VARNISH

Composition Manipulation Properties

Uses

Definition:

It is a natural gum like copal rosin or synthetic resin dissolved in organic solvents such as ether, chloroform or alcohol

Composition:
Copal and nitrated cellulose are typical examples of natural

gum and the solvents used to dissolve these materials can be

ether, acetone benzene, ether acetate, ethyl alcohol,

chloroform,

amylacetate

and

medicaments

such

as

chlorobutanol, thymol and eugenol are also added. Recently fluoride are included in its composition.

Manipulation:
On a patient, Cavity varnish is applied with the help of small cotton pellet with the help of wire or R.C Reamer or a brush applicator. Thin layers of varnish are applied on the floor, walls including cavosurface margins. Gentle stream of air can be used to remove the excess and bottle should be

tightly capped after use to minimize loss of solvent.

Contraindication:
Composite free monomer layer dissolves the varnish Ca(OH)2/ ZOE beneficial affects are lost

Polycarboxylate interferes with adhesion

GIC blocks fluoride penetration.

Properties:
1. It is not a physical or mechanical insulator, provides chemical barrier. 2. Thickness: 2-40mm 3. Always applied in 3 layers to be more effective

Uses:
1. Prevents marginal Leakage / Microleakage 2. Prevents penetration of acids from ZnP cement i.e prevents chemical penetration. 3. Prevents penetration of corrosion products from

amalgam therefore prevents discoloration of tooth. 4. Decreases post operative sensitivity and pain.

Liners:

Definition: It is liquid in which CaOH and zinc oxide

(occasionally)are suspended in a solution of natural

or synthetic resins.

Composition:
1. Ca(OH) / ZnO Therapeutic agent 2. Ethyl alcohol Solvent 3. Ethyl cellulose Thickening agent 4. Barium sulfate Radiopacifier

5. Fluorides Anticariogenic

Manipulation:
Trade names:Dycal and Life

It is available as 2 paste systems both of which contain Ca(OH) and one consists of accelerator

Equal amounts of material from each tube is collected over a

glass slab or mixing pad with help of PD probe both are

mixed till homogeneous colour is got and with same

instrument

it is carried to deepest portion of the cavity and since it is fluid

in consistency it readily flows or gets painted over the cavity

over which the thermal insulating base or temporary

restoration is provided.

Properties:
1. Acts as a barrier between the restoration and the remaining dentine. 2. Like cavity varnish it neither possesses mechanical properties nor provides thermal insulation. 3. Should not be applied on cavity margins.

Uses:
1. As pulp capping agent. 2. As anticariogenic cement 3. Prevents post operative sensitivity or pain.

BASES

Bases :

Chemical and Thermal, Mechanical Insulation

Cements: General applications Classification Individual Cements - Composition - Manipulation

- Properties
- Uses

General Applications:
1. Thermal and chemical insulation 2. Temporary restorations Zn OE 3. Intermediate restorations IRM

4. Permanent restorations GIC

5. Temporary Luting Type I ZOE

6. Permanent Luting GIC, ZnP, Zn Poly Carb

7. Cementation of orthodontic appliances

8. As sedative dressing for the pulp of freshly prepared tooth 9. As pulp capping agents 10. Pit and fissure sealants Composites, GIC

11. Core build-up

12. Root canal sealants Gutta-percha

13. Periodontal dressings

Clinical Considerations:
Clinical Judgements about the need for specific liners and
bases are linked to the amount of remaining dentin thickness (RDT), considerations of adhesive materials, and the type of restorative material being used.

In a shallow tooth excavation, which includes 1.5 to 2mm or

more of RDT, there is no need for pulpal protection other than in terms of chemical protection. For an amalgam restoration,

the preparation is coated with two thin coats of a varnish, or a

dentin bonding system, and then restored.

For a composite restoration, the preparation is treated with a

bonding system (etched, primed, coated bonding agent) and

then restored.

In a moderately deep tooth excavation for amalgam that

includes some extension of the preparation toward the pulp so that a region includes less than ideal dentin protection, it

may be judicious to apply a liner only at that site using ZOE or

calcium hydroxide.

