Can Icon be used preventively?
Healthy, non-demineralized enamel cannot absorb the infiltrant. However, it can block the progression of an early caries to prevent the need for drilling and filling.
How far can the caries have progressed to still allow for a treatment with Icon?
Up to the first third of the dentin (D1).
Can Icon be used in children? At what age?
Caries infiltration is successful even with deciduous teeth and as young as 3 years of age. In general, the safety recommendations in the instructions for use are to be carefully observed and cooperation of the child to undergo a dental treatment is required.
For which type of caries can Icon be used?
For non-cavitated enamel caries and dentin caries that has not progressed beyond the first third of the dentin.
Can Icon be used in subgingival areas?
No. Icon is used in the enamel, and on the dental neck there is only a very thin enamel layer, if at all.
Can Icon be used in patients with hypomineralization?
No, because the porous system is different from that of carious demineralization and therefore the result would not be optimal.
Should Icon be used as preventive measure?
No, the infiltration method only works for carious enamel lesions with pore volume.
How many teeth can be treated with one Patient Pack?
Smooth surface 4-8, proximal 2
How many applicators does a Patient Pack contain?
How many Patient Packs are in one Package/Cube?
How many Patient Packs does the Starter Kit/Mini-Kit contain?
What are the diagnostic methods to detect infiltratable lesions?
Visually: using the eye, Radiography: bitewing radiographs, or tactile: with a probe
How should the tooth be cleaned after etching and infiltration?
Remove excess when withdrawing the applicator and then clean thoroughly with the air-blowing and suction device. For smooth surface applications cotton rolls are recommended. Before light-curing be sure to clean the interdental spaces (proximal and smooth surface) with dental floss. We recommend Superfloss.
Can the infiltrant be wiped out of the lesion when removing excess material?
No. Once the infiltrant has penetrated the capillary system it cannot be removed with dental floss or cotton rolls (smooth surfaces).
Fluoridation before or after an Icon treatment?
Afterwards only, especially on smooth surfaces since the entire tooth front was etched.
Which product is used for cleaning the tooth?
For the initial cleaning of the tooth the dentist can use the usual prophylaxis pastes.
How long does a treatment generally take?
The actual infiltration treatment includes the following steps:
- Etching for 2 minutes (maybe longer when etching smooth surfaces), rinsing for 30 seconds
- Rinsing with ethanol for 30 seconds, air drying
- First infiltration step for 3 minutes, excess removal, light-curing for 40 seconds
- Second infiltration step for 1 minute, excess removal, light-curing for 40 seconds
About 15 minutes excluding rubber dam placement
What are the bonding properties of Icon?
By etching with HCl gel we achieve a bond strength of about 20 MPa on enamel.
Is Icon visible on x-rays?
No, the infiltrant is not radiopaque. Therefore, the documentation in the patient card is very important.
How should Icon be stored?
At room temperature up to 25°C. In case of higher ambient temperatures it is recommended to store Icon in the refrigerator.
How is a treatment with Icon to be followed up?
Check up after 1 – 2 years with a new bitewing radiograph. If the lesion remains unchanged there is no need for further treatment. If the caries progressed a filling restoration should be considered depending on the indication. A follow up appointment should be scheduled one year after the treatment at the earliest, if necessary earlier for risk patients (poor oral hygiene).
Can one be sure that caries treated with Icon will not progress?
Clinical studies revealed that caries treated with Icon will not progress for at least 18 months. These clinical studies are extended and monitored for an additional 5 years.
What if a filling needs to be placed at a later date?
The infiltrant can easily be removed with a drill.
Will the infiltrant change color after a period of time?
A Suntest showed that the infiltrant is color-stable both as cured pigment and as infiltrated lesion. In vitro studies with coffee and red wine revealed similar discolorations as with composite fillings. A clinical study on color stability (Cleveland) is currently in progress. Results are expected to be available in October 09.
Can a Icon-treated tooth be bleached or whitened following treatment?
Yes. Wait a minimum of 2 weeks before bleaching or whitening, after treatment.
Which check-up interval is recommended for proximal lesions?
The check-up interval is determined by the attending dentist and depends on the individual caries risk of the patient. Please observe general radiation protection guidelines.
How important is to use a rubber dam?
We strongly recommend the use of a rubber dam since the area to be infiltrated must be kept absolutely dry for successful treatment (similar to a composite filling). Therefore, the drying step with ethanol is also very important. If the dentist can ensure to keep the area dry even without the use of a rubber dam it is at his/her discretion.
Which rubber dam can be used for an Icon treatment?
The following rubber dam systems have been tested at DMG and work well with Icon:
- Optradam (Ivoclar Vivadent): “Rubber dam without metal clips.”
- Opal-Dam (Ultradent): can suffice when treating labial smooth surfaces.Hygienic “Dental Dam Latex” Heavy and Medium
- Roeko “Dental Dam Silicone non-latex”
- Ivoclar Vivadent “Optra Dam” and “Optra Dam Plus”
- Sigma Dental Systems “Isodam non-latex”
- Sigma Dental Systems “Ivory Rubber Dam”
- Dental dam by Crosstex, non-latex
- Zirc Company “Latex Free Insti-Dam”
- Aseptico “Handi Dam – LF”
TRY ME! DMG’s MiniDam provides fast protection where it’s needed. It is fast and easy to use, and protects the interdental space being treated.
