Bioactive Giomer Materials Can Help Improve Clinical Outcomes

Bioactive Dental Materials

Today’s patients seek treatments that are not only aesthetic but also innocuous, healing and have beneficial influence on their overall health. Over the past several decades, dentistry has been seeing a shift from reactive treatments of dental disease to preventive and conservative models with bioactive technologies. This includes biomimetic materials that encourage remineralization of the tooth structure and contribute to a patient’s long-term health and well-being.

New Bioactive Giomer Chemistry

Although many restorative materials are inactive with respect to biological tissues of the tooth, some are bioactive (interact with or affect the biological tissues). These materials effectively work with the dental tissues to re-mineralize and heal them. Giomers are the latest category of direct materials with bioactive attributes. They combine biological effectiveness of glass ionomers (release/recharge of fluoride and other beneficial ions) with outstanding physical, mechanical and optical properties of direct resins.

The proprietary Giomer concept is based on surface pre-reacted glass (S-PRG) technology in which pre-reacted multifunctional fluoro-boro-alumino-silicate glass particles—surrounded by a glass-ionomer phase—are trapped within a polyacid matrix and actively release six beneficial ions, fluoride, strontium, borate, aluminium, silicate and sodium. Among these ions, silicate and fluoride are strong inducers of remineralization of the dentin matrix, while fluoride and strontium act on hydroxyapatite to convert it into fluoro-apatite and strontium-apatite, respectively, which improves the resistance of teeth.

Giomer materials have been clinically vetted in a series of long-term clinical trials. An eight-year clinical research recorded 100% retention rate with intact esthetics, no secondary caries, no failures and no post-operative sensitivity. A thirteen-year recall study demonstrated 96% of restorations with no secondary caries, in a 66% retention rate.

Shofu has successfully incorporated Giomer technology into a versatile line of products including, nano-hybrid composites (packable, injectable, flowable, bulks), cements, adhesive systems, sealant, and light-cured varnish.

Beautifil II LS – functional and aesthetic Giomer restorative for all indications

A bioactive Giomer restorative indicated for all cavity classes, I—V, Beautifil II LS provides general practitioners with the means to reduce volumetric shrinkage and shrinkage stress while creating predictable and functional aesthetics.

83% filled by weight, Beautifil II LS demonstrates excellent compressive (364 MPa) and flexural strength (117 MPa), maintains ideal color stability, and polishes in less than 15 seconds, producing a durable, life-like sheen (78 gloss units). Other distinct features of Beautifil II LS include the material’s low-shrink attributes, which present the lowest values among all universal composites existing in dentistry today.

• Minimal volumetric shrinkage (0.8%) and shrinkage stress (2.7 MPa)
• Greater strength and higher wear resistance
• Tooth-like aesthetics with natural fluorescence and chameleon effect
• Instant polishability
• Sustained fluoride release/recharge with Giomer chemistry

Beautifil II—Giomer composites in dentin, enamel, and gingiva shades

Approved for all classes of restoration, Beautifil II is a highly filled bioactive nano-hybrid composite designed to produce long-lasting restorations that resemble natural teeth, are reversible and cost-effectively repairable.

This fluoride-releasing-and-recharging bioactive composite demonstrates enhanced thixotropic properties for excellent marginal adaptation and efficient contouring without sticking. Demonstrating high compressive and flexural strength, Beautifil II whether placed in the anterior or posterior regions facilitates long-term stability in the oral environment. The key features of Beautifil II accentuate

• Superb handling optimized for non-sticky consistency
• Ability to facilitate fast and easy finishing and polishing with a long-lasting shine
• Outstanding chameleon effect
• Natural fluorescence with high level of radiopacity

The success of Beautifil II prompted the development of additional shade lines including Beautifil II Gingiva. The color concept of Beautifil II Gingiva shades evolved from Shofu’s signature Ceramage line, a nano-ceramic indirect composite, designed for artistic restorations of anterior regions. Similarly to the Ceramage concept, the five shades of Beautifil II Gingiva –dark pink, light pink, orange, brown and violet can be coalesced to custom shade-match a variety of soft-tissue topographies.

Indications of this novel gingiva-colored composite are not limited to defects in the cervical area of a tooth. Beautifil II Gingiva can be utilized by the clinicians, chairside, to camouflage the exposed implant abutments or crown and bridge margins, to repair and re-contour the gingival portion of indirect restorations, to modify the aesthetics of provisional restorations, and to improve soft-tissue appearance in denture patients by revitalizing a worn or fractured denture.

Also introduced as a line extension to the original Beautifil II is Beautifil II Enamel. Featuring 4 translucent shades, high-value translucent, translucent, low-value translucent, and amber translucent, Beautifil II Enamel allows general practitioners to create artisanal restorations chairside.

Incorporating the Giomer technology, the bioactive enamel shades can be layered and blended together to produce highly aesthetic results. The chameleon-like optical characteristics of the enamel tones allow for achieving polychromatic restorations with morphology and aesthetics of natural teeth, providing the clinicians with a cost-effective alternative to ceramic veneers.

Beautifil Flow Plus—injectable composite for all indications

The Giomer fillers have also been incorporated into Beautifil Flow Plus, an all-in-one bioactive base, liner and final restorative approved for all cavity classes. Combining the ease of delivery unique to an injectable with the strength, durability and aesthetics specific to a nano-hybrid, this universal material is available in two viscosities—both with identical physical properties. The highly viscous F00 “Zero Flow” formulation allows for precise placement and stacking, while the F03 “Low Flow” viscosity handles more like a base and liner, allowing for just enough movement to comfortably manipulate the material. Both viscosities demonstrate self-leveling attributes that successfully aid in achieving aesthetic results with fewer intermediary steps.

