NuSmile BioCem Technical Support
How do you mix the two NuSmile BioCem components; is a special mixing apparatus required?
All NuSmile BioCem kits come with single-use of low-waste automix tips (25 for a 5mL syringe kit and 15 for a 2.5mL syringe kit). Additional automix tips can be purchased separately. Using automix tips is the most efficient, effective and accurate way to mix. There is also a cannula style tip available for purchase.
When would I use the cannula tip versus using the regular tip supplied in the kit?
The cannula tip is designed for pinpoint placement of NuSmile BioCem when in cementing space maintainers and similar orthodontic appliances, and for getting into tight spots (such as filling lower incisor pediatric crowns). The tip supplied in the kit can be used for all applications but is especially useful for bulk filling of preformed pediatric crowns.
How many crowns can I load with cement before I need to change the automix tip?
If working on multiple restorations in a single sitting, a single automix tip can be used to load multiple crowns if done all at the same time. Note, however, that all the crowns must then be seated within 60 seconds, so typically it’s advisable to load only a few crowns (2-4) with cement at any given time.
It was hard for me to get the automix tip onto the syringe. Is the syringe or the automix tip defective?
It’s not likely. There is a small v-shaped groove on the side of the syringe and also on the side of the automix tip. This is an alignment marker. Line up the two v-shaped grooves, then press the automix tip down to the base of the syringe (this should press down easily), and finally twist the automix tip collar to lock the tip onto the syringe.
Can I reuse the cap that came on the end of the syringe?
Yes. You should save the cap and reuse it every time. There is a small v-shaped groove on the side of the syringe and also on the side of the cap. This is an alignment marker. Line up the two v-shaped grooves, then press the cap down to the base of the syringe, then twist the cap to lock the cap onto the syringe.
What should I do if I lose the cap for the NuSmile BioCem syringe?
If you lose the cap you can simply leave the automix tip on the syringe. The cement will cure in the tip and form a seal to preserve the cement in the syringe.
Do I need to treat the tooth with an etchant (acid etch) or a primer/bonding agent as part of the tooth preparation before cementing the crown to the tooth?
Not typically. NuSmile BioCem will bond to the tooth directly, no etching or priming is required. If the prepared tooth is severely tapered (>15°) or very short (<4mm) it may be advisable to create mechanical undercuts or horizontal grooves in the prepared tooth prior to cementing to provide more surface area and some mechanical retention. If there is very little tooth structure left, using an acid etchant and bonding agent on the tooth prior to cementation may achieve a better bond to the tooth.
Do I need to treat the crown with an etchant (acid etch) or a primer/bonding agent as part of the tooth preparation before cementing the crown to the tooth?
No. NuSmile BioCem will bond to stainless steel, pre-veneered stainless steel and zirconia crowns directly, no etching or priming is required. However, with zirconia crowns, studies have shown that it is extremely important to avoid saliva and/or blood contamination of the intaglio surface of the crown.
Is NuSmile BioCem a self-curing (self-set) cement or is it a light-cure cement?
NuSmile BioCem is a dual-cure cement, meaning it has both a self-curing mechanism and a light-curing mechanism. The cement will set using the self-curing mechanism only (no light cure), but cementation is accelerated with the use of a curing light. This makes NuSmile BioCem the optimal cement for use in cementing either stainless steel, pre-veneered stainless steel or zirconia crowns.
What makes NuSmile BioCem a bioactive cement?
It’s "CemBiotic™", meaning NuSmile BioCem releases beneficial ionic species (phosphate, calcium and fluoride), while also forming hydroxyapatite available to integrate with and replenish tooth structure. It’s also biocompatible, containing no HEMA, BIS-GMA, BPA or BPA derivatives.
How long does it take NuSmile BioCem cement to set once it is dispensed?
Self-set cure time (self-curing) is 2-3 minutes depending on moisture conditions and temperature in the mouth. Light cure through zirconia is 40 seconds or less depending on the thickness of the cement between the crown and the tooth (20 seconds on both buccal and occlusal of the crown). NuSmile ZR crowns ultra-thin walls allow for maximum light cure. Maximum curing light penetration to initiate light cure is 4mm.