Either one may provide pulpal medication, but the effects will

be different. ZOE cement will release minor quantities of

eugenol to act as an obtundent to the pulp.

How ever, in a composite tooth preparation, eugenol has the

potential to inhibit polymerization of layers of bonding agent

or composite in contact with it.

Therefore calcium hydroxide is normally used, if a liner is

indicated. If the RDT is very small or if pulp exposure is a

potential problem, then calcium hydroxide is used to stimulate

reparative dentin for any restorative material.

Cements Used In operative Dentistry:

Silicate Cement Zinc Phosphate Cements Zn Silicophosphate Cements Zn Polycarboxylate Cements

Zinc Oxide Eugenol Cements

Glass Ionomer Cements

Resin Cements
Calcium hydroxide cements

Zinc Phosphate Cement: Available as Powder and Liquid Powder.

Zn Oxide 90%
Mg Oxide 8-9% SiO2, Bismuth trioxide, Barium oxide traces Liquid. Phosphoric acid (85%) and water (33+ 5%)

Chemistry of Setting:
When the alkaline powder comes in contact with acidic liquid it partially dissolves in liquid. It is an exothermic reaction. The set

cement consists of hydrated amorphous network of ZnP that

surrounds partially dissolved ZnO2 particles.

Manipulation:
Properties:
1. Mixing time 60-90secs 2. Setting time 5-9mins 3. Compressive strength (24hrs) 13000psi : 103.5Mpa

4. Tensile strength (24hrs)

800psi

5.5Mpa

5.

Film Thickness 25-40mm

Solubility/Disintegration 0.2%

6.

7.
8.

Pulp response Moderate / Severe

pH 3Mins 3.5

24hrs 6.6
Because of pulp irritation, cannot be used deep carious lesions.

Uses: Primary Uses 1. As luting agent for restorations and orthodontic appliances. Secondary Uses: 1. Thermal insulating agent 2. Intermediate restoration

ZINC SILICOPHOSPHATE

It is a combination of silicate and ZnP cement

Properties fall between those of ZnP and silicate.

pH: lower than of ZnP

and has got degree of translucency.

Anticariogenic property because of fluorides.

Zinc Polycarboxylate: Composition: Available as powder and liquid Available as powder to be mixed with plain water Powder ZnO MgO Traces of other oxides

Liquid:
Polyacrylic acid

Tartaric acid
Maleic acid Iticonic acid

Properties:
1. Working time : 3-6mins 2. Setting time 5.5mins 3. Mixing time: 30 to 60secs 4. Compressive strength (24hrs): 8000psi

5. Tensile strength: 900psi

6. Film thickness: 21mm

7. Pulp response: mild

Binds chemically to tooth structure

Uses:
Primary Uses
1. Luting agent for cementation of restorations
2. Thermal insulating base Secondary uses cementation of orthodontic appliances and intermediate restorations

Advantages over ZnP

Not irritant to pulp due to high mol. size

Binds chemically to tooth structure

Can be used safely in moderately deep cavities.

No need to use cavity varnish.

ZINC OXIDE EUGENOL

Type I : Type II: Type III:

Temporary luting or cementation Permanent cementation ex: kalzinol Intermediate restoration, thermal insulating base, temporary restoration.

Type IV: Examples:

Cavity liners or subbase

Type III: IRM Type IV: Dycal and life

Basic Composition: As Powder and Liquid Powder: ZnO- Main ingredient 70%

White rosin reduces brittleness of cement

Zinc acetate improves strength Zinc stearate acts as plasticizer

Liquid:
Eugenol : 85%

Sedative effect to pulp

Olive Oil: 15%

Modifications in basic composition Type II Ethoxy benzoic acid/Resins are added increases the strength of the cement

Type III-

Resin reinforced, partially polymerized surface

treated with propionic acid

Type IV

Increases strength and abrasive resistance

2 paste system. Active ingredient in both pastes is Ca OH.

