Filtek Ultimate technical product profi le Filtek TM
Table of Contents Introduction... 1 Product Description... 2 Indications for Use... 2 Composition... 2 Shades... 3 Fluorescence... 3 Background... 4 Fillers... 4 Nanocomposites... 4 Filler Improvements in Filtek Ultimate... 5 Resin System...6-7 Physical Properties... 8 Volumetric Shrinkage... 8 Polish Retention... 9 Toothbrush Abrasion... 9 In-vitro, 3-Body Wear... 10 Fracture Toughness... 11 Compressive and Diametral Tensile Strength... 12 Flexural Strength and Modulus... 13 Field Evaluation... 14 Current Flowable Usage... 14 Evaluation of Filtek Ultimate... 15 Questions and Answers... 16 References... 16 Technical Data Summary... 17
Introduction Introduction Building upon over 40 years of innovation in the fi eld of restorative dentistry, 3M ESPE created, at the turn of this century, a new category of dental material the nanocomposite. Through precise manipulation of the fi ller architecture at the nanoscale, 3M ESPE developed a breakthrough composite fi lling material that signifi cantly advanced the clinical performance of universal composites. In 2002, 3M ESPE launched Filtek Supreme Universal Restorative. This was the fi rst product that utilized nanotechnology to provide the esthetics of a microfi ll and the strength of a hybrid. All of the fi ller particles in this novel composite are surface-modifi ed, bonded nanofi llers. Incorporation of this fi ller technology into a fl owable restorative was realized in 2005, with the introduction of 3M ESPE Filtek Supreme XT. This product was formulated to blend the strength and esthetics offered in 3M ESPE Filtek Supreme XT Universal Restorative, while still maintaining the fl ow-on-demand handling of 3M ESPE Filtek. Through global customer research and discussions with general dentists and opinion leaders, usage and areas of potential improvements for fl owables were identifi ed. Flowable usage has increased over the past 5 years because of new indications, better physical properties, better handling characteristics and, fi nally, their ease of use. In order for this trend to continue, enhancements were needed. Based on customer feedback, the following improvements are realized with the launch of Filtek Ultimate. Improvements Lower shrinkage Improved esthetics Added fl uorescence Improved polish retention Delivery Easier-to-read shade designation Syringe delivery These improvements were made without compromising the strengths of Filtek Supreme XT fl owable restorative: Flow-on-demand handling Wear-resistance Physical properties Shade match to the tooth and to Filtek Ultimate Universal Restorative 1
Product Description Filtek Ultimate is a low-viscosity, visible light-cured, radiopaque fl owable nanocomposite. Bonding to the tooth structure is accomplished through the use of dental adhesive systems, either total-etch or self-etch, that are designed to be compatible with methacrylate composites. Filtek Ultimate fl owable restorative can be used alone, after placing a compatible adhesive, or in conjunction with a methacrylate-based restorative such as Valux Plus Restorative, Filtek Z250 Restorative, Filtek P60 Restorative or Filtek Ultimate Universal Restorative. The restorative is packaged in syringes. It is available in a variety of tooth-colored shades. The shades offered with Filtek Ultimate fl owable restorative were designed to coordinate with shades offered with Filtek Ultimate universal restorative. Indications for Use Filtek Ultimate fl owable restorative is indicated for: Base/liner under direct restorations Undercut blockout Class III and V restorations Restoration of minimally invasive cavity preparations (including small, nonstress-bearing occlusal restorations) Repair of small defects in esthetic indirect restorations Pit and fi ssure sealant Repair of resin and acrylic temporary materials Composition Filtek Ultimate fl owable restorative contains BisGMA, TEGDMA and Procrylat resins. The fi llers are a combination