everStick® Clinical Guide

www.sticktech.com everStick®NET everStick®PERIO

everStick® fibre
reinforcements for
splinting
• periodontal splints
• splinting of traumatised teeth
www.sticktech.com everStick®NET everStick®PERIO

everStick® fibre reinforcements for periodontally

compromised patients and for traumatised teeth

Traditional methods are considered expensive or time- When splinting traumatized teeth, reliability, aesthetics and
consuming, leaving patient comfort in second place. As for patient comfort are the decisive factors. The extremely thin
fibres available, considerable differences exist between and aesthetic everStickNET is the optimal choice for labial
them. Pre-impregnated everStick glass fibre splints are splints in trauma cases.
gaining more and more popularity due to their minimal
invasiveness, reliable bonding, optimised handling Depending on the trauma case, you can easily choose
properties and aesthetics. They offer a dynamic and cost between a rigid or a more flexible splint. If the splint is
effective alternative for stabilizing and replacing teeth. bonded interdentally you will get a more rigid splint, which
is the case for example when the root is fractured. When the
Periodontal splinting with everStickPERIO can be success­fully splint is no longer needed it can be easily removed.
used as a part of periodontal treatment. It has been shown that
teeth with healthy, but severely reduced ­periodontium can be
maintained with the aid of splints or fixed bridges.

The ideal splint

• supports teeth effectively • is comfortable for the patient
• has superior durability • can be designed to be
(excellent bonding, fatigue self-cleansing
and flexural strength) • does not interfere with
• is aesthetically pleasing masticatory function
• is minimally invasive • is easy to remove when
• does not cause torsional necessary
stresses or act as an unintended
orthodontic appliance

Unique product characteristics together with extensive research

background and long clinical experience ensure that everStickPERIO
and everStickNET are unparalleled in creating strong and
functionally reliable splinting solutions. Labial splint in place

02
www.sticktech.com everStick®NET everStick®PERIO

Liberate
smiles!
Improve quality of life
You can immobilize periodontally
compromised teeth effectively.
Because of this fixed solution, the
patient can eat and smile without
difficulties. Quality of life improves
considerably.

Quick and easy

Compared to many other fibres, the
everStick fibre reinforcements are
easy to handle and position, because
there is no fraying of fibres. Just fol-
low the simple placement steps.
Indications
Change of treatment plan
• Surface-retained or intra-coronal splinting (everStickPERIO)
• Combined periodontal splints and surface-retained
– no problem!
bridges (everStickPERIO) Splints can be re-activated and are
• Periodontal and post trauma labial splinting (everStickNET) easy to remodel or repair. If the
splint needs to be extended or if
an extracted tooth needs to be re-
Properties placed, there is no need to remove
the whole splint. Instead, due to the
everStickPERIO and everStickNET fibre reinforcements are a combination unique IPN structure the splint can
of glass fibres and a polymer-resin gel matrix. The matrix holds the be remodelled.
individual glass fibres in a bundle and makes it flexible. This makes the
handling and use of everStick fibres comfortable and fast. 2 in 1 – only in everStick®
fibre re­inforcements
everStickPERIO everStickNET The patented IPN structure ensures
both an excellent micromechanical
Form: Unidirectional fibre bundle Bi-directional fibre mesh and a chemical bonding to composites.
Size: Effective diameter of ~­ 1.2 mm Thickness ~ 0,06 mm
Create happy smiles
Fibre type: E-glass fibre impregnated E-glass fibre impregnated
with PMMA with PMMA everStickPERIO and everStickNET
splints are totally metal free. Being
Amount of ~ 2000 individual glass Not applicable
transparent, high aesthetics is easy
fibres: fibres in one bundle
to achieve with them.

The splint the patient

can forget
everStick fibre reinforcements can be
flattened to create thin splints with
smooth surfaces. This results in high
patient acceptance because splint is
easy to clean and very comfortable
to wear.

03
 www.sticktech.com Instructions for use – everStick®PERIO

1. 2. 3. 4.

5. 6. 7. 8.

