RECENT ADVANCES IN

COMPOSITES
By sathwik
 CONTENTS

• Introduction

• Briefly on composites
• Research on advances in composites
• Direct composites
• Packable
• Flow able

• Compomers

• Giomers

• Ormocers
Smart composites
Siloranes
Glass inserts
Anti bacterial composites
Chitosan composites
Bio active composites
Flouride releasing composites
Compo bonds
Nano-composites
• Indirect composites

• Art glass

• Bell glass HP

• sinfony

• Ceromer

• Fiber-reinforced substructure

• Other important advances

• Future advances
 INTRODUCTION

• This highly competitive market continues to evolve, with the major emphasis in the past being to produce
materials with adequate strength, and high wear resistance and polishability, retention.

• The more recent research and development efforts have addressed the issue of polymerization shrinkage
and its accompanying stress, which may have a deleterious effect on the composite/tooth interfacial bond.

• Current efforts are focused on the delivery of materials with potentially therapeutic benefits and self-
adhesive properties, the latter leading to truly simplified placement in the mouth.
 DEFINITION

According to Anusavice

• It may be defined as a compound of two or more distinctly different materials with properties that are
superior or intermediate to those of the individual constituents
 HISTORY

• 1955: Buonocore – acid etch technique

• 1956: Dr.Bowen formulated Bis GMA
• 1962: Silane coupling agents
• 1970: First photo cured composites using UV light
• 1972: Visible light curing unit was introduced
• 1976: Micro filled composites
 HISTORY
• Early 1980’s : hybrid composite
• Mid 1980’s: First generation indirect composites
• Early 1990’s: Second generation indirect composites
• 1996: Flowable composites & Ceromer indirect composites
was introduced
• 1997: Packable composites
• 1998: Ormocers was developed
• 2003: Nano filled composites resins
• 2009: self adhesive composites
 COMPOSITE RESINS

3 structural components – matrix, fillers & coupling agent

Matrix - BIS-GMA, TEGDMA, UDMA
TEGDMA- Diluent monomer , cross- linking

Fillers - ↑ comp strength, tensile strength, stiffness, abrasion resistance, hardness ↓ wear, poly shrinkage,
thermal exp & contr, water sorption
Quartz or glasses, amorphous silica {0.1 – 100 µm},30- 70 vol % or 50 –85% wt

Refractive index:
BIS-GMA – 1.5, TEGDMA – 1.46, Quartz – 1.55
• Coupling agent :

• Organosilanes (-methacryloxypropyltrimethoxy silane) It contains Silanol group and methacrylate group

Activator – initiator system:

• Chemically activated resins- Benzoyl peroxide + Tertiary amine

• Visible light activated resins – camphoroquinone(0.2wt%) +DMAEMA(0.15 wt%)(N ,N -dimethylaminoethyl

methacrylate)

Inhibitor – Butylated hydroxytoluene(0.01 wt%)

Optical modifiers – TiO 2, Al 2O3 (0.001 – 0.007 wt %)

 • shrinkage
• flouride

Why • Bio compatability

• polishability

• strength
 POLYMERIZATION INDUCED SHRINKAGE

• Failure in composite restoration

• Several generalized approaches have been attempted

• (i) manipulating the curing protocol and timing to allow for relaxation and flow of the network prior to
gelation

• (ii) altering the amount of shrinkage that occurs through changes in the monomer or functional group
density

• (iii) changing the polymerization mechanism from conventional radical chain-growth polymerization of
methacrylates to alter the network structural evolution.
 ADVANCES IN CURING PROTOCOL

1. photoinitiation

In this visible-light-activated initiator system, camphorquinone (CQ) absorbs a photon to generate a short-
lived excited-state species that complexes with the tertiary amine to promote a sequential electron and
proton transfer that creates the active α-aminoalkyl-initiating radical.

ethyl-4-dimethylaminobenzoate (EDMAB), including N,N-dimethylaminobenzyl alcohol, 4-

(N,Ndimethylamino)phenethyl alcohol (DMPOH), and N,N-3,5-tetramethylaniline (TMA)

(Schroeder et al., 2007a, b,2008; Schroeder and Vallo, 2007)

• naturally occurring 1,3-benzodioxole and its derivatives were evaluated as potential replacements for
conventional amine co-initiators and were found to be effective co-initiators, resulting in kinetics and
polymer properties similar to those of equivalent systems initiated by CQ/EDMAB (Liu et al., 2007; Shi
and Nie, 2007; Shi et al., 2007).
 2.ALTERNATIVES TO CAMPHORQUINONE/AMINE SYSTEMS

• Phosphine oxide initiators

• benzoylgermanium derivatives have been synthesized and demonstrated to be efficient visible light
photoinitiators.
• Some commercial formulations have included other photoinitiators, such as PPD (1-phenyl-1,2-propanedione),
Lucirin TPO (monoacylphosphine oxide), and Irgacure 819 (bisacylphosphine oxide), which are less yellow than
CQ and thus potentially more color stable.
• Additional photoinitiators, such as OPPI (p-octyloxyphenyl-phenyl iodonium hexafluoroantimonate) have been
proposed based on encouraging experimental results.
• (Guo et al., 2008
• (Ganster et al., 2008a,b; Moszner et al., 2008b, 2009)
• (Ogunyinka et al., 2007; Schroeder et al., 2007a, b, 2008; Felipe et al., 2008; Schneider et al., 2009
 3.SOFT-START CURING

