Danville's StarFlowTM (Light Cure) and StarFillTM 2B (Dual Cure): For Light Cured Posterior Composite or "Directed Shrinkage" Posterior Composites

The following "bite form" technique is advocated by Raymond L. Bertolotti, D.D.S.

Recommended bonding agent: Clearfill Liner Bond 2V. The technique will also work with most other modern bonding agents such as All Bond 2, Optibond FL, Clearfill Photo Bond.

1. Cut conservative prep, using Caries FinderTM as a guide.

2. Place trimmed Palodent matrix or short Garrison (GDS) matrix and wedge. Check for centric occlusion and adjust matrix height if necessary. Add bitine ring. (If using a rubber dam, be sure matrix does not extend above the marginal ridge.)

3. Apply LB2V Prime to dry or damp enamel and dentin for 30 seconds (minimum time, longer OK, agitation improves it).

4. Dry only (no wash).

Option A. Light cure technique using StarFlowTM:

5A. Apply LB2V Bond (bottle A only), air thin (to avoid radiolucency), light cure.

6A. Apply light cure StarFlowTM flowable composite with needle tip to the cervical margin and all dentin, and on the matrix up to near the contact. Light cure.

Or Option B. Directed shrinkage technique using StarFillTM 2B:

5B. Apply LB2V Bond (bottle A mixed with catalyst bottle B), air thin (to avoid radiolucency), light cure.

6B. Mix dual cure (StarFillTM 2B) flowable composite and load into a Centrix needle tip. Apply to cervical margin and all dentin, and on the matrix up to near the contact. Let it self-cure, catalyzed by the bonding agent, to "direct" the initial shrinkage toward the tooth. The self-cure will take around 2 minutes after placement. (StarFillTM 2B may be stabilized by a very brief light cure, approximately 1 sec., to avoid slumping.)

7. Place light cure composite (such as Heliomolar, Charisma, Herculite, etc.) slightly overfilling, taking care to insure all margins are covered. (One increment will suffice after the first increment of cured StarflowTM, except in very deep preps.)

8. Apply Liquid LensTM to the occlusal surface.

9. Remove bitine ring (and rubber dam if one is used).

10. Have patient bite into CO, then open.

11. Light cure from occlusal. (Sometimes a "trans enamel" buccal cure while in CO is prudent, especially when the composite is placed next to thin enamel.)

12. Finish and polish. Very useful diamonds to define grooves are "Top Spin" diamonds (Pollard Dental) that resemble an acorn amalgam burnisher.