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oh right well let's go ahead and get things kicked off I'm dr. Liam Brady and I'm the director of education at the panky Institute and it's my absolute pleasure to be with you this evening doing this webinar on both built composites and so as we kick off and we move into this conversation the really the piece for me that I want to start out with is to tell you that if you give questions while we go through the presentation please feel free to send those to me the way to do that is with a chat box and so you'll either see a chat button in your controls for zoom or if you don't it's underneath the word more that's got a couple of dots and you just click on that and then they'll say chat and then you can literally chat and just send it to everybody and and I will see that and I'm happy to stop for questions so when we think about folk fill composites really the first question for me is why would we use those because I have to tell you being a practicing dentist for a long time doing composites in my practice for you know several decades on the industry and dentistry as a profession have you eat really really well trained that we don't ever do both fill composites that we have to layer you know and we spent years and years and years trying to come up with different techniques for placing composites to increase the success the longevity and lots of theories we used to learn about something called the C factor that led us to want to layer composites and so you know what was all that about because really for years and years and years it was smaller layers smaller layers smaller layers and it was angled layers and you know all of these conversations well the predominant piece of the puzzle that we were trying to overcome was the shrinkage of the composite material and the shrinkage of the composite material and we're going to talk about that a little bit a little bit more really could create a problem you pull on the bonded interface and as it pulls on the bonding interface it can actually decrease the bonded or the adhesive attachment between the composite and the tooth we used to see these little white lines around the enamel margins especially on class one composites and literally the shrinkage was so significant to the composite that that was actually fracturing of the enamel rods in cavity preparation that then would cause that area of the cabinet to leak at secondary decay stained margin leakage and it would just decrease the longevity of the restoration the other piece of doing the layering was really depth of pure answer you know traditional composites most of the manufacturers tell us that we can cure in about one millimeter increments now the manufacturers know that we tend to take some liberties with those rules so typical depth of cures if you actually look at the science are probably more like two to two-and-a-half millimeters of composite but certainly we can't our traditional composites couldn't be cured in both and the ability of our light curing unit to actually Blumer eyes that material is related to lots of properties and so darker colored composites you have a lower depth of fear and you need more lights input highly reflective composites like bleach shades tend to bounce the light back and they don't get the same light going through the material so they have a lower depth of cure so between shrinkage and the ability to actually polymerize the material layering became really important and then another really important reason that we would layer is because there's really nothing more frustrating when you do a composite restoration is then to take x-rays of your patient at their next hygiene visit six-month recall and in a bitewing all of a sudden that composite looks like Swiss cheese and you've got all these little voids and you're trying to you know trying to figure out like are those voids at the margin or they you know you know could they create sensitivity you know and the when you see those we really feel prompted to take that restoration out and do that restoration again and having the more material you have because condensing composite is really a difficult piece of the technique of placing composite the more likelihood there was of having these velocities or voids in the film so layering also made sure that we avoided that and we had a nice dense fill when we thought about what that composite would look like radiographically and so you know this concept of spring kajam the material you know so you know today you'll have you know in the previous slide I use the terminology shrinkage stress and you may more commonly refer to that as polymerization shrinkage and so the concept of polymerization shrinkage versus shrinkage stress is gonna be really important as we talk about both fill composites and so polymerization shrinkage is actually sort of the older terminology that we use for a physical property of composite because polymerization shrinkage really refers to sort of the bulk shrinkage percentage of the material and today we more commonly refer to the terminology using it as shrinkage stress so what the manufacturers were able to do and the scientists looking at this is by altering the chemistry of the composite by altering the type of filler particles the shape of the pillow particles you know really sort of reimagining the chemistry of composite what they were able to do is actually impact the direction of the polymerization shrinkage and so classically when you hear a bulk of composite it's sort of strength right to the center and so if you