ISSN: 2320-5407 Int. J. Adv. Res.

10(06), 901-906

Journal Homepage: - www.journalijar.com

Article DOI: 10.21474/IJAR01/14968

DOI URL: http://dx.doi.org/10.21474/IJAR01/14968

RESEARCH ARTICLE
CURRENT ADVANCES IN DENTAL COMPOSITES- A REVIEW ARTICLE

Shweta Chaudhary and Siddhant Sachdeva

Intern, SGT University, Gurugram, Haryana.
……………………………………………………………………………………………………....
Manuscript Info Abstract
……………………. ………………………………………………………………
Manuscript History Dental composites have almost entirely replaced amalgam restorations
Received: 25 April 2022 in the recent times. Amalgam restorations were highly un-aesthetic and
Final Accepted: 27 May 2022 toxic to the human body. Dental composites prove to be an aesthetic
Published: June 2022 and biocompatible alternative to the dental amalgam. But however,
composite resins present with certain limitations such as inadequate
Key words:-
Dentistry, Dental Composite, Composite mechanical properties and wear resistance in contact areas, primarily in
Resin, Dental Material, Restoration restorations in posterior teeth, in contrast to dental amalgam. Therefore,
not entirely accepted in the dental profession, the continued
advancements of composite resins have broadened the scope of
acceptance into posterior restorations. This article presents a review of
new age composite resins with advanced properties.

Copy Right, IJAR, 2022,. All rights reserved.

……………………………………………………………………………………………………....
Introduction:-
"Composite" refers to a mixture. In materials science, a composite is a mixture produced from at least two of the
different classes of materials, i.e., metals, ceramics, and polymers. Dental composites are complex, tooth colored
filling materials composed of synthetic polymers, particulate ceramic reinforcing fillers, molecules which pro- mote
or modify the polymerisation reaction that pro- duces the cross-linked polymer matrix from the di-methacrylate resin
monomers, and silane coupling agents which bond the reinforcing fillers to the polymer matrix. Each component of
the composite is critical to the success of the final dental restoration. However, the most significant developments in
the evolution of commercial composites to date have been a direct result of modifications to the filler component.

Dental composites have been considered acceptable restorative materials for anterior applications for many years.
Their tooth-matching ability and lack of metallic mercury have caused them to be promoted as an adjunct to or
substitute for dental amalgam in the restoration of the posterior dentition. Though not universally accepted by the
profession, the continued "fine tuning" of composite formulations by dental manufacturers has produced acceptable
materials for more expanded use in the posterior dentition. These alterations have mainly involved the use of
radiopaque glass fillers that are capable of being ground or formed into very fine particle sizes, thus enhancing the
polish-ability and intra-oral abrasion resistance of the resultant composite. Favourable results from long-term
clinical trials demonstrate that when placed correctly, composites can produce aesthetic posterior restorations with
excellent longevity (el-Mowafy et ai, 1994; Taylor et al, 1994). However, there remain significant problems that
limit the usefulness of these materials in the routine practice of dentistry. Although one of the concerns relates to
what is perceived as a limited durability when the material is placed in occlusal contact, the most significant
problems relate to the excessive contraction accompanying intra- oral polymerisation of composite. It is likely that
the development of a new matrix polymer that undergoes zero or negligible curing contraction would be a major
step toward solving the majority of the difficulties involved in the use of dental composite.1

Corresponding Author:- Shweta Chaudhary 901

Address:- Intern, SGT University, Gurugram, Haryana.
ISSN: 2320-5407 Int. J. Adv. Res. 10(06), 901-906

Classification Of Composites:
Composites may be classified as;
1) Particle-reinforced
• Large Particles
• Dispersion Strength
2) Fiber-reinforced
• Continuous (Aligned)
• Discontinuous (Short), this may further be classified as:
• Aligned
• Randomly Oriented
3) Structural
• Laminates
• Sandwich Panels

Composition Of Dental Composites:

Dental composites consist of the following components,
• Resin Matrix-
It is the phase that polymerises to form a solid mass, which bonds to the tooth structure. It’s the weakest and the
least wear resistant phase. It absorbs water and helps to minimise the filler content. It comprises of,
a. Bis-GMA (bisphenol-A glyceril methacrylate)
b. UDMA (urethane dimethacrylate)
c. TEGDMA (triethylene glycol dimethacrylate)
If the composite is made up of just the resin metric, it’s called as Unfilled resin.

