Filling Materials

Durability – More important now than ever

Now more than ever, dental patients want treatment results that last. However, they also value shorter treatment times and aesthetic outcomes. To achieve all this, utilising the right products, technologies and protocols is key for practitioners.

Patients first 

Whether patients require urgent treatment to rid them of pain, restorative procedures to repair damage from trauma or disease, or elective treatments to improve their self-confidence, they want results that will endure. This represents value, providing maximum return on their investment of both time and money, while giving them peace of mind that their oral health is protected for the foreseeable future.

The promise of fewer visits is another attractive advantage for most patients, with at least 10 million in the UK suffering from some form of dental fear. [i] This benefit is intensified in light of the on-going pandemic. Many people have and will continue to limit their contact with people outside their households in order to protect themselves and their loved ones. Patients will therefore appreciate not needing to travel to and enter the dental practice too often.

As important as durable treatment options are to modern patients, they are often not willing to compromise aesthetics. This, coupled with growing uncertainty among the general population about the safety of amalgam fillings due to the potential mercury release, means that most people will appreciate an alternative restorative option. This is when materials like glass ionomers come into their own – they provide long-lasting solutions with better aesthetics than amalgam and that facilitate quicker treatment times for less time spent in the chair.

Supporting business

Meeting patients’ desire to limit practice visits and reduce treatment times – without compromising quality of care – can help the dental practice to maintain its patient base. Delivering treatment results that last for longer means that patients stay healthy and their satisfaction with the treatment received remains high. In turn, this can encourage word-of-mouth recommendations and enhance the business’ reputation among the local community for long-term support and stability.

On a day-to-day basis, the practice diary can be made more efficient. By ensuring that patients don’t require additional follow-up appointments to repair chips in their restorations, for example, practitioners are better able to optimise their surgery time. This is further supported by the rapid workflows that solutions like glass ionomers enable in a wide range of clinical indications. In view of the backlog of patients that many practices are still facing due to a year of pandemic-related restrictions, this greater speed and efficiency means that more patients can be seen for improved health of the local community and maximum revenue to support business recovery.

Achieving durability

It is important to achieve this durability of treatment results without compromising quality of the procedures or patient experience. This involves careful management of various protocols in place throughout the practice. For instance, meticulous treatment planning will help clinicians to avoid potential complications and prepare for enduring treatment results that their patients will love. The use of digital technologies, where appropriate, and the workflows employed will therefore have a significant impact on the quality and durability achieved.

It is also essential to consider how patients are communicated with. Their compliance with oral hygiene advice will be integral to protecting the outcomes delivered and enabling them to enjoy the benefits for longer. Ensuring they understand their role is a crucial element of the planning and consent processes.

Product selection

Of course, product selection is just as important for quality treatment and long-lasting effects. When it comes to restorative dentistry, the filling materials chosen are often the key to success. Particularly in the posterior region, clinicians need products that feature high resistance to chipping, without compromising aesthetics, clinical efficiency or workflow flexibility.

As already mentioned, selecting glass ionomers instead of amalgam allows much simpler application for a faster treatment time when compared to amalgam or composites. They also require less drilling and preparing of the tooth than that required for amalgam restorations. All of this ultimately reduces chair time for the benefit of both patient and practitioner, delivering the efficiency that is so beneficial in times of COVID-19.

A fine example is the Kemdent Diamond Rapid Set Glass Ionomer Cement Capsules. Extreme durability and chipping resistance mean they are ideal for non-load-bearing Class I and Class II restorations, as well as for deciduous teeth, the sandwich technique and core build ups. The innovative formula renders the material resistant to saliva almost immediately, minimising the risk of contamination from moisture for maximum material strength – after 6 months a compressive strength of 350MPa is achieved. Supporting the clinical workflow, the material offers just over a 2-minute working time and adheres to both dentine and enamel. The capsules are also individually wrapped in easy-open foils, facilitating single-dose dentistry and optimising both efficiency and hygiene in the surgery. The Kemdent Diamond Rapid Set Glass Ionomer Cement even release fluoride to provide a level of protection against caries.

A win-win

Achieving outstanding clinical results is only one step in the delivery of high-quality patient treatment. Both patient and practitioner benefit from more efficient treatment workflows and that still achieve durable outcomes – especially in the world we live in today. With careful product selection, the very best results can be encouraged in a wide range of restorative procedures.

Article by Alistair Mayoh

For more information, please visit Diamond Rapid Set Capsules Information Page

Time – a fickle friend

Most would agree that time is a fickle thing. It often seems to do the exact opposite of what we would prefer – in awkward situations the clock stands still, while moments of happiness fly by faster than we ever want them to. In the dental practice, managing your time effectively and utilising products like Kemdent Diamond Carve to save precious time in everyday routines is key to business recovery and patient satisfaction.

