Asian Journal of Biomedical and Pharmaceutical Sciences

Reach Us +1 (202) 780-3397

Review Article - Asian Journal of Biomedical and Pharmaceutical Sciences (2023) Volume 13, Issue 99

Recent advances in composite resins- an overview

Dr Yesh Sharma1*, Dr Diya Sharma2, Dr Akshat Waran1, Dr Kailash Asawa2, Dr Mridula Tak2, Dr Sai Kancharlawar2, Dr Ankita Rawal2

1Department of Conservative Dentistry and Endodontics, Pacific Dental College and Hospital, Rajasthan, India.

2Department of Public Health Dentistry, Pacific Dental College and Hospital, Rajasthan, India

*Corresponding Author:
Dr Yesh Sharma
Department of Conservative Dentistry and Endodontics
Pacific Dental College and Hospital
Udaipur, Rajasthan, India
E-mail: syesh50@gmail.com

Received: 01-Mar-2023, Manuscript No. AABPS-23- 91554; Editor assigned: 04-Mar-2023, PreQC No. AABPS-23- 91554 (PQ); Reviewed: 18-Mar-2023, QC No. AABPS-23- 91554; Revised: 22-Mar-2023, Manuscript No. AABPS-23- 91554 (R); Published: 29-Mar-2023, DOI:10.35841/2249-622X.99.175

Citation: Sharma Y. Recent advances in composite resins- an overview. Asian J Biomed Pharmaceut Sci. 2023;13(99):175

Introduction

The accordance of material used till dates were not aesthetically acceptable with the tooth. Since the mental health of the patient relies on aesthetic quality of the restoration, in the same way patient’s physical / dental health depends upon biological and technical qualities of the restoration [1].

Since last 50 years, these composite resins have been used in clinical dentistry [2]. as it restores biological tissue not only in appearance but also in function. Composite resins have taken over amalgam as a posterior restorative material. Resin reinforced with silica / porcelain particle constitute these composite resin [3]. Micro leakage and postoperative sensitivity further leading to low protection due to discoloration, tensile pressure and scrapped area van be considered to be imposing flaws of these materials [4].

These composite resin contribute to multifarious success of modern biomaterial research [5]. Certain properties of inorganic filler of composite resin that comprises of rigidity, strength and hardness and that of organic resin matrix include subsequent polymerization for rapid setting, sufficient fluidity for easy application. A silane coupling agent bonds the filler and matrix together [6]. In order to directly bond the composite resin filler to dentine / enamel a separate binding agent is used [7].

Additionally, to strengthen the composite resin various other variants have been found which includes:

• Nano composite.

• Fiber reinforced composite.

• Direct composite resin.

• Indirect composite resin.

• Silver diamine fluoride (SDF) composite.

• Antimicrobial composite.

• Micro-hybrid composite.

• Bulk- fill composite.

• Gingival-color composite.

• Self-healing composite.

• Stimuli responsive composite.

• Ormocers.

• Compomers.

Definition

Skinners (1991) defined composite as “a compound of two or more distinctly different materials with properties that are superior or intermediate to those of the individual constituents [8,9].”

Classification

Based On Density

1. Low density (Fluid).

2. Medium density (Conventional).

3. High density (Packable).

4. Super high density (Ceromers).

Types of Composite Resin

The most popular classification is based on filler particle size given by Lutz and Phillips in 1983 [10]. According to this classification, composite resins were divided into

1. Macro filled composites,

2. Micro filled composites and

3. Hybrid composite

Recent advances in composite

Recent advancements expedite the utilization of composite resin in various industries such as aerospace, automotive, and construction.

Organically modified ceramic oligomers (ORMOCER)

An initialism of organically modified ceramic technology (Cunha et al ., 2003)- ORMOCER is considered to be moleculesized hybrid structure [11-13]. They are high molecular weight, relatively low viscosity crosslinking molecules and flexible. The inorganic network provides abrasion resistance through its glass-like structure and low water. Sorption due to its hydrophobicity and low-level polymerization shrinkage is due to large spacing between crosslinks [14].

