PMMA and Bis-GMA impregnated E-glass fibers
All the advantages of Preat Perma Fiber, but without the need to “wet” the material!
Kits and Technical Information
The BIS-GMA allows eFiber to bond with light cure composites and well as acrylic (PMMA).
eFiber provides 28 MPa of adhesive strength to etched enamel/dentin and 27 MPa to composite.
45cm of Perma Mesh
10cm eFiber 1.6mm
10cm eFiber 1.2mm
Bonding Adhesive (white bottle)
Wetting Agent (black bottle)
Flowable Composite with extra tips
Goats Hair Polishing Wheel
244 Blue Polishing Paste
F8 Silicone Cutter/Polisher
Refills of all material are available individually.
eFiber Perio Kit
The eFiber Perio Kit includes two 10cm units of eFiber 1.2mm, one silicon tool, instructional DVD, and user instructions.
PERIO contains 2000 individual glass fibers, for an effective diameter of 1.2 mm.
No special tools are needed to work with this unique PMMA and Bis-GMA impregnated glass fiber.
eFiber Ortho Kit
The eFiber Ortho Kit includes two 10cm units of eFiber 1.2mm, one 2mL syringe of flowable composite, one silicon tool, an instructional DVD, and user instructions.
ORTHO contains 2000 individual glass fibers, for an effective diameter of 1.2 mm.
No special tools are needed to work with this unique PMMA and Bis-GMA impregnated glass fiber.
eFiber 1.6 x 10 cm
eFiber pre-impregnated glass fiber for all polymer crown and bridge prosthodontics.
1.6mm is suitable for reinforcing:
- Surface retained bridges
- Inlay and hybrid bridge frames
- Full cover crown bridges
- Temporary bridges
- Temporary bridges for healing period of implants
- Reinforcement and repair of acrylic prosthetics
eFiber1.6mm contains 4000 individual glass fibers, for an effective diameter of 1.6 mm. Each package contains one 10 centimeter fiber bundle.
Quantity breaks available at 2, 3, 5, and 10 units
eFiber 1.2 x 10 cm
eFiber 1.2mm is an ideal product for all types of splinting and orthodontic applications. It is suitable for:
- lingual/palatal splinting
- labial splinting
- occlusal splinting
- post trauma labial splinting
- it can also be used as a combined periodontal splint and surface-retained bridge
eFiber 1.2 contains 2000 individual glass fibers, for an effective diameter of 1.2 mm.
Quantity breaks available at 2, 3, 5, and 10 units
Some of the clinical advantages of eFiber:
- easy to use – simply measure, position, and cure
- no fraying of fibers – can be easily polished
- saves time – only one patient visit required
- bonds reliably to teeth
- easy to maintain
- metal-free, aesthetically pleasing, transparent
- patient-friendly – feels natural
- interproximal flexibility
Hand Held Curing Light
Rechargeable curing light, ideal for working with eFiber and Perma Mesh.
- Lithium Battery
- Dormant Function to Save Battery
- 3 Solidification Working Mode: Full Mode; Ramp-up Mode;Gradually Mode.
- Sound Alert Feature. One Year Warranty.
Voltage Range of the Charger
Charge one time can use about
100-240v AC 50/60Hz
About 8 hours
Case Design and Applications
Esthetic and Easy to use?
eFiber New Denture Reinforcement
The goal is to stop fractures before they begin. Therefore, in order to increase flexural strength and fatigue resistance, it is important that the reinforcement is placed in the optimal position.
Historically, full mandibular and maxillary dentures fracture in the area of the incisal notch, or midline area beneath the anterior teeth.
The red areas on the image illustrate the areas of tension/strain (most likely to fracture) on a maxillary complete denture utilizing digital 3 dimensional FED analysis.
This study confirms what dental professionals have long understood–the midline is the key area to reinforce.
The stronger unidirectional eFiber will be placed underneath the teeth, at the junction of teeth and acrylic. The placement should be perpendicular to fracture forces, while being placed on the tension side.
