Press Release. Press Contact. The concept for Class II restoration Delicate preparation, rapid procedure and reliable results

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1 Press Release The concept for Class II restoration Delicate preparation, rapid procedure and reliable results by Dr. Arzu Tuna and Dr. Umut Baysal, Attendorn, Germany Composite restorations have always been an attractive option. They provide esthetic, tooth-colored restorations and allow for minimal invasive treatments that preserve as much natural tooth substrate as possible. Thanks to advancements in material properties (universal adhesives, bulk fill composites, esthetic composites), composite restorations are continuously getting more reliable and convenient. All-in-one treatment solutions (e.g. Class II Solution, Dentsply Sirona Restorative) further increase convenience and efficiency, as the following patient case illustrates. Press Contact Marion Par-Weixlberger Senior Corporate PR Manager Sirona Straße Wals bei Salzburg, Austria T +43 (0) F +43 (0) marion.parweixlberger@dentsplysirona.com Meghan Smith Corporate Communications Manager Susquehanna Commerce Center 221 W. Philadelphia St. Suite 60W York, PA Phone: meghan.smith@dentsplysirona.com Given the material improvements over the past years, the number of indications for direct composite restorations has expanded considerably. In addition to esthetics, the main advantages lie in their ability to support undermined tooth structure and their truly diverse range of application: a specific retention form is not required. For this reason, the use of adhesives and composites in direct restorations facilitates a procedure which is gentler on the tooth substrate and more focused on the defect than all other conventional materials. Significant improvements have also been made in terms of dental adhesives: posterior tooth fillings with full matrices or multi-bottle adhesives including complex composite shading systems have been replaced by modern systems, which, today, are key to the success of direct restorative treatments. ABOUT DENTSPLY SIRONA: Dentsply Sirona is the world s largest manufacturer of professional dental products and technologies, with a 130-year history of innovation and service to the dental industry and patients worldwide. Dentsply Sirona develops, manufactures, and markets a comprehensive solutions offering including dental and oral health products as well as other consumable medical devices under a strong portfolio of world class brands. As The Dental Solutions Company TM, Dentsply Sirona s products provide innovative, high-quality and effective solutions to advance patient care and deliver better, safer and faster dentistry. Dentsply Sirona s global headquarters is located in York, Pennsylvania, and the international headquarters is based in Salzburg, Austria. The company s shares are listed in the United States on NASDAQ under the symbol XRAY. Visit for more information about Dentsply Sirona and its products.

2 Page 2/6 Sectional matrix systems facilitate the reliable and predictable creation of anatomically correct contact points. Versatile universal adhesives are resilient in use and, given the milder acids used and the associated lower risk of over-etching, the risk of post-operative sensitivity is reduced. Since only a few individual steps are required, this also equates to a reduced failure rate. State-of-the-art composites offer major advantages in terms of processing and handling and, with simplified shading systems, today the shade can be selected quickly and accurately. The "Class II Solution" represents a safe and rapid complete system, true to the motto "Class II everything from a single source". As such, major success and high levels of patient satisfaction can be achieved in daily routine. Case presentation The 23-year-old male patient came to our practice for a routine examination. Following a visual examination, in order to rule out proximal caries, bite wing images were made from both sides. The radiological assessment of tooth 15 confirmed the clinical diagnosis which, on the basis of a distal opacity on tooth 15, suggested a carious lesion and resulted in lucency up to the middle of the dentin (Fig. 1). The logical therapeutic step was a minimally invasive restoration. After being provided with visual and oral information, the patient agreed to the treatment. The next steps are self-evident: A delicate preparation which sacrifices the minimum amount of healthy tooth substance to enable the safe removal of the infected dentin not only increases the life expectancy of the tooth affected, but also

3 Page 3/6 helps in creating shade match and modelling of the restoration. The smallest possible cavity opening into the enamel also leads to a smaller filling margin length and thus to a lower risk of gap formation when subject to functional loading. To keep the cavity opening as small as possible, following the administration of anesthesia, a rotating mini diamond was used for preparation. Ultrasonics could then be used for further preparation (Fig. 2). Excavation was done using a slowly rotating rose-head bur. To ensure that conditions were completely dry, a rubber dam was placed from tooth 14 to 16. An excellent adaptation and a well-shaped anatomical marginal ridge were accomplished using the sectional matrix system (Palodent V3, Dentsply Sirona Restorative). The matrix and wedge were applied safely by simply using the associated forceps. The wedge was inserted as far as it would go to ensure a good marginal seal and an adequate contact point. The interproximal distance was determined perfectly using the ring to result in good cervical adaptation (Fig. 3). For the purpose of cleaning to achieve better adhesion, the cavity was rinsed with chlorhexidine gluconate solution, using foam pellets before and after etching. The cavity was etched with 36% phosphoric acid, starting in the enamel area (approx. 20 to 30 seconds) with the areas close to the pulp conditioned for the shortest amount of time (approx. 10 to 15 seconds) (Fig. 4). A suitable amount of bonding agent was applied into the cavity, creating a homogeneous adhesive layer, which was air-dried and light cured. (Prime&Bond active, Dentsply Sirona Restorative; Fig. 5, 6).

4 Page 4/6 Prime&Bond active with the patented Active Guard technology is versatile in use for all etching techniques and indications. The good balance between hydrophobic and hydrophilic properties ensures an ideal surface tension and thus facilitates the active, complete penetration and coverage of the cavity surfaces. This can be easily observed in everyday clinical practice, even with differing degrees of moisture. Even on overly moist or dry dentin a reliable bond is guaranteed which offers active protection against the main causes of adhesion failure. Following polymerization of the adhesive layer, the cavity had a glossy appearance and the filling could be placed (Fig. 7).The cervical margin of the cavity was lined with SDR flow+, which is easily achieved due to the metal application tip (Fig. 8). This section was finally polymerized (at least 20 seconds) to produce a gap-free cervical seal. In the next step, the cavity was restored in one go (ceram.x universal, Dentsply Sirona Restorative; Fig. 9), and the restoration was then polished quickly and easily (ceram.x gloss; Fig. 10). ceram.x universal is a nano-ceramic, light-curing, radiopaque universal composite based on the innovative SphereTEC filler technology with granulated spherical fillers in combination with an optimized resin base for direct and indirect restorations. The material is characterized by a pleasant consistency and excellent modeling properties together with first-rate stability. The esthetic design process is also a child's play in the practice, as the so-called CLOUD concept covers the entire

5 Page 5/6 VITA 1 Classical System with just five shades. The good color adaptation of the filling to the adjacent teeth is down to the pronounced chameleon effect. Discussion and conclusion In this patient case, the combination of an anatomically shaped matrix system, a homogeneous and easy to create adhesive layer, an excellent cervical adaptation and welladapted and esthetic occlusal layer lead to an excellent final restoration. The check-up two days later demonstrated perfect color match and a barely visible filling to the great satisfaction of the patient (Fig. 11). In terms of handling, the universal composite used is particularly worth mentioning. This product offers a unique combination of good modeling properties and excellent consistency. The advances made in adhesive technology have also played a key role in establishing composite fillings as an essential part of everyday routine. Universal adhesives that combine the three treatment options (etch&rinse, self-etch, selective enamel etching) have further spurred this development; and in some cases go even further, offering additional benefits like active moisture control and active spreading in the cavity. Overall, the patient case demonstrates just how efficient, safe and reliable posterior tooth fillings can be created particularly 1 Not a registered trademark of Dentsply Sirona, Inc.

6 Page 6/6 if all the components are combined into a complete system for Class II restorations (Class II Solution, Dentsply Sirona Restorative).