Dental

Composite
resins
Guided by:
PRESENTED BY :
DR. P. KARUNAKAR
R.DEEPIKA
DR.RAJI VIOLA SOLOMON
PG FIRST YEAR
DR.SRAVAN KUMAR
 CONTENTS

 INTRODUCTION
 EVOLUTION & HISTORY
 CLASSIFICATION
 COMPOSITION
 PROPERTIES
 INDIVIDUAL COMPOSITE
RESINS
ADVANCES IN COMPOSITES
 PACKABLE COMPOSITES
 FLOWABLE COMPOSITES
 COMPOMERS
 INDIRECT COMPOSITE RESINS
 CEROMERS
 FIBER REINFORCED COMPOSITES
 COMPOSITE INSERTS
 SMART COMPOSITES
 ORMOCERS
 GIOMERS
 NANOCOMPOSITES
 SIALORANE TREATED COMPOSITES
 Part 2
 Classes I,II,III,IV,V and VI restorations
 Foundations or core buildups
 Inlays and onlays
 Sealants and conservative composite restorations
(Preventive Resin Restoration)
 Esthetic enhancement procedures
 Partial veneers
 Full veneers
 Tooth colour modifications
 Diastems closures
 Cements (for indirect restorations)
 Temporary Restorations
 Periodontal splinting
 Orthodontic bracket placement
 INTRODUCTION

The search of beauty can be traced to

earliest civilization.

Dental art has long been a part of the

quest to enhance the esthetics of teeth
and mouth.

The constant desire of dental profession

to achieve a natural appearance has led
to development of various tooth colored
materials, one among them being dental
composites.
Of all the innovative esthetic materials available today composite
restorative materials have assumed a thrust in restorative dentistry.

Skinner in 1959 stated, “ The esthetic quality of a restoration may be as

important to the mental health of the patient as the biological and
technical qualities of the restoration are to his/her physical or dental
health”.
Three individuals who made the most significant contributions in this
aspect are:

MICHAEL BUONOCORE: Introduced the acid–etch technique and

demonstrated the concept of bonding acrylic resin to the surface of
enamel.
RAFAEL BOWEN: Developed composite resin matrix –BISGMA (Bis
Phenol A Glycidyl Methacrylate)
NOBUO NAKABAYASHI: His efforts have led to the technique for
bonding of resin composites to the surface of dentin
 EVOLUTION
SILICATES DURING
FIRST HALF OF 20 TH
CENTURY

ACYLICS
IN EARLY 1950

1956 DR . BOWEN
FOMULATED BIS
-GMA

1962: Dr.Ray L Bowen

of the ADA research
unit
COUPLING AGENTS-
MACROFILLED

1970 LIGHT
CURED UV LIGHT
1972 VISIBLE LIGHT
CURE

1976: Micro filled composite

resins
SECOND GENERATION OF
COMPOSITE.

Mid 1980
HYBRID COMPOSITES
THIRD GENERATION OF
COMPOSITES.

1991: Mega – filled

composites with glass
ceramic inserts coated
with silane

1992 FIBER –
REINFORCED
COMPOSITES
1996: Flowable
composites

PRIMM- POLYMER
RIGID INORGANIC
MATRIX MATERIAL
1997-98

1998:
Introduction of
COMPOMER,
GLASS IONOMER
and COMPOSITES

1998
ORGANICALLY
MODIFIED
CERAMICS

2003-NANO
COMPOSITES
 DEFINITION
 According Skinners “A highly cross linked polymeric material
reinforced by a dispersion of amorphous silica, glass crystalline or organic
resin filler particles and/or short fibers bonded to the matrix by a
coupling agent.

 According to Baum and Phillips – they are defined as 3 dimensional

combinations of at least two chemically different materials with distinct
interface.

 According to McCabe – A composite material is product which consists

of at least two distinct phases normally formed by blending together
components having different structures and properties
CLASSIFICATION
ADA specification No. 27
o Type I – unfilled and filled resins
o Type II – composite resin materials to which a filler has
been added

o 2. Skinner’s classification (10th edition)

Traditional composites (Macro filled) 8-12micro meter
Small particle filled composite – 1-5micrometer
Micro filled composite – 0.04 – 0.4 micro meter
Hybrid composite – 0.6 – 1 micro meter
According to Anusavice (11th edition)
 According to sturdevant
Based on filler content(weight/volume%)

Based on range of filler particle size

Mega fill-β quartz , large size
Macro fill – 10-100 micro meter
Midi fill – 1-10 micro meter
Mini fill – 0.1-1 micro meter
Micro fill – 0.01-0.1 micro meter
Nano fill – 0.005-0.01 nano meter
Composites with mixed range of particles sizes are called hybrid
and the largest particle size range is used to define the hybrid type
 Midifill hybrid
 Minifill hybrid

According to whether composite is a homogenous mixture of resin

and filler or includes the pre-cured composite
 Homogeneous – if composite consists of filler and uncured matrix
material
 Heterogeneous – if it includes pre-cured composites or other unusual
filler

Modified composites-
Based on area of application
Anterior
Posterior composites
Based on method of curing
Chemical curing
Light curing
 UV light
 Visible light
 Plasma arc
 Laser curing
Dual cure
Based on consistency
Light body – Flowable composite
Medium body – Homogeneous microfills, macrofills and midifills
Heavy body – Packable hybrid minifills
 ACCORDING TO MARZOUCK
Generation Fillers
Size of fillers
First Generation Macro ceramics 1-5 m
Silica / silicate based fillers 80% volume
Quartz fused silica
Silicate glasses
Crystalline lithium

Second Generation Colloidal silica 0.04 m

Pyrogenic silica 0.05-0.1 m
50% volume
Third Generation Hybrid composite with macro and micro colloidal ceramics in 75:25%
ratio

Fourth Generation Hybrid contains reinforced composite contain heat cured irregularly
shaped highly reinforced composite with composite particles with
reinforcing phase of micro ceramics

Fifth Generation Continuous phase reinforced with micro ceramics and heat cure
spherical highly reinforced composite particles

Sixth Generation Continuous phase reinforced with micro ceramics and agglomerates of
sintered micro ceramics
 INDICATIONS

Restoration of class I, II, III,

IV, V, VI cavities.
Foundations or core build-
ups.
Pit & fissure sealants.
Conservative composite
restorations or preventive
resin restorations .
Aesthetic enhancements such as:
Full veneers
Partial veneers
Tooth colour modifications.
Closure of Diastema
As luting cements
Eg: Resin cements for indirect restorations
Temporary restorations
Periodontal splinting.
 CONTRAINDICATIONS

The operating site cannot be properly isolated.

When the occlusal contacts are in such a way that
they are on the composite material.
Heavy occlusal stresses such as bruxism
Deep sub gingival areas that are difficult to prepare.
Extension onto root surfaces may exhibit marginal
gap formation.
 MERITS
Aesthetics
Conservation of tooth structure.
Improved resistance to micro leakage
Strengthening of remaining tooth structure
Low thermal conductivity
Completion of restoration in one
appointment
Economic – Less expensive compared to
gold or porcelain restorations
No corrosion
 DEMERITS
Very technique sensitive
High coefficient of thermal
expansion than tooth structure
Low modulus of elasticity
Biocompatibility of Bis GMA and
TEGDMA resins is not known
Limited wear resistance in high
stress areas
Finishing procedures are prolonged
and tedious
Post operative sensitivity
COMPOSITION OF COMPOSITE RESIN
Matrix: Plastic resin material which forms continuous phase and
binds filler particles (Inorganic phase)
Filler: Reinforcing particle and/or fibers dispersed in the matrix.
Coupling agent: Bonding agent that promotes adhesion between
filler and resin matrix.
Activator initiator system –
Chemical activation
Light activation
Inhibitors:
(Prevent premature polymerization)
Optical modifiers:
(Obtain opacity and translucency).
Colouring agent
(Pigments) to provide appropriate shade.
RESIN MATRIX –ORGANIC PHASE

PRINCIPAL MONOMERS
 BIS-GMA-aromatic-1962-”BOWEN’S RESIN”
 Modified BIS-GMA
 UDMA- 1974 (Foster and Walker)

DILUENT MONOMERS
 TEGDMA-aliphatic
 EGDMA
 HEMA

NEW MONOMERS
Other base monomers used in present commercial
composites include

Urethane dimethacrylates (UDMA), with or without Bis-GMA

Urethane tetramethacrylate (UTMA)
Bis(methacryloyloxymethyl) tricyclodecane
Ethoxylated bisphenol-A-dimethacrylate (BisEMA);
Linear polyurethane made from Bis- GMA and
hexamethylenediisocyanate
Advantage of
Disadvantage
Bis-GMA

High molecular weight Difficult to crystallize and purify

Extensive cross-linking- increases rigidity High molecular weight – increase
Decreased polymerization shrinkage viscosity

Non-volatile
It produces less heat during Stability of color is questionable
polymerization.
 cyclic acid anhydrides - as cross-linking agents for Bis-GMA
or UDMA composites

- 20% of bisfunctional ketones, such as diacetylacetone, to

UDMA and Bis-GMA composites

reported on the synthesis of a series of cyclopolymerizable

monomers described as "oxy bismethacrylate

Fluorinated monomers and oligomers which are more

hydrophobic than existing base monomers have been
synthesized
 To overcome the disadvantage of Bis-GMA; diluent was added
Diluent is any fluid methacrylate – TEGDMA
Ratio of Bis-GMA to TEGDMA – 3:1

Functions of Disadvantage
the diluent – of the diluent

Reduce the viscosity

Results in higher filler Greater polymerization
loading. shrinkage.
Results in higher degree of Increased flexibility
conversion.