Indications

1. As a liner of class I and II cavities

2. Restoration of GV BLACKS class I, II, V cavities

3. Reconstruction of traumatically damaged anteriors

4. Splinting of loose teeth

5. As a extended fissure sealant

6. Fabrication of composite inlay

7. Core build up

Contraindications

In areas where esthetics is of prime importance.

Advantages

1. Better marginal seal.

2. Limited cure shrinkage.

3. Very high biocompatibility.

4. Good manipulation properties.

5. Excellent esthetics.

Disadvantage

• Highest cytotoxicity

• Tendency to discolour.

• Lower wear resistance.

Nanocomposites

The composite is said to be made up of a matrix and filler reinforcement. The filler reinforcement brings to the composite material its greater mechanical performance, and the role of the matrix is to transmit the external mechanical load along with protection of the composite restoration against external attack15. These composites are considered to have approximately 60% volume filler loading, making the Nanofilled resins as strong as the hybrid and micro-hybrid resins. Nanofillers may consist of colloidal silica or ormocers, such as Inceram X from Dentsply. Nanoparticle filled dental particles can provide an enhanced fracture toughness and adhesion to tooth tissue [15-18].

Advantages

1. Improved mechanical characteristics

2. High cost

3. Resistance to corrosion

4. Improved handling properties

5. Good thermal stability

6. Increased transulency leading to surface gloss

Condensable composites or packable composites or polymer rigid Inorganic matrix material (PRIMM)

The filler mainly constitutes Aluminium oxide, Silicon oxide glass particles or barium aluminium silicate or strontium glasses. The colloidal silica ultrafine particles are also encompassed to control the handling characteristics such as resistance to flow, condensability, viscosity and reduced stickiness [19]. The physical and mechanical behaviour of these materials beat hybrid-composites and silver amalgam [20]. The clinical performance of these materials are similar to that of the hybrid composites [21-23].

Indication

In class II cavities.

Fiber Reinforced Composites (FRC)

The most commonly used fibers in dental composites are Glass fibres, carbon fibres polyethylene fibres, aramid fibres, etc. Orientation of these fibres can be done in different directions; unidirectional, weave type, mesh type, etc., in the resin matrix in order to improve the physical and mechanical properties of composites. The durability of the fibre-reinforced composite is an subject to essential factors including fibre loading within the resin, the orientation of fibres, adhesion of fibres to the matrix ,volume of fibres in composite matrix, etc24. To provide bonding between resin matrix and fibres silane coupling agents are commonly used [24,25].

Advantages

1. Strength

2. Stiffness

3. Improved wear resistance

Indications

1. Fixed partial denture

2. Periodontal splinting/ post trauma splint

3. Fixed orthodontic retainers

4. Reinforcing or repairing dentures

5. Root posts

6. Reinforced biomedical implants.

Self-healing / repairing materials

It has a inbuilt intrinsic mechanism to manage the micro cracking before it starts affecting the integrity of the material [26].

Indications

GV BLACKS Class I, II cavities.

Contraindications

GV BLACKS Class III, IV V cavities.

Advantages

1. Increased resistance to fracture.

2. Reduces polymerization shrinkage

3. Better durability and toughness as compared to conventional composites

4. Increased flexural strength and wear resistance.

Disadvantages

Technique sensitive.

Antimicrobial Composite

The antimicrobial properties of these composites can be accomplished by introducing agents such as silver (Peng et al., 2012) titanium particles, immobilized antibacterial components (Xie et al., 2011; Imazato et al., 2012) or one or more antibiotics into the material [27,28]. New dental composites that contain quaternary ammonium dimethacrylate (QADM) and silver nanoparticles (AgNP) have been manufactured and observed to inhibit Streptococcus mutans (S.mutans) (Zhang et al., 2013; Cheng et al., 2018).

