Procedure Solution

Class II Restorative Solution

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Connect with one of our Restorative product specialists to learn how our Class II solutions can help you.
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Restore your love for Class II Procedures

Every year, a large percentage of your patient base will receive a Class II restoration, providing an opportunity to strengthen their relationship with your practice. Yet, they are tedious and can be difficult to place efficiently and predictably. An approach that addresses the most common challenges with Class II restorations can help you be successful.

Approach Class II cases with confidence. The Dentsply Sirona Class II Approach is the first and only complete approach to Class II restorations designed to increase efficiency and predictability for more consistent, successful clinical outcomes.

Workflow

Class II Restorations complete procedure solution

Contact creation presenting a challenge?

For 70% of clinicians, contact creation is the most challenging part of a Class II restoration.1

You'll love our Palodent Family of Matrix Systems!

When using resin-based composite materials, both isolation and accurate contact creation are essential for successful Class II restorations. Palodent sectional and circumferential matrix systems are designed to help you get it right the first time, every time. The retaining ring, wedge, and sectional or circumferential matrix bands are designed to complement the tooth’s natural anatomy, working together to isolate, seal, and shape the restoration.

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Radiographs inconclusive?

It can sometimes be difficult to determine whether a radiolucent area is caries or adhesive.

You'll love Prime&Bond active Universal Dental Adhesive!

Thick adhesives can pool in the corners of the proximal box, leading to possible misdiagnosis as secondary decay on radiographs. Prime&Bond active offers a low film thickness, minimising the risk of adhesive pooling and overtreatment without sacrificing the bond strength that is needed for successful restorations. And with almost no reported postoperative sensitivity, Prime&Bond active helps to ensure patient satisfaction.

Image: On the left side, a restoration has been placed with competitive adhesive presenting as a translucent area due to pooling while Prime&Bond active has been used on the right.

Uncertain of gap formation?

2 out of 3 dentists indicate cavity adaptation is the most important attribute for a successful restoration.2

You'll love SDR flow+ Bulk Fill Flowable!

SDR flow+ material is a one-of-a-kind breakthrough in dentistry—a bulk fill flowable that combines exclusive self-levelling properties and category-best shrinkage stress—which allows for placement up to 4 mm with excellent cavity adaptation, enabling the placement of gap-free restorations.

Internal microscopy image of typical cross sections of a conventional bulk fill composite in cavity preparations of extracted teeth, showing gaps being created within the adhesive layer.⁷

Internal microscopy image of typical cross sections of SDR flow+ material in cavity preparations of extracted teeth, showing no margin gaps.⁷

Too many Choices?

Dentists may spend as much as 14% of chair time selecting the appropriate composite shade.3

You’ll love Ceram.x Spectra ST Universal Compositae Restorative! 

A2 easily matches 80% of cases with a chameleon effect that's far more natural than single-shade universal composites.

Simplify shade matching by using the A2 shade for the final occlusal layer. Combined with preferred handling and a formula that does not stick to instruments, Ceram.x Spectra ST with SphereTEC Filler Technology delivers the benefits that matter to dentists: optimised handling, enhanced chameleon blending ability, and improved durability, including stain resistance. For full VITA® shade coverage, choose from additional CLOUD shades A1, A3, A3.5, and A4.

Image: Natural teeth filled with A2 shade of Ceram.x Spectra ST composite. 

Unsure if material at the floor of the proximal box is fully cured?

Many lights deliver less than 35% of their stated output to the floor of a proximal box.6

You’ll love SmartLite Pro Modular LED Curing Light!

Confidently cure even large restorations to the full depth and width of the restoration with 4 optimised LEDs that provide uniform light distribution over a full 10-mm diameter. A low profile design provides excellent access to posterior restorations, and combined with excellent beam collimation, the SmartLite Pro easily handles wide restorations and cures reliably even over larger distances.

Image: Beam profiles of 4 lights showing the distribution of light emitted across the light tips.⁶ All images taken at 0 mm distance from the tip under identical conditions showing the un-filtered irradiance distribution of all wavelengths of blue and violet light (350-550 nm).

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Spending too much time finishing restorations?

Finishing and polishing represents 14% of total chair time for a Class II restoration. 7

You’ll love Enhance Finishing System!

The Enhance Finishing System accomplishes the entire process of excess removal, contouring, and finishing simply by varying the pressure. Push harder to remove excess composite; lessen the pressure for final results. The Enhance Finishing System delivers a smooth, contoured surface with a natural-looking finish in just 1 step.

Image: Excess removal and contouring (left) and Finishing (right)

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"The Dentsply Sirona Class II Approach has been the foundation of my posterior composite armamentarium and teaching protocols for more than 15 years. Using this system simplifies the protocol and enables the clinician to produce efficient and consistent successful outcomes without the stresses of complications and failures."

Dr. Alan Atlas 

Solutions for key challenges of class II restorations

Navigating key challenges of Class II Restorations

It may be difficult to achieve your goals due to challenges associated with Class II restorations. Predictably and efficiently manage Class ll restorations to keep patients happy and your practice profitable. Learn more!

Isolation

2/3 of doctors' experience difficulty achieving adequate isolation in a Class II restoration. 12

If the restorative field is contaminated with moisture, the physical properties and ultimate success of the composite restoration may be compromised.13

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Contact Creation

70% of clinicians find contact creation to be the most challenging part of a Class II restoration. 14

An open or improperly placed or shaped proximal contact can result in a fracture or food impaction, which can lead to periodontal inflammation, bone loss, and recurrent caries.15

Use Palodent Matrix System together with SDR flow+ material to alleviate the challenges of contact creation.

