DIRECT AESTHETIC RESTORATIVE MATERIALS

Dr.Eglal Galal
 REQUIREMENTS
• For a filling material to be used to restore an anterior teeth , it should have the
following requirements:
• It should match the tooth in color, and not stain or discolored by time.
• It should not dissolve in saliva or in fluid taken by mouth
• It should not be irritant to the bulb or to the gingiva
• It should have adequate mechanical properties to withstand the forces of
mastication
• It should have coefficient of thermal expansion similar to that of enamel and dentin
• It should undergo minimal dimensional setting
• It should take and retain a smooth surface finish
• It should be radiopaque to enable to detection secondary caries
• Ideally adhesion between the filling material, enamel and dentin should occur
 DIRECT AESTHETIC RESTORATIVE MATERIAL
• Silicates
• Unfilled acrylic polymer
• Composites
• Glass ionomer restoration
 Silicates
prepared from alumina-silica glass powder
and phosphoric acid liquid.
Advantage :
an anticariogenic feature,
Disadvantage :
1. dissolution in oral fluids,
2. loss of translucency,
3. surface crazing,
4. and a lack of adequate mechanical
properties.
Unfilled acrylic resin
unfilled, low molecular weight polymers and
lacked the reinforcement provided by the
ceramic filler particles
Disadvantage:
• dimensional instability,
• resulting in stains and often recurrent caries.
• Thermal dimensional change
 COMPOSITE
• To overcome the drawbacks of silicate and acrylic resin materials ,
composite restorative materials come out in early 1970s.
• A composite: is a combination of two or more chemically different materials
with distinct interface separating the components and having properties
which could not be achieved by any of components alone.
• In dentistry , the term composite referred to resin restoration. Which contain
two principle phases:
• An inorganic filler dispersed in
• Resin matrix that induce polymerization
 COMPOSITION

• Resin matrix O
CH3
O

• Inorganic filler CH2=C-C-O-CH2CH-CH2O -C- OCH2CHCH2O-C-C=CH2

• glass CH3 OH CH3 OH CH3

• quartz
• colloidal silica
• Coupling Agent
• Initiator
• Inhibitors
• pigments
 ORGANIC MATRIX PHASE( POLYMER
MATRIX)
A- High molecular weight monomer (oligomer):
 Either Bisphenol A-glycidyl methacrylate (BIS-GMA)
 Or urethane dimethacrylate (UDMA) . Or mixture of both
UDMA are superiorto BIS-GMA by:
1. Lower viscosity
2. Lower water sorption
3. Grater toughness
4. Greater susceptibility to visible light curing.
B- Diluent :
is a lower molecular weight monomer used to decrease the viscosity of oligomer to
allow incorporation of more organic filler, enable proper blending with the inorganic
filler and facilitate cilinical manibulation . E.g diethylene glycol dimethacrylate or
triethylene glycol dimethacrylate
• These oligomer products are superior to methelmethacrylate monomers by:
I. Lower polymerization shrinkage (due to higher molecular size)
II. Lower volatility
III. More rapid hardening
IV. Production of stiffer and stronger resin due to higher molecular weight and
more cross-linkage.
 INORGANIC FILLERS
• Crystalline quartz
• larger particles
• not polishable
• Silica glass
• barium
• strontium
• lithium
• pyrolytic
• sub-micron
Recently : calcium fluoride has been used as filler
 ROLE OF INORGANIC FILLERS
1. Improve in mechanical properties such as compressive strength ,modulus
of elasticity and hardness. High concentration chive good mechanical
properties
2. reduction in coefficient of thermal expansion
3. Glass is able to reflect color of surrounding tooth material.so fillers
contributes to aesthetic
4. Redaction on the polymerization shrinkage
5. Less heat evolve in polymerization
6. The composite is radiopaque if the barium and strontium glass are used

The filler particle size, shape and distribution have an important effect on the properties
 COUPLING AGENT
• Coupling Agent: is the chemical compound that have tow functional
groups: An inorganic group that react with the filler And organic group that
react with the organic matrix. Thus the filler and matrix are coupled.
• function of coupling agent:
1. Improve the mechanical properties of composite by transferring the stress
from the weak resin to the stronger filler.
2. Reduce early loss of the filler particles caused by penetration of water
between the resin and filler

CH2 OH
Bis-GMA CH3-C-C-O-CH2-CH2-CH2-Si-OH
Bonds with resin Bonds with filler
O OH
Silane
 OTHER COMPOSITION
1-Initiator – activator system
a. Chemical activation : Benzoyl peroxide (intiator) activated by Tertiary
amine
b. light activation :diketone such as benzyl or camphorquinone (intiator ) and
amine initiator activated by visible blue light of wave length 470nm
The advantage of visible light than ultraviolet for activation :
1. Ultraviolet light has limited depth of polymerization than visible light
2. Potential harmful effect of ultraviolet light such as skin cancer and eye
damage
• Advantage of light cured materials over chemical cured resin:
1. Light activate materials are single component paste that required no mixing, thus eliminating
human variables
2. Commend setting time
4-polymerization inhibiters:
• Prevents spontaneous
polymer formation
• Extends shelf life
• E.g. hydroquinone
5-Pigments and UV Absorbers
• Pigments
• metal oxides
• provide shading and opacity
• titanium and aluminum oxides
• UV absorbers
• prevent discoloration

