COMPOSITE

DEFINITION – Composite can be defined as compound of two or more distinctly different

materials with properties that are superior or intermediate to those of individual constituents.

CLASSIFICATION – Composites can be classified based on filler size, percentage of filler loading,
type of resin matrix, viscosity, method of polymerization and uses. Various authors have
purposed different classification.

1. On the basis of mean particle size of major fillers-

a. Traditional/conventional/macro filled composites (8-12 µm)

b. Small particle filled composites (1-5 µm)

c. Micro filled composites (0.001-0.04µm)

d. Hybrid composites (0.6-1 µm)

2. On the basis of filler particle size and distribution

a) Bayne and Heyman classification

a. Megafilled composites - very large fillers

b. Macrofilled composites (10-100µm)

c. Midifilled composites (1-10µm)

d. Minifilled composites (0.1-1µm)

e. Microfilled composites (0.01-0.1µm)

f. Nanofilled composites (0.005-0.01µm)

b) Philips and Lutz classification

a. Macrofilled

b. Microfilled

c. Hybrid

3. On the basis of viscosity (Summit)

a. conventional
b.Packable

c. Flowable

4. on the basis of matrix composition

a. Bis GMA (Bisphenol glycidyl methacrylate)

b. UDMA (Urethane dimethacrylate)

c. Bis EMA (Bisphenol-A-polyethylene glycol diether dimethacrylate)

d. TEGDMA Triethylene glycol dimethacrylate

5. on the basis of method of polymerization

a. Self cure/autocure/chemical cure

b. Light cure

1. U.V light

2. Visible light

c. Dual cure Combine both self cure and light cure

d. Staged curing

6. on the basis of their chronological development

a. FIRST GENERATION- consist of macro ceramic reinforcing phases in resin matrix

b. SECOND GENERATION- consists of colloidal and micro ceramic phases in continuous resin
phase.

c. THIRD GENERATION – consist of hybrid composite having combination of macro and micro
ceramic reinforces in suitable resin phase.

c. FOURTH GENERATION – consist of hybrid composite having heat cured ,irregularly shaped ,
highly reinforced, composite macro particles , with reinforcing phase of micro ceramics.

d. FIFTH GENERATION – consist of hybrid composites, having continuous resin phase reinforced
by micro ceramics and macro, spherical, highly reinforced, heat cured composite particles.

e. SIXTH GENERATION – consist of hybrid composites, having continuous resin phase reinforced
with a combination of micro ceramics and agglomerates of sintered micro ceramics.
COMPOSITION-

Composite resin are composed of four major components which are resin matrix, filler particles,
coupling agents and activator-initiator system ; also present inhibitors and optical modifiers.

RESIN MATRIX- it is continuous phase into which all other constituents are added. Example –
bis GMA and UDMA. They are highly viscous. Diluent monomers such as TEGDMA are added to
reduce viscosity and fillers particles to be added.

FILLER PARTICLES – They are dispersed in resin matrix. The type, concentration, particle size
and particle size distribution of fillers determine the physical properties and working
characteristics of the material. They provide dimensional stability to soft resin matrix.
Commonly used fillers are quartz, colloidal silica and various types of glasses as aluminosilicates
and borosilicate.

OPTICAL MODIFIERS- They are added in minute amount to produce shades in composite.
Example – aluminum oxide, titanium oxide.

COUPLING AGENTS – For composite resin to perform well filler particles have to be well
bonded to resin matrix. This is achieved through coupling agent. They are responsible for bond
between organic and inorganic phase of composite. Hence promote stability to system.
Example – organosilanes, Zirconates, Titanates

ACTIVATOR- INITIATOR SYSTEM - They help in generating free Radicles required for starting the
polymerization reaction. However to counteract spontaneous polymerization of monomers,
inhibitors like butylated hydroxyl toluene are provided.

Chemical cure – initiator – benzoyl peroxide

Activator – tertiary amine

Light cure - initiator – benzoin methyl ether

Activator – UV light

Initiator – camphoroquinone

Activator – visible light

POLYMERISATION MECHANISMS – Based on mode of activation of polymerization there are 2

main types

a. CHEMICALLY ACTIVATED RESINS – They are also referred to as self cure resins. They are
marketed in two pastes one containing initiator and one containing activator. As two pastes are
mixed activator reacts with initiator to produce free radicals and compound with reactive
unpaired electron. These materials attack the carbon double bonds in resin monomer initiating
additional polymerization.

b. LIGHT ACTIVATED RESINS- They are of two types UV light and visible light.

The earliest systems used ultraviolet light for curing. Light activation put control of working
time firmly in the hand of dentist.

