Evolution of Dental Composites

PBL 2014

Timeline

Source: http://portlandor.sites.acs.org/jan/jan.html

Introduction
An ultimate goal of TCR is to have dimensionally
and chemically stable material that is able to seal
the restoration without any marginal leakage
(micro or nano)
Generally, composites progressed from large
particle size inorganic filler particle to smaller
particle size configurations with enhanced fillers
This resulted in composite resins that are
smoother and stronger, and have less
polymerisation shrinkage

Classification

Macrofilled
Filler: Crystalline quartz ground into a fine
powder
particles 1 to 50 microns (M) in diameter
70% to 80% glass by weight, 60% to 65% by
volume.

Shrinkage: compensated partially by glass

particles
Shrinkage still significant microleakage and
recurrent caries

Brands: Adaptic and Concise

 Advantage:
Large numbers of particles can be incorporated
into the paste without making it too stiff to
manipulate.

Disadvantage:
Not polishable
Restoration shows significant wear over time
bite may change, teeth will move over time

Microfilled
Extremely small filler particles (0.02 m to 0.04
m)
Advantages

very translucent
highly polishable
low wear characteristics
excellent handling characteristics

Disadvantages
Small particle size translated to low strength
Should not be used in heavy stress-bearing areas

 Inferior to hybrid composites

Lower percentage of filler content

Higher coefficients of thermal expansion
Greater water sorption
Greater polymerization shrinkage
Lower module of elasticity
Lower tensile strength
Lower fracture toughness
Exception is their compressive strength, which can
be relatively high

Used in anterior applications and cervical

abfraction lesions where aesthetics is important
and functional stresses are low

Hybrid
Combination of:
1. the larger particle size of the early composites
provided strength
2. the smaller particles of the microfilled composites
which assisted with esthetics and wear.

Usually filled 70% to 80% by weight with 0.04m and 1-m to 5-m filler particles
Can be filled to a much higher density with glass
particles than those composites containing only
micro sized particles

 Advantages:
Retains easy working characteristics due to the high
percentage of larger particle sizes
Much more resistant to wear than the older macros
Good for posteriors

Disadvantages:
Do not retain a high polish for long
due to the tendency of the largest particles to pop out of the
surface

Brands: Prisma APH, Herculite, Alert and P-50 (by 3-M)

Flowables
Flows freely over the inside surface of the cavity
preparation
Utilized in a wide variety of clinical applications:
ranging from Class I, III, and V restorations, to
sealants and preventive resin restorations (PRRs),
to base/liners, to repair of temporary restorations

Some brands contain Al-Fl-Si glass particles

release fluoride to the adjacent tooth structure

Delivered into a cavity using a syringe

 Advantages:
Possible to fill small cavities on occlusal surfaces without
anaesthesia
Useful in the restoration of highly conservative
preparations
Indicated in areas of difficult access and irregular cavity
preparations

Disadvantages:
more prone to shrinkage and wear due to the low level of
filler particles generally not used in bulk to fill large
cavities
Possess inferior mechanical properties

Microhybrid
Maintains the strength of the hybrid materials
while significantly improving esthetics
Uses up to three distinct particle sizes for more
efficiency, and a much smaller size range of
larger particles (0.6 -0.7 microns)
Uses uniformly cut small filler particles between
the larger particles, as well as resin hardeners
Brands: Prisma TPH, Herculite XRV, Tetric
Ceram, and Charisma

 Advantages:
greater polishability
Maintains surface polish during prolonged function

superior colour optics

mechanical properties strong enough for
rebuilding incisal edges on anterior teeth

Disadvantages:
suffer from lower particle density due to the small
size of the largest particles in the mix not
recommended for posterior

Nanofilled
Consist of nanomers (5 nm to 75 nm particles)
and nanocluster agglomerates as the fillers
Nanoclusters are agglomerates (0.6 m to 1.4 m)
of primary zirconia/silica nanoparticles (5 nm to
20 nm in size) fused together at points of contact

Most common brand: Filtek Supreme Plus

 Advantages:
similar mechanical and physical properties to
those of microhybrid composites, but perform
significantly better when it comes to polish and
gloss retention
wear quite well and are suitable for restorations
on the occlusal surfaces of the posterior teeth

Nanohybrid
Marketed as universal composites
Prepolymerized, finely milled agglomerated
nanoclusters
Consists of:
Larger (sub-micron sized) glass or silica particles
in the range of 0.4 micron
Individual nano-sized particles (.05 micron)

 Advantages:
suitable for both posterior and anterior
applications (because of their surface hardness)
high polishability
their excellent esthetic qualities
inherent strength
Has extremely wear resistant surface
superior handling characteristics: unset composite
paste fluid and easy to work with

Bulk fill
Designed to have a deep depth of cure
recommended depth: 4 mm.
Recent development of dramatically improved
matrix systems
has since enabled clinicians to use bulk-fill
systems and create excellent proximal contacts
Eg. Composi-Tight 3D System, Triodent V3
System

 Advantages:
features low percentage of polymerization
shrinkage

Disadvantages:
Esthetic capability not so good- only a minimum
selection of shades is available

Conclusion
Currently, the new generations of composite
resins offer excellent performance materials for
anterior and posterior direct placement
restorations.

 In general, the microhybrid and nanofilled

composites offer an alternative to microfilled
composites in their ability to be highly
polishable with toothlike translucency
This class of composites would be considered
universal-use composite resins.

References
http://www.dentalaegis.com/cced/2013/01/compo
site-resins-in-2013-an-update-on-their-progre
ss
http://doctorspiller.com/Composites/types_of
_composites.htm
http://www.sso.ch/doc/doc_download.cfm?
uuid=BC57B04E903739FBB9D6BA480B2D2018
http://www.dentalaegis.com/id/2007/08/direct
-composite-resins