Decreased abrasion
Increase the number of
resistance.
cross-linking reactions.
Tends to encourage microbial
Increases the gelation
activity – potential for
time
secondary caries
Estrogenicity of bisphenol A released from sealants and composites: a
review of the literature
Stefano Eramo, DDS,1 Giacomo Urbani, MD, DDS,1 Gian Luca Sfasciotti,
MD, DDS, PHD,2 Orlando Brugnoletti, MD, DDS,2 Maurizio Bossù, DDS,
PHD,2 and Antonella Polimeni, MD, DDS2
 There is also evidence that some dental sealants, and to a lesser
extent dental composites, may contribute to very low-level BPA
exposure.
 The ADA fully supports continued research into the safety of BPA
but, based on current evidence, the ADA does not believe there is a
basis for health concerns relative to BPA exposure from any dental
material”.
Chemical activation:
Chemical activation resin system
supplied in two paste systems.
The one paste system contains
benzoyl-peroxide (BP) initiator and
aromatic tertiary amine activator
(BN, N-dimethyl-P-toluidine).
When two pastes are mixed
together the amine reacts with BP
to form free radicals and thus
addition polymerization reaction
initiated.
Disadvantage:
Air entrapment which weaken resin matrix.
No control of working time.
Indications:
Restorations
Large foundations (build ups)

Amine- discolouration: In chemical cure resin we can see

sometimes change in colour of restoration in oral cavity.
This is due to mainly reaction of tertiary amine.
 LIGHT ACTIVATED RESINS
The first light activated systems were
formulated for UV light to initiate free
radicals.
But UV light today replaced by visible light
because
No depth of cure
Harmful to skin and eyes
Lack of penetration through tooth structure.

Visible light is nowadays most commonly used

because it has good penetration power through
thicker increments of composite resins (up to
2mm) and has good control over working time.
The light cured dental composites are supplied as a single paste
system contained in syringe which consists of photo-initiator
camphoroquinone.
It has an absorption range between 400-500nm i.e. in the blue region
of the visible light spectrum.
The paste also contain amine activator i.e. dimethyl amino ethyl
methacrylate (DMAEMA).
When camphoroquinone is exposed to blue light with wave length
468nm it is excited and reacts with amine activator to produce free
radicals.
 ADVANTAGES
1. Single paste system, no mixing hence no porosity.
2. Suitable for incremental build up.
3. Adequate working time.
4. Improved marginal adaptation.
5. Faster cure depth.
6. Instant finishing possible.
7. Good color stability.
.8 No oxygen inhibition.
 DISADVANTAGES
1. Technique sensitive
2. Polymerization may start under operating light
3. Additional equipment necessary
4. Polymerization shrinkage
5. Discoloration.
6. Limited depth of light penetration
7. Time consuming
8. Relatively poor accessibility in certain posterior
and interproximal locations
9. Variable exposure times because of shade
differences, resulting in longer exposure times
for darker shades and/or increased opacity
 Chemical Light cure

Polymerization is central Peripheral

Curing is one phase
Sets within 45 seconds
No control over working time
Shrinkage towards centre of bulk
More chances of air entrapment
More wastage of material
Not properly finished
Is in increments
Sets only after light activation
Working time under control
Shrinkage towards light source
Air may not get incorporated
Less wastage
Better finish
 DUAL CURED COMPOSITES
To over come problems of limits on curing depth and some other
problems associated with light curing chemical curing and visible
light components are combined in some resins.
These are called dual cure resins.

Commercially available consists of two light curable pastes.

1st Paste contains benzoyl peroxide.
2nd paste aromatic tertiary amine.
When these two pastes are mixed and then exposed to light.
The light curing is promoted by free amine and camphoroquinone
Chemical curing is promoted by amine and benzoyl peroxide.
Indications:
Dual cure materials are intended for any situation that does not allow
sufficient light penetration to produce adequate monomer conversion.
For example: Cementation of bulky ceramic inlays. Air-inhibition and
porosity are potential problems with dual cure cements.

Extra oral curing:

Used to promote higher level of cure

Used mainly for inlays

A heat of 150oC for 1 hour is employed.

 INORGANIC FILLERS
 Incorporation of filler partially into a resin matrix
significantly improves the properties of the matrix
material obviously since less resin is present the
polymerization shrinkage is reduced as compared with
unfilled resins.
Benefits of filler:
A primary purpose of filler is to strengthen a composite.
Increased hardness strength and decreased wear
Reduction in polymerization shrinkage
Reduction in thermal expansion and counteraction
Increased viscosity ,improved workability
 TYPES OF FILLERS
Quartz
Fused silica
Aluminium silicate
Barium glasses
Fluoro silicates
Boro silicates
Aluminium silicates
Fused silica
Strontium glasses
Lithium aluminium silicate, pyrogenic silica
Zirconium glasses
Yttrium trifluoride
Ybbrium trifluoride
Tri calcium phosphate
Zirconium di oxide
Silorane treated fillers
 FILLER PRODUCTION

By grinding or milling quartz or glass to produce

particles ranging from 0.1-100m.

Silica particles of colloidal size (0.004m) are obtained

by a pyrolytic or precipitation process.

These are called pyrogenic because the low molecular

weight silicon particles typically polymerized by burning in
an oxygen and hydrogen atmosphere.
 Filler size and production
Basically there are 3 sizes of fillers
Traditional macrofiller 15-30m.
Microfiller (pyrogenic silica) 0.04m
Microfiller based complexes
 Sintered prepolymerized microfilled complex (1-200m)

 Spherical polymer based microfilled complex (20-30m)

 Agglomerated microfilled complexes (1-100m)

 Filler volume

Fillers are added to resin matrix in percentage between 30-

70% or 50-80%wt.
A distribution of particles sizes is necessary to incorporate a
maximum amount of filler into a resin matrix than uniform
filler particles size.
The amount of filler, which incorporated in resin matrix, is also
influenced by total filler surface area with surface area
increasing as size decreases for constant volume of filler.
REFRACTORY INDEX: The translucency of filler particles should
be similar to that of tooth structure to ensure acceptable aesthetics.
Most of the filler have the refractive indices approximately 1.5 which
adequate to achieve sufficient translucency.

RADIO OPACITY: is provided in a number of glasses and ceramics

that contain heavy metal such as barium, strontium and zirconium. Most
commonly used is barium glass (1.5 Refractive Index).
The quartz containing composites are difficult to polish and cause
abrasion on opposing teeth or restoration.
Composites with finer filler particles give better finishing than
with larger filler particles size.
The highly radio opaque filler particles like glasses and ceramics
(barium glass, strontium, zirconium) are not inert as quartz and
are slowly leached out from resin matrix when they come in
contact with acids and oral fluids.
INTERFACIAL PHASE /COUPLING PHASE
The coupling agent provides the bond between organic resin
matrix and the filler particle.
This also helps in transferring stress from the flexible matrix
to stiffer particles.
A properly applied coupling agent can impart improved
physical and mechanical properties and inhibit leaching by
preventing water from penetrating along the filler resin
interface (although Titanates and Zirconates can be used as
coupling agent) organosilanes such as Y-methacryl-
oxyprophyl trimethoxy silane used most commonly.
In the presence of water the methoxy groups (-OCH3) are
hydrolyzed to silanol (-Si-OH) groups that can bond with other
silanols on the filler surfaces by formation of a siloxane bond (-
Si-O-Si).
The methacrylate group of coupling agent forms covalent bond
with resin when polymerized.
Clinically a properly applied coupling agent imparts improved
physical and mechanical properties and it also gives the resin
hydrophilic stability by preventing water from penetrates along
filler resin interface
 INHIBITORS

They are added to minimize or prevent spontaneous

polymerization of monomers in resin system.
This inhibitor has strong reactivity potential with free radicals
and inhibits chain propagation by terminating the ability of
the free radicals to initiate the polymerization process.
The most commonly used inhibitors is Butylated hydroxy
toluene (BHT) in concentration 0.01wt%.
Functions:
They extend the storage time
Ensures sufficient working time.
 OPTICAL MODIFIERS
The optical modifiers are added so that the visual colourization
shading and translucency of the composite resin simulate the tooth
structure.
Shading achieved by using different metal oxides which are added
in minute amounts.
Translucency or opacity is provided to simulate dentin and enamel
and is achieved by addition of opacifier.
The most commonly used opacifiers are
Titanium dioxide
Aluminium oxide (0.001 to 0.007%wt)
Clinical significance:
Inadequate amount of opacifiers allow too much light to
pass through the restoration less light is reflected back or
scattered, thus making the restoration appear dark.
Excessive opacifier leads to reflection of tooth much light
making restoration look whiter.
 CURING LIGHTS
Most curing lamps are hand held devices that contain the light
source and are equipped with relatively short, rigid light guide
made up of fused optical fibers.
Most commonly used light source quartz bulb with tungsten
filament in halogen environment.
There are 4 types of curing lamps which available for curing of
composite resin.
Light emitting diode (LED)
Plasma arc curing (PAC)
Quartz tungsten halogen (QTH)
Argon laser lamps (ALL)
 UV-LIGHT CURING SYSTEM

Came into existence in the early 1970s - as Nuva light (Dentsply/Caulk).

