation of CAD/CAM restorations with simplified procedures, easy clean up, superior color stability, high adhesion and minimal post-op sensitivity, the benefits are easy to see. We are pleased to introduce Dr. Mark J. Fleming as he shares his experiences using Kerr’s NX3 XTR cementation system for CEREC restorations.
Dr. Fleming, can you tell us about the journey that brought you to Phoenix?
Dr. Mark Fleming: I’ve been practicing dentistry since 1978, really enjoy it. First started out in Cincinnati, Ohio, which was basically my area that I grew up in. I loved the city. The only problem with it was it was a thousand miles too far north. So, my wife and I in 1993 moved to Sarasota, Florida, because everybody jumps on I-75 and just goes south, and that’s where we ended up.
So, I really enjoyed practicing in Sarasota until the end of 2011, but about five years ago, I was asked by Dr. Spear Perry [sp] at the Scottsdale Center to come out and help teach CEREC courses, and I’ve always enjoyed teaching. And so, I jumped on that opportunity. We’ve become busier and busier out at the center, which meant more and more plane rides between Sarasota and Scottsdale and actually just began to wear on me after a period of time. So, I knew I still wanted to practice dentistry, and I knew I still wanted to teach, so my wife and I moved out here at the beginning of 2012 and have been enjoying it ever since.
In dentistry we’re bombarded with many, many choices from materials and how we do things and it’s an ongoing process. When I look at a product, I want to look at the clinical needs of, you know, is it going to give me the properties that I want. I want long lasting dentistry. I want to do dentistry right the first time and have it last a long time. We all know nothing is permanent, but I like to have my work last as long as possible. And one of the things I want to look at first is the company that stands behind their materials. I want to be able to have the confidence when I use the material that it’s going to benefit the patient and benefit myself and benefit the practice.
Some of the biggest reasons why to use the NX3 and the XTR system was, first, that it’s backed by Kerr, who’s been a leader in adhesive dentistry over all the years and having a gold standard, but also the silination [sp] process. I know that it’s going to be fresh each time because of the chemistry that’s involved between the two products, and keeping it in the same family from the same manufacturer is very important. An added benefit to the XTR and the NX3 also was the great clean up afterwards. Sometimes that can be problematic in adhesive dentistry and this just made it a breeze.
Unidentified Woman: Today, we will be demonstrating the placement of a CEREC onlay using NX3 XTR cementation system. What’s unique about the combination NX3 and OptiBond XTR technology, one, for ceramic and porcelain restorations OptiBond XTR adhesive can be used in place of silane after hydrofluoric etching, two, for metal-based PFM and zirconia restorations OptiBond XTR adhesive can also be used in place of metal primers after preparation of the metal surface, three, because of the superior compatibility between NX3 and OptiBond XTR you have the option of light curing OptiBond XTR or using both products in a total dark-cure scenario on both restoration substrate and the prep. After imaging powder has been applied take the initial scan of the area to be restored. The amalgam is removed and the tooth is prepared. The prep area is rinsed and then air dried. Spray Sirona Optispray, scan, then rinse. Review the scan and make adjustments as needed. The restoration is ready to be milled and prepared for final cementation. After the restoration has been fitted, we’ll prepare the e.max only by etching with hydrochloric acid for 20 seconds and then rinsing. We apply OptiBond XTR adhesive directly inside the restoration for 15 seconds and then air thin for five seconds. After the crown has been fitted, scrub OptiBond XTR primer to enamel and dentin surfaces for 20 seconds and air thin for five seconds using medium air. Apply OptiBond XTR adhesive with a brushing motion for 15 seconds, then air thin with medium and then heavy air for five seconds. If using OptiBond XTR in a total dark-cure mode with NX3, then air thin for 15 seconds. Again, because of the versatility of NX3 light curing of OptiBond XTR is optional at this point. Next, syringe the proper amount of NX3 directly into the preparation, or tooth structure, or both, then seat the prepared restoration. Allow NX3 to reach gel state or tack cure for two seconds. Remove the excess cement. Light cure all surfaces for 20 seconds. When using NX3 XTR you’ll see that the low film thickness of OptiBond XTR does not interfere with the occlusal scheme. The restoration is now complete, and with NX3 XTR Dr. Fleming and his patient can count on the beautiful new restoration to last for years to come.
Thank you, Dr. Fleming, for showing us how the NX3 XTR cementation system has helped improve your CEREC restorations. The NX3 XTR cementation system is one more example of Kerr’s dedication to you, the dental professional. Try NX3 and OptiBond XTR today and experience the effortless removal and predictable results for yourself.
Dr. Mark Fleming: NX3 and XTR are very important in my placement of ceramic restorations. I have a practice that I use the CEREC technology every day. When I place a restoration, I want to know that it’s going to be done well, the adhesion is going to be tremendous, it’s going to sit, it’s going to be in there for a long time. For me, the procedure when I’m placing the restoration, when I’m actually bonding in place, is the most trying part of the procedure, and when I get to that part of the procedure, I want to make sure that everything goes smoothly, and with that combination of XTR and NX3 it helps out a great amount. I know I’m going to get a great bond. I’m going to be able to clean up easily, know that my patient’s going to be well taken care of and that restoration’s going to last a long time.
Anytime one switches any type of procedure, my recommendation is talk to your colleagues. I know companies are going to put out lots of information because it is their product, and I know deep in their heart they’re not going to put out a product that’s not going to work, that they know it’s not going to work, but anything in dentistry we want to be comfortable with. We want to know that we can utilize it. We can utilize it at our best. And so, it treats our patients the best. So, when I looked at the XTR, the NX3 combination, first, I looked at the company. Kerr’s got a long lasting reputation in dentistry as a whole, but also in adhesion dentistry. And then, I talked with a lot of people on CERECdoctors.com. A mentor group got to try it out and there was a lot of good feedback from that, and I have close colleagues that I value their opinion, and they told me once they started using it with the bond strengths and the ease of cleanup it was something that I should take a look at. So, I did. And, you know, I jokingly say at times maybe, you know, you don’t want to discuss with dentists politics, religion and bonding solutions, but at the same time you’re always looking for that little edge that you can help treat your patients better, and that’s what I believe, you know, that you have with XTR and NX3 from Kerr.