1

Good Morning
 2
POLYMERIZATION SHRINKAGE
Anusavice: Science of Dental Materials. Eleventh edition 3

KEY TERMS
1. MONOMER: A chemical compound capable of
reacting to form a polymer.

2. POLYMER: A chemical compound consisting of

large organic molecules formed by the union of
many repeating smaller monomer units.

3. POLYMERIZATION/CURING: A chemical reaction in

which monomers of a low molecular weight are
converted into chains of polymers with a high
molecular weight.

4. FREE RADICAL: A compound with an unpaired

 4

5. CHAIN TRANSFER: A stage of polymerization in

which the growing end of a chain is transferred to
another molecules, initiating further chain growth.

6. PROPAGATION: Stage of polymerization during

which polymer chains continue to grow to higher
molecular weights.

7. TERMINATION: Stage of polymerization during

which polymer chains cease to grow.
 5

APPLICATIONS OF RESINS IN DENTISTRY

I. Dentures (bases, liners and

artificial teeth)
II. Cavity filling materials (composites)
III.Sealants
IV.Impression materials
V. Equipment
VI.Cements

Anusavice: Science of Dental Materials.

Eleventh edition
 6

HISTORY

• 1948 – acrylic resins

– polymethylmethacrylate
– high polymerization shrinkage
• 1962 – Bis-GMA 7

– stronger resin

• 1969 – filled composite resin

– improved mechanical properties
– less shrinkage
– paste/paste system

• 1970’s – acid etching and microfills

• 1980’s – light curing and hybrids

• 1990’s – flowables and packables

 8

TYPES OF POLYMERIZATION REACTIONS

1. Condensation Polymerization-

• yields polymers with repeating units having fewer atoms

than the monomers from which they are formed.
• Generally involves the elimination of small molecules such
as H2O or HCl.

2. Addition Polymerization

3. Chain Polymerization/Free Radical

Polymerization-

A. Initiation
B. Propagation
 9

CHAIN & STEP POLYMERIZATION

 10
Composites undergo free radical
addition polymerization:

Types:
1) Ring Opening Polymerization
2) Ionic Polymerization
3) Free radical Polymerization

Stages in Addition Polymerization:

1) Initiation
2) Propagation
3) Termination
 11

INITIATION STAGE

• Formation of free radicals , or by the transfer

of a single electron to or from an ion or
molecule (redox).
 12

PROPAGATION STAGE

• Growth of the chain is propagation reaction which

continues until the growing free radical is terminated.
•

TERMINATION STAGE

• Free radical polymerization can be terminated by the

presence of any material which will react with the free
radical thus decreasing the 'rate of initiation. Eg.,
hydroquinone, eugenol, large amount of O2.
 13

BASIC TYPES OF POLYMERIZATION

1. Chemically activated

• Organic peroxide initiation & organic amine accelerator.

• Initiator and accelerator must be kept separately until the

restoration is just placed.

• Supplied as 2 pastes: one with the initiator and other with the
accelerator.

• Operator has no control over the working time after the two
components have been mixed
 14

2. Light Activated:
Chemical Light cure
• Compositeisiscentral
Polymerization exposed to Peripheral
intense light which initiates the
Curing is one phase Is in increments
reaction.
Sets within 45 seconds Sets only after light activation
• Light isover
No control absorbed by a diketone,
working which in the
time Working presence
time under of an
control
organic amine starts polymerization.
Shrinkage towards centre of Shrinkage towards light source
bulk • So, Diketone and the amine can be supplied as a single paste.
Air may get incorporated Less chance of air
• But the paste must be protectedentrapment
from the blue light before it
is ready to use.
More wastage of material Less wastage

Not properly finished Better finish

 15

INHIBITION OF ADDITION POLYMERIZATION:

• Impurities in the monomer inhibit the reactions

by reacting with free radicals.

• An impurity can react with the activated

initiator or with an activated growing chain to
prevent further growth.

• Oxygen reacts rapidly with free radicals and its

presence retards the polymerization reaction.

• Eg hydroquinone which retards the

polymerization in the presence of an initiator.
 16

CO-POLYMERIZATION
• Two or more chemically different monomers,
each with desirable property can be combined
to yield specific physical properties.

• Many useful resins are manufactured by co-

polymerization.

• Methyl methacrylate acrylic esters

and
• methacrylic esters all copolymerize
• readily.
 17

SETTING REACTION
• Once the reaction begins, the monomers in the
composite paste are transformed into a cross-linked
polymer matrix within 15 to 30 seconds.

• This rapid hardening is often referred to as a “snap-

set”.

• This means that the consistency or handling

characteristics of the material remains the same
throughout the working time, but that the viscosity
increases quickly once hardening begins.
 18

Pre-gel Phase
• Composite polymerization
can be divided into PRE
AND POST GEL PHASES.

• In the pre-gel phase, the

reactive species present
enough mobility to
rearrange and compensate
for the volumetric
shrinkage without No Stress, No Translation
generating significant (Compensation from Free Surface)
amount of internal and
interfacial stresses.