How much enamel is etched away with the HCl gel?
The two-minute etching process removes an enamel layer of 40 µm. (Please note that healthy enamel has a thickness of 1,000 – 1,500 µm.)
How do I know when I’ve etched enough?
The etched enamel should have a chalky white appearance. Once you have etched, apply Icon-Dry to see a preview of the final result. If the discolored lesion is no longer present, the etching step is complete. If the discolored lesion remains, the etching step should be repeated. You may repeat the etching step up to two more times after the first etch. If the lesion remains discolored after three total rounds of etching, contact your local DMG representative for further instruction. The etched surface must not be touched or contaminated with saliva until the treatment resumes.
Is the etching process with HCl gel painful?
No, the application of HCl gel on sufficiently thick enamel is not painful.
What happens if the HCl gel comes in contact with the gums?
Gum areas that come in contact with the HCl gel will turn white but will return to their natural color after about 2 weeks. Since a rubber dam is used for this treatment step though, contact should not occur.
Will brownish discolorations of so-called white spots disappear, too?
Yes, as long as they are in the pseudo-intact surface layer. The removal of the pseudo-intact surface layer also removes the discolorations embedded therein. In case of insufficient removal the etching step can be repeated locally.
Why is drying of the teeth required?
Drying of the teeth to be treated reveals if the etching process was successful, especially when treating smooth surfaces, and facilitates successful penetration of the infiltrant into the lesion body.
Can the infiltrant also penetrate into the dentin?
No. Due to the permanent moisture in the dentinal tubule Icon cannot infiltrate the dentin. dentin is organic and hydrophilic, the infiltrant is hydrophobic. Therefore, the infiltrant cannot penetrate into the dentin.
Can the infiltrant also be used for dentin caries?
Yes, it can be used for lesions up to the first third of the dentin. Due to the permanent moisture in the dentinal tubule, Icon cannot infiltrate the dentin. Dentin is organic and hydrophilic and the Icon Infiltrant is hydrophobic. Therefore, it cannot penetrate into the dentin.
How many turns add up to the content of an Icon-Infiltrant syringe?
0.45ml = 5.5 rotations: approximal: 1.4 rotations per tooth x 2 teeth x 2 applications. Vestibular (3 smooth surfaces) = 0.92 rotations x 3 teeth x 2 applications
How much material should be dispensed for one lesion to be treated?
One to two turns of the rotary plunger are recommended so that there is slight excess.
Can the Icon-Infiltrant run over during the application?
If too much material is dispensed, the Icon-Infiltrant will run over. It is recommended to use a dental mirror during the application. Minimal excess on the surface is recommended.
Will the infiltrant shrink, and, if yes, to what extent?
There is shrinkage, but due to the ratio of free to bonded surface (C factor) it has no negative impact. In order to compensate for the shrinkage during polymerization the application of Icon is repeated (for 1 minute) to fill any voids.
Is Icon visible under black light?
Areas treated with Icon are not visible under black light (only the dentin is fluorescent which is treated only to a small extent, if at all. Enamel is not fluorescent).
Is Icon-Infiltrant compatible with composite fillings?
The infiltrant is readily compatible with composites since it is also a monomer/composite material.
What is the difference between sealing and the infiltration method?
A sealant is applied as a surface layer onto the enamel surface. This is done mostly on occlusal surfaces (fissure sealing). Fissure sealing is generally used preventively (exception: extended fissure sealing).
Icon penetrates into the enamel, seals the lesion from the inside and does not create a filling margin or a layer on the surface. The infiltration fills an existing pore volume and is thus not preventive.
How is Icon dosed?
The wedge in the rotary disk of the plunger shaft helps with the dosing: Generally, 1.5-2 rotations of the plunger shaft are enough to dispense sufficient material. Working with a slight excess is recommended.
Should the proximal applicator remain on the tooth during the application time?
Yes, during the infiltration step the proximal applicator serves as a reservoir for Icon-Infiltrant; if needed, more material can be applied (visual check). For proximal treatments the applicator must remain on the tooth during the application time of the HCl gel and the infiltrant in order to protect the adjacent tooth from contamination with both substances.
Can several teeth be treated with the same Proximal applicator?
Due to the infiltrant’s high light sensitivity (hardened material residue can remain) reuse of a Proximal applicator is not recommended with Icon-Infiltrant. Each Patient Pack contains an ample amount of Proximal applicators.
How thick is the tear-resistant applicator tip?
Smooth Surface Tip/Smooth Surface Applicator
Can several teeth be treated with the same Smooth Surface Tip?
Yes, when treating adjacent smooth surfaces per work step several lesions can be treated at the same time with the same applicator.
Can several teeth be treated with the same Smooth Surface Tip?
Most patients describe the separation of the teeth with dental wedges as light pressure between the teeth. For very sensitive patients a light surface anesthesia of the gingiva can be recommended. In case of anatomical crowding or restriction the use of properly carved wooden wedges is possible.
What kinds of lamps are used to light-cure Icon-Infiltrant?
LED or halogen lamps with the usual output.