Tetric EvoCeram® (10 yr)

Consultants’ Comments

• “After more than 10 years, the restorations still look beautiful.”
• “Retains esthetics and polish over time.”
• “Amazing resistance to wear.”
• “I love the handling of Tetric EvoCeram – it is definitely my go-to composite.”

Clinical Evaluation Protocol:

At the 10-year recall, there were 801 restorations available for monitoring, of which 592 were recalled. The restorations included both anterior restorations (5%) and posterior restorations (95%) (Figure 1). Figure 2 depicts the various classes of restorations in which Tetric EvoCeram was used.

Clinical Observations:

At recall the following categories, esthetics, resistance to fracture/chipping, resistance to marginal discoloration, and wear resistance were rated on a scale of 1 to 5 with 1=poor, 2=fair, 3=good, 4=very good, 5=excellent. Any restoration receiving a rating of 1 or a 2 in a category was replaced. Restorations receiving a rating of 3 or 4 in a category were considered clinically acceptable.

Esthetics

The esthetics of Tetric EvoCeram were excellent (Figure 4). Of 592 recalled restorations, 92% received an excellent rating and close to 8% received a good to very good rating. Only two restorations required replacement because of poor esthetics. Tetric EvoCeram layered with a translucent shade often resulted in improved esthetics.

Resistance to Fracture/Chipping

More than 94% of the 592 recalled Tetric EvoCeram restorations received an excellent rating based on resistance to fracture and chipping (Figure 4). Fifteen restorations (2.5%) had minor chips and received ratings of 3 or 4. These restorations were either smoothed or repaired with flowable composite. Twenty restorations (3.4%) were replaced as a result of tooth fracture and/or recurrent decay – not due to composite failure.

Resistance to Marginal Discoloration

Eighty-six percent (86%) of the recalled restorations had no visible marginal discoloration and were rated excellent (Figure 4). Of the remaining restorations, 12% had slight to moderate marginal discoloration requiring no intervention, while 2% had excessive marginal discoloration that necessitated their replacement.Both the composite and the bonding agent can affect marginal discoloration. A variety of bonding agents were used, with approximately 89% being self-etch and the remainder total-etch bonding agents. Excessive microleakage can lead to caries.

Wear Resistance

97% of the restorations received a rating of excellent and showed no evidence of wear (Figure 4). Only 12 (2%) restorations had slight to moderate wear, requiring no intervention. Four restorations had excessive wear that resulted in their replacement.

Conclusion

This 10-year evaluation of 592 restorations demonstrated that Tetric EvoCeram had superior performance in esthetics, resistance to fracture/chipping, resistance to marginal discoloration, and wear resistance. Tetric EvoCeram has excellent handling characteristics. It is non-slumping, not sticky, contours well, and is easy to finish and polish. Tetric EvoCeram received a 97% clinical performance rating.

Description:

Tetric EvoCeram ® is a universal, nano-hybrid composite indicated for anterior and posterior esthetic restorations. The composite is radiopaque and formulated to meet any esthetic need. The Tetric EvoCeram shade range includes 22 shades offering 4 dentin, 4 bleach, 13 enamel and a highly translucent incisal shade for optimal customization. This light-cured composite incorporates well-balanced filler technology combining the advantages of all filler sizes ranging from 40 to 3,000 nm with an average particle size of 550 nm. The composite is available in 0.2g, color coded, unit dose capsules and 3g color-coded syringes.