6-Fluorescent agent
 CLASSIFICATION OF COMPOSITE
• According to partials size, shape and distribution
type Range of % by Properties
particle size weight
(µm) of filler
Large particle 20-35 78 Difficult to polish surface roughness, may
(conventional) attract plaque , good mechanical
properties
Fine particle 0.5-3 70-86 Good mechanical properties with superior
finishing and polishing characteristics than
above
microfilled 0.04-0.2 25-63 Easy to obtain and maintain smooth
surface, mechanical properties are
poor,wear resistance poor, grater
shrinkage and more absorption of water
hybrid 0.04 and 1-5 77-88 Developed in an attempt to obtain the
benefits of both types
• According to the method of activation
1. Chemically cured materials
2. Light cured materials
3. Dual cured resin composite : polymerized by both mechanisms
 PROPERTIES OF COMPOSITE
• 1- biological consideration :
• Pulpal irritation due to the free monomer. So
• good seal of deep cavity and high degree of curing is importance to
decrease the free monomers
• 2-Solubility : very low solubility
• 3- water sorption : is less than unfilled acrylics due to
1. Higher molecular weight and more cross linked of BIS_GMA or UDMA
2. Good adhesion between polymer matrix and fillers
4- thermal properties:
a. Thermal conductivity
b. Coefficient of thermal expansion
Natural tooth 11x 10 -6 microfile 55-68 x10 hybrid 25-38 x 10 -6
• 5- polymerization shrinkage : is the function of organic matrix (as it nature of
polymer), so the composite with more organic matrix has more
polymerization shrinkage.
• Lead to: formation of polymerization stresses between composite and the
cavity of tooth.
• Theses stress can lead to failure of the interfacial bond between the
composite and tooth leading to formation of very small gap. That lead to
• marginal leakage
• secondary caries formation
• post-operative sensitivity
• To reduce this ,by:
• use lower shrinkage composites
• incremental placement of composite
• Obtaining strong bond between composite and tooth
• Composite inlay
• 6-mechanical properties:
• Compressive and tensile strength , modulus of elasticity and hardness are
more in fine and hybrid composite than microfine composite
• Composite wear: is a complex phenomena involving abrasion, attrition and
erosion. It reduced with smaller particles and higher filler load
• 7-Aesthetic and optical properties
• Composite material are translucent materials which can match the color of
teeth and have good aesthetics
• The aesthetic can be change by:
• Roughness of surface due to wearing of polymer phase and then dislodge of
filler particles .
• Cracks of polymer
• Debonding of filler as result of hydrolysis
• 8-bonding and retention to tooth structure: through bonding system
• Enamel
• Dentine
• basic Steps of bonding (tissue conditioner ):
• Acid etch (phosphoric acid 35%)
• Priming : bifunctional group , hydrophilic improve witting dentine and
hydrophobic group witch reacts with resin
• Bonding unfilled polymer (BIS-GmA) or UDMA
 RECENT CLASSIFICATION OF BONDING SYSTEM

Bonding system

Total etch Self etch

3steps: 2steps:
2 steps: 1 step:
Etching Etching
Acidic primer Etching/primer/
Priming primer/bonding
bonding bonding
bonding
 COMPOSITE APPLICATION
• Anterior/stress (Class 4)
• Hybrid
• nanocomposit
• Anterior/non-stress (Class 3 or 5)
• hybrid
• Microfill
• Posterior
• Hybrid
• nanocomposit
 RECENT ADVANCE IN COMPOSITE
RESTORATION
• Modification on organic matrix to reduce the polymerization shrinkage:
1. Ormocers: they are polymeric inorganic-organic hybrid
materials(inorganic polysiloxane are chemically bound to organic
methacrylate group)
2. Silorane : the polymerization reaction by ring opening reaction
• Modification on inorganic fillers:
• Nanocomposite:
 NANOFILLED COMPOSITE
• Filler particles
• filled: 78% wgt
• nanomers
• 0.02 – 0.07 microns Hybrid Microfill Nanocomposite
• nanocluster
• act as single unit
• 0.6 – 1.4 microns
Properties:
• Trance lucent materials
• Low polymerization shrinkage
• Good mechanical properties as hybrid
 COMPOSITE VARIANTS
• Packable
• Flowable
 QUIZ
• Give reason :
• The denture base is putted in plastic bag filled with water after processing