of ytterbium trifl uoride fi ller with a range of particle sizes from 0.1 to 5.0 microns, a non-agglomerated/non-aggregated surface-modifi ed 20 nm silica fi ller, a non-agglomerated/ non-aggregated surface modifi ed 75 nm silica fi ller, and a surface-modifi ed aggregated zirconia/silica cluster fi ller (comprised of 20 nm silica and 4 to 11 nm zirconia particles). The aggregate has an average cluster particle size of 0.6 to 10 microns. The inorganic fi ller loading is approximately 65% by weight (46% by volume). Filtek Ultimate fl owable restorative is a modifi cation of Filtek Supreme XT based on customer needs. In a global market research study on fl owable restoratives, overall esthetics and shrinkage were identifi ed as key features that would impact product desirability. Also, many respondents believed that materials, made by the same manufacturer and utilizing similar components, work better together. The preference for fl owables was determined to be growing globally. The formulation improvements of Filtek Ultimate fl owable restorative take advantage of the advancements made in fi ller processing and resins since the introduction of Filtek Supreme XT fl owable restorative. The formulation was modifi ed to improve properties, such as shrinkage, fl uorescence and polish retention. 2
Product Description Shades Filtek Ultimate fl owable restorative is available in the same shades as Filtek Supreme XT fl owable restorative. These shades are matched to the VITAPAN Classical Shade Guide and correspond to shades of Filtek Ultimate universal restorative. The opacity of the shades corresponds to the Body shade opacity, except for the paque shade which has the opacity of the Dentin shades in Filtek Ultimate universal restorative. Shades: A1, A2, A3, A3.5, A4, paque A3 B1, B2 C2 D2 W (White), XW (Extra White) Fluorescence ne additional esthetic property of natural dentition is fl uorescence. Fluorescence occurs when energy is absorbed and emitted at a longer wavelength. In teeth, this means the absorption of light in the UV region (350-365 nm) and emitting light in the visible region (400-600 nm with a peak maximum of 440 nm). It is thought that this property contributes to the vitality and lifelike appearance of dentition. In natural teeth, Filtek Ultimate dentin (due to amino acids contained in the collagen) 2 exhibits higher fl uorescence than enamel. The fl uorescence of Filtek Ultimate fl owable restorative is similar to Filtek Ultimate universal restorative. Both fl uoresce more than the disc of Filtek Supreme XT fl owable restorative (Figure 1). Filtek Ultimate Universal Restorative Filtek Supreme XT Figure 1: Fluorescence 3
Background Fillers Nanocomposites Figure 2: Filtek Z250 Restorative Magnification 30,000X Figure 3: Filtek Supreme XT Universal Restorative (DEB Shades) Magnification 30,000X Figure 4: Filtek Supreme XT Universal Restorative (T Shades) Magnification 30,000X 3M ESPE manufactures many of its fi llers using a sol gel process. The sol gel process is a route wherein fi llers are made from liquids precursors, or a sol. These liquids are chemically and mechanically processed to produce particles. ne aspect of this process results in sintering which effectively coalesces primary particles together to form larger fi ller particles. Sintering can be viewed as a type of melting process whereby the particles are softened, creating a surface which can attach to neighboring particles resulting in a particle-to-particle bond. The sintering process can produce fi llers that are highly densifi ed or compacted, as found in 3M ESPE Valux Plus Restorative and Filtek Z250 Universal Restorative (Figure 2). 