Cliniclands Praktisk guide Komposit

Kompositer är ett av de mest använda materialen inom restaurerande tandvård. Populariteten för kompositfyllningar har vuxit avsevärt de senaste åren, eftersom patienter i allt högre grad efterfrågar estetiska lösningar för att behålla ett vackert leende.

PRACTICAL GUIDE COMPOSITE

C hapter 1 WHAT ARE DENTAL COMPOSITES?

Introduction and Index

Composites are among the most widely used materials in restorative dentistry. The popularity of composite fillings has increased sharply in recent years as patients increasingly demand esthetic solutions to maintain a pleasant smile. Numerous types of composites with different characteristics and uses have appeared on the market to meet the specific needs of each patient. When a user chooses composite brands that are practical for daily use, personal preference is one of the most important factors, but there are more variables to consider to find the right material. With more dental composites available than ever before, this guide is designed to help you find the perfect materials to meet your needs. Log in to your account at Cliniclands or register as a new customer to profit from our large assortment of products and favorable pricing. Log in to your account here: www.cliniclands.se Click to register as a new customer here: www.cliniclands.se/register

Dental composites are synthetic, hydrophobic materials that combine a polymeric matrix with a dispersion of glass, mineral, or resin fill particles, a coupling factor, and an initiator. They are primarily used to restore tooth structure lost due to trauma, caries or other diseases. Composites are also used as cement for crowns, bridges and orthodontic facilities. Composites are classified as either chemically activated (self-curing) resins or as photochemically activated (light-curing) resins.

Your Cliniclands Team

Distinction and Classification of Dental Composites

01 W hat are D ental C omposites ? �� 3 02 U niversal C omposites �� 6 03 E sthetic C omposites �� 13 04 P osterior C omposites �� 18 05 B ulk F ill C omposites �� 20 06 B iocompatible C omposites �� 23 07 B ioactive C omposites �� 24 08 F lowable C omposites �� 25 09 O rthodontic C omposites �� 29 10 S pecial A pplication C omposite �� 30 11 P olymerization �� 32 12 P olishing �� 34

Micro-filled Composites Micro-filled composites contain very small filler particles (40–50 nm). This makes them easy to polish and esthetically beautiful. However, the disadvantage is they are not very strong or durable; therefore, they are not recommended for the restoration of posterior teeth.. Macro-filled Composites Macro-filled composites contain large particles, which make the material very strong and durable. Unfortunately, this compound is not suitable for finishing and polishing. Its finish is not esthetic, which is undesirable for the restoration of anterior teeth. Hybrid (universal) Composites Hybrid or micro-hybrid composites contain a mixture of small particles (0.6–1 micron + microfiller), and combine the strength of macro-filled composites with the esthetics of micro-filled composites. Thus, the material is suitable for both anterior and posterior teeth. Nanocomposites Nanocomposites or Nano-hybrid composites consist of particles of less than 100 nm in size. They contain nanoparticles that cluster together to form a larger filler rate. These clusters provide the right strength and opacity; they are highly polishable and offer excellent gloss retention. Currently, nanocomposites are the most widely used. They are popular because their material meets all the requirements for esthetics and wear resistance. They are easy to shape in the anterior teeth, and they are strong enough for the posterior teeth.

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Two more esthetic properties of natural teeth are fluorescence and opalescence. These two properties contribute to the vitality and lifelikeness of teeth. In natural dentition, dentin (specifically the hydroxyapatite minerals and organic matrix) is more fluorescent than enamel. The shade of the dentin, which should be considered the base among the dentin elements, is recorded at the level of the central part of the vestibular cervical third. The least amount of enamel is found here, but a large volume of dentin is present. On the other hand, the shade of the enamel should be recorded at the middle third of the teeth, where it is generally two or three shades lighter than the shade chosen for the dentin. When a tooth is built up with composite, it can be difficult to achieve the desired color result. When the enamel layer is too thick, it may appear too gray and if it is too thin, the restoration may be too opaque. In addition to the traditional shades, the composite systems offer pale or white shades. However, these colors often have insufficient value gradient and as a result are very white. Consequently, for higher value esthetic cases, specially calibrated products are available that provide smooth transitions and achieve ideal variations.

Nanoparticles are proportional to a football, like a football is to the earth

Dental Composite Handling Properties Fillers largely determine the strength of composite. The more filler, the stronger the composite. However, too much filler leads to a material that is too rigid. The ideal blend optimizes strength and the ability to be processed. The content of composite filler can be expressed in two ways: as weight% or volume%. Importantly, since filler particles weigh far more than resin, it stands to reason that the percentages of weight% are much higher than the volume%.

But perhaps the most important consideration for most dentists when choosing a composite is how the material feels. Working comfortably with a material is critical to the overall result of a restoration.

Ideal Characteristics of Composites

• Radiopaque • Low shrinkage when curing • Easy to handle, non-sticky, easy to shape • Easy to dispense • Excellent and lifelike esthetics • Stable color

HuFriedy Akro-Flex

American Eagle

• No color difference after curing • Not sensitive to ambient light • Chameleon effect with neighboring elements • Short application and finishing time • Little polishing required • No voids or bubbles • Strong and durable without marginal leakage, fractures or discoloration • Excellent physical properties, tested scientifically

Akro-Flex is an extremely flexible composite tool and performs like a paintbrush. The ultra-thin blades made of titanium easily reach the interproximal spaces and provide better visibility compared to traditional composite instruments.

