Restorative Materials

(Dental Composite)
Introduction

. Composite filling material is a polymeric

restorative material reinforced with
filler particles.

Ass.Prof.Dr.Mohamed ALsakkaf 1
Composite resin was developed first by .
Bowen in 1962 to overcome the
shortening in physical properties of
:unfilled resin and silicate. They showed
.Better strength -
.Better color -
Considerably less shrinkage than unfilled -
. resin

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They depend for their bonding to tooth .
structure on mechanical bonding, to E,
. after its acid etching

Development in adhesive technologies .

. succeeded to allow bonding to D

:Resin composite are placed .

.Directly into prepared cavity -
Indirectly by fabricating inlay, luted into -
. cavity by resin luting agent
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 Composition
:R.C consist of the following phases
.Matrix Phase. (Organic Resin Matrix) .1
The nature of resin may alter slightly
from one product to another,
essentially, they all contain
.""dimethacrylate monomer

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Fillers .2
They are (silicate particles) in two -
forms, either crystalline (quartz), or
non crystalline form (glass like
particles alumino-silicate) also zinc,
barum ions may be add to produce
.radio-opacity in the composite
Quartz particles are harder than glass -
particles, so they are difficult to polish
.to a smooth surface
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:Fillers are used for the following

Polymerization shrinkage is reduced -

(due to less resin is present in the
.composite)
Water absorption and C.T.E are -
. reduced

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Mechanical properties such as compressive -
strength tensile strength, abrasive
.resistance are improved

Optical properties (color matching and -

. radioopacity) are also improved

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:Coupling Phase .3
It provides interfacial bonding between -
. fillers and matrix
.Organo – silane in nature -
It transfer the stress to the stiffer filler -
. particles through the weaker resin
Prevent the filler from being dislodged from -
. the resin
Hydrolytic stability, prevents the water from -
. penetrating along resin – filler interface
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Inhibitors: (Butylated hydroxytoluene) .4

Inhibitors are added to prevent spontaneous

polymerization of monomers. They have
strong reactivity potential with free
radicals that has been formed before
exposure to light when the materials are
.dispersed

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:Pigments .5
like (Aluminum Oxide) )Inorganic Oxide(
or (Titanum Oxide) are added in small
amount to provide shades that match
.the majority tooth shades

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 Classification According To
Lutz and Phillips in 1983
Macrofilled Composite (conventional) .1
.Porticle Size: From 5 – 30 µm -
.Filler Loading: 75 – 80 % by weight -
The most commonly used filler is ground -
. quartz (silica in nature)

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.Adequate strength and wear resistance -
A major clinical disadvantage is the -
rough surface texture, that develops
as a result of abrasive wear of soft
resin matrix that leaves the more
.resistant hard particles elevated

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:Rough Surface Texture, will lead to
.Plaque retention .1
.Discoloration from extrinsic staining .2
.Soft tissue irritation .3
.Poor resistance to occlussal wear .4
This composite is described as non - .
Polishable

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 Microfilled Composite.2

.Particle Size: 0,02 – 0,4 µm

.Filler Loading: 35 – 60 % wt
These composites were developed in -
. attempts to improve the Polishability

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The problem with this kind of composite -
is the low percent filler and high resin
content, which will lead to increased
coefficient of thermal expansion and
.lower strength

Excellent esthetic qualities due to its -

. polishability

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High viscous as small filler particles -
have a large surface area which affect
friction between filler particle surface
and monomer (which controls the
.fluidity of the material)
Microfilled composite is used when -
. esthetics are the dominant
This kind of composite termed -
. Polishable
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Be aware: Optimal polish is obtained at
the expense of physical properties. So it
becomes the resin of choice for esthetic
restoration of anterior teeth particularly
.in non – stress bearing situations

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 Hybrid Composite .3
Combination of microfillers and -
. macrofillers

.The total filler content 75 – 80 % wt -

.Particle size of filler 0,6 – 1,0 µm -

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They combine the Advantages of both -
. the macro and microfilled types

:So these resins -

Adequate esthetics and good surface .1
. characteristics
Satisfactory physical and mechanical .2
properties (acceptable strength and
. abrasion resistance)

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 Flowable composites .4
.Light cured, low–viscosity composite -

