CDE0211

32 I I industry report _ compobonds comparable to bonding to cut, prismatic enamel. However, the SBS is lower with uncut or aprismatic enamel, which is similar to using SE agents alone. For this reason, it is advisable to either bevel or etch aprismatic enamel beforehand to ensure a sustain- able and durable marginal seal (Fig. 7). Conversely, pre-etching dentine when using Vertise Flow re- duces the SBS to dentine, and is therefore contra- indicated. Another disadvantage of pre-etching dentine is opening dentine tubules that may not be sealed to the same depth by the subsequent use of VertiseFlow,andcouldcontributetopost-operative sensitivity. The chemical composition of Vertise Flow incor- porates four types of fillers, with a total 70 % load- ing. The inclusion of nano-ytterbium fluoride yields excellent radiopacity and fluoride release (for bio- activity), the pre-polymerised fillers reduce micro- leakage, and nanoparticles improve polishability and thixotropic properties. The FS is 120 MPa for mitigating bulk fracture, and the MOE is low, ap- proximately 7 GPa, for shock absorbing capability (Fig. 8). BecauseVertiseFlowfunctionsasbothadentine adhesive and a resin restorative material, a longer curing time is necessary to ensure that both constituents are fully polymerised. In addition, the light-curing reaction also halts the etching process of the SE agent, increasing its pH from approxi- mately 2 to 7, so that continual acidity does not erode the dentine bond. A further advantage of Vertise Flow is inclusion of the acidic phosphate monomer, which provides chemicaladhesiontoavarietyofintagliosurfacesof indirect prostheses, including non-precious alloys, gold,alumina,zirconiaandsilicaceramics,forexam- ple feldspathic, lithium-disilicate or other pressed ceramic systems. This adhesive property is excep- tionally useful for repairing intra-oral fractured porcelain, for example all-ceramic crowns, inlays or onlays, or patching up chipped porcelain defects without replacing the entire prosthesis (Fig. 9). The handling properties of Vertise Flow are fav- ourable for numerous applications. For example, its viscosity occupies a middle ground, neither too viscousnortoorunny,andthereforesatisfiesawider range of clinical applications, both as a liner/sealant and for entire small cavity restorations. Vertise Flow is available in a selection of shades for the subtlest of aesthetic requirements, ranging from XL for bleachedteethtoTranslucentforfissuresealingthat allows visibility of any future decay (Fig. 10). Similar to glass-ionomers and their variations, compobonds offer adhesion to natural tooth sub- strate. However, whilst both materials have similar indications, their properties and handling charac- teristicsvaryconsiderably.Glass-ionomersessential- ly adhere exclusively to dentine, have low mechan- ical strength, average aesthetics and low wear, but offerbothfluoridereleaseandrecharge.Inaddition, the setting reaction is affected by the degree of moisture of dentine, and involves a two-stage clin- ical procedure. On the other hand, compobonds offerdentineandenamelbonding,highmechanical strength, low wear, better aesthetics, a single-stage clinical procedure and fluoride release, but not fluoride recharge. Fig. 28_The initial layer of Vertise Flow is light cured before adding further material. Fig. 29_The finished restorations are polished with tips for a high lustre, ensuring impeccable integration with the surrounding enamel. Fig. 30_Pre-op occlusal contacts to verify that the cavity is not in a stress-bearing area. Fig. 31_After rubber dam isolation, pumice is used to cleanse the tooth. Fig. 32_A cavity is prepared with bevelled enamel margins. Fig. 33_Post-op view showing the cavity restored with A3 Vertise Flow. cosmeticdentistry 2_2011 Fig. 29 Fig. 30Fig. 28 Fig. 32 Fig. 33Fig. 31