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Glass Ceramic Block

technical product profile

Paradigm C

2

Table of contents
1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 2. Overview of Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 3. Clinical Application of Glass Ceramic Blocks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 4. Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 5. Shades . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 6. Composition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 7. Test Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 a) Strength of specimens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 b) Strength of real geometries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14 c) Cementation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 d) Solubility/Biocompatibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 e) Machinability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 f) Aesthetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 8. Application Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19 9. Instructions for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 10. Clinical Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24 11. Questions and Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27 12. Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28 13. Literature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29

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A1.2: 3M ESPE Paradigm™ C is available in different sizes (from left to right: V5-12.5.5. 1.1. I 10. Bleach) and offered in 5 different block sizes. I 12. Fig.3: 3M ESPE Paradigm™ C is available in 6 different well-balanced shades (from left to right: Bleach. B3) 5 . A3. B3. A3. A2. Paradigm C block exhibits a chameleon effect once seated due to its brilliant translucency and fluorescence. Paradigm C ceramic block is made out of a two phase leucite ceramic available in 6 different Vita™ classic shades (A1. A3. A2. I 8. 1. veneers and crowns grinded with the Cerec® chairside CAD/CAM and inLab systems (Sirona.1: 3M ESPE Paradigm™ C block made of glass ceramic Fig. onlays. Bensheim). 1. A3. I 14) Fig. Introduction Paradigm™ C is a 3M ESPE grindable glass ceramic block for the preparation of inlays.

In this ternäre system feldspars can have different chemical compositions resulting in different crystalline structures. 6 . ceramics can be subjected to ten times more stress under pressure than when pulled or bent (see Figure 2.) SEM picture of polycrystalline ceramic Lava™ zirconium oxide Glass Ceramics: Feldspatic and leucite ceramics are used as veneering porcelains for either metal or all ceramic frameworks. Due to their special chemistry both have higher translucency compared to the other ceramics (infiltrated and polycrystalline). Albit (NaAlSi3O8) and Anorthit (CaAl2Si2O8).2. therefore.) SEM picture of Paradigm™ C glass ceramic. Since the introduction of CAD/CAM technology 20 years ago. New ceramic materials with higher strength were developed and with the introduction of new technologies like CAD/CAM could be processed for the first time in the dental operatory. but also lower flexural strength (Figure 2.) for indications like inlays. b. Overview of Materials In the last two decades the amount of all-ceramic restorations and the variability in different ceramic materials steadily increased. However. whereas ProCad and Paradigm C are both leucite reinforced ceramics.) SEM picture of Infiltrated ceramics.1). The former perception of fragile ceramics was overcome by new materials and it is now recognized that there are ceramic materials with enormous variation in specific characteristics.1a. Today three main classes of ceramic materials are distinguished in dentistry: glass ceramics. The glass powder is applied to the restoration and fired in a dental oven at 700 to 900 °C. feldspatic ceramics are also industrially prepared as blocks. The dental community became convinced on the use of ceramics. The two ceramic materials leucite and feldspatic ceramics are both considered as Aluminosilicate consisting of amorphous and crystalline parts. biocompatibility and strength. They have mainly an amorphous structure resulting in a high translucency and a very low crystalline content (< 5%). because they fulfill all the requirements of a dental restoration: aesthetics. Vita Mark II is a Sanidine (K[AlSi3O8]) reinforced feldspatic ceramic. where compressive stresses play a more important role and where tensile stresses are not as important compared to a bridge design. Later on Leucite ceramic blocks were introduced with a high content of Leucite crystals in order to improve the strength of the material. 2. c. glass ceramics show a sufficient and clinically proven strength (see chapter 3. Leucite is a K[AlSi2O6] crystal whereas feldspars are best explained by a ternary system of Orthoclas (KAlSi3O8).3). They have ten times higher compressive strength compared to flexural strength and. They highly differ in their chemical composition and their 3D structure resulting in different mechanical and optical characteristics (Figure 2. Nevertheless they differ in their chemical composition and crystalline structure.2). Fig. infiltrated and polycrystalline ceramics. onlays. veneers and crowns.

