COMPOSITES New Gauri

COMPOSITE
Dr. Gauri P. Tiwari

Post-Graduate Student
Department of Conservative Dentistry And
Endodontics
Himachal Dental College
CONTENTS:-
• Introduction.
• History.
• Definition.
• Composite restorative material
(Components, Composition and function)
- Matrix.
- Filler.
- Coupling agent.
- Activator – Initiator system.
- Inhibitors.
- Optical Modifiers.
• Classifications.
• Properties.
- Degree of conversion.
- Matrix Constraints.
- Toughness.
- Polymerization shrinkage and Shrinkage stresses.
- Wear.
- Marginal leakage.
- Radio- opacity.
• Biocompatibility of composites.
- Bisphenol A toxicity.
• Longevity/ survival probability of composite.
• Repair of composites.
• Innovations and recent advances in dental composites.
INTRODUCTION
• 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 material, one among them being DENTAL
COMPOSITES.
• Population’s burgeoning interest in health and beauty, is driving increased

demand for cosmetic dental procedures.
Harry F. Albers, DDS; TOOTH-COLORED RESTORATIVES PRINCIPLES AND TECHNIQUES Ninth Edition
• Historically, for many adults, the achievement of a pretty smile has meant
submission to extensive invasive procedures and high-cost fixed prosthodontics.
• Improvements in tooth-colored restoratives and bonding technology have made

cosmetic dental procedures more palatable and feasible.
• In addition, newer technology allows the general practitioner to handle many

previously complex esthetic problems more simply, conservatively, and
economically.
HISTORY
• In 1873, Thomas Fletcher introduced the first tooth-colored filling material, silicate
cement. Silicate did not become popular until Steenbock introduced an improved
version in 1904, but even the improved silicates discolored easily and lasted only a
few years.
• In the early 1940s, German chemists developed the first acrylic resins. The first
dental acrylic resin product was introduced in 1948. These acrylics demonstrated
better color stability but significant shrinkage, limited stiffness, and poor adhesion.
• In 1951, Swiss chemist Oscar Hagger developed the first dimethacrylate molecule, which
allowed for a cross-polymerized matrix. The first dental product to use the more durable
and color-stable dimethacrylate was produced in 1964.
• In 1955, Michael Buonocore published a milestone article that described a simple

method of increasing the adhesion of acrylic fillings to enamel. His ideas resulted in the
development of dental adhesives with the ability to bond to tooth structure.
• In 1962, Ray Bowen and others developed a large-molecule, hydrophobic dimethacrylate

monomer (Bis-GMA), a key advance in resin chemistry. Bis-GMA forms the basis of
present-day composite resins because of its limited shrinkage and fracture resistance. It
was first used in a composite in 1969.
• In 1963, Dennis Smith developed the polyelectrolyte cement that led to the
polycarboxylate adhesive cements, the key component for developing glass-ionomer
cement.
• In 1974, Wilson and Kent, with the assistance of John McLean, developed the first
glass-ionomer cement.
• In 1980, the first edition of Tooth-Colored Restoratives was published.
Anusavice; Phillips’ Science Of Dental Materials, 12th Edition, Chapter 13- Resin Based Composites
DEFINITIONS:
COMPOSITE
In materials and science, a solid formed from two or more distinct phases (e.g.,
particles in a metal matrix) that have been combined to produce properties superior
to or intermediate to those of the individual constituents.
DENTAL COMPOSITE
Dental composite is defined as 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.
Anusavice; Phillips’ Science Of Dental Materials, 11th Edition, Chapter 15-RESTORATIVE RESINS
COMPOSITE RESTORATIVE MATERIAL
MAJOR COMPONENTS
FILLER.
MATRIX.
COUPLING
AGENT.
COMPOSITE RESIN
Dental composites are made up of three major
components:
1 Matrix - A plastic resin material that forms a continuous phase and binds the
filler particles.
2. Filler - Reinforcing particles and/or fibers that are dispersed in the matrix.
3. Coupling agent - Bonding agent that promotes adhesion between filler and
resin matrix
Anusavice; Phillips’ Science Of Dental Materials, 11 th Edition, Chapter 15-RESTORATIVE RESINS

RESIN MATRIX
• The resin matrix in most dental composites is based on a blend of aromatic and/or
aliphatic dimethacrylate monomers such as bis-GMA and urethane dimethacrylate
(UDMA) to form highly cross-linked, strong, rigid, and durable polymer structures.
• This matrix forms a continuous phase in which the reinforcing filler is dispersed.
• Because of the large molecular volume of these monomers, polymerization

shrinkage can be as low as 0.9% when combined with inorganic particulate fillers at
levels of up to 88% by weight.
Ronald L. Sakaguchi, Craig’s RESTORATIVE DENTAL MATERIALS, THIRTEENTH EDITION, CHAPTER 9 – RESTORATIVE MATERIALS
– COMPOSITE AND POLYMERS.
• However, UDMA and bis-GMA are highly viscous (800,000 centipoise, similar to honey
on a cold day) and are difficult to blend and manipulate.
• Thus, it is necessary to use varying proportions of lower-molecular-weight highly fluid

monomers such as triethylene glycol dimethacrylate (TEGDMA, 5 to 30 centipoise) to
blend with and dilute the viscous components to attain resin pastes sufficiently fluid for
clinical manipulation and for incorporating enough filler to reinforce the cured resin.
Ronald L. Sakaguchi, Craig’s RESTORATIVE DENTAL MATERIALS, THIRTEENTH EDITION, CHAPTER 9 – RESTORATIVE MATERIALS – COMPOSITE AND
POLYMERS.
FILLERS
• Various transparent mineral fillers are employed to strengthen and reinforce composites
as well as to reduce curing shrinkage and thermal expansion.
• These include “soft glass” and borosilicate “hard glass”, fused quartz, aluminum silicate,
lithium aluminum silicate (beta-eucryptite, which has a negative coefficient of thermal
expansion), ytterbium fluoride, barium (Ba), strontium (Sr), zirconium (Zr), and zinc
glasses.
• The latter five types of fillers impart radiopacity because of their heavy metal atoms.
Anusavice; Phillips’ Science Of Dental Materials, 12 th Edition, Chapter 13- Resin Based Composites
• Quartz had been used extensively as a filler in the early versions of dental composites.
It has the advantage of being chemically inert but it is also very hard, making it
abrasive to opposing teeth or restorations as well as difficult to grind into very fine
particles; thus, it is also difficult to polish.
• Amorphous silica has the same composition and refractive index as quartz; however, it
is not crystalline and not as hard, thus, greatly reducing the abrasiveness of the
composite surface structure and improving its polishability.
• For acceptable esthetics, the translucency of a composite restoration must be similar
to that of tooth structure.
• Thus, the index of refraction of the filler must closely match that of the resin. For bis-
GMA and TEGDMA, the refractive indices are approximately 1.55 and 1.46,
respectively, and a mixture of the two components in equal proportions by weight
yields a refractive index of approximately 1.50.
• Most of the glasses and quartz used for fillers have refractive indices of approximately
1.50, which is adequate for sufficient translucency.
• The most commonly used glass filler is barium (Ba) glass. Although glass fillers
containing metals of a high atomic number provide radiopacity, they are not as
inert as quartz and amorphous silica and are slowly leached and weakened in acidic
liquids such as citrus juices, high pH solutions, and other oral fluids.
• Most important properties are improved by increased filler loading. A distribution

of particle sizes is used to maximize loading.
• If particle size is uniform, no matter how tightly packed the particles are, spaces
will exist among them.
• The maximal theoretical packing fraction for
close-packed spherical structures of uniform-
size is approximately 74% by Volume.
• However, if smaller particles are inserted

among the larger spheres, the void space can
be reduced.
Function of Fillers:-
Fillers can provide the following benefits:
1. Reinforcement.
2. Reduction of polymerization shrinkage/contraction.
3. Reduction in thermal expansion and contraction.
4. Control of workability/viscosity.
5. Decreased water sorption.
6. Imparting radiopacity.
COUPLING AGENT
• It is essential that filler particles be bonded to the resin matrix.
• This allows the more flexible polymer matrix to transfer stresses to the higher-modulus
(more rigid and stiffer) filler particles.
• The chemical bond between the two phases of the composite is formed by a coupling
agent; this is a difunctional surface-active compound that adheres to filler particle
surfaces and also co-reacts with the monomer forming the resin matrix.
• 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 agents, organosilanes—such
as γ-methacryloxypropyl trimethoxysilane— are used most commonly.
• In the presence of water, the methoxy groups (–OCH3) are hydrolyzed to silanol (–Si–
OH) groups, which can bond with other silanols on the filler surfaces by forming siloxane
bonds (–Si–O–Si–).
• The organosilane methacrylate groups form covalent bonds with the resin when it is
polymerized, thereby completing the coupling process.
• Proper coupling by means of organosilanes is extremely important to the clinical

performance of resin-based composite restorative materials.
OTHER COMPONENTS
 Activator initiator system
 Colour stabilizers
 Inhibitors
 Optical modifiers
 Pigments
ACTIVATOR INITIATOR SYSTEM
 Both monomethacrylate and dimethacrylate monomers polymerize by the addition

polymerization mechanism initiated by free radicals.
 Free radicals can be generated by chemical activation or by external energy

activation (heat, light, or microwave).
 Dental composites for direct placement use :-
 Chemical activation.
 Light activation/ Photochemically Activated Resins.
 Or a combination of the two.
1. Chemically Activated (Self-Cure) Resins
• Chemically activated resins (chemically cured composites) are supplied as two

pastes,
 One of which contains the benzoyl peroxide initiator,
 The other an aromatic tertiary amine activator (e.g., N, N-dimethyl-p-toluidine).
• When the two pastes are mixed together, the amine reacts with the benzoyl peroxide
to form free radicals, and addition polymerization is initiated.
2. Photochemically Activated (Light-Cure) Resins
 The first light-activated systems were formulated for UV light to initiate free radicals.
 Today, UV light–cured composites have been replaced by visible blue-light–activated

systems with greatly improved depth of cure, a controllable working time.
 The free radical initiating system, consisting of a photosensitizer and an amine initiator,
is contained in the paste.
 Exposure to light in the blue region (wavelength of about 468 nm) produces an excited
state of the photosensitizer, which then interacts with the amine to form free radicals
that initiate addition polymerization.
 Camphorquinone (CQ) is a commonly used photosensitizer that absorbs blue light
with wavelengths between 400 and 500 nm.
 Only small quantities of CQ are required (0.2% by weight or less in the paste).
 A number of amine initiators are suitable for interaction with CQ, such as
dimethylaminoethyl methacrylate (DMAEMA), which is also present at low levels
of about 0.15% by weight.
 Once curing is initiated, an exposure time of 40 seconds or less is required to

light-cure a 2-mm-thick layer, as compared with several minutes for chemically-
cured materials.
 They must be placed incrementally when the bulk exceeds approximately 2 to 3

mm because of the limited depth of light penetration.
The light-cure process is activated when a
diketone photosensitizer such as
camphorquinone (CQ) absorbs a quantum of
blue light and forms an excited-state complex
(exciplex) with an electron donor such as an
amine (e.g., dimethylaminoethyl methacrylate
[DMAEMA]). In the figure “••” denotes
the unshared pair of electrons “donated” by the
amines to the > C = O (ketone) groups in CQ.
While in this activated complex, CQ extracts a
hydrogen atom from the α-carbon adjacent to
the amine group, and the complex decomposes
into amine and CQ free radicals. The CQ free
radical is readily inactivated.
Thus, in photoinitiation only the amine free
radicals act to initiate the addition
polymerization reaction.
FACTORS INVOLVED IN PHOTOCURING
 Curing Lamps :-
• Most curing lamps are handheld devices that contain the light source and are
equipped with a relatively short, rigid light guide made up of fused optical fibers.
• At present the most widely used light source is a quartz bulb with a tungsten
filament in a halogen environment, similar to those used in automobile headlights
and digital projectors.
• Four types of lamps may be used for photoinitiation of the polymerization process.
 The following is the list of these lamps in order of lowest intensity to
highest intensity.
 Light-emitting diode (LED) lamps.
 Quartz-tungsten-halogen (QTH) lamps.
 Plasma arc curing (PAC) lamps.
 Argon laser lamps.