• The soft-start curing method originated with work by (Unterbrink and Muessner, 1994, 1995) (Braga et
al., 2005; Ferracane, 2005)

• Reduced irradiation intensity during the early stages of polymerization is hypothesized to allow stress
relaxation to occur prior to vitrification

• Extensive research has gone into and will continue to be devoted toward evaluating curing conditions and
the subsequent effects on conversion, mechanical properties, and shrinkage stress.
 ADVANCES IN MONOMER FORMULATIONS

• The resin phase is composed primarily of dimethacrylate monomers typically selected from BisGMA,
BisEMA, and/or UDMA.

• monomers such as these generally result in low methacrylate conversion, which leads to significant
amounts of unreacted monomer that may be leached from the restoration over time, resulting in concerns
regarding long-term biocompatibility.
 1.MULTI METHACRYLATES

• Bile acids were utilized as starting materials to form multimethacrylate monomers (Gauthier et al., 2009)

• Polyhedral oligomeric silsesquioxane methacrylates (POSS-MA) were evaluated as alternatives to

BisGMA (Fong et al., 2005), and it was found that small amounts of POSS-MA (2-10 wt%) did indeed
improve the mechanical properties of these resins

• Methacrylated beta-cyclodextrin derivatives have also been evaluated as alternatives to BisGMA and
were found to exhibit flexural strength and volume shrinkage comparable with those of
BisGMA/TEGDMA (Hussain et al., 2005).
 2.ULTRARAPID MONOMETHACRYLATES

• Inclusion of monovinyl monomers into dental resins was changed with the development by Decker of a
novel class of monovinyl (meth)acrylate monomers that exhibited greatly enhanced polymerization
kinetics and significantly improved mechanical properties.

• These materials showed great promise when utilized as diluents, and several monomethacrylates were
evaluated as alternatives to TEGDMA (Lu et al., 2005; Kilambi et al., 2009)
 3.ACIDIC MONOMERS

• Incorporating acidic monomers in relatively small mole fractions into methacrylate resins may enable a
separate adhesive layer to be eliminated and result in improved overall performance.

• Current acidic resins do not exhibit the necessary mechanical properties to function as resin-based
composites, and hence research has focused on developing acidic monomers with improved mechanical
properties.

• (López-Suevos and Dickens, 2008).

 NOVEL POLYMERIZATION MECHANISMS
1.POLYMERIZATION-INDUCED PHASE SEPARATION

• In one creative approach, specific methacrylate monomers, chosen to be miscible as liquids but phase-
separated at higher conversions, were incorporated into conventional methacrylate resins and
composites.

• When phase separation occurs, the volume expands, eliminating a portion of the volume shrinkage that
arises from the methacrylate polymerization.

• In particular, the use of dimer-acid-derived dimethacrylate (DADMA) monomers in novel dental resin
formulations is examined as a potential means to address the combined aims of high conversion and low
shrinkage and shrinkage stress.
 2.THIOL-ENE PHOTOPOLYMERIZATION

• The thiol-ene polymerization reaction proceed via a step-growth polymerization mechanism in which
propagation and chain transfer alternate (Cramer and Bowman, 2001; Hoyle et al., 2004, 2010; Lu et al.,
2005; Hoyle and Bowman, 2010).

• The step-growth nature of the polymerization results in uniform polymer networks with narrow glass
transition regions and reduced brittleness.

• Also, the gelpoint conversion is significantly higher in thiol-ene networks as compared with methacrylate
networks. and

• hence thiol-ene systems exhibit significant reductions in polymerization shrinkage stress (Carioscia et al.,
2005; Lu et al., 2005; Cramer et al., 2010).
 3.HYBRID POLYMERIZATION REACTIONS

• Hybrid polymers are formed from co-monomers with different reactive groups that polymerize via
different curing mechanisms and are often utilized to synergistically achieve desired properties.

• The order of the reactions can be controlled by the selective addition of inhibitors of each polymerization
type or through manipulation of the initiating wavelength-initiator combination.
 4.RING-OPENING POLYMERIZATION

• unique shrinkage behavior observed in these polymerizations.

• ring-opening reaction relies on the opening of a cyclic structure to facilitate intermonomer bonding and
crosslinking.

• A recent exciting development in ring-opening polymerization is the commercial release of the

cationically photopolymerizable silorane material (Filtek LS) by 3M/ESPE (Weinmann et al., 2005).
 FILLER AND FILLER MODIFICATION

• A study on the influence of mono-,bi-, and tri-modal distributions of fillers on the wear properties of
composites showed that filler size and shape significantly influence wear resistance, with the inclusion of
nano-sized filler a critical feature, often leading to enhanced properties (Turssi et al., 2005).