Examples: Type

I: Tempbond / Neogenol / Freegenol

II: Kalzinol III: IRM

IV: Dycal
Chemistry of Setting: ZnO + H2O Zn (OH)2 Zn hydroxide

Zn (OH)2 +2HE
Base Acid

ZnE2 + 2H2O
Zn eugenolate salt

MANIPULATION

Mixed on glass slab or mixing pad. Powder is dispensed and liquid is collected just prior to the mixing. Bulk of the powder is incorporated into the mixture and spatulated with a stainless steel spatula till it becomes paste on creamy in consistency. Powder or cotton fibers can be added which will improve the

retention of the cement in the cavity.

Properties: Setting time : 4-10mins

Compressive strength (after 24hrs): 4000psi

Film thickness: 25um Solution and disintegration: 0.04% by wt Pulp response mild

Uses:
Primary Application 1. Temporary restoration 2. Intermediate 3. Temporary luting 4. Permanent 5. Thermal insulating base

6. Pulp capping agent

Secondary application As root canal sealants and in RC restorations Periodontal dressings

CALCIUM HYDROXIDE CEMENT

Available as powder or 2 paste cements

It is available as dry powder or two paste system. Mixed either with distilled water or saline to form a paste as

it can also be suspended in chloroform and conveyed to the

required area with the help of a syringe

When available as 2 paste cements. One paste monomer of methyl cellulose as initiator and CaOH Other paste: Calcium hydroxide and catalyst, when they are brought in contact methyl cellulose undergoes polymerization and porous matrix is formed pH:11

Mechanism of action: Uses: 1. Cavity liner

2. Pulp capping agents

GLASS IONOMER CEMENT

Invention, Composition, Classification,

Setting Reaction,
Properties,

Variations in basic composition,

Indications,

Contraindications,
Manipulation and clinical procedures for placement.

Invented in 1969 but first reported by Wilson & Kent

1971. It was invented in a creative response to inadequate

materials particularly from deficiencies of silicates.

1. It adheres to tooth structure

2. Translucent

3. Releases fluorides

4.Has also all favorable properties

5. Biocompatible and Bioactive

COMPOSITION

POWDER Consists of calcium aluminosilicate glass containing fluoride. SiO2 Al2O3 Al F3 30% 19.9% 2.6%

CaF2
NaF

34.5%
2.6%

AlPO4

10%

Radioopacifiers like Strontium, Barium and Lanthanum

Fluoride is one of the main components.

It lowers fusion temperature, Improves strength provides translucency and therapeutic

value
and improves working characteristics of the cement

Powder particles are obtained by heating all these particles

between 11000 C - 16000 C

LIQUID
Polyacrylic acid which is a polyacrylite which is a polymer

of carbonic acid.
Some amount of maleic acid and itaconic acid is added. Sometimes poly acrylic acid is blended dry with the powder

so that it is mixed with either water or tartaric acid.

CLASSIFICATION BASED ON USE

Type I: As luting agent Type II: As restorative agent Type III: Liners and bases and pit and fissure sealants Type II: Conventional Reinforced Metal modified Glass Ionomers

CHEMISTRY OF SETTING

When the powder comes in contact with the liquid to form a

paste, surface of powder particles are attacked by liquid. Ca,

Al, Na, F ions are released into the aqueous medium.

Calcium polysalts form 1st eventually followed by a Al poly

salts which form cross linking's. They undergo hydration to form gel matrix and there are untreated powder particles surrounded by silica gel. Set cement consists of agglomeration of powder particles surrounded by silica gel in an amorphous

matrix of hydrated Ca and Al polysalts.

PROPERTIES

1. Translucency mainly due to fluoride

2. Adhesion

3. Biocompatibility

1. Glass Ionomer cement is an esthetic filling material. Its translucency arises because of powder particles which is a clear glass. But it takes 24hrs to achieve, mature and develop full translucency. Only after this period one can appreciate the colour match with the adjacent structure. Color of GIC remains unaffected by oral fluids composite resins which tends to discolor. unlike tooth

2.

It

enables

the

conservative

approach

for

the

restoration because providing mechanical undercuts to retain the material is not necessary. This is of particular importance while restoring cervical abrasions

and erosions and there will be a tight marginal seal.

Hence less percolation of bacteria around cavity

margins and walls

Type of Adhesion

Chemical bond and can be improved using conditioners

like polyacrylic acid and citric acid.

