Premise Indirect 2010

Lab for Life.
Premise Indirect | Biomimetic nanotechnolgy
Premise Indirect / Biomimetics
Biomimetic refers to human-made processes,

substances, devices or systems that imitate nature.
Burs on a dogs coat

led to the invention of
Velcro.
Premise Indirect / Biomimetics
The art and science of designing and building

biomimetic apparatus is called biomimetics.
Replicating the water

repellant nature of
certain leaves in the
manufacturing of paint.
Premise Indirect / Nanotechnology
Nanotechnology involves the creation and

manipulation of complex structures on the scale of
nanometers something organisms have done for
about 3.8 billion years.
The ideal nanohybrid

restorative that ages,
feels, wears, functions
and looks like a natural
tooth.
Premise Indirect / Features
The result of science born from the

success of Heruculite XRV,
belleGlassNG and Premise.
Premise Indirect utilizes the same

optimized trimodal polymerization as
belleGlass NG, the most respected
indirect restorative of its kind.
Indications: Inlays, onlays, crowns,

veneers, bridges, splints and ideal for
implant restorations with proprioceptive
tooth-like response.
Premise Indirect / Features
Natural look and wear. Closely matches

natural dentition in wear characteristics, as
well as an opalescent appearance that
virtually replicates natural enamel like no
other restorative material.
Performance. Trimodal curing (light, heat

and pressure) achieves over 98% material
conversion, as compared to 60 70%
achieved with light-cure only materials.
Proven History. Twelve years of positive

clinical history, and tens of thousands of
successful restorations placed since 1996.
Premise Indirect / Research
Nanohybrid technology. The combination of large prepolymerized filler

(PPF) particles, 0.4 micron structural filler and small silica nanoparticles
allows higher filler loading, improved physical properties, optimal handling,
higher surface gloss and reduced polymerization shrinkage.
Prepolymerized filler
Point 4 filler
Silica nanoparticles

SEM OF FILLER PARTICLES
Fig: Field Emission Microscope photo 50,000X; Submicron
Hybrid filler (67%), 50 nm Discrete Silica particles (33%)
High gloss retention. The particle size of fillers in PPF particles is below
the wavelength of visible light and light-scattering effects are minimal.
Plucking of PPF particles is reduced because mechanical properties are
more similar to the cured paste number rather than ceramic particles.
Cured traditional composites wear

unevenly causing a loss of luster and
gloss.
Premise Indirect PPF particles wear

more uniformly, wear resistance is
improved and surface remains
smoother and glossier with time.
In-vivo measurements of wear over a

five year period shows an average of
1.2 microns a year closer to the wear
of natural teeth than any other material
tested.
Premise Indirect more closely

matches the coefficient of
thermal expansion (CTE) of
natural dentin resulting in a
material that looks and acts
virtually the same as natural
tooth structure.
Premise Indirect vs. belleGlass NG

Increased chroma and opacity in the Facial Dentins, allowing for better shading
when used with metal reinforced C&B restorations. belleGlass Translucent
Dentins were highly translucent and created a darker shade due to the inability
to completely mask the metal.

Q. How is Premise Indirect different from belleGlass?
A.Premise Indirect provides increased chroma in the facial dentin shades to
improve shading over metal, as well as new fillers.
Q. Can Premise Indirect be used or repaired with Premise Indirect or
flowable?
A.Premise Indirect can be repaired intraorally with any Premise family direct
composite. Premise direct or flowable should not be used in the preparation of
the indirect restoration.
Q. I have a belleGlass customer. Do they need to buy the new equipment
to use Premise Indirect?
A.No. Premise Indirect cures using the same methods of light, heat and
pressure as belleGlass NG.
Q. Does Premise Indirect work with belleGlass?
A. Yes, While the shading is enhanced on Premise Indirect, the technique is
the same.
Q. Do I have to use the curing unit to cure Premise Indirect?

R. Yes. As with belleGlass, polymerization of the metal is achieved by a tack
cure with the light and then a final cure in the curing unit.
Q. Are you discontinuing belleGlass?
A. Yes, belleGlass will continue to be sold until supplies are exhausted. Users
of belleGlass refills can continue to use until the expiration date.
Q. I have a customer who uses another brand of indirect material. Can
they use their curing unit with our material?
A. No. The customer will need to use our Curing Unit to ensure they are getting
a proper cure, and complete conversion.

