A.S. Mikhailov, dentist, Moscow
N.D. Vladychenkova, dentist, Smolensk

"Dental Market" journal, № 2, 2005

Russian dentists at present have no shortage of information about modern restorative materials. Moreover, they have all opportunities of buying and using these materials in their clinical practice. A doctor just has to solve the question of which manufacturer of materials he would prefer.

The dentist, who has set a goal to choose a modern restoration system for his clinical practice, is doomed to some analytical steps. Each doctor in this case has its own criteria for assessment. Although dental products are specific goods, but, nevertheless, they are goods, production and distribution of which obeys objective economic laws.

In order to make a correct choice from a large number of dental materials presented on the dental market, we had to define our selection criteria:

• Possibility to obtain any information about the material, from any source, including completeness of data about chemical composition, physical and mechanical characteristics, availability of independent laboratory and clinical tests results, possibility to obtain training programs, seminars, practical demonstrations etc.
• Legality of presence of material on the Russian market.
• Configuration of restoration sets represented on the Russian market. Universality and sufficiency of standard set of restorative material. Possibility of free purchase of any components separately.
• Demand on the market (from our patients, in this case) for the material. Preliminary volume of restoration work made with the use of this material, expected project profitability.
• Availability of material in the Russian regions, i.e. availability of distribution network.
• Price competitiveness of standard set.
• Cost of one unit of finished restoration.
• Feedback for consumer (the dentist) from manufacturer and distributors (via professional publications, conferences, seminars, Internet, etc.).
• Practical experience of colleagues with new restorative systems.

While studying all variety of modern filling materials presented on the dental market, we noted a rather small selection of domestic composites. A detailed study of product catalogs of domestic manufacturers allowed us to conclude the following:

At present the leader among domestic manufacturers of advanced composites is JSC "StomaDent", Moscow.

In fairness, it should be noted that this situation has developed historically. Formed back in Soviet times as a joint venture with Dentsply International, the company was intended to bring up domestic production to the world level. Cooperation with Dentsply proved invaluable to the enterprise. Highly qualified employees have been prepared, and Densply technologies have allowed to solve difficult tasks. Everyone who is familiar with the product catalog of «StomaDent» or will visit its Web site, will notice this. That’s how we have come to the idea of ??a separate research on «StomaDent» restoration filling materials.

To start with, a dentist from almost any region of Russia, who decides to use in his practice dental materials produced by "StomaDent" is carrying out this task without problems. The company "StomaDent" has an entire network of distributors in Russia and some CIS countries, where they sell at prices recommended by manufacturer. Thus, there is no difference where to buy the material whether in Kaliningrad or in Khabarovsk. There is information about distributors in the catalog and on the website. All products of «Stomadent» are certified and correspond to international and Russian standards.

One of the most advanced materials produced by «StomaDent» is «UniRest». It is a light-cure hybrid composite with the average dispersion of filler 1 micron, degree of filling of inorganic filler up to 79% and convenient consistency.

According to prescription, this material is intended for restoration of Classes I-V. Data about chemical composition, filling degree, physical and mechanic properties suggests that restoration made with «UniRest» will be aesthetic and will have good clinical result. The standard «UniRest» set, which has been produced for a few years, contains prefilled syringes with 4.5 g of material in 5 colors including opaque, 4 ml of «Primer-adhesive», 2 ml of etching gel, cannulas, brushes, etc. This set is still available today.

The latest product, «UniRest Plus», is considered to be more universal. This set includes 6 enamel colors (A2, A3, A3.5, B2, C2, C4) and 1 opaque (OA3.5) and allows to perform almost all types of restoration. Glass bottle of «Primer-adhesive» is replaced by a very convenient plastic one. In addition, enamel color A1 and incisor color are also available. High quality and durability of restorative material "UniRest" is provided by modern adhesive «Primer-adhesive». Any part of the restoration system can be purchased separately, which is very convenient.