 Limitations of UV light curing- lack of penetration through tooth structure.

 Limited penetration of light into resin.

Visible light activated resins totally replaced the use of ultraviolet light. They are widely used
than chemically activated resins.

PROPERTIES-

1. Linear coefficient of thermal expansion – it is the property which determines the rate of
dimensional change of a material per unit change in temperature. Ideally for any restorative
material LCTE should be either close or coinciding to that of enamel. This is important to
success of restoration, as it reduces gaps and voids at tooth – restoration junction with a
change in temperature. Composites have high LCTE compared to tooth structure. With
improvement in type and content of filler particles attempt is being made to reduce LCTE of
composites.LCTE for composites is 28-45 ppm/C which is twice for amalgam.

2. WEAR RESISTANCE – It is property which relates to material ability to resist surface loss due
to abrasive forces. Wear resistance of composites is good, better than GIC, but less than that of
enamel. Factors influencing wear of material are

A. filler content of composite material

B. occlusal contact relation of restoration

C. location of restoration on tooth and tooth’s position in arch

D. rubbing of tooth contacts occlusally.

E. degree of polymerization

3. WATER SORPTION – It is the material’s ability to absorb water over time. resin matrix in
composites tends to absorb water making it swell. This leads to reduction in effectiveness of
composite material and can also cause filler debonding. High filler contents lowers water
absorption tendency.

4. SOLUBILITY - It is the loss in weight per unit volume or surface area due to dissolution of
materials in oral fluid over time at a given temperature. Composites do not show clinically
significant solubility.

5. MODULUS OF ELASTICITY – It is measure of stiffness of material. Micro filled composites

have low modulus of elasticity, hence higher flexibility whereas hybrid composites
comparatively exhibit more rigidity.

6. RADIOPACITY - It is an important requirement for aesthetics restorative material to

differentiate restoration from radiolucent recurrent caries. Quartz and silica are used are
radiolucent. Radiopaque fillers are barium, strontium and zirconium.

7. COLOUR STABILITY – It is an important property of esthetic restorative material. Change of

colour can result due to a. Staining (b) oxidation (c) water exchange within the polymer matrix
(d) loss of filler (e) stress cracks within the matrix

8. POLYMERISATION SHRINKAGE – When the composite material is cured monomer gets

converted to polymer and during this process there occurs polymerization shrinkage in the
material. It has been observed that during the process of polymerization about 55 – 65% of
monomer gets converted into polymer and remaining resin do not polymerize. The
phenomenon of polymerization shrinkage occurs in this 55 – 65% cured resins. It leads to
generation of internal stresses within the polymer chains and surface of restoration. The
material already bonded to enamel and dentin wall tends to pull back creating stress as high as
13 Mpa and sometimes failure. This can lead to gap formation at tooth – restoration junction
causing microleakage. The unbounded material present at surface of restoration tends to
distort trying to accommodate stress. This brings into picture the C factor.
C FACTOR – i.e. configuration factor is the ratio of bonded surfaces of restoration to unbounded
surfaces.

C Factor = bonded surfaces

Unbonded surfaces

C factor was first analyzed by Davidson and Feilzer in 1980’s. They described an in vitro model
in which restorations with c-factor <1 , are the only one likely to survive polymerization
shrinkage stresses. The significance of this ratio is that higher the value, greater is the
polymerization shrinkage.

With the increase of c-factor, the surface area of resin composite bonded to the cavity wall
increases relative to surface area of unbounded resin composite. Therefore less the free,
unbounded area there is in a cavity, less well be the ability of resin to flow. Hence greater will
be shrinkage stress at bonded surfaces. The ability of resin to flow helps to accommodate the
stresses be generated and protects the adhesive bond.

Cavity preparation bonded surfaces unbounded surfaces C-factor

Class 1 5 1 5

Class 2 4 2 2

Class 3 3 3 1

Class 4 2 4 0.5

Class 5 1 5 0.2
CLINICAL CONSEQUENCES OF POLYMERISATION SHRINKAGE

 Gap formation at tooth-restoration margin.

 Development of secondary caries.
 Postoperative sensitivity.
 Discoloration of restoration margins.
 Failure of restoration

METHODS TO REDUCE POLYMERISATION SHRINKAGE

1. It can be decreased by incrementally adding and independently curing each increment of

composite material. The contraction within each small increment is less, thereby generating
less stresses. The c- factor of each increment is reduced compared to bulk placement and
curing. As the c- factor decreases, the bond strength increases.
2. Increasing the filler content of the restorative material.

3. A stress breaking liner Flowable composite , or RMGI.

4. ‘Soft start’ polymerization method helps in reducing internal stresses instead of high intensity
light curing.

