Composite Warming for the Best of Both Worlds

Dental Products Report, Dental Products Report June 2021, Volume 55, Issue 6

VOCO’s thermoviscous bulk-fill composite VisCalor bulk provides clinicians with the viscosity of a flowable composite and the sculptability of a packable composite in a single material.

As a clinician who has been warming composites for a decade and who serves as an instructor at the Bioclear Learning Center, Frank Milnar, DDS, AAACD, is not easily impressed by a dental material coming along and claiming to provide a major change to the way clinicians perform restorative dentistry. But he’s plenty impressed by VOCO’s VisCalor bulk composite material and fully expects this new composite warming option to have a big impact on the industry.

“There’s moments in time where something transitions from a buzzword to something that’s real. It happened for Amazon and Apple, Bitcoin and Invisalign, and this is one of those moments,” Dr Milnar says of VisCalor bulk, the first thermoviscous bulk-fill composite. “This is where something goes over the line and it’s not a buzzword anymore. It’s real and it’s going to influence how dentistry is going to be taught in the future.”

Designed to be warmed before placement, allowing it to flow into the prep, and then as it cools to body temperature, become sculptable, VisCalor bulk provides clinicians with the viscosity of a flowable composite and the sculptability of a packable composite in a single material. This combination is what makes it a “disruptive innovation,” according to Dr Milnar.

As far back as the early 1980s, some clinicians began tinkering with composite warming, he says, but the advantages were unclear and often unrealized because the techniques were not understood and perfected. But Dr Milnar and others with Bioclear learned about 10 years ago that warming composite has numerous benefits, especially as more clinicians move away from traditional G.V. Black preparations.

When a composite is heated, the physical properties of the material are modified and many of the modifications can make it easier to handle and better able to adapt the material into the preparations. Between 50 referenced articles on the benefits of thermoviscous technology and having used VisCalor bulk in practice now for a couple of months, he is sold on this.

“I get it as a clinician, I get it as an educator,” he says. “This is not going away. It is the footprint of disruptive technology and innovation. It’s going to get larger and larger and larger.”

Although this new material offers physical properties that make treatment more efficient and less complex, it also stands out by doing a great job of blending in. The material has a low water absorption and is available in 4 shades—universal, A1, A2, and A3—which helps it provide optimal esthetics. Additionally, the capsules are optimized for warming, and the narrow tips allow enhanced access to posterior preps for bubble-free application.

Typically, flowables have a lower fill rate and a lower viscosity, and you cannot sculpt them. But when you look at the scientific evidence, a lower filled liner material, for instance, will cause more polymerization shrinkage and possibly more polymerization stress in the cavity preparation. This is not the case with VisCalor bulk.

Thermoviscous technology with VisCalor bulk changes everything because the warmed material changes the viscosity to allow you to inject the material as a flowable, and you don’t need a baseline or multiple layers underneath if you’re bulk-filling.

“This is the best of all worlds. The beauty is that, in a matter of, say, 30 seconds, as soon as you’re expressing this material, it becomes sculptable at 80.6 ºF,” he explains. “Nobody has this. This is the only material in the marketplace that was made with the sole intention to be warm. I’m happy to be part of the emerging frontier of thermoviscous technology.”

Dr Milnar quickly lists several reasons why he would recommend the product to a colleague, including the increased physical properties of the materials, reduced gap formation, reduced microleakage, reduced curing time, reduced shrinkage stress, and enhanced depth of cure.

“This optimizes procedural efficiencies and it is effective and time-saving,” he summarizes. “This is the future of dentistry as we speak today.”