INDIAN DENTAL ACADEMYLeader in Continuing Dental Education    www.indiandentalacademy.com
Introduction      Resin composites……      Advantage         Excellent    esthetics         Relatively    low thermal c...
Stress induced                             Disruption incontraction force                         marginal integrity      ...
To overcome shrinkage……  Acid etching – effective method  Indirect restoration  ‘C’ factor modification  ↑filler content –...
Aim     To evaluate sealing ability ofclass V composite resin restorationusing cooled prepolymerizedcomposite inserts & co...
Materials & Methods                        Preparation of insertsTeeth stored insaline            www.indiandentalacademy....
Room temperature                              Cooled inserts         inserts       www.indiandentalacademy.comStandardized...
Acid etching & Bonding agent application Group A    www.indiandentalacademy.com Group C                   Group B
Immersion of teeth in Methylene blue solutionfor 12 hrs                  Making of                  sections           www...
Intra oral camera with software for microleakageevaluation Group A     www.indiandentalacademy.com Group C                ...
Scoring criteria for microleakage   ♥ Score 0 – no leakage   ♥ Score 1 – dye penetration within 1/3 of cavity wall   ♥ Sco...
Statistical analysisMann Whitney’s ‘U’ test for group wise comparisonKruskal Walli’s test for leakage between inserts &res...
Occlusal [Enamel] microleakage scores    Groups                    Leakage score                 0        1          2    ...
ResultsIn occlusal marginGroup A vs Group B – no significant difference (P=0.85)Group B vs Group C – significant differenc...
Discussion  ۩   Limitation of filler loading (70 -75%)  ۩   Use of inserts……       ۩   ↑ filler resin ratio       ۩   ↑ we...
β Quartz inserts    In 1993 Tjan et al – do not significantly    improve the marginal integrity    Disadvantage……         ...
Composite inserts  Improved resin – insert interface  Size - ↓ light transmission – improper curingSmall room temperature ...
Cooled inserts    Hybrid layer remained intact    Thermal expansion of cooled inserts     Curing rate & degree of cure ↓ w...
Conclusion Under the condition of this study,      Small prepolymerized composite inserts       have improved resin – inse...
www.indiandentalacademy.com
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Cooled composites inserts /certified fixed orthodontic courses by Indian dental academy

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

  1. 1. INDIAN DENTAL ACADEMYLeader in Continuing Dental Education www.indiandentalacademy.com
  2. 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. 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. 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. 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. 6. Materials & Methods Preparation of insertsTeeth stored insaline www.indiandentalacademy.com
  7. 7. Room temperature Cooled inserts inserts www.indiandentalacademy.comStandardized class V cavity preparation
  8. 8. Acid etching & Bonding agent application Group A www.indiandentalacademy.com Group C Group B
  9. 9. Immersion of teeth in Methylene blue solutionfor 12 hrs Making of sections www.indiandentalacademy.com
  10. 10. Intra oral camera with software for microleakageevaluation Group A www.indiandentalacademy.com Group C Group B
  11. 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. 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. 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. 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. 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. 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. 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. 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. 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. 20. www.indiandentalacademy.com

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