Decreased the filler content to reduce -

the viscosity and increase flow of these
.materials

.Weaker, less abrasion resistant -

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:Recommended for
.Cervical restoration .1
.Small, low–stress bearing restorations .2
.Pediatric restoration .3
Flowable composite is typically used as -
the initial increment of composite
restoration and then covered with a
.hybrid material
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 Classification according to the mode
of Polymerization
Chemically Activated Resins .1

Supplied as two pastes, one of which -

contains the benzoyl peroxide initiator,
the other contain the tertiary aromatic
.amine activator
Light Activated Resins .2
Curing process take place by using light
.source
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 Advantages of Resin Composites
.Superior esthetics .1
.Low thermal conductivity .2
Satisfactory physical and mechanical .3
.properties
.Easy to repair .4
Reinforcement of the remaining tooth .5
.structure via bonding system
.Conservation of tooth structures .6
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 Disadvantages of Resin
Composites
Polymerization Shrinkage: This will .1
: lead to
a. Ingress of oral environmental bacteria,
. fluids, and stain
.b. Dentin hypersensitivity
.c. Adverse pulp reactions
.d. Recurrent caries
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:Low Wear Resistance: It leads to .2
.a. Opening of interproximal contacts
b. Loss of anatomic form and vertical
. dimension
Hydrolytic Instability .3
They are subjected in the mouth to time
– dependent structural, interfacial, and
: surface deterioration by

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 .a. Complex mechanisms of hydrolysis
.b. Water sorption
c. Marginal percolation with progressive
. deterioration of marginal adaptation
.Technique Sensitivity .4
.Lack of Cariostatic Potentials .5

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 Indications
Carious defects (which require esthetic .1
. and non – invasive restorative dentistry)
Class I + II cavities that can be isolated -
well and where centric contacts on tooth
. structure are present
.Class III , IV and V -

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Non – Carious Lesions .2

.Hypoplasia, Hypocalcification -

.Abrasion and erosion -

Class VI cavities (faulty pit on occlusal -

. cusps)
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.Veneer for Metal Restoration .3
Fractures of teeth and repair of .4
. restorations
.Core under crowns .5
.Cementation of orthodontic brackets .6
.Splining of mobile teeth .7
.Luting purposes .8
.Indirect restoration .9
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 Contraindications
When the occlusal contacts will be on .1
. the composite
Deep subgingival areas those are .2
. difficult to prepare or restore
.Poor oral hygiene .3
.Bruxing Patients .4

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 Designs of Cavity Preparation
Rounded line and point angles, because -
R.C is viscous and require rounded
.walls to facilitate their adaptation
:Beved Cavo–Surface Angle -
This improve peripheral seal and .1
attachment, which improve adaptation
. and micromechanical retention
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:This improvement occur as a result of .2
a. Increasing the surface area of enamel
.available for bonding
.b. Removal of fluoride rich layer
c. Exposing the ends, rather than the
sides, of enamel rods provides for
.more effective acid etching
Improved Esthetics: Gradual .3
transition of color between tooth
.and restoration
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Contraindications for beveling of
Cavo–surface angle
Enamel walls at high stress bearing .1
areas: (occlusal cavities, and lingual
cavities in upper anterior) to avoid
. marginal chipping of composite

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Gingival sites (which end in D,C, or .2
. thin enamel)

.Gingival grooves are incorporated -

A glass ionomer cement liner is placed -

.for retention and improved adaptation

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 Manipulation
.Selection of composite, type and shade .1

.Field isolation .2

.Pulp protection .3

.Matricing and wedging .4

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.Pre–treatment of the substrate surface .5

.Packing .6

.Caving .7

.Polymerization .8

.Finishing and polishing .9

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 Selection of Composite
Shade selection should be accomplished -
before the restorative procedure is
. initiated

Selection is made while the tooth is -

moist, before the cavity preparation,
.and placement of rubber dam
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Desiccation of the tooth cause lightening -
of the shade and the presence of a rubber
. dam can distort color perception

The selected shade can be confirmed with -

a small amount of composite (test shade)
.on unetched surface

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 :Matricing and Wedging to
Protect the adjacent tooth against .1
.accidental acid etching
.Establish proper contour .2
.Prevent marginal over hangs .3
Increase density and adaptation of .4
restoration, and elimination of internal
.voids
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:Prevent air–inhibited polymerization .5

