Dentsply Caulk's Surefil SDR flow

February 2011  | Dental Products Report

product watch: benchmark

DENTSPLY Caulk's Surefil SDR flow

Catapult presents its review of this new material, based on feedback from evaluators nationwide.

by Dr. Lou Graham, President of Catapult, and Dr. Mark Latta, Catapult’s Consultant for technical & scientific affairs

surefil sdr flow
Said to allow clinicians to place posterior composites up to 40% faster, SureFil SDR  flow posterior bulk fill flowable base allows for bulk placements up to 4 mm with a 20-second cure time for the universal shade (40 seconds for A1, A2 and A3). The material features stress absorption and optimal cavity adaptation with the added benefit of bulk filling.
dentsply caulk • surefilsdrflow.com

SureFil SDR  flow was evaluated last year, prior to its launch, and is now a product that has been tried by more than 18,000 dentists. So why has this product been so overwhelmingly used? The answer from a majority of our evaluators was that it offers a simplified approach to Class I and Class II restorations while potentially enhancing long-term outcomes. Gone are the days of filling a deep Class I or II box with the end result either being porosities on your X-ray, poor margins gingivally, or techniques that simply were  time consuming with mediocre results. We all want easier and better results; it’s that simple. If you want to spend an hour building up a box obliquely with 4 layers as we were taught years ago, put this article down!

In looking at what makes SureFil SDRflow an advancement in adhesion dentistry, we have to look at the issues of shrinkage and stress. Visible light cure resin composites contain multifunctional, reactive molecules called monomers. As these monomers link together to create large molecules called polymers, shrinkage occurs as the net volume decreases. The change in volume generates stress (called polymerization shrinkage stress) at the interface between the restorative material and the bonded wall of the cavity. This stress builds up very fast during light curing and may create many clinical problems such as: enamel fractures, cuspal movement, cracked cusps, potential enhanced post-op sensitivity, micro-leakage and other issues. Thus, the introduction of SureFil SDRflow from DENTSPLY Caulk into dentistry.

The survey of evaluators showed that more than 90% of us use some type of “liner” underneath our composites and these include glass ionomers, resin ionomers and flowable composites. Thus in this group, it was rare to have an evaluator do a moderately deep Class I or II with just a universal composite.

Findings from Catapult evaluators
75% felt the two most important benefits of the product were the simplicity of the procedure along with the bulk filling capability of up to 4 mm. These attributes we believe in the “clinical dentistry world” are very valuable, because doctors prefer speed and simplicity without compromising quality. Though stress reduction and internal adaptation ranked far lower, they are essential to the overall message as to handling and handling properties.

87% rated the handling very good to excellent and the majority of the group really liked the delivery

Compula Tips system.
Approximately 80% preferred the handling to their current flowable or rated it equal, again a very high percentage that approved of the handling.

The most divided aspect on handling was stickiness where almost one-half found it to be better and one-third found it worse. The uniqueness of the material is that it self levels so it rarely should require the use of an instrument to manipulate it.

75% would use this product in their practice and this is a very high percentage for a new product amongst the evaluators.

60% of the users said this would replace their current flowables for Class Is and Class IIs.

More than 66% felt the one shade was fine for the indication of a bulk fill flowable (up to 4 mm) and that it was very easy to visualize the material. DENTSPLY Caulk has since introduced three additional shades, A1, A2 and A3, for this product.

Though the group’s usage in Class Is and IIs was not overwhelming, the reason is if the majority of this group are glass ionomer/resin ionomer users, these may override usage of this SureFil SDRflow formulation for many Class I restorations. This may not be typical of most dentists in the U.S. We believe a key aspect here is the shrinkage stress at the gingival and proximal margins of a Class II. Even in most closed sandwich techniques on Class IIs, these margins do not have glass ionomer coverage and this would only complement the overall restoration.

Key tips to this product
When injecting, slow is essential with keeping the tip in the material.
Allow the material to “self level” and this will maximize marginal coverage and minimize use of an explorer, which can create bubbles.

Do not overfill the box. Leave enough room for 2 mm of composite overlay with your favorite composite.

About catapult
Catapult is an organization that consists of more than 50 clinicians spread throughout Canada and the United States. As a company, manufacturers pay a fee for their product to be evaluated and what we deliver are truthful, independent answers from surveys that we develop with them. We have had many products that have either had to be altered before hitting the market or simply never arrived because of our openly honest evaluations. In this way, Catapult assists the manufacturer to avoid potentially releasing a faulty product, or simply a product that needs refinement. Lastly our clients are omnipresent in the industry, small to large, no favoritism, simply reviewing the latest products in our practiceYou must use a light that has energy! In our eyes, 1000mw is OK, more is better. Keep your light close to the material and cure for at least 20 seconds. Yeah, we know those 5 second docs are out there, but it is essential to get that light to cure the greater depths so go 20.
Don’t use on the mesial boxes of upper first or second bicuspids if you see them in a high smile. The material is too translucent. If you do choose to use for these indications, try one of the new shades instead.

This review represents a summary of findings amongst the Catapult evaluators. There are members within the group who may want more long-term data before routine use in Class I and II restorations. Equally, within the group, those who use glass ionomer as bases and liners may not have as much usage of this technology as those who prefer to bond their entire restorations. We can be reached at catapultyourpractice.com for your comments.