Composite Resins

September 18, 2007

Topics

Dr. Jorge Perdigo

Definition and evolution
Classification according to the particle size
Classification according to their clinical indication
Composite resins for universal use
Matrix systems for anterior composite restorations
Division of Operative Dentistry

Matrix systems for posterior composite restorations

www.jorgeperdigao.net

Finishing.
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1964

First commercial composite

What are composite resins made of?

Resin monomers
Mineral filler coated with coupling agent (silane)
Pigments
Initiators of polymerization (light initiation or chemical initiation)

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s
Pa
ck
ab
le

Composite used in 2002

Na
Hy nofi
br lled
id
s

M
icr
Na o-fi
lle
no
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fill
ed

Composite used in 1982

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Nanofilled composites
Average particle size = 20 nm
Clustered in larger particles

Hybrid composites
Average particle size <1 m
Blend of different sizes from 40 nm to >1 m

Duarte, Perdigo, Lopes, PPAD

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Filtek Supreme Plus, 3M ESPE

According to the NNI (www.nano.gov) "nanotechnology" involves all
of the following:
1. Research and technology development at the atomic, molecular or
macromolecular levels, in the scale of appr. 1 - 100

nanometers (0.001 - 0.1 m).

2. Creating and using structures, devices and systems that have
novel properties and functions because of their small and/or
intermediate size.
3. Ability to control or manipulate on the atomic scale.
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Size of nanoparticle in Filtek Supreme

0.02 m = 20 nm

Width of human hair

Volumetric shrinkage of 2.1% - lower than
some hybrids.

60-120 m = 60,000120,000 nm

Polish retention similar to that of microfilled

composites, better than that of hybrids
2 m = 2,000 nm

High resistance to toothbrush abrasion,

especially for the translucent shades
Short-term clinical studies in posterior
restorations show acceptable clinical behavior
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- Very good wear resistance

- Most only available in medium opacity (body)

- Mylar strips

- Have been used as universal composites for over

10 y with excellent results

- Free-hand (no band)

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Open contacts are frequent with posterior

composite restorations
Greenstein Instrument

?
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Matrices for posterior

composite restorations

This study evaluated the influence of the type of composite

('packable' vs conventional) and the matrix system on the
quality of the contact area in Class II composite restorations.
For the resin composite, no significant differences were noted
when Palodent was used.

- Tofflemire Ho-Band (ultra-thin Tofflemire)

Peumans et al. Dent Mater 2001 Nov;17(6):533-41

- Sectional band Palodent1 and Triodent2 V-ring

1 www.caulk.com
2 www.triodent.com
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Palodent with Bitine rings

Ideal conditions

V-Ring
9 Excellent isolation
9 Limited occlusal contacts
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9 Narrow class I or class II preparations

9 Margins on enamel
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Clinical behavior of hybrids

148 restorations in 123 patients

27 occlusal class I, 121 class II
140 restorations recalled at 2 years
5 restorations failed for sensitivity, 1
for marginal caries,1 for fracture
Success
of 95%QI Nov 2004
Lundin & rate
Rasmusson,

Z250 has the lowest wear

rate among several
composite resins

CRA, 2003
KUL, 2004

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Not material-related
A clinical study at the U of Minnesota in 60 posterior composite restorations found NO
differences in post-operative sensitivity between the self-etch adhesive Clearfil SE
Bond and the etch&rinse Prime&Bond NT at 2 weeks, 8 weeks, and 6 months.
All restorations were inserted under rubber-dam isolation.
Perdigo et al, JADA 2003

Prime&Bond NT vs. Clearfil SE Bond

100 posterior composite restorations. In 50 class II composite restorations a flowable
composite was used as the cervical increment
No difference in post-operative sensitivity at 2 weeks
Perdigo et al, Quintessence Int 2004

Multi-step rubber points

Multi-blade burs (8,12, 30 blades)

Fine aluminum oxide discs (Sof-Lex disks)

Fine diamond burs

Enhance - Coarse Finishing

Coarse aluminum oxide discs (Sof-Lex disks)

Aluminum oxide sandpaper strips

PoGo - Fine Finishing

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