Tetric EvoCeram Bulk Fill
POSTERIOR COMPOSITE OFFERS FAST BULK PLACEMENT AND LOW SHRINKAGE
Very simply, I use Ivoclar Vivadent?s Tetric EvoCeram Bulk Fill nanohybrid composite for every single posterior direct composite my staff and I place. I consider the technology advancement of this material and technique to be one of the most exciting evolutions for the practicing general dentist.
Success from the Beginning
In 2009, Ivoclar Vivadent asked me to use Tetric EvoCeram Bulk Fill and provide clinical feedback. I am very methodical about my protocols and I rarely submit to such an invitation, but the truth is I?d been waiting for this breakthrough for 15 years; I was placing direct posterior composites under the strenuous protocol of 3-step etch-and-rinse followed by incremental composite placement. The simplified methodology was an immediate hit for my assistant and myself?we reduced our steps by more than half. After our second patient received Tetric EvoCeram Bulk Fill restorations and responded to our postrestorative call with absolutely no issues, I knew there was no going back. Once I had success with this material and protocol, the thought of going back to incremental fill, with or without liners, was inconceivable.
It is incredibly beneficial to be able to cure a restoration that is no deeper than 4 mm in 1 increment and 1 cure (thanks to Ivoclar Vivadent?s proprietary Ivocerin light initiator). To be able to sculpt a restoration to the occlusal cavosurface margins (with plenty of working time courtesy of an integrated light-sensitivity filter), cure it, and encounter no white lines when finishing and curing was almost surreal the first few times. I expected the polymerization shrinkage to have reaped havoc. However, with the polymerization shrinkage reduced to 1.9% and the shrinkage stress to 1.4 MPa, I have not seen a white line from marginal stress since using Tetric EvoCeram Bulk Fill. I also expected to accept less with esthetics as a trade-off for the 3 available shades. I used to layer 4 different opacities and shades to complete the layered appearance I was trying to emulate. However, I did not experience any downgrade at all, since the monomer and fillers have similar refractive indices, giving the restoration a chameleon effect. My restorations blend in just as well as ever.
Tetric EvoCeram Bulk Fill is compatible with all curing lights, allowing increments of 4 mm to be cured in 10 seconds. With that said, Ivoclar Vivadent?s Bluephase LED curing lights and Tetric EvoCeram Bulk Fill material are suited for optimal compatibility and maximum efficiency. As dental materials continue to advance, it is imperative to incorporate LED curing lights with broad-spectrum, or polywave technology, into the practice. Without the presence of 1 violet LED to accompany the traditional blue LEDs, a dentist takes a big risk by relying on the curing compatibility of the light to various materials.
1 filling, 1 material, 1 increment
I have found Tetric EvoCeram Bulk Fill clinically useful for a variety of composite indications including class I, II, and V, and composite buildups. In terms of productivity, we lowered our steps by 50%. The use of the material translated into a 30% to 60% reduction in the time it took to perform the same restorations with my old protocol.