Advantages

1. Reduces formation of secondary caries near margin of restorations due to inhibition of bacterial growth

2. Enhanced biocompatibility

3. Reduced demineralization and buffering of acids produced by cariogenic microbes.

Disadvantage

1. Deterioration of physical and mechanical properties of the material

2. Short lived antibacterial activity

3. Toxic effects of released materials.

Flow able composite

They lack adequate strength to withstand high stresses as the filler content was reduced [29-33]. These composite show more polymerization shrinkage and less elastic moduli due to increase in resin content. These composite tend to wet the tooth surface better and flows easily into the every undercuts. It forms in thin layers reducing the formation of air pockets at the tooth-restoration interface.

Compared to camphor-quinone amine system, these materials contain a germanium based photo initiator which is more effective and has a much higher significant yield [34].

Compomers

They are resultant of a combination of composites and glass ionomer cements and were showcased as polyacidmodified composite resins. These materials gives fluoride articulation can adhere efficiently to dental hard tissues and is a biocompatible material [35]. The core of composers is shaped of polycarboxylate polymers and methacrylate with resins which can undergo polymerisation, glass filling particles, for eg, fluoroaluminoxylate, and also strontium fluoroxylate or it may also contain barium fluoroxylate glass and photograph triggers (camphoroquinone/amine framework) and balancers [36].

Siloranes (siloxane + oxirane)

The purpose of oxyrane configuration is to lessen polymerisation shrinkage that usually occurs and the siloxane works in development of a hydrophobic structure [37,38]. These resins also help in diminishing negligible discoloration to a base, expanding protection from debilitating and giving protection from fluids, not being mutagenic. Investigations discovered that the shrinkage pace of silorane-based composites is <1%.

Indirect composite resin

These resins exhibit contour, superior marginal adaptation, and proximal contact as it is fabricated on a die than in cavity preparation [39]. Micro hybrid filler of second generation composites have diameter of 0.04-1 μ with twice the filler content than that of first generation. The polymerization shrinkage is diminished by lessening the organic resin matrix, and the mechanical properties and wear resistance is improved by expanding filler load.

Omichroma

These material with its 260nm round filler particles use auxiliary shading. To cause production of red-to-yellow shading, fillers of essentially specific size and shape are anticipated. The round fillers that consolidates with the reflected shade of the patient’s encompassing dentition, making the ideal match from A1 to D4 and beyond lead to red to yellow shading [40].

Giomer

Giomer is a resin-based dental adhesive, fluoride-releasing material that comprises Pre-Reacted Glass-ionomer fillers. Glass ionomers have high fluoride release, low polymerisation shrinkage, are easy to place, fast-setting ,hydrophilicity and bonding ability to enamel and dentin. Benefits of reduction in microleakage and immediate finishing and polishing are due to light activated glass ionomer [41].

A surface prereacted glass (S-PRG)filler to the resin matrix is present in Giomer and this filler helps in fluoride release. BISGMA(Bisphenol-A glycidyl dimethacrylate), UDMA(urethane dimethacrylate), BISMPEPP(2, 2 bis(4-2 methacrlyloxy)ethoxy)phenyl propane), TEGDMA(triethylene glycol dimethacrylate are also present in organic matrix.

Indications

1. GV BLACKS III, IV V cavities.

2. Restorations of deciduous teeth.

3. As a base/liner under restorations.

4. Repair of fractured incisal edges

5. Restoration of fractured composites and porcelain

6. As a fissure sealant

7. Veneers and post

8. Cervical erosion and root caries.

Contraindications

In areas where esthetics is of prime concern.

Advantages

1. Better esthetics

2. Improved handling and physical properties compared to conventional composites

3. Increased radioopacity compared to conventional composites

4. Low shrinkage stress

5. Shade stability before and after curing.

6. High fluoride release and recharge capability.

Disadvantage

1. Rough surface resulting in tooth discoloration

2. Vickers hardness value are less than composite

3. Not beneficial in high recurrent caries lesions as release of fluoride is less than that of GIC

4. Long term fluoride release is questionable.

Stimuli responsive / smart materials

External stimulus such as temperature, pH, mechanical stress, moisture, etc are the properties on which these material depend. Depending on the pH, these composite materials release fluoride, calcium, and hydroxyl ions into the surroundings of the filling. A significant number of ions than that at the neutral pH are released especially when the pH is less than 5.5. They also provide additional caries protection [42-44].

