Dr. A. YOGHA PADHMA

1ST YEAR POSTGRADUATE

DEPT OF CONSERVATIVE DENTISTRY

The aim of the esthetic

and restorative dentistry is to

replace the lost or damaged

structures with artificial

materials that possess

biological, physical and

functional properties similar

to natural teeth.

(Chu and Ahmed, 2003)

TRENDS IN

COMPOSITE

DENTISTRY

Composite resins occupy a

paramount position because they offer

excellent esthetic potential and

acceptable longevity without the need

for extensive sound structure

preparation.

(Dietschi et al., 2006)

HISTORY

DIRECT COMPOSITE RESIN

MATERIALS

INDIRECT COMPOSITE RESIN

MATERIALS

FLOWABLE COMPOSITES

Introduced in late 1996

• Amalgam margin repair.• Class I, II, III, IV and V• Composite repairs.• Core build up.• Crown margin repair.• Enamel defect repair.• Incisal edge repair.• Liners in class I & II• Preventive resin restorations• Pit and fissure.• Porcelain repairs.

I

N

D

I

C

AT

I

ON

S

NANO-FILLED FLOWABLE COMPOSITES

Developed in late 1990 – Posterior

teeth

Introduced as amalgam derivatives

Stiff consistency – Packable /

Condensable like amalgam

FILLERS

Class I restorations

Class II restorations

INDICATIONS

BULKFILL

COMPOSITES

Applied in thickness upto 4mm thickness

SONICFIL BULKFILL

Filtek Bulfill

Contains two novel methacrylate monomers that in combination

act to lower polymerization stress.

FILTEK

BULKFILL

TETRIC EVO CERAM

BULKFILL

29

GINGIVAL MASKING

COMPOSITES

Cervical area, including composite

restorations in gingival colours

V-shaped defects Exposed cervical

areas

Aesthetic corrections of the

gingival area,

Primary splinting, and the correction of red/white aesthetics

Ability to mask exposed crown

margins to improve aesthetics and

patient satisfaction.

NANOCOMPOSITES

Nanotechnology consists of reducing components of a

material to the nanometric scale for use in a new material to

improve the final characteristics.

To establish polish of a microfill but the strength and wear

resistance of hybrid composites

Particles of size 1-100 nm

Swift, J Esth Rest Dent, 2005

ORMOCERS

Was introduced to overcome the

limitations and concerns of traditional and

new packable restorative material

Dr. Herbert Wolters from Fraunhofer

Institute for Silicate Research introduced

this in 1994

Cunha et al., 2003

ORGANICALLY

MODIFIED

CERAMICS

Inorganic-organic co-polymers with

inorganic silanated fillers.

Described as 3-dimensionally cross-linked

copolymers with multi-polymerization with no

residual unreacted monomer

Manufactured by a Sol-Gel Process from Multifunctional Urethane and

thioether(meth)acrylate alkoxy silanes.

COMPOMERS

• Introduced in 1994.

• An acronym of the words compo site and glass ionomer.

Polyacid modified resin composite

Primarily composite resin-like materials that contain one or more basic GIC components.

To have a kind of modified composite having the main advantages of glass ionomer cement.

Compositional modifications

Certain liquid monomer (HEMA) is modified by polyacrylic acid grafts

Filler particles similar to the powder of glass ionomer cement(calcium- fluoro-alumino-silicate- glass)

Drawbacks:

Using bonding systems still mandatory

Lower wear resistant < regular composites

Insignificant release of fluoride

Indications

Sealing occlusal pits and fissures

Restorations of primary

teeth

Minimal cavity

preparations

Lining and Core build-

up

Repair of defective

margins in restorations

Class III, Class V, Erosion lesion -

Restorations

Sealing of root surface

Potential root canal

sealers

Retrograde filing

materials

INDICATIONS

GIOMERS

To overcome some drawbacks of compomers

The filler particles are a kind of

pre-polymerized glass ionomer

agglomerates

Restoration of Class I. II. III. IV, & V

Restoration of cervical erosion and root caries

Laminate veneers and core build-up

Ideal for pedodontic restorations

Other dental applications repair of fractured porcelain and composite restoration

INDICATIONS

SMART COMPOSITES

Smart Composites are active

dental polymers that contain

bioactive amorphous calcium

phosphate (ACP) filler capable of

responding to environmental pH

changes by releasing calcium

and phosphate ions and thus

become adaptable to the

surroundings.