‘SOFT START’ polymerization is a method recently advocated to reduce polymerization

contraction stresses in resin – composite restorations. During early polymerization, the resin
composite cross linking network is relatively weak, allowing “flow” to fairly easily accommodate
for stresses and prevent damage to adhesive bonds. With further polymerization, contraction
and flow decrease, while stiffness and stress increase. This may cause adhesive failure. The
bond strength must exceed the contraction stress to provide a stable marginal adaptation.
“SOFT START “polymerization proposes that a slower rate of conversion will allow better flow of
resin with decrease in contraction stress. It is divided into three separate techniques: stepped,
ramped or pulse delay. A stepped program emits a low irradiance for 10 sec. and then increases
immediately to maximum value for duration of exposure. In ramped program, the irradiance
gradually increases from low value to maximum intensity over 10 sec. after which it remains
constant. Pulse delay uses a short low level burst, delay for polymerization, and finally a long
exposure at full intensity.

DIFFERENT TYPES OF COMPOSITES

1. TRADITIONAL/ CONVENTIONAL/MACROFILLED COMPOSITES – These were developed

in 1970’s and referred to as macro filled because of large size of filler particles. Most
commonly used filler in early composites was ground quartz. It had excellent esthetics
and durability but lack radiopacity. To overcome this now preferred are strontium /
barium glasses or heavy metal glass fillers. They exhibit property of radiopacity allowing
better visualization of caries. Filler loading is 70-80 wt%.

Advantages

 They have better properties in terms of compressive strength, tensile strength, hardness
compared to unfilled acrylic resins.
 Polymerization shrinkage and COTE are reduced.

DISADVANTAGES –

 They have poor resistance to occlusal wear.

 Fracture of restoration is another commonly occurring consequence.
 Rough surface so tendency to discolor

2. MICROFILLED COMPOSITES - They designed to overcome the drawbacks of conventional

composites, chiefly being the rough surface characteristics. They contain colloidal silica particle
as filler particles. Colloidal silica is added to resin till it becomes viscous. The resin composite is
then polymerized and ground into 5 – 50 µm particles (Pre polymerized resin fillers) and are
incorporated into non polymerized resin matrix. The resin is then filled with micro filler, but
only at half the concentration of polymerized resin fillers to avoid excessive thickening.
Inorganic filler content is 35-60 wt %

 ADVANTAGES –Due to small sized particles they are polished to highest lustre and
smooth surfaces.
  Most esthetics of all types of composites.
 They have low modulus of elasticity, hence high flexibility.

DISADVANTAGE -

 The bond between resin filler – matrix interface is weak resulting in loss of resin filler
from material’s surface.
 Low tensile strength.
 High water sorption which softens the resin matrix.
 Coefficient of thermal expansion is high.
 They show high polymerization shrinkage.
 Low stiffness and less fracture resistance.

HYBRID COMPOSITES – (colloidal and small particle fillers)

This class of composites was developed to improve the physical and mechanical properties
along with retaining surface smoothness. This could be achieved by combination of macro and
micro fillers in same material. This produced a hybrid category containing a blend of submicron
fillers and small filler particles. They have improved physical properties due to high filler
content. The material so produced is very successful and have almost universal clinical
applicability.

FILLER CONTENT- Ground heavy metal glasses 75 – 80 wt%

Colloidal silica approx. 10 – 20 wt %

RECENT ADVANCES –

They can be grouped as follows

DIRECT RESTORATIONS

 PACKABLE COMPOSITE
 FLOWABLE COMPOSITE
 ORMOCER
 ION LEACHING COMPOSITE
 NANOFILLED COMPOSITE
 SMART COMPOSITE
 COMPOMER
 GIOMERS
 INDIRECT RESTORATIONS –

 ART GLASS
 BELLE GLASS
 FIBRE REINFORCED COM POSITES

1. Polymeric rigid inorganic matrix material (PRIMM) Packable / condensable / high

density -

Developed by Lars Ehrnford 1995. These are composite materials having high filler loading.
They are developed with an idea of having a composite material that has handling
characteristics similar to amalgam. They are viscous and usually have large filler particles.
The inorganic fillers may be ceramic fibers or irregular particles having filler loading of about
50 – 70 % by volume. The average particle size varies from 0.2 to 20 µm..

Commercially available as solitaire

USES - They are intended for large posterior restorations like class 1, class 2

 ADVANTAGES – They can be easily packed in cavity.

