A Step Up for Bulk-Fill Composites
Kerr Dental’s SimpliShade™ Bulk Fill and SimpliShade™ Bulk Fill Flow offer single-shade options with a greater depth of cure
Matthew R. Miller, DDS
For Matthew R. Miller, DDS, the best part of working in a large group dental practice is the opportunity for collaboration. "It's great to be able to offer a lot of interdisciplinary care under one roof, and being able to review cases in conjunction with my colleagues and work on them together is so valuable," he says. "We have the opportunity to learn from each other, the younger dentists receive mentorship, and the more experienced dentists even learn new concepts from the younger ones." Miller touts the many advantages, but he has not always worked in such a large practice. Having previously worked as an associate in smaller practices where it was only him and the owner, he feels that although working in a solo practice has its own advantages, one can also end up feeling isolated, and being alone on an island doesn't foster new ideas in the way that collaboration does.
Even so, every group practice is different. When Miller graduated from dental school in 2007, he initially started working in a large group practice with 13 other dentists, but the experience wasn't as collaborative, and it didn't provide the guidance he was looking for as a new dentist. "My first experience in a group practice just didn't end up being the right setup for me," he explains. "It was pretty overwhelming, and the model they ran on just didn't feel right for me, so I left to get experience in a smaller practice." After that, Miller joined a multi-office implant teaching institute with the goal of eventually buying out one of the locations, but the partnership ultimately dissolved while he was still an associate, and he was left at a crossroads. "I hadn't actually planned on ending up in a large group practice again," he says. "In the beginning, my current practice was actually much smaller; it was just myself and a husband-and-wife duo who I partnered with. But as we've grown over the years, we have brought on one more partner and a number of associates, and we went from a 3,000 square foot office with six chairs to a 6,000 square foot office with 20 chairs that includes a surgical suite." Although Miller's practice, which is located in Huntersville, North Carolina, has become larger than he anticipated, he continues to enjoy collaborating with his colleagues as they all learn and build their skills so that they can truly take on any case.
In a large and busy practice, efficiency is critical. One material that has improved the efficiency of Miller's practice is Kerr Dental's SimpliShade™ Bulk Fill, which is also available in a flowable formulation (SimpliShade™ Bulk Fill Flow). A single-shade composite capable of matching all 16 shades on the VITA classical A1-D4® shade guide, SimpliShade Bulk Fill eliminates the need for shade selection and reduces the time spent on inventory management. It does not require a capping layer and features an enhanced curing mechanism that enables it to be polymerized at depths of up to 5 mm. "My favorite thing about SimpliShade Bulk Fill is its 5-mm depth of cure," Miller says. "Most bulk-fill materials can only be cured in increments of up to 4 mm, but with SimpliShade Bulk Fill, I can achieve a good cure with a 5-mm increment without having to worry about leakage or instability within those dimensions."
In Miller's opinion, the standout feature of SimpliShade Bulk Fill is the chameleon effect that it demonstrates. "Some one-shade composites end up looking a little translucent or don't polish well," he says. "But SimpliShade Bulk Fill polishes nicely, has a great consistency, and blends well to produce natural esthetics. The flowable does tend to be a little more translucent than the packable, but it has great handling characteristics and self-levels. I actually prefer to use them hand in hand and will start with the flowable composite and then use the packable composite as a capping layer to deliver a nice, natural-looking restoration with a good polish."
According to Miller, SimpliShade Bulk Fill is ideal for posterior restorations, including all cavity classifications, core buildups, filling underneath crowns, closing up root canal accesses, and more. "I don't use SimpliShade Bulk Fill as much in the anterior region because for many of our more high-esthetic anterior cases, we are actually looking to change or enhance the tooth shade, rather than just match it. In these cases, the traditional formulation of SimpliShade with its three shade offerings or Harmonize nanohybrid universal composite are better options," Miller says. "However, in the posterior region, SimpliShade Bulk Fill is able to impressively blend with the natural tooth structure. I've asked patients at their recare appointments if they have had any issues with the fillings, and they often actually say that they completely forgot about them and that they feel natural. And that is really the goal-to create such natural esthetics that it looks like nothing was done and to not have any sensitivity or failures."
SimpliShade Bulk Fill and SimpliShade Bulk Fill Flow also feature the next generation of Kerr's Adaptive Response Technology (ART), which is found in the company's Harmonize™ and SimpliShade universal composites. This technology is responsible for SimpliShade Bulk Fill's ease of handling, lower shrinkage stress, and ability to blend seamlessly, among other benefits. Miller appreciates the improved marginal adaptation that can be achieved with the ART technology as well, particularly with SimpliShade Bulk Fill Flow. "The flowable formulation settles nicely toward the tooth without being runny or slumping, and the packable formulation sculpts well to blend into the tooth structure without leaving any gaps between it and the tooth," he says. "Kerr also offers a nice feature in the way the carpule is packaged. The flowable formulation is centrifuged, so it does not have air bubbles in it like some other bulk-fill materials, and I don't need to worry as much about ending up with a void in the filling."
Together, SimpliShade Bulk Fill and SimpliShade Bulk Fill Flow meet all of Miller's posterior restorative needs. These materials take bulk-fill composites to the next level with a single-shade option that offers high wear resistance, strong mechanical properties, and excellent handling characteristics. "With such an effective single-shade option, I can increase patient satisfaction and decrease chair time, all while managing my overhead and improving cost efficiency without compromising restorative outcomes," he says. "SimpliShade Bulk Fill is easy to use, looks natural, and holds up over time."
Key Points
• A single-shade composite capable of matching all 16 shades on the VITA classical A1-D4 shade guide.
• Enhanced curing mechanism permits placement of increments up to 5-mm thick with no capping layer required for the packable version. It is recommended to use a 2-mm capping layer when using the flowable version.
• Adaptive Response Technology imparts excellent handling characteristics, reducing viscosity during handling then recovering stability for light curing.
• Demonstrates higher flexural strength, lower polymerization shrinkage, and lower shrinkage stress for improved marginal adaptation.
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