Restorative materials in dental caries

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PBL Coordinator: Dr. Jyotsna Rimal

Resource Faculty: Dr. Sneha Shrestha

Restorative Materials in Dental Caries

Prepared By: Raman DhungelBDS 2014, BPKIHS

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Contents:Restorative Materials : IntroductionClassification Advantages and Disadvantages Choice of appropriate Restorative materialSuccess and Failure of Restorative MaterialSummary

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Introduction:

Dental restorative materials are specially fabricated materials designed to restore the function, integrity and morphology of missing tooth structure, usually resulting from, but not limited to, dental caries.

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Loss of tooth structure due to Caries

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Classification:Temporary, intermediate and permanent• Zinc Oxide Eugenol (ZOE) -Temporary• Polymer reinforced cement (IRM) & improved ZOE – intermediate• Direct filling gold, amalgam, composite, GIC, Porcelain, composite &

cast metal inlays and onlays - Permanent

Direct and Indirect• Amalgam, composite, GIC, direct filling gold - direct• Porcelain, composite and cast metal inlays and onlays - indirect

Esthetic and non esthetic• Composite , GIC & porcelain- esthetic• Amalgam, direct filling gold, cast metal inlays and onlays – non

esthetic © RAMAN2016

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Amalgam: Amalgam is a metal alloy of which one of the elements is mercury (Hg).

Alloys are metals that are a combination of several elements.

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Classification of amalgam alloys:Based on copper content• High Copper (13-30% copper)• Low Copper (<6% copper)

Based on Zinc Content• Zinc-containing (>0.01% zinc)• Zinc –free (<0.01 % zinc)

Based on size of alloy• Microcut• Macrocut

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Classification of amalgam alloys:Based on shape of the alloy particle• Spherical• Spheroidal• Lathe cut

Based on no of alloyed metals• Binary alloys, e.g., silver-tin• Ternary alloys, e.g., silver-tin-copper• Quaternary alloys, e.g., silver-tin-copper-

indium.© RAMAN2016

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AmalgamInexpensiveEasy to useTechnique insensitiveDurableMarginal seal improves with time

Advantages: Disadvantages: Non adhesive Requires mechanical

retention Poor esthetics Environmental and

occupational hazards

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Composites:Restorative material composed of two phases: Matrix and Filler bound together by coupling agents

Further divided into macro-filled (70-80% filler), micro-filled (40-50 % filler) & hybrid (75-80% filler )

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Composites: Essential Components : Resin matrix/ binder — BisGMA or urethane dimethacrylate Filler — Quartz, colloidal silica or heavy metal glasses Coupling agent — Organo silanes

Additionally, they also contain: A curing system , Inhibitors, UV absorbers Opacifiers — e.g. titanium dioxide and aluminum oxide Color pigments — to match tooth color

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Composites:AdhesiveEstheticReasonable wear propertiesMicromechanical bond to enamelMinimal tooth preparation required

Advantages: Disadvantages: Technique sensitive Expensive Time consuming Post-operative

sensitivity Polymerisation

shrinkage

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Glass Ionomer Cement:First truly adhesive restorative materialsRelease fluoride over timeBiomimetic- resembles dentinSupplied as powder/liquid systems

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Composition: Powder:Silica (SiO)2 — 41.9 %Alumina (Al2O3) — 28.6 %Aluminum fluoride (AlF3) Calcium fluoride (CaF2) — 15.7%Sodium fluoride (NaF) Aluminum phosphate (AlPO4)

Liquid: Polyacrylic acid Tartaric acid & Water

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Classification of GIC: Type I — For luting Type II — For restorations Type III — Liners and bases

Difference between various types: Various types chemically identical: vary primarily in the powder/liquid ratio and particle size.

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Glass Ionomer Cement:

EstheticFluoride leaching -anticariogenicChemically bonds to enamel and dentine Minimal tooth preparation Higher moisture tolerance than resin-based restorative materials Biocompatible: low pulpal toxicity if applied to intact dentine Thermal expansion similar to enamel and dentine

Advantages: Disadvantages:

Brittle

Susceptible to erosion and wear

Sensitivity to moisture in the early setting process

Esthetics not as good as resin-based restorative materials

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GIC : Esthetic Restoration

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Others: Dental cements: zinc phosphate , zinc polycarboxylate, Zinc oxide eugenol cement, calcium hydroxide cement

Metal reinforced GIC, highly viscous condensed GIC, resin modified GIC

Compomers: resin cements

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Indirect Restorative Materials:

Based on amount of tooth material restored:• Inlays• Onlays• Veneers• Dental bridges• Crowns • Complex restorations

Classification by material:• Metals• Ceramic materials• Ceramometals• Composite Materials

Indirect restorations are those restorations that are constructed outside the mouth.

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Choice of appropriate Restorative material:

The choice of material mainly depends on:Location and extent of cariesAge and sex of patient (esthetic reasons)Strength of material desiredEconomic factorsAllergy to specific material

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Success and Failure of Restoration:Depends upon:Material Contamination during restorationTechnical expertiseOral hygieneDietary habits

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Summary:A wide range of restorative materials availableHave different properties to meet the requirementsAdvantages and disadvantages of different materialsChoice of material Success and failure of restoration

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Classification:Temporary, intermediate and permanent• Zinc Oxide Eugenol (ZOE) -Temporary• Polymer reinforced cement (IRM) & improved ZOE – intermediate• Direct filling gold, amalgam, composite, GIC, Porcelain, composite &

cast metal inlays and onlays - Permanent

Direct and Indirect• Amalgam, composite, GIC, direct filling gold - direct• Porcelain, composite and cast metal inlays and onlays - indirect

Esthetic and non esthetic• Composite , GIC & porcelain- esthetic• Amalgam, direct filling gold, cast metal inlays and onlays – non

esthetic © RAMAN2016

Restorative materials in dental caries

Health & Medicine

Transcript of Restorative materials in dental caries