The evolution of modern composites offers a lot of options for dentists to obtain increasingly efficient results from both an esthetic as well as a functional point of view. At the beginning of the journey, composite systems originally comprised few shades only. Over the years, the shade range grew steadily and significantly. Today, the trend sees a backward movement towards more simplified arrangements and so called one-shade composite systems. In this interview, Dr. Erik-Jan Muts shares his insights on Transcend™ Universal Composite.
 

1. Thank you for coming here and having this short interview with us, Dr. Muts. My first question is: which role do direct composite systems play in restorative dentistry today?
Well, I think there would be no dentistry as modern dentistry if we didn’t have composites. I mean, direct composites are your go-to material for restoring teeth, for treating decay. There are so many different options. We wouldn’t be real dentists without direct composite materials.    


2. What are the benefits of using a one-shade composite when compared to traditional multi-shade composites? 
For sure there are a lot of benefits regarding the stock that you need to have in your practice. I sometimes have beautiful kits with all different kind of colors. And when my assistant organizes the room, which she does once in a while, she takes the expiry dates of all the composites. There always those colors that you don’t use often, like A4 or A3.5, which are then expired. When they are expired, you can’t use them anymore and you have to throw them away. I think that’s not good for the budget and that’s also not good for the environment. It’s just a waste of material. So, when you can put it all down to one shade, it will be the better option – economic wise and also environmental wise. 


3. Which kinds of composite do you prefer and why? 
I think there are different composites for every indication. Each indication can require a different composite. For example, if you do an esthetic case, you are looking for a composite with filler particles that are very easy to polish. If you are using a composite in a case with a lot of tooth wear you are looking for a very strong material with filler particles that might be a little stronger or a little bit thicker, for example. I would not say there is a one fits it all. It really depends on the situation where you use which composites. And overall, there can be an 80% go-to composite, but I always prefer to have a different composite for those 20% exceptions.

4. What is important to you in terms of the handling properties?
A composite for sure should be easy to manipulate and to apply. There are different things: when a composite is very very stiff, for example, and you want to adapt it to the matrix, you can create some voids in there. Because if it is not soft enough and you don’t apply enough pressure or you do not pay enough attention, you can create voids between the matrix and the composite or in the tooth. That would be a reason for secondary decay, for example. You want it to be very smoothly adapting, that’s important. You want a great handling and easy adaptability with your instrument so that it does not stick to your instrument, that’s important. And it should be easy to expel from the compule. So, when you apply it, it goes pretty smooth.

5. How long have you been using one-shade composites, and Transcend Universal Composite particularly?
I have already been using one-shade composites for quite some time now. I think it has been for more than four or even five years. Transcend composite from Ultradent Products specifically, I have been using for around two months now. That’s not that long yet, but still enough to get a feeling for the material and to see how it works in the daily practice.

6. For which indications do you use Transcend composite? 
I use Transcend composite for different indications. I tried it first in the posterior region just to see how the material works and how well it functions or how well it holds its shape. It actually has a chameleon effect, so to say. When it worked out very well, I also started with the anterior teeth, because I really like the way the color system works. You do not have to use a blocker for example, but you can also rely on different colors, which are still within the systems.

7. Okay, so you already kind of answered my next question, which is: would you also recommend Transcend composite for anterior restorations? 
Yes, I would. But still if you are using a new composite system, always try it out and see how it works, because every composite system has its own benefits but also its own instructions. You need to know how to work with the material before you are using it in your most highly esthetical cases.


8. In which cases would you prefer a layering approach and how would you manage this with Transcend composite? 
I personally always like a layering technique, even in posterior cases. I like to re-shape the enamel with enamel shade and the dentin with dentin shade. When it comes to Transcend you have the enamel and the dentin shades. For me that works perfectly. And of course, for posterior restorations you can always go with the universal shade, that’s not a problem at all. For the anteriors I really like to use a dual-shade system. That’s not a multi-layer, but a dual-layer, for which you can use the enamel and the dentin shades. And I think, by including the dentin shade you do not need a blocker. That’s one of the great benefits of the system. You can still switch a little bit with the color of the dentin. Therefore, I can create beautiful anterior restorations.  


9. So, as you already said: Transcend composite does not require any additional opaquer or blocker. What are the advantages and how will this influence your treatment results? 
The advantages are that, if you needed a separate blocker you would need it to block the translucency of the material. That made me already think, why not using a dentin shade? Actually, a dentin shade also blocks the translucency of the material. And with the dentin shade, you can even switch the colors a little bit more, so you are more in control of the final color of the restoration. Therefore, I think you need a blocker to block the translucency of the material, because otherwise your restoration ends up too greyish. But when using a dentin shade, you can even vary from the amount of warmth you want to have in your restoration. You could use an A1, for example, if you want to be it light. Or you could use an A2 or A3 dentin shade. I think that the benefit of that is that you are more in control of the final colour of your restoration.


10.  How do you evaluate the esthetics and the polishability of Transcend composite restorations?
I think the esthetic results and the polishability are very, very good. It's easy to polish and the end results – well, you will see it when you use it. But when you start polishing it, you need just a spiral. I like to use diamond impregnated spirals. And when you just use a medium and a fine one, it already shines. You don't need to do anything else than that. So, it's easy to handle and it's also particularly easy to polish.


11.  Do you remember a specific patient case, which you treated successfully with Transcend composite? Which procedures and protocol did you follow?
I would just follow a normal composite recipe. Just etch, prime, bond, apply the matrix system and apply the composite. I found the material pretty easy to manipulate. And it's also not too hard, but just soft. It easily fills up the voids with the matrix. You don't have the problem I previously described that the material is too rigid or too hard, so that you end up with some voids between the tooth and the material. Here the material is soft enough that when you apply it, you press it a little bit and it already adapts very well to the matrix. And that's what I really like about Transcend.


12.  The last question and then we are done. In one sentence: how does Transcend composite change your daily practice life?
It changes for sure when you go for the universal shades. It definitely changes the way you need to buy composite, the way you have your stock organised, and the amount of composite you will throw away because it expired. And I think that's a very big benefit.


Thank you so much for the interview!