think about that it's pulling away from the bonded inner face and so it's putting stress on the marginal integrity or the place that the composite is up against the walls of the teeth it's actually stressing the dentin adhesive that you put down so we can decrease the bonds gravity can increase degradation and as we said it even fracture enamel rods and really compromise the margin of the restoration which we all know is the first place that a restoration is going to show signs of aging and need to be redone so we don't want to add any more stress for a marginal interface then we then we have to and so you know because of the concept of polymerization shrinkage we were taught layering techniques and one-millimeter layers and angled layers to reduce the factor for years we also use polymerization tricks so we talked about wave curing and ramp carrying and using special curing lights that sort of increase the light intensity so that you could try to decrease the total polymerization shrinkage of that material and so we had all of these factors and all of these concerns about composite materials that had really existed in dentistry for a very long time and so I have to tell you when both feel composites first came on the market and they were coming on the market from manufacturers that I really respect and I trust their science but there's they're telling me oh we have this book feel composite and I'm going note both filling is bad you all taught me not to both so we're not both filling so it actually took me a while to step in to the bulk fill arena and what it took for me to finally sort of make that leap of faith into the world of bulk fill materials was truly understanding the science behind both fill composites and I will have to tell you after spending a lot of time talking to different scientists who created these materials different from different manufacturers from people who've done the independent science what I've come to understand is bulk fill composites actually are an improvement in composite technology over the generations of composites before them because the scientists really had a solve a lot of these problems in order for them to be able to allow us to bulk film you know and there's a lot of just like everything else in dentistry there's always some complexity to it and so there's things you need to understand about vocal composites and not all bulk fills are created equal so we're gonna talk through that in general terms when a manufacturer says it's a bulk fill composite what they now mean is you have a depth of here of somewhere between four and six millimeters and that pretty much covers everything that's out on the market today but you need to know specifically for the manufacturer that you're working with for the type of bulk drill composite because a lot of the manufacturers actually make more than one time of bulk fill composite what is the specific specific depth of cure that they recommend another thing that you need to know is does the manufacturer tell you that this book fill composite is rated so that it can actually be what we called a cap layer or it can be the layer of composite that's on the occlusal surface of a tooth so it's gonna take a close old contact that means it has adequate wear resistance it has adequate physical properties to be under occlusal loading or is this particular boat fill composite it's recommended that you actually use a different type of composite most likely a more traditional nano category composite so nano hydrate nano fill mental cluster and you're gonna do a one to two millimeter tap layer at the very aku's 'el interface so that that's composite that has superior physical properties that let it resist occlusal loading and goozle wear is actually where the contacts are then we have on composites that are in the boat fill category that are condensable composites so you're going to need to have condensing instruments we also have materials that are more flowable and they have properties called self leveling so that they actually sort of fill an axial box plus key box or an occlusal preparation and they sort of level themselves from right to left that's a property of the composite that it's thick so perfect so it actually gets pulled along the wall cavity preparation and then there's also ways to decrease the viscosity of other composites that are bulk fill so you can get it to flow temporarily but yet it's a thicker more highly filled material so you've got lots and lots of choices obviously there are books or composites that come in the little plastic containers that go in a composite gun manufacturers called those comp tools PL T's they have all sorts of names for those there's both fill composites that come in a syringe there's both fill composites that come in a syringe that looks like a flowable and you can put a flowable tip on it those are the less viscous materials so you've got lots and lots of choices in the world of bulk fill materials so let's kind of go through that and talk through some of the different the varieties that we have so I told you that both fill composites are actually an improvement in composite science and so when we think about that what did the manufacturers have to do so the manufacturers actually figured out how to control the polymerization shrinkage and how to direct the polymerization the shrinkage stress that it's away from the bonded interface so pretty much across the whole category of bulk fill composites all of these materials have lower shrinkage stressed numbers they do better as far as maintaining the integrity