Wednesday, November 27, 2019

Clinical Trial of VOCO Admira Fusion X-Tra


I’m really excited about the future of operative dentistry.  In the last couple of years, we have seen tremendous progress in the development of highly aesthetic composite materials that require very little effort to create a nice shade match.

As composite technology has evolved, the industry has seen composites evolve in leaps and bounds.  Composites are a combination of resin and filler particles.  These fillers are what contribute to the aesthetics, polish-ability, and wear resistance.  Companies have been experimenting with these fillers, types, and ratios for years and have found several different combinations that work well in different circumstances.

The latest development has been spherical fillers.  In the past, fillers, when viewed under an electron microscope, looked like tiny pieces of gravel.  When light hit these particles, their shape caused the light to bounce around at all kinds of crazy angles and that meant that the resin holding the particles had to be embedded with a shaded material.  This meant that multiple shades were needed and sometimes shade matching was a challenge.

Spherical fillers do not have the same reaction when light hits them.  They allow the light to pass through the material and to then illuminate the surrounding tooth structure.  The reflection of the tooth structure is what gives the composite its shade… not some type of coloration added at the factory.  This allows for one material to handle every shade.  The other advantage of these materials is that since the light passes easily through them, the depth of cure is better.  Photons are not stopped by the color embedded in the resin so the light penetrates deeper into the composite.

A week ago I started to work with VOCO’s Admira Fusion X-tra which has spherical particles between 20-40nm.  While I have only been using the material for a few days, my overall impressions are extremely good.  The clinical case shown in the photos above are my second uses of the material.  The cases consists of a traditional MO on #4 (FDI 1-5) and a DO slot prep on #5 (FDI 1-4).  The margins were beveled using a #4 course round diamond.  Bonding was accomplished by using a 5th Generation Total Etch Technique with Ultra-Etch and Ultradent Peak Universal Bonding Agent.  Under normal testing circumstances I would have used a VOCO product, but I didn’t happen to have any available.  However, this also shows the variability of Admira Fusion X-tra as it is compatible with all conventional bonding agents.  

The matrix used was a Triodent Super Curvey band, held with a standard Triodent V3 Ring, and a Garrison Composi-Tight 3D Fusion Wedge.  The restorations were polished with an Ultradent Jiffy Original Composite System array of polishers.  

The material looked incredible immediately after placement.  Finishing was quick and easy because the aesthetics were so good.  I’m also impressed with Admira Fusion X-tra for a few other reasons as well.  The material has a depth of cure of 4mm (due to the lack of shading and the spherical fillers).  It also has a flat out incredible volumetric shrinkage of 1.25%.  This means that the margins stay intact; there are no “white lines” along the margins due to polymerization shrinkage.  

Since this is the first time I’ve worked with the material I’m going to be monitoring the restorations for the foreseeable future.  Any time I use a new material I’m always cognizant of the fact that I don’t know *for sure* how well they will wear and hold up to the everyday wear and tear that dental materials undergo.  However, I’m optimistic about the wear because the filler is ceramic-based which should allow for it to easily withstand occlusal forces without excessive material wear.

I’m just starting to work with Admira Fusion X-tra so you can expect to see more posts on it in the future.  At this point in my work I’m excited about the material.  I am really excited about the future of materials such as this and their ability to provide almost undetectable shade matching.  Any product that can provide gorgeous results that benefits the patient is something I’ll gladly do testing on...

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