I have been conducting a clinical study of a new color-free, universal, light-cured, shade-adaptive composite. We wanted to evaluate this innovative, trending type of technology from at least 2 standpoints: first, how it works to match the shade spectrum of patients’ teeth virtually cosmetically, and second, from a clinical view, regarding other benefits offered to the dentist via its use in the office that are saving time and effort and the ability to increase patient cases. I chose to look at a new product called SpheriChrome (Oxford Scientific) for this purpose.
SpheriChrome is based on an innovative, shade-adaptive, state-of-the-art solution to color matching characterized by the natural, universal structural coloration principle that occurs in nature. It has been adapted for use in all classes of dental restorations, dental uses, and shade matching to patients’ dentitions. In living things, “structural coloration,” as it can be called, is the production of color by microscopically structured surfaces fine enough to interfere with visible light, sometimes in combination with pigments.
The filler’s exact size and shape needs to be controlled to generate red to yellow color without the use of dyes or pigments as ambient light passes through the composite. The red to yellow color generated by the spherical fillers can combine with the selected color of the patient’s surrounding dentition, yielding a perfect match.
From one product and one naturally occurring color principle, one adaptive nanofiller yields multiple shades for multiple uses to virtually match patients’ dentitions to produce excellent cosmetic restorations. The white or ambient light is refracted and reflected from the patient’s dentition’s color spectrum, giving a virtually perfect match. This virtually eliminates the need to shade match each restoration, saving significant chair time when color matching with a shade guide, even under different lighting circumstances.
Today’s composites primarily operate by having red and yellow dyes or pigments added to resins and fillers to simulate tooth colors or shades. This requires the dentist to have a considerable inventory of shades needed to properly offer the correct color for a restoration.
SpheriChrome utilizes structural color with 200-nm spherical fillers. The fillers are the exact size and shape needed to generate red-to-yellow color as ambient light passes through the composite without the need for added pigments or dyes. This color generation by the spherical fillers combines with the reflected colors of patients’ dentitions, creating the perfect match from Al to D4 and even more shades.
Not only is the time saved matching the shade a significant benefit, but the need to no longer stock various shades of composites reduces the inventory and reduces storage space and waste. Of course, if there is a desire to change the shade of the natural tooth, shaded composites are still needed.
Figure 1 shows a preoperative view of a mature patient who wanted to improve the appearance and alignment of her mandibular anterior teeth without orthodontic treatment. She chose direct composite veneers because they were more affordable than ceramic alternatives.
The 8 most anterior teeth were recontoured to make room for approximately 0.5 mm of composite (Figure 2). I started by building a direct veneer for tooth No. 25 using SpheriChrome. SpheriChrome Blocker (Oxford Scientific) was used only at the incisal and lingual areas, and regular SpheriChrome was layered over the entire facial surface. Figure 3 shows the finished direct veneer for No. 25. The final result after all 8 mandibular teeth were veneered with SpheriChrome is shown in Figure 4.
You can see the fine gloss finish that naturally matched the dentition. This was easily accomplished as SpheriChrome exhibits features like a microfill composite, polishing quickly and aesthetically and yielding a smooth, fine gloss surface.
I found the consistency of SpheriChrome makes it easy to place. It was also a benefit during placement, knowing that if I needed to change the handling slightly, I could use a standard composite warmer to adjust or modify the handling properties as needed for my personal preferences. The ability to change the viscosity and flow by warming, if required, allows me to achieve excellent marginal adaptation. Time saved by eliminating the tooth-matching process made the chair time shorter and increased the patient’s comfort and decreased concerns.
I liked the idea that there was a SpheriChrome Blocker available to use in the few situations where it could be needed for the masking of tooth discolorations or for extended Class III and IV cavities. SpheriChrome Blocker can also be used as a first layer for Class I, II, and V cavities.
In Figure 5, you can see a patient’s maxillary central and lateral incisors before treatment. The patient wished to have the central diastema closed without orthodontic treatment and have a more “normal-looking” smile. In order to provide correct proportions, it was decided to place direct composite veneers for all 4 incisors. Minimal preparation was performed using fine diamond burs. The prepared teeth are shown in Figure 6. SpheriChrome Blocker was used only at the interproximal area between the central incisors. Regular SpheriChrome was layered over the entire facial surfaces of each tooth. The final result can be seen in Figure 7.
The color-adaptive technology of this composite to mimic the patient’s natural dentition won me over the more I used it. SpheriChrome produces excellent restorations with less effort and fits easily into the everyday procedure while delivering on claims to eliminate shade matching, save time, and yield improved restorations.
The fact that it can be used in all different classes of restorations adds to its versatility. When faced with several types of restorations and different patient needs, this blocker is available and that its viscosity can be varied by warming makes it convenient to use and adapt not only to my needs but also to the patient’s needs.
Excellent restorations, reducing inventory, and increasing patient flow in the office are just some of the many reasons I like SpheriChrome. But the most important reason I like it is the quality of the restoration, as you have seen in this article.
ABOUT THE AUTHOR
Dr. Nash maintains a private practice in Huntersville, NC, where he focuses on aesthetic and cosmetic dental treatment. An accredited Fellow in the American Academy of Cosmetic Dentistry and a Diplomate of the American Board of Dental Aesthetics, he lectures internationally on subjects in aesthetic dentistry and has authored chapters in 2 dental textbooks. He is co-founder of the Nash Institute for Dental Learning in Huntersville and is a consultant for numerous dental product manufacturers. He can be reached at (704) 895-7660, via email at [email protected], or via the website thenashinstitute.com.
Disclosure: Dr. Nash received an honorarium from Oxford Scientific for this article.