In 1962, Dr. Rafael Bowen revolutionized dentistry with the invention of the dental composite. In the late 1990s, another advancement arrived in the world of dentistry: the bulk composite.
Within a brief period of time, bulk composites began to be integrated as a staple product and an integral part of the direct composite workflow, especially regarding deep or large posterior lesions. Bulk composites were specifically engineered to simplify posterior resins and reduce layer time, in turn significantly reducing chair time.
Dr. Naana Mensah Coleman.
Bulk fills are one of the fastest-growing divisions in restorative dentistry. With increased pressures in time, bulk fills allow for a more streamlined and efficient protocol with predictable and reproducible clinical outcomes.
Of course, most dentists desire to achieve superior clinical outcomes that result in a satisfied patient, all while saving chair time. However, all of us have experienced the reverse/less than ideal outcomes, patient sensitivity, and restorations that break down far too soon, costing us mental anguish and valuable chair time.
Kettenbach has traditionally been known as an industry leader with their impressive cements and impression material, but in recent years, they have taken the restoration industry by storm by introducing Visalys Bulk Flow and Fill. This article will discuss Visalys Bulk Fill and why it deserves a place in your restorative workflow.
When evaluating bulk fills, three factors matter most: handling, cure reliability, and clinical efficacy. Visalys Bulk Fill performs strongly across all three and adds a fourth advantage its competitors rarely deliver: superior aesthetics.
The Catapult Evaluators' verdict
Handling
When considering the handling of Visalys Bulk Fill, Catapult Evaluators found this to be one of the stronger attributes of the product. Discharge force, consistency, and moldability were rated strongly among the evaluators.
Stability stood out with the highest ranking. The material was very easy to place and control. In my experience with the material, in my own clinical use, I found the ability to pack the material with low stickiness was ideal.
Unlike many bulk fills that claim to be a bulk fill but handle more like a bulk flow, Visalys Bulk Fill is a true bulk fill with packable capabilities. It succeeds in allowing the material to reach deep corners of the prep, avoiding underfilled preps and air bubbles.
Cure reliability
Compared to its competitors, Visalys Bulk Fill's cure reliability is consistent with top-tier bulk fills on the market. When curing within the recommended increment depth thickness of 4-5 mm, evaluators rated cure reliability favorably.
Clinical efficacy
Overall clinical efficacy was rated as strong among Catapult Evaluators. Visalys Bulk Fill holds its own among the industry’s leading bulk fills.
“Visalys bulk satisfies the necessary minimum promises of the category ... [it] certainly scores adequate to well above average. All evaluators indicated they would recommend Visalys Bulk Fill to a colleague. The material met expectations for posterior bulk fill performance without requiring changes in technique or workflow.”
Visalys Bulk Fill is incredibly wear and stain-resistant due to its remarkably low absorption rate. This is unusual for a bulk fill, which is a quality that is worth highlighting.
Editor's note: Dr. Mensah Coleman recently spoke with DrBicuspid.com's Editor-in-Chief Kevin Henry about the qualities she appreciates about Visalys Bulk Fill.
Aesthetics
Along with its reliable clinical capabilities, Visalys Bulk Fill also had strong posterior aesthetics that rivaled those of its competitors. It has a one-shade system with a chameleon effect, which adds to its ease of use and time efficiency.
Its seal and blend into the cavosurface margin is above average and yields great aesthetics in the posterior region. The product was also easy to polish and finished with a high gloss.
What makes Visalys Bulk Fill so impressive?
Visalys Bulk Fill has reliable curing up to 4 mm, a low-volume shrinkage of 2.2%, and exceptional marginal adaptation with a high flexural strength of 129 MPa. But what really sets Visalys Bulk Fill apart from its competitors is its incredibly low water absorption.
Many competitors’ water absorption ranges tend to be between 15-25 µg/mm³ and sometimes greater. Visalys Bulk Fill is well below that, with a measurement of 9.79 µg/mm³.
Low water absorption allows for less material expansion, better long-term stability, a lower risk of marginal discoloration, and better mechanical resistance over time, in turn, making Visalys Bulk Fill an excellent choice when considering longevity.
Patient scenario
Figure 1: Initial pre-op photo of tooth #30.All images and captions courtesy of Dr. Naana Mensah Coleman.
Figure 2: Tooth #30 class II prep. This box was about 5-6 mm in depth. Visalys Bulk Flow was used at the base of the box for about 1-2mm. The rest of the prep was completed in one increment using Visalys Bulk Fill.
Figure 3: Final restoration. Great shade match; the chameleon system aided with ease of use and time efficacy. The surface was easy to polish, and a high gloss finish was achieved.
At the end of the day, Visalys Bulk Fill checks the boxes we’re all looking for in a bulk fill: It’s easy to place, adapts well, and cures the way you expect it to when used within the recommended depth. It doesn’t try to change your workflow or force you into a different technique, which is part of what makes it so easy to integrate into daily practice.
It’s a material that does what it says it will do, and does it well, without adding complexity. That combination of reliability, ease of use, and solid clinical outcomes is what ultimately led evaluators to award Visalys Bulk Fill the Catapult Vote of Confidence™.
Dr. Naana Mensah Coleman is originally from St. Paul, MN. She received her Bachelor of Science degree in biological sciences from Marquette University. She received her Doctor of Dental Surgery degree from Marquette University School of Dentistry. Mensah Coleman enjoys all aspects of general dentistry and welcomes challenging and complex cases that restore her patient’s confidence and smile. She is an active member of the ADA, the Illinois State Dental Association, and the Chicago Dental Association.
The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.
