Restorative

Resin
Composites
For Direct Restorations

Dr. ANIL KUMAR M

Senior Lecturer
Department of Conservative Dentistry and Endodontics
Composite !!! What does it mean?
• Materials made up of 2 /+
distinct, chemically different
phases
• The resulted material
(composite) combine the
properties of the phases
included

Examples
• Jell-o & fruits
• Concrete
• Tooth enamel and dentine
• Resin composite
Dental Resin
Composites
 Dispersed phase
(fillers)

Matrix
phase Coupling
phase

1. Organic phase (matrix) 1. Polymerization-

2. Inorganic dispersed associated additives
phase (fillers)
3. Coupling phase
+ 2. Coloring additive
3. Ultraviolet stabilizers
4. Radioopacifiers
 Organic Phase (Resin Matrix )
1. Monomer system
- BIS-GMA or UDMA. (viscous monomers)
- Silorane resins (in the most recent, minimal-shrink
type)
• Diluents
1.TEGDMA & HEMA

Function
1.Hold all ingredients in one mass
2.Able to polymerize (Responsible for material’s setting )
3.Accept pigments (Responsible for material’s color )
4.Responsible for the setting contraction
 Dispersed Phase (Fillers )
1. Inorganic fillers
- Quartz, glass, barium and lithium
alumino-silicates, barium fluoride
- Zinc (Zn), Boron (B), zirconium (Zr)
and yttrium (Y) ions are added to
produce radioopacity

• Pre-polymerized organic fillers

- Ground resin composites Function
  Mechanical Prop.
  Wear resistance
3. Alternative fillers   Coeff. of th. Exp.
- fibers, tri-modal, non-slumping fillers,   Poly. shrinkage
fluoride-releasing – Nano-sized
fillers
Classification based on fi ler size and loading
Types Filler size Filler load
Traditional types
1.Macro-filled 8-12 µm 75-80 wt%
2.Small particle 1-8 µm 70-85 wt%
3.Hybrid 0.4-1 µm 70-75 wt%
4.Micro-filled 0.04-0.4 µm 50-60 wt%

Macro-filled Small-particle Hybrid Micro-filled

Recent types
5. Nano-hybrid 0.02-2.5 (Av 0.6) µm 70-75 wt%
Properties of traditional Composites

Property Traditional Microfilled Small P. Hybrid

Compr. strength (MPa) 250-300 250-300 350-400 300-350

Tensile strength (MPa) 50-65 30-50 75-90 70-90

Elastic Modulus (GPa) 8-15 3-6 15-20 7-12

Coeff .Th. Exp. (10-6/ºC) 25-35 50-60 19-26 30-40

Knoop Hardness 55 5-30 50-60 50-60

Anusavice K. Phillip’s Science of Dental Materials 2003

Quoted from: Deliperi S, Bardwell d. J Am Dent Assoc. 2002; 133:1387-1398
Quoted from: Deliperi S, Bardwell d. J Am Dent Assoc. 2002; 133:1387-1398
 Coupling Phase
1. Vinyl triethoxy silane (vinyl silane)
•γ-Methacryloxy propyl trimethoxy Silane

Mechanism of attachment
2. They are composed of bi-functional molecules
3. The silane group chemically bonds to the inorganic materials
4. Both the ethoxy and methoxy groups react with resin molecules of
the matrix

Function
  The water uptake
  The solubility rate
  The crack propagation
Bonding of fillers to resin matrix
 Polymerization associated
additives
 Polymerization initiator…..
1. Benzoyl proxide in case of chemical and heat-cured
materials
2. Camphroquinon in case of light-cured materials

 Polymerization activator…Tertiary amine in case

of chemically-cured materials

 Polymerization inhibitor… (hydroquinon) prevents

material’s polymerization on storage
 Other Additives
• UV stabilizers… (2-hydroxy-4- methoxy
benzophenone) Provide color stability under
electro-magnetic waves

• Coloring agents (Pigments)…. To provide

materials with different shades
Chemically-Cured Composite
 COLD CURING/SELF CURING

SUPPLIED AS:

SELF CURE

BASE CATALYS
T

TERTIARY
AMINE BENZOYL
PEROXIDE
: N-N DIMETHYL-
P-TOLUDIEN
Light-cured composite
 LIGHT CURING/PHOTOCHEMICALLY
ACTIVATED RESIN

UV LIGHT CURED VISIBLE LIGHT CURED

UV LIGHT CURED:
USED BEFORE.