of the interface between the composite material and the deficit and the debt mctizic and the actual walls of the cavity preparation then the categories of material that have come before them they had to come up with a way to get increased depth of cure and so one of the things that we do see in both fill composites and this tends to be generally true across this category of materials is that you see increased translucency so in order to get the light to actually go deeper into the material they had to make the composite itself on less colorful less reflective so they increase the translucency of the materia and said one of the things that I hear about vocal composites especially when they're used without a cap layer of a different kind of composite is that they're not as aesthetic as non bulk fill composite so only each of us individually can answer how exact and perfect the match of a poster composite has to be to the surrounding - and then of course that varies from patient to patient and so in some patients that's going to be a less critical factor than others and now today what we've actually seen is several manufacturers and IVA for evident kind of started this trend with their Tetrick evoke low bulk fill is we've seen on both no composites that are reasonably translucent because of depth of pure when they are unblemished and then when they polymerize they actually get more opaque so that the translucency decreases and so talking to the scientist that has to do with lining up the filler particles so the light can go past when we're light curing and then polymerization actually sort of changes the direction of those filler particles so now they reflect light back and it increases the opacity of the appearance of the material the other thing that a lot of the manufacturers have done in order to make their materials now bulk fill and so they're going to go four to six millimeters is they actually had to create new photo initiators they had to increase the chemical efficiency of their photo initiators so that a smaller quantity of light would set off an equal amount of polymerization and so you know there's been a lot of scientific advances that have gone into doing both fill composites now we do use the term bulk fill and one of the things to think about because there's a real big kind of a conversation out there when I lecture about this about you know do I want to use a bulk fill that requires a cap layer versus a bulk fill that doesn't require a cap layer so I don't have to use two different kinds of composite and so I do want to and she ate between the word bulk fill and single fill or single increment so you know if you're using a material that is a four millimeter depth of pure the only way to do a single increment is if the entire prep is less than four millimeters away from the curing light and so you know when you're doing a cavity preparation whether it be a deep class one or as in this photograph you've got a class two cavity preparation you know one of the things that I will do is I'll just take a periodontal probe and I'll just set it at the base of the preparation so that I can actually now measure and I can actually see exactly how deep that cavity preparation is so I did see that someone was raising their hand and again if you want to ask question if you'll just type that in for me in the chat box I can just read the question to everyone and then I can go ahead and answer it so I'm absolutely happy to do what but I do want to make sure that I'm not trying to fill more than four to six millimeter increment and then I'm not going to get out of what light penetration I'm not gonna get adequate polymerization so you know using a cap layer for me really honestly isn't a big deal because of the fact that most of the time when I do a class two I'm gonna need a second second thing ferment of composite anyway because my class two box is more than four millimeters deep so I can just switch to a different composite that I do think has different properties and you know in a class one preparation that's you know insipient to moderate where I don't have much depth then using a bowlful composite that doesn't require cap layer may be something that you prefer but you do need to now start to think about the fact that so can't you still can't here eight millimeters ten millimeters 12 millimeters so you may still have to do more than one increment and so when we do think about a cap layer you know the cap layer only has to be one two millimeters and thickness and actually shouldn't be more than that because the depth of care of these composites and so using things like genial sculpt from GCC America traditional Petra ethos ran from I have a flower Venus diamond from closer till texture cream from 3m lots of our traditional sort of nano category postural composites we could use they all have a depth of care of one to two millimeters so that's really going to be what we're gonna do so that we have that cat bowl so we're gonna use a traditional I feel composite because it has a high color content it's gonna have improved physical properties so better rare resistance it's going to have long and durable aesthetics it's going to have great physical properties as far as water absorption flexural strength it's a lots of reasons to go ahead and to use a nice cap layer these materials have improved aesthetics so they are not translucent like our both fill materials so we can actually go in and really improve those aesthetics and we get that better physical properties so we did get a question to come in and the name is what's