Manufacturer: Ivoclar Vivadent
Cention N is a radiopaque, self-curing filling material with light-curing option, which releases fluoride, calcium and hydroxide ions. It is suitable for use as a full volume replacement material in restorations for Class I, II and V cavities. Cention N can be optionally cured with light in the wavelength range of 400–500 nm.
Cention N offers tooth-coloured esthetics together with high flexural strength. The new filling material belongs to the materials group of Alkasites. The patented alkaline filler increases the release of hydroxide ions to regulate the pH value during acid attacks. As a result, demineralization can be prevented. Moreover, the release of large numbers of fluoride and calcium ions forms a sound basis for the remineralization of dental enamel. The initiator system enables good chemical self-curing.
The application of Cention N is contraindicated
1. Isolation Appropriate isolation is required.
2. Cavity preparation
2.1 Cavity preparation when using Cention N without an adhesive When using Cention N without an adhesive, the preparation guidelines for the placement of amalgam fillings apply (retentive preparation design, resistance form). Retentive undercuts need to be prepared in all areas of the cavity. Enamel portions not supported by dentin must be avoided. In order to prevent fractures of class II fillings, the area of the isthmus should be sufficiently deep and wide: on the occlusal/proximal aspect it should be at least 1.5 mm in depth, and the isthmus width should be at least 1.5 mm. The cavity floor must be rounded from the occlusal to the proximal aspect in order to reduce tension peaks. A dental adhesive should always be used when large defects are restored. Preparations with severely undermined areas that lead to a weakening of the cusps should be avoided. The distance between the cavity margins and the cusp tips should be ≥1mm. Enamel margins should not be bevelled. Subsequently, rinse the cavity with water spray to remove all the residue and dry with water- and oil-free air.
2.2 Cavity preparation when optionally using Cention N with an adhesive The cavity is prepared according to the principles of the adhesive technique, i.e. by preserving as much of the tooth structure as possible. Do not prepare sharp internal angles or additional undercuts in caries-free areas. The geometry of the cavity is predetermined by the dimensions of the caries lesion or the old filling. Slightly bevel or round out the enamel margins using finishing diamonds (grit size 25–40 µm). Subsequently, rinse the cavity with water to remove all residue and dry with water- and oil-free air.
3. Pulp protection / Base If no adhesive is used, areas close to the pulp should be selectively coated with a calcium hydroxide preparation (e.g. ApexCal®). If a dental adhesive is used, a base material does not have to be applied. Only in very deep cavities, selectively coat the area close to the pulp with a calcium hydroxide-based preparation (e.g. ApexCal®) and cover it with pressureresistant cement (glass ionomer cement, e.g. Vivaglass® Liner) before applying the adhesive. Do not cover other cavity walls, since they can be used to support the bond with an adhesive.
4. Placing the matrix / interdental wedge If the cavity includes proximal areas, place a matrix band and secure it with a wedge.
5. Conditioning / Applying the adhesive When using Cention N without an adhesive, do not condition the tooth structure with phosphoric acid. Condition and apply the adhesive (e.g. Tetric® N-Bond Universal) according to the Instructions for Use of the product in use.
6. Dispensing and mixing The mixing ratio for a small cavity is: 1 measuring scoop of Powder and 1 drop of Liquid (this corresponds to a weight ratio of 4.6:1). For larger cavities, a mixing ratio of either 2 measuring scoops of Powder and 2 drops of Liquid or 3 measuring scoops of Powder and 3 drops of Liquid should be used. Shake the Powder bottle well before use. Dispense Powder and Liquid next to each other on a mixing pad. Hold the bottle containing the liquid perpendicular when dispensing and squeeze to extrude one drop. It is important to make sure that the drop detaches before it makes contact with the mixing pad and to avoid the inclusion of air bubbles. Overfill the measuring scoop with Powder and scrape off the excess material on the plastic insert in the bottle neck. Close the Powder bottle and the Liquid bottle carefully after use. Separate the powder into two equally large portions using a plastic spatula. Spread the Liquid to enlarge the surface. Mix the first portion of Powder with the entire Liquid dispensed on the mixing pad. Once the components have been thoroughly mixed, add the remaining Powder and mix again until a homogeneous consistency is achieved (45 –60 s). The working time is 3 min from the start of mixing. Apply the material to the cavity. Carefully adapt and condense it and remove any occlusal excess.
Processing and setting times
Mixing time (at 23 °C) – – – 45–60 s Working time – – – – – – 3 min Setting time (self-curing) – – – – – – – – – 5 min (from the start of mixing) The indicated working and setting times were determined under clinical conditions. High temperatures during mixing decrease the working and setting time; low temperatures increase it.
– When using the self-curing mode, the matrix band can be removed after the setting time has elapsed and finishing can be started. – In order to remove the matrix band and start finishing of the restoration in a timely fashion, the restoration can be optionally light-cured after placement (for exposure times see Table). When filling cavities measuring more than 4 mm in depth, wait until the entire setting time has elapsed.
7. Finishing / Checking the occlusion After polymerization, remove excess material with suitable tungsten carbide finishers or fine-grit diamonds. Remove proximal excess with diamond or tungsten carbide finishers or using finishing strips or flexible finishing discs. Check the occlusion and articulation and grind in the necessary adjustments to prevent premature contacts or undesired articulation paths on the surface of the restoration.
1. In the case of adjustments, additional Cention N can be directly applied to the polymerized material. If the inhibition layer has already been removed, the restoration surface must be roughened and coated with adhesive (e.g. Tetric N-Bond Universal) before fresh Cention N can be applied. The adhesive must be applied according to the manufacturer’s instructions.
2. Use Cention N at room temperature. Cold components may be difficult to mix.
3. Do not use oxidizing disinfectants to disinfect the bottles.
Warning: – Prevent any contact of uncured Cention N with the skin / mucous membrane and eyes. Uncured Cention N may have a slight irritating effect and cause sensitization to methacrylates. – Customary medical gloves do not provide protection against the sensitizing effects of methacrylates.
Storage: – Storage temperature 2–28 °C (36–82 °F). If the storage temperature is exceeded, the proper function of the product can be impaired. – Close bottles immediately after use. – Expiry date: see note on the Liquid and Powder bottles and packages. – Do not use Cention N after the indicated date of expiration. – Once the Cention N Powder bottle has been opened, the product should be used up within 24 months.
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