BIOCOMPATIBILITY

GIC are therapeutic materials. Their adhesion to the tooth

structure ensures a marginal seal thus eliminating secondary caries by sustained release of fluorides. These materials are not only biocompatible and bioactive because they promote bone growth can be used as bone cements after endodontic surgery.

The adverse effects on vital tissues are minimal. Hence a protective barrier is rarely required 4. Setting time 4-5mins

5. Compressive strength (24hrs): 20000 psi

6. Tensile strength: 400 psi

7. Hardness: 60KHN
8. Solubility and disintegration 0.4% by wt

9. Pulp response Mild

10. Anticariogenic activity.

Variation in Composition:

1. Miracle Mix

2. Cermet ionomer

GIC are weak in tensile strength. so incorporation of

metal alloy particles into the powder can reinforce the

cement one such product commercially available is

miracle mix.

Here alloy powder particles and glass ionomer powder

particles are mixed by dentist or assistant before mixing with liquid. There is improvement in strength. It does not take up a good surface finish and cannot be burnished.

Abrasive resistance is less than conventional GIC.

Hence in an attempt to improve these properties cermet

ionomer cements were introduced, in this cement metal alloy particles like Ag and Au are sintered to the powder particles which have to be mixed with polyacrylic acid to get a smooth paste.

These get a good surface finish and can be burnished and

have good abrasive resistance.

But cannot be compared with composites and amalgam.

INDICATIONS:
1.Can be used as a luting agent

2. Can be used for restorations

Restoration of cervical abrasions and erosions without cavity preparation. Restoration of class III carious lesions

Restoration of class V carious lesions

3. Pit and fissure sealants

4. Thermal insulating base

5. As cavity liner wherein cariostatic action is required

6. Core building material 7. Tunnel preparation 8. Sandwich technique

CONTRAINDICATIONS

It is a brittle material with low tensile strength and

esthetically not as good as composites therefore cannot be used in following situations. Class II cavity Class IV cavity Fractured incisal edge Lost cusps Restorations where esthetic is a prime consideration

MANIPULATION AND CLINICAL PROCEDURE:

1. Select the shade

2. Prepare the cavity required

If remaining dentine is less than 0.5mm provide Ca hydroxide lining.

3.
4.

Isolate the tooth from saliva

Apply surface conditioner which will improve adhesion

5.

Wash and gently dry the cavity without dehydrating dentine

Reisolate and dry gently Dispense cement on a glass slab or a mixing pad and mix thoroughly for 30 sec with agate spatula using folding method. Convey the material to the cavity

6. 7.

8.

9.

Place matrix if required matrix can be cellophane or mylar strip. Allow cement to set

10.

Remove the matrix and remove the excess by using sharp surgical blade or knife and before it comes in contact with moisture a protective barrier is applied either with cavity varnish, petroleum jelly

Final polishing is postponed for 24hours but however modern GICs can be finished and polished immediately after their restorations.

Matrices in operative Dentistry

 Definition Objective ideal requirements classification

Indications of matrices

Definition:

properly shaped piece of metal or non metal that

supports and gives form to the restoration during its insertion and hardening

Objectives:
1. To provide temporary wall of resistance during insertion
and hardening of the material. 2. To displace or retract gingiva and rubber dam 3. To achieve dryness and non-contamination of operating field. 4. To maintain shape of the restoration till it sets 5. To resist and compensate for dimensional changes that can occur during setting.

6. To maintain natural contact and contours

7. To promote health of inter dental gingiva by preventing

overhanging restorations.

Ideal Requirements:
1. Should replace the missing wall temporarily 2. Should be rigid, flexible 3. Should have good stability 4. Should be easily applied and removed 5. Should be less cumbersome

6. Should be more comfortable for the patient

7. Should be reusable, sterilisable

8. Inexpensive
9. Should not react or adhere to the restoration material 10. Should be small and handy so that access and visibility

is not affected.
11. Matrix band should extend about 1mm over marginal ridge.

CLASSIFICATION:

I Based on area of restoration

a) Anterior Cl III, Cl IV b) Posterior extended Cl I and Cl II

II Based on material used.

