Clinician's Choice® Evanesce® Injectable Restorative

A: The injection molding technique is a restorative approach where a highly filled, flowable composite such as Evanesce® Injectable is injected into a transparent matrix or stent that replicates the final tooth shape. This matrix is typically fabricated from a diagnostic wax-up. The composite resin is injected into the matrix and then light-cured through it.

This technique can be used for anterior restorations, such as veneers or full facial build-ups for cosmetic dental procedures, tooth wear, or diastema closures. And for posterior restorations, including small Class I or II restorations, or minimally invasive cusp build-ups where precise control and adaptation are required.

A: Ideal cases include:

• Worn dentition from erosion, attrition, or parafunction
• Diastema closures
• Incisal edge repositioning or correction, post Invisalign® treatment
• Peg laterals or microdontia
• Esthetic smile makeovers (non-prep veneer alternative)
• Class V cervical lesions
• Small Class I and II posterior restorations
• Lost vertical dimension

A: Injection molding offers several advantages:

• Cost: Lower cost over porcelain veneers.
• Minimally invasive: Often requires little to no tooth preparation.
• Reversible and repairable: With little to no tooth preparation, the injection molding technique can be reversed to the previous tooth condition if required. It is also reparable by adding more composite in the event of a fracture. With porcelain, repairs are more difficult to perform.
• Highly precise: The stent ensures exact replication of the wax-up design.
• Efficient: Reduces chair time and eliminates incremental layering.
• Predictable esthetics: Achieves excellent contour and polish with minimal finishing.
• Ideal for wear cases: Useful in managing erosion or abrasion cases with conservative composite additions.

A: The advantages of using Evanesce Injectable for the injection molding technique include:

• High fracture toughness and strength
• Excellent polishability and long-term esthetics
• Matches all Evanesce composite shades, excellent for seamless blending and layering
• Predictable adaptation and handling
• Low shrinkage and high wear resistance
• Compatible with transparent matrices for efficient curing

Lawson, N. University of Alabama at Birmingham, School of Dentistry. Fracture Toughness of Injectable Composites. April 2024.

A: Injection-molded composite restorations can be considered long-term direct restorations, especially when using a high-performance injectable composite like Evanesce Injectable, which offers excellent fracture toughness and wear resistance. While some clinicians may use this technique as a transitional phase before final restorations, many use it as a definitive treatment, particularly in cases where preservation of tooth structure or cost considerations are priorities. The injection molding technique is versatile for both permanent or transitional restorations.

A: The wax-up can be fabricated using:

• Digital design and 3D printing (CAD/CAM-generated mockups)
• Additive wax-ups are done intraorally or indirectly using composite resin without adhesive. These wax-ups are then impressed to fabricate a clear silicone matrix or stent through which the composite is injected.
• Traditional analog techniques (wax on a stone model)

A: Evanesce Inkectable compares as follows:

• Paste: Evanesce Injectable would exhibit lower compressive strength than a traditional paste but would be similar to a paste in flexural strength.
• Flowable Composites: Compared to other flowable composites, Evanesce Injectable’s higher viscosity improves stackability, handling, and strength as a result of the resin and filler composition.
• Injectable Composites: In independent studies, it demonstrated a 35% higher fracture toughness than G-aenial™ Universal Injectable, making it ideal for both esthetic and functional restorations, including anterior veneers and small posterior restorations.

Lawson, N. University of Alabama at Birmingham, School of Dentistry. Fracture Toughness of Injectable Composites. April 2024.

A: Evanesce Injectable has a non-slumping, high-viscosity formulation that provides excellent control during injection and shaping. It remains in place once applied, even in facial or incisal positions, while still flowing well enough to adapt to all internal surfaces of the matrix.

A: Evanesce Injectable is available in VITA®-based shades that match the Evanesce family, allowing seamless blending and layering across both systems. Evanesce Injectable are available in 85% opacity Universal shades, include A1, A2, A3, B1, BL1, and a non-VITA shade Enamel White.

A: Evanesce Injectable is designed to maximize efficiency and clinical results specific to the injection molding technique. However, Evanesce Injectable can also be used for any restoration where a flowable composite is indicated.

A: Yes. A bonding agent is required and recommended. For optimal adhesion, use a total etch technique with Max Etch 35% Phosphoric Acid Etchant followed by MPa Max™ adhesive or MPa Universal™ adhesive.

A: Evanesce Injectable features an optimized nano-hybrid filler system that is designed for excellent polishability and esthetic results. Its formulation allows clinicians to achieve a smooth, high-gloss surface, supporting natural-looking restorations.