A Flowable that Offers Flexibility, Esthetics, and Durability

Flowable resin-based composites have become a popular restorative material and are comparable to packable composites. Due to their high flexibility and viscosity characteristics, flowable composites are a good material choice to use at a tight/conservative restoration area. The high flexibility means the flowable will be less likely to be displaced in a stress-concentrated area. Clinicians can use this popular restorative material by placing it at the gingival floor before placing packable composite material. This ensures penetration into every irregularity and ultimately seals the margin via the open-sandwich technique.

Major clinical indications for flowable composites are preventive resin restorations, pit-and-fissure sealants, cavity liners, minimally invasive Class II restorations, and Class V lesions. Our office also uses flowable composite to restore the access channel on screw-retained implant crowns. In this case, a 42-year-old male patient presented to our clinic with a failing tooth No. 19. It was an asymptomatic tooth with a periapical radiolucency lesion. Since the tooth had a poor prognosis, we extracted it and decided to replace it with a Straumann PURE 2-piece ceramic implant (Figure 1).

On the implant crown restoration day, we first confirmed the crown fit on a bitewing radiograph and re-tightened the abutment screw to the ideal torque using a torque wrench. We then placed Teflon tape to protect the screw and applied a thin layer of universal adhesive to the access channel wall.

Afterwards, we thinned out the material via air and light cured for 20 seconds with the Patterson LED Curing Light (Figures 2 & 3). This curing light unit has excellent ergonomics, and the curvature of the head allows for it to reach even the most remote areas of the mouth. This feature allows the dental assistant and doctor to practice with correct posture, without the need to twist the neck or to bend to reach certain areas or teeth.

Once the bonding agent is cured, we placed Patterson Flowable Composite in Regular Viscosity in shade A2 (Figure 4) and light cured it with the Patterson LED Curing Light. After curing the composite, we used an articulating paper to check the occlusion and adjusted the crown occlusion with a fine grit, football-shaped diamond until we achieved the ideal occlusion for the implant crown restoration. We used a series of porcelain polishing burs (coarse, medium, and fine) and Jiffy polishers to polish the crown, including the composite restoration.

The final restoration (Figure 5) with shade A2 of the Patterson Flowable Composite blended well, and the patient was very pleased with the outcome. The final photo shows the great shade and margin adaptation of the composite material, allowing for an esthetic outcome. Since the occlusion is highly controlled on implant crowns, we were comfortable with using flowable composite in this case. Not only is the Patterson Flowable Composite strong enough to withhold occlusal forces, but it will alert us in cases of excessive occlusion. By using a combination of the Patterson LED Curing Light and the Patterson Flowable Composite, we are able to achieve efficient and esthetic restorations.