Professional Documents
Culture Documents
Recording Esthetic Biomaterials and Principles
Recording Esthetic Biomaterials and Principles
Recording Esthetic Biomaterials and Principles
Principles - 2
Muhammad Amber Fareed
BDS (Lahore), MSc (London), PhD (Birmingham),
FRACDS (Sydney), FDSRCPS (Glasgow), DipMedEdu (Cardiff)
1
Learning Outcomes
• Discuss the different esthetic restorative materials
• Understanding the importance of polymerization shrinkage
• Illustrate strategies used to reduce polymerization shrinkage stress
• Discuss the commonly used restorative materials (GIC, RMGIC, MTA,
Resin Cement) and the oral environment
Prof MA Fareed 2
Resin-based Composites – Composition
1. Resin monomer – (bis-GMA, UDMA, TEGDMA,)
2. Reinforcing fillers – (macro, micro, nano, hybrid, etc)
3. Silane coupling agent – (bonds fillers and resin)
4. Optical modifiers – Composite Shade (TiO2, Al2O3 )
5. Initiator/Light-activator – (Camphorquinone)
6. Inhibitor – (Butylated-hydroxytoluene)
3
Resin Composite - Filler Particles Benefits
• Filler particles reduce the amount of matrix (resin) materials to control
the shrinkage of the composite during polymerization.
• Provide the appropriate degree of translucency and are radiopaque
• Increase hardness and strength, also increasing viscosity (75 wt.%)
• Reduce wear, water sorption / staining and
• Reduce polymerization shrinkage and thermal expansion/ contraction
• Small filler particles are more polishable
4
Composite Resin – Classification
1. According to the polymerization reaction initiation
Light cure Camphorquinone (photo initiator)
Chemical cure
Duel cure both light and chemical cure, used as cement
5
Composite Resin - Manipulative Variables
• Compsite resin should not be cured in thick section > 2mm,
• Curing light should be checked periodically with radiometer
• The closer the light, the greater the irradiance
• Major deficiency inherent polymerization shrinkage (2.2%–2.4%)
• Substantial contraction gaps between the restorative material and the
cavity margin, can result in postoperative sensitivity and recurrent
caries.
• The shrinkage of composite resin materials cannot be avoided, but
the stress created by the shrinkage can be reduced
Prof MA Fareed 6
Polymerization Shrinkage Reduction Tips
Reducing polymerization shrinkage stress prevent microleakage
1. The incremental composite placement technique is recommended
(always keep C-factor in your mind)
2. Create a relatively thick primed layer with dentin bonding agent (low
modulus, deform slightly while curing composite to absorb stress)
3. Place a thin layer (0.5 mm) of flowable composite to (absorb stress)
4. Use of ‘soft-start’ polymerization prolong the composite curing time
5. Use a thin layer of resin-modified GIC under composite (RMGIC bond
to the tooth and have low modulus to absorb shrinkage stresses)
Prof MA Fareed 7
Properties of Resin-based Composites
Biocompatibility: Generally biocompatible but should be treated as
potentially harmful materials, handled with caution, pulp protection
Depth of Cure
Reduced exposure time and less depth of cure
Light absorption and scattering reduce the power density and
degree of conversion with depth of penetration
Degree of conversion –(typical 50-70% are achieved) and it depends
on resin composition; the irradiance of the light source; the light
transmission; concentrations of sensitizer, initiator, and inhibitor. Curing
depth is limited to 2-3 mm
8
Resin Composites – Polymerization
shrinkage
More resin, more shrinkage (micro hybrid shrink less than mircro-filled),
Larger polymer/copolymer molecules less shrinkage
More fillers less shrinkage, volumetric contraction is around 1.0-4.0%
Shrinkage compromises the marginal seal at tooth-restoration interface
Minimized with incremental technique (2 mm) while doing restoration.
Post operative sensitivity in about 10% cases
More likely due to micro-leakage or induced internal stress, which can
be minimized with better clinical skills (isolation, pulp protection,
incremental build-up)
9
Resin Composites – Mechanical Properties
Mechanical Properties depends upon filler contents, filler type,
efficiency of filler-resin coupling process and the degree of porosity in
the set composite
Most composite have good mechanical properties but fail in tension
Compressive strength of mircohybrid have higher than microfilled
Strength generally increase with volume fraction of fillers
Elastic modulus or stiffness = increase with increase in volume
fraction of fillers. Lower filler contents of microhybrid composite
result in elastic modulus to one-fourth to one-half compared to
highly filled microhybrid composite
10
Resin Composite Restoratives
Prof MA Fareed 12
Factors Contributing in Bonding
• Good adhesive and bonding is achieved by:
1. Surface energy and wetting
2. Interpenetration (formation of a hybrid zone)
3. Micromechanical interlocking
4. Chemical bonding
Prof MA Fareed 13
Bonding Agents - Mechanisms of Adhesion
• Adhesion bonding occurs either through chemical attraction and/or
micromechanical interlocking
• The fundamental mechanism of adhesion to tooth involves:
1) Removing hydroxyapatite to create micropores
2) Resin monomers infiltration in micropores and forming resin-tags
• Bonding with tooth structure requires three conditions:
1. Sound tooth structure must be conserved
2. Optimal retention must be achieved
3. Microleakage must be prevented
Prof MA Fareed 14
Acid-etch Technique – Enamel Etching
• Bruonocore first reported phosphoric acid for acid-etching
