Anterior Resin Restorations: Which Resin Do I Use?
In this series, I plan on taking you through a quick journey of choosing a composite resin for your restoration, including the steps in the process of creating a layered restoration that will blend in naturally with the surrounding tooth structure.
Composite or resin is used every day in my practice and just like a lot of things in dentistry today, it continues to be an ever-changing field. Everything from the chemistry in the material, to filler size, shape and names, it keeps everyone guessing.
In the beginning, like many things in dentistry, you had one or two composite resins to choose from. Today there are a lot choices, from many different manufacturers with different properties to that go along with each one.
In this article I will summarize (I DO MEAN SUMMARIZE) the many “types” of composite resin restorations available and when to use them, and why:
Microfills: This type of dental material has been around since the 1980s and made up of having a microfiller, consisting of relatively small, silicone dioxide particles.
PROS: Highly polishable, enamel-like; Indicated in anterior teeth, cervical regions not receiving a lot of stress.
CONS: Not for use in stress bearing areas; tends to be more translucent.
Examples: Durafil VS, Renamel, EPIC-TMPT, Matrixx
Hybrids: This type of resin has a variety of larger, irregular, filler particle sizes that help enhance the overall strength along with being more filled than Microfills.
PROS: Can be used in posterior and anterior teeth and has good physical properties.
CONS: Tend to lose luster/polish over time and do not polish as well.
Examples: Charisma, Herculite XRV, Spectrum TPH
Microhybrids: Manufactures figured out that if they have a resin that would work for anterior/posterior teeth and would be more polishable, then they could be now have a “universal” composite. So they made the filler size smaller in the hybrids and developed the microhybrids, highly filled with variable particle sizes.
PROS: Polishable, and indicated for use in anterior and posterior teeth; have a variety of shades, including enamel and dentin.
CONS: Not as polishable as microfills.
Examples: Filtek Z-250, Venus, Tetric Ceram, 4 Seasons, Miris, Point 4, Gradia Direct, Vit-l-escence, Esthet-X
Nanofills: In the continued drive for the “true” universal, manufactures have come out with this classification of resins that have “nanoclusters” or “nanoparticles” that are used as fillers and allow for both strength and polishability.
PROS: Very polishable and can rival microfills; can be used in posterior and anterior restorations.
CONS: Too early to determine as this is the newest class of resins, but research is very promising.
Examples: Premise, Filtek Supreme Plus, Clearfil Majesty Esthetic, Venus Diamond, Esthet-X HD
In the next article, I will discuss and show some techniques for using the different resins as well as layering and creating a natural looking restoration.
Jeff Lineberry DDS, Visiting Faculty, Spear Education. [ www.jefflineberrydds.com ]