COMPOSITES

CONTENTS:
 INTRODUCTION
 HISTORY
 BASIC COMPOSITION
 CLASSIFICATION
 INDICATIONS
 MANIPULATION
 PROPERTIES
 TYPES
 RECENT ADVANCES
 REFERENCES
 Dental resin composite
 soft organic-resin matrix
polymer

 hard, inorganic-filler particles

ceramic

 Most frequently used

DEFINITION:

 In materials science, a solid formed from 2 or more distinct phases

(eg: filler particles dispersed in a polymer matrix) that have been
combined to produce properties superior to or intermediate to
those of the individual constituents.
HISTORY
 1871 – silicates
 alumina-silica glass &
phosphoric acid
 very soluble
 poor mechanical properties

 1948 - acrylic resins

 polymethylmethacrylate
 high polymerization shrinkage
 1962 – Bis-GMA - Bowen
 stronger resin
 1969 – filled composite resin
 improved mechanical properties
 less shrinkage
 paste/paste system
 1970’s – acid etching and microfills
 1980’s – light curing and hybrids
 1990’s – flowables and packables
 2000’s – nanofills
EVOLUTION OF COMPOSITES
STRUCTURAL COMPOSITION

Matrix

Polymerization
Fillers
inhibitors

UV absorbers Coupling agents

Activator initiator
Plasticizers
system
A challenge for users of resins…
“Polymerization Shrinkage”

 Solutions:
 Incremental Curing: Allow for curing between layers
 Use dentin bonding adhesives in prep site
INDICATIONS

Sealant & Esthetic

Class-I, II, III, IV, V Foundations or
Preventive resin enhancement
& VI restorations. core buildups.
restorations. procedures.

Temporary Periodontal
Luting
restorations splinting.
CONTRAINDICATIONS

2) Excessive 3) Restorations
1) Inability to 4) Other
masticatory extending to the
isolate the site. operator errors.
forces. root surfaces.
ADVANTAGES

Esthetics

Conservation of tooth structure

Adhesion to tooth structure

Low thermal conductivity – insulative

Alternative to amalgam

Repairable
DISADVANTAGES

 Technique sensitivity
 Polymerization shrinkage

 marginal leakage

 secondary caries

 postoperative sensitivity

 Decreased wear resistance

 Higher linear coefficient of thermal expansion.

 RESIN MATRIX
Blend of aromatic / aliphatic di-methacrylate monomers
Forms a continuous phase & binds the filler particles
There must be ‘C=C’ at each end of the monomer chain
Widely used:
•Bisphenol A Glycidyl Methacrylate (Bis-GMA) - aromatic dimethacrylate – Rafael Bowen, 1960s
•Urethane Dimethacrylate (UDMA ) - aliphatic dimethacrylate - Foster and Walker, 1974
 DILUENTS:- MMA : methylmethacrylate
BIS-DMA : bisphenol dimethacrylate
UDMA : urethane dimethacrylate
 CROSS LINK DILUENTS
TEGDMA : triethylene glycol dimethacrylate
EGDMA : ethylene glycol dimethacrylate

Shrinkage : 2 – 7 % ; marginal gap formation

 Adv :
 High molecular weight of dimethacrylate monomers reduces curing
shrinkage
 Polymerisation of dimethacrylate monomers results in extensive
cross-linking, which increases the strength and rigidity of the
polymer.
 Disadv :
 Presence of numerous –OH groups that form hydrogen bond
results in high viscosity which makes it difficult to blend &
manipulate
 Questionable color stability
FILLER PARTICLES:
 Usually fillers are produced by grinding or milling quartz(0.1µ to
100µ).

 Microfillers sub micron particles of colloidal silica

Pyrolytic or Precipitation process
H2+O2

 SiCl4 SiO2(Chains)

 Inorganic filler particles

FILLER PARTICLES
Improves material properties, reinforcement of matrix resin; resulting in increased
hardness & decreased wear

Reduction in polymerization shrinkage.

Reduction in thermal expansion and contraction

Improved workability by increasing viscosity

Reduction in water sorption, softening and staining

Increased r/o and diagnostic sensitivity through Sr and Ba glass and other heavy metal
compounds that absorbs X-rays
PROPERTIES OF FILLER

Size

Hardness Volume

Filler
R/O
distribution
Refractive
index
 Types Of Fillers:

 Based on chemistry
• Inorganic fillers – Quartz, Glass & Amorphous silica

• Organic fillers - Pulverised, precured resins

 Classification According to Size:-
MACROFILLERS ---- 10 to 100um
MIDIFILLERS ----- 1 to 10 um
MINIFILLERS ----- 0.1 to 1um
MICROFILLERS ----- 0.01 to 0.1 um
NANOFILLERS ----- 0.005 to 0.01 um
 Amount of filler α Total filler surface area
α-1 Particle size
 Continuous distribution of particles - Max. Filler loading.
 Silica surface can form polar bonds with monomer molecule and can
increase viscosity.
 Marzouk
 Filler – interrupted phase

 Macro ceramics – silica based eg: quartz, fused silica , silicate

glasses,AlSiO4 etc
 Micro ceramics – colloidal silica in the form of silicic acid

 Fabricated macro reinforcing phases with colloidal micro

ceramic component bases
Index of refraction
 Should closely match with that of Resin

 Bis GMA 1.55

Mixture 1.5
 TEGDMA 1.46

Radio Opacity(R/O)
 International standards r/o = 2mm Al

 Ba, Sr, Zr(Glasses and ceramics)

 Are slowly leached and weakened in oral fluids

METHODS OF FILLER PARTICLE FABRICATION:

 Air Abrasion
 Erosion

 Grinding / Milling

 Precipitation

 Ultrasonic Interaction
COUPLING AGENT
 Bonding between filler and resin
 examples: titanates and zirconates
organosilanes (gamma methacryloxypropyl trimethoxy silane)

 Methoxy silanol
hydrolysis
 Advantages:

 Coupling agents are used to improve adherence of resin to filler

surfaces.

 Coupling agents chemically coat filler surfaces and increase strength.

 Disadvantages.
 Age quickly & become ineffective.
 Sensitive to water so the silane filler bond breaks down with moisture.

 Water absorbed into composites results in hydrolysis of the silane bond

and eventual filler loss

 Yoshida et al (2002) - Presilanization decontamination improved the

bonding of silane molecules to silanol groups at the silica surface.
ACTIVATOR INITIATOR SYSTEM
 Both monomethacrylate and dimethacrylate monomers polymerize
by the addition polymerization mechanism initiated by free radicals.
 Source of free radicals – Initiator
 Source of energy for activating initiator – Activator
INHIBITORS
 Minimize or prevent spontaneous or accidental polymerization
 Have a strong reactivity potential with free radicals
 They react with free radicals faster than monomers
 Chain propagation begins once the inhibitor is consumed
Eg. Butylated-hydroxy toluene (0.01 wt percentage)
Hydroquinone compounds
 Extent shelf life
 Ensure sufficient working time
OPTICAL MODIFIERS

 Shading is achieved with the help of various pigments

 Less opacifier → More light will be transmitted and less light will be
reflected; perceived as dark

 More opacifier →Less light will be transmitted and more light will be
reflected; perceived as white

