Dental Composites - Manipulation PPT

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DENTAL COMPOSITESManipulation and Properties

Stephen C. Bayne

Professor and ChairDepartment of Cariology, Restorative Sciences,

and EndodonticsSchool of DentistryUniversity of MichiganAnn Arbor, MI 48109-1078

DENT112, UNC School of Dentistry

2006, Bayne and Thompson.

BISCO http://www.bisco.com/Caulk http://www.caulk.com/Denmat http://www.dentalmaterial.com/Dentsply http://www.dentsply.com/DMG Hamburg http://www.dentalmaterial.com/ESPE http://www.espe.de/english/GC-America http://www.gcamerica.com/

Ivoclar http://www.ivoclar.com/Jeneric-Pentron http://www.jeneric.com/Jelenko http://www.jelenko.com/Kerr Dental http://www.kerrdental.com/Kulzer http://www.kulzer.com/3M http://www.mmm.com/dental/Morita http://www.jmorita.com/SDI http://www.sdi.com.au/Shofu http://www.shofu.com/Sun Medical http://www.sunmedical.co.jp/Ultradent http://www.ultradent.com/

http:// www.iadr.com/ dmg/

MANUFACTURER WEBSITESAccessing Information

1950 19701960 2010200019901980

OriginalDevelopment

SELF-CURED

UV-CURED

VLC-CURED

MACROFILLSelf-Cured

Composites

MIDIFILL

Composites

MICROFILLComposites

MIDIFILLComposites

Midi-HYBRIDComposites

UnbondedComposites

Acid-Etching andEnamel Bonding

Dentin-BondedComposites

3c, 2c, 1cDentin Bonding System

[QTH, PAC, Laser, LED]

COMPOSITE REFINEMENTSReviewing the last 50 years.

FLOWABLES

PACKABLES

Nano-HYBRIDCOMPOSITE

CONTROLLEDSHRINKAGEPrototypes

Mini-HYBRIDComposites

UnfinishedComposite Surface FinishedComposite Surface

EtchedEnamel Rods

Voids atMargins

Silicate

Reinforcing FillerCrosslinkedResin Matrix

COMPOSITE

EnamelSurface

INTERFACE

INTERFACE INTERFACE

INTERFACE

DEFINITION OF COMPOSITEPhases and Interfaces

50 v/o filler = 75 w/o filler

CLASSIFICATION SCHEMESFiller (or Matrix) Classification

70% 30%

TEXTURES

MEGAFILL MACROFILL MIDIFILL MINIFILL MICROFILL NANOFILL

DifferentFiller Particle

HYBRID(MIDIFILL)

HYBRID(MINIFILL)

MixturesOf Filler

Hetero-geneousMIDIFILL

Hetero-geneousMINIFILL

Hetero-geneous

MICROFILL

MixturesOf Pre-Cured

Pieces ofComposite

FILLER PARTICLESSchematic Examples

HOW DO YOU MAKE FILLERS?• Crushing, Grinding, Sieving• Vapor Phase Condensation• Sol-Gel Precipitation

Midi-Hybrid70% 30%

100 10-1 10-3 10-4 10-5 10-6 10-7 10-8 10-9 10-1010-2

METERS

Mini-Hybrid

1 m 1 cm 1 mm1 mm 1 nm1 dm 1 Å

StandardDentistryReference

Mega-Filler

Macro-Filler

Midi-Filler

Mini-Filler

Micro-Filler

Nano-Filler

0.011 mm 0.110100 0.001 0.0001

IPS Targetfor Wear

Resistance

Nano-Hybrid

AtomicDimensionsBacteria

Dentinal TubuleWidth

NANOCOMPOSITESWhat is all this “nano” stuff all about?

COMMERCIAL EXAMPLESHistorical vs Recent Commercial Products

FLOW BUTTONS(area calculated in mm2)

Enamel

DentinFlowableComposite

Composite

Second Generation FlowablesBayne SC, Thompson JY, Swift EJ Jr, Stamatiades P, Wilderson M. A characterization of first-generation flowablecomposites. J Am Dent Assoc 1998;129:567-577.

