INDIRECT COMPOSITE

A. DIRECT VS. INDIRECT COMPOSITE

I. Technique
Direct Composite

Indirect Composite

directly placed in the

tooth (Intraorally)

fabricated outside the

mouth

Incremental Technique

Cured in a small furnace

Sandwich Technique

Cementation

II. Indications
Direct Composite

Indirect Composite

Esthetics

Esthetics

Small to medium Class I

and Class II cavities

Large Class I and Class II

cavities

Class III, Class IV and

Class V cavities

Replacement of large
compromised existing
restorations

III. Contraindications
Direct Composite
Heavy occlusal surfaces
Inability to maintain a dry
field
Restorations that extend
onto root surface

Indirect Composite
Heavy occlusal surfaces
Inability to maintain a dry
field

 Deep subgingival
preparations

IV.Advantages
Direct Composite

Indirect Composite

Esthetics

Better physical properties

Conservative tooth
structure removal

Wear resistance

Easier and less complex

tooth preparation

Reduced polymerization
shrinkage

V. Disadvantages
Direct Composite

Indirect Composite

Greater localized wear

Increased cost and time

Polymerization shrinkage

Bonding difficulties

Marginal Leakage

Affected by the type of

cement used

Postoperative sensitivity

Technique Sensitivity

B. MATERIALS
CERAMICS
a) Feldspathic Porcelain Inlays and Onlays
b)Hot Pressed Glass-Ceramics
c) Machinable Ceramics designed by CAD/CAM systems

INDIRECT RESIN COMPOSITES

-- Can be constructed from
a) Hybrid resin composite
b)Microfilled resin composite

SILICATE

C. PROCESSING
Laboratory Fabrication
Chairside Fabrication

D. CLINICAL PROCEDURES
I. Tooth Preparation
1.The patient is anesthesized and the area should be isolated
2.Removal of compromised restorations or caries
3.Criteria :
All margins should have a 90-degree butt-joint cavosurface
angle
All internal and external line and point angles should be
ROUNDED
Isthmus (at least 2mm wide)
Pulpal floor flat , 1.5 and 2 mm depth
Facial and Ligual walls occlussaly divergent
Facial,lingual and gingival margins extended at least 0.5
mm
II. Impression

 III.Temporary Restoration
IV.Fabrication
V.Try in
VI. Cementation
1. Etch
2. Apply Cement both in the tooth preparation and in the
restoration
3. Curing
VII. Finishing and Polishing

E. PROCESSING
LABORATORY FABRICATION
A. Indirect Composite Inlays and Onlays
- More resistant to occlusal than direct composites
- Less wear resistant than ceramic restorations
- Indicated when : 1. Maximun wear resistance

2. Difficulty in achieving proper

contours and contacts

3. If ceramic restorations is not

indicated
Laboratory Processing :
a. Initially formed on a replica of the prepared tooth
b. Curing of the composite
c. Coating of special gel
d.Final curing using an oven like curing device
e.Trimming, finishing and polishing

B. Ceramic Inlays and Onlays

1. Feldspathic Porcelain inlays and onlays

- partially crystalline minerals (feldspar,silica,

alumina) dispersed in a glass matrix
- made from finely ground ceramic powders
Laboratory Processing:
- Fabricated in dental laboratory by firing dental porcelains
on refractory dies

2. Hot Pressed Glass- Ceramics

Laboratory Processing:
a. Wax pattern
b. Spruing
c. Pressing heated ceramics
d. Final adjustments and finishing

CHAIRSIDE FABRICATION

Take note: Indirect Composite can be done Chairside if

the materials and devices used in processing indirect
composites are present and available in the clinic

A. COMPUTER-AIDED DESIGN/ COMPUTER- ASSISTED

MANUFACTURING
- Computerized device that can fabricate ceramic inlays
and onlays from high quality ceramics in a matter of
minutes
- CEREC SYSTEM
-- was the first CAD/CAM system for chairside
design and fabrication of ceramics restorations
-- newer version can mill occlusal surfaces
contours and can also extrapolate existing
contours beyond cavosurface margin and central
groove

Chairside Processing

1. Optical Impression
2. Designing the restoration
3. Milling
4. Ready for Try-in,contouring,cementation and polishing

DOLOSO, Shyra Jane B.