 Darker shade or greater opacity require increased exposure time or

application of thinner layer when cured.
 Pigments
• Compounds used for shading

• eg: metal oxides

 Radio-opacifiers
• Compounds used for increasing radiopacity

• eg: glass & ceramics that contain heavy metals such as Zr, Sr & Ba

 UV Stabilizers
• Compounds which absorb electromagnetic radiation & improves
color stability
• eg: 2-hydroxy-4 methoxy benzophenone
CLASSIFICATION OF COMPOSITES
BASED ON CURING / POLYMERIZATION METHOD

A) Auto / Chemical / Self cure composites

B) Dual cure composite
C) U-V light cure composites
D) Visible light cure composite
BAYNE AND HEYMAN’s CLASSIFICATION (1994)

Composite Size of largest filler particles

Megafilled 0.5- to 2 mm
Macrofilled 10 to 100 μm
Midifilled 1 to 10 μm
Minifilled 0.1 to 1 μm
Microfilled 0.01 to 0.1μm
Nanofilled 0.005 to 0.01 μm
CRAIG’s CLASSIFICATION
ISO 4049 /ADA No. 27 CLASSIFICATION

Type 1: Polymer based materials suitable for restoration involving occlusal surfaces
Type 2: Other Polymer based materials
Class 1: Self cured materials
Class 2: Light cured materials
Group 1: Energy applied intra-orally
Group 2: Energy applied extra-orally
Class 3: Dual cured materials
LUTZ & PHILIPS CLASSIFICATION (1983)

Traditional composite resins

Hybrid composite resins
Homogeneous micro filled composite resins
Heterogeneous micro filled composite resins
•Splintered pre-polymerized particles
•Spherical pre-polymerized particles
•Agglomerated micro filler complexes
RONALD D JACKSON’s CLASSIFICATION (2000)
Light-body
Medium body
Heavy body
SKINNER’s CLASSIFICATION
SKINNER’s CLASSIFICATION – simplified
Avg. Particle Filler Type Inorganic Filler
Size Loading
Traditional 8 - 12 μm Amorphous 60 - 70 vol%
Composites silica or finely 70 - 80 wt %
ground quartz
Small Particle 0.5 -3 μm Amorphous 65 – 77vol%
Filled Composites silica 80- 90 wt %
Finely ground
quartz
Glass containing
heavy metals
Microfilled 0.04 – 0.4 μm Colloidal silica 25 – 59 vol%
Composites 35 – 57 wt %
Hybrid Composites 0.4 – 1 μm Colloidal silica 60 – 65 vol%
Glass containing 75 – 80 wt %
heavy metals
WILLEM’s CLASSIFICATION (1992)

Densified composite; midway filled

•ultrafine midway-filled
•Fine midway-filled
Densified composites; compact filled
•Ultrafine compact
•Fine compact
Homogenous microfine composites
Heterogeneous microfine composites
•With splintered prepolymerized filler
•With agglomerated prepolymerized filler
•With sintered agglomerates
•With spherical prepolymerized filler
Traditional composites
Fiber reinforced composites
POLYMERIZATION
 Initiation
 production of reactive free radicals
 typically with light for restorative materials

 Propagation
 hundreds of monomer units
 polymer network
 50 – 60% degree of conversion

 Termination
Examination, prognosis and treatment plan

•Finalized before the patient is scheduled for operative treatment.

Local Anesthesia

•More pleasant and uninterrupted procedure.

•Reduction in salivation.

Preparation of Operating Site

•Prophylaxis paste containing flavoring agents, fluorides

or glycerin are avoided
•Slurry of pumice is recommended
Shade Selection

•Done before the teeth are subjected to any prolonged drying

•While selecting, hold the entire shade guide near the teeth to
determine the general color.

•Then select and hold specific shade tab beside the area of the
tooth to be restored.

•Shade tab should be partially covered with patients lip /

operator’s thumb to create the natural effect of shadows.

•Make selection as rapidly as possible

Isolation of the Operating Site

•Rubber dam

•Cotton rolls

Tooth preparation

•For routine restoration

Tooth preparation

•For routine restoration

Pulp Protection

•Calcium hydroxide
•GIC
•Resin Bonding agents
Matrix & Wedge Placement

Class II - Tofflemeire matrix / sectional matrices

Class III & IV - Translucent / Polyester strip

Light transmitting wedges – preferred

Placement of matrix sequence depends and varies from operator

to operator.
•Some prefer to do it before etching & bonding

•provides the best isolation of the tooth preparation

•helps in assessment of any fracture in the tooth during

application of wedge.

•but there is chances of pooling up of bonding materials

especially the adhesive along the gingival marginal junction.
Enamel Etching & Dentin Bonding

•Prepared area is washed with water and dried with

compressed air.

•Etchant (37% ortho phosphoric acid as gel / liquid) -for

15-30 seconds.

•Etching - right angle to the surface of enamel (prism

heads) so as to produce retentive valleys and honey –
combs.
•Etchant is rinsed away with water (15 seconds) and the surface is dried with compressed
air (15 seconds). If the enamel is properly etched, it appears chalky or frosty white.

•If both enamel and dentin have been etched the area must be left slightly moistened

•Significance:
increases surface energy which promotes wetting and adhesion
creates micropores for micromechanical retention.
Apply bonding agent to the dry & moist dentine.

Air dry the bonding agent

Light cure.

Placement Of Composite
Curing Of Composite
A) Auto / Chemical / Self cure composites
B) Dual cure composite
C) Heat cure composite
D) U-V light cure composites
E) Visible light cure composite
Auto / Chemical / Self cure Light cure composite
Voids can be incorporated while Less number of voids
mixing
Bulk placement is possible Bulk placement is not possible
Polymerization proceeds from Polymerization proceeds from
periphery to centre centre to light source
Reduced working & setting time Adequate working time &
command setting
More staining due to aromatic Less staining due to aliphatic
initiator initiator
HEAT CATALYST

 Polymerization of resin requires initiation by a free radical.

 Initiation starts propagation or continued joining of molecules at double

bonds until termination is reached.

 Hydroquinone is most commonly used as a stabilizer.

 Common heat based initiators are peroxides such as

benzoylperoxide
t-butylperoxide
t-cumythydroxyperoxide
CHEMICAL CATALYST
 Chemical activation of peroxides produces free radicals. Chemical accelerators are
often not color stable and have been improved for this reason.

 Chemical composites mix a base paste and a catalyst paste for self cure.

 Oxygen inhibits curing resulting in a weaker restoration.

 Chemical accelerators include:

Dimethyl p-toludine
N,N-bis(hydroxy-lower-alkyl)-3,5-xylidine
 Advantages:
 Avoiding porosity

 Not sensitive to oxygen inhibition

 Command polymerization is possible

 Exposure time 40 sec or less for 2mm thickness

Disadvantages
 Limited depth of penetration

 More time for large restoration

 Cost

 Poor accessibility in posterior and inter proximal location

 Variable exposure time for varying shades

 Sensitivity to room illumination

PHOTOCHEMICAL CATALYST

 Early photochemical systems used were benzoin methyl ether which is

sensitive to UV wavelengths at 365 nm.

 UV systems had limited use as depth of cure was limited.

 Visible light activation of diketones is the preferred photochemical systems

 . Diketones activate by visible, blue light to produce slow reactions.

 Amines are added to accelerate curing time.

 Presently, different composites use different photochemical systems.

 These systems are activated by different wavelengths of light.

 Composite materials must be matched to curing lights.