These are also called as

Intelligent composite

49

Ivoclair introduced a material named AristonpHC (pH control).

Releases Fluoride & Ca Hydroxide when the pH inrestoration in the material is less than 5.5

Ariston is an ion releasing composite

material, which releases fluoride, hydroxyl

and calcium ions as the pH drops in the

areas immediately adjacent to the restorative

material. This is said to neutralize the acid

and counteract the decalcification of enamel /

dentin.

BIOACTIVE

COMPOSITES

BIOACTIVE FORMULATIONS

-ACP (amorphous calcium phosphate)-2000

-ACP + BIS-GMA /TEGDMA/HEMA with Zirconyl

methacrylate

Fluorinated Bis-GMA analogues

Liquid crystalline monomers

FLUORIDE RELEASING

COMPOSITES

Methacryloyl fluoride –

Methyl methacrylate

copolymer in pit and fissure

sealant where fluoride

delivery lasted for 2 years

Diethylaminoethyl

methacrylate into dental resin

system - Fluoride is released

by hydrolysis at a rate of 2-

5µg/cm2/day for 1 year.

CEROMERS

Class I and II posterior restorations (stress bearing areas)

Class III and IV anterior restorations Class V restorations cervical caries, root erosion,

abfraction, wedge-shaped defects Inlays/onlays with extraoral post-tempering

INDICATIONS

SILORANANES

Guggenburger and Weinmann (2000)

Siloxane + oxiranes

Siloxane backbone – hydrophobic nature

Ring opening monomers, cationic cure

As silorane-based

composite polymerizes,

“ring-opening”

monomers connect by

opening, flattening and

extending toward each

other.

As methacrylate-based

composites cure, the

molecules of these

“linear monomers”

connect by actually

SHIFTING closer

together in a linear

response.

ANTI BACTERIAL

COMPOSITES

MINIMAL SHRINK COMPOSITES

The development of minimal-shrink composites was based on ….

1. INCREASING THE FILLER LOAD

Using prepolymerized composite fillers

Using nano-sized fillers (TetricEvoceram, Ivoclar-Vivadent)

2. USING ORGANIC MATRICES WITH

LOWER POLYMERIZATION SHRINKAGE

Spiro-orthocarbonate, can produce composites with no setting contraction,

Oxy bis-methacrylates (bifunctionalmonomer) shows also a reduced rate of the polymerization contraction

Oxirane and silorane-based monomers (Feltick LS, 3M-ESPE)

CHITOSAN

COMPOSITES

Chitosan and chitosan derivatives appear to be good

candidates for the elastomeric matrix

These natural biopolymers – Biocompatible,

Biodegradable and Osteoconductive.

CPC–chitosan composites - Stable in a wet environment

Have sufficient physical strength

SELF HEALING

COMPOSITES

One material – Showed similarities to resin based dental material

If a crack occurs in the epoxy resin material, some of the

microcapsules are destroyed near the the crack & release the resin.

The resin fills the crack & reacts with Grubbs catalyst dispersed in the

epoxy composite resulting in polymerization of resin & repair of crack

P. Benly et al., 2016

COMPOBONDS

Trade name :- vertise flow

First compo bond introduced in 2009 by (Kerr Corp., USA)

Self adhering flowablecombining a resin-based

composite and a SE bonding agent based on the 7th

generation DBA, OptiBond®All-in-One

It is a light-cured composite with similar properties to conventional flowables but with the added advantage of

eliminating the bonding stage.

