Ketac Molar Easymix – glass ionomer restorative material

Ketac Molar Easymix
Ketac Molar Easymix, manufactured by 3M ESPE, is a glass ionomer cement for manual mixing that is exceptionally easy to mix.

The feature of the material to chemically bond to enamel and dentin provides for ease of preparation and excellent sealing of the margins of fillings.

The material can be applied without lining. It releases fluoride ions and is radio-opaque.

Ketac Molar Easymix is also suitable for use in minimal invasion filling therapy (MI) and for applications involving A.R.T. (atraumatic restorative treatment) technique.
Ketac Molar Easymix is available in A3 shade.

For details on the below mentioned Ketac Conditioner and Ketac Glaze, all products manufactured by 3M ESPE, please refer to the pertinent Instructions for Use. Instructions for Use should not be discarded for the duration of product use.

Indications
Conventional filling therapy:

  • As lining for single- or multi-surface composite fillings
  • Core build ups
  • Primary tooth fillings
  • Single-surface fillings in areas not involved in occlusion
  • Cervical fillings without cosmetic priorities
  • Semi-permanent single- and multi-surface fillings

Minimal intervention (MI) filling therapy (A.R.T. technique):

  • Primary tooth fillings
  • Single-surface fillings in areas not involved in occlusion
  • Class V fillings where appearance is not a priority
  • Semi-permanent single- and multi-surface fillings
  • Semi-permanent class III fillings
  • Fissure sealings

Precautions During Processing
Only Ketac Molar Easymix Liquid should be used to process Ketac Molar Easymix Powder.
Mixing Ketac Molar Easymix Powder with other liquids of the Ketac product line will alter the concentration of acid in the filling material.

This may result in post-operative sensitivity. In addition, the mechanical properties of the material will be impaired and setting speed altered.
Banner_Ketac_Molar_product_1

Steps prior to Preparation Ketac Molar Easymix

Conventional filling therapy and A.R.T. technique:

  • Keep handy all required instruments and materials.
  • In the case of multi-surface fillings, place a matrix band to protect neighboring teeth and simplify contour shaping.

Especially in the A.R.T. technique:
A minimal set of instruments should include: dental mirror, probe, tweezers, excavator (large, medium, small), modeling instrument, carver (axe-shaped cutting instrument), mixing spatula, mixing pad, a matrix band (if required), cotton rolls, cotton pellets, water cup (sterilizable or disposable). This basic set can be supplemented with additional instruments depending on the available financial resources and local circumstances.

  • Prior to commencing preparation, the working area should be thoroughly cleaned and dried. This renders discolored, demineralized enamel easy to recognize and treat.
  • If no suction is available during treatment, the working area must be kept dry with repeated changes of cotton rolls.

Preparation
Conventional filling therapy:

  • Only remove the carious substance; no undercuts required.
    – Do not prepare thin edges since the material requires a minimal wall thickness of 0.5 mm!
  • Clean the cavity with water and dry with air.

A.R.T. Technique:

  • Extend the orifice of small cavities with a dental hatchet or carver to gain better access. As a consequence, any enamel jutting out will break off and sufficient space for access of the smallest manual excavator is created.
  • Commencing at the enamel-dentin interface, use circular abrasive motions of the smallest manual excavator to completely remove any carious dentin from the cavity. Unsupported enamel should also be removed.
  • Subsequently, clear the floor of the cavity.
    – Use the largest suitable excavator to treat large cavities, and exert little pressure in order not to inadvertently expose the pulp due to excessive pressure!
  • Clean the cavity with water and dry.

Protection of the Pulp
Conventional filling therapy and A.R.T. technique:
Cover areas in close proximity to the pulp by applying spots of a hard-setting calcium hydroxide material in order to protect the pulp from irritation.

Conditioning
Conventional filling therapy and A.R.T. technique:

  • For optimal chemical bonding to the teeth the smear layer produced in the preparatory steps must be carefully removed by applying Ketac Conditioner or, for use with the A.R.T. technique, Ketac Molar Easymix liquid to the prepared surfaces and allowing the substance(s) to react for 10 sec.
  • Then rinse with copious amounts of water and blow dry in only 2-3 short intervals with water and oil-free air or dab dry with cotton pellets.
    – The cavity should be just so dry that the surface has a matt shiny appearance. Excessive drying can result in post-operative sensitivity after filling.
  • Avoid further contamination; repeat the procedure, if surfaces become recontaminated.