 Common photochemical initiators are:

Camphoroquinone

Acenaphthene quinone

Benzyl
LIGHT CURING
 Light curing can be accomplished with:-
1) Quartz-Tungsten-Halogen
2) Plasma Arc Curing
3) Light Emitting Diode
ADVANTAGES:

 Mixing is not required.

 Less porosity
 Less staining
 Increased strength
 Enhanced color stability (aromatic amine)
 Command polymerization
CURING LAMPS

 Hand held devices

 Contain a light source
 Equipped with a relatively short rigid light guide made up of fused optical fiber
Types of lamps:

1. LED lamps
2. QTH lamps
 Quartz bulb with tungsten filament

 Radiate UV and White light

 Must be filtered to remove heat and other wavelength than violet-blue range

 Intensity diminishes with use-calibration meter required

3.PAC lamps
 Plasma arc curing lamps use xenon gas that is ionized to produce plasma

 High intensity white light is filtered to allow blue light to be emitted

4.Argon laser lamps
 Highest intensity

 Emit light at single wavelength (~ 490nm)

 QTH is cheaper,
 LED and laser do not require filters
 Polymerization is initiated when a critical concentration of free radical is
formed.
Curing Of Composite
C-factor

Ratio of bonded surfaces to the unbounded, or free,

surfaces in a tooth preparation.

Polymerization shrinkage & Residual polymerization

stress increases directly with this ratio.

During curing, shrinkage leaves the bonded cavity

surfaces in a state of stress and the nonbonded, free
surfaces (i.e., those that reproduce the original external
tooth anatomy) relax some of the stress by contracting
inward towards the bulk of the material.

C-factors for dental restorations typically range from

0.1 to 5.0.
Light-cured composites polymerize both during and after visible light-activation. These two
curing reactions are known as the “light” and “dark” reactions.

The light reaction occurs while light from the curing unit penetrates the composite.

The dark reaction, also called post-irradiation polymerization, begins immediately after the
curing light goes off and continues for up to 24 hours, even in total darkness, but most of it
occurs within 10 to 15 minutes post cure.
Components Of A Resin-dentine Bond

• 1. Hybrid layer (resin- dentine interdiffusion zone) a

hydrophilic primer and an adhesive bonding agent
penetrate approximately 5µm around and into partly and
completely demineralized inter¬tubular dentine on the
cavity wall.

• 2. Resin tags: The primer and bonding agent form tags of

resin, up to 100µm long, in the dentinal tubules.

• 3. Elastic bonding zone: The hybrid layer and the adhesive

bonding agent that covers it provide an "elastic cavity
wall" or “shock absorber" that assists the bond to resist
stresses from polymerization contraction and functional
loading.
 Curing Lights

Source Of Light
Radiation & Need For Filter
Power Required
Need For Cooling Fan
Intensity & Exposure Time
Cost
Soft start curing - Ramped curing - Delayed curing
Degree of Conversion

 Measure of the percentage of carbon-carbon double bonds that have been converted
to single bonds to form a polymeric resin.

 Maximum DC achieved is 65%.

 Higher DC, better the clinical & mechanical properties.

 DC of 60% indicates adequate polymerization.

Depth of Cure

 Thickness of resin that can be converted from a monomer to polymer under a

specific light curing condition

 Usually 2 – 3mm
FACTORS THAT AFFECT DEGREE OF CONVERSION & DEPTH OF
CURE

Air Inhibition
•Oxygen in the air competes with polymerization and inhibits setting of the resin.
•The extent of surface inhibition is inversely related to filler loading.
•The undercured layer can vary from 50 to 500 μm, depending on the reactivity of the
photointiators used.
•Unfilled resins should be cured, then covered with an air-inhibiting gel, such as a thin
layer of petroleum jelly, glycerin, and then re-cured.
Area Of Composite To Be Cured

•When the area of composite to be cured is larger than the diameter of the light tip,
composite sections must be overlapped at least 1 mm. Failure to properly overlap
during curing can result in poorly polymerized areas in the restoration.

•Curing time also must be increased to compensate for the increased area of resin.
Area Of Composite To Be Cured
.
•To avoid the time-consuming and tedious process of
overlapping, a number of wide-diameter attachments are
available for many visible light curing units. The attachments
are particularly useful in curing composite veneers.

•Some wide diameter curing attachments are adaptable to

existing curing units and emit more light because of a larger
curing tip on the unit connector.

• Others, however, spread the same narrow unit-connector

light source over a larger diameter with the use of optics; most
of these have reduced light intensity. This reduces the depth of
cure, so composite must be cured in thinner layers.
Concentration of Initiator & Inhibitor

Concentration & Type Of Fillers

•Generally, the more heavily loaded a composite is with larger inorganic fillers, the more
easily the resin cures.
•However, extremely high loading can make a composite opaque, which actually increases
the required duration of exposure.
Curing Through Tooth Structure

•It is possible to light-cure resin through enamel, but this technique is just one- to two-
thirds as effective as direct curing and is appropriate only when there is no alternative.

•Such curing is possible through up to 3 mm of enamel or 0.5 mm of dentin, but the

clinician should double or triple exposure times.

•When light-curing through tooth structure, porcelain veneers, and other barriers, it is
advisable to use a high-intensity light.
Distance
•A good rule of thumb is that the minimum power density output should never
drop below 300mW/cm2
•Intensity of light is inversely proportional to the distance from the fiber optic tip to
the composite surface.
•Ideally, the fiber optic tip should be adjacent to the surface being cured but this will
lead to tip contamination.
•Therefore, the tip should be within 2mm of
composite to be effective.
•Light transmitting wedges for
interproximal curing & light focusing tips
for access into proximal boxes are available.
•Intensity of the tip output falls off from the
centre to the edges. So bulk curing of the
composite produces bullet shaped curing
pattern
Heat Generated

•The heat given off by a curing light increases the rate of photochemical initiation and
polymerization reaction and increases the amount of resin cured.
•However, the heat generated in the tooth during light-curing results in higher
intrapulpal temperatures, which could be harmful.
•Deep layers of resin should be cured thoroughly; cooling with a dry air syringe may be
helpful.
Shade (Transmission of light through material)

•Darker composite shades cure more slowly and less deeply than lighter shades.

•At a depth of 1 mm, a dark composite shade achieves just two-thirds of optimum depth of
cure achieved in translucent shades.

•Hence, when esthetics is not critical, the lightest shade should be used.
Ocular Hazard

•The 468 to 480 nm wavelength of light that polymerizes composite resin is among the
ranges of light most damaging to the eyes.

•The best eye protection is to completely avoid looking at the curing light source. Covering
the curing site with a dark object would be ideal.

•Some clinicians cover the curing site with their hand. This may prove an unsafe practice.
In cell research, blue light is used to induce cancer growth; therefore, skin exposure is
highly discouraged.
•A simple yet effective way to provide shielding from curing lights is to cover
the curing field with the reflective side of a mouth mirror. This prevents
excess blue light from reflecting back against the restorative and improves
curing. If the mirror is not large enough, a folded patient napkin easily
covers most fields. A slight amount of brightness will show through the
napkin and shows if the light is on or off.

•If it is necessary to look at the light source for placement, eye protection is
warranted. Unfortunately, most optical glasses and plastic contact lenses
transmit blue light and near-UV light radiation with little attenuation.
•A number of colored plastic glasses and handheld shields are available. Some of these
plastics (usually red and orange) can block blue light. They can be cut and made into
custom shields. Over time, they may need to be replaced, since the organic dyes used to
color plastic fade with use.

