Photos provided by Gary Jackson.

Direct Composite Resins Can Lead to Everyday Success
BALTIMORE, MD - A dentist that is contemplating changing direct composite resin products should do thorough research beforehand, and refrain from letting sales representatives be his or her only source of information, according to a speaker at the Dental Learning-sponsored event, “Updates in Contemporary Dentistry,” held here. G. Franklin Shull, Jr., DMD, who has a private practice in Lexington, SC, addressed a group of about 350 dentists and noted that although he believes the innovations being made with porcelain “will change the way we’re practicing, there are people who cannot afford ceramics, and we need to offer viable restorations for these patients.” Also, dentists need to be aware of the best technology to complete these restorations, he said, adding that nanotechnology is the “wave of the future.” Shull said that nanotechnology has made increased filler concentration possible, paving the way for stronger composites with better wear characteristics, improved esthetics and the ability to be used in the anterior and posterior. He cited the 3M ESPE and VOCO America products, and he encouraged attendees to look at their studies with regard to volumetric shrinkage and polishability. “If you are looking for a new all–purpose composite, consider one in the nanofilled catagory,” Shull said. Discussing silorane-based composite resins, Shull mentioned the Filtek Low Shrink Posterior Restorative System. These composites are not indicated for anterior restorations, but he said that the low shrinkage should “reduce stresses on the tooth that can cause sensitivity and adhesive failures.” Adhesives Shifting gears to adhesive systems, Shull noted that there are several options, including multibottle total etch, single bottle total etch, multibottle self-etch and all-in-one self-etch. Total etch remains the standard, however, many dentists are having success with selfetching systems. If you are in the market for a new selfetch adhesive be sure you know if it can be used with all restorative types. Shull stated the all-in-one from Voco can be used with direct and indirect restorations. He said to consider unit dose for self-etching adhesives to assure fresh chemistry. Clinical Techniques Shull noted that it is important to clean the prepared tooth of all debris before etching, and said he uses 2% chlorhexidine gluconate. He said that he uses Gluma or G5 to rewet after etching and before placing dentin bonding agent for direct composites. Studies show this technique does not decrease bond strength. He encouraged attendees to use a rubber dam during composite resin procedures. He said that many dentists opt to use VOCO America’s Grandio, the universal light-curing nanohybrid restorative that provides low shrinkage (1.57% by volume) and high transverse strength. According to VOCO America, this is due to its composition of 87% fillers by weight and 30% to 50% less resin compared with standard microhybrids. Dr. Shull offered this pearl for those who use Grandio, noting, “When cured, this composite is very hard. After finishing I use a porcelain polishing system for a very high luster.”

G. Franklin Shull, Jr., DMD
G. Franklin Shull, Jr., DMD, graduated from the Medical University of South Carolina School of Dentistry in 1993 and completed his General Practice Residency in 1994 at Palmetto Richland Hospital. He has a private practice in Lexington, SC, and is on the teaching faculty at both the Palmetto Richland Hospital in the General Practice Residency Program and at the Medical College of Georgia School of Dentistry. Dr. Shull also is a member of the faculty at the L.D. Pankey Institute in Key Biscayne, FL. In addition to being a Fellow of the Academy of General Dentistry and a member of the American Dental Association, Dr. Shull is the past president of both the Greater Columbia Dental Association and the South Carolina Academy of General Dentistry. Dr. Shull writes and lectures on esthetic dentistry, dental materials, and dental photography. Dr. Shull Disclosure: Financial support/consultant to: VOCO America and Ivoclar Vivadent.

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