If desired, Perma Mesh may be used in the anterior and posterior of the palate for maxillary dentures.
These fibers are translucent and easily adjusted and polished, allowing for optimal (and uniquely esthetic) placement.
eFiber is ideal to use to strengthen both implant supported and implant retained cases, or any case where the masticatory forces are great, or there is less than the ideal bulk of acrylic resin.
After boil out and wax removal, prepare a groove in the denture teeth to receive the fiber reinforcement.
Paint eFiber Bonding Agent in the groove for maximum bond strength between the efiber and denture teeth.
Allow the bonding agent to dry.
Run a length of wax rope (or floss) along the groove in the tooth setup. This will provide the accurate length of the eFiber reinforcement needed.
Use the wax rope to measure the length of Fiber needed and cut the fiber. Keep the fiber protected from light.
Place the eFiber into the prepared tooth areas.
Using the clear silicone matrix, press the fiber into the prepared grooves in the tooth and light cure the fiber to the teeth, one tooth at a time.
The PMMA and Bis-GMA in the fiber will bond to acrylic and composite denture teeth, splinting the teeth together, while at the same time, providing a superior surface for acrylic to bond to.
If multiple pieces of eFiber are needed, gently overlap two sections and press together prior to curing.
Proceed with normal acrylic processing technique.
After acid etching, clean the area to be bonded using a pumice and water mix. Rinse with water and air dry. Use the composite bonding technique according to the bonding agent manufacturer’s instructions. Apply bonding agent to the entire tooth area to be bonded. Light cure the bonding agent as described by the manufacturer. Apply a think layer of flowable composite to the bonded teeth surfaces. Do not light cure the composite yet.
Re-activate the fiber wings with unfilled resin or monomer.
Place the pontic in place, with the fiber wings on the uncured flowable composite. Use the clear silicone tool to press and hold the fiber wings in place. Use the eFiber tool to block out the pontic area, and light cure the fiber wing for 5-10 seconds. Use the same technique to light cure one tooth/pontic area at a time.
Place flowable composite on the bonded fiber wings as well as the pontic area, and light cure one tooth/pontic area at a time for 40 seconds. Polish and finish the restoration as needed.
eFiber and Perma Mesh: General Information
eFiber is pre-wetted with both PMMA and Bis-GMA; do NOT wet this material. It is ready to use right out of the package.
eFiber is light sensitive and comes packaged in a protective foil pouch. Please be sure to store the eFiber in the pouch, or out of the light, when not in use. eFiber is packaged in a clear silicone matrix, which may be used as a tool during fabrication. The fiber is sticky, and sometimes the fiber sticks to the paper backing on the silicone matrix.
If this happens, gently roll the fiber back into a bundle using your fingers, gloves are not mandatory.
You can touch the fiber, and do not need special tools or scissors to cut the fiber. The “four finger” cutting technique is recommended for best results.
The PMMA in Perma Mesh needs to be wet, or activated, prior to using. Two choices:
- When using Mesh with acrylic, wet with a very slurry/thin mix of self-cure acrylic.
- When using Mesh with composite or light cure resins, wet with PREAT Light Cure Wetting Agent.
The Light Cure Wetting Agent requires more wetting time to activate the PMMA than self cure acrylic.
Always “wet” Perma Mesh on a clean surface. A plastic bag works well.
When the PMMA in the Mesh is thoroughly activated, the Mesh will be translucent
You do not need any special tools when working with Perma Mesh. Any sharp scissors will work fine to cut the Mesh.
Denture Repair with eFiber
Re-assemble the broken denture and make a matrix to hold in place. Measure and cut the appropriate length of eFiber needed to repair a midline fracture (recommended from cuspid to cuspid). Cut a groove at the junction of the teeth and acrylic. Paint a small amount of Bonding Adhesive in the groove. Place the eFiber into the groove, and light cure for 5 seconds per unit. Apply repair acrylic using the technique of choice, process, and polish to a high shine.
