Dr. Carla Cohn, DMD

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Composite Applications for Our Pediatric Patients

By Carla Cohn DMD There are so many excellent composite resin materials to choose from in the dental market today that it can be overwhelming to know which to use, and when. Many of the composite resin materials come with features that are compelling. Bioactivity, bulk fill, sonic fills, ultra-polishable, low shrinkage, self leveling, nano hybrid, specialized aesthetic shading systems, universal use, the list of attributes available goes on and on. Ultimately, we want the very best for our patients and their restorations. At the same time, it is inconceivable that we carry the inventory in our practice of each material that has a distinct attribute. A simple and unique solution is OMNICHROMA, a resin restorative material manufactured by Tokuyama Dental America. OMNICHROMA combines a number of excellent properties such as excellent esthetic properties due to uniform sized 260 nm supra-nano spherical SiO2-ZrO2 filler particles. These fillers result in unprecedented color matching, extremely high polishability, and color stability. Physical-mechanical properties due to the types of fillers and high fill content of 79% weight/68% volume give the material high wear resistance, high compressive strength, and exceptional handling. As the name implies OMNI = all, or universally + CHROMA = a quality of color combining hue and saturation (Merriam Webster Dictionary). OMNICHROMA is a universal shade that blends and reflects allowing us to be able to use this one OMNICHROMA composite shade for a multitude of different tooth shades. Little patients have little patience. When treating children, simplicity and durability of materials is key to successful restorations. The less time spent in a child’s mouth, the better. Although primary dentition is transitional, the occlusal forces, bruxing, and wear and tear are substantial in a short period of time. Intracoronal restorative materials for primary teeth must deliver reliable physical and mechanical properties in order to have successful long-lasting restorations. In my experience, highly filled composite resin combined with excellent isolation and technique yield reliable restorations. Case study #1  4-year-old boy presented with early childhood caries. I completed full mouth rehabilitation under general anesthetic consisting of full coverage crowns, intra-coronal composite restorations, and extractions. The focus and feature in this case study is a simple intra-coronal restoration on primary tooth H / 63. Pre-operative photos showing caries and a shade guide for reference. Teeth were prepared using a high-speed Pana-Max (NSK) with a #556 carbide bur ensuring an adequate undercut in preparation to incorporate some mechanical retention. Figures 1 - 2. Enamel was etched using phosphoric acid etch and Bond Force (Tokuyama Dental America) as adhesive in a selective etch technique and light cured. In this case, due to some remaining dark dentin, OMNICHROMA BLOCKER (Tokuyama Dental America) was used and light cured. Figure 3. OMNICHROMA (Tokuyama Dental America) was placed in bulk (2mm), as the lesion was minimal in depth and light cured. Figures 4 - 5. Resulting restoration shade blended beautifully providing a functional and aesthetic result. Figure 6.

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