Composite resin is presently the most popular tooth colored filling material. Composite material is a compound of two or more different materials with properties superior or intermediate to those of the individual component. The various components of a composite resin are resin matrix, fillers, coupling agents, coloring agents.

 

a). The resin matrix initially used was Bis GMA(Bisphenol Glycidyl methacrylate). Now, UDMA( Urethane dimethacrylate) and TEGDMA(Triethylene glycol dimethacrylate) are also being used.

 

b). Fillers used are quartz, silica, tricalcium phosphate, zirconium dioxide. They provide strength, hardness, rigidity to the material.

 

c). Coupling agent binds the resin matrix to the filler particles. Organic silanes are commonly used coupling agents.

 

d). Coloring agents used are aluminium oxide, titanium dioxide.

 

Composites are divided into 3 types depending upon the size, amount and composition of the inorganic filler. These types are Conventional, Microfilled and Hybrid. Placement of a composite filling requires an etchent (like phosphoric acid) and a bonding agent.

 

Various advances have been made in composites, these are Flowable composites, Packable composites, Antibacterial composites, Laser curing composites.

 

 

Composite Filling

Composite filling done to restore carious front tooth

FAILURES OF COMPOSITE RESINS

1. discoloration of the fillings, specially around the margins
2. recurrent caries
3. marginal fractures
4. gross fracture of the restoration
5. failure in maintaining proximal contact
6. post operative senstivity

HOW TO AVOID THESE FAILURES

1. complete removal of dental caries
2.  complete etching
3. proper isolation while placement of the restoration
4. uniform and single coat of bonding agent
5.  avoid bulk placement of composite material
6. avoid contact with fingers or gloved hands
7. proper curing of composite
8.  keep cavity as small as possible
9.  avoid sharp internal line angles
10. use small increments
11.  composite at bevelled areas should be polished properly  

 GLASS IONOMER CEMENT (GIC)

 

The glass ionomer cements have evolved as a hybrid of Silicate cements and Polycarboxylate cement. It is available in powder and liquid form. The powder contains silica, alumina, aluminium fluoride, calcium fluoride, sodium fluoride, Aluminium phosphate. The liquid contains polacrylic acid, itaconic acid, maleic acid, tricarballylic acid, tartaric acid, water. The powder and liquid are mixed on a paper pad in the ratio 3:1 and then placed in the cavity formed.

 

Glass Ionomer Cement Dental Filling

Types of GIC

There are 4 types of GIC- Conventional, Hybrid, Tri-cure and Metal reinforced.

 

1. aesthetic
2. good adhesion to the tooth
3. releases fluoride, so anti carcinogenic
4. high retention
5. biocompatible
6. good marginal seal
7. requires minimal cavity preparation

DISADVANAGES:

1. soluble
2. water affects the setting reaction
3. abrasive
4. not as aesthetic as composite resins

1. used both in deciduous and permanent teeth
2. class V and class III cavities
3. abraded or eroded areas
4. root caries
5. rampant caries, nursing bottle caries
6. luting or cementing in veneers, metallic and nonmetallic inlays and onlays
7. protective liner under amalgam, composite
8. core build up
9. retrograde fillings
10. splinting of periodontically weak teeth
11. a traumatic restorative treatment
12. repair of perforations in tooth

INDIRECT RESTORATIONS

INLAYS AND ONLAYS

An Inlay is an intracoronal cast restoration designed mainly to restore occlusal and proximal surfaces of the posterior teeth without involving the cusps of the teeth. They are custom made to fit the prepared cavity and then are cemented in that place. Its placement usually takes two appointments. During the first visit: an impression is made of the tooth and a temporary inlay is placed. The impression is then sent to a dental lab, which will make the inlay according to a particular tooth. On the second appointment: the temporary inlay is removed and permanent placed on the tooth.

An Onlay is a combination of intracoronal and extracoronal cast restorations when one or more cusps are covered. It is a more extensive reconstruction and indicated in areas where lots of tooth structure needs to be restored. It is made in the same way as an inlay and then the permanent onlay is securely bonded using high strength dental resin.

1. extensive tooth loss
2. teeth having periodontal problems also
3. endodontically treated teeth
4. for correction of occlusion
5. retainers for fixed prosthesis
6. teeth having fracture lines in enamel
7. patients with good oral hygiene

CONTRAINDICATIONS{cke_protected}

1. developing or deciduous teeth
2. high caries index
3. dissimilar metals
4. high plaque index

Porcelain inlays and onlays are highly recommended for anterior teeth since they are aesthetic and natural looking as compared to metal fillings. They are long lasting once bonded to the tooth surface and cover large decayed areas.

DIRECT FILLING GOLD

Gold foil is one of the earliest available dental filling materials.

Its available in various forms like gold foil sheets, pellets, ropes, laminated foil, platinized foil, mat gold, mat foil, powdered gold.

1. incipient carious lesions
2. eroded areas
3. vent holes in crowns
4. cavities on cusp tips