Direct Esthetic Adhesive Restorative Material

Esthetic restoration material

1. 1. 1. 1. Composite Compomers Glass-Ionomers Resin- modified glass Ionomers ( RMGIs)

These material have become more desirable restorative because they provide patients with a superior esthetic result , with acceptable physical and chemical properties The roots of adhesive dentistry can be traced to Buonocore in 1955 Buonocore suggested that acids be used on tooth structure as a surface treatment before the application of resin Important adhesive dentistry generation First generation :enamel only bonding with little or no dentin adhesion yielding bond strengths of only Sixth generation system: is 2 type Seventh generation : is a self-etching adhesive system that dose not require mixing In the late 2002 these new system combine enchant , primer and adhesive in a single bottle Sixth generation Type 1: adhesive components and self- etch primer that are applied severalty to the tooth Type 2: adhesive components and self- etch primer that are

Resin based composite

Most commonly used direct esthetic restorative material is resin composite 1. 1. 1. Consist of three primary ingredients: organic resin matrix Inorganic filler particles Coupling agent

Resin matrix Monomer : bis-GMA (bisphenol A glycidyl methacrylate ), UDMA ( urethane dimethacrylate) Diluent : TEGDMA (terithyleneglycol dimethycrylate Photoinitiator : camphorquinone Co-initiator : tertiary amine Polymerization shrinkage: Current systems : 2-3 % vol shrinkage Methacrylate-based monomers Free radical, addition polymerization Products in development : no shrinkage Ring-opening reaction expand Size of fillers.....Type of composite Macrofilled composite4,10-30 Microfilled 0.04-0.4 Small particle (Microfine) 0.4- 4 Hybrid (micro hybrid) 0.1-1 (3) Quantity of filler % by weight % by volume (10-15% lower than weight percent) Fillers o Significantly improves the properties of the matrix o Decrease Polymerization shrinkage Water resorption Coefficient of thermal expansion o o Increase: Fracture toughness Flexure modulus Important Radiopacity Polishability

Other ingredients in resin-based composites 1. Polymerization initiators: like camphoroquinone are required as catalysts for light activation and curing in composite 2. Polymerization inhibitors : added to prevent the composite from autocuring during storage

3. Color stabiliztors: help to absorb ultraviolet radiation that would otherwise cause discoloration of composite over time 4. Pigments: play the obvious role of providing the composite with the appropriate tooth matching shade composite : Classified based on filler size and volume as previously sated and also depending on consistency or viscosity Microfilled composites Hybrid and microhybrid composite Nanofilled and nanohybrid composite Packable composites Flowable composite Compomers, ceramers , ormocers, samrt composites

Microfilled composite: Marketed in late 1980s Very smooth surface Colloildal silica particle size 0.04-0.2(0.4) m 25%V(by volume ), 38%W(by weight ) Very high surface area High coefficient of thermal expansion, water absorption & polymerized shrinkage Clinical application Class III, V, IV (small) Esthetic area Composite veneers when bruxism is not present Not be used in stress-bearing situation (Class I,II,IV) Have shown lower fracture resistance , stiffness and fatigue in comparison with more heavily filed composites Hybrid composite and hybrid Microhybrid, Blended, All- purpose Since late 1980s Strong and well polished (Smooth) 0.4 -1 (0.1-3) Microfiller + Small particle Clinical used Small-medium class I & IIStrong & wear resistance Class III & IV ..Polishable & strong

 Hybrid composite :Fillers

All-purpose

Physical & mechanical properties Small particle~Hybrid> Macrofilled>Microfilled o Surface smoothness Microfilled > Hybrid ~ small particle >Macrofilled Generally shown less Wear than compomor and resin-modified glass inomer Nanofill & Nanohybrid composites: Nan fills nanometer-sized particles throughout matrix Nanohybrids nanometer-sized particles combined with more conventional filler technology Nanofilled Composite Filtek Supreme (3M ESPE) Filler particles filled: 78% wgt nanomers 0.02 0.07 microns nanocluster act as single unit 0.6 1.4 microns Most well known nanofiled resin-based composite is Filtek Supreme Advantage : 1. 2. 3. 4. Shown good esthetics Good mechanical properties Good handling Good polishing

Composite Variants :

Packable Flowable PACKABLE COMPOSITES : Marketed for posterior use increase in viscosity better proximal contacts? handle like amalgam? 4

Subtle alteration of filler shape size particle distribution Similar resin chemistry and filler volume Mechanical properties similar to hybrids

Advantage :
1. Introduced to the profession as an amalgam substitute 2. They have a stiffer consistency than more conventional hybrid composites which is produced by altering the particle size distribution or filer type 3. They do not necessarily contain a higher filler loading as studies have shown 4. Greater ease in establishing interproximal contacts while placing class II restorations

Flowable Composites :
Marketed class 1, 3, 5 liner Particle size similar to hybrid composites Reduced filler content reduces viscosity

Mechanical properties inferior to hybrids Clinical applications o preventive resin restorations o small Class 5 o provisional repair o composite repair o liners have increased shrinkage decreased wear resistance and decreased strength

Compomers ceromers , ormocers , smart composites : compomers is the result of the hybridization of the words composite and glass ionomer Compomers are polyacid modified resins that are basically light-cured low-fluoride-releasing composite resin

Difference between compomers and composites : I. Compomers contain some monomers with acidic functional groups that the can potentially participate in an acid /base glass ionomer reaction after polymerization II. The level of fluoride release from the compomers is significanty lower than what is seen for conventional glass-ionomers or RMGIs Cermoer : Stands for ceramic-optimized polymer and was introduced by Ivoclar Vivadent to describe their composite Tetric Ceram The properties of the ceromers are identical to those of composites and they exhibit fluoride release lower than conventional glass Ionomers or compomers Ormocer: Is the acronym for organically modified ceramics This class of material represents a novel inorganic-organic copolymer in the formulation The inorganic organic copolymers are synthesized from multifunctional urethane and hioether (meth) acrylate alkoxysilanes as sol-gel precursors The filler particles are 1m to 1.5m in size 7% filler weight and 61% filler volume Smart composite : Are a class of ion-releasing composites Since 1998 With in color and indicated for posterior teeth It releases fluoride hydroxyl and calcium ions as the pH drops at the area immediately adjacent to the restorative material Work based on the developed alkaline glass filler which was designed to reduce secondary caries formation at the margin of restoration by inhibiting bacterial growth