Composite Resin Fillings
Shre Vinayakaa Dental Clinic
Composite Resin Fillings
Dental composite resins are types of synthetic resins which are used in dentistry as restorative material or adhesives. Synthetic resins evolved as restorative materials since they were insoluble, aesthetic, insensitive to dehydration, easy to manipulate and reasonably inexpensive. Composite resins are most commonly composed of Bis-GMA and other dimethacrylate monomers (TEGMA, UDMA, HDDMA), a filler material such as silica and in most current applications, a photoinitiator. Dimethylglyoxime is also commonly added to achieve certain physical properties such as flow ability. Further tailoring of physical properties is achieved by formulating unique concentrations of each constituent. Many studies have compared the longevity of composite restorations to the longevity of silver-mercury amalgam restorations. Depending on the skill of the dentist, patient characteristics and the type and location of damage, composite restorations can have similar longevity to amalgam restorations. (See Longevity and clinical performance.) In comparison to amalgam, the aesthetics of composite restorations are far superior.
Initially, composite restorations in dentistry were very prone to leakage and breakage due to weak compressive strength. In the 1990s and 2000s, composites were greatly improved and have a compression strength sufficient for use in posterior teeth.
Today's composite resins have low polymerization shrinkage and low coefficients of thermal shrinkage, which allows them to be placed in bulk while maintaining good adaptation to cavity walls. The placement of composite requires meticulous attention to procedure or it may fail prematurely. The tooth must be kept perfectly dry during placement or the resin will likely fail to adhere to the tooth. Composites are placed while still in a soft, dough-like state, but when exposed to light of a certain blue wavelength (typically 470 nm[1]), they polymerize and harden into the solid filling (for more information, see Light activated resin). It is challenging to harden all of the composite, since the light often does not penetrate more than 2–3 mm into the composite. If too thick an amount of composite is placed in the tooth, the composite will remain partially soft, and this soft unpolymerized composite could ultimately lead to leaching of free monomers with potential toxicity and/or leakage of the bonded joint leading to recurring dental pathology. The dentist should place composite in a deep filling in numerous increments, curing each 2–3 mm section fully before adding the next. In addition, the clinician must be careful to adjust the bite of the composite filling, which can be tricky to do. If the filling is too high, even by a subtle amount, that could lead to chewing sensitivity on the tooth. A properly placed composite is comfortable, aesthetically pleasing, strong and durable, and could last 10 years or more. (By most North American insurance companies 2 years minimum)