DENTAL MATERIALS REVIEWER PT.

10 1970’s

RESTORATIVE COMPOSITE RESINS  Acid etching and microfills

Historically, four materials have been used as direct 1980’s

esthetic dental restorations:
 Light curing and hybrids
 Silicates
 Acrylic Resin (Unfilled Resin) 1990’s
 Dimethacrylate Polymers containing inorganic  Flowables and packables
reinforcing agents (Composites)
 Glass Ionomer 2000’s

SILICATE CEMENT  Nanofills

 The first transluscent filling material, introduced in INDICATIONS

1878 by Fletcher in England
 Anterior restorations
 Alumina-Silica glass and Phosphoric Acid
 Posterior restorations
 Very soluble
o Preventive resin
 Poor mechanical properties
o Conservative class 1 or 2
ACRYLIC RESIN (UNFILLED RESIN) POLYMETHYL
CONTRAINDICATIONS
METHACRYLATE
 Large posterior restorations
 Self curing (chemically activated) acrylic resin for
 Bruxism
anterior restorations was developed in Germany in
 Poor isolation
the 1930s
 Poor water resistance ADVANTAGES
 It would not maintain its contour in areas subject to
abrasion or attrition  Esthetics
 Conservative tooth preparation
In an effort to improve the physical characteristics of  Insulative
unfilled acrylic resins, Dr. Rafael Bowen of the National  Bonded to the tooth structure
Bureau of Standards developed a polymeric dental  Repairable
restorative material reinforced with silica particles
DISADVANTAGES
The introduction of this filled resin material in 1962
became the basis for the restorations that are  May result in gap formation when restoration
generically termed composites extends to the root surface
 Technique sensitive
1969
 Expensive
 Filled composite resin  May exhibit more occlusal wear in areas of higher
 Improved mechanical properties stresses
 Less shrinkage  Higher linear coefficient or thermal expansion
 Paste/paste system
IDEAL COMPOSITE WOULD HAVE

 Good marginal seal

 Realistic appearance  BIS-DMA bisphenol
 Minimal wear and shrinkage dimethacrylate
 Good strength  UDMA urethane
 Insolubility and biocompatibility dimethacrylate

CLASSIFICATION

 Conventional (Macrofilled) o Cross Link Diluents

 Microfilled  TEGDMA triethylene glycol
 Hybrid dimethacrylate
o Flowable
INORGANIC FILLERS
o Packable
 Nanofilled  Fillers are placed in dental composites to reduce
shrinkage upon curing
COMPOSITION
 Inhibits deformation of the matrix
Organic Resin  Reduce the coefficient of thermal expansion of the
resin matrix
 Forms the matrix  Physical properties of composite are improved by
fillers
Inorganic Filler
o Fused silica, crystalline quartz, lithium
 To reduce shrinkage upon curing aluminum, silicate, borosilicate glass

Coupling Agent Grinding quartz or different glasses makes these

particles. The filler particles were used in the first dental
 Unite the resin with the filler composites have diameters ranging from 20-40 um

COMPOSITION FILLER CLASSIFICATION

ORGANIC RESIN  Fillers are classified by material, shape and size

 Fillers are irregular or spherical in shape depending
 Forms the matrix
on the mode of manufacture
 Dimethacrylate monomer
 Spherical particles are easier to incorporate into a
 Typically consists of a resin-based oligomer matrix,
resin mix
such as a bisphenol A-glycidil methacrylate
 Adding smaller particles fills the space between the
(BISGMA) or urethane dimethacrylate (UEDMA)
larger particles to take up more space
ORGANIC RESIN MATERIALS  There is less resin remaining and therefore, less
shrinkage on curing the more size particles used in
 BIS-GMA resin is the base for composite proper distribution
 Diluents are added to increase flow and handling
characteristics or provide cross linking for improved COUPLING AGENT
strength. Common examples are
 To make a composite (polymer matrix containing
o Resin/Monomer
silica and/or glass particles), the filler particles
 BIS-GMA bisphenol
must be bonded to the resin
glycidylmethacrylate
 Unite the resin with the filler
o Diluents
o Stress absorber of the filler and resin
 MMA methylmethacrylate
The most efficient coupling agent is o 0.01 – 0.04 micron colloidal silica
methacryloxypropyltrimethoxy silane  Increases viscosity
 Some physical and mechanical properties are
INITIATOR SYSTEM
inferior
 Activate the setting mechanism  Wear resistant
 Begins the polymerization reaction of the resins  Low modulus of elasticity (allow restoration to
when the external energy (light/heat, etc) is flex)
applied  High resin content results in an increased
 Polymerization of resin requires initiation by a free coefficient of thermal expansion and lower
radical
strength
 Free radicals can be generated by chemical
activation or by visible light activation USE OF MICROFILLED COMPOSITES
The chemically activated systems are supplied as 2
 Used for low stress restorations
pastes which contains Benzoyl peroxide as the initiator
 Buccal and ligual surfaces of class III and class V
The visible high activated systems are supplied as single
HYBRID COMPOSITES
paste which contains Photosensitizer as
Camphorquinone, Initator as a tertiary amine  Combines the properties of conventional and
microfilled
STABILIZERS/INHIBITORS
 Contains 75-85% inorganic filler by weight
 Resins require stabilizers to avoid spontaneous  Particle size – 0.4 – 1 um
polymerization  Physical properties is superior to conventional
 Stabilizers are also used to control the reaction of  Predominant direct esthetic resin
activators and resin mixtures  Have universal clinical applicability
 Hydroquinone is most commonly used as a
HYBRIDS
stabilizer
 Popular as all purpose
CONVENTIONAL (MACROFILLED)
o AKA universal hybrid, microhybrids,
 Developed in the 1970’s microfilled hybrids
 Crystalline Quartz o Microfills added
o Produced by grinding or milling  Improved handling
o Large – 8 – 12 microns  Reduce stickiness
 Difficult to polish
USE OF HYBRID COMPOSITES
o Large particles prone to pluck
 Poor wear resistance  Used in moderate stress restorations where
 Fracture resistant strength and wear resistance are more important
 Prone to staining than surface luster
 Examples: Adaptic, Concise  Class I, II, IV
 Suitable for class 3,4, and 5
HYBRID COMPOSITES
MICROFILLS
 Strong
 Better esthetics polishability  Good esthetics
 Tiny particles o Polishable
FLOWABLE COMPOSITES WATER SORPTION AND SOLLUBILITY

