Nanohybrid glass-ceramic composite polymerized in ideal conditions and commercialized in the form of blocks for milling in automated lathes.
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Description

Brava Block is a nanohybrid glass-ceramic composite polymerized in ideal conditions and commercialized in the form of blocks for milling in automated lathes. The composite presents particles in the range between 40 nm and 5.0 μm, with total inorganic charge content in weight of 72% to 82% (52% to 60% in volume) in a highly polymerized resinous matrix. The block has conversion rate of approximately 86%, significantly higher than most of conventional composite resins (55% to 60%). This factor and the adequate distribution of the size of the particles result in a composite with elevated hardness, mechanical and wear resistance, features that are necessary for the application in anterior and posterior teeth. Brava Block allows for the production of pieces with excellent finishing with smooth and highly shiny surfaces.

Presentation

• A1-LT
• A2-LT
• A3-LT
• A3.5-LT
• B1-LT
• C2-LT
• D2-LT
• Bleach

• A1-HT
• A2-HT
• A3-HT
• B1-HT

Characteristics and Advantages

• High conversion degree.
• High wear resistance.
• Customizable for better aesthetic results.
• Allows for repair.
• Easy to adjust.
• Maintains its high polishing and shine over time.
• Versatile for the production of indirect pieces, including veneers.
• Wide range of colors with two translucency options.
• Compatible with two different milling systems.

Indications

Brava Block is suitable for indirect restorations such as total unitary crown over teeth, inlays, onlays and veneers.

Step by Step

1 - Mechanical preparation of the tooth:

For the piece to have an adequate mechanical performance, it is necessary to follow certain guidelines during dental preparation, according to the work to be done:

A) Inlays and onlays.

The internal axial walls of the restoration area should present an expulsive angle of approximately 5o to allow for the seating of the pieces. Acute corners should be rounded. The occlusal reduction (or of the cusps) should be of 1.5mm and the vestibule-lingual distance (or vestibule-palatal) should be at least 1.5mm.

B) Veneers.

The amount of wear on the vestibular surface varies in the different thirds of the teeth: in the cervical area, the suggestion is 0.4mm, while in the medium third the suggestion is 0.6mm. The incisal reduction recommended is from 0.5mm to 1.5mm. In the case of palatine enveloping, round all angles.

C) Total unitary crown

The axial walls of the prepared cavity must have approximately 5o of inclination and undergo abrasion of 1.0mm in the cervical area and 1.5mm in the medium third. The incisal/occlusal region should be reduced in 1.5mm. The completely prepared cavity should present round angles.

2 - Occlusal adjustments in the piece and polishing:

Once ready, the piece should be fitted in the mouth before cementing. Possible needed occlusal adjustments can be done with fine granulation diamond drill bits. After those fittings, polishing can be carried out with rubber or abrasive disks of medium and fine granulation, felt (e.g.: Diamond, FGM) and polishing paste (e.g.: Diamond Excel, FGM).

3 - Adhesive preparation of the piece:

1st – Blast the internal part of the piece using aluminum oxide of up to 50 micrometers, with pressure of around 3 bar until the surface becomes matte. As an alternative, etch the piece with hydrofluoric acid at 10% for 60 seconds.
2nd – Proceed to the washing of the pieces in ultrasonic basin in water for 180 seconds.
3rd – Apply 70% alcohol and dry the surface for 30 seconds.
4th – Apply silane (preferably one containing MDP) and let it react for 60 seconds. Remove excess with air jet.
5th – Apply adhesive (preferably one containing MDP, e.g.: Ambar or Ambar Universal, FGM) for 30 seconds and then apply air jet for 10 seconds to volatize the solvent and level the thickness of the layer. Then, light cure the whole surface for 20 seconds.

4 - Adhesive preparation of the tooth:

A) Two-step adhesive application (ex.: Ambar, FGM).

1st – Remove any dirt from the surface of the restoration. If necessary, use the Robinson brush and prophylactic paste. Isolate the tooth, preferably with absolute isolation.
2nd – Apply 37% phosphoric acid etchant (e.g.: Condac 37, FGM) on enamel and dentine for 15 seconds. Then, wash and gently dry, leaving the dentine humid.
3rd – Apply the adhesive with friction all over the surface of the tooth, for 10 seconds, in two layers. Then, apply air gently to spread the adhesive better and reduce the thickness of the adhesive layer. Light cure it for 20 seconds.