Self-etching/self-bonding restorative composites

Rationale

To get restorations with higher mechanical properties

To reduce the subsequent effect of the polymerization shrinkage(i.e. weak bonding, microleakage, improper contact)

Chair-side

Start with Light or chemical-curing inside

the mouth.

Then apply post-curing heat or light treatment

CAD-CAM composites

Laboratory

Cured with heat & pressure

or light & pressure on a cast

Fiber-reinforced composites

LABORATORY

COMPOSITES

FIRST GENERATION

Introduced in 1980s as an attempt to decrease the

rate of the polymerization shrinkage and Improve the wear

resistance of the restoration.

MANUFACTURERPRODUCT COMMERCIAL NAME

3M-ESPE1. Visio-gem

Kulzer2. Denta Color

Ivoclar-Vivadent3. Concept

Ivoclar-Vivadent4. Isoset

SECOND GENERATION

Appeared in 1990s and named ceromers, most of

these materials are light-cured over a cast for 60 seconds and

then followed with heat treatment.

MANUFACTURERPRODUCT COMMERCIAL NAME

Heraeus-Kulzer1. Artglass

Kerr2. BelleGlass

Ivoclar-Vivadent3. Targis

3M-ESPE4. Simphony

ARTGLASS

Launched in 1995 by Heraeus-kulzer

MATRIX FILLER

Organic resin matrix

[BisGMA / UDMA]

Barium silicate glass

0.7µ

ADVANTAGES

Wear resistant

Better marginal adaptation

Better esthetics

Superior proximal contact

BELL GLASS HP

Introduced by Belle de St. Claire in 1996

Resin matrix – BisGMA & fillers

Belleglass

Polymerized

Esthetically appealing & wear resistant

Pressure – 29psi Reduces the

vaporization potential

of monomers

Temperature – 138ºC Increases the

polymerization rate

Nitrogen – Inert gas Increase in wear

resistance

CLEARFIL CR INLAY

COLTENE INLAY

SYSTEM

CRISTOBAL

SCULPTURE

Polycarbonate based composite resin

ADVANTAGES

Excellent polishability & esthetics

Long term luster retention

Extremely lower wear less than 1.5µm/year

SINFONY

Introduced by 3M ESPE

MATRIX FILLER

Polyfunctional

metharylate

polymer

Pyrogenic silica

0.05µ

Visco alpha

halogen lamp source

10sec

Visco beta

Fluorecent lamp

source

15min

TARGIS

MATRIX FILLER

BisGMA TRIMODAL

1. Barium glass – 1µm

2. Spheroidal silica –

0.25µm

3. Colloidal silica –

0.015 to 0.050µm TARGIS gel

TARGIS power

curing unit

Light emmision 10

min+ temp. 95ºC

Cooling 5min

• Also called ceromer (ceramic optimized polymer)

• Contains approximately 77wt% of filler and 23wt% of organic resin.

TRUE VITALITY

VISIOGEM

Initially used for anterior composite

veneers

Light vacuum cured composite

Initial curing – Direct – Visio alpha units

Final cure & vaccum chamber – Visio

beta units

SINGLE

CRYSTAL

MODIFIED

COMPOSITES

An experimental indirect composite system has

been recently developed which uses silicon

carbide single crystals as filler component.

These are silanized and incorporated into the

resin matrix.

Have symmetric shapes like long plates and

behave like fibers.

TRIMODAL TECHNOLOGY

• Novel filler technology, using 3 different fillers--prepolymerized

filler, patented Point 4 filler, and 0.02 micron filler.

• Excellent polishability, durability, and strength

FANTASISTA

4 part filler system

Unique restorative material with extraordinary handling

properties, cosmetics and long-term performance

NANOFILLED

COMPOSITES

FUSIO

ESTELITE SIGMA

Light-cured submicron filled resin composite

containing 82 wt% , 71 vol% of filler.