3 In 2002, 3M ESPE discovered a way to modify the sintering process to produce loosely agglomerated nanoparticles, i.e., nanoclusters. Although structurally different from densifi ed particles, these nanoclusters behaved similarly to the densifi ed particles found in other composites in terms of providing a range of particle sizes which allow for high fi ller loading. This resulted in a material with the strength and wear of hybrids with signifi cantly improved polish retention and optical properties. This technology advance was fi rst used in 3M ESPE Filtek Supreme Universal Restorative (Figures 3 and 4). Filtek Supreme XT was formulated using the same surface-modifi ed zirconia/silica nanocluster fi ller found in the Filtek Supreme universal restorative Dentin, Enamel and Body shade composition. The nanocluster fi ller particles consist of loosely bound aggregates of engineered zirconia and silica nanofi ller particles. Two non-agglomerated/non-aggregated nanofi llers were added to the formulation to reduce the interstitial spacing of the fi ller particles leading to higher fi ller loadings. ne was the 75 nm non-agglomerated/non-aggregated silica previously found in Filtek Supreme Universal Restorative Translucent shades. The other was a 5-10 nm zirconia particulate which was unique to the fl owable composition, and enhanced the radiopacity provided by the nanoclusters. This optimized fi ller system contributed to the excellent physical, wear and polish properties of Filtek Supreme XT fl owable restorative, while still allowing for the desired fl owable handling. 4
Background Filler Improvements in Filtek Ultimate This fi ller technology was improved again. The manufacturing process, where the clusters are formed, was modifi ed to produce less sintering. nce again, the zirconia/silica nanoclusters are produced in a broad range of sizes enabling high fi ller loading and are surface-treated to chemically bond them to the resin. As the particles are not as strongly sintered, the cluster size range could be broadened (vs. Filtek Supreme XT fl owable restorative) without adversely affecting properties such as polish retention. These nanoclusters still have the structural integrity to provide strength and fracture resistance. The bonded nanoclusters wear at a similar rate as the surrounding resin matrix. In the SEM (Figure 5), note the shape of the primary nanoparticles are still evident in the clusters. Two additional surface-treated engineered nanoparticles are added that, upon photoinitiation, will crosslink with the resin matrix. These fi llers were previously used in Filtek Supreme XT Universal Restorative. The 20 nm non-agglomerated/non-aggregated silica was used in Dentin, Enamel and Body shades. The 75 nm non-agglomerated/non-aggregated silica was used in the Translucent shades and Filtek Supreme XT fl owable restorative formulations. Figure 5: Filtek Ultimate Magnification 100,000X The fourth fi ller in this system, ytterbium trifl uoride, is added to enhance radiopacity. 5
Resin system The key feature of fl owable restoratives is their fl ow properties. The ability to wet the surface of the cavities quickly and with minimal instrumentation defi nes this fi lling material category. These materials are used as liners, as well as actual fi lling materials for small restorations. Besides fl owable handling, these materials must possess adequate physical properties, such as strength and wear resistance, to ensure clinical success in a variety of indications. The challenge to creating these materials is achieving a clinically acceptable balance of properties. Frequently modifi cations that produce a fl owable restorative (lower viscosity) adversely affect strength, wear resistance and shrinkage. Both resin composition and fi ller loading contribute to shrinkage. Methacrylate composites inherently shrink during polymerization. The amount of shrinkage is impacted by the monomers used. Generally speaking, low viscosity monomers are low molecular weight. Low molecular weight monomers can cause the polymerized resin matrix of the composite system to be harder because the higher number of double bonds per unit of weight enables higher conversion and crosslinking. However, it can also lead to higher shrinkage. Typically, in order to reduce