As dentists, we are forever in the pursuit of clinical excellence and long-term success. We continually seek new trends and different innovations that not only simplify procedures but that also elevate aesthetic outcomes.
One of the most exciting areas of dentistry in recent years has been the evolution and development of new techniques, as well as the improvement of restorative materials we use daily. As a private practice general dentist, I am fortunate enough to have the ability to provide comprehensive care for my patients in all aspects of their treatment. In doing so, I have a passion for restorative procedures, which, in my opinion, is the basis for all aspects of modern dentistry.
Dr. John Zalesky.
One recent trend has been the development of universal single-shade or chameleon composites. It appears every company has an entry into this field with its own variation of this product. In their pursuit of continued excellence, Ultradent enters the equation with Transcend universal composite. It is a groundbreaking material, which is revolutionizing direct and indirect restorations in both the anterior and posterior regions. Designed with Ultradent's Resin Particle Match technology, Transcend composite redefines the standards of shade matching and durability in dental composites.
For the past 11 years, I have worked with tried-and-true, well-established traditional composites from several different manufacturers. This provided me with a wide range of material options depending on the clinical situation at hand. Each product used a number of shade options, allowing for different handling and polishability, resulting in desired predictability and outcomes.
When the so-called one-shade or chameleon composite systems were launched initially, it was met with some skepticism. I had used some other products and found that the results were not optimal in certain situations, as every patient and case presented in your chair is uniquely different.
With high expectations and the drive for perfection, I found the launch of the Transcend composite system by Ultradent to be a game changer. It is vital to be able to place any material quickly and efficiently without compromise. For me, it is extremely important knowing that Transcend will provide tremendous results while being exceptionally durable and predictable while maintaining high aesthetics.
Ultradent’s Transcend composite is a substantial improvement for universal shade composites. As previously mentioned, one of the key features of Transcend composite is its Resin Particle Match technology. This involves closely matching the refractive indices of the resin and the filler particles in the composite to create high levels of translucency. This allows for ideal pigmentation and opacification, which in turn enables Transcend to match the color of surrounding dentition, no matter the tooth shade. A true chameleon composite.
Resin Particle Match technology allows clinicians to complete most restorations with just one shade of composite without a blocker or a more opaque shade to hide darker underlying colors. Many dentists are using A2 as their universal shade, which we all know is the easy way out -- it simplifies supply ordering, and the patient will not know any better.
For those clinicians, they can use Transcend UB (universal body shade), which will be like using A2 but significantly better. This composite will make you and your work look better by making it difficult to distinguish it from the surrounding natural tooth color.
Some of the other “one-shade systems” advertise “one shade for all colors,” which is not exactly true. Most require the use of a blocker, which makes it two shades -- the blocker plus one shade. Transcend, on the other hand, is one shade, cured. Another advantage of Transcend is a lower, simplified composite inventory.
Yes, some people have unique colors of teeth, say in the C and D shades. In the past, I rarely had these shades on hand, used them once or twice, and by the next time I need that shade, it’s been a year and a half since it was last used, and it’s gone bad and expired.
Thus, one shade for everything simplifies your day, streamlines supply ordering, reduces inventory, decreases chair time, and increases revenue. If you are inclined to use a layering technique, to be fancy, the Transcend kit does have four dentin (B1, A1, A2, and A3) and two enamel shades (enamel neutral and enamel white), but the workhorse is the universal body.
If you have a patient in need of a class IV restoration and their tooth has a bit more translucence or characterization, I recommend layering Transcend as follows: Start with a thin lingual shell of either enamel shade you feel is best for the patient. I would then layer a thin layer of dentin shade, up to just below the long enamel bevel, and pick the dentin shade based on the true shade of the tooth using a shade guide.
Next, add a thin layer of Universal Body and finish with another thin layer of whichever enamel shade you used for your lingual shell. This will result in a composite restoration that blends well and matches the surrounding shade of the area with a great chameleon effect.
Figure 1: Patient presented with an Ellis class II fracture of their central incisor #8.Images courtesy of Dr. John Zalesky.
Figure 2 (bottom): The restored central incisor #8 with Ultradent Transcend composite.
Handling is a very important factor to consider when selecting a composite. I found Transcend composite’s design features allow me to achieve natural results with a highly durable and glossy finish, which is maintained over time.
The viscosity of Transcend composite is finely malleable and doesn’t crack during manipulation or stick to composite instruments. The result is a composite that moves and sculpts the way you want it to and stays in place without drooping or slumping. It flows, or adapts, really well to irregular preparations.