Especially ZrO2 is the dental ceramic with the highest flexural strength of approximately 1000 MPa and excellent long term stability (see also Lava Crowns & Bridges. However due to their different chemical composition (e. ZrO2 is the material of choice for bridges especially in the posterior region.2). Ceramic Materials for chairside CAD/CAM technology: There are lab-based systems for dental technicians and chairside CAD/CAM systems for dentists in the market today. high strength ceramics may be processed for the first time which made a dental application for polycrystalline ceramics possible. They have a crystalline 3D structure without amorphous parts. and it is clinically proven for crowns and bridges in the anterior and posterior region. The core framework is milled out of the ceramic material and polycrystalline ceramics are subsequently sintered to full density. University of Homburg). Al2O3 and ZrO2) and the higher percentage of crystalline structure. however with a small stone underneath the weight of a child (b) may already break the tile. Polycrystalline ceramics: With the introduction of CAD/CAM technology. 2. they show 3 to 4 times higher strength compared to glass ceramics (Figure 2. In the left picture compressive stresses are dominant whereas in the right picture tensile stresses lead to fracture (Courtesy Prof. Figure 2. With infiltrated ceramics the framework needs to be infiltrated with glass and finally fired. The restoration frameworks are additionally veneered with the respective overlay porcelain in order to achieve optimal aesthetics of the restoration. mixture of SiO2. Infiltrated ceramics: Similar to the glass ceramic materials. 2.2). Pospiech.2000 1750 Flexural strength [MPa] 1500 1250 1000 750 500 250 0 LavaTM Zirconia Strength according to ISO 6872 InCeramTM Zirconia InCeramTM Allumina ParadigmTM C Vita MarkTM II Fig. infiltrated ceramics consist of amorphous and crystalline parts.2: Flexural strength of different ceramic materials (3M ESPE internal data) a b Fig.g. They have sufficient strength for crowns in the anterior and posterior region and a sufficient strength for anterior bridges. 3M ESPE. P. 7 . Therefore.3: An adult person (a) can stand on a tile without breaking it. Polycrystalline ceramics and infiltrated ceramics are used in lab-based systems.

Sirona) are in the market. onlays or crowns. onlays. the composite block MZ100 shows a higher strength. Excellent aesthetics Advantages 8 . onlays. glass ceramics are the material of choice with short milling times of approximately 20 min for inlays. a composite block for Cerec systems (3M ESPE). crowns 1. 3M ESPE). ideal for chairside applications Crowns and bridges (anterior and posterior) 1. ideal for chairside applications Inlays. Fast milling time.The advantage of a chairside CAD/CAM system is the treatment of the patient during one appointment. milled and cemented in place. Ceramic materials are perceived to have a higher aesthetics. Excellent aesthetic material 2. the restoration will be designed. Zirconia is a high strength ceramic (> 1000 MPa) 2. Therefore. the following materials are recommended for the respective indications: Table 2. veneers. veneers. crowns 1. Due to the special chemistry and the resulting mechanical parameters.4: Recommended materials for different CAD/CAM fabricated restorations and indications Paradigm™ C block Paradigm™ MZ100 block Lava™ Crowns & Bridges (Leucitic glass ceramic) (Composite) (Zirconium oxide) Indications Inlays. a higher elasticity and lower wear (see technical product profile Paradigm MZ100. Long span restorations 3. In one appointment the prepared tooth will be scanned. Higher flexural strength than glass ceramics 2. Two glass ceramic materials for chairside CAD/CAM technology (Cerec®. the glass ceramic Vita™ Mark II (Vita Zahnfabrik) and ProCAD‚ (Ivoclar Vivadent) [Figures 2. Fast milling time. Additionally.3].1-2. in certain regions dentists may use Paradigm™ MZ100. The benefit of one appointment can only be achieved if the milling process of the restoration is not too time consuming. Excellent wear 3.

2] and since then several clinical studies showed survival rates of 100% to 89% after 1 to 18 years (see Table 3. and Jedynakiewicz N.2 years. Table 3. 9 .5]) and on the clinical performance of class I and II restorations (2004. Later. Clinical Application of Glass Ceramic Blocks Restorations out of CAD/CAM milled glass ceramic blocks have a clinical history of about 20 years. cast) Ceramic (CAD/CAM) Gold Class I and Class II [3.4] summarized 15 clinical studies with glass ceramic CAD/CAM milled restorations and found a mean survival rate of 97. Summary of clinical review of Hickel and Manhart ([58]) Posterior restorations [3. [3.M. In 1997 Hickel and Dasch reported a success rate of > 90% after 3 years for the first clinical studies with CAD/CAM milled glass ceramics [3. [3. [3.2).6] 0-7% 0-7% 0-8% 0-5% 0-6% 0-8% 0-6% 0-6% CAD/CAM milled glass ceramic inlays and onlays showed the same annual failure rates compared to gold and hence showed a similar clinical performance compared to state-of-the art dental materials. CAD/CAM ceramic inlays.6]) made from different materials (amalgam. cast). gold.1).3.5] Direct restorations: Amalgam Indirect restorations: Ceramic (Pressed. In 1999 Martin N. In conclusion.4% over 4. Hickel and Manhart published two very thorough reviews on the clinical performance of posterior restorations (2001. The first patient was treated in 1985 with a Cerec® restoration by Professor Mörmann from the University of Zürich [3. ceramic (pressed. The first clinical study was started soon after [3.3].1]. glass ceramics are clinically proven for specific indications by their long clinical history. see Table 3.1: Mean annual failure rates of different dental materials.

