How to Finish All On 4 Cases with Nano Ceramic, Trilor Bar, Pink Layering Tutorial

Master Dental Technician
20 Apr 202411:29

TLDRThis tutorial offers a comprehensive guide on the All-on-Four dental procedure using Nano Ceramic and Trilor Bar. The process begins with milling the Nano Ceramic jacket in a dedicated program, followed by preparing the Trilor Bar and ensuring a passive fit. The surfaces are meticulously cleaned and treated with a bonder before fusing the two components. The restoration is then shaped and contoured with attention to natural aesthetics. The video demonstrates the layering of pink composite to replicate gum tissue, using various shades and tools for a realistic appearance. The final steps include curing, staining to simulate veins, and applying a glaze for a lasting finish. The method is designed for immediate practical application, as evidenced by a student's successful case featured in the video.

Takeaways

  • 🦷 The nano ceramic jacket is milled using a dedicated program and contains 78% C-Tetraconic, a high-performance polymer matrix with glass fiber reinforcement.
  • 🔍 After milling, a fit check is performed to ensure a passive fit of the Trio bar into the nanoceramic jacket.
  • 🛠️ Surface preparation involves steam cleaning and sandblasting with aluminum oxide to remove any dirt or oils before bonding.
  • 🧪 A bonder is applied to the surfaces of both materials to act as a mediator between the materials and the fusing agent.
  • 🔗 The Trio bar and nanoceramic jacket are fused together using a resin, with care taken to avoid high contact points.
  • 📐 Trimming around the neck of the teeth and the gingival area is done to refine the gingival section without damaging the structure.
  • 🏗️ The material is contoured carefully to avoid shaping the teeth into an unnatural square shape.
  • 💡 Applying Peck Bond and using a micro brush is crucial for preparing the material for the gingival material.
  • 🔨 The tie bases are inserted into the Trio bar after treating the bar with Peck Bond and light curing.
  • 🎨 Layering the pink tissue involves using different shades of pink composite to create a natural appearance.
  • 🔴 Applying red and blue stains with a fine brush can add the look of veins for a more realistic effect.
  • 🛡️ A trans cover gel is used for the final curing cycle to eliminate the inhibition layer and ensure thorough curing.

Q & A

  • What is the main material used for the nano ceramic jacket in the All on Four cases?

    -The nano ceramic jacket is milled from a high performance techno polymer matrix with 78% zirconia and multi-directional glass fiber reinforcement.

  • What type of burs are recommended for grinding the nano ceramic after milling?

    -Diamond or tungsten carbide burs are recommended for grinding the nano ceramic after milling.

  • How is the surface prepared before fusing the Trio bar to the nano ceramic jacket?

    -The surface is prepared by steam cleaning both the jacket and the bar to remove oil and dirt, followed by sandblasting with aluminum oxide at 110 mu at two bar.

  • What is the role of a bonder in the process of fusing the Trio bar to the nano ceramic jacket?

    -The bonder, such as PEG Bond or Bond LC, acts as a mediator between the materials and the fusing agent, ensuring a strong bond between the Trio bar and the nano ceramic jacket.

  • What is the recommended curing time for the bonding agent in a UV box?

    -The recommended curing time for the bonding agent in a UV box is no longer than 90 seconds.

  • How is the excess cement cleaned off after joining the parts together?

    -The excess cement is cleaned off with a micro brush after joining the parts together.

  • What is the purpose of using a hot steam cleaner to remove wax from the excess holes in the bar?

    -The hot steam cleaner is used to remove wax from the excess holes in the bar to ensure a clean surface for the cement and to prevent contamination.

  • How does the layering of the pink tissue with composite material contribute to the final appearance of the restoration?

    -The layering of the pink tissue with composite material helps to create a natural and three-dimensional appearance, mimicking the look of the patient's gum tissue.

  • What is the significance of applying a trans cover gel for the final curing cycle?

    -The trans cover gel is spread across the entire surface of the pink to eliminate the inhibition layer, ensuring a thorough curing of the restoration and preparing the surface for polishing or glazing.

  • Why is it important to avoid using light cure only resins in this process?

    -Light cure only resins can be difficult to cure later in the process, which may affect the durability and integrity of the restoration.

  • What is the recommended method for glazing the surface of the restoration?

    -Nanov vanish from Draver is recommended for glazing the surface due to its ability to be applied very thin and not yellow over time.

Outlines

00:00

😀 Nanoceramic Jacket and Trio Bar Preparation

This paragraph outlines a comprehensive tutorial on creating a nanoceramic jacket and Trio bar. It begins with milling the nanoceramic jacket using a dedicated program and a disc containing 78% C Trois, a high-performance polymer matrix. The recommended milling strategy involves diamond or tungsten carbide burs. After milling, a fit check is performed to ensure a passive fit of the Trio bar into the jacket. The surfaces are prepared by steam cleaning and sandblasting with aluminum oxide. A bonder is applied to both materials, and they are fused together using a resin. The restoration is then cured in a light box for 7 minutes. The paragraph emphasizes the importance of cleaning the materials, preparing surfaces, and ensuring a secure fit before proceeding to the next steps.

