Dental Composite

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WRITTEN REPORT: DENTAL COMPOSITES

Group Members:

Cruz, Anne Jillene


Cruz, Patricia
Diaz, Patricia Mae
Duana, Donna Jane
Foja, Pamela

To be submitted to: Dr. Menandro Sumang

BRIEF OVERVIEW ON TOOTH-COLORED RESTORATIONS

I. EVOLUTION OF TOOTH COLORED RESTORATION

● In the 20th century, silicates were the only tooth-colored aesthetic materials available for
cavity restoration. Although silicates release fluoride, they are no longer used for
permanent teeth because they become severely eroded within a few years due to marginal
leakage.
● Silicate cement
- anterior aesthetic filling material
- it is a fluoride releasing cements based on silicate glass and phosphoric acid
- demonstrate anti-cariogenic potential

● Acrylic resins - replaced silicates during late 1940’s because of their tooth like because
of their toothlike appearance, insolubility in oral fluids, ease of manipulation, and low cost.
Aside from restorative material, this is also used for custom impression trays and
dentures). Disadvantages: These acrylic resins also have relatively poor wear resistance
and they shrink severely during curing, which causes them to pull away from the cavity
walls and produce leakage along margins.
● GIC - (1996) Glass ionomer cement (GIC) has been suggested as an alternative to acrylic
resin in bracket bonding because of its fluoride release. The aim of this clinical trial was to
evaluate further the suitability of GIC as a bonding adhesive compared with an acrylic
resin with regard to frequency of bracket failure, fracture modes and clean-up time after
debonding. Also is successor of silicate cement, not very soluble to oral fluids, less soluble
by silicates, highly polishable, releases fluoride. There are three types: Type 1 (luting
agent), Type 2 (GIC as restorative material) Type 3 (liners and bases).

● Dental Composites - the problems of acrylic resins were reduced somewhat by the
(structural components) addition of quartz powder to form a composite structure.
Incorporation of inert filler particles (type 1) became a practical means of reducing curing
contraction as well as thermal expansion. The filler occupies space, but it does not take
part in the setting reaction. In addition, commonly used fillers have extremely low
coefficients of thermal expansion, approaching that of tooth structure. Thus the
stresses resulting from thermal expansion and contraction were greatly reduced as well.

II. FILLED AND UNFILLED RESINS (CLASSIFICATION OF TOOTH COLORED


RESTORATION BASED ON ABSENCE & PRESENCE OF FILLERS)

According to American Dental Association Specification no.27 for direct filling resins.
Type I : unfilled resins : acrylic resin → (without filler, purely resin matrix) (based on our past
lessons, used in denture bases but we will not be focusing on this type)
Type II : filled resin/ composite resins → (resin matrix + fillers + coupling agent )

Filled Resin
Physical, mechanical, and Chemical Properties of Dental Composites
1. Stronger than unfilled resins when loaded in compression.
-34,000-50,000 psi (unfilled resin: 10,000 psi)
2. Have higher tensile strength
3. Have much higher modulus of elasticity than do the unfilled acrylic resins. This would
suggest that the stiffer the material would be less susceptible to elastic deformation when
subjected to masticatory forces
4. Hardness: 60 khn
5. The composites are much harder than unfilled acrylic resins however, wear problems have
been encountered when composites were used to restore occlusal surfaces of teeth.
6. The composite resins appear to withstand abrasion by a toothbrush and a dentifrice
somewhat better than the unfilled resins.

Unfilled resin
- certain inherent characteristics in poly(methyl methacrylate) limit its use and its
effectiveness as a restorative material.
- the low hardness (15khn) and compressive strength (10,000 psi), high coefficient of
thermal expansion and lack of adhesion of tooth structure place restrictions as to where
it may be effectively employed.