Why does time fly when you’re having fun?

Our “sense” of time is unique and very different to how our other senses work. How we perceive time is subjective and supported by data from all our other senses put together. It can be affected by emotional state, level of attention, memory and disease.[i] Interestingly, neuroscientists believe that our perception of time changes depending on how much information our minds are processing. This concept has been around for many years[ii] and is based on the idea that the more your brain is learning and processing new information, the slower it perceives time to go by. The speed with which we process information also appears to increase with age,[iii] further supporting the theory that time seems to pass much slower for children than it does for adults. It has also been postulated that how a person judges time is impacted by working memory capacity, going some way to explain why time seems to pass quickly for more elderly individuals.

Managing time in the dental practice

Getting back to the dental practice, for dental professionals, perception of time is less important than time management itself. Time is often against them when attempting to meet patient expectations, deliver high quality clinical care and safely see as many patients as possible each day to reduce the backlog created by the pandemic so far. The challenges have been added to with the target of 60% pre-COVID UDAs set for all practices with an NHS contract. This means that while time is very much of the essence, being able to maximise efficiency and save time must be balanced with affordable and
cost-effective products and workflows.

Optimising efficiency

From teamwork and collaboration among professionals, to daily protocols, appointment booking organisation and the products used for everyday clinical procedures, every piece of the puzzle needs to be reviewed and refined for optimal time management. The aim of the game is to get more done in a shorter space of time, without compromising on the effectiveness of the process or the quality of the outcome.

Consider the restorative treatment workflow. A common procedure in the general dental practice, it provides the perfect opportunity to minimise treatment steps and maximise efficiency, all the while maintaining a pleasant patient experience and achieving beautiful, functional and durable outcomes.

Something as simple as using a quick and reliable cement could be key. Kemdent Diamond Carve is a hand-mixed glass ionomer cement, which instantly saves time while being far less expensive than composites and capsulated glass ionomers. With a working time of three minutes and 40 seconds to four minutes, it does not require the practitioner to rush while placing and shaping the restoration. It also needs minimal preparation – the practitioner need only remove soft caries and undermine the enamel, no varnishing, no hassle. Its lack of dimensional change during chemical curing means it can be placed in one increment for significant time-saving advantages.

Kemdent Diamond Carve provides a highly aesthetic alternative to traditional composite, glass ionomer or amalgam in posterior, non-loading bearing Class I and II restorations, as well as Class V abrasion cavities. It bonds to enamel and dentine without the need for acid etching making it quicker and cheaper to use in surgery once again. Plus, it is radiopaque and displays much higher compressive strength than most conventional glass ionomers for total peace of mind.

Time waits for no one

Though we might all have conflicting perceptions of how time has passed over this last year, we can all agree that making the most of our time is important. In the practice, this means streamlining workflows and optimising efficiency to improve both the patient and practitioner experience. Time management has always been important in dentistry, but recent restrictions and challenges have made it even more crucial.

Dr Hamish Morton, Principal of Birchfield Dental Practice in Hampshire, is one of many satisfied users of Kemdent Diamond Carve glass ionomer cement. He says:

“This is a great material for restoring teeth with a poor prognosis, especially those in elderly patients. I have used it already for 5 years.”

For more information about the Diamond Carve Click Here or call 01793 770 256

Diamond Carve is not only the ideal alternative to Amalgam it is a low cost/ high margin product.

The continued use of mercury rich dental amalgam has been controversial for decades, but now the globally binding treaty on the use of mercury, which was signed in Japan in October 2013, has ultimately signed its death knell. Whilst this won't happen overnight, it means dentists will all need to find a suitable alternative. There are many to choose from, all with their own relative merits, but many believe that Kemdent's Diamond Carve offers an extremely user friendly and cost effective option worthy of serious consideration.   

Dentists recommend Diamond Carve 

"I use Diamond Carve because it is easy to mix and you can mix the exact quantity you require. There is no waste. I also like the way it bonds well to the tooth and is a lot harder than other Glass Ionomers, therefore, it lasts longer."

"I use Diamond Carve to restore primary teeth and class Vs in adults, where the restoration is held in place and shaped using a metal cervical foil, which gives a very smooth finish after the initial snap-set."

Quote from Dr John Rees - Rees Dental Practice, Birmingham.

Diamond Carve is available in 1 shades: A3

Setting time: 2 minutes, 15 seconds
Packaging: 10g Powder, 7ml Liquid

Our products are made in England by Associated Dental Products Ltd


Click Here to find out more about Diamond Carve

Talk to our qualified sales team about Kemdent's high quality UK manufactured products available at competitive prices!

