Review: Tetric EvoCeram Bulk Fill from Ivoclar Vivadent | 'Bulk-fill composites from the trenches'

As a general dentist practicing in a small, rural, blue-collar town in the state of Washington, and as a dentist who runs a practice focused on cosmetic and restorative dentistry, I still rely heavily on meeting my patients’ routine needs to hit my revenue targets. Therefore, the quest to find time-saving materials and techniques - ones that do not compromise quality - is always on my mind.

My introduction to bulk-fill composites came approximately five years ago as a result of my membership with the Spear Education Faculty Club. At that time, we were given the opportunity to test and provide product feedback to manufacturers on a few selected products. One of those products was Ivoclar Vivadent’s Tetric EvoCeram Bulk Fill. Like most general dentists, I was intrigued by the promises of bulk-fill composites, so agreed to provide user feedback about this already scientifically tested material. I continue to use this product in my practice today in some specific applications. This article will focus on what I have learned about this material in recent years: the challenges, the advantages, the indications, and a brief summary of the technique used for placing the material.

 

Challenges

Tetric EvoCeram Bulk Fill has a low viscosity, which makes it challenging to adapt to all aspects of the cavity preparation. It also tends to move when manipulated. For example, when the material is placed in bulk on a conservative Class II restoration, I’ve noticed that while I’m adapting the material to the lingual cavosurface margin, the resin often starts to pull away from where I had already adapted the buccal cavosurface margin. I then have to carefully readapt the buccal margin without, in turn, creating an open margin on the lingual.

Shade matching is also a challenge, depending on how much you obsess about these things. In my five-plus years of placing the composite, I can’t recall a single patient complaining of the shade match. As an American Academy of Cosmetic Dentistry-accredited dentist with a higher level of obsessiveness, and one who is trying to stay ahead of my patients’ expectations, I have found that the material generally blends quite well. However, it occasionally tends to be either slightly too low or too high in value. It comes in three shades: a universal A shade (IVA), a universal B shade (IVB), and a white shade (IVW) for light or deciduous teeth. For Class II restorations, there is an insignificant difference between the A and B shades. The IVA, due to its higher level of translucency on deeper preparations, can appear slightly too low in value, whereas the IVW, because of its low translucency, can often be slightly too high in value.