Every inorganic filler – Spherical submicron filler

Size range: 0.1 um-0.3um

Outstanding mechanical strength,

Superior esthetics

Strength - Posterior restorations.

18 different shades available.

RAP

TECHNOLOGY

Reduced curing time

Excellent stability to ambient light

Maintaining the superior esthetic and physical properties

ESTELITE® SIGMA QUICK

utilizes Tokuyama's patented innovative initiator system

STIMULI

RESPONSIVE

COMPOSITE

Purva et al., 2016

Composites of the 2nd generation reinforced with fiber substructure

Good alternative to all and metal-ceramic restorations

- Braid

- Unidirectional- Mesh

- Weave

• Major components: resin matrix and fibers

• Fibers- Ceramic

Glass

Carbon

Alumina

Silicon nitride

- Polymer

KEVLAR (unidirectional)

HDLPE

• Due to translucent appearance of these materials no masking

materials are needed, which allows a thin layer(0.5mm) of

composite to be placed , which is esthetic .

Triaxial Woven Spectra Fibers

Ultra-high Molecular Weight Polyethylene

(Spectra)

RIBBOND

EVER STIK

125

REVIEW OF VARIOUS

ARTICLES

Journal of Pharmaceutical Sciences & Research

Vol 8 (8), 2016, 881 - 883

International Journal of Recent Advances in Multidisciplinary Research

Vol 03, Issue 06, pp1528-1530, June 2016

NJDSR Volume 1, Number 4, 2016

International journal of Scientific Study

December 2015 Vol 3 Issue 9

CONCLUSION:

There is much room for the improvement and further development

of resin – based dental materials.

New quality of composites can be created if nanotechnology is

used & new developments in material science and biomaterials are

considered in composites in future.

Arrals & Essences of dentistry

Volume 2 Issue 3 July – Sept 2010

“The world hates change, yet it is the only thing

that has brought progress.”

-Charles Kettering

REFERENCES

Anusavice , K J., 2004. Restorative resins: (In) Philips Science of

Dental Materials. 11thed. Restorative resins, Elsevier, India 399-

441.

Vimal K Sikri; 2009. : (In) Text book of Operative Dentistry. 2nded.

Composites, CBS publications, India 387-426

Gayathri R menon et al. Recent advancement in Restorative

composite materials. Int J of Recent Advances and Multidisciplinary

research 2016; 03 (06):1528-1530.

P.Benly. Recent advances in composite-A review. J of

Pharmaceutical Sciences and research 2016;8(8); 881-883.

Purva. S et al. Smart composite: A review article. NJDSR 2016; 1(4)

: 57-63.

N.B. Cramer et al . Recent Advances and Developments in

composite Dental Restorative Materials. J Dent Research 2015;

90(4); 402-416

Robert A.Lowe et al. Advances in Composite Resin Materials.

Inside Dentistry 2015; 2(12)

Prachi Singh et al. Overwiew and recent advances in composite

resin – A review. Int J of Scientific Study 2015; 3(9); 169-172.

Zohaib Khurshid et al. Advances in Nanotechnology for

Restorative Dentistry. Materials 2015; 8: 717-731.

Yousef A. Aljehani et al. Current Trends in Aesthetic Dentistry.

Journal of health 2014;6: 1941-1949.

Smart materials in dentistry. Journal of Pediatric dentistry 2014

Robert A.Lowe. Advances in Direct Composite

Restorations.Inside Dentistry 2012; 8(9)

Mahantesh Yeli et al. Recent advances in composite resins – A

Review. Arrals and Essences of Dentistry 2010; 2(3): 134-136.

Yeli M et al. Recent advances in composites resins – A review. J

Oral Res Rev 2010;2: 8-14.

Leinfelder KF. New developments in resin rstorative systems. J

Am Dent Ass0c 1997; 128: 573-581.