Ivoclar Tetric N-Flow

Tetric N-Flow is a light-curing, radiopaque flowable nano-hybrid composite based on nano-optimized technology. Tetric N-Flow is based on 10 years of tradition and the clinical performance of Tetric Flow. Because of the material’s outstanding wetting ability even in areas that are hard to reach, it is particularly suitable for use as a cavity liner and for small cavities of any kind. At the same time, the material offers outstanding stability and is thus ideal for Class V restorations.

Tetric N-Flow is the ideal complement to Tetric N-Ceram for an esthetic restoration.

Tetric N-Flow is available in 10 shades – 6 enamel, 1 dentin, 1 incisal and 2 bleach shades. It is supplied in both syringes and Cavifils.

 Indications:

• As initial layer under class I and II restorations
• Anterior restorations (Classes III, IV)
• Class V restorations (cervical caries, root erosion, wedge-shaped defects)
• Small restorations of all types
• Extended fissure sealing
• Splinting of mobile teeth
• Blocking out of undercuts
• Adhesive cementation of translucent ceramic and composite restorations

• 1 x 2gm syringe

Description

Tetric® N-Flow Bulk Fill is a flowable, light-curing radiopaque composite for direct restorations in posterior teeth. As its opacity increases during polymer- ization, Tetric N-Flow Bulk Fill is also suitable for discoloured tooth structure. It is applied in increments of up to 4 mm as an initial layer in Class I and II restorations. Tetric N-Flow Bulk Fill cures with light in the wavelength range of 400–500 nm.

Shades

Tetric N-Flow Bulk Fill is available in three universal shades (IVA, IVB and IVW).

Composition

Tetric N-Flow Bulk Fill contains barium glass, Bis-EMA, copolymer, Bis-GMA, CMPEGMA, ytterbium trifluoride, DCP.

Total content of the inorganic fillers: 45-48 vol.%.

Particle size of inorganic fillers: between 0.1 μm and 30 μm.

Indication

• As initial layer / first increment in Class I and II composite restorations in permanent teeth
• Restorations in deciduous teeth

Contraindication

Placement of Tetric N-Flow Bulk Fill is contra-indicated

• if a dry working field cannot be established or the prescribed application technique cannot be applied.
• if the patient is known to be allergic to any of the ingredients in Tetric N-Flow Bulk Fill.
• Tetric N-Flow Bulk Fill must not be used as a luting composite.

Side effects

In rare cases, components of Tetric N-Flow Bulk Fill may lead to sensitization. The product must not be used in such cases.

Interactions

Materials containing eugenol/clove oil may inhibit the polymerization of composite materials. Consequently, the application of such materials together with Tetric N-Flow Bulk Fill must be avoided. Discolouration may occur in combination with cationic mouthwashes, plaque disclosing agents and chlorhexidine.

Application

1. Shade selection

Clean the teeth prior to shade determination. The shade is selected with the tooth still moist using a shade guide. The shade of the composite will correspond with that of the shade tab after the change in opacity has taken place, i.e. after polymerization.

1. Isolation

Adequate relative or absolute isolation using suitable auxiliaries, such as OptraGate® or OptraDam Plus, is required.

1. Cavity preparation

The cavity is prepared according to the principles of the adhesive technique,

i.e. by preserving as much of the tooth structure as possible. Do not prepare any sharp internal edges or angles or additional undercuts in caries-free areas. The geometry of the cavity is predetermined by the dimensions of the caries lesion or the old filling. Slightly bevel or round out the enamel margins using finishing diamonds (grit-size 25–40 μm). Subsequently, rinse the cavity with water spray to remove all the residue and dry with water- and oil-free air.

1. Pulp protection / Base

In very deep cavities, areas close to the pulp should be selectively coated with a calcium hydroxide-based preparation (e.g. ApexCal®) and subsequently covered with pressure-resistant cement (glass ionomer cement). Do not

cover other cavity walls, since they can be used to support the bond with an enamel/dentin adhesive.

1. Application of the matrix / interdental wedge

Use a wrap-around matrix for cavities affecting the proximal area or a sectional matrix band and secure it with wedges.

1. Conditioning / Application of the bonding agent

Condition and apply the bonding agent according to the Instructions for Use of the product in use. Ivoclar Vivadent recommends using the following

bonding agent: Tetric® N-Bond Universal (using the self-etching protocol or in conjunction with phosphoric acid etching).

1. Application of Tetric N-Flow Bulk Fill

• Cover the syringe with a suitable hygienic barrier sleeve according to the manufacturer’s instructions.
• Tetric N-Flow Bulk Fill can be applied in increments of up to 4 mm thickness.
• Tetric N-Flow Bulk Fill must be covered with a layer of methacrylate based universal or posterior composite (e.g. Tetric® N-Ceram/Tetric®

N-Ceram Bulk Fill/IPS Empress® Direct). Processing and finishing should be conducted according to the respective Instructions for Use.

• Proximal contacts must be established by means of a matrix system. The filling material does not exert any pressure on the matrix band. The matrix band can be shaped with a suitable hand instrument (e.g. a balltype condenser) before and/or during light-curing.
• Complete polymerization requires a sufficiently long exposure time. For the recommendations regarding exposure time and light intensity see table 1.
• When using a metal matrix, additionally polymerize the composite material from the buccal or lingual/palatal aspect after removing the matrix, if no Bluephase® polymerization light is used or the light probe cannot be ideally positioned, e.g. distant to composite or diverging scattering angle.
• Avoid contact of the reusable syringe with the patient’s mouth without the protective sleeve.
• Do not reuse syringe if it becomes contaminated.