the name of the blue matrix band from the prior slide and those two three matrix bands come from garrison so you just go to garrison dental they cells or whites that's who makes those blue bands I don't know the exact name of that product but they but if you go on the garrison website you should be able to find those and so I personally really don't mind doing a player and I know there's times I decide to do a cap layer and there's times I don't do a cap layer and again for me that's how fussy is the patient aesthetically how visible is the restoration are we talking a lower first premolar versus an approach second molar and you know how much occlusal where does this person have so this is the person who'd para functions they have higher functional risk I may want to have a nicer material as far as wear resistance on the occlusal anyway even if I don't have to use one so those are always a choice so let's go through now sort of some of the variety of different vocal materials out there and so one of the both fill materials that people are always curious about is a material called sonic bill from Kirk so the sonic flow material I've used you know quite a bit I have the handpiece in my office and so one of the pieces about this material is it does require a heavy and so you do have an upfront investment in order to buy this special handpiece and what the handpiece does is it actually delivers sonic vibration so it adds kinetic energy to the composite that kinetic energy actually takes a highly filled very viscous composite and when you add the energy it makes the composite blow so it temporarily lowers the viscosity of this material and because it lowers the viscosity we love that handling property of just being able to inject a low viscosity material into a cavity prep it means less risk of having voids and velocities on easier placement don't need a condensing instrument to really make sure you're getting this in a deeper cavity prep but you still have the physical properties of the high filler content and then the material after its expressed out of the handpiece and the kinetic energy dissipates comes back to its normal viscosity because of the filler content of this material they say it does not require a half layer it does have a six millimeter depth of cure and part of the reason it has a negative six millimeter depth of cure is the material is very translucent so my experience is it's not a very aesthetic material so what you're gonna compromise for that six millimeter depth of cure is an aesthetic appearance is it's highly translucent and again you have to have the handpiece in order to place the composite probably what I think is probably the more popular versions of both fill composites is injectable or flowable both fill composites um and so this was actually the original book fill that came from on the market was sort of the SBR version of this and most of the manufacturers have a bulk fill flowable composite in order for materials to blow they have to have a lower filler content the higher the filler content the greater the viscosity of the material so it's pretty easy to tell the filler percentage of a composite material just by its viscosity it's sort of just a sort of an off-the-cuff way to look at the filler content and why do we care about the filler content we actually care about filler percentage because the higher the filler percentage the better the physical properties of the material then you know so composites science over its entire iteration has been trying to figure out the balance of increasing filler percentage without the viscosity of the material making it unmanageable so we want to improve the physical properties but we don't want to destroy the handling properties and so it's in this really fine balance you know most of us prefer using lower viscosity materials especially for lots of different applications and but yet when we do that on we compromise physical properties so it's this balancing so all of the flowable versions of bulk fill materials actually require a cap layer because of the different physical properties so they don't have adequate clues on where they're not gonna be able to resist oh please a loading and handling as well because it below of filler properties now I will tell you in an inception the genial bulb actually called there is an injectable versus flowable to sort of try to differentiate it so it does have a higher filler percentage than the ones that call themselves global and there are very specific clinical applications with that material where you can use it all the way to the surface of the cavity preparation so that's kind of a unique material in this so we preferentially love these because they're lower viscosity easier to place the easier they are to place when you don't need a condenser you minimize or reduce completely having voids that you would pick up on radiograph a lot of these materials are highly thixotropic on what we say is their self leveling so you also don't need to move the tip around because that introduces voids and pretty much across the board all of these have a four millimeter depth of the clip one of the pieces of these materials is radial has to be so we each probably have a clinical preference as to the radio opacity of these materials and what we actually like to use so that we are composite to look the way we like them on a rainy breath so I actually like really radio opaque materials I like to easily be able to differentiate the composite from the dentin from the enamel or possibly from decay and so I'm personally pretty picky about