Low-Shrink Composite Technology
A new class of composite material with optimized mechanical properties is designed to reduce shrinkage stress.
Confused by all of the composite terminology over the past decade? Macrofill, microfill, hybrid, microhybrid, nanohybrid, low-shrink, etc; these materials have made important contributions to our industry and the manner in which we provide care. Yet, of all the different composite choices, nothing has garnered more excitement in recent years than the promise of "low-shrink" composites. Low-shrink composite materials have promised to make posterior adhesive dentistry easier, safer to use, and more appealing to the masses of dentists concerned about placement methodology and long-term clinical results. In fact, for more than a decade, achieving low-shrink has been the Holy Grail in adhesive dentistry for composite manufacturers and dentists alike. Dental material companies are finding, however, that low-shrink does not achieve all that they and others believed it would.
Today, we are beginning to see a new class of composite material with optimized mechanical properties designed to reduce shrinkage stress as opposed to merely addressing the issue of shrinkage. This fact is significant given that a lower-shrink material does not necessarily offer a low-shrinkage stress value. The result of using a low-shrink, higher-stress building composite can be just as deleterious and harmful to the tooth as placing an older composite material using a bulk-placement technique.
Thankfully, these new low-stress materials allow for simpler, faster, and fewer steps in placing composite, making placement safer and more time efficient than ever before.
The technique used in the case presented in this article began by using a self-etch adhesive (Figure 1, Figure 2, Figure 3, Figure 4, Figure 5, Figure 6). iBOND® Self Etch adhesive (Heraeus Kulzer, https://www.heraeusdentalusa.com) was chosen because of its high bond strength to both enamel and dentin, simple one-coat technique, and proven clinical efficacy.
After placement of the self-etch adhesive, a low-shrink, flowable composite material (Venus® Bulk Fill, Heraeus Kulzer) was used to fill up all but approximately 1.5 mm of the occlusal surface (Figure 7 and Figure 8). The approximate total depth of the low-shrink, flowable material was 4 mm. Venus® Diamond Bulk Fill material was chosen because it can be placed up to 4 mm deep. In the author's opinion, this bulk-flow flowable allows for fast, safe, and efficient placement without compromising the clinical result (Figure 9 and Figure 10).
After placement of Venus® Bulk Fill, a final layer and single shade of Venus® Diamond Universal Composite (Heraeus Kulzer) was chosen specifically because of its durability, high wear resistance, and color-adaptive qualities. Primary, secondary, and even tertiary anatomy is simple to carve and create with the wax-like consistency of Venus® Diamond (Heraeus Kulzer) (Figure 11, Figure 12, Figure 13, Figure 14, Figure 15).
Venus® Bulk Fill base/liner flowable composite material allows for fast, simple, and safe clinical application of composite in a posterior restorative situation. Heraeus' entire Venus Esthetic Solution System provides for a complete solution to what has historically been a difficult task: Restoring posterior teeth to proper function and esthetics using a system that provides simplicity, repeatability, and the promise of long-term success.
About the Author
Amanda Canto, DDS