Flowable(Company)

Flow (mm 2 )

StarFlow (Danville) 208 16 aWave (SDI) 206 20 ac

FlowLine (Kulzer) 197 31 ac

Heliomolar Flow (Ivoclar) 191 13 ac

UniFil Flow (GC) 173 21 ac

Revolution F2 (Kerr) 159 17 ac

LuxaFlow (DMG) 156 6 ac

Tetric Flow (Ivoclar) 156 13 ac

Flow-It ALC (Pentron) 152 10 bc

MetaFil Flo (Sun Dental) 148 27 b

Filtek Flow (3M-ESPE) 144 10 b

Point 4 Flowable (Kerr) 140 2 b

, PBNT

31 5 22 3 40 722 4 17 6 31 3

24 2 19 1 39 4

26 2 19 1 44 1

24 1 15 2 33 3

23 1 34 3 61 5

39 4 37 5 55 3

38 1 23 4 45 3

38 1 35 5 52 4

41 5 47 7 72 4

54 3 53 10 73 3

51 2 35 3 58 4

Flowable(Company)

Flow (mm 2 )

StarFlow (Danville) 208 16 aWave (SDI) 206 20 ac

FlowLine (Kulzer) 197 31 ac

Heliomolar Flow (Ivoclar) 191 13 ac

UniFil Flow (GC) 173 21 ac

Revolution F2 (Kerr) 159 17 ac

LuxaFlow (DMG) 156 6 ac

Tetric Flow (Ivoclar) 156 13 ac

Flow-It ALC (Pentron) 152 10 bc

MetaFil Flo (Sun Dental) 148 27 b

Filtek Flow (3M-ESPE) 144 10 b

Point 4 Flowable (Kerr) 140 2 b

= 25 GoodWetting

Porosity (%)

Second Generation FlowablesProblems with flow onto bonding systems.

• SOLITAIRE and SOLITAIRE 2 (Hereaus-Kulzer) • A.L.E.R.T. CONDENSABLE (Jeneric-Pentron) • SUREFIL (LD Caulk )•

GLACIER (Southern Dental Industries) • PYRAMID (BISCO) • PRODIGY CONDENSABLE (Kerr) • FILTEK P60 (3M) • SYNERGY COMPACT (Coltene / Whaledent) • HELIOMOLAR HB (Ivoclar-Vivadent)

PACKABLE RESTORATIVESAvailable in 2005

• HI-DENSE CONDENSABLE GI (Shofu) • FUJI IX PACKABLE (GC-America)

Ruddell DE, Thompson JY, Stamatiades PJ, Ward JC, Bayne SC, Shellard ER. Mechanical properties and wearbehavior of condensable composites. J Dent Res 1999; 78 (Spec Issue):156, Abstr 407.

PACKABLE COMPOSITESLaboratory Mechanical Properties

S T R E N G T H

( M P a )

CS DTS FS DPH

MECHANICAL PROPERTY

Solitaire

SureFil

Prodigy C

Herculite

COMPOSITE MANIPULATIONOperative Procedure Considerations

Second increment

First increment 1.5 to 2.0 mm

Quartz-Tungsten-Halogen (QTH) , Plasma-Arc (PAC), Lasers, Light-Emitting Diode (LED)

Curing EquipmentFactors

ProceduralFactors

RestorationFactors

• Bulb frosting or degradation• Light reflector degradation• Optical filter degradation• Fiber-optic bundle breakage• Light-guide fracture• Tip contamination by resin buildup• Line voltage inconsistencies• Sterilization problems• Infection control barriers

• Light tip direction• Access to restoration• DISTANCE from surface• Size of tip• Tip movement• TIME of exposure

• Restoration thickness• Cavity design• Filler - amount and size• Restoration shade• Monomer ratios

FACTORS AFFECTING CUREEquipment + Procedural + Restorative Factors

Curing EquipmentFactors

ProceduralFactors

RestorationFactors

• Bulb frosting or degradation• Light reflector degradation• Optical filter degradation• Fiber-optic bundle breakage• Light-guide fracture• Tip contamination by resin buildup• Line voltage inconsistencies• Sterilization problems• Infection control barriers

