Documente Academic
Documente Profesional
Documente Cultură
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INTRODUCTION
Humankind has always been plagued by the problem of restoring
parts of the body lost due to an accident or disease. The replacement
of lost teeth is desired for two primary reasons:
Esthetics
Restoration of function (partial or complete).
Restorative dental materials include noble and base metals, amalgam
alloys, cements, composites, glass ionomers, ceramics, denture base
resins, and other materials used in restorative dental operations.
Each material has several advantages and disadvantages.
To overcome the drawbacks of various materials, there has been
continuous research for the advent of newer and better restorative
materials.
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nanotechnology
The term nanotechnology was coined by
Prof. Kerie E.Drexler.
Nanotechnology is the engineering of
molecularly precise structures.
The prefix nano means 10
-9
or one
billionth of a unit.
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NANODENTISTRY
Defined as the science and technology of
diagnosing, treating and preventing oral
and dental diseases, relieving pain,
preserving and improving dental health
using nano-structured material.
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nanomaterials
Nanomaterials include nanoparticles,
nanoclusters, nano-crystals, nanotubes,
nanofibres, nanowires, nanorods,
nanofilms etc.
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Nanoparticles
Molecular units typically
defined as having diameters of
between 0.1 and 100 nm.
Represent the most
widespread use of nanoscale
units in dentistry.
They are currently being used
in resin-based composite
restorations (RBC).
Organosilanes such as
allyltriethoxysilane, have also
demonstrated good
compatibility with nanoparticle
fillers, such as TiO
2
.
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YbF
3
Nano particle
Mono-dispersed powders
produced by sol-gel reaction
Properties
Optical transparency
High radio opacity
Low shrinkage
Easy to polish
Safe for patients
Applications
Improving radio opacity for X-
ray diagnosis
YbF
3
lens
Filler for flowable composite
Barium glass & Strontium
glass
Homogeneous composition
Glass powder produced by
melting
Properties
Low optical opacity
High radio opacity
Easy to polish
Provides hardening and strength
Easy miscibility with resin
Fine particle size
Application
Composite filler
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Silver nanoparticles
Used as an alternative to dental filling agents.
The unique advantages of these nanoparticles are the anti wear;
antibacterial and antifungal properties enable their use in
restorative dentistry.
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Incorporating silver zeolite in endodontic filling
materials increases the material bactericidal effect
against some microorganisms.
Composite resins modified by microparticulated silver
revealed antiadherence activity and bactericidal
effect against S. mutans.
The application of nanoparticles to control biofilm
formation within the oral cavity, as a function of their
biocidal, antiadhesive, anti-inflammatory, antiviral, and
delivery capabilities, is worthy of serious consideration
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The bactericidal activity of silver nanoparticles has
been attributed to mechanisms such as the release of
Ag
+
.
However, according to Chaloupka et al. nanosilver has
intrinsic antibacterial properties that do not depend on
the elution of Ag
+
.
Silver causes bacterial membrane disruption probably
due to the production of reactive oxygen species,
including free radicals.
The active oxygen causes structural damage in
bacteria, which is called an oligodynamic action.
Membrane disruption allocates nanosilver particles into
cytoplasm causing subsequent damage of DNA and
other phosphorus containing compounds, impairing the
respiratory chain and cell division .
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Nanorods
Nanorods are of particular
interest in a restorative
context.
Since they are similar to
the enamel rods that make
up the basic crystalline
structure of dental enamel,
nanorods could contribute
to a practical artificial
approximation of such a
naturally occurring
structure.
Chen et al. have synthesized
enamel prism-like
hydroxyapatite (HA)
nanorods that exhibit self-
assembly properties.
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Nanospheres
Nanospheres are
explored in
restorative systems in
conjunction with
calcium phosphate
deposition and
amelogenin nanochain
assembly to mimic the
nanoprocesses already
inherent in natural
tooth development.
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Nanotubes
Titanium oxide
nanotubes have
been shown in vitro
to accelerate the
kinetics of
hydroxyapatite
formation, mainly in
a context of bone-
growth applications
for dental implant
coatings.
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More recently,
modified single walled
carbon nanotubes
(SWCNT) have been
shown to improve the
flexural strength of
RBC.
They have silicon
dioxide applied to
them in conjunction
with specialized
organosilane bonding
agents.
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Nanofibers
Polymer nanofibers
permit easier addition
of surface
functionalities compared
to polymer microfibers.
Polymer nanofiber
materials have been
studied as drug-delivery
systems, scaffolds for
tissue engineering, and
filters.
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More recently, nanofibers
have been used to generate
ceramics containing
hydroxyapatite and fluor-
hydroxyapatite.
Nanofibrillar silicate crystals
have also been recently
studied in the reinforcement
of dental composites.