Metallic ex: stainless steel, copper and brass

Non metallic ex: Celluloid and polyester

available as strips, open faced crowns (semicircular shape),

crown forms (surrounds full tooth)

III Based on method of retention a) Without mechanical retainers b) With mechanical retainers Ex: A] Blacks matrix and copper band supported by impression compounds

B] Toffelmire, Ivory no. 1,8, Sequiland

IV Gilmores classification:
a) Custom made Prepared by dentist or assistant suitable size matrix is cut and impression compound placed in the place of wedge. b) Mechanical Toffelmire, sequiland, ivory no. 1 and 8 c) Miscellaneous T-Band, soldered band, copper band, orthodontic band, seamless band, blacks matrix.

V Patented (Branded) and Non patented

INDIVIDUAL MATRICES

Ivory No. 1 The band encircles one of posterior proximal surfaces therefore indicated in unilateral Class II cavities. Band is attached to the retainer through wedge shaped projections which engage the tooth thru the embrasures of unprepared surface.

Ivory No. 8: Band encircles entire crown therefore indicated for bilateral

class II cavities,
Extended Class I and also for unilateral

Class II in which adjacent tooth is missing.

Tofflemire:
Also called as universal matrix

designed by B.R.Toffelmire.
Best used when 3 surfaces of posterior teeth have been prepared.

Advantages: Convenience Placement on tooth buccal and lingual surface but however lingual approach requires contra angle design Retainer can be easily separated from band without disturbing restoration.

Available in smaller sizes also so that it can be

comfortably used in deciduous dentition.

Bands available in 2 thickness 0.05 and 0.038mm

Blacks Matrix: A metallic band is cut so that it will extend only slightly over buccal and lingual surfaces of the tooth beyond buccal and lingual extremities of cavity preparation.

This band is tied to the tooth with either a floss or wire at the
corners of gingival ends of band.

Auto matrix: Retainers not used, designed for any tooth in the arch regardless of its dimension. Best used in large class II cavity. Those replacing one or more cusps and

In pin amalgam restorations.

Advantages: Convenience Improved visibility due to absence of retainer

Facial and lingual placement

Reduced time for application Number of teeth can be restored in one visit

Disadvantages: Expensive

WEDGES
Definition Classification

Uses

Definition:

Material made up of either wood or synthetic material that is

used along with matrices during insertion and hardening of

plastic restoration material.

 It is pointed, Triangular in cross section

Base of cone is towards interdental papilla.

Classification:
I Based on material used:

Wooden
Plastic

II Based on availability Preformed Custom made prepared by dentist / assistant

III Based on surface treatment: Medicated coated with astringents

Non medicated

IV Based on material used Natural Synthetic

USES: Used along with matrix during insertion and hardening of restoration material. It helps in close adaptability of matrix band to the tooth thereby preventing restorative material getting accumulated over the inter dental papilla which is called overhang of restoration thereby preserving health of periodontium.

To immobilize matrix band

To cause separation

To retract gingiva and rubber dam

To arrest bleeding temporarily

SEPERATORS:

Tooth movement

Objectives of separation

Principles of separation

Methods of separation

TOOTH MOVEMENT:

Act of separating / involved teeth from each other or

bringing them closer to each other or changing their

positions in one or more directions.

OBJECTIVES: 1. To move drifted, tilted and rotated teeth to their physiologically indicated position to maintain natural contacts and contours. 2. To close the space between the teeth which is not closed by

restorative methods.

3. To move the teeth in order to improve the health of

periodontium. 4. To move the teeth apically (intrusion) and to move the teeth incisally (occlusally) called extrusion to make them restorable. 5. In order to expose the proximal surface to polish proximal restorations. 6. To change the position of teeth from non-functional position to a functional position.

7. To detect proximal caries which is not detected by conventional methods.

8. For easy placement of matrix band

9. To remove foreign bodies collected between teeth which

is not removed by floss, brush or explorer.

Principles:

1. Wedge principle

2. Traction principle

1. Wedge principle: Separation is achieved by placing pointed wedge shaped device between the teeth and slowly inducing pressure. Ex: Elliots separator, Wedges.

