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Resin Composite Restorations IIDr.Ghada Maghaireh

BDS, MS, ABOD

Advantages of Resin Composite as a Posterior Restorative

Material

Esthetics. ConservationofTooth Structure:- The preparation tends to be shallower.

- The preparation tends to have narrower outline form.

- The preparation has rounded internal line

angles.

- No extensionfor prevention.

Advantages of Resin Composite as a Posterior RestorativeMaterial

Adhesion to Tooth Structure. Low Thermal Conductivity. EliminationofGalvanic Currents. Radiopacity. Alternative toAmalgam. Disadvantages of Resin Composite as a Posterior Restorative

Material

Polymerization Shrinkage. Secondary Caries. Postoperative Sensitivity. Decreased Wear Resistance. O

ther MechanicalP

roperties:- Fracture toughness.

- High degree ofelastic deformation.

- Coefficientofthermal expansionofcomposite is higher

than thatoftooth structure.

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Disadvantages of Resin Composite as a Posterior RestorativeMaterial

Water Sorption. Variable degree ofcure. InconsistentDentin Bonding (Marginal Leakage). Technique Sensitivity.

Indications of Resin Composite as a Posterior RestorativeMaterial

Esthetic should be a prime consideration. The faciolingual width ofthe cavity preparation should berestricted tono more thanone thirdofthe intercuspal distance and

inClass II the gingival margin should be on enamel.

Centric occlusal stops should be primarily on enamel. The patient shouldnot exhibit excessive wear from clenchingor

grinding.

The tooth should be amenable to isolation.Preventive Resin Restorations (PRR)

Limits preparation to pits andfissures that are carious. Ifthe resultant cavity is limited tonarrow and shallowopeningof

the fissures, a resin sealant (fissure sealant) or flowable composite

is placed.

Ifthe additional tooth structure is removed, resin composite isplaced in the cavity and then the remainingfissures and composite

are covered by fissure sealant.

Advantages of PRR

Conservationoftooth structure. Enhanced esthetics. Improved seal ofesthetic material to tooth structure. Minimal wear.

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Good longevity.Indication and Contraindications for PRR

PRR is indicatedwhen there is minimal or moderate cariousfissures.

PRR is not indicatedfor restorations thatwill occupy a large area ofthe occlusal surface.

Preventive ResinRestoration (PRR) A small round bur is used toopen the fissures. Removal ofcarious dentin and unsupported enamel. Acid etching and bonding as with other composite restorations. Ifthe preparation is shallow sealantor flowable composite is used. Resin composite is used tofill deep areas that extend intodentin

and light cured.

Sealant is placedover the resin composite and the unpreparedfissures.

Preventive Resin Restoration (PRR)

Class II resin Composite Restorations Prewedging: Compensate for the thickness ofthe matrix band. Obtaining an adequate interproximal contactwith the adjacent

tooth.

Protect rubber dam andgingival tissue and reduce leakage. Protect adjacent teeth from damage during preparation. Class IIComposite Preparation Limited to removal ofcarious tooth structure. Provide access restoration placement andfinishing.

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Class II Composite Preparation

Ifthere are more arrears offissure caries lesions they should betreated separately ifpossible.

Bevel placement is a a controversy issue.Class II Composite Restoration

Placementofmatrix andwedge. Acid etching: 35% phosphoric acidfor 15 seconds and rinsed. Primer and adhesive application: light cure for 20 seconds. Placementofcomposite (incremental technique).

Matrix Application Clear and metal matrix bandwith Tofflemire retainer. Metal matrix is easier to place, retain their shape better, and can be

burnished against the adjacent tooth.

MatrixApplication

The sectional matrix system with the metal rings. Good interproximal contact.

Finishing

Aluminum oxide disks. Fine diamond burs. Aluminum oxide impregnated rubber points and cups.

Finishing

Aluminum oxide coatedfinishing strips.References

Chapter # 9 ofFundamentals ofOperative Dentistry