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Vishesh Gupta
Babu Banarasi Das College of Dental Sciences,Babu Banarasi Das University
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All content following this page was uploaded by Vishesh Gupta on 21 December 2016.
*Corresponding Author
Aniket Kumar
Post Graduate Student, Dept. of Dentistry, Babu Banarsi Das College of Dental Sciences, Lucknow
E-mail: aniketrajghat@gmail.com
Polymers: Most commonly used polymers are based on .Maximum flexural strength in dry condition for glass
poly methyl methacrylate/ methyl methacrylate fibre with 65% fibres is 1230 MPa. Increasing the fibre:
(PMMA/MMA) mixtures. Activation of the content also reduces water sorption as the relative
polymerization, by heat or chemically, initiates free portion of water absorbing polymer matrix decreases.17
radical formation from benzoyl peroxide (BPO) and an
exothermic free radical addition polymerization takes Adhesion of Fibres to the Polymer Matrix: The
place. The polymerization leads to interpenetrating adherence of fibres to the resin matrix is an important
polymer network (IPN) formation by combining the quality for good mechanical properties. Fibre
PMMA beads and monomer-based polymer matrix12, reinforcement is effective only when a given load can be
because PMMA becomes partly (large PMMA beads) or transferred from the matrix to the reinforcement, and this
totally (small beads) dissolved in the monomer. The can be accomplished when there is complete adhesion
addition of cross-linking agents may improve many of between resin matrix and fibres. Insufficient adhesion of
the physical properties of polymers.13 fibres by resin matrix results in voids and porosities in
the fibre-reinforced composite that are susceptible to
Fibre-Reinforced Polymers: The strength of polymers water sorption. Voids and porosities in the fibre
can be improved by adding reinforcing fibres. 14 By reinforced composite may lower flexural properties and
combining two or more materials to make a composite, silane coupling agents can optimize chemical and
better mechanical properties than those obtained by the physical bonding between different components in
polymers alone can be achieved. composite materials.
In dentistry, glass fibre reinforcement is frequently
used for the following applications. Post endodontic Properties of Fibre Reinforced Composite
restoration, Restoration of grossly carious tooth, Water sorption: Water sorption of a material includes
Crowns, Fixed partial dentures (FPD), Implant both water adsorbed on the surface and water absorbed
prostheses, Facial prosthesis, Splinting teeth, Root canal into the body of the material during preparation and
posts and Orthodontic retention devices. while the material is in service. Poly (methyl
methacrylate) absorbs water because of the polarity of
Resin Matrix: Special considerations are required for the water molecule and because it is smaller than the
developing a resin material for the fibre reinforcement. inter chain distance in the polymer. The volume of water
Ideal requirement are that a resin material intended for uptake by a polymeric material is determined by polymer
incorporation of fibres must possess mechanical structure, content of various polar and hydrophilic
properties that tolerate masticatory forces, the material groups in the polymer structure, temperature,
should be biocompatible, be able to resist degradation, concentration of various additives, presence of voids
should have low water sorption and solubility, low within the matrix, Physicochemical and mechanical
residual monomer concentration. properties can be affected by absorbed water.
Orientation of Fibres: Mechanical and physical Flexure Strength: These materials are often tested in the
properties are related to the orientation of the laboratory, although the mode of failure and many other
reinforcement. Fibre orientation can influence the properties affect clinical performance. Investigators
Strength, Modulus and Coefficient of thermal expansion. accentuate the importance of fatigue and fracture
Fibre orientation can change the properties of a fibre- toughness in predicting clinical performance of several
reinforced polymer from isotropic to anisotropic and classes of dental materials, including fibre composites. It
even orthotropic. Continuous unidirectional fibre- is important to note that test methods, procedures for
reinforced polymers give anisotropic properties to the preparing the samples, and, in particular, the geometry
composite. Continuous bidirectional fibres (weaves) of the test specimens all affect the calculated flexure
give orthotropic properties in a plane and Random- strength. Flexure strength for commercial laboratory–
oriented fibres give isotropic properties. Unidirectional processed fibre-reinforced composites may range from
longitudinal fibres exhibit superior mechanical approximately 300 to 1,000 MPa, depending on the
properties along their long axis. specimen preparation and geometry.