• FILLER PARTICLES- It is composed of,

a. Silica particles
b. Quartz
c. Glass (Ba, Sr, Zr)

If the composite is made up of the resin matrix and fillers, it’s called as Filled resin. Increase in fillers, increases the
mechanical properties of the dental composite.

• Coupling Agent-
They help to improve the physical and mechanical properties. Coupling agents form a chemical bond between the
filler particles and the resin matrix, therefore inhibiting leaching by preventing water from penetrating along the
resin-filler interface. Organosilane (bifunctional molecule), which is the coupling agent, its siloxane end bonds to
the hydroxyl groups on filler and the methacrylate end polymerises with resin.

• Optical Modifiers/Pigments-
They provide the opacity or translucency which is required to make the composites similar to the natural tooth
tissue. Generally, metal oxide particles such as titanium dioxide and aluminium oxide are present to provide
adequate opacity or translucency.

Properties Of Dental Composite Resins

Biocompatibility
Newly placed composite resins placed in deep restorations can release chemicals that can pass into the pulp through
dentinal tubules, causing an inflammatory reaction. Therefore, these tubules are required to be sealed by dentin
bonding agents or protected with a base or liner. Polished composite restorations are well tolerated by the
surrounding soft tissues, and very few individuals may be allergic to one or more of the components of the material.

Polymerisation shrinkage
In dental restoration, the dimensional stability of restorative materials plays an important role in the prevention of
micro-leakage at the tooth-restoration interface. The restorative material must remain dimensionally stable during
polymerisation and thermal and mechanical cycles. However, most composite resins do not meet this requirement,
and their dimensional stability is influenced by the polymerisation reactions of the matrix. The polymerisation
shrinkage of composite resins occurs following the conversion of monomer molecules to a polymer structure

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through the replacement of van der Waals spaces with covalent bonds, leading to a decreased free volume.2 The
polymerisation process and the magnitude of the volumetric shrinkage are influenced by the composition of the
restorative material. The magnitude of this shrinkage is influenced by factors such as the curing time, high
intensities of the curing light, the matrix composition, the filler content, and the concentration of photo-initiators in
composite resins.2

Strength
Composite resin posterior restorations are influenced by mechanical properties, such as fracture toughness,
compressive strength, flexural strength, wear resistance and diametral tensile strength.3,4 The variation in strength
between different composites may be explained by the differences in the chemical composition of the matrix, fillers,
and filler size and distribution.5,6 Thus, a reduction in size and increase in volume of fillers are directly proportional
to an increase in compressive strength and surface hardness.7,8

Wear
Composite restorations tend to wear faster than amalgam restorations. Filler content in composites has a direct effect
on rate of wear of composite. Composite restorations with lower volume of filler(flowable) tend to wear faster as
compared to more heavily filled composite restorations. Wear of the composite restorations can result from abrasion
by foods or toothbrushing. It is also caused by contact with opposing teeth during mastication or luxing.

Degree of conversion
The term 'degree of conversion' applied to resin composites, refers to the conversion of monomeric carbon-carbon
double bonds into polymeric carbon-carbon single bonds. Increasing the conversion results in higher surface
hardness, flexural strength, flexural modulus, fracture toughness, and diametral tensile strength. The wear resistance
is also known to be increased. This improvement in its properties may be because of increased cross-linkage.9
Composites, when photo-polymerised, exhibit an incomplete degree of conversion. Preheating the composite prior
to photo-polymerisation can increase the degree of conversion. Preheating has also been shown to increase the flow
and enhance the adaptation of the resin to the prepared tooth walls and, thus, potentially reduce micro-leakage.9

Thermal conductivity
Dental composites transmit hot and cold temperature much like the natural tooth structure. However, a low thermal
conductivity is desired for a composite restoration for efficient pulp protection due to variation in temperatures. The
thermal conductivity of composite is compatible with the teeth and lower than that of metal such as amalgam or
gold. It is therefore biologically protective material for the dental pulp.

Water sorption
Over time, the resin matrix absorbs water from the oral cavity. This water sorption is directly proportional to the
amount of resin content in the restoration. Water absorbed tends to softens the matrix which gradually degrades the
material. Water also causes some hydroscopic expansion of the composite over the first week after placement.

