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Cooled composites inserts /certified fixed orthodontic courses by Indian dental academy

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Welcome to Indian Dental Academy …

Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.


Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients

State of the art comprehensive training-Faculty of world wide repute &Very affordable.

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  • 1. INDIAN DENTAL ACADEMYLeader in Continuing Dental Education www.indiandentalacademy.com
  • 2. Introduction  Resin composites……  Advantage Excellent esthetics Relatively low thermal conductivity Preservation of tooth structure  Disadvantage Polymerization shrinkage (2.6 – 7.1) ↓ wear resistance Difficulty in obtaining proximal contacts www.indiandentalacademy.com Varying thermal expansion
  • 3. Stress induced Disruption incontraction force marginal integrity rb ate ce Passage of fluids,ions Exa Expansion (microleakage) Hypersensitivity , Secondary caries www.indiandentalacademy.com Failure of restoration
  • 4. To overcome shrinkage…… Acid etching – effective method Indirect restoration ‘C’ factor modification ↑filler content – limitation Nanofillers Expanded co-polymers ↓ setting stress – soft start polymerization Inserts - ↑ filler resin ratio Curing rate & degree of cure ∞ temperature www.indiandentalacademy.com
  • 5. Aim To evaluate sealing ability ofclass V composite resin restorationusing cooled prepolymerizedcomposite inserts & comparing withroom temperature resin inserts &without any inserts. www.indiandentalacademy.com
  • 6. Materials & Methods Preparation of insertsTeeth stored insaline www.indiandentalacademy.com
  • 7. Room temperature Cooled inserts inserts www.indiandentalacademy.comStandardized class V cavity preparation
  • 8. Acid etching & Bonding agent application Group A www.indiandentalacademy.com Group C Group B
  • 9. Immersion of teeth in Methylene blue solutionfor 12 hrs Making of sections www.indiandentalacademy.com
  • 10. Intra oral camera with software for microleakageevaluation Group A www.indiandentalacademy.com Group C Group B
  • 11. Scoring criteria for microleakage ♥ Score 0 – no leakage ♥ Score 1 – dye penetration within 1/3 of cavity wall ♥ Score 2 – dye penetration within 2/3 of cavity wall ♥ Score 3 – dye penetration within last 1/3 of cavity wall upto the axial wall. ♥ Score 4 – dye penetration spreading along the axial wallEvaluation of penetration leakage Scored as present or absent www.indiandentalacademy.com
  • 12. Statistical analysisMann Whitney’s ‘U’ test for group wise comparisonKruskal Walli’s test for leakage between inserts &resin compositeMann Whitney’s ‘U’ test for comparing occlusal &gingival microleakage valuesLevel of significance – 5% www.indiandentalacademy.com
  • 13. Occlusal [Enamel] microleakage scores Groups Leakage score 0 1 2 3 4 Group A (28) 1 6 4 6 11 Group B (29) 16 6 2 1 4 Group C (32) 28 2 2 0 0Gingival [Dentin] microleakage scores Groups Leakage score 0 1 2 3 4 Group A (28) 2 5 4 3 14 Group B (29) 11 5 7 4 2 Group C (32) www.indiandentalacademy.com 20 7 3 2 0
  • 14. ResultsIn occlusal marginGroup A vs Group B – no significant difference (P=0.85)Group B vs Group C – significant difference (P=0.0017)Group A vs Group C – significant difference (P=0.0038)In gingival marginGroup A vs Group B – no significant difference (P=0.72)Group B vs Group C – significant difference (P=0.0011)Group A vs Group C – significant difference (P=0.0026)Gingival > occlusal (P=0.0065)No leakage between insert & composite resin www.indiandentalacademy.com
  • 15. Discussion ۩ Limitation of filler loading (70 -75%) ۩ Use of inserts…… ۩ ↑ filler resin ratio ۩ ↑ wear resistance ۩ Volumetric thermal expansion = 0 ۩ ↓ failure fatigue of posterior restoration www.indiandentalacademy.com
  • 16. β Quartz inserts In 1993 Tjan et al – do not significantly improve the marginal integrity Disadvantage…… Resin – insert interface Possible contamination during manipulation Failed to reduce stress generated by contraction force www.indiandentalacademy.com
  • 17. Composite inserts Improved resin – insert interface Size - ↓ light transmission – improper curingSmall room temperature inserts Curing phase reduction – not enough to significantly ↓ leakage Adhesion to enamel better than to dentin or cementum www.indiandentalacademy.com
  • 18. Cooled inserts Hybrid layer remained intact Thermal expansion of cooled inserts Curing rate & degree of cure ↓ when setting reaction occurs at lower temperature Pregel period could be longer Shrinkage vectors Thermal effect of curing light www.indiandentalacademy.com
  • 19. Conclusion Under the condition of this study, Small prepolymerized composite inserts have improved resin – insert interface Cooled prepolymerized inserts showed improved sealing ability of class V composite restoration with respect to room temperature inserts & bulk insertion technique www.indiandentalacademy.com
  • 20. www.indiandentalacademy.com