• Light tip direction• Access to restoration• DISTANCE from surface• Size of tip• Tip movement• TIME of exposure

• Restoration thickness• Cavity design• Filler - amount and size• Restoration shade• Monomer ratios

FACTORS AFFECTING CUREEquipment + Procedural + Restorative Factors

WAVELENGTH (nm)

UV Visible IRCQ

INTRAPULPAL HEAT,GINGIVAL IRRITATION

I N T E N S

U V b a n d - p a s s

f i l t e r

I R b a n d - p a s s

f i l t e r

• Power Supply• Cycle Timer (Circuit Board)• Bulb / Reflector• Filter • Fan• Fiber-Optic Train

Check Fiber Optic Tips

Check Bulband Reflector

Clean Reflector

180-1100mW/cm2

WAVELENGTH (nm)

Visible CQ

I N T E N S I T

LED LIGHTSLight Emitting Diodes

Advantages:

Matched to CQ peak.Reduced “I” needed.Easy to clean.Totally quiet; No fan.Small; Handy.No wires.

LOWCOST

FirstGeneration

LED CURING LIGHTS[Output = LED power; #; focusing]

Visible Light LED: Company: Price: # LEDs:

Elipar FreeLight 3M ESPE $ 999 19NRG Dentsply/Caulk $ 949 7Ultra Lume LED 1 Ultradent $ 899 ($699)

Ultra Lume LED 2 Ultradent $1299 ($999)CoolBlue Dental Systems $1195Nova Curing Techologies $1495 7GC e-Light GC America $1495

Allegro Denmat - - - - - 1Elipar FreeLight 2 3M ESPE $1495 1LEDemetron Kerr - - - - - 1Ultra-Lume LED 5 Ultradent - - - - - 5the CURE Spring Health Products $ 499 1SmartLite iQ Caulk/Dentsply - - - - - 1Radii SDI $ 695 1Cool Blue Wand Milestone - - - - - 1

Significantmaterial

removal

Originalrough

surface

COARSEfinished

New surfaceapproximates

abrasive size

Polished

Smearing andburnishing to

smoothen surface

FINEfinished

Fine grooves

FINISHING AND POLISHING

TWO CRITICAL FACTORS for Finishing and Polishing:(1) Abrasive size(2) Filler particle size

SURFACE ROUGHNESS = Ra Average up-and-down geometry =

20 mm 2 mm 0.2 mm

0 25 50 75 1000

CONVERSION (%)

H R I N K A G E ( % )

65%Conversion

50% Filler25% Bis-GMA25% TEGDMA

Bond Stretching(External Contraction)

Porosity Formation(Internal Contraction)

POLYMERIZATION SHRINKAGE

15-25% =Gellation

Curing Light

2. SHAPE-OF-CURE

3. DEPTH-OF-CURE

1. DEGREE-OF-CONVERSION

CHEMICAL PROPERTIES

COMPOSITE WEAR

5 Wear Types:

CFA = food bolus wearOCA = impact wearFCA = sliding wear

PCA = sliding wearTBA = abrasive wear

100% 1st Molars

2nd Molars

2nd Premolars

1st Premolars

FOOD BOLUS

Wilder AD, May KN, Bayne SC, Taylor DF, Leinfelder KF.17-year clinical evaluation of UV-cured composite resinsin posterior teeth. J Dent Res 1996; 75: 173, Abstr 2100.

1 2 5 10 20

TIME (years)

W E A R ( C

F A ,m m

)R2 = 0.99

ENAMEL

MACROPROTECTION

MICROPROTECTION

LATEWEAR

MIDDLEWEAR

EARLYWEAR

SC Bayne

???• Degradation by esterase, bleaching, …. • Generation of formaldehyde and water.

BIOLOGICAL PROPERTIESVery poorly understood.

THANK YOU

Dental Composites - Manipulation PPT

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