shrinkage in a composite, manufacturers increase fi ller loading. The lower the viscosity of the resin system, the more fi ller can be added to the resin before the viscosity becomes stiff. In the case of fl owable restoratives, increasing fi ller loading is not usually a viable option to reduce shrinkage because the fl ow properties diminish. The challenge the Filtek Ultimate development team faced was how to reduce the shrinkage without adversely affecting the fi nal composite hardness and the fl ow. The resin system of Filtek Supreme XT is a combination of two (2) high-molecular weight monomers BisGMA (2,2-bis[4-(2-hydroxy-3-methacryloxypropoxy)phenyl]propane) and BisEMA(6) (2,2-Bis[4-methacryloxypolyethoxyphenyl]propane), and one low-molecular weight monomer TEGDMA (Tri[ethylene glycol]dimethacrylate). BisEMA(6) Molecule TEGDMA is a low-viscosity monomer which can contribute to higher shrinkage but helps create a hard resin matrix. TEGDMA is present in a relatively high concentration to keep the viscosity of Filtek Supreme XT fl owable restorative low enough to fl ow, while containing a high enough fi ller load to impart good strength and wear resistance. The shrinkage of Filtek Supreme XT fl owable restorative, while higher than universal restoratives, was similar to other fl owables. TEGDMA Molecule 6
Background To reduce the shrinkage, a substitute for TEGDMA needed to be found. The team identifi ed a monomer, Procrylat (2,2-bis[4-(3-methacryloxypropoxy)phenyl]propane), which is high molecular weight but low viscosity. The high-molecular weight monomer is similar to BisGMA. The difference between BisGMA and Procrylat is the lack of pendant hydroxyl groups. The lack of hydroxyl groups reduces the viscosity of this monomer due to decreased hydrogen bonding potential. BisGMA Molecule H H In Filtek Ultimate fl owable restorative, the new monomer replaces all of the BisEMA(6) and a portion of the TEGDMA and BisGMA monomers. This optimized combination of monomers results in a low-viscosity resin system which allows for a similar fi ller loading as Filtek Supreme XT fl owable restorative. While the strength and wear resistance is similar for the two products, the shrinkage of Filtek Ultimate fl owable restorative is signifi cantly less than its predecessor. Procrylat Molecule In addition, a dimethacrylate polymer is added as rheology modifi er to produce the fl ow-on-demand feature as in Filtek Supreme XT fl owable restorative. This additive enables the viscosity of Filtek Ultimate fl owable restorative to change when manipulated, offering greater control during placement. Many fl owable composites will run when subjected to gravitational force. This property makes control of the restorative diffi cult in certain indications such as Class V restorations or liner indications. Filtek Ultimate fl owable restorative holds its shape under these conditions. However, when a shear force is applied to Filtek Ultimate fl owable restorative, such as during extrusion through the dispensing tip and manipulation on the preparation, the viscosity of the restorative decreases. This means Filtek Ultimate fl owable restorative becomes more fl uid, allowing for easy adaptation to the preparation. nce this shear force is removed, such as when manipulation stops, Filtek Ultimate fl owable restorative returns to its original, non-slumping viscosity. 7
Physical Properties Volumetric shrinkage A method for determining polymerization shrinkage was described Transducer Deflection by Watts and Cash (Meas. Sci. Technol. 