18
 19

• The working time for a self-

curing composite usually is on
the order of 2 minutes after
mixing has begun.

• The reaction is the same in self

cured and light cured forms,
although it proceeds to
completion faster in the light –
cured material.
 POLYMERIZATION SHRINKAGE 20

During polymerization, the molecules

previously existing at van-der Waal’s force
distances become linked through shorter
covalent bonds, & the reduction in free vol.
within the monomer structure, as it transforms
to a more densely packed polymer, contributes
to the overall contraction which is referred as
polymerization shrinkage.

20
 21

• 60% of the total contraction occurs

with in 60 seconds after photo
initiation.

• Prolonging the activation time

from 30-60 seconds will increase
the total contraction .

• Polymerization contractions affects

adaptation to dentin, marginal
adaptation and marginal seal.
 22

• Shrinkage is greatest where the polymerization is happening at

the fastest rate.

• For the self-curing composite, the reaction happens fastest in

the centre because it is insulated and builds up heat, which
accelerates the chemical reaction.

• Therefore the shrinkage is towards the centre of the restoration

and away from the walls.

• The reaction of the light cured material is similar, except it starts

and proceeds fastest in the region closest to the activator.

• Therefore the shrinkage is towards the light source.

 23

FACTORS AFFECTING POLYMERIZATION

 24
Do Dental Composites Always Shrink
Toward the Light?
A.Versluis*, D. Tantbirojn, and W.H. Douglas
J Dent Res 77(6): 1435-1445, June, 1998

Abstract

Many of the current light-curing composite restorative techniques are rationalized in compliance with
the theory that composite shrinks toward the light. Shrinkage directed toward the margins is believed
to be responsible for the observed improved marginal properties. However, the dental literature does
not consistently support this theory.

In this study, a finite element technique is used to analyze the direction of

composite shrinkage as it cures.

It was concluded that composite does not shrink toward the light, but that
the direction is predominantly determined by cavity shape and bond quality.
Improved marginal properties should be pursued by the optimization of other factors, such as the
polymerization process, the curing procedure, and the bond quality. The direction of shrinkage vectors
in response to light position does not seem to be an appropriate criterion for the optimization of
marginal quality.
 25

METHODS TO 1) Volume dilatometry

DETERMINE - Total volume change
POLYMERIZATION
SHRINKAGE 2) Non-volume dilatometric
methods
- 1D or 2D change

Strategies to Overcome Polymerization Shrinkage − Materials

and Techniques. A Review
Malhotra et al.
 26

DEGREE OF CONVERSION (DC)

• It is a measure of percentage of consumed

Carbon double bonds that have been
converted into single bonds to form a
polymeric resin.

• Higher the degree of conversion, the better is

the strength and wear resistance.

• Degree of Conversion of Composites: 55-65%.

 27
C-FACTOR(CONFIGURATION FACTOR)

• Is a ratio of bonded surfaces to the

unbonded, or free, surfaces in a tooth
preparation.

• The higher the C-factor, the greater is the

potential for bond disruption from
polymerization effects.

• (Class I) cavities have the highest (most

unfavorable)

• Feilzer et al developed this concept

 28

The less the free, unbonded

area in a cavity, the less will be
the ability of resin to flow, and 28
 29

C-FACTOR IN ENDODONTICS
• The adhesive dentistry concepts have also been applied
in root canals by the introduction of methacrylate based
root canal sealers and dentin adhesives.

• Eg Endorez, Epiphany, Realseal, Simplifill are designe to

bond simultaneously to root canal dentin and to resilon as
well.

• Shrinkage stresses associated with polymerization of

methacrylate-based resins are higher in low-filled, lower
viscosity resin cements, and root canal sealers than
Tay et al.
highly filled resin composites.JOE—Volume 31, Number 8, August 2005
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 GEOMETRIC FACTORS AFFECTING DENTIN BONDING
IN ROOT
CANALS: A THEORETICAL MODELING APPROACH
Tay et al.
JOE—Volume 31, Number 8, August 2005 31
Abstract

• C-factors in bonded root canals exhibit a negative correlation with sealer

thickness. For a 20 mm-long canal prepared with a size 25 file, calculated
C-factors ranged from 46 to 23,461 with decreasing sealer thickness (500–
1 m), compared to a C-factor of 32 when the canal was filled only with
sealer.

• As the thickness of the adhesive is reduced, the volummetric shrinkage is

reduced, which results in a reduction in shrinkage stress (S-factor).

• C-factors above 954 calculated with sealer thickness smaller than 25 m

are partially compensated by increases in bonding area and decreases in
 32

FACTORS RESPONSIBLE FOR

POLYMERIZATION SHRINKAGE STRESSES
1) FILLER CONTENT
• Shrinkage is a direct function of volume fraction of polymer
matrix in the composite.

• Space occupied by filler particles doesn’t participate in curing

contraction.