Added in the correct
proportions and with uniform
distribution of the
fibers/crystals, nanofibers
have been demonstrated to
improve the physical
properties of these
composites
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Dendrimers and dendritic copolymers
Dendrimers and dendritic copolymers have been studied less
extensively than other nanostructures in relation to dental
composite applications.
Combinations of specific polymers to optimize efficacy of
restorative applications have been reported.
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Nano restorative materials
Various nanostructures are manipulated
together to either modify the existing
dental materials or produce the newer
better alternatives.
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Advances in amalgam
based on
nanotechnology
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A NEW DENTAL POWDER FROM
NANOCRYSTALLINE MELT SPUN Ag-Sn-
Cu ALLOY RIBBONS
A new non-gamma-2 dental powder has been developed
from nanocrystalline melt-spun Ag-Sn-Cu alloy ribbons.
The amalgam made from this powder exhibits
excellent properties for dental filling.
The nanocrystalline microstructure was found for the
first time in as-spun and heat treated Ag, Sn, Cu alloy
ribbons, using X-ray diffraction, scanning electron
microscopy and energy-dispersive spectroscopy.
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Structure
As-spun ribbons exhibited
a multi-phase
microstructure with
preferred existence of
(Ag
4
Sn) phase formed
during rapid solidification
(RS) due to
supersaturating of copper
(Cu) atoms and homogenous
nanostructure with
subgrain size of about 40-
50mm, which seems to be
developed during the rapid
solidification process and
can be caused by eutectic
reaction of the
Ag
3
Sn/Ag
4
Sn-Cu
3
Sn
system.
The cross-sectional and top-viewed OM
micrographs of as-spun Ti
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Ni
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ribbons.
(a) Cross-sectional view of as-spun
ribbons, (b) top view near the edge of as-
spun ribbons and (c) top view in the
middle of as-spun ribbons.
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In heat treated ribbons the clustering of Cu
atoms was always favored and stable in an ageing
temperature and time interval determined by Cu
content.
The heat treatment led to essential changes of
subgrain morphology, resulted in the appearance
of large-angle boundaries with fine Cu
3
Sn
precipitates and forming typical recrystallization
twins.
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Such a microstructure variation in melt-spun
ribbons could eventually yield enhanced
technological, clinical and physical properties of the
dental products.
Thus, using the rapid solidification technique a new
non-gamma-2 dental material of high quality,
nanocrystalline ribbon powder, can be produced.
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Advances in glass ionomer
cements based on nano
technology
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Nanoparticulated resin-modified
glass ionomer cement
Nanoionomer is the latest development in a
long history of glass ionomer technology
developed by 3M ESPE.
Nanoparticulated ionomer is the first resin-
modified glass ionomer cement with
nanotechnology, combining the benefits of
resin-modified light-cure glass ionomer
cement (RMGIC) and bonded nanofiller
particles.
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Advantages
Improved polish and aesthetics,
abrasion resistance, strength, optical
properties, and increased fluoride
release.
In addition, there is also less number of
voids, cracks, and microporosities on
the surface in nanoionomer than the
other ionomers available.
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Ketac N100 Light CuriNg Nano-Ionomer
Restorative
A nano-ionomer is an aesthetic, fluoride-releasing
restorative solution.
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Indications
Primary teeth restorations
Small Class I restorations
Class III and V restorations
Filling defects and undercuts
Laminate/Sandwich technique
Core build-up where at least 50% of
coronal tooth structure is remaining for
support
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composition
The nano-ionomer is based on the acrylic and itaconic
acid copolymers necessary for glass-ionomer reaction
with fluoroaluminosilicate (FAS) glass and water.
It contains a blend of resin monomers, BisGMA,
TEGDMA, PEGDMA and HEMA which polymerize via
the free radical addition upon curing and the primary
curing mechanism is by light activation.
The originality of this glass-ionomer cement is the
inclusion of nano-fillers which constitute up to two
thirds of the filler content (69 wt%).
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Nano fillers are further surface modified
with methacrylate silane coupling agents to
provide covalent bond formation into the free
radically polymerized matrix.
The fluoroaluminosilicate glass is radiopaque,
has particle size of less than 3 microns
Provides the basis for the glass ionomer
reaction and extended fluoride release in the
presence of water and a polycarboxylic acid
functional polymer.
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Contains combination of two types of
surface treated nanofillers (5-25 nm) and
nanoclusters (1.0 to 1.6 microns).
The methacrylate functionalized nanofillers
in this composition include those chemically
derived from both silica and zirconia.
The nanocluster fillers are loosely bound
agglomerates of nano-sized zirconia/silica
that appear as a single unit enabling higher
filler loading, radioapacity, and strength.
