3M Filtek™ Supreme Plus and 3M Filtek™ Supreme Ultra (15 YR)

Introduction

3M Filtek™ Supreme was launched in 2002, 3M Filtek™Supreme Plus in 2005 and 3M Filtek™ Supreme Ultra in 2009. Since the introduction of 3M Filtek Supreme brand, DENTAL ADVISOR has clinically placed and monitored over 3000 restorations. Some of these restorations date back more than 15 years ago with the initial launch of 3M Filtek Supreme. 3M Filtek Supreme Plus and 3M Filtek Supreme Ultra are indicated for both anterior and posterior composite restorations. The Dentin, Enamel and Body shades are filled 63% by volume with a combination of 4-20 nm particles and 0.6-20 micron clusters. The Translucent shades are filled 56% by volume. 3M Filtek Supreme Ultra is fluorescent, opalescent and radiopaque and available in 36 shades and 4 opacities (dentin, body, enamel and translucent).

Clinical Evaluation Protocol

More than 3000 restorations were placed since the year 2000. Twenty-three percent of the restorations were not recalled due to patient attrition. Of the 2310 remaining restorations, 77% were 3M Filtek Supreme Plus and 23% were 3M Filtek Supreme Ultra (Figure 1). Both anterior and posterior restorations were evaluated (Figure 2). The distribution of the recalled restorations by years of service is shown in Figure 3.

These restorations were evaluated in the following categories: esthetics, resistance to fracture/chipping, resistance to marginal discoloration, and wear resistance. Each parameter was rated on a 1-5 scale:

1 = poor, 2 = fair, 3 = good, 4 = very good, 5 = excellent

Results at 15 years

Esthetics

The many shades of 3M Filtek Supreme Plus and 3M Filtek Supreme Ultra blended very well with the surrounding enamel and dentin. Eighty-eight percent of the restorations received an excellent or five rating, while 10% received a very good or 4 rating, and only two percent received a rating of good or 3 (Figure 4). The improvement in fluorescence achieved with the new formulation of 3M Filtek Supreme Ultra is noticeable. There has also been an improvement in shade stability over time. Only a handful of the restorations were replaced due to lack of esthetics. Many of the recalled restorations exhibited a very shiny and smooth surface texture, making it almost impossible to distinguish from the actual tooth.

Resistance to Fracture/Chipping

Ninety-five percent of the recalled 3M Filtek Supreme Plus and 3M Filtek Supreme Ultra restorations exhibited no chipping or fracture (Figure 4). Five percent of the restorations chipped or fractured. Only two percent required replacement; the remaining restorations were smoothed, re-contoured or repaired with flowable composite.

Resistance to Marginal Discoloration

Ninety-two percent of the recalled 3M Filtek Supreme Plus and 3M Filtek Supreme Ultra restorations had no visible staining at the margin and received a rating of 5 (Figure 4). Six percent had minimal staining at the margins not requiring replacement with a rating of 3 or 4. Only two percent of the restorations needed to be replaced due to marginal discoloration. Marginal discoloration is often the result of compromised bonding or excessive stress resulting in weakening of the bond and subsequent micro-leakage.

Wear Resistance

Ninety-six percent of the recalled 3M Filtek Supreme Plus and 3M Filtek Supreme Ultra restorations exhibited no wear, while two percent exhibited minimal to moderated wear with a rating of 4 or 3 (Figure 4). Another two percent required replacement due to excessive wear. Half of these replaced restorations were anterior restorations with wear on the incisal edges due to bruxism. The remaining replaced restorations were in second molars.

Clinical Observations

• There were 80 debonds (3.5%) recorded. Most of these debonds were associated with Class V restorations. These failures are most often related to the bonding agent and placement technique.
• Fourteen percent of the restorations were replaced due to decay. These failures are most likely due to the bonding agent or even the clinician’s technique.
• Five percent of the restorations were on teeth that were crowned at a later date. It is likely that the composite restorations were placed as interim restorations.

Consultants’ Comments

• “In 15 years of using 3M Filtek Supreme Plus and 3M Filtek Supreme Ultra, they have proven to be reliable and very esthetic restorative composite materials.”
• “This composite holds up really well, even in large four-surface posterior restorations.”
• “Great selection of shades to meet all my needs.”
• “On rare occasions, I have noticed some staining and microleakage at the composite-tooth interface.”

Conclusion

Over 2300 3M Filtek Supreme Plus and 3M Filtek Supreme Ultra were placed and monitored since 2000. The performance of these restorations has been exceptional, regardless of the size of the restoration. Excellent esthetics, low rate of fracture/chipping, minimal marginal discoloration, and minimal wear have been instrumental to the long-term success rate of these restorations. 3M Filtek Supreme Plus and 3M Filtek Supreme Ultra earned a clinical performance rating of 96%.