Self-adhering composites

Also called as compo bonds that combines the advantages of both dental adhesives and restorative materials technologies (8th generation) in a single product [45]. Self-etching dentin bonding agents and nano-filled resins are its benefits. These composite got rid of the precursory bonding stage necessary to adhere, resin to tooth substrate, thus reducing the chances of postoperative sensitivity. They act as shock absorbers beneath the resin-based composite restoration as they also have the properties of 7th generation of dentin bonding agents [46].

Calcium phosphate nanoparticles

To make mineral releasing dental composites, calcium phosphate such as Hydroxyapatite phosphate, anhydrous calcium phosphate, tetra calcium phosphate and dicalcium phosphate anhydrous have been used as fillers. Stress-bearing capacity and ion release that inhibit dental caries is improved due to incorporation of these particles [47,48].

Bellglass HP

Indirect restorative material introduced in 1996 by Belle de St. Claire. are cured under pressure (29 PSI) at an elevated temperature of 1380C and in the presence of nitrogen gas due to which they have increased polymerization rate. Due to curing in the presence of nitrogen gas they have increased wear resistance. As nitrogen gas provides an oxygen-free environment the rate of curing is also improved. There is reduction in translucency of composite and delay in polymerization reaction due to role of oxygen as polymerization inhibitor [49,50].

Art glass

Art glass is a nonconventional dental polymer. The fillers used are radiopaque Barium glass with an average particle size of 0.7 micrometres and colloidal silica. They are used in making indirect restorations such as inlays, onlays, and crowns. Improved wear resistance and other physical and mechanical properties due to the greater level of crosslinking are displayed by these materials. For curing of these resins, a special light curing unit such as Xenon stroboscopic light-curing device with the emission ranges from 300-500 nm is used.

Advantages

1. High wear resistance compared to traditional composites

2. Good marginal adaptation

3. Esthetics

4. Superior proximal contact.

References

  1. Schulein TM. Significant events in the history of operative dentistry. J Hist dent. 2005;53:63-72.

    2. Indexed at, Google Scholar

  2. Cramer NB, Stansbury JW, Bowman CN .Recent advances and developments in composite dental restorative materials. Journal of dental research. 2011;90:402-16.

    3. Indexed at, Google Scholar, Crossref

  3. Stein PS, Sullivan J, Haubenreich JE, et al. Composite Resin in Medicine and Dentistry. J Long-Term Eff Med Impl. 2005;15:641.

    4. Indexed at, Google Scholar, Crossref

  4. Ferracane J . Current trends in dental composites. Crit Rev Oral Biol Med. 1995;6:302-18.

    5. Indexed at, Google Scholar, Crossref

  5. Cangul S, Adiguzel O. The Latest Developments Related to Composite Resins. Int Dent Res. 2017;7:32–41.

    6. Indexed at, Google Scholar, Crossref

  6. Prasad N. Sarkar in Contemporary Dental Materials ed VB Dhuru. Oxford Univ Press Oxford. 2004.

    7. Google Scholar

  7. J F McCabe, Walls AWG, Applied Dental Materials ninth edn Blackwell Publishing. Oxford, 2008.
  8. Phillips RW. Skinner's science of dental materials philadelphia. Saunders. 1973.

    9. Indexed at, Google Scholar, Cross Ref.

  9. Wei S H, Tang el. Composite resins: a review of the types, properties and restoration techniques. Annals of dentistry university of malaya. 1994;1:28-33.

    10. Indexed at, Google Scholar, Crossref

  10. Vijay prakash, Ruchi gupta. Textbook of dental materials 1 st edition 2018.
  11. Rama Krishna Alla. Restorative Materials: Composite Resins, (In) Dental Materials Science.  Jaypee Brot Medi Publ, 2013; 130-48.

    12. Google Scholar

  12. Sivakumar A, Valiathan A. Dental Ceramics and Ormocer Technology – Navigating the future. Trends Biomater Artif Organs 2006; 20: 40-3.

