Vertise™ Flow Self-Adhering Flowable Composite

Self-Adhering Flowable Composite

Vertise Flow, the first self-adhering dental composite powered by OptiBond™. It greatly simplifies your direct restorative procedures by incorporating a bonding agent into a flowable. With this flowable dental composite there is no need to bond separately, reducing steps and saving time. Vertise Flow shares the same characteristic inherent in self-etch materials and reduces the chance of post-op sensitivity. Our leadership in resin restorative dentistry comes after decades of innovation in dental composites and expertise in adhesives - both of which come together in Vertise Flow.

Should I still etch with phosphoric acid when using Vertise Flow?

You do not need to etch when using Vertise Flow unless working with uncut enamel (as in a sealant application). Vertise Flow offers high bond strengths to both dentin and enamel without the need for a separate adhesive. For those who want to etch regardless, you should only etch on enamel, which further improves marginal integrity. Etching on dentin, however, opens dentin tubules that, unless sealed properly, can lead to post-op sensitivity. Vertise Flow does not open dentin tubules, minimizing the chance of post-op sensitivity.

Why is it necessary to etch the tooth prior to placement of Vertise Flow as a sealant?

Vertise Flow needs a clean surface for optimal adhesion. Uncut enamel is more prone to contamination than cut enamel. Etching uncut enamel helps prepare a clean surface to which Vertise Flow can securely bond. An alternative to etching is air abrasion. If you prefer to etch rather than air-abrade, remember to also use non-fluoridated pumice to clean the tooth prior to etching.

Should I use a bonding agent with Vertise Flow?

You do not need to apply a bonding agent when using Vertise Flow. Vertise Flow is a self-adhering material that has a bonding agent already incorporated. Vertise Flow offers high bond strengths to both dentin and enamel without the need for a separate bonding application step. Using a bonding agent with Vertise Flow will enhance the bond strengths to both dentin and enamel.

Why does Vertise Flow need refrigeration?

Like self-etch materials currently available on the market - such as OptiBond All-In-One and Xeno IV - Vertise Flow self-adhering composite contains acidic adhesive monomers to effectively bond to the tooth. Just as self-etch materials need a consistently cool environment to keep stable and perform optimally, Vertise Flow is no exception. Prolonged exposure to heat will compromise the bond strengths of Vertise Flow.

How long should I brush Vertise Flow onto the prep?

The process of coating a thin layer of the material onto the tooth prep will take approximately 15-20 seconds; the material should be applied with moderate pressure to ensure adequate contact to the tooth.

If I use the Demi with Vertise Flow, can I just cure for 5 seconds?

No. The 5-second feature applies to curing bonding agents and composites separately. As Vertise Flow is a hybrid product combining both adhesive and composite into one, a longer curing time of 20 seconds is necessary. For A3.5 and Universal Opaque, cure for 40 seconds.

Why can't I use Vertise Flow on Class III or V restorations?

Kerr is conducting long-term clinical studies on these indications. At this time, Kerr has not indicated these two classes for use with Vertise Flow until in-vivo data becomes available.

What are the shades available for Vertise Flow?

XL, A1, A2, A3, A3.5, B1, B2, Universal Opaque, and Translucent

Do I need to use a bonding agent between the initial layer of Vertise Flow and subsequent layers of universal composite?

No. The resin in Vertise Flow and universal composites are similar and bond well to each other. Therefore, no bonding agent is required.

Do I need to brush every increment of Vertise Flow?

No. You only need to brush the first layer of Vertise Flow. Subsequent layers can be added without brushing.

How acidic is Vertise Flow?

Vertise Flow approaches neutral acidity once cured. Its pH level reaches 6.5-7 upon polymerization. Before light-curing, the pH level is 1.9 to effectively bond to the tooth.

What is the shelf life of Vertise Flow?

Shelf life is 18 months with refrigeration. Kerr cannot guarantee the full shelf life if a product is not properly stored, i.e. in refrigeration.

What are the advantages of Vertise Flow over glass ionomers?