Works at 360 to 400nm range
Disadvantages
Because of spectral distribution of UV light, it may cause
damage to eye and soft tissue burns
Depth of cure achieved was less
Lack of penetration through tooth structure
Possibility of selectively altering the oral flora of the patient’s
mouth.
Intensity of light source decreased rapidly with use
 Quartz-tungsten halogen lamps:-

Have a quartz bulb with a tungsten filament that

irradiates both UV and white light that must be
filtered to remove heat and all wavelengths except
those in the violet-blue range (~400 to 500 nm)
Minimum output should never drop below
300mW/cm2

Wavelength varies among the units from 450 to

490nm
A typical resin composite requires an energy density
of 16J cm2 (400 mW/cm2 X 40 seconds =16,000mWs/
cm2) for polymerization.
 Factors causing decrease in intensity of light
from QTH light using units and maintenance
hints
Factors Maintenance hints

Dust or deterioration of reflector Clean or replace reflector

Burn out of bulb filament

Darkening/ frosting of bulb Replace bulb

Age of components Monitor intensity, replace units.

Chipping in line voltage Replace light tip

Resin deposit on light tip Clean or replace light tip.

Change in line voltage Get built in voltage regulator

Lack of uniformity across light tip Overlap curing on larger surface

Keep light tip close to material

Increased distance of the tip from material to
be cured
 Enhanced halogen light

Provide greater curing intensity and faster cure

Accomplished is by the use of light guides that
diminish in size as they exit from the curing light
The turbo tip decreases the time necessary to cure
by about 50%
Tip cause an increase in heat, and also the cost is more than that of
the standard curing light.
 Plasma-arc curing units
(NASA) developed the original plasma arc technology

Two electrodes with a large voltage potential ionize a gas

(Xenon gas) that emits light.

The PAC light produces a high intensity limited

spectrum light that is filtered to blue light in the
range of 460 – 490 nm

Able to cure composites with photo-initiators other than

Camphorquinone.

10 seconds from a PAC light Use of 2 mm increments is

still required.
Advantages -
Shorter polymerization time (3-5 seconds)
Shorter curing times makes overall procedures shorter and more
integrated 
Disadvantages –
Heat production
Expensive.
Although lamps last many hours, when a lamp wears out or is
broken, replacement of lamp is costly.
Most of the devices are large, heavy and bulky.
Very low efficiency.
Continuous spectrum must be narrowed by filter systems.
PAC lights can burn soft tissue if the tissue is left exposed to it for
standard curing times recommended by adhesive manufactures, so
caution must be exercised.
 Argon Laser curing units
The first laser, a pulsed ruby laser, was
developed by Theodore H. Maiman in 1960

Argon laser emit a monochromatic coherent

light in wavelength (488nm) that cover the
blue light region of the visible light spectrum.

Does not employ filters.

Five seconds argon laser exposure results in a

resin composite cure at 2mm depth
Advantages -
The thoroughness and depth of composite resin polymerization

Less un polymerized monomer is found

Thoroughness in curing results in enhancement of certain physical

properties of the laser-cured composite resin

Laser-cured bond strengths did not decrease with increasing

distance, whereas there was a significant decrease in VLC bond
strengths at distance greater than 0.5 mm
Laser requires less time to achieve equivalent or
greater polymerization of the restorative material.

No refractory period,

In cases where it is impossible to place the light

wand in close proximity to the restoration, the laser
beam offers the advantage of no loss of power over the
distance, as is suffered by the VLC units

Can cure thicker increments satisfactorily

Disadvantages –
 Cumbersome and occupies considerably more space.

 Generate a substantial amount of heat.

 Expensive.

 From in vitro and in vivo studies, there is a temperature rise in the

dentinal roof of the pulp chamber as well as within the pulp itself .

 Increased shrinkage and brittleness of some small-particle filled resins

have been reported when they have been cured with a laser especially class
V restorations
Extreme care must be exercised to avoid direct exposure of the
patients eye, as exposure could result in immediate visual damage.

The greater depth of penetration and intensity of the laser beam

results in a rapid polymerization with no chance for stress
relaxation.

The reported enhancement of physical properties achieved by laser

polymerization may become less significant with aging of the
cured resin.
 Light-emitting diode

 In 1995, Mills et al proposed using

solid state light emitting diode
technology.

 Use junction of doped

semiconductors (p-n junction) for
the generation of a monochromatic
light.
Generations of LED’S –
First generation - relatively low-powered chips offering a comparative low
output and poor curing performance compared with conventional QTH lights

Second generation - have a single high-powered diode with multiple emission

areas E.g. Elipar Freelight 2

Third generation - they have two or more diode frequencies and emit light in
different ranges to activate CQ and alternative photo-initiators. E.g. – UltraLume
5
 Advantages -

Consistent output, with no bulbs to

change
No need for filter systems
High efficiency leads to:
Low temperature development (no
ventilation fan required)
Low power consumption (battery-
operation is possible)
Frame can be easily cleaned, since no
slots for a ventilation fan are needed
Long service life of LED’S
Quiet
Cordless, light weight
 Disadvantages -

Due to the narrow emission spectrum LEDs can only

polymerize materials with an absorption maximum between
430 and 480 nm (camphorquinone as photoinitiator)
New technology.
Slower than PAC
Batteries must be recharged
Cost more than halogen lamps
Dissipation of heat produced during LEDs use -
Critical for the durability of the LED based system
The heat is dissipated by use of heat sink or cooling fan
With heat sink; it uses a highly thermally conductive aluminum
integrated in the housing
Pulsed output in LED technology –
Periodic level shifting (PLS) or “Micro-pulsing
Light curing variables
 Curing rate control
Soft start curing: It consists initial low intensity curing and which
finishes with high intensity.
 It allows for a slow initial rate of polymerization and provides time for
stress relaxation before resin matrix reaches gel point.
 Thus there is less polymerization shrinkage.

Ramped cure: in this method curing intensity is gradually

increased or ramped up. This ramped up may be
 Stepwise
 Exponential
 Linear
Delayed curing:
Here restoration is initially incompletely cured at low intensity.
Then clinician contours resin to correct occlusion and later applies
second exposure for final cure.
Thus longer the time period available for relaxation of residual
stresses
 • 1970’s
TRADITIONAL • Ground amorphous silica and quartz (8-12mm)
COMPOSITES in 60-70% volume
• Modification of traditional composite resins
• Here broad sized particle distribution is used to
SMALL get high filler load (80-90wt%). SIZE 0.5-3 mm
PARTICLE • Glass particles with heavy metals
• Colloidal silica
• The problems of surface roughening and low
translucency overcome by.
• Colloidal silica particles added to resin matrix by
MICROFILLED two ways: sintering of colloidal silica
FILLED • And prepolymerized colloidal silica

An effort to obtain better surface smoothness with good

physical properties.
Colloidal silica (10-20%) and glass particles with
HYBRID heavy metals (75-80%).
COMPOSITES Filler size 0.4 –1.0mm.
 Characteristic
Unfilled acrylic Traditional Small particle Hybrid Microfilled
property
Size (m) - 8-12 0.5-3 0.4-1.0 0.04-0.4
Inorganic filler
0 60-70 65-77 60-65 20-59
(vol%)
Inorganic filler
0 70-80 80-90 75-80 35-67
(wt%)
Compressive
70 250-300 350-400 300-350 250-350
strength (MPa)

Tensile strength
24 50-65 75-90 40-50 30-50
(MPa)

Elastic modulus
2.4 8-15 15-20 11-15 3-6
(GPa)

TEC (ppm/ °C) 92.8 25-35 19-26 30-40 50-60

Water sorption
1.7 0.5-0.7 0.5-0.6 0.5-0.7 1.4-1.7
(mg/cm2)

Knoop hardness
15 55 50-60 50-60 25-35
(KHN)

Curing shrinkage
8-10 - 2-3 2-3 2-3
(vol %)

Radio
0.1 2-3 2-3 2-4 0.5-2
opacity(mm\Al)
 MICROHYBRID COMPOSITES

They use up to three distinct particle sizes for

more efficiency, and a much smaller size range
of larger  particles (0.6 -0.7 microns) than the
older hybrids.
greater polishability but suffer from
lower particle density due to the small
size of the largest
particles in the mix.

Eg:  Prisma TPH, Herculite XRV,

Tetric Ceram, and Charisma
PROPERTIES OF COMPOSITES
Of all the tooth colored materials composite resins possess the
highest tensile and compressive strengths.

The modulus of elasticity is high.

The modulus of resilience is very low which may explain some of

the crazing, cracking and wear failures of composite resins.

The co-efficient of thermal expansion of composite resin is close

to that for amalgam (25-35 PPM/10C).
Composite resins show less resistance to abrasion. The abrading
forces dislodge the particles.

The interfacial failure is precipitated first by exposure of resin matrix

and further by deterioration of coupling agents by environmental
factors

Solubility of resins is influenced by the residual monomer and

discontinuity or weakness in the bond between the dispersed and
dispersion phase in composite and filled resin.
 PROPERTIES

PHYSICAL MECHANICAL CLINICAL

WORKING & SETTING TIME
Light cure: surface hardens in 60-90 sec
Chemical cure: 3-5 min
Thermal properties –
The thermal conductivity of composites with fine particles
(25 to 30 ×10-4 cal/sec/cm2[0C/cm]) is greater than that of
composites with microfine particles (12 to 15 ×10-4
cal/sec/cm2[0C/cm]).
PROPERTIES

HARDNESS Of all the tooth coloured restorative materials, composite resins show
greater Knoop Hardness Number ( KHN) of 30-100 as compared to
300 of enamel.

SURFACE Of all tooth coloured restorative materials composite resins in

ROUGHNESS general have the highest and deepest scratches after all finishing and
polishing procedures.