When curing bonding layers or composite, -

the outermost layer will remain
unpolymerized due to the inhibiting
effect of oxygen in the adjacent (air
.inhibited layer)

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 :Air Inhibited Layer
This 3 – 20 micron thick layer cure as .
soon as oxygen is excluded. After adding
all the increments, the outermost layer
will remain sticky due to this air
.inhibition

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This sticky layer is eliminated during .
. finishing and polishing

Improve surface texture of composite .6

. and leaves the surface smooth

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Conditioning the enamel and dentin
(etching)
Instrumentation of the tooth during -
cavity preparation produces a Smear
Layer. Therefore, the natural tooth
surface should be cleaned and
.pretreated before bonding
Acid etching of the highly mineralized -
tooth structures enlarges its surface
.area for bonding
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Enamel etching, transforms the smooth -
enamel surface into an irregular
. surface

The bond between enamel and the -

restorative material is established be
polymerization of monomers inside
.the microporosites

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Use of a phosphoric acid concentration -
30 – 40% and etching time not less
than 15 seconds, and washing time of
.10 – 20 seconds

Rinsing times are required to remove -

dissolved calcium phosphates from
.etched surface

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 Smear Layer
During cutting this layer is formed
consisting of burnished components and
.hydroxyapatite fragments

The etching procedure not only dissolves -

the smear layer but also demineralizes
.the dentin surface
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After etching the dentin and rinsing -
the acid from the cavity wall, the
demineralized dentin remains as a
collagen network, since it last the
.support from the hydroxyapatite

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The space between the fibers previously -
filled with hydroxyapatite now contains
water. This water has to be replaced by
:monomer, so keep in mind the following

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Any drying of the dentin would result -
in a loss of water with a collapse of
the collagen fibers, preventing the
monomers from penetrating the
.decalcified dentin
:Remember: Etching of dentin
.Eliminating of smear layer .1
.Exposure of dentin collagen .2

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 Packing of Composite Resin
Bulk – Packing.1

Applied in one increment. It is suitable .

for chemically curable composites,
because the degree of polymerization is
not affected by the bulk of the
.restoration

It may be used with light curd composites .

. in small cavities
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Incremental Packing .2
Involve packing of the restoration in .
small increments (not thicker than
2mm), each is pressed into place and
.is light cured for 20 – 40 seconds
Remember

The initial increment must be thin to .

copolymerize adequately to the
. bonding resin, to reduce shrinkage
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 Carving
Gold – Plated or Teflon – Lipped carving .
instrument are used to overcome
. composite stickiness

Bonding agent is a better lubricant for .

preventing composite resin from sticking
. to the plastic instrument

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 Polymerization Shrinkage and its
Clinical Significance
Auto cured composite polymerizes .
toward the Center of the mass, while
VLC Composite Polymerizes toward
.the Light Source

Stresses arising from polymerization .

shrinkage may produce defects in the
: composite – tooth bond, leading to
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.Bond failure .1

.Marginal Leakage .2

.Past operative sensitivity .3

Discoloration of marginal and / or .4

. recurrent caries
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 Efforts to reduce the shrinkage

.Incremental condensation technique .1

The lamination (sandwich) technique .2

. with glass – ionomer cement

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.Use of improved adhesive system .3

.Correct use of light source .4

Application of flowable composite .5

. over the hybridized dentin (as a liner)

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 Finishing and Polishing
Chemically cured restorations may be .
finished 24 / h after polymerization to
allow for more and maximum surface
.hardness

Light cured composites are finished .

. immediately following polymerization

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:Finishing Procedures Include
a. Removal of grass excess and marginal
. finish

.b. Disc contouring

.c. Paste polishing

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 Last finishing instruments
.bladed carbide burs – 12 .1
.diamond points .2
.abrasive discs (soft) .3
.finishing strips .4
:Remember

Polishing should be done with a very .

fine abrasive polishing paste applied
.with a soft rubber tips
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Finishing and Polishing are completed in .
a moist field to prevent overheating of
.the restoration

Sealers or bond may be applied to .

composite surface to seal microscopic
.defects
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