    13. Indexed at, Google Scholar.

  13. Leinfelder KF. New developments in resin restorative systems. J Am Dent Assoc. 1997; 128: 573-81.

    14. Indexed at, Google Scholar, Crossref

  14. Chatzistavrou X, Lefkelidou A, Papadopoulou et al. Bactericidal and bioactive dental composites. Frontiers in physiology. 2018;9:103.

    15. Indexed at, Google Scholar, Crossref

  15. Singh P, Kumar N, Singh R, et al. Overview and recent advances in composite resin: a review. Int j sci stud. 2015;3:169-72.

    16. Indexed at, Google Scholar

  16. Ravi RK, Rama Krishna Alla, Shammas M, et al. Dental Composite – A Versatile Restorative Material: An Overview. Ind J Dent Sci. 2013; 5:111-15.

    17. Indexed at, Google Scholar

  17. Mitra SB, Wu D, Holmes BN. An application of nanotechnology in advanced dental materials. J Am Dent Assoc. 2003;134:1382-90.

    18. Indexed at, Google Scholar, Crossref

  18. Beun S, Glorieux T, Devaux J, et al. Characterization of nanofilled compared to universal and microfilled composites. Dent Mater. 2007;23:51-9.

    19. Indexed at, Google Scholar, Crossref

  19. Faras R, Pujar M, Lahiri A, etal. Recent advances in composite resins – A review. Paripex-Ind J Res. 2018;7: 93-94.

    20. Indexed at, Google Scholar, Crossref

  20. Suzuki S. Does the wear resistance of packable composite equal that of dental amalgam. J Esthet Restor Dent. 2004;16:355-65.

    21. Indexed at, Google Scholar, Crossref

  21. Herva s-Garcí a A, Martí nez-Lozano MA, CabanesVila J, et al. Composite resins A review of the materials and clinical indications. Med Oral Patol Oral Cir Bucal. 2006; 11:215-20.

    22. Indexed at, Google Scholar

  22. De Souza FB, Guimaraes RP, Silva CH. A clinical evaluation of packable and microhybrid resin composite restorations: one-year report. Quintessence Int. 2005;36:41.

    23. Indexed at, Google Scholar

  23. Benly P. Recent Advances in Composite – A Review. J Pharm Sci Res. 2016;8: 881-83.

    24. Indexed at, Google Scholar

  24. Alla RK, Sajjan S, Ramaraju AV, et al. Influence of fibre reinforcement on properties of Denture base resins. J Biomater Nanobiotech, 2013;4: 91-97.

    25. Indexed at, Google Scholar, Crossref

  25. Konakanchi A, Alla RK, Guduri V. Silane Coupling Agents – Benevolent Binders in Composites Trends Biomater. Artif Organs, 2017; 31: 102-107.

    26. Indexed at, Google Scholar

  26. Freilich MA. Fiber-reinforced composites in clinical dentistry. Quintessence Publishing (IL); 2000.

    27. Indexed at, Google Scholar, Cross Ref

  27. Singh P, Kumar N, Singh R, et al. Overview and recent advances in composite resin: A review. Int J Sci Study. 2015;3(9):169-72.

    28. Indexed at, Google Scholar

  28. Zhang JF, Wu R, Fan Y, et al. Antibacterial dental composites with chlorhexidine and mesoporous silica. J Dent Res. 2014;93(12):1283-9.

    29. Indexed at, Google Scholar, Cross Ref

  29. Olmez A, Oztas N, Bodur H. The effect of flowable resin composite on microleakage and internal voids in class II composite restorations. Oper Dent. 2004;29(6):713-9.

    30. Indexed at, Google Scholar

  30. Cohen RG, Newtown PA. The expanded use of improved flowable composite. Dent Town. 2008;64:25-35.

    31. Indexed at, Google Scholar

  31. Attar N, Tam LE, McComb D. Flow, strength, stiffness and radiopacity of flowable resin composites. J Can Dent Assoc. 2003;69(8):516-21.