 Flows into cavity due to lower viscosity
 Inferior physical properties (lower wear resistance,
lower strength)
 Used in small Class I, pit and fissure sealant,
marginal repair, liner
 Easy to use
 Good wettability
 Favorable handling properties
PACKABLE (CONDENSABLE)
 More viscous, “thicker, stiffer feel”
 Have filler particle feature that prevents sliding of
the filler particle by one another
 Easier restoration of proximal contact
 Water sorption is higher for microfilled resins and
for hybrid and macrofilled resins
 Composite materials do not show any clinically
relevant solubility
POLYMERIZATION CONTRACTION
 Composite material shrink while hardening. This is
referred to as polymerization shrinkage
 Usually does not cause significant problems with
restorations having all enamel margins
 When a tooth preparation has extended up to
tooth surface, the polymerization shrinkage can
cause a gap formation at the junction of composite
and root surface (V-gap)

NANOCOMPOSITES WEAR

 Nanotechnology or, for short, nanotech, refers to a  Surface loss

field of applied science whose theme is the control  Dues to abrasive contact with opposing tooth
of matter on an atomic or molecular scale structure, restorative material, food boli and items
 Generally, nanotechnology deals with structures such as toothbrush bristles and toothpicks
100 nanometers or smaller, and involves
COMPOSITE WEAR
developing materials or devices within that size
 Nanocomposites are materials that are created by Less wear
introducing nanoparticulates (often referred to as
filler) into a macroscopic sample material (often  Small particle size
referred to as the matrix) o Less abrasion
 nanofilled composites are those that contain filler  Heavier filled
particles no larger than 0.1 micron o Less attrition
 Non-contact areas
NANOFILLED COMPOSITES o 3 – 5 times less
 Less surface area
 Filtek Supreme (3M ESPE)
 Anterior location
 Filler particles
o Premolars vs Molars
o Filled – 78% wgt
o Nanomers BIOCOMPATIBILITY
 0.02 – 0.07 microns
o Nanocluster  The biocompatibility of restorative materials
 Acts as single unit usually relate to the effects on the pulp from 2
 0.6 – 1.4 microns aspects
o The inherent chemical toxicity of the
material
o The marginal leakage of oral fluids
MARGINAL LEAKAGE The size and composition of the filler particles primarily
determine the smoothness of a restoration, and the
 V-shaped gap materials’ ability to be finished and polished
 Microleakage
Microfill Composites – smoothest restorative surface
RADIOPACITY
Hybrid Composites – provide surface texture that are
 Resins are inherently radiolucent esthetic and compatible with soft tissues
 However, leaking margins, secondary caries, poor
proximal contacts, wear of proximal surfaces, and MODULUS OF ELASTICITY
other problems cannot be detected unless
 It is the stiffness of a material
adequate radiographic contrast can be achieved
 Radiopacity is imparted by certain glass filler COMPOSITE SELECTION
particles containing heavy metal atoms
 Anterior/Stress (Class 4)
REPAIR o Hybrid
o Hybrid/Microfill veneer combo
 Composite can be repaired by placing new
 Anterior/Non-Stress (Class 3 or 5)
materials over the oral (material) composite
o Hybrid
When a restoration has just been placed and  Mini-fill
polymerized, it may still have the oxygen inhibited layer o Microfill
or resin on the surface, so the addition of new  Posterior
composite can be made directly to this layer because o Hybrid
this represents an excellent bonding substrate o Reinforced microfill

OXYGEN INHIBITED LAYER

 Oxygen inhibition is useful during the restorative

process to allow layering techniques that minimize
negative effects of shrinkage

LINEAR COEFFICIENT OF THERMAL EXPANSION (LCTE)

 LCTE is the rate of dimensional change of a material

per unit change in temperature “So, if you think you are standing firm, be careful that
you don’t fall! No temptation has overtaken you except
The closer the LCTE of the material is to the LCTE of
what is common to mankind. And God is faithful; he will
enamel, the less chance there is for creating voids or
not let you be tempted beyond what you can bear. But
openings at the junction of the material and the tooth
when you are tempted, he will also provide a way out so
when temperature changes occur
that you can endure it.” – 1 Corinthians 10:12-13
SURFACE TEXTURE

 It is the smoothness of the surface of the

Aral ng maigi sa Dent Mat! :) God Bless us!
restorative materials
 Restorations in close approximation to gingival
tissues require surface smoothness for optimal
gingival health