Constic- the self-etching and self-adhesive filling material
Matthias Hodecker and Julia Gerke, images Matthias Hodecker
Because of today’s wide selection of bonding systems with complicated work processes, the desire to simplify working steps during restorative treatment is becoming greater than ever before. Particularly in the case of small Class I restorations, as well as fissure sealing and lining, which can be performed relatively quickly, preparatory steps such as etching and bonding protract the working time unnecessarily. At the same time, they increase the number of possible sources of error since, if certain working steps are neglected, the durability of the restoration can be drastically reduced.
Many dentists would like to have fewer work steps required, in order to be able to work more reliably and focus primarily on the restoration. This can be achieved through the use of self-etching and self-adhesive synthetic materials.
Constic is the new self-etching and self-adhesive flowable composite from DMG, which combines etching, bonding and filling in one step and features superior adhesion to enamel and dentine along with good aesthetics.
In the following case, a small and inadequate Class I restoration on tooth 17 can be seen (Fig. 1).
Fig.1 Baseline situation: Occlusal amalgam restoration in tooth 17
After preparing the cavity, it is initially recommended to clean the tooth, remove any debris using water-spray and blow it dry (Fig. 2). Then an approximately 0.5mm thick layer of Constic flowable composite is applied to the cavity using the Luer-Lock-Tip and massaged in for 25 seconds using the brush (Fig. 3 & 4). Thereafter any excess should be removed (Fig. 5). Then the layer is light-cured using a polymerisation light for 20 seconds (Fig. 6).
Fig.2 Depiction of the defect of the Class I cavity
Fig.3 Application of Constic using the Luer-Lock-Tip
Fig.4 Massaging in Constic with a small brush
Fig.5 Removing the excess using a foam pellet
Fig.6 Light polymerisation of the first layer
The actual restoration is then performed. For the restoration, the material is applied in layers that are a maximum of 2mm thick (Fig. 7). The low-viscosity and uniform consistency of Constic ensures that the restoration has no trapped air or marginal gaps. This is facilitated by the fact that no additional bonding materials are used. Each layer is light-cured for 20 seconds (Fig. 8).
Fig.7 Application of another layer of Constic
Fig.8 Light polymerisation of the second layer
Using a dental probe, a high-quality aesthetic fissure surface can be achieved prior to final curing (Fig. 9). Apart from the Luer-Lock-Tips and the brush, which are included in the set, few additional modelling instruments are required. Thus sterilisation costs and instrument wear are kept to a minimum. The cured restoration is then checked for overhangs, which are removed using a scaler (Fig. 10, 11 & 12)
Fig.9 Result after contouring the restoration using a probe
Fig.10 Polishing the restoration using a Super-Greenie
Fig.11 Constic restoration after finishing and polishing
Fig.12 Checking the occlusion
Constic, as a self-etching and self-adhesive flowable composite, stands out due to its uncomplicated application with simultaneously high-quality aesthetic results.
Since Constic is available in many different shades, a restoration that is individually characterised can be prepared for each tooth. The range includes shades A1, A2, A3, A3.5, B1, as well as opaque-white. Since the working steps of etching, bonding and filling are combined into one step, the Dentist is able to have a shortened working time on the one hand and also stress-free work on the other hand.
In addition, considerably fewer instruments are required, which improves both the work flow and also the Dentist's concentration on his/her own work and thus has a positive effect on the final results.
Steps such as etching, which represent a certain degree of patient risk, are combined with filling into one work step and this increases reliability for the Dentist. In addition, this ensures that no intermediate step is forgotten. Due to its versatile applicability - Constic is suitable for lining and also for small Class I restorations, as well as fissure sealing - the size of the inventory improves, while purchasing costs for other systems are minimized at the same time.
The radiopacity of the material also ensures easy identification of the restoration by Dentists in the future.
Finally, it can be said that Constic enables work to be performed in a more relaxed fashion, while decreasing the amount of work and achieving an aesthetically challenging and functionally high-quality result.
Address for correspondence:
ZA Matthias Hodecker
Fachpraxis für Kieferorthopädie
Dr. med. dent. Peter Wüllenweber