Dental Tribune USA

Wanted: A universal composite restorative material with truly universal applications

By Douglas Harvey, BSc, DDS
February 22, 2017

While the demand for esthetically pleasing composite restorations that also mimic the natural dentition is rising, there is a similar growth in the desire for a comprehensive, yet simple, system that will allow dentists of every skill level to deliver beautifully sculpted esthetic restorations regardless of their location in the mouth.

Most dentists want to create these quality composite restorations that meet their esthetic goals but that are also structurally and functionally sound. The challenge is not only how to provide this level of service within a reasonable amount of chair time and at a reasonable cost to the patient but to not be burdened with a cumbersome composite system with so many choices of shades, opacities and characterizers that confusion stifles creativity.

Keeping it real

There are a myriad of composite restorative materials that purport to enable the dentist to esthetically restore a tooth to its original form or enhance its natural beauty. The characteristics of a good universal composite restorative system, as far as shades and opacities are concerned, should include only the most frequent naturally occurring Vita shades in the most commonly occurring opacities. Additionally, a very limited number of non-Vita shades and characterisations may be available for the most demanding of cases. Systems that go beyond this only add confusion to the selection process.

Evanesce Nano-Enhanced Universal Restorative System (Clinician’s Choice, New Milford, Conn.) offers shades and opacities limited to the most common natural occurring shades and opacities, plus two bleach shades and three Enamel FX shades to be used when rendering a more demanding esthetic application. Evanesce is ideal for the single-shade cases in its Universal opaque shades; for those cases where layering is required, Enamel and Dentin opacities are offered and often can be used with limited and simplified layering techniques; and for those clinical situations where surface flaws and inclusions exist, the three Enamel FX’s shades can be sparingly used for maximum esthetic effect. Evanesce offers a comprehensive, yet simplified, selection of composite for ease of use while resulting in highly esthetic restorations regardless of the technique.

Work with me

An excellent universal composite will allow itself to be sculpted and manipulated into position without slumping or pull-back because of tackiness. Even further thinning and blending with fine brushes should allow the composite to be feathered to an infinity margin. Special rheological modifiers in Evanesce Universal Nano-Enhanced Restorative material give this composite putty-like handling with the capability of being adapted and spread to the exact desired position without slumping prior to curing.

Aging gracefully

Polymerization shrinkage of your chosen universal composite material will play a large part of your restoration’s lifespan. Too much shrinkage upon curing will quickly lead to marginal breakdown and recurrent decay. A desirable low shrinkage rate of 2 percent for Evanesce is a direct result of its unique chemistry. UDMI (Urethanedimethacrylate) is combined with Barium glass filler, ytterbiumtrifluoride, silicon dioxide and abundant pre-polymerized fillers to minimize its polymerization shrinkage and regulate opacity.

Universal composite restoration material, by definition, has to have great strength and wear characteristics regardless of its location in the mouth. Once polymerized, the universal composite must be able to withstand harsh forces of mastication and occlusion, all the while retaining its dimensional stability.

However, strength of a composite restoration should not come at the expense of its polishability or ability to hold on to that shine over the years. In fact, for a composite to be deemed universal, strength and polishabilty must exist in balance. Some universal composites are strong but do not polish well or easily or even hold that shine past a few months. Others may exhibit high shine but lower strength and high wear factors.

It is this category that Evanesce has the most to offer. High-strength characteristics and low-wear rates are significant traits that are seen in Evanesce restorations, anteriorly and posteriorly. Polishabilty of an Evanesce restoration is achieved quickly to a high, long-lasting shine.

Moreover and true to its name, Evanesce has the ability to blend in and disappear into the adjacent tooth structure. This is accomplished by the use of a proprietary process that optimizes the refractive index of Evanesce’s unique nano pigments and fillers.

By managing the lifespan-shortening effects of polymerization shrinkage, strength and wear, Clinician’s Choice’s Evanesce has enabled all anterior and posterior restorations to be placed simply and esthetically with total confidence in their longevity.

Universal composite: Concept to reality

At first glance, the meaning of a universal composite restorative material is easy to describe: Use anywhere on the tooth, anywhere in the mouth and perform equally well in both anterior and posterior applications. This list is the bare minimum for your selection. Clinician’s Choice has purposefully added highly desired esthetic qualities to the list, as well as achievements in engineering and formulation, in order to extend the definition of “universal.”

That one universal composite system in your operatory should address all of your clinical applications without sacrificing any esthetic or long-term expectations. Clinician’s Choice offers Evanesce Nano-Enhanced Universal Restorative Material — the one composite restorative system with the capability to be used universally, with no compromises.


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