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There are several classification of filling materials. Depending to which group the tooth belongs, filling materials are distinguished: For front group of teeth( filling materials should correspond to high esthetic requirements); For molars and premolars (filling materials should stand high occlusion press)
According to the material from what restorative materials are produced, they are divided into:
Separate group of filling materials consist from adhesives, sealants, varnishes. Its not filling materials, but dentist cant work without them. From the point of view of functionality and peculiarities of their usage in the clinic, all filling materials are divided into 2 groups: 1. Restorative (should provide complete restoration of the shape of the tooth, and also renew the function of the tooth for long time); 2. Curative-prophylaxis (should have good curativeprophylaxis qualities).
Available materials
The direct restoratives in current, general use are amalgam, composite, glass - ionomer cements and combinations of the last two groups
Dental amalgam
Dental amalgam is a mixture of mercury and an alloy containing silver and tin with added copper and zinc. The alloy and mercury are held together in a capsule, with the two components separated by a plastic diaphragm. When the diaphragm is broken and the capsule is placed in the mixing machine (amalgamator), the two components are mixed together (triturated) to form a silver-coloured paste. This paste is then condensed into the cavity. This is a very important stage: well-condensed amalgams are stronger than poorly condensed ones, as more of the weaker, mercury-rich 2-phase is removed during carving. Amalgam is weak in thin section so cavities have to be cut suitably deep (2 mm) and because amalgam does not adhere to tooth tissue, the cavity must be undercut.
Resin composites
Resin composites used in dentistry have several components: Resin matrix: commonly a uid monomer, BisGMA. Filler particles of silica-based glass. Silane: an agent that allows the resin and ller particles to bond together. Activator for the setting reaction: normally camphorquinone. Pigments.
Direct resin composites are the material of choice for anterior restorations and they are increasing in use and popularity for posterior restorations, mainly because of their appearance. Composites do not adhere directly to tooth tissue and rely on the acid-etch technique and the use of dental adhesives for adhesion to enamel and dentine.
Light curing
Light curing of resin composites is initiated by light in the wavelength range 450500 nm. This blue light can damage the eyes so an orange lter should be used when the light is in use. The tip of the light source should be placed as close as possible to the surface of the restoration and each increment of composite should be cured for 4060 seconds. Under-cured composites will readily absorb stain and will rapidly degenerate.
Polymerisation shrinkage of the resin during curing (in the order of 23%) still occurs and may contribute to marginal defects, cuspal distortion and crack formation in the enamel or dentine, and may therefore contribute to postoperative pain or sensitivity for the patient. There are, however, a number of clinical techniques available to overcome these problems and the longevity of restorations using the newer resin composites is much improved over that of the original materials.
Reducing the effect of polymerisation shrinkage may be achieved by incremental packing of the composite. Each increment should touch as few walls of the cavity as possible . The stress induced by polymerization shrinkage is highest in cavities with more bonded than unbonded surfaces: the occlusal cavity has the potential for the most stress.
Glass ionomers
Glass ionomers contain poly(alkenoic) acid and uoroaluminosilicate glass which set by an acidbase reaction to give a cement. They adhere directly to tooth substance and to base metal casting alloys. They release uoride after placement, giving the materials cariostatic properties, although this may only be short term.
They also have a low tensile strength which makes them brittle and unsuitable for use in load-bearing areas in permanent teeth. They are used as lining and luting materials and to restore abrasion and erosion lesions, cervical lesions and deciduous (primary) teeth and as interim restorations. It must be appreciated, however, that they are less translucent than resin composite restoratives and therefore their appearance is less acceptable.
Resin-modied glass ionomers have a resin (monomer) component as well as the poly(alkenoic) acid and uoroaluminosilicate glass of conventional glass ionomers. They set by two mechanisms: acidbase reaction and curing of the monomer (chemically, by light or both). They have improved appearance and physical properties compared with conventional glass ionomers. They are used in similar situations to glass ionomers and may also be used for small core build-ups.
Acid etching
Acid etching with phosphoric acid creates pores within the enamel into which resin ows to create tags. This micromechanical retention is very reliable unless there has been contamination of the etched surface by saliva or blood. This technique is used to retain ssure sealants, composite restorations, orthodontic brackets, resinretained bridges, veneers and other tooth-coloured restorations.
There is some merit in etching preparations prior to placing a sealer, liner or base, as etching will remove the smear layer which is contaminated with bacteria. Removal of the smear layer in this way affords gross debridement of the preparation and will also improve the quality of the interface between the sealer/liner and the dentine substrate.
Dental adhesives
Bonding to dentine is more difcult than bonding to enamel as, unlike enamel, dentine contains water and has a greater proportion of organic material. Bonding to dentine may be achieved reliably with current systems which involve between one and three steps and which either remove or modify the smear layer (this is a layer of debris created by cutting through dentine). The bond to dentine is a combination of chemical and micromechanical bonding.
Liners
Preparation liners also seal freshly cut dentine but have additional functions, such as adhesion to tooth structure, uoride release and/or antibacterial action. Preparation liners are applied in thin section (<0.5 mm) and materials currently used include RMGICs, dentine adhesive systems, owable resin composites and hardsetting calcium hydroxide cements.
To assess the prognosis of the tooth and/or pulp. To prevent drifting, over-eruption, tilting or gingival overgrowth. For caries prevention: by using a uoride leaching material, such as glass ionomer.
How long the temporary restoration is to be in place: this depends on the wear characteristics of the material used.
The choice of eventual restoration: eugenol plasticizes composite resin restoratives so there is a risk that any eugenol remaining from the temporary restoration could adversely affect a subsequent composite resin restoration, although recent research suggests this is not a problem.
It should also have an acceptable colour, taste and smell and be cheap and readily available. It is essential that it is easy to remove and is compatible with other materials.
Choice of material
This depends on: The size and shape of the cavity: a self-adhesive material such as a glass ionomer may be required if the cavity has no inherent retentive form. The position in the mouth: tooth-coloured material should be used for anterior teeth. Stronger materials should be used for the occlusal surfaces of posterior teeth.
Available materials
and easy to insert and remove, but are unaesthetic, lack compressive strength and the taste is sometimes considered unpleasant. Polycarboxylates. Glass ionomers. Light-cured polymers.