• A method was developed to prepare single-walled carbon nanotubes (SWCNT) with suitable compatibility
and polymerizability such that they could be introduced into dental composites as a secondary filler.

• A good dispersion of the SWCNT in the composite was demonstrated, along with a significant increase in
flexural strength compared with that of the unaltered composite material (Zhang et al., 2008).
 SILANE TREATMENT OF INORGANIC FILLERS

• Surface modification of most fillers used in dental composites is necessary:

• (a) to reduce the filler surface energy such that composite paste consistency and hydrophilicity are
reduced while filler dispersion within the resin is enhanced; and

• (b) to provide a functional interface that permits covalent attachment between the polymer matrix and
the reinforcing higher-modulus filler.

• methacryloxypropyltrimethoxysilane (MPS) remains the most widely used surface treatment for the
inorganic fillers used in dental composites
Packable

• Introduced as amalgam alternatives.

• Supplied:
• Unit-dose, compules or in syringes.

• Higher filler loading:

• Fibers
• Porous filler particles
• Irregular filler particles
• Viscosity modifiers.
• Non sticky
• Easily transferable and packable.
• Moisture tolerant
• High critical shear bond strength
• Has excellent visible light depth of cure
• Cures rapidly to final hardness but with minimal residual stress
• Little shrinkage on curing
• Easily carved, burnished (smoothened).
 Polymeric rigid inorganic
matrix material

• Inorganic phase:

• Continuous network or scaffold of ceramic fibers-

Alumina and silica dioxide fibers.

• Fiber diameter is 2.0 um or smaller.

• Cross-sectional dimension of scaffolding

150-200 um.

• Silanation is completed with addition of

BIS-GMA OR UDMA resin.
Advantages :
Produce acceptable class II restorations.

• High depth of cure possible.

Reduced polymerization shrinkage.
As low as 2%.
• Filler loading: > 80% by weight.

• Medium to high strength.

• High stiffness.

• Low wear rate: 3.5 um per year.

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• Modulus of elasticity: similar to amalgam

Disadvantages
Recommended uses:
• 1. Less polishable.

• 2. Limited shades.
• 1. Class I restorations.

• 2. Class II restorations (2-3

• 3. Increased post- op sensitivity. surfaces).

• 4.  Sensitivity to ambient light.

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PRODUCT MANUFACTURER

Solitaire Heraeus Kulzer

ALERT Jeneric-Pentron

SureFil Dentspl y/Ca u I k

Prodigy Condensable KerdSybron

Filtek P60 3M Dental Products

Pyramid Bisco, Inc.

Glacier Southern Dental Industries

Synergy Compact Coltene-Whaledent

Definite Degussa
 • 70% filler volume.
• Very good for
proximal Contacts.
Solitaire
67% filler volume

Releases fluoride.

Insensitive to ambient light 34

80% filler vol Easy to finish and polish
 BulkFill composites

Reduced polymerization Increased depth of

shrinkage-Changes in cure-Novel photo
filler composition- initiators,polymerizati Ease of flow&
shrinkage stress relievers on boosters or by adaptability
or polymerization increasing
modulators translucency

Higher strength
Good esthetic
& Better wear
properties
resistance
 Flowable composites

• Introduced in late 1996

• Similar to resin cements &pit and fissure sealants with filler loading + particles
size less than hybrid composites resulting in a material of low viscosity.

• Filler content less than 50% by vol polymerization shrinkage will be greater
than for more heavily filled materials.

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Advantages

 Low viscosity Disadvantages

 Easy to use
 Improved marginal adaptation
 High wettability
 wear
 poor mechanical properties
More polymerization shrinkage
Sticks to the instrument

 High depth of cure

 Penetration

 High flexibility

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Artiste® nano-hybrid Flowable composite

Exceptional polish ability

Reduce shrinkage
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Increase wear resistance
 ENA HRi flow

No bubbles formulation
• HRi features breakthrough technology - a light refractive index (1.62) that is
identical to natural enamel, with optical properties that can't be found in any other
composite.

• The ENA HRi Flow formulation eliminates air bubbles, resulting in superior physical
properties.

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 Gingival masking composites
• An aesthetic gingiva-shaded light-cured composite resin recently
introduced, providing practitioners with the option of correcting
gingival recession with a minimally invasive and less costly
procedure.

• Pink-colored composite  available in one translucent gingival

color and 3 pink flowable opaquers  mixed together to better
match an individual's gingival shade
 Cervical area,
including composite Exposed cervical
V-shaped defects
restorations in areas
gingival colours

Ability to mask
Primary splinting,
Aesthetic exposed crown
and the correction
corrections of the margins to improve
of red/white
gingival area, aesthetics and
aesthetics
patient satisfaction.
 Esthet x flow
• Pseudo plastic handling - flows on command

• Superb strength and wear resistance

• Highly radiopaque

• Low shrinkage & porosity

• 8 VITA shades plus 1 opaque and 1 bleach

shade

• Excellent polish & Fluoride release

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 Uses

• Low stress applications but not in class I and II in premolars and molars.

• Resurfacing composite or GIC restorations or for rebuilding worn composite

contact areas.