color match.marginal integrity.O. Dentistry (2006) 1. 605-612 [3. 3. 3. 2. secondary caries. marginal adaption. 122-128 [3. endo-crowns. 3. and Curilovic Z. anatomic form.24] Sjorgen G. and De Nisco S.16] Bindl et. 6.IntJ Comp. antomical form. (2003) Schwezer Monatszeitschrift für Zahnmedizin 113. 219-224 20 patients received each one cerec.13] Reich S.al (1999) Quintessenz International 30.11-22 Study duration Tested indication Survival rate 1 year crowns 100% (no failure) 2 years crowns 95% (18 in situ after 26. 4 crowns on implants. et. 434. 2.18] Mörmann W. 231-246 [3.5 173-176 [3.3.al A (2005) IntJ Prosthodontics 8. surface texture.5 years (55 month +/-15 month) different restorations crowns classic: premolar/molar 97%/ 95%reduced crowns 93%/92% endo crowns 69%/87% 5 years inlays/onlays 100% gold 92% ceramic inlays 5 years inlays/onlays 100% 5 years inlays/onlays 88% all materials 93% for Cerec (one fracture) 5 years inlays/onlays 100% 8 years inlays/onlays 91% [3.W. secondary caries. one Empress.23] Otto T. et. (2004) IntJ Periodontics & Restorative Dentistry 24. evaluation of color matching.al (2001) Compendium of clinical education dentistry 22. and Krejci I. sensitivity and fracture 50 inlays.9] Posselt A. 187 were evaluated after 10 years CDA criteria USPHS criteria modified CDA criteria [3.6 month) 2. 2.156-169 10 years inlays/onlays 90.al (1999) Compendium of Continuing education in dentistry 20.9 years (mean) 99% 3 years inlays/onlay 94% 3 years inlays/onlay 87% 3 years different restorations 100% 4 years different restorations 100% 4 years inlays/onlays 100% 4. stain and discoloration.25] Reiss et. 12. and Kerschbaum T.4% (nach Kaplan Meier) Clinical study from 1987 to 1990 (1010 restorations placed in 299 patients). 1171-1181 modified USPHS criteria USPHS criteria modified [3. marginal discoloration 50 inlays.27] Reiss B. anatomic contour. (2000) IntJ Computerized Dentistry 3. 241-246 [3.2. and Walther W. marginal integrity. 829-836 USPHS criteria [3. 1.2: Main clinical studies with chairside CAD/CAM milled restorations Success rate Crowns (n=10) and endo-crowns (n=10) Evaluation of marginal adaption. bleeding. 1345 [3. crowns.10] Isenberg et. secondary caries.Table 3. 340 66 Cerec inlays 84. 5. overall quality. surface texture.al (1992) J Estethic Dentistry 4. 1.8] Bindl A. and van Dijken J. et. 14-18 [3. one Mirage and one gold inlay First clinical evaluation of 8 Cerec restorations Evaluation of the clinical performance of direct and indirect inlays out of ceramic and composite no significant difference among the survival rate of the different inlays 13 inlays and onlays in one patient 32 ceramic inlays 200 Cerec restorations were placed. (2000) European Journal of Oral Science 108.26] Reiss B.al (2004) IntJ Prosthodontics 17.(2003) IntJ Computerized Dentistry 6.7] Otto T.al (2000) IntJ Prosthodontics 13. 255-265 [3. tooth vitality. et. post-op sensitivity clinical wear of the anatomic form 80% (chipping and hairline chracks in 2 cases from Celay) 97% USPHS criteria 58 onlays. (2002) IntJ Prosthodontics 5.15] Heyman H. evaluation of marginal integrity.al (2004) JADA 135.al (2001) Quintessenz International 32. Evaluation of failure rate.al (1996) J AmDentAssoc 127.12] Thordrup et.14] Estafan D. 194-200 [3. 8.22] Otto T. 6 555-560 [3. (1999) Journal of Adhesive Dentistry 1. recurrent decay. color match. veneers.21] Pallesen U.20] Mörmann W. 3 199-201 USPHS criteria USPHS criteria modified USPHS criteria [3. 5. (1992) Quintessenz International 23.4% (Kaplan Meier) 10 years inlays/onlays 89% 18 years inlays/onlays 89% . 109-115 [3.19] Thordrup M. and Mörmann W. staining. 9-23 [3.17] Molin et.2. (1991) Acta Stomatologica Croatica 25. color match Determination of the clinical performance of 19 endo-crowns 2328 Cerec inlays were fixed in 794 patients from 1990 to 1999 with Cerec 1 and 2 121 inlays/onlays Evaluation of marginal discoloration. tooth anatomy modified USPHS criteria USPHS criteria [3. et.2139-2146 [3. evaluation of open margin.11] Isenberg (1991) Journal of Dental Research 70. and De Nisco S. surface texture and postoperative sensitivity 208 crowns and endo-crowns (n-86) USPHS criteria 30 inlays CDA criteria USPHS criteria modified USPHS criteria [3. 446-455 Amount of restorations/Evaluation Evaluation criteria Reference First Author + year 10 [3.