E-mail sales@kemdent.co.uk
Tel: 01793 770256

Step 1. Diamond Rapid Capsules must be activated for a minimum of 10 seconds before you can use them. When you activate a capsule you are adding the liquid to the powder. Place the capsule in the activator clamping device and clamp the capsule saddle to release the liquid, ensuring that the capsule top does not turn clockwise at this stage.

Step 2. Fix the activated capsule in a capsule mixer and mix for approximately 5 - 10 seconds at ~3000 rpm.

Step 3. You must open the capsule by twisting the dispensing nozzle through 180° before you can dispense the mixed material.

Step 4. Fix the mixed capsule into the gun. Place the Cement Capsule material directly into the prepared cavity, adjusting the capsule direction as required.

Click here to learn more about Diamond Rapid Set Capsules

Some existing users explain why Kemdent’s Diamond Carve is the ideal alternative to amalgam…

The continued use of mercury-rich dental amalgam has been controversial for decades, but now the globally binding treaty on the use of mercury, which was signed in Japan in October 2013, has, ultimately, signed its death knell. Whilst this won’t happen overnight, it means dentists will all need to find a suitable alternative. There are many to choose from, all with their own relative merits, but many believe that Kemdent’s Diamond Carve offers an extremely user-friendly and cost-effective option worthy of serious consideration.

Kemdent first introduced the Diamond glass ionomer cement (GIC ) range to the dental market in March 1999. Now,15 years later, the Diamond range is one of the world’s leading GIC’s used daily by thousands of dentists in more than a dozen countries worldwide.

Diamond provides dentists with a clinically proven GIC restorative material that effectively performs highly aesthetic restorative procedures, replacing traditional composite, glass ionomer and amalgam methods of working. Chemical curing, without dimensional change, means Diamond restorations can be placed in one increment, saving time and avoiding the creation of stresses within the restoration that can be caused by incremental build-up using composites. Both of these advantages also contribute to its relative lack of post-operative sensitivity compared with bonded composites. Fluoride release is another significant advantage.

Diamond is also far less susceptible to moisture around the operating site, partly due to its rapid chemical snap-set and its healthier, mercury-free composition. It quite categorically adheres to both enamel and dentine, without the need for acid etching – saving time and additional expense. Finally, there is no polymerisation shrinkage and consequent cracking associated with Diamond.

The Diamond range allows dental practices to perform various styles of chairside treatment. The firm consistency of the Diamond GIC range allows easy placement of the materials and rapid “snap-setting”, matching tooth colour in just over two minutes at normal room temperature. Gone are the days of sending away patients with poorly aesthetic, opaque, moisture sensitive restorations, with instructions to return a week later for polishing, hoping that when they return, the restoration would not have a crazed appearance and have been weakened by moisture contamination. There are various options available, including Diamond Carve and Diamond Rapid Set capsules.

Diamond Carve

Diamond Carve is a hand-mixed glass ionomer cement for posterior indications, including non-load bearing class I and II restorations, together with class V abrasion cavities. It can also be used for restorations in deciduous teeth, core build-ups, amalgam repairs – where it helps minimise the health risks associated with the removal of old amalgam restorations, and the cementation of posts in root canal restorations.

Diamond Carve Powder is made from alumina-silicate glass, containing calcium fluoride as well as strontium and barium for radiopacity, plus a number of dry acids to enhance the setting reaction. Diamond Carve Liquid is a water-based acidic solution. They are combined together in a 4:1 ratio, with one scoop of powder to one drop of liquid. Setting occurs through an acid/base reaction. Diamond Carve is self-adhesive to both enamel and dentine.

Available in one aesthetic shade, an immediate advantage over “dirty old amalgam”, it is manufactured from a special GIC which contributes to a range of features, including versatility and strength – with a 350MPa compressive strength, Diamond Carve is up to 50 per cent stronger than other glass ionomer cements; saliva resistance; excellent finishing; and wear resistance properties. In addition to this, tests have proven that there is no dimension change during the setting reaction and no post-operative sensitivity. These advantages, together with its packable consistency, durability and ease of use, make it the ideal aesthetic alternative to amalgam.

Hints and tips for using Carve

Diamond Carve has a working time of two minutes-two minutes and 30 seconds, and a setting time of three minutes and 40 seconds-four minutes. It requires minimal preparation, simply the requirement to remove soft caries and undermined enamel, and no varnishing afterwards. It adheres to dentine and enamel without the need for any preparation of the tooth surface or a bonding system, thereby saving valuable surgery time and additional expense compared with composite materials. Carvable, it offers a “waterproof” chemical snap-set.

The procedure is as follows:

Step 1 – select the appropriate shade. When placed, the fresh cement is opaque. Translucency develops over the first couple of weeks.

