by Jason H. Goodchild, DMD
Choosing which composite material to use can be a difficult decision. To simplify decision-making and offer a composite that can ensure excellent performance in all clinical situations, DENTSPLY Caulk has introduced TPH Spectra Universal Composite. This new composite is based on the resin technology of TPH3 and contains nanohybrid and microfiller components. The result is a composite that has the potential to perform well in either the anterior or posterior, and should have toothlike translucency, improved polishability and color stability, and good wear resistance. TPH Spectra also comes in two handling choices: a creamy light-viscosity formulation and a packable high-viscosity formulation. The physical properties are similar for both viscosities. Because handling preference is subjective and highly individualized, practitioners are now able to select the right viscosity for all clinical situations.
In order to make shade selection simpler, TPH Spectra is available in the seven most popular shades: B1, A1, A2, A3, A3.5, A4, and C2. According to DENTSPLY's internal data, the seven shades of TPH Spectra represent more than 80% of total sales from the previous TPH3 formulation. The TPH Spectra shade guide was condensed for several reasons. First, some practitioners may be overwhelmed with the number of current shades; the VITA Classic (Vident) shade guide has 16 shades, and the TPH3 shade guide has 26. Because only seven of the current 26 TPH3 shades are regularly purchased, the color difference (i.e., Delta-E value) between shades was calculated to determine if a top-seven shade could be used in place of another shade not offered. TPH Spectra also offers excellent color blending between restorative materials and natural tooth, often called "the chameleon effect." Again, building and improving from the previous TPH3 composite formulation, TPH Spectra has a refractive index that falls directly between enamel (1.63) and dentin (1.54). Because of TPH Spectra's excellent translucent properties and an appropriate refractive index similar to natural tooth structure, it will have an excellent chameleon effect and create restorations that are unable to be detected.
Clinical procedures
- A female patient presented with a complaint of a lost filling. Intraoral exam revealed a lost disto-occlusal amalgam restoration on tooth No. 12. The patient was experiencing no pain but did note occasional sensitivity to cold liquids. After verifying the medical history and reviewing the radiographs, a direct composite resin restoration was treatment planned.
- Anesthesia was achieved with one carpule of 2% Xylocaine© with 1:100,000 epinephrine via buccal infiltration. The preparation was refined using a 330 carbide bur on a high-speed handpiece and a No. 4 round bur on a low-speed handpiece. Caries removal was verified with Snoop caries detector (PULPDENT Corporation).
- Because of the depth and size of the final preparation, a selective etch technique with Prime & Bond Elect (DENTSPLY Caulk) was used. This technique was chosen to maximize enamel bonding while minimizing the potential for postoperative sensitivity. The enamel was etched with 34% phosphoric acid for 15 seconds and then rinsed.
- Prime and Bond Elect was scrubbed into the preparation for 20 seconds followed by a five-second air-drying to remove the solvent. The adhesive was light-cured for 10 seconds. Isolation of the preparation was achieved using Palodent Plus (DENTSPLY Caulk). The patient's shade was judged to be approximately A2 according to the VITA Classic (Vident) shade guide. TPH Spectra High-Viscosity shade A2 was selected because of its firmer handling and placed in 2 mm increments. Each composite increment was light-cured for 20 seconds.
- The final restoration was finished with fluted composite finishing burs and white stones to achieve proper shape and contour. After occlusal adjustment, the composite was polished with Enhance and PoGo (DENTSPLY Caulk).
