Introdaction to restorative materials

Dental Materials
Bases and Liners
Cavity varnishes
Dentin-bonding agents
Restorative materials
Sealants
Cements

Bases and Liners
Used in pediatric dentistry to prevent sensitivity to teeth
PULPAL PROTECTION
Calcium Hydroxide
Zinc Oxide- Eugenol
Zinc Phosphate
Glass Ionomer Cements

Calcium Hydroxide
Can be either a two paste system or a visible light-cured system
It’s alkaline pH aids in preventing bacterial invasion
Often used in direct pulp caps

Zinc Oxide- Eugenol
Provides a *sedative effect*
Often used when confronted with multiple areas of excessive decay and sensitivity
Used as a temporary cementation of crowns
Used to fill obliterated pulp chambers following a pulpotomy

Video IRM

Zinc Phosphate
Good to use over calcium hydroxide and under large amalgams as a base
Used primarily to cement stainless steel crowns

Video- Zn Phosphate

Glass Ionomer Cements
Popular basing agent
Releases fluoride
Less microleakage than ZOE, CaH, or Zinc Phosphate
Must be mixed exactly as directed to prevent sensitivity of pulp
Has good coefficient of thermal expansion

Cavity Varnish
Copalite- Made from natural gums in an organic solvent
Used with vital teeth in cavity prep prior to placement of amalgams
NOT used with composites

Dentin-bonding agents
Relies on a phosphate- calcium bond for retention
Promotes infiltration of monomers into a zone of demineralized dentin that polymerize and interlock with the dentin matrix
Every product has their own unique system with different variations

Restorative materials
Amalgams
Resin-based composites
Glass Ionomer
Compomers

Amalgam restorations

Advantages of Amalgam Restoration
Strong, durable and withstand occlusal forces
Placed in one visit
Lower in expense
Self sealing with minimal to no shrinkage
Resistance to further decay is high
Frequency of repair and replacement is low
Can be used in wet environment (good in pediatrics)

Disadvantages of Amalgam Restorations
Special handling required for disposal (mercury content)
Amalgam can darken over time
Tooth preparation may require removal of some healthy tooth structure
Rare but possible localized allergic reaction to amalgam
Short term sensitivity to Hot and Cold

Video 2 Amalgam Trituration

Composite restoration

Composite Resin
Mixture of acrylic resin + powdered glass-like particles
May be self curing or light activated
Used for restorations, inlays and veneers
Can be used for replacement of portion of broken or chipped tooth

Advantages of Composite resins
Color and shading can be matched to existing tooth
Withstands moderate occlusal pressure
Utilized in anterior and posterior regions
Restorations completed in one visit

Advantages of Composite resins
Moderately resistant to breakage
Permits greater preservation of tooth structure
Low risk of leakage if bonded to enamel
Frequency of repair or replacement is low to moderate

Disadvantages of composite resins
Usually wear out more frequently than metal restorations- need to be replaced more frequently
Placement more time consuming
Can not be used in wet environment
More expensive than amalgams
May wear faster than dental enamel
May leak when bonded on dentinal layer

Types of Composites
generational advancement
Macro filled 8-12 micron
Adaptic, Consise
Mini filled 1-5 micron Estilux
Micro filled .04-0.1 micron
Durafil VS
Macro Hybrid 8-12 micron/ 0.04-0.1 micron
Prisma

Types of Composites
Micro- hybrid 1-3micron / 0.04-0.1 micron
Herculite, Charisma
Total Complete Composite 5-8 m / 1-5m / 0.01-0.1 micron
Prisma, Herculte XRV

Glass Ionomer Filling Material

KetacTM Fil Plus AplicapTM

Indications
Class III and V restorations
Erosions or Wedge-shaped defects
Small Class I fillings
Core build-ups
Minimally Invasive Dentistry (MID)
Glass ionomer Filling Materials

Clinical Advantages
Ideal for pediatric and geriatric patients
Indicated for cervical erosion or lost restorations
Less shrinkage than traditional composites
Chemical bond to enamel and dentin
Coefficient of thermal expansion close to that of enamel and dentin
High fluoride release
Radiopaque
Good system of delivery
Glass Ionomer Filling Material

Taken from 3M ESPE 2008

Compomers
Good for pediatric patients
Blend/ combination of resin based composite and glass ionomers
Combination of Acid+ Base reaction and light activated
Used with bonding agent – manufacturers say etching of enamel is optional

Compomers
Combines wear resistance/ rapid light set 40 seconds/ fracture resistance
Releases fluoride (glass ionomer property)
Vitremer Tri-Cure (3M)
Photac-Fil (ESPE)
Fuji II LC

Sealants
Preventative
Used to close Pit and Fissure areas
May contain fluoride
Either A +B system or Light activated

Dentsply FluroShield
Tooth colored or
Opaque
Contains Fluoride

Necessary Items for working with all restorations
A great assistant
Pleasant room temperature 21-24 C0
Isolation- Rubber Dam
Good Visibility
Clean oral environment