How to make a fibre reinforced, surface-retained

splint with everStick®PERIO

1. Measure and cut the fibre 4. Bond the tooth surfaces light-curer away from the uncured fibre
bundle. Press the fibre into the approximal
Measure the length of fibre needed by using, Use the adhesive bonding technique for areas as well. Make sure that the interden-
for example, a periodontal probe or dental bonding teeth according to the instructions tal spaces are not blocked with fibre and
floss. Cut the appropriate amount of the of the bonding agent manufacturer. Apply composite.
everStickPERIO fibre with the silicone bed the bonding agent to the entire area to be
using sharp scissors. bonded. Light-cure the bonding agent as 8. Cover and finish the splint
described by the manufacturer.
2. Clean the teeth After pre-curing, cover the entire fibre splint
5. Apply flowable composite with a thin layer of composite. Note that in
The entire length of the fibre splint must be surface-retained areas the fibre bundle can
bonded to tooth surfaces. Clean the tooth Apply a continuous thin layer of flowable be coated with a thin layer (0.5 mm) of flow-
surfaces and approximal areas with a paste of composite (for example, StickFLOW) on the able composite. Then light cure the whole
pumice and water, rinse and air-dry the area. teeth including the approximal areas. Leave retainer for 40 seconds, one tooth or coverage
Place wedges in the interdental spaces as enough space for cleaning the interdental area of the light-curer at a time. Be careful not
necessary, so that the spaces to be cleaned spaces. Do not cure the composite during this to cut the fibre when finishing/polishing the
are not filled with composite. If you are phase. splint.
working without wedges, be careful not to
block these spaces with composite. 6–7. Position and light-cure Intra-coronal periodontal splint-
the fibre ing of anterior and posterior
3. Etch the tooth surfaces teeth
Place the fibre bundle on top of the uncured
In the area of the splint etch the tooth flowable composite. Aim to place the fibre The steps for the intra-coronal splint are the
surfaces and approximal areas thoroughly as incisally as possible in the anterior area. same as for the surface retained splint except
with ortho-phosphoric acid. Preferably etch Make sure that it will not be in occlusion. for that a masial-to-distal groove is prepared
a slightly wider area than necessary rather in the teeth to be splinted.
than too little. The recommended enamel Position one end of the fibre bundle first
etching time for surface-retained areas is 45 by pressing it down with the StickSTEPPER
to 60 seconds. Rinse with water and air-dry instrument. Pre-cure the fibre in place, one
the tooth surfaces after etching. As with all tooth at a time, for about five seconds, using
bonded restorations, a dry operating field is a curing light. The wide-tipped StickSTEPPER
absolutely necessary. A rubber dam isolation instrument shields the rest of the fibre from
is highly recommended. light. As the fibre is made of light-conduct-
ing material, it is recommended to direct the

Clinical tips: • Keep the fibre protected from light • While curing tooth-by-tooth, direct
to avoid premature curing the light away from the rest of the
fibre and cover the remaining
• Adapt the fibre close to the
uncured fibre with StickSTEPPER
incisal edge to achieve maximum
strength

04
 www.sticktech.com Instructions for use – everStick®NET

1. 2. 3. 4.

5. 6. 7. 8.