DISINTEGRATION Composite resins undergo disintegration due to failure at interphase

between dispersed and dispersion phases

PLASTICITY Composite resins & unfilled resins are viscoelastic in nature and
show limited degree of plasticity that may lead to a change in shape
under loading
WATER SORPTION Water sorption swells the polymer portions of the dental composite
and promotes diffusion and desorption of any unbound monomer.
degrade the matrix
disruption of adhesive bonds,
, susceptibility to discoloration

MICROLEKAGE The unfilled resins and II generation composites show greatest micro
leakage, especially when inserted with a bulk-pack technique.
The use of acid – etched technique reduced the micro leakage
OPTICAL Translucency to that of tooth enamel.
PROPERTES Translucency depends mainly on the type and nature of unreacted
particles of fillers.

COLOUR Composite resins may undergo discoloration may be intrinsic or

STABILITY extrinsic .

BIOCOMPATABILT Relates to Two aspects.

Y OF COMPOSITES a) Inherent chemical toxicity of the material and
b) Marginal leakage

RATE OF Composite resins gain most of their mechanical properties within 15

HARDENING minutes; and can usually be finished and polished after 5-8
minutes.
WEAR:
The second most frequent clinical problem apart form polymerization
shrinkage of composite is Occlusal wear.
The wear rate of posterior composite is 0.1 to 0.2 mm/year more than that
of enamel.
The principal mechanisms of composite wear
are:
a) TWO BODY WEAR:
This is due to direct contact
of restoration with an
opposing cusp / adjacent
proximal surfaces that
result in high stresses in the
contact area.
Two body wear causes
significant wear of
composite rather than three
body wear.
b) THREE BODY
WEAR:
Three body wear explains
loss of composite
material in non-
contacting areas.
This is due to the contact
with food bolus as it is
forced across occlusal
surface.
 DEGREE OF CONVERSION:
It is the percentage of Carbon – Carbon double bonds that
have been converted to single bonds to form a polymeric resin.
A 65% conversion is considered to be good.

The higher is the degree of conversion, better will be the

strength and wear resistance.
Conversion of the monomer to polymer depends on resin
composition, transmission of light through the material,
concentration of sensitiser, initiator & inhibitor.
Due to faster polymerization of Visible Light Cure resins there
are chances of building up of residual stresses.
 DEPTH OF CURE

It is determined by the boundary between somewhat cured

and uncured material.
Most light curing requires minimum of 20 seconds under
optimal conditions of access.
The problems of light penetration can be slightly overcome
by increasing curing times.
Curing again after completion of recommended procedure
(Post –curing) for 20 – 60 seconds may slightly improve the
surface layer.
 POLYMERIZATION SHRINKAGE
All composites shrink while hardening in order
of 2-3 % volume. This is referred to as
Polymerization shrinkage .
It usually does not cause significant problems
with restorations cured in preparations having
all- enamel margins.
However when a tooth preparation extends on
to the root surface polymerization shrinkage
can cause gap formations at the junction of
composite and root surface, as the force of
polymerization of composites is greater than the
initial bond strength of composites to tooth
structure.
1. C-factor
2. Monomer formulations
3. Elastic modulus
4. Filler content
5. Self curing or light-curing
composite
6. Degree of conversion
7. Water sorption
This problem though cannot be eliminated, can be minimized.

This polymerization contraction depends on two factors:

The quality of bond
The shape of the cavity preparation - C –Factor configuration.
Multipurpose composite – 0.7 to 1.4%
Microfill composite – 2 to 3%
Packable composite – 0.6 to 0.9%
Macrofilled composite – 1.2 to 1.3%
Small particle filled composite – 2 to 3%
Nanocomposite and other types – yet to be determined
It was first analyzed by Feilzer in 1987 and is described in terms
of the ratio of surface area of bonded surfaces to the surface area
of unbonded surfaces.
The higher is the C –factor the greater is the potential for bond
disruptions from polymerization effects.
Most technique sensitive preparations to restore successfully
are class V, and I both of which have five bounded and one free
surface, thus resulting in the maximum stresses.
A veneer on the other hand has five free and only one
bounded surface.
The magnitude of development of stresses is influenced by the
rate at which the composite is cured .
Light cured materials demonstrated twice the magnitude of
stress compared to self-cured materials.
Also heavily filled composites exhibited higher stress.
Maximum stresses developed are at internal line angles and
stress on lateral walls increases with depth of the cavity.
Clinical techniques to reduce c-factor:

1.Layering technique:
The restoration is built up in increments, curing one layer at a
time. This reduces ‘C’ factor by reducing the surface area of
bonded surfaces and increasing the non bonded surface areas.
This is done in increments whereby problems of depth of cure
and residual stress concentration are both eliminated

2 . Sectioning
The composite is sectioned horizontally and vertically to reduce the stresses.
Stress Absorbing Layers with Low Elastic Modulus
Liners

 According to the “elastic cavity wall concept” the shrinkage stress

generated by a subsequent layer of higher modulus resin
composite can be absorbed by an elastic intermediary layer,
thereby reducing the stress at the tooth-restoration interface.
  Flowable resin composites have shown shrinkage stress
comparable to conventional resin composites, supporting the
hypothesis that the use of flowable materials does not lead to
marked stress reduction and the risk of debonding at the
adhesive interface as a result of polymerization contraction is
similar for both type of materials .
 Dental
Composite
Resins part 2
Guided by:
PRESENTED BY :
DR. P. KARUNAKAR
R.DEEPIKA
DR.RAJI VIOLA SOLOMON
PG FIRST YEAR
DR.SRAVAN KUMAR
Part 2 NEW CLASSES OF COMPOSITE RESINS
PACKABLE COMPOSITES
COMPOMERS
INDIRECT COMPOSITE RESINS
CEROMERS
FIBER REINFORCED COMPOSITES
COMPOSITE INSERTS
FLOWABLE COMPOSITES
SMART COMPOSITES
ORMOCERS
GIOMERS
NANOCOMPOSITES
SILORANE TREATED COMPOSITES
ANTIBACTERIAL COMPOSITES
SELF REPAIR MATERIALS
 Classes I,II,III,IV,V and VI restorations
 Foundations or core buildups

 Sealants and conservative composite restorations

(Preventive Resin Restoration)
 Esthetic enhancement procedures
 Partial veneers
 Full veneers
 Tooth colour modifications
 Diastems closures

 Periodontal splinting
 Orthodontic bracket placement
 PACKABLE COMPOSITE
A number of problems have been associated with using resin
composite for posterior restorations, including
staining,
marginal ditching,
post operative sensitivity,
increased wear compared to metallic restorations
difficulties in obtaining adequate interproximal contacts.

In an effort to overcome these problems, manufacturers have

developed a subset of posterior resin composites called the
"condensable" or "packable" resin composites, which they market as
amalgam alternatives
The preferred term for these resin composites is "packable" rather than
"condensable," because during placement, they are simply being packed
rather than condensed.
HISTORICAL DEVELOPMENT

It was as early as 1980s that the first packable

composite formulations were designed but the first
composite to be marketed i.e. Solitaire was introduced
in 1997.
 DESIRABLE PROPERTIES
Nonsticky, wets tooth surfaces, easily transferable and packable.
Moisture tolerant
Should not show much elastic recovery (viscoelasticity)
High critical shear strength (to hold the proximal contact of matrix
band)
No access problems for cure (uses bulk cure, chemical cure, or has
excellent visible light depth of cure)
Cures rapidly to final hardness but with minimal residual stress
Little or no shrinkage on curing
Easily carved, burnished (Smoothened).
This ensured sufficient flow to adapt the composite to the cavity
preparation during packing.

The early versions of packable composites were available by admixing

PRIMM (Polymeric rigid inorganic matrix material), fused glass fiber
powder with conventional composites.

It produced improvement in mechanical properties only under a few

circumstances hence it was not approved as an effective material.
POLYMERIC RIGID INORGANIC MATRIX
MATERIAL

After silanating
a continuous
the fibers the
resin and network or
space within
scaffold of
ceramic ceramic fibers,
the fibrous
component network is filled
ceramic fibers
with Bis-GMA
is 2.0μm
or UDMA resin
The wear rate is only several micrometers
more than that for enamel.

The consistency of the loaded or resin-

infused PRIMM material is similar to
freshly triturated mass of amalgam and
insertion is similar to amalgam.

The restoration is then light cured for 30

sec and polished. The material can be
cured to a depth of nearly 6 mm possibly
due to the light conducting properties of
the individual ceramic fibers.
 FLOWABLE COMPOSITES

introduced in late 1996.

Filler content is generally less than so polymerization shrinkage will be
50% by volume greater

allow the material to flex and flow under the conditions thought to occur in
Class
advantages of flowable materials are that they are V cavities
excellent access and placement can be
fast and easy, that achieved using the syringe tips

excellent access and placement can be achieved using the syringe tips
 COMPOMER

Compomer is resin- ionomer hybrid restorative material

may release fluoride but have only limited glass ionomer properties

resinous photopolymeristation and no acid base reaction can occur until the material
absorbs water

contains functional groups of polycarboxylic acid and methacrylate combined in one

molecule.
This provides methacrylic groups for cross linking (as in composite resins) and carboxyl
groups to undergo an acid-base reaction in the presence of water and metal ions (as in glass
ionomers).