Composite instruments coated with XP technology. XP is a nanotechnology in which the surface of the instrument is microscopically infiltrated with a coating that creates a super hard, smooth and scratch- resistant surface and prevents the adhesion of composite to the instrument. For common instruments, the composite adheres to the microparticles of the instrument.

What Colors Are Available? Composite is a synthetic material that adheres to the surface of a tooth for a perfect tooth filling. Emulating natural dentition and adjusting the color to achieve an unnoticable restoration and an increased esthetic involves 3 aspects: shade, saturation and value.

The XP composite instruments are non-stick.

LM Arte Set Style Italiano

The LM Arte family of composite instruments were developed in collaboration with Style Italiano, a group of Italian dentists specializing in esthetic dentistry. LM-DuraGrademax is made of high- quality steel and non-stick.

Today, most composite systems use VITA ® to classify shades. The classic shades are: A, B, C and D.

A represents the highest value (brightness), and D the lowest value. In addition, each letter has a number-code. This number- code provides information about the chroma (saturation): 1 = lowest saturation, highest brightness, and 4 = highest saturation, lowest brightness.

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C hapter 2 UNIVERSAL COMPOSITES

Henry Schein Natural Elegance Maxima Nano

Composition

Filler Content weight% volume%

This composite has a Duo Shade formula and contains advanced spherical nanofillers. It is suitable for many clinical indications. The Duo Shade formula is translucent and fluorescent . It is used for anterior restorations and in the posterior layering technique. The HCM (high cohesive molecular) resin matrix combines excellent wear resistance (like enamel) with low polymerization shrinkage. The material is pleasant to process and its consistency makes it ideal to contour accurately and easily while maintaining anatomy. The high filler rate with nanofillers makes it quick and easy to polish on high gloss.

Nano-hybrid

77%

58%

TYPES OF DENTAL COMPOSITES AND THEIR MAIN APPLICATIONS

Universal composite is considered a material versatile enough to accommodate most types of restorations, both anterior and posterior. The material is designed for both indirect and direct restorations, and should be layered in increments (up to 2 mm). Although not as fast to apply as a bulk filler, the universal composites are very popular due to their well-documented clinical performance. Indications include the restoration of Class I, II and III and IV.

Clinician’s Choice Evanesce Universal Restorative Universal composite for both simple and complex treatments. Evanesce means “ gradually disappearing or fading ” and this is the result that is achieved. Evanesce composite blends effortlessly into the natural dentition. The formula of the composite is a patented process that optimizes the refractive index of the unique nanopigments and fillers, and ensures a high-gloss finish after polishing. The “handling” of Evanesce is easy to adjust during placement and manipulation due to its rheological modifiers. The material does not collapse and retains its shape until polymerization. Truly amazing esthetics are easy to achieve, often with just one color, or, in more complex cases, with only a few layers of composite.

Composition

Filler Content weight% volume%

Additional Products

Adhesive

Flowable

Polymerization

Polishing

Natural Elegance Universal Bond

Nano-hybrid

82%

74%

Evanesce Flow

Ultimate LED

A.S.A.P. Polishers

3M Filtek Universal Restorative Filtek Universal Restorative is an optimized restorative composite for esthetic anterior and posterior restorations. Filtek Universal Restorative contains NaturalMatch technology. NaturalMatch technology consists of nanofillers, pigments and proprietary low-stress monomers that provide a combination of esthetic and physical properties. Filtek Universal Restorative is available in the following colors: A1, A2, A3, A3.5, A4, B1, B2, D3-plus and Extra White (XW). The shades have a body-like opacity, allowing for a curing depth comfortably up to 2 mm. All colors are radiopaque. There is also a Pink Opaquer to mask discolorations and stains.

Composition

Filler Content weight% volume%

Nanocomposite

76,5%

58,4%

Additional Products

Adhesive

Flowable

Polymerization

Polishing

Natural Elegance Universal Bond

Evanesce Flow

Ultimate LED

A.S.A.P Polishers

Additional Products

Adhesive

Flowable

Polymerization

Polishing

Scotchbond Universal Plus Adhesive

Filtek Supreme Restorative Flow

Scan the QR code to learn more about Clinician’s Choice Evanesce

Elipar Deepcure LED

Sof-Lex Diamond Spiral

Before

After

PRACTICAL GUIDE COMPOSITE

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Dentsply Sirona Ceram.x Spectra ST

GC G-ænial Universal Injectable

Composition

Filler Content weight% volume%

Composition

Filler Content weight% volume%

Ceram.x Spectra ST is a nanoceramic universal composite based on the new SphereTEC filler technology for direct and indirect restorations. SphereTEC stands for spherical granulate filler technology combined with an optimized resin matrix. The result is: excellent adaptation and malleable-smoothness; quick and easy to polish to a high gloss. Ceram.x Spectra ST is available in HV (High Viscosity) and LV (Low Viscosity). The color system is basic: 5 colors covering the complete VITA ® system. In addition, 3 Ceram.x Spectra ST Effects (2 opaque dentin colors and 1 translucent enamel color) can enhance a simplified layering system for esthetic anterior restorations when used in combination with the 5 universal colors of Ceram.x Spectra ST HV (High-Viscosity).