How to make a surface retained labial splinting

with everStick®NET

everStickNET is recommended for surface-retained areas is 45 to 60 seconds. StickSTEPPER instrument. Protect the rest of
use in the following applications: Rinse with water and air-dry the tooth surfaces the fibre strip with a wide StickSTEPPER instru-
carefully after etching. Keep the working area ment, so that light does not cure it prema-
• Labial periodontal splinting dry until the fibre splint is entirely covered with turely, light-cure the other end of the fibre for 5
• Labial splinting of traumatized teeth composite and has been light-cured. to 10 seconds. Press the rest of the fibre tightly
• Veneer repairs
onto the tooth (including the approximal
4. Bonding areas), and continue light-curing the rest of the
1. Measuring and cutting fibre one tooth at a time.
Use the composite bonding technique for bond-
the fibre ing the teeth according to the instructions of Apply a thin layer of light-curing resin (for
For the splint measure and cut 2 to 3 strips of the bonding-agent’s manufacturer. Apply the
example, StickRESIN) on top of the cured fibre
everStickNET fibre with suitable length and bonding agent to the entire area to be bonded.
strip. Then place the second fibre layer on top
width. everStickNET is easier to cut before the Spot bonding will not create a sufficient bond
for a permanent fibre splint. The splint must of the first one, and light-cure just as with the
protective papers are removed. The fibre strips
be bonded to the teeth for its entire length, first fibre strip. Repeat the procedure with a
must be cut so that the bottom strip is the
largest and each of the layers to be placed on including the approximal areas. Light-cure the third fibre, if necessary.
top of the first strip is slightly smaller than the bonding agent as described by the
previous one. This will ensure that the marginal manufacturer. 7–8. Finishing
areas of the splint are not formed too steep.
Shield the strips of fibre from light by placing 5. Applying flowable composite After the initial light-curing, cover the entire
them under a cover during the preparation of everStickNET fibre splint with a thin layer of
the teeth to be splinted. Apply a thin layer of flowable composite (for flowable composite (for example, StickFLOW).
example StickFLOW) to the surface of the teeth. Light-cure the entire fibre and composite unit
2. Cleaning the teeth Cover the bonding area carefully, including the for 40 seconds on each tooth. If necessary,
approximal areas, but leave
finish and polish the splint. Be careful not to
The fibre splint must be bonded to the teeth sufficient cleaning spaces. Do not light-cure
cut the fibres when finishing.
over an adequately wide area. Clean the area the composite at this stage.
to be bonded using a pumice and water mix, If needed, the splint can be removed by drilling.
rinse with water and air-dry the area. 6. Positioning the fibres
Position the everStickNET fibre strips on top Splinting traumatized teeth with
3. Etching everStickNET
of the teeth in layers one fibre strip at a time.
Etch the tooth surfaces and approximal areas Remove the white protective papers from both
with care, using ortho-phosphoric acid over sides of the fibre, and hold the fibre with twee- Prepare like a surface-retained splint, but do
the entire proposed area of the splint and zers. Place the first fibre on top of the uncured not bond the fibre splint in the interproximal
overlying composite layer, according to the flowable composite. Press the other end or areas. This will allow you to make a more
bonding agent manufacturer’s instructions. the entire fibre strip onto the tooth using a flexible splint that is easier to remove. Use
The recommended enamel etching time for StickREFIX D silicone instrument or a three layers of everStickNET.

• The fibres must always be covered • A small brush can be used to with composite or a support made
entirely with composite. apply a thin layer of flowable com- of putty impression material.
posite to cover the fibre.
• Use a rubber dam to keep the • To achieve a more flexible splinting
working area dry. • During the procedure you can immo- of traumatized teeth, do not bond
bilize the teeth labially or lingually the fibre in the interproximal areas.
 www.sticktech.com Case report everStick®PERIO

1. 2. 3. 4.

5. 6. 7. 8.

By courtesy of
Tiina Varrela, DDS, MSc, PhD, Specialist in Clinical Dentistry and Periodontology

A surface retained glass fibre

reinforced periodontal splint
1. An orthopantomograph from 1998. The patient was a 69-year old female.
She had several fillings on her teeth and many of her teeth had been
extracted due to ­periodontitis or caries. The patient also had an upper partial
denture. She was aware of the impaired condition of her periodontium and she
had previously been advised to turn to a periodontist in order to have periodontal
surgery. Because of the financial situation of the patient, the chosen solution was
to build a provisional surface retained periodontal splint using everStick fibre.

2–3. About two years ago, the patient’s lower anterior teeth, from 33 to
43, were splinted using a polyethylene fibre (Ribbond®). The Rib-
bond splint has since broken and become partly loose. In the initial phase, scal-
ing, root planing and curettage of the deep pockets was carried out under local
anaesthesia. The response to the treatment was positive, the pocket depths were
reduced to a satisfactory level and the patient was clearly more motivated as was
shown by her improved oral hygiene.

