GrandioSO, VOCO's universal, light-cured, 89% filled nano-hybrid composite, celebrates its 10-year anniversary in 2022. Its success is a function of a combination of toothlike physical properties, including Modulus of Elasticity, Thermocycling Coefficient, Edge Strength and many more. When taken as a whole, these properties make GrandioSO the most toothlike composite available on the market.

Fortunately, several high-profile practitioners have been impressed enough by GrandioSO's handling, esthetics and toothlike physical properties to use it in various clinical cases, some calling it a "supercomposite." What follows are some of those cases, spanning the application spectrum from pediatric to geriatric, posterior and anterior, and even straddling the globe, with practitioners from New Zealand, Brazil, Canada and the United States.

These clinical cases will be presented in brief below, including before and after images. In all of them, the cases themselves present images and explanations detailing the restorative process. Click the links in their respective titles for the full reports.

Six-Year Followup of a Semi-direct, Large Posterior Restoration

by Dr. Mauricio Watanabe

In this clinical case, Dr. Mauricio Watanabe not only walks us through repairing a broken crown of a 62 year-old patient  on the maxillary right first molar after “biting very hard food,” he is able to provide images of the restoration during a follow-up appointment six years later. This serves to show the long-term esthetics and longevity of a GrandioSO restoration. He says: "[GrandioSO's] wear resistance is similar to well-known amalgam... which is a trait we want for the material that will be used as its substitute. Therefore, it is an excellent choice for challenging clinical situations where strength is essential for the longevity of the restoration."

Upon clinical examination, it was observed that most of the structure of the clinical crown was absent

                                                                                                                 Before                                                                     Buccal View, One Week After

                                                                                    Occlusal View, One Week After                                               Occlusal View, Six Years Later

Building Naturomimetic Complex Direct Restorations Using a Modern Supercomposite

by Dr. Clarence Tam

In a report detailing three clinical case all featuring GrandioSO, Dr. Tam says: "In contemporary clinical practice where emphasis is placed on minimally invasive dentistry, hyperfilled composites, termed "supercomposites," can serve as a cost-effective, high-performance, and time-efficient esthetic restorative solution. Featuring compressive and flexural strength properties that match and often exceed those of natural teeth, when bonded adhesively in place these materials are capable of exhibiting excellent clinical performance over time."

Case 1

Tooth No. 14 exhibited an existing mesio-occlusal (MO) restoration with recurrent caries noted radiographically along with a fractured marginal ridge leading to food impaction. Erosive pitting also was evident on the buccal cusp tips.

                                              Before                                                                                                  After

Case 2

The teeth affected, Nos. 7 through 11, exhibited chromatic, stained, and radiolucent restorations.

                                                                                                                   Before                                                                                               After

Case 3

Teeth Nos. 20 (mesial-occlusal-distal [MOD]) and 21 (distal-occlusal [DO]) were retreated 9 years ago due to marginal failure of amalgam restorations.

                                                                                                                           Before                                                                                   9-year Follow-Up

Dr. Tam's Conclusion: "Modern supercomposite materials are exciting because they are able to mimic various layers of tooth structure not only physically but also optically, in many cases performing as well as their bonded porcelain restoration counterparts. These materials offer the flexibility of repair and addition or modification via relayering if required without having to excavate the restoration in its entirety. These characteristics speak to a material used in an expanded function utilizing conservative direct techniques that embody the ethos of minimally invasive dentistry: that of responsible functional esthetics."

How to Use Composites That Stand the Test of Time for Pediatric Patients

by Dr. Carla Cohn

Dr. Cohn illustrates how GrandioSO remains esthetic and stable after two years, and again, after four years in a pediatric patient in this clinical case. She concludes the case by saying: "Time has given us a wide range of dental materials as companies continue to innovate and respond to the demands of dentists in the field as well as their patients’ needs. In terms of composites, many of these innovations revolve around making placement faster for dentists and make restorations longer lasting for patients—in both cases, the common thread is time. The fact that GrandioSO has lasted 10 years in a competitive marketplace is a testament to its being a fixture in time for practitioners and patients. Here’s to another 10 years!"