III. 4 TYPES OF TOOTH COLORED RESTORATIONS

1. Plain/composite/ dental composite


- A highly cross-linked polymeric material reinforced by a dispersion of amorphous
silica, glass, crystalline, or organic resin filler particles and/or short fibers bonded
to the matrix by a coupling agent.
- Used for all classes of cavity
- This part will be the focus of our report and will be further discussed later
2. Compomers
- The term compomer is derived from the words composite and ionomer.
- It is also known as polyacid-modified resin-based composite;
- It is a resin-based composite material containing silicate glass filler particles and
methacrylate and acidic monomers as matrices
- More composite, small part of GIC
- Releases fluoride for chemical lesions
- Used for restorations in low-stress-bearing areas

3. Hybrid / resin modified GIC


- Modified glass ionomer cement that incorporates polymerizable monomer and a
cross-linking agent
- This type of cement has a longer working time and is less sensitive to water
contamination than conventional glass ionomer cement; also called hybrid ionomer
cement.
- Has better aesthetic than GIC
- More GIC and small part of composite

4. GIC
- An aqueous-based material that hardens following an acid-base reaction between
fluoroaluminosilicate glass powder and a polyacrylic acid solution
- Also referred to as conventional GIC.
- GIC is an adhesive tooth colored anticariogenic restorative material
- Originally, the cement was intended for the aesthetic restoration of anterior teeth,
and it was recommended for use in restoring teeth with Class III and Class V cavity
preparations.
- Because of its adhesive bond to tooth structure and its caries prevention potential,
the types of glass ionomers have expanded to include their use as luting agents,
orthodontic bracket adhesives, pit and fissure sealants, liners and bases, core
buildups, and intermediate restorations.

DENTAL COMPOSITES

IV. 3 COMPONENTS OF DENTAL COMPOSITES

● Matrix
● Filler
● Coupling Agent

● Matrix
A plastic resin material that forms a continuous phase and binds the filler particles.
Resin Matrix
The most common resins are based on dimethacrylate (Bis-GMA, bisphenol A-glycidyl
methacrylate) or urethane dimethacrylate (UDMA) oligomers. Bis-GMA and UDMA oligomers are
viscous liquids to which low-molecular- weight monomers (dimethacrylates) are added to control
the consistency of the composite paste.
● Filler
Reinforcing particles and/or fibers that are dispersed in the matrix.
- Incorporation of filler particles into a resin matrix greatly improves material properties,
provided that the filler particles are well bonded to the matrix. If not, the filler particles do
not provide reinforcement and can actually weaken the material. Because of the
importance of well-bonded filler particles, the use of an effective coupling agent is
extremely important to the success of a composite material.

● Coupling agent
Bonding agent that promotes adhesion between filler and resin matrix. To provide a good bond
between the organic fillers and the resin matrix, manufacturers treat the surface of the filler with
silane, which has groups that react with the inorganic filler and other groups that react with the
organic matrix.

V. SHORT DEFINITION OF DENTAL COMPOSITES

Dental Composites
Dental composites are highly cross-linked polymeric materials (Structural units of the polymer are
often connected together in a manner to form a nonlinear/ non proportional, branched or cross-
linked polymer) reinforced by a dispersion (size) of glass, crystalline, or resin filler particles
and/or short fibers bound to the matrix by silane coupling agents.

Other names:
- Filled resins
- Filled Composite
- Dental composite
VI. BIOLOGIC PROPERTIES OF DENTAL COMPOSITES (Skinner’s Science of Dental
Materials 8th Edition, Ralph W. Philips)

- The irrational characteristics of composite resins are comparable to those of the unfilled
acrylic resins. Thus, the same protective measures should be used as was described for
those materials.
- As for many other restorative materials, whenever the cavity preparation is deep, the pulp
must be protected from possible injury from the irritants in the resin
- A calcium hydroxide cement base is the preferred material for placement on the cavity
floor before insertion of the resin
- As a general rule, cavity varnish or a zinc oxide eugenol cement is contraindicated
because of the potential softening of the resin at the interface by the eugenol or solvent in
the varnish, as for acrylic resins.

VII. 4 TYPES OF DENTAL COMPOSITES IN GENERAL

Nanofilled
- Used in Class I, II, III, IV, V
- Nanofill and nanohybrid composites have average particle size less than that of microfilled
composites.
- It combines conventional filler technology with nanoparticles to achieve both strength and
aesthetics in one material. Currently, two distinct types of nanofill composites are in the
marketplace: completely nanofilled resins and nanohybrids
- The nanofilled composites present similar mechanical and physical properties to those of
microhybrid composites, but when it comes to polish and gloss retention they perform
slightly better
- Advantages: it is highly polishable, tooth-like translucency, high wear and stain resistance,
and good handling characteristics

