How to Use A GroundBreaking 1-Shade Flowable Composite

Once you have spearheaded a paradigm shift, what is next? That is a classic question in the corporate world and an interesting question in dentistry. Much as Apple changed an industry with the introduction of the iPhone, Tokuyama Dental America has rocked the dental composite world with the introduction of OMNICHROMA—the world’s first 1-shade universal composite. Suddenly, it appears that every dental products company is introducing composites that require 5, 3, or 1 shade. This is a huge reversal of the 30-year-long trends of introducing products with 15 to 36 shades.

OMNICHROMA FLOW is part 2 of this groundbreaking trend initiated by Tokuyama Dental. This innovative product brings the same benefits of convenience, time-saving, inventory control, and reduction of composite waste as 1-shade universal OMNICHROMA. Like OMNICHROMA, the flowable version matches every tooth shade from A1 to D4. In fact, it is the world’s first single-shade flowable composite. OMNICHROMA FLOW uses Tokuyama Dental’s Smart Chromatic Technology and uniformly sized spherical fillers to create highly esthetic, easily polished, and durable restorations.

This material is designed to treat all types of direct restorations as a complete restoration or as a base under a veneered filling. OMNICHROMA FLOW is particularly useful as a repair for almost any shade temporary crown, veneer, or composite restoration. Virtually every other flowable composite on the market comes in 10 or more shades. The ability to use a single-shade flowable composite results in a diminished need for shade decisions and less cross-contamination, a huge benefit in today’s dental world. It also drastically controls expenses for the practice, as does OMNICHROMA.

Like its predecessor, OMNICHROMA FLOW relies on structural color instead of chemical color. This implies that both materials do not rely on dyes or pigments to create the color of the restoration. The structural color of the tooth itself is reflected by the filler particles in the material to create a seamless tooth shade. The material manifests extremely high glossiness that leads to a great shine, higher than all other flowable composites tested.*

An interesting study soaked OMNICHROMA FLOW in coffee for 24 hours and noted that this material showed less staining than other flowable products on the dental market.* Flexural strength, wear, and abrasion are among the best of all flowable products as well.* Viscosity level falls in the middle of flowable spectrum as shown by Tokuyama Research and Development.

The technique for incorporating this material into your dental world will feel familiar for most dentists. It is virtually identical to using shade-specific flowable composites. Curing depth is 2 mm. A bevel (like 1-shade universal OMNICHROMA) is highly recommended as a 347895means of making the margin disappear. OMNICHROMA FLOW appears quite opaque white when placed. It matches the surrounding shade after light curing is completed.

OMNICHROMA BLOCKER FLOW is an additional portion of the OMNICHROMA FLOW. It works similarly to OMNICHROMA BLOCKER and should be used in very deep, discolored Class lll and Class lV restorations beneath the flowable. The effect is to block out stains as well as to keep OMNICHROMA FLOW from mimicking shades from the tongue, lips, and other oral structures. OMNICHROMA BLOCKER FLOW is recommended to be used in 0.5 to 1.0 mm thickness, depending on the case. OMNICHROMA FLOW should take up the bulk of the space so the surrounding tooth surface can be matched.

The new flowable is truly a utility material. The author has had the opportunity to use it for Class I, Class II, and Class V restorations and as a base under 1-shade universal OMNICHROMA. The material is an excellent option for repairing temporary crowns, veneers, and onlays. This single shade system will easily bond to any resin temporary material and match the shade beautifully.