•Colored protective lenses in glasses are another option. The drawback is that they
require a 2- to 6- minute recovery period before normal color perception returns. This
temporary distortion can interfere with the ability to judge shades.
Finishing & Polishing

Once a composite has been cured, it must be finished and polished to produce the final
surface.

During finishing (cutting) and polishing (smearing), the irregularities on the surface
are being removed. This step also removes the air-inhibited layer.
The irregularities are a function of the finishing burs, diamonds, or abrasive points
(grooving), particle size in the composite (because particles are ripped out during
finishing), and the particle size in finishing materials (abrasive particles in disks, strips,
pastes).

Proper finishing of restorations is desirable not only for esthetic considerations but
also for oral health.
Steps in finishing and polishing

•Gross reduction where excess restorative material is removed.

• Contouring, which includes the reproduction of the size, shape, grooves and other
details of the tooth form. Re-establishing contact with adjacent teeth to a normal and
functional form.
•Finishing and polishing establishes an even, well-adapted junction between the tooth
surface and the restoration and removes scratches to produce a visually smooth and
shiny surface.
The primary goal of finishing is to obtain a restoration which has good contour,
occlusion, healthy embrasure forms, and smoothness.

The polish should be smooth enough to be tolerated well by gingival tissue. It has been
proven that rough surfaced restorations can create clinical problems such as plaque
retention, gingival irritation, staining, higher wear rates, and recurrent caries.

Tight margins should blend esthetically into the tooth’s natural contours.
Several factors can affect the final finish of a restoration: the matrix and fillers within
the material, finishing instruments, preparation design, curing, and post cure time.

A heavily filled material may require coarser instruments, whereas microfills require a
more delicate touch.
Chemical cured materials must be accurately timed to complete polymerization. It
has been suggested that before finishing the restoration it should be left undisturbed
for a minimum of 10 minutes to allow the resin to completely polymerize. This may aid
in reducing surface trauma from the finishing process.

Type of INSTRUMENTS USED:-fluted carbide bur; diamond burs; stones; coated

abrasive discs and strips; polishing pastes; and soft or hard rubber type cups, points,
and wheels impregnated with various abrasives grits.
PROPERTIES OF COMPOSITES
BIOCOMPATIBILITY

Acid etching the dentin removes the smear layer and opens the dentinal tubules,
allowing a positive dentinal fluid flow and this leads to an increase in the wetness of the
dentin surface & subsequent marginal leakage occur.

It is therefore currently recommended that until reliable techniques and materials are
available for resin bonding to dentin, as a general rule.
•Dentine should not be etched in vital teeth
•Glass ionomer base should completely cover the dentin of all the cavity walls before
acid etching the enamel margins.
BIOCOMPATIBILITY

If acid etching the enamel did not come into contact with underlying dentin of the
involved Pulp - Dentin organ & when the:

•Effective - depth is 3 mm or more we can expect a healthy reparative reaction.

•Effective - depth is 1.5 - 3 mm then composite resins can induce an unhealthy

reparative reaction or sometimes even destruction.

•Effective - depth is less than 1.5 mm composite resins induce always destruction
of Pulp - Dentin organ.
BIOCOMPATIBILITY

BPA that leaches from dental composites (likely to be from hydrolysis of bis-DMA), can
act as a xeno-estrogen.

Maximum acceptable or "reference" dose for BPA of 0.05 mg/kg body weight/day.

The highest level of BPA reported in saliva from dental sealants is 50,000 times lower
than the LD50 values that have been reported for BPA.

Therefore, human exposure to BPA from dental resins is minimal and poses no known
health risk.
BIOCOMPATIBILTY

Completely polymerized resin causes minimum pulpal irritation.

Incompletely cured resin is a potential hazard (may be due to unpolymerised

monomers or the surface active complexes formed between the low molecular weight
components of the light activated initiator systems)

Incompletely cured resin, particularly in those materials with low filler content, appears
to be a tissue irritant.
BIOCOMPATIBILTY

HEMA is hydrophilic and also strongly allergenic. It has been shown that HEMA is able
to transverse dentinal tubules and appear in the pulpal tissue leading to allergic
responses.

Light activation units generating intense visible light have the potential to cause pulpal
injury. Temperature rise of 0.5-10°C have been reported through dentine measuring 1-
2mm in thickness this may lead to pulp damage.
BOND STRENGTH TO DENTAL SUBSTRATES

Bond strength of composites to acid etched enamel is in the range of 3500 lbs/in2
(24MPa) and the variation in the values reported is much smaller than for bond strength
to dentin.

Bond strength to dentin after removal of the smear layer from cavity preparation
(mainly collagen with hydroxyapatite particles) ranges from 700 lbs/in2 (5MPa) to 3500
lbs/in2 (24MPa) with many products reporting values from 2300 lbs/in2 (16MPa) to 2600
lb/in2 (15MPa).

The wide variation may be due to:

•amount of intertubular dentin
•difference in morphology of dentin
•penetration of the bonding agent into the dentin
BOND STRENGTH TO DENTAL SUBSTRATES

Minimum bond strength estimated to be required to prevent marginal gaps as a result

of polymerization shrinkage - 2900 lbs/in2 (20MPa).

Repair bond-strength is about 60% to 80% of the cohesive strength of the original
composite.
COLOR STABILITY

Change of color and loss of shade-match with surrounding tooth structure are reasons for
replacing restorations.

Composite resins may undergo discoloration, which may be either intrinsic or extrinsic.
COLOR STABILITY

Extrinsic discoloration: It is the most common type and can occur marginally or
on surface.

A) Marginal discoloration:
may be due to dissolution of varnish, micro leakage, recurrent decay

B) Surface discoloration:
mainly due to surface roughness or irregularities that increase
stainability or possibility of plaque accumulation on the surface. It may also be
a continuation of intrinsic discoloration.

Intrinsic discoloration: Due to chemical changes or deterioration of one or more

component phases of the material with coloring by products
COLOR STABILITY

Discoloration can also occur by oxidation and water exchange within the polymer
matrix and its interaction with unreacted polymer sites and unused initiator or
accelerator.

Stress cracks within the polymer matrix and partial debonding of the filler to the resin
as a result of hydrolysis tend to increase opacity and alter appearance.

Chemically activated composites become yellowish within 1-3 years, as a result of

oxidation of excess amine from the initiator system and may require replacement.
Visible light activated composites lighter in colour and may become more translucent
during placement and curing. Further lightening may occur over the next 24-48 hrs;
probably caused by the decomposition of the camphoroquinone.

In the long term, light activated composites are relatively colouring stable, provided
that the resin in adequately cured.
ELASTIC MODULUS / STIFFNESS

Elastic Modulus α volume fraction of filler

More heavily loaded composites have higher values & have almost same stiffness as that
of dentine (18.5 Gpa) but substantially less rigid than enamel (82.5 Gpa).

Flexible restorations (Low Elastic modulus) would be clinically more retentive because of
improved accommodation to flexural forces. The opposite requirement would be true for
large MOD restorations. Composites in those cases should be very rigid and thus minimize
tooth flexure of remaining cusps.
FRACTURE TOUGHNESS

A measure of the energy required to propagate a crack within a material indicates

resistance to crack growth

Fracture toughness α volume fraction of filler

Fracture toughness α size of filler particle

More heavily loaded composites and those with coarser particles have greater
fracture toughness.

