Notes

Outline

Restorative Materials in  Pediatric Dentistry S.Lal, DDS Course Director

Preventive Materials Fluoride gels, foam and varnish: Used for remineralisation of decalcified enamel and incipient caries. Sealants: Indicated for preventing and arresting incipient lesions. Available as clear or white, filled or unfilled, containing Fluoride or not.

Resin based composites(RBC)        Resin matrix (Bis-GMA) with inorganic filler particles. 1.    Filler content-        Filled vs Unfilled        Flowable vs packable        Anterior vs posterior composite Particle size-        macro, microfilled and hybrids

Resin Restorations Steps: Etch, wash, dry or dessicate? Enamel and Dentin adhesives Composite selection and placement Curing tools and techniques

Resin Restorations Disadvantages: Polymerization shrinkage Technique sensitive Performance of posterior composites in large, stress bearing preparations is questionable

Dentin/Enamel adhesives in Pediatric Dentistry Dentin bonding agents or Primers: Smear layer Etch Hydrophillic and hydrophobic component (HEMA) Enamel adhesives or bonding agents: Hydrophobic resin such as Bis-GMA Hybrid layer- copolymerized layer of primer, bonding resin and collagen

Dentin/Enamel adhesives in Pediatric Dentistry 3-step total etch Total etch using prime and bond Self etch primers with bonding agent All-in-one adhesives e.g.- prompt L-pops

Glass Ionomer cements Fluorosilicate glass powder(base) combined with a water soluble polymer(acid)     e.g. - Ketac cement Resin-modified glass ionomer cements:    are glass ionomers  with a light polymerised resin component.    e.g.- Vitrebond and Vitremer

Resin-modified glass ionomers Advantages: Increased mechanical properties Physiochemically bonds to tooth structure Biocompatible, moisture forgiving Similar coefficient of thermal expansion as dentin therefore a good dentin replacement material. (sandwich technique) Ion lechability - Fluoride release(anticariogenic action) Minimal polymerization shrinkage

Compomers Polyacid-modified, resin based composite with fluoride releasing glass fillers.    e.g.- compoglass, dyract Better results after etch and bond Good mechanical properties and polishability

Amalgam No polymerization shrinkage Moisture forgiving Excellent mechanical properties Mercury toxicity Esthetics

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Research trends Polymerization shrinkage Mechanical properties More ‘forgiving’ materials

In  summary….     “ Primary teeth are a temporary dentition with known life expectancies of each tooth. By matching the ‘right’ restoration with the expected lifespan of the tooth, we can succeed in providing a ‘permanent’ restoration that will never have to be replaced.”