What do you use for your Class II restorations?

Class II restorations are something you’ll have to do for as long as patients hate flossing. But they don’t have to be something you dread. Learn how to make them faster, easier, and more predictable with these tips from Erin Elliott, DDS, Joshua Austin, DDS, MAGD, and Howard S. Glazer, DDS, FAGD, FACD, FICD, FASDA, FAAFS.

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Class II restorations are something you’ll have to do for as long as patients hate flossing. But they don’t have to be something you dread. Learn how to make them faster, easier, and more predictable with these tips from Drs. Erin Elliott, Joshua Austin, and Howard S. Glazer.

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Erin Elliott, DDS


1. Total etch, selective etch, or self-etch?

Selective etch and self-etch.

2. What bonding system do you use?

Prime & Bond Elect (Dentsply Sirona). We have tried some other bonding agents and the different carriers. I like the single-use compules and the delivery method. I like the consistency. It’s not too thick, especially on radiographs, and I can see when it has been properly bonded.

3. What is your flowable composite?

SureFil SDR Flow+ (Dentsply Sirona). I like the fact that it goes where I tell it to, even when I’m working on maxillary teeth. I have confidence that there are no voids. And it’s radiopaque so any future dentists will know there is not recurrent decay.

4. What is your posterior composite?

TPH Spectra ST HV (Dentsply Sirona) and Grandio (Voco). Most posterior composites are made the same, so for me, it comes down to consistency and the “feel.”

5. What polishing system do you use?

A Brownie (Shofu Dental) and Enhance PoGo (Dentsply Sirona).

6. What matrix system do you use?

Composi-Tight (Garrison Dental Solutions) and Palodent Plus (Dentsply Sirona). We recently moved to the Palodent matrices, but we have Garrison matrices left, so it depends on what room I’m working in. I have my assistant do the matrix, so it only really matters what she thinks.

7. Any tricks or technology that changed your Class II game?

Yes! My favorite bur for breaking contacts and interproximal finishing: Two Striper 201.3F
(Premier Dental).

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Joshua Austin, DDS, MAGD


1. Total etch, selective etch, or self-etch?

Selective etch, all the way. Phosphoric acid is detrimental to dentin. It’s harsh. It’s easy to overetch dentin with phosphoric acid. And phosphoric acid etchants activate matrix metalloproteinases (MMPs) in the dentin that begin the process of breaking down the dentin bond. The self-etch component in our universal bonding systems works great on dentin without overetching and activating MMPs, but it’s just not strong enough for etching enamel. That is where the selective-etch part comes in. Phosphoric acid etches the enamel, which is so much more resilient to etching than dentin is, and we have a great interface for bonding.

2. What bonding system do you use?

I use universal adhesives. The brand names don’t particularly matter. The technique does. With good technique and proper isolation, anything works. I choose universal bonding agents to simplify my armamentarium and because they allow me to selectively etch.

3. What is your flowable composite?

I prefer a bulk-fill flowable, and I use the snowplow technique. The flowable is basically forced out of the prep using the hydraulic pressure of the paste composite, leaving only flowable where there would have been a void.

4. What is your posterior composite?

Again, I prefer a bulk-fill composite. I want to be able to cure the box all in one shot. With most small to moderate preps, you can do that with bulk-fill materials. I find that most clinicians tend to overfill their increments, even when trying to be judicious, so you might as well use a material that is made to be cured in deeper increments. If I have a really deep box, I will fill it incrementally, but that’s an exception. For everyday Class IIs, bulk-fill composite works great. I use the snowplow technique for most of my Class IIs, meaning I put a dot of bulk-fill flowable composite around the edges and then immediately start to load it with bulk-fill composite paste. The bulk-fill composite paste forces the flowable out. The only thing left is filling in where there would have been a void without it. The snowplow technique is a great technique to use with bulk-fill materials.

5. What polishing system do you use?

Polishing has to be practical for me—one or two steps. Let’s be real. I’m on Delta too. I’m getting $138 for that Class II. I don’t have time to spend five-plus minutes polishing it with a four- or five-step polishing system. It ain’t happening. Find a nice one- or two-step system you like. Enhance PoGo, OptraPol Next Generation (Ivoclar Vivadent), and Sof-Lex Diamond (3M Oral Care) all work great—and probably a bunch of other systems do too. The key is to find one you like and use it, but it shouldn’t take more than 30 seconds to a minute. Thanks a lot, Delta.

6. What matrix system do you use?

A sectional matrix system is a must for using bulk-fill composites, and it should definitely be something you own. There are a handful of great sectional matrix kits. Composi-Tight 3D Fusion (Garrison Dental Solutions), Palodent Plus, Bioclear, and Waterpik ClearView are all great. Another thing to keep in mind is that you can assemble your own kit if you’d like. There are things I like about each of those kits. You can use the wedges from one kit, the matrices from another, and the rings from yet another. Try them all out and see what you like best out of each kit. Then put them all together to make the best kit for you.

7.Any tricks or technology that changed your Class II game?

This is so rote and boring, but a rubber dam just makes my life easier and makes me faster.

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Howard S. Glazer, DDS, FAGD, FACD, FICD, FASDA, FAAFS


1. Total etch, selective etch, or self-etch?

I generally use seventh-generation bonding agents or eighth-generation universal agents, which are self-etch for most restorative procedures. That said, whenever I do not think I have sufficient enamel, I selective etch the preparation.

2. What bonding system do you use?

I use several seventh-generation agents, such as Beautibond (Shofu Dental), Bond Force (Tokuyama Dental), iBond SE (Kulzer), and G-Aenial Bond (GC America). For universal agents, I like the Adhese Universal VivaPen (Ivoclar Vivadent), All-Bond Universal (Bisco Dental), and Futurabond U (Voco).

3. What is your flowable composite?

There are several that I like and use based on the thixotropy of each: Beautifil Flow Plus F00 and F03 (Shofu Dental), G-Aenial Flow (GC America), Wave HV Flow (SDI), and Admira Fusion Flow (Voco).

4. What is your posterior composite?

I use several different composites in the posterior, and I still layer to adapt the shade to match the natural tooth. Remember, this is the art and science of dentistry, and not every "A2" is the same shade. Packable composites I like include Venus Diamond (Kulzer), Admira Fusion (Voco), Beautifil II (Shofu Dental), Aura Easy (SDI), Estelite Sigma Quick (Tokuyama Dental), G-Aenial Sculpt (GC), and Evanesce Nano-Enhanced Universal (Clinician’s Choice). For bulk fill, I like Tetric EvoCeram (Ivoclar Vivadent).

5. What polishing system do you use?

I regularly use Super-Snap Singles and Super-Snap X-Treme (Shofu Dental) and Jazz Polishers (SS White).

6. What matrix system do you use?

Both the Triodent V3 rings (Ultradent) and Composi-Tight 3D Fusion rings.

7. Any tricks or technology that changed your Class II game?

By far, the instrument that has made a huge difference in how I pack Class II composites is the OptraSculpt Pad kit (Ivoclar Vivadent). The instrument has disposable tips that allow you to pack, sculpt, and contour the composite, and it leaves the surface about 95% finished and polished. One word of advice—make sure you order at least two handles per treatment room. Otherwise, you will have tips to use but the handle will be in the autoclave.

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