COMPOSITE RESINS
INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
Contents Definitions Other terminologies Composition Classification Properties Advantages and disadvantages Indications and contraindications Placement of composites Latest advances in composites
www.indiandentalacademy.com
Definitions Other
terminologies
– Composite resins – Filled composites – Composite restorative material – Filled resins – Resin composite
www.indiandentalacademy.com
Composition
www.indiandentalacademy.com
Initiator
system Inhibitors Optical modifiers Color pigments U v stabilisers
www.indiandentalacademy.com
Resin matrix BISGMA
–Bis phenol A-Glycidyl methacrylate. UDMA – urethane Dimethocrylate. TEGDMA-Triethyelene glycol dimethacrylate HEMA-Hydroxy ethyl methacrylate
www.indiandentalacademy.com
Filler particles ď ľ Benefits
of fillers ď ľ Factors determining the properties and clinical application of composites
www.indiandentalacademy.com
Types of fillers Ground
Quartz Colloidal Silica Glass or ceramic containing heavy metals
www.indiandentalacademy.com
Other fillers : Tricalcium phosphate, Zirconium dioxide, Fillers containing fluoride www.indiandentalacademy.com
Coupling agents 1. Organo-Silane (r-methacryloxy propyl trimethoxysilane) 2. Titanates. 3. Zirconates.
www.indiandentalacademy.com
Activator initiator system Chemically
activated resins Light activated resins Dual cure Staged curing
www.indiandentalacademy.com
Light activated resins U
v light Visible light – Advantages – Draw backs Curing
lamps
– LED Lamps – QTH Lamps – PAC Lamps – Argon laser lamps www.indiandentalacademy.com
QTH
PLASMA ARC
ARGON ION LASER
www.indiandentalacademy.com
LED
SOFT START POLYMERIZATION MIYAZAKI and colleagues demonstrated that composite exhibited improved physical properties when cured with slow polymerization v\s.higher intensity and faster polymerization. Since then, studies
have
reported
improved
marginal
adaptation and physical properties of resin-based composite using this technique, aptly named “soft-start "polymerization‌ www.indiandentalacademy.com
PLACEMENT TECHNIQUES TO REDUCE POLYMERIZATION SHRINKAGE…
Three site novel matrix technique.
Oblique-layering technique.
Successive cusp buildup technique.
www.indiandentalacademy.com
THREE SITE NOVEL MATRIX TECHNIQUE…
www.indiandentalacademy.com
OBLIQUE LAYERING TECHNIQUE…
www.indiandentalacademy.com
SUCCESSIVE CUSP BUILD UP TECHNIQUE..
www.indiandentalacademy.com
Factors influence the polymerization process
Curing time
Shade of resin
Temperature
Thickness of resin
Type of filler
Polymerization shrinkage www.indiandentalacademy.com
classification
According to sturdvent – – –
On the basis of matrix composition On the basis of polymerization method Based on range of filler particle size range
According to Phillips – – – –
Traditional Small particle Micro filled hybrid
www.indiandentalacademy.com
According to MARZOUK FIRST
GENERATION SECOND GENERATION THIRD GENERATION FOURTH GENERATION FIFTH GENERATION SIXTH GENERATION
www.indiandentalacademy.com
IDEAL
REQUIREMENTS PROPERTIES
www.indiandentalacademy.com
PROPERTIES Biocompatibility Microleakage IRRITATION FROM ACTIVATOR LIGHT RESPONSE OF THE GINGIVAL TISSUES Water sorption and solubility DEGRADATION IN THE ORAL ENVIRONMENT Color stability Polymerisation contraction
www.indiandentalacademy.com
www.indiandentalacademy.com
MECHANICAL PROPERTIES HARDNESS RIGIDITY FRACTURE
TOUGHNESS
CREEP STRENGHT THERMAL
PROPERTIES RADIOPACITY www.indiandentalacademy.com
INDICATIONS FOR COMPOSITES Indications:
Class I, II, III, IV, V & VI Pit & fissure sealants Veneers Core build up Splinting Midline diastema
www.indiandentalacademy.com
www.indiandentalacademy.com
MICROFILLED COMPOSITE RESINS
THEY ARE PUT TO USE IN CASES OF— CLASS 3
CLASS 5
www.indiandentalacademy.com
CONTAINDICATIONS Grossly
destructed tooth Areas difficult to isolate Heavy occlusal stresses Poor oral hygiene Deep subgingival areas
www.indiandentalacademy.com
Advantages Good
esthetics Conservation of tooth structure Improved resistance to microleakage Strengthening of remaining tooth structure Low thermal conductivity Completion in one appointment Economical www.indiandentalacademy.com
Disadvntages Highly
technique sensitive Higher coefficient of thermal expansion Low modulus of elasticity BiocompatibilityOf some components unknown Limited wear resistance in high areas www.indiandentalacademy.com
Clinical consideations Depth
of cure Marginal defects Incremental build up Selection of an activator light Selection of matrix band Placement of a wedge Post restoration sequale www.indiandentalacademy.com
Placement of composites Pulp
protection Acid etching Applying bonding agents
www.indiandentalacademy.com
Placement of matrix Restoration
– Instruments used for insertion – Restoring anterior teeth – Restoring posterior teeth
Finishing and polishing www.indiandentalacademy.com
www.indiandentalacademy.com
Gross finishing with tungsten carbide burs
Further finishing with silicon carbide stone
www.indiandentalacademy.com
Finer finishing with finishing disk
Final finishing with rubber disc www.indiandentalacademy.com
Failures in composite restorations Discoloration Marginal
fracture Recurrent caries Post operative sensitivity Gross fracture of restoration Lack of maintaining contact Accumulation of plaque around the restorations www.indiandentalacademy.com