LIMITED PENETRATION OF LIGHT INTO RESIN.

LACK OF PENETRATION THROUGH TOOTH

STRUCTURE

CAUSED DAMAGE TO RETINA

VISIBLE LIGHT CURED:

SINGLE PASTE

PHOTOINITIATOR AMINE ACCELARATOR

CAMPHORQUININONE DIMETHYLAMINOETHYL-
METHACRYLATE
0.2 WT%
0.15 WT %
 POLYMERIZATION

Exposure to
Photosensitizer Addition
light Excites Free radicals
reacts with polymerization
(Wavelength photosensitizer formed
Amine starts
400-
500nm)
 FACTORS INVOLVED IN
PHOTO CURING
LED LAMPS

CURING LAMPS
QTH LAMPS

DEPTH OF CURE PAC

FACTOR AND LAMPS
S EXPOSURE
TIME
ARGON LASER
LAMPS

SAFETY
PRECAUTIONS
•Hand held devices which contain the light source and have a rigid light guide
made
up of fused optical fibers.

•The most widely used light source is QUARTZ bulb with a Tungsten filament in a
Halogen enviroment.

•Four types of lamps are used: 1.Light emitting Diode lamps (LED)

2.Quartz-tungsten-halogen (QTH) lamps

3.Plasma arc curing lamps (PAC) 4.Argon laser lamps

 LED lamps
 These light sources emit radiation only in the blue part of the visible spectrum between
440 and 480 nm

 do not require filters

 LEDs require low wattage,can be battery powered,generate no heat and are quiet
because a cooling fan is not needed.

 Produce lowest intensity radiation

 The latest versions utilize two or more LED units to increase intensity and extend
wavelength range
 Quartz-tungsten-Halogen (QTH) lamps

QTH lamps have a quartz bulb with a tungsten filament that irradiates both UV and
white light

Must be filtered to remove heat and all wavelengths except those in the violet blue
range (~450 to 500 nm)

Intensity diminishes with use.

 Plasma arc curing (PAC) lamps

 Use ionized xenon gas to produce plasma

 High intensity white light is filtered to remove heat

 Blue light is then emitted (400-500nm)

 Argon lamps

 Highest intensity

 Emit at a single wavlength

 Emit wavelength of 490nm.

A curing lamp with wavelength matching the absorbance range of
photoinitaiator must be selected.

Critical concentration of free radicals must be formed to initiate

polymerization

Intensity decreases with distance so lamp tip must be placed at

minimum
distance through out exposure interval

Curing angle should be 90 degrees to resin surface to deliver maximum

intensity

Lamp intensity should be evaluated frequently.

 DEPTH OF CURE AND EXPOSURE TIME

•Amount of photons absorbed by initiator depends on

Wavelength Light intensity Exposure time

•For maximum curing radiant energy influx should be 16,000 mJ/cm2

•Light absorbtion and scattering in resin composites reduce the degree of

conversion and depth of penetration so exposure time should be increased.

•Curing depth should be kept 2-3mm

•Exposure time depends on the intensity of curing units.

•Higher the intensity lesser will be the exposure time

•Light attenuation varies for different composites so manufacturers instructions
should be followed.

To maximize the degree of polymerization and clinical durablity clinician should

adjust curing time and curing technique to intensity of light source.

Light is also absorbed and scattered as it passes through tooth

structure especially dentin ,causing incomplete curing so in
critical areas like proximal box so here the exposure time must
be increased to compensate for reduction in light intensity
Combination of light cure and self cure composites
dual-cure resins are commercially available and consist of two light-
curable pastes

One paste contains benzoyl peroxide and other

contains aromatic
tertiary amine.
Chemical curing occurs by mixing the pastes and is accelerated
on command with the light source
light curing is promoted by the amine/CQ combination

and chemical curing is promoted by the amine/BP interaction.