• Areas of difficult access or areas that require greater penetration, amalgam,

composite or crown margin repairs, pit and fissure sealant or preventive resin
restoration.

• As liner or base in class II proximal box.

• Cementing porcelain veneers.

• Restoration of air abrasion preparation, class v lesions, porcelain repairs, enamel

defects, incisal edge repair in anteriors, class III lesions.

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 Compomers

• Contains the major ingredients of both composites (resin component) and glass
Ionomer cements (Polyalkenoate acid and glass fillers component) except for water

• Resin component  bulky macro-monomers, such (bisGMA) or UDMA with

viscosity-reducing diluents, such as Triethylene glycol dimethacrylate (TEGDMA).

• Fillers  fluoride containing glasses

46
Strength and Wear Performance:

GIC – 140 MPa,

composite- 300 MPa,

compomer 200 – 250 Mpa

• Dyract has 3 times the wear rate of a hybrid composite.

Fluoride Release :
Dyract shows fluoride release for more that 12 months and maintains the same rate
of diffusion.

It is shown that more fluoride is released in acidic solution

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 Indications

Sealing
occlusal pits
and fissures
Retrograde Restorations
filing of primary
materials teeth

Potential Minimal
root canal cavity
sealers preparations
Indications
Lining and
Sealing of
Core build-
root surface
up
Class III,
Repair of
Class V,
defective
Erosion
margins in
lesion -
restorations
Restorations
 Advantages:

• Superior working characteristics to RMGIC

• Ease of use

• Easily adapts to the tooth

• Good esthetics

EX: DYRACT Ap, Compo glass F, Compo glass flow, F2000, Hytac
 Giomers

• GIOMER is basically a modified GLASS IONOMER.

• It is a true hybrid of two compounds, Glass

Ionomer and Composite

• The properties of GIOMER is fluoride release and fluoride recharging of

glass ionomer and esthetics, easy of polishing, and strength of composite.

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COMPOSITION of GIOMER :

• Bisphenol A glycidyl
dimethacrylate&TEGDMA

• Inorganic glass filler-Aluminuoxide, silica

• Pre-reacted glass ionomer filler

• DL-Camphorquinone
51
• Reactmer bond is the glass ionomer based, tricurable, all -in-one, filled
adhesive based on PRG technology
52
Indications:

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

Other dental
applications  repair of Restoration of cervical
fractured porcelain and erosion and root caries
composite restoration

Ideal for pedodontic Laminate veneers and

restorations core build-up
Advantages:
• Fluoride release
• Biocompatibility
• Clinical Stability and Durability
• Excellent aesthetics
• Smooth Surface Finish
• Excellent Bonding
Limitations:
• Giomers are not as beneficial as GIC’s in
patients who are at risk for recurrent
caries
• Long term fluoride release is questionable
• Auj Yap etal (2002) hardness value (VHN)
for Giomer was less than composite
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 Ormocer
• Dr. Herbert Wolters from Fraunhofer Institute for Silicate Research introduced
this class of material in 1994

• acronym of Organically Modified Ceramic

• described as 3-dimensionally cross-linked copolymers.

Composition:
Silicon oxide, a filler--basic substance
It is modified originally by adding polymerisable side chains in the form of
methacrylate group

Filler 1-1.5 µm in size

material contains 77% filler by weight and 61 % by vol

essential difference between ORMOCER and the previously available

composites is found in the matrix
The matrix, consisting of ceramic polysiloxane (siliconoxygen-chains)
Ormocer was formulated in an attempt to overcome the problems created
by the polymerization shrinkage of conventional composites because the
coefficient of thermal expansion is very similar to natural tooth structure. 56
 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

57
Based on a newly developed alkaline glass filler and is expected
to reduce the formation of secondary caries at the margins of the
restorations due to inhibition of bacterial growth, reduced
demineralization and buffering of acids produced by cariogenic
micro-organisms
• Smart composites work is based on the newly developed alkaline glass. The paste
contains Ba, Al, and F silicate glass filler (1m) with Ytterbium trifluoride, silicon
dioxide and alkaline glass (1.6 m) in dimethacrylate monomers

• Ivoclar 1998 named Ariston pHC (pH control) which was claimed to
release:Fluoride

• Hydroxyl Calciumif PH falls in the vicinity of the restoration < 5.8

• This was said to neutralize acid and counter act the decalcification of enamel and
dentine.

59
 Smart nano composites

• In 2007,Hockin Xu used nanosized(25-100nm)Dicalcium phosphate with reinforcing

nanofillers – Load bearing, decay inhibiting ability

• Nanofillers-Small fibres fused at high temp with Nanoscale silica particles

• This material can buffer tooth against decay caused by acid producing bacteria by
“Smartly” increasing ion release in presence of acids
 Siloranes

• 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.
 Filtek™ P90 low shrink posterior restorative
system

• Combines the lowest-shrinking

silorane-based composite with a
dedicated two-step, self-etching
bonding system.
 Glass inserts
• An alternative to conventional composites has been developed (Bowen et al, 1991)
known as "Megafilled" composite restorations are produced by filling the bulk of
the cavity preparation with beta-quartz glass inserts.