• More the monomer entities unite to polymer chains and form

networks, higher the composite contraction.

• Higher content of filler particles is fundamental to reduce

 33
Polymerization shrinkage values
Conventional
Composite Eg;
Adaptic, Concise etc. • Polymerization Shrinkage 3-5%

Microfilled Composite
Eg; Prisma, Herculite •
XRV etc. Polymerization Shrinkage 1.5-2%

Hybrid Composite Eg;

Alert, P-50 etc. • Polymerization Shrinkage 1-1.5%

33
 34

DEGREE OF CONVERSION
• Reduction in final degree of conversion
will lead to a lower shrinkage and lower
contraction stress.

• But a low degree of conversion might

compromise some of the material’s
mechanical properties.

• So, small increases in the degree of

conversion will produce substantial
increase in stress but will improve the
mechanical properties.
 35

ELASTIC MODULUS
• At a given shrinkage value, the most rigid
material (the material showing the
highest elastic modulus) will cause the
highest stress.

• Elastic modulus also increases as the

polymerization reaction proceeds.

• Higher the elastic modulus and

polymerization shrinkage of the
composite, higher the contraction stress.

J Contemp Den Practice 2006;7(4)1-14

 36

WATER SORPTION
• Water sorption of resin composites
and their resulting hygroscopic
expansion could compensate for
the resin composite shrinkage.

• But water sorption causes

deterioration of mechanical
properties and alteration of color
stability of composites.
 37

C-factor

• Flat surfaces and shallow cavities represent

the most favourable conditions for the
formation of durable composite-dentin bond.

• In these cavities, polymerization contraction is

restricted to one direction thus allowing
composite to flow freely in early rigid stage.
 38

• Three main factors concur to

reduce shrinkage stress: use of a
small volume of material, a lower
cavity configuration factor, and
minimal contact with the opposing
cavity walls during polymerization.

The Journal of Contemporary Dental

Practice, 2006;7:233-40
 39

MEANS TO MINIMIZE POLYMERIZATION

SHRINKAGE

Strategies to Overcome Polymerization Shrinkage − Materials and

Techniques. A Review Malhotra et al.
Dent Update 2010; 37: XXX–XXX
 40

GIC LINER BELOW COMPOSITES

1) OPEN SANDWICH

• GIC placed on the base of the class 2

proximal box upto the level of DEJ.

• Final portion of the restoration is filled

with composite till the occlusal level.

• Benefit : A large surface area occupied

by GIC.

Geoffery Knight: Aesthetic Update, May 2011

 41

CLOSED SANDWICH TECH.

• GIC liner placed on the base of the proximal
box of class 2 cavity just short of the external
cavosurface margin.

• Composite is then applied encasing the GIC

completely.

Geoffery Knight: Aesthetic Update, May 2011

 42

CO-CURE TECHNIQUE
• Bond a thin layer of RMGIC
bonding agent directly onto
etched enamel and dentin.

• A second layer of RMGIC (hybrid

ionomers)bonding agent is then
applied after which composite is
directly filled prior to light curing.

• The second layer acts as a stress

breaker during photo-initiation of
composite.
 43
THE OPEN SANDWICH TECHNIQUE WITH GLASS IONOMER
CEMENT – A CRITICAL EVALUATION
Int J Innovative Research Science, Engineering and Technology 2013;2(8):3874-88
Dr. Vipin Arora 1, Dr. Vineeta Nikhil 2, Dr. Shefali Sawani 3, Dr. Pooja Arora

CONCLUSION :

Glass ionomers in this technique are utilized for

• Dentin replacement.
• Long term fluoride release that can create fluoro-appetite in replacement of
damaged dentin and have long term caries inhibition effects.
• Similar thermal expansion properties as dentin.
• Insulation from the affects of higher temperature from curing lights.
• Insulation from the potential of uncured monomer from bonding agents that
could seep into dentin tubules.
• Less shrinkage and stress than composites.
• Less microleakage than adhesion products.
• Overall a far less technique sensitive procedure.
 A COMPARISON OF RESIN-MODIFIED GLASS- 44

IONOMER AND RESIN COMPOSITE

POLYMERISATION SHRINKAGE STRESS IN A WET
ENVIRONMENT.
J Mech Behav Biomed Mater. 2014 Jan;29:33-41.
Cheetham JJ1, Palamara JE, Tyas MJ, Burrow MF

• Abstract
• OBJECTIVE:

• The aim of this study was to investigate the polymerisation shrinkage stress under water of four resin-modified glass-ionomers
and three resin composite materials.

• METHODS:

• Transparent acrylic rods (5mm diameter×30mm) were prepared and secured into drill chucks connected to a universal testing
machine. A plastics cup was placed around the lower rod and a distance of 1.00mm was established between the prepared
surfaces which provided a C-factor of 2.5. For composite only, an adhesive layer (Scotchbond Universal Adhesive) was placed
on the rod ends and cured to achieve a bond with the rod end. Materials were placed between the rods and a strain gauge
extensometer was installed. Materials were light cured for 40s and the plastics cup was filled with ambient temperature water.
To determine polymerisation shrinkage stress (σpol) three specimens of each material were tested for a 6-h period to
determine mean maximum σpol (MPa), σpol rate (MPa/s) and final σpol (MPa). ANOVA and post hoc Tukey tests were used to
determine significant differences between means.

