Dental Tribune UK Edition, October 25-3, 2010, No.26 Vol.4

25ClinicalOctober 25-31, 2010United Kingdom Edition VOCO GmbH · P.O. Box 767 · 27457 Cuxhaven · Germany · Tel. +49 (0) 4721 719-0 · Fax +49 (0) 4721 719-140 · www.voco.com SO “I need a composite that behaves like a tooth!” Dr. Arne Kersting NEW SO TOOTH-likE in the sum of its physical properties, Grandio® SO is the filling material that on a world-wide scale is most similar to natural teeth.* The advantages you will gain are: durable, reliable restorations, and above all satisfied patients. • Meeting highest demands, universally usable in the anterior and posterior areas • Natural opacity for tooth-like results using only one shade • Intelligent colour system with new shades that make good sense: VC A3.25 and VC A5 • Smooth consistency, high light stability, simple high-gloss polishing Please visit us at BDTA Dental Showcase 2010 · london 14.-16.10.2010 · Stand: l04 * Please feel free to request our scientific product information. VOCO_DTI-UK_2610_GrandioSO_210x297.indd 1 22.09.2010 9:44:51 Uhr R ecent developments in composite resin materials and bonding technology have made possible the routine use of these materials in posterior teeth (Van der Vyver & Bridges, 2002). Direct posterior composite resin restorations are now pre- dictable and durable, and in many instances their superior aesthetic and tooth-supporting properties make them the optimal treat- ment option when restoring the posterior dentition (Liebenberg, 1997). The main shortcomings of composite resin materials are po- lymerisation shrinkage (Dietschi, Magne & Holz, 1994) and polym- erization stress. Polymerization stress can result in contraction forces on the cusps that can re- sult in cuspal deformation (Pear- son & Hegarty, 1989), enamel cracks and ultimately decrease the fracture resistance of the cusps (Wieczkowski et al, 1988). This article aims to provide clini- cians with a protocol on how to use SDR (Dentsply) as a flowable base material for direct and in- direct restorations, by means of a pictorial essay illustrating the benefit of this new innovative re- storative material. Cavity configuration and the method of insertion of compos- ite resin into the cavities can in- fluence the gaps at the interface between the dentine/enamel and the restoration (Walshaw & Mc- Comb, 1998). According to David- son and De Gee (1984), the par- allel walls of a box shaped cavity may restrict the flow of composite during polymerization, causing stresses at the resin dentine inter- face (Feilzer, De Gee & Davidson, 1987). The present generation of chemically or light activated flowable composites undergo free volumetric shrinkage of 4-9 per cent as compared to regular vis- cosity and packable composites at 2-5 per cent, with an average of 3.5 per cent. According to Jensen and Chan (1985), polymeriza- tion shrinkage stresses have the potential to initiate failure of the composite-tooth interface which could cause deformation of the tooth, which might result in post- operative sensitivity and could even open pre-existing enamel micro-cracks (Jensen & Chan, 1985). SDR is marketed as a low stress flow-able base material that can be placed in layers of up to 4mm in thickness and each bulk increment light-cured for only 20 seconds, as long as you leave at least 2mm on the occlu- sal surface for regular viscosity composite resin. According to the manufacturer, a polymerizable modulator was chemically em- bedded into the flowable resin material that allows extended polymerization without a sudden increase in cross-link density. This extended “curing-phase” maximizes the overall degree of conversion, minimizing the polymerization stress by up to 60per cent compared to conven- tional flowable composite res- ins (Inside Dentistry, 2009). The volumetric shrinkage is 3.6per cent but more importantly, the stress generated during the po- lymerization is 1.4 MPa, whereas many other flowable composites are above 4 MPa. The material is available in only one univer- sal shade and can be used with any dentine bonding system. Figs 1-19 outlines two clini- cal case reports that illustrate the benefits and clinical application of this new innovative flowable base material for direct posterior composite resin restorations. Base materials are mainly in- dicated to reduce the volume of filling material (Lutz, et al., 1986) Protocol on how to use SDR Prof Peet van der Vyver presents a pictorial essay on the use of Dentsply’s SDR page 26DTà ContaCt us for your frEE saMPLE* • Bulk-fill in increments of 4mm without layering • Excellent cavity adaptation reducing post-operative sensitivity • Provides excellent self-levelling properties • Already thousands of users** Changing dentistry 4mm at a time the 1st flowable bulk-fill base +44 (0)1932 837303 To join the SDR revolution, contact us now for your FREE SAMPLE* (quoting ‘free SDR sample’ and giving your full name and practice address) UKP00265*Limitedstockavailable.Pleaseallowupto28daysfordeliverybyyourSalesSpecialist.**Usersworldwide