What composite material provides ultimate translucency and natural esthetics?

I've had some trouble with class IV resins with regard to creating a natural looking restoration as opposed to having too much translucency. I've been using Kerr's Point 4 composite for almost 2 years and am very pleased with it. The down side is that it doesn't have any dentin shades to create the lingual shelf that helps to create a natural appearance. I've tried using an A-4 shade for the lingual shelf and then the appropriate A-2 shade followed by a translucent overlay, however it just doesn't give me the look that I desire. I think Contemporary Esthetics had an article on this topic and suggested using the XL2 shades for the lingual shelf due to it's opaque quality. I've tried it once but still didn't really like the result. I know that one of the suggestions will be to switch to EsthetX, but I've tried it before and just didn't like the handling qualities as much as the Point 4. Any suggestions?
sself
Official Townie
Member # 8597

Ultradent makes a composite material called Vitalescence. Order the pearl frost shade. It is an opaque composite that is meant to be used as the lingual wall. It will give you the opacity you need and then you can place your point 4 on top. Just call them. I think the shade is called pearl frost or you could just switch to EsthetX. That is the one I have been using with great success.
socalsam
Official Townie
Member # 8453

Sam, can you recommend a good overall incisal shade composite, in a translucent shade that can be used for incisal edges and for overlaying posterior composites? Thanks.
encino Official Townie
Member # 7932

I use the EsthetX kit. It has translucent shades in it. Ultradent also makes translucent shades. Call them and ask which ones they have. Actually come to think of it, Point 4 should also have translucent shades
socalsam
Official Townie
Member # 8453

Yes point 4 has the translucent shades. I think a person needs 3 translucent shades and all these kits have them–a yellow tinted translucent–a gray translucent and a white tinted translucent. With these you can create a chameleon for almost any restoration. The EsthetiX kit is great in that it provides a formula for making the shades you desire. The Vitalesence kit comes with tabs you can place over each other to preview the shade combination. It is like a big box of Crayola crayons–play till your heart's content. You should also have a color resin kit (Kerr color plus, Tetric color, and probably others out there) to make any minor modifications to the composite.
Tarun Agarwal
Official Townie
Member # 8682

I'll back Sam and Tarun's comments. I really like Esthet-X. It has a few different opaque and translucent shades. It is a very versatile system. I also have Ivoclar's Tetric Color stain system.
Mike Barr
Moderator
Member # 8298

I second Sam's opinion about pearl frost. Ultradent also has "snow white" types of composites for the same purpose if I am not mistaken.
smile4u
Official Townie
Member # 8695

I recently started using Palfique Estelite by J Morita. This composite has the best handling of any product I have ever used. Here is a description, straight from their website: "Palfique Estelite's uniquely manufactured spherical filler is responsible for the integrity and esthetics of this technologically advanced composite. Palfique Estelite offers the clinician high resistance to abrasion, minimal color change after polymerization and chameleon effect shade matching. Palfique is available in 14 radiopaque shades including: incisal, cervical and 2 opaque shades. Indications: Dental restorations where esthetics is a primary concern. Class I, V, and small Class II composites on posterior teeth. All surfaces for anterior composites. Advantages: 82% filled by weight with unique patented "sub-micron" spherical filler. All shades are highly radiopaque. Minimal change color when polymerized Chameleon effect shade matching. High polishability in less time. Highly esthetic. Available in syringes and PLTs. Try it, you'll love it!
mgoodman
Official Townie
Member # 8250

I've been using Estelite Palfique (www.jmoritausa.com–thanks! to Mark Goodman ) for my translucent shade layers over Herculite XRV dentin shades for the lingual shelf. Excellent results, and the Palfique polishes like nothing I've ever used. VERY nice handling, I might add! Maybe you could try Herculite dentin shades for your lingual shelf under the Point 4. Herculite XRV has a tremendous track record for both stability and strength (it's a conventional hybrid.) Just an idea since you love the Point 4.
marshall_white_dmd
Official Townie
Member # 7916

I just spoke with Maria at J Morita and she will give a free sample to any dentist that calls her and mention my name. Call Maria at: 1-800-752-9729
mgoodman
Official Townie
Member # 8250