Tends to reduce overtime in the oral environment because of water sorption and
degradation.
LINEAR COEFFICIENT OF THERMAL EXPANSION

Coefficient of thermal expansion compared to natural tooth structure & amalgam is high.

Coefficient of thermal expansion α volume fraction of resin matrix

coefficient of thermal expansion 1/α volume fraction of inorganic fillers

Coefficient of thermal expansion ranges from

25 - 38x10-6 /0C for composites with fine particles
55 - 68 x 10-6 /0C for composites with microfine particles
LINEAR COEFFICIENT OF THERMAL EXPANSION

Constant thermal cycling can lead to material fatigue and early bond failure.

During extreme intraoral temperature changes and times, significant stresses may
be generated at the tooth/restoration interfaces where composites are
micromechanically bonded, causing microleakage, unaesthetic staining, pulpal
sensitivity, pulpal irritation due to diffusion of bacterial endotoxins, and/or
predisposition toward recurrent caries.
OPTICAL PROPERTIES

Transparency - chiefly controlled by absence / presence of and type of filler. That is why
unfilled resins have high transparency.

Translucency - depends mainly on nature & type of unreacted particles of the original
powder material or its filler. Composite have the most appropriate translucency to that of
tooth enamel.

Reflectiveness - mainly the product of surface texture. Smoother the surface, more rays
are reflected. Saliva will impart certain reflectiveness on the surface of the tooth and
material, that is why in choosing a shade the tooth should be covered with saliva.

Hue, Value and Chroma are products of the inherent coloration of the material and the
nature of incorporated pigments. Inorganic pigments seem to produce the most stable
and predictable coloration and shading.
POLYMERIZATION SHRINKAGE

One of the main factors that determine the longevity of composite restorations.

Polymerization reaction of the liquid resin components of a composite resin into a

solid matrix results in polymerization shrinkage with measurements invitro reported
to range form 0.2 – 0.9% linear shrinkage and 1.2-1.4% vol. shrinkage.

Polymerization shrinkage leads to production of polymerization shrinkage stresses

within the resin that pulls it away from tooth structure.

Residual stresses of 2.8 to 7.3 MPa have been reported for composite resin
(Davidson and Degee 1984).
POLYMERIZATION SHRINKAGE

Residual stresses are less than the tensile strength of enamel, which is
about 20-40 MPa (Hegdahl and Gjerdet 1977).

To offset contraction stresses, the resin to tooth bond should be atleast
17Mpa

Ways to reduce contraction stresses generated as a result of

Polymerization shrinkage

•Autocure resins

•Light cure resins

RADIOPACITY

Resins are inherently radiolucent.

However, addition of radiopaque filllers have rendered them somewhat radioopaque

For composite, international standards accept radiopacity equivalent to 2 mm of

aluminum.

For a composite used for class II filling, must be radiopaque for the following reasons
(Roulet, 1988).
•Diagnosis of secondary caries:
•Diagnosis of Over hanging margins.

Taria et al, 1993 - use of Zr –Si fillers (ZrO2-SiO2) have much better radiopacity then
silica alone.
RHEOLOGICAL PROPERTIES

Viscosity α volume fraction of filler

Viscosity 1/α size of the filler

Viscosity of the composite resin has significant clinical implication and

can vary from 18-1370 N/m2.
RHEOLOGICAL PROPERTIES

Composites are rather viscous, sometimes sticky and cannot be condensed to create a firm
interproximal contact area.
Friction between the filler particle surfaces and the monomer is a principal factor controlling
the fluidity.

Jacobsen and Ferrcane et al reported that the composites are pseudoplastic and the fluidity is
strongly dependent on the resin phase.
Lee et al (2005) reported that resin matrices were Newtonian fluids and all experimental
composites exhibited pseudoplasticity.
WATER SORPTION / ABSORPTION

All the available tooth-colored materials exhibit some water sorption.

Water sorption 1/α volume fraction of filler, degree of polymerisation

Water sorption is accompanied by the swelling of composite but this has not been as
effective way to counteract polymerization shrinkage .

A limited amount of water sorption may be beneficial to a newly placed composite

resin restoration because it will bring about a degree of expansion and help to counteract
setting contraction.

Water sorption promotes diffusion and desorption of any unbound monomer.

WEAR / MECHANICAL DEGRADATION

2nd most frequent clinical problem apart from polymerization shrinkage of composite is
occlusal wear.

Wear classification

1) Wear by food (Contact free area or CFA wear)

2) Impact by tooth contact in centric (occlusal contact area or OCA wear)

3) Sliding by tooth contact in function (Functional contact area or FCA wear)

4) Rubbing by tooth contact interproximally (Proximal contact area or PCA wear)

5) Wear from oral prophylaxis methods (tooth brush or dentifrice abrasion)

The relative contribution of these processes is poorly understood.

Wear mechanism

I. According to Anusavice

1. Two body wear

2. Three body wear

Two body wear causes significant wear of composite rather than three body wear.

II. According to Sturdevant

1. Microfracture theory: (Karl.F.Leinfelder)

2. The Hydrolysis theory (K.J. Soderholm, 1981)
3. The Chemical degradation theory: (Wu. W, Cobb EN 1981)
4. The Protection theory: (S.C. Bayne, D.F Taylor, H.O. Heymann,
1992)
Wear Rate

ADA guidelines for posterior composites include that mean maximum wear should
not exceed 50 μm when measured over the 1-year period from 6 to 18 month (2001).

Of posterior composite is 0.1 to 0.2 mm/year more than that of enamel.

Studies:

•Condon and Ferracane (1997) - wear of composites depend on degree of cure, filler
level, and silanation. The wear depths did reflect cure values. Greater wear was
correlated with lower filler levels, significantly increasing below 48 vol%. Wear
increased linearly as the percent of Silane-treated fillers was reduced.

•Soderholm et al (2001) - average wear rate on contact-free surfaces was 8.5+3.7 to

9.2+4.2 μm/month. The urethane-based composites performed significantly better
than those which were bisGMA-based.
Wear Resistance Of Composites

Macroprotection

Microprotection

Wear resistance of posterior composites has been extensively evaluated in

longitudinal clinical studies at the university of North Carolina and the University of
Alabama over 15 years. Results of this research have demonstrated that macrofilled
composites are the more wear resistant formulations.
WORKING AND SETTING TIMES

Working time of light-cured composites depends on the operatory light and

the ambient room light to which the composites are exposed.

Operatory lighting - most operatory lights operate at high temperatures that

produce spectrums in the blue range. This spectrum is included to improve the
color selection of dental restoratives, but it initiates curing.

Incandescent lighting - incandescent lights are low in blue light and provide
the longest composite working time.
Fluorescent lighting - in general, fluorescent lighting has the shortest working
time for light-cured composites, because it emits a large amount of blue light.

Within 60 to 90 seconds after exposure to ambient light, the surface of the

composite may lose its capability to flow.

Newer, faster-setting composites are even more sensitive.

Working time can be improved in following ways:

1. Place the operatory light further from the working field. Generally, doubling
the distance of the operatory light from the patient greatly increases the working time
while still providing adequate light for composite placement.

