Don Tyndall is a professor with the Division of Diagnostic Sciences at the University of North Carolina at Chapel Hill Adams School of Dentistry. He became a Diplomate of the American Board of Oral and Maxillofacial Radiology in 1990. In 2009 Professor Tyndall was elected a fellow of the International College of Dentists. He has taught at UNC-CH for 35 years and maintains a private practice within the Adams School of Dentistry.

He has won several awards for teaching excellence at UNC-Chapel Hill. Tyndall has been the director of radiology for the Adams School of Dentistry since 1988 and serves as the course director for two pre-doctoral radiology courses. Tyndall has also served as a commissioner on the North Carolina Radiation Protection Commission from 1988 to 2005 and was founder and program director of the Oral and Maxillofacial Radiology Graduate Program at the Adams School of Dentistry from 1993 to 2006.

He was a director and past president of the American Board of Oral and Maxillofacial Radiology. Tyndall has served two terms as the Councillor for Scientific Affairs and Public Policy of the Executive Council of the American Academy of Oral and Maxillofacial Radiology.

Don Tyndall, DDS, MSPH, PhD

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Technique Touch-Ups 2022

Tokuyama made a big splash in our industry a few years ago with the introduction of OMNICHROMA. It was a unique product in an otherwise well established, and somewhat boring, space. The company itself has been around for a while and this by far is not its first innovation. When I first used their hard REBASE material for denture relining, it was as good as anything I got back from the lab. Accurate, chairside, no lab fee. It was a push against the norm with a simple but elegant solution. For me, OMNICHROMA was equally innovative, as well as impressive.

The whole idea of “one shade for every tooth” was obviously a compelling story. I am always looking for a way to simplify our armamentarium and streamline our product supply. OMNICHROMA’s success stems from a basic optical property of the composite. Most composites are shaded by having a particular color of the filler. A1 shaded composite has particles that are A1, for example. A light source hits the surface of the composite and reflects light to your eye for your brain to perceive color. In the case of OMNICHROMA products, the filler actually regenerates light from the surrounding tooth against the filler particles. This essentially creates the illusion that the composite itself is the same color as the structure around it. If you could isolate that composite, you would see it hasn’t actually changed color at all.

One technicality of using the product is that you do need actual structure to reflect that color. If you have an incisal extension that extends out, it would have less to reflect back and potentially look a bit too translucent or gray. In this case, Tokuyama recommends using their OMNICHROMA BLOCKER or OMNICHROMA BLOCKER Flow. It has similar regenerative properties but also creates a base layer of color to avoid that grayed-out look. Because of its ability to block color, it is only recommended to use a 0.5 mm layer of OMNICHROMA BLOCKER Flow. I find this is also useful when I have a darker base shade, such as a tooth with amalgam staining or a dark root surface. The opaque layer nicely blocks out the undesirable shades for a more esthetic color match in the final result.

The introduction of OMNICHROMA Flow BULK further redefines this category with simplicity and greater efficiency. Like other bulk composites, you don’t have to place the material in small incremental layers. The reason we used to place composites small layer by small layer is because large layers would exhibit greater shrinkage affecting marginal integrity and deeper layers could remain uncured if light could not get to the material in the deepest parts of the prep for proper curing. In the case of OMNICHROMA Flow BULK, this is no longer an issue. Its flowability and self-leveling help to not only layer evenly but the supra-nano fillers allow reflection of red to yellow structural color. It also enables the material to have a high level of polishability. Considering extensive studies that show great compressive strength, flexural strength, and lack of polymerization shrinkage, the company has definitely backed their claims with good science. 

When I first got a chance to use OMNICHROMA Flow BULK, I was most surprised by the simplicity of the packaging. A syringe and some tips were all that was in there, again reinforcing the value of OMNICHROMA products when it comes to helping declutter our storage. According to their recommendations, I can use the material on any posterior or anterior application. The instruction card had just a few steps that basically consisted of apply your bond of choice, fill it up, cure, and polish. The viscosity of the material is noticeable and flowed well into crevices, especially the floor of a Class II prep. I used the OMNICHROMA BLOCKER Flow in all cases of amalgam stain and it definitely helps keep the restoration at the brighter shade of the surrounding teeth. I did not have a single case that developed that “little white line” from poor bonding. If anything, it feathered well across any bevel.

Simplicity Goes Even Deeper with OMNICHROMA Flow BULK case images by Jeff Rohde, DDS

The only tricky part for me was for Class V applications. Due to the viscosity of the material, if I overfilled the preparation at all it would pool across onto the gingiva and make finishing a little more laborious. In this case, I found that it was best to initially wet the preparation right up to the margins, but not totally filled. After an initial cure, I would then layer the regular OMNICHROMA material over that due to its thicker handling. Sandwiching like this gave a great optical result, I still got a good seal, and simplified finishing. If this were a Class IV fracture, I would only use the original OMNICHROMA to ensure you can build out that body of the material to the intended incisal edge. One nice thing about OMNICHROMA Flow BULK is you don’t have to have that topper layer to protect it. In the Class V case switching materials to cap the restoration with the original OMNICHROMA viscosity was to be able to shape and sculpt the material.

Because of the viscosity of OMNICHROMA Flow BULK, I would recommend confirming you have nice four wall preparation to get the best results with the material. This would include a Class I, a Class II with a matrix band, a Class III with a matrix band, etc. You can also very easily adapt this for use with the Bioclear technique, especially in the posterior.

In a Class II situation, the material flowed nicely in the bevel areas of the buccal and lingual walls. Once placed in those areas, I filled the bulk of the rest with no issues. I still did another round of curing after I removed the matrix band but that was more out of habit than necessity. For anterior restorations with Bioclear matrix bands, I would place OMNICHROMA BLOCKER Flow into the deeper areas of the black triangle to block off the dark background and then fill with the regular OMNICHROMA Flow BULK material over the top of that.

OMNICHROMA Flow BULK definitely delivers on the simplicity of the system, as well as its broad range of use. It’s an excellent addition to Tokuyama’s line-up and continues to push the boundaries of what can be accomplished when solid science and research are applied to developing innovative and effective dental materials.

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