Product review
Alternative aesthetics
The use of bulk fill materials appear to provide the advantages of an aesthetic material with less sensitive placement, offering a real alternative to amalgam in posterior restorations
O
ver re c e nt decades, the demand for more aestheti- cally pleasing,
tooth coloured restorations has led to composite being one of the most commonly used dental materials. With the Minamata Convention 20ı3 calling for the phase-out of dental amalgam, it is likely that the dental profession’s reliance upon composite for the restoration of posterior teeth will only increaseı
. The placement of posterior
composites is not without its limitations. Proper isola- tion of the tooth is required and an incremental layering technique is currently recom- mended2
. Layering composite
improves light penetration, allowing for complete poly- merisation of the material, and controls polymerisation
shrinkage. However, this tech- nique can be time-consuming and can lead to the introduc- tion of voids to the restoration. In order to simplify and
speed up the placement of large posterior composites, a number of bulk-fill composite resins have come on the market, aiming to produce a composite restoration that does not require the multi- layering technique. Bulk-fill restorative materials
can generally be categorised into bulk-fill composites (e.g. Tetric Evoceram, Ivoclar Vivodent) and bulk-fill flow- able composite materials (e.g. Venus bulk fill, Smart Dentine Replacement (SDR) and Filtek). The latter often require a conventional layer of composite to cap the resto- ration due to the reduced wear resistance and hardness properties 3
.
Properties and clinical handling of Fill Up! Fill Up! is a new dual-cure bulk-fill composite. The manufacturer claims to have produced an aesthetic, single- step composite material that is suitable for class I and II posterior restorations4
. The majority of bulk-fill
composites on the market are light-cured. Manufacturers have attempted to increase the depth of cure, by either increasing the translucency or reducing the filler content of the material. Despite these changes, these materials are still limited to being used in increments of 4-5mm. In restorations greater than
this, there is a significant ques- tion if the base of the restoration has been fully polymerised. In addition, the effectiveness of light cure units within general practice has often been found
to be inadequate, with up to 50 per cent of units not reaching minimum irradiation levels5
.
Some evidence suggests that the manufacturers’ recom- mended cure times for bulk-fill composites cannot be endorsed, with longer curing times being required6
. In an attempt to overcome
this problem, Fill Up! is a dual cure composite. The surface can be light cured, to allow imme- diate finishing and polishing, while the full depth of the resto- ration will be chemically cured within three minutes. Fill-up has been shown to be suitable for bulk-filling cavities of up to ı0mm in depth. The placement of Fill Up!
is simpler than conventional composites, but slightly more technique sensitive than for amalgam. Proper isola-
Continued »
Cavity prepared Fig 1
Fig 2
Etchant Gel S applied for 15 seconds and rinsed thoroughly
ParaBond Adhesive was applied to the dry cavity Fig 3
Ireland’s Dental magazine 35
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