Radiopacity
Composite resins are composed of organic resins and reinforcing inorganic particles. To make the resin portion of a
composite radiopaque is challenging, as resins typically contain chemical elements with low atomic numbers, such
as hydrogen, oxygen, carbon or nitrogen. For this reason, composite resin manufacturers preferred to achieve
adequate radiopacity by incorporating radiopaque glass particles – such as barium, strontium and zirconia atoms, or
micro-fillers containing yttrium and ytterbium – into their formulations.

Bonding To Tooth Structure:

The enamel is about 96% inorganic hydroxyapatite crystals, 1% organic material and 3% water by weight 10. The
hard tissue of dentin is about 70 % inorganic hydroxyapatite, 20% collagen fibrillar network and 10% water by
weight 11. The dentin is interlaced with tubules containing cell processes from the odontoblastic layer in the pulp.
Bonding techniques must be refined to achieve strong, consistent, and long-lasting results to both surfaces. There are
two goals to bonding: 1) to obtain strong retention onto the tooth structure; and 2) to maintain an impervious seal of
the restoration against the tooth. Failure to maintain the seal can lead to hypersensitivity of the tooth and to recurrent
decay. The retention gained by the bonding procedures may allow the dentist to retain more complex fillings with
less cutting of un-decayed tooth structure.

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Bonding To Enamel:
The system for bonding to enamel was developed by Buonocore in the 1950s.12 This acid etch procedure requires
the preparation of the enamel surface with an acidic solution, usually about 37% phosphoric acid. The surface then
has altered surface tension and altered topography with enamel prismatic "tags" approximately 25 microns long and
5 microns apart.10, 13 An unfilled, low viscosity resin can be allowed to flow between these tags and then polymerise
to form a tight junction with the tooth enamel.14

The monomers used in the commercial enamel bonding systems have usually been that of the composite. Primarily
the systems have been based on BisGMA with significantly larger amounts of diluents such tri-ethyleneglycol di-
methacrylate.15 Other agents could be added to further reduce the surface tension of the liquid and increase the
efficiency of the flow into the enamel tags. This bonding technique offers strength of retention to the enamel16 and
significant resistance to leakage around the restoration.17

Bonding To Dentin:
Technology for bonding to dentin is currently going through significant changes and critical controversy. The
current systems rely on a multistep procedure. Generalisation of these procedures follow.
Step 1: etch the dentin with a mild acidic solution or agent to remove some inorganic material. Such procedures
produce a brush network of collagen fibers on the surface.
Step 2: a primer containing a monomer solvent system is applied and allowed to dry.
Step 3: an unfilled resin is applied to penetrate into the intricacies that have been impregnated with primer. This
unfilled resin is polymerised.

The major developments in this area have been led by Bowen.18

The primers have contained such monomers as N- glycidyl methacrylate (NPG-GMA), and pyromellitic acid
dianhydride-2-hydroxyethyl methacrylate (PMDM). Other systems include 4-methacryloxyethyltrimellitic
anhydride (4- META).19 The theory is that these primers carried in the solvent will penetrate wet dentin and produce
a hybrid layer containing collagen and resin.20 The acetone/alcohol solvent carries the monomer into the wet dentin
removing the water and evaporating. This leaves a monomer impregnated collagen network that allows the resin to
penetrate into the partially de-mineralisedstructure below the exposed collagen.21, 22.

The resin adhesive applied in the third step is primarily the enamel bonding resin systems with further modifications
by such monomers as 2-hydroxyethyl methacrylate. Though there are considerable variations in the results obtained
for bond strengths to dentin by many investigators, the newest systems are capable of producing bond strengths to
dentin comparable to that previously obtained for enamel.23 The ability to seal has been improved with these dentin
bonding systems to the point that some are claiming complete elimination of leakage. Studies on the theory that
elimination of any bacterial contamination removes any pulpal response suggest that these bioactive agents are
biocompatible.24 The stability of these bonds have as yet not been established. Earlier dentinal bonding mechanisms
revealed significant failure within one year.25

Should these bonds prove to have a long prognosis clinically then improvements in the properties of the composite
resin restorative system could make dental composite a superior direct filling material for any application in the
dentition.

