Calset Composite Warmer: Does it Improve the Quality of Composite Restorations?

Dr. L. asks:

calset.jpgThere is some controversy over the use of flowable composite. I have heard some lecturers say not to use it because of its high polymerization contraction. I have also heard some lecturers talk about warming about the hybrid composite compules to increase its flow and adaptation to the cavity preparation, especially into the line angles. I have seen the Calset Composite Warmer (AdDent) that can warm up the composite compule from 98 – 155 degrees F. I would like to find out if this works. For those of you using this device, does it improve the quality of your composite restorations?

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Filed Under Operative Dentistry, Restorative, What's New 

Comments

3 Responses to “Calset Composite Warmer: Does it Improve the Quality of Composite Restorations?”

  1. ddsny on April 13th, 2008 10:14 pm

    Below is an interesting study from Oper Dent. 2008 Jan-Feb;33(1):72-8, addressing some of the issues raised in this question.

    Introduction:
    Improving the adaptation of resin composites during placement is necessary to increase durability and reduce microleakage. Flowable resin liners have been introduced to improve adaptation in composite restorations. In addition, a device that lowers the viscosity of regular dental composites has been introduced (Calset, AdDent Inc, Danbury, CT, USA). This device lowers the viscosity of composites by preheating them to 54.4 degrees C, which should lead to improved adaptation. This study compared microleakage in Class II composite restorations prepared using: 1) preheated resin composite, 2) unheated composite and 3) a flowable liner followed by unheated composite.

    Method:
    Class II cavities were prepared on the mesial and distal surfaces of extracted third molars. Ten preparations were restored with resin composite (Esthet-X, Dentsply, York, PA, USA) for each of the following four techniques: Control (Esthet-X with Prime & Bond NT, Dentsply), Flowable (f) (as Control but used Esthet-X Flow liner), Preheated (p) (as Control but with preheating composite to 54.4 degrees C) and Delay (d) (as Preheated but followed by a 15-second delay before curing).

    The teeth were restored, finished, stored in distilled water for 24 hours, then thermocycled between water bath temperatures of 5 degrees C and 55 degrees C with a one-minute dwell time for 1000 cycles. Tooth apices were sealed with epoxy and varnish was applied to within 1 mm of the restoration margins. The teeth were placed in 0.5% basic fuschin dye for 24 hours, rinsed, then embedded in self-curing resin. The embedded teeth were sectioned mesiodistally with a slow-speed diamond saw, providing multiple sections per restoration.

    Microleakage was rated by two evaluators using a 0-4 ordinal scale at the occlusal and cervical margins of each restoration and light microscopy (40x). The data were analyzed with Kruskal-Wallis ANOVA and pairwise testing with the Sign test (alpha=0.05).

    Results:
    No statistical differences were observed among materials at the occlusal margin. However, at the cervical margin, the preheated samples P showed statistically lower microleakage than the controls and all other treatments. The D samples showed higher microleakage than the P and F samples. Ranked sum scores for the cervical were D (4516), C (3974), F (2756) and P (1958). There was a statistically greater amount of leakage at the cervical margins compared to the occlusal . p<0.05

    Conclusion:
    Preheating the composite resulted in significantly less microleakage at the cervical margins compared to the flowable liner and control. Delaying light curing of the preheated composite for 15 seconds (D) was counterproductive and led to increased microleakage.

    Source:
    Oper Dent. 2008 Jan-Feb;33(1):72-8.
    Wagner WC, Asku MN, Neme AM, Linger JB, Pink FE, Walker S.
    Restorative Dentistry, University of Detroit Mercy, Detroit, MI, USA.

  2. Dr. T. on April 14th, 2008 7:23 pm

    Delivering the heated resin and curing it in 15 seconds seems reasonable. I think most us could accomplish that.

  3. John Rodriquez DDS on April 26th, 2008 12:22 am

    You can find an inexpensive wax warmer at a crafts store and warm the composite for around $7.00

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