Universal restorative composite with exceptional strength and resistance for long-lasting esthetic restorations. The high levels of ultra-fine barium particles and the full-coverage of silane coating technology (FSC) make G-ænial Universal Injectable exceptionally strong. Due to these excellent properties, the material is indicated for all non-coated cavity classes. It is also characterized by a high radiopacity of 252% – ideal for follow-ups and easy diagnosis of any secondary caries. Due to its unique high thixotropic viscosity, it can be adapted to any clinical situation: the material does not “run” during application and has good flow properties when used with instruments. G-ænial Universal Injectable is available in 16 colors and three levels of translucency for superior long-term esthetics.

Nano-hybrid

78 - 80% 60 - 62%

Nano-hybrid

69%

Additional Products

Adhesive

Flowable

Modeling

Polymerization

Adhesive

Flowable

Polymerization

Polishing

G2 Bond

G-aenial Universal Flo

Composite Modeling Kit

D-Light Pro

Prime&Bond Active

Ceram.x Spectra Flow

SmartLite Pro

Enhance PoGo

Ivoclar Tetric Prime

Composition

Filler Content weight% volume%

DMG Ecosite Elements The secret of Ecosite lies in the color combination of up to three modules. It enables natural esthetic restorations with any technique. It offers a maximum combination of diversity and is remarkably quick to polish - consisting of three modules, it is easy to blend the shades for a perfect result. PURE : 5 VITA® colors for natural-looking dentin or enamel replacements. LAYER: 4 enamel colors to replace enamel or for a layering technique using PURE colors. HIGHLIGHT: 4 signature colors to personalize and mask discoloring. Due to its innovative NC1-technology (‘non-clustering’), the material meets all the requirements of daily work. The precise silanization of individual ultra-fine filler elements allows for a particularly homogeneous distribution, resulting in optimal handling properties and maximum gloss.

Composition

Filler Content weight% volume%

Tetric Prime is the new malleable universal composite for use in both anterior and posterior regions. The reduced color pallet and the optimal processing quality of the instantly malleable composite place the focus on what really matters: efficient esthetics in daily work routines. The light-curing, X-ray opaque material is available in a compact selection of the twelve most commonly used colors. The material is comfortable to use and Tetric Prime is characterized by its efficient handling properties : the creamy, smooth consistency is easy to apply while being sufficiently stable, without being sticky. This simplifies adjustment in the cavity, the ability to form a homogeneous layer and create anatomical contours. Tetric Prime can also be applied in very thin layers, especially in the anterior area. The end result is a beautiful surface shine and a natural color adaptation , due to the chameleon effect.

Nano-hybrid

75 - 80% 53 - 61%

Nano-hybrid

81%

65%

Additional Products

Workflow Efficient Esthetics

Adhesive

Flowable

Polymerization

Polishing

Isolate

Adhesive

Flowable

Shaping

Polymerization

Polishing

EcoSite Bond

Ecusphere Flow

Ultimate LED

Composite Polishers

OptraGate

Adhese Universal

Tetric EvoFlow OptraSculpt

Bluephase

OptraGloss

PRACTICAL GUIDE COMPOSITE

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Kerr SimpliShade

Kulzer Venus One Shade ONE Shade - one universal color for the majority of restorations.

Composition

Filler Content weight% volume%

Composition

Filler Content weight% volume%

Simplified universal composite system suitable for all cavity classes. SimpliShade features Adaptive Response Technology (ART) and covers all 16 classic VITA® shades with just 3 colors. In addition, Bleach White and Universal Opaque are available. Adaptive Response Technology (ART) is a filler network that helps achieve lifelike restorations with exceptional strength and an unparalleled esthetic. Reduce the inventory and save time when selecting the right color shade with SimpliShade.

Nano-hybrid

81%

65%

Nano-hybrid

78%

58,7%

Venus ONE Shade is virtually invisible due to its stunning color adaptation and its incorporation into the surrounding dentition.

Venus Pearl One has a smooth consistency and Venus Diamond One has a firm consistency. Both contain the proven TCD monomer which provides high flexibility and low shrinkage.

Additional Products

Adhesive

Flowable

Polymerization

Polishing

Additional Products

Optibond Universal

Herculite XRV Ultra Flow

Demi Plus

Optidisc

Adhesive

Flowable

Polymerization

Polishing

I-Bond Universal

Venus Diamond Flow

Translux LED

Venus Supra

Scan the QR code and read the clinical case about Ivoclar.

Septodont Restofill Restofill is based on Multi Nano-sized Particles distribution Technology (MNPT) with 76% filler. The highly esthetic material has excellent mechanical properties, making for durable and esthetic restorations both posteriorly and anteriorly. Restoration durability is achieved through a low shrinkage rate (2.4%), a high compressive strength (275 MPa), and flexible strength (145 MPa). Restofill is available in 10 colors (including the main VITA ® colors, two opaque and a Bleach color).