For direct technique, make an impression prior to preparing the abutments. For indirect technique, wax the bridge on the model and make a putty matrix. Measure and cut a length of eFiber that will run the entire length of the bridge. Use the clear silicone to hold the eFiber in position, and light cure the eFiber through the clear silicone. Cut two or more small squares of Perma Mesh, and wet the Mesh with Light Cure Wetting Agent until the Mesh is translucent.
Fill the impression/matrix with the parent material chosen for the temporary bridge. Place the cured eFiber, and then the wet Perma Mesh, into the matrix last. The eFiber should run the length of the bridge, and the Mesh will be placed over the abutments. Process the bridge, and easily cut and grind any excess fibers. Polish and finish.
Surface Retained Periodontal Splinting
Use a rubber dam to isolate the area to be splinted. Clean the teeth, then acid etch and apply bonding agent, according
to the bonding agent manufacturer’s instructions. Use dental floss or wax rope to measure the length of eFiber needed.
Cut the appropriate length of eFiber. Place a thin (0.5mm) continuous layer of flowable composite over the teeth. Do not cure. Place the eFiber onto the composite. Use the stepper tool or silicone matrix to hold in place, and start at one end, light curing 5 seconds per tooth. Use the stepper to keep the adjacent tooth out of the light. Place another thin layer of flowable composite over the eFiber, and cure for 40 seconds per tooth. Polish and adjust the splint.
CHAIRSIDE DENTAL ATTACHMENT LIGHT CURE BONDING TECHNIQUE
Light cure acrylic resin in pre-filled syringes for visible light polymerization of denture attachments.
COMPONENT ORDER NUMBERS
9403 Light Cure Kit
9412 Light Cure Acrylic Resin Syringe (Clear Color)
9413 Light Cure Acrylic Resin Syringe (Tissue Color)
9414 Black Macro Syringe Tip (Bag of 20)
9415 Bottle of Resin Curing Primer
9416 Disposable Primer Brush (Bag of 20)
9519 Access Drill
The Light Cure Acrylic Resin is appropriate for use in chairside pickup of most dental attachments into an overdenture or partial denture, where autopolymerizing resin, (self-curing acrylic), may cause negative patient reactions or pose difficulties in replacing denture attachments.
The Light Cure Acrylic Resin Syringe is not appropriate for use in a case where attachments are being processed into a new denture by the dental laboratory.
Chairside Light Cure Acrylic Resin:
- Clear and Tissue colored light cure acrylic resins prepackaged in handy, ready to use syringes.
- The denture can be placed over the intra-oral attachment with less chance of movement due to the unobstructed attachment recess.
- There is no rush to perform the important step of checking occlusion and proper seating of the patient’s appliance. When everything is correct, the denture remains in place while light cure acrylic resin is injected in and around the attachment through a small access hole.
Self-Curing Acrylic Resin:
- Time consuming mixing is necessary. Possible negative patient reaction to the unpleasant taste and burning sensation related to liquid monomer.
- Filling the denture attachment recessed with self-curing acrylic and then forcing it over the attachment can cause displacement of the attachment as well as “locking in” of the attachment.
- A time factor exists when determining proper seating of denture intra orally while the self-curing acrylic resin proceeds to set up.
From compromises to ideal solutions
THE FUTURE IS NOW!
There is an ever-growing abundance of materials in today’s marketplace. Today, as in the past, it is incumbent upon the practitioner to be mindful of what products can be used to create a long lasting result in a manner that is cost-effective, durable, aesthetic and less invasive to natural tooth structure. We have already seen a surge in the focus on aesthetics in the new millennium. The amount of television shows and print media devoted to “cosmetic makeovers” has been at times overwhelming. However, in our chosen field of dentistry, we need to, as always, be mindful of the conservation of tooth structure, along with the need to satisfy the patient’s demand for highly aesthetic restorations.