• Phosphoric acid (37%) removes the smear layer and about 10
microns of enamel to expose prisms of enamel rods
• Create a honeycomb-like, high-energy retentive surface
• The higher surface energy ensures that resin monomers will
readily wet the surface, infiltrate into the micropores, and
form resin tags
• Resin tags are 6 μm in diameter and 10 to 20 μm in length
• Stronger bonding occurs if the smear layer is removed to allow
resins to directly bond to the intact tooth hard tissue
Prof MA Fareed 15
Acid-etch Technique – Dentin Etching
• Dentin etching (37% phosphoric acid) is more technique sensitive than enamel
• Dentine etching removes hydroxyapatite and expose a microporous collagen
• Etched enamel must be completely dry to form a strong bond
• Etched dentin must be moist to form a hybrid layer
• If insufficient water is present, the collagen network will collapse, no hybrid layer
• If too much water remains, resin infiltration cannot occur in the collagen network
• Priming step maintains a hydrated collagen network while removing excess water
• After dentin-etching hydrophilic resins can infiltrate into the dentin
• A hybrid layer structure forms very strong resin bonds through the
micromechanical interlocks at the resin–hybrid layer interface
Prof MA Fareed 16
Acid-etch Technique – Moist Dentin
Prof MA Fareed 20
Bonding Agents
https://multimedia.3m.com/mws/medi https://multimedia.3m.com/mws/me
a/276903O/3m-adper-single-bond-plus- dia/1275587O/3m-scotchbond-univer
adhesive-nanofiller-technology.pdf sal-adhesive-total-versatility.pdf
GIC – Classification Based on Usage
• Type I: Luting crowns, bridges, and orthodontic brackets
• Type II a: Esthetic restorative cements
• Type II b: Reinforced restorative cements
• Type III: Lining cements and bases
• Pit and fissure sealant
• Metal modified GICs (cermet, miracle mix) for core-build-up
• Resin modified GICs (compomer etc) for core-build-up, restoration
• Prevention of caries, have high F-ions (Fuji VII)
• Atraumatic restorations (Fuji VIII)
• Pedodontics and geadiatric (Fuji IX)
Dental Cements
https://www.gcindiadental.com/wp-conten https://www.gcindiadental.com/wp-content/upl
t/uploads/ifu/GC_Fuji_I_IFU.pdf oads/ifu/GC_Gold_Label_IX_IFU.pdf
Clinical Applications and Indication of GIC
• Used as liner / Base under composite restorations
• Sandwich technique (GIC followed by composite)
• Permanent restorations for primary teeth
• Luting cement for indirect restorations (crowns, inlays, veneers)
• Retrograde filling material after surgical endodontic treatment (RCT)
• Temporary/intermediate restorative materials for permanent teeth , or
• Fissure Sealant for permanent teeth (low viscosity)
• Root Caries Cervical Restoration (Class-V)
• Core bulid-up materials
• Atraumatic Restoration
GIC Modifications – Resin-modificed
(RMGIC)
• Conventional GIC are moisture sensitive and have low early strength
• Hybrid materials containing the properties of both GIC and composite
were developed (Hybrid ionomer, dual cure, tri-cure, compomers)
• The monomers in hybrid glass-ionomer cements make the cements
more translucent
RMGIC – Compositon and Setting Reaction
• Available in capsules, two-paste system, and powder/liquid system
which contain water-soluble polymerizable monomers in a liquid
• RMGIC Powder fluoroaluminosilicate glass particles, resin (bis-
GMA/HEMA), coupling agents (silanes), Initiators (light activation,
chemical or both), Benzoyl peroxide (Chem), Camphoroquinone (Light)
• RMGIC Liquid Poly(acrylic acid) and copolymers solution, PAA is
modified with methyl-methacrylate or HEMA, Light activators (diethyl
aminoethyl methacrylate
• Setting Reaction Dual-cure (acid-base and light activation setting
reaction) tri-cure (acid-base reaction, light-curing and chemical curing)
GIC + Composite = Compomer
• Compomer is available in a one-paste restorative system (water-free)
• Compomer, a combination of GIC and composite integrates the fluoride
releasing capability of GIC with the durability of composite
• Composition non-reactive inorganic filler particles, reactive silicate
glass particles, sodium fluoride, a polyacid-modified monomer (e.g., di-
ester of HEMA with butane carboxylic acid and photo activators.
• Setting reaction Set by a polymerization reaction, and then absorb
water from the saliva to initiate the slow acid–base reaction between
the acidic functional groups and silicate glass particles
• Compomer require a dentin-bonding because not self-adhesive (GIC)
Resin Cements
• Resin cements are low-viscosity versions of resin-based composites.
• Self-cured and dual-cured resin have two pastes (base and catalyst)
• Compositon matrix of methacrylate monomers (HEMA, 4-META, MDP),
dispersed fillers, silane coating on the filler particle surfaces.
• Acid-etching and bonding is required for most same as composite
• Not all resin cement systems require a bonding agent (self-etch system)
• Polymerization (Setting) Self-cure, light-cure or dual-cured (common)
• Used for cementing ceramic veneers and direct bonding of ceramic or
polymeric orthodontic brackets
• Most esthetic resin cements are light-cured as have better color stability
Dental Cements
https://www.prevestdenpro.com/wp-
content/uploads/2021/08/ENDOSEAL-1.pdf
https://www.prevestdenpro.com/wp-content/upl
oads/2021/08/MTA-Plus.pdf
Dental Cements
https://tgdent.com/product/tgtempfill-white/?print-
https://www.prevestdenpro.com/wp-
products=pdf&doing_wp_cron=1666767005.8547461
content/uploads/2021/08/ENDOSEAL-1.pdf
032867431640625
Thank you!
Prof MA Fareed 31