• The highest mean maximum σpol of (5.4±0.5) MPa was recorded for RMGIC and
(4.8±1.0) MPa for composite. The lowest mean final σpol of (0.8±0.4) MPa was recorded for RMGIC. For mean
maximum σpol,σpol rate and final σpol there were significant differences between
materials within groups, although no significant difference (p>0.05) was observed when
comparing the RMGIC group to the composite group.
 VOLUMETRIC CONTRACTION IN SOME TOOTH- 45

COLOURED RESTORATIVE
MATERIALS
Bryant et al
Australian Dental Journal 2007;52:(2):112-117

Abstract
• Background: Much of the concern about the setting contraction of tooth-coloured restorative materials has
been focused on the composite resins. This study investigated setting contraction of a range of glass ionomer
materials and included, for comparison, products from other groups of restorative materials.

• Methods: A deflecting disk method was used to determine the volumetric contraction
of three conventional (non-light cured) glass-ionomer cements (GICs), two restorative,
one “lining” consistency and one adhesive/lining consistency resin-modified glass-
ionomers (RMGIs), two resin adhesives, three restorative composite resins and two
compomers. The influence of powder:liquid ratio on two hand-mixed materials was also examined.

• Conclusion: Although
the conventional GICs contract more slowly in the
first 5 minutes, by 30 minutes the current restorative GICs and RMGIs
exhibit a volumetric setting contraction that is comparable with the
composite resins and compomers and is generally in the range of 2–3
 46

Post-gel Phase
In the post gel phase

• When the degree of conversion

approaches 10-20%, the
network is extensive enough to
create a gel.
• To reduce the shrinkage and the following stress,
As a consequence, the
continued polymerization is
different kinds of curing modesDistortion
associated with elastic modulus have been
proposed.
development, stress generation
within the material, at the
If bond strength exceeds stress

tooth/restoration interface and

in the tooth structure.
• Beyong the gel point,
polymerization shrinkage
creates strain on the network
and the attachment area to the
bonding system.
• This facilitates gap formation, Gap Formation
affecting the longitivity of the If stress exceeds bond strength
restoration.
 Polymerization Shrinkage Stress of Composites 47

Photoactivated by Different Light Sources

Carvalho et al.
Braz Dent J (2009) 20(4): 319-324

• The purpose of this study was to compare the polymerization shrinkage stress
of composite resins (microfilled, microhybrid and hybrid) photoactivated by
quartz-tungsten halogen light (QTH) and light-emitting diode (LED).

• The shrinkage stress for all composites was higher at 10min than at 40s,
regardless of the activation source. Microfilled composite resins showed lower
shrinkage stress values compared to the other composite resins. For the
hybrid and microhybrid composite resins, the light source had no influence on
the shrinkage stress, except for microfilled composite at t10min.

• It may be concluded that the composition of composite resins is the factor

with the strongest influence on shrinkage stress.
 EFFECT OF TYPE OF POLYMERIZATION ON DIFFERENT 48

PROPERTIES OF DENTAL COMPOSITES.

Biomed Mater Eng. 2005;15(6):483-93.

Kaprielian N1, Lagneau C, Zydowicz N, Lissac M, Grosgogeat B.

Abstract

The aim of this study is to assess the influence of plasma lamps on the properties of the
composites compared to the influence of conventional polymerization. Vickers hardness tests,
three-point bending tests, and measurement of the shrinkage marginal gap by scanning electron
microscopy were carried out on three resin composites (Tetric Ceram, Z-100 and Inten-S)
irradiated with to lamps (Flipo) plasma and Astralis 7 halogen lamps). With a 3-second exposure,
the results of Vickers hardness and resistance to flexion (excepting values for Z-100) were lower
for the composites cured by the Flipo plasma lamp, than after 40-second curing by the
conventional halogen lamp (Astralis 7), notably at a depth of 3 mm. With a 5-second exposure the
results of Vickers hardness and resistance to flexion obtained using the plasma lamp approached
those obtained by using the halogen lamp. Whatever the polymerization protocol used, the
measurements of the gap between the tooth and the filling are very similar except for
Z-100/Astralis 7, for which shrinkage results are more important. For any one resin composite and
lamp used, the shrinkage values obtained at a depth of 4 mm are twice higher than those obtained
at the surface. In conclusion, for a 3-second exposure the level of polymerization obtained by
plasma curing is lower than the one obtained by halogen curing, particularly in depth. On the other
hand, 5-second plasma curing results recommends the use of this kind of lamp.
 49

CONTINUOUS CURING TECHNIQUES

• Light is on continuously.

