New dental technology has also produced new materials. So-called paste ceramics are a big trend. I attended a course at the CM Academy and tried out the Swiss paste ceramic Soprano Surface by myself. Here is my course report:
When I arrive at the CM Academy in Biel, I immediately meet familiar faces. A colleague graduated from the HFZ (Higher Technical School for Dental Technology) with me, and I know another as a speaker. The mood is good and the level of expertise is high, I think, and one could assume that my classmates already knew (almost) everything about dental technology. At the end of the day, however, they all admit in unison that they have learned a lot! But from the beginning:
We are here in Biel in the beautiful Cendres et Metaux course room to get to know and use Surface. Surface appears in small 20g jars, it is neither ceramic nor paint. It is not suitable for interim firings and it cannot be mixed into the ceramic either. No, Surface is different. And can do other things.
“First of all, as the name implies, it belongs on the surface,” course instructor Robert Arvai explains the goal of the course right at the beginning: “It’s not about perfect layering, or about replicating a tooth based on a photo template. It’s about understanding the material. Anyone who knows how Surface works can not only efficiently refine monolithic work, but also solve many problems that can arise in everyday dental laboratory work. Surface is also a repair ceramic. Can be used on any material and any ceramic!«
The first question already comes from the course room. Participant Nicola Lanfranconi from Zurich asks: “Can Surface also be used to repair chipping in PMF?” Arvai says, “Yes, that’s exactly what it’s all about. Surface can be used on lithium disilicate, zirconium and also PMF “Surface is fired at low temperatures. Therefore, it can be used with any ceramic. One can apply Surface as a general-purpose repair ceramic. It fires at 700 degrees just as stably as at 770 degrees.”
Arvai gives the example of a finished bridge that returns to the lab because there is not enough pressure on the gingiva, so the pontic has to be built up afterwards. You could use Surface for this, for example, he says.
Course report practice
Here at the course, we have been provided with a monolithic zirconia crown on our workbenches, which we are now processing ourselves.
First, the crown is sandblasted. Then the application of the surface can begin on the unwetted crown. Some material is taken from the pot and thinned if necessary. Here you must pay attention to two things. Firstly, use the correct liquid for this purpose and in no case the glaze fluid (the liquids are already different in consistency, you can feel this when rubbing between your fingers).
And secondly, do not dilute the paste too tightly! It should have the consistency of soft ice, then it is perfect.
The goal is
The goal is to mill a standard crown, sandblast and then apply cusps yourself. In two firings. VoilA! As mentioned, we are all experienced dental technicians here at the course, but each of us feels like a beginner at the beginning. That makes for a few hearty laughs. The atmosphere at the course is generally very good. Because we are used to layering and/or painting thinly with glaze and stains, we have to completely rethink.
Surface is “spread” is how I personally would describe it. To me, it’s like spreading thick honey on a crispbread roll. But I quickly realize that this clumsiness (fortunately) is not only due to myself but also to my brush. A plastic brush is much better suited for this than the ceramic brush we usually use. And it’s easier for me if I really only use mini-portions. In the end, no more than 0.2 to 0.4 mm of material should be applied per firing. If you stick to this, the monolithic construction gets shape and structure.
I see if this works with course colleague Igor Milenkovic from the Weber lab in Zug and ask him how it’s going. He wipes a strand from his face, laughs and says: “Whew, more difficult than it looks! But very interesting! Yes, I think it’s great!” Course participant Daniela Mitrovic, owner of dlm dentaldesign in Zurich, has a similar opinion: “What I really like is the fine, pleasant consistency for processing. And the stability of the material! But yes, it does take some practice! I wonder if I can really apply it to other ceramics without hesitation. Because I don’t really want to change the whole system.”
Time is money
Arvai says that if we have some practice, the total amount of work for the finishing is only about 1.5h. Because his goal is: “To achieve a beautiful result with efficiency in everyday dental work, less effort more return.”
We agree, you won’t get a single anterior tooth with Surface. What needs depth and transparency, you have to layer, says Arvai. However, monolithic crowns can be lightened with Enamel Value materials, for example, or veneer axes can be subsequently corrected, says the course instructor.
Surface is used on monolithic zirconia or lithium disilicate crowns to create buccal and occlusal shape and texture. Or just to apply contact points subsequently, on any material. For my course report I ask participant Lobsang Wangyetsang, Dentalteam Bern, how he sees the following area of application for himself: “I would like to use Surface in our laboratory to embellish anterior teeth with an incisal edge in monolithic zirconia work”.
I learn at the course for my report that Surface can be applied in several ways. 1) In 2 firings: First glaze and characterize. Then apply mass and texture with Surface 2) In 2 firings: First shape crown with Surface and fire. In a second firing glaze the crown 3) In 1 firing: Conduct Surface and Glaze firing simultaneously. However, it is of elementary importance that the two materials do not mix!
What is not possible is to use Surface on highly polished zirconia. Otherwise, everything is possible.
My neighbor at the table, Mewaidin Selimi, owner of Primadenta Zahntechnik GmbH Amriswil TG, whom I know from the master school, is currently spackling some Surface out of the pot with great concentration and brushing it onto his crown. I wonder how he finds the material. “It’s interesting, something new! Not so easy to use, though,” he says, adding with a grin, “I’m a beginner! But I’d like to use it in the lab, because I think it’s faster and more efficient.
First firings are out of the furnace. The course participants stand in front of the kiln and examine their work. I ask participant Lanfranconi if he likes his result: “Its an exciting material and a good approach, it has a need for it in my lab. I find a material super when I have worked with it for 2 years. Of course, I can’t say that after 1 day. But I am curious”.
What I personally always like very much is the economy of a product. In traditional layering with ceramic powder, you should not mix the ceramic several times. Surface residues, on the other hand, go back into the jar! And can be reused any number of times.
First of all, it has to be said, the courses at the CM Academy are always very well organized! The course supervisors are very friendly and helpful. A really nice place for further education! With a fun group like we were today, the time flies by and you always learn a lot. Course instructor Robert Arvai has an enormously broad range of expertise and is happy to share it. I often hear that Swiss dental technicians are lazy about continuing education. This is a pity, because I believe that we can only remain competitive internationally if we continue to educate ourselves.
In the monolithic trend, in my opinion, every technician must know a system with which he can process a milled crown within a useful period of time so that it looks like a tooth. With a little practice, Soprano Surface seems to me to be a good tool for this. However, I would like to leave the final sentence for my course report to instructor Arvai: “Soprano Surface allows me to produce dental restorations more economically. And the simplicity of use allows stable consistent results.
This course report was published in German in ZZS Zahn-Zeitung Schweiz.