Kuraray Noritake Clearfil Majesty ES-2 Universal A comprehensive color assessment is not necessary to choose the correct variant. Determine color intuitively. The application of Light Diffusion Technology (LDT) refracts light in restorations in the same way as it is in tooth tissue. The material integrates easily into the surrounding tooth structure and results in invisible restorations. A large proportion of direct composite restorations are done in the posterior region. The color Universal (U) is suitable for this. Along with intelligent optical integration, it is particularly important that the material can withstand wear and tear, is flexible and can tolerate high compression. For anterior restorations, it must have the following characteristics: the right level of translucency, a long-lasting natural shine, and an intelligent optical integration for a seamless connection. Use Universal Light (UL) for A1–A2 range restorations, or UD (Universal Dark) for darker elements.

Composition

Filler Content weight% volume%

Nano-hybrid

78%

69%

Additional Products

Adhesive

Flowable

Modeling

Polishing

Peak Universal

PermaFlo

Valo Grand

Jiffy

Additional Products

Adhesive

Flowable

Modeling

Polishing

Clearfil Universal Bond Quick

Clearfil Majesty ES Flow Estenia Modeling Liquid

Clearfil Dia Twist

PRACTICAL GUIDE COMPOSITE

C hapter 3 ESTHETIC COMPOSITES

Voco GrandioSO

Composition

Filler Content weight% volume%

Benefiting from its physical properties, GrandioSO is a filling material that matches teeth extremely well. This results in long-lasting, reliable restorations and most importantly, satisfied patients. The filling material meets the highest requirements for anterior and posterior restorations based on factors including a very high filler rate (89 weight%), low shrinkage (1.61%), high compressive and tensile strength. A natural opacity for tooth-matching results are achievable with just 1 color. In addition, the new, sensible colors GA3.25 and GA5 have been added to the intelligent color system. GrandioSO has a smooth consistency, high light stability and is easy to polish to a high gloss.

Nano-hybrid

89%

73%

Esthetic composites, also known as front or anterior composites, are used for restorations where a stable esthetic result with a highly durable high gloss is required. In modern esthetic dentistry, the specific esthetic composites are often applied in multiple layers of dentin and enamel to create naturally matching restorations. Due to the differences in opacity and translucency, different color scales are used. The opaque dentin colors, which determine the final color of the restoration, are mostly based on the VITA® colors (A1, A2, A3). The translucent enamel colors, which are responsible for the brightness of the restoration, are usually based on white, neutral and gray shades. Controlling the aspects of brightness is a crucial element in restorative dentistry. The key to beautiful, natural results is finding a sophisticated balance between the opacity of the dentin and the translucency of the enamel.

Additional Products

Adhesive

Flowable

Polymerization

Polishing

Futurabond U

GrandioSO Flow

Celalux 3

Dimanto

Optident White Dental Beauty CompoSite The White Dental Beauty CompoSite system is an open invitation to think about esthetic direct restorations. Working in close collaboration, Style Italiano and White Dental Beauty have combined approaches, knowledge and sophisticated manufacturing processes to form this unique composite material. The CompoSite system consists of the following: Smart hybrid shades of white: Si0, Si0.5, Si1, Si2 & Si3: are specially designed to color match bleached or naturally white teeth. These multi-functional colors can be used as a monolayer for full veneers or in combination with Si E enamel in a dual-layer technique. This Si E enamel color has a calibrated transparency and is designed to connect seamlessly with all Si universal colors. It is ideal for a two-layer technique and for simply characterizing the incisal edge.

Composition

Filler Content weight% volume%

Nano-hybrid

80%

Additional Products

Adhesive

Flowable

Polymerization

Polishing

Natural Elegance Universal Bond

CompoSite Si Flow

Ultimate LED

A.S.A.P Polishers

Five tips for getting the most out of CompoSite User Experience

PRACTICAL GUIDE COMPOSITE

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Clinician’s Choice Evanesce Enamel & Dentin Shade Evanesce Enamel Shade has an opacity of 80% and can be used in a layering technique with Evanesce Dentin (opacity 90%) for esthetic anterior restorations. To further improve the esthetic enamel characterization, 3 “glaze” shades have also been developed: Enamel White, Enamel Incisal and Enamel Clear. Evanesce means “ gradually disappearing or fading ” and this is the result that is achieved. Evanesce composite blends effortlessly into the natural dentition. The formula of the composite is a patented process that optimizes the refractive index of the unique nanopigments and fillers, and ensures a high-gloss finish after polishing. The “handling” of Evanesce is easy to adjust during placement and manipulation due to its rheological modifiers. The material does not collapse and retains its shape until polymerization. Truly astonishing esthetics are easy to achieve, often with just one color or a few layers of composite. .

GC G-ænial A’Chord

Composition

Filler Content weight% volume%

Composition

Filler Content weight% volume%

Esthetic composite restorative with a simplified color system. The material is designed to cover all immediate restorations with 5 CORE shades. A unique combination of 2 technologies, Full- Coverage Silane Coating (FSC) and high-quality pulverized CERASMART (HPC) , means that the restoration remains beautiful, shiny and intact over time. This is a solution that makes choosing the right color easier: 5 main colors (A1, A2, A3, A3.5, A4) cover all 16 VITA® shades. The material uses four types of filler in different sizes and refractive indices, and through its interaction with light, blends seamlessly into the tooth structure. In addition to the 5 standard colors, 2 cervical colors for older patients, 3 opaque colors for masking discoloration, 2 enamel colors for vivid translucency, and 2 bleach colors are available. The composite has a natural fluorescent end result in all light conditions, including black light. .