1. Light-emitting diode (LED) lamps.
Using a solid-state electronic

process, these light sources emit
radiation only in the blue part of
the visible spectrum, between 440
and 480 nm.
Anusavice; Phillips’ Science Of Dental Materials, 12th Edition,

Chapter 13- Resin Based Composites
2. Quartz-tungsten-halogen (QTH) lamps.
QTH lamps have a quartz bulb with a

tungsten filament that irradiates both
UV and white light, which must be
filtered to remove heat and all
wavelengths except those in the
violet-blue range (about 400 to 500
nm).

3. Plasma arc curing (PAC) lamps.
PAC lamps use a xenon gas that is

ionized to produce a plasma.
The high-intensity white light is
filtered to remove heat and to
allow blue light (about 400 to 500
nm) to be emitted.
Anusavice; Phillips’ Science Of Dental Materials, 12th

Edition, Chapter 13- Resin Based Composites
4. Argon laser lamps.
Argon laser lamps have the highest

intensity and emit at a single
wavelength. Lamps currently available
emit light at wavelength of about 490
nm.

• The tungsten and plasma arc lamps are filtered to transmit light only in the
part of the violet-blue region of the spectrum that matches the photo-
absorption range of CQ.
• Currently available LED and laser dental curing lamps are designed to emit light
only in the blue spectral range within the 400- to 500-nm photo- absorption
range of CQ. Thus, they do not require filters.
• A few photosensitizers and light sources have been introduced that absorb or
emit, respectively, at wavelengths outside the 400- to 500-nm range, which will
provide inadequate curing unless the lamp and resin/photosensitizer are
matched to each other.
• For maximum curing, a radiant energy influx of approximately 16,000 millijoules/cm2
(16 J/cm2) is required for a 2-mm-thick layer of resin.
• This can be delivered by a 40-second exposure to a lamp emitting 400 mW/cm2 (40
seconds × 400 mW/cm2 = 16,000 mJ/cm2 or 16 J/cm2).
• The same result can be produced by a 20-second exposure at 800 mW/cm2, or an

exposure of about 13 seconds with a 1200-mW/cm2 lamp.
• Thus, increasing the power density of the lamp increases the rate and degree of cure.
However, faster curing with higher-intensity light sources can increase shrinkage
stress.
DEPTH OF CURE AND EXPOSURE TIME.
• Recently QTH, PAC, laser, and LED lamps have been introduced with substantially
increased intensities (greater than 1000 mW/cm2), thus opening the possibility of
reduced exposure times and/or greater depth of cure.
• However, light absorption and scattering in resin composites reduces the power density
and degree of conversion (DC) exponentially with depth of penetration.
• Intensity can be reduced by a factor of 10 to 100 in a 2-mm-thick layer of composite.
• Thus, the surface must be irradiated for a longer time to deliver sufficient power
density well below the surface.
• Given the limits imposed by the light scattering and absorption inherent in
current restorative resins, the tradeoffs are such that : -
 Increased intensity will allow either shorter curing times for a given depth of
cure (or)
 Increased depth of cure for a given exposure time,
 But there is little advantage in attempting to achieve both simultaneously.
• The practical consequence is that curing depth is limited to 2 to 3 mm unless

excessively long exposure times are used, regardless of lamp intensity.
• Light attenuation can also vary considerably from one type of composite to
another, depending, for example, on the opacity, filler size, filler concentration,
and pigment shade.
• To maximize both degree of polymerization and long-term clinical durability, the

exposure time and curing technique to the intensity of the light source used
should be adjusted.
• Light is also absorbed and scattered as it passes through tooth structure,

especially dentin, thereby causing incomplete curing in such critical areas as
proximal boxes.
• Therefore, when one attempts to polymerize the resin through tooth structure,
the exposure time should be increased by a factor of 2 to 3 to compensate for the
reduction in light intensity.
In summary, technique and lamp maintenance are critical:
• A curing lamp with a wavelength range strongly overlapping the absorbance range of
the resin photoinitiation system must be selected.
• Intensity of light decreases with distance to the log scale; therefore, the lamp tip
must be placed and held at the minimal distance possible throughout the exposure
interval (20 seconds or more).
• Curing angle is critical, since maximal intensity is delivered perpendicular (90°) to the
resin surface therefore, the lamp tip must be placed and held as close as possible to
90° throughout the exposure interval.
• Lamp intensity should be evaluated frequently and adjustments made to ensure

sufficient radiant energy influx (about 16 J/cm2) for adequate curing.
SAFETY PRECAUTIONS FOR USING CURING LAMPS.
• The light emitted by curing units can cause

retinal damage if a person looks directly at
the beam for an extended period or even for
short periods in the case of lasers.
• To avoid such damage, never look directly

into the light tip and minimize observation
of the reflected light for longer periods.
• Protective eyeglasses and various types of

shields that filter the light are available for
increased protection for both clinical
personnel and patients.
DUAL-CURED RESINS
• One way to overcome limits on curing depth and some of the other problems
associated with light curing is to combine chemical curing and visible-light curing
components in the same resin.
• Dual-cure resins are commercially available and consist of two light-curable pastes,
one containing benzoyl peroxide and the other containing an aromatic tertiary amine
accelerator.
• They are formulated to set up very slowly when mixed via the self-cure mechanism.
The cure is then accelerated on “command” via light-curing promoted by the amine/
CQ combination.
• The major advantage of this system is assurance of completion of cure throughout,

even if photocure is inadequate.
Ronald L. Sakaguchi, Craig’s RESTORATIVE DENTAL MATERIALS, THIRTEENTH EDITION, CHAPTER 9 – RESTORATIVE MATERIALS – COMPOSITE AND POLYMERS
• The major disadvantage is porosity caused by the required mixing. But this has
been greatly alleviated by the use of mixing syringes.
•
• There is also less color stability than with the photocure resins owing to the
aromatic amine accelerators, but this is still better than for self-cure systems,
since the concentration of the accelerators is reduced compared with self-cure
resins.
•
• Finally, as with the chemically cured resins, air inhibition and porosity are
problems with dual cure resins.
• 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.
INHIBITOR
• Inhibitors are added to resin systems to minimize or prevent spontaneous or accidental

polymerization of monomers.
• Inhibitors have a strong reactivity potential with free radicals. If a free radical is formed,
for example, by brief exposure to room lighting when the material is dispensed, the
inhibitor reacts with the free radical faster than the free radical can react with the
monomer.
• This prevents chain propagation by terminating the reaction before the free radical is
able to initiate polymerization. After all of the inhibitor is consumed, chain propagation
can begin.
Ronald L. Sakaguchi, Craig’s RESTORATIVE DENTAL MATERIALS, THIRTEENTH EDITION, CHAPTER 9 – RESTORATIVE MATERIALS – COMPOSITE AND POLYMERS.
• A typical inhibitor is butylated hydroxytoluene (BHT), which is used in
concentrations on the order of 0.01% by weight.
• Thus, inhibitors have two functions: to extend the resin’s storage life
and to ensure sufficient working time.
OPTICAL MODIFIERS
• For a natural appearance, dental composites must have visual shading and
translucency similar to the corresponding properties of tooth structure.
• Translucency and opacity are adjusted as necessary to simulate enamel and dentin.
• For example, if a class IV incisal area is reconstructed, the translucency of an

unmodified composite might allow too much light to pass through the restoration. As
a result, less light is reflected or scattered back to the observer, who perceives the
incisal edge as too dark.
• This deficiency can be corrected by adding an opacifier. However, if an excessive

amount of opacifier is added, too much light may be reflected and the observer then
perceives that the restoration is “too white,” or more correctly, “too high in value”.
• Shading is achieved by adding various pigments, usually consisting of minute
amounts of metal oxide particles.
• To increase the opacity, the manufacturer adds titanium dioxide and aluminum
oxide to composites in minute amounts (0.001% to 0.007% by weight).
• It is important to realize that all optical modifiers affect light transmission through
a composite. Thus, darker shades and greater opacities have a decreased depth of
light-curing ability and require either an increased exposure time or a thinner layer
when cured.
PIGMENTS
• Fluorescent agents are sometimes added to enhance the optical vitality of the
composite and mimic the appearance of natural teeth.
• These are dyes or pigments that absorb light in the ultraviolet and violet region
(usually 340-370 nm) of the electromagnetic spectrum, and re-emit light in the
blue region (typically 420-470 nm).
• These additives are often used to enhance the appearance of color causing a
perceived “whitening” effect, making materials look less yellow by increasing
the overall amount of blue light reflected.
POLYMERS.
CLASSIFICATION OF COMPOSITES
Anusavice; Phillips’ Science Of Dental Materials, 11 th Edition, Chapter 15-RESTORATIVE RESINS
CLASSIFICATION OF COMPOSITES BY MANIPULATION
CHARACTERISTICS : -
 Flowable Composites.
 Condensable (Packable) Composites.

BASED ON THE ACTIVATION : -
 Chemically Activated (Self-Cure) Resins.
 Photochemically Activated (Light-Cure) Resins
 Dual-Cured Resins
ACCORDING TO STURDEVANT: -
 Conventional Composites.
 Microfill Composites.
 Hybrid Composites.
 Flowable Composites.
 Packable Composites.
 Nanofill Composites.
Sturdevant’s : Art and science of operative dentistry ; 5th edition

ACCORDING TO CRAIG :-
COMPOSITES FOR SPECIAL APPLICATIONS
1. Macrofills.  Microfilled Composites.
2. Hybrid and Microhybrid composite.  Packable Composites.
3. Nanocoposite  Flowable Composites.

- Nanofills.
- Nanohybrids.  Laboratory Composites.
 Provisional Composites
Ronald L. Sakaguchi, Craig’s RESTORATIVE DENTAL MATERIALS, THIRTEENTH EDITION, CHAPTER 9 – RESTORATIVE
MATERIALS – COMPOSITE AND POLYMERS.
TRADITIONAL/ CONVENTIONAL/ MACROFILLED
COMPOSITES
• Developed during the 1970s .
• Most commonly used filler for these

materials is finely ground amorphous silica
and quartz.
• The average particle size is 8 - 12µm,

particles as large as 50 µm may also be
present.
• Filler loading generally is 60 – 70 vol%
ADVANTAGES
•- Compressive, tensile •- Rough surface finish

strength •- Poor polishibility
•- Stiffness •- More wear
•- Hardness •- More prone to staining
•- Water sorption, thermal
expansion
DISADVANTAGES
A scanning electron micrograph of the
posterior, occlusal surface of a traditional
composite restoration that had been in clinical
service for 5 yr. The composite has been worn
away from the occlusal margins on the right,
and coarse filler particles have been exposed,
malting the surface very rough.
SMALL (FINE) PARTICLE COMPOSITES.
• Small-particle composites have mean particle diameters between 0.1 and 10 μm.
 Midfillers : - 1 to 10 μm.
 Minifillers : - 0.1 to 1 μm.
• These composites, while more polishable than traditional macrofilled composites (i.e.,
10 to 100 μm), cannot be polished to a high gloss.
• However, filler loadings are as high as or higher (77% to 88%) than those of
macrofilled composites, which provides a high degree of hardness and strength but
also brittleness.
• Its excellent balance among polishability, appearance, and durability make this
category suitable for general anterior use.
ADVANTAGES
•-Good mech properties - prone to wear and