A3.5. I12. A2. Shades Paradigm C Glass Ceramic Blocks are available in 6 different shades: A1. Fig. A1. Indications Paradigm™ C Glass Ceramic Blocks can be used for the following indications: • • • • Inlays Onlays Crowns Veneers 5.1: Different shades of Paradigm™ C glass ceramic blocks: Bleach. A3. I14. I10. V5-12). 5.4. A2. B3 11 . B3 and Bleach and in 5 different sizes (I8. A3.5. A3.

Therefore. 12 . Composition The Paradigm™ C millable Glass Ceramic Block is derived from a molten Alumino-Silicate glass composition with Alkali Oxides like K. Na and Earth-Alkali Oxides like Ca.6. After grinding and compacting of the glass powder a special heat treatment process creates approximately 30% ± 5% Leucite crystals within the blocks. Ba and Ce. the user of Paradigm C does not need any further crystallization step to achieve the final strength of Paradigm C.

only the occlusal surface is polished. Based on ISO the ceramic specimens were polished in order to get an optimal surface before the measurement. All distributions are similar.7.1: Flexural strength of Paradigm™ C glass ceramic block in comparison to competitor materials. The advantage is that the probability of failure can be determined at a certain load.2x4. its strength.2 the Weibull distribution of the three materials are shown. ProCAD®). long-term stability. 13 . In the following pages. the characteristics of Paradigm™ C glass ceramic blocks will be compared to glass ceramic materials currently in the market. onlays and crowns a minimum strength of 100 MPa is required. n=30) ParadigmTM C VitaTM Mark II ProCAD® Fig. Additionally. n=10) Milled from Cerec system (3x4x12 mm. The graph shows two sets of data which compare the specimens tested based on ISO 6872 and specimens milled by the Cerec system. where tensile stresses normally occur is clinically still in the as-milled state of the instrument. Test Results The clinical success of dental restorations highly depends on the mechanical and optical characteristics of the material. Milled specimens of Paradigm C glass ceramic have the same strength compared to Vita Mark II and ProCAD® (3M ESPE internal data) The strength of ceramics are usually reported with a Weibul statistic instead of Gaussian statistic. Paradigm C block did not show any significant difference compared to Vita Mark II. its translucency and fluorescence as well as the bond to the cement.1 the flexural strength of Paradigm C is compared to competitive glass ceramic blocks (Vita™ Mark II. Clinically. whereas ProCAD showed a higher strength. a. In Figure 7. than both Paradigm C and Vita Mark II blocks. Here. In Figure 7. For dental ceramics used for the fabrication of inlays. 200 180 160 140 Flexural strength [MPa] 120 100 80 60 40 20 0 based on ISO (18x1. The surface. Strength of specimens The DIN EN ISO 6872 defines the strength requirements for dental ceramics according to their intended use. Paradigm C block showed the same strength compared to Vita Mark II and ProCAD.g. e. Paradigm C glass ceramic shows the same flexural strength based on ISO compared to Vita™ Mark II.0 mm. The failure probability < 100 MPa was 0% for Paradigm C material. the flexural strength of milled specimens without any further surface optimization was analyzed. 7.

Vita™ Mark II. 7.0 mm and occlusal wall thickness of 2 mm was measured for Paradigm™ C Glass Ceramic Blocks and the competitive materials. the strength was measured in an universal testing machine (Instron 5566).95 % CI 99 90 80 70 60 50 40 30 20 10 5 3 2 1 90 100 110 120 130 140 150 160 170 Flexural strength (MPa) Fig.3: Long term stability (3M ESPE internal data) Paradigm C glass ceramic shows the same strength and long-term stability compared to the competitive materials. Ten crowns of each material were milled with the same design (same Cerec® project). ProCAD® Weibull . 14 .Probability Plot of Paradigm™ C. Subsequently. After cyclic loading (1. cemented with RelyX™ Unicem Self-Adhesive Resin Cement and cyclically loaded.2: Weibull plot for the different glass ceramic materials (3M ESPE internal data) b.2 Million Cycles 35 N/Thermocycling) 1000 Probability Variable ParadigmTM C Measurement O ProCAD®_1 VitaTM Mark II_1 750 Strength (N) of Crowns 500 250 0 ParadigmTM C VitaTM Mark II ProCAD® Fig. Strength of real geometries (crowns) The strength of crowns with an axial wall thickness of 1. 7.

