Contemporary Cosmetic Dentistry – Part III: Modern Restorative Materials

Video Transcript:

Hi there, I'm Dr. Susan McMahon. I'm a clinician from Pittsburgh Pennsylvania.

So composite resin, one of the most conservative treatments we can, we can do, right. But it's also one of the most esthetic treatments that we can do.

And we've been placing composites for a very long time here, my whole career i've been using composites, and I think that statistically, long term stability of composites has been a challenge for many of us dentists. And statistically, they last between 5 and 6 years. And we want to do better than that.

And so when we are looking at composite restorations, there are several places where the composites tend to fail. They're failing in class IIs at the base of the gingival box, they're failing at the margin areas in all classes of restoration, posterior restorations, and class V restorations. So how many of us see those class V that we put in, they get that little brown stain around them, or an occlusal restoration that has that little brown stain around it, or the class II restoration, that when you take an x-ray of it, your heart sinks a little bit because you see that translucency down at the base of the box.

So I think there's some really interesting new products that are coming our way that have been developed to address those situations. So we've taken all the things that we love and learned about composite over the years. When I started in dental school, we started with self-cure composites. And with big macro filled self-cure composites, and they were just as ugly as can be, they didn't finish well, they didn't adhere well, and we've learned so much about adhesive and composite over the over my career. And I think what's really, what we could do really well with composite now is we get beautiful esthetics with composite, we get beautiful finish, we get beautiful tensile strength and compressive strength. But sometimes we still have these issues where we're not getting long term adhesion. And we're seeing the failure in our class IIs, IIIs, IVs, Vs, all of that. So as we're looking to do, maybe better with our composites, get more longevity out of them, we look, we're looking at newer products that have some a different approach, let's say.

And the Stela product by SDI is a relatively new product. And it's a self-cure composite. And I know when I heard self-cure composite, I was like, oh, that sounds like a long time ago. But in fact, it's a composite that has taken all the things that we've learned about composite, and built it into a self-cure that gives us an unlimited depth of cure.

When we think about light cured composites, there's a lot of things that we're concerned about. And one of the main things is the shrinkage, is the polymerization happening too fast. And it's pulling adhesive layers off the wall, causing micro voids in the adhesive perhaps. And that's possibly where we're getting the failure in our adhesive. So when we look at a newer product that says self-cure, it's going to start its cure layer down at the adhesive layer. And it's going to cure toward the adhesive as opposed to away from it. And it's also an unlimited depth of cure. So there's no worry about trying to layer your composite 2 mm at a time, or maybe obliquely pack it, so you don't have, you know, see factor factoring in. So these are the these are the things that I find really interesting about the Stela that it's kind of overcome some of those problems, some of those challenges, let's say with traditional composite packing.

So it's a product that is very simple to use. You prep your tooth, you get your decay out of your teeth, and it works for me really well in areas that maybe are dark, deep class II restorations, I just did a really deep class III restoration with this the other day. You clean out your decay, grab your primer, and for five seconds, give it a quick air dry and then you place your the Stela composite and it has a really nice needle tip that let you get it all the way down into the deepest areas of the cavity. You flow it in. It flows in really nicely and you can fill it up the entire way. You can fill it the whole way to the top. It's a one and a half minutes or so, initial set, and then 4 minutes till you get to polish it. So it's a 4 minute set, but during that time, it is curing with the adhesive layer and it is married to the adhesive layer. It's a gap free adhesive layer. And I think that's one of the most exciting things is that we're going to have adhesive and composite gap free in between them. So that's something I'm looking forward to seeing how it performs over time. And it's also very esthetic. So I was sort of surprised how esthetic it is. And it's just a single shade. So very, very simple.

The things that I think are really important for clinicians today, moving forward in dentistry, is that we are looking for the most conservative treatment we can do to get the results that we wan. That the more enamel we're able to keep, the better our patients are going to be long term. If we're able to do minimal prep veneers or almost no prep veneers, if we're using composites, to finesse the smile as opposed to deep cutting, indirect restorations on them. I think it's also important that we kind of minimize our inventories in our offices. The simpler things are, the better it is not just for us, our team, but for our patients we're able to do more efficient dentistry and still get incredible results.