• Four types :

• Uniform continuous cure

• Step cure
• Ramp cure
• High-energy pulse

• Continuous curing is conducted with

halogen, arc, and laser lamps.
 UNIFORM CONTINUOUS 50

CURE
• A light of Composite is first cured at
constant low energy, then stepped
intensity is up to high energy, each for
applied to a a set duration.
composite for a
specific period of
time.
 51

R I N G
P C U
ov e rall
STE
Red uc e s t h e
n
polymerizatio
he
shrinkage at t l
i n o f the fi na
marg is
g
restoration. u r in
Step c e only with
l
possib lamps
l o ge n
ha
RAMP CURE
52

• Light is initially applied at

low intensity and
gradually increased over
time to high intensity.

• Allows the light-cured

material to have a longer
gel phase in which
polymerization
contraction stresses are
dissipated more readily.
 53

HIGH-ENERGY PULSE CURE

• Uses a brief (10 second) pulse of
extremely high energy {1000-2800
mw per cm²), which is three to six
times the normal power density.
 54

STAGED (DELAYED CURING)

• The restoration is initially cured at
low intensity to contour and
shape the restoration in occlusion,
followed by a second exposure to
completely cure the restoration.

• This allows substantial relaxation

of polymerization stresses.
 CONTEMPORARY CURING PROFILES: STUDY OF 55

EFFECTIVENESS
OF CURE AND POLYMERIZATION SHRINKAGE OF COMPOSITE
RESINS: AN IN VITRO STUDY
Vipin Sudheer, MK Manjunath
Journal of Conservative Dentistry 2011;14(4):383-6

• Aims: This study was undertaken to determine the effect of step-curing, ramp curing, single intensity
on the effectiveness of cure and polymerization shrinkage of composite resin. The influence of filler
loading on the effectiveness of cure and polymerization shrinkage of composite resin was investigated.

• Materials and Methods: In this study, a total of 80 specimens divided into four groups were used. Group I – specimens
cured with the step-cure mode. Group II – specimens cured with single high intensity. Group III – specimens cured with
the ramp-cure mode. Group IV – specimens cured with single low intensity. Each group had two subgroups based on the
composite resins used for making the specimen. The effectiveness of cure was determined from surface hardness values
obtained from Rockwell hardness testing. A mathematical volumetric method was used to assess the volumetric
shrinkage.

• Results: Group III showed the best effectiveness of cure followed by group I and II. Group IV showed the least.
Polymerization shrinkage was highest with group III and group II, were as was lowest for group I and IV. Charisma showed
better effectiveness of cure and low polymerization shrinkage compared to Durafill VS.

• Conclusion: This study emphasizes on the fact that, the soft–start polymerization modes (step curing
and ramp curing) should be preferentially used over the conventional single (high or low light)
 56

PULSE-DELAY CURE
• An initial e
xposure of up
1 j/cm² is cons to
idered to be
most efficient
in reducing
shrinkage stre
sses.

• The lower-
intensity light
slows the rate
of
polymerization
, which
allows shrinka
ge to occur
until the mate
rial becomes
rigid, and is re
ported to
result in fewer
problems at
the margins
 57

INTERMITTENT LIGHT-CURING

• The composite is polymerized

during short periods of light-on
and light-off.

• Similar to the other techniques,

the aim of this approach is to
reduce the polymerization-
induced stress by using light-off
 58

TRANS ENAMEL POLYMERIZATION TECHNIQUE / BULK FILL

TECHNIQUE :

• Adhesive, a flowable
composite, and a composite
resin are placed into the
tooth in bulk and then
polymerized by curing
through the tooth from the
buccal and lingual through
the enamel.
 3-SIDED LIGHT CURING TECHNIQUE / SLOW 59

POLYMERIZATION TECHNIQUE :

• In this technique, an increment of composite

resin is applied at the gingival margin and
cured using a light reflecting wedge.

• Then an increment is used to fill the facial

two thirds of the box, which is cured from
the facial.

• Another increment is added and cured from

the lingual.

• Additional increments complete the occlusal

portion of the restoration.
 60

COMPOSITE PLACEMENT TECHNIQUES INCLUDE

• Horizontal technique
• Vertical technique
• Three-site technique
• Wedge shaped oblique layering technique
• Successive cusp build up technique
• Bulk fill
• Centripetal build-up
• U shaped layering
• Stratified layering technique
• Split increment horizontal
 61

INCREMENTAL TECHNIQUES

• Decrease shrinkage stress.

• Each increment is compensated by the

next, and the consequence of
polymerization shrinkage is less damaging
since only the volume reduction of the last
layer can damage the bond surface.

• Minimum contact with the cavity walls

during polymerization is another
advantage.
 62

HORIZONTAL TECHNIQUE
• Small increments placed
horizontally one above the other
starting from gingival wall to the
occlusal end.