2. Traction principle: It is achieved by a mechanical device which engages proximal surface of teeth to be separated by holding arms and then separation is achieved. Ex: Non interfering true separator, Ferrior double bow separator.

Methods of separation:

Rapid / Immediate Separation

Slow / Delayed Separation

Advantages of Rapid Separation:

Procedures is quick and stable Disadvantages: Chance of rupturing Periodontal Ligament fibers and it

will cause pain or soreness.

Examples:

Wedge, Ivory Separator, Elliots separator, Non interfering

true separator, Ferrior double bow separator.

Delayed Separation:
Advantages: 1. Less chances of tearing Periodontal ligament fibers and doesn't cause much pain. 2. No mechanical device required.

3. Separators can be left in place for weeks together.

Disadvantages:
Procedure is time consuming and is not stable.

Examples:
Brass wire/ligature wire, heavy rubber dam material, rubber elastics, oversized temporaries. Orthodontic

appliances.

MANAGEMENT OF DEEP CARIOUS LESIONS

Zones of dentinal caries

Effects of caries on pulp dentin organ

Diagnosis of deep carious lesions

Prognosis based on pulp exposure

Treatment.

Zones of Dentinal Caries:

1. Decayed zone
2. Septic zone 3. Dimineralized zone 4. Transparent zone zone of dentinal sclerosis 5. Opaque zone

Zones of decay in acute decay.

Zones of decay in chronic decay.

Decayed zone:

Characterized by
Complete absence of mineral structure Organic matrix is completely decomposed Collagen fibres are lost and if they are present they have lost their cross striations and internal links

Significantly invaded by microorganisms and plaque deposits.

Septic zone Called so because here you find highest population of microorganisms, even though dentine is demineralized its appreciated. Collagen fibers may have normal cross links but internal links are lost. frame work structure can be

Dentinal tubules are widened and cavitated. Remaining mineral structure are deformed and scattered irregularly.

Color may range from light yellow to dark reddish brown

Dimineralized Zone: Important diagnostically and therapeutically Dentinal matrix intact

Collagen fibers normal

Dentinal tubules normal dimensions

Repair is taking place in the form of re-mineralization

Transparent Zone: Also called zone of dentinal sclerosis. Looks transparent in ground section but radio opaque in radiographs. Here undisturbed repair mechanism is taking place. We can find few microorganisms. Slightly discoloured and very hard when compared to normal dentine.

Opaque Zone:

It is characterized by intratubular fatty degeneration with lipid deposits being precipitated from fatty degeneration of

the peripheral odontoblastic processes.

The maximum resistance to pulpal penetration occurs with

the arrival of the transparent and demineralized zone. However, if the septic zone penetrates the pulp chamber, the

P-D organ will be unable to offer any resistance, and will

suffer complete collapse.

Caries can produce 3 types of irritation to underlying

pulp.

Biological from microorganisms and their metabolites

Chemical Acids released Physico Mechanical due to reduced effective depth of pulp

dentine organ.

Severity of these irritation depends on

Type of Decay

Duration of Decay
Depth of Involvement Number and pathogenecity of microorganisms Tooth resistance depends on thickness of remaining dentine, permeability and Ca++, F+ content.

Diagnosis and Prognosis of Deep Caries Lesions 1. Pain 2. Radiographs

Indicate
a. The proximity of carious lesions to pulp chamber and root canal system Any pulpal changes in the form of intra pulpal and peripulpal calcification The thickening of periodontal ligament with an intact lamina dura etc.

b.

c.

3. Pulp testing
a. Thermal b. Electric pulp testing

4. Direct pulp exposure

5. Percussion
6. Type of dentine

Treatment: Direct

Pulp capping
Indirect

Indirect pulp capping

Clinical Procedure

Decayed and infected zones and the external part of decalcified zone are excavated using a spoon excavator.

All surrounding walls should be cleared of soft tooth

structure and debris to improve the stability of temporary restoration. Suitable capping material either calcium hydroxide or ZnO liner is placed over the remaining dentine at the deepest

portion.

Then the cavity is sealed with either modified ZnOE Type III or polycarboxylate cement or sometimes amalgam can be used.

