Composite Power: Versatility Unsurpassed (Part 1)
Learn about the advantages of composite materials for today’s dental restorations from a pioneer in the field in this, the first in a four-part series on the versatility of composite bonding.
The Presenter: Dr. Bud Mopper, DDS MS
Dr. Bud Mopper has been practicing composite restoration for over 40 years and is a renowned lecturer on the topic. He co-authored A Complete Guide to Dental Bonding, which was the first definitive book for the dental profession describing bonding techniques. Dr. Mopper is a Life Fellow of the Academy of Esthetic Dentistry, Founding Member and Fellow of the American Academy of Cosmetic Dentistry, Life Fellow and Diplomat of the American Board of Pediatric Dentistry, and Fellow of the American College of Dentistry. He teaches continuing education courses in direct resin bonding at multiple universities and has won numerous awards for his pioneering work in composite dentistry.
Overview: The Versatility of Dental Composites
There are numerous reasons why composite material is ideal for dental restorations. Learning the different types of composites available, their characteristics, and their uses opens up whole new avenues of opportunity for a dental practice.
This webinar begins that education, with an introduction to the advantages and disadvantages of dental composites as well as an overview of the composite materials available for use today. Through several example case studies, Dr. Mopper demonstrates step-by-step techniques for using direct resin bonding to achieve natural-looking, durable restorations.
Advantages of Composites
Several advantages of composites are reviewed:
- They give dentists control. Composites are a very forgiving kind of material; dentists can shape it, add more material, shape some more, and so on. Even after the restoration is finished, it’s able to be updated or repaired.
- They are minimally invasive. Compared to other restoration materials, composites are the least invasive, with some restorations requiring no preparation at all. With composite restorations, the goal is preservation of the existing tooth structure, which also leads to optimal soft tissue results.
- They are versatile. As shown through examples throughout the webinar, composites can be used in a wide variety of cases.
- They allow for creativity. Versatility leads to increased creativity on the part of dentists who use the material in exciting ways.
- Its use can be motivational. Seeing the possibilities of what can be done with composite restorations motivates dentists and patients alike. Happy patients send new business to their dentist through word of mouth recommendations and glowing smiles.
- There’s instant gratification. A beautiful restoration that can be completed in a single visit makes for satisfied customers. Patients don’t need to wait for results. Further, unlike other types of restorative materials, results can be changed on the spot if necessary.
- Repair is easy. Composites can be repaired easily directly in the mouth.
- Profitability. Composites require no impressions, no third-party lab fabrication costs. It’s just the dentist and the materials.
- It’s a practice builder. Creating beautiful, invisible restorations using composites is a practice builder for all the reasons above.
- It’s fun! The sky is truly the limit given the creativity and flexibility afforded by composite techniques for restoring smiles.
Disadvantages of Composites
Dr. Mopper lists—and then quickly refutes—the most commonly stated disadvantages of composites.
- Confusion and misinformation. New materials are introduced to the market often, which leads to misinformation and confusion about which is best. Dr. Mopper notes that tried-and-true materials are preferable, and often technique is more important than choice of material.
- Unpredictable results. While some educational materials can lead to results that are difficult to replicate in practice, Dr. Mopper stresses that the techniques he has developed and demonstrated in this webinar are designed to be simple so as to be highly replicable.
- Longevity. The longevity of composites is often reported to be about 5-7 years. This is not what Dr. Mopper has experienced in the field, where longevity is much longer.
- Durability. Like any restoration, composites may fracture. However, they are easily repairable. Dr. Mopper notes that, given the sheer number of composites he’s placed, the incidence of decreased durability is much lower than is typically stated.
- Time consuming. Composites take longer to place than other restorations. However, preparation time, including tooth prep, is greatly reduced. No impressions or lab fabrications are needed. Any problems can be addressed immediately without the need for a restoration to be re-made, and so on.
Types of Composite Materials
Placing a composite restoration involves restoring two surfaces—the enamel and the dentin— both structurally and esthetically. Dr. Mopper notes that many dentists today favor nanofill, which has replaced micro-hybrid as the material-of-choice over time. Both materials were designed to be universal, i.e., used for enamel and dentin, and are favored for their physical properties, with esthetics given secondary importance.
For this reason, Dr. Mopper takes a different approach. Instead of picking a universal material to repair enamel and dentin, he uses microfill for the enamel alone. Microfill offers a number of advantages: Due to its smaller particle size, it provides superior handling for placement, sculpting, and shaping. Additional advantages of microfill compared to other materials include:
- Increased polishability and long term polish retention
- Easier to marginate
- More stain and plaque resistant
- More biologically compatible
- Better wear-resistance
- Better refractive and reflective index
- More realistic translucency and transparency
- More flexible
- Larger particle size
- Greater strength
- Increased opacity
- Excellent wetting properties
- Decreased polishability
- Doesn’t maintain polish long term
- More difficult to marginate
- Less refractive and reflective
- More closely simulates dentin
Nanofill characteristics include:
- Includes large and minute particles
- Excellent handling
- Increased strength
- Increased polishability over micro-hybrid; won’t hold polish like microfill
- Easier to marginate
- Decreased shrinkage
- More stain & plaque resistant (not as much as microhybrid)
- Has “opacious” translucent quality
This approach helps ensure maximum strength and durability with equal importance given to the esthetics of the restoration.
Dr. Mopper uses the Renamel line of composite resin, which includes:
Dental Composites: Clinical Case Studies
Dr. Mopper explores several types of restorations in great detail, describing the tooth preparation process, placement of the composite material, and polishing techniques. These include:
- Invisible Class III restorations
- Invisible Class IV restorations
- Invisible Class V restorations
The object for each case is to make the restorations invisible with a process that is simple, predictable, and long-lasting.
Up Next: Part 2
Dr. Mopper concludes the webinar with a look forward to the next installment, where he will show examples of incisal reinforcement. He notes that he is gathering questions to be answered later in the series.