Microfilled
- Are small filler particles
- Used in Class III, V for anterior aesthetic restoration
- Filler used is colloidal silica
- The average particle size of microfilled resins ranges from 0.04-0.1 microns
- Its filler content is 35-50% by weight
- Advantages: good aesthetics: appearance like enamel and high polishability
- Because of its high luster, microfilled composites are most frequently used for class V
restorations or as the top layer on an anterior restoration. It can be polished to a high luster
to look like enamel.
- Disadvantages: has poor mechanical properties due to more matrix content, poor color
stability, low wear resistance, less modulus of elasticity and tensile strength, more water
absorption, high coefficient of thermal expansion

Packable composite
- These composite is recommended for use in Class I, II (MOD, mesial-distal-occlusal), and
VI cavity preparations
- It is composed of light-activated dimethacrylate resins with fillers that are fibers, porous or
irregular particles with a filler loading of 66% to 70% by volume
- The interaction of the filler particles or modifications of the resin matrix causes these
composites to be packable.
- Important properties include: high depth of cure, low polymerization shrinkage, radiopacity
and low wear rate. Note that radiopaque composites are used in posterior restorations
- Light-cured bonding agents are used with this composite

Flowable composite
- These light-cured, low viscosity composites are recommended for cervical lesions,
pediatric restorations, and other small low-stress-bearing restorations.
- Used in cervical areas because of their lower filler content and because it exhibits higher
polymerization shrinkage and lower wear resistance compared to microhybrid composites
- Contains dimethacrylate resin and inorganic fillers with a particle size of 0.4 to 3.0 μm and
filler loading of 42% to 53% by volume
- It has low modulus of elasticity which may make them useful in cervical erosions and
abfraction areas

VIII. 4 TYPES OF DENTAL COMPOSITES BASED ON FILLER PARTICLES


Nanofilled Composites
- Smallest, fine as sand
- Its particles are nanometer-sized throughout the matrix
- It has 78% filler content
- Its nanomers ranges between 0.02 – 0.07 microns
- It has nanoclusters that act as single unit which are about 0.6 – 1.4 microns

Microfilled Composites
- Filler used: colloidal silica
- It has an increased viscosity because of its small filler size
- Filler size: 0.04μm (200-300x smaller than average particle size of traditional composites)
- 40 to 80 vol% of the restorative material is made up of resin

Macrofilled Composites (Traditional)


- These materials are no longer widely used hence the term traditional
- Filler is made up of crystalline quartz
- It has comparatively large particles that ranges from 8-12 microns. Although that is the
average size, particles as large as 50 μm may also be present.
- Its filler loading is generally around 60 to 70 vol%.
- Suitable for Class III, IV, V
- These are difficult to polish as its large particles are prone to pluck
- It also has poor wear resistance as it develops a rough surface during abrasive wear of
the soft resin matrix, thus exposing the more wear-resistant filler particles, which protrude
from the surface
- Macrofilled composites have large filler particles, which result in a restoration that feels
rough to a dental explorer and can appear rough to the eye. The likelihood of plaque
accumulation and stain is greater. This material is used most frequently by orthodontists
to bond brackets or other orthodontic appliances.

Hybrid Composites
- As the name implies, hybrid composites contain two kinds of filler particles.
- Hybrid composites are composed of glasses of different compositions and sizes, with
particle size diameter of less than 2μm and containing 0.04μm sized fumed silica
- Filler content in these composites is 75 to 80 percent by volume
- It is suitable for Class I-V
- It has different degrees of opaqueness and translucency in different tones and
fluorescence and is available in various colors
- It has an excellent polishing and texturing properties and good abrasion and wear
resistance
- Hybrid composites have sufficient strength to restore fractured incisal edges.

IX. HOW COMPOSITES ARE ALLOWED TO SET/CURED


This can also be considered as 3 types of composites based on the manner of activating benzoyl
peroxide

