Ivoclar Vivadent Telio Lab User Manual

Telio Lab Telio CAD

Instructions for Use

Table of Contents

Telio – A comprehensive system with a future 4

Product information 5

Material Uses Composition Conditioning of the Telio products for the adhesive bond CAD/CAM partners

Clinical working steps, fabrication process 10

Shade determination Fabricating the model Minimum material thicknesses

General processing instructions 13

Designing the shape with a wax-up and silicone key Minimum material thicknesses / layer thicknesses Preparing and isolating the model

Fabricating temporaries in the casting technique 15

Polymerization Individualizing the incisal area using the cut-back technique Casting the Telio Lab Transpa Incisal materials Finishing and polishing

Injection technique 18

Wax-up and silicone doubling Model preparation and isolation First injection (Dentin) Polymerization Individualizing the incisal area using the cut-back technique Second injection (Incisal) Polymerization in the pressure pot Finishing and polishing

Telio Lab

Fabricating a temporary veneer 22

Minimum material thicknesses / layer thicknesses Grinding and set-up Designing the silicone key Model preparation and isolation Preparing the ground artificial teeth Completion Polymerization Finishing and polishing

Telio Lab

Telio CAD

Metal-supported temporaries 25

Framework design Application of retention beads Surface finishing Metal bond Telio Lab Opaquer

Masking of model cast retention grids with Telio Lab Opaquer 28

Surface conditioning with SR Link Applying Telio Lab Opaquer

CAD/CAM processing 29

Fully anatomical fabrication and final polishing 30

Finishing Polishing

Telio Lab/Telio CAD – Cut-back technique with Telio Lab (light-curing) 33

Characterization Polymerization Polishing

Telio CAD – Cut-back technique with Telio Lab (cold-curing) 38

Characterization Finishing and polishing

General information 41

Repairs and add-ons Placement Frequently Asked Questions Polymerization times Materials combination table

Telio –

The 3-in-1 solution for temporary restorations

Telio is a comprehensive, fully integrated product system for temporary restorations designed for dentists, CAD/CAM users and dental technicians. All Telio materials are ideal for the manufacture of conventional and implant-borne temporaries. The materials are compatible with each other and their shades are optimally coordinated.

• Telio Lab

For dental technicians: Resin for temporary crowns and bridges, including a light-curing composite for additional individualizations.

• Telio CAD

For CAD/CAM users: Acrylate polymer blocks for the CAD/CAM manufacture of temporary crowns and bridges.

• Telio CS

For dentists: Self-curing temporary C&B materials, including a desensitizer and cement.

All materials are out of one hand:

Telio is a system of compatible materials for temporary restorations

Telio

Telio CS Telio CAD Telio Lab

chairside labside

Material

Telio Lab

Telio Lab is a PMMA-based two-component powder/liquid system for the cold poylmerization in A-D shades. It is used for the fabrication of temporary crowns and bridges.

Telio Lab exhibits excellent polishing properties and thus a resulting smooth surface. Stains and/or layering materials can be used to apply final esthetic optimizations. Relinings, add-ons, emergence profiles and occlusal build-ups can be carried out with Telio Lab (laboratory), Telio CS C&B (dental practice) or Telio Add-On / Flow in both areas.

Telio Lab can be used in conjunction with different processing techniques:

• Casting technique

• Injection technique

• Casting of temporary veneers for pre-ground

artificial teeth

Product information

Telio CAD

Telio CAD are cross-linked PMMA blocks for the fabrication of long-term temporaries by means of the CAD/CAM technique. As a result of the industrial polymerization process, the blocks feature a high material homogeneity. There is neither polymerization shrinkage nor an inhibited layer. Given the CAD/CAM fabrication, the temporary can be easily reproduced at all times. Stains and/or layering materials can be used to apply final esthetic optimizations.

Flexural strength [MPa] 130 ± 10

Modulus of elasticity [MPa] 3200 ± 300

Water absorption [µg/mm3] <28

Water solubility [µg/mm3] < 0.6

Source: Ivoclar Vivadent R&D, Schaan/Liechtenstein, 2009

In accordance with ISO 10477

Product information

Flexural strength [MPa] 90 ± 10

Modulus of elasticity [MPa] 3000 ±100

Water absorption [µg/mm3] 26 ± 1

Water solubility [µg/mm3] 0.8 ± 0.5

Physical properties in accordance with ISO 10477

Source: Ivoclar Vivadent R&D, Schaan/Liechtenstein, 2009

Uses

Telio Lab

Indications

• Temporary metal-free crowns and bridges with

a maximum wear period of 12 months

• Temporary metal- or Vectris-supported crowns

and bridges with a maximum wear period of 12 months

• Characterization, repair, supplements and

relining of temporaries

• Cementation of Ivoclar Vivadent denture teeth

to removable dentures (e.g. model cast dentures)