In addition to aesthetics, the buzz phrase for the 21st century is “Minimally Invasive Dentistry” (MID). These two wonderful concepts of tooth conservation and aesthetics have ramifications in all aspects of dentistry and can be married to a myriad of products and techniques that will allow you to afford patients with the most sophisticated, beautiful, and beneficial dentistry available today.
A perfect case in point is the use of fiber reinforced composites (FRC) in techniques to stabilize periodontally involved teeth. Through the years several methods have been employed for intra and extra coronal splinting. These included, braided wire, titanium bars, acrylic/resin bonding, composite bonding, and yes even paper clips. In many cases, full coverage crowns were splinted together to insure stability when less than adequate bone would allow for mobility of otherwise sound dentition. In most instances, this was the antithesis of MID by requiring tooth preparation and the removal of otherwise healthy tooth structure for the placement of un-aesthetic splints.
Undoubtedly, everStickPERIO has provided us with the perfect cost-effective material for satisfying the need for aesthetics and preservation of healthy tooth structure. We can now place an extra-coronal splint with adhesive techniques that requires no tooth preparation, is highly durable, minimally invasive to the oral environment, and extremely comfortable for the patient. With intra-coronal splinting, less tooth structure needs to be removed in order to provide for a strong and wear resistant splint. In an age where metal free restorations are the state-of-the-art, this is a wonderful way to use FRC’s to secure and stabilize teeth with more natural looking tooth colored material.
The use of FRC’s in periodontal splinting is not the only area in which fibers can be most helpful. In orthodontics, for example, similar techniques to periodontal splinting can be used for arch stabilization and retention. These orthodontic retainers would be more aesthetic and highly durable over a long period of time. In prosthetics, fibers can be used to create cost-effective bridges in single tooth replacement cases wherein a more invasive acid etched, resin bonded metal retainer might have otherwise been used in the past. Such a fixed retainer may be viewed as a short or long term temporary that can be “built” chairside.
Repairs of denture prosthesis can benefit from fiber products such as everStickNET. This will undoubtedly add to the strength of the repair over a longer period of time then simply using an acrylic resin and/or a potentially visible metal retentions device (such as a piece of metal meshwork as an internal reinforcement). But more, important, the use of this same product intra-orally, for stabilization of traumatically involved teeth is extremely beneficial. In such instances where teeth have become hyper-mobile and are surrounded by fragile and/or friable tissue, we want to be able to stabilize these teeth without cutting them or tying them up with wires.
If the 60’s and 70’s were heralded as the “golden age of dentistry,” than surely this must now be considered the “platinum age of dentistry.” With the advent of products like FRC’s, the dentist can be more artistic and less invasive as he/she sets out to help the patient save and/or restore teeth to normal form and function.
Howard S. Glazer, DDS, FAGD, FACD, FICD, FASDA
Dr. Glazer is a fellow and past president of the Academy of General Dentistry and former assistant clinical professor in dentistry at the Albert Einstein College of Medicine (the Bronx, New York). Currently he holds the academic rank of adjunct assistant clinical professor at several universities around the United States. Dr.Glazer has lectured extensively in the US, Canada, Korea, India, and the United Kingdom on the subjects of aesthetic dentistry, patient management, and forensic dentistry.
Frequently Asked Questions
When using a direct method, Stick and everStick are bonded with adhesives or flowable composites. When using an indirect method, the surfaces of the final fiber frame are dissolved first for five minutes with Stick resin or another suitable resin. After this, luting is performed with either dual or chemically curing composite cements. See luting instructions.
Two according to our experience. We know that longer solutions have also been done successfully. In each patient case one must naturally always take into consideration other relevant factors such as the occlusion, the antagonistic material, the amount of fibers used, and the placing/positioning of the fibers etc. When the prognosis is good, a fiber bridge for three pontics should last as well as bridges made of other materials. The bridge’s lifespan is determined by the durability of the crown material and of the clinical circumstances. We recommend to use in the anterior area one fiberbundle for one pontic and two fiber bundles for one pontic in the posterior/molar area. For two or three pontics, one should use at least two fiberbundles. If there is enough space for more fiber bundles, one should use them.
