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Indirect Composite: A Great Restorative Option

mm Written by Andrew Sedler

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Advances in Composite Materials

Composite materials have gained significant popularity in dental restorations due to their versatile applications in tooth restoration and cosmetic enhancements. These materials have undergone notable advancements, resulting in enhanced physical and aesthetic characteristics. Consequently, they are extensively utilized to repair damaged or decayed teeth and to improve the overall appearance of the dentition.

The Benefits of Composite Restorations
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Composite restorations offer distinct advantages when compared to alternative dental materials. They present a viable option in various restorative cases due to their minimal thickness requirements and conservative preparation designs. With the ability to be directly bonded to teeth and their natural tooth-like properties, composites achieve a high level of esthetics. Moreover, compared to other materials, they cause less wear on opposing dentition.

Furthermore, composite restorations allow for easy chairside customization as they can be easily adjusted.

Dentists may benefit from prescribing indirect composite restorations in several ways:

  • Improved aesthetics: Indirect composite restorations can provide better aesthetics than direct restorations as they can be customized to match the color, shape, and size of the adjacent teeth.
  • Durability: Indirect composite restorations are made of strong materials that can withstand biting and chewing forces, making them more durable than direct restorations.
  • Better marginal adaptation: Indirect restorations are fabricated outside the mouth and can be precisely designed to fit the tooth preparation with a better marginal adaptation, reducing the risk of recurrent decay.
  • Time efficiency: Indirect composite restorations can be fabricated in a dental lab, allowing the dentist to use their chair time more efficiently, as the patient may not have to return for multiple appointments.
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Improvements in Dental Composites
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Like other materials in dentistry, composite has evolved and made advancements improving the performance of this material in a variety of ways. This is especially true when comparing direct composite materials to indirect laboratory composites.

Laboratory-fabricated composite resins offer additional curing methods beneficial to the material’s strength and longevity.

Other recent advancements in composites in dentistry include:

  • Improved strength and durability: Composite materials are stronger and more durable than earlier versions. This allows them to withstand greater stress and last longer, reducing the need for frequent replacements.
  • Enhanced aesthetics: Newer composites offer improved color-matching capabilities, making it easier to create natural-looking restorations that blend in seamlessly with surrounding teeth.
  • Reduced shrinkage: Shrinkage during the curing process can lead to gaps between the restoration and the tooth, increasing the risk of decay and other complications. Advances in composite materials have led to reduced shrinkage, improving the overall quality of the restoration.
  • Increased versatility: Composite materials can be used for a wide range of dental restorations, including fillings, crowns, bridges, and veneers. This versatility allows dentists to provide more comprehensive and customized treatment plans for their patients.
  • Improved handling: Advances in composite materials have made them easier for dentists to handle and manipulate, allowing for greater precision and control during the restoration process.

Overall, these advancements in composite materials have led to improved outcomes for dental patients, with stronger, more durable, and more aesthetically pleasing restorations.

Indirect laboratory fabrication methods can use a variety of composite materials. Researchers and testers at Burbank Dental Lab have found great success with Ceramage (SHOFU), Lava™ Ultimate (3M™), and Burbank Dental Labs’ own SmartComposite® Hybrid.

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Ceramage Composite
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Zirconium silicate is integrated into Ceramage, which is a layered composite. Micro-fine ceramic particles are embedded in an organic polymer matrix, accounting for 73% of the material. As a result of this formulation, this product has exceptional flexural strength, polishability, and flexibility.

Our experience at Burbank Dental Lab has shown that this material can create natural-looking dental restorations that blend beautifully with natural dentition. Furthermore, Ceramage offers the following advantages:

  • Strengths exceeding 140MPa in compression and flexure
  • Abrasion-resistant
  • Natural tooth-like refractive index
  • The color remains stable for more than five years
  • Chairside repairs are easy
  • A highly polishable material
  • A plaque-resistant material
  • Biocompatible
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Lava Ultimate
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The 3M™ Lava™ Ultimate CAD/CAM restorations are resin nano ceramics (RNC). Restorations using LAVA Ultimate are milled from blocks that contain nano-ceramic particles encapsulated in a resin matrix. Resin-to-ceramic ratios are precisely controlled in the manufacturing of blocks or discs for milling. Due to this, the material has unique esthetic and durability properties.

These restorations can be customized intra- or extra-orally once they have been milled. Using this technique ensures a seamless adaptation to the existing dentition. Lava Ultimate also offers the following benefits:

  • Surface polish that lasts for a long time
  • Opposing dentition wears less than glass ceramics
  • Exceptional durability
  • HT and LT shades are available in this highly translucent material

Inlays and onlays can be made from Ceramage or Lava ultimate restorations. The wear rate of composite is similar to that of natural enamel, making it ideal for cases with occlusal margins.

A composite restoration can also be used in the following ways:

Note: When fabricating long-span bridges or areas where bonding is not feasible, Ceramage and Lava Ultimate are not recommended.

Preparation Design

Carefully following and complying with ideal preparation guidelines can help ensure the best results from composite restorations. Isthmus width and occlusal clearance should both be 1.5mm.

There should be a 90° shoulder margin and an occlusal margin, and the internal line angles should be rounded. When the right foundation is laid, the restorations will fit perfectly and be well-adapted to the patient.

Cementation and Finishing

The first step for proper cementation and finishing should be to use an adhesive resin or a dual-cure resin. Salinate and clean the restoration, then follow the manufacturer’s instructions for the bonding agent you have chosen.

Chairside adjustments can be made once the case has been seated. A diamond polishing paste and fine diamonds can be used to make these adjustments. It is recommended to use a composite rotary instrument for applying the polishing paste.

SmartComposite Hybrid
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For larger cases, the best option may be the SmartComposite® Hybrid. It consists of a milled composite with a cobalt-chromium (Co/Cr) alloy frame. An overlay of composite is milled over the Co/Cr framework for this restoration option. An overlay of composite material is then bonded to the framework. To replicate tissue, a pink composite is added.

The use of SmartComposite Hybrids provides the following benefits:

  • Durable with a compressive strength of over 480MPa
  • Internally polishable
  • It is possible to repair composites on the spot
  • Implant restorations are less stressed
  • Wear is similar to that of natural teeth
  • A lightweight product

Hybrid SmartComposite® cases are excellent options for cases requiring a material that will wear gradually and be easy to repair. SmartComposite is an excellent option when two screw-retained implant-supported prostheses are opposing each other in larger, more complex cases.

Clinical practitioners often prescribe monolithic zirconia prostheses for the upper jaw. A SmartComposite prosthesis should be fabricated on the lower arch if both arches are being restored, which relieves stress in the mouth.

There is constant change and evolution in the dental field. Keep up with the latest materials available and add solutions to your arsenal that provide unique treatment options for your patients. Dedicated to providing the best restorations possible, Burbank Dental Lab continually researches materials.

Even though indirect composite restorations aren’t the most prescribed in dentistry, they are essential to providing excellent oral health. Obtain the best treatment plan and material options by contacting Burbank Dental Lab today.

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