    32. Indexed at, Google Scholar

  32. Ganesh IJ, Vasanthakumari A, Reddy V, et al. Revolutionary excellence of composite resins-a review. World J Pharm Med Res. 2018;4(9):116-9.

    33. Google Scholar

  33. Gupta R, Tomer AK, Kumari A, et al. Recent advances in bulkfill flowable composite resins: A review. Int J App Dent Sci. 2017;3(3):79-81.

    34. Indexed at, Google Scholar

  34. Jaya Singh, Rajkumar B, Boruah LC, et al. Bulk fill composites in dentistry- A review. Ind J Conser Endodont. 2019;4(1):9-13.

    35. Indexed at, Google Scholar, Cross Ref

  35. Hickel R, Dasch W, Janda R, et al. New direct restorative materials. Int Dent J. 1998;48(1):3-16.

    36. Indexed at, Google Scholar, Cross Ref

  36. Resin PM. Clinical evaluation of a polyacid-modified resin composite (compomer). Oper Dent. 1998;23:77-80.

    37. Indexed at, Google Scholar

  37. Eick JD, Smith RE, Pinzino CS, et al. Stability of silorane dental monomers in aqueous systems . J Dent. 2006;34(6):405-10.

    38. Indexed at, Google Scholar, Cross Ref

  38. Eick JD, Kotha SP, Chappelow CC, et al. Properties of silorane-based dental resins and composites containing a stress-reducing monomer. Dent Mater J. 2007;23(8):1011-7.

    39. Indexed at, Google Scholar, Cross Ref

  39. Singh P, Kumar N, Singh R, et al. Overview and recent advances in composite resin: A review. Int J Sci. Study. 2015;3(9):169-72.

    40. Indexed at, Google Scholar

  40. Available from https://www.tokuyama-us.com/omnichroma-dental-composite/.
  41. Meena N. GIOMER-the intelligent particle (new generation glass ionomer cement). Int J Dent Oral Health. 2015;2(4).

    42. Indexed at, Google Scholar, Cross Ref

  42. Badami V, Ahuja B. Biosmart materials: Breaking new ground in dentistry. Sci World J. 2014; 2014.

    43. Indexed at, Google Scholar, Cross Ref

  43. Yeli M, Kidiyoor KH, Nain B, et al. Recent advances in composite resins-A review. J Oral Res Rev. 2010;2(3):134-6.

    44. Indexed at, Google Scholar, Cross Ref

  44. Jandt KD, Sigusch BW. Future perspectives of resin-based dental materials. Dent Mater J. 2009;25(8):1001-6.

    45. Indexed at, Google Scholar, Cross Ref

  45. Shaalan OO, Abou-Auf E, El Zoghby AF. Clinical evaluation of self-adhering flowable composite versus conventional flowable composite in conservative Class I cavities: Randomized controlled trial. J Conserv Dent. 2018;21(5):485.

    46. Indexed at, Google Scholar, Cross Ref

  46. D’Alpino PH, da Rocha Svizero N, Carrilho M. Self-adhering composites. Dent Mater J. 2018:129-51.

    47. Indexed at, Google Scholar, Cross Ref

  47. Xu HH, Moreau JL, Sun L, et al. Nanocomposite containing amorphous calcium phosphate nanoparticles for caries inhibition. Dent Mater J. 2011;27(8):762-9.

    48. Indexed at, Google Scholar, Cross Ref

  48. Xie XJ, Xing D, Wang L, et al. Novel rechargeable calcium phosphate nanoparticle-containing orthodontic cement. Int J Oral Sci. 2017;9(1):24-32.

    49. Indexed at, Google Scholar, Cross Ref

  49. Nandini S. Indirect resin composites. J Conserv Dent. 2010;13(4):184.

    50. Indexed at, Google Scholar, Cross Ref

  50. Lutz F, Phillips RW. A classification and evaluation of composite resin systems. J Prosthet Dent. 1983;50(4):480-8.

    51. Indexed at, Google Scholar, Cross Ref

Get the App