that I will tell you that all three the materials that are most on the side I've used in my practice I classically I'm using the Tetrick Ito for bulk fill for my class two boxes because it has a really high radio paucity it is got really nice self leveling properties and again that's the material I told you that strands Lucent before its glimmer eyes and then becomes more of eight after you polymerize it and I've actually been using the genial bulky injectable to do some small class ones and some class five it's a really aesthetic material it's a really really nice material for that okay and so lots of different applications where I'll use these I will tell you because they all come out of a syringe with a throwable tip and you're gonna inject them into a cavity preparation what I like to do is I like to inject the material sort of in a central position in a class two box and I like to actually try to move the tip of the syringe as little as possible and I really don't want to pull the tip up and put it back in when you do that you get a phenomenon called stuck back and you introduce a velocity and so I'll inject that material I watch as I inject that the material is spreading to the buccal lingual axial walls up against the matrix fan and then I'm very slowly lifting the tip of the global syringe probably occlusal as the box is filling or as the occlusal population is filling so there is a little bit of technique the piece with these of making sure that you don't get voids I don't play with it with an explorer or a condenser again you get stuck back and introduce porosity but I will wait a solid 10 seconds before I bloom rise and give it time to do that self leveling effect and then I'm gonna go ahead and hit this with a light curing unit and then we have our both fill composites that are like more traditional composites so they have the viscosity of a more traditional composite and so there's lots of these on the market um you know dmg America just brought their echo sites out on the market probably in the last year year and a half and one of the things that's really cool about it is they have a really cool color schema and they have two blue and they have other colors that help with opacity issues you know 3m makes a flowable version of the Tetrick book film plus a condensable version Tetrick makes their evo flow from iva floor and they also make a condensable version so once as I said lots of the manufacturers have they're both fill composites in multiple different types of handling properties so if you can find something that meets your requirements that's gonna give you something that you like to work with so these materials are higher viscosity the thing we know about them because they're higher viscosity and they require require condensation they have a higher filler content as soon as you go to a high enough filler content that the material doesn't flow on its own um then you know you have really good physical properties that are gonna mean you don't need a cap layer these materials can withstand um he's a loading they have really good wear resistance but now you do have the challenge of placing these materials and condensing them and condensation is really not a good term when we think about composite materials because we really shouldn't condense them we should place them we use the term condensing because we used to condense amalgam then we use the same instrument again you don't want the tip of the instrument to go more than a millimeter into the material is when you lift it you get sucked back and these materials all pretty consistently have a four millimeter depth of pure so one of the things to introduce when we talk about these higher filler percentage materials condensable composites and by the way this applies to both throw and to traditional non-vocal composites is the idea of warming composite so I told you earlier that if you had kinetic energy to composite as the molecules start to vibrate the material flows even though it has a really high filler percentage and the same thing is true when you add thermal energy to composite and so when we warm a composite we increase the flow ability we lower the viscosity of the material and we do it temporarily so quick quick question that came up is when I test a curing light what number should I look for and how often do I need to test hearing boats those are actually great questions there's actually no specific number you should actually know what the light output is of the light that you bought so you should know what the manufacture is telling you that you're gonna get pretty common LED carrying lights that tell you typically of a 10 or 20 second life here is gonna be somewhere you know around a thousand but you know 850 872 1,100 you can have a range but it's probably gonna be around thousand light hearing is actually just a math equation it's the light energy of your light or the light output time's the time of exposure and that gives you the total light energy and the manufacturers know the total light energy to get to a polymerization threshold for their material so light during units to tell you they have five seconds here are putting out twice the light energy of a 10 second care if they have a three second care they're putting out three times light energy of a ten second cure but you got to get to that total amount how often should you test your throwing light I recommend highly that you test your current lights once every 30 days have your auxiliaries create a lot where they can keep those numbers buy yourself a light during testing unit they're $250 and keep it long the thing that's much more important than the light output of your unit is the trend and if you start to see your light carrying units light output decreasing a month-to-month then either the battery is failing the electronics is failing it's not getting the full charge depending on the old bahla curing unit is or potentially the light guide is being obstructed either because you're getting composite on the air and you're getting identities upon the end you are and your distilleries are cleaning them and scratching the end and the light is reflecting but if the light energy is going down and month-over-month you need that probably send uncaring light back to the manufacturer and then you're going to need service or buy a new light body so we like to test ours about once a month and we just want to see consistency so great question so let's go back to the idea of composite warmers and what we were talking about is that the addition of thermal energy the composite actually causes these materials to flow and so this these have any pictures of that calset composite warmer from a dent is the name of the company ad BB&T and these are the composite warmers that I have in my office they're not a very expensive piece of equipment you keep them in an opera Tori you plug them in they're kind of like coffee warmers they stay at a consistent temperature all day long you can choose the black base is the part that creates the heat and then the silver pieces on top they have about four different varieties and you can pick what kind of silver piece you want so you can just heat up the little peel T's or comp Ewell's I actually have the one in the center because I actually will have one in my composite gun ready to go and we literally just put it down in the warmer you can also buy them that keep syringes if you like syringes of material better you can put the tips of instruments so that the instruments get warm and once you start using a composite warmer you will never go back it's like everything you buy in your office you actually have to buy it take it out of the box plug it in and then you sort of have to force yourself to use it the first time or two but once you start to use a composite warmer you're gonna get addicted because every single composite has these awesome physical properties and they flow and they go right where you want it whether you're using it for anterior or posterior and just like with the sonic energy it makes the handling properties 20 times better but as soon as the composite cools the density returns and you actually have good to take advantage of the great physical properties of a higher phil composite and the great handling properties of a composite that flows so let me just stop and ask have another question and we'll come back to this is an infusion of bonding question so we'll come back to this in just one second so let's just finish the conversation about composite warmers so I did say that it increases the flow ability temporarily so that while the temperature is there it actually believe it or not also decreases the required cure time so it actually increases the ability of the composite to polymerize it actually increases the depth of the cure so you actually get greater light penetration when the composite is warm because the material is glowing and you don't have to condense it just goes where you want it you reduce boyd's and marginally Michael if you actually get better adaptations and emulsion and it also reduces the shrinkage stress so not only does the composite warmer improve your ability to work with the material it's gonna make it so much easier to fill applause to deep class one I actually use it for my interiors as well but it actually in decreases some of the technique sensitivity of composite and increases some of the phenomenons that go to longevity of a composite and so if you've not played with a composite warmer I highly recommend they're worth trying and by the way another thing I will just I'll just mention is the composite gun in this photograph um is probably the best composite gun on the market so it's actually a metal it's not a plastic composite gun it's a metal composite gun and there's two places you can get these they are sold by a dent with their pal set warmer and closer it sells this composite done and I will tell you the first time I used them was in a hands-on workshop I was teaching and we had them and I was like oh my god this is the best in posit gun I've ever used and you know it's silly to probably say you can fall in love with a composite done but I love those composite guns and they to me I would never go back to using the plastic ones these are they're worth having and they're not super expensive so the question that came up was about adhesives and so I do want to just they're back and sort of answer that question before we wrap up our time together so the question was about micro leakage and adhesives and specifically about universal adhesives and so I will tell you just like with Volkl composites the universal demikhov's are an actual leap forward in the scientific technology behind dense engine pieces and so when we use the word Universal pretty much across manufacturers what we mean is you can choose the etching technique so you can self-etch meaning no glue gel of any kind no phosphoric acid you can total edge which means you're gonna put phosphoric acid on the enamel and the dentin simultaneously rinse dry and then go to your adhesive process you can also either hybrid h which means you put phosphoric acid on the enamel only