5 a and b). 7. Moreover. the fracture strength is further increased [7. RelyX™ ARC. because it has the advantage of leading to a chemical bond between the restoration and the tooth.4: The silane molecules (on the right) approach the inorganic glass ceramic surface which is covered with hydroxide groups and water molecules. Paradigm C glass ceramic material in combination with Ceramic Primer and RelyX Unicem shows the same shear bond strength compared to a adhesive cementation (e.c. J.g. the surface can be sealed and in consequence. These compounds normally have two functional groups. Fig. Cementation Glass ceramic restorations must be bonded adhesively. Variolink) and only slightly lower than Panavia F/2. Fischer from the University of Bern and compared to the respective shear bond strength of the cements to Vita Mark™ II (Figure 7. Glass ceramic materials are usually etched by hydrofluoric acid.1].g. By HF etching and silanization of Paradigm C glass ceramic material a high shear bond strength can be achieved in combination with different adhesive and self-adhesive cements (Figure 7. All specimens were incubated in water for 24 hours (36 °C) prior to thermocycling (1500 cycles. The silane end of the molecule reacts with the hydroxy groups at the ceramic surface. whereas the double bond polymerizes with the monomers of the resin cement (see Figure 7. Paradigm™ C Glass Ceramic Block restorations must be cemented in conformity with general rules of adhesive technology.0 by following an easier handling process (for more information on RelyX Unicem see also the Technical Product Profile RelyX Unicem). The glass ceramic material was etched with HF (< 5%).4). one silane group and one double bond. The etching step causes an increase in the surface roughness resulting in increased micromechanical retention. using an adhesive (e. The shear bond strength of Paradigm C glass ceramic material to different adhesive and selfadhesive cements was determined by PhD Dr. RelyX™ Veneer for veneer indications) or Self-Adhesive Resin Cement (RelyX™ Unicem). 5/55 °C). In this way.5 a and b). silanized (Ceramic Primer) and sub-sequently the cement was added and polymerised either by light curing or chemically curing dependent on the kind of cement used. The silanization agent leads to chemical bond between the inorganic ceramic material and the organic resin. silanized by a silane agent and subsequently bonded by a resin cement. 15 .

Fischer. 7. CAD/CAM milled restorations have to show a solubility lower than 100 µg/cm2. 7. 7. According to ISO 6872 ceramic materials must have a solubility lower than 2000 µg/cm2 for materials used with frameworks and lower than 100 µg/cm2 for those in contact to the surrounding humidity in the mouth of the patient. Solubility/Biocompatibilty Ceramics are considered as biocompatible material because of their very low solubility. J. 100 Solubility Solubility (µg/cm2 0 ParadigmTM C VitaTM Mark II ProCAD® Fig. J.5 a: Shear bond strength after chemical curing (PhD Dr. University of Bern) d. University of Bern) 45 40 35 Shear bond strength [MPa] 30 25 20 15 10 5 0 VariolinkTM II PanaviaTM 21 RelyXTM ARC RelyXTM Unicem VitaTM Mark II ParadigmTM C Shear bond strength after chemical curing Fig.7.70 60 Shear bond strength [MPa] 50 40 30 20 10 0 Shear bond strength after chemical curing VitaTM Mark II ParadigmTM C VariolinkTM II PanaviaTM 21 RelyXTM ARC RelyXTM Unicem Fig. Paradigm™ C Glass Ceramic Block meets the requirements of the ISO norm and shows a very low solubility (Fig. Fischer.5 b: Shear bond strength after chemical curing (PhD Dr.6).6: Solubility of different glass ceramic materials for CAD/CAM technology (3M ESPE internal data) 16 .

For more information concerning machinability see also chapter 8.(3M ESPE internal data) 17 . Aesthetics Shade match.00 2.00 ParadigmTM C VitaTM Mark II Fig. 7. Machinability Paradigm™ C material showed the same grinding behavior as other competitive glass ceramic materials.8:Translucency of different CAD/CAM glass ceramic materials.e. In Figure 7.7. 45 40 35 30 Translucency 25 20 15 10 5 0 VitaTM Mark II ProCAD® ParadigmTM C A1 A2 A3 A3.00 12.8 and 7.5 B3 Bleach Mean over all colors Fig. 3M ESPE Application test. 15.50 Milling time [min] 10. Paradigm C Glass Ceramic Block shows a high translucency and fluorescence over all colors (Figure 7.7 the mean grinding time for 10 crowns of Vita™ Mark II and Paradigm C material are shown.7: Mean milling time of 10 crowns of the same design out of Vita™ Mark II and Paradigm™ C Glass Ceramic Block (3M ESPE internal data) f. translucency and fluorescence are main requirements for excellent aesthetics.50 5.9).50 0. Comparison of different shades (standard shades).00 7.