Eg: DYRACT, DYRACT AP, COMPOGLASS

There is a dominant light initiated free radical polymerization followed by a
later acid-base reaction. The setting reaction occurs in two stages:
Stage 1 reaction
 Typical of light activated composite resins forming a resin network
enclosing the filler particles.
 The light curing mechanism leads to hardening of the material in the
cavity.
Stage 2 reaction
 Occurs slowly after placement in the cavity. Water sorption will occur for
unto 2-3 months and in the presence of carboxyl groups from the
polyacid and metal ions from the ionomer glass, there will be a relatively
slow ionic acid -base reaction.
 Hydrogels will form within the resin structure and there will be a slow
and low-level release of fluorides.
Fluoride release from glass-ionomer and compomer restorative
materials: 6-month data – A.J SHAW etal; Journal of Dentistry
Volume 26, Issue 4, May 1998
Objective: To investigate the daily fluoride release of two glass
ionomers (Ketac-Fil and ChemFil Superior) and two compomers
(Compoglass and Dyract Restorative) over 6 months.
Conclusion:
Fluoride release from the glass ionomers is initially higher than
for the compomers.
Fluoride release from glass ionomers falls rapidly to approach
levels released by compomers.
Compomers produce no initial burst of fluoride and levels of
release remain relatively constant.
 INDIRECT COMPOSITE RESINS

In the early 1980s, Mormann and Touati and colleagues

pioneered the use of Composite resins for the fabrication of
indirect inlays and onlays.

In the mid 1980s, Touati and Pissis developed the concept

of metal composite inlays and bridges after the silinating
technique, which enabled a strong bond between polymer and
metal because of a very thin (0.1 mm) aluminium oxide layer.
INDICATIONS

Metal free dentistry

Esthetics
Decreased wear of opposing dentition
Conservative tooth preparation
 
CONTRAINDICATIONS
Bruxism
Opposing porcelain
Long span fixed partial dentures
High caries rate
Difficult moisture control adhesion
First Generation Indirect Composite Resins:
(Low filler and high matrix load)
 They are microfilled composite resins, with 66% resin
content and 33% inorganic particles.
 Particle size of 0.04 – 0.4 m.
 Inorganic fillers are round in shape and consist of
colloidal silica.
Eg., VISIO-GEM (ESPE), DENTACOLOUR (Kulzer), CONCEPT (
Ivoclar)
Low wear resistance (owing to a low percentage of inorganic
filler particles and a high percentage of exposed resin).
 First generation laboratory composites remain somewhat fragile
and subject to chipping and color variation.

 The lower the percentage of inorganic particles, the lower the

mechanical properties of the composites resulting in failure of first
generation laboratory composites.

 Uses:
 For inlays, onlays and laminates and implant supported
prosthesis.
Second Generation Indirect Composite Resins:
(High filler and low matrix loads)
Advantages:
 Decreased polymerization shrinkage
 High elastic moduli
 Better wear resistance
They are suitable alternatives to ceramics in some clinical
situations.
Second Generation are microhybrid composite resin (sometimes
called ceramic polymers) with a high density of ceramic filler particles.
Eg., ARTGLASS (Kulzer), BELLEGLASS HP (Kerr), TARGIS (Ivoclar),
COLOMBUS (Cendres), SINFONY (ESPE).
Clinical applications:
Inlays and onlays
Laminated veneers and jacket crowns
Implant supported restorations (for progressive loading of implant
supported prostheses).
Clinical applications:
Inlays and onlays
Laminated veneers and jacket crowns
Implant supported restorations (for
progressive loading of implant
supported prostheses).
 CEROMERS

 The term ceromer stands for Ceramic Optimized Polymer and was
introduced by Ivoclar to describe their composite Tetric Ceram.  
 They are microfilled hybrid resins or universal composite
resins.
This material consists of a paste containing
 barium glass (< 1 µm),
 spheroidal mixed oxide,
 ytterbium trifluoride, and
 silicon dioxide (57 vol%) in dimethacrylate monomers (Bis-GMA
and urethane dimethacrylate).
 They are set by a polymerization of C=C of the methacrylate.

The properties of the ceromers are identical to those of

composites and they exhibit fluoride release lower than
conventional glass-ionomers or compomers.

In 1996 a CEROMER (or Ceramic optimized polymer) was

developed for indirect composite restoration Targis (Vivadent)
.
It consists of 77% wt filler and 23% wt of organic resin.
Uses:
Ceromer can be used for veneers, inlay/onlay without a metal
framework.
Also can be used with Fiber Reinforced composite framework
for inlays/onlay, crowns and bridges (3 unit) and for crown
and bridges including implant restorations on a metal
framework.
These Ceromers combine the advantages of ceramics with those
of state-of-the-art composites
 ADVANTAGES
On the basis of their composition and structure,
Ceromers combine the advantages of ceramics and
composites like:
1. Durable esthetics
2. High abrasion resistance
3. High stability
4. Ease of final adjustment
5. Excellent polishability
6. Effective bond with luting composite
7. Low degree of brittleness
8. Conservation of tooth structure
FIBER REINFORCED COMPOSITE RESIN

The use of fibers to improve

the mechanical properties of
resin-based materials has
been known for many years.
The fibers used are
composed of Kevlar,
polyethylene and glass
fibers.
 FIBER REINFORCED SYSTEMS
1.Pre- impregnated e.g., TARGIS / VECTRIS
SCULPTURE/ FIBERKOR
2. Non – impregnated e.g., BELLE GLASS,HP/CONNECT
RIBBOND, GLASS PAN

FIBER REINFORCEMENT MATERIALS

CONNECT (polyethylene)
DVA (polyethylene)
FIBERFLEX (Kevlar)
FIBREKOR (glass)
FIBER-SPINT (glass)
GLASSPAN (glass)
RIBBOND (polyethylene woven)
SPLINT-IT (glass)
VECTRIS (glass)
CLINICAL APPLICATIONS

Splinting
Restoration of endodontically
treated teeth
3 unit bridge work
Metal free crowns
 COMPOSITE INSERTS
Preformed shapes and sizes of glass ceramic whose surfaces have
been silane treated.
They are available in different shapes L, T, round, conical,
cylindrical size 0.5-2mm (mega fillers).
Application: Used to minimize the marginal contraction gaps in
composite fillings.
Properties:
Low coefficient of thermal expansion
Wear resistant
Their presence reduces polymerization shrinkage by upto 75% and
increases the stiffness of the filling.
Radiopaque
Manipulation:
 These inserts are pressed into a cavity preparation that is
already filled with unpolymerized composite.
 The composite which is extruded during the insertion is
removed and that which remains is cured.
 The restoration is then contoured using diamond rotary
instruments and polished.
 SMART COMPOSITES

INTRODUCTION

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 composites.

 • This class of composite was introduced as the product Ariston pHc
in 1998.Ariston is an ion releasing composite material.

releases functional ions like fluoride, hydroxyl, and calcium ions as the pH
• It

drops in the area immediately adjacent to the restorative materials, as a result of

active plaque

• The composite material releases fluoride, hydroxyl and calcium ions in

dependence on the pH value immediately adjacent to the restorative material.

• With a decreasing pH value due to active plaque the release rate of the
functional ions increases and vice-versa.
This phenomenon is 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 an inhibition of bacterial
growth, a reduced demineralization and a buffering of acids
produced by cariogenic micro-organisms.

COMPOSITION
Smart composites work is based on the newly developed alkaline
glass.
The paste contains Ba, Al, and F silicate glass filler (1m) with
Ytterbium trifluoride, silicon dioxide and alkaline glass (1.6 m) in
dimethacrylate monomers
 FILLER CONTENT
: 80% by weight and 60% by volume
It reduces secondary caries formation at the margin of a restoration
by inhibiting bacterial growth.
This results in reduced demineralization and buffering of the acid
produced by caries forming microorganisms
PROPERTIES
Fluoride released is lower than glass ionomers but
more than that of compomers.
Flexural strength : 118 MPa
Flexural modulous : 7.3 GPa
Fracture toughness : 1.9 MNm-3/2
Mean wear rate : 7194 m
 ORMOCER

INTRODUCTION
Recently a new material was made available for dental restoration
therapy the ORMOCER.
Dr. Herbert Wolters from Fraunhofer Institute for Silicate Research
introduced this class of material in 1994.
ORMOCER, the acronym of Organically Modified Ceramic is a brand-
new material for all filling indications in the anterior and posterior
area which serve as an optimum and upto date replacement for
amalgam, composite and compomers.
This class of material represents a novel inorganic-organic
copolymers in the formulation that allows for modification of its
mechanical parameters.
Eg., DEFINITESSS
 PROPERTIES

Definite permanently releases fluoride, calcium and phosphate

ions that protect the adjoining cavity margins.
Biocompatible
Physical properties as given by Wolter are
 
Bending strength (3 point bending test) : 100-160 MPa
Modulus of elasticity : 10-17 GPa
Coefficient of thermal expansion : 17- 25 x 10-6 K-1
Water uptake : < 1.2%
Solubility in water : Not detectable
Shrinkage : 1.7 – 2.5 vol%
 
ADVANTAGES

1. Biocompatibility
2. Reduced polymerization shrinkage
3. High abrasion resistance
4. Anticariogenic property
5. Lasting aesthetics
6. Fast and safe handling
7. Cost effective
 GIOMERS
INTRODUCTION

The true hybridization of glass ionomer (GI) and composite resin 

feature of a stable surface prereacted glass ionomer (S-PRG), which is coated with an
ionomer lining incorporated in a resin matrix.

