The ability to deliver effective restorative care is subject to a wide range of variables. From the type of restoration needed, to the patient’s oral health history and oral hygiene practices, the balance of longevity and aesthetics, and so much more, there is never simply one solution that can be used to tackle every challenge. As the idiom goes, it’s about picking horses for courses – and being able to adapt to each new hurdle.
Flowable composites are a leading choice for many clinical indications. They differ from conventional restoratives in a variety of properties, enabling dental professionals to adapt to problems such as decay or fracture.
It’s important to understand how these solutions are designed to provide alternative approaches to restorative care. Just as imperative is the ability to recognise how modern developments have improved the use of such restoratives, particularly in the design of the syringes for user application.
Unique form
Flowable resin-based composites uniquely reduce the filler load and/or utilise less viscous monomers.[i] They can be used in conjunction with conventional composites, but many modern solutions match the clinical results of traditional materials, meaning they will often be used for the entirety of a restoration (where appropriate) without compromise.
Most often, the filler load of a restorative composite will sit between 37-53%.i It’s important to note that this inorganic filler only differs in quantity when compared to a conventional composite solution, as well as an increase of dilutant monomer. Other variable factors such as size of the filler particles typically remains the same.[ii]
This is not to say that each product will be identical; different flowable composites are designed to contain unique inorganic fillers, with characteristics such as type, size and geometry changing between each solution.ii This then affects the clinical properties of the material, which gives clinicians the opportunity to employ different flowable composites dependent on the targeted outcome, or their own clinical preference.
Compressive strength, or the endurance of a filling over time, is one measurable outcome that has been found to typically correlate with the amount of inorganic filler in flowable resin-based composites – where there are outliers, previously mentioned properties (inorganic filler type, size and geometry) are thought to affect the result.ii
Avoiding voids
Clinical skill will also play a role in the success of a restoration, including the ability to avoid potential complications.
Void creation is one such example, and has been observed when using some flowable resin-based composites.[iii] If an application technique is insufficient, material distribution may not be uniform, creating imbalance in a restoration. Pre-existing air may also be present within the composite itself, in turn creating the voids.iii
The trapped air pockets can create clinical complications. If minor, a patient may experience no difficulties, and the greatest inconvenience will be a poor visual result in a radiographic exam – cause for concern for the clinician, but not the patient.iii However, if the void is of an adequate size, a restoration can be compromised. Cracks can begin to form under fatigue loading at the voids, and initial stress around an air bubble can lower the durability and performance of the restoration.[iv]
A defect such as this at the restorative margins can lead to microleakage and discolouration,iv both significant problems for the success of a restoration, and potentially resulting in extensive, and even more invasive, retreatment for an individual.
In the modern age
Modern flowable composites can optimise application whilst reducing the incidence of void creation in a number of ways. This includes adjusting the shape of the syringe used by a clinician. Dental professionals should seek a flowable composite that maintains and improves the ease of access to a restorative site to minimise clinician error. Then, a solution should allow for air to escape and not become trapped within the composite, which can lead to void creation.
The Filtek Supreme Flowable Restorative from Solventum, formerly 3M Health Care, offers such advantages to clinicians. With an upgraded syringe and new tip design, air that is trapped is pushed out by the front flow of the paste, and venting on the plunger allows air to escape, resulting in virtually no bubbles. The Filtek Supreme Flowable Restorative offers excellent adaption in the oral cavity, and long-lasting polish retention and wear resistance with natural-looking results that serve your patients for many smiles to come.
Flowable resin-based composites can be an effective solution for the dental professional, but success relies upon the properties of the material and the syringe, as well as the clinician’s abilities. Taking the time to choose an approach that optimises both solution and skill is key for long-lasting success.
To learn more about Solventum, please visit https://www.solventum.com/en-gb/home/oral-care/
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About Solventum
Solventum, enabling better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers’ toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients’ lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue. We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you.
[i] Vouvoudi, E. C. (2022). Overviews on the progress of flowable dental polymeric composites: their composition, polymerization process, flowability and radiopacity aspects. Polymers, 14(19), 4182.
[ii] Mirică, I. C., Furtos, G., Bâldea, B., Lucaciu, O., Ilea, A., Moldovan, M., & Câmpian, R. S. (2020). Influence of filler loading on the mechanical properties of flowable resin composites. Materials, 13(6), 1477.
[iii] Körner, P., Gerber, S. C., Gantner, C., Hamza, B., Wegehaupt, F. J., Attin, T., & Deari, S. (2023). A laboratory pilot study on voids in flowable bulk-fill composite restorations in bovine Class-II and endodontic access cavities after sonic vibration. Scientific Reports, 13(1), 18557.
[iv] Nazari, A., Sadr, A., Saghiri, M. A., Campillo-Funollet, M., Hamba, H., Shimada, Y., … & Sumi, Y. (2013). Non-destructive characterization of voids in six flowable composites using swept-source optical coherence tomography. Dental Materials, 29(3), 278-286.