We believe the best way to learn more about the aesthetic possibilities of Paradigm™ C Glass Ceramic Block is to put a Paradigm™ C restoration. A2(b). 7. but still aesthetics is something very subjective.5(d). 18 . A3. B3(e). Photography under UV lamp.9: Fluorescence of Paradigm™ C Glass Ceramic Block (in each picture left) in comparison to Vita™ Mark II (in each picture right) A1(a).a b c d e Fig. A3(c). to your own test.(3M ESPE internal data) Aesthetic requirements can be optimized.

Application Test Summary of Results: Paradigm™ C Glass Ceramic Block was clinically evaluated within an application test by European dentists in 2005.8. 8. Altogether 146 restorations were made. Shade match in comparison to preselected color matches very well 1 2 2 3 4 does not match at all 5 A1 A2 A3 A3. The combination of Paradigm™ C Glass Ceramic Block with RelyX™ Unicem Self-Adhesive Resin Cement was part of this evaluation. color matching. grindability. Paradigm C Glass Ceramic Block showed the similar good performance to other glass ceramic blocks (Fig. Overall satisfaction with the Paradigm C Overall satisfaction 50% 40% dentists 30% 20% 10% 0% 0% very satisfied satisfied neutral dissatisfied very dissatisfied 0% 17% 44% 39% Fig.9 1. 19 . The best ratings were given for chameleon effect and translucency.2: Shade match in comparison to preselected color The inserted restorations matched well to the preselected colors.9 2. handling. For other parameters.1: Overall satisfaction Overall the dentists were highly satisfied with Paradigm C Glass Ceramic Block. marginal fit and overall aesthetics. 8. the system Paradigm C – RelyX Unicem cement was judged to provide optimized process flow regarding time.g. Shade match of Paradigm C restorations after insertion in comparison to the pre-selected color. According the majority of the dentists. e. The majority of the testers indicated the system Paradigm C – RelyX Unicem cement guarantees a simple and safe process flow. polishing. Overall 83% of the dentists were satisfied or very satisfied with the Paradigm C. which were judged as better compared to other available glass ceramic blocks.2 2 2 Fig.3).5 B3 Bleach 1. 8.

Polishing result of Paradigm C Dentists judged the polishing behaviour of Paradigm C restoration as very good.9 2.Handling of Paradigm™ C Glass Ceramic Block Overall the handling of Paradigm C was judged as easy. safe and timely optimized process flow in the office.2 2.4 2. translucency and chameleon effect were rated as better. 20 . and the removal of the blocks from the packaging.7 2. followed by the insertion of the blocks into the holder. Translucency and chameleon effect of the Paradigm™ C Glass Ceramic Blocks Compared to other glass ceramic blocks. and slightly better compared to competitive products. Properties of 3M ESPE glass ceramic in comparison other glass ceramic blocks much better 1 2 2.3: Properties of 3M ESPE glass ceramic in comparison other glass ceramic blocks The new glass ceramic in the system Eighty-three percent (83%) of the dentists stated that the system Paradigm C Glass Ceramic Block and RelyX™ Unicem Self-Adhesive Resin Cement guarantees a simple.7 Fig. Cutting-off the grinded work from the block was rated best. e ty rs cy ect ling etic al T bili enc olo Eff cen sth and rgin ll C esc nda slu l i H a on Ae a r a n r e l l M l a G e e r Op era Ov ll T am Ov Ch era Ov 2.7 3 4 much worse 5 .3 2. Also the time required for polishing was judged as somewhat shorter compared to their current material. 8.8 2.

Indications • Manufacture of all-ceramic inlays.7 mm minimum wall thickness – Crowns: 2 mm occlusal and 1. and wear protective goggles and a mask. Instructions for Use Product Description Paradigm™ C Glass Ceramic Block. B 3. – As necessary. onlays. I10. – Check the fit of the restoration in the cavity or. The restoration is fabricated in the grinding unit. Please see the Instructions for Use for information about operation of the CEREC® or inLab devices. Germany. applying slight pressure.5 mm circular wall strength Shaping Caution: ceramic dust is harmful to your health! Whenever working on ceramic. A3. then dry with air free of oil and water. I12. and anchors • Restorations for patients with hyperfunction (bruxism) Cavity Preparation – Prepare the tooth in conformity with guidelines for all-ceramic restorations prescribed in dentistry. – Clean the restoration with a steam blaster or with a brush under running water. They are available in six colors (A1. crowns.5. finalize the restoration with diamond grinding tools.5 mm minimum wall thickness in the fissure – Veneers: 0. see Cementing. also CEREC® 3D preparation guidelines: – Inlays. I14. Bleach) and five sizes (I8. are grindable glass ceramic blocks for CEREC® and inLab® devices of the company Sirona. Fabrication of the Restoration The clinical situation is optically scanned and then processed by the software. and veneers Contraindications: • All types of bridges. on the model. 21 . – Grind down the studs left by the grinding process with a fine-grain diamond grinding tool. V5-12). for Sirona inLab. Paradigm C blocks are characterized by strength and outstanding esthetics. seat the restoration adhesively. – If no glaze firing is to be performed. use a suction device with a fine dust filter commonly used in the dental practice. Bensheim. cf. telescope crowns.9. A3. onlays: 1. – Take into consideration the following parameters when modeling the restoration. manufactured by 3M ESPE. A2.