• The layers can be 3,4 or 5

depending upon the depth of the
proximal box.
•
 63

VERTICAL LAYERING TECHNIQUE

• Increments are placed in vertical
fashion starting from one wall
i.e. buccal or lingual and carried
on to other wall in small
increments.
 64

THREE-SITE TECHNIQUE
• A layering technique associated with the
use of a clear matrix and reflective wedges.

• First, the curing light is directed through

the matrix and wedges in the attempt to
guide the polymerization vectors toward
the gingival margin, thus, preventing any
gap formation.

• Then wedge-shaped composite increments

are placed to further prevent distortion of
cavity walls and reduce the C-factor.
Quintessence Int 2000;31:231-9
 65

WEDGE-SHAPE LAYERING (OBLIQUE)

• In this technique, wedge- shaped
composite increments are placed to
prevent distortion of cavity walls
and reduce the C-factor.
 66
DURABILITY OF RESIN COMPOSITE RESTORATIONS IN HIGH C-FACTOR
CAVITIES: A 12-YEAR FOLLOW-UP.
van Dijken JW1.
J Dent. 2010 Jun;38(6):469-74.

Abstract
OBJECTIVE:
Polymerization shrinkage and shrinkage stress has been considered as one of the main disadvantages of resin
composite restorations. Cavities with high C-factors increase the risk for interfacial failures. Several restorative
techniques have been suggested to decrease the shrinkage stress. The purpose of this study was to evaluate
the durability of techniques as oblique layering, indirect curing and/or a laminate with a poly-acid modified
resin composite in direct Class I resin composite restorations in a 12-year follow-up.
METHODS:
Each of 29 patients received one or two pair(s) rather extensive Class I restorations. The first restoration was a
poly-acid modified resin composite/resin composite sandwich restoration and the second a direct resin
composite restoration. Both restorations, except for the laminate layer, were placed with oblique layering
and two-step curing technique. 90 restorations were evaluated annually with slightly modified USPHS criteria
during 12 years.
RESULTS:
At 12 years, 38 pairs were evaluated. Two cases of slight post-operative sensitivity were observed in one patient. A
cumulative failure rate of 2.4% was observed for both the resin composite and the laminate restorations. One
laminate restoration showed non-acceptable color match, but was not replaced and one resin composite restoration
showed a chip fracture. Five restorations were replaced due to primary proximal caries.
CONCLUSIONS:
The high failure rate expected in the high C-factor Class I cavity, associated with polymerization shrinkage
and shrinkage stress, were not observed. The techniques used resulted in an excellent durability for the
 67

SUCCESSIVE CUSP BUILD-UP TECHNIQUE:

• In this technique the first composite

increment is applied to a single
dentin surface without contacting the
opposing cavity walls, and the
restoration is built up by placing a
series of wedge-shaped composite
increments to minimize the C-factor
in 3-D cavity.

• Each cusp is then built up separately.

 68

CENTRIPETAL BUILD-UP

• This technique was

especially developed for
class II cavity
restorations.

Nizdan Bicacho Cosmetic Dentistry Edition 1994

 69

U SHAPED LAYERING DESIGN:

• At the base, U-shaped increment
is placed first and over that
horizontal and oblique
increments are placed.
• Curing is carried out as in
routine from all the sides.
EFFECT OF FOUR DIFFERENT PLACEMENT TECHNIQUES ON
MARGINAL MICROLEAKAGE IN CLASS 2 COMPOSITE
RESTORATIONS
Nadig et al
World Journal of Dentistry 2011;2(2):111-6.

70
71

ADVANCES IN COMPOSITES
 72

SONIC DELIVERY OF COMPOSITE RESINS

• Consists of a handpiece manufactured by KaVo
(Germany), activated sonically and attached to the high-
speed multiflex connection.

• The composite contains about 83.5% of fillers by

weight, mainly silica and barium aluminoborosilicate
glass and is available in four shades (A1, A2, A3 and B1).

• Unique property of SonicFill is that it has a

polymerization shrinkage of about 1.6% and can be bulk
filled to a depth of 5 mm.
 73

• These materials are placed in up to 4-

mm increments and can cure to that
depth.

• The composition of these materials

has been altered in various ways to
allow for increased depth of cure while
having less shrinkage and shrinkage
stress than previous generations of
composite materials.
 74

BULK-FILL FLOWABLES AS “DENTIN

REPLACEMENTS”

A class of newer flowable composites (eg, SureFil® SDR® flow

Posterior Bulk Fill Flowable Base, DENTSPLY; X-tra Base, VOCO
America; Venus Bulk Flow, Heraeus; HyperFil DC™, Parkell) is
indicated for use as a bulk-fill base (dentin replacement) beneath
posterior composite restorations and can be bulk filled in layers
up to 4 mm in depth.

According to the manufacturers, these composites have:

increased depth of cure; a viscosity that will readily adapt to the
internal walls of the cavity without the need for manipulation of
the material; and low polymerization shrinkage stress.
 75

Packable COMPOSITES
• First marketed in 1996 as Composites that pack,
carve and handle similar to amalgam as well as being
able to be light cured in bulk upto 5mm in depth.

