Simplified Posterior Restorations

Direct restorations in posterior teeth are a routine and frequently performed dental procedure. Despite their commonality, when using direct composite resin, it demands meticulous attention to detail and roughly twice the time compared to traditional amalgam fillings. The process involves the precise layering and curing of multiple composite layers to ensure complete polymerization and a successful restoration.

While this technique offers benefits, it also comes with limitations. Polymerization shrinkage and insufficient adhesion can lead to marginal leakage and a persistent gap between the composite and tooth, resulting in postoperative sensitivity and potential cavities. Incorrect execution of this technique-sensitive protocol can also lead to premature failure of direct posterior restorations.

In the search for a material that addresses these concerns, Tetric EvoCeram Bulk Fill was developed. This innovative composite material, characterized by its smooth consistency, offers superior cavity adaptation, reducing the likelihood of voids compared to other materials. Many modern bulk-fill composites have reduced technique sensitivity, minimizing the risk of shrinkage-related issues. They also demonstrate excellent handling and adaptability, making the placement of predictable and aesthetic posterior restorations faster and simpler.

Tetric EvoCeram Bulk Fill, from Ivoclar Vivadent, stands out due to its unique composition, featuring layered silicates that create a smooth and adaptable consistency. This allows for the filling of cavity preparations up to 4 mm in a single layer, often eliminating the need for a flowable liner. Moreover, the inclusion of a polymerization booster enables complete curing of 4-mm thick increments in just 10 seconds, while maintaining a natural appearance and providing sufficient working time. Additionally, it incorporates a shrinkage stress reliever, reducing the overall shrinkage stress on cavity walls and surfaces during polymerization.

Thanks to its adaptability and curability, Tetric EvoCeram Bulk Fill allows for filling a Class II restoration in half the time required with traditional materials. This composite conforms well to cavity walls, is easily contoured, and allows for anatomic detailing with standard dental instruments, eliminating the need for extra equipment. It's available in three universal shades, blending seamlessly with natural dentition and easily achieving a high-gloss polish. Tetric EvoCeram Bulk Fill represents the perfect combination of productivity, performance, and aesthetics.

Case Study 1

A 17-year-old patient presented with recurrent decay under a previously placed restoration on tooth No. 30. The restoration was roughly a decade old, and the patient had not visited the dentist for over four years. Radiographs showed that the decay had moderately reached the dentin layer.

The patient was anesthetized with a 2% lidocaine block, and a non-latex dam was used to isolate tooth No. 30. The existing restoration and decay were removed, followed by the application of a 35% phosphoric acid-etch. A two-step bonding system was employed to ensure optimal adhesion. The bulk-fill restorative, Tetric EvoCeram Bulk Fill, was applied in a single layer due to the 4-mm depth of the preparation. Shade IVB was used for this case, and the restoration was shaped, cured, and polished, resulting in a strong, lifelike, and aesthetically pleasing outcome.

Figures: 1-6

Case Study 2

A 31-year-old patient presented with recurrent decay and irregular margins on teeth Nos. 30 and 31. Radiographs showed moderate decay on the distal of tooth No. 31 at an overhanging margin. The same procedure was employed for this case, utilizing Tetric EvoCeram Bulk Fill. The results were again impressive, with excellent handling and material properties ensuring efficient placement, contouring, and polishing.

Figures: 7-15

In Conclusion

Selecting a bulk-fill material with excellent handling and material properties can significantly benefit both dentists and patients by saving time and delivering highly aesthetic posterior restorations. Tetric EvoCeram Bulk Fill excels in sculptability and optical properties, allowing for the addition of intricate anatomical details and lifelike aesthetics. The numerous advantages of Tetric EvoCeram Bulk Fill, including minimized polymerization shrinkage, make it an efficient and effective solution for posterior Class II restorations.