Advancements In Composites:
Natural Fiber Polymer Composites
The evolution of fiber composites began when scientists discovered plastics, although natural resins were used as a
gluing material. During the 1900’s the synthetic plastics like vinyl, polystyrene, phenolic, and polyester were
discovered. However, plastics could not meet certain applications like load transferring parts of automobiles,
aircraft, sports equipment, wind turbine blades and so many; due to their low strength, therefore to enhance their
properties reinforcements were introduced. The first Fiber Reinforced Composite (FRC) was developed during
1935, but the major evolution of fiber composites during World War II because of the necessity of lightweight
materials. After the world war, during 1970s various resins and synthetic fibers were discovered which completely
changed the conventional material usage (Tsai and Hahn, 2018; Vinson and Chou, 1975). Synthetic fibers like glass,
carbon, and aramid fibers are the most common reinforcement material in the polymer composites because of their
exclusive mechanical behaviour in various applications (Edie, 1993).26

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Though synthetic fibers are attractive in their mechanical characteristics, they are non-bio degradable and create
more ecological problems (Harish et al., 2009). In search of alternatives for synthetic fibers and owing to the
availability, renewability, cost-effectiveness and high specific properties, the bio reinforcement natural fibers were
found to be a promising replacement for the synthetic fibers in preparation of Fiber-Reinforced Plastic (FRP)
composite materials (Abilash and Sivapragash, 2013; Burgueño et al., 2004).

Natural fibers possess low cost, density and weight, they are eco-friendly nature having less pollution and minimal
health hazards. The natural fibers are extracted from various parts of the plants like leaves, stems, fruits and seeds.
The biological, chemical, environmental, as well as economic properties of natural fibers can sufficiently improve
the last properties of the fiber composites and their usage in different modern applications. The degradability of
natural fibers would strongly support the recyclability characteristic of fiber composites which consequently
encourage the development of NFRP (Al-Oqla et al., 2017). The density of NFRP (1.2–1.6 g/cm3) is lower than
glass fiber (2.4 g/cm3), which prompts light-weight composites (Thyavihalli Girijappa et al., 2019).26

Polymer Rigid Inorganic Matrix Material (PRIMM)

This system is composed of a resin matrix and an inorganic ceramic component. Unlike in conventional composites;
in this system, the resin is incorporated into the fibrous ceramic filler network rather than including the filler
particles into the composite resin matrix. The filler mainly consists of Aluminium oxide, Silicon oxide glass
particles or barium aluminium silicate or strontium glasses. Further, colloidal silica ultrafine particles are also
incorporated to control the handling characteristics such as viscosity, resistance to flow, condensability and reduced
stickiness.27

Organically Modified Ceramic Oligomers (ORMOCER)

ORMOCER is an acronym for organically modified ceramics. They are considered to be molecule-sized hybrid
structures consisting of inorganic, organic copolymers. Organic reactive monomers are bound to inorganic –si-o-si-
network. These molecular hybrids consist of, for example, methacrylate-terminated chains grafted on to a central
cyclic poly-silioxane 2-3nm particles. These nanoparticles are dispersed on a molecular scale.28, 29 These are high
molecular weight, flexible, relatively low viscosity cross-linking molecules. The large spacing between crosslinks
resulting from curing produces a low-level polymerisation shrinkage, while the inorganic network provides abrasion
resistance through its glass-like structure and low water sorption due to its hydrophobicity.28, 29, 30

Self-Healing or Self-Repairing Composites

Materials usually have a limited shelf-life and degrade over time due to different physical, chemical or biological
stimuli. But researchers have developed materials which can repair themselves. The self-healing and self-repairing
composite is an epoxy-based system which contains resin-filled microcapsules. These microcapsules may be
destroyed and release the resin when the epoxy resin undergoes crazing. The resin subsequently fills these cracks
and reacts with a Grubb’s Catalyst that is dispersed in the epoxy composite. This may eventually polymerise the
resin and repair the crack.31

Stimuli Response Materials

These are also called “smart materials”. The properties of these materials essentially depend on external stimulus
such as temperature, pH, mechanical stress, moisture, etc., These composite materials release fluoride, calcium, and
hydroxyl ions into the surroundings of the filling depending on the pH. These materials release, especially when the
pH is less than 5.5, a significant number of ions than that at the neutral pH. Therefore, it provides additional caries
protection.31-33

Conclusion:-
Due to increased demand for aesthetics by patients, dental composite hassuccessfully managed to replace amalgam
as the restorative material for choice. However. it is also apparent that current formulations remain less than ideal in
terms of dimensional change during curing and long-term fatigue and fracture resistance. Current dental composites
have improved clinical performance in posterior restorations as compared to its previous predecessors.1 More
clinical research is required to develop new varieties of composites to combat against the existing limitations of the
same.

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