A New Era of Composites Has Arrived

Joseph S. Kim, DDS, JD

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Sponsored Editorial 

When it comes to composite restorations, dentists are often asked to sacrifice speed for quality or quality for speed. This has been especially true when it comes to bulk fill composites, which brought the promise of larger increment sizes but required specialized equipment or were otherwise difficult to handle.

Now, clinicians can have a composite that easily adapts to the tooth and can be used in a true bulk fill technique. REVEAL HD Bulk is BISCO’s new bulk fill light-activated restorative composite, optimized for simpler and faster posterior restorations. REVEAL HD Bulk combines appropriate handling, depth of cure, and polishability, allowing clinicians to provide patients with functional and aesthetic composites while saving valuable chair time. 

REVEAL HD Bulk allows for layering increments up to 5 mm due to its predictable depth of cure. This feature is accompanied by low volumetric shrinkage, high flexural strength, and excellent radiopacity, resulting in long-lasting, durable restorations. While REVEAL HD Bulk is indicated for all direct and indirect restorations, clinicians will appreciate the significant time savings that bulk filling provides, especially in posterior teeth. 

Like other restorative composites, it is important to maintain adequate isolation to prevent contamination of the tooth from saliva and blood. When indicated, use of a sectional matrix system with significant separating force will ensure excellent adaptation to the proximal margins, as well as minimize interproximal food impaction. 

After excellent isolation has been achieved, a universal bonding agent such as ALL-BOND UNIVERSAL is applied to all prepared surfaces according to manufacturer instructions. When possible, it is ideal to selectively etch the enamel surfaces where the composite is intended prior to application of the bonding agent, resulting in minimal long term marginal leakage and dentinal sensitivity issues.

Depending on operator preference, a flowable composite resin may be used in the deepest and least accessible areas of the preparation, including undercuts and the cavosurface margins of proximal boxes. The appropriate shade of REVEAL HD Bulk can be placed in a single increment for most Class 1, 2, and 3 restorations.

For preparations that include areas that are deeper than 5 mm, it is advisable to build the restoration in appropriately sized increments. Keep in mind that, due to its unique chemistry, care should be taken to avoid unnecessary exposure to light, including from ambient and overhead sources, to avoid premature hardening of the material.

Finally, the restoration can be finished with fine diamonds and finishing carbides, followed by finishing points. It is worth noting that since REVEAL HD Bulk’s viscosity has been tuned for bulk fill applications, it is preferable to limit occlusal carving and shaping to primary anatomy prior to curing. After curing, greater detail may be added with finishing burs, as needed.

Alternatively, when darker or opaceous restorative composite shades are required, REVEAL HD Bulk can be placed and cured short of the occlusal cavosurface margins. The final layer can be a traditional restorative composite in an ideal shade and opacity. Because REVEAL HD Bulk is universally compatible, it will serve as an excellent base under all light-activated restorative composites.

Download the case study at http://revealhdbulk.bisco.com/.

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