•- Good smoothness deterioration.
•- Wear resistance
•- Less polymerization
shrinkage
•- Radiopacity
DISADVANTAGES
Typical particles of a small-particle
filled composite.
MICROFILLED COMPOSITES
• In the late 1970s the Microfill or

polishable composites were introduced.
• These materials were designed to replace

the surface roughness of traditional
composites.
• Colloidal silica – 0.04 m -20-59 % vol
Ronald L. Sakaguchi, Craig’s RESTORATIVE DENTAL MATERIALS, THIRTEENTH

EDITION, CHAPTER 9 – RESTORATIVE MATERIALS – COMPOSITE AND POLYMERS.
• Agglomerates of 0.01- to 0.1-μm inorganic colloidal silica particles embedded in
5- to 50-μm resin filler particles.
• Filler is made by a pyrolytic precipitation process where a silicon compound such
as SiCl4 is burned in an oxygen/hydrogen atmosphere to form macromolecular
chains of colloidal silica resulting in amorphous silica (colloidal, noncrystalline
SiO2), which produces highly polishable esthetic composite restorations.
ADVANTAGES
- Highly polishable •- Poor mechanical properties

- Good esthetic. due to more matrix content
•- Poor color stability
•- Low wear resistance
•- Less modulus of elasticity
and tensile strength
•- More water absorption
•- High coefficient of thermal
expansion
DISADVANTAGES
Craig's.Restorative.Dental.Materials.13th.Ed
HYBRID COMPOSITES
• This was developed in an effort to combine the favorable physical and
mechanical properties of conventional composites with the smooth
surface typical of microfill composites .
• As the name implies, hybrid composites contain two kinds of filler

particles.
• Fillers
• 0.4-1m – 60-65 % vol
• Colloidal silica (10-20 wt%)
• Glass particles with heavy metals (75-80 wt%)
• Intermediate properties
ADVANTAGES OF HYBRID COMPOSITES
• Different degrees of opaqueness and translucency in different tones

and fluorescence
• Excellent polishing and texturing properties
• Good abrasion and wear resistance
• Similar coefficient of thermal expansion
• Ability to imitate the tooth structure
• Decreased polymerization shrinkage
DISADVANTAGES OF HYBRID COMPOSITES
• Not appropriate for heavy stress bearing areas
• Not highly polishable as microfilled because of presence of larger filler

particles in between smaller ones
• Loss of gloss occurs when exposed to tooth brushing with abrasive

toothpaste.
NANOHYBRID COMPOSITES
• The most recent generation of resin-based composites are the

nanohybrids.
• Their resistance to fracture and wear, along with their high margin
strength, make them ideal for placement in posterior teeth.
• The wide selection of dentin colors, translucent enamel colors, and

their polishability make them equally suitable for anterior
restorations.
Ronald L. Sakaguchi, Craig’s RESTORATIVE DENTAL MATERIALS, THIRTEENTH EDITION, CHAPTER 9 – RESTORATIVE MATERIALS – COMPOSITE
AND POLYMERS.
• Nanohybrids contain silica nanoparticles averaging 20nm to 50nm in size,
promoting increased polishability and decreased shrinkage.
• Prepolymerized fillers are added to optimize the handling characteristics of

the composite and to reduce the shrinkage.
• The use of a flowable base, such as a glass-ionomer cement, along with

incremental addition of restorative material has made this generation of
composite easy to place and predictably not sensitive to temperature and
chewing forces.
COMMERCIAL NAMES OF NANOHYBRID
• Grandio (VOCO America)

• IPS Empress Direct (Ivoclar Vivadent)
• Tetric Evo Ceram (Ivoclar Vivadent)
• MIRIS 2 (Coltene Whaledent)
• Brilliant (Coltene Whaledent)
INDICATIONS
1. Class I, II, III, IV,V, and VI restorations

2. Foundations or core buildups
3. Sealants and preventive resin restorations (conservative composite restorations)
4. Esthetic enhancement procedures
• Partial veneers
• Full veneers
• Tooth contour modifications
• Diastema closures
5. Cements (for indirect restorations)
6. Temporary restorations
7. Periodontal splinting

CONTRAINDICATIONS
• When isolation of operating field is difficult.

• Very high occlusal forces are present
• Subgingival area/root surface
• Poor oral hygiene
• High caries index
• Habits (bruxism)

ADVANTAGES
• Esthetic.
• Conservative of tooth structure removal (less extension, uniform depth
not necessary, mechanical retention usually not necessary).
• Less complex when preparing the tooth.
• Insulative, having low thermal conductivity.
• Used almost universally.
• Bonded to tooth structure, resulting in good retention,
• Repairable.

DISADVANTAGES
• The primary disadvantages of composite restorations relate to potential gap
formation and procedural difficulties.
• May have a gap formation, usually occurring on root surfaces as a result of the
forces of polymerization shrinkage of the composite material being greater than the
initial early bond strength of the material to dentin.
• Are more difficult, time-consuming, and costly (compared with amalgam

restorations) because Tooth treatment for bonding usually requires multiple steps.
• Insertion is more difficult. Establishing proximal contacts, axial contours,

embrasures, and occlusal contacts may be more difficult.

• Are more technique sensitive because the operating site must be
appropriately isolated, and the placement of etchant, primer, and adhesive on
the tooth structure (enamel and dentin) is demanding of proper technique.
• May exhibit greater occlusal wear in areas of high occlusal stress or when all
of the tooth’s occlusal contacts are on the composite material.
• Finishing and polishing procedures are more difficult.

PROPERTIES OF RESIN-BASED COMPOSITES
 Degree Of Conversion (Dc)

 Matrix Constraint
 Toughness.
 Physical Properties.
 Thermal Properties.
 Water Sorption.
 Polymerization shrinkage.
 Wear
 Radioopacity.
Anusavice; Phillips’ Science Of Dental Materials, 12 th Edition, Chapter 13- Resin Based Composites.
Ronald L. Sakaguchi, Craig’s RESTORATIVE DENTAL MATERIALS, THIRTEENTH EDITION, CHAPTER 9 – RESTORATIVE MATERIALS –
COMPOSITE AND POLYMERS.
DEGREE OF CONVERSION (DC)
 The DC is a measure of the percentage of carbon-carbon double bonds that have been
converted to single bonds to form a polymeric resin.
 The higher the DC, the better the strength, wear resistance.
 A conversion of 50% to 60%, typical of highly cross-linked bis-GMA–based composites,

implies that 50% to 60% of the methacrylate groups have polymerized.
 Conversion values of 50% to 70% are achieved at room temperature for both curing
systems.
• Conversion of the monomer to a polymer depends on several factors, such as resin
composition, the transmission of light through the material, and the concentrations of
sensitizer, initiator, and inhibitor.
• Polymerization shrinkage of comparable light-activated and chemically activated

resins is not significantly different.
• In light-cured materials, curing shrinkage leads to substantially greater stress buildup

and leakage at the resin margins, in turn leading to staining, sensitivity, and secondary
caries.
Anusavice; Phillips’ Science Of Dental Materials, 12th Edition, Chapter 13- Resin Based Composites.
Degree of conversion (DC) reflects the
percentage of methacrylate double bonds that are
converted to single bonds during the curing reaction.
This figure shows that a cured resin can contain
dimethacrylates groups with zero, one, or two
unreacted double bonds. If at least one double bond
has reacted, the dimethacrylate group is bound to the
polymer network as a “pendant” group with one
double bond available for further reaction. Any
completely unreacted monomers can migrate out of
the cured resin. Cross-linked groups strengthen and
make the resin rigid while pendant groups plasticize
the resin , and unreacted
monomer softens and swells the resin structure,
Anusavice; Phillips’ Science Of Dental Materials, 12 th

Edition, Chapter 13- Resin Based Composites.
MATRIX CONSTRAINT
• The presence of filler particles bonded to the matrix via coupling agents reduces
thermal expansion and contraction of the composite.
• During expansion, while the space occupied by the filler tries to increase, the filler
with lower coefficient of expansion does not—and since the filler is chemically
bonded to the matrix, it prevents the space from getting larger and hence prevents
or reduces the expansion.
• Conversely, during cooling, the matrix contracts and decreases the space occupied
by the filler, but since the filler occupies that space, contraction is prevented or
reduced.
 During expansion, the composite can fracture within the matrix because of the
added tension caused by the non-expansion of the filler particle, within the filler
particle, or at the interfacial bond, depending on whether the interfacial bond is
stronger than the fracture toughness of the filler or the matrix.
 In contraction, the composite can fracture within the matrix or within the filler
particle, depending on which is weaker.
TOUGHNESS
• The strength of composites is highly dependent on the ability of the coupling agent to
transfer stresses from the weak matrix to the strong filler particles.
• Without the coupling agent, the filler particles cannot absorb stresses in the matrix and
act as if they were voids, thereby weakening instead of strengthening the matrix. Thus
a crack traveling through the matrix simply bypasses the particles.
• The energy required to detour around noncoupled particles is low because the lack of
coupling at the particle-matrix interface makes this interface behave the same as an
already existing “crack.”
• Consequently, in a true composite, the matrix and filler are chemically bonded. As the
crack propagates to a bonded filler particle, the crack must pass around the particle,
since it is stronger than the matrix and the interfacial bond.
• Therefore the energy needed for the crack to propagate is increased; this makes the
composite tougher.
• If the interfacial bond is weaker than the matrix, a process of crack blunting occurs.
• As the crack propagates to the weak interface, a void or tear opens up in front of the
advancing crack because of the stresses that the weak bond experiences.
• However, this void is perpendicular to the propagating crack; thus when the crack
arrives, the tip of the crack has been blunted and significantly more stress is required
to propagate the crack.
• Note that the use of a cross-linked polymer matrix also increases toughness, since it
prevents the polymer chains from being drawn and separated as the crack propagates.
A crack propagates through the resin matrix
under the influence of a tensile stress toward a
weak interface (A), and initiates a secondary
crack when the stress induced at the weak
interface is greater than the interfacial bond
strength (B). When the main crack reaches the
extended secondary crack, its propagation is
impeded by a process called crack blunting (C).
(Adapted from Darvell BW: Materials Science for
Dentistry, ed 9, Woodhead Publishing Ltd,
Cambridge, UK, 2009.)
Anusavice; Phillips’ Science Of Dental Materials,

12th Edition, Chapter 13- Resin Based Composites.
PHYSICAL PROPERTIES
Working and Setting time :
- For light cured composites initiation of polymerization is related

specifically to application of light beam.
- 75% of polymerization occurs - first 10 mins while the curing

reaction continues - period of 24 hours.
Sturdevant’s : Art and science of operative dentistry ; 5th edition.

• - Within 60-90secs after exposure to light the surface looses its capability to
flow readily against tooth structure.
• - Setting time for chemically activated resin 3-5mins.

Linear Coefficient of Thermal Expansion
• The LCTE is the rate of dimensional change of a material per unit change in
temperature.
• The closer the LCTE of the material is to the LCTE of enamel, the less chance there
is for creating voids or openings at the junction of the material and the tooth
when temperature changes occur.
• The LCTE of improved composites is approximately 3 times that of tooth structure.
• Bonding a composite to etched tooth structure reduces the potential negative

effects as a result of the difference between the LCTE of tooth structure and that
of the material.
Sturdevant’s : Art and science of operative dentistry ; 5 th edition.

WATER ABSORPTION
• Water absorption is the amount of water that a material absorbs over time
per unit of surface area or volume.
• When a restorative material absorbs water, its properties change, and its
effectiveness as a restorative material is usually diminished.
• All of the available tooth-colored materials exhibit some water absorption.
• Materials with higher filler contents exhibit lower water absorption values.