B) One-step adhesive application (e.g.: Ambar Universal, compatible with all FGM’s cements):

1st – Remove any dirt from the surface of the restoration area. If necessary, use the Robinson brush and prophylactic paste. Isolate the tooth, preferably with absolute isolation.
2nd – Apply the adhesive with friction all over the surface of the tooth, for 10 seconds, in two layers. Then, apply air gently to spread the adhesive uniformly on the surface and reduce the adhesive layer thickness. Light cure for 20 seconds.

5 – Cementation of the piece to the tooth:

1st – With the prosthetic piece and the tooth prepared, in an isolated operatory field free from fluids, the piece is cemented. For that, manipulate the resinous cement or use the double-body syringe (e.g.: Allcem or Allcem Core, FGM) according to the Instructions for Use of the chosen product.
2nd – Apply the cement inside the prosthetic piece and adapt it to the tooth. The excess cement that may overflow must be removed. Light cure each surface of the tooth (vestibular, palatal/lingual and occlusal) for 20 seconds during a total time of 60 seconds of light application. Following that, keep the field isolated for 10 minutes after mixing the cement to cure chemically.
3rd – Verify proximal excess with dental floss and, if necessary, remove remaining resin/adhesive excess.

6 - Repairing the piece after cementation:

If, at any time, the professional needs to repair a prosthetic piece due to fractures or chipping, the following is suggested:
1st – Remove any dirt from the surface of the restoration area. If necessary, use the Robinson brush and prophylactic paste. Isolate the tooth, preferably with absolute isolation.
2nd – Roughen the area to be repaired with fine diamond tipped drills, wash and dry the surface.
3rd – Apply Ambar Universal (FGM) or Prosil (FGM) on the piece, according to their Instructions for Use.
4th – Do the necessary repair by using a conventional composite (e.g.: Opallis or Llis, FGM) and light cure the increments according the product’s Instructions for Use.
5th – Proceed with the finishing and polishing according to the steps of a conventional restoration.

FAQ

1 - What is the advantage of indirect restoration with composite material compared to the ceramic one?

Basically, the easiness for adjusting in the mouth and the repair capability, when necessary. The cementation is also easier and the adhesion to resinous cement is facilitated because it is a material of the same nature of the direct composites.

2 - What is the advantage of indirect restoration with composite material compared to a direct restoration with composite?

Besides being materials of similar nature, composite block for milling has a higher conversion degree and superior mechanical resistance. It is also noticeable the polishing capabilities and its longevity, which contributes to achieving a long-lasting aesthetic result.

3 - Which adhesives and cements are compatible with Brava Block?

All classes of adhesives are compatible with Brava Block. Regarding cements, dual or light-curing cements (when used for thin veneers) are recommended.

4 - What should one do if a restoration made with Brava Block chips or fractures?

Depending on the extension of damage, this can be repaired with increments of composites (please see the Instructions for Use).

Information for the Professional

Precautions and contraindications

• For odontology use only.
• Read carefully the Instructions for Use before using the product.
• The steps of manufacturing in the CAD/CAM systems are described in the Instructions for Use and in the manuals of each equipment manufacturer. The manufacturer recommendations should be followed.
• The milling process should be done with the use of water. Dry machining is not feasible for Brava Block.
• Make sure to leave an internal space for the cement.
• Preferably, the piece must be blasted in its internal surface. If such blasting is not possible, it may be etched with hydrofluoric acid at 10% for 60 seconds.
• The piece should not be laser-conditioned.
• Do not use hydrogen peroxide solution, EDTA, bicarbonates or astringent products on the surface of the piece.
• Do not use temporary cements that contain eugenol.
• The piece should not be heated.

• This product has contra-indications. Please refer to the instructions manual.

Conservation and storage

• Protect from direct sunlight.
• Store the product between 5°C and 35°C (41°F and 95°F).

Warnings

• Make sure to mill the material with water (refrigerated process). Brava Block cannot be milled when dry.
• The product is recommended for professional use only.
• Do not use the product after its expiration date.
• For disposing the product, follow your country’s legislation.
• Keep out of the reach of children.
• Avoid the use in patients with a history of allergy to the composite resins containing methacrylates. In case of allergy, suspend the use and advise the patient to seek a doctor.