Fillings & Restorations with VOCO Admira Fusion

 

At Biological Dentistry of Southern California, the materials we place in the mouth matter to us. When a tooth can be predictably restored rather than crowned or removed, our goal is to preserve as much healthy natural tooth structure as reasonably possible while using a durable, highly aesthetic restorative material. For this reason, our preferred restorative system is VOCO Admira Fusion, a Nano-ORMOCER® restorative material designed around an organically modified ceramic matrix rather than the conventional resin chemistry used in many traditional dental composites.

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What Makes Admira Fusion Different?

 

Admira Fusion uses what VOCO calls Pure Silicate Technology. According to the manufacturer, both the restorative matrix and its fillers are based on silicon-oxide chemistry, creating what VOCO describes as an “all ceramic-based” direct restorative material. Its ORMOCER® technology, short for Organically Modified Ceramics, uses large, pre-condensed, highly cross-linked molecules to form the restorative matrix. This allows us to obtain many of the handling and aesthetic advantages associated with modern direct composite dentistry while using a distinctly different material chemistry.

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No Bis-GMA, BPA, TEGDMA, UDMA or HEMA

 

One of the primary reasons we selected Admira Fusion is what it doesn’t contain. According to VOCO, Admira Fusion contains no conventional resin monomers such as Bis-GMA, TEGDMA, UDMA or HEMA, and the manufacturer identifies the material as not containing BPA as part of its Bis-GMA chemistry. For patients seeking to minimize exposure to conventional methacrylate-based restorative materials, this makes Admira Fusion an option that aligns particularly well with our material-conscious approach to dentistry. We do not claim that any dental material is universally “non-toxic” or appropriate for every individual; material selection is based on what we feel will provide the outcome of reducing the overall toxic load overall based on current available materials and current research.

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Why We Do Not Routinely Perform Dental Material Sensitivity Testing

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Because of our material-conscious philosophy, patients sometimes ask whether they need sensitivity or compatibility testing before receiving a filling. At Biological Dentistry of Southern California, we do not perform dental material sensitivity testing before placing the Voco Admira Fusion line, or any of our materials. This is due to our extensive research and commitment to stay as current as possible to choose one material we feel places the lowest possible toxic load on patients. We welcome patients to ask us our views on each product we use, and why we use it as opposed to other "clinically acceptable" options.

 

For Voco Admira Fusion specifically, we use it do to its Nano-ORMOCER® ceramic-based matrix and the absence of conventional monomers such as Bis-GMA, TEGDMA, UDMA and HEMA. We have selected Admira Fusion as our preferred direct restorative material for patients seeking to minimize exposure to conventional resin components. We believe its material profile represents an excellent option for this purpose and therefore do not routinely use sensitivity testing to choose among multiple filling materials.

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Low Polymerization Shrinkage

 

Every light-cured direct restorative material undergoes some dimensional change during polymerization. VOCO reports 1.25% volumetric polymerization shrinkage for Admira Fusion, along with low polymerization shrinkage stress. This is important because polymerization stress can affect the interface between a restoration and the surrounding tooth. Our goal is to combine careful adhesive technique, appropriate isolation and incremental restorative principles with a material engineered for low shrinkage and dimensional stability. Low shrinkage does not guarantee the absence of postoperative sensitivity or restoration failure, but it is one of the material characteristics we consider when selecting a restorative system.

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Strength Without Sacrificing Appearance

 

Admira Fusion isn’t selected solely because of its chemistry. VOCO reports an 84% filler content by weight, along with high surface hardness, polishability, radiopacity and wear resistance. The system is available in numerous tooth-colored shades and different levels of opacity and translucency, allowing us to reproduce natural tooth anatomy rather than simply “fill a hole.” The result can be a restoration designed to blend naturally with the surrounding enamel while providing the mechanical properties required for appropriately selected anterior and posterior restorations.

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An Alternative to an Inlay or Onlay

 

Our philosophy is to preserve healthy tooth structure whenever doing so is clinically appropriate. Traditionally, a moderately damaged posterior tooth might be restored with a laboratory or CAD/CAM inlay or onlay. We do not routinely prescribe an inlay or onlay simply because a restoration is larger than a small filling. When adequate sound tooth structure remains and the tooth can predictably support a bonded direct restoration, we may instead restore it directly with Admira Fusion. This can avoid additional preparation required solely to accommodate an indirect restoration and can often be completed without a separate laboratory restoration.

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That does not mean a direct Admira Fusion restoration is appropriate for every tooth that would otherwise receive an inlay or onlay. Remaining tooth structure, cusp thickness, cracks, occlusal forces, isolation, caries extent, parafunctional habits and the overall prognosis of the tooth all influence the restorative decision. When the tooth requires cuspal coverage or an indirect restoration offers a more predictable prognosis, we will discuss those options with the patient. Our objective is not to eliminate a particular procedure; it is to use the least invasive predictable restoration appropriate for that individual tooth.

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Flowable Restorative & Indirect Restorations

 

The Admira Fusion family also includes Admira Fusion Flow, a flowable Nano-ORMOCER® material. VOCO lists applications including small restorations, cavity lining, repair procedures and luting translucent prosthetic pieces. Where indicated by the manufacturer’s instructions and the particular restorative situation, materials within the system can therefore be incorporated into our adhesive restorative and indirect-restoration protocols. The specific bonding or luting material used for a crown, bridge or other prosthesis is selected according to the restorative material, preparation, retention and manufacturer’s instructions rather than applying one cementation protocol to every restoration.

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Why We Chose It

 

There are many excellent restorative materials available in modern dentistry, and Admira Fusion is not the only material capable of producing a strong, beautiful restoration. We chose it because its combination of Nano-ORMOCER® chemistry, absence of several conventional monomers, low reported polymerization shrinkage, high filler content, polishability and broad restorative indications fits our philosophy of material-conscious, conservative dentistry. Whenever we restore a tooth, our goal is simple: remove what needs to be removed, preserve as much healthy natural tooth as reasonably possible, and rebuild the tooth with a material selected for that patient’s specific clinical situation.

Admira Fusion and Nano-ORMOCER® are products/technologies of VOCO. Material properties and numerical values described above are based on manufacturer-provided technical information. No restorative material is appropriate for every patient or clinical situation, and no dental restoration can be guaranteed to eliminate sensitivity, fracture, recurrent decay, wear or the need for future treatment. Treatment recommendations are based on examination, diagnosis, remaining tooth structure, functional demands and individual patient factors.