POLYMERIZATION SHRINKAGE AND STRESS
• Curing shrinkage arises as the monomer is converted to polymer and the free space it
occupies reduces (approximately 20% less than that among unreacted monomers).
• In turn, this polymerization shrinkage produces unrelieved stresses in the resin after it
reaches the “gelation” point and begins to harden.
• When a tooth preparation has extended onto the root surface, however, polymerization
shrinkage can (and usually does) cause a gap formation.

EFFECTS OF POLYMERIZATION SHRINKAGE
• Tooth deformation(cuspal deflection,

enamel and dentin microcracks)
• Micro leakage and post operative sensitivity
• Marginal Loss
• Secondary caries
• Damage within the composite itself
• The V-shaped gap occurs because the force of polymerization of the composite is
greater than the initial bond strength of the composite to the dentin of the root.
• The V-shaped gap is probably composed of composite on the restoration side and
hybridized dentin on the root side.
• If extending onto the root surface, there may be benefits to placing a RMGI first in
the gingival portion of the preparation on the root followed by the composite.
• This approach may reduce the microleakage and gap formation potential and
render the surrounding tooth structure more resistant to recurrent caries

Sturdevant’s : Art and science of operative dentistry ; 5th
edition
• The polymerization shrinkage and resultant stress can be affected by the: -
(1) Total volume of the composite material,

(2) Type of composite,
(3) Polymerization speed
(4) Ratio of bonded/nonbonded surfaces or the configuration of the tooth
preparation (C-factor).
C-FACTOR
 The C-factor is 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.
 A Class IV restoration (two bonded surface and four unbonded surfaces) with a C-
factor of 0.5 is at low risk for adverse polymerization shrinkage effects.
 A Class I restoration with a C-factor of 5 (five bonded surfaces, one unbonded

surface) is at much higher risk of bond disruption associated with polymerization
shrinkage, particularly along the pulpal floor.

REDUCTION OF SHRINKAGE STRESSES
• Two general approaches have been followed in seeking to overcome the problem of
stress concentration and marginal failure experienced with light-activated resins:
(1) Reduction in volume contraction by altering the chemistry and/or composition

of the resin system.
(2) Clinical techniques designed to offset the effects of polymerization shrinkage.
• The former is the more desirable solution, and intensive research and development
efforts are currently in progress to develop resins with low shrinkage and low thermal
expansion.
INCREMENTAL BUILDUP AND CAVITY
CONFIGURATION
• During curing, shrinkage leaves the bonded cavity surfaces in a state of stress; the
nonbonded, free surfaces.
• A layering technique in which the restoration is built up in increments, curing one layer at
a time, effectively reduces polymerization stress by minimizing the C-factor.
• That is, thinner layers reduce bonded surface area and maximize nonbonded surface
area, thus minimizing the associated C-factor.
• In any case, limitations on the depth of cure of photoinitiated resins dictate the use of
incremental buildup of the composite.
• Thus, an incremental technique overcomes both limited depth of cure and residual
stress concentration but adds to the time and difficulty of placing a restoration.
Soft-Start, Ramped Curing, and Delayed Curing
• In this technique, whereby curing begins at low light intensity and finishes with
high intensity.
• This approach allows for a slow initial rate of polymerization and a high initial level
of stress relaxation during the early stages and it ends at the maximum intensity
once the gel point has been reached.
• This drives the curing reaction to the highest possible conversion only after much
of the stress has been relieved.
• Variations of this technique include ramping and delayed cure.
• In ramping, the intensity is gradually increased or “ramped up” during the exposure.
• Such ramping employs stepwise, linear, or exponential modes.
• In delayed curing, the restoration is initially incompletely cured at low intensity. The
clinician then sculpts and contours the resin to the correct occlusion and later
applies a second exposure of light for the final cure.
• This delay allows substantial stress relaxation to take place.
• The longer the time available for relaxation, the lower is the residual stress. Delayed
curing and exponential ramp curing appear to provide the greater reductions in
curing stress but do require more time.
WEAR (VOLUME LOSS BY ABRASION AND OTHER
MECHANISMS)
• In addition to polymerization shrinkage, other frequent clinical problems have been

occlusal and interproximal wear, especially in the case of posterior composites.
• Although wear rate differences of 10 to 20 μm/ year may seem small for posterior
composites, this wear rate still amounts to 0.1 to 0.2 mm more than enamel over
10 years.
• Thus, it is important to be cautious in selecting the clinical cases to be treated with

posterior composites.
Scanning electron micrograph of a 9-year-old small
particle- filled composite, illustrating generalized,
three-body wear.
(Courtesy of Robert L. Erickson.)
• Composites in which the filler particles are

small (1 μm or less), high in concentration,
and well bonded to the matrix are the most
resistant to wear. Large restorations tend to
wear more than do smaller ones.

• Two principal mechanisms of composite wear have been proposed : -
 The first mode is two-body wear, based on direct contact of the restoration with
an opposing cusp or with adjacent proximal surfaces to mimic the high stresses
developed in the small area of contact. This is related to the higher force levels
exerted by the opposing cusp or forces transferred to proximal surfaces.
 The second mode is three-body wear, which simulates loss of material in

noncontacting areas, most probably owing to contact with food as it is forced
across the occlusal surfaces. This type of wear is affected in a complex way by a
number of composite properties such as toughness, porosity, stability of the
silane coupling agent, degree of monomer conversion, filler loading, and the size
and types of filler particles.
RADIOPACITY
• It is very difficult to locate enamel-composite margins radiographically because of

the relatively low radiopacity of composites.
• Modern composites include glasses having atoms with high atomic numbers,
• such as barium, strontium, and zirconium.
• Some fillers, such as quartz, lithium-aluminum glasses, and silica, are not
radiopaque and must be blended with other fillers to produce a radiopaque
composite.
• Even at the highest volume fraction of filler, the amount of radiopacity is noticeably
less than that exhibited by a metallic restorative like amalgam.
• Some microhybrid composites achieve some radiopacity by incorporating finely
divided heavy-metal glass particles.
• Others use ceramic particles containing heavy metal oxides. In the nanofilled
composite, radiopacity is achieved by using nanomeric zirconia (5-7 nm) or by
incorporating the zirconia in the nanoclusters along with silica.
BIOCOMPATIBILITY OF COMPOSITES
Concerns about the biocompatibility of restorative materials usually relate to the

effects on the pulp from two aspects: -
(1)The inherent chemical toxicity of the material
(2) The marginal leakage of oral fluids.
• This situation is of particular concern for light activated materials.
• If a clinician attempts to polymerize too thick a layer of resin or if the

exposure time to the light is inadequate (as discussed previously), the
uncured or poorly cured material can release leachable constituents
adjacent to the pulp.
• Nonetheless, adequately polymerized composites are relatively

biocompatible because they exhibit minimal solubility,
• The second concern is associated with polymerization shrinkage of the
composite and the subsequent marginal leakage.
• The marginal leakage might allow bacterial ingrowth, and these

microorganisms may cause secondary caries or pulp reactions.
• Therefore, the restorative procedure must be designed to minimize

polymerization shrinkage and marginal leakage.
BISPHENOL A TOXICITY
• Bisphenol A (BPA), a precursor of bis-GMA, has been shown to be a xenoestrogen, a

synthetic compound that mimics the effects of estrogen by having an affinity for
estrogen receptors.
• BPA has recently also been shown to exhibit antiandrogenic activities, which may prove
to be detrimental in organ development.
• Studies have shown that the estrogenicity of resin compounds is mainly associated
with BPA and BPA dimethacrylate (BPA-DM), monomers found in the base paste of
some dental sealants.
• In vitro reports have confirmed that BPA and BPA-DM applied to cancer cells
significantly increase cell proliferation and DNA synthesis, similar to the effect
of estrogen.
• Controversy surrounds this issue because it is unclear how much BPA or BPA-
DM is released to the oral cavity and what dosage is enough to affect human
health.
• A clinical study (Olea et al., 1996) revealed that BPA was collected in saliva after
1 hour of sealant placement, leading the authors to conclude that sealant
application led to xenoestrogen exposure in children.
LONGEVITY OF COMPOSITES
• The most commonly cited reasons for the failure of composites in clinical studies are
secondary caries, fracture, marginal deficiencies, and wear.
• Properly placed, composites can last many years even in posterior regions, where wear
and bite forces are greatest.
• Several studies report the clinical performance of posterior composite restorations over
time.
• Opdam and colleagues (2007) published a retrospective study on the longevity of 1955
posterior composites placed in a private practice setting.
• Life tables calculated from the data reveal a survival rate for composite resin of
91.7% at 5 years and 82.2% at 10 years.
• There was a significant effect of the amount of restored surfaces on the survival of
the restorations—that is, the moreconservative the restoration, the longer it
survived.
• A number of other studies published in the past 10 years report success rates ranging
from 70% to 100% for posterior composites.
• Very few clinical studies with evaluation periods longer than 10 years
are available.
• A study by Wilder and colleagues (1999) reported a 76% success rate

for 85 UV-cured posterior composites after 17 years, whereas da Rosa
Rodolpho and colleagues (2006) reported a 65% success rate for 282
hybrid visible light−cured composites after 17 years.
• A recent evidence-based review of the longevity of amalgam and composite
restorations was based on a critical review of clinical data over 10 years.
Ten-year survival probability for

posterior composite and amalgam
restorations.
(Data from Chadwick BL, Dummer
PMH, Dunstan F, et al: The Longevity of
Dental Restorations: A Systematic
Review. National Health Service Centre
for Reviews and Dissemination,
University of York, 2001.)
• Note that the most consistent survival levels are exhibited by amalgam restorations.
• The variability among studies is much larger for the composite restorations compared with
amalgam restorations.
• The comparative survival probabilities for amalgam versus composite restorations in permanent
teeth at 3, 4, 5, and 7 years are summarized
REPAIR OF COMPOSITES
• Composites can be repaired by replacing lost material. This is a useful procedure
for correcting defects or altering contours on existing restorations.
• The procedures for adding new material differ depending on whether the
restoration is freshly polymerized or an older restoration.
• When a restoration has just been placed and polymerized, it may still have an
oxygen-inhibited layer of resin on the surface.
• Additions of new composite can be made directly to this layer because this
represents, in essence, an excellent bonding substrate.
• Even after the restoration has been polished, adding more material can still repair a
defect.
• A restoration that has just been cured and polished may still have more than 50% of
unreacted methacrylate groups to copolymerize with the newly added material.
• As the restoration ages, fewer and fewer unreacted methacrylate groups remain
and greater cross-linking reduces the ability of fresh monomer to penetrate the
matrix.
• The strength of the bond between the original material and the new resin
decreases in direct proportion to the time that has elapsed between polymerization
and addition of the new resin.
• Furthermore, polished surfaces expose filler surfaces that are free from silane.
Thus, the filler surface area does not chemically bond to the new composite layer.
• Even ideally—that is, with the addition of a silane-bonding agent to the surface
before the addition of new composite—the strength of repaired composite is less
than half the strength of the original material.
Nanofilled composites
• Fillers – 0.005 – 0.01 µm
• These small primary particles can be easily agglomerated
• So, a full range of filler sizes is possible  high filler levels can be used in the
restorative material
• Good physical properties, esthetics & high polishability
Başeren M,Surface roughness of nanofill and nanohybrid composite resin and ormocer-based tooth-
colored restorative materials after several finishing and polishing procedures. J Biomater Appl. 2004
.
Oct;19(2):121-34.
Commercial names of nanofilled composites
• Synergy D6 (Coltene whaledent)
• Filtek supreme (3M ESPE)
• Simile (Pentron)
LINEAR COEFFIECT
Linear
Coefficient of thermal expansion of :-
1. Dentin – 8 X /ᵒ C
2. Enamel - 11 X /ᵒ C
3. Composite – 25 to 68 X /ᵒ C
Packable composite Flowable composite