Dual-cure materials are intended for any situation that does not allow
sufficient light penetration to produce adequate monomer conversion, for
ADVANTAGE:
•Complete curing throughout is the advantage

DISADVANTAGE:
•Porosity

•Colour instability
•Light emiitted by curing units can cause retinal damage.

•Never look directly into light tip and reflected light for longer periods

•Wear protective eye glasses and shields that filter light both for operator and
patient.
PROPERTIE
S
Light cured composites:

 Composite may appear to be fully hard and

cured after curing by light source,but curing
reaction continues for 24 hours.

 Degree of conversion is 75 %

 Prematurepolymerization can occur with 60-

90 seconds of exposure to the ambient light.
 Degree of conversion/Degree of
cure /Degree of monomer to polymer
conversion
•Percentage of carbon carbon double bonds
converted to single bonds during curing to
form a polymer resin

•Higher the DC greater is the strength,wear

and other properties
Conversion of monomer to polymer depends on
several factors like:

1.Resin composition

2.Transmission of light through material

3.Concentration of Sensitizer,initiator and

inhibitor

4.Lamp intensity

5.Absorbtion through composite 6.Scattering

through composite
 2.POLYMERIZATION
SHRINKAGE
 The normal range of curing shrinkage is 1.5
to 4 vol % 24 hours after curing

 Composites with a high filler loading shrink

less


3.POLYMERIZATION SHRINKAGE STRESS
Curing

Spacing between
monomers reduced

Polymerization
shrinkage

Unrelieved stresses
in resin

Stresses may break

interfacial bond

Microleakage
The polymerization shrinkage and stress
affected by:

 1.Totalvol of composite
 2.Type of composite

 3.polymerization speed

 4.C-Factor
 1.Incremental build up and cavity
configuration
CONFIGURATION FACTOR (C-Factor)
•Is the ratio between the bonded surface areas of
a resin based composite restoration to the non-
bonded or free surface area

•Bonded surface/non bonded surface = C factor

• Residual polymerization stresses increases directly with this ratio.

• During curing, shrinkage leaves the bonded cavity surfaces in a state of

stresses

• The non bonded ,free surfaces release some of the stresses by

contracting inwards towards the bulk of material

• A layering technique in which the restoration,is build up in

increments ,curing one layer at a time efficiently reduces
polymerization stresses by minimizing the c factor

• The thinner layer lower the bonded surface and maximize the non
bonded
surface area.

ADVANTAGE

• This technique overcomes the limited depth cure and residual stress
concentrations

DISADVANTAGE
2.Soft start,ramp curing and delayed curing

 Photo-polymerization stress buildup

inspired by chemical initiation by
providing an initial low rate of
polymerization thereby extending the
available time for stress relaxation before
reaching gel point .
 SOFT START

 In this technique curing begins with a low

intensity and finishes with high intensity

SLOW INCREASED GELATION POINT INCREASE

POLYMERIZATIO STRESS INTENSITY TO
REACHED
N INITIALLY RELAXATION MAXIMUM
 Ramped curing and delayed curing
 Variations of soft start

RAMPING CURING:

 The
intensity is gradually increased or
ramped up during exposure.

 Consistof either stepwise, linear or

exponential modes
Delayed
curing:
CONTOUR SECOND
LOW INCOMPLETE AND EXPOSURE
INTENSITY CURING SCULPTING FOR FINAL
RESIN CURE

 Delay allows substantial stress relaxation to

take place.

 The longer the time period available for

relaxation the lower the residual stresses.

 Delayed and exponential ramp curing appear to

provide the greater reduction in curing stress.
 4.COEFFICIENT OF THERMAL
EXPANSION
 Linear coefficient of thermal expansion of
composite ranges between 25-30 x 10-6 /℃ and
55-68 x 10-6 /℃

 Large differences between CTE of tooth and

composite causes expansion and contraction
resulting in stress

 Filler loading is the only way to reduce the

CTE.
 5.WATER
SORPTION
 Water sorption may occur when:

1.Material may have a high solublity rate.

