Filtek Z250 – universal restorative material 3M ESPE

Filtek Z250 Universal Restorative material is a visible-light activated, radiopaque, restorative composite. It is designed for use in both anterior and posterior restorations. The filler in Filtek Z250 restorative is zirconia/silica. The inorganic filler loading is 60% by volume (without silane treatment) with a particle size range of 0.01 to 3.5 µm. Filtek Z250 restorative contains BIS-GMA, UDMA, and BIS-EMA resins.

A dental adhesive, such as manufactured by 3M ESPE, is used to permanently bond the restoration to the tooth structure. The restorative is available in a variety of shades. It is packaged in traditional syringes and single-dose capsules.

Filtek Z250

Indications
Filtek Z250 restorative is indicated for use in:

  • Direct anterior and posterior restorations
  • Core buildups
  • Splinting
  • Indirect restorations including inlays, onlays and veneers

Precautionary Information for Patients
This product contains substances that may cause an allergic reaction by skin contact in certain individuals. Avoid use of this product in patients with known acrylate allergies. If prolonged contact with oral soft tissue occurs, flush with large amounts of water. If allergic reaction occurs, seek medical attention as needed, remove the product if necessary and discontinue future use of the product.

Instructions for Use Filtek Z250

Preparation

1. Prophy: Teeth should be cleaned with pumice and water to remove surface stains.

2. Shade Selection: Before isolating the tooth, select the appropriate shade(s) of restorative material. Shade selection accuracy can be enhanced by the following hints.
2.1 Shade: Teeth are not monochromatic. The tooth can be divided into three regions, each with a characteristic color.
2.1.1 Gingival area: Restorations in the gingival area of the tooth will havevarious amounts of yellow.
2.1.2 Body area: Restorations in the body of the tooth may consist of shades of gray, yellow, or brown.
2.1.3 Incisal area: The incisal edges may contain a blue or gray color. Additionally, the translucency of this area and the extent of the translucent portion of the tooth to be restored and neighboring teeth should be matched.
2.2 Restoration depth: The amount of color a restorative material exhibits is affected by its thickness. Shade matches should be taken from the portion of the shade guide most similar to the thickness of the restoration.
2.3 Mock-up: Place the chosen shade of the restorative material on the unetched tooth. Manipulate the material to approximate the thickness and site of the restoration. Cure. Evaluate the shade match under different lighting sources. Remove the restorative material from the unetched tooth with an explorer. Repeat the process until an acceptable shade match is achieved.

3. Isolation: A rubber dam is the preferred method of isolation. Cotton rolls plus an evacuator can also be used.

Direct Restorations

1. Cavity Preparation:
1.1 Anterior restorations: Use conventional cavity preparations for all Class III, IV and Class V restorations.
1.2 Posterior restorations: Prepare the cavity. Line and point angles should be rounded. No residual amalgam or other base material should be left in the internal form of the preparation that would interfere with light transmission and therefore, the hardening of the restorative material.

2. Pulp Protection: If a pulp exposure has occurred and if the situation warrants a direct pulp capping procedure, use a minimum amount of calcium hydroxide on the exposure followed by an application of 3M ESPE Vitrebond Light Cure Glass lonomer Liner/Base or 3M ESPE Vitrebond Plus Light Cure Glass lonomer Liner/Base. Vitrebond or Vitrebond Plus liner/base may also be used to line areas of deep cavity excavation. See Vitrebond or Vitrebond Plus liner/base instructions for details.

3. Placement of Matrix:
3.1 Anterior restorations: Mylar strips and crown forms may be used to minimize the amount of material used.
3.2 Posterior restorations: Place a thin dead-soft metal, or a precontoured-Mylar or a precontoured-metal matrix band and insert wedges firmly. Burnish the matrix band to establish proximal contour and contact area. Adapt the band to seal the gingival area to avoid overhangs.

Note: The matrix may be placed following the enamel etching and adhesive application steps if preferred.

4. Adhesive System: Follow the manufacturer’s instructions, for example 3M ESPE adhesives, regarding etching, priming, adhesive application and curing.

5. Dispensing the Composite: Follow the directions corresponding to the dispensing system chosen.
5.1 Syringe: Dispense the necessary amount of restorative material from the syringe onto the mix pad by turning the handle slowly in a clockwise manner. To prevent oozing of the restorative material when dispensing is completed, turn the handle counterclockwise a half turn to stop paste flow. Immediately replace syringe cap. If not used immediately, the dispensed material should be protected
from light.
5.2 Single-Dose Capsule: Insert capsule into 3M ESPE Restorative Dispenser. Refer to separate restorative dispenser instructions for full instructions and precautions. Extrude restorative directly into cavity.