• The inserts are surrounded by lightcured composite, which bonds to the insert via
a silane coupling agent. The inserts are produced in a variety of shapes and sizes
to fit most cavity preps.

• When fitted into the cavity, they minimize the volume of shrinking composite and
reduce curing contraction (George and Richards, 1993). The integration of inserts
reduces the polymerization shrinkage stress and lowers the overall coefficient of
thermal expansion.

64
65
Available insert systems:

Beta quartz: glass ceramic inserts:

• Beta quartz inserts are manufactured of a cast glass ceramic based upon a lithium
aluminium silicate with the addition of iron, sulphur. The surface of inserts is
presilanized. Beta quartz silane liquid is available for the chairside resilanization
of contaminated inserts

SDS feldspathic inserts:

• SDS inserts ( Schumacher Dental Systems, Germany) consists of a feldspathic
ceramic with a flexural strength of upto 10-20% greater Other insert systems

66
Ceramic leucite reinforced Ceramic inserts:

• Cerafil inserts consists of a dental ceramic reinforced by leucite crystals. The

cerafil system offers conical, symmetrical ceramic inserts of various sizes with
matching preparation instruments and finishing diamonds.

Sonic Sys leucite-reinforced ceramic inserts:

• Sonic Sys inserts (Vivadent) are made of leucite reinforced glass ceramic. The
Sonic sys inserts allows the finishing preparation and restoration of a non
symmetrical proximal cavity.

Cerena glass ceramic inserts:

• Cerena inserts (Noediska Dental, Sweden) are manufactured of a translucent

glass ceramic material without any addition of color pigments. 67
 Antibacterial composites

• Chlorhexidine has been tried in an attempt to reduce plaque accumulation on the

surface of filling materials. However, this was not successful since the release
was not uniform and lead to certain disadvantages like:

• -toxic effects of the released materials

• -population shift of microorganisms

• - short-lived antibacterial activity

• -deterioration of physical and mechanical properties of the materials.

68
Imazato et al (1994) attempted to make the composite antibacterial by
incorporating a non releasing newly synthesized monomer, MDPB with
antibacterial properties into the composite resin.

Metacryloyloxydodicylpyridinum bromide

MDPB was found to be effective against important species in plaque

formation like actinomyces, Neisseria and veilonella

69
• Silver has also been added in the composites to make it antibacterial - ‘oligodynamic
action’

• Silver can be added either:

• Silver ions are incorporated into inorganic oxides like silicon dioxide

• silver ions may be hydrothermally supported into the space between the crystal
lattice network of filler particles.

• Silver ions may be incorporated into the silica gel and the thin films are coated over
the surface of composites.

1wt%halo(active against S.mutans and A. viscous for 10 wks).

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 Antibacterial activity of dental composites containing zinc
oxide nanoparticles.
June 2010 in J Biomed Mater Res B appl biomater, 94(1):
22-31.

• ZnO-NP-containing composites (10%) qualitatively showed less biofilm after 1-

day-anaerobic growth of a three-species initial colonizer biofilm after being
compared with unmodified composites, but did not significantly reduce growth
after 3 days.

• It is demonstrated here that zinc oxide nanoparticles (ZnO-NPs) blended at 10%

(w/w) fraction into dental composites display antimicrobial activity and reduce
growth of bacterial biofilms by roughly 80% for a single-species model dental biofilm.
 Chitosan composites

• Chitosan and chitosan derivatives appear to be good candidates for the

elastomeric matrix. These natural biopolymers are biocompatible ,biodegradable
and osteoconductive. They have been used in surgical interventions for the
reduction of periodontal pockets.

• Biocompatibility , biodegradable, muco adherent

• CPC–chitosan composites are stable in a wet environment and had sufficient

physical strength for many clinical applications. The strength did not decrease
with time under simulated physiological conditions.

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 Bioactive composites

• Bioactive formulations:

• -ACP (amorphous calcium phosphate)-2000

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

• Fluorinated Bis-GMA analogues

• Liquid crystalline monomers

 Amorphous calcium phosphate (ACP)

• Replace missing/decayed tooth structure by remineralization-Antonucci , Skrtic

• Intermediate in hydroxyapatite formation

• Single solid phase precursor

• Biocompatible with hard & soft tissues

• Sustain Ca & PO4 release

• Effective remineralising agent – sealants, adhesives, bases, liners

 Hydroxyapatite (HAP)

• As a reinforcing filler

• Synthetic HAP- hardness similar to tooth- Improved wear

• Intrinsic radio opacity

• Enhanced polish ability

• Less expensive

• Biocompatible

• High refractive index

 Flouride releasing composites

• Tanaka et al used methacryloyl fluoride – methyl methacrylate copolymer in

pit and fissure sealant where fluoride delivery lasted for 2 years (MF-MMA).

• Kwan et al used Lewis acid i.e. BF3 and Lewis base i.e. diethylaminoethyl
methacrylate into dental resin system fluoride is released by hydrolysis at a
rate of 2-5µg/cm2/day for 1 year.