2. Place an orange filter over the operatory light.

3. Fluorescent lights labeled "gold" can be substituted to provide unlimited

working time for light-cured composites.
The setting times for chemically activated composites range from 3 to 5
minutes. The optimum physical properties are not reached until about24
hours after the reaction is initiated.

For light cured about 75% of the polymerization takes place during the
first 10 minutes. The curing reaction continues for a period of 24 hours.
TYPES AND RECENT ADVANCES OF
COMPOSITE RESINS
CONVENTIONAL COMPOSITES: (1970’S)

Resin base + large quartz fillers (50-60%)

Good strength & hardness
Difficult to polish well – rough surface
Stains and discolors; poor esthetics
Uses: not used for restorations anymore; may be
used as an ortho cement
MICROFILLED COMPOSITES:

 Resin base + silica particle fillers (30-55%)

 Weaker material ( fillers)
 Very high polish – excellent esthetics
 May be used as final layer of deep restoration
 Use: Great for anterior restorations (III, V)
(NOT Class IV)
SMALL PARTICLE COMPOSITES:

• 1 - 5 micron heavy-metal glasses

• Fracture resistant
• Polishable to semi-gloss
• Suitable for Class 1 to 5
• Example: Prisma-Fil
HYBRID COMPOSITES:
 Resin + quartz or glass fillers (65-70%)

 Small or midsize particles

 Minifills (largest particles are 1 – 2 um)

 Midfills ( average particle size is 3 – 8 um)

 Metals added to glass to make them radiopaque

 Combination of esthetics & durability

 Universal use
NANOFILLED V/S NANOHYBRID

• Nanofills
• nanometer-sized particles throughout matrix
• Nanohybrids
• nanometer-sized particles combined with more
conventional filler technology
NANOCOMPOSITES

Contains nanofillers that range in size from 0.005 to 0.01 μm, which is below the
wavelength range for visible light (0.02 to 2 μm).
Potential advantages:
•Nanofillers are so small that they fit between several polymer chains. These
characteristics permit the opportunity to achieve very high filler loading levels in
composites while still maintaining workable consistency.

•Nano-sized filler particles allow the polish and polish retention typical of a
microfill in addition to good handling, strength and wear properties.
PACKABLE/CONDENSABLE COMPOSITES

Based on newly introduced concept, called the PRIMM [polymer rigid

inorganic matrix material].

Consistency of PRIMM based composites is similar to that of a freshly

triturated mass of amalgam

Enable clinicians to apply techniques similar to those used for amalgam

restorations.
FLOWABLE COMPOSITES

Modifications of the SPF & hybrid composites

Introduced in 1996

Have a reduced filler level as to provide a consistency that enables the

material to flow readily, spread uniformly, and intimately adapt to a
cavity form to produce a desired dental anatomy

Depth of cure is approximately 6mm

Indications:
•Small class III cavities & small class I cavities frequently referred to as ‘preventive resin
restorations’
•Sealing gingival floor of the proximal box of class II restorations.
•First increment of all deep restorations to prevent voids and porosities and to get good
seal.
•Class v cavities
•Blocking out cavity undercuts during inlay, onlay and crown preparations.
COMPOMER (Polyacid Modified Composite Resins)

Dyract Flow  Caulk

Elan  Kerr
F-20003M
Hytac  ESPE
Compoglass F  Ivoclar

Contain dimethacrylate monomer & ion-leachable glass

Excludes water from composition to prevent premature setting of the
material and also to ensure that setting occurs only through a
polymerization reaction.

Limited acid base reactions are believed to occur after the material with
hydrophilic monomers absorb H2O from tooth and the oral environment. –
which contribute to fluoride release
CEROMER (CERamic Optimized polyMER)

Composed of specially developed, closely packed (75 – 85 wt %) and

conditioned fine particle ceramic fillers of submicron size (0.04 and 1.0 µm
EXPANDING MATRIX RESINS

Resins that expand slightly during polymerization are highly desirable as these
would facilitate bulk placement of the material, and reduce post operative sensitivity.

Expansion of spiro orthocarbonates [SOCs] on polymerzation may be the possible

solution.

Epoxy resins show relatively low volumetric shrinkage compared to methacrylate

based resins

Epoxy resins contract approx 3.4% and SOCs expand approx 3.6%, there fore
combining these two will achieve a net polymerization expansion.
ENA HRi flow
No bubbles formulation
• HRi features breakthrough technology - a light refractive index (1.62) that is
identical to natural enamel, with optical properties that can't be found in any
other composite.
• The ENA HRi Flow formulation eliminates air bubbles, resulting in superior
physical properties.
GINGIVAL MASKING COMPOSITES

An aesthetic gingiva-shaded light-cured composite resin recently introduced,

providing practitioners with the option of correcting gingival recession with a
minimally invasive and less costly procedure.

• Pink-colored composite - available in one translucent gingival color and 3 pink

flowable opaquers - mixed together to better match an individual's gingival
shade
• Cervical area, including composite restorations in gingival
colors V-shaped defects
• Exposed cervical Areas
• Aesthetic corrections of the gingival area,
• Primary splinting, and the correction of red/white aesthetics
• Ability to mask exposed crown margins to improve aesthetics
and patient satisfaction.
ESTHET X FLOW

• Pseudo plastic handling - flows on command

• Superb strength and wear resistance
• Highly radiopaque
• Low shrinkage & porosity
• 8 VITA shades plus 1 opaque and 1 bleach shade
• Excellent polish & Fluoride release
Uses:
 Low stress applications but not in class I and II in premolars and molars.
 Resurfacing composite or GIC restorations or for rebuilding worn composite
contact areas.
 Areas of difficult access or areas that require greater penetration, amalgam,
composite or crown margin repairs, pit and fissure sealant or preventive resin
restoration.
 As liner or base in class II proximal box.
 Cementing porcelain veneers.
 Restoration of air abrasion preparation, class v lesions, porcelain repairs, enamel
defects, incisal edge repair in anteriors, class III lesions.
ION RELEASING COMPOSITES

Releases fluoride, hydroxyl and calcium ions as the ph drops in the area
immediately adjacent to the restorative material.

Paste consists of Ba, Al and F silicate glass filler (1 mm) with ytterbium trifluoride,
silicon dioxide and alkaline calcium silicate glass in dimethacrylate monomers.
Introduced as the product Ariston in 1998

Fluoride release from this material is claimed by the manufacturer to be lower

than glass ionomers but more than that of compomers.

