A Close Look at the Benefits of Shofu’s Giomer Technology

Plenty has been written about Shofu Dental Corporation’s bioactive Giomer Technology in the past years, but many clinicians may not yet know exactly what it is and why materials incorporating these benefits can be a great way to restore patients’ smiles and to do so for a long time.

The dental company has released a line of products featuring Giomer Technology, including Beautifil II Nano-Hybrid Universal Composite, BeautiLink SA, and Beautifil KIDS SA. Here, Shofu answers a series of questions from Dental Products Report designed to explain how this unique technology benefits dental materials and patients and to answer any questions clinicians may still have about Giomer Technology.

DPR: Explain what Giomer Technology is and why it helps Shofu products stand out compared with other products available in the market.

Figures 1-2. Giomer products have been proven in numerous clinical and laboratory studies to reduce secondary caries, neutralize acid, minimize sensitivity,and strengthen tooth structure. | Image Credit: © Shofu Dental Corp.

Shofu: Giomer Technology is a proprietary filler particle engineered and manufactured by Shofu Dental for use in our restoratives, preventatives, and cements. Unlike inert products created by other name-brand competitors, Giomer products have been proven in numerous clinical and laboratory studies to reduce secondary caries, neutralize acid, minimize sensitivity, and strengthen tooth structure through their release and recharge of fluoride and 5 other healthful ions for the life of the restoration. For decades, Shofu has been the leader in the advancement of bioactive dental materials to fulfill our mission of helping clinicians to “create healthy and beautiful smiles all over the world.”

Figures 1-2. Giomer products have been proven in numerous clinical and laboratory studies to reduce secondary caries, neutralize acid, minimize sensitivity,and strengthen tooth structure. | Image Credit: © Shofu Dental Corp.

DPR: Tell us about the process and the research and development of this technology.

Shofu: The practice of ohaguro, or teeth blackening, was common in Japan from the 1600s to the mid-1800s. It is believed that the ingredients used in this practice effectively prevented tooth decay, making it the pioneer of bioactive materials. By the mid 1800s, Japanese people no longer practiced this treatment, but still had the desire to have healthy teeth. Over the decades, many dental companies have tried various technologies and additives to achieve this purpose. Fast forward to the 1990s, when Nakatsuka, et al of Shofu’s Research and Development Department created the Giomer particle, which could be used as part of the filler for resin-based dental materials to offer clinicians a healthful alternative to numerous inert competitors.

DPR: Why does Shofu Dental feel it is important to offer products that provide a bioactive and therapeutic alternative to other, traditional restoratives?

Shofu: Since Shofu’s mission is to “create healthy and beautiful smiles all over the world,” we enable dentists who use Giomer products to enhance their patients’ smiles and promote the longevity of their teeth. Secondary decay, which is caused by bacterial infiltration and accumulation at the restorative margin, is the main cause of restorative failure.¹

Figures 3 & 4. Before and after images of a case using Beautifil II Gingiva from Frank Milnar, DDS, AAACD.

Clinicians who choose products that are clinically proven to significantly reduce secondary decay also reduce the likelihood of restorative failure, thus improving the durability of their work.

In recent years there is a greater acceptance that good oral health contributes to good systemic health. Chronic health conditions such as endocarditis, cardiovascular disease, Alzheimer disease, diabetes, and many others are statistically linked to poor oral health.² This “oral-systemic link” continues to be proven stronger every year as additional studies are released. This is why it is so important for clinicians to consider these materials for clinical use.

DPR: These ions have been clinically proven to inhibit plaque, neutralize acid, and eliminate secondary decay. Please share any key findings from clinical studies as well as Shofu research explaining the bioactive and therapeutic benefits of Giomer Technology products.

Shofu: Based on the technical knowledge of each element, the bioactivity of each ion listed below is well known in dentistry and medicine. Here is a list of the individual ions released and recharged by the Giomer particle with the healthful features of each.

Figure 5. Minimal bacterial colonization (Giomer Technology).

Figure 6. Advanced bacterial colonization (conventional composites).

F-: Fluoride

Acid resistance via fluorapatite

Antibacterial effect

Remineralization

Strengthens tooth structure

Sr2+: Strontium

Acid neutralization

Acid resistance via strontium-apatite

Inhibits dentinal hypersensitivity

Accelerates calcification

Accelerates bone formation

AI3+: Aluminum

Inhibits dentin hypersensitivity

SiO32-: Silicate

Calcification of bone tissue

BO33-: Borate

Antibacterial

Inhibits bacterial adhesion

Antiplaque

Accelerates bone formation

Na+: Sodium

Promotes ion absorption

During the initial stage of developing Giomer, it was assumed that each ion would independently produce the bioactive effect listed above. However, after exhaustive clinical research, additional bioactive effects were realized due to the synergistic effect of the 6 ions. We have resources listed on our website, Shofu.com, or you can Google Giomer studies to review the studies and learn more about the healthful benefits of Giomer.

Figures 7 & 8. Giomer Technology features fast acid neutralization. | Image Credit: © Shofu Dental Corp.

DPR: How many Shofu products include this technology and what cases are these materials indicated for?

Shofu: Shofu’s composites all feature bioactive Giomer Technology. We also offer cements, a desensitizer, and a sealant that incorporate this innovative technology.

