Teaming up to advance composite placement

I’m always on the lookout for a better mousetrap. Whether it be a laser, a smartphone or some other amazing piece of equipment that will change my life, I’m driven to find the “next great thing.” The wonderful part of being the Technology Editor here at Dental Products Report is that when I find these things, they not only change my life for the better, but I get the chance to share them with you!
This month’s article deals with a product you might have heard of, but may not know a whole lot about. So let’s dig in and take a look at a new device from Kerr called SonicFill. It very well may change the way you place composites.

The backstory
SonicFill is a new device, but the concept has an interesting history. Before we get to the device, let’s take a look at the way this product came together.

A few years ago I stumbled across an interesting device that helped me to place indirect porcelain restorations. It was an air-driven scaler made by KaVo and called the SONICflex Airscaler. It is a device that has a sonic handpiece that uses a standard air line to oscillate the device in the <6.5 kHz range. It comes with a variety of tips and can be used for a wide variety of uses, the most common of which would be scaling.

The smart people at KaVo had come up with a really great idea. They created a tip for the SONICflex that had a rubberized component right at the end. When bonding an indirect restoration, you could etch, bond and fill the prep with a regular posterior composite. Next you could place the restoration into the composite, put the rubberized tip against the restoration and step on the rheostat.

The resulting sonic energy would pass through the tip and vibrate the restoration. This would cause the composite to vibrate and become almost buttery in consistency. The composite would express around the edges and could then be wiped away and the restoration cured with a high intensity curing light.

State of the art
Fast forward to 2009 when Kerr came to me with a “top secret” prototype device. Kerr and KaVo had been working on a combination device that featured the best both companies had to offer. What they showed me was a specialized and significantly changed/improved handpiece and a special composite delivery system that would attach to it.

The product was eventually called SonicFill and it was brought to market in the Spring of 2011. The system uses a special highly filled composite that becomes almost liquefied (think vibrating stone as you pour it into an impression) and adapts to all the nooks and crannies of a preparation.

SonicFill is composed of both the sonic vibrating handpiece as well as the composite delivery cartridge that attaches to it.

Sound in motion
Use of the SonicFill system is very straightforward and easy. A cartridge containing the SonicFill composite is selected and attached to the SonicFill handpiece.

The doctor prepares the tooth in the traditional manner and uses whatever bonding system he or she prefers. SonicFill is not dependent on any certain type of system or bonding agent. In my office, we place the sectional matrices (if needed) and then get ready to fill.
Once the cavity preparation is completed and the prep is ready for the composite, the SonicFill is ready to shine.

Simply attach the SonicFill handpiece to your airline using whatever quick disconnect system you happen to use. In my office, we just take off the highspeed and attach the SonicFill handpiece.

The caps are (unidose tips come with two caps-one on either end) removed from the cartridge and the tip of the cartridge is placed in the deepest part of the prep. Stepping on the rheostat creates vibration within the handpiece. This causes the composite to undergo a physical change to become a consistency thicker than a flowable and less viscous than cookie dough.

The composite simply flows into the prep filling all the area without need for a base, liner or flowable. Because the composite is changed by the vibration, it can be made very thick and is highly filled. Normally a composite this highly filled would be difficult to express from a traditional “composite gun,” however the use of the sonic energy makes the composite flow in a very direct and controlled manner.

Because the composite is highly filled, polymerization shrinkage is much less than with traditional composite. This means that SonicFill can be used in a “bulk fill” application because the highly filled composite exhibits less polymerization shrinkage than traditional bonded restorations.
The material is placed into the preparation where it maintains its “thinner viscosity” for a few minutes, which allows the doctor to carve and then cure in one bulk increment using a high powered curing light.