The features and benefits of Beautifil Flow Plus emphasize

• Compressive strength and low wear similar to those of nano-hybrid composites
• Exceptional self-leveling and bubble-free consistency
• High radiopacity that permits effective viewing of treated areas
• Sustained fluoride release and recharge
• Resistance to bacterial colonization

Beautifil Flow Plus X—revolutionary injectable composite with nano fillers for universal indications

Beautifil Flow Plus X is the latest bioactive injectable hybrid restorative in the Beautifil product line with a newly developed patented nano S-PRG filler. Beautifil Flow Plus X has all of the Giomer chemistry attributes, including fluoride release and recharge, with improved handling and effortless polishing maintaining a long-lasting shine. This self-leveling flowable has the strength, durability and aesthetics of a hybrid composite.

• Achieves more surface gloss in less time—effortless polishing
• Improved handling
• Stackable & sculptable; stays put
• Chameleon effect—aesthetically blends with the natural tooth
• High flexural strength
• Low wear resistance & shrinkage
• Indicated in classes I, II, III, IV, & V

Beautifil-Bulk Flowable and Beautifil-Bulk Restorative— bulk composites with Giomer chemistry

Beautifil-Bulk Flowable and Beautifil-Bulk Restorative are bioactive Giomer bulk restorative materials. They effectively integrate clinical benefits of S-PRG technology with a fast and easy bulk-fill system that fully polymerizes at 4 mm depth of cure. Unique chameleon-like optical properties of these materials help the clinicians achieve a balance between light dispersion and transmission to match the opacity of surrounding teeth. Available in syringes and tips, in universal and dentin shades, Beautifil-Bulk Flowable and Restorative deliver brilliant aesthetics in a fast and convenient bulk-like manner.

Beautifil-Bulk Flowable

• Ideal as base and liner in classes I and II
• Exceptional handling and self-leveling for optimal adaptation to any cavity floor
• High level of radiopacity
• Continuous fluoride release and recharge for effective neutralization of bacteria

Beautifil-Bulk Restorative

• Suitable for all posterior restorations
• Optimal translucency for aesthetic shade reproduction
• Outstanding condensability and sculptability to create durable and visually-appealing results
• Inclusive of Giomer filler to reinforce acid resistance and anti-plaque attributes

BeautiCem SA – self-adhesive, dual-cure resin cement with bioactive attributes

Conceptualized to deliver high bond values across all substrates, BeautiCem SA, a bioactive self-adhesive dual-cure resin cement helps the practitioners handle any clinical situation with predictability and confidence. With a unique formulation optimized for easy handling, BeautiCem SA promotes a fast and easy cleanup with a quick 2-second flash-cure. The low film thickness, less than 12µm, of this bioactive cement allows for extra space in tight-fit situations while exhibiting nearly undetectable margins.

The Giomer fillers incorporated into BeautiCem SA release and recharge fluoride and other beneficial ions, demonstrate antiplaque properties and neutralize acid, helping facilitate the longevity of a restoration and improve the patient’s oral health. Key characteristics of BeautiCem SA emphasize

• Broad indications including, inlays, onlays, posts and all PFM and ceramic restorations as well as alumina and zirconia crowns and bridges
• Self-adhesive properties without the need for primers, conditioners and other bonding agents
• Optimal handling and the ability to set without oozing, thereby promoting easy cleanup

BeautiSealant—Giomer pit-and-fissure sealant without phosphoric acid

A BPA- and HEMA-free BeautiSealant is a pit-and-fissure sealant inclusive of the proprietary Giomer technology proven to inhibit plaque formation, neutralize acid, and release and recharge fluoride when treated with fluoridated household products such as fluoride-based toothpaste or mouthwash.

To facilitate strong and predictable bonding BeautiSealant is formulated with mild yet effective adhesive monomers—carboxylic and phosphonic acid. These monomers thoroughly penetrate and prepare pits and fissures yet are gentler on the tooth than phosphoric acid.

Exhibiting optimal handling, viscosity and bubble-free consistency, BeautiSealant is easy to apply in less than 30 seconds, an important factor when working with pediatric, geriatric, and other patients with special need.

The top features of BeautiSealant underscore

• Formulation without BPA, HEMA, and phosphoric acid
• Fast and simple application, in less than 30 seconds
• Optimal handling and viscosity with bubble-free consistency
• Inclusive of S-PRG particles proven to release and recharge fluoride, neutralize acid and inhibit plaque formation
• Ideal application for pediatric, geriatric and special-need patients

PRG Barrier Coat—light-cured Giomer desensitizer for hypersensitivity relief

Developed to provide immediate and prolonged relief for patients suffering from severe dentinal hypersensitivity, PRG Barrier Coat is a light-cured, resin-based Giomer varnish for the instant hypersensitivity and desensitization for up to 6 months.

Containing no alcohol, acetone or HEMA, PRG Barrier Coat is self-adhesive, with no separate etching or bonding steps required. Only an ultra-thin layer, up to 15µm, is needed to instantly deliver long-lasting pain relief.

Along with treating hypersensitivity, PRG Barrier Coat can also be utilized in a broad range of other preventive applications, including desensitizing hard-to-brush zones (surrounding orthodontic brackets, clasps, and crowded teeth) and areas with a high risk of caries, such as exposed root surface, newly erupted molars and white spots.

Key attributes of PRG Barrier Coat underline

• Sealing and protecting of exposed dentinal tubules for up to 6 months
• Versatility—can virtually be utilized in any location in the oral cavity
• Incorporation of Shofu’s bioactive Giomer technology, clinically proven to release and recharge fluoride and other beneficial ions, inhibit plaque build-up and neutralize acid
• Containing no alcohol, acetone or HEMA, making it safe to use adjacent to soft tissue