Proximal caries on first and second primary molars have been filled with GrandioSO

          2-year recall                                                           5-year recall

Hold Firm, Or Go With the Flow?

by Dr. Foroud Hakim

In two clinical cases, Dr. Hakim demonstrates the efficacy of using not only GrandioSO, but two of its three flowable counterparts: GrandioSO Flow and GrandioSO Heavy Flow. In the first case, GrandioSO is used as an esthetic capping layer. He concludes by saying: "The opportunity for precision is made available by a relatively viscous flowable composite, which also reduces some of the problems with overfill and the need for excessive rotary reduction during finishing and polishing. Colleagues who train in this technique will quickly comment on how much kinder they find this technique to be on the periodontium, the increased speed and time savings, as well as the improvement in final contour and aesthetic potential. I firmly believe that a contemporary doctor cannot practice at the highest level possible without deploying a variety of composite viscosities."

Case 1

A 64-year-old patient presented with recurrent decay involving a long-standing occlusal amalgam on tooth #30. A thin layer of an opaque shade of flowable composite (Grandioso Flow Opaque A2) was deployed to mask the amalgam-stained dentin and mitigate any unsightly shine through. Final restoration was achieved using x-tra Base bulk-fill flowable composite  in a universal shade for the base layer and GrandioSO nano-hybrid composite  in shade A1 for the capping layer.

                                                      Before                                                                                 After

Case 2

A 46-year-old patient presented with multiple noncarious cervical lesions (NCCLs) on bicuspids and first molars in all four quadrants. The lesion was restored to natural contour (Fig. 8) using GrandioSO Heavy Flow high-viscosity flowable composite.

                                                           Before                                                                           After

Application of Modern Supercomposites: A Paradigm Shift for Preservation

by Dr. Clarence Tam

In this clinical case, Dr. Tam treats a 12-year-old patient from a pediatric dentist referral to manage bilateral maxillary bicuspid hypo-mineralization with secondary caries undermining all surfaces of the teeth as an extension of Amelogenesis Imperfecta Type II (hypocalcified variant). The teeth were reported to be hypersensitive. She concludes by saying: "Modern composite resins [GrandioSO in this case] exhibit exceptional physical and optical properties, allowing them to succeed and survive in clinical situations that would previously have been contraindicated. Bonded porcelain restorations are still the gold standard with large dose, large surface area replacement restorations; however, with controlled functional load, direct restorations can often equal that of their indirect counterparts."

A 12-year old patient presented to manage bilateral maxillary bicuspid hypomineralization with secondary caries undermining all surfaces of the teeth as an extension of Amelogenesis Imperfecta Type II (hypocalcified variant). The teeth were reported to be hypersensitive.

                                Before                                                                After

10 years of clinical success with composite resin technology: Case studies

by Dr. Gary Radz

Dr. Gary Radz presents two clinical cases featuring GrandioSO, both in the posterior. Dr. Radz closes these clinical cases by saying: "...the 10-year run of GrandioSO represents a pinnacle of silicate/methacrylic restorative manufacturing demonstrated by the composite’s toothlike physical properties which, collectively, have optimized what is possible with nanohybrid composite resins, elevating expectations of what we are able to do within this category of material in terms of longevity and performance."

Case 1

Second premolar radiographically demonstrates decay, and the distal marginal ridge has been undermined and fractured

                                                                                                                                               Before                                                                                   After

Case 2

Second molar presents with an old leaking, large class II restoration that has been previously repaired and has radiographic recurrent decay

                                                                                                                        Before                                                                                          After

10 years from its release, GrandioSO remains a top composite--even dubbed a "supercomposite" by some practitioners--and renowned for its toothlike physical properties, longevity and esthetics. Doctors have also enjoyed its easy, non-stick handling - a more visceral and immediate benefit.

If you would like to experience GrandioSO for yourself, please click the button below to request a free sample.

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