ADVANCES IN COMPOSITES
INNOVATIONS IN DENTAL COMPOSITES
• Numerous variations have been introduced in order to improve composites beyond

those obtainable with bis-GMA, TEGDMA, and UDMA dimethacrylates as the main
monomer ingredients.
• The products based on these monomers typically also include TEGDMA, bis-GMA, or
UDMA in a formulated blend for such purposes as lowering viscosity and improving
handling properties, reducing cure shrinkage and/or residual stress, increasing
conversion, and improving esthetics.
• Filler systems are trending toward even smaller particle sizes.
POLYCARBONATE DIMETHACRYLATE
• “Alert” is a polycarbonate dimethacrylate product (Pentron Clinical Technologies,
Wallingford, CT) .
• The cured polymer is a polyester using carbonate (-O-CO-O-) links, instead of the
urethane links (-NH-CO-O-) found in UDMA, to connect the methacrylate ends to the
central section of the monomer.
• Reported to be packable like amalgam, photocurable in bulk segments, and readily
curable without generating high residual shrinkage stress.
HIGH-MOLECULAR-WEIGHT URETHANE WITH A RIGID
CENTRAL SECTION AND FLEXIBLE END GROUPS
• “Kalore,” also known as “DX-511” (GC America, Alsip, IL) , has a high molecular weight
and a long rigid central section with flexible methacrylate end groups.
• This, together with dilution of the number of polymerizable end groups due to the high
molecular weight reduces curing shrinkage, while the flexible end groups promote
reactivity and enhance monomer-polymer conversion.
DIMETHACRYLATE WITH A BULKY, SPACE-
FILLING CENTRAL GROUP
• “Venus Diamond” (Heraeus Kulzer, South Bend, IN) is a
resin product based on 4,8-di(methacryloxy methylene)-
tricyclodecane (TCDDMA), a bulky, space-filling
dimethacrylate monomer.
• The bulky three-ring central group provides steric

hindrance, and thus slows the rate of polymerization.
• This lengthens the time needed for the cross-linking

reaction to reach the gel point, and relieve developing
stresses, resulting in one of the lower curing-stress resins
currently reported among commercial products.
High-Molecular-Weight Phase-Separating Dicarbamate
with Hydrophobic Side Chains
• “N’Durance” (Septodont USA, Confi-Dental Products, Louisville, CO) is a dimer
dicarbamate dimethacrylate (DDCDMA) product that contains a bulky central group,
• The bulky center is made up of a 6-carbon aliphatic ring with two long hydrocarbon
side chains derived from a linoleic acid dimer.
• The chain length between reactive ends is very long which provides double-bond
dilution and hence reduced shrinkage; the bulky center section allows greater
conversion during copolymerization as well as greater stress relaxation prior to the
gel point.
• A further advantage is the hydrophobic nature of the center group, which restricts
water absorption and solubility with the other dimethacrylates in the formulation.
• Flowable composite resin.
• Packable or condensable resin
• Bulk fill composites
• Nanocomposites.
• Compomers
• Giomers
• Ormocers.
• Silorane resin-based composite
• Smart composite
• Fiber reinforced direct composite
FLOWABLE COMPOSITES.
• A modification of the small-particle composite and hybrid composite results in the

flowable composites, which have become popular since 1995.
• These resins typically have a lower viscosity through a reduced filler loading, which
enables the resin to flow readily, spread uniformly, intimately adapt to a cavity form,
and produce the desired dental anatomy.
• This improves the clinician’s ability to form a well-adapted cavity base or liner,
especially in class II posterior preparations and other situations in which access is
difficult.
 Indication : -
• Cavity base or liner in class 1 and class 2 cavities.
• Can be used as a pit and fissure sealents .
 They are inherently inferior in mechanical properties owing to the lower filler
loading and higher susceptibility to wear and other forms of attrition.
CONDENSABLE (PACKABLE) COMPOSITES.
• Condensable composites (also known as packable composites) were developed by

adjusting their filler distribution to increase the strength and stiffness of the uncured
material and provide a consistency and handling characteristics similar to those of
lathe-cut amalgam.
• Specifically the packable/condensable characteristics are derived from the inclusion of

elongated, fibrous filler particles of about 100 μm in length and/or rough textured
surfaces or branched geometries that tend to interlock and resist flow.
• This causes the uncured resin to be stiff and resistant to slumping yet moldable under
the force of amalgam condensers (“pluggers”).
Properties:
• Increased resistance to wear and marginal deterioration.

• Consistency is similar to freshly triturated mass of amalgam.
• Colloidal silica ultrafine particles are also incorporated to control the:
• Handling properties.
• Viscosity.
• Condensability.
• Reduced stickiness.
Leinfelder KF Et Al,packable Composites: Overview And Technical Considerations. J Esthet Dent. 1999;11(5):234-49.
BULK FILL COMPOSITES
 In the recent past a new variety of composite resins have been launched which
claim to provide ease of use with large increments.
 Should satisfy the following requirement: -

• Low polymerization shrinkage
• Decreased microleakage
• Improved elasticity
• Improved depth of cure (4 mm)
• Easy cavity adaptation
• good compressive strength and wear resistance
1. Low viscocity material – Eg :- SureFil
SDR (Dentsply), venus bulkfill (Heraus
Kulzer), Filtek bulk fill (3M ESPE)
Indications: -
• Dentin replacement.
• Small occlusal restoration.
2. High viscocity material Eg:- Materials such

as Tetric EvoCeram Bulk Fill (Ivoclar), SonicFill
(Kerr), and BeautiFil Bulk (Shofu) X tra fill
(VOCO) .
Indications : -
• Use to restore larger cavities.
EXAMPLES
• Polymer rigid inorganic matrix material (PRIMM)
• Solitaire (Heraeus Kulzer),
• Surefil (Dentsply),
• Filtek P60 (3M),
• Prodigy condensable (Kerr),
• ALERT( Jeneric Pentron),
• Pyramid (Bisco)
COMPOMER
• Compomers or poly acid–modified composites are used for restorations in low
stress–bearing areas, although a recent product is recommended by the
manufacturer for class 1 and class 2 restorations in adults .
• Compomers are recommended for patients at medium risk of developing caries.
• Compomers contain poly acid–modified monomers with fluoride-releasing silicate

glasses and are formulated without water.
• The volume percent filler ranges from 42% to 67%, and the average filler particle
size ranges from 0.8 to 5.0 μm. Compomers are packaged as single-paste
formulations in compules and syringes.
Ronald L. Sakaguchi, Craig’s RESTORATIVE DENTAL MATERIALS, THIRTEENTH EDITION, CHAPTER 9 – RESTORATIVE MATERIALS –
COMPOSITE AND POLYMERS.
Examples……
• Dyract and Dyract AP
• Compoglass
• Compoglass F
• F2000
• Hytac Aplitip
GIOMER
• Giomers are newly introduced hybrid aesthetic restorative materials for dental
restorative therapy.
• They are based on pre-reacted glass-ionomer (PRG) technology. Chemically, they

consist of fluoroalumino silicate glass reacted with polyalkenoic acid in water prior
to inclusion into the silica-filled urethane resin.
• Giomers contain both of the essential components of glass-ionomer cements and

resins.
Arora V, Bogra P. Giomer a new hybrid aesthetic restorative material. J Cons Dent, 2002; 5:149-155
 Properties: -
• These materials have significant fluoride release,
• fluoride recharge biocompatibility,
• smooth surface finish,
• excellent aesthetics and clinical stability.
 Indications : -
• For restoration of root caries.
• Non-carious cervical lesions.
• Class V cavities.
• Deciduous tooth caries.
ORGANICALLY MODIFIED CERAMIC OLIGOMERS
• Ormocer is an acronym for organically modified ceramics.
• They are considered to be molecule-sized hybrid structures consisting of inorganic-

organic copolymers.
• Organic, reactive monomers are bound to an inorganic -Si-O-Si- network.
• These molecular hybrids consist of, for example, methacrylateterminated chains

grafted onto a central cyclic polysiloxane 2- to 3-nm particle.
 Properties:-
• High-molecular-weight,
• Flexible,
• Relatively low-viscosity
• A low level of polymerization shrinkage
• Abrasion resistance
• Low water sorption due to its hydrophobicity
• Very high biocompatibility
• Good manipulation properties
• Excellent esthetics.
Ormocers are used in the formulation of several commercial composites (e.g.,

“Definite” and “Admira,” Voco GmbH; “Ceram-X,” Dentsply International, York,
PA).
“Silorane” Ring-Opening Tetrafunctional Epoxy
Siloxane
• “Filtek LS” (3M ESPE, St. Paul, MN) involves an

entirely different chemistry based on epoxy,
rather than acrylic functionality.
• These tetra-functional “silorane” monomers

use ring-opening polymerization.
• Silorane chemistry utilizes a combination of

epoxy functionality, that can be cured with low-
shrinkage
• When the rings open, they lengthen and occupy more space; the resulting
expansion offsets a substantial proportion of the polymerization shrinkage—
thus, the “LS” (low shrinkage) designation for the commercial product.
Advantages
• Low polymerization shrinkage and stress ( less than 1% polymerization
shrinkage, while other composites more than 1.5% polymerization
shrinkage ).
• Less microleakage and better marginal integrity.
• Less water sorption and solubility.
SMART COMPOSITE RESIN
Ariston has introduced in 1998 and is an ion releasing composite resin.

 It is white in colour.
 Its monomer matrix consists of a mixture of dimethyl metacrylates and inorganic
fillers include
• alkaline calcium silicate glass (1.6µm),
• barium-alumino fluorosilicate glass (1µm),
• ytterbium trifluoride and highly dispersed silicon dioxide.
• The filler content is 80% by weight or 60% by volume.
The ADVANTAGE of this restorative material is that

• it releases fluoride, calcium and hydroxyl ions to the surroundings of the
filling and thus provides additional caries protection.
INDICATED
• for posterior restorations in primary and young permanent teeth and as
preventive restorations.
FIBRE REINFORCED COMPOSITES
• Composites reinforced by fibres.
• Have 2 constituents---
Reinforcing component- providing strength and stiffness
Surrounding matrix----
1) provides workability
2) Protects the fibres from mechanical damage and moisture.
• Polymethylmethacrylate- based semi-interpenetrating polymer matrix –
improves the bond between matrix and fibres.
Fibres used--- GLASS, carbon/graphite, aramid boron, metal fibres
• Advantages Indications
Non-corrosiveness
Translucency Periodontal splinting
Good bonding properties Orthodontic retention
Repair ability
Fibre-reinforced post crowns
Repair of FPD and RPD
164
ANTIBACTERIAL COMPOSITES
• Since composites show more tendency for plaque and bacteria accumulation in
comparison to enamel, attempts have been made to develop caries resistant
antibacterial composites.
• For this, following have been tried to incorporate in the composites:

I. Chlorhexidine
II. Methacryloxydecyl Pyridinium Bromide (MDPB)
III. Silver
CHLORHEXIDINE
• Several attempts have been made to incorporate chlorhexidine to resins, GIC, RMGIC
and bonding agents through addition of several forms of chlorhexidine, including: -
• Chlorhexidine acetate
• Chlorhexidine diacetate
• Chlorhexidine gluconate
• Chlorhexidine hydrochloride.
• All forms of chlorhexidine used increased antibacterial activity against cariogenic

bacteria.
• Higher concentrations of chlorhexidine resulted in effects which last longer but
accompanied by more deterioration of the material.
Farrugia C, Camilleri J; Antimicrobial properties of conventional restorative filling materials and advances in antimicrobial properties of composite resins
and glass ionomer cements-A literature review.; Dent Mater. 2015 Jan 9.
• Optimal antibacterial, physical and bonding properties were obtained with the
incorporation of 1% chlorhexidine diacetate.
• Antibacterial properties of this formulation have also been confirmed with an in

vivo trial .
• Marti et al in 2014 claim that a concentration of 0.5% chlorhexidine gluconate

resulted in increased antibacterial activity without reduction in mechanical
properties.
• These materials have been mostly indicated for the ART approach due to the
generally reduced mechanical properties.
Farrugia C, Camilleri J; Antimicrobial properties of conventional restorative filling materials and advances in
antimicrobial properties of composite resins and glass ionomer cements-A literature review.; Dent
Disadvantages:-
• Decline in the mechanical properties of the materials.
• Decreased bond strength.
• Increased setting time.
• Although in recent years, attempts have been made to increase mechanical

properties of chlorhexidine incorporated dental materials.
Farrugia C, Camilleri J; Antimicrobial properties of conventional restorative filling materials and advances in antimicrobial properties
of composite resins and glass ionomer cements-A literature review.; Dent Mater. 2015 Jan 9.
Methacryloxydecyl Pyridinium Bromide (MDPB)
• A new monomer, methacryloxydodecyl pyridinium bromide (MDPB), was

synthesized by combining an antibacterial agent and methacryloyl group.
• The monomer was incorporated into resin composite to develop a non-

releasing antibacterial composite.
• It has the ability to inhibit the growth and plaque accumulation by

Streptococcus mutans.
Imazato S, Torii M, Tsuchitani Y, McCabe JF, Russell RR. Incorporation of bacterial inhibitor into resin composite.
Journal of dental research. 1994 Aug;73(8):1437-43.
Imazato S, Torii M, Tsuchitani Y, McCabe JF, Russell RR. Incorporation of bacterial inhibitor into resin composite. Journal of dental research. 1994
Aug;73(8):1437-43.
• Study conducted by Imazato et al in 1994 showed that after composite
incorporating MDPB was cured, no elution of the antibacterial
components was observed from the material, even after 90 days'
immersion in water or other solvents.
• Growth of S. mutans on agar under specimens of MDPB containing

composite was inhibited compared with controls.
• Incorporation of MDPB had no significant influence on the mechanical

properties of the composite.
Imazato S, Torii M, Tsuchitani Y, McCabe JF, Russell RR. Incorporation of bacterial inhibitor into resin
composite. Journal of dental research. 1994 Aug;73(8):1437-43.
Silver
Composite resins containing silver or zincoxide

nanoparticles exhibited antibacterial activity
against Streptococcus mutans and Lactobacillus.
Kasraei S, Sami L, Hendi S, AliKhani MY, Rezaei-Soufi L, Khamverdi Z. Antibacterial properties of composite resins incorporating silver and zinc oxide
nanoparticles on Streptococcus mutans and Lactobacillus. Restorative dentistry & endodontics. 2014 May 1;39(2):109-14.
CHITOSAN CONTAINING COMPOSITE RESIN
• Chitosan (2-amino-2-deoxy-β-D-glucan) is a naturally acquired polysaccharide that is

prepared by the deacetylation of chitin, which is mainly obtained from crab and
shrimp shells.
• It is classified in three types of chitosan L/M/H (L, Low; M, Medium; H, High)

according to their molecular weights.
• Chitosan is generally regarded as non-toxic, biocompatible, biodegradable and is

intrinsically antibacterial in nature.
• In dental field, chitosan has been used in studies for the prevention of dental caries as
it provides bactericidal and/or bacteriostatic characteristics.
Kim JS, Shin DH. Inhibitory effect on Streptococcus mutans and mechanical properties of the chitosan containing composite resin.
Restorative dentistry & endodontics. 2013 Feb 1;38(1):36-42.
• Interaction between positively charged amino groups in chitosan with negatively
charged microbial cell surfaces results in the loss of barrier function of microbial
cell wall and the leakage of proteinaceous and other intracellular material.
• Chitosan has an in vitro antibacterial effect on Streptococcus (S) mutans,

Aggregatibacter actinomycetemcomitans, and Porphyromonas gingivalis
• Moreover, chitosan has been suggested as a bioadhesive polymer that provides an

extended retention time on the oral mucosa.
• The application of chitosan as a chemical agent for mouthwashes or dentifrices was

limited because of its insolubility in water.
Kim JS, Shin DH. Inhibitory effect on Streptococcus mutans and mechanical properties of the chitosan containing composite
resin. Restorative dentistry & endodontics. 2013 Feb 1;38(1):36-42.
• All chitosan powder showed inhibition effect against S. mutans. CFU number
in chitosan-containing composite resins was smaller than that of control
resin without chitosan.
• The chitosan containing composite resins did not show any significant
difference in flexural strength and Vickers hardness in comparison with the
control resin.
GINGIVAL MASKING COMPOSITES
• Periodontal recessions can cause aesthetic and functional problems, especially
in the anterior region or when combined with exposed crown margins.
• A combination of periodontal disease, recession with exposed root surface,

hard-tissue defects and age emphasizes the need for treating these defects.
• If crown margins are exposed and surgical treatment is not possible, aesthetics
and function can only be improved by replacement of the restoration.
• The restorative treatment option with a gingiva-shaded composite is especially

valuable for older patients with general or local risk factors, surgical contra-
indications or Class III and IV recessions with questionable prognosis of surgery.
Günay H, Geurtsen W, Lührs AK. Conservative treatment of periodontal recessions with class v-defects using gingiva-shaded
composite–a systematic treatment concept. Dental update. 2011 Mar 2;38(2):124-32.
• The restoration of cervical defects associated with severe recession could lead
to dissatisfying results, if tooth colored materials are used, because of the
appearance of a disproportional elongation of the visible crown.
• Gingiva shaded composites are therefore an alternative for a minimal-invasive

and adhesive restorative treatment, especially if they are used in combination
with tooth-coloured materials.
Günay H, Geurtsen W, Lührs AK. Conservative treatment of periodontal recessions with class v-defects using gingiva-
shaded composite–a systematic treatment concept. Dental update. 2011 Mar 2;38(2):124-32.
• Amaris® Gingiva which is part of the
Amaris® system (Voco, Cuxhaven,
Germany), a methacrylate-based
composite with BIS-GMA, UDMA,
TEGDMA used as matrix monomers and a
filler content of 80 wt%.
• Amaris® Gingiva consists of the gingiva

shaded composite and three different
coloured flowables (‘opaquers’).
• The Amaris® system can be used with

every methacrylate based light curable
adhesive system.
Günay H, Geurtsen W, Lührs AK. Conservative treatment of periodontal recessions with class v-defects using gingiva-shaded composite–a systematic
treatment concept. Dental update. 2011 Mar 2;38(2):124-32.
Günay H, Geurtsen W, Lührs AK. Conservative treatment of
periodontal recessions with class v-defects using gingiva-shaded
composite–a systematic treatment concept. Dental update. 2011
Mar 2;38(2):124-32.
Günay H, Geurtsen W, Lührs AK. Conservative treatment of periodontal recessions with class v-defects using gingiva-shaded composite–a
systematic treatment concept. Dental update. 2011 Mar 2;38(2):124-32.
SELF-HEALING DENTAL COMPOSITES
• The value of resin-based dental restorations could be improved by increasing

their service lives.
• One way to improve longevity is to obturate micro-cracks that form during or

after the composite hardens in the dental cavity.
• SHDC made with contemporary dental components plus two additional

ingredients: a healing powder (HP, strontium fluoroaluminosilicate particles)
and a healing liquid (HL, aqueous solutions of polyacrylic acids) that is enclosed
within silica microcapsules.
Huyang G, Debertin AE, Sun J. Design and development of self-healing dental composites. Materials & design. 2016 Mar 15;94:295-302.
• Conventional dental composites generally comprise two key components:
1) dimethacrylate-based polymers to provide a resin network,
2) reinforcing filler particles treated with coupling agents to bind the resin to
the particles.
• In contrast, the SHDCs have two additional components:

(1) healing powder (HP): strontium fluoroaluminosilicate particles,
(2) healing liquid (HL): aqueous solutions of polyacrylic acids encapsulated in
silica microcapsules.
• The microcapsules will protect the HL from premature release during

composite preparation.
As micro-cracks develop, they will break the microcapsules in their
propagation path, thereby releasing HL.
This liquid reacts with particles of HP exposed by the crack formation,

forming an insoluble reaction product that fills and seals the
cracks.
• The SHDC restored micro-cracks without external intervention, thereby

showing potential for increasing the service lives of dental restorations.
• Importantly, this SHDC contains only clinically-tested, biocompatible

materials, making it readily applicable.
WHISKER-REINFORCED COMPOSITE
• Reinforcement of composites by fibers or whiskers has been considered an
effective way to improve the mechanical properties and reliability of biomedical
composites due to their unusually high tensile strength and other remarkable
characteristics, hence fiber- or whisker-reinforced composites have attracted a
great deal of attention in dentisty.
• Short fibers have given improved handling and better mechanical Properties.
• Xu et al have used single-crystal ceramic whiskers treated by fusing silicate glass

particles onto their surface for bis-GMA – triethylene glycol dimethacrylate
(TEGDMA)-based composites.
Zhang H, Darvell BW. Mechanical properties of hydroxyapatite whisker-reinforced bis-GMA-based resin composites. Dental materials. 2012 Aug
1;28(8):824-30.
• Calcium phosphate cement powders or nanoscopic anhydrous dicalcium
phosphate (DCPA) have been also used together with silicon carbide whiskers to
reinforce bis-GMA resin, which was said to produce non-cytotoxic composites
with both strength and caries-inhibitory capability.
• Bioactive particulate fillers, such as hydroxyapatite (Ca10(PO4)6(OH)2, HA),

amorphous calcium phosphate, glass–ceramic particles, have also been tried,
with modest improvements in strength but showing good bonding ability to
bone directly through a Ca–P-rich Layer.
• The use of HA in restorative dentistry offers intrinsic radio-opacity, closer to

ideal hardness (i.e. similar to that of natural teeth), and therefore improved
wear behavior.
Zhang H, Darvell BW. Mechanical properties of hydroxyapatite whisker-reinforced bis-GMA-based resin composites. Dental materials. 2012
Aug 1;28(8):824-30.
HA whiskers provided better mechanical properties in bis-GMA-based
composites, Such whisker-reinforced materials may be beneficial
compared with currently used dental restorative materials.
SDR flowable bulkfill
• In 2009, SDR was the first technology that allowed

4mm bulk placement in flowable consistency.
• With the incorporation of Stress Decreasing Resin (SDR)

technology and high depth of cure, SDR has exhibited
good clinical performance and great commercial
success due to their excellent physical properties and
handling characteristics
• SDR has minimal overall shrinkage (3.5%) compared to

other conventional flowable composites.
SDR flow layout-dentsply sirona 2017

• Lower volumetric shrinkage contributes to overall lower polymerization stress. SDR
provides an approximate 20% reduction in volumetric shrinkage and almost an 80%
reduction in polymerization stress compared to conventional methacrylate resins

SDR flow+ has incorporated 70.5 wt% / 47.4 vol% glasss filler.
 The resin matrix contains :-

• Modified urethane dimethacrylate resin;
• TEGDMA; polymerizable dimethacrylate resin;
• Polymerizable trimethacrylate resin;
• Camphorquinone (CQ) photoinitiator;
• Ethyl-4(dimethylamino)benzoate photoaccelerator;
• Butylated hydroxy toluene (BHT);
• Fluorescent agent, and UV stabilizer.
 The filler contains : -

• Silanated barium-alumino-fluoro-borosilicate glass;
• Silanated strontium alumino-fluoro-silicate glass;
• Surface treated fume silicas;
• Ytterbium fluoride;
• Synthetic inorganic iron oxide pigments, and titanium dioxide.
 Shades
In addition to one universal shade,
three new A-shades of SDR flow+, A1, A2, and
A3 are available.