6. Placement:

  • 6.1 Place and light cure restorative in increments as indicated in Section 7.
  • 6.2 Slightly overfill the cavity to permit extension of composite beyond cavity margins. Contour and shape with appropriate composite instruments.
  • 6.3 Avoid intense light in the working field.
  • 6.4 Posterior placement hints:
  • 6.4.1 To aid in adaptation, the first 1 mm layer may be placed and adapted to the proximal box.
  • 6.4.2 A condensing instrument (or similar device) can be used to adapt the material to all of the internal cavity aspects.

7. Curing: Filtek Z250 restorative is intended to be cured by exposure to a halogen or LED light with a minimum intensity of 400 mW/cm2 in the 400-500 nm range. Cure each increment by exposing its entire surface to a high intensity visible light source,
such as a 3M ESPE curing light. Hold the light guide tip as close to the restorative as possible during light exposure. The recommended exposure time and maximum increment thickness for each shade is shown below.

filt1

8. Finishing: Contour restoration surfaces with fine finishing diamonds, burs or stones. Contour proximal surfaces with 3M ESPE Sof-Lex Finishing Strips.

9. Adjust Occlusion: Check occlusion with a thin articulating paper. Examine centric and lateral excursion contacts. Carefully adjust occlusion by removing material with a fine polishing diamond or stone.

10. Polishing: Polish with 3M ESPE Sof-Lex Finishing and Polishing System and with white stones or rubber points where discs are not suitable.

Indirect Procedure For Inlays, Onlays Or Veneers

1. Dental Operatory Procedure
1.1 Shade selection: Choose the appropriate shade(s) of Filtek Z250 restorative prior to isolation. If the restoration is of sufficient depth, use of an opaque shade is recommended. Use of an Incisal shade on the occlusal surface will help to achieve esthetic appearance.

1.2 Preparation: Prepare the tooth.

1.3 Impressioning: After preparation is complete, make an impression of the prepared tooth by following the manufacturer’s instructions of the impressioning material chosen. A 3M ESPE impressioning material may be used.

2. Laboratory Procedure
2.1 Pour the impression of the preparation with die stone. Place pins at the preparation site at this time if a “triple tray” type of impression was used.

2.2 Separate the cast from the impression after 45 to 60 minutes. Place pins in die and base the cast as for a typical crown and bridge procedure. Mount or articulate the cast to its counter model to an adequate articulator.

2.3 If a second impression was not sent, pour a second cast using the same impression registration. This is to be used as a working cast.

2.4 Section out the preparation with a laboratory saw and trim away excess or, expose the margins so they can be easily worked. Mark the margins with a red pencil if needed. Add a spacer at this time if one is being used.

2.5 Soak the die in water, then with a brush, apply a very thin coat of separating medium to the preparation, let it dry somewhat, then add another thin layer.

2.6 Add the first third of composite to the floor of the preparation, stay short of the margins, and light cure for 20 seconds.

2.7 Add the second third of composite. Allow for the last third (incisal) to include the contact areas, light cure for 20 seconds.

2.8 Place the die back into the articulated arch, add the last third of incisal composite to the occlusal surface. Overfill very slightly mesially, distally, and occlusally. This will allow for the mesiodistal contacts and the proper occlusal contact when the opposing arch is brought into occlusion with the uncured incisal increment. Light cure for only 10 seconds, then remove the die to prevent adhering to adjacent surfaces. Finish the curing process.

2.9 With the occlusal contacts already established, begin removing the excess composite from around the points of contact. Develop the inclines and ridges as per remaining occlusal anatomy.

2.10 Care must be taken when removing the prosthesis from the die. Break off small amounts of the die from around the restoration, the die stone should breakaway cleanly from the cured restoration, until all of the restoration is
recovered.

2.11 Using the master die, check the restoration for flash, undercuts, and fit. Adjust as necessary, then polish.

3. Dental Operatory Procedure

  • 3.1 Roughen the interior surfaces of the indirect restoration.
  • 3.2 Clean the prosthesis in a soap solution in an ultrasonic bath and rinse thoroughly.
  • 3.3 Cementation: Cement the prosthesis using a 3M ESPE resin cement system by following manufacturer’s instructions.

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