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Dental Blog Post

Raising the Bar with a New Technology in Warm Composites

by Dr. Phil Klein
This article is based on the DentalTalk podcast below:

Many dentists have made the switch to warm composites. Which makes sense, as warm composites offer a number of benefits:

· Better placement behavior – You have the ability to push and compress the warm composite against the nuances of the prep.

· Excellent shaping and sculpting – You can manipulate the final layer so that the occlusal surface is shaped just the way you want it.

· Less gapping – If you’re layering a composite, the layers better integrate with each other, so you’re less likely to get a gap or void.

· A more total conversion after curing – The research has vetted this out.

Now VOCO has released a new technology in warm composites that gives you all of the advantages listed above and then takes things to another level.

 

A body composite and a flowable composite in one

This novel material is called VisCalor. VOCO’s VisCalor comes in two formulations: a traditional 11-shade composite and a 4-shade bulk fill version. Both have a thermoviscous, on-demand heatability that is essentially like having two composites in one.

As Dr. Foroud Hakim, an expert in the field of esthetic dentistry who lectures worldwide and maintains a private practice in California, explains, with VisCalor and VisCalor Bulkyou can have on-demand behavior where a body composite begins to behave more like a flowable composite.

“Within just a few seconds,” says Dr. Foroud, “we can get that composite warmed up to where it behaves very much like a fairly stiff flowable. Which means that when the operator puts this inside of the preparation, inside of a cavosurface, it will quickly flow down to the bottom, and with some very subtle push with our composite instruments, really adapt and ‘butter’ against all those walls, eliminating voids and gaps.

“But very quickly, by the time it touches a tooth and has the ambient oral temperature involved, within a few seconds it starts to turn into what would be a more traditional semi-warm composite where it’s very sculptable. It doesn’t stiffen up too much, but it’s also not runny. As you build up the anatomy, it stays put where you want it to.”

As an added bonus, VOCO has made a placement tip that’s small enough to get into the tight preps of today’s minimally invasive dentistry. These tips can fit into a narrow box and enable you to backfill upwards.


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This composite also eliminates the “base layer compromise”

There’s another advantage to the “two composites in one” aspect of VisCalor, and this has to do with strength.

When we do sheer bond strengths, the adaptive layer—meaning that first layer of composite between a flowable layer and the adhesive—is very critical to the strength of thefinal outcome. When we test sheer bond strength, if there are no voids in that initial layer, we tend to have better results.

This is why starting with a flowable has always been a type of compromise. As Dr. Hakim observes, “The flowables were necessary evils. We knew that they made a better adaptive layer, but it was a compromise because they have lower physical characteristics—lower compressive strength, higher shrinkage. But it made more sense to have a better adaptation.”

Now, we have athermoviscous warm composite that momentarily becomes a flowable. This eliminates the need for a separate flowable base layer, simplifies the procedure and produces a superior end resultthat has better sheer bond strength.

 

Conclusion

“With a short learning curve,” Dr. Hakim shares, “because the product is that easy to use, we’re really cranking out what I consider high-end restorations in just a few minutes.”

Less chair time. More efficient workflow. Fewer products to keep in inventory. Excellent results in terms of esthetics and strength. VisCalor is a new technology in warm composites that truly does raise the bar.