Dia. Tens.
Str.Mpa (sd)
Comp.
Str.Mpa(sd)
Flex Str.
Mpa(sd)
Flex Mod.
Mpa(sd)
Fracture
Resist.
MPam1/2(sd)
Resistance to
Bulk Fracture
56 (4)
50 (10)
50 (10)
370 (28)
450 (60)
510 (10)
158 (11)
150 (30)
150 (10)
21,000 (1400)
11,100 (200)
10,900 (300)
1.48 (0.09)
1.1 (0.1)
1.1 (0.1)
Yes
Yes
Yes
48 (8)
395 (20)
136 (9)
126 (21)
12,700 (400)
10,500 (300)
1.13 (0.16)
Yes
yes
Cristobal+
Opaceous Dentin
Incisal
49 (6)
66 (10)
450 (38)
473 (19)
179 (11)
156 (20)
13,000 (400)
12,000 (200)
1.14 (0.27)
1.22 (0.09)
Yes
Yes
Estenia
Dentin
Enamel
60 (9)
66 (4)
441 (60)
> 500
155 (13)
136 (18)
16,129 (601)
17,980 (715)
1.27 (0.2)
1.19 (0.09)
Yes
Yes
Sinfony
Dentin
Enamel
63 (3)
66 (4)
430 (18)
457 (43)
89 (8)
89 (3)
3,557 (338)
3,219 (228)
1.12 (0.05)
1.31 (0.08)
No
No
Adoro
Dentin
55 (2)
414 (20)
117 (19)
6,297 (808)
1.07 (0.09)
Gradia
Dentin
57 (5)
403 (6)
103 (10)
5,995 (214)
1.21 (0.05)
Ceramage
Dentin
57 (3)
321 (12)
143 (13)
9,407 (237)
1.39 (0.11)
Premise Indirect
Primary Dentin
Facial Dentin
Incisal
Sculpture+
Dentin
Enamel

Rockwell
15 T Hard
CTE
Ppm/Deg.C(sd)
Wt. % Filler
(Vol. %)
Vol%
Shrink.(sd)
Equilibrium
Gloss 60
High Clinical
Gloss
89.1 (1.0)
84.0 (0.7)
87 (0.8)
13.1 (0.7)
28.6 (1.4)
33.9 (0.8)
87.1 (72.5)
78 (63)
77 (70)
0.94 (0.1)
2.3 (0.2)
2.3 (0.3)
14
No
Yes
Yes
78.7
24.0 (1.4)
78.7
2.62 (1.4)
Cristobal+
Opaceous Dentin
Incisal
87.8 (0.2)
86.4 (1.0)
27.0 (1.0)
75.1
73
3.26 (0.3)
2.91 (0.10)
15
No
No
Estenia
Dentin
Enamel
93 (0.4)
93.9 (0.2)
15.3 (2.8)
13.7 (1.1)
86.8 (72.4)
88.2
1.55 (0.15)
1.62 (0.07)
21
No
No
Sinfony
Dentin
Enamel
51.5 (1.3)
56.6 (1.2)
62.6 (3.0)
68.6 (1.5)
44.7
44.7
4.53 (0.04)
4.62 (0.3)
44
Yes
Yes
Premise Indirect
Primary Dentin
Facial Dentin
Incisal
Sculpture+
Dentin
Enamel
No
No
Adoro
Dentin
73 (1.2)
2.41 (0.05)
47
Gradia
Dentin
73 (0.6)
2.48 (0.09)
17
Ceramage
Dentin
80 (1.2)
2.38 (0.26)
46
Premise Indirect / Research / Gloss Retention
Figure 1a: Surface gloss under 60

reflected light, BG Exp. vs. CB+ Inc.
Figure 1b: Surface gloss under 60

reflected light, BG Exp. vs. HM
Figure1c: Surface gloss under 60

reflected light, BG Exp. vs. E En.
Figure 1d: Surface gloss under 60

reflected light, BG Exp. vs. SF En.
Premise Indirect / Research / Gloss Retention

PURPOSE: Compare the surface luster, after long-term tooth brushing, of an experimental small
particle hybrid indirect composite resin versus several hybrid and microfill resins of known clinical
luster.
Gloss vs. Time
BelleGlass Experimental
Estenia Enamel
Heliomolar
Sinfony Enamel
Cristobal + Incisal
100.00
Y = a + be-X (Y = 60 Gloss (%), a = Equilibrium Gloss (%), b = constant)