• Esthetic modification of denture teeth

Contraindications

• Direct intraoral use of unpolymerized material

• The material should not be used if a patient is

known to be allergic to any of the ingredients of Telio Lab

• Patients with parafunctions, e.g. bruxism

• Long-span bridges without reinforcements for a

wear period longer than 12 months

• Occlusal appliances to elevate the vertical

dimensions

Important processing restrictions

Failure to observe the following restrictions may compromise the results achieved with Telio Lab and/or Telio CAD:

• Failure to observe the general Telio Lab

minimum layer thickness of 1.5 mm

• No evenly supporting framework design

• Long-span bridges without reinforcement

• Insufficient connector dimensions

• Lack of mechanical retentions on the veneering

surface of the metal framework, (e.g. SR Micro, SR Macro Retention Beads from Ivoclar Vivadent)

• Staining/layering using materials that are not

approved and/or recommended

• Milling the Telio CAD blocks in an no-

compatible CAD/CAM system

• For the processing of Telio CAD with the inLab

MC-L and/or CEREC®MC-L System from Sirona, the CAD-Waxx Starter Kit (Sirona) with modified tank and reinforced filter system is required (available from dental dealers). In comparison with ceramic materials, a reduced quantity of Dentatec fluid per tank filling is required (milling additive) (see Ivoclar Vivadent abrasives overview).

Telio CAD

Indications

• Temporary anterior and posterior crowns with a

maximum wear period of 12 months

• Temporary anterior and posterior bridges with

up to 2 pontics with a maximum wear period of 12 months

• Implant temporaries

• Shape templates for permanent restorations

• Therapeutic restorations to correct TMJ

problems and occlusal adjustments

Contraindications

• Use for permanent restorations

• Bridge reconstructions with more than two

pontics

• Use of an incompatible / non-authorized

CAD/CAM system

• Patients with parafunctions, e.g. bruxism

• The material should not be used if a patient is

known to be allergic to any of the ingredients of Telio CAD

Prevention of premature loss of retention:

Apart from a retentive preparation design, the reliable cementation of Telio CAD restorations using a temporary luting material (e.g. Telio CS Link) depends on the accuracy of fit, which is determined by the CAD/CAM system used.

Composition

• Telio Lab Cold Liquid / Telio Activator

Components: Methyl methacrylate, triethylene glycol dimethacrylate (TEGDMA), dimethacrylate and catalyst (<1%)

• Telio Lab Dentin, Transpa Incisal, Neck and

Intensive Powder

Components: Polymethyl methacrylate, catalyst, and pigments (<2% wt.)

• Telio Lab Opaquer Powder

Components: Copolymer, aluminium oxide, barium sulphate and titanium dioxide, catalyst, and pigments (<2% wt.)

• Telio Lab Opaquer Liquid

Components: Methyl methacrylate, catalyst (<1% wt.)

• Telio CAD Blocks

Components: Polymethyl methacrylate (PMMA), pigments

• Telio Lab LC Transpa Incisal

Components: Urethane dimethacrylate, dimethacrylate, copolymer and silicon dioxide (65% wt.)

• Telio Stains

Components: Bis-GMA, urethane dimethacrylate, triethylene glycol dimethacrylate, fillers, stabilizers, initiators and pigments

• Telio Lab LC Base

Components: Urethane dimethacrylate, dimethacrylate, copolymer and silicon dioxide (65% wt.)

• Telio Add-On Flow

Components: Bis-GMA, urethane dimethacrylate, triethylene glycol dimethacrylate, fillers, initiators, stabilizers and pigments. Total content of inorganic fillers: 30% vol., filler particle size: 0.04–0.20 µm.

• SR Composiv

Components: Dimethacrylate; silicon dioxide (16–17% wt.). Additional contents are catalysts, stabilizers and pigments (< 2.5% wt.)

Side effects

Systemic side effects are not known to date. In individual cases allergic reactions to PMMA materials have been reported. In rare cases, components of the Telio Lab materials may lead to sensitization. Telio Lab should not be used in such cases.

Storage instructions

– Store packages in use at room temperature

(2–28 °C/35–82 °F). – Protect the materials from direct sunlight. – Observe the storage instructions and the date

of expiration on the secondary packaging. – Do not use the products after the indicated

expiration date. – Keep out of the reach of children!

Warning

– Telio Lab Cold Liquid, Telio Activator and

Telio Lab Opaquer Liquid contain methyl methacrylate (MMA).

– Do not use in case of known allergy to

methyl methacrylates.

