January 7, 2019
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.
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.
The Giomer Concept.
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.
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.
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.
A complex anterior restoration created with Beautifil II. Photos: Frank J. Milnar, DDS, AAACD
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
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.
Beautifil II Gingiva can improve the appearance of pink and white aesthetics.Photos: Hugh Flax, DDS, AAACD, MICOI , DABAD
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.
Beautifil II Enamel helps replicate natural dentition’s optical anisotrophy and fluorescence.Photos: Frank J. Milnar, DDS, AAACD
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.
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.
An anterior reconstruction achieved chairside with Beautifil Flow Plus.Photos: Jack D. Griffin, DMD, MAGD
The features and benefits of Beautifil Flow Plus emphasize
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.
Class I restoration using Beautifil Flow Plus X. Photos taken with EyeSpecial C-III (Shofu Dental)Photos: Howard Glazer, DDS, FAGD
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.
A large posterior restoration accomplished with Beautifil-Bulk Flowable and Beautifil-Bulk Restorative.Photos: Robert A. Lowe, DDS, FAGD, FICD, FADI, FACD, FIADE, FASDA
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.
Cementation of an anterior all-ceramic crown with BeautiCem SA.Photo: Jack D. Griffin, DMD, MAGD
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
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.
BPA- and HEMA-free BeautiSealant does not require phosphoric acid etching.Photos: Dr. Satoshi Fukumoto, Toshoku University, Japan
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
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.
Indications of PRG Barrier Coat include desensitizing of areas with a high risk of caries.Photos: SHOFU.
Indications of PRG Barrier Coat include desensitizing of areas with a high risk of caries.
Key attributes of PRG Barrier Coat underline
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