1. Chemical cured
- Also referred to as cold curing or self curing
- Chemically activated polymerization is initiated by mixing two pastes just before
use -- one with initiator and one with activator
- initiator - composed of benzoyl peroxide
- Activator - composed of dimethyl paratoluene
- Disadvantages:
- Possibility of entrapment of air bubbles due to rough surface / underfilling
(outside) and weaker restoration (inside). During mixing it is almost
impossible to avoid incorporating air into the mix, thereby forming pores
that weaken the structure and trap oxygen, which inhibits polymerization
during curing.
- The clinician has no control over the working time after the two components
have been mixed.
- Therefore both insertion and contouring must be completed quickly once
the resin components are mixed.
2. Light cured
- Single paste form (most common)
- Camphorquinone - a photoinitiator that triggers polymerization of light-curing
materials such as dental adhesives and composites
- UV light, Halogen light, Blue (diode) light
- Halogen light - does not cause skin irritation, can cure thicker bulk (2mm thickness)
of composite
- Amine accelerator - diethylamino ethyl methacrylate
- Advantages:
- Mixing is not required, which results in less porosity, less staining, and
increased strength
- Allows the clinician to complete insertion and contouring before curing is
initiated.
- Command polymerization on exposure to light, provides the control of
working time
3. Dual cure
- Combination of chemical curing and visible-light curing components in the same
resin.
- Inner part that can't be reached by light is chemically cured
- The surface part is light cured. → stronger
- Can be used as cementing medium for example posts, porcelain crowns,
composite and porcelain veneers (labial veneers), composite inlay and onlay
- Opacifier (is a substance added to a material in order to make the ensuing system
opaque) - ex. titanium dioxide and aluminum oxide
- Like the chemically cured resins, air inhibition and porosity are problems with dual-
cure resins.

X. INDICATIONS OF USE : DENTAL COMPOSITES

1. Restoration of cavities
- For direct aesthetic anterior restorations
- For restoration of posterior occlusal areas and other high-stress–bearing sites

2. Pit and fissure sealants


- Sealants are applied for permanent teeth especially in the newly erupted 1st permanent
molar which erupts at 6-7 years old. The sealant is applied on occlusal surfaces of teeth.
The objective is for the composite resin to penetrate into the pits and fissures, polymerize,
and seal these areas against the oral flora and debris. Sealants must be relatively low
viscosity so that they will flow readily into the depths of pits and fissures and wet the tooth.

3. Badly stained teeth - labial veneer (change the shade of anterior teeth)
- Bonding of ceramic veneers
- Resin composites can also be used as a conservative alternative to conventional
prosthodontic restorations, such as veneers for masking tooth discoloration or
malformation. The resins are used as preformed laminate veneers, in which resin shells
are adjusted by grinding and the contoured facing is bonded to tooth structure using the
acid-etching technique with either chemically activated, visible light-activated, or dual-cure
luting resin cements. Resins used to cement indirect restorations, veneers, and prosthetic
devices are similar to flowable restorative resins, but are adjusted to match the needs of
luting applications.

4. Fracture tooth

5. Diastema closure
- Have limitations, if the space is beyond 2.5mm, do not restore with composite.

6. Core build-up (provisional foundation for the crown)


- When a tooth is severely damaged and there's not enough natural tooth structure to
support a restoration, a procedure called a “core build-up” is performed using composite
(tooth-coloured filling) to add enough structure so the tooth can accept the crown or onlay.

7. Splinting (bond periodontal splints) - healing therapy for periodontium

8. Repair of porcelain

9. Peg shaped tooth: change the shape of lateral

10. Bond all ceramic restorations

11. Bond orthodontic brackets

12. Indirect Posterior Composite: inlays and onlays:


- Indications: when more than half of the tooth biting surface is damaged a dentist will often
use an inlay or an onlay.
- Inlays: are restorations fabricated inside the patient's mouth when there is class 1 or 2
caries (confined within the walls of cavity, does not involved the cusp)
- Onlays: restoration fabricated outside the patient’s mouth replaces tooth tissue including
cusps.
- Onlays also fit inside the tooth, but extend onto the chewing surface of a back tooth to
replace one or more cusps

XI. CONTRAINDICATIONS OF USE : DENTAL COMPOSITES

1. Habit bruxism (bruxers, clenchers) (night grinding)


2. Deep gingival preparation - difficult to ensure close marginal adaptation and marginal
seal (pag masyadong malalim yung cavity lagpas na sa gingiva)
3. Poor Moisture control - results to microleakage, staining, recurrent caries and sensitivity
(wag ilagay ng masyadong basa ang tooth, di pwedeng pwede na, dapat tama na, wag
too much air drying or kulang)
4. Large restoration - increases polymerization shrinkage → possible treatment should be
evaluated first whether to do root canal therapy or surgical extraction

XII. INSTRUMENTS/ARMAMENTARIUM

Basic instruments/armamentarium
● mouth mirror - for retraction, to provide indirect illumination on the gums and teeth where
direct light doesn't reach
● dental explorer - used to examine the tooth surface to determine the presence of caries
and to look for pulp exposure
● spoon shaped excavator - used to spoon out dental caries from the prepared cavity
● non-locking cotton plier - for the placement of cotton rolls for isolation.

