Composite restorations have been used in dentistry since the 1960s.
Over the last few decades, there has been an increased demand for cosmetic procedures. This demand has pushed dental material manufacturers to continuously develop materials that are not only durable but that also closely mimic natural dentition.
Composite materials have evolved over the years to provide an economical, conservative option for both anterior and posterior restorative procedures. The unique properties of composite materials make them ideal for cases that may require easy repair or the need to self-adjust.
Composite restorations have clear advantages over other dental materials.
They provide a viable option and should be considered for treatment in various restorative cases.
Composites have limited minimal thickness requirements, which allows for incredibly conservative preparation designs.
Composite is highly esthetic, with properties that mimic natural teeth, and also can be bonded to the tooth.
Composite restorations provide less wear to opposing dentition than other dental materials.
They are also straightforward to adjust, making it simple to customize chairside.
Laboratory fabricated composite resins offer additional curing methods beneficial to the material's strength and longevity.
There are many composite materials on the market for use in the indirect laboratory fabrication method. After researching and testing numerous composite materials, the restorative team at Burbank Dental Lab has found great success with the Ceramage (SHOFU) and Lava Ultimate (3M).
The following are benefits to consider for each of these material options.
Ceramage is a layered composite that is a zirconium silicate integrated restorative.
It consists of 73% micro-fine ceramic particles, which are embedded in an organic polymer matrix. This formulation provides for exceptional flexural strength, a high degree of polishability, and elasticity. We have found this material is strong and resilient; it can be used to create natural-looking restorations that blend beautifully to natural dentition.
Also, Ceramage offers the following benefits:
Unlike Ceramage restorations, Lava Ultimate (3M) is a computer-aided design/ computer-aided manufacturing (CAD/CAM) resin nano ceramic (RNC) (image is shown below).
With LAVA Ultimate, the restorations are milled out of blocks that consist of nano-ceramic particles embedded in a cured resin matrix. The blocks or discs that are used in the milling process are manufactured with precise resin-to-ceramic ratios. This gives the material unique durability, as well as esthetic properties.
Once milled, these restorations can be customized either intra-orally or extra-orally. This is an excellent way to ensure a seamless adaptation to the existing dentition.
Other benefits of Lava Ultimate include:
Both the Ceramage and Lava ultimate restorations are excellent for inlays and onlays. Composite is known to wear at about the same rate as natural enamel, making this material ideal for cases with occlusal margins. Also, composite restorations are indicated for:
Ceramage and Lava Ultimate are not recommended for areas where bonding is not viable or when fabricating long-span bridges.
As with all restorations, proper handling of the case is critical in ensuring the best results. One way to provide the best results from composite restorations is to adhere to ideal preparation guidelines. First, both the occlusal clearance and the isthmus width should be 1.5mm.
The shoulder margin and occlusal margins need to be at 90°, and the internal line angles need to be rounded. Setting the proper foundation will result in excellent fits and well-adapted restorations.
Proper cementation and finishing are critical to the success of the case. First, start with an adhesive resin product or a dual-cure resin. Clean the restoration and salinate, then follow the instructions from the manufacturer of your chosen bonding agent. Once the case has been seated, final adjustments or customizations can be made chairside.
These adjustments can be achieved by using fine diamonds and composite polishing paste. The polishing paste should be applied with a composite rotary instrument.
For larger cases, the SmartComposite Hybrid can be prescribed. This restoration is a combination of milled composite with a milled cobalt-chromium (Co/Cr) alloy frame (fig.4). With this restorative option, a composite overlay is milled to fit over a Co/Cr framework. The composite overlay is then bonded to this framework.
Pink composite is added to replicate tissue.
The benefits of using a SmartComposite Hybrid are as follows:
SmartComposite Hybrid cases are excellent options for cases where issues in the oral cavity call for a material that is easy to repair and will wear gradually.
In larger, more complex cases such as when two screw-retained implant-supported prostheses are opposing each other, prescribing SmartComposite is an excellent option. It is very common for clinicians to prescribe a monolithic zirconia prosthesis on the upper.
If both arches are being restored, it is recommended to fabricate a SmartComposite prosthesis on the lower arch. This helps to relieve stressors in the mouth.
The dental field is constantly changing and evolving. It is essential to stay on top of the different materials available and add solutions to your armamentarium that provide patients with unique treatment options.
At Burbank Dental Lab, we are dedicated to researching materials to provide the best restorations possible. While composite restorations are not the most highly prescribed restoration in dentistry, they play an essential role in providing excellent oral health.
Call or click the blue Chat Icon along the bottom right-hand corner of this page to discuss your ideal treatment plans and material options with Burbank Dental Lab Service Representative.
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