90.00
G loss (P ercent)
80.00
70.00
60.00
50.00
40.00
30.00
20.00
10.00
0.00
0
10
12
14
16
Time (Hour)
CONCLUSION: The stable higher surface gloss of the B.G. Exp. After tooth- brushing suggests that
a
clinically stable gloss by a hybrid composite may be possible.
V. Bui, A. Kobashigawa, and D. Tobia: Surface Luster of a New Indirect Composite Resin.
J. Dent. Res. Special Issue Abst. # 621, March 2003

INTERNAL BONDING - SANDBLASTED AND HF ETCHED SURFACES
Vita
Porcelain
Premise
Indirect
XRV
Premise Indirect / Systems
Intro System
Master System
Starter system offering everything

needed for Inlays and Onlays.
Complete system offering

everything needed for Inlays to full
bridges.
Premise Indirect / Materials
Primary Dentins are used for foundation

and coping layers and improve strength.
Facial Dentins cover all foundation and

coping layers to produce a stable long
lived polished surface.
Incisals are placed onto the incisal /

cuspal area and are designed to match the
vitality of tooth enamel.
Modeling Resin is an unfilled

universal wetting agent used for
sculpturing.
Opaques are applied after metal

prep and block out any
underlying metal color.
Cervicals simulate root and

cervical color,
Rubber Sep is a removable

latex release agent and spacer
applied to all dies and contact
areas creating a 20 micron
space.
Silane Primer is applied to the

fitting surface of any metal free
restoration prior to bonding.
Kolor Plus is applied

internally to add effect on
occlusal and interproximal
surfaces.

Premise Indirect Gingival Shades
The simulation of lost soft tissue on implant reconstructions.
Two new gingival tissue shade kits, including a gingival and
opaque in light and dark pink.
Premise Indirect / Inlays & Onlays

When layering note that maximum Facial Dentin
thickness should not exceed 1.5 mm.
Primary
Facial
Incisal
If desired, duplicate the working die and

articulate. Isolate adjacent tooth contact
points and opposing dentition with Rubber
Sep.
Prepare the model and working die. Block
out all undercuts.
Apply a thin layer of Primary Dentin into

the floor and axial walls and adapt to the
desired contour. Finish slightly short of the
marginal periphery. Apply Kolor Plus to
modify the occlusal color if needed. Light
cure all aspects for 20 seconds.
Adapt Facial Dentin in small increments to

desired contour. Continuously verify
occlusal clearance. Work one cusp at a
time. Apply Kolor Plus modifier to simulate
occlusal staining. Light cure each
increment for 10 seconds.
Finalize the occlusal scheme with Cuspal /

Incisal to desired contour. Remove the die
from the working model. Add contact areas
if needed. Light cure all aspects for 20
seconds. Polymerize for 20 minutes in the
curing unit. Remove the restoration from
the die as soon as possible after full
polymerization.
The completed restoration after polishing.
Premise Indirect / Crowns & Veneers

When layering note that maximum Facial Dentin
thickness should not exceed 1.5 mm.
Primary
Facial
Incisal
If desired, duplicate the working die and

articulate. Isolate adjacent tooth contact
points with Rubber Sep.
Prepare the model and working die.
Apply Primary Dentin and contour to the

desired shape. Finish slightly short of the
marginal periphery. Light cure each aspect
for 20 seconds.
Adapt Facial Dentin onto the margin for

precision fit.
Adapt Facial Dentin to the desired contour.

Repeat on all aspects. Light cure at
frequent intervals. Once final contour has
been achieved, light cure all aspects for 20
seconds.
Adapt Incisal material in small increments.

Light cure each increment for 10 seconds.
Finalize contour at the incisal edge. Create

a restoration that is slightly longer than the
tooth being replicated. (This allows for
correct morphology after polishing
procedures). Remove the die from the
working model. Add contact areas. Light
cure all aspects for 20 seconds.
Polymerize for 20 minutes in the curing unit.