 It is easy to establish good proximal contact.
 They have low polymerization shrinkage.
 They can also be used as support for larger composite restoration.
 They have low wear rates.
 They show less stickiness to instruments.
 DISADVANTAGES – They are opaque and unaesthetic materials.
 Due to high viscosity different layers do not wet each other.
 Presence of dry spots from inadequate resin saturation resulting in weak areas.
 They do not accomplish handling properties similar to amalgam.

2. FLOWABLE COMPOSITES –

These are low viscosity, lightly filled composite materials. As these materials have low filler
loading, they tend to show high flow and inferior physical properties compared to conventional
composites. The particle size of inorganic filler is in the range of 0.2 – 0.3 µm and filler loading is
42- 60.3%. These materials should be placed in thin layers as they show high polymerization
shrinkage. Placing them in bulk is avoided.

Commercially available as Tetric Ceram.

  USES- Pit and fissure sealants
 restoration of small class I, class III and angular class V
 Layer of thin wash and liner, which improves the adaptation of first increment of
condensable composite.
 For repair of defective composite margins
 Sealing of ditched amalgam margins.
 Tunnel restorations.
 Pediatric restorations
 Luting agent for composite veneers.

ADVANTAGES –

1. Easy to use, syringable materials.

2. They show high wettability, which allows good adaptation of restorative material to the
prepared tooth surfaces.

3. High flexibility hence used in areas of tooth abfractions.

4. They have high depth of cure.

5. Esthetic materials available in different shades.

DISADVANTAGES –

1. They cannot be used in high stress bearing areas due to low wear resistance and low
strength.

2. High polymerization shrinkage.

3. The material stains easily.

4. The material fatigues more quickly and breaks more frequently.

SMART COMPOSITE – Smart composite are based on recently introduced alkaline glass fillers
which inhibit the bacterial growth and thereby reduce formation of secondary caries. it was
introduced in 1998 under name Ariston phc.

In smart composite micron size senser particles are embedded during manufacturing process
into composite. These sensers react with resin matrix and generate quantifiable ions like
fluoride, calcium and hydroxyl ions, If the ph falls in vicinity of restoration. Fall in ph occurs
because of plaque accumulation in that area.
Paste of smart composites contains barium, aluminium fluoride, silicate glass fillers with silicon
dioxide, and ytterbium trifluoride and calcium silicate glass in dimethacrylate monomers. Filler
content in these composites is 80% by weight.

ORMOCERS – They are organically modified non metellic inorganic composite materials. They
were first introduced in 1998.

They basically consist of three components – organic portion, inorganic portion and
polysiloxanes. inorganic components are bound to the organic polymers by multifunctional
silane molecules. After polymerization, organic portion of methacrylate groups form a three
dimensional network. Thus they can be described as three dimensionally cross linked
copolymers. They are synthesized by sol-gel process. Their coefficient of thermal expansion is
very similar to tooth structure. These materials were formulated in attempt to overcome
problems created by polymerization shrinkage. This class of materials also combines the surface
properties of silicones, toughness of organic polymers and hardness and thermal stability of
ceramics.

 ADVANTAGES – They show low polymerization shrinkage.

 Low wear rates
 High abrasion resistance
 Good biocompatibility
 Provide protection against caries
 Highly esthetic, providing excellent final burnishing.

 USES – Direct restoration for all types of cavities

 Sealants
 Cosmetic veneers
 Orthodontic bonding adhesives

NANOFILLED COMPOSITES –

The development of nanofilled composites has led to significant improvements in dental

materials and their properties. They contain small filler particle of range 0.005 – 0.01 µm. These
primary particles can be easily agglomerated allowing a full range of filler size. This makes
possible increased filler loading and reduced amount of resin matrix, thereby reducing
polymerization shrinkage while providing esthetics and strength.

Ion releasing nanocomposites can also be used to increase mineral content of dental caries.
Fluoride release can be achieved by using calcium fluoride nanoparticles. Nano DCPA whiskers
(dicalcium phosphate anhydrous) and Nano TTCP whiskers ( tetra calcium phosphate) for
calcium and phosphate ions.

COMPOMERS – (POLYACID-MODIFIED COMPOSITE RESINS)

They were introduced in Europe and available since 1993. The term compomers is an acronym
derived from composite and glass ionomer. Basically compomers are light polymerized
composite resin restoratives, modified to contain ion leachable glass particles and anhydrous
polyalkenoic acid. That is why the term polyacid modified composite resin was proposed by
McLean et al. unlike true glass ionomers these are resin based materials containing no water.
Also their setting or polymerization reaction involves no mixing. They are essentially one paste
system that is light cured for polymerization to take place. A typical composite resin network
around filler particles is formed on light activation. The absence of water prevents glass
particles and anhydrous acid from reacting. Eventually water uptake from oral environment
initiates acid-base reaction between these components with resultant diffusion of low level
fluoride from the restoration.

