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

Slide 12

Slide 13

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.”


	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 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


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


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


	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


	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


	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


	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


	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


	No polymerization shrinkage
	Moisture forgiving
	Excellent mechanical properties
	Mercury toxicity
	Esthetics


	Polymerization shrinkage
	Mechanical properties
	More ‘forgiving’ materials


	“ 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.”