This arrangement aids in the protection of the glass core from moisture ,
COMMERCIAL FORMULATIONS

BEAUTIFUL

FL-BOND
INDICATIONS

Giomers are mainly indicated for:

 Restoration of root caries

 Non-carious cervical lesions
 Class V cavities
 Deciduous tooth caries
LIMITATIONS

Giomers are not as beneficial as GIC’s in patients who are at

risk for recurrent caries as long term fluoride release is
questionable,
The hardness value (VHN) for giomer was less than composite
in this study and light barriers such as wrapping of light tips
and use of mylar strips further decreased the hardness value
Giomers have certain clinical advantages
1. Fluoride release:
PRG Composite/Giomers release substantial amount of
fluoride and are effective in prevention of secondary caries
and One-up bond on inhibition of secondary caries in outer
and inner wall lesions.
The results indicated that giomer based adhesives are effective
in prevention of secondary caries, especially when used in
combination with a fluoride releasing adhesive
Fluoride Re-charging:
The fluoride recharging effect on giomers significantly reduces
the incidence of recurrent caries and also increases thickness of
caries inhibition zone
P. Senawogse (2002)_ evaluated the rechargeable affect of current
fluoride releasing restoratives: Giomer (Reactmer, ionomer
cement (Fuji IX) with 2.2% NaF gel to conclude that fluoride
recharging with sodium fluoride gel significantly reduces depth
of lesions restored with these restoratives and the effect is more
marked in giomers
3.Biocompatibility
4. Clinical Stability and Durability
5. Excellent aesthetics
6. Smooth Surface Finish
7. Excellent Bonding
 NANO COMPOSITES
These products are different from other types of composites in
that they contain nano-sized fillers.
One such product is Filtek Supreme XT, introduced in early 2003.
Supreme purportedly uses unique nanofiller technology; that it is
formulated with nanomer and nanocluster filler particles.
As a result, Supreme is claimed to combine the strength of a
hybrid and the polish of a microfill, a claim similar to that made
by manufacturers of universal composites and reinforced
microfills.
 COMPOSITION

Nanomers are discrete non-agglomerated and non-aggregated

particles of 20-75 nm in size.
Nanoclusters are loosely bound agglomerates of nano-sized
particles.
Nanotubes have remarkable tensile strength and could dwarf
the improvements that carbon fibers brought to composites.

Nanomer nanotube
nanocluster
Supreme comes in 30 different shades in 4 opacities (dentin, body,
enamel and translucent).

Most shades contain a combination of non-agglomerated 20 nm size

nanomer filler and aggregated zirconia/silica nanocluster (primarily
5 to 20 nm size) filler.

The cluster particle size ranges from 0.6 to 1.4 microns.

The combination of nanomer-sized particles and the nanocluster

formulations reduces the interstitial spacing of the filler particles.
 ADVANTAGES
Superior translucency and esthetic appeal, excellent colour, high
polish and polish retention.
Superior hardness, flexural strength and modulus of elasticity.
About fifty percent reduction in polymerization shrinkage.
Excellent handling properties.
 ANTIBACTERIAL COMPOSITES

 Composites that offer antibacterial properties are promising since

several studies have shown that a greater amount of bacteria and
plaque accumulate on the surface of resin composite than on the
surface of other restorative material / enamel surface.

 Imazato et al 1994 incorporated a non-releasing newly synthesized

monomer MDPB with anti-bacterial properties into resin composites.

 MDPB is methacryloxy decyl pyridinium bromide.

It was found to be effective against various streptococci
SILORANE BASED COMPOSITES:
 SILORANE system has been developed to minimize
polymerization shrinkage and polymerization stress, while
providing a high performance bond to the tooth.

 The name silorane derives from its chemical building blocks

siloxanes and oxiranes.

 The combination of the two chemical building blocks of

siloxanes and oxiranes provides the biocompatible, hydrophobic
and low-shrinking silorane base of Low Shrink Posterior
Restorative.
SILORANE COMPOSITES METHCRYLATE
 Self –Repairing Materials

 These materials are made of epoxy system with the resin

filled microcapsules
 If crack occurs in epoxy material ↔ micro
capsules are destroyed ↔ resin is released ↔ resin
fills the crack.
Future Research
1.Longer duty cycle
2.Enhanced clinical performance
Review of literature
 Antibacterial Activity of Restorative Dental Biomaterials in vitro-
Clemens Boeckh etal; Caries Res 2002;36:101-107
This study investigated the antibacterial effects against Streptococcus
mutans of
a fine-hybrid resin composite (FH-RC; Tetric ceram),
an ion-releasing resin composite (Ariston pHc),
a self-curing glass ionomer cement (SC-GIC; Ketac-Molar),
a resin-modified GIC (RM-GIC; Photac-Fil)
a zinc oxide eugenol cement (ZOE; IRM)
The inhibitory effect of Ariston pHc was similar to that of the SC-GIC
and the RM-GIC.
Microleakage and Polymerization Shrinkage of Various Polymer
Restorative Materials David Alain Gerdolle DDS, MS Eric Mortier,
DDS, MS Dominique Droz, DDS, PhD

 Within the experimental conditions of this in vitro study, the

microleakage was significantly lower at the enamel margins than at the
cementum margins for the four restorative materials tested.
 The ormocer and the packable resin composite exhibited the best
sealing ability, as well as the lowest polymerization shrinkage.
 One-Year Clinical Comparison of Two Posterior Composite
Resins
Fatemeh Maleknejad etal;Journal of Mashhad Dental School,
Mashhad University of Medical Sciences, 2007; 31(Special
Issue): 39-43.
 This study compared a one-year clinical performance of
two composites (Ariston PHC with Tetric) in class II cavity
preparations.
 The clinical criteria consisted of
 post-operative sensitivity = no difference
 marginal discoloration = less for ariston PHC
 recurrent caries = seen in few cases with tetric {5.1%}
 marginal adaptation = no difference.
A comparison between the microleakage of direct and indirect composite
restorative systems
W.H.DouglasaR.P.Fields∗J.Fundingsland∗
https://doi.org/10.1016/0300-5712(89)90072-9

 The present study compares the microleakage of direct and

indirect restorations. Two dentine bonding agents were
evaluated with both techniques.
 Choice of adhesive for the indirect method was also
significant, perhaps due to polymerization shrinkage of the
composite cement used for placement.
1.PACAKBLE COMPOSITES Posterior tooth restoration because of improved mechanical
properties
2.FLOWABLE COMPOSITES In difficult access areas
Pit and fissure sealants
Liner or base in class 2 proximal box
Cementing of porcleain veneers
Class v lesions
Porclein repairs
Enamel defects
Incisal edge repairs
Class III lesion

3.COMPOMERS Rampant caries

4.GIOMERS Restorations of root caries
Non carious cervical lesions
Class v cavities
Decidous tooth caries
FIBER REINFORCED High stress areas
COMPOSITES Splinting
Restoration of endodontically treated teeth
Metal free crowns

GIOMERS Restoration of root caries

Non cervical lesions
Class v cavities
Deciduous tooth caries

COMPOSITE INSERTS Used in areas to minimize the marginal contraction gaps in

composite fillings

SMART COMPOSITES Incipient lesions

ceromers Indirect composite restorations
Veneers
Inlays
onlays

Nano composites High stress bearing areas

In esthetic areas
Composite restorations
Preparation of operative site:

 If composite procedure only requires minor or no tooth preparation,

it may be necessary to clean the operative site with a slurry of pumice
to remove plaque, pellicle, and superficial stains.

 These steps create a site more receptive to bonding.

 Prophy pastes containing flavoring agents, glycerine, or fluorides

acts as contaminants and should be avoided to prevent a possible
conflict with the acid-etch technique
 Golden Proportions:
 Levin used the golden proportion to relate the successive width of the
anterior teeth as viewed from the frontal.
 Levin stated that “the width of the central incisor should be in golden
proportion to the width of the lateral incisor and the width of the
lateral incisor to the width of the canine should also be in golden
proportion as should the width of the canine to the 1st premolar.”
 color
 Color is the result of the physical modification of light by
colorants as observed by the human eye and interpreted by
the brain” (Billmeyer and Saltzman)
 Perceiving and analyzing colour is a skill that can be taught
and one that can be improved with practice.
 Color cannot be perceived without light, which is a form of
electromagnetic energy visible to the eye..
 PROPERTIES OF color

Opacity and translucency:

 As light strikes a surface it is either totally reflected (opaque),
totally transmitted (transparent) or a combination of both
(translucent).
 Translucent objects transmit part of the incident light and
scatter the rest. Translucency decreases with increased
scattering within the material.
 It is the three-dimensional spatial representation of hue.
Highly translucent teeth tend to be lower in value, while
opaque teeth have higher value.
 Metamerism:

 The change in colour perception of two objects under different

lights is called metamerism.
 Two objects with identical spectral distribution curves will
always match regardless of the illumination. .
 Fluorescence:

The emission of light by an object at a different wavelength from

that of the incident light is called fluorescence

Surface Gloss:

Gloss is an optical property that produces a lustrous surface

appearance, thus reducing the effect of colour difference and
increasing the brilliance.
 Tooth structure, porcelain and other tooth colored restoration
materials have different spectral distribution curves.
 They should, therefore, be tested under three light sources:
 daylight
 cool white fluorescent light
 incandescent lamp.
MEASUREMENT OF COLOR
Manual method: Shade guides e.g.Vita-Lumin, 3D-Vitapan,
Chromoscope

Instrumental method: Colorimeters, Spectrophotometers and Computer

Analysis Techniques
 Limitations of shade guides:

 Does not cover the complete color space of natural teeth color
 Shades are not systematic in their color space
 Lack of consistency among the individual dentist in matching colors
 Cannot be transformed into the CIE- l* a* b* color scale
 None of the commercially available shade guides are identical
 Shade Selection:

 The shade of the tooth should be determined before the teeth are subjected
to any prolonged drying, because dehydrated teeth becomes lighter in
shade as a result in decrease in translucency.