Sensitivity

Research shows that on average, 10-15% of posterior composite restorations result in postoperative sensitivity.5

The leading causes of postoperative sensitivity are:

  • Over-etching of the dentin8
  • Insufficient adhesive sealing of the dentin 9,10
  • Poor adaptation, leading to unfilled areas or voids 9,10
  • High shrinkage stress11
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Adaptation

2 out of 3 dentists indicate cavity adaptation is the most important attribute for a successful restoration. 16

High shrinkage stress may lead to marginal gap formation. Even if unfilled areas are avoided during placement, a gap-free restoration isn’t guaranteed if materials with high shrinkage stress are used.17,18

Use Prime&Bond active together with SDR flow+ material to alleviate the challenges of adaptation.

Shade Matching

Dentists spend as much as 14% of Class II chair time selecting the appropriate composite shade. 19

Closely matching the shade of a natural tooth can be challenging because of the time spent taking a shade and the inherent limitations of the human eye to accurately match colour.20,21

Depth of Cure

Many lights deliver less than 35% of their stated output to the floor of the proximal box. 22

An insufficient cure can lead to adverse effects on physical properties, including:23

  • Reduced bond strengths
  • Breakdown at the margins
  • Microleakage
  • Secondary caries

Cure fully and reliably with confidence, including bulk filled restorations. Use SmartLite Pro curing light together with SDR flow+ material for faster, fully cured restorations that last.

Discover more about Class II Restorations

Class II Clinical Cases

As part of its Class II approach, Dentsply Sirona provides the tools and techniques necessary for patient satisfaction and procedure success.

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Find out more about our Restorative products and solutions.

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Sources:

  1. DentalTown. Restorative dentistry monthly poll: What is the most challenging part of a Class II Restoration? 2012. For more information, contact Consumables-Data-Requests@dentsplysirona.com
  2. Key Group International Survey, 2019. For more information, contact Consumables-Data-Requests@dentsplysirona.com
  3. Dentsply Sirona Restorative, GNY 2016 Attendee Survey. For more information, contact Consumables-Data-Requests@dentsplysirona.com
  4. Internal data on file. For more information, contact Consumables-Data-Requests@dentsplysirona.com
  5. Usman AB, Ahmed A, Qasim J. Frequency of postoperative sensitivity in posterior class I composite restorations. Pakistan Oral Dent J. 2014;34(3):532-535. / Berkowitz GS, Horowitz AJ, Curro FA, aet al. Postoperative hypersensitivity in class I resin-based composite restorations in general practice: interim results. Compend Contin Educ Dent. 2009;30(6):356-363. / Haller, Die postoperative Hypersensibilität, zm 99, Nr. 6a, 13.03.2009 S. 44-51./ Briso ALF, Mestrener SR, Delício G, aet al. Clinical assessment of postoperative sensitivity in posterior composite restorations. Oper Dent. 2007;32(5):421-426. doi:10.2341/06-141
  6. BlueLight Analytics. Irradiance value comparison among commercially available curing lights. 2012. Unpublished commissioned study, data on file. For more information, contact Consumables-Data-Requests @dentsplysirona.com 
  7. Internal data on file. For more information, contact Consumables-Data-Requests @dentsplysirona.com
  8. Perdigão J, Geraldeli S, Hodges JS. Total-etch versus self-etch adhesive: effect on postoperative sensitivity. JADA. 2003;134(12):1621-1629. 
  9. Jackson RD. Placing posterior composites: increasing efficiency. Dent Today. 2011;30(4):126,128,130-131. 
  10. Kuper NK, Opdam NJ, Ruben JL, aet al. Gap size and wall lesion development next to composite. J Dent Res. 2014;93:108S-113S. 
  11. Schneider LFJ, Cavalcante LM, Silikas N. Shrinkage stresses generated during resin-composite applications: a review. J Dent Biomech. 2010;131630. doi:10.4061/2010/131630
  12. Key Group International Survey, 2019, n=300. For more information, contact Consumables-Data-Requests@dentsplysirona.com
  13. Gilbert GH, Litaker MS, Pihlstrom DJ, Amundson CW, Gordan VV. DPBRN Collaborative Group. Rubber dam use during routine operative dentistry procedures: findings from the Dental PBRN. Oper Dent. 2010;35(5):491-499. doi:10.2341/09-287C
  14. DentalTown. Restorative Dentistry. Monthly poll: what is the most challenging part of a Class II restoration? 2012
  15.  Rosenburg JM. Making contact: a method for restoring adjacent posterior direct resin. Dent Today. 2013;32(3):92,94-95
  16. Key Group International Survey, 2019, n=300. For more information, contact Consumables-Data-Requests@dentsplysirona.com. 
  17. Jackson RD. Placing posterior composites: increasing efficiency. Dent Today. 2011;30(4):126,128,130-131. 
  18. Kuper NK, Opdam NJ, Ruben JL, aet al. Gap size and wall lesion development next to composite. J Dent Res. 2014;93:108S-113S. doi:10.1177/0022034514534262
  19. Data on file. Dentsply Sirona Restorative. GNY 2016 Attendee Survey. For more information, contact Consumables-Data-Requests@dentsplysirona.com
  20. Clinicians Report March 2021. 
  21. Paul S, Peter A, Hämmerle CHF. Visual and spectrophotometric shade analysis of human teeth. J Dent Res. 2002;81(8):578-582. 
  22. BlueLight Analytics. Irradiance value comparison among commercially available curing lights. 2012. 
  23. Boksman L, Santos GC. Principles of light curing. Inside Dentistry. 2012;8(3). https://www.aegisdentalnetwork.com/id/2012/03/principles-of-light-curing

 

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