COMPOSITE

RESTORATIONS

Dr. Dina Nouri

 Tooth colored restoration:
 1908 ceramic inlays and only.
 1878 silicate cement(discoloration, loss of contour, poor
of wear resistance).
 1930 acrylic resin (high CTE, high polymerization
shrinkage, poor of wear resistance).
 1972 conventional glass ionomer (favorable coefficient of
thermal expansion).
 Resin modified glass ionomer( better strength, wear
resistance and esthetic).
 Compomers (polyacid modified composite)
 Composite.
 composite
 In effort to improve physical characteristics of unfilled
resin.
 Bowen developed a polymeric dental restorative
material reinforced with inorganic filler composite
 strenght thermal expansion.
 Classification of composite:
 According to size ,  According to handling
amount and composition characteristics:
of filler: 1. Flowable
1. Macrofill composite 2. packable
2. Microfill composite
3. Hybrid composite
4. Nanofill composite
 Important properties of composites
 Successful composite restoration.

 Specific technique be incorporated into the

restorative procedure either in tooth preparation or in
the application of the material.
 Linear coefficient of thermal expansion:

 Rate of dimensional change of a material per unit

change in temperature.
 LCTE of composite 3 times of tooth.

 Good bonding reduce gap formation between

composite and the tooth.
 Water sorption:

 Amount of water that a material absorbs over time

per unit of surface area or volume.
 Property change and effectiveness .

 Higher filler content lower water absorption values

than materials with lower filler content.
 Wear resistance:

 Ability to resist surface loss as a result of abrasive

contact( opposing tooth, restorative material, food,
tooth brush, tooth picks).
 Filler particles size, shape, and content affect
composite wear.
 Location of restorative in the dental arch and occlusal
relation ship.
 Surface texture:

 Smoothness of the surface of the restorative material.

 Restoration in close approximation to gingival tissues
require surface smoothness for optimum health.
 Composition of filler particles.
 Materials ability to be finished and polished.
 Radiopacity:

 Esthetic restorative materials must be sufficiently

radiopaque recurrent caries.

 Most composite contain radiopaque filler such as

barium glass.
 Modulus of elaticity:

 Stiffness of a material.

 modulus rigid material.

 modulus more flexible material.

 Greater flexibility may perform better in certain class V more than

rigid materials ( microfilled).
 Solubility:

 Loss in weight per unit surface area or volume

secondary to dissolution or disintegration of material
in oral fluids over time at a given temperature.

 Composite materials do not show any clinically

relevant solubility.
 Polymerization of composite:

 Composite materials shrink while polymerizing.

 Carful control of the amount and insertion point of the
material and appropriate use of an adhesive on prepared
tooth structure to improve bonding reduce these
problems.
 No significant problem if preparation have all enamel
margins.
 Composite extending to the root surface may create a
V shaped gap formed between the root and the
composite because the force of polymerization
shrinkage of the composite is greater than the initial
bond strength of the composite to the dentin of the
root.
 It may be beneficial to place an RMGIC or
FLOWABLE composite first in gingival margin
then followed by composite placement.

 Reduce the potential for micro leakage and gap

formation and render the surrounding tooth
structure more resistant to recurrent caries.
 Configuration factor( C- Factor):
 The ratio of bonded surfaces to the unbonded, or free,
surfaces in a tooth preparation.
 The higher the c-factor , the greater is the potential for
bond disruption from polymerization effects.

Increase risk of contraction shrinkage

Low ratio high flow

High ratio low flow & more stress on the resin-

tooth interface
 Increase risk of contraction shrinkage

C = 0.5 C=2 C=5

 To over come problems of polymerization
shrinkage related to high c- factor we need to use
these methods:
1. “Soft start” polymerization instead of high intensity
light curing
2. Incremental additions.

3. A stress breaking liner such as a filled dentinal

adhesive, flowable composite , or RMGIC.
incremental addition and polymerization of thin layers
 Reducing polymerization shrinkage stress with
composites is to use a different polymer as
matrix( silorane) .

 Or by increasing filler content.

 Method of polymerization

 The method of polymerization of a composite may

affect the technique of insertion, direction of
polymerization shrinkage, finishing procedure, color
stability, and amount of internal porosity in the
material.
 There are 3 methods of composite polymerization.
A. Self cure
B. Light cure
C. Dual cure
 Self cure:

 2 component catalyst and base which are mixed together

to cause material to polymerize.

 Working time is restricted.

 Lower color stability(breakdown of tertiary amine).

 Polymerization shrinkage toward the center of the mass

so maintain marginal adaptation to prevent microlekage .
 Light cured:

 Require the use of light curing units.

 Can cause retinal damage.
 Provide increased working time during insertion.
 Greater color stability and less internal porosity.
 Polymerization shrinkage toward light source.
 Light curing units:

Types:

1- quartz tungsten halogen (QTH)

2- plasma arc

3- argon lasers

4- light emitting diodes (LEDs)

 Indication for composite restoration

 Class I, II, III, IV, and VI restorations.

 Foundations or core buildups
 Sealants and preventive resin restoration.
 Esthetic enhancement procedures:
Partial veneers
Full veneers
Tooth color modification
Diastema closures
 Cements for indirect restorations.

 Temporary restorations.

 Periodontal splinting.
 Contraindication for composite restorations

 Isolation factor:
 If the operating site cannot be isolated from
contamination by oral fluids, composite should not be
used.

 Occlusal factor:
 Contraindicated in patient with heavy occlusal forces.
 Patient factors:
 Poor oral hygiene
 Root caries

 Operator factors:
 Technical ability and knowledge of the materials use
and limitations are required.
 Advantages of composite restoration

 Esthetic.
 Conservative in tooth structure.
 Less complex when preparing the tooth.
 Insulating ; having low thermal conductivity.
 Used almost universally.
 Bonded to tooth structure, resulting in good retention.
 Repairable.
 Disadvantages of composite restorations

 Gap formation due to forces of polymerization

shrinkage or improper insertion of the composite by
the clinician.
 More difficult , time consuming, and costly.
 Most technique sensitive.
 Greater occlusal wear in areas of high occlusal stress
or when all of the tooths occlusal contacts are on the
composite material.
 Have higher LCTE , resulting in marginal percolation
if an inadequate bonding technique is used.
 Clinical technique

 Initial clinical procedures:

 Complete examination, diagnosis , treatment plane.
 Checking of the occlusion.

 Local anesthesia:
 Comfortable not interrupted procedure,
 Reduction in salivation.
 Preparation of the operating site:

 With slurry of pumice to remove plaque, pellicles,

and superficial stains.
 Avoid prophy pastes containing flavoring agents,
glycerin, or fluorides which may acts as contaminant
or conflict with acid etch technique.
 Shade selection:
 Before teeth drying (lighter, decrease in translucency).
 Good lighting ( natural day light).
 Vita classical shade guide commonly used.
 Isolation of the operating site:

 Contamination of etched enamel or dentine by saliva

results in a significantly decreased bond.
 Contamination of the composite material results in
degradation of physical properties.
 Rubber dam, cotton roll, and retraction cord commonly
used.
 Pre-wedging in case of class II to create space for matrix
placement and assists in reestablishing a proximal contact.
 Tooth preparation for restoration.
Thank you