for 10 seconds rinse and dry and then use this to finish patching the enamel and etch the dentin so you can use any edging technique and a universal adhesive will work because the pH has been perfectly balanced to get enough edging without over etching the dentin and all of those different techniques now on you you know some of the universal adhesives come with a dual cure activator so if you want to turn them into a dual cure adhesive you could do that but pretty much across the board the universal adhesives once they are light cured will not impair or impede the polymerization of dual cure materials because the pH is such that it doesn't get rid of chemical polymerization so there are some unique differences across the manufacturers that you need to know about but really what happened the reason we went to Universal adhesives believe it or not was because kirari corporation held the patent on something called MVP and when their patent expired allowed the other manufacturers to use that chemistry in their detonate pieces and MVP is what allows us to use the word Universal so MVP is the perfect pH I think you can total edge self-etch ever that select the batch and it doesn't have any negative implications MVP actually works against enamel dentin composite traditional ceramic lithium basilica's or Konya and metal you know MDP is what allows that sort of nice pH that means that they're they don't interfere with door here so it was really the addition of that chemistry and that MDP chemistry is better chemistry them our generations so when Universal competitive Jesus came out and I understood chemistry behind them I did switch to a universal adhesive and I actually used two Universal that diffuses in my private practice and so I actually use I bond Universal from closer for my direct restorations when I do composites and I use a diffuse Universal from I've applause evident when I'm seating in direct restorations because I might when I'm using an IVA forgiving a cement like very linked aesthetic like cured ovarian aesthetic dual cured I want to use their universal adhesive with it so I will use that add these Universal with that I do believe in sticking with a manufacturer when you're in the world of indirect restorations which of course is we were talking about direct restoration and so but across the board if you're using a universal adhesive I think that's better chemistry than the prior generations and by the way less less worries with inventory control cause you can buy one adhesive and not have to worry about it less problems with your assistant knowing what to put out so there's some other advantages as well just make sure you know the manufacturer directions for whatever you're using good news is all of those what we call is use instructions for use or DF use directions for use are in the internet so you can just google them and you can really easily find those instructions and a lot of the times they actually print those on a pictograph like a little lemonade card so you can have those as well so yeah so I have definitely endorsed using a universal adhesive now if you are having challenges with micro leakage which was one of the crux of the question before you switch adhesives one of the things I would tell you is you know Michael leakage recurrent decay is probably the primary thing that causes us to replace direct composite and there's lots of pieces that's happening prematurely the composite hasn't gotten longevity in the mouth that you feel comfortable with then there's a lot of things to look at and it could be your preparation design and how you're doing the margins it could be how you're finishing the composite like one of my all-time favorite things is to finish composites with a brownie point of brown silicone point running with slow speed you get this great infinity margin and it doesn't clap the stain and bacteria you also need to look at your adhesive protocol so you want to make sure that your itching enamel long that you're not over a chain you do need to understand your adhesive if you're you know using any piece of that requires in preservation should be refrigerated if you're using an adhesive that's a shake vigorously before you use gotta shake it vigorously or you're not getting all of the chemistry a huge challenge with Technic pieces is that they're liquefiable is solvent and that's either acetone or ethanol the solvent evaporates very rapidly so three to seven seconds definite besom should not be dispensed and be out in the air more than three to seven seconds before you take that micro brush to the tooth and so I only use that little white plastic thing with the wells so that I can put the tip of the micro brush over it and then we can get our adhesive on it for my assistant will literally put the adhesive out and then I don't get as we're gonna use it so if your assistant is trying to be time efficient and putting your adhesive out ahead of time and then covering it with a little orange plastic shield that keeps it from white curing but it doesn't keep the solvent from evaporating and when the solvent evaporates the viscosity increases and you're not going to actually get good hybrid zone development good penetration into the enamel so you have an inferior bonded interface and that's probably a huge piece of what we have challenges with it's also one of the reasons I'm not a super big fan of Unidas adhesive delivery systems there's there's a lot of adhesive in there and we always feel obligated when we pop the top use it for multiple team but once you pop the top its evaporated so I really