Fuji Triage

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
New name – From Fuji VII to Fuji Triage
Fuji VII – why so popular amongst dentists
Nice handling, good flow
Moisture tolerant
Good clinical results
Especially used in the fissure protection indication where bonding or etching is not needed when using Fuji VII
However, more and more requests
For a white version
For powder to liquid packaging...

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage means more choice
Choice of
Pink or white shade
Mixing technique: hand mixed or encapsulated
Curing technique: light cure or chemical set - no difference in physical properties
Choice of
Specific clinical applications
Non invasive techniques
A true Minimum Intervention product

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage - Seals, protects and fortifies teeth
Application of a thin layer of glass ionomer to tooth surfaces at increased risk
To create a hardened tooth surface
To form a more acid-resistant ion exchange layer which acts as additional protection for the tooth
Стеклоиономерный цемент
Эмаль
Ионообменный слой
Dr H. Ngo
What is surface protection?

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage - Seals, protects and fortifies teeth
The perfect GIC for tooth surface protection
Flowable
Moisture tolerant
High Fluoride release
Acts as a protective coating once set
Prevents acid contact with tooth
Difficult for plaque to adhere to Fuji Triage
Dr. M Gryst
Dr. J Lucas

Fuji Triage
from GC.
Composition
Characteristics
Indications
Procedure
Packaging and pricing
Physical properties
Sales arguments

Fuji Triage
from GC.
1. Composition

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage – Composition
Conventional GIC in composition
Two components
H2O containing
No resin reinforcement

Fuji Triage
from GC.
2. Characteristics

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage – Characteristics
General features
Self curing conventional GIC
Easy to apply
No etching, no bonding
Chemical adhesion to tooth structure
No addition of resins
Moisture tolerant
Stable adhesion also when saliva control is not possible
Low viscosity
Easy to apply
Very high level of fluoride release
Protection

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
GC R&D
Fuji Triage – Characteristics
Fluoride release
Six times higher Fluoride release than packable GIC's

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage - Characteristics
Translucent pink shade
Optional Command set with VLC unit
For early protection against de-hydration
Visible control during recalls: diagnostic marker
Communication tool
White shade
For aesthetic demand / anterior protection
Dr G Milicich

Fuji Triage
from GC.
3. Indications

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fissures of newly erupted molars
Fuji Triage - Indications
Main indication

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage - Indications
Fissures of newly erupted molars
Two major intra-oral key factors for occurrence of cariogenic micro organisms
Stage of eruption / functional usage of teeth
Tooth specific anatomy

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Caries formation
Fuji Triage - Indications
Fissures of newly erupted molars
Erupting molars are more likely to develop caries due to very unfavourable intra oral conditions
No functional usage over a long period of time / no natural removal of plaque
Newly erupted molars have immature outer enamel and are consequently more vulnerable to acid attack
Difficulties to keep clean by brushing
This uncertain situation can last for molars between 1 to 1.5 years!
Protection is needed!
Newly erupted molar
Caries in newly erupted molar

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Eruption period
Caries can start
1. NO natural cleaning – NO functional contacts
2. Difficult to keep clean by brushing
3. Immature enamel
Molars 1 – 1.5 years
Difficult to diagnose
Seal hidden caries?
Moisture control?
Fuji Triage - Indications
Possible reasons for failure of sealants

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Prevention of caries
Fuji Triage - Indications
A new approach for fissure protection

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Molar at risk
End result
Fuji Triage - Indications
Fissure protection

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Dentine hypersensitivity
Fuji Triage - Indications
Additional indications: more and more users

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage - Indications
Dentine hypersensitivity
Offering instant long-lasting relief
6 months
12 months
Fuji Triage is still in place

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage - Indications
Temporary restoration of endodontic access - key to success
Coronal leakage is an important cause of root canal treatment failure (Bobotis, 1989)
48.6 % periradicular inflamation when poor temporary restoration versus “only” 30.2 % periradicular inflamation when poor endodontics (Ray and Trope, 1995)
“Glass ionomer and resin-modified glass ionomer restorative materal provide a better coronal seal against Streptococcus Mutans than Zinc oxide / eugenol” (Seiler, 2006)

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage – Indications
Intermediate restoration to stabilise caries
Sealing caries at the preliminary stage before making a decision on next course of treatment
For use on all tooth surfaces to provide a seal to halt the progress of caries
Special application in situations of rampant caries or caries in xerostomia patients
Particularly useful for elderly, caries prone and dental phobic patients
Use slow handpiece or hand instrument and
leave 2 mm clean margins at the periphery

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage – Indications
Protection of exposed root surfaces
Protects older patients more at risk for developing root surface caries
reduced saliva flow
diminished buffering and poor remineralisation capacities
Dr. H. Ngo
Application of thin layer of glass ionomer

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage - Indications
Triage definition
“A process for sorting injured people into groups based on their need for or likely benefit from immediate medical treatment. Triage is used in hospital emergency rooms, on battlefields, and at disaster sites when limited medical resources must be allocated.”

