So far Dr. John Carson and I have presented a comparison of Venus Diamond and Sonicfill 2 as well as a comparison of Venus Diamond and Estelite Omega. Now we're left with a comparison between Sonicfill 2 and Estelite Omega.
I will share with you that I use both of these products in my office, but for very different applications. While Sonicfill 2 is a great bulk-fill composite for posterior restorations when indicated, I wouldn't use it in the anterior. While Estelite Omega has fantastic esthetics and handling for anterior composites, I wouldn't use it in the posterior for a number of reasons. So we aren't comparing apples to apples here. Perhaps elucidating the differences rather than holding one to the other's standards will help you determine how each could best serve you in your practice.
You can read about Sonicfill in the previous article comparing it to Venus Diamond, but I primarily use it for Class I and II composites in the posterior. Estelite Omega, on the other hand, is a fantastic esthetic composite for Class III, IV and V composites as well as direct resin veneers.
What are the differences in these two materials?
Estelite Omega is a polychromatic supra-nanofilled composite, whereas Sonicfill 2 is a nanohybrid activated by sonic energy.
Compressive strength: The compressive strength is important when placing posterior composites in high-function areas that must be able to withstand heavy occlusal forces. Though no information on the compressive strength was directly listed on Kerr's website, studies have shown it to be between 254 MPa (Sonicfill 1) and 316.596 ± 22.23 MPa. The compressive strength for Estelite Omega was listed at approximately 400MPa by Tokuyama. Sonicfill is better able to handle the compressive stresses in the posterior.
Adaptation and handling: These are two of my favorite materials to work with in practice; both are extremely user friendly and fun to place. The adaptation of Sonicfill is exceptional and feels more like a flowable composite at the very early stages of placement. It doesn't stick to my instruments, and it is very carvable in the later stages of placement, allowing for minimal finishing. Because it is a highly translucent material, it can be cured reliably up to 5 mm deep, so only one layer was placed.
Estelite Omega is extremely user-friendly to place and adapt. As Dr. Carson pointed out in the previous article, it feels almost creamy, like it melts into the tooth. Estelite also tends to avoid sticking to my instruments.
Translucency: Sonicfill's translucency is high, which can be a disadvantage when the remaining tooth structure is discolored. This can necessitate stains and opaquers to get a more esthetic result. Estelite Omega has a system that allows more or less translucency depending on how much tooth structure you are replacing, the desired translucency, and the translucency of the surrounding teeth. When using a matrix to place it in the anterior, the milky-white and trans composite shades in Estelite Omega can increase the incisal edge translucency. The dentin shades can control how opaque the restoration is if you want to decrease your translucency. There is much more control with a layering composite like Estelite Omega than a bulk fill like Sonicfill.
Flowability: Sonicfill and Estelite Omega are moderately flowable; they feel creamy on placement and are flowable enough to adapt well, but not so flowable that you can't shape your restorations. The flowability really is a huge benefit for both of these materials.
Shrinkage: Sonicfill's shrinkage is 1.88 percent, while Estelite Omega's is 1.3 percent.
Polishability: On initial polish, Sonicfill 2 has a glossy, smooth appearance. On post-op, the glossy finish is not quite as impressive as on the day of placement. Estelle Omega is extremely polishable, and looks equally as good both at placement and on recall.
Overall ease of use: Sonicfill 2 is fairly easy to use once you determine the use of the handpiece speed for placement. Estelite Omega can yield phenomenal esthetic results in the anterior, but I would argue it takes a hands-on workshop to really garner the benefits of the material. I don't know how I use to practice without Estelite Omega in my armamentarium (or an anterior layering composite for that matter), but I don't know that I would have been able to implement the system successfully without significant training first.
While this series focused on composite comparisons, I don't think that I can give you a true comparison on Sonicfill 2 vs. Estelite Omega. They aren't meant for the same applications, and you won't reap the benefits of their best properties on the same procedure. In my practice, I wouldn't want to give up either. Sonicfill is a workhorse for posterior composites, while Estelite Omega is the material that brings me the most fun in my workday. Sonicfill 2 gives me asymptomatic, functional, esthetic posterior composite restorations while Estelite Omega gives me predictable, beautiful anterior restorations. If I were to choose one over the other, it would be choosing whether I like esthetic anterior composite placement more (which I do!) or posterior composites. It would be comparing procedures, not materials.
Sonicfill 2 gives you a technology that allows easy, bulk placement without compromising the function or esthetics. Estelite Omega takes your anterior composites to the next level. Both are phenomenal, each in their own right.
Second Opinion by Dr. John R. Carson
As always Dr. Lavigne has given us some great insight! Just like our first article together, I agree with much of what she said here in this article. However, there are few points on which our opinions differ.
For sure I agree both Sonicfill and Estelite Omega are great products. Additionally, I will also agree they are very different from each other and marketed toward very different applications. Because of this, they have way more differences than similarities. Therefore, while you could say comparing them is not fair, I think it is still worthwhile to compare them. Of course Sonicfill 2 is much faster, and you would not want to use Sonicfill in the anterior when esthetics are in play. This is where Estelite Omega shines.
However, I will respectfully disagree with Dr. Lavigne in that, while I would often prefer to use Sonicfill over Estelite Omega in the posterior, you could use Estelite Omega in the posterior if you wanted. In fact, Tokuyama classifies Estelite Omega as a universal composite and includes posterior restorations, including Class 1 and 2 restorations, in their list of indicated restorations. I get we have other choices we might prefer to use in posterior in many cases, but the fact of the matter is you can use Estelite Omega in the posterior if you want.
So in closing, and just to be clear, in most cases I would personally prefer to use Sonicfill on my posterior cases, but I could use Estelite Omega in posterior cases understanding it will require much more work and, in most cases, will not be worth the extra effort and time. On the other hand, if esthetics are in play, Sonicfill is not an option in the anterior.
Thus, if I had to pick just one, it would be Estelite Omega as I could use it in the posterior. The bottom line for me is being able to have – and indeed, I do have – both in my practice.
Courtney Lavigne, D.M.D., Spear Visiting Faculty and Contributing Author - www.courtneylavigne.com
John R. Carson, D.D.S., P.C., Spear Visiting Faculty and Contributing Author - www.johncarsondds.com