Printer Friendly Email Article

Nano-optimized universal hybrid composite Features • Formulated with three different nano particles—fillers, pigments and a modifier   •   Demonstrates low wear and low shrinkage and is easy to polish •  Restorations exhibit a natural fluorescence and high radiopacity •  Supplied in syringes and Cavifil unit-dose capsules •  Color-coded labeling system facilitates dental procedures Ivoclar Vivadent Inc. ivoclarvivadent.com 800-533-6825 (800-263-8182 in Canada)

Tetric EvoCeram is a nano-optimized universal hybrid composite that can be used for anterior and posterior restorations. This innovative composite is easy to use and comes with other advantageous features, including three different types of nano particles—fillers, pigments and a modifier—combined in its formulation.

As a result, Tetric EvoCeram demonstrates low wear and low shrinkage and is easy to polish. Restorations created with Tetric EvoCeram exhibit a natural fluorescence and high radiopacity and retain their polish long-term.

Supplied in syringes and Cavifil capsules, Tetric EvoCeram is color-coded to facilitate dental procedures. To ensure clinicians can work more efficiently during each dental procedure, the syringe label colors and the colors of the caps imitate the A to D shade system.

The composite is available in 19 shades, including 11 A through D shades. Overall, this composite facilitates nice blending of shades and demonstrates excellent handling characteristics.

Case Presentation

A 40-year-old female presented after completing a maxillary all-ceramic esthetic makeover (IPS e.max). However, after the makeover, she elected to bleach her mandibular arch and requested removal of the amalgam restorations in her posterior teeth to complete her “smile makeover.”

The original objective was to place two direct composite restorations in teeth Nos. 28 and 29 (Fig. 1), but because of circumstances such as recurrent decay under the amalgam in tooth No. 29, an indirect restoration was necessary. For tooth No. 29, the preparation dictated an all-ceramic onlay (IPS e.max). However, tooth No. 28 received a direct composite resin restoration created using the nano-optimized universal composite.

The procedure

1. After tooth preparation (Fig. 2) and isolation with rubber dam, a contoured metal matrix band is placed around the tooth (Fig. 3).

2. Phosphoric acid etching gel is applied to the tooth for 30 seconds (Fig. 4).

3. A single-component bonding agent (ExciTE) is placed onto the tooth for 15 seconds, after which a warm air drier is used to evaporate the solvent (Fig. 5).

4. The bonding agent is light-cured for 10 seconds (Fig. 6).

5. A thin layer of flowable composite (Tetric EvoFlow) is applied to help seal the apical portion of the proximal box (Fig. 7). This seal is used to ensure no macroleakage occurs. This layer is cured for 40 seconds with the Demi (Kerr Corp.).

6. Using the Tetric EvoCeram composite, an initial layer of A1 body shade is placed into the preparation, sculpted and cured for 40 seconds (Fig. 8). A second increment of shade A1 is then applied, sculpted into place and then cured for 40 seconds with the Demi (Kerr Corp.).

7. A final layer of Tetric EvoCeram composite in a translucent shade of bleach Evo is then sculpted onto the tooth (Fig. 9) and cured for 40 seconds. Isolation with the rubber dam helps ensure a good bonding technique and provides the time to control and place multiple layers of composite onto the tooth.

8. Using an abrasive finishing point, the final occlusal contour is achieved (Fig. 10).

9. After the occlusion is verified, the resin receives a final polish (Fig. 11).

10. The direct resin restoration demonstrates natural- looking esthetics (Fig. 12). The final bleach shade layer helps to create the optical properties necessary to blend the restoration seamlessly into the tooth.

Conclusion

Tetric EvoCeram is a nano-optimized universal hybrid composite suitable for anterior and posterior restorations. This composite is constructed of three different nano particles that represent the optimal mix of filler particle sizes, enabling clinicians to achieve the desired functional and esthetic outcomes patients expect. Because Tetric EvoCeram is available in a variety of shades, as well as with convenient color-coded labels on the syringes and Cavifils, clinicians can realize lifelike restorations with natural-looking fluorescence and high long-term polish. 

* Unless otherwise indicated, all products mentioned in this article are from Ivoclar Vivadent Inc.

Fig. 1 Pre-operative view of teeth Nos. 28 and 29 showing old restorations in place and recurrent decay.	Fig. 2 View of the final preparation for a Class II composite resin restoration on tooth No. 28; a pressed ceramic onlay was planned for tooth No. 29.	Fig. 3 A contoured metal matrix band was placed around the tooth.
Fig. 4 Tooth No. 28 was etched with phosphoric etch for 30 seconds.	Fig. 5 A single-component bonding agent (ExciTE) was applied to the preparation of tooth No. 28.	Fig. 6 The bonding agent was light-cured for 10 seconds.
Fig. 7 A thin layer of a flowable composite (Tetric EvoFlow) was placed into the preparation to seal the apical portion of the proximal box.	Fig. 8 Using the nano-optimized composite, an initial layer of A1 body shade was placed and sculpted.	Fig. 9 The final layer of a translucent composite resin (Bleach, Tetric EvoCeram) was sculpted.
Fig. 10 An abrasive finishing point was used to finalize the occlusal contour.	Fig. 11 Once the occlusion was verified, the resin was given a final polish.	Fig. 12 Post-operative occlusal view of the final direct composite resin restoration on tooth No. 28.