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Product Review:
Compex HD™

The Next Generation in Composite Warming Technology

Compex HD™ by AdDent, Inc, is awarded the Catapult Education Vote of Confidence™
after evaluators test it on 100 patients.

Warming composite to assist clinicians in seating restorations, placing, and manipulating composites has been in regular use since the 1980s.

AdDent, Inc, has a long history in developing warming technology to improve clinical outcomes and provide a predictable way of effortlessly placing composite restorations.

As composite resin technology has improved, with increased strength, higher filler content, lower volumetric shrinkage, and better polishability, composite handling has become more challenging. The improvements made in composite resin technology have produced products that are far stiffer than previous generations, which has created a conundrum for clinicians.

Should they continue to use inferior, older technology with easier handling or move to a new composite with dramatically improved characteristics but with significant challenges when placing the restoration because of significantly higher stiffness? Fortu- nately, the answer does not have to be either one or the other. Clinicians can incorporate composite warming tech- nology and pair that with a modern, nano-filled composite of their choice, which will dramatically lower the viscosity of the composite with higher filler loading, making it easy to place and manipulate.

The Science of Warming Composite

Composite warming was first discussed in literature in the early 1980s. These articles discuss the physical properties and changes that occurred with warming composites. From these articles, many clinical techniques were developed using the concept of warming composite. Warmed composites have an increase in kinetic energyand great movement compared with room-temperature composites. This phenomenon leads to heated composites experiencing greater monomer conversion and increased depth of cure.

Examination of margin adaptation has demonstrated that heated composites lead to better marginal adaptation than those restorations placed at room temperature. Muñoz et al demonstrated that both hybrid and nanohybrids had significantly increased surface hardness and depth of cure when composite heating was utilized. Heated composites provide several advantages to clinicians and have the potential to dramatically improve clinical outcomes.

Direct Restorations

Warming conventional composites for all anterior and posterior direct restorations

Liners

Warming flowable composites for use as a liner in various clinical situations

Injection Molding

Warming flowable and conventional composites for injection molding techniques

Resin Cement

Warming composite resin to be used as a resin cement for indirect restorations

Traditional Composite Warming Technology Compared With Compex HD™

AdDent has a long history of producting comopsite warming technology, with many substantial improvements over the past several decades, including the Calset Composite Warmer (Figure 1). Traditionally, all composite warmers were stand-alone technologies that utilized a warming deviceto heat composites to 155°F. These systems heated composite by warming a traditional composite gun preloaded with the selected composite. Although quite effective, once the gun leaves the warming device, the composite begins to lose heat immediately. 

Between each incremental layerof composite, the gun should be returned to the warmer to maintain its temperature at 155°F. This problem has been eliminated with the creation of AdDent’s Compex HD composite warming gun (Figure 2). This wireless, rechargeable composite gun warms composite in 1 to 2 minutes and can dispense approximately 100 compules before the unit needs to be recharged. The unit is extremely lightweight and possesses an ergonomic design, making composite placement easy and efficient.




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A total of 100 patients were treated using the Compex HD, with more than 150 restorations being placed. All evaluators (100%) said they would use the Compex HD composite warming device in all restorative and composite procedures, 87% were “very satisfied” with the performance and construction of the warmer, and the remaining 13% were “satisfied” with its performance and construction. The evaluators felt the Compex HD greatly assisted in the placement of composite, making the material far easier to manipulate.

AdDent’s Compex HD was awarded the Catapult Education Vote of Confidence™, which is a demarcation reserved for only those products that receive overwhelmingly positive reviews and feedback.

Compex HD™ was evaluated by 8 of Catapult's clinical evaluators

7 of which had extensive experience with composite warming technology and techniques.

Clinical Case

This 24-year-old patient presented with fractured incisal edges of #8 and #9, which occurred during a traumatic accident as an adolescent.

His desire was to have the incisal edges of his front teeth restored as conservatively as possible without sacrificing an esthetic outcome. With this in mind, the decision was made to utilize a diagnostic wax-up and corresponding incisal edge putty matrix to aid in the placement of class VI composite resin restorations. 

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Prior to anesthesia and tooth preparation, the putty matrix was tried in to confirm proper seating and fit, and composite shades were selected. Teeth #8 and #9 were prepared using a pointed diamond bur, establishing an irregular bevel along the incisal 1/3 of each incisor.
A Mylar strip was placed in the putty between #8 and #9 to prevent bonding the teeth together. Using the Compex HD, the lingual incisal portion of the putty was loaded with A1 composite (Mosaic; Ultradent Products, Inc) and placed under an orange protective shield. The incisal edges of both incisors were etched with 37% phosphoric acid (Ultra-Etch; Ultradent Products, Inc).

A bonding agent was applied to all etched surfaces and cured with a LED curing light . The preloaded putty matrix was carried to the mouth and placed to deliver the lingual portion of the composite to the prepared teeth. Excess material was cleared from the facial aspect of the restorations to provide room for the enamel veneering composite. This lingual layer of composite was cured using a LED curing light. The lingual matrix was removed, leaving the Mylar strip in place between #8 & #9.
Using the Compex HD, Enamel Neutral composite (Mosaic; Ultradent Products, Inc) was placed on the facial aspect of #8 and #9. The composite was quickly manipulated into place using a composite placement instrument and cured using a LED curing light. The restorations were then finished using interproximal finishing strips and polished using the ASAP polishing system (Clinician’s Choice Dental Products, Inc).

The completed restorations created a beautiful result and were made simple to place by using the Compex HD™ by AdDent.

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