The new Tetric EvoFlow® is a further developed version of the flowable hybrid composite Tetric Flow®, which has proven its exceptional qualities in more than 10 years of clinical use. It is predominantly employed in conjunction with conservative cavity preparation techniques using micro-grinding tools, ultrasonic instruments or micro-air abrasion. Even though the flowable nano-hybrid composite offers a limited indication range compared to conventional, sculptable composite due to its reduced filler content, it is ideally suited for restoring micro-invasive Class I and II cavities in low-stress areas, extended fissure sealing in premolars and molars, the filling of anterior teeth (Class III) and Class V cavities (cervical caries lesions, wedge-shaped defects).

Further indications of the material include the cementation of composite and ceramic restorations and repair of composite and ceramic veneers. In addition, it can be used  as a cavity liner under Class I and II restorations to create an intimately adapting initial composite layer under conventional, sculptable  composites particularly in the proximal box and provide a flat cavity floor on which to build high-quality restorations. Due to the reduced filler content (silicon dioxide and finely ground glass/quartz fillers), the material features a lower viscosity and enhanced flow properties. This ensures excellent surface affinity and allows the composite to be adapted to the cavity surfaces without any bubbles or voids. Simultaneously, the material exhibits high tensile and compressive strength as well as wear resistance. Another important clinical feature of Tetric EvoFlow is its exceptionally high radiopacity, which facilitates diagnosis of secondary caries and the detection of material excess.

Case report

In a young female patient, pit and fissure caries was diagnosed in teeth # 34 and 35 during a dental checkup (Fig 1). After brief cleaning, the tooth shade was determined while the teeth were still moist. A rubber dam was placed to ensure a dry operating field (OptraDam®, Figs 2 to 4). Next, the carious lesions were removed preserving as much tooth structure as possible. The cavities were rinsed with water spray and then dried (Fig 5). Following this, the prepared teeth were conditioned with 37 % phosphoric acid using the total-etch technique (Figs 6 and 7). Then a light-curing single-component dentin/enamel adhesive was applied (Excite®, Fig 8).

Subsequently, composite material of the selected shade was applied to the cavities using Cavifils. The restorations were pre-contoured with a small condenser and then light-cured (Fig 9 to 11). After light-polymerization, fine-grit diamonds were used to finish the restorations and polishing was performed. After removal of the rubber dam, the occlusion was verified and fluoride was applied topically to the teeth (Figs 12 and 13).