Nano-hybrid

82%

74%

Micro-hybrid

76%

63%

More Information

meer

Additional Products

Adhesive

Flowable

Polymerization

Polishing

Adhesive

Flowable

Modeling

Polymerization

Natural Elegance Universal Bond

Evanesce Flow

Ultimate LED

A.S.A.P Polishers

G2 Bond

G-aenial Universal Flo

Composite Modeling Kit

D-Light Pro

3M Filtek Supreme XTE

Kuraray Noritake Clearfil Majesty ES-2 Premium Dual-Layering composite for highly esthetic restorations, achieved easily and with predictable success, using fixed color combinations. Light Diffusion Technology (LDT) adjusts the right shade (hue) and color saturation (chroma) on the adjacent tooth tissue. It covers one solid color combination of Enamel and Dentin composite with as many as three VITA® colors. The built-in fluorescence and opalescence are in accordance with the natural dentition. The right enamel translucency and dentin opacity is built-in and ensures optimal tooth-composite integration. The colors are the same as the polymerized material prior to polymerization.

Composition

Filler Content weight% volume%

Composition

Filler Content weight% volume%

Filtek Supreme XTE’s innovative technology consists of nanomers with a particle size between 20–75 nm. Some of these nanomers are linked together in so-called nanoclusters . The result is a smooth surface structure with little to no scattering of the visible light, and thus the restoration maintains a high surface gloss. Filtek Supreme XTE can be used in a Duo or Multi Shade layering technique and it consists of four opacities: Dentin (most opaque), Body, Enamel and Translucent (very transparent).

Nanocomposite

72,5%

56,6%

Nano-hybrid

78%

66%

Additional Products

Adhesive

Flowable

Polymerization

Polishing

Adhesive

Flowable

Modeling

Polishing

Scotchbond Universal Plus Adhesive

Filtek Supreme Restorative Flow

Elipar Deepcure LED

Sof-Lex Diamond Spiral

Clearfil Universal Bond Quick

Clearfil Majesty ES Flow Estenia Modeling Liquid

Clearfil Dia Twist

PRACTICAL GUIDE COMPOSITE

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Micerium Enamel Plus HRi Natural enamel cloned in composite.

Edelweiss Dentistry Veneer The Edelweiss VENEER is the perfect veneer solution for modern, minimally invasive, esthetic dentistry. It is now possible to work in a direct technique with preformed veneers. The laser-based manufacturing process combines the best of two worlds: the homogeneous, inorganic and shiny surface in combination with the thermally hardened, dynamic composite core ensure optimal integration between functionality and beauty.

Composition

Filler Content weight% volume%

Composition

Filler Content weight% volume%

Nano-hybrid

78 - 80% 58 - 63%

Nano-hybrid

82%

The Universal Enamel (UE) colors have the same refractive light index as natural teeth and the same brightness as natural enamel. A modern composite system should contain dentin colors with a fluorescence intensity calibrated to the natural tooth. Universal Dentin (UD) colors that have hue-chroma values (hue- color saturation) close to natural teeth, have been developed for this purpose. To make the most of the Enamel Plus HRi System, the anatomical layering technique of Dr. Vanini is recommended. This technique combines enamel - dentin colors to mimic the exact color dimension of the natural tooth.

The VENEER contains the color VITA ® Enamel A 0.

Additional Products

The respective composite dentin and enamel colors used to cement the VENEER determine the final color shade of the restoration.

Adhesive

Flowable

Modeling

Polishing

EnaBond

Enamel Plus HRi Flow

Arte set

Enamel Plus Shiny

Additional Products

Adhesive

Flowable

Polymerization

Polishing

Veneer Bond

Nano-Hybrid Flowable

VALO Grand

Jiffy

Scan the QR code and read the case “Less is more”.

Scan the QR code and read the article about Edelweiss.

Voco Amaris

Composition

Filler Content weight% volume%

The Amaris Composite System invites you to think differently: It provides a system that follows the natural principle and simplifies esthetic direct restoration in two steps.

Nano-hybrid

80%

64%

First, choose from the opaque base colors , O1 to O5, which cover the entire color range of dentin.

Second, confirm or adjust the chosen base color using one of the translucent enamel colors TN, TL or TD. Additionally, the colors HT (High Translucent) and HO (High Opaque) are available to apply special effects.

Additional Products

Adhesive

Flowable

Polymerization

Polishing

Futurabond U

GrandioSO Flow

Celalux 3

Dimanto

PRACTICAL GUIDE COMPOSITE

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C hapter 4 POSTERIOR COMPOSITES

GC EverX Posterior

Composition

Filler Content weight% volume%

Esthetics are not the first priority when designing posterior composites, but taking the increased chewing pressure that restorations are exposed to into account is. Properties materials must have included: high physical strength, low wear and they must be fatigue resistant. Traditional posterior composites need to be layered (up to 2 mm) in order to achieve full polymerization and take shrinkage and shrinkage stress into account.