• Other experiments are still under progress using – morpholinoethyl

methacrylate hydrofluoride – tetrabutyl ammonium tetrafluoroborate.
 COMPOBONDS

• Compobonds exploit the benefits of SE DBAs and nanofilled resins, eliminating the
precursory bonding stage necessary to adhere a resin to tooth substrate, and are
termed Self-adhering Composites.
 Trade name :- vertise flow

Self adhering flowable combining

a resin-based composite and a SE
First compo bond introduced in
bonding agent based on the 7th
2009 by (Kerr Corp., USA)
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

Preoperative view showing the existing
amalgam restorations which were in need Amalgam restorations were removed
of replacement.

The cleaned-out preparations. Vertise (Kerr) flowable composite was

A 37% phosphoric acid etchant (Kerr) was dispensed onto a microbrush in order
used on the cavo-surface margin. to accurately place it into the
conservative preparation
 Application of the flowable composite
into the preparation.
The restorative material was scrubbed
onto the prepared tooth and then light-
cured for 20 seconds.

The completed self-etching, self-

bonding flowable composite
restorations.
 Fusio™ liquid dentin

• It is a 4-META (4-methacryloxyethyl trimellitic acid) based flowable composite

featuring nano-sized amorphous silica and glass fillers.

81
Characteristics and properties of compo bonds

Incorporates the properties of the 7th generation DBA,

OptiBond®

• Acts as a Shock Absorber beneath resin-based composite

restorations.

The bonding mechanism to dentine is two-fold.

• 1) Chemical adhesion by the phosphate function group of the

GPDM& 4-META monomer uniting with the calcium ions within
the tooth
• 2) Micromechanical adhesion by formation of the hybrid layer
composed of resin impregnation with the collagen fibres and the
dentine smear layer.
• Because Compobonds function both as a dentine adhesive and a
resin restorative material, a Longer Curing Time Is Necessary to
ensure that both constituents are fully polymerised.

Light curing
Increasing its pH So that continual
reaction also
from acidity does not
halts the etching
approximately 2 erode the dentine
process of the SE
to 7 bond.
agent
 Nanofilled composites

• Nanotechnology consists of reducing components of a material to the nanometric

scale for use in a new material to improve the final characteristics.

• To estabilish polish of a microfill but the strength and wear resistance of hybrid
composites (Swift, J Esth Rest Dent, 2005).
 Nanoparticles

• Particles of size  1-100 nm in diameter exhibit unique electronic, optical,

photonic and catalytic properties.

• Display properties intermediate between quantum and bulk material because

of their intermediate size and large surface area-to-volume ratios.

• Nanoparticles of different sizes and shapes exhibit different absorbance and

fluorescence features
Advantages of nano fillers

Does not thicken the Enhance the

Size (0.4-0.8µ).
resin polishability of resin.

An extreme surface
to volume ratio gives Increased wear 50% decrease in
a high filler loading resistance & polymerisation
in a workable hardness. shrinkage
consistency.

Reduced staining
• Nano hybrid composites have nanometer sized
particles combined with more conventional filler
technology.

• Nanofilled resins have approximately 60%

volume filler loading, making the Nanofilled
resins as strong as the hybrid and micro hybrid
resins.

• Nanofillers have a refractive index of 1.508.

 Nanomer Nanotubes
Discrete non-agglomerated and Nanotubes have remarkable
non-aggregated particles of 20-75 tensile strength
nm

Nanocluster
Loosely bound agglomerates
of nano-sized particles
TRADE NAMES TYPE OF NANO COMPOSITES IMPORTANT POINTS

Tetric EvoFlow NANO-OPTIMIZED FLOWABLE Class V restorations , fissure sealing &

adhesive cementation technique

Filtek supreme XT NANOFILL COMPOSITES •Superior translucency and esthetics

•Superior hardness, flexural strength and
modulus of elasticity.
•50% reduction in polymerization shrinkage.
•Excellent handling properties.
TRADE NAMES TYPE OF NANO COMPOSITES IMPORTANT POINTS

Ceram·X™ duo+ Nanohybrid •highly esthetic restorations

Double Translucency System •Nano-Ceramic matrix in combination with
the optimized filler particle size

Ceram.X® mono+ Nano hybrid improved handling features; reduced

stickiness and improved slump resistance.

AELITE™ AESTHETIC Nano hybrid High strength

ENAMEL Excellent polishability
Easy manipulation and highly sculptable
Low attrition and wear
High flexural strength
TRADE NAMES TYPE OF NANO COMPOSITES IMPORTANT POINTS

Filtek™ Z350 Universal NANOHYBRID •Low polymerization shrinkage.

Restorative •High wear resistance
•Anterior and posterior restorations, core-
build-ups, splinting and indirect
restorations

Tetric EvoCeram NANOHYBRID Anterior and posterior restorations.

(Ivoclar Vivadent) 3 types of nanoparticles - fillers,
pigments and modifier.

Aelite Aesthetic Enamel NANOHYBRID High strength,excellent polish ability

Bisco Filler Anterior and posterior restorations.
70 - 75%
TRIMODAL APPROACH TO NANOTECHNOLOGY

Premise Universal
 Indirect composite resins

• Three type of composite materials are available for use in indirect

technique,microfilled resins (sr adoro ), small particle resins and hybrid resins.