2.Resin may contain voids
3.Hydrolytic breakdown of the bonds between
fillers and resin

 Water sorption can decrement the longetivity of

the restorations.
6.SOLUBILITY
 Inadequate light intensity and duration
especially in deeper areas causes incomplete
polymerization and increased solublity.

 ADAspecifies solublity should be less than or

equal to 7.5 µg/mm

 Highervalues lead to reduce wear and

abrasion resistance.
 7.RADIO
OPACITY
 Radio opacity is to check the integrity of resin

 Radioopacity can be provided by glass

ceramics with heavy metals like Ba,Sr and Zr

 Not chemically inert

 8.COLOUR
STABILITY
 Esthetics is the major factor for use of
composites

Discolouration can be; 1.Marginal

2.Surface 3.Bulk
 1. Marginal discolouration

 May occur due to:

1. Improper adaptation of material to cavity

margin

2. Breakage of interfacial bonds between resin

and cavity
 Marginal
discolouration

Broken
interfacial Improper
bonds adaptation

Marginal gap

Accumulation Marginal
of debris staining
 2.SURFACE DISCOLORATION

Related to surface roughness of the composite.

Seen in composites with larger filler sizes.

Debris gets entrapped between the spaces and

cannot be removed by routine brushing.

Dark pitted discolouration may be seen due to

exposure of air void when composite wears
away.
 Effect of classical curing techniques on composite properties
Difference Chemical-cured (CC) Light-cured (VLC) Heat-Cured (HC)

• Presentation forms 2 paste (Base & Single paste (Syringe, - 1 paste

Catalyst) capsules) - Powder and liquid

• Mixing Mixing of equal parts of No mixing is required Mixing of P&L form only
base and catalyst (only direct
over paper pad by dispensing from
the use of plastic either the syringe or
spatula capsules)

• Setting reaction Addition polymerization Addition polymerization Addition polymerization

• Polymerization Benzoyl peroxide Camphroquinon Benzoyl peroxide

initiator

• Polymerization - 3ry amine (old) UV light, Blue VL, or Heat, or Heat&pressure

activator - N-dihydroxy Laser
ethyl–P- toluidine

• Method of Direct, using bulk Direct, using incremental Indirect (Laboratory

application technique technique processed)
Property Chemical-cured (CC) Light-cured (VLC) Heat-Cured (HC)

• Working time -Limited -Unlimited -Unlimited

-The chemical reaction -The chemical reaction -The chemical reaction
starts once base and starts when the material starts when the material
catalyst are mixed is subjected to light is subjected to heat

• Degree of Higher than VLC and The lowest The highest

polymerization lower than HC

• Residual Monomer Lower than VLC and The highest The lowest
• (act as plasticizer) higher than HC

• Polymerization Higher than VLC and The lowest The highest

shrinkage lower than HC

• Strength and Higher than VLC and The lowest The highest
hardness lower than HC

• Porosity Voids could exist as a Less Than CC (No Less than CC

result of air trapping Mixing) (Depending on the
during mixing packing technique)

• Color stability The lowest, due to Higher than CC and The highest
presence of 3ry amine lower than HC
and porosities

• Bonding to resin Lower than VLC and The highest The lowest
bonding agents Higher than HC
Clinical Hints

in your mind
Composite polymerization is retarded in presence of
Eugenol and oxygen.
It is mandatory to incrementally insert
the light-cured material
The chemically-cured materials is no longer be used clinically
Mechanical, Micro-mechanical and inter-penetration means
help the composite retain to the tooth structure
 Direct applications of resin composites
 Filling class III, IV, V and VI cavities in anterior teeth
 Filling small and moderate Class I, II, V cavities in post. teeth
 Core build-up (strengthening of weakened teeth)
 Diastma Closure
 Direct laminate veneer
1. Esthetic.
2. Conservative cavity.
3. Low thermal conductivity.
4. Quite resistance to microleakage Advantages
5. No corrosion.
6. Strengthening of the remaining tooth st.

1. Polymerization shrinkage.
2. High coefficient of thermal expansion
3. Pulp irritation due to residual monomer
Disadvantages …… i.e. deep cavities should be protected
4. Low wear resistance.
5. Technique sensitive.
Step By Step Re s to ra tio n
Done