Indications
• Base in cavity Class I and II direct restorations
• Liner under direct restorative materials – Class II box liner
• Pit & Fissure Sealant
• Conservative Class I restorations
• Core Buildup
• Class III and V restorations
Contraindications
• Use with patients who have a known hypersensitivity to
methacrylate resins

IPS EMPRESS DIRECT
• The IPS Empress Direct shade system is based on

the principle that dentin structure is replaced by
a dentin substitute and enamel structure by an
enamel substitute.
• The dentin materials feature opaque properties
and therefore influence the overall shade from
within the tooth.
• The enamel materials are more translucent. This
allows light to scatter naturally in the dentin
material.
• The three additional materials Trans 20, Trans 30 and Trans Opal are available
for controlling light reflections in the incisal region.
• These effects closely imitate those of the existing tooth structure.
• Translucency is the ability of a material to transmit light. The enamel and dentin
components of a tooth show different levels of translucency: dentin is opaquer than enamel,
in other words, it transmits less light than enamel.
• A dental composite resin is adequately translucent when the refractive index of the fillers
and that of the matrix are similar.
aromatic tertiary amine
activator (e.g., N, N-
dimethyl-p-toluidine)
Anusavice; Phillips’ Science Of Dental Materials, 12th

Edition, Chapter 13- Resin Based Composites.
WEAR (VOLUME LOSS BY ABRASION AND OTHER
MECHANISMS)
• In addition to polymerization shrinkage, other frequent clinical problems have been

occlusal and interproximal wear, especially in the case of posterior composites.
• Although wear rate differences of 10 to 20 μm/ year may seem small for posterior
composites, this wear rate still amounts to 0.1 to 0.2 mm more than enamel over
10 years.
• Thus, it is important to be cautious in selecting the clinical cases to be treated with

posterior composites.
Scanning electron micrograph of a 9-year-old small
particle- filled composite, illustrating generalized,
three-body wear.
(Courtesy of Robert L. Erickson.)
• Composites in which the filler particles are

small (1 μm or less), high in concentration,
and well bonded to the matrix are the most
resistant to wear. Large restorations tend to
wear more than do smaller ones.

• Two principal mechanisms of composite wear have been proposed : -
 The first mode is two-body wear, based on direct contact of the restoration with
an opposing cusp or with adjacent proximal surfaces to mimic the high stresses
developed in the small area of contact. This is related to the higher force levels
exerted by the opposing cusp or forces transferred to proximal surfaces.
 The second mode is three-body wear, which simulates loss of material in

noncontacting areas, most probably owing to contact with food as it is forced
across the occlusal surfaces. This type of wear is affected in a complex way by a
number of composite properties such as toughness, porosity, stability of the
silane coupling agent, degree of monomer conversion, filler loading, and the size
and types of filler particles.
CURING TECHNIQUES
• Over the past few years, the industry has focused on reducing the resin curing time
by using stronger curing lights or altering resin composition.
• Manufacturers have introduced new composites that yield a greater depth of cure.
• This assumes that one thick layer creates a superior restoration.
• In fact, a single, thick composite layer is a poor restoration because it increases the
polymerization stress on the restoration margins.
• Stress from resin shrinkage results in white lines, which are cracked enamel rods or
marginal gaps, and open .
A, Photographic view of a white line margin in a Class I composite restoration. These typically occur on
larger composites with opposing walls. B, Electron microscopic photograph of fractured enamel rods at the
margin between enamel and composite on a Class I restoration—the same type as shown in A. (Courtesy of
Bisco, Schaumburg, Illinois.)
• Hence, composites or curing units that provide larger depths of cure are of limited
value, since composites must be layered to limit the effects of polymerization
shrinkage.
• Careful attention to composite layering and curing technique can reduce the
incidence of broken enamel margins.
• Two categories of technique are commonly used in curing polymers:
1. Uniform continuous cure
• A light of constant intensity is

applied to a composite for a
specific period of time.
• Most familiar method of curing
currently used.
2. STEP CURE
• In the step cure technique, the composite is first cured at
low energy, then stepped up to high energy, each for a
set duration.
• The purpose is to reduce polymerization stress by
reducing polymerization shrinkage.
• However, is small and results in less composite
polymerization because the lower intensity light yields
lower energy levels.
• This technique results in an uneven cure, since the top
layer is more saturated with light and thus more highly
cured.
• Step curing is possible only with halogen lamps; arc
lamps and lasers cannot be used because they work by
applying large amounts of energy over short periods of
time.
3. RAMP CURE
• In the ramp cure, light is initially applied at low

intensity and gradually increased over time to
high intensity.
• This allows the composite to cure slowly,

thereby reducing initial stress and optimizing
polymerizaton.
• It is possible to ramp cure manually by holding a

conventional curing lamp at a distance from a
tooth and slowly bringing it closer to increase
intensity.
4. HIGH-ENERGY PULSE CURE
The high-energy pulse cure technique uses a brief (10
second) pulse of extremely high energy (1000–2800
mW per cm2), which is three to six times the normal
power density. there are three areas of potential
concern:
• The rapid application of energy might result in a
weaker resin restoration owing to the formation of
shorter polymers;
• It is possible that rapid applications of energy could
reduce diametral tensile Strength.
• There may be a threshold level at which a resin has
good properties, and thus, higher energies would
result in more brittle resins
5. PULSE-DELAY CURE
• In pulse-delay curing, a single pulse of light is
applied to a restoration, followed by a pause
and then by a second pulse cure of greater
intensity and longer duration.
• It is best thought of as an interrupted step

increase.
• The lower-intensity light slows the rate of
polymerization, which allows shrinkage to
occur until the material becomes rigid.
• The second, more intense pulse brings the

composite to the final state of
polymerization.
INDIRECT RESIN COMPOSITES
• Dental restorative composite materials can be divided into direct and indirect resin
composites (IRC).
• IRCs are also referred to as prosthetic composites or laboratory composites.

•
• These materials offer an esthetic alternative for large posterior restorations.
• IRCs were introduced to reduce polymerization shrinkage and improve the properties
of material.
Leinfelder KF. Indirect posterior composite resins. Compend Contin Educ Dent 2005;26:495-503.
• Though the mechanical properties of the IRCs are much inferior to that of
ceramics, in some clinical situations, IRCs can supplement and complement (rather
than replace)ceramic restorations: for example, in coronal restoration of dental
implants.
• As ceramics exhibit a high modulus of elasticity and absorb little of the masticatory
energy, considerable amount of the masticatory force is transmitted to the implant
and the periosseous structure, reducing the longevity of the restoration.
• Polymers become the materials of choice in this situation because they absorb
relatively more of the occlusal stress.
• For patients with poor periodontal structures who require occlusal coverage,
stress-absorbing materials like IRCs are indicated.
Leinfelder KF. Indirect posterior composite resins. Compend Contin Educ Dent 2005;26:495-503.
FIRST-GENERATION COMPOSITES
• Touati and Mörmann introduced the first generation of IRCs for posterior
inlays and onlays in the 1980s.
• The first generation IRCs had a composition identical to that of the direct
resin composite marketed by the same manufacturer.
• Upon light initiation, camphoroquinone decomposes to form free radicals

and initiates polymerization, resulting in the formation of a highly
crosslinked polymer.
• It is observed that 25%–50% of the methacrylate group remains

unpolymerized.
Miara P. Aesthetic guidelines for second-generation inlays and onlay composite restorations. Prac Periodont Aesthet Dent 1998;10:423-31.
Asmussen E. Factors affecting the quantity of remaining double bonds in restorative resin polymers. Scandinavian J Dent Res 1982;90:490-6.
• For inlay composites, an additional or secondary cure is given extraorally, which
improves the degree of conversion and also reduces the side effects of
polymerization shrinkage.
• IRCs showed improved properties only in lab studies but had failures in clinical
studies.
• With the first-generation composites either a : -
 Direct–indirect / semi-indirect method

 An indirect method was used to fabricate the restoration
Burke FJ, Watts DC, Wilson NH, Wlson MA. Current status ans rationale for composite inlays and onlays. Br Dent J 1991;70:s269-73.
Garber DA, Goldstein RE. Porcelain and Composite inlays and onlays. Illinois: Quintessence Publishing Co Inc; 1994. p.117-33.
Direct–indirect/semi-indirect method
• The composite material is condensed into the cavity after the separating
medium is applied to the cavity.
• This separating medium helps in easy removal of the inlay after the initial
intraoral curing.
• The restoration is then subjected to extraoral light or heat tempering in an oven.

• DI-500Oven (Coltene Whaledent) or a Cerinate Oven (Den-MatCorp) can be
used at 110°C for 7 min.
• This technique eliminates the need for an impression of the cavity and the
procedure can be completed in a single sitting
Garber DA, Goldstein RE. Porcelain and Composite inlays and onlays. Illinois: Quintessence Publishing Co Inc; 1994. p.117-33 .
EXAMPLES
• Brilliant DI® (Coltene Whaledent)
• True Vitality® (Den-Mat Corp)
Nandini S. Indirect resin composites. Journal of conservative dentistry: JCD. 2010 Oct;13(4):184.
.[12]
INDIRECT METHOD
• After the separating medium is applied to the die, composite material is

condensed in increments into the cavity and light cured for 40 sec for each
surface.
• The inlay is then removed and heat cured in an oven at 100°C for 15 min (CRC-100
Curing Oven®,Kuraray).
• The advantage of this technique is that the proximal contours can be achieved
appropriately.
Garber DA, Goldstein RE. Porcelain and Composite inlays and onlays. Illinois: Quintessence Publishing Co Inc; 1994. p.117-33.
Sturdevant’s : Art and science of operative dentistry ; 5 th edition
EXAMPLES
• SR-Isosit by ivoclar
• Clearfil CR Inlay® (Kuraray),
• EOS® (Vivadent),
• Dentacolor® (Kulzer)
• Visio-Gem® (ESPEPremiere)
PROPERTIES OF FIRST-GENERATION
COMPOSITES: -
• Degree of conversion increased by 6%–44%.
• Flexural strength ranges from 10–60 Mpa.
• Elasticity modulus ranges from 2000–5000 MPa.
• Wendt et al demonstrated that a 5-min post-light-heat treatment at 123°C

(253°F) increased the hardness and wear resistance by as much as 60%–70%.
Peutzfeldt A. Indirect Resin and Ceramic Systems. Oper Dent 2001;200:1153-76

Ferracane JL, Hopkin JK, Condon JR. properties of heat treated composites after aging in water. Dent Mater 1995;11:354-8..
DISADVANTAGES OF FIRST GENERATION COMPOSITES
• Deficient bonding between organic matrix and inorganic fillers
• Unsatisfactory wear resistance.
• High incidence of bulk fracture, marginal gap, microleakage, and adhesive

failure.
SECOND-GENERATION IRC
• The second-generation composites have a ‘microhybrid’ filler with a diameter of

0.04–1 μ, which is in contrast to that of the first-generation composites that were
microfilled.
• The filler content was also twice that of the organic matrix in the latter
composites.
• By increasing the filler load, the mechanical properties and wear resistance is
improved, and by reducing the organic resin matrix, the polymerization shrinkage
is reduced.
Miara P. Aesthetic guidelines for second-generation inlays and onlay composite restorations. Prac Periodont Aesthet Dent
1998;10:423-31.
Polymerization techniques for second generation IRC’s
1. Heat polymerization: - The temperature usually used for IRC ranges from 120–
140°C. The combination of heat and light increases the thermal energy sufficiently to
allow better double-bond conversion.
2. Nitrogen atmosphere: - Air, because it contains oxygen, tends to inhibit

Polymerization. Entrapped oxygen increases the wear rate by weakening the wall
around it. Nitrogen pressure eliminates internal oxygen before the material begins to
cure. This influences the degree of conversion, esthetics, wear, and
abrasion.
Santana IL, Lodovici E, Matos JR, Medeiros IS, Miyazaki CL, Rodrigues- Filho LE. Effect of Experimental Heat Treatment on
Mechanical Properties of Resin Composites. Braz Dent J 2009;20:205-10
3. Electron beam irradiation: - Breakage of chains occurs at the region of
entanglement subjected to the beam, there is induction of dense packing. This
influences the bond between the filler and matrix, thus improving the mechanical
properties and increasing success rates. The possible disadvantage of this method is
polymer degradation and discoloration of the resin. Due to economic reasons it is
impossible to irradiate single crowns or FPDs.
Vaishnavi C, Kavitha S, Lakshmi Narayanan L. Comparison of the fracture toughness and wear resistance of IRCs cured by conventional
post curing methods and electron beam irradiation. J Cons Dent 2010;13:152-5.
Fiber reinforcement
• Fiber-reinforced composites were introduced by Smith in the 1960s.
• Glass and polyethylene are the commonly used fibers in dentistry.