Quantity of FibresFibre quantity in a polymer matrix Fracture toughness: The fracture toughness of a
can be given in weight percent (wt. %) or in volume material reflects the resistance of a material to fracture
percent (vol. %). Due to the differences in the density of and represents the energy required to propagate a crack
fibres, presentation in volume percent is recommended.15 through the material to complete fracture. Fracture
Increasing the content of fibre-reinforcement improves toughness of polymer composites depends on the type of
flexural properties.16 However, higher fibre content does polymer and reinforcement. Fracture toughness of a
not always result in higher mechanical properties. With monomethacrylate-based material is lower than in a
a controlled manufacturing process, a volume fraction of dimethacrylate-based material. Generally, “intrinsic”
glass fibre incorporation into matrix can be 45-65% physical aging and/or storage in a humid environment at
Annals of Prosthodontics and Restorative Dentistry, January-March,2016;2(1): 11-16 12
Aniket Kumar et al. A Review on Fibre Reinforced Composite Resins
elevated temperatures can decrease fracture toughness, particulate ceramic fillers (dense and porous) and
as well as other mechanical properties. However, an optimization of filler content are among the methods that
increase in fracture toughness can be achieved by adding have been studied.
reinforcing fibres to a polymer to prevent or slow down
crack growth. Clinical Applications of Fibre Reinforced
Linear coefficient of thermal expansion: The variation Composite
of the coefficient of thermal expansion between different The properties of fibre-reinforced composites
materials is important because a mismatch can lead to (FRCs) that make them well suited for various clinical
strains, resulting in stress formation and adverse effects applications include strength; desirable esthetic
on the interface. Therefore, thermally induced strains characteristics; ease of adaptability to various shapes;
and stresses adversely affect long-term stability of and potential for direct bonding to tooth structure.
intraoral multiphase materials. By adding fibres to a
polymer, the coefficient of thermal expansion decreases. Restoration: Restoring teeth with minimal sacrifice of
In general, the thermal coefficient varies with the sound tooth structure depends mainly on adhesives that
direction of the fibres in a composite rigid fibres appear provide strong and durable bonding to the remaining
to prevent expansion of the matrix in the longitudinal sound enamel and dentin. Laboratory reports18 have
direction so the matrix is forced to expand in the proven that modern adhesives do effectively bond to
transverse direction. One of the major concerns in the tooth tissue in the short term.
development of dental materials is physical and chemical However, clinically, marginal deterioration of
durability. composite restorations remains problematic in the long
term and still forms the major reason to replace adhesive
Biocompatibility restorations.19,20 When resin composite is bonded to
Solubility: Over time, components such as stabilizers, tooth structure using adhesives, the initial and residual
plasticizers, monomers, residuals of initiators and polymerization stresses that are present along the cavity
degradation products may be released to the oral walls may result in gap formation, leakage, recurrent
environment. Thus, the quantity of such components caries and pulp irritation.21
should be as small as possible, ensuring that the polymer Restoration of anterior tooth need quick, aesthetic
retains its characteristic properties and that no and functional repair. Along with aesthetics, the physical
components adversely influence biocompatibility. properties of restorative material should also be
considered for long-lasting restoration. Fibre
Residual monomer: Biological features, as well as reinforcement has been tried as a newer technique to
mechanical properties, of polymeric materials are highly improve the physical properties of composite materials.
influenced by the monomer-polymer conversion. High fracture resistance of the restorative material is
Residual monomer will alter the property and may leach required in the clinical situations where the high impact
out to pulp if a protective layer of base is not given. stresses are experienced and incisal angle restoration is
one such demand. Attempts have been made to improve
Cytotoxicity: Some substances released from materials the fracture resistance of restoration by using different
are cytotoxic and residual monomers leached out into the bonding agents, adhesive resins and different restorative
oral environment may induce toxic and allergic techniques using fibre reinforced technique.
reactions.