Vertise Flow is a more esthetic material than glass ionomers. Its translucency allows for better replication of natural dentition. Vertise Flow also offers superior mechanical properties with higher flexural strength, diametral tensile strength, and compressive strength, yet lower wear - all of which enable longer-lasting restorations.

If I use Vertise Flow as a sealant, should I still etch prior to placing the material?

To use Vertise Flow as a sealant, the clinician must do one of the following:

Air-abrade the tooth
Clean the tooth with non-fluoridated pumice, then etch with phosphoric acid

Would Vertise Flow be strong enough for touch-ups on a temporary restoration?

Yes. Vertise Flow offers physical strength comparable to a traditional flowable composite, which typically can be used for this purpose. (With the bonding agent incorporated, Vertise Flow can be used for this purpose without the need to bond separately.)

What is the bond strength on a porcelain touch-up? What is the appropriate protocol?

When bonding Vertise Flow to porcelain, no hydrofluoric acid etch or silane primer is necessary. The bond strength of Vertise Flow to non-HF-etched/non-silanated porcelain is very good (approximately 34 MPa). The protocol is as follo

Sandblast porcelain bonding surface (along with metal/tooth surface, if involved)
Apply the first layer of Vertise Flow with moderate pressure for 15-20 seconds, light-cure for 20 seconds. For A3.5 and Universal Opaque, cure for 40 seconds.
If necessary, build the restoration incrementally with Vertise Flow in 2mm or less thickness, light-cure for 20 seconds. For A3.5 and Universal Opaque, cure for 40 seconds.

How is Vertise Flow different from Maxcem Elite?

Vertise Flow's primary indications are for direct restorations, whereas Maxcem Elite's primary indications are for indirect restorations. Vertise Flow offers the characteristics and aesthetic capability of a flowable composite and the adhesion of a bonding agent combined.

Can Vertise Flow be used as a core buildup material?

Vertise Flow can be used underneath a core material (light-cure, dual-cure, or self-cure) in place of a bonding agent. Here are the dentin bond strengths of Vertise Flow when the core material is self-cured:
    Core Material                   Dentin SBS
       FluoroCore 2                     19.9 (2.1) MPa
           LuxaCore                          19.3 (1.5) MPa
           CoreRestore 2                   19.5 (3.4) MPa

Additionally, Vertise Flow can be used as a core buildup material in minor, non-stress bearing areas (<2 mm deep).

Can Vertise Flow be used over a GI or RMGI. What is the protocol?

Vertise Flow can be used over a GI or RMGI. The appropriate protocol is as follows: After placement of the RMGI, brush the first layer of Vertise Flow with moderate pressure for 15-20 seconds. Light cure for 20 seconds. For A3.5 and Universal Opaque, cure for 40 seconds. Then build the restoration incrementally with Vertise Flow or other restorative material, light cure, and finish.

Can Vertise Flow be used as the final layer of a restoration (i.e., build up the restoration, then apply Vertise Flow to seal small voids)?

Yes, Vertise Flow can be used to seal small voids.

Can Vertise Flow be used to block the undercuts of a prepped tooth before an impression is taken (digital scan for CEREC restorations or an impression material for traditional or non-CEREC restorations)?

Yes, Vertise flow can be used to block out the undercuts of a prepped tooth before an impression is taken. For digital scan (CEREC restorations), make sure to thoroughly clean the contrast-enhancing powder off the prep and Vertise Flow before cementation. After rinsing with water, use alcohol to wipe off any residual contrast-enhancing powder off the prep and Vertise Flow.

Can Vertise Flow be used to cement direct veneers or temporary veneers?

No. Vertise Flow's film thickness is not suitable for veneer cementation. Kerr recommends NX3 Nexus Third Generation cement, which is ideal for veneer cementation.

Can Vertise Flow be used as a pulpal floor liner?

Vertise Flow can be used as a pulpal floor liner on a non-vital tooth. Otherwise, when there is pulpal exposure on the deep cavity floor of a vital tooth, cover the exposed area with a calcium hydroxide liner/base material first, prior to adhesive application.

Vertise™ Flow

Self-Adhering Flowable Composite

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