Remove the restoration from the die as soon
as possible after full polymerization.
The completed restoration after polishing.
Premise Indirect / Metal Restorations
Premise Indirect can be incorporated onto

any recommended dental alloy. Use of
mechanical retention is recommended.
Metal frameworks should incorporate
smooth rounded edges especially for incisal
and occlusal areas. Produce a framework
thickness of 0.3 0.5 mm. For bridges,
design the framework for correct placement
of pontics and connectors. Ensure adequate
space for veneering material.
Primary
Facial
Incisal
Metal
Opaque
Wax to full contour.
Assess available space.
Remove waxed crown.
Trim framework to desired shape.
Ideal margin space.
Trim and polish backings

before applying material.
Rounded and smoothed.
Rounded and smoothed.
To achieve maximum bond strength, it is

essential to ensure cleanliness of the metal.
Sandblast all veneering areas with 50 micron

Aluminum Oxide at no more than 2 bar (30
PSI) pressure.
After cleaning, apply Metal Prep with an

applicator brush or directly from the bottle.
All veneering areas are covered with Metal

Prep. Allow to fully dry approximately 1
minute. Blast excess metal prep off with
compressed air at 1 bar (15 PSI) pressure.
Apply Opaque to a final thickness of 0.1

0.2 mm. Ensure that there are no visible grey
areas. This may require 2 3 applications.
Light cure each opaque layer for 40 seconds
per surface. Create a first wash Opaque. If
desired, mix a small amount of Modeling
Resin with Opaque.
If desired, modify Opaque shades with Kolor

Plus.
Orange modifier is ideal for cervical areas or

for producing a warmer color.
Wash application of Opaque with cervical

area completed. Light cure each layer for 40
seconds.
Complete masking of the underlying metal

framework. Note a slight surface shine.
Premise Indirect / Construct
Construct reinforcing braid is the ideal

building block. It has a patented weave
designed for more complete resin wetting.
Delivers superior strength and toughness
Made from polyethylene fiber
Cold gas plasma treated
Three widths available
Three times stronger than steel
Impregnated with Silane and Resin
Available in three shades, one neutral
and two opaque shades designed to
eliminate shine through.
Indications (Lab)
Single-unit posterior crowns
Posterior bridges
Anterior bridges
Selected anterior single crowns
Selected Inlays and Onlays
Guidelines
Assess all prescribed cases to ensure a successful outcome.
Always use the largest width of Construct fiber available.
Ensure complete wetting of the fiber with Construct Resin.
Keep the design of frameworks as simple as possible.
Common indications by Dentist

Splint loose teeth together
Connect teeth that have tissue / bone loss
(usually lower anteriors)
Make single tooth temporaries with stock
teeth for upper anteriors
Reinforce broken dentures (repairs)
Hold temporaries together while final
restorations are being done in the lab

Before / Splint
Before / Bridge
After
After

PURPOSE: In this study, the apparent flexural strength (FS) and fracture toughness K 1C of a fiber
reinforced composite resin laminate, Connect TMbelleGlassTM, was measured and compared to that
of the unreinforced composite.
RESULTS: The mean FS of unreinforced belleGlass was 126 (15) MPa and the apparent FS of
the single ply Connect laminate was 335 (36) MPa. The mean K 1C of unreinforced belleGlass was
1.48 (0.09) MPa(m)1/2 and the apparent K1C of the single ply Connect laminate was 12.9 (1.0)
MPa(m)1/2. ANOVA analysis of the means (p<0.05) indicate that the laminate substructures were
significantly higher in FS and K1C than the unreinforced substructures.
CONCLUSION: The data indicate that fiber reinforcement by Connect ribbon significantly
improves strength and crack arresting properties of composite resin substructures.
A.I. Kobashigawa* and E. Shellard; Crack Arresting Properties of a Fiber Reinforced

Composite Resin Laminate.; J. Dent. Res. V. 79 Special Issue Abst. # 289, Apr. 2000

Fig. 1: Flexural Bar Connect
Laminate. Note Deflection of
Specimen Without Failure.
Fig. 2a: Fracture Toughness Bar

Before Loading.
Fig. 2b: Fracture Toughness Bar in 3 Point

Load. Note Complete Arrest of Crack by
Single Ply of Connect.

Effect Of Fiber Reinforcement On The Breaking Strength Of Crowns, C.A. MunozViveros, et al., Abst.#1177 J. Dent. Res. 77 Special Issue B, June, 1998).
PURPOSE: This study evaluated the effect of fiber reinforcement on the breaking strength of two
commercially available fiber reinforced systems: belleGlass TM (Kerr Corp.) and Targis/VectrisTM
(Ivoclar Corp.).
RESULTS:
__________________________________________________________
Mean
Kg.
Group A 252
Group B 264
Group C 248
45
49
38
SD
4
Comp.
Fract.
2
2
3
Tooth Fiber
Fract. Interface
4
3
0
5
7_______
Group A: Belleglass/Connect (axial wall); Group B: Belleglass/

Connect (axial + occlusal wall); Group C: Targis/Vectris.
CONCLUSION: Within the design of this study and under the

Conditions used, there was no difference in breaking strength for fiber
Reinforced crowns made of belleGlass TM or Targis/VectrisTM.
Prepare the model and working die.
Asses size and area of the preparation.