• Fibers act as crack stoppers and enhance the property of composite.
• Boron oxide, a glass forming agent is present at 6–9 wt% in E-fibers and <1 wt% in S-
fibers. E- and S-fibers are the ones most commonly used in dentistry.
• The fibers can be arranged in one direction (unidirectional), with the fibers running
from one end to other in a parallel fashion.
• Alternatively, the fibers can be arranged in different directions to one another,
resulting either in a weave- or mesh-type architecture.
Ladizesky NH, Ho CF, Chow TW. Reinforcement of complete denture bases with continuous high performance polyethylene fibers.
J Prosthet Dent 1992;68:934-9
31. Meiers JC, Freilich MA. Conservative anterior tooth replacement using fiber reinforced composite. Oper Dent 2000;25:239-43.
40
• When the directional orientation of the fiber long axis is perpendicular to the
applied forces, it will result in strength reinforcement.
• Forces that are parallel to the fiber orientation will produce matrix-dominated
failures and consequently yield little reinforcement.
• Multidirectional reinforcement is accompanied by a decrease in strength in any one

direction when compared with unidirectional fiber.
Ladizesky NH, Ho CF, Chow TW. Reinforcement of complete denture bases with continuous high performance polyethylene fibers. J Prosthet Dent
1992;68:934-9
31. Meiers JC, Freilich MA. Conservative anterior tooth replacement using fiber reinforced composite. Oper Dent 2000;25:239-43.
EXAMPLES OF SECOND GENERATION IRC’S
 Artglass Launched in 1995 By Heraeusl- Kulzer.
 Belleglass HP introduced by Belle de St. Claire in 1996.
 Sinfony Introduced by 3M ESPE.
 Targis Launched in 1996 by Ivoclar Vivadent.
 SR Adoro (Ivoclar Vivadent).
 Solidex Introduced by Shofu.
 Sculpture plus (Pentron)
 TESCERA ATL (BISCO INC)
 Vita ZetaLC (Vita Zahnfabrik)
 Pearleste E2(Tokuyama Dental Corp)
 Estenia C&B (Kuraray)
 Gradia (GC Corp)
PROPERTIES OF SECOND GENERATION IRCS
• The additional cure and the increased volume of in organic fillers has improved flexural
strength to 120 -160 MPa and elastic modulus to 8.5–12 GPa.
• Chung et al observed a positive relation between the volume fraction of filler and
diametral tensile strength and hardness, which is greater in IRC’s
• Better wear resistance
• Leinfelder et al. observed that heat-treated inlays showed less microleakage than direct
restorations.
• Marginal adaptation and bond strength of an indirect resin System after thermocycling
was better than that after direct restoration.
ADVANTAGES: -
• A properly fabricated indirect restoration is wear resistant, esthetic, and relatively less
prone to postoperative sensitivity.
• Indirect laboratory-processed composite resin systems provide an esthetic alternative
for intracoronal posterior restorations and may also reinforce tooth structure.
• Better mechanical performance and a significant reduction in polymerization shrinkage
• Precise marginal integrity, ideal proximal contacts, excellent anatomic morphology, and
optimal esthetics
• Composite materials have shown a greater capacity to absorb compressive loading
forces and reduce the impact forces by 57% more than porcelain.
DISADVANTAGE
• One of the main failures of IRC restoration is the formation of secondary caries due to
plaque accumulation, which is aggravated by the surface roughness of the material.
SURFACE TREATMENT OF IRCS:-
• The treatment of the intaglio surface of indirect restorations determines the bonding
of the restoration to the tooth.
• The use of hydrofluoric acid for surface treatment causes microstructural alteration
of the composite because of the dissolution of the inorganic particles.
• The best alternative method to raise the surface energy is by sand-blasting with
aluminium oxide particles for 10 sec.
• This causes a nonselective degradation of the resin and promotes better adhesion.
• According to Soares, application of silane after sand-blasting resulted in higher bond

strength.
• Since the compositions of the IRCs are similar, the surface treatment for all materials
can be the same.
Soares CJ, Soares PV, Pereira JC, Fonesca RB. Surface treatment protocols in the cementation process of ceramic and laboratory
processed composite restorations. A literature review. J Esthet Restor Dent 2005;17:224-35.
CONCLUSION
• The use of composites is increasing because of its benefits from adhesive
bonding to tooth structure, esthetic qualities and universal clinical usage.
• When done properly, a composite restoration can provide excellent service

for years.
• It is the duty of the clinician to select the appropriate material from the wide
variety of composite resins for a particular clinical scenario for the overall
success and long term benefits from the restoration
TRI-CURE GLASS IONOMER SYSTEM
• These are resin-modified glass ionomers with an additional curing mode.

• If only photo-initiators are used for cross-linking of the methacrylate groups, the resin-
modified glass ionomer has to be cured in layers because penetration of visible light can
occur only to a limited depth.
• Here, in addition to the photoinitiators, self-cure redox imitators are added so that the
methacrylate polymerization can proceed in the absence of light.
• The three curing reactions are as follows:
1. Acid-base glass ionomer reaction.
2. Light-activated polymerization
3. Chemically activated polymerization
Reactions 2 and 3 are chemically
similar but differ in the mode of
initiation.
Reactions 1 and 3 take place
spontaneously when the powder
and liquid are mixed.
Reaction 2 occurs only when
initiated by light.
“Silorane” Ring-Opening Tetrafunctional Epoxy
Siloxane
• “Filtek LS” (3M ESPE, St. Paul, MN) involves an

entirely different chemistry based on epoxy,
rather than acrylic functionality.
• These tetra-functional “silorane” monomers

use ring-opening polymerization.
• Silorane chemistry utilizes a combination of

epoxy functionality, that can be cured with low-
shrinkage
• When the rings open, they lengthen and occupy more space; the resulting
expansion offsets a substantial proportion of the polymerization shrinkage—
thus, the “LS” (low shrinkage) designation for the commercial product.
Advantages
• Low polymerization shrinkage and stress ( less than 1% polymerization
shrinkage, while other composites more than 1.5% polymerization
shrinkage ).
• Less microleakage and better marginal integrity.
• Less water sorption and solubility.
RESIN CEMENTS
These cements have been available since 1952 for cementation of inlays, crowns
and other appliances.
To achieve high bond strength, these cements depend on acid etch technique with
dentin conditioning, similar to composite restorations.
Types of Resin Cements

• Unfilled resin cements.
• Filled resin cements.
Available in the form of:

• Powder and liquid system.
• Dual cure—two paste system.
• Supplied as single paste with accelerator in bonding agent.
Composition
• Unfilled resin cements: It is not used nowadays. It is based on methylmethacrylate and
comonomers.
Accelerator and initiator are tertiary amine and peroxide setting reaction is accomplished by
liberation of heat and shrinkage of polymer.
• Filled resin cements: these are almost identical to resin based composite restorative
materials.
Polymerization can be achieved by any means:

• Conventional chemical cure system
• Light activation
• Dual cure system.
Resin cements are marketed under different commercial names by
manufacturers:
• Panavia Ex,
• Rely X,
• ARC–Resin cements,
• Scotchbond resin cement,
• Porcelite dual cure
Uses: -
• For cementation of inlays/onlays:

– Metal
– Porcelain
– Precured composite.
• For cementation of crown and bridge

• For cementation of orthodontic brackets
• For cementation of endodontic posts.
THANK YOU

COMPOSITES New Gauri

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COMPOSITE

Dr. Gauri P. Tiwari

• Population’s burgeoning interest in health and beauty, is driving increased

• Improvements in tooth-colored restoratives and bonding technology have made

• In addition, newer technology allows the general practitioner to handle many

• In 1955, Michael Buonocore published a milestone article that described a simple

• In 1962, Ray Bowen and others developed a large-molecule, hydrophobic dimethacrylate

• In 1980, the first edition of Tooth-Colored Restoratives was published.

Anusavice; Phillips’ Science Of Dental Materials, 11 th Edition, Chapter 15-RESTORATIVE RESINS

• Because of the large molecular volume of these monomers, polymerization

• Thus, it is necessary to use varying proportions of lower-molecular-weight highly fluid

• Most important properties are improved by increased filler loading. A distribution

• However, if smaller particles are inserted

Fillers can provide the following benefits:

2. Reduction of polymerization shrinkage/contraction.

3. Reduction in thermal expansion and contraction.

5. Decreased water sorption.

• It is essential that filler particles be bonded to the resin matrix.

• Proper coupling by means of organosilanes is extremely important to the clinical

 Activator initiator system

 Both monomethacrylate and dimethacrylate monomers polymerize by the addition

 Free radicals can be generated by chemical activation or by external energy

 Dental composites for direct placement use :-

• Chemically activated resins (chemically cured composites) are supplied as two

 Today, UV light–cured composites have been replaced by visible blue-light–activated

 Once curing is initiated, an exposure time of 40 seconds or less is required to

 They must be placed incrementally when the bulk exceeds approximately 2 to 3

 Light-emitting diode (LED) lamps.

 Quartz-tungsten-halogen (QTH) lamps.

 Plasma arc curing (PAC) lamps.

 Argon laser lamps.

Using a solid-state electronic

Anusavice; Phillips’ Science Of Dental Materials, 12th Edition,

QTH lamps have a quartz bulb with a

Anusavice; Phillips’ Science Of Dental Materials, 12th Edition,

PAC lamps use a xenon gas that is

Anusavice; Phillips’ Science Of Dental Materials, 12th

Argon laser lamps have the highest

Anusavice; Phillips’ Science Of Dental Materials, 12th Edition,

• The same result can be produced by a 20-second exposure at 800 mW/cm2, or an

• Intensity can be reduced by a factor of 10 to 100 in a 2-mm-thick layer of composite.

• The practical consequence is that curing depth is limited to 2 to 3 mm unless

• To maximize both degree of polymerization and long-term clinical durability, the

• Light is also absorbed and scattered as it passes through tooth structure,

• Lamp intensity should be evaluated frequently and adjustments made to ensure

• The light emitted by curing units can cause

• To avoid such damage, never look directly

• Protective eyeglasses and various types of

• The major advantage of this system is assurance of completion of cure throughout,

• Inhibitors are added to resin systems to minimize or prevent spontaneous or accidental

• For example, if a class IV incisal area is reconstructed, the translucency of an

• This deficiency can be corrected by adding an opacifier. However, if an excessive

 Condensable (Packable) Composites.

 Chemically Activated (Self-Cure) Resins.

 Photochemically Activated (Light-Cure) Resins

Sturdevant’s : Art and science of operative dentistry ; 5th edition

2. Hybrid and Microhybrid composite.  Packable Composites.

3. Nanocoposite  Flowable Composites.

• Most commonly used filler for these

• The average particle size is 8 - 12µm,

• Filler loading generally is 60 – 70 vol%

•- Compressive, tensile •- Rough surface ﬁnish

•-Good mech properties - prone to wear and