Nano-hybrid

77%

53,6%

EverX Posterior is a fiber-reinforced composite designed to replace dentin, and when combined with a conventional composite, can be used as an enamel replacement layer. The short fibers of EverX Posterior render it just as break-resistant as collagen-containing dentin and almost twice as break-resistant as any conventional composite. As a result, EverX Posterior is the strongest possible understructure for strengthening composite restorations in large cavities.

Optident White Dental Beauty CompoSite Si P - Posterior

Composition

Filler Content weight% volume%

Voco X-tra Fil

Micro-hybrid

80%

Composition

Filler Content weight% volume%

This posterior composite has a homogeneous color and a light- diffusing universal opacity that mimics tooth substance. A single color is thus the solution for the vast majority of posterior restorations. The material has a high filler content at 80%, and is specially designed to work in the Fast Modeling Technique (FMT) . It combines rapid application and simplified occlusal anatomy.

Multi-hybrid

86%

70,1%

Highly radiopaque hybrid composite material. Combining multi- hybrid filler technology and an innovative initiator-system forms the basis of this filling material with its low polymerization and shrinkage, and its excellent curing characteristics. X-tra Fil can safely cure layers up to 4 mm thick with very short exposure time. The reduction in shrinkage stress forms the basis for good adaptation. Physical firmness and high resistance against abrasion are required to meet the high demands that fillings are subjected to, such as the intense forces of chewing.

CompoSite Si P Posterior is wear-resistant and very easy to polish.

Kuraray Noritake Clearfil Majesty Posterior

Composition

Filler Content weight% volume%

Nano-hybrid

92%

82%

Dentsply Sirona Surefil one

Nano Dispersion Technology filler technology creates an optimal connection and distribution between filler particles and resin. Improving the filler’s adhesion to the resin results in a composite that is less susceptible to breakage, wear and tear, as well as degradation in the oral environment. The higher filler content does not necessarily lead to a stiffer composite; the material is excellent for injecting and thus guarantees a good adaptation to the cavity.

Self-adhesive hybrid composite; dual-cure for permanent tooth- colored restorations (Class I, II and V).

• Self-adhesive: no cavity etching, bonding or conditioning • Equally durable as conventional composite • Faster than conventional composite • Ideal for complex cases • Fluoride release

The material offers 3 superior properties that are essential to the application of composites in the premolar and molar region.

1: Mechanically very strong and resistant to degradation caused by fatigue. 2: Minimal polymerization shrinkage (1.5 volume%). 3: Low thermal expansion coefficient.

PRACTICAL GUIDE COMPOSITE

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C hapter 5 BULK FILL COMPOSITES

Henry Schein Natural Elegance Bulk Fill Universal

Composition

Filler Content weight% volume%

Bulk Fill composites are designed to create posterior restorations easily and quickly. Their unique optical properties and improved opacity make it possible to fill a cavity in one application. Layers can be up to 5mm thick while the esthetics are maintained. The majority of Bulk Fill materials are more translucent than conventional composites, resulting in increased cure depth. Using a Bulk Fill composite facilitates and shortens the time it takes to place a restoration. Bulk Fill composites use less filler than hybrid composites.

Multi-hybrid

86%

70%

Highly radiopaque composite specifically designed for rapid application in the posterior area.

The high translucency of the material allows it to adapt as a chameleon to the color of the surrounding tooth substance and provides the ability to place up to 4mm layer thickness and polymerize in just one work step. Trouble-free processing and a reduced processing time together contribute to excellent cost-effectiveness when constructing a restoration. Combining multi-hybrid filler technology and innovative initiator system for polymerization form unique physical properties. Its low shrinkage makes restorations of sustainable marginal integrity possible. Its physical stability and high resistance against abrasion answer the special requirements of load-bearing restorations. Based on its high radiopacity, Natural Elegance Bulk Fill is clearly distinguishable from tooth substance on an X-ray.

3M Filtek One Bulk Fill

Composition

Filler Content weight% volume%

Nanocomposite

76,5%

58,5%

Bulk Fill composites have become increasingly popular because of their simplicity and efficiency. However, quick and easy placement is often done at the expense of esthetics. Filtek One Bulk Fill offers a Bulk Fill material that retains esthetics through its unique optical properties and optimal opacity. Its unique Smart Contrast Ratio Management technology increases opacity while maintaining the curing depth. The innovative AUDMA and AFM monomers ensure low shrinkage and remove shrinkage stress which allows for the placement of bulk fillings up to 5 mm. The applied nanotechnology offers unmatched resistance against wear and tear and retains shine excellently .

Dentsply Sirona SDR Flow+

Composition

Filler Content weight% volume%

Nano-hybrid

70,5%

47,4%

SDR flow+ is the improved generation of the leading and still unrivalled flowable bulk fill material SDR.

DMG Ecosite Bulk Fill

The tension-reducing SDR technology provides 4 mm of bulk placement in a smooth consistency for excellent adjustment and self-leveling . Its handling properties make it ideal for several other indications, such as the treatment of primary posterior dentition, pit & fissure sealant, post-endodontic restorations, and even rebuilding from stubs. The formulation of SDR flow+ adds even more versatility. Increased wear resistance and three additional colors (A1, A2, A3) extend SDR flow+ indications into Class III and V restorations. More esthetic options are added for class II creation and primary posterior dentition.