– Cement the Paradigm C restorations in conformity with general rules of adhesive technology. – Then apply an appropriate silane in accordance with the instructions for use. using the polishing brushes and pastes commonly used for ceramic.Cementing Do not use glass ionomer cements or resin-modified glass ionomer cements (RMGI) and compomeres. 22 .com or contact your local subsidiary. or RelyX™ Veneer. If this product is defective within the warranty period. Procedure and indications: see the relevant instructions for use. g. Polishing – Polish the cemented restoration. RelyX™ Ceramic Primer. Storage and Stability Store the product at 15-25°C/59-77°F. then blow completely dry so that the solvent evaporates completely. please follow the instructions for use for the cement precisely. all manufactured by 3M ESPE. RelyX™ ARC. Pre-treatment of the cavity: – The cavity must be pre-treated in different ways depending on the cement to be used. – Do not use the etching gel in the patient’s mouth. Warranty 3M ESPE warrants this product will be free from defects in material and manufacture. g. manufactured by 3M ESPE: allow to react for 5 sec.mmm. Precautionary Measures 3M ESPE MSDSs can be obtained from www. Do not use after the expiration date.: RelyX™ Unicem Aplicap™/Maxicap™. using an adhesive or self-adhesive composite cement. – Following steps: see instructions for use of the cement. – Do not allow the rinse water to enter the drainage system until it has been neutralized. your exclusive remedy and 3M ESPE’s sole obligation shall be repair or replacement of the 3M ESPE product. User is responsible for determining the suitability of the product for user’s application. Customer Information No person is authorized to provide any information which deviates from the information provided in this instruction sheet. We recommend that you not sandblast the glass ceramic. e. 3M ESPE MAKES NO OTHER WARRANTIES INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. Pre-treatment of the restoration: – Etch the basal surface of the restoration with a < 5% hydrofluoric etching gel for 90 seconds. e. – Follow manufacturer’s instructions for use when processing the hydrofluoric etching gel. and always wear protective clothing! – Then rinse with water for 15 seconds and dry with air free of water and oil.

negligence or strict liability. 3M ESPE will not be liable for any loss or damage arising from this product. incidental or consequential. including warranty. whether direct. contract. regardless of the theory asserted. Information valid as of April 2006. special.Limitation of Liability Except where prohibited by law. 23 . indirect.

9. 9. 9. Stergios Zafiriadis.2: Color selection Fig.3: Preparation on tooth 26 after removal of amalgam filling and secondary caries 24 .1: Initial situation: Amalgam filling on tooth 26 Fig. Zollikerberg.10. Clinical case Clinical images by Dr. Schwitzerland Restoration of tooth 26 with 3M ESPE Paradigm™ C Glass Ceramic Block. Fig.

9.6: Etching of inlay with HF (<5%) Fig.5: Adaptation of the approximal contact points and try-in of the inlay Fig.4: Prepared tooth with scanning powder Fig.Fig.7: Seating of silanized inlay 25 . 9. 9. 9.

9. 9.9: Light curing Fig.8: Cementation with resin cement Fig. 9.11: Final Cerec® Inlay made of 3M ESPE Paradigm™ C Glass Ceramic Block color A1 26 . 9.Fig.10: Removing of rubber dam adapting and polishing of the occlusion Fig.