• New category of processed composite resin recently was introduced-polymer glass,

polymer ceramic and Ceromer

• All show excellent wear resistance & small particle composite resins and hybrid
resins can be etched to produce micromechanical retention

• They can all be silanated to increase bond strength

94
 Early 1980s, Mormann and Touati Composite resins for the fabrication of indirect
inlays and onlays

 Mid 1980Touati and Pissis developed the concept of metal composite inlays and
bridges after the silanating technique

 Disadvantages of direct composites:

 Inadequate wear resistance
 High incidence of secondary caries

 Indirect composites:
 Allow improved adaptation of the restoration to the cavity walls – better
marginal integrity, less post operative sensitivity
 Post-cure heat treatment (125° C or 275° F) increases double bond conversion-
better polymerization, better wear resistance

95
 Art glass
• Launched in 1995 by Heraeus-kulzer

COMPOSITION

Matrix Filler
Organic resin Barium silicate
matrix glass 0.7µ

Silica-reduces slumping, improve sculptability, high degree of conversion (multifunctional

monomers)

xenon stroboscopic light ( high cross linking)

96
 Bell glass HP

Bell de in 1996
The opaceous dentin material of BelleGlass HP
incorporates a specific filler size and particle
distribution that helps to achieve thermal
expansion, flexibility and stress response
characteristics similar to natural dentin.

• polymerized under pressure at elevated

temperature
138ºc rate 20 min & in presence of Nitrogen
, an inert gas. inc. polymerization &wear Matrix Filler
resistance.
Base : BisGMA Base : silanated
Surface: microhybrid
 Curing method- Light, heat and pressure TEGDMA filler 0.6µ
 Improved D.C Surface:
borosilicate
 Improved translucency

97
 Sinfony
• Introduced by 3M ESPE

Matrix Filler
Polyfunctional Pyrogenic silica
metharylate 0.05µ Visco alpha
polymer halogen lamp
source
10sec

Visco beta
Fluorecent lamp
source
15min
 Advances in indirect composite resin systems

Ceromers:
• The term ceromer stands for Ceramic Optimized Polymer and was introduced by
Ivoclar.

• Composed of specially developed & conditioned fine particle ceramic fillers -

barium glass (< 1 µm), spheroidal mixed oxide, ytterbium trifluoride, and silicon
dioxide (57 vol%) of submicron size ( 0.04 & 1.0 μm ), which are closely packed (
75 – 85 weight %) & embedded in an advanced temperable organic polymer
matrix-dimethacrylate monomers (Bis-GMA and urethane dimethacrylate.

• Setting is by a polymerization of C=C of the methacrylate.

99
Ceromers combine the advantages of ceramics and composites

• Durable esthetics

• High abrasion resistance

• High stability

• Ease of final adjustment

• Excellent polish ability

• Effective bond with luting composite

• Low degree of brittleness

• Conservation of tooth structure

 Targis

• Ivoclar in 1996

• Provided –base, dentin and TARGIS gel

incisal shades
TARGIS power
Matrix Filler curing unit
BisGMA Ceromer (ceramic – Light emmision
optimized polymer) 10 min+ temp.
95ºC
Cooling 5min

101
 Laboratory based, Preimpregnated fiber reinforced
systems
Targis/vectris:
• Highly filled Targis Ceromer (ceramic optimized polymer)
composition, along with Vectris, a fiber reinforcing composite
framework

Consist of 2 major components

1. Targis - forms the bulk of the restoration
2. Vectris - fiber framework.
Sculpture/fibrekor:
• Involves veneering a composite resin (Sculpture) to a resin
preimpregnated glass fiber network (Fibrekor)
• Fibers available in 15 cm lengths of various widths.
• Sculpture is polycarbonate based composite resin.

Ribbond:
• It is a cross-linked leno stitch weave of polyethylene fibers.
• Can be used chair side or in laboratory to fabricate composite resin
bridges .
 Single crystal modified composites

• Have symmetric shapes like long plates and behave like fibers.

• 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.

104
 fiber reinforced composites
Properties of FRC:
• Geometrical arrangement of fibers
Wave, Braided, Unidirectional, Mesh

• Nature of the fiber

Stresses on the matrix are transmitted to fibers

• Adequate adhesion of the fibers to the polymer matrix-Covalent

bond
Proper adhesion maximizes reinforcement and transfer of stresses
Silane coupling agents – to improve adhesion

105
 Forms

• Short staple:
Reduces matrix volume
Improves wear resistance

• Long lengths:
Can improve strength and stiffness

• Woven material:
Also improves strength and stiffness
Assist in forming structure

106
 Classification

• Pre- Impregnated Lab Products ( ex: vectris)

• Pre- Impregnated chairside products ( connect – kerr)

• Impregnation required- Chairside ( glaspan)

• Preimpregnated prefabricated posts ( everstick )

107
 Advantages
• Single visit immediate treatment
• Suitable for transitional& long term replacement.
• Suitable for young pt
• Metal free restoration
• Improved esthetics
• Easy to make
• Can be frequently used with minimal or no tooth preparation
• Less wear of opposing tooth as compared to traditional
composites
• Suitable for transitional and long term provisional
restorations.
• Readily repaired.
 Disadvantages:

• Potential wear of overlying veneering composite—pt with para

functional habits
• Excellent moisture control required– for adhesive technique
• Space requirement greater in comparison to metal occlusal surfaces
to allow sufficient room for fibers & adequate bulk for veneering
composite onlay
• May lack sufficient rigidity for long span bridges.
• Uncertain longevity in comparison to traditional technique.
 Clinical applications

• Reinforced resin based composites.

