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I have it—you want it! Nanohybrid composite material and more

Feb. 2, 2019
Dr. Howard S. Glazer reviews Ecosite Bulk Fill nanohybrid composite material, Beautifil Flow Plus X injectable hybrid composite material, Riva Star silver diamine fluoride desensitizer, and the Foresight 45 SGL high-speed LED handpiece.

Howard Glazer, DDS, FAGD

Ecosite Bulk Fill nanohybrid composite material from DMG America

Bulk-fill resins are all the rage and becoming increasingly popular among restorative dentists, so it seems that each manufacturer tries to offer a unique advantage. Such is the case with DMG’s Ecosite Bulk Fill composite restorative material, which has, as a distinction, a depth of cure up to 5 mm in just 20 seconds.

This exciting new material is available in either syringes or unit doses called Safetips. I prefer the Safetips, so I can dispense the material exactly where I want it and avoid potential air entrapment, voids, and cracks. I also like that I do not usually need a “cover coat” to mimic the shading of the natural tooth.

Handling is easy since it packs well and easily adapts to the cavity walls. This is a nanohybrid composite with a mix of fine glass fillers and nanofillers (82% filled by weight). Ecosite handles nicely for sculpting the occlusion and has low shrinkage stress values.

Ecosite Bulk Fill is available in three shades: light, universal, and contrast. The contrast color is particularly useful for core buildups and allows you to easily differentiate natural tooth structure from composite. Indications for Ecosite include Class I, II, and V restorations, along with use in pediatric dentition and the aforementioned core buildups. You can achieve a high luster after polish, and Ecosite Bond is an excellent seventh-generation bonding agent companion to Ecosite Bulk Fill.

Beautifil Flow Plus X injectable hybrid composite material from Shofu Dental Corporation

It has been more than eight years since Shofu launched Beautifil Flow Plus F00, which I call a “no-flow flowable,” along with a more conventional flowable F03. These F00 (no flow, stays where placed) and F03 (moderate flow) designations simply indicate the degree of flow when the material is placed on a pad and held vertically for one minute. Beautifil Flow Plus X is the next generation of this wonderful flowable resin with proprietary Giomer chemistry, now with patented nano S-PRG (surface prereacted glass) filler particles, providing improved mechanical properties and effortless polishing that produces a sustainable high-gloss finish.

Beautifil Flow Plus X remains a sculptable flowable and does not need another resin layer on top of it to achieve maximum esthetic results. This is an ideal material for root caries and Class V caries since an added benefit of Giomer chemistry is its antiplaque component, along with its ability to release and recharge fluoride.

There are 15 shades for F00, including opaques, incisal, and bleach white, and 16 shades for F03, including unique milky and cervical shades. I am also impressed by the great chameleon quality of these resins. You can achieve the ultimate shine with Shofu’s Super-Snap X-Treme polishing system.

Beautifil Flow Plus X is also useful in creating cusp height and marginal ridges. This is a useful resin product that allows us to truly emphasize our artistic capabilities in the art and science of dentistry. Perhaps the X in the product name Beautifil Flow Plus X really stands for “10 times better!”

Riva Star silver diamine fluoride desensitizer from SDI Inc.

It has been well established that the combination of silver, iodide, and fluoride has an almost immediate and long-lasting effect on dentinal hypersensitivity. We have seen silver diamine fluoride products that provide such relief, but black discoloration is associated with their use. Riva Star, a silver diamine fluoride and potassium iodide product that inhibits biofilm, now affords us the opportunity to provide noninvasive or minimally invasive treatment for decayed dentin. Riva Star allows us to detect and treat decay at its earliest stages, while desensitizing the tooth and cleansing the cavity prep—all without the black stain.

The product comes in silver and green color-coded capsules, with silver containing the silver diamine fluoride and green containing the potassium iodide. Each capsule combination can treat five teeth sufficiently. The product’s instructions clearly indicate how this two-step procedure minimizes staining. When the potassium iodide is applied over the silver diamine fluoride, a precipitate is formed that does not stain the teeth. You can then restore over this combination with a glass ionomer such as Riva Self Cure glass ionomer, then a bonding agent such as Riva Bond LC, and a composite resin such as Aura Easy.

This so-called SMART (silver-modified atraumatic restorative treatment) technique is designed to treat and reduce pulpal inflammatory response and facilitate the remineralization of carious dentin, thereby arresting decay and protecting from future bacterial invasion—all in an esthetic fashion. Be aware, though, that this treatment is not indicated for symptomatic teeth. And further, make sure in verbal and written fashion that the patient is informed that this treatment may show decay under the restoration when viewed by another dentist (so keep good notes!).

There is definitely a need and place for this type of treatment, and SDI’s new Riva Star is the key.

Foresight 45 SGL high-speed LED handpiece from Medidenta

If you are looking for extra illumination in those hard-to-light areas of the mouth, Medidenta’s Foresight 45 SGL (45-degree angled head) uses a micro light generator located in the rear of the handpiece to produce an abundant field of LED light at the working end of the handpiece. The light is activated when air flows through the handpiece.

I had a GP colleague who does a lot of surgery, Roy Sonkin, DDS, try out the handpiece when performing third-molar extractions. He says, “The handpiece has a robust feel in your hand and easily supplies extra illumination where and when needed. If it is necessary to section a molar for extraction, gain endo access for a molar, or perform periodontal osseous recontouring, this handpiece is an excellent addition to your armamentarium.”

Medidenta says the LED light won’t yellow with sterilization, there is no need for additional fiber-optic equipment, and the handpiece has a one-year warranty. Unlike most handpieces, the water stream is not aerosolized, so the Foresight 45 SGL supplies a “jet stream” for irrigation and cooling. Although strange at first, you get used to it very quickly, along with the fact that the excess air from this powerful 22-watt handpiece is exhausted through the rear of the handpiece and not the head.

If you are looking to eliminate the shadows cast by your loupe light or overhead mounted operatory light, and if you want to gain better visualization with a brighter field of operation, this handpiece is for you. Alternatively, if you are not interested in additional light, Medidenta offers the Air Free 45º Surgical, a slightly less heavy, non-LED version.

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