Although favorable short-term data is available, there is no long-term

independent data to support the claims of the cariostatic effect
GIOMER

Composition of giomers is based on PRG (Pre-Reacted Glass

ionomer) technology

Presence of a pre-reacted hydrogel is responsible for the high

levels of fluoride release and the recharge of giomers.
PRG-technology is classified into two categories:
•FPRG (full reaction type)
•where the entire filler particle is attacked by polyacrylic acid,
•eg: Beautifil

•S-PRG (surface reaction type)

•where only the surface of the glass filler is attacked by polyacrylic acid
and a glass core remains.
• eg : Reactmer
SMART COMPOSITES

• Smart Composites are active dental polymers that

contain bioactive amorphous calcium phosphate (ACP)
filler capable of responding to environmental pH
changes by releasing calcium and phosphate ions and
thus become adaptable to the surroundings.
• These are also called as Intelligent composite
• Based on a newly developed alkaline glass filler and is expected to
reduce the formation of secondary caries at the margins of the
restorations due to inhibition of bacterial growth, reduced
demineralization and buffering of acids produced by cariogenic micro-
organisms
Smart composites work is based on the newly developed alkaline glass. The paste
contains Ba, Al, and F silicate glass filler (1µm) with Ytterbium trifluoride, silicon
dioxide and alkaline glass (1.6 µm) in dimethacrylate monomers
• Ivoclar 1998 named Ariston pHC (pH control) which was claimed to release :
Fluoride
• Hydroxyl Calcium if PH falls in the vicinity of the restoration < 5.8
• This was said to neutralize acid and counter act the decalcification of enamel and
dentine.
SILORANES
• Guggenburger and Weinmann (2000)
• Siloxane + oxiranes
• Siloxane backbone – hydrophobic nature
• Ring opening monomers, cationic cure
• As silorane-based composite polymerizes, “ring-opening” monomers connect by
opening, flattening and extending toward each other.
• As methacrylate-based composites cure, the molecules of these “linear monomers”
connect by actually SHIFTING closer together in a linear response.
FILTEK™ P90 LOW SHRINK POSTERIOR
RESTORATIVE SYSTEM
• Combines the lowest-shrinking silorane-based
composite with a dedicated two-step, self-etching
bonding system.
GLASS INSERTS
• An alternative to conventional composites has been developed (Bowen et al, 1991) known
as "MEGAFILLED" composite restorations are produced by filling the bulk of the cavity
preparation with beta-quartz glass inserts.

• The inserts are surrounded by light cured composite, which bonds to the insert via a
silane coupling agent. The inserts are produced in a variety of shapes and sizes to fit most
cavity preps.
•.
When fitted into the cavity, they minimize the volume of shrinking composite and reduce
curing contraction (George and Richards, 1993). The integration of inserts reduces the
polymerization shrinkage stress and lowers the overall coefficient of thermal expansion
AVAILABLE INSERT SYSTEMS:
Beta Quartz: Glass Ceramic Inserts:
• Beta quartz inserts are manufactured of a cast glass ceramic based upon a lithium
aluminium silicate with the addition of iron, sulphur. The surface of inserts is presilanized.
Beta quartz silane liquid is available for the chairside resilanization of contaminated inserts.

SDS feldspathic inserts:

• SDS inserts ( Schumacher Dental Systems, Germany) consists of a feldspathic ceramic with
a flexural strength of upto 10-20% greater Other insert systems
Ceramic Leucite Reinforced Ceramic Inserts:
• Cerafil inserts consists of a dental ceramic reinforced by leucite crystals. The
cerafil system offers conical, symmetrical ceramic inserts of various sizes with
matching preparation instruments and finishing diamonds.

Sonic Sys Leucite-reinforced Ceramic Inserts:

• Sonic Sys inserts (Vivadent) are made of leucite reinforced glass ceramic. The
Sonic sys inserts allows the finishing preparation and restoration of a non
symmetrical proximal cavity.
Cerena Glass Ceramic Inserts:
• Cerena inserts (Noediska Dental, Sweden) are manufactured of a translucent
glass ceramic material without any addition of color pigments.
ANTIBACTERIAL COMPOSITES
• Chlorhexidine has been tried in an attempt to reduce plaque accumulation
on the surface of filling materials. However, this was not successful since the
release was not uniform and lead to certain disadvantages like:
• -toxic effects of the released materials
• -population shift of microorganisms
• - short-lived antibacterial activity
• -deterioration of physical and mechanical properties of the materials.
Imazato et al (1994) attempted to make the composite antibacterial by
incorporating a non releasing newly synthesized monomer, MDPB with
antibacterial properties into the composite resin.

Metacryloyloxydodicylpyridinum bromide
MDPB was found to be effective against important species in plaque
formation like actinomyces, Neisseria and veilonella
Silver has also been added in the composites to make it antibacterial - ‘oligodynamic
action’

• Silver can be added either:

• Silver ions are incorporated into inorganic oxides like silicon dioxide
• silver ions may be hydrothermally supported into the space between the crystal
lattice network of filler particles.
• Silver ions may be incorporated into the silica gel and the thin films are coated
over the surface of composites. 1wt%halo(active against S.mutans and A. viscous
for 10 wks).
Antibacterial activity of dental composites containing zinc oxide nanoparticles. June
2010 in J Biomed Mater Res B appl biomater, 94(1): 22-31.

• It is demonstrated here that zinc oxide nanoparticles (ZnO-NPs) blended at 10%

(w/w) fraction into dental composites display antimicrobial activity and reduce
growth of bacterial biofilms by roughly 80% for a single-species model dental
biofilm.

• ZnO-NP-containing composites (10%) qualitatively showed less biofilm after 1-day-

anaerobic growth of a three-species initial colonizer biofilm after being
compared with unmodified composites, but did not significantly reduce growth
after 3 days.
BULKFILL COMPOSITES

• Reduced polymerization shrinkage- Changes in filler composition shrinkage

• stress relievers or polymerization modulators
• Increased depth of cure-Novel photo initiators, polymerization boosters or by
• Increasing translucency
• Higher strength & Better wear resistance
• Ease of flow & adaptability
• Good esthetic properties
LABORATORY / FIBER – REINFORCED/ INDIRECT COMPOSITES

Use for fabrication of veneers, onlays, inlays & crowns are polymerized outside the oral
environment, which are luted to the tooth with a compatible resin cement.

Artglass (kulzer), belleglass hp (kerr), clearfil cr inlay (kuraray co., Ltd.), Coltene inlay
system, cristobal (dentsply ceramco, inc.), Targis vectris (ivoclar), sculpture-fibrekor (jeneric
pentron)
Potential advantage
•Higher degree of polymerization is attained
•Not as abrasive to opposing tooth structure as ceramic inlays.
•Polymerization shrinkage does not occur in the prepared teeth
•Repairable in the mouth
ORMOCER (ORganically MOdified CERamic)

Dr. Herbert Wolters from Fraunhofer Institute for Silicate Research introduced this
class of material in 1994.

Filler - Silicon oxide

Matrix - ceramic polysiloxane

Filler phase instead of being incorporated in to composites as
ground particles is present as a continous network of ceramic
fibers (about 100 μm in length), that tend to inter lock and resist
flow. This causes the uncured resin to be stiff and resistant to
slumping, yet moldable under the force of amalgam –condensing
instruments.

