Inside Dental Assisting
A New Approach to Posterior Restorations
Simplify the process without compromising quality
Placing posterior restorations is one of the greater challenges in a dental assistant’s daily workload—especially for those assistants who may be new to the procedure. In addition to the manual dexterity required for the posterior, there are also the factors of patient discomfort, and ensuring that surfaces hidden from view have been adequately treated. Even for dental assistants with a wealth of experience, posterior restorations can be time-consuming.
Recently, this author had the opportunity to try a new approach to posterior restorations: a single-step bulk fill composite system (SonicFill™, Kerr™, www.kerrdental.com). Designed to provide faster, easier posterior restorations, this bulk fill composite does not require an additional capping layer. This allows the practitioner to proceed from placement to a polished restoration in less than 3 minutes, on cavities up to 5 mm.
At the center of this new system is a handpiece that uses sonic technology to lower the viscosity of the composite significantly (as much as 87%) during placement. This results in a highly flowable consistency that provides superior adaption to the cavity walls. After adaption is complete, the sonic energy is stopped, and the composite returns to a non-slumping consistency that facilitates sculpting. After sculpting and contouring are completed, curing is achieved in as little as 20 seconds.
The SonicFill system incorporates other features that make it exceptionally easy to use. The unique tip design enables easy access for the user to dispense composite, even in challenging posterior situations. The composite is delivered directly through the handpiece, with a controlled, smooth flow.
With many new technologies, the user must learn additional steps or procedures. Instead, SonicFill’s design removes some of the steps normally associated with posterior restorations, allowing a dental assistant to perform quality restorations without additional extensive training.
Efficiency Benefits Patient and Practice
On an average placement, this system can often save minutes, which improves patient comfort. Time in the chair is further reduced because of the degree of control—the assistant can finish the placement with a surface that is much closer to final form. Once the placement is done, less time is needed for trimming and adjusting.
The ability to place composite in a single increment instead of incremental layering represents more than efficiency—it also provides an improvement in quality. Layering increases the potential for voids, which can lead to substandard restorations, or even require the procedure to be redone.
Because of the composite’s flowability, the assistant can be confident that areas that are not visible are sealed, secured, and bonded. Delivering the composite material through a handpiece promotes accuracy and facilitates esthetic restorations.
Beyond tooth preparation, dental assistants with expanded functions training are able to perform as much of the general dentistry work as possible to free the dentist up to handle more major procedures. In this case, a patient presented with defective, leaking margins on old Class II amalgam restorations on teeth Nos. 20 and 21 that required replacement (Figure 1). The patient was shown radiographs of the areas affected with recurrent decay (Figure 2). After the case presentation, the patient selected composite resin fillings (SonicFill), which would result in more esthetically pleasing restorations.
Using a rubber dam and sectional matrix system, this author placed the posterior restorations (Figure 3). The delivery and handling properties of the single-step bulk fill composite system allow for maximum efficiency while resulting in a beautiful restoration with excellent anatomical form and proximal contacts (Figure 4).
When adding a technology, procedure, or instrument into a practice, it is important to determine how it will impact the workload and patient care. In a busy practice, dental assistants can contribute greatly by utilizing all of the expanded functions delegable by their state dental practice acts. SonicFill effectively addresses many of the more time-consuming and difficult aspects of posterior restorations—simplifying the process without compromising quality.
About the Author
Cosmetic Dentistry of Colorado