Tokuyama Dental America has a strong reputation for easy-to-use products that endure the test of time. Its recently introduced Estelite Bulk Fill Flow also is sure to impress. If you place posterior composites on a regular basis, as most clinicians do today, you need 2 key ingredients for a successful restoration.
First, the operator needs to be confident the restoration can be placed in a reasonable amount of time to ensure efficiency and profitability. With changes in reimbursement and rising overhead costs, dentists are continually looking for new ways to get more done in the same amount of time.
Bulk fill composites have come about because of those specific needs. While composite restorations look better than traditional amalgam restorations, they are much more technique sensitive and less predictable because of environmental and contamination issues. How quickly a clinician can complete a restoration is often indicative of how well the restoration will perform long-term.
Estelite Bulk Fill Flow is specifically designed to be placed in one or 2 increments (up to 4 mm) in the tooth preparation (Figure 1). Class I and III restorations often can be restored in one bulk cure. Class II and IV restorations can be placed in one or 2 increments. The narrow pre-loaded tips allow even the smallest Class II restorations to be filled with ease. In addition, the viscosity is optimal for quick filling of dental preparations so the operator can move on to the next tooth or patient.
The second ingredient to a successful restoration is cosmetics. It is increasingly important for clinicians to make sure all restorations, even in the posterior, have a pleasing result to the eye. Patients are more concerned than ever about how all of their teeth look, not only their anterior teeth.
Estelite Bulk Fill Flow has beautiful results. After adjusting occlusion and polishing, it is indistinguishable from traditional packable composites. You will experience, as I have, high satisfaction in using and placing this composite.
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| Figure 1. Estelite Bulk Fill Flow (Tokuyama Dental America) does not require a capping layer. No additional layers or composites are needed up to 4 mm. | Figure 2. The preoperative view of teeth Nos. 18 and 19 demonstrate the tired, aged, and failing amalgam restorations in need of replacement. |
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| Figure 3. Completed restorations are beautiful and can blend in seamlessly with the surrounding tooth structure. | Figure 4. This preoperative photo indicates the significant cervical decay present in teeth Nos. 10 and 12 that now require excavation. |
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| Figure 5. The final restoration is highly aesthetic, glossy, and very pleasing to the patient and the eye. |
Case No. 1
The patient presented for treatment-planned replacement of failing amalgam restorations. Preoperative photos revealed corrosion and marginal failure. Following anesthesia, the teeth were prepped routinely.
The size of the caries dictated very large occlusal preps, with tooth No. 19 extending buccally into the buccal grooves (Figure 2). Once caries were completely removed, the teeth were isolated with cotton rolls and ready for definitive restorations.
Enamel was acid etched with 38% phosphoric acid (Pulpdent). Dentin was bonded with Scotchbond Universal (3M) adhesive and cured. Preps were filled completely with Estelite Bulk Fill Flow shade U #19 and B1 #18 in one increment (up to 4 mm) and cured for 20 seconds. Occlusion was adjusted using a Piranha #8 (SS White Dental) round single-use diamond.
The restorations were polished and shaped with Moore’s discs, Enhance Cups (Dentsply Sirona), and PoGo (Dentsply Sirona) to achieve the final shine. Anatomy was added using a Piranha single-use pointed football diamond bur prior to polishing. The result was both functional and aesthetically pleasing (Figure 3). The patient experienced no post-operative sensitivity on these large restorations.
Case No. 2
The patient presented with significant anterior decay in the cervical areas of teeth Nos. 10 and 12 (Figure 4). While crowns in the anterior region are optimal, the patient elected to restore with composite due to finances.
The teeth were prepped using a round-end cylinder Piranha single-patient-use diamond, and decay was removed completely. Due to large “apple-core” type Class V and Class III combination fillings, it was desirable to be able to fill those preparations in one setting and with one restorative material. Estelite Bulk Fill Flow was chosen because of those clinical indications.
The teeth were isolated with the Greater Curve matrix band. The enamel was etched with the 28% phosphoric acid etchant (Pulpdent). After enamel-only etching, the dentin was bonded and cured with the Scotchbond Universal bonding agent.
The entire preparation was filled in one increment with Estelite Bulk Fill Flow shade B1. The preparation was shaped with the same Piranha cylinder bur, and the embrasure spaces were shaped with a Piranha single-patient-use needle 0.8-mm diamond bur.
Polishing was accomplished with Moore’s discs and Enhance Cups. The final polish was reached with Dentsply PoGo. The patient was pleased with the beautiful and quick aesthetic result (Figure 5).
For more information, call Tokuyama Dental America at (877) 378-3548 or visit the website tokuyama-us.com.