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage – Summary of indications
For emergency situations
Immature enamel – newly erupted molars
Protection when it is most needed
Dentine hypersensitivity
Good immediate remmedy to relieve pain
Access cavity restorations in endodontics
Better sealing for succesful endodontic treatments
Temporary sealing of open cavities – intermediate restoration
Maintain tooth structure when prognosis is uncertain – gain time
Stabilisation material: create a mineralising seal, e.g. after use of Heal Ozone

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage - Summary of indications
For emergency situations

Fuji Triage
from GC.
4. Procedure

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage - Procedure
Procedure
Clean with pumice
Apply Dentin or Cavity Conditioner

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage - Procedure
Procedure
Application
Distribute with instrument or brush
Apply Fuji COAT LC or Fuji Varnish
Optional lightcuring

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji triage – Procedure
Procedure

Fuji Triage
from GC.
5.Packaging and pricing

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage - Packaging and pricing
Fuji Triage Capsules
50 Capules
(mixed volume per capsule 0.13 ml)
Fuji Triage P/L
15 g powder
10 g (8 ml) liquid
6 g (5.7 ml) Dentin Conditioner
powder scoop
mixing pad

Fuji Triage
from GC.
6. Physical properties
0
100
200
300
400
500
600
700
800
900
0
5
10
15
20
25
30
Time (day)
Fluoride release (
μ
g / cm.2)
Fuji Triage CAPSULE & P/L

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage - Physical properties (1)
GC R&D

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
*Without conditioner
Fuji Triage - Physical properties (2)
GC R&D

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage – Physical Properties
Working and setting times in min.
GC R&D

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage – Physical Properties
Compressive strength in MPa
GC R&D

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Without conditioner
Fuji Triage - Physical Properties
Adhesive strength in MPa
GC R&D

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage – Physical Properties
Surface hardness Hv
GC R&D

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage – Physical Properties
Fluoride release in µg / cm2
GC R&D

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
IADR,San Diego,2002
Fuji Triage – Physical Properties
Antibacterial effect

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Hien Ngo, April 2002
Fuji Triage – Physical Properties
Antibacterial effect

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
GC R&D
Fuji Triage - No light irradiation
Fuji Triage - With light irradiation
Fuji IX GP Fast
1’ 2’ 3’ 4’
Fuji Triage – Physical Properties
Water sensitivity

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage – References
Available literature references: 23

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Fuji Triage - Simplicity itself
Easy to mix
Easy to place
Easy to finish
Easy to identify

Fuji Triage
from GC.
7. Sales arguments

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Sales argument - 1
Q: “Which product do you use for fissure sealing the partially erupted tooth in a high caries risk child?”
In most the dentist will answer: NOTHING!
… or wait for the tooth to erupt because the dentist knows that a composite sealant cannot be placed before that, as there is a risk of recurrent caries or loss of retention due to moisture sensitivity

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Sales argument – 1 - Answer
A: Fuji Triage is the answer!!
Use the Geoff Knight article “The fissure Seal Time Bomb” (ref #1) to explain that Fuji Triage is the only material that
Can be used on immature enamel
Needs minimal isolation
Does not affect the occlusion when the molar erupts
Can bond reliable eve, when parts of the molar is covered by the hyperculum
Deposits fluoride to form fluor apatite making the tooth more acid resistant and will prevent plaque accumulation
Suggest that the dentist can use
The pink shade for partially erupted teeth (i.e. good colour to monitor the wear/indicates temporary status) and
The white shade for post-eruption (better colour for more permanent fillings)
Fuji Triage is the perfect material to “Protect" the teeth.

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Sales argument – 2
Q: How do you restore lingual root cavities in ageing dentitions?
Difficulties to permanently restore these cavities with composite/compomers
Cavities are near the saliva glands, so difficult to isolate from moisture
If too much of the caries is removed and the pulp is exposed the dentist sometimes can end up doing endodontic treatment
A: to avoid these problems, Fuji Triage can be used as a temporary plaster to “Seal & Heal”
Procedure
Soft caries is removed
Fuji Triage is placed onto moist semi-hard dentine
Protected with Fuji Coat LC
Left in place for up to 6 months whilst
Tooth heals underneath
Composite/Fuji IX can then be placed on a healed tooth surface for better aesthetics

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Sales argument - 3
Q: How do you desensitise Hypoplastic /(Wisdom) Teeth?
Few materials stick to the hypoplastic tooth with a sticky dentine coating
Problem for dentists to treat with resins
A: Fuji Triage works brilliantly as a protective desensitising coating,
can seal the dentine and prevent further demineralisation
also works well for partially erupted sensitive wisdom teeth
The “Protect & Seal” message works well in this case.

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Sales argument – 4
Endodontic sealing
Many endodontists have turned to GICs to seal access cavities after root canal treatment
GICs give a much better seal due to the chemical bond to tooth structure
Many of them require a material that is not tooth coloured so that they can identify it
Good endodontic filling with poor coronal restoration
Good endodontic filling with good coronal restoration

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Sales argument – 5,6,7......
There are many more uses for Fuji Triage such as
Temporary filling material- pink, to make sure the patient returns for their permanent filling!
Lining when near the pulp in e.g. a child’s tooth etc.
Sealing cavities after treatment with Ozone/Photo Activated Disinfection (PAD) Dentists have been recommended to use Fuji Triage by Kavo and Denfotex

GC Fuji Triage, ppt Master GB, version 1.0, 09/2006
Sales argument - summary
1sts questions
“Do you treat lots of children/elderly patients?”
“Do you do much fissure sealing?”
Then choose the best argument
Possibility to use a plastic model to demonstrate
How the Fuji Triage flows into the fissures
How the dentist can use one capsule to protect 3-4 fissures at once
If the dentists/hygienists find that it sets too quickly for them,
Store Fuji Triage somewhere cold to increase the working time