• Deeper depth of cure because of light conducting

properties of individual ceramic fibers and less
polymerization shrinkage.

• Filler content : 75-85% by weight

• Solitaire, Alert, Surefill, Filtek P60, Prodigy

condensable Pyramid BISCO, Synergy Compact,
Definite, Aristele PHC.
 76
POLYMERIZATION CONTRACTION STRESS IN
LIGHT-CURED PACKABLE COMPOSITE RESINS
Chen et al
J Dent Materials 2001;17(3):253-9
Abstract

• Objective: Determination of the polymerization contraction stress of packable composites (ALERT,

Surefil, Solitaire, Solitaire 2) and a packable ORMOCER material (Definite) in comparison with a
conventional hybrid composite (Tetric Ceram).

• Methods: Contraction force generated by the test materials (10 replications each) was measured by
polymerizing the composites filled in a plastic tray between two aluminum attachments mounted in a
Stress–Strain-Analyzer testing machine (specimen size: 4×4×2 mm, C-factor=0.33). Contraction force
was recorded for 300 s under a standard exposure condition (40 s, 800 mW/cm2). Maximum contraction
stress (MPa), force rate (N/s), relative force rate (%/s) of each material were statistically analyzed by
ANOVA (α=0.05) and post-hoc Tukey's test.

• Results: Maximum contraction stresses of the packable materials were 4.60±0.32 MPa (ALERT),
4.16±0.18 MPa (Definite), 3.36±0.08 MPa (Solitaire 2), 3.33±0.23 MPa (Solitaire) and 3.13±0.18 MPa
(Surefil), which were significantly higher than that of Tetric Ceram (2.51±0.14 MPa). Tetric Ceram
exhibited the significantly lowest force rate. Force/time curves were S-shaped. Solitaire especially
showed a longer pre-gelation phase before contraction force was recorded.

• Significance: High contraction stress and rapid contraction force development can lead to failure of
bond to tooth structure. This study suggested that, packable composite resins are less capable of
reducing the contraction stress during the early setting stage, thus not superior in maintaining the
bond with cavity walls to conventional hybrid composite Tetric Ceram.
 77

NANOCOMPOSITES

• Nanocomposites use nanometer-sized

particles throughout the resin matrix.

• Excellent aesthetics, polishability and

very low polymerization shrinkage
(1.4-1.6%) coz filler content can be
increased owing to small size.

• Filler loading can increase upto 90-

95% by weight.
 POLYMERIZATION SHRINKAGE EVALUATION ON 78

NANOSCALE-LAYERED SILICATES: BIS-GMA/TEGMA

NANOCOMPOSITES, IN PHOTO-ACTIVATED POLYMERIC
MATRICES
Campos et al.
J. Appl. Polym. Sci., 2014, 131, 40010.
ABSTRACT
• This study concerns to the
investigation of the polymerization shrinkage in
dental experimental composites filled with silanized silica Aerosil®
OX-50 and clay nanoparticulated Montmorilonita (MMT) Cloisite®
30B, in glycidyl methacrylate resin. The characterization of the experimental
composites was established with the following analyses: Thermo-Mechanical Analysis (TMA) at
isotherm temperature, Differential Scanning Calorimetry Analysis (DSC) under nitrogen atmosphere,
X-Ray diffraction (DRX), and Micro Hardness analysis. Through the TMA analysis was observed that
the polymerization shrinkage varies according to the filler type and concentration in the
experimental composite. The polymerization shrinkage ranged from 0.98% to
0.22% in the experimental composites added with Cloisite® 30B and
ranged from 2.73% to 1.01% in the experimental composites containing
silanized silica. Due to the intercalation of the clay nanoparticle in relation to the polymer
matrix, the experimental nanocomposites with Cloisite® 30B showed better performance compared
 79

ORMOCER (1998)
• Organically Modified Ceramic - its a three
dimensionally cross-linked copolymer.

• While composites are based on a purely

organic resin matrix.

• An inorganic-organic network matrix formed

through polycondensation i.e. inorganic
backbone based on silicon dioxide (SiO2 )
with polymerizable organic units.

• These long ormocer molecule chains are very

rigid, have extremely high molecular weight
with a preformed structure, exhibit low
polymerization shrinkage(1.88%) than the
currently available composites owing to
their
cross-linked structure

• (Filler content – 77-80%).

• Eg. Definite (Degussa), Admira.

 80
POLYMERIZATION SHRINKAGE OF ORMOCER BASED DENTAL
RESTORATIVE COMPOSITES
M. Cattani-Lorente, S. Bouillaguet, Ch. Godin, and J.M. Meyer

European Cells and Materials;1(1), 2001:25-6

Two commercially available ormocers (Admira from Voco and Definite from
Degussa), a hybrid (Z250 from 3M) and four condensable composites (Solitaire from
Heraeus, SureFil from DeTrey, Synergy from Coltene and P60 from 3M).
 81

EXPANDING MONOMERS

• In 1992, Stansbury synthesised spiro-

orthocarbonate monomers that
expand during polymerization through
a double ring – opening process.