Case 1

A female patient age 49 presented with decay and brown stain at the gingival margin of tooth #29 (Figure 1). The tooth shade was a B2 shade. One-half carpule of Mepivacaine HCl 3% and one-half carpule of Articaine 4% were administered by infiltration. A DryShield was used to reduce aerosol generation. Decay was excavated and removed with a #330 carbide bur and a #4 low-speed round bur. The enamel was beveled using a #1923c football diamond bur (Microcopy). Consepsis Scrub (Ultradent Products) was administered as an antibacterial slurry. Ultra-Etch 35% phosphoric acid solution (Ultradent) was placed on the bordering enamel in a selective etch technique. The enamel and dentin were treated with Tokuyama Universal Bond. This product is a unique self-cured bonding agent that does not require light curing or additional activators. The bonding agent does not have to be agitated when applied to the tooth. OMNICHROMA FLOW was applied and contoured with an explorer. The restoration was subsequently light cured using the Bluephase Style curing light from Ivoclar Vivadent for 10 seconds. The Class V restoration was then polished using a flame-shaped NeoDiamond #863 from Microcopy. Final polishing was completed using A.S.A.P. All Surface Access Polishers and D-Fine Diamond Polishers both from Clinician’s Choice. Note the excellent shade match with single-shade OMNICHROMA FLOW (Figure 2).

Figure 1

Note buccal/gingival decay on #29. Following decay removal, the tooth was restored using an etchant, Tokuyama Universal Bond, and OMNICHROMA FLOW. Note the ideal color match to Vita Shade B2.

Figure 2

Note buccal/gingival decay on #29. Following decay removal, the tooth was restored using an etchant, Tokuyama Universal Bond, and OMNICHROMA FLOW. Note the ideal color match to Vita Shade B2.

Figure 3

Note amalgam in the distal pit with radiating fractures toward the distal marginal ridge. The fractures were obliterated and restoration removed, followed by treatment using an etchant, universal bond and OMNICHROMA BLOCKER FLOW, and several 2-mm applications of OMNICHROMA FLOW. Initial shade: A1.

Figure 4

Note amalgam in the distal pit with radiating fractures toward the distal marginal ridge. The fractures were obliterated and restoration removed, followed by treatment using an etchant, universal bond and OMNICHROMA BLOCKER FLOW, and several 2-mm applications of OMNICHROMA FLOW. Initial shade: A1.

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Case 2

A male patient age 54 presented with a failing Class I composite on tooth #20 with distal marginal ridge fractures (Figure 3). The initial shade was Vita A1. One-half carpule of Mepivacaine HCl 3% was administered by infiltration followed by one-half carpule of Articaine 4% (the author prefers initial norepinephrine anesthesia placed for comfort reasons, to be followed by epinephrine-containing anesthetic). The amalgam restoration was removed using a #556 carbide bur and the fractured tooth structure was obliterated. The tooth was contoured for a Class II restoration with the same bur. To eliminate decay, #2 and #4 low-speed carbide burs were used. Finally, a #1923c football-shaped diamond from Microcopy created bevels on the D Fusion sectional matrix band was placed along with Composi-Tight 3D Fusion wedges from Garrison Dental Solutions to create excellent contacts. The cavity preparation was treated with Consepsis Scrub from Ultradent. Enamel was etched using Ultra-Etch 35%, also from Ultradent and dentin and enamel surfaces were treated with Tokuyama Universal Bond without agitation. OMNICHROMA BLOCKER FLOW was placed in a 0.5-mm increment over a dark stain. OMNICHROMA FLOW was then applied in 2-mm increments and light cured using the Bluephase Style Curing Light for 10 seconds. The final layer was manipulated with the back end of an explorer and a contouring instrument. At this point, this layer was cured for 10 seconds with the Bluephase Style.

Anatomy was established using a fine football diamond 1923f from Microcopy and polished using A.S.A.P. All Access Polishers and D-Fine Diamond Polishers from Clinician’s Choice. Note the material’s ability to correctly match the A1 premolar shade (Figure 4).

Conclusion

OMNICHROMA FLOW and OMNICHROMA BLOCKER FLOW are perfect companions to OMNICHROMA. The single-shade option makes our dentistry easier, less costly, and more hygienic. The ability to place a single shade in the operatory is perfect for today’s disinfection protocols. There are no other shades exposed to contamination and there is no need to open drawers or containers during the procedure, which could result in contamination of everything in the drawer.

It is no wonder that many companies are suddenly downplaying their multishade composite products in favor of materials with few shade options. Many have a long way to go to meet the quality and reliability of the Tokuyama Dental America’s OMNICHROMA product family.

*Tokuyama R & D