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Ketac Nano Primer
Ketac Nano primer is a one part,
visible light-cure liquid specifically
designed for use with Ketac Nano
restorative.
Comprised of the Vitrebond
copolymer, HEMA, water, and
photoinitiators.
The primer is acidic in nature.
Its function is to modify the smear
layer and adequately wet the tooth
surface to facilitate adhesion of Ketac
Nano restorative to the hard tissue.
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Ketac Nano primer is applied to the
surface for 15 seconds, and air dried.
The primer is then light cured for 10
seconds.
Adequately air drying followed by light
curing of the primer before placement of
Ketac Nano restorative provides adhesion
to tooth structure.
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Advantages
Easy to create a high initial gloss and
achieve a smooth final surface
Saving time in difficult to polish
situations such as Class V restorations.
Reduces waste, quick delivery of the
material and the right mix every time.
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Related studies
N100 and other glass-ionomer cements from
the Fuji family were compared but Ketac
N100 showed less porosities and surface
cracks than Fuji materials.
(Markovic et al 2008)
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A study on bonding orthodontic brackets
showed significantly lower shear bond
strength for Ketac N100 compared to a
conventional light-cure orthodontic bonding
adhesive (Transbond XT).
However, it has been suggested that this
nano-ionomer may be used for bonding
orthodontic brackets since the obtained shear
bond strength is within clinically acceptable
range.
(Uysal et al. 2009)
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Another study using the shear bond strength as
an adhesion parameter showed that Er:YAG
laser dentine pre-treatment results in lower
bond strength values compared to acid etching
or a combined acid-etching and laser pre-
treatment.
(Korkmaz et al. 2009)
A study on microleakage around Class V cavities
showed that Er:YAG preparation results in
greater microleakage than a conventional cavity
preparation with a bur when a nano-ionomer
(Ketac N100) and a nano-composite (Filtek
Supreme XT) were used as restorative
materials.
(Ozel et al. 2009)
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In a study by Leuven BIOMAT Research Cluster it
has been concluded that Ketac N100 bonded as
effectively to enamel and dentin as a conventional
glass-ionomer (Fuji IX GP), but bonded less
effectively than a conventional resin-modified glass-
ionomer (Fuji II LC).
Its bonding mechanism should be attributed to micro-
mechanical interlocking provided by the surface
roughness, most likely combined with chemical
interaction through its acrylic/itaconic acid
copolymers.
(Coutinho et al. 2009)
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Advances in composites
based on nano
technology
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Nanocomposites
Nanoproducts Corporation has
successfully manufactured non-
agglomerated discrete nanoparticles
that are homogeneously distributed in
resins or coatings to produce
nanocomposites.
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composition
The nanofiller used include an
aluminosilicate powder having a mean
particle size of 80nm and a 1:4 M ratio
of alumina to silica and a refractive
index of 1.508.
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Advantages
Superior hardness
Superior flexural strength, modulus of
elasticity and translucency
50% reduction in filling shrinkage
Excellent handling properties
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Filtek O supreme universal restorative
pure nano O
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PROPERTIES
Mechanical strength and wear resistance :
Provided by the filler particles.
Similar to hybrid composites.
Superior polish and gloss retention similar to microfill
composites.
Flexural strength:
Depends on the filler content and filler chemistry.
Flexural strength of nanocomposites were found to be
statistically equivalent or higher than those of the hybrid or
microhybrid composites and significantly higher than those of
the microfill composites.
Nanofill composites, which have higher filler loading, show
greater flexural strength than nanohybrid composites, which
have lesser filler loading.
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Polymerization shrinkage:
Low shrinkage due to the low shrinkage epoxy resin
and strong interfacial interactions between resin and
nanoparticles.
The volumetric shrinkage depends on the total
content of organic matrix of composites.
Nanohybrid composites (Grandio) showed least
amount of organic matrix (13.0 wt-%) and least
shrinkage when compared to nanofill composites
(Filtek Supreme Translucent), which had 30.0 wt-%
organic matrix.
Polymerization shrinkage also depends on the
chemistry of the organic matrix.
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Water Sorption:
Water uptake in the polymeric phase of composites
causes the solvent to extract unreacted components,
mainly monomer, resulting in shrinkage, loss of weight,
and reduction in mechanical properties.
Conversely, solvent uptake leads to a swelling of the
composite and increase in weight. The solvent
diffuses into the polymer network and separates the
chains creating expansion.
Nanohybrid composites show less water sorption than
nanofill composites.
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Wear and gloss retention:
The nano-sized primary particles in the nanoclusters
wear by breaking off individual primary particles
rather than plucking out the larger secondary
particles from the resin. Thus resulting wear
surfaces have smaller defects and better gloss
retention as that of a microfilled composites.