• Expansion upto 3.5%. Makes up for the

volumetric shrinkage.

• SOC + epoxy resins react at room

temp by UV light. = decrease
polymerization shrinkage, increase
toughness, decrease water permeation
 82
CHARACTERIZATION OF A LOW SHRINKAGE DENTAL COMPOSITE
CONTAINING BISMETHYLENE SPIROORTHOCARBONATE
EXPANDING MONOMER
Fu et al.
Int. J. Mol. Sci. 2014, 15, 2400-2412

Abstract:
In this study, a novel dental composite based on the unsaturated bismethylene
spiroorthocarbonate expanding monomer was prepared.

Distilled water contact angle measurements were performed for the wettability
measurement. Degree of conversion, volumetric shrinkage, contraction stress and
compressive strength were measured using Fourier Transformation Infrared-FTIR
spectroscopy, the AccuVol and a universal testing machine, respectively.

Within the limitations of this study, it can be concluded that the resin composites
modified by bismethylene spiroorthocarbonate and BisS-GMA
showed a low volumetric shrinkage at 1.25% and a higher contact angle.
The lower contraction stress, higher degree of conversion and compressive strength of the
novel dental composites were also observed.
 83

SILORANES
• One of the latest developments of
ring-opening monomers for dental
purposes.

• A merging of siloxanes and oxiranes,

combining the properties of both.

• Low shrinkage values (0.5–0.8 vol %).

• Because of ring opening which

compensates for the shrinkage.
 POLYMERIZATION PROFILE ANALYSIS OF RESIN 84

COMPOSITE DENTAL RESTORATIVE MATERIALS IN REAL

TIME
J Dent. 2012 Jan;40(1):64-70.
Naoum SJ1, Ellakwa A, Morgan L, White K, Martin FE, Lee IB.

• Abstract
• METHODS:
• Five commercially available composites were analysed: one "low shrinkage" non-methacrylate based
composite (Silorane); one "low shrinkage" high molecular mass methacrylate based composite
(Kalore) and three conventional methacrylate based composites (Gradia Direct X, Filtek Supreme XT
and Beautifil II). Polymerization shrinkage was measured using an electromagnetic balance which
recorded changes in composite buoyancy occurring due to volumetric changes during polymerization. This instrument allowed real
time volumetric shrinkage measurements to be made at 40 ms intervals.

• RESULTS:
• All five resin composites demonstrated a similar volumetric shrinkage profile during polymerization. The rate of shrinkage of all five
composites decreased from t=0 at a rate approximating x=t. After 170 s the rate of shrinkage of all five composites was at or below
0.01%/s. During the initial 5s of light exposure Silorane and Kalore exhibited a significantly lower (p<0.05) rate of contraction relative
to the three conventional methacrylate composites. After 640 s of analysis, Silorane exhibited a significantly lower (p<0.05) percentage
volumetric contraction compared to the other four analysed materials.

• CONCLUSIONS:
• The newly developed "low shrinkage" composites (Silorane, Kalore) in the present study
demonstrated significantly lower (p<0.05) shrinkage rates and shrinkage volumes compared to the
three conventional methacrylate composites. Investigation to identify whether polymerization shrinkage profile analysis
is a good predictor of relative polymerization contraction stress levels generated by different composites, is warranted.
 85

CONCLUSION

By deligent combination of different

materials, curing techniques, light
sources, and composite placement
techniques in addition to the other
methods, polymerization shrinkage can
be minimised.
 86

REFERENCES
• Anusavice Science of Dental Materials. Eleventh edition.
• Centripetal buildup for composite resin posterior restorations byNizdan Bicacho Cosmetic Dentistry
Edition 1994.
• Strategies to Overcome Polymerization Shrinkage − Materials and Techniques. A Review. Dent Update
2010; 37: XXX–XXX
• Polymerization profile analysis of resin composite dental restorative materials in real time. J Dent. 2012
Jan;40(1):64-70.
• Characterization of a low shrinkage dental composite
containing bismethylene spiroorthocarbonate
expanding monomer. Int. J. Mol. Sci. 2014, 15, 2400-2412.
• Polymerization shrinkage of ormocer based dental
restorative composites. European Cells and Materials;1(1), 2001:25-6.
• Polymerization contraction stress in light-cured packable composite resins. J Dent Materials
2001;17(3):253-9.
• Polymerization shrinkage evaluation on nanoscale-layered silicates: bis-gma/tegma nanocomposites, in
photo-activated polymeric matrices. J. Appl. Polym. Sci., 2014, 131, 40010.
• Effect of four different placement techniques on marginal microleakage in class 2 composite
restorations. World Journal of Dentistry 2011;2(2):111-6.
• Durability of resin composite restorations in high c-factor cavities: a 12-year follow-up. J Dent. 2010
Jun;38(6):469-74.
Thank You
87