There are 2 nano-hybrid universal composites: Beautifil II and Beautifil II LS. Both offer superior strength and polishability. The unique filler structure combines the light transmission and diffusion properties of both dentin and enamel to blend with the surrounding dentition. The esthetics make them ideal for anterior restorations, and the high filler load, wear resistance, and low shrinkage make them strong enough for posterior restorations. The main difference between the 2 universal composites is the handling: Beautifil II has a smooth consistency, while Beautifil II LS has a firm consistency.

Beautifil II Gingiva is a specialty composite available in 5 gingiva shades, which can be layered and blended to create custom gingival shades for all ethnicities. This composite is designed to improve gingival symmetry, repair recession, and disguise exposed crowns and bridges margins and implant abutments. Additionally, Giomer Technology may enhance tissue response and periodontal health in Class V restorations and noncarious cervical lesions.

Figures 9 & 10. Flavio Henriques, DDS, MS, PhD, used Beautifil II LS for this restoration.

Beautifil II Enamel is a specialized nano-
hybrid universal composite offered in 4 unique translucent shades. It is suitable for esthetically restoring cases involving incisal edges, naturally translucent dentition, enamel loss, composite veneering, and other complex cosmetic cases.

Shofu has 2 nano-hybrid flowable composites, Beautifil Flow Plus and Beautifil Flow Plus X. These products are quite similar and are for all restoration classes, including occlusal and cusp. Beautifil Flow Plus was the first flowable composite to receive FDA approval for use on restorative Classes I to V. Both composites offer better compressive strength and wear resistance than many leading universal composites. They also have similar light transmission and diffusion properties to our universal composites.

Beautifil Flow Plus and Beautifil Flow Plus X are available in 2 viscosities: Zero Flow and Low Flow. The Zero Flow (F00) provides excellent shape retention and accurately restores occlusal morphology without slumping, while the Low Flow (F03) thoroughly wets the cavity walls and offers superior adaptation. The main difference between the 2 is that Beautifil Flow Plus X is the newest version, which features improved polishability and handling.

There are 2 self-adhesive flowable composites: Beautifil Kids SA and FIT SA. Both have eliminated the technique-sensitive bonding procedure. Beautifil Kids SA is ideal for preventive resin restoration and small Class I restorations, while FIT SA F10 is used as a liner.

BeautiSealant is a pit and fissure sealant that does not require acid etching, saving time and money. It offers superior bond strength for long-term durability and features BPA- and HEMA-free chemistry.

BeautiLink SA is our newest addition to the line of Giomer products. This unique self-adhesive resin cement is a dual-cured product specifically designed for zirconia restorations, which are the standard material for today’s crowns. Giomer Technology reduces the caries-causing bacteria in the preparation or infiltrating the margins, greatly reducing the No. 1 cause of crown failure.

Finally, PRG Barrier Coat is a light-cured, resin-based desensitizer that is the ultimate solution for prolonged desensitization. It blocks occludes and protects the dentin tubules from external irritants for up to 6 months.

DPR: What has been the feedback from clinicians using these products?

Shofu: The doctors who use our products have given very positive feedback. They have mentioned that the products are easy to use [and] look great, and their patients do not experience postoperative sensitivity. They appreciate the bioactive Giomer Technology, which significantly reduces secondary decay and the need for redoing their restorations due to failure from bacterial infiltration. In addition, Giomer Technology products have received multiple awards and recognition from independent organizations, including The Dental Advisor, Catapult, and Dental Product Shopper.

Figures 11 & 12. Beautifil Flow Plus X case from Paiman Lalla, DDS, AEGD, FICOI, FAAIP.

DPR: This technology appears primed to have a significant impact on dental restorations going forward. What does Shofu see with this technology going forward and just how impactful might these materials be in the future?

Shofu: Shofu’s R&D constantly explores how Giomer Technology can be used in other products. We anticipate a few new products coming in the next few years. As time goes by and the benefits of the bioactive Giomer Technology continue to be more recognized and accepted, it will become increasingly clear why doctors should use these types of products that benefit their patients.

DPR: Elaborate on some of the esthetic benefits and how the unique filler structure gives Giomer restoratives the light transmission and diffusion properties of both dentin and enamel to blend well with surrounding dentition without the need for complex layering techniques required by many competitors.

Shofu: With its exceptional light transmission and diffusion properties, this material offers superb shade-matching capabilities. The chameleon effect successfully replicates the internal structure of natural teeth, virtually eliminating complex layering techniques to simplify the placement of composite restorations. Clinicians have told us that the reduced procedure time and reduction of composite inventory has made their practices more efficient. This is especially beneficial to dental service organizations, health centers, dental schools, and practices who accept insurance.

In conclusion, Shofu believes that Giomer products should be available and affordable for all dentists; therefore, they are available from virtually every dental distributor at prices that are typically 30% less than most other name brands.

References

1. Mjör IA, Moorhead JE, Dahl JE. Reasons for replacement of restorations in permanent teeth in general dental practice. Int Dent J. 2000;50(6):361-366. doi:10.1111/j.1875-595x.2000.tb00569.x

2. McMains V. Healthy mouth, healthy body. National Institute of Dental and Craniofacial Research News. May 8, 2024. Accessed September 5, 2024.
https://www.nidcr.nih.gov/news-events/nidcr-news/2024/healthy-mouth-healthy-body