Composition

Filler Content weight% volume%

Nano-hybrid

82%

65%

Designed to deliver superior esthetics and perfect customization with one fast 20-second light cure.

Ecosite Bulk Fill is suitable for fillings up to 5 mm - no cover layer is required. The special nanotechnology creates an extremely homogeneous distribution of submicron particles, creating low shrinkage stress and laying the foundation for a high gloss finish . Ecosite Bulk Fill offers a functional and practical color system that includes two universal and esthetic Colors (Universal and Light), as well as Contrast when more contrast with the tooth is desired.

PRACTICAL GUIDE COMPOSITE

Order online via www.cliniclands.se or by phone on 0410 - 741 220

C hapter 6 BIOCOMPATIBLE COMPOSITES

Ivoclar Tetric PowerFill & PowerFlow

Composition

Filler Content weight% volume%

Today, biocompatible aspects of restoratives increase in importance. This has led to the development of composites using a new monomer technology that excludes unwanted biological side effects.

Nano-hybrid

76 - 77% 53 - 54%

Tetric PowerFill is a malleable light-curing radiopaque composite for direct posterior restorations.

Micerium Enamel Plus HRI Bio

Tetric PowerFlow is a flowable 4 mm posterior composite with a short exposure time: 3 seconds.

Composition

Filler Content weight% volume%

A chameleon effect is created by the Aessensio Technology. An equivalent esthetic to conventional composites is achieved. The Ivocerin Technology provides tension reduction to counteract shrinkage from polymerization. The short exposure time provides higher process certainty due to the reduced layer technique. The material is available in 3 Universal colors: IVA, IVB and IVW. The Bluephase PowerCure (light intensity 3.050 mW/cm²) enables even curing in a 3 second Cure mode. The 3S PowerCure System appears to be the systematic advancement of composites. Deficiencies in the materials have been identified and comprehensive solutions have been formalized. The material has been redesigned to cure faster, be harder, and negative side effects of sensitive or premature marginal degradation have been eliminated. To make this possible, a new Polywave high intensity curing light that works with this new chemistry has been created. Up to 4 mm cured layers in 3 seconds means noticeable savings in your treatment time.

Nano-hybrid

74%

60%

Biocompatible composite with unique features.

Enamel composite system for microinvasive function restoration, respecting the neuromuscular system and achieving excellent esthetic integration. Enamel shades with low abrasion are similar to natural enamel. Ideal for use on posterior teeth in a direct or indirect technique and especially for prosthetic repair. Fully biocompatible , to ensure perfect integration in harmony with the human body, without toxic release. The resin matrix has a high stability resin matrix and does not contain Bis-GMA and free nanoparticles .

Voco Admira Fusion (ORMOCER)

Composition

Filler Content weight% volume%

Nano-hybrid

84%

Restorative material on a pure ceramic base.

The ORMOCER Pure Silicate Technology uses fillers and resin matrix purely based on silicon oxide and does not contain classic monomers. Admira Fusion is inert, so it is highly biocompatible and highly resistant to discoloration. The material has low polymerization shrinkage (1.25 volume%) and very low shrinkage compared to many conventional restorative composites. Admira Fusion is available as a universal, flowable, bulk fill and a base restorative material.

PRACTICAL GUIDE COMPOSITE

Order online via www.cliniclands.se or by phone on 0410 - 741 220

C hapter 7 BIOACTIVE COMPOSITES

C hapter 8 FLOWABLE COMPOSITES

The recent development of “bioactive” restoratives represents a significant advance in dental materials. Restorative materials are continuously under biological scrutiny due to acid attacks and the effects of demineralization on tooth structure. Bioactive restoratives generate an ionic interaction of calcium, phosphate and fluoride to help neutralize acid attacks and thus support the natural remineralization process. The bioactive restoratives are also a solution to many of the challenges typically associated with the treatment of pediatric and geriatric patients.

Fluid or flowable composites have a lower filler content than conventional composites and are known for their excellent handling properties. Traditional flowables used to have a high resin content with a low filler content. They could be used in places where strength was not a concern, in minimally invasive dentistry, as a sealant, or for repairs. Today, the new generation of flowable composites contain a higher filler content to compensate for the greater chance of shrinkage due to polymerization, and they are now strong enough to be used in high-stress areas.

Parkell Predicta Bioactive Bulk

Composition

Filler Content weight% volume%

Nano-hybrid

68%

Low-filled

Predicta Bioactive Bulk is a dual-cure Bulk Fill composite material. Predicta Bioactive Bulk is a bioactive material that releases calcium, phosphate and fluoride ions. This promotes the formation of mineral apatite and allows for better remineralization and stronger adhesion at the material-tooth interface. The material is easy to apply and links strength to exceptional durability. The material also has optical characteristics that are very close to the appearance of natural teeth. Predicta Bioactive Bulk-Fill is available in Regular (High Viscosity) or Low Viscosity (LV).

