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Intermediate restorative skills (Den 305) > Dental composite in advanced restorative dentistry > Flashcards

Dental composite in advanced restorative dentistry Flashcards

1
Q

Advanced uses of resin composite

A 
Polychromatic conformative restoration
Altering morphology (veneering/bonding)
Occlusal rehabilitation (reorganisation)
Repairing failed composite and ceramic
Tooth splinting and temporary bridges
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2
Q

Resin composite ideal properties

A 
Perfect colour match
High polishability and durable finish
High wear resistance
Low shrinkage and good radiopacity
Compatible with all bonding agents
Range of handling characteristics for
different clinical situations
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3
Q

Restorative composite selection based on choice of

A 
Shades and opacity
Filler composition
Physical properties
Handling characteristics
Cost
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4
Q

Greater complexity of composite selection =

A

Greater time and cost

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5
Q

Restorative composite classification

A

Classification by filler:

  • macrofilled
  • micro-hybrid
  • continuum filled
  • nanofilled
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6
Q

Macrofilled composite

A

Amorphous silica (35-63%)
Average particle size 0.04 µm
Examples: Heliomolar (vivadent)

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7
Q

Micro-hybrid composite

A

Glass particles and microfillers (>80%)
Average particle size 0.4-0.8 µm
Examples: EsthetX (Dentsply) or Point 4 (Kerr)

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8
Q

Continuum filled composite

A

Zirconia/ silica (87%)
Average particle size 0.01-3.5µm
Examples: Z100 and Z250 (3M ESPE)

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9
Q

Nanofilled composite

A

Zirconia/ silica nanofillers and clusters
Average particle size 5-20nm Zr/Si or 75nm Si
Examples: Filtek Supreme XT (3M ESPE) or Ceram.X Dentsply

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10
Q

Composite selection by complexity

A 
Universal “Every day” composites
Dual opacity composites
Polychromatic layered composites
Tints, opaquers, intensives and
opalescents
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11
Q

Universal composites

A 
“Every day” use for small cavities
Limited shade sub micron hybrids 
-Spectrum TPH 
-Dentsply
-Prodigy 
-Kerr
-Z100 
-3M ESPE
-Charisma 
-Heraeus Kulzer
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12
Q

Dual opacity composites

A

Provide a range of dentines and enamels in “vita
classic” matched shades
Low cost introduction to layered multi colour
techniques
Excellent cosmetic results in selected cases
-Ceram.X Duo (Dentsply)
-Vanus (Heraeus Kulzer)

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13
Q

Layered composites examples

A

Multi-opacity systems

  • Esthet-X
  • Dentsply
  • Premise & Herculite
  • Kerr
  • Miris
  • Coltene
  • Enamel HFO
  • Micerium
  • Filtek Supreme XT
  • 3M ESPE
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14
Q

Layered composites

A 
Kits are complex and costly
Two or more levels of opacity
Intensive and translucent shades
Some shades may never be used!
Training required to achieve best results
Special instruments
used for placement
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15
Q

Filtek Supreme XT (3M ESPE)

A

Four opacities in 34 vita based shades
Carefully refined shade matching
Mechanical properties of hybrid composites
Outstanding polishability similar to microfills with
good retention of surface finish
Excellent handling characteristics
Very high wear resistance

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16
Q

Multi shade approach

A 
Supreme WE to form halo
Supreme A2 Dentin
n Supreme GT
Supreme Body A2
Supreme YT
17
Q

Enamel plus HFO

A 
Dentine and enamel base shades
Intensives and opalescent shades
Slight “slumpy” handling
Shade guides match optical properties of the
resins
Steep learning curve
Training and practice needed for optimum
results
18
Q

Anterior layered build technique

A 
Diagnosis - cosmetic trial and/or imaging
Preoperative wax up or index
Shade and characterisation assessment
Tooth preparation
Index build palatal, proximal and incisal enamel
Multiple dentine shades and intensives
Labial enamel, contour and polish
Possible revision at review
19
Q

Shade assessment (Vanini method)

A
  1. Base chroma (dentine shades)
  2. Value (enamel shades)
  3. Intensives (diffuse/opaque white)
  4. Opalescents (translucencies)
  5. Characterisations (Halos, cracks,
    banding)
20
Q

Finishing Systems

A 
Fine Diamonds and TC finishers
-finishing bur kits (Schottlander)
Polishing discs
-SofLex (3M ESPE)
Smoothing and high gloss
-enhance kit (Dentsply)
Fast gloss polishing
-occlubrush (Kerr)
21
Q

Composite to composite repair

A 
Bond strength dependent on adhesive and
structure of aged composite*
-prime and Bond NT (Dentsply)
-optibond solo (Kerr)
Clinical studies lacking on longevity
Viable option for small fractures and
margin failures in large restorations
22
Q

Ceramic repair

A 
Heterogeneous ceramics (leucite/
feldspathic) can be HF acid etched
-reliable high strength bond with silane
coupling and appropriate resins
Low fusing homogenous ceramics: alumina and zirconia cores can not bonded
If in doubt use CoJet silicoating and silane
-highly successful with combined
metal and ceramic exposures.
23
Q

Single composite retained bridges

A

Composite and pin retained denture tooth

Resin bonded extracted natural tooth

Intermediate restorative skills (Den 305) (16 decks)

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