Consultants’ Comments

• “Excellent strength and wear resistance after 3 years.”
• “I used it for a very large posterior restoration which I thought needed a crown. It is still performing well after 3 years.”
• “Looks beautiful!”

Purpose

Tetric EvoCeram® Bulk Fill is a nano-hybrid bulk fill composite indicated for direct restorations in posterior teeth. This radiopaque composite has a unique composition of:

• Patented pre-polymers that reduce shrinkage stress
• Ivocerin, a photo-intiator that results in a deeper depth of cure
• Light sensitivity filters for extended working time.

The composite is filled 53-54% by volume with particles in the 40-3000 nm range. Tetric EvoCeram® Bulk Fill cures in 10 seconds and can be placed in layers up to 4 mm, requiring no capping layer.

Clinical Evaluation Protocol

After three years of tracking, 114 Tetric EvoCeram® Bulk Fill restorations were recalled. Figure 1 summarizes the distribution of the units recalled with the majority in the posterior region. Figure 2 indicates the age of the restorations at recall.

Results at 3 years

Esthetics

The esthetics reported at placement were maintained and reflected in the high rating (Figure 3). While the material was reported as slightly translucent at placement, minimal additional stain or color change was reported after 3 years.

Resistance to Fracture/Chipping

98% of the restorations were in excellent condition (Figure 3) with a few of the very large posterior composites exhibiting slight chipping. Clinicians were easily able to finish/polish the imperfections.

Resistance to Marginal Discoloration

At the three-year recall, nearly all of the restorations were in excellent condition (Figure 3) with closed, undetectable margins. A few of the large restorations in patients with bruxism showed minor changes at the margin.

Wear Resistance

Tetric EvoCeram® Bulk Fill is a strong nano-hybrid composite that held up very well to occlusal forces both in the posterior region and in larger restorations (Figure 3). Very little evidence of wear was reported.

Lack of Postoperative Sensitivity

No post operative discomfort was reported in any of the restorations after 3 years in service (Figure 3).

Summary

Tetric EvoCeram® Bulk Fill performed exceptionally well after 3 years. Clinicians reported excellent esthetic and functional results. Tetric EvoCeram Bulk Fill received 98% clinical performance rating.