Additional instruments
● Woodson plastic instrument - is used for contouring and placing composite resins easily
● plugger - is used for packing, condensing and compacting the filling material into a tooth
cavity
● Ball tip end applicator - used in applying the calcium hydroxide and GIC
● high speed handpiece and burs - is for the removal of tooth tissue efficiently and rapidly
with no pressure, heat or vibration
● air and water syringe - used to clean a tooth or surface during the procedure
● composite trimmers/ polishing bur - is used for recontouring and polishing the surface of
the composite material placed on tooth

XIII. MATERIALS & EQUIPMENT

MATERIALS
● acid etchant, bonding agent and composites
● microtip or microbrush - used for acid etchant and bonding agent
● bonding agent well - where we place the bonding agent
● calcium hydroxide - remember we use ball tip-end applicator in applying calcium hydroxide
if there is exposed pulp
● GIC - we use plastic spatula and mixing pad in mixing GIC cement. Ball tip end applicator
is also used in applying GIC
● cotton rolls - used for isolating tooth
● cotton pellets - use in acid etching
● rubber dam assembly - considered the optimal method to isolate a dental operative field
and to prevent moisture contamination
● mylar matrix - this will be discussed in the succeeding slides

EQUIPMENT
● light curing machine - a piece of dental equipment that is used for polymerization of light-
cure resin-based composites.

❖ Acid Etchant

In an article posted in Colgate titled, “Acid Etching: How Does it Work?”, the etching process
makes the tooth surface rougher, so the attached dental material is more secure.
This improves the marginal seal and mechanical bonding of the resin to tooth structure to
condition or pretreat the enamel with acid etch technique.

Phosphoric acid is used as the ethant. Most manufacturers supply acid etch kits that include
solutions which vary in concentration between 30 and 50%.
-Acid etchant used in dentistry has a concentration of 37%.
-A monocalcium phosphate monohydrate rapidly forms on the enamel which then protects the
tooth from further dissolution.

Steps of Acid Etching:

1. Isolate the tooth using cotton rolls


2. Air dried tooth surface cavity, not desiccating it. (slow blow of air from air syringe)
3. Apply acid etchant on enamel walls using a cotton pellet or mini sponge, continually being
dubbed gently onto enamel. Leave it there for 15 seconds. (the surface is not scrubbed or
rubbed during etchant application, as this may damage fragile enamel lattice network)
Side note:
-In etching, the dentin must be protected against the acid , particularly if the preparation
is deep. Only the enamel is treated. Therefore, wherever possible, a protective layer of a
calcium hydroxide liner is placed over the exposed dentin.
-Acid etchant is not applied when there is pulp exposure because this contains phosphoric
acid. It will irritate the pulp (soft tissue and highly vascularized).
4. Wash acid etching agent with continuous supply of water from the water syringe for 15-
20 secs and dry with a slow blow of air from the air syringe.
5. Enamel surface becomes porous (20 microns) after etching. Creating resin tags, which
are the spaces/pores for composite to interlock, providing retention for the composite to
the prepared cavity.
● A properly acid conditioned surface will have an opaque matte appearance as
compared with the glossy translucency of normal enamel. Once the enamel attains
this appearance, the etching is stopped. If no frosty white appearance on etched
enamel → reapply another for 15 seconds.

Advantages of Acid Etching


-The improved retention via the etching increases the stability of the restoration.
-It also simplifies the procedure, since less retention is required in the cavity preparation itself.
-The more intimate bonding of the resin to enamel should reduce the incidence of marginal stains
of any resin restoration, as such discoloration is indicative of microleakage.

❖ Bonding agent - used to bond composite, does not have filler.

→ after acid etching (15 secs), rinse with water (15 secs again), air dry
→ then apply bonding agent and cure for 10 seconds

-The composite resins are more viscous and the presence of fillers, it has been theorized that
they might not readily penetrate into the discrepancies produced in enamel by acid etching.
-The accompanying reduction in the depth of penetration into the etched areas could reduce the
resin tag length and total surface area of the resin tooth interface, mechanical retention, marginal
adaptation of the restoration could be impaired.
-on the basis of such reasoning, bonding agents were developed for use in conjunction with
composite resins.
-that is why when we buy ng composite resin, it is accompanied by bonding agent and acid
etchant.