Does the tooth need to be completely dried prior to cementing the crown? Should the tooth be desiccated?
No, the tooth should NOT be desiccated. NuSmile BioCem is a hydrophilic (moisture loving) cement. The tooth should be dry but not chalky in appearance. There should be no pooling of water, saliva or blood. Removing excess/pooled moisture from the tooth with a cotton pellet and then drying with compressed air is sufficient. An overly wet tooth surface will result in decreased bond strength.
Can I use hemostatic control agents on the tissue prior to using the cement? Will it affect the cement’s ability to bond to the tooth?
Pressure, tissue infiltration or a hemostatic agent may be used to control gingival bleeding prior to cementation. The most commonly used agents, however, are peroxide based, and can interfere with the cement-to-tooth bond. If a hemostatic agent is used, thoroughly rinse with water to remove excess hemostatic agent, then dry before cementing the crown.
How can I sterilize the NuSmile BioCem 5mL Dispenser?
Clinicians may sterilize the dispenser by autoclave (134 °C / 3 min.).
Are there any special precautions or procedures needed if I use a eugenol based material on or in the tooth prior to cementation of a crown? Is the cement compatible with eugenol?
NuSmile BioCem is NOT compatible with eugenol. If pulpal therapy has been performed and a eugenol based material placed, cover the eugenol based material with a pure glass ionomer before cementation.
Does NuSmile BioCem contain HEMA, Bis-GMA, BPA or BPA derivatives?
No. NuSmile BioCem does not contain HEMA, Bis-GMA, BPA or BPA derivatives.
Can I use the crown to test the fit to the tooth before cementation?
Yes, for stainless steel and pre-veneered (NuSmile Signature) crowns you would use the crown to test the fit. If the crown is contaminated with blood or saliva it should be simply water rinsed and air dried before cementation. For zirconia (NuSmile ZR) crowns scientific studies have shown that it is very important that saliva or blood does not contaminate the internal surface of the crown. For this reason, it is recommended to use NuSmile Try-In crowns during trial fitting to avoid saliva or blood contamination of the actual NuSmile ZR crown being used. The NuSmile Try-In crowns are precision manufactured to be identical in size and shape to NuSmile ZR crowns and can be used and then autoclaved for reuse. If using zirconia crowns where Try-In crowns are not available, such that contamination of the internal zirconia surface does occur, one of two processes should be undertaken; either clean the inner surface of crown with Ivoclean according to manufacturer’s instructions prior to cementation (Mfgr: Ivoclar Vivadent; www.ivoclarvivadent.com), or sandblast the inside of the crown with pure aluminum oxide.
Can I use NuSmile BioCem to cement stainless steel, pre-veneered stainless steel and zirconia crowns to amalgam or composite, or to a RMGI or GI encapsulated tooth?
Yes. If cementing to amalgam, composite, RMGI or GI, clean, mechanically roughen and rinse. Make sure these surfaces are completely dry.
What is the shelf-life of the NuSmile BioCem?
NuSmile BioCem’s shelf-life is two years. The expiration date is printed on the syringe.
Can I reuse the automix tips?
No. Automix tips are not reusable. The cement will start to self-set in the automix tip within 60 seconds and should be discarded after each use.
Is there a dispenser available for NuSmile BioCem and is it required?
There is a dispenser available for the 5mL syringe, which is helpful in preventing hand fatigue when the dentist is seating a large number of crowns in one sitting or day. Some clinicians feel it allows them to easily and accurately control dispensing of the cement. The dispenser is recommended when using the cannula tips. There is no other special mixing equipment needed.
How do I store NuSmile BioCem?
NuSmile BioCem should be stored in a cool-dry place. A typical air-conditioned space is adequate. Refrigeration is not required but you can refrigerate, which may extend the shelf life of the cement.