 Teeth are predominantly white, with varying degrees of yellow, grey or

orange tints.

 Color also varies with the translucency, thickness, and distribution of

enamel and dentin and the age of the patient.

 Other factors such as fluorosis, tetracycline staining, and endodontic

treatment also affect tooth color.
 However most manufacturers also cross-reference their shades with
those of the VITA Shade Guide (Vitazahnfabrik, Germany), a universally
adopted shade guide.

 Good lighting, either natural or artificial, is necessary when the color

selection is made.
 Natural light is preferred for selection of shades. However if no windows
are present to provide natural daylight, color corrected operating lights
are available to facilitate accurate shade selection.
 To be more certain of the proper shade selection, a
small amount of material of the selected shade can
be placed directly on the tooth, in close proximity to
the area to be restored, and cured.
 ISOLATION OF OPERATING SITE

 Isolation for tooth colored restoration can be accomplished

with rubber dam or cooton rolls, with or without retraction
cord.
  Rubber Dam:
 A heavy rubber dam is an excellent means of acquiring
superb access, vision and moisture control.
For proximal surface restoration, the dam should attempt to isolate
several teeth mesial and distal to the operating site.
This provides adequate access for tooth preparation, application of the
matrix and insertion and finishing of the material.
If a lingual approach is indicated for an
anterior tooth restoration, it is better to
isolate all of the anterior teeth and
include the 1st premolar to provide more
access to the lingual area.

For class V caries and other facial or

lingual defects, it may be necessary to
apply a No. 212 retainer (clamp), which
may be stabilized with impression
compound.
 If a proximal restoration will involve all of the contact area and/or
extend subgingivally, insert a wedge in the gingival embrasure after
dam application and before tooth preparation.

The wedge :
Depresses the interproximal soft tissue
Shields the dam and soft tissue from injury during the operative procedure
Produces separation of the teeth to help compensate for the matrix
thickness.
Before placing the wedge from facial approach, stretch the portion of the
rubber dam that covers the interproximal papilla facially and gingivally
(stretch lingually & gingivally if inserting wedge from the lingual).
Cotton Rolls (with or without retraction cord):
 A cotton roll is placed in the facial vestibule directly adjacent to the tooth
being restored.
 When restoring a mandibular tooth, a second, preferably larger, cotton roll
should be placed adjacent to tooth in the lingual vestibule.
 When the gingival extension of a tooth preparation is to be positioned
subgingivally, or near the gingival, a retraction cord can be used to
both temporarily retract the tissue and reduce seepage of tissue fluids
into the operating site.
 If hemorrhage control is needed, the cord can be first saturated with a
liquid astringent material.
 A piece of cord approximately 0.5 to 1mm in diameter and 8 to 10 mm
long is usually sufficient, deepening on the dimension of the involved
gingival crevice.
Anterior restorations

Perfection is not attainable, but if we chase it we can reach excellence.

Vince Lombardi
 Class III Restorations
Truly "invisible" Class III and Class IV restorations are possible only
through proper cavity preparation in conjunction with pr0per color
matching.
Class III lesions :
1. Not involving facial surface
2. Involving facial surface
Not involving facial surface
Conventional Class III Tooth
Preparation

90˚ cavosurface angle

Initial outiine : no. ½, 1 2 round
bur
Depth: 0.75mm into dentin
Retentive grooves: 0.25mm deep
with ¼ round bur
 Beveled Conventional Class III
Tooth Preparation
Lingual access:
Initial preparation:
Axial wall depth 0.2 mm inside
DEJ i.e; 0.75 to 1.25 mm deep
Axial line angles - 0.2 mm into
dentin.
If a retention groove is to be
placed, the axial wall should be
0.5 mm into dentin at retention
locations.
Finishing of enamel walls : 8-3-
22 hoe
FINAL TOOTH PREPARATION:
Cavosurface bevel - flame-shaped or round
diamond instrument - 45˚ to external tooth
surface
Retention groove: 0.2 mm inside the DEJ, and
0.25 mm deep
Facial Access
Modified Class III Tooth Preparation

indicated for small and moderate lesions or faults.

No effort is made to produce preparation walls that

have specific shapes or forms other than external
angles of 90 degrees or greater.
 Restorative part:
Matrixing
 LIGHT TRANSMITTING WEDGES
Teflon coated instruments
CLASS IV COMPOSITERESTORATIONS
Chamfer preparations:
1-mm long(or half the length of the
fracture) to half the depth of the enamel
on the labial and lingual surface.
Bevel preparations:
2- to 3-mm bevel
CLASS V COMPOSITE
RESTORATIONS
Conventional Class V Tooth
Preparation:
A tapered fissure carbide bur (No. 700, 701, or 271)
entry at a 45-degree angle to the tooth surface
initial tooth preparation stage, the extensions in
every direction are to sound tooth structure, except
the axial depth should only be 0.75 mm
retention grooves : 0.25mm depth- No. 1/4 bur along
the full length of the gingivoaxial and incisoaxial
(occlusoaxial) line angles.
Beveled Conventional Class V Tooth
Preparation:

indicated either for:

(1) the replacement of an existing,
defective Class V restoration that
initially used a conventional preparation
(2) for a large, new carious lesion.
Advantages are:
(1) increased retention due to the greater surface
area of etched enamel afforded by the bevel,
(2) Decrease microleakage due to the enhanced
bond between the composite and the tooth, and
(3) decreased need for groove retention form (and
consequently less removal of tooth structure).
 Initial axial wall depth :only 0.2 mm into dentin
 if groove retention necessary 0.5mm
 Bevel: flame-shaped or round diamond
instrument, 45˚, to a width of 0.25 to 0.5 mm.
 Composite placement

One phase placement, small preparations

One phase placement, large preparations

involving dentin
 Diastema closures
 Diastema is a space between front teeth.  
 Space closure requires placement of composite two adjacent teeth. 
 Placement of composite onto one tooth can be done it proper tooth
dimensions allow it.
 Diamond burs prepare tooth structure creating a rough surface for
improved bond strength and to produce bevels that show through tooth
color at restoration cavosurface areas.  
 Cross section of enamel rods improves enamel bond strength.  
  
Placement of opaque material to the lingual covered with
translucent material to the facial achieves a natural looking
restoration that is not influenced by this darkness.
Wrapping a matrix is avoided because it produces a straight
contour and eliminates the oxygen inhibited layer. 
A contoured matrix or hand shaping produces convex
interproximal areas. 
 Pit & fissure sealants
Indicated when demineralized, decalcified, undermined, or carious
tooth structure is present at pit n groove areas.
preventive resin restoration (PRR) or conservative composite
restoration (CCR) (which combines a small Class I composite with a
sealant).
Regardless of age, caries risk of an individual should be the major
factor for selecting teeth for sealant application.
Sealants may be indicated for either preventive or therapeutic uses,
depending on the patient's caries risk, tooth morphology,
Or presence of incipient enamel caries.
Initial depth: 1mm - No. 1/2 or No. 330 bur or diamond
CLASS VI COMPOSITE RESTORATIONS
Indications: Small faulty developmental pit located on a cusp tip
CLASS I COMPOSITE
RESTORATIONS
Conventional: Inverted cone bur
Modified Class I Tooth Preparation:
Minimally involved Class I lesions or faults.
Scoopedout appearance.
The initial pulpal depth is still 1.5 mm or approximately 0.2 mm inside the
DEJ, but may not be uniform.
CLASS II COMPOSITE RESTORATIONS
Conventional:
Occlusal Step: No. 330 or No. 245 shaped
diamond - to enter the pit opposite the
faulty proximal surface

Initial pulpal depth: 1.5 – 1.75mm

Axial wall depth: 0.2mm into DEJ = ¼

no.245 diamond
AMALGAM COMPOSITE
 Bevels
Facial & lingual proximal margins: 0.5mm bevel, 45˚

Gingival margins
According to J. Park et al (NOV’2008) Dent Mater.– Studied to
determine the effect of different layering techniques on cuspal
deflection in direct composite restorations.

The bulk filling technique yielded significantly more cuspal

deflection than the incremental filling techniques, while there was
no significant difference between the horizontal and oblique
increment methods.
SIGNIFICANCE: Cuspal deflection resulting from
polymerization shrinkage can be reduced by incremental filling
techniques to obtain optimal outcomes in clinical situations.
 According to RONALD D. JACKSON JADA, Vol. 131, March 2000:

 He described a simplified placement technique of

Heavy Body (packable) Composites.
 Light-body composite resin: 1st layer 0.5-1mm
 Heavy body composite: 3-3.5mm in increments
 Medium body restorative: final occlusal layer for
translucency
Slot preparation: using facial/lingual access to remove
interproximal decay in a posterior tooth.
right choice when carious lesions are below the contact point
and the caries is clinically visible and accessible.
Tunnel Preparation:
Indications : Incipient proximal lesions
on
premolar or molar teeth.
Open bite technique:
 Direct veneers

A veneer is a layer of tooth-colored material that is applied to a tooth to

restore localized or generalized defects and intrinsic discolorations.
Common indications for veneers include
1. teeth with facial surfaces that are
a. malformed,
b. discolored,
c. abraded,
d. eroded,
2. have faulty restorations
(1) partial veneers: indicated for the restoration of localized defects
or areas of intrinsic discoloration .