2(1991), 788-794). In this Cover Slide method, a disc-shaped test specimen and uncured paste are Glass Slide Light sandwiched between two glass plates and light cured through the lower rigid plate. The fl exible upper plate is defl ected during the polymerization of the test specimen. The less the fl exible plate bends, the lower the shrinkage. Defl ection is measured and recorded as a function of time. Although this process actually measures linear shrinkage, volumetric shrinkage was closely approximated due to the fact that the dimensional changes were limited to the thickness dimension. The lower the value, the less the shrinkage. In this test, samples were exposed for 60 seconds to a 3M ESPE Visilux 2 Visible Light Curing Unit. The fi nal shrinkage was recorded 4 minutes after the end of light exposure. Polymerization Shrinkage Source: 3M ESPE internal data % Shrinkage 6.00 5.00 4.00 3.00 2.00 Polymerization Shrinkage 1.00 0.00 Filtek Ultimate Filtek Supreme XT Revolution Formula 2 Flow-It ALC Venus Flow Vertise Flow EsthetX Flow TPH3 Flow Heliomolar Flow Premise Flowable Grandio Flow SDR The shrinkage of Filtek Ultimate is lower than, Premise Flowable, Heliomolar Flow, Filtek Supreme XT, TPH3 Flow, EsthetX Flow, Vertise Flow, Venus Flow, Flow-It ALC and Revolution Formula 2. The shrinkage of Filtek Ultimate fl owable restorative is comparable to Grandio Flow. 8
Physical Properties Polish retention Toothbrush abrasion Composite materials were shaped into tiles and thoroughly cured. The surfaces were polished wet using a Beuhler variable-speed grinder-polisher to remove the air-inhibited layer and to ensure a uniform surface. They were stored in water at 37ºC for 24 hours. Gloss was measured. The samples were brushed with toothpaste and a toothbrush that was mounted on an Automatic Toothbrush Machine. Gloss measurements were taken after 500 cycles and then every 1000 cycles. The test was terminated after 6000 toothbrush strokes. 100 Polish Retention Gloss Units 90 80 70 60 50 40 30 20 10 Polish Retention versus other flowable restoratives Source: 3M ESPE internal data 0 Filtek Ultimate Filtek Supreme XT SDR Vertise Flow Grandio Flow Flow-It ALC Venus Flow Revolution Formula 2 TPH3 Flow EsthetX Flow Premise Flowable Heliomolar Flow Cycles of Toothbrush Abrasion Initial 500 3000 6000 After 6000 toothbrush abrasion cycles, Filtek Ultimate fl owable restorative exhibits better polish retention than Filtek Supreme XT fl owable restorative, Grandio Flow, Flow-It, SDR,, Venus Flow and Vertise Flow. 9
In-vitro, 3-Body wear The wear rate was determined by an in-vitro 3-body wear test. In this test, composite (1st body) is loaded onto a wheel, which contacts another wheel, which acts as an antagonistic cusp (2nd body). The two wheels counter-rotate against one another dragging abrasive slurry (3rd body) between them. Dimensional loss during 200,000 cycles is determined by profi lometry at regular intervals (i.e., after every 40,000 cycles). As the wear in this method typically follows a linear pattern, the data is plotted using linear regression. The wear rates, i.e., the slope of the lines, are determined. The comparison of rates reduces some of the variability in the test due to sample preparation and can be predictive of anticipated wear beyond the length of the actual test. Wear Rate (in-vitro) Wear Rate Source: 3M ESPE internal data um loss/200,000 cycles 40.00 35.00 30.00 25.00 20.00 15.00 10.00 5.00 0.00 Filtek Ultimate Filtek Supreme XT SDR Heliomolar Flow Revolution Formula 2 Vertise Flow TPH3 Flow Venus Flow EsthetX Flow Flow-It ALC Premise Flowable Grandio Flow The wear resistance of Filtek Ultimate is similar to the wear resistance of Filtek Supreme XT. The 3-body wear rate (in-vitro) of Filtek Ultimate fl owable restorative is lower than Flow-It ALC, Venus Flow, EsthetX Flow, TPH3 Flow, Vertise Flow, Revolution Formula 2,, Heliomolar Flow and SDR. The 3-body wear rate (in-vitro) of Filtek Ultimate fl owable restorative is comparable to Premise Flow. 10
