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Using Composite in a Patient with Bulimia

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Pre Op

Dr. John Kanca reported a case where a bulimic patient of his had a level of damage to the lingual side of her anterior teeth that required restoration. Noting that, ideally, the best thing to do would be get her bulimia under control, and that he debated providing crowns, he decided to do direct restorations, feeling that the added cost and increased loss of tooth structure couldn’t be justified at the time and the teeth in question needed protection immediately.


Dr. Kanca removed residual decay, while preserving as much tooth structure as possible, and used the same protocol and materials he uses for all direct restorations: the Surpass Self-Etch Adhesive system, Titan Flowable Composite, and Exquisite Restoration Low Shrink, Nanofil Composite, from Apex Dental Materials.


The Surpass three-bottle system includes a conditioner, a primer, and a bond resin. There is only one technique for all procedures, no catalysts are needed, and it offers the highest bond strength.

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Post Op

Titan Flowable Composite offers optimal handling, unsurpassed strength, radiopacity, and ideal esthetics with different levels of shading and translucency.


Exquisite Restoration is a visible light-cured nanofill composite suitable for both anterior and posterior restorations. It has low shrinkage, abrasion, and wear, as well as excellent handling properties.


Dr. Kanca’s reasoning for using direct restorative products in a case where treatment may seem futile or impossible is because he has the utmost confidence in the materials. After looking at the cost/benefit ratio, he thought these materials would hold up under these adverse conditions, and protect the patient’s teeth while she continued to work through the underlying causes of her disorder.


For more information on these materials, click here.









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