Tooth Stabilization and Splints: Fibre reinforced
Polymerization shrinkage: In the last decade, the composite materials are an excellent choice for the
continuous improvement in adhesive systems and stabilization of mobile teeth due to periodontal reason or
increased awareness among clinicians to protect and due to any trauma. Chair side-fabricated fixed splints
reinforce the remaining sound tooth structure, resulted in have previously been made from material combinations
the increased use of particulate filler composite resin that have included resin composites, wire, wire mesh,
materials (PRFC) both at the anterior and posterior wire embedded in amalgam and resin and fibre mesh
regions. Despite the continuous improvement through embedded in composite.22,23,24 All of these materials
modifications in formulation, polymerization shrinkage suffered from various problems like Poor handling
seems to be a problem for the PRFC. characteristics, Over bulking ,Insufficient bonding of the
Various steps have been undertaken to evaluate and internal structural materials to the dental resins, Poor
improve restorative composite resin against wear and esthetic outcome, Fibre splints overcome these
lower the polymerization shrinkage. Attempts have been drawbacks and provide ease in tooth splinting. Splinting
made to change type of filler or filler size and their can be done on palatal/lingual surfaces, labial surface or
silanization, by changing the polymerization kinetics of both the surfaces.
resins and to influence to degree of monomer
conversion. Reinforcing the resin with glass fibres with Conservative treatment of missing tooth
fibre-reinforced composite (FRC) substructure whiskers replacement: Chair side tooth replacement is an
Annals of Prosthodontics and Restorative Dentistry, January-March,2016;2(1): 11-16 13
Aniket Kumar et al. A Review on Fibre Reinforced Composite Resins
excellent application for fibre reinforcement composite root fracture moreover, the FRC post will yield prior to
technology. Previous attempts at chair side tooth catastrophic root failure better than will custom- made
replacement involved the use of pontics derived from cast metal or prefabricated metal post systems.27
extracted teeth, acrylic resin denture teeth with or Two categories of FRC posts are available: chair
without lingual wire reinforcement, and resin composite. side-fabricated and prefabricated. Chair side fabricated
These were attached to abutment teeth with acid-etched posts are custom designs that use polyethylene non pre-
bonded particulate composite. The abutment teeth used impregnated woven fibres (Ribbond, Connect) or glass
for these approaches were usually not prepared; most fibres (Glass Span) to reinforce the root and hold a
often, tooth replacement was only for the anterior region composite core. 18 Prefabricated posts are constructed
and the procedure was considered a short-term solution. of two kinds of fibre: carbon fibres embedded in an
The chair side fibre reinforced composite prosthesis epoxy matrix (C-Post, U-M CPost, and Aestheti-Post)
offers a fast, minimally invasive approach for tooth and S-type glass fibres embedded in a filled resin matrix
replacement that combines all of the benefits of the fibre (FibreKor Post).28,29 Fibre-reinforced composite posts
reinforced composite material for an esthetic, functional, consist of a resin matrix, in which structural reinforcing
and potentially durable result. A denture tooth or a carbon fibres or quartz/glass fibres are embedded. Black
natural tooth (in the case of an extraction of a carbon fibre-reinforced composite posts are, on the one
periodontally involved incisor) can be used as the pontic. hand, poorly suited for combination with translucent full
Selection criteria for this tooth replacement approach ceramic restorations due to their unfavourable optical
include: properties. On the other hand, carbon fibre posts also
1. A patient who desires an immediate, minimally have unfavourable biomechanical properties
invasive approach The favourable optical properties of tooth-colored
2. A patient who requires an extraction in an esthetic fibre posts (glass- and quartz-fibre), which are consistent
area and desires an immediate replacement with natural teeth in their ability to conduct light,
3. Abutment teeth with a questionable long term facilitate the goal of esthetic, high-quality restorations
prognosis when they are combined with full ceramic materials. The
4. Anterior disarticulation during mandibular posts can be processed in one time-saving surgery visit
protrusive movements that eliminates the laboratory step, due to the direct
5. A non-bruxing patient technique in combination with an adhesive composite
6. Cost considerations build-up. They also permit a procedure that is gentle to
the tooth substance: Thin dentin walls are stabilized by
Post Endodontic Restorations: To prevent the failure the plastic build-up composite and the composite
of root canal treatment, a simple, quick, high strength, cement. Moreover, the areas underneath can be saved
direct and cost effective restorative procedure may be and maintained as additional retentive areas for the
desirable. Adhesive technology is advancing by leaps plastic build-up composite restoration.
