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    The evolution of dental materials

    Examining the past, present and future of composites.

    Most dental professionals would agree that the use of composites and adhesive materials have changed the dental practice. But as technology develops and results in new materials, futuristic possibilities arise that could change medicine. Could dental materials one day be more than a Band-Aid for the tooth? Glass ionomers release fluoride to strengthen the health of the teeth, but perhaps future materials will go far beyond, using the platelet-rich fibrin that is mostly used in implant cases to encourage regrowth for decayed teeth. One day, dental filler materials could even produce antibiotics for the oral cavity, as one professional I interviewed suggested.

    Before we get too far ahead of ourselves, let’s review where dental restorative materials have been, where they’re heading now and where they could end up in the future.

    A shift from rudimentary materials to resin composites and glass ionomers 

    Rudimentary restorative materials, such as amalgams, have been commonly used since the 1800s, although their use has been documented to go as far back as A.D. 659, when they were used during the Tang Dynasty in China.

    To the relief of dental professionals everywhere, amalgam restorations met some competition when resin composites arrived on the scene in the 1960s.

    There were a few kinks to work out in terms of looks and durability, and once microfilled composites came out around 20 years later, they were much more successful, but they were also technique sensitive. By the early 2000s, resin composites had been drastically improved and were suitable for long-term use in posterior restorations.
    Unfortunately, the first decade of the 2000s brought little improvement to the resins that hold the fillers together, says Larry Clark, director of clinical affairs and marketing at Pulpdent.

    In fact, he argues that it was only in the last eight or nine years that resins started to undergo improvements.

    Trending article: Choosing the right composite for your patients

    “Before the resins started to improve, it was kind of like cement,” Clark says. “The rain would come and wash away the cement, and you’d get pits and holes in your roads and sidewalks. Composites in the ’70s and early ’80s