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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.
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’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.
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.
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.
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.
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.
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.
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.
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.
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.
Clinicians may sterilize the dispenser by autoclave (134 °C / 3 min.).
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.
No. NuSmile BioCem does not contain HEMA, Bis-GMA, BPA or BPA derivatives.
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.
NuSmile BioCem’s shelf-life is two years from manufacturing date. The expiration date is printed on the syringe.
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.
NuSmile BioCem should be stored in a cool-dry place. A typical air-conditioned space is adequate. Refrigeration is reccommended to ensure optimal product performance.
• Dispense a level scoop of Powder onto a glass slab.
• Dispense 1 drop of Gel.
• Using a medium flex spatula, pull half of the first drop into the Powder. Mix the Powder and Gel thoroughly with a spatula.
(Note: Always mix the Gel into the Powder, not the Powder into the Gel. Otherwise, the Powder can become too wet and waste may occur).
• Gradually add more Gel for desired consistency.
• If too dry, dispense another drop of gel, gradually add enough gel for desired consistency. If too wet, add more powder.
• If not using immediately, cover with dappen dish or damp cotton gauze to delay setting.(Once practiced, it takes less than 1 minute to mix to the desired consistency)
• Add a small amount of Powder (less than 1 scoop).
• Alternatively, spread out mixture to a thin layer on the glass slab to allow some drying. Then use the edge of a metal spatula to gather the material into a putty or other desired consistency.
• To prevent a sticky mixture, for future mixes use less Gel when mixing.
• Add ½ drop of Gel to gradually break up the matrix to achieve the desired consistency. This method works well before the mixture is set within the first ½ hour after mixing. Alternatively, cover the mixed MTA with a moist gauze “tent” or a dappen dish to avoid drying out.
• For a pulpotomy, liner, base or pulp cap apply a layer at least 1.5mm thick.
• For root apexification compact the NeoMTA product in the apical region to create a 3 to 5 mm apical barrier.
We recommend placing NeoMTA products with a plastics instrument, Hollenbach instrument, amalgam carrier, or an MTA carrier. The material can be gently spread with a moist cotton pellet, amalgam plugger, or ball burnisher.
Use any convenient instrument, to deliver a small cone or cylinder of NeoMTA product to the site. A Messing gun, amalgam carrier, Dovgan MTA carrier, or the MAP™ system may be used. Reversed paper points or gutta percha points can guide the putty in the root to the apex for apexification.
Working time at room temperature is about 14 minutes when mixed as a putty, and 21 minutes when mixed to a thinner consistency. The working time can be extended if needed by covering the mixed cement with a moist gauze “tent” or a dappen dish or by rehydrating the mixed material with more Gel.
• When the powder is mixed to a putty-like consistency using the gel, the resulting putty is immediately wash-out resistant.
• A thick mixture takes about 14 minutes to set within the tooth.
• A thinner, sealer-type mixture will set in about 1 hour 10 minutes.
It’s not required but a quick and easy method is to apply a layer of a flowable composite, light-cure glass ionomer, RMGI, IRM®, ZOE or any other restorative material over the NeoMTA product prior to the final tooth restoration. If you use a flowable composite that requires etching, etch the tooth, not the NeoMTA product, then proceed with the restoration.
Yes, you can complete the restoration or cement a crown immediately after placing the NeoMTA product. The NeoMTA product will harden/set underneath the restoration. The NeoMTA product is immediately wash-out resistant and dimensionally stable when placed with zero shrinkage and negligible expansion to ensure gap-free sealing.
• The products have a 3-year shelf life.
• Do not leave the Powder or Gel containers open. The Powder can absorb humidity, which reduces shelf life by increasing the set time and reducing the compressive strength. After expiration, the Gel may be too thin to be satisfactory.
No, this doesn’t help extend the shelf life, and the humidity of the refrigerator may cause the Powder to absorb more moisture and deteriorate.
Use alcohol or water for cleanup. If the MTA is completely set, soak the glass slab or instrument in vinegar or water until the cement softens.
Yes, NuSmile manufactures NeoPUTTY™, a premixed Root & Pulp bioactive bioceramic MTA paste packaged in a syringe.
• NuSmile does not manufacture a light-curing MTA. We prefer to maximize the concentration of bioactive powders in NuSmile products and deliver them in a formula that allows the bioactive powders to readily hydrate and form Ca(OH)2 for hydroxyapatite formation5 .
• Light-curable and dual-cure MTA products contain resins which dilute and inhibit the MTA’s bioactivity.
• Resins never cure 100%. Uncured resin leaves cytotoxic monomers in the MTA-resin matrix and in contact with the pulp.
• Resins shrink during curing; they are not dimensionally stable. NuSmile bioactive cements (MTAs) expand very slightly to ensure sealing.
5 Formosa L M, Mallia B, Camilleri J The chemical properties of light and chemical curing composite with mineral trioxide aggregate filler. Dent Mater. 2013 Feb;29(2):e11-9.