High-filled

versus

The low-filled flowable composites are less viscous; are well suited for minimally invasive restorations, sealants and minor repairs, but they do not have the strength or

Compared to traditional composites, the high-filled type of flowable composites offer more universal applications for all cavity classes.

stress resistance of high-fill composites..

Bisco TheraBase CA

Composition

Filler Content weight% volume%

Calcium Silicate

TheraBase CA is a dual-cure, calcium-releasing, self-adhesive base/ liner. The chemistry of TheraBase CA is based on Bisco Thera technology using a hydrophilic insoluble resin matrix. Indications : • Serves as a base layer in deep restorations for pulp protection. Unique Benefits: • Continuous release of calcium ions • Self-adhesive, no extra adhesive required • High compressive strength, absorbs shocks and stress from occlusal forces without breaking • Radiopaque; allows X-ray identification and effective diagnosis • Auto-mix system: the dual syringe ensures a consistent mix with minimal material waste • Dual-cure material that cures even in deep restorations where light cannot reach

Henry Schein Natural Elegance Nano Flow

Composition

Filler Content weight% volume%

Nano-hybrid

63%

42%

• Generates an alkaline pH (pH=11*) in minutes, promoting pulp vitality • Contains the MDP monomer for reliable and optimal adhesion to dentin

Radiopaque, flowable nano-hybrid composite. Suitable for: cervical caries, root erosion, wedge-shaped defects (Class V); restorations in the front (Class III, IV); filling small cavities, repair of composite and porcelain veneers, blocking undercut, as well as for adhesive cementation of composite and porcelain restorations and orthodontic retainers where sufficient light penetration is possible.

Clinical Benefits:

PRACTICAL GUIDE COMPOSITE

Order online via www.cliniclands.se or by phone on 0410 - 741 220

Clinician’s Choice Evanesce Flow

GC EverX Flow

Composition

Filler Content weight% volume%

Composition

Filler Content weight% volume%

Nano-hybrid

68%

Nano-hybrid

70%

Evanesce Flow is ideal for visible Class I and II restorations due to its esthetics and ability to adapt to the surrounding tooth structure. It is also ideal for Class V restorations as it does not cause clumping and has a wide range of opacities and shades. Due to its low shrinkage, Evanesce Flow is invaluable as a liner / base in posterior restorations, support for dentinal adhesion, and to prevent post-operative sensitivity. Evanesce Flow is easily distinguished from the tooth structure and adjacent composite with a radiopacity of 200% Al.

EverX Flow, a short fiber reinforced flowable composite, is designed to replace dentin and strengthen restorations. Like a concrete reinforcement, the fiberglass in EverX Flow strengthens restorations and prevents them from cracking. The Full-coverage Silane Coating (FSC) technology optimizes the silanization of both the filler particles and the fibers, which enables a high filler load while maintaining the low viscosity of the material. EverX Flow has excellent fracture resistance similar to dentin since it has a large amount of short fibers that adhere securely to the resin matrix. This allows the material to effectively reinforce large posterior restorations in combination with a conventional composite as an enamel layer. The material is available in 2 colors: Bulk (for deep cavities) and Dentin (for esthetic restorations).

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Optident White Dental Beauty CompoSite Flow

Composition

Filler Content weight% volume%

Micro-hybrid

64%

Ivoclar Tetric EvoFlow

Si M – Masque: A unique opaque flowable material for the ‘Camouflage technique’. It can be used to mask, resulting in a lighter base color for esthetic restorations. Si MP – Multiplo: A universal flowable material ideally used as a base / liner, for Class V restorations or cementation of veneers and overlays. The material has an optimal viscosity and excellent processability.

Composition

Filler Content weight% volume%

Nano-hybrid

57,5%

30,7%

Tetric EvoFlow is a flowable, radiopaque composite in a popular consistency. The material is flowable when desired and stable when required and can be used as a liner for Class I and II, for small fillings, but also for Class V cavities. Available in: • Enamel color shades: A1, A2, A3, A3.5, A4, B1, B3, T • Dentin color shades: A2 Dentin, A3.5 Dentin, B2 Dentin • Bleach shades: Bleach XL, Bleach L, Bleach M

3M Filtek Supreme Flowable Restorative

Composition

Filler Content weight% volume%

Nanocomposite

65%

55%

Kuraray Noritake Clearfil Majesty ES-Flow

Light-curing, radiopaque, flowable nanocomposite with a renewed application system that virtually eliminates air bubbles. The ergonomic and easy-to-use syringe with flexible dispensing tip provides improved access. The restorative remains versatile for a wide range of indications and techniques, including “injection molding”. Filtek Supreme flowable colors are designed to match the colors of Filtek Supreme XTE Universal Composite and Filtek Universal Restorative.

Composition

Filler Content weight% volume%

Nano-hybrid

78%

64%

Universal flowable composite in 3 different flowabilities. High : high flowable for small cavities and as base/liner Low : medium flowable for universal restorations Super Low : low flowable for posterior cusps and edges build-up Clearfil majesty ES Flow ensures sustainable and esthetic restorations and is suitable for all cavity classes

PRACTICAL GUIDE COMPOSITE

Order online via www.cliniclands.se or by phone on 0410 - 741 220

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