like bottles where I can do a single drop or at the cars Viva Pen system ways that we can control evaporation so there could be a number of things that are going into that again depth of pure if you're using a traditional composite or a bulk fill and you are doing a greater depth of pure than the manufacturer recommends you could have increased shrinkage stress it's putting stress on the bonding interface that's causing those margins to break down prematurely so lots of possible things to look at in your composite technique if you are seeing premature leakage around the margins and then of course one of the things that we always have to be concerned about is isolation our newer materials Universal adhesives are much more moisture tolerant from prior generations but all adhesives is best done in an isolated field and if you have contamination it'll decrease the life span of your composites so ideally inverted well-placed rubber dam I know as soon as I say that people cringe because there's so many hassles and placing the rubber dam but isolate if you work with an isolate is great an isolation device from closure called really far out and it's great for patients who can't tolerate an isolate or have tmv issues and we shouldn't put them on the fight block opto gate from my before he began to reflect in the interior if you're doing class 3 class or composites so some sort of retraction device try to increase the ability to isolate the field and keep it free from saliva and moisture it'll increase the longevity of your West relations so lots of options from that perspective so we are getting sort of to the end of our time together but also want to just invite if there's more questions that you go ahead and put those in the chat box and we will go ahead and we'll get those answered so next question is can I recommend a great composite polishing kit you know there's actually lots of these on the market people really love to use Pogo polishers they make the Venus super polishers there's lots of different publishers around I will tell you personally for me I use a polishing sequence for my composites I use brass lers feather light composite polishers they have a latch and they're going to slow speed handpiece you run them with your hand piece on the slow speed setting set about you know between 7 and 12 to 13 if you run them too fast they fall apart and they really should be multi-use they also make new ones called their Brio polishers that are sort of multi-purpose and people are loving those but I use the traditional feather lights or composite there's two colors sort of a lightish Memphis green and then sort of a grey and then probably for me and that are what silicone-based polishing system that you use the very best way to finish polishing is with diamond polishing paste so my last step is always a bristle brush you can use a perfect up in a latch handpiece I use ultra dense fine micron down and polishing paste and you will get really beautiful surface sector they feel smooth your patients will love them and they look really gorgeous so you've not played with diamond polishing paste might be worth time so as we wrap up I did want to just invite everyone to come and visit us at the pinky Institute we are located on a little island called Phoebus game we're about 20 minutes from Miami International Airport so we're not actually down in the keys although we are on an unbelievable barrier island with beautiful ocean and it's a great destination location but super convenient to Miami International our main for the Killam is called the essentials and that journey starts with B 1 and I've gone ahead and I'll put up a link here and you'll actually get that in a follow-up email as well to a webpage where you can go get more information about one and coming down and joining us for that we also have for two day lecture courses which are a great way to come and just sort of try out hankie there Friday Saturday and shorter days and so you get to kind of just see the facility and experience hankie before you dive into the essentials along with a whole host of topic specific classes so sleep and TMD we have a great hygiene program we have a business of Dentistry class that we run every year so an esthetics program so you can check all of that out either on pantygram org is a great blog site for the Institute lots and lots of free content from all of our faculty and also has great course listings where you can go to our main website which is painting board so we have one more question that looks like it popped up here oh and yes on Thank You Jennifer maybe about our women's retreat we do have a great women's retreat that happens every year so definitely check out all classes on either one of our websites I am absolutely happy if you have any further questions - to answer those my email is Elle Brady at panky org and still drop me an email if there's a question they didn't get in tonight and for those of you who are on the webinar we actually are recording the webinar and we will send you a follow-up email we'll have a link to the landing page that's listed here and a link to the recording if you want to go back and watch it again or potentially have your normally use watch it so I'm gonna say thank you to everybody for joining us this evening we got one more question that's getting in here under the wire let's see what just ping him yes I can repeat my email that's an easy question it's el rey v-b rdy at Thank You PA and Katie why dot o-r-g with that I'll say good night everyone enjoy the rest of your evening on thanks for joining us