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Authors: Dr. Annil Dhingra
 

Posterior composite restorations are widespread used in todays dentistry. They are a popular material of choice . Despite various developments and improvements in the material , and the introduction of newer composites the posterior composites still l represent some shortcomings such as polymerization retraction and obtaining a tight contact point. The stickiness of the composite on the instrument and void inclusions are also important problems facing thepractitioners ,when placing the first composite layer in the bottom of the cavity.

Many solutions were suggested, but so far no one gave satisfactory results at all the levels.Packable composites, were launched many years ago aiming to replace amalgamrestorations. They were supposed to have higher mechanical properties and allow to obtain a tighter contact point.But it was shown that those materials did not have higher properties than universal hybrid composites and mostly, did not help to improve the contact point . Another suggestion to overcome the stickiness of resin composites, and enhance their adaptation to the cavity floor, was to place a very thin layer of flowable composite in the bottom of the cavity. Many studies were conducted regarding this issue The main conclusions were that the use of flowable composite resin as intermediate material does not reduce micro-leakage or gingival margin adaptation.All composites shrink; the material and placement technique must account for the polymerization shrinkage stress on the bonded interface. If it is excessive, then debonding or cuspal flexure will occur. It has been reported that avoiding bonding to opposing walls of the restorations all at once can mitigate shrinkage stress (the incremental technique). The most current literature shows that bulk filling with these revolutionary bulk-fill composites does produce lower shrinkage stress than the traditional universal composites placed in oblique layersThere are two categories of bulk fills. Low viscosity flowables (e.g., Surefil SDR Flow, Dentsply Caulk; 3M ESPE Filtek Bulk Fill Flowable Restorative, Voco X-tra Base, HeraeusKulzer Venus Bulk Fill), and high viscosity restorative (e.g., IvoclarVivadentTetricEvoCeram Bulk Fill and Voco X-traFil and Kerr SonicFill).

A low-viscosity flowable is placed in the bottom of the preparation as a dentin replacement base and then a second increment of composite is placed as enamel on the top layer. Two layers are placed and cured. The high-viscosity restoratives are strong, but they do not adapt to the cavity walls, so it may be wise to place a low-viscosity composite or a resin ionomer liner to achieve intimate adaptation to the gingival and pulpal floors. Again, two layers are placed and cured.

One exception is Kerr's SonicFill. It is the only sonic-activated, single-step, bulk-fill composite that starts out as a low-viscosity composite. The handpiece is activated, liquefaction occurs, the viscosity drops, and optimal cavity adaption occurs, much like a true flowable. The cavity is filled in seconds; the composite goes through a phase change and it is transformed to a high-viscosity composite.

The Journal of the American Dental Association reports that 37% of our restorations are not fully cured. Undercured composites will display cracks, fractures, poor crosslinking, and color instability. Christensen reports that most curing lights are inadequate and delivered around 512mW/cm2.

A high-output LED light (1000mW/cm2) with a powerful collimated (directed, not scattered) beam is a requirement when curing these bulk-fill composites. The lights should be regularly checked for consistent output. There is an enormous difference between the clinical outcomes associated with a 500-watt light versus a 1000-watt light.

Increasing the curing time increases the bond strength. Since there is a distance between the light tip and the deeper placed composite, it is recommended to final cure the composite 10 seconds from the occlusal, 10 seconds from the buccal, and 10 seconds from the lingual.

Long-term clinical performance of the Bulk Fill shows that sonic fill have all the advantages over the incremental placement of composites and incremental technique will be antiquated and invalid in the coming years . Bulk fill is thefuture .

SonicFill 2 meets the key requirements

  • Excellent adaptation and handling
  • High depth of cure
  • Lasting marginal integrity
  • Improved esthetics, durability and more working time

SonicFill 2 transforms tedious, repetitive posterior restorations into easy and reliable SingleFill placement: filling cavities up to 5mm in depth in a single increment, with a single material – and no liner or capping layer

 
  • Simple,Fast,Predictable,Voidfreerestorations
  • BulkFillcomposite 5mmincrementinClassIIsituations
  • Monoblockrestorations Noneedofflowable
  • Mechanicalhandpeice,justfitinslotofairotor,autoclavable
  • Clinicallyproventechnology
  • Greatperformanceofcomposite Strength,Polish,LowShrinkage
  • Unidosecapsules Hygieneandhighqualityimage
  • Greathandling,nonstick&scuptablecomposite

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