Dosing
Conventional filling therapy and A.R.T. technique:

  • Shake bottle to render the powder free-flowing. Use a mixing ratio [weight ratio] of 4,5 parts of powder (1 spoonful with leveled powder surface) : 1 part of liquid (1 drop).
  • Removing the powder, wipe off the spoon level at the plastic insert. Avoid compressing the powder.
  • Dose sufficient quantities of powder and liquid in adjacent spots on the
    same mixing block. Keep liquid bottle vertical for dosing.
    – The drop dosing device must be free of any dried residue of the liquid!
    – Drops must not contain any air bubbles!
  • Close bottles of powder and fluid securely after use and ensure that no powder residue remains on the wiper ring of the bottle.

Mixing
Conventional filling therapy and A.R.T. technique:

  • Process Ketac Molar Easymix at room temperature (20-25 °C/68-77 °F).
  • Use a metal or plastic cement spatula and a mixing pad or glass slab for mixing.
  • Ideally, the powder should be transferred into the liquid in not more than two portions.
  • Streak out the paste repeatedly until the consistency is homogeneous.
    – Moisture can have a negative effect on the properties of the glass ionomer cement. If a homogeneous paste is not obtained with the given mixing ratios, discard the material.

Application
Carefully avoid contamination during application!


Conventional filling therapy:

  • Apply Ketac Molar Easymix in several portions using a suitable instrument. Undercuts may need to be treated first.
    – Carefully avoid trapping air bubbles under enamel undercuts.

A.R.T. technique:

  • Apply Ketac Molar Easymix in several portions using a suitable instrument. Undercuts may need to be treated first.
    – Carefully avoid trapping air bubbles under enamel undercuts.
  • Slightly over-fill cavities; apply the material to adjacent grooves and fissures.
  • Apply a small amount of Vaseline to your forefinger and use this finger to firmly press the glass ionomer cement into cavities, fissures, and grooves.
  • Repeatedly move the tip of the forefinger in a mesio-distal and buccolingual direction to distribute the material over the entire occlusal surface (“finger press technique”).
  • Finally remove the finger sideways to prevent the restorative material from lifting out of the cavity.

Fissure sealing with the A.R.T. technique:

The same steps of cleaning, conditioning, application, and processing as in the A.R.T. technique are performed to seal fissures with the only difference being that there is no preparation involved.

Times
At an ambient temperature of 23 °C/73 °F and 50% relative humidity the following times apply: min:sec

Mixing –  00:30
Processing from start of mixing –  03:00
Setting from start of mixing –  05:00

At higher temperatures, the time available for processing is shortened, whereas it is prolonged at lower temperatures than indicated (e.g. mixing on a chilled glass slab). The processing time is also shortened, if the amount of powder exceeds the recommendation. Exceeding the indicated processing time leads to reduced bonding to enamel and dentin.

Filling protection
In the first phase of their 2-phase setting process, glass ionomers are sensitive to moisture. Subsequently, there is the possibility of dehydration which may be prevented by applying Ketac Glaze or Vaseline directly after shaping.

Conventional filling therapy and A.R.T. technique:

  • Apply Ketac Glaze or Vaseline to all exposed surfaces of the glass ionomer cement.
  • Cure Ketac Glaze with light for 10 seconds, if applicable.
    – The inhibition layer produced during polymerization may impede the setting process of addition reaction silicone impression materials. Consequently, such layers must first be removed or a polyether impression material used instead!

Finishing
Conventional filling therapy:

  • Beginning no earlier than 5 minutes after the start of mixing, use Arkansas stone, fine-grain diamonds, polishing discs of decreasing grain size or silicone polishers for finishing.
  • If desired, apply Ketac Glaze again to seal the surface and light-cure for 10 sec.

The patients must not expose the filling to any stress for 1 hour!

A.R.T. technique:

  • Remove any excess material with a carver or large excavator as soon as possible without pulling the material from the cavity.
  • Even before the filling material is completely cured, test the occlusion with some articulation paper.
  • Carefully remove any increase in vertical dimension with a carver.
  • Especially at the edge of the filling the occlusion should be slightly out-of-contact.
  • Apply more Vaseline to the working areas to protect the restoration.

The patient must not expose the filling to any stress for 1 hour!

Notes
The material bonds to metal instruments. Therefore, residual quantities of the cement should be removed with water before they set on the instrument.

Storage and Shelf-life
Store the product at 15-25 °C/59-77 °F.
To protect the powder from moisture, do not open the powder bag until immediately prior to the first application.

Replace the cap securely after use.
Do not use after the expiration date.

Customer Information
No person is authorized to provide any information which deviates from the information provided in this instruction sheet.

Product Information
Starter Kit Ketac™ Molar Easymix
1 Powder 12.5 g, Shade A3, 1 Liquid 10 g, 1 Ketac™ Conditioner, 1 Ketac™ Glaze, 1 Mixing Pad, Accessories

Starter Kit Ketac™ Molar for M.I. incl. A.R.T.
1 Powder 15 g, Shade A3, 1 Liquid 10 g, Accessories

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