How competitive is the price of «UniRest Plus» and «UniRest» sets is to be judged by consumer. It should be noted, however, that the set consisting of 4.5 g syringes with seven colors of hybrid composite, 5th generation adhesive system and accessories, priced at 2,200 rubles, may be considered rather competitive as well as 1 separate syringe of 4.5 grams for 250 rubles, or the system «Primer-adhesive» for 950 rubles, or etching gel for 75 rubles. In clinical practice «UniRest» received approbation immediately as soon as it appeared on the Russian market.

We tested «UniRest» together with Dentsply materials in control groups. It was noted that the use of «UniRest» for restoration provided good clinical result in pediatric and adult dentistry. Also, we compared properties of «UniRest» in clinical application on phantoms with composites Filtek Z 250 and Esthet-X.

We performed cavity restoration of Class 4 and transformation of supernumerary tooth into canine. The Class 4 restoration was conducted in tooth 12; with the use of Aesthete X TrueMatch scale the color was identified as W. Since there is no such color in «UniRest Plus» set, we decided to use A1 color. The preparation of tooth 12 was performed by usual method, followed by edges finishing by diamond bur with particles dispersion of 15 microns (Fig. 1).

All stages have been completed during the test. Etching was made with gel; adhesive treatment was made with «Primer-adhesive» in accordance with the manufacturer’s instructions (Fig. 2, 3). It should be noted that etching gel has very apt consistency, which does not change during long storage. «Primer-adhesive» was applied twice and polymerized within 10 seconds. After the adhesive preparation has been completed, the next stage was to apply a layer of OA3.5 color within near-pulp and basic dentin areas. Opacity of OA3.5 is not bright enough for restoration of near-pulp dentin, but it doesn’t differ from that of the material Filtek Z 250, which we used for restoration of tooth 11. Basic enamel was restored with the use of A2 and A1 colors, while for its surface the cutting edge color was used (Fig. 4, 5).

Restorative material UniRest has good consistency. It does not flow during processing, does not stick to the tool, but does not hold its shape like previously studied Filtek Z 250 and Esthet-X.

There is enough time to work with the material, but if temperature is higher than required, it is better to work with thinner layers. Polymerization takes more time than it does by the best foreign composites, but it is offset by adequate quality of restoration and much lower price.

The fact that «UniRest» set colors choice did not allow us to imitate the restored tooth color exactly, does not seem to be a drawback. The study of the latest generation of a big group of foreign composites has shown that only a complete set of Esthet-X allowed to fully match the color and to restore accurately absent parts of phantom teeth.

Final processing of seal was conducted in two ways:

• Only by discs, with the comparison of polishing discs 3M-ESPE and Kerr - Hawe,
• By the polishing system Enhance (Dentsply).

While following these two options, we noted that the result of UniRest polishing was absolutely identical to that of Filtek Z 250.

Therefore, for doctors who are used to work with disks, and for those who prefer the "Enhance" system, the quality of UniRest polishing can be guaranteed to be at the level of best foreign composites.

Transformation of supernumerary tooth into tooth 13 turned to be an operation which has shown even greater capabilities of UniRest (Fig. 8-12). Opacity of enamel shades allowed to imitate transparency of restored tooth with accuracy. We did not prepare the transformed tooth, while adhesive preparation was carried out as usual. Final processing was done with "Enhance" system. Having done that, we obtained well polished surfaces.

To summarize, we would like to make the following conclusions:

• Russian company "StomaDent" produces modern restorative materials.
• Products of «StomaDent» may be purchased in almost any region of the country and some CIS countries.
• «UniRest Plus» set is apt in its composition and competitive vis-а-vis foreign materials in price and quality.
• Such properties of UniRest as convenient consistency, color stability, different shades of opacity, polishing capability allow to expect good results in clinical practice.
• Restoration materials of «StomaDent» may be rightfully considered as materials of choice in the practice of any dentist.

The source: www.rusdent.com/modules.php?name=Pages&go=page&pid=137