4–5. The broken splint in the lower anterior area was removed and the
tooth surfaces were thoroughly cleaned. A suitable length of the
everStick fibre was measured with the help of dental floss. Wooden wedges were
placed into each of the interdental spaces. This will prevent the flow compos-
ite from filling the interproximal spaces and hence good cleaning spaces are
maintained. The lingual surfaces of teeth were etched with 35% phosphoric acid
(Ultra-Etch®, Ultradent).

6–7. After etching, adhesive (StickRESIN, Stick Tech Ltd.) was applied to
the tooth surfaces and was light cured for 10 seconds. After light
curing, a flowable composite (Tetric®Flow, Vivadent) was applied to the teeth
surfaces and the everStick fibre bundle was pressed onto the teeth surfaces.
StickSTEPPER (Stick Tech Ltd.) was used to press the fibre bundle onto the teeth
and the fibre was light cured for 2–3 seconds on each tooth. When the fibre
bundle was in place, it was covered entirely with flow composite and light cured
40 seconds.

8. The fibre glass cannot be left visible in a permanent splints, but should be
covered entirely by the composite. If required, the composite surface of
the splint can be polished. Finally, the patient’s occlusion was checked and she
was reminded of the use of interproximal brushes. The final result was
functionally and aesthetically pleasing to the patient.

06
 www.sticktech.com Case report everStick®PERIO

1. 2. 3. 4.

5. 6. 7.

By courtesy of
Ass. Prof. Péter Vályi, D.D.S., Dip. in Periodontics, Dept. of Conservative Dentistry and Periodontology
Ass. Prof. Andras Kocsis, D.D.S., Dip. in Orthodontics, Dept. of Orthodontics University of Szeged, Hungary

Use of everStick®PERIO as a reinforcement

in perio­dontal splint with conjuction of the
regenaritive perio surgery and
ortho­dontic treatment
38 year old healthy female was referred for a periodontal treatment. She was diagnosed having combined
endo-perio lesion in region 21. In addition, she was having diastema between the teeth 12–11 t and 31–32.
Clinical examination revealed that she was suffering from generalized aggressive periodontitis and had
pocketing between 3–12 mm (premolar and molar, and lower incisor: 4–6 mm; upper central incisor 7–12
mm) in her dentition. Her oral hygiene was fair and she had supra- and subgingival calculus on all of her
teeth, as well as BOP (Bleeding On Probing) in several sites. She had mobility grade I in the following teeth
11, 31, 41 and her left upper incisor had severe mobility of grade III. Her both diastemas were decided to
be closed orthodontically. Overall treatment time was 12 months.

1. Pre-operative study
models. 6. Intra-coronal groove was prepared for the fibre
splint (everStickPERIO).

2. Root canal therapy of tooth 21 was performed

and the filling was done with lateral condensed
­technique. (Guttapercha and sealer: AH Plus).
7. Definitive retention with intracoronal FRC splint
(everStickPERIO, Tetric Flow, Tetric Ceram).

3. Post-operative view after

orthodontic treatment.

4. Regenerative periodontal surgery was per-

formed in the region 21–22. Bone substitute
Bio-Oss was placed in the defect and collagen
Materials used:
Fibre: everStickPERIO, Stick Tech Ltd.
membrane was placed over the augmented Etching: Vococid, Voco.
area.
Adhesive: Clearfil SE Bond – Kuraray Medical Inc.

5. Radiographic view after the

regenerative surgery. Composite: Tetric Flow and Tetric Ceram, Ivoclar Vivadent

07
 www.sticktech.com Case report everStick®NET

1. 2. 3. 4. 5. 6.

7. 8. 9. 10. 11.