• Individual restorations (inlay, onlay, full veneer crown).
• Periodontal splinting/ post trauma splint.
• Immediate replacement trasitional-long term provisional
bridges.
• Fixed bridges-ant & posterior,
1. Simple cantilever
2. Implant supported
• Reinforcing or repairing dentures.
• Fixed orthodontic retainers.
GC EVEREX posterior:

The short fibres used in everX

Posterior provide a fracture
toughness equal to collagen-
containing dentine and almost
double that of a conventional
composite.
composite restoration in large
preparations.*
 Core build up composites

• They are available as:

• Light cure • Ti-Core EDS
• Dual cure • Core paste Den-Mat
• Self cure • Build-it J/P
• Bis-core BISCO
• Corestore Kerr
• Fluorocore Caulk
• Clearfil photocure J-Morita

113
Composite splints

• Resins along with the reinforcement of

fibers can also be used as splints for
System
esthetic purposes. s
• These fibers are strong and durable.
Ribbond Ribbond
• These are applied with flowable or
hybrid composites. Connect Kerr

• They are available in different: Splint-it J/P

• Thickness. Glass span Glass Span
• Breadth.
• Pattern.
114
 Root posts

• Resin reinforced with carbon or quartz fibers have been

used to produce black or white root posts with stiffness similar to
that of dentin.

• Fiberglass resin posts – refracts and transmits light to

the luting resin cements even after light curing cycle.

115
 Future advances
• Carbon Nanotubes- Applications of carbon nanotubes
reinforcement of composites
• Boron nitride Nanotubes

Addition of small amounts of the carbon nanotube filler to a commercial

composite (Durafill) yielded a material with good dispersion of the SWCNT,
along with a significant increase in flexural strength compared with that of
the unaltered composite material (Zhang et al., 2008).
 Liquid crystals
• Liquid crystals are structurally
intermediate between liquids and solids

• Transforming from a highly organized

state at room or mouth temperature to
an isotropic amorphous state when
photocured, with sufficient expansion to
offset the contraction that accompanies
the formation of covalent bonds.

• Used as Fillers as well as matrix in

composites.
 Quantum dot materials

• Quantum dots are a unique

class of semiconductor
particles, ranging from 2-10
nanometers (10-50 atoms) in
diameter.

• The core-shell quantum dots

have unique shells that
stabilize the material, improve
quantum yield and reduce
photo-degradation.
 Quantum dot composites

• Quantum dots exhibit high fluorescent brightness, stable, long

lasting, and have narrow emissions
 Self-repairing Composites:

• One of the first self-repairing synthetic materials reported,

interestingly shows some similarities to resin-based dental materials ,
since it is resin based.

• This was an epoxy system which contained resin filled microcapsules. If

a crack occurs in the epoxy composite material, some of the
microcapsules are destroyed near the crack and release the resin.

• The resin subsequently fills the crack and reacts with a Grubbs catalyst
dispersed in the epoxy composite , resulting in a polymerization of the
resin and repair of the crack.
 Conclusion

• The field of composite dental restoratives continues to propose and

achieve significant and exciting advances in resin formulation, filler
loading and modification, and curing methodologies and
mechanisms.

• While most of the advances remain in the research stage, the future
both in regards to research and in clinical practice remains bright
with exciting new developments translated into practice at an ever-
increasing rate 121
 References

• Properties of packable dental composites. J Esthet Dent. 2000;12(4):216-26.

• Dental Ceramics and Ormocer Technology - Navigating the Future!-A.Sivakumar

• Polyacid-modified composite resins (“compomers”) and their use in clinical dentistry-John W. Nicholson∗

• Text book of operative dentistry:Summit

• Text book of operative dentistry:Sturdvent

• Esthetic Dentistry:Ascheim Dale:Second edition

• Text book of operative dentistry-vimal .k .sikri

• Jada-1997

122
• J am dent asso 132(5); 639-645,2001
• Dental materials(2005),21,68-74

• Dental materials(2002).18,413-421

• Journal of esthetic dentistry (2000)12,216-226

• J Am dent asso(1990),20;177

• Dental Materials Volume 20, Issuse 9, Pages 789-795, November 2004

• Journal of Esthetic and Restorative Dentistry Vol 11 issuse 5,pages 234–249, September 1999

• Dental Materials 19 (2003) 449–457

• Fiber-reinforced composites in clinical dentristry: Quintessence Books; 2000.

• JDR:91- 1178-1783-December 2012

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