– MMA is highly flammable and irritating

(flash point: +10 °C/50 °F). – Irritating to eyes, respiratory organs and skin. – Do not inhale vapours. – Keep away from sources of ignition. Do not

smoke. – Prevent contamination of sewage system. – Take measures against electrostatic charge. – Contact of the uncured Telio materials with

the skin, mucous membrane or eyes must be

avoided. Unpolymerized Telio CS materials

may cause slight irritation and may lead to a

sensitization against methacrylates.

Customary medical gloves do not provide

protection against the sensitizing effect of

methacrylates.

Product information

Conditioning of the Telio products for the adhesive bond

Basic material Surface preparation Bonding agent Add-on material

Telio Lab Telio CAD

Ivoclar Vivadent denture teeth

*except Ivoclar Vivadent ceramic

teeth

Alloys

Vectris

Blast the restorations

with Type 100 Al

1-2 bar (15-30 psi)

2O3

pressure or grind

Blast the restorations

with Type 100 Al

1-2 bar (15-30 psi)

2O3

pressure or grind

Blast the restorations

with Type 100 Al

1-2 bar (15-30 psi)

2O3

pressure or grind

Blast with Al according to the

2O3

instructions of the

manufacturer

Blast with Type 100

at 1–2 bar

2O3

(15–30 psi) pressure

Telio Activator

Telio Lab Cold Liquid

Telio Activator

Telio Lab Cold Liquid

and SR Composiv

Telio Activator

Telio Lab Cold Liquid

Telio Activator

Telio Lab Cold Liquid

and Vetris Wetting

Telio Lab

Telio Stains

Telio Lab LC Transpa

Incisal

Telio Add-On

Telio Lab

SR Link Telio Lab

Telio Lab

Liquid

CAD/CAM Partners

Telio CAD is processed by means of inhouse CAD/CAM systems or milling centers from our authorized partners. Please read the respective handbooks on the hard- and software of your CAD/CAM device before fabricating the restorations.

For questions regarding the different systems, please contact the respective cooperation partners.

Sirona Dental Systems GmbH

Fabrikstrasse 31 64625 Bensheim Germany E-mail: contact@sirona.de www.sirona.com

Nobel Biocare Holding AG

P.O. Box 8058 Zurich-Airport Switzerland www.nobelbiocare.com

Product information

For more information, please contact your Nobel Biocare representative.

Clinical working steps, technical fabrication process

Working step

Preparation, shade determi-

nation, impression-taking

Fabrication process

Temporary restoration

Casting technique, injection

technique, temporary

veneers, metal-supported

CAD/CAM

Characterization

Polishing

Ivoclar Vivadent

Products

Optra Gate

A–D shade guide

Virtual

Telio Lab

Telio CAD

Telio Lab/

Telio Lab LC components

Universal Polishing Paste

Preparing for cementation

Cementation

Checking the articulation /

occlusion

Telio CS Desensitizer

OptraGate

Telio CS Link

bluephase

Astropol OptraPol

Shade determination

Shade determination of the natural tooth

After tooth cleaning, the tooth shade of the non-prepared tooth and/or the adjacent teeth is determined with the help of a shade guide. Individual characteristics have to be considered when deter-mining the tooth shade. If a crown preparation is planned, for example, the cervical shade should also be determined. In order to achieve the best possible true-to-nature results, shade determination should be carried out at daylight. Furthermore, the patient should not wear clothes of intensive colours and/or lipstick.

Fabricating the model

Fabricate a master model or a model with detachable segments according to the impression in the usual manner. Generally, a sealant for surface hardening should be applied once the preparation margins are exposed.

The directions of the manufacturers of the different CAD/CAM systems regarding the plaster to be used must also be observed for the use of Telio CAD blocks.

Important for die preparation:

• Check the radius of the incisal/occlusal edge on the prepared dies

(maxilla and mandible).

• The prepared incisal edge should be at least as thick as the dia-

meter of the bur used in the cavity during the CAD/CAM process. If the incisal edge of the prepared die is more pointed and thinner than the diameter of the bur, the incisal edge has to be blocked out accordingly.

• Also observe the information provided by the manufacturer of the

CAD/CAM system regarding the die geometry.

Clinical working steps, technical fabrication process

Minimum material thicknesses / layer thicknesses

The design of the restoration is the key to a successful temporary restoration that also paves the way for the incorporation of the permanent restoration. The more attention is given to the design, the better the final results and the clinical success will turn out to be.

The following basic guidelines have to be observed:

• In large preparations and for veneered or partially veneered

restorations, the excess available space must be compensated by the corresponding dimensions of the stable Telio Lab and/or Telio CAD component and not by the layering material.

• The transition to the layering material must not be located in the

area of the functional contact points.

• With Telio CAD the design of the restoration generated by the

software has to be individually adjusted in accordance with the clinical situation using the design tools. The build-up of missing areas that support and reinforce the shape and cusps of the restoration are constructed with the integrated design tools of the different types of software used.