Forma a flat disc of Primary Dentin 0.5 0.6
mm thick.
Apply the disc to the occlusal surface and adapt

excess material over the axial walls to form a
coping. Finish short of the margin periphery.
Light cure each aspect for 20 seconds. The
ideal coping thickness is 0.2 mm.
Construct needs to be wrapped around the

periphery of the preparation. Apply to the
occlusal surface if space permits. Follow the
preparations contour for optimal placement.
Using Construct scissors, cut a length of
fiber. Wet one end of the fiber with Construct
Resin. Apply to the proximal axial walls into
its desired position. After full adaptation and
saturation, light cure for 3 5 seconds.
Apply Construct Resin in small increments 1

2 mm at a time. Wrap around the periphery.
After each adaptation and saturation of the
fiber, light cure for 3 5 seconds.
Wrap around the entire periphery. Light cure

little and often.
After full adaptation overlay by 0.1 0.2 mm

and cut the fiber. Light cure 3 5 seconds.
Measure a length of Construct for the

occlusal surface.
Apply Construct as before and light cure 3

5 seconds. Once completed light cure all
aspects for 20 seconds.
Continue layering of the crown to final

completed restoration.
Premise Indirect
Continued improvements over the years

with our indirect restorative line has resulted
in superior handling characteristics as well
as exceptional polishability.
Please refer to the complete Directions for

Use for more information.
Visit www.kerrlab.com for more information.
Premise Indirect / Cases
Clinical and laboratory work Pascal Magne, PHD, DMD
Case by Gary Radz DDS
No Prep Veneers, using Premise Indirect and Nexus NX3

Laboratory work by Mizrachi Dental Lab
Laboratory work by David M. Zielinski CDT, FNBC

Premise Indirect 2010

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Lab for Life.

Premise Indirect | Biomimetic nanotechnolgy

Premise Indirect / Biomimetics

Biomimetic refers to human-made processes,

Burs on a dogs coat

Premise Indirect / Biomimetics

The art and science of designing and building

Replicating the water

Premise Indirect / Nanotechnology

Nanotechnology involves the creation and

The ideal nanohybrid

Premise Indirect / Features

The result of science born from the

Premise Indirect utilizes the same

Indications: Inlays, onlays, crowns,

Premise Indirect / Features

Natural look and wear. Closely matches

Performance. Trimodal curing (light, heat

Proven History. Twelve years of positive

Premise Indirect / Research

Nanohybrid technology. The combination of large prepolymerized filler

Premise Indirect / Research

Premise Indirect / Research

Cured traditional composites wear

Premise Indirect PPF particles wear

Premise Indirect / Research

In-vivo measurements of wear over a

Premise Indirect / Research

Premise Indirect more closely

Premise Indirect / Research

Premise Indirect vs. belleGlass NG

Premise Indirect / Research

Premise Indirect / Research

Q. Do I have to use the curing unit to cure Premise Indirect?

Premise Indirect / Research

Premise Indirect / Research

Premise Indirect / Research / Gloss Retention

Figure 1a: Surface gloss under 60

Figure 1b: Surface gloss under 60

Figure1c: Surface gloss under 60

Figure 1d: Surface gloss under 60

Premise Indirect / Research / Gloss Retention

Y = a + be-X (Y = 60 Gloss (%), a = Equilibrium Gloss (%), b = constant)

Premise Indirect / Research

Premise Indirect / Systems

Starter system offering everything

Complete system offering

Premise Indirect / Materials

Primary Dentins are used for foundation

Facial Dentins cover all foundation and

Incisals are placed onto the incisal /

Premise Indirect / Materials

Modeling Resin is an unfilled

Opaques are applied after metal

Cervicals simulate root and

Rubber Sep is a removable

Silane Primer is applied to the

Kolor Plus is applied

Premise Indirect / Materials

Premise Indirect / Inlays & Onlays

Premise Indirect / Inlays & Onlays

If desired, duplicate the working die and

Apply a thin layer of Primary Dentin into

Premise Indirect / Inlays & Onlays