Have not demonstrated any advantageous properties or

characteristics over the hybrid resins, other than being somewhat
similar to amalgam in their placement technique.
CHITOSAN COMPOSITES
• Chitosan and chitosan derivatives appear to be good candidates for the elastomeric
matrix. These natural biopolymers are biocompatible ,biodegradable and osteoconductive.
They have been used in surgical interventions for the reduction of periodontal pockets.
• Biocompatibility , biodegradable, muco adherent
• Stable in a wet environment and had sufficient physical strength for many clinical
applications. The strength did not decrease with time under simulated physiological
conditions.
BIOACTIVE COMPOSITES
• Bioactive formulations:
• -ACP (amorphous calcium phosphate)-2000
• -ACP + BIS-GMA /TEGDMA/HEMA with Zirconyl methacrylate
• Fluorinated Bis-GMA analogues
• Liquid crystalline monomers
HYDROXYAPATITE (HAP)
• As a reinforcing filler
• Synthetic HAP- hardness similar to tooth- Improved wear
• Intrinsic radio opacity
• Enhanced polish ability
• Less expensive
• Biocompatible
• High refractive index
AMORPHOUS CALCIUM PHOSPHATE (ACP)
• Replace missing/decayed tooth structure by remineralization-Antonucci ,Skrtic
• Intermediate in hydroxyapatite formation
• Single solid phase precursor
• Biocompatible with hard & soft tissues
• Sustain Ca & PO4 release
• Effective remineralising agent – sealants, adhesives, bases, liners
COMPOBONDS

New dental
Advancements
Advancements restorative
in bonding
in resins (COMPOBOND
agents
S)

• Compobonds exploit the benefits of SE DBAs and nanofilled resins, eliminating the
precursory bonding stage necessary to adhere a resin to tooth substrate, and are
termed Self-adhering Composites.
TRADE NAME :- VERTISE FLOW

• First compo bond introduced in 2009 by (Kerr Corp., USA)

• Self adhering flowable combining a resin-based composite and a SE bonding
agent based on the 7th generation DBA, OptiBond®Allin- One
• It is a light-cured composite with similar properties to conventional flowables
but with the added advantage of eliminating the bonding stage.
• Self-etching/self-bonding restorative composites
Preoperative view showing the
existing amalgam restorations Amalgam restorations were removed
which were in need of replacement.

Vertise (Kerr) flowable composite was

dispensed onto a microbrush in order
to accurately place it into the
conservative preparation
 Application of the flowable composite into
the preparation.
The restorative material was scrubbed
onto the prepared tooth and then
lightcured for 20 seconds.

The completed self-etching, selfbonding

flowable composite restorations.
FUSIO™ LIQUID DENTIN
• It is a 4-META (4-methacryloxyethyl trimellitic acid) based flowable
composite featuring nano-sized amorphous silica and glass fillers.
Characteristics and properties of compo bonds
• Acts as a Shock Absorber beneath resin-based composite restorations.
Incorporates the properties of the 7th generation DBA, OptiBond®
• 1) Chemical adhesion by the phosphate function group of the GPDM& 4-META
monomer uniting with the calcium ions within the tooth
• 2) Micromechanical adhesion by formation of the hybrid layer composed of resin
impregnation with the collagen fibres and the dentine smear layer
The bonding mechanism to dentine is two-fold.
• Because Compobonds function both as a dentine adhesive and a resin
restorative material, a Longer Curing Time Is Necessary to ensure that both
constituents are fully polymerised.

• Light curing reaction also halts the etching process of the SE agent
• Increasing its pH from approximately 2 to 7
• So that continual acidity does not erode the dentine bond.
SELF-REPAIRING COMPOSITES:
• One of the first self-repairing synthetic materials reported, interestingly shows some
similarities to resin-based dental materials , since it is resin based.
• This was an epoxy system which contained resin filled microcapsules. If a crack
occurs in the epoxy composite material, some of the microcapsules are destroyed near
the crack and release the resin.
• The resin subsequently fills the crack and reacts with a Grubbs catalyst dispersed in
the epoxy composite , resulting in a polymerization of the resin and repair of the
crack.
WHISKER REINFORCED COMPOSITE

Silica glass particles are fused onto high-strength fine sized ceramic crystalline whiskers
(Mean diameter– 0.4 μm & Length - 5 μm) at high temp.These whiskers were then
silanized and incorporated into dental resin.

The resulting composites possess strength and toughness values similar to those of
currently available resin composites.

However, when nano-sized silica particles were thermally fused onto the surfaces of
whiskers, the strength and toughness of the composites doubled.
 REPAIR OF COMPOSITES

Composites may be repaired by adding new material over the old composite.

Procedure for adding the new material differs , depending on whether the
restoration is a freshly polymerized or aged.
 Freshly polymerized restoration:
•An oxygen inhibited layer of resin on the surface
•More than 50% of unreacted methacrylate groups

Aged restoration :
•Fewer unreacted methacrylate groups
•Filler particles free from silane
•Greater cross-linking

Strength of the bond between the original material and the new resin
decreases in direct proportion to the time.

Useful procedure for altering contours & correcting defects in an existing

composite restoration
PRACTICAL IMPLICATIONS:
 Class III
62.9%
restorations
Overall probability of
survival at 5 years
Class V
71.8%
restorations

van Noort R, Davis LG. A prospective study of the survival of chemically activated anterior resin composite restorations in
general dental practice: 5-year results. J Dent. 1993 Aug;21(4):209-15.

at 5 years 91.7%
Survival rate of posterior
composite resin
restorations
at 10 years 82.2%

Opdam NJ, Bronkhorst EM, Roeters JM, Loomans BA. A retrospective clinical study on longevity of posterior composite
and amalgam restorations. Dent Mater. 2007 Jan;23(1):2-8.
 When clinically
unacceptable restorations
were not included into the 11.0 years
Median survival failure
times of composite When clinically
resin restorations unacceptable restorations
9.7 years
were included into the
failure

Kim KL, Namgung C, Cho BH. The effect of clinical performance on the survival estimates of direct restorations. Restor
Dent Endod. 2013 Feb;38(1):11-20

Annual failure
2%
Median survival rate
times of composite
resin restorations Cumulative 84.3% at 8
survival rate years

Pallesen U, van Dijken JW, Halken J, Hallonsten AL, Höigaard R. Longevity of posterior resin composite
restorations in permanent teeth in Public Dental Health Service: a prospective 8 years follow up. J Dent.
2013 Apr;41(4):297-306.
Longevity of resin composite restorations in Class I and II cavities of posterior teeth - 5.0
years

Rho YJ, Namgung C, Jin BH, Lim BS, Cho BH. Longevity of direct restorations in stress-
bearing posterior cavities: a retrospective study. Oper Dent. 2013 Nov-Dec;38(6):572-82.
CONCLUSION
References:
• Phillip’s Science of Dental Materials - Kenneth J. Anusavice

• Restorative Dental Materials - Robert G. Craig

• Text Book of Operative Densitry - Dr. Vimal K. Sikri

• The Art of Science of Operating Dentistry - Clifford M. Sturdevant

• Esthetic composite Bonding - Jordan Ronald

• Change your Smile - Goldstein Ronald

• Textbook of operative dentistry - Marzouk

• Rho YJ, Namgung C, Jin BH, Lim BS, Cho BH. Longevity of direct restorations in stress-bearing posterior cavities: a
retrospective study. Oper Dent. 2013 Nov-Dec;38(6):572-82

• Kim KL, Namgung C, Cho BH. The effect of clinical performance on the survival estimates of direct restorations.
Restor Dent Endod. 2013 Feb;38(1):11-20

• Pallesen U, van Dijken JW, Halken J, Hallonsten AL, Höigaard R. Longevity of posterior resin composite restorations
in permanent teeth in Public Dental Health Service: a prospective 8 years follow up. J Dent. 2013 Apr;41(4):297-306.

• van Noort R, Davis LG. A prospective study of the survival of chemically activated anterior resin composite
restorations in general dental practice: 5-year results. J Dent. 1993 Aug;21(4):209-15.

• Opdam NJ, Bronkhorst EM, Roeters JM, Loomans BA. A retrospective clinical study on longevity of posterior
composite and amalgam restorations. Dent Mater. 2007 Jan;23(1):2-8.