User Report by Dr. David Stachowicz
During my professional career as a dentist, I have been working in all parts of dentistry. However, I am especially passionate in restorative procedures. From my point of view, the restorative part is the basis of every aspect in modern dentistry. All other treatment steps and protocols are build-up on restorative dentistry.
Within the past 5 to 10 years, the evolution in restorative dentistry has been tremendous. New approaches and techniques were developed. Also, the next generation of composite materials, polishing, and air-abrasion devices were launched and established on the market. The combination of all these aspects started to deliver, for example, optimized bonding qualities and a better reproducibility of the clinical cases. Step-by-step, restorative dentistry turned into a genuinely modern treatment approach, providing more predictability. Sometimes it can be more demanding to perform a top-quality restorative procedure than delivering an implant for example. Although my restorative cases are not always easy, I try to make the best out of it and to find the best solution for my patients. For this purpose, I need reliable materials, devices, and tools.
For many years, I have been working with well-established traditional composites, spanning various shades, as they met my expectations regarding their handling features and the results. When the so-called one-shade composites systems were launched initially, I tested some of them. However, I never became a big fan of the concepts themselves and those materials particularly, as I was not happy with the outcomes in terms of esthetics. With the recent launch of the Transcend composite system (Ultradent Products), I changed my mind. Transcend offers a unique universal one-shade composite system, that requires no blocker. Yet, if more challenging clinical situations arise, more color options are available.
I have been using Transcend composite for several months now and find it a very nice composite, which is easy to handle and to manipulate—and which finally gives the answer to my esthetic requirements. Transcend offers a more compact shade system. The Transcend composite Universal Body shade matches and covers the natural tooth shades extremely well. It blends-in seamlessly, so that you would hardly notice the difference between the restoration and the natural tooth. Additionally, it has a great balance between opacity and translucency, thanks to the elaborated Resin Particle Match™ Technology.
As Transcend composite is an efficient and real one-shade composite system, I can reduce my inventory significantly. I do not have to stock a variety of different colors and syringes, which sometimes I had to throw away as I did not use them regularly and their shelf life expired. Also, my practice team is relieved, as it is easier to pick out the required shade properly.
The concept and idea behind Transcend composite is an exceptional light transmission that blends with natural enamel and dentin. It can mask discolorations effectively, without the need for a blocker or opaquer. In most of my clinical cases I do not feel the necessity of an opaquer or blocker to get seamless results with it. Nevertheless, it may from time to time be appropriate to use an opaquer or blocker, when it comes to very old amalgam residues or trauma cases.
As Transcend composite handles very well and equally gives me the good feeling of achieving beautiful results, I can use it for all kind of cases and indications.
I even recommend it for anterior restorations, due to the seamless transition between tooth and composite. Furthermore, the polishing process can be done nicely and quickly. The additional use of brushes minimizes the polishing effort even more. Transcend composite’s Universal Body shade is ideally suitable for smaller anterior defects, in cases which still provide an opaque tooth substance. In case of large, esthetically demanding restorations with a shine through effect, e.g. Class IV restorations, I would rather opt for a layering approach. The Transcend system offers four additional dentin shades and two enamel shades providing a perfect natural match for these kinds of clinical situations.
Recently, a 40-year-old male patient visited my practice, feeling a discomfort at tooth 14 and 15. During the inspection I found both teeth heavily destroyed by caries. The usual examinations, using X-ray and pulp testing, revealed that the teeth were still vital. As the tooth structure was destroyed to such a huge extent, I typically would have taken an endodontic treatment and a crown into consideration. The alternative in this case was to do a comprehensive restorative treatment, which the patient finally preferred.
Before the restoration
The patient's teeth were quite difficult to treat, as the clinical crowns are very short. Additionally, there was a big distance between tooth 14 and tooth 15. That is why I had to place matrices to create an appropriate contact between the teeth and why I decided to treat the patient in two separate appointments. During the first visit, I started the treatment protocol of tooth 14 with a traditional caries removal technique, followed by an air abrasion treatment. After the bonding and matricing steps, I used a separator to provide a suitable separation effect as well as a good cervical seal. Next, I performed a deep marginal elevation to build upfront. Finally, I could easily create the restoration with the Universal Body shade of Transcend composite and do the polishing.
During the restorative process
Two weeks later the patient came back to the practice in order to get tooth 15 done. I followed the same protocol as I did with tooth 14 and finished the treatment correspondingly.
Being located in the anterior region of the mouth, this case had clear requirements in terms of esthetics, e. g. buckles, etc. Transcend composite offers me a lot of options to correspond ideally to these esthetic requirements. I do not have to invest a lot of time and patience to choose and handle different colors. Equally, there is no need to do a lot of sculpting and polishing, which I find very comfortable. In the end, it was more than easy to create a durable, beautiful restoration. My patient was overwhelmed by the outcome and spontaneously reacted with some “WOW” expressions. Some days later he even called again to tell me that he did not suffer from any discomfort or pain anymore. He reported that the restorations feel like his own teeth, and everything was perfect. Although this was not an easy case, we got seamless results, thanks to Transcend universal composite.
After the restoration with Transcend universal composite
In summary, the most important point to me is that Transcend composite is easy to handle and to manipulate. The Universal Body shade blends in nicely and grants beautiful, seamless results—even in the anterior regions. I can save a lot of time and effort, as there is no need for extensive polishing steps. The polishing step is usually done at the end of the treatment, and from my experience, time frequently runs out at this stage. Therefore, the quick and uncomplicated polishing process with Transcend composite is a particularly great advantage. It also offers me the freedom of easy and adaptable treatment processes. In most cases I only have to choose one color (Universal Body) but in difficult cases I benefit from the liberty to go ahead with the bespoke additional enamel and dentin colors in combination with a layering technique.
Working with Transcend composite is easy and smooth. Every dentist could do it without any training or challenges.
If I had to give some recommendation from my personal point of view, I would additionally use some modelling wetting resin or, if preferred, heat the composite. Wetting resin may even cut down the required treatment time as it simplifies the manipulation with any instrument, offers frictionless contact with the resin, and reduces the risk of pushing the composite accidentally into a position where it does not belong. The second recommendation would be to use brushes for an even nicer transition. As the brushing provides a natural composite flow, it can be easily placed in any position. Being easy to handle, reproducible and repeatable, Transcend universal composite facilitates my daily practice life significantly and thus convinced me completely.
About the dentist
Dr. David Stachowicz