How to: Use a self-adhering flowable composite

If a vertex, as defined by Webster, is the intersection of two lines that form an angle, Vertise Flow is the intersection of composite and bonding agent where speed and convenience collide without sacrificing performance.

It’s rare, these days, that a dental manufacturer introduces a material that is truly unique. Admittedly, there are “new” products touting different chemistries, improved bond strength and better elasticity, but these “improved” materials often are basically the same products slightly modified.

Vertise Flow, however, is a new class of composite material: self-adhering flowable composite. This is an advanced approach to composite technology that I believe is the next logical development in restorative materials. However, the concept is so novel it has many dentists wondering if it is too good to be true.

The purpose of this article is to demystify this exciting new technology so more clinicians will decide to incorporate it into their armamentarium of restorative solutions.

The composite

Kerr has incorporated its proven, proprietary OptiBond adhesive technology into Vertise Flow as well as an optimized resin matrix and filler system with an average particle size of 1 micron. This particle size ensures optimal wear resistance, comparable with the leading flowables on the market today.¹

Equally impressive is Vertise Flow’s shear bond strength, with its 22.4 MPa in enamel and 26 MPa in dentin.² This should allay any fears that this technology does not work.

Microleakage is another concern clinicians have with any bonded restoration. In a University of Siena study³ that compared the microleakage of various flowable composites and dental adhesives in Class I composites, Vertise Flow outperformed many of the systems.

It's versatile

Clinicians know viscosity is important when using a flowable. Vertise Flow has a viscosity that is well suited for both anterior and posterior restorations. In a recent North American hands-on in-vitro field test,3 clinicians favored Vertise Flow’s physical characteristics over the flowables they currently used. All-in-all Vertise Flow is a pretty remarkable product that deserves a spot on your shelf of restoratives.

Case presentation

The following is a step-by-step pictorial showing the ease of use of Vertise Flow. I’ve chosen to show a direct Class I restoration, however this material can be used in Class I, II or even as the restorative of choice when doing a sealant.

The procedure

01. Isolate the tooth you’re working on from the adjacent teeth before you start the procedure (Fig. 1).

02. Prepare the cavity, wash thoroughly with water, and dry with air. Research has shown that with Vertise Flow, dry dentin surfaces enhance bond strength. Vertise Flow composite is self-adhering and therefore does not require an etching or bonding protocol prior to placement.

03. Select the desired shade. Dispense Vertise Flow into the preparation with the provided dispensing tip. Place the tip into the deepest area of the preparation and begin dispensing (Fig. 2).

04. Use the provided brush to apply Vertise Flow to the entire cavity wall. Brush with moderate pressure for 15-20 seconds to obtain a thin layer. The initial layer should be no more than 0.5 mm (Fig. 3).

05.Light cure for 20 seconds. After lining the cavity wall with Vertise Flow, you can either build the restoration with more composite in increments of 2 mm or less, or you can build the restoration with a traditional universal composite resin such as Kerr’s Premise or Herculite Ultra. The thickness of each increment of the traditional universal composite should be no more than 2 mm.

06. Light cure each increment for 20 seconds. Now the final restoration (Fig. 4) is ready for you to place.

Dr. Sam Simos is nationally recognized as a leader in cosmetic and restorative dentistry. He teaches post-graduate courses to dentists through Allstar Smiles’ state-of-the-art Learning Center and client facility in Bolingbrook, Ill. and throughout the country. Dr. Simos can be contacted through allstarsmiles.com.