2)Full veneers : indicated for the restoration of generalized defects or

areas of intrinsic staining involving the majority of the facial surface of
the tooth.
Depth of preparation:
Partial veneer: 0.5mm-0.75mm – coarse elliptical/round diamond

Full veneer: 0.5-0.75mm – midfacially

0.2-0.5mm – cervically
If subgingival – 0.5mm01mm cervical to the mark indicating the
gingival tissue level and into the facial embrasures
Placement of material:
1. If tooth length is to be maintained/window preparation
2. If incisal lengthening is required/ incisal lap joint
 Why the multilayering…?
The shades and distribution of color modifiers are related to the three
zones of the clinical crown.
Each of the three zones may require a different combination of colors
based on the individual requirements of the tooth to be restored
Finishing and polishing

Finishing refers to all of the procedures associated with

contouring, eliminating excess at the margins, and polishing.

Polish relates to surface smoothness, luster, or gloss.

Smoothness is both the subjective appearance and the objective

measurement of a polish.
Wet or dry finishing

Dry finishing should be reserved for microfilled composite resins because

they contain only resin fillers, which melt and produce an artificial smear
layer of resin that enhances the surface gloss.
Two kinds of polish:
1. The acquired polish is the surface placed by the operator.
2. The inherent polish is the surface the material naturally reverts to
through mastication and erosion.
This surface is largely determined by the size and solubility of the dispersed
phases of the material used (eg, fillers, fibers, etc).
 Heterogeneous materials such as glass ionomers and composites generally
attain a smoother acquired polish than inherent polish. Heterogeneous
materials revert to their inherent polish after a short time regardless of the
initial finish achieved.
 Microfills usually attain an acquired polish that is similar to their inherent
polish because there is less difference between the wear resistance of the
fillers and the matrix
Acquired:inherent polish ratio –

Microfills have a low A:I ratio since both filler and matrix are similar.
Large-particle macrofills have a large A:I ratio, because their surface
becomes more rough over time: “I” becomes smaller relative to “A.”

Surface transition time

The surface transition time (STT) is the time it takes a material to transition from
its acquired polish to its inherent polish each composite has a an almost
predictable STT.
Clinical significance
A composite resin that achieves a high acquired polish tends to pick up
fewer stains, accumulate less plaque, and show better wear.
Ideally, the inherent polish should be smooth enough to be well tolerated by
gingival tissue.
To maintain maximum esthetics, the STT should be greater than the time
between cleaning appointments
POLISHING METHODS
A composite is under stress and tension at placement.
It takes 10 to 15 minutes for a composite to stabilize enough following
curing to allow finishing to be accomplished without considerable damage
to the restoration.

Armamentarium:
1. Rotary
2. Hand
 Rotary
1.Rotational abrasive, dry:
Diamonds, white stones, discs, or dry rubber points to soften and cut away
particles and the matrix.

2. Rotational abrasive, wet:

Diamonds or other abrasives, such as aluminum oxide discs, with water or a
water-soluble lubricant.

3. Rotational abrasive, erosive

uses pastes to soften and erode the attachment between larger particles and the
matrix. pastes - contain submicron aluminum oxide particles.
Eg. Herculite (Kerr) and Prisma Gloss (LD Caulk,).
4.Handpiece-driven oscillation:
Best used in place of strips when more aggressive cutting is needed (eg,
removal of overhangs).
Eg. Profin (Dentatus)- use small oscillating diamond points
 Burs

330, 1 round, 56-R 12-fluted 30- and 40-fluted

 Diamonds

Coarse diamonds (>125 μm) are particularly useful in resin-to-resin bonding

because the roughness creates a mechanical interlock between the old and
newly added composites.
Fine diamonds are ideal for gross contouring.
Micron diamonds are suited for the lingual surfaces of incisors and the
occlusal surfaces of posterior composites
USAGE
Micron diamonds (40 to 60 μm) are used for bulk reduction on surfaces
unreachable with discs.
Medium or coarse diamonds leave a rough surface that could extend
finishing and polishing times.
Burs cut the composite surface, which increases the likelihood of resin
fatigue fracture.
1.Sof-Lex Discs (3M) :
The abrasive is aluminum oxide.
4 grits.
Available for either Moore’s standard mandrels (16-mm diameter) or “Pop-
On” mandrels.
The Pop-On mandrel has a smaller circular head and uses smaller discs (13-
and 9.5-mm diameters).
Moore Discs (E.C. Moore Flexidiscs (Cosmodent

Super-Snap (Shofu)
More textured look: Intermittently touching surface
Usage:
Flexible discs and strips (eg, Sof-Lex, 3M) give an excellent finish.
Flexible discs cut composite more rapidly than enamel and can easily ditch
composite.
 Rubber wheels, cups, and points

 Soft rubber : Burlew wheels have an intermediate grit that is good for
initial contouring and smoothing.
 Medium rubber: Suitable for gross and final finishing
 Hard rubber : Ceramic discs (Shofu) have abrasive points for gross
reduction and rubber points for final finishing.
 Usage: They are effective with microfill composites because of the
homogeneous nature of these materials.
 Some cups (eg, Enhance, LD Caulk) are designed as a single-use
instrument for contouring and polishing.
Proximal finishing strips
 HAND INSTRUMENTS
A standard No. 12 or No. 15 Bard Parker blade can remove excess
restorative material interproximally.

Carbide composite carvers: Instruments numbered 150.17 to 150.20 are

bladed instruments that are excellent for chipping away excess veneer
cement.
Instruments numbered 150.18 and 150.19 are curved to the shape of a
tooth and can be used subgingivally to remove small amounts of
composite flash.
Usage:
Metal instruments effectively trim microfilled
composites because resin filler is not abrasive to metal.
Their use is particularly helpful in proximal areas with
limited access.
 POLISHING PASTE
 Aluminum oxide : A thin mixture of aluminum oxide
powder can be used on microfilled composites and some
smallparticle hybrids.
 Luster Paste (Kerr) is a 0.3-μm paste that gives a higher
polish than pastes with larger particles.
 The grit in the polishing material should be smaller
than the inorganic filler size of the composite.
 Prisma Gloss (LD Caulk) gives a polish similar to
Luster Paste on submicron composites, and
improves the polish achieved with extra-fine discs.
 SURFACE COATINGS
 Placing unfilled resin on a composite margin increases sealing and
reduces marginal leakage from contraction gaps.
 Although quick and easy, the result usually is a large amount of air
inhibition in the outer surface, preventing a complete cure.
 Note: detrimental for delayed curing composite – dual cure.

Specialized glazing products

Some materials are specially made for surface repairs.
Most of the glazes are thin resins with highly reactive
accelerators that compete more successfully with oxygen
to reduce air inhibition.
 Problems on recall visits
White line margins:
 If a composite restoration has any thin, knife-edge
margins, a white line at this margin may be
noticeable at placement.
 Microfills generally produce more white lines at the
margins.
 Finishing burs cause the most
white line margins, whereas
micron
diamonds and flexible
discs cause
the least.
 Treatment:

1. Restorations with sufficient bulk : trim it with a sharp

instrument (Bard Parker blade, gold foil knife, or carbide
hand instrument) and then polish the restoration with flexible
discs.
Restorations with no excess bulk should be removed with a
diamond, and resin should be added by the delayed resin–resin
bonding technique.
 Chipping
Pits • Chipping is common with
larger composites, such as
Poor placement is the veneers.
major cause of pitting • In general, microfills chip
In general, highly viscous in large pieces when
materials are more likely stressed, which can cause
to have voids during a shear failure.
placement, owing to • The most frequent cause
poorer adaptation during of chipping is excessive
layering and injection. occlusion
 Cohesive fracture:
 Cohesive fracture is more common with microfills than macrofills.
 A cohesive fracture is treated by completely removing the restoration or,
in less severe cases, with delayed resin–resin bonding.
 Color change:
There are three common explanations for a color that appears too light:
(1) the tooth was allowed to dehydrate before final shade selection,
(2) there was a disparity between the shade guide and the composite
restoration
(3) the composite was not completely cured.

If the final restoration color is too dark, there was likely a problem in shade
selection.
A common cause is clinician “color saturation” from looking at a tooth too long,
which tends to lead to selection of a too dark color.
 SANDWICH TECHNIQUE

Developed by McLean.
 Laminate or Bilayed technique.
Large Class III, IV, V & Class I, II.
 In close sandwich the GIC is placed over pulpal
floor and axial wall then composite is placed and
cured on the GIC
 In open sandwich the GIC is placed on the
gingival seat and on that composite is cured till
the occlusal level
ADVANTAGES
Favourable pulpal response due to
biocompatibility of GIC.
Fluoride release minimizes recurrent caries.
Less composite, less polymerisation
shrinkage.
DISADVANTAGES
Time consuming.
Technique sensitive.
Adhesion of composite with GIC is a worry.
Wall papering technique
Concept of covering the
cavity walls with
overlapping closely
adapted pieces of Leno
Weaved Ultra High
Mol.wt Polythelene
(LWUHMWPE) ribbons
LONGEVITY OF COMPOSITES
 REPAIR OF COMPOSITES

OLDER RESTORATION FRESHLY POLYMERIZED

 Etch, primer,  if not yet contoured Directly place
 adhesive, composite composite
 Bond strength- 50%  if contoured and polished
 Re-etch, adhesive, composite
 conclusion
 Composite resins have a promising future in dentistry.
 The technology is progressing rapidly, and composite resins
that rival porcelain in every way are expected within the next
few years.
 Systems will be available for office and laboratory use, and
both esthetic and functional requirements will be met.
 The need for metal support will be eliminated, and bonding
agents will ensure strong, long-lasting adhesion to tooth
structure.
 REFERENCES

 Sturdevant’s Art & Science of operative

dentistry; 5th Edition
 Phillips science of dental materials;11 th
edition
 Operative Dentistry Modern Theory and
Practice – M.A. Marzouk