“Quick and beautiful, please!” In restorative dentistry, this patient request often feels like asking for the impossible. Bulk-fill composites are known for speed and efficiency – but what about esthetics? As covered in an earlier blog post, the truth is, bulk-fills have not always delivered the esthetic results patients expect, especially in anterior restorations.
Time is a constant constraint in daily dental practice. Many patients want fast treatments but still expect their restorations – particularly in visible areas – to look great. While standard bulk-fill materials are user-friendly, they have often been too translucent to deliver satisfactory esthetic results in anterior teeth. As a result, the conventional incremental technique has remained the go-to for esthetically demanding anterior cases.
Why thick layers and esthetic results typically do not mix
A composite will only cure reliably if the curing light penetrates to the deepest layers. This becomes difficult if the material is too opaque. Yet, if the material is too translucent – so that light can pass through – it often fails to deliver good esthetics. This is especially true in anterior teeth.
How does it work?
Translucency shift
Our patented technology initiates a change in translucency during polymerization. Translucency is influenced by the refractive indices of a composite’s components. In Tetric plus, the refractive indices of the monomer and fillers are initially the same, allowing light to pass through easily. When uncured, Tetric plus is highly translucent, enabling reliable and quick light-curing in layers of up to 4 mm. During polymerization, the monomers convert to polymers, changing their structure and density – and thus their refractive indices. After curing, the refractive indices of the filler and polymer are no longer the same, causing light to scatter rather than pass through. This provides Tetric plus with the desired enamel-like translucency, suitable also for use in anterior teeth.
Image: left: before curing, right: after curing
4-filler technology
Carefully coordinated filler particles ensure increased opacity after curing. We have precisely tuned the size, shape and composition of the fillers: Tetric plus includes a blend of spherical and irregularly shaped fillers. While spherical fillers allow light to travel straight through, irregular shapes scatter light more intensely, reducing the composite’s translucency and improving its shade blending. This helps prevent the composite from appearing too translucent and minimizes visual flaws like shadows or discolourations.
Image: 4-filler technology shown under the electron microscope
Chameleon effect
The diffuse light scattering properties of Tetric plus enhance its chameleon effect. Instead of passing straight through, light is scattered in multiple directions by specially engineered fillers of varying sizes and shapes. This results in internal light reflections and diffusions that visually integrate the shade of the adjoining tooth structure into the restoration. Consequently, the restoration blends seamlessly with its environment - an effect that is critical for esthetic outcomes.
Tetric plus was specifically developed to streamline your workflow and save chairside time – without sacrificing quality or esthetics. With Tetric plus, 4-mm layer thicknesses and esthetic excellence are no longer mutually exclusive – instead, they form a new standard in restorative dentistry.
Left: Inadequate restorations with marginal discolouration on teeth 12 and 21. Restoration on tooth 11 is missing. Proximal fillings on teeth 11 and 21 are inadequate and need replacement.
Right: Teeth restored with Tetric plus in shades A3 plus and A3.5 plus.
Source: Dr Ronny Watzke, Ivoclar, Liechtenstein
Discover even more insights about Tetric® plus! Dive into how our four shades were inspired by natural tooth colors, or read how the Simplified Universal Composite can truly make your daily practice easier. We’ve linked all blog posts related to Tetric® plus in one place – so you won’t miss a single detail.