5 mm minimal wall thickness in fissure 1. RelyX™ ARC. RelyX™ Veneer for veneer indications) or self-adhesive composite cement (RelyX™ Unicem) and e. Inlays. RelyX™ Ceramic Primer. How can a Paradigm C restoration be polished? Paradigm C can be polished with common polishing brushes and polishing pastes for ceramic.11.g. Questions and Answers How is a Paradigm™ C restoration cemented? Paradigm C Glass Ceramic Block restoration must be cemented in conformity with general rules of adhesive technology.5 circular wall thickness 0. Wall thickness With the allowed wall thickness from Cerec‚ 3D you can reach adequate stability of the restorations. using an adhesive (e.7 mm minimal wall thickness 27 . Onlay: Crowns: Veneers: 1.5-2 mm minimal occlusal wall thickness and 1.g.

which are fabricated in an easy and fast procedure with the Cerec® chairside system in only one patient appointment. Paradigm C Glass Ceramic Block has an optimal strength for these indications. onlays and veneers. Technical Data Property Flexural Strength (ISO 6872) Flexural Modulus Vickers Hardness Solubility (ISO 6872) Number of Shades Number of different sizes > 110 MPa 24 GPa HV 596 2. 3M ESPE expands the portfolio of materials for CAD/CAM technology.8 µg/cm2 6 5 28 .12. Due to the optimal translucency and fluorescence of the Paradigm C glass ceramic material. Besides lab based Lava™ System for high strength restorations. the restorations are characterized by an optimized chameleon effect. Summary Herein. Paradigm™ C Glass Ceramic Block is a strong and highly aesthetic glass ceramic indicated for Cerec® chairside and inLab® restorations like inlays.

[2. (2004) JADA 135. (2004) Int J Periodontics & Restorative Dentistry 24. 3. 109-115 Hickel R. et al.1] Pallesen U. et al. 5.9] [3. and Manhart J. 54-61 Hickel R. 555-60 [3. et al. et al. 247-258 Martin N. 6. 173-176 Isenberg (1991) Journal of Dental Research 70. 1345 Thordrup M.2] [2. 2. Quintessenz International 23. (1992) J Esthetic Dentistry 4. 45-64 Manhard J. (2001) Compendium of clinical education in dentistry 22.11] [3. and Kerschbaum T. 5.3] 3. 6.14] 29 .4] [3.2] [3. and Jedynakiewicz N. 653-660 Estafan D. 2139-2146 Bindl A. 5.7] [3.13. 6.8] [3.12] [3. 605-612 Estafan D. et al. 446-455 Bindl A.13] [3. (1999) Dental Materials 15.M. 434. 1. 829-836 Reich S.6] [3. and vanDijken J. 555-552 [2. [3. et al. 2. (1999) Compendium of Continous Education in Dentistry 20.W. (1999) Quintessenz International 30. (1997) Int Dent Journal 47.1] Reiss et al. (2001) J Adhesive Dentistry 3. 14-18 Mörmann W.10] [3. (2003) Int J Prosthodontics. (2004) Operative Dentistry 29.5] [3. 12. and Mörmann W. 255-265 Posselt A. (1992). and Dasch W. 5.3] [3. 481-508 Otto T. (1999) Journal of Adhesive Dentistry 1. Literature 2. (1999) Compendium of Continuing education in dentistry 20. 5. 3. 231-248 Isenberg et al. 6. and Krejci I. 16. (2000) European Journal of Oral Science 108. (2003) Int J Computerized Dentistry 6.

et al. 1. 194-200 Mörmann W. and vanDijken J.18] [3.17] [3. 6. 2. (2001) Quintessenz International 32. 156-169 Sjorgen G.24] [3. 3.26] 7. and Walther W. (2003) Schweizer Monatszeitschrift für Zahnmedizin 113. (1992). A. et al.W. and De Nisco S. (2005) Int J Prosthodontics 18. 291-295 30 . 2. 1. (2000) European Journal of Oral Science 108. (2002) Int J Prosthodontics 15.22] [3. (2000) Int J Prosthodontics 13.3. et al. (2001) Compendium of clinical education in dentistry 22. 2. 3. 2139-2146 Otto T.25] [3. Sindel et al. Quintessenz International 23. and Krejci I. 2.23] [3. (2004) Int J Prosthodontics 17. 14-18 Reiss B.19] [3. 8. and De Nisco S. (1998) Journal of Materials Science: Materials in Medcine 9. and Curilovic Z.16] [3. [7. (1991) Acta Stomatologica Croatica 25. 2. 219-224 Molin et al.[3. 9-23 [3. (2000) Int J Computerized Dentistry 3. 241-246 Reiss et al.199-205 Mörmann W.20] [3.21] [3.1] J. 122-128 Otto T. 109-115 Thordrup M.O. 3-10 Pallesen U. (1996) J Am Dent Assoc 127. 1171-1181 Bindl et al.15] Heyman H.

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06) .3M ESPE AG · ESPE Platz 82229 Seefeld · Germany E-mail: info3mespe@mmm. Panavia are not trademarks of 3M or 3M ESPE AG. ESPE. Maxicap. Lava. Vitamark. Aplicap. Variolink.com 3M. RelyX are trademarks of 3M ESPE or 3M ESPE AG. 702009XXXXX/01(03. Cerec is a registered trademark of Sirona Dental Systems GmbH. Paradigm.3mespe. InCeram.com Internet: http://www. ProCad. Vita.