Photos provided by Gary Jackson.
Direct Composite Resins
Can Lead to Everyday Success
BALTIMORE, MD - A dentist that is contemplat-
ing 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 prac-
tice in Lexington, SC, addressed a group of about 350
dentists and noted that although he believes the innova-
tions 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 technol-
ogy 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 com-
posites 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 self-
etching systems. If you are in the market for a new self-
etch adhesive be sure you know if it can be used with all
Dental Learning
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 encour-
aged attendees to use a rubber dam during composite
resin procedures.
He said that many dentists opt to use VOCO Amer-
ica’s Grandio, the universal light-curing nanohybrid
restorative that provides low shrinkage (1.57% by vol-
ume) 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 stan-
dard 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 Medi-
cal University of South Carolina School of Dentistry in
1993 and completed his General Practice Residency
in 1994 at Palmetto Richland Hospital. He has a pri-
vate 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 Medi-
cal 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 Ameri-
can 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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