CATEGORY 84 AUSTRALASIAN DENTIST CLINICAL Introduction With ongoing advances in filler technology, polymerisation kinetics, and optical engineering, resin-based composites now offer improved mechanical performance, lower polymerisation shrinkage stress, and more predictable esthetic integration with natural dentition. A key milestone has been bulk-fill composite technology, developed to simplify cavity placement by allowing placement in a single increment at depths of up to 4 mm. Reliable curing at this depth requires either increased translucency to enhance light transmission or more reactive photoinitiator systems that enable deep polymerisation without making the material overly translucent. While increased translucency supports bulk placement, it can impair esthetics, limiting the use of many first-generation bulk-fill materials in highly demanding cases. Tetric plus (Ivoclar, Schaan, Liechtenstein) was developed to meet this challenge. This simplified universal composite for anterior and posterior use combines efficiency and esthetics through two innovations. Ivocerin, a patented germanium-based photoinitiator, is highly reactive across 370-460 nm and enables a reliable 4 mm depth of cure without excessive translucency. Aessencio technology then shifts the material optically during curing: a progressive refractiveindex mismatch between filler and monomer phases converts the composite from a highly translucent pre-cure state (supporting deep light penetration) to a more opaque, enamel-like post-cure appearance. This supports bulk placement while helping mask discoloured dentin substrates. A further practical advantage is the simplified shade system: four shades designed to cover the full range of VITA classical and bleach shades. The four plus shades were derived from spectrometer measurements of 368 anterior teeth from ~120 adults and plotted in the CIEL*a*b colour space. Combined with practitioner input, the analysis identified A2, A3, and A3.5 as the most relevant everyday shades, with Bleach plus added to meet demand for a brighter appearance. Together, these shades cover 16 VITA classical shades and several bleach shades, and are harmonised across Tetric plus Fill and Tetric plus Flow to support consistent results across viscosities. The “colour cloud” concept is best understood when visualized in the CIEL*a*b colour space (Fig. 1). In this system, L describes brightness from black (low=0) to white (high=100), while a* and b* describe chromaticity (hue and chroma) with positive and negative values from red to green (a+ to a−) and yellow to blue (b+ to b−), respectively. Each measured tooth shade is represented as an individual point; the area covered by these points forms a “cloud” that depicts the natural colour space of anterior teeth. The number of composite shades was not “reduced” at random. Following extensive market research and consultation with dentists, the shades A2, A3 and A3.5 were established as the most commonly used for standard practice purposes. The natural-tooth shade cloud was therefore divided into three separate clusters, with A2, A3 and A3.5 representing each cluster and the centre values serving as starting points for shade design (Fig. 1). Although the measured natural shades did not extend into the bleach range, an additional cluster was calculated and developed to meet modern demand for brighter restorations, resulting in the four cluster-based shades A2 plus, A3 plus, A3.5 plus and Bleach plus. Instead of a large shade library, accurate colour matching is achieved through a pronounced chameleon effect, allowing the composite to blend with surrounding tooth structure after polymerisation. Clinically, this simplifies and speeds shade selection, reduces inventory, and supports predictable esthetic outcomes across a wide range of cases. This case report presents a step-by-step direct composite restoration of teeth #36 and #37, demonstrating how Tetric plus can deliver functional, durable, and esthetically integrated outcomes within a streamlined workflow. Efficiency vs. Aesthetics – Can They Be Combined in a Single Composite? By Dr. Maja Petrevska Dr. Maja Petrevska Fig. 1: Shade clusters (“colour clouds”) underlying the four-shade concept of Tetric plus. Spectrometer measurements of 368 anterior teeth (#21, #22 and #23) from approximately 120 male and female adult patients were mapped in the CIEL*a*b colour space and grouped into four clusters represented by A2 plus, A3 plus, and A3.5 plus and Bleach plus. (Source: Scientific Report Tetric plus, Vol.01/ 2025, p. 7–8, Ivoclar)
RkJQdWJsaXNoZXIy MTc3NDk3Mw==