-In most instances the composition of the commercial bonding agent is basically that of the
matrix of its companion composite resin. Therefore, it has no true adhesion to the tooth structure.
The resin in the bonding agent has been diluted with other monomers to a degree that it has low
viscosity and readily wets the tooth surface. When painted on the cavity walls, it freely penetrates
into the tiny porosities produced by the acid etching where it polymerizes.
-It is rationalized that when the composite restorative resin is then inserted into the cavity , it will
polymerize to the bonding agent present on the cavity surface. In this way, there will be better
adaptation to the enamel walls of the cavity achieved with improved mechanical retention of the
restoration.
-Bonding agents are generally supplied as two liquids. As with the composites, the components
are the same except the bonding agent contains “benzoyl peroxide initiator” and the other is
the “amine activator.”

XIV. APPLICATION: Packing of composite/condensation

APPLICATION: Packing of composite/condensation

Condensation: In dentistry, the process of packing a filling material into a cavity, using such force
and direction that no voids result.

1. Isolate the tooth using rubber dam assembly to prevent premature contact with fluids
(blood, saliva).
2. Tooth preparations: remove carious lesions depend on class of caries using high speed
handpiece and bur.
3. Rinse with water to remove the debris and air dry without desiccating it (not to the level
that is super dry)
4. Apply etchant for 15 seconds. (Note: only on the enamel walls).
5. Wash acid etching agent with continuous supply of water from the water syringe for 15-
20 secs. And dry with a slow blow of air from the air syringe.

Following steps will be based on the depth of cavity. Radiographs is useful in determining
cavity depth

If class A depth of cavity:


Class A (ideal: depth is 0.2 - 0.5 mm. beyond DEJ) (no dej involvement)
● Apply a bonding agent using the microbrush or microtip then cure.

If class B
Class B: 1 mm. Thickness of dentin to cover the pulp, but less than 0.5 mm. beyond the DEJ.

● Before acid etching, we should apply a liner (GIC type III) using a ball end tip
applicator in 1 mm. thickness.
● Apply a bonding agent then cure.

If class C, D:
Class C: with pinpoint pulp exposure
Class D: with pulp exposure.

➔ before acid etching:

● Apply calcium hydroxide using a ball tip end applicator on the pulp exposed.
● Then apply the base (the base we should use should be GIC, not ZOE since : zinc oxide
eugenol is only used for amalgam restorations and according to many investigations, a
resin-based composite material should not be used over ZOE because eugenol
suppresses/inhibit the polymerization of composite resin)
● Apply a bonding agent then cure.

➔ After the bonding agent has been cured, we can now place the composite resin. In
applying composite resin it should be applied and cured layer by layer.

❖ Apply dental composite and cure (for 20 seconds) layer by layer (per increment: 1.5
- 2mm) to avoid spaces. (instruments used: woodson plastic instrument, plugger)
→ Fill the cavity in an overlapping zigzag pattern.
→ Put a mylar matrix/ celluloid strip in between the adjacent tooth and the tooth you're
working on (if not doing single isolation rubber dam assembly). This will replace the
missing cavity wall, also used to displace excess composites (remove excess before
curing), to prevent premature contact with moisture and air.
❖ Polish using finishing burs or composite trimmers (white stones of different shapes). Note
the precise occlusal anatomy of the final restoration with no occlusal adjustments needed.

Sidenote:
Proper light curing is important, the tip should be within 2mm to be effective. The duration is a
minimum of 20 seconds, but still, it depends on the light curing machine.

Also it should be done layer by layer, to avoid air spaces and to set/polymerize properly. If not, it
can be a source of microleakage or it can result in a restoration that can dislodge easily (ampaw)
simply because only the top surface of the restoration polymerizes (tumigas) by the light cure
while the innermost layer of the composite is not set.

XV: DENTAL COMPOSITES VS AMALGAM

Advantages of Composite Advantages of Amalgam

Natural tooth-like appearance Easy to use

Time controllable Less experience needed

Adhesion to enamel Easier to carve

Repairable Economic (less expensive than composite)

Low thermal conductivity

Disadvantages of Composite Disadvantages of Amalgam

Difficult to form good posterior contact Unnatural-looking appearance because of its


color

May irritate the pulp Patients worry over mercury. Dental amalgam
is a mixture of metals, consisting of liquid
mercury and a powdered alloy composed of
silver, tin, and copper. Approximately half
(50%) of dental amalgam is liquid mercury by
weight.

More expensive Longer setting time

No adhesion to enamel

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