Transcend composite is created using a blend of resin monomers and filler particle sizes for increased sculptability and durability. Teeth have peaks and valleys, each with their own intricacies.
As a clinician with fine attention to detail, I try to mold and shape the composite to mimic some of that natural anatomy and structure, because I want a finished tooth to still look like a tooth and as if there is no filling there. I do not want a poorly contoured blob that looks like I plugged it with my finger and sent the patient out the door.
Now for some of the nitty-gritty details. Great dental composites are expected to present mechanical properties comparable to the tooth and should not be too hard or abrasive as to wear the opposing dentition. Transcend composite measures at or near those known average values of natural dentition and enamel.
A high conversion degree of monomers into polymers is essential to obtain longevity of restorations. For this to be achieved, the use of a quality curing light, like Ultradent’s Valo X in conjunction with Transcend composite (2.58 mm) provides an ideal depth of cure. It has a high compressive strength that helps provide long-lasting restorations that can withstand the forces of mastication.
Furthermore, Transcend composite is incredibly wear-resistant to forces of mastication, brushing, and parafunctional habits such as bruxing and clenching, all of which could cause increased wear, thus changing the anatomy of the restoration and ultimately impacting the patient.
Lastly, one of the coolest features I have found is how Transcend composite responds to whitening treatment. Usually, when discussing whitening with patients, we make sure to communicate the fact that whitening is to be performed first prior to any anterior restorative work.
However, with Transcend composite, this is no longer the case. If you perform any restorative work with Transcend, there is no need to complete new composite restorations after the whitening treatment is completed, as the shade of the composite can adapt itself to continue to match the optical properties of the surrounding dentition as teeth get whitened.
In summary, Transcend composite is a material solution that every dentist could use without any training or challenges. With its Resin Particle Match technology, simplified shade system, ideal handling properties, flexibility, strength, and long-lasting gloss retention, Transcend composite is quickly becoming a go-to choice for dentists looking to simplify their restorative work while providing the best possible results for their patients. It also offers clinicians the freedom of ease of use and adaptable treatment processes.
In most cases, you only have to choose one color (Universal Body), but in more complex cases, use a layering technique with additional options of both enamel and dentin colors in combination. Transcend composite has allowed me to perform beautiful, predictable, long-lasting, highly aesthetic restorations for improved comprehensive outcomes and increased patient satisfaction.
The evaluation
As a practicing dentist dedicated to incorporating innovative technology and materials to enhance patient care and procedural efficiency, the Catapult Evaluators participated in an evaluation of Ultradent’s Transcend composite. This product was reviewed by 17 experienced dental professionals who assessed its handling, aesthetics, shade matching, and overall performance in daily clinical use. The feedback revealed a composite with outstanding aesthetic capabilities but some mixed reactions regarding its handling.
When it comes to aesthetics, Transcend stood out. Evaluators noted its ability to blend seamlessly into natural dentition, making it a strong candidate for anterior restorations. One dentist remarked, “The polishability is among the best I’ve seen, and it blends beautifully with surrounding dentition.”
However, handling received mixed feedback. A combined 70% of evaluators reported being satisfied with the material’s overall performance, while 18% found it challenging to manipulate. Some dentists felt that Transcend’s firmness allowed for precise sculpting, while others struggled with its lack of flow. Those who warmed their composites encountered additional stickiness.
Transcend’s aesthetic capabilities received near-unanimous praise. A combined 88% of evaluators were pleased with the final polish and shade-matching abilities, making it an excellent choice for highly visible restorations. Its aesthetic performance was the driving factor for the Catapult Vote of Confidence™.
Transcend Universal Composite is an excellent choice for clinicians seeking outstanding aesthetics and polishability in their restorations. Its natural translucency and seamless blending set it apart. However, handling remains an area where opinions differ. While some clinicians found its firmness ideal for sculpting, others struggled with its lack of flow. If refinements are made to improve handling, Transcend could become a more versatile go-to material for a variety of restorative needs.
Editor's Note: Learn more from Dr. Zalesky about the product below.
Dr. John Zalesky received his Master of Biomedical Science degree from the New Jersey School of Biomedical Sciences. He was awarded his Doctor of Dental Medicine degree from Nova Southeastern University College of Dental Medicine and completed a general practice residency at Denver Health Medical Center. He is a fellow of the Academy of General Dentistry and a fellow of the International Congress of Oral Implantologists. Dr. Zalesky has been published in several respected dental journals. He is the executive director and treasurer for Region 14 of the Academy of General Dentistry. He is the founder and owner of Aurora Hills Dental in Aurora, CO.
The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.
