Allan Deutsch
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 SSENTIAL
DENTAL SYSTEMS recently released an upgraded and improved Ti-Core®.
This new material is called Ti-Core Auto E. The “Auto” stands for
auto-mix and the “E” stands for esthetic. This composite core material
is a dual-cured hybrid composite reinforced with the lanthanide series
of metals. Using proprietary chemistry and manufacturing processes,
we were able to keep approximately 90 percent of the physical properties
of the original Ti-Core natural yet make Ti-Core Auto E less viscous.
The lower viscosity enables us to package the material in a dual-barrel
syringe with an auto-mix stator and very small delivery tip (See Figure
1). This material can easily be extruded and mixed all in one operation.
The Vita A2 color enables the material to be used in any situation where
esthetics is a concern. A 2?4 mm increment will light-cure in approximately
20 seconds. The material will finish self-curing in approximately
six minutes.
I have been working with this material for several
months now. About two months ago, it occurred to me that since this
material was so easy to use and relatively inexpensive there was another
great use for it in addition to building up cores. I have been using
Ti-Core Auto E as a temporary material to close the access opening.
I etch all the dentin and surface enamel with 37.5 percent phosphoric acid
for approximately 20 seconds. This procedure removes the smear layer
and opens up the tubules. It also etches the intertubular dentin
itself. Since the composite has a low viscosity and flows very well,
it will flow into the tubules and also form resin tags into the etched
intertubular dentin. The net effect of all of this is a very good
seal. This seal will stop coronal leakage after the endodontics is
completed. Sometimes the patient does not have the tooth restored
for months. If the temporary material leaks or wears away during that time
and the root becomes infected, the endodontics must be redone. Ti-Core
Auto E will not leak since it is mechanically bonded into the tubules and
the intertubular dentin, and since it is a hybrid composite it certainly
will not wear away in a matter of months.
Cavit also seals well coronally. However,
the problem with this material is that it is rather soft and prone to wear.
Sometimes when used as an occlusal seal between visits it washes out, and
the tooth often becomes infected between appointments. We long ago
stopped using Cavit as a primary interappointment sealing material because
there were too many unnecessary infections.
The clinical technique is very simple and quick.
First fill the entire access cavity with the 37.5 percent phosphoric acid
(Figure 2). Let this etch the dentin and coronal enamel for 20 to
30 seconds. Then wash off the etchant with water. Assemble
the syringe and express the Ti-Core Auto E through the auto-mix syringe
and small placement tip, directly into the access cavity (Figure 3).
FIGURE 2: First fill the
entire access cavity with the 37.5 percent phosphoric acid. |
FIGURE 3: Express the Ti-Core
Auto E through the auto-mix syringe and small placement tip, directly into
the access cavity. |
Smooth and shape the occlusal surface with an instrument. Light-cure
the Ti-Core Auto E for 20 to 40 seconds, depending on the thickness of
the temporary seal you want to create (Figure 4).
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| FIGURE 4: Light-cure
the Ti-Core Auto E for 20 to 40 seconds, depending on the thickness of
the temporary seal you want to create. |
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You are now done! This is a very quick and easy approach to temporization
of the access cavity for any root-canal treatment. No fear of infection,
and esthetically pleasing results also!
January-March 2005
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FIGURE 1: Ti-Core Auto E.
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