PROPERTIES –

ADHESION – For proper adhesion of the restoration to the tooth surface, acid etching of tooth
needs to be done. The restoration is retained micromechanically through resin tags.

FLUORIDE RELEASE – It shows limited fluoride release, which starts after 2-3 months. it is less
than other comparable glass ionomer formulations.

MECHANICAL PROPERTIES – These are inferior to those of conventional composite resins, thus
limiting their use to low stress bearing areas.

 USES – Bases for composites

 Pit and fissure sealants
 Small core build ups
 For restoring non carious cervical lesions

GIOMERS – As the name suggests are combination of glass ionomers and composites,
possessing properties of both materials. They are resin based materials containing prereacted
glass ionomer particles. PRG particles comprise of fluorosilicate glass, which has been reacted
with polyacrylic acid. and then incorporated into resin. If this prereaction involves only surface
of glass particles, it is called surface PRG ionomer

PROPERTIES

SIMILAR TO GIC
  Fluoride release
 Fluoride recharge

SIMILAR TO COMPOSITES

 Light activated materials

 Show excellent esthetics
 Easy polishability
 Biocompatibility

USES

 Class 5 abrasion , erosion, abfraction lesions

 Root caries

FIBRE REINFORCED COMPOSITE (FRC) –

They were introduced to increase the compressive and tensile strength of composites. Glass
and polyethylene fibers are utilized for this purpose. Fibers act as crack stoppers and improve
property of composites. The fibers are arranged in one direction, running from one end to
another end in parallel manner or multidirectional resulting in mesh type configuration. When
the applied forces act perpendicular to long axis of fibers, it results in strength reinforcement.

The second generation of indirect composite resins may be combined with fiber reinforced
substructure.

USES –

 Metal free restorations, inlays, crown

 Periodontal splitting
 Fixed bridges
 Implant supported crowns
 Fixed orthodontic retainers
 Repairing dentures
Light cure units- photo initiator camphoroquinone , when exposed to 474 nm wavelength of
light, initiates polymerization reaction.

light cure can be accomplished with

A. QTH (Quartz Tungsten Halogen) curing unit

B. Plasma –Arc curing unit
C. Laser curing unit
D. LED (Light Emitting Diode) curing unit

A. QTH
It consists of following parts
1. Bulb
2. Reflector (silverized mirror)
3. Fan to cool the unit
4. Bandpass filter to eliminate UV and infrared rays, which is converted to heat
5. Light pipe
6. Light-tip
7. Light guard
8. Circuit
9. Trigger

It contains a bulb having tungsten filament filled with halogen gas. Light produced by bulb is
reflected by the reflector placed behind the bulb. The reflected light first passes through
bandpass filter and then through fibre optic band to be emitted from tip. Only 0.5% light is
suitable for curing and rest is converted into heat. The minimum output of LCU should never be
less than 300mW/cm2 .

Light intensity decreases due to

a. Scattering by molecules of air

b. Scattering by filler particles of composites
c. Absorption of light by darker coloring agents

To achieve optimum curing

a. Distance of light cure tip from material 1-2mm

b. Thickness of increment 1.5-2mm
c. Curing time 20-40 secs
d. Light intensity 300mW/cm2
B. Plasma arc light curing unit
High intensity curing units containing xenon plasma lamps. light is obtained from
electrically conductive gas called plasma. It forms between two tungsten electrodes
under pressure.
 High intensity light, so more penetration depth
 3-10 sec equivalent to 40sec of QTH
 380-500nm wavelength
 Output filtered for UV and infrared rays

Disadvantages

 Very fast curing so risk of polymerization shrinkage

 Large size and more expensive equipment

C. LED ( light emitting diode)

It utilizes semiconductor devices of n-p type of two layers one doped with electrons (n-
doped) and other doped with holes (p-type). Gallium nitride LEDs (blue LEDs) are used.
 Wavelength range is 450-490nm, so effective only for camphoroquinone based
composites
 Filters not required
 Long life span
 Don’t heat up
 Depth of cure is higher

D. Laser Sources
They emit monochromatic light so eliminates the need for filtering undesired
wavelengths.
Argon lasers generates blue light in band width of 450-500nm.
Advantages
 Uniform polymerization, greater depth of cure and higher degree of
polymerization
 Less time required.
 Better physical properties of composites.
 Not effected by distance of curing tip.
Disadvantages

 Greater polymerization shrinkage which can cause microleakage.

 Rise in temperature which can affect the pulp.