A radiograph is taken
Patient is recalled after 4-6wks if it is Calcium hydroxide and 6-8 wks if it is ZnO.

When the patient comes back a fresh radiograph is taken and

diagnostic information regarding pain is collected and compared with pre treatment records.

If signs and symptoms and radiograph findings indicates no

degeneration in the pulp the pulp capping procedure is considered as a clinical success and we can plan for permanent restoration.

If repair has not taken place it is better to go in for RCT.

Direct pulp Capping The tooth can be considered a candidate for DPC a. There are no signs and symptoms of degeneration in PD organ. b. The exposure has small diameter relative to the pulp size c. There is no hemorrhage from the exposure site, if there is then blood should immediately coagulate in the form of

small button.
d. Dentine at periphery should be sound.

TREATMENT

All the procedures are same except few things.

1. The tooth to be operated should be isolated from saliva

application of rubber dam is mandatory.

2. Cavity floor and exposed site should be gently washed and

irrigated with sterile water or saline solution.

3. Drying should be done with cotton pellet but never with air from 3 way syringe patient is called after 6-8wks if it is

Ca OH and 8-9wks if it is ZnO.

Composite Resins: Definition Composition Classification Polymerization mechanisms Advantages and Disadvantages Indications and Contraindications Clinical procedures for Placement

Definition: It is a compound with two or more distinctly different materials

the props of which are either superior or intermediate to those of

individual constituents. Examples: Natural: Tooth, Enamel and Dentine

Composition:

Organic matrix
Inorganic fillers

Major constituents

Coupling agent
Activator or initiator Inhibritor Hydroquinone Colour pigments Radiopaque fillers Barium, Strontium, Zirconium

Commonly used matrix: Are monomers that are aromatic diacrylics examples: BISGMA Biphenol Glycidyl dimethacrylate UEDMA Urethene Dimethacrylate TEGDMA Tri ethylene Glycol Dimethacrylate Inorganic Fillers are manufactured by grinding glass or quartz to produce particles ranging from 0.1-100um. Silica particles small as 0.04um called as micro fillers can also be produced by option process incorporation of filler particles into the resin matrix will significantly improve physical and therm expansion water sorption polym. Shrinkage ___ reduced whereas compressive, tensile it and modulus of elasticity are increased.

Coupling agents help in binding filler particle to the resin matrix. This not only improves mechanical properties but also provides hydrolytic elasticity i.e it presents water penetrating at matrix filler interface. Commonly used: Organosilanes Class I Based on filler particle size Conventional 8-12um Small particle - 1-5um

Micro filled 0.04-0.4um

Hybrid - 1um

II Based on polymerization mechanical

Chemically (or self activated) Light activated

III Based on area of restorations

Anterior Posterior Polymerization mechanisms Chemically Available as 2 paste systems one or contains benz perox initiator and the other contains tent amine activator. When thus 2 or brought in contact free radicals are released and polymerization begins.

Light:
Available as single paste system loaded in a syringe. Has a photo initiator mol and amine activator. When it is exposed to the light of correct wavelength photo initiator gets excited reacts with activator, free radicals are released and polymerization starts has also range between 400-500nm. Visible light of the spectrum is used to cure the composites. It is produced by a hallogen bulbwhich is delivered to the required area by a fibre optic disadvatgaes of using U.V light. 1. Limited depth of curing

2. Polymerization shrinkage
3. Occlar hazards

Indications and Contraindications:

1. From Class I to Class IV cavities except high stress bearing areas like extensive Class II and extended Class Is 2. Class V cavities in which control of saliva can be achieved. 3. In restoration of developmental defects like enamel hypoplasia, densein dente microdontia, malpositioned teeth 4. Non carious lesions like cervical abrasions erosions.

5. Treatment of fracture incisal edge

6. Splinting of luxated teeth.

7. Closing diastema (less than 1mm)

8. Veneering of discoloured teeth.

9. Veneering of metallic restorations

10. Core buildings

11. Composite Inlays

12. Repair of old composite restorations

Contraindications:
1. High stress bearing areas like ext class I class V cusp heights and redges