05:00

🎨 Layering and Glazing the Pink Tissue Nano Ceramic

The second paragraph details the process of layering and glazing the pink tissue on the nano ceramic restoration. It starts with applying a dark pink composite at the junction of natural tissue and the Trio bar, followed by a light pink layer for a more natural emergence profile. The light pink is also used around the neck of the teeth, with flowable pink being easier for small areas. The paragraph explains the use of a silicone tool and modeling liquid for blending and achieving a seamless junction. It also covers the application of red and blue stains to mimic veins and the use of orange pink paste for the final layer. The restoration is then cured in a UV light box and any gaps are filled before a final curing cycle with a trans cover gel to ensure a thorough curing and eliminate the sticky layer on the surface.

10:01

🔍 Final Polishing and Glazing

The final paragraph focuses on the finishing touches to the restoration, including polishing and glazing. It emphasizes the importance of using a glaze that does not yellow over time, such as Nanov Vanish, and applying it carefully to avoid bubbles or pits. The glaze is applied for approximately 4 to 5 minutes in the UV light box. The paragraph concludes with a call to action for viewers to like, share, and subscribe to the channel, and to watch a related video on contouring teeth for a more in-depth understanding of achieving natural-looking results.

Mindmap

Keywords

💡All-on-Four

All-on-Four is a dental procedure that refers to placing four dental implants into the jawbone, which then serve as a foundation for a set of dentures or a fixed bridge. This method is used to replace a full set of teeth and is mentioned as the main subject of the tutorial video.

💡Nano Ceramic

Nano Ceramic is a high-performance material used in dentistry, composed of a techno polymer matrix with multi-directional glass fiber reinforcement and a high content of ceramic particles. In the video, it is used to create the jacket for the dental restoration, which is milled and shaped to fit over the Trio bar.

💡Trilor Bar

The Trilor Bar is a type of dental implant bar that is used to support the dental prosthesis. In the context of the video, it is prepared and contoured to fit with the Nano Ceramic jacket, forming the base structure for the All-on-Four restoration.

💡Sandblasting

Sandblasting is a process used to clean and prepare surfaces for bonding. In the video, the Nano Ceramic jacket and Trilor Bar are sandblasted with aluminum oxide to ensure they are free of oil and dirt before the bonding process.

💡Bonding Agent

A bonding agent is a substance used to promote adhesion between two materials. In the video, a bonder is applied to the surfaces of both the Trilor Bar and the Nano Ceramic jacket to act as a mediator for the fusing process, ensuring a strong bond between the two components.

💡Resin Cement

Resin Cement is a type of dental cement used to bond dental restorations to tooth structure. The video demonstrates the application of resin cement on the interior of the jacket and the exterior of the bar to join them together as part of the All-on-Four restoration.

💡Articulator

An articulator is a device used in dentistry to mimic the patient's jaw movements. It is recommended in the video to check the inclusion of the fusing process to ensure no high contact points are created, which could affect the fit and function of the restoration.

💡Pink Tissue

Pink Tissue refers to the gum tissue around the teeth. In the video, a layering technique is demonstrated to recreate the appearance of natural gum tissue using composite materials, adding a realistic aesthetic to the dental restoration.

💡Contouring

Contouring is the process of shaping or carving a material to achieve a desired form or appearance. The video discusses contouring the Nano Ceramic material to create a natural look for the dental restoration, avoiding a square or overly angular appearance.

💡Glazing

Glazing is the final step in the dental restoration process where a transparent or translucent material is applied to the surface to give it a shiny, lifelike appearance. In the video, a glaze is applied to the pink tissue to complete the restoration and give it a more natural look.

💡Model LC

Model LC is a liquid used in dentistry to clean and prepare surfaces for bonding or to smooth and shape dental materials. The video mentions using Model LC to clean the surfaces before bonding and to blend the junction of materials seamlessly.

Highlights

All-on-four dental restoration process using nano ceramic and Trilor Bar

Nano ceramic jacket milled with a dedicated program containing 78% ceramic particles

Trilor Bar prepared for fusion with the nano ceramic jacket

Surface preparation includes steam cleaning and sandblasting with aluminum oxide

Application of a bonder as a mediator between the materials and the fusing agent

Use of UV light to cure the bond on both the bar and the jacket

Relax from 3M or multi-link from Ivoclar as recommended fusing agents

Technique for checking the inclusion on an articulator to prevent high contact points

Process of cleaning the screw access holes in the jacket with a micro brush

Use of a hot steam cleaner to remove wax from excess holes in the bar

Contouring the nano material with care to avoid shaping teeth like squares

Application of Peck Bond on the material before adding gingival material

Insertion and curing of tie bases into the Trilor Bar with a micro brush

Layering pink composite using dark pink as a base and orange pink for overlay

Use of flowable light pink for areas around the neck of the teeth

Technique for creating a label phom on the upper arch using light pink

Application of red and blue stains to achieve the look of veins in the gingival area

Final curing cycle with a trans cover gel to eliminate the inhibition layer

Use of nanov vanish for glazing the surface without causing discoloration over time

Importance of not overlapping stained areas when glazing to avoid bubbles or pits

Complete curing of the restoration in the UV light box for 5 minutes