Marginal staining and ditching
Recurrent caries
www.indiandentalacademy.com
Excess bonding agent
caries not removed completely
www.indiandentalacademy.com
Lack of isolation
www.indiandentalacademy.com
Composi te being touched with fingers
Composite fallen on the tongue
Composite being placed in the bulk
www.indiandentalacademy.com
Features leading to failures Incomplete
excavation of caries Incomplete etching or failure to remove residual acid from the enamel tags Double or nonuniform coat of bonding agent Lack of isolation Touch of composites with fingers www.indiandentalacademy.com
Avoid
bulk placement of composites Curing Finishing and polishing
www.indiandentalacademy.com
Advances in composites
www.indiandentalacademy.com
Flowable
composites
– Introduced in 1996 – 20-25% less filler content – Mechanical properties 60-90%
www.indiandentalacademy.com
FLOWABLE COMPOSITE RESINS •These light cured low viscosity resins are indicated in conditions like— •Cervical lesions •Pediatric restorations •Small, low-stress bearing areas •As a liner below posterior composite restorations
www.indiandentalacademy.com
Packable
/condensable composites
– PRIMM based – Consistency – Improved properties Increased
flexural modulus Increased wear resistance Higher depth of cure Reduced polymerization shrinkage nonstickiness www.indiandentalacademy.com
CONDENSABLE (PACKABLE) COMPOSITE RESINS THESE COMPOSITE RESINS ARE RECOMMENDED FOR USE IN--CLASS 1 CLASS 2 CLASS 6 (MOD) CAVITY PREPRATIONS www.indiandentalacademy.com
Solitare
– Introduced in late 1997 – Crushed barium aluminosilicate glass surfaced with small particles – Greater the condensation force better is the packing
www.indiandentalacademy.com
Alert
– Chopped miroglass fibre added to the standard hybrid composite fillers – consistency of triturated amalgam – Bulk curing of thickness 5mm(J Dent Res 75 (3):1998)
www.indiandentalacademy.com
Surefil
– Execellent handling properties – Urethane modified BISGMA resin – Contains 3 different sized fillers – Tight proximal contact can be achieved – Bulk curing (J of Esthetic and restorative Dentistry)
www.indiandentalacademy.com
Antibacterial composites – Chlorhexidene – MDPB(methacryloxydecyl pyridinium bromide)Imazato et al(1994) – silver
www.indiandentalacademy.com
Expanding
matrix resins for composites – Spiro orthocarbonates – Thompson et al (1979) – BISGMA was not compatible – Curing time prolonged
www.indiandentalacademy.com
Compomers Resin
ionomer hybrid restorative material Contains both major ingredients of composites and glass ionomer E.g., Dyract Dyract AP COMPOGLASS www.indiandentalacademy.com
Giomers Pre
reacted glass ionomer technology Fluoride release and recharge – F-PRG TECHNOLOGY – S-PRG TECHNOLOGY Ideal
for pedodontic restorations E.g., Beautifil – FL-Bond – Fluorosealant www.indiandentalacademy.com
SMART COMPOSITES Ariston
in 1998 Ion releasing composite material Releases fluoride,hydroxyl and calcium ions Fluoride release more than compomers
www.indiandentalacademy.com
Ormocers
Organically modified ceramics Anterior and posterior restorative material Differs in matrix constituent Polysiloxane matrix Advantages – – – – – – –
Biocmpatible Reduced polymerization shrinkage High abrasion resistance Esthetically pleasing Anticaries properties Safe handling Cost effective www.indiandentalacademy.com
Fiber reinforced composite resin systems Preimpregnated
systems
fibre reinforced
– Targis\vectris – Sculpture\fibrekor Non
impregnated fibre reinforced
– Ribbond – Glass span
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
LABORATORY COMPOSITE RESINS Used for Indirect Preparation of Restorations on the Dies in the Laboratories for Fabrication Of:
•Inlays •Crowns • Veneers bonded to metals •Metal free bridges www.indiandentalacademy.com
CORE BUILD UP COMPOSITE RESINS At times, much of the tooth structure is lost from caries that the crown of the tooth must be built up to receive a crown.They can be light cured or dual cured. They offer the following advantages: •Good bonding to dentin •Can be finished immediately •Easy to contour •High rigidity •Good color under porcelain www.indiandentalacademy.com
PROVISIONAL COMPOSITE RESINS These materials are used in the fabrication of temporary inlays,crowns, and long span bridges. The purpose of these is to• Maintain the position of the prepared tooth •Seal and insulate the preparation and protect the margins • Establish proper vertical dimension • Aid in the diagnosis and treatment planning • And evaluate esthetic replacements. www.indiandentalacademy.com
Nanocomposites Nanostructured
composites
Biocompatible Maintains
the appearance Improved perfofmace Longetivity Superior mechanical properties
www.indiandentalacademy.com
Companies\ materials
3M ESPE BISCO DENMAT DETRAY DENTSPLY KERR PARKELL PREMEIR ULTRADENT IVOCLOR VOCO ZENITH www.indiandentalacademy.com
www.indiandentalacademy.com
References PHILIP’S SCIENCE OF DENTAL MATERIALS-ELEVENTH EDITION STURDEVANT’S OPERATIVE DENTISSTRYFOURTH EDITION VIMAL K SIKRI’S TEXTBOOK OF OPERATIVE DENTISTRY DALE ASCHEHEIN’S ESTHETIC DENTISTRY-SECOND EDITION WILSON’S ADVANCES IN OPERATIVE DENTISTRY GOOGLE SEARCH
www.indiandentalacademy.com
www.indiandentalacademy.com