and bounds every day, making it possible to create
conservative and highly aesthetic restorations with direct Repair of Acrylic Resin Prosthesis
bonding to the teeth. A significant increase in the fracture Both unidirectional and woven light-polymerized
resistance of root filled teeth was observed when they FRC strips can be used effectively for chair side repairs
were intra coronally restored with a resin composite of fractured acrylic resin prostheses. As mentioned
material. Reinforcing composites with polyethylene earlier, FibreKor (Jeneric/ Pentron) and Vectris (Ivoclar/
fibres and glass fibres has successfully provided superior Williams) are unidirectional materials available for
resistance. laboratory use. Splint-It (Jeneric/Pentron), another
chairside material, is available either as a unidirectional
Endodontic Fibre Reinforced Composite Posts: FRC or a woven fibre. All of these materials have significantly
posts are a recent addition to the systems traditionally greater flexural properties than unreinforced resin. As
used to retain a core in severely broken down, explained earlier, woven FRC has a shorter memory than
endodontically treated teeth: custom-made metal or cast unidirectional FRC, which makes it easier to handle;
posts and cores and prefabricated metal and zirconium however, unidirectional FRC has superior flexural
posts. properties and will likely provide a stronger repair.
The FRC posts offer greater flexure and fatigue
strength, a modulus of elasticity close to that of dentin,
the ability to form a single bonded complex within the Indications for Chair side Repairs with Light-
root canal for a unified root post complex, and improved polymerized FRC
aesthetics when used with all-ceramic or FRC crowns as Virtually any acrylic resin prosthesis or appliance
compared to custom-made cast or metal-prefabricated can be repaired with light-polymerized FRC:
posts.25,26 The properties of this post design have the 1. Complete dentures
potential to reinforce a compromised root and to 2. Acrylic bases of partial dentures
distribute stress more uniformly on loading to prevent 3. Provisional removable partial dentures
Annals of Prosthodontics and Restorative Dentistry, January-March,2016;2(1): 11-16 14
Aniket Kumar et al. A Review on Fibre Reinforced Composite Resins
one and two-step self-etch adhesives to bur-cut enamel and interpenetrating polymer network matrix. Dent Mater
dentin. Am je dent 2003;16:414-420. 2007;23:1356-62.
20. Collins CJ, Bryant RW, Hodge KL. A clinical evaluation
of posterior composite resin restorations: 8-year findings.
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21. Hayashi M, Wilson NH. Marginal deterioration as a
predictor of failure of a posterior composite. Eur j oral sci
2003;111:155-162.
22. Tay FR, Pashley DH, Suh BI, Carvalho RM, Itthagarun A.
Single-step adhesives are permeable membranes. J dent
2002;30:371-382
23. Bounocore MG. The uses of adhesives in dentistry.
Springfield IL: Charles C Thomas, 1975:334.
24. Strassler HE. Planing with diagnostic casts for success
with direct composite bonding. J Esthet Dent
1995;7(1):32-40.
25. Fredriksson M, Astback J, Pamenius M, Arvidson K. A
retrospective study of 236 patients with teeth restored by
carbon fibre-reinforced epoxy resin posts. J Prosthet Dent
1998;80(2):151-157.
26. Nash RW. The use of posts for endodontically treated
teeth. Compend Contin Educ Dent 1998;19(10):1054-
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27. Yaman P, Thorsteinsson T. Effects of core materials on
stress distribution of posts. J Prosthet Dent 1992;68:416-
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28. Duret B, Duret G, Reynaud M. Long life physical property
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Composipost. Compend Contin Educ Dent
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29. Duret B, Duret G, Reynaud M. Long life physical property
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Composipost. Compend Contin Educ Dent
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30. Selz CF, Strub JR, Vach K, Guess PC. Long-term
performance of posterior In Ceram Alumina crowns
cemented with different luting agents: a prospective,
randomized clinical split-mouth study over 5 years. Clin
Oral Investig 2013 (Epub ahead of print).
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32. Gegauff AG, Garcia JL, Koelling KW, Seghi RR.
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33. Fennis WM, Kuijs RH, Roeters FJ, Creugers NH, Kreulen
CM. Randomized control trial of composite cuspal
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ahead of print)
34. Wilder Jr. AD, Bayne SC, Heymann HO. Long-term
clinical performance of direct posterior composites. Trans
Acad Dent Mater 1996;9:151-69.
35. Xu HH. Dental composite resins containing silica-
fusedceramic single-crystalline whiskers with various
filler levels. J Dent Res 1999;78:1304-11.
36. Garoushi S, Vallittu PK, Lassila LVJ. Short glass fibre
reinforced restorative composite resin with semi-