For 6 years, I have been placing composite restorations using Clark Class II cavity preparations, which are smaller on the inside and bigger on the outside. They are created with long infinity edge margins, which have better resistance to ditching. To be successful, however, this treatment demands a specific technique for composite placement, as well as the use of an ideal composite. I have found 3M's Filtek Supreme Plus flowable restorative and its paste counterpart, Filtek Supreme Plus universal restorative to be very well-suited.
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Many flowable composites are too translucent and lack the esthetics to rival their paste counterparts. With this hybrid technique, clinicians can be confident that the 3M flowable is as esthetic as the paste. The new generation of this product, Filtek Supreme Ultra universal restorative, makes it even easier to create strong and esthetic Class II restorations.
Easy Handling Solution
Paste composite is often a fussy material. Product handling can make an enormous difference in the success of the restoration, minimizing voids, staining margins, white lines, and gaps. I've found Filtek products to be consistently easy to manipulate because they are not as stiff as other composites. This standard has been maintained with Filtek Supreme Ultra universal restorative, and improved in the translucent shades.
In vitro studies have shown that the polish retention of this new generation also is improved. The wear resistance is equivalent to that of Filtek Supreme Plus universal restorative, which wears at essentially the same rate as enamel and is known for its strength in the anterior and posterior. The expanded range of body shades offers more choices for singleshade restorations.
Injection-molding Technique
In the injection-molding technique I use with Clark Class II restorations, the combination of Filtek Supreme flowable and Filtek Supreme Ultra universal restoratives helps achieve an esthetic, voidfree result. To perform the procedure, a Bioclear matrix is placed around the tooth and adhesive is applied. A small amount of flowable composite is injected into the matrix, not light cured, followed by the universal paste and then cured together. The initial application of the flowable allows the material to reach all areas inside the matrix, and it serves as a wetting agent for the heavier paste composite. Once the paste is injected, much of the flowable material is displaced and removed. In large or deep cavities, this technique is modified to account for C-factor and complete curing (details at www.bioclearmatrix.com).
Some dentists make the mistake of relying too heavily on flowable composites to fill minimally invasive cavity shapes. Using the injection-molding technique, the more wear-resistant and stronger paste composite can be successfully applied to the preparation, with the flowable helping it get to hard-to-reach areas.
Meeting the Demand
Minimally invasive preparations demand materials that are easy to place. Now that dentistry is moving away from old-fashioned boxy preparations, we need a composite that is well-suited for minimally invasive preps. The ease of use, handling, wear resistance, strength, and increased polish retention of Filtek Supreme Ultra universal restorative combined with judicious use of Filtek flowable is a clear choice.
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