Framework thickness

Telio CADTelio Lab

Minimum wall thicknesses

1.5 mm

0.8 mm

min. 12 mm min. 12 mm

min. 12 mm min. 16 mm

Connector dimensions anterior bridges

Connector dimensions posterior bridges

occlusal

circular

with 1 pontic

with 2 pontics

with 1 pontic

with 2 pontics

1.5 mm

0.8 mm

min. 12 mm min. 12 mm

min. 12 mm min. 16 mm

Failure to observe the stipulated framework design criteria, minimum thicknesses and minimum connector dimensions may result in clinical failures, such as fracture of the restoration.

Telio Lab

General processing instructions

Designing the shape with a wax-up and silicone key

The tooth shape and function are designed with the help of a wax-up and secured with a silicone key.

Wax-up Silicone key

Minimum material thicknesses / layer thicknesses

The restoration design is key to the success of a temporary restoration. The more attention given to the design, the better the final results and the clinical success will turn out to be.

The following basic guidelines have to be observed: – Support the restoration with a framework (metal, Vectris) in long-span bridges or if space is limited. – The minimum wall thickness of 1.5 mm occlusal and 0.8 mm circular must be observed at all times. – The connector dimensions for anterior bridges with up to two pontics must be at least 12 mm – The connector dimensions for posterior bridges with one pontic must be at least 12 mm2and with up

to two pontics at least 16 mm

Telio Lab – General processing instructions

Important

Support the restoration with a framework (metal, Vectris) in long-span bridges or if space is limited.

Preparing and isolating the model

– Remove the silicone key from the model once it is set and clean off any wax residue from the model. – Block out undercuts and cuts between model segments. – Immerse the model in water for 5 minutes. Then, apply two layers of Separating Fluid. Wait between

the two layers until the surface is no longer shiny.

Information

Rough surfaces or undercuts may be isolated or blocked out using the elastic isolating gel SR Ivocron

Powder/liquid mixing ratio

. Apply SR Ivocron Separator and allow to dry for approximately 5 minutes.

Volume mixing ratio

1 part polymer :

1 part monomer

Weight mixing

ratio

1 g polymer :

0.83 g monomer

Mixing time Dough time Casting phase Plastic

20 s 2 min 2 min 3 min

phase

Polymerization in the pressure pot 2-6 bar/29-87 psi, 40-50°C/104–122°F

15 min

Processing time at 23 °C/73 °F approximately 8 minutes

Important

A higher room temperature shortens the processing time. The mixing ratio between the polymer and the monomer also influences the processing time. If the mixing ratio is correctly observed, a relatively flowable consistency is achieved.

– Pour the desired amount of Telio Lab Cold Liquid into a clear mixing beaker. – Dispense the same amount of powder into a second mixing beaker. – Subsequently, add the powder to the Cold Liquid and mix without creating air bubbles using a model-

ling spatula. – Cover the beaker and allow a dough time of approximately 2 minutes. – Pour the now well-flowable Telio Lab resin evenly into the silicone key. – Once the resin has reached its plastic phase, it can be contoured using an instrument that has been

wetted with monomer.

Mixing ratio 1:1 2 minutes dough time

Fabricating temporaries in the casting technique

– Fill the silicone key with ready-mixed and well-flowable Telio Lab Dentin without causing any air bubbles. – Apply Telio Lab Dentin on the isolated model without air bubbles. – Place the silicone key on the model in the correct position. – Once Telio Lab has reached its plastic phase, the material is polymerized under pressure in a water

bath for 15 minutes at 2-6 bar / 29-87 psi and a temperature of 40-50 °C / 104-122 °F.

Even pouring Application on the isolation model Placing the silicone key

Polymerization in a water bath

(e.g. Ivomat®IP3)

Pressure (bar/psi) Temperature (°C/°F)Time (min)

2–6/29–87 40–50/104–12215

Telio Lab – Fabricating temporaries in the casting technique

Individualizing the incisal area using the cut-back technique

– After polymerization is completed and the restoration has been removed from the silicone key, the

incisal area of the Telio Lab restoration is reduced by means of cross-cut burs. – Check the reduction (cut-back) with the silicone key. – Blast the surface with aluminium oxide at 2 bar / 29 psi pressure or roughen. – Apply Telio Lab Cold Liquid (monomer) on the clean surface (reaction time min. 2 to max. 4 minutes). – After that, condition the surface with SR Composiv in order to ensure a sound bond between the

restoration and Telio Stains. The layer thickness of SR Composiv must be between 0.2 and 0.5 mm;

the processing time is 3 minutes. – The material is cured in a light-polymerization device (e.g. Spectramat). – The incisal area is now individualized using Telio Stains.

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