By courtesy of Dr Jörg Weiler, Cologne, Germany

Creating an aesthetically pleasing emergency fibre

retained bridge and a labial splint
In this case study we will describe a classical emergency situation in which
a patient requires an immediate, practical and suitably aesthetic result. 1. Initial situation

The patient attended my office a couple of days prior to a vacation with a

loose tooth 42. Because we didn’t have time for a “classical” treatment 2. Sectioned extracted tooth with prepared slot

with extractions and/or implants, we chose a fibre reinforced composite

bridge as an appropriate alternative.
3. Slot etched with phosphoric acid

After extraction of the tooth, the tooth was shortened apically and the root
canal sealed with composite. We also treated the interproximal lesion. To
help ensure the best possible bond strength for the tooth, a slot was cut 4. Proximal view

lingually in the coronal portion.

The adjacent teeth of the extracted tooth were prepared with small slots, 5. Fibre bundle in extracted tooth, bonded without
pre-polymerization of the ‘retentive arms’
using a round bur with a diameter of 1.0 or 1.2 mm, to increase the bonding
results in this area and to enhance the thickness of the materials (fibre and
flowable composite). 6. Lingual view showing everStickC&B
fibre bundle in situ

Then we etched and bonded all the teeth and the bridge, and polymerised
them with a flowable composite and everStickC&B fibre to the correct position.
7. The fibre bundle covered with composite

In cases when all the teeth are stable and do not have any periodontal
problems, the treatment is finished and a long term provisional solution is
provided to the patient. But for this patient, I produced a more ­predictable 8. Etching the entire buccal and lingual aspects of
the anterior region
and better long-term result by stabilizing all teeth in the treated area with
a full splint.

In this case there was enough space and I chose to use everStickNET on 9. Adaptation of the everStickNET

both sides, labial and lingual, each in a double layer.

Another option would have been a cantilever bridge. However, this 10. Polymerisation of the everStickNET

depends, for example, on the occlusal and functional situation and the
periodontal condition.
11. The final result

Clinical tip:
Treatment steps: etch, bond, cover with flowable composite and press the everStickNET
into the flowable composite. For a proper adaptation and for protecting areas from the
polymerization light a spatula or a StickSTEPPER is useful.

08
www.sticktech.com IPN inside

The view inside the everStick fibre: A cross sectional view of everStick fibre.
individual fibres, bis-GMA and Silanated glass fibres are impregnated
PMMA form the unique IPN structure. with PMMA and bis-GMA.

IPN* – The heart of everStick® fibres

Proper bonding between the fibres and ­composite
is the key factor for the successful treatment result.
Reactivation is crucial for
Only everStick products have a unique, patented superior bonding when
interpenetrating polymer network* structure (IPN).
Clinically this leads to superior bonding enabling • laboratory-manufactured restorations are
reliable surface retained applications and perfect cemented to teeth
handling properties. • everStickPOST root canal posts are cemented
• FRC devices are repaired
The unique IPN feature ensures both microme-
chanical and chemical bonding of everStick fibres everStick fibre products consist of individual,
to composites, adhesives or composite cements. ­silanated glass fibres. The fibres are locked to each
The bond strength is based on the ability of the other with linear polymers (PMMA) and cross link-
polymer matrix to partially dissolve in the resin ing monomers (bis-GMA) to form an IPN structure
used for bonding. The significance of this is that for polymer matrix that is strong and tougher com-
surfaces can be reactivated even after final poly- pared to plain dimethacrylate polymer matrix.
merisation.
The IPN structure makes the everStick products
fundamentally different from any other fibre or
composite materials available.

Surface Tissue
Superior retained saving
IPN Inside bonding applications minimally
possible invasive

Fibre Reparation
surface and Reversible
can be remodelling
reactivated possible

Aesthetic, cost effective and fast treatment solutions

09
 Stick Tech Ltd
Stick Tech Ltd is a Finnish technology focused
company dedicated to the advancement of
dentistry. We manufacture fibre reinforced
composites to meet demanding dental
require­ments. Stick Tech Ltd has developed
­a fibre reinforcement technology that
enables the use of completely new treatment
methods in dentistry. Patented Stick and
everStick products are used by dentists and
dental technicians worldwide.

5:1011 updated 2008-09

Stick Tech Ltd

Lemminkäisenkatu 46, P.O. Box 114, FI-20521 Turku, Finland. Tel. +358 2 4808 2500, www.sticktech.com