Optimal Restorative Materials are Critical to DSO Profitability and Patient Satisfaction

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According to an ADA published estimate, well over 76 million posterior composite restorations are placed every year in U.S. dental practices.1

Mastering the posterior composite restoration is crucial to not only provide excellent clinical and operational excellence, but to avoid gaps in both clinical outcomes and practice productivity.

One way to avoid these gaps is through a new generation of bulk-fill composites led by Ecosite Bulk Fill from DMG America, which has a significant impact on the clinical and financial success of dental groups and DSOs.


Ecosite Bulk Fill not only delivers dramatic time savings versus the traditional multi-layer technique using a flowable composite, it also produces more durable restorations.

Its enhanced features save money, time, and materials by not requiring an additional occlusal covering layer that is necessary with flowable bulk-fill materials to achieve marginal integrity and aesthetics.

The material’s advanced nanosubmicron technology avoids the two major drawbacks traditionally associated with bulk fill composites: compromised esthetics due to high translucence and insufficient time to pack the restoration:

  • 5mm fill, no capping layer

    Ecosite Bulk Fill optimizes productivity with a maximum depth of 5mm in a single-layer, one quick 20-second light cure, low shrinkage stress, excellent adaptability, packability and handling. It also delivers high polishability, fluoride release. It does not require a capping layer or stick to instruments.

  • It offers truly exceptional esthetics via a functional and practical shade system available in 3 shades – contrast, light, and universal. The universal shade has a chameleon effect that allows you to achieve every common Vita color with only one universal color.


Using the $216 U.S. average hourly production rate for dentists reported by Sikka Software2, each dentist could use freed-up hours to generate roughly $48,000 in additional production each year by using Ecosite Bulk Fill.

Alternatively, the average clinician could theoretically choose to work 28 fewer days per year without sacrificing production.

And when you do the math, that 110 seconds saved per tooth adds up over a year.

While the numbers will obviously vary from dentist to dentist, there can be no denying that Ecosite Bulk Fill’s impact on a practice’s productivity and profitability can be profound. And when you add the impact of lower re-treatment expenses and the strengthening of the practice’s brand, the financial advantages become even more impressive.

The time savings generated by Ecosite Bulk versus the traditional multi-layer technique are significant, as can be seen in the table below:


Two studies were conducted to test Ecosite Bulk Fill.

One study tested the compatibility of Ecosite Bulk Fill to four different generations of bonding agents on dentin. The study concluded:

  • There were zero debonding failures at the composite to adhesive interface, indicating compatibility of Ecosite Bulk Fill to these 4 generations of bonding agents
  • There was no decrease in bond strength to dentin after thermocycling for Ecosite Bond.

The other study compared the important properties of Ecosite Bulk Fill and competitive materials. The study concluded:

  • Ecosite Bulk Fill exhibited excellent polishability compared to the competitive materials tested, with a relatively fast and consistent polishing rate.
  • Ecosite Bulk Fill also achieved the greatest depth of cure determined by two test methods among the materials tested.
  • Ecosite Bulk Fill’s combination of excellent polishability and high depth of cure highlights two exemplary properties for bulk-filled composites.
  • Ecosite Bulk Fill resulted in a higher depth of cure than the other products tested in both test methods used.

Dr. David Rice provides a clinical case example on why choosing the optimal restorative materials is critical to mastering posterior composite restorations and filling gaps in clinical outcomes and practice productivity. This clinical case demonstrates how choosing the right restorative materials makes it possible to fill both the clinical outcomes gap and the practice productivity gap with posterior composites.

The shade of the restoration was a very close match to the surrounding teeth. The total procedure took less than one hour.


View an easy step-by-step video using Ecosite Bulk Fill:



As can be seen in the image below, Ecosite Bulk Fill is an exceptionally homogeneous nano-filled material, which helps account for its superior durability and reliability.

Image Source: Internal REM images, DMG 2018. *These brands are not registered trademarks of DMG

Indications for Use:

  • Restorations in the posterior region (classes I and II, including replacement of individual cusps)
  • Restorations of class V (cervical caries, root erosion, wedge-shaped defects)
  • Core build-ups
  • Restorations of deciduous teeth

Advantages of a packable material:

  • Applicable in one layer (up to max. layer thickness). Pourable materials require an additional cover layer.
  • Easy modeling of the filling or occlusal surface with great results.
  • Precision formation of contact-point with the neighboring tooth is significantly easier with a high-viscosity material.
  • In many areas, the mechanical properties of materials with high viscosity are significantly better than those with low viscosity.



1 American Dental Association (2007) 2005-06 Survey of Dental Services Rendered. American Dental Association, Survey Center. Chicago, IL

**Source: M. Vargas, E Teixeira;, S. Armstrong / University of Iowa Department of Operative Dentistry: IADR 2019 Poster – Performance of different bulk-fill dental composite materials

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