Step 2 – remove caries and prepare the cavity with minimal tooth reduction

Step 3 – clean the cavity with water and gently dry. Remove smear layer by applying Kemdent Diamond Carve liquid for 15 seconds using a cotton pellet. Wash and gently dry.

Step 4 – place a vaselined matrix band, if required.

Step 5 – shake the bottle of powder to fluff the powder. Dispense the powder and liquid onto either one of the mixing sheets provided, or a glass slab at room temperature in the proportion of one scoop of powder to one drop of liquid. Do not compress the powder.

Squeeze the liquid bottle gently to clear the opening, then hold the bottle vertically to avoid air bubbles and dispense one drop. For larger cavities, use multiple quantities of powder and liquid in the same 1:1 ratio.

Using a plastic spatula, mix half of the powder with the liquid to form a smooth, creamy paste. Then, mix in as much of the remaining powder as possible to form a firm, putty-like consistency. Do not make it dry or crumbly. In the case of multiple scoops of powder, incorporate each, in turn, into the liquid, making sure the final cement has a smooth and firm consistency.

It should take approximately 30-40 seconds to mix them together. Due to Diamond Carve’s snap-set and to achieve good adhesion to the enamel and dentine, always mix fresh material for each cavity.

After dispensing, the assistant should replace the caps tightly and start to clean the instruments and mixing slab before the material has set.

Step 6 – place the mixed material into the cavity and pack into place using conventional packing instruments. Diamond Carve has a firm, putty-like consistency, which makes it easy to pack. Once placed, carve as desired. The working time from start of mixing is approximately two minutes and 15 seconds. Diamond Carve has a snap-set after three minutes and 40 seconds, which quickly makes the restoration water resistant.

Step 7 – six minutes after start of mixing, excess material can be removed using either fine diamond finishing burs or diamond impregnated rubber cups, irrigated and water cooled.

Step 8 – as a precaution, instruct the patient not to bite on the restoration for about one hour.

Customer feedback

Dr Martin Harris, of West Earlham Dental Health Practice, Norwich, said,

“I mainly use Diamond Carve for deciduous fillings, core build-ups, some interproximal restorations and as a fissure sealant. I like it because it is strong, quick and easy to use, reasonably aesthetic and caries inhibiting. I prefer to use it instead of amalgam in some circumstances because it bonds to the tooth and is good for open shallow cavities.”

Dr John Rees, from Rees Dental Practice, Birmingham, commented, “I use Diamond Carve because it is easy to mix and you can mix the exact quantity you require. There is no waste. I also like the way it bonds well to the tooth and is a lot harder than other glass ionomers, therefore, it lasts longer.
“I use Diamond Carve to restore primary teeth and class Vs in adults, where the restoration is held in place and shaped using a metal cervical foil, which gives a very smooth finish after the initial snap-set.”

Dr C P Taylor runs a mainly private practice in Wrexham and understands that time spent on good restorative techniques is the key to ensuring profitable success, as well as a satisfied patient. He said

“I first started using Diamond 90 in 1999 because I quickly recognised how it could help me cut down on treatment time and successfully provide more aesthetic results for my patients. However, I now use Diamond Carve as my preferred choice of restorative material.
Prior to using Diamond, restorations were often time-consuming and work intensive. They could take up to 40 minutes in total for a large cavity. By using Diamond Carve, I have reduced this time dramatically”.

“I use it primarily for class I and class II restorations, class V abrasion cavities, restoration of deciduous teeth and core build-ups. I’ve also used it to repair amalgams and to cement posts in root canals. I feel confident in using it for all of these indications because of its flexibility and versatility. When mixed together, the powder and liquid form a packable consistency that is almost like bread dough (flexible enough to roll, firm enough to pack). It doesn’t require light curing – saving loads of time – and, once set, it is rock hard and completely waterproof. It is then easy to finish and has excellent wear resistance. The final result is very aesthetically pleasing”

“Finally, thanks to its special composition, I no longer need to worry about dimensional changes within the restoration or post-operative sensitivity.”
Dr S R Sparks added, “My favourite use is in the domiciliary situation, where conditions are far from ideal. The patients are usually elderly with a lot of exposed dentine and glass ionomer is the only safe filling material. Diamond Carve is particularly useful as it can be used in both anterior and posterior teeth, giving an aesthetic and long-lasting restoration. It withstands loading well, without excessive wear or fracture, which is particularly important in posterior regions.”

Diamond Carve is part of the Diamond GIC range is one of the few dental restorative materials manufactured by Kemdent in the UK and an export success. For further information contact Kemdent on 01793 770090 or CLICK HERE

Find out how to use Kemdent's Diamond Carve a restorative material with a performance unmatched by any conventional Glass Ionomer Cement. Extremely durable, hard wearing, strong and versatile.