Tetric EvoCeram® Bulk Fill (4 yr)

Ivoclar

(98%)

Awards:

Consultants’ Comments

“The esthetics was excellent – retains surface gloss over time.”
“Easy to place, not sticky and contours well.”
“Blends very well with the tooth, especially when tooth is not discolored.”

Description:

Tetric EvoCeram Bulk Fill is a nano-hybrid composite indicated for direct restorations in posterior teeth. This radiopaque composite contains patented pre-polymers that reduce shrinkage stress; Ivocerin, a photo-initiator that results in a deeper depth of cure; and light sensitivity filters for extended working time. The composite is filled 53-54% by volume with particles in the 40-3,000 nm range. Tetric EvoCeram Bulk Fill cures in 10 seconds (1000 mW/cm 2) in increments up to 4 mm in depth.

Clinical Evaluation Protocol:

Over a four-year period, 117 of 130 Tetric EvoCeram Bulk Fill restorations were recalled. Figure 1 indicates the distribution of restorations with the majority of placements in the posterior region. Figure 2 indicates the age of the restorations at recall.

Clinical Observations:

The recalled restorations were evaluated in the following areas: esthetics, resistance to fracture/chipping, resistance to marginal discoloration, and wear resistance. Restorations were evaluated on a scale of 1-5 with 1=poor, 2=fair, 3=good, 4=very good, and 5=excellent.

Esthetics

Tetric EvoCeram Bulk Fill is available in three universal shades (Universal A – IVA, Universal B – IVB, and Universal White – IVW). Eighty-three percent of recalled Tetric EvoCeram Bulk Fill restorations received an excellent rating (Figure 3). Seventeen percent received a very good to good rating. In cases where the tooth was discolored, consultants used flowable composite opaquer to improve the esthetics.

Resistance to Fracture/Chipping

At the four-year recall the resistance to fracture/chipping was rated excellent (Figure 3). Of the recalled restorations at four years, 111 restorations (95%) received an excellent rating. 3.5% of the restorations received very good to good ratings and required no action. Only two restorations needed to be replaced. Both were tooth failures – one required a crown and one required extraction due to root fracture.

Resistance to Marginal Discoloration

Resistance to marginal discoloration was also rated excellent (Figure 3). Eighty-eight percent of restorations (103 of 117) received an excellent rating, while 12% of the remaining restorations received a very good to good rating. Tetric EvoCeram Bulk Fill offers low shrinkage and low shrinkage stress for superior adaptation to the margins. There was minimal marginal discoloration evident at recall. Four restorations that had previously exhibited superficial staining at the cavosurface margin at the two-year recall had been re-polished with excellent results.

Wear Resistance

Wear resistance was rated excellent (Figure 3). None of the recalled restorations exhibited any wear of the composite or the opposing dentition (Figure 3). Tetric EvoCeram Bulk Fill’s nano-filler technology provides improved strength, high gloss, and low wear properties.

Conclusions

Tetric EvoCeram Bulk Fill performed very well at four years. The clinical outcomes of this four-year evaluation of 117 restorations were excellent. Tetric EvoCeram Bulk Fill received a clinical rating of excellence with a 98% overall performance at 4 years.

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