Restorative Materials in Pediatric Dentistry

Restorative Materials in Pediatric Dentistry
Presentation by: 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
• 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


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.”
Restorative Materials in Pediatric Dentistry.ppt