Based on our clinical studies up to date, we can promise at least a four year lifespan for correctly made fiber restorations. Based on laboratory tests we can expect bridges to last over ten years or more. (Note: the 5-year survival rate study report has been sent for publishing).
Stick fiber frame can be bonded to ceramics the same way as composite. The crucial thing is to choose the right etching material (hydrofluoric acid) and adhesive, one that is meant to be used especially with ceramics.
everStick fiber material offers an easy to use, reliable and cost-effective solution which is very easy to handle. everStick fiber reinforcements are the only fiber products on the market that have been preimpregnated with PMMA polymer. The advantage of having such preimpregnation is that the complete wetting of the fibers is easier to achieve even with high viscosity composite resins and acrylic liquid – powder systems. Also the bonding between the individual silanized glass fibers and the resin matrix is proven to be strong and stable. For these reasons everStick fibers work effectively with both acrylic and composite systems. In addition, having part of the resin matrix composed of PMMA thermoplastic polymer means the fiber frame surface is always partially re–dissolvable in the composite cement. This property is unique to Stick and everStick materials and even allows excellent bonding of indirect bridges to the composite cement and teeth.
everStick fiber reinforcements are developed for easy chairside use. They are durable, aesthetic and comfortable for the patient.
Stick fibers are stronger than the metal inside the acrylic dentures. They can be used for both reinforcing new dentures as well as repairing broken ones. They provide an aesthetic and cost effective method for difficult cases (for instance the ones that tend to break often). Stick technology is a very quick way to build up all kinds of structures, both acrylic and composite. Using Stick fibers does not require any big investment. In addition, with Stick fiber know-how one can improve the laboratory’s services to dentists. A premium charge is recommended for all reinforced work
EverStick Literature / Chapters in Books / Reviews
Kreulen, CM. Vezelversterkte adhesiefbruggen. Ned Tijdschr Tandheelkd 2003; 110:255-260.
Ruyter IE, Kaaber S, Vallittu PK. Plast og protetikk (Plastics and prosthetic dentistry). Suom Hammaslääkärilehti 1999; 6: 292 – 302. (Published also in: Tandläkärtidningen, Tannlaegebladet, Tidende).
Vallittu PK. A review of fiber reinforced denture base resin. J Prosthodont 1996;5;270-276.
Vallittu PK. A review of methods used to reinforce polymethyl methacrylate resin. J Prosthodont 1995;4:183-187.
Books and Chapters in Books
Vallittu PK. Strength and interfacial adhesion of FRC-tooth system. In: Vallittu PK (ed.): The second international symposium on fibre reinforced plastics in dentistry. University of Turku, Institute of Dentistry, Turku, Finland. Paper 1.
Vallittu PK (Editor). The second international symposium on fibre reinforced plastics in dentistry. A scientific workshop on dental fibre-reinforced composites on 13 October 2001 in Nijmegen, the Netherlands. University of Turku, Institute of Dentistry & Biomaterials Research, Turku, 2002.
Vallittu PK, Könönen M. Chapter 4.1: Prosthodontic materials. Biomechanical aspects and materials properties. In: Karlsson S, Nilner K, Dahl B (editors): A textbook of fixed prosthodontics – The Scandinavian approach, Publishing House Gothia, Stockholm, 2000, pp. 116-130.
Vallittu PK. Experiences of using glass fibres with multiphase acrylic resin systems. Theoretical background and clinical examples. In: Vallittu PK (ed.): The first symposium on fibre reinforced plastics in dentistry. University of Turku & Biomaterials Project, Turku, 1999. Paper 2.
Vallittu PK (Editor). The first international symposium on fibre reinforced plastics in dentistry on 27-29 August 1998 in Turku, Finland. University of Turku & Biomaterials Project, Turku, 1999.
