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Porcelain repair and bonding success

Jan. 21, 2010
Dr. Howard J. Kirschner shares how he makes porcelain repairs simple, fast, and reliable — predictably — with Kuraray bonding materials.
By Howard J. Kirschner, DDSIt’s magic ... it may seem unbelievable! After you try it, you will become a believer in the magic of Clearfil Repair – Multi Purpose from Kuraray. It really works, and you do not have to be a magician to get amazing results!
For best results, isolate the area, keeping the area dry and free from saliva and moisture.Repairing a chipped PFM, regardless of the metal type, precious or nonprecious, begins first with a coarse diamond to roughen the surface of the exposed metal, chipped porcelain, and surrounding porcelain area.If the repair is of an all-porcelain restoration, follow the same step as indicated above.First, apply K-etchant GEL for five seconds to cleanse the surface; rinse and dry. This would only be done for a repair on traditional porcelain ceramics; Zirconia and Alumina do not require this step.Next, apply Alloy Primer with a micro-brush, or brush tip, to the exposed metal. Allow the surface to air dry; let it evaporate on its own.Next, apply Clearfil Ceramic Primer to the chipped and exposed porcelain, and to the surrounding porcelain area, with a micro-brush or brush tip (carefully to the porcelain only). Do not get it on the metal. The Clearfil Ceramic Primer does not require use of a curing light; air dry only.If the surface you are repairing contains metal, you want to use Clearfil ST Opaquer. Squeeze a little onto a pad and mix thoroughly. Apply thickly, using a fresh brush tip to completely cover and hide the metal surface. Carefully avoid the porcelain; light-cure the Opaquer for 40 seconds, using an LED or conventional halogen light. Add more Opaquer, if necessary, to completely cover the metal.Next, complete the repair by applying composite resin (Clearfil Majesty Esthetic) to the exposed porcelain/metal. Manually apply or press the composite onto the chipped area. Featheredge the composite resin onto the undamaged porcelain surface. When the repair appears satisfactory, light-cure for 20 seconds with an LED or halogen curing light. Contour, finish, and polish the polymerized resin using a fine sandpaper disc or smooth diamond. It is optional, as a final step, to roughen the restoration surface using a diamond point, then rinse and dry. Apply a thin layer of Surface Coat to the restoration surface. It is best to use the flat type disposable brush tip. The Surface Coat will produce a glaze and extend the life of the restoration. However, you must light-cure only with a conventional halogen light for 20 seconds, as an LED light will not work. Recommended storage for the kit is in the refrigerator in order to maintain its shelf life (two years from date of manufacture). It is important to bring the product to room temperature before use (approximately 15 minutes).“Clearfil Repair – Multi Purpose” is a repair system that works — and lasts. The kit contains: K-etchant GEL, Alloy Primer, Clearfil Ceramic Primer, Clearfil ST Opaquer, Surface Coat, plus accessories. Suggested retail price is $200, and it is available through all major dental distributors.The “Multi-Purpose” bonus uses of the individual components of the kit include:Alloy Primer: this is used to activate metal surfaces to produce a chemical bond when using resin cements (ex. Clearfil Esthetic Cement and DC Bond).Clearfil Ceramic Primer: a one-bottle silane coupling agent which is applied to porcelain or ceramic restorations prior to cementing or repair. Here again, the special Kuraray chemicals will yield a most impregnable bond. In addition, Clearfil Ceramic Primer can be used when repairing a fractured composite with new resin.Clearfil ST Opaquer may be used to hide or cover metal areas prior to resin placement.K-etchant GEL is used to clean an internal porcelain surface, or anytime phosphoric acid gel is needed.Adjunctive Kuraray products include:Clearfil SA (self-adhesive) resin cement is an adjunct to your bonding armamentarium (no pretreatment or bonding agent needed for most procedures). Clearfil SE (self-etch) bonding agent is for use on enamel or dentin. This is the gold-standard product for Kuraray.Clearfil DC (dual-cure) bonding agent also may be used equally on enamel or dentin. This is a self-etch product, which can be used for composites and with resin cements for indirect restorations.I find it important to embrace the products of one company and not to mix and match. The chemistries of various companies are not interchangeable and are not necessarily compatible. The Kuraray products are a system; the dentist will have more predictable results when these products are used together.I find the new bonding materials to be remarkable. I have had long-term success in restoring larger fractures, such as the corner of central incisors, using these products.Your repairs will be simple, fast, and reliable. There is no need for toxic hydrofluoric acid. No tricks up your sleeve — just predictable results. Your patients will think you are a magician!Howard J. Kirschner, DDS, is a Certified Dental Consultant of the American Association of Dental Consultants and is an attending dentist at Mt. Sinai Hospital Dental Clinic in NYC. He is the recipient of the NYSDA award for more than 3,000 hours of CE, Pierre Fauchard Academy, and is the president of Steinway Dental Study Group in Astoria, N.Y. Dr. Kirschner is in private practice at Far Rockaway, N.Y.Dr. Howard Kirschner would like to thank Ms. Lois M. Richstein, who collaborated on this article. Ms. Richstein has been a member of the dental community since 1975. She has taught dental assisting at New York University, specializing in dental materials and radiology. Other positions have included long-term employment relationships with both Henry Schein, Inc., and Darby Dental Supply as product training manager for both inside and outside sales representatives. Ms. Richstein holds a teaching degree from New York Institute of Technology, with a specialty in health occupations education; as well as CDA, IC, and radiation health certification. Currently, Ms. Richstein is a product specialist for Kuraray America, Inc. She provides educational programs to study groups, hospital residency programs, and dental schools. You may contact her at (800) 879, 1676, x152 or by e-mail at [email protected].