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Nanohybrid composite restorations
The evolution of composites initially created two families of
materials:
Microfilled composites :
Smaller particle fillers
Better polish retention
Enhanced aesthetics
Less strength.
Chosen primarily for esthetic-
driven anterior restorations.
Hybrid composites :
Larger particle fillers
Improved strength
Less polishable
Chosen for their durability for
posterior restorations.
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The latest generation of
nanohybrid composites,
combine the best of both
materials and create durable
restorations that maintain a
gloss shine for many years.
Important for maximized
esthetics, as well as reduced
plaque accumulation.
The clinical success of
hybrids, such as Tetric and
Herculite, has paved the way
for development of their
nanohybrid siblings.
These include Premise and
Herculite Ultra.
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Advantages
1) Minimal removal of tooth material: Adhesive properties allow
adding material to defective areas without the need for
additional preparation.
2) Expenses associated with lab fees and multiple appointments
increase the cost of lab-processed restorations. Direct
nanohybrid composite restorations, on the other hand, can
result in cost savings when provided in lieu of crowns.
3) Nanohybrid composite restorations are completed in one
appointment, this saves time and inconvenience required for a
separate cementation appointment.
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4) Can be polished to a high- gloss finish which
ensures optimum esthetics resembling natural
teeth with minimal plaque accumulation.
5) Ease of color matching maximizes esthetic
results. The material blends seamlessly into
the teeth being restored, showing no evidence
of the repaired area and without looking
prosthetic.
6) Nanohybrids create more tools to solve
multiple problems for patients. When stress
factors are favorable, immediate single-tooth
replacement can be accomplished with direct
composite bonding without the need to remove
additional tooth structure.
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Fusion Ceramfil
Aesthetic, syringeable, sculptable, radiopaque, highly
filled nano-hybrid composite for the restoration of all
teeth.
Cured at a wavelength of 400 - 500 nm (blue light).
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Fusion Ceramfil is
available in following
VITA shades: A1,
A2, A3, A3.5, A4,
B1, B2, B3, C2,C3
etc.
Packaging:
1 x 4g Refill packs
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The fillers consist of barium glass fillers,
radio-visible fillers and silicone dioxide with a
particle size between 0.04 and 3 m.
The inorganic fillers amount to a portion of
80% (w/w).
Methacrylates (22% w/w).
It comprises additives, prepolymer, initiators,
stabilizers and dyes (0.8% w/w).
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IndicationS
Universal inlay material for direct restoration
of cavities of anterior and posterior teeth
(also occlusal stress bearing)
Class III and IV anterior tooth inlays
Class V inlays (cervical caries, root caries,
wedge-shaped defects)
Class I and II posterior area inlays
Veneering for discoloured anterior teeth
Fixation of loose teeth
Fissure sealing in the molar and posterior area
Repair of composite and ceramics veneers
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Application
Colour selection: Prior to colour determination,
the tooth should be cleaned and polished and
the tooth be moist.
Cavity preparation
Pulp protection/lining: For very deep areas near the pulp,
introduce a calcium hydroxide preparation, then overlay
with pressure-resistant cement. The cavity walls should not
be covered since they will be needed for bonding with
enamel/dentine adhesive.
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Enamel
and
Dentine
conditioning
Bonding:
Follow the manufacturer's
instructions for the use of the
product applied. Application
of Fusion Ceramfil is introduced at
a layer thickness of no more than 2
mm and shaped using a suitable
instrument. Each layer is cured with
a light lamp for 40 seconds. In
doing so, the light conductor is held
as close to the material as possible.
If metal dies were used, the buccal
or lingual/palatinal sides,
respectively, should be light-cured
once more after removal of the die
Completion of the
restoration:
After light-curing, excess
material is removed using
suitable finishers or fine
diamond grinders. Control
occlusion and articulation
and adapt if necessary.
Finally, polish to high gloss
using silicone polishers,
disks or stripes
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Storage
Do not use Fusion Ceramfil after
the indicated date of expiration.
Storage temperature (28 C / 82
F).
Close syringe immediately after
use.
Store material protected from
light.
Shelf life: see date of expiration.
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If necessary, Fusion Ceramfil may be
applied directly to cured material. If the
inlay has been polished before, it should
be roughened first, and bonding should be
applied to the surface prior to applying
new Fusion Ceramfil.
Fusion Ceramfil should be used at room
temperature only (not at temperatures
exceeding 28 C). At lower
temperatures, the material is more
difficult to squeeze out.
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Ormocer
Acronym for organically modified ceramics.
Represents a new technology based on Sol gel
synthesis using particles comprising silicones organic
polymers and ceramic glass.
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Ormocer