Vallittu PK. Factors contributing to the fracture of an acrylic resin based denture. A study to improve the mechanical properties of polymethylmethacrylate with continuous fibres. Kuopio University Publications B. Dental Sciences 6. 1994. 89 p.
Other FRC Related Articles
Kangasniemi I, Vallittu P, Meiers J, Dyer S., Rosentritt M. Consensus Statement on Fiber-Reinforces Polymers: Current Status, Future Directions, and How They Can Be Used to Enhance Dental Care. The International Journal of Prosthodontics 2003;16 (2):209.
Kallio, P, Moxom R. “Pre-impregnated glass-fibre reinforced splints and bridges in the occlusal therapy of periodontitis, part two”. Independent Dentistry, Restorative & Aesthetic Practice, vol. 4, no 3, April 2002.
Tanner J, Vallittu P. Juurikanavanastat ja niiden käyttöön liittyvät riskit. Suom Hammaslääkärilehti 2001;8(8):478-482.Kallio, P, Moxom R. “Pre-impregnated glass-fibre reinforced splints and bridges in the occlusal therapy of periodontitis, part one”. Independent Dentistry, Restorative & Aesthetic Practice, vol. 4, no 2: 73-79, March 2002.
Vallittu P, Lastumäki T. Muovit hammasprotetiikassa. Hammasteknikko, 1999;(3):4-10.Vallittu P. Kestävät paikat amalgaamin jälkeen. Hyvä Terveys 2001;9:52-54.
Sevelius C, Vallittu P, Sewón L. Parodontaalinen kiskotus kuitulujitteisella muovilla. Suom Hammaslääkärilehti 1999;6:726-729.
Vallittu P. Lasikuiturunkoinen silta kultasillan sijasta, tapausselostus. Suom Hammaslääkärilehti 1999;6:360-364.
Kallio T, Vallittu P. Kuitulujittenen muovi tuo protetiikkaan uusia mahdollisuuksia: Pitkäaikaisväliaikainen silta. Suomen Hammaslääkärilehti 1998;5(17):954-957.
Vallittu P. Preimpregnerade fibrer förstärker dentala kompositer. NIOM-info 1997;(3):1-2.
Vallittu P, Nohrström T. Kuitulujitteiset muovit hammaslääketieteessä. Osa II: Kliininen käyttö. Suomen Hammaslääkärilehti 1997;4:2012-2018.
Vallittu P. Kuitulujitteiset muovit hammaslääketieteessä. Osa I: Lujitetun muovin ominaisuudet. Suomen Hammaslääkärilehti 1997;4:844-848.
Vallittu P. Onko kuitulujitteisten proteesimuovien aika jo tullut? Hammasteknikko 1997;(2):12-15.
Vallittu PK. Fiber composite materials in prosthetic dentistry. International Union of Schools of Oral Health. Newsletter 1996;(10):21-23.
Vallittu P. Voinko vaikuttaa akryyliproteesin korjaussauman lujuuteen? Hammasteknikko 1995;(2):12-14.
Vallittu P. Kuitukomposiitti proteesimateriaaliksi. Hammasteknikko 1994;(3):4-6.
Vallittu P. Metallivahvikkeet akryyliproteeseissa. Hammasteknikko 1994;(2):4-7.
Vallittu P. Tutkimus polymetyylimetakrylaatin mekaanisten ominaisuuksien parantamisesta jatkuvilla kuiduilla. Suom Hammaslääkärilehti 1994;1(16):923.
Vallittu P. Lectio praecursoria: Hammasproteesin vaurioiutuminen – menetelmät proteesin vahvistamiseksi. Suom Hammaslääkärilehti 1994;1:1114-1117.
Vallittu P. Katsaus irroitettavien hammasproteesien vaurioitumiseen. Hammasteknikko 1993;(4):12-15.
Vallittu P. Levyproteesimateriaalin vahvistaminen. Suom Hammaslääkärilehtilehti 1990;37:1080-1084.