The overall goal of this article is to provide the clinician with an overview of the information on a newly developed glass hybrid system (EQUIA Forte® HT) and as well as to give useful application tips based on results from clinical cases.
What differentiates glass hybrid from other conventional GI restoratives is its chemistry. The highly reactive fluoro-alumino-silicate (FAS) micronsized fillers (<4 μm) were added to the standard FAS glass filler particles of EQUIA Fil. The micron-sized filler particles release more metal ions, which improve the cross-linking of the polyacrylic acid matrix and the overall physical properties.
Additionally, EQUIA Forte HT Fil liquid comprises a high-molecular-weight polyacrylic acid, which helps to improve the chemical stability, acid resistance, and physical properties of the set cement.
The light-cured, nano- filled resin coating (EQUIA Forte Coat) was improved by incorporating a reactive multifunctional monomer that increases resistance to wear, has a higher
polymerisation conversion and thinner film layer, and also provides a smoother surface to the final restoration.
EQUIA Forte® HT was used in a 34-year-old female patient for the emergency treatment of a vital lower first molar (tooth 36) with a deep, large carious lesion (Fig 1a). The vitality of the tooth was first determined by pulp testing and a radiograph was taken to check the depth of the lesion (Fig 1b).
Local anaesthesia was applied and caries was removed using tungsten carbide burs (Busch "AU" Carbide Burr - TF1AU). Infected dentine was removed with an excavator (Fig 1c). The cavity walls were cleaned with 20% polyacrylic acid (Cavity conditioner, GC) for 10s (Fig 1d), rinsed thoroughly with water (Fig 1e) and dried gently (Fig 1f).
EQUIA Forte® HT capsules were prepared and mixed for 10 s, then restorative was directly applied into the cavity in a sufficient quantity using a bulk-fill technique with a special applicator (Fig 1g). EQUIA Forte® HT was condensed against the cavity with a plastic hand instrument and was allowed to set undisturbed for approx. 2.5 min (Fig 1h). This restorative does not require a special surface coating during the setting reaction.
The finishing process was performed with the use of rotary instruments in 2 steps:
a) tapered trimming & finishing tungsten carbide burs were used for forming the fissures and occlusal anatomy of the restoration;
b) flame-shaped rubber points (blue and gray) were used for polishing (Fig 1i). All burs and polishers were used under water irrigation to avoid over-drying the restorative. The occlusal contact points were checked (Fig 1j).
A final layer of the coating agent (EQUIA Forte® HT Coat) was applied on the surface of the restoration without air- blowing (Fig 1k), then it was light-cured for 20 s with a D-Light DUO LED curing device at 1400 mW/cm2 (Fig 1l).
The final clinical and radiographic views of the restoration are shown in Figures 1m-o, demonstrating excellent contour and aesthetics.