Physical Properties Fracture toughness The values reported for fracture toughness (K1c) are related to the energy required to propagate a crack. In this test, a short bar of material is cured. A notch is cut into it. The bar is placed on a fi xture that supports either end, and an anvil is positioned above the notch. The anvil presses down until the bar breaks. This is similar to 3-point bend (similar to the fi xture that provides fl exural strength and modulus data). Sample Instron Fixture Anvil Notch Fixture 2.50 Fracture Toughness K1c 2.00 1.50 1.00 0.50 Fracture Toughness Source: 3M ESPE internal data 0.00 Filtek Ultimate Filtek Supreme XT Grandio Flow Premise Flowable Flow-It ALC Heliomolar Flow TPH3 Flow Vertise Flow Revolution Formula 2 EsthetX Flow Venus Flow SDR The fracture toughness of Filtek Ultimate fl owable restorative is higher than Grandio Flow. The fracture toughness of Filtek Ultimate fl owable restorative is comparable to Filtek Supreme XT fl owable restorative, EsthetX Flow, Flow-It, Heliomolar Flow, Premise Flow, Revolution Formula 2,, TPH3 Flow and Vertise Flow. 11
Compressive and diametral tensile strength Compressive strength is particularly important because of chewing forces. Rods are made of the material and simultaneous forces are applied to the opposite ends of the sample length. The sample failure is a result of shear and tensile forces. The compressive strength of Filtek Ultimate is higher than SDR. The compressive strength of Filtek Ultimate fl owable restorative is comparable to Filtek Supreme XT, EsthetX Flow, Flow-It, Grandio Flow, Heliomolar Flow, Premise Flow, Revolution Formula 2,, TPH3 Flow, Venus Flow and Vertise Flow. Compressive Strength Compressive Strength Source: 3M ESPE internal data MPa 450 400 350 300 250 200 150 100 50 0 Filtek Ultimate Filtek Supreme XT SDR Flow-It ALC Venus Flow EsthetX Flow Grandio Flow Vertise Flow Revolution Formula 2 TPH3 Flow Premise Flowable Heliomolar Flow Diametral tensile strength is measured using a similar apparatus. Compressive forces are applied to the sides of the sample, not the ends, until fracture occurs. The diametral tensile strength of Filtek Ultimate fl owable restorative is higher than Revolution Formula 2, Premise Flow, Heliomolar Flow, SDR and. The diametral tensile strength of Filtek Ultimate fl owable restorative is comparable to Filtek Supreme XT fl owable restorative, EsthetX Flow, Flow-It, Grandio Flow, Vertise Flow, Venus Flow and TPH3 Flow. Diametral Tensile Strength Diametral Tensile Strength Source: 3M ESPE internal data MPa 80 70 60 50 40 30 20 10 0 Filtek Ultimate Filtek Supreme XT Heliomolar Flow SDR Revolution Formula 2 Premise Flowable Vertise Flow Flow-It ALC Venus Flow EsthetX Flow TPH3 Flow Grandio Flow 12
Physical Properties Flexural strength and modulus Flexural strength is determined in the same test as fl exural modulus. Flexural strength is the value obtained when the sample breaks. This test combines the forces found in compression and tension. The fl exural strength of Filtek Ultimate fl owable restorative is comparable to Filtek Supreme XT fl owable restorative, EsthetX Flow, Vertise Flow, Grandio Flow, Venus Flow, TPH3 Flow,, Flow-It ALC, SDR, Heliomolar Flow, Revolution Formula 2 and Premise Flow. Flexural Strength MPa 160 140 120 100 80 60 40 20 0 Filtek Ultimate Filtek Supreme XT Premise Flowable Revolution Formula 2 Heliomolar Flow SDR Flow-It ALC TPH3 Flow Venus Flow Grandio Flow Vertise Flow EsthetX Flow Flexural Strength Source: 3M ESPE internal data Flexural modulus is a method of defi ning a material s stiffness. A low modulus indicates a fl exible material. The fl exural modulus is measured by applying a load to a material specimen that is supported at each end. The fl exural modulus of Filtek Ultimate fl owable restorative is comparable to Filtek Supreme XT fl owable restorative, Premise Flow and Grandio Flow. Flexural Modulus MPa 9000 8000 7000 6000 5000 4000 3000 2000 1000 0 Filtek Ultimate Filtek Supreme XT Heliomolar Flow Venus Flow Vertise Flow Revolution Formula 2 SDR Flow-It ALC EsthetX Flow TPH3 Flow Grandio Flow Premise Flowable Flexural Modulus Source: 3M ESPE internal data 13
Field evaluation A fi eld evaluation was conducted in two countries, Germany and Sweden, to confi rm the clinical performance and acceptability of Filtek Ultimate. Data detailed in this section includes the 133 respondents. Recruitment criteria were designed to obtain 80% competitive flowable users and 20% Filtek Supreme XT users. Approximately 43% of the former were users. Evaluators received a selection of 6 shades. Current fl owable usage Sixty-three percent of the respondents use more than one fl owable in their practice. Dentists are using fl owable for a variety of indications, both as an interior surface material and as a fi nal fi lling material. The frequency that these types of restorations are done in a week and the frequency a fl owable is used in these indications varies signifi cantly. Therefore, the number of times a fl owable is used in each indication varies from a high of 12 liner/base applications per week (mean), to a low of 2 porcelain or composite repair restorations per week. Percent of Dentists Using Flowable in Each Indication Percent of dentists using flowable Source: 3M ESPE internal data % of Respondents 100 80 60 40 20 75.2 71.4 94.7 80.5 71.4 94 77.4 78.2 63.9 0 Liner/Base Block-out of Small Undercuts Class I Class II Class III Class V Sealant Enamel Defect Repair Porcelain or Composite Repair The primary reasons cited for using a flowable composite as a liner/base include: Stress relief Cavity and marginal adaptation (including the ability of the material to wet the surface, fl ow, the ability to seal dentin, and to produce a gap-free restoration) Handling Ease of use Shades (either a layer that can be discriminated from dentin, or to have a material that matches surrounding tooth or universal composite) The primary reasons cited for using flowables as filling materials include: They provide a smooth transition from restoration to tooth Handling in terms of fl ow, ability to adapt to the cavity and margins, and the wetting characteristics The procedure is faster fi nishing and polishing time is reduced 14 The procedure is simple frequently dentists don t need to touch the material to adapt, and they are easy to apply
Field Evaluation Evaluation of Filtek Ultimate There were 5,063 placements made with Filtek Ultimate fl owable restorative during the fi eld evaluation. Thirty percent of the placements were internal surface applications. The remaining 70% of the placements were as a fi lling material. Dentists, including users, rated their satisfaction with the following features signifi cantly higher for Filtek Ultimate fl owable restorative than their current, most frequently used fl owable. Esthetic features: Ease of polish Shade blend with surrounding tooth structure Shade match with the universal (no matter which universal composite was used) Final polish Chameleon effect verall esthetic results ther flowable Total Placements 5,063 Block-out of Small Undercut 9% Porcelain or Composite Repair 2% Enamel Defect Repair 5% Sealant 7% Worse Liner/base 21% ther 2% Class III 8% Better Small Class I 16% Small Class II 11% Class V 19% Filtek Ultimate Flowable Restorative Compared to Current Flowable verall Handling Handling features: Ability to hold shape (stays where I put it, doesn t slump) Cavity adaptation Stickiness ther flowable ther flowable Ease of Polish Flow verall satisfaction with the product: More than 50% of the dentists rated the Flow and the verall esthetic results as better with Filtek Ultimate fl owable restorative than their current, most frequently used fl owable. In all features compared, more than 80% of the dentists rated Filtek Ultimate fl owable restorative the same or better than their most frequently used fl owable. ther flowable ther flowable 20 10 0 10 20 30 40 50 60 70 % Respondents Match to VITAPAN Shade Guide verall Esthetic Results 1 2 3 = Filtek Ultimate is Much Worse to Worse 4 = Filtek Ultimate is the Same (not shown) 5 6 7 = Filtek Ultimate is Better to Much Better 15
Questions and Answers Q. What is the difference between Filtek Supreme XT and Filtek Ultimate? A. There have been changes made in the fi ller, pigments and resin system. These changes have provided for lower shrinkage, better polish retention and fl uorescence. Q. Do the shades of Filtek Ultimate match Filtek Ultimate Universal Restorative? A. Yes. In addition, the shades of Filtek Ultimate fl owable restorative are the same as its predecessor, Filtek Supreme XT fl owable restorative. Q. What is the source of the almost 20% shrinkage reduction in Filtek Ultimate Flowable Restorative compared to its predecessor? A. The changes in the resin system components have provided a low viscosity and lower shrinking framework. References 1. Mitra SB, Wu D, Holmes BN. JADA (2003) 134, 1382-1390. 2. Takahashi MK, Vieira S, Rached RN, Almeida JB, Aguiar M, Souza EM. perative Dentistry (2008), 33(2), 189-195. 3. SEMs courtesy of Dr. Jorge Perdigao, University of Minnesota, Division of perative Dentistry, Department of Restorative Sciences. 16
17 Q&A, References, Technical Data Summary Filtek Ultimate Filtek Supreme XT Heliomolar Flow Premise Flowable Revolution Formula 2 SDR TPH3 Flow Venus Flow Vertise Flow Tetric EvoFlow Shrinkage % K1c MPa MPa MPa MPa Loss per 200,000/cycles /200,000/cycles 3.28 0.03 1.67 0.07 317.82 17.20 67.25 8.51 120.96 18.64 6815.80 924.00 19.33 0.97 4.04 0.16 1.71 0.10 313.22 27.43 68.91 3.21 117.19 15.05 6410.80 210.00 16.27 1.07 3.28 0.10 1.42 0.05 306.52 21.92 72.31 2.58 118.03 12.48 6420.30 308.80 13.91 1.21 3.92 0.07 1.64 0.13 339.51 34.29 46.04 3.75 107.84 6.14 4095.40 78.10 31.95 1.09 3.86 0.07 1.51 0.07 332.89 12.99 57.26 2.90 105.96 4.18 6443.30 93.50 17.58 0.41 5.09 0.01 1.74 0.13 312.57 25.05 53.41 3.85 106.96 7.58 4706.30 330.00 26.07 2.14 2.97 0.04 2.04 0.07 236.65 11.26 52.65 1.92 112.82 11.76 5230.65 475.51 33.96 1.45 3.79 0.06 1.57 0.04 333.25 17.98 44.70 2.88 115.49 7.20 4560.22 143.80 26.66 0.85 4.06 0.06 1.69 0.06 314.23 18.84 66.21 5.01 117.70 7.01 6044.89 104.23 24.09 1.07 4.58 0.27 1.89 0.09 301.95 25.23 65.15 4.08 117.84 12.21 4322.40 53.50 23.58 1.53 4.50 0.03 1.71 0.14 312.40 10.02 63.53 6.21 124.42 9.04 4669.50 413.20 25.58 1.64 Level Compressive Strength Fracture Toughness Diametral Tensile Strength Flexural Strength Flexural Modulus 95.15 1.98 89.52 3.43 82.81 3.31 77.85 3.13 74.66 3.43 74.47 3.00 70.53 3.49 71.23 2.43 68.87 2.63 1.70 0.05 95.00 1.93 86.33 2.35 79.78 1.97 68.45 3.66 62.33 5.84 59.68 4.24 52.08 1.65 45.60 2.93 50.50 4.94 1.72 0.04 89.58 0.71 78.93 3.04 69.98 5.20 64.97 6.85 56.45 8.60 33.80 5.67 29.03 3.16 23.13 1.95 20.42 0.82 1.50 0.06 89.98 1.11 83.43 3.20 80.16 3.31 78.18 3.10 75.93 2.74 75.76 1.68 70.86 2.10 72.57 2.08 69.65 2.69 2.04 0.03 93.28 1.51 85.48 3.82 81.90 3.11 79.42 2.34 75.87 3.55 72.65 3.75 69.60 4.13 68.00 3.29 65.48 2.45 2.14 0.02 91.52 1.18 84.44 2.69 82.90 2.45 79.76 3.19 77.80 3.62 70.79 5.08 69.47 6.48 66.12 8.00 62.79 8.68 0.77 0.05 80.60 0.42 28.53 3.88 13.65 2.10 13.38 2.00 12.88 1.60 12.24 1.48 11.70 0.97 11.40 1.68 11.99 0.74 2.18 0.02 92.08 2.20 78.77 4.42 74.15 4.18 67.40 2.40 64.15 2.17 62.53 2.28 56.55 1.25 57.42 1.26 51.67 2.11 2.35 0.04 92.18 1.75 87.03 1.68 85.02 1.62 81.77 1.34 79.63 0.97 74.58 1.74 71.88 1.70 67.25 2.40 63.35 4.20 1.51 0.12 95.03 0.16 87.68 4.55 70.37 8.95 64.37 7.88 58.17 8.37 51.58 6.04 46.32 6.27 37.53 3.72 37.97 3.70 1.23 0.05 83.97 1.83 74.63 4.54 65.33 6.22 56.82 2.67 45.60 3.96 34.52 4.81 23.17 2.18 17.13 2.54 16.98 2.28 2.44 0.10 Mean Mean Mean Mean Mean Mean Mean Mean Mean mm AI Polish Retention Initial 1,000 cycles 500 cycles 1,500 cycles 2,000 cycles 3,000 cycles 4,000 cycles 5,000 cycles Grandio Flow 4.89 0.08 1.54 0.04 297.80 18.94 64.73 4.67 114.88 16.89 5969.10 600.90 20.63 1.05 91.03 1.02 78.05 2.68 63.95 6.65 54.23 8.70 45.23 10.61 40.00 9.66 35.75 7.43 36.48 4.05 36.44 3.30 1.56 0.01 Flow-It ALC 4.14 0.03 1.76 0.18 304.19 11.27 65.79 7.02 127.86 5.21 5970.70 226.20 23.02 1.21 92.23 2.82 83.25 5.75 79.18 7.20 74.73 6.02 73.12 7.17 70.11 6.63 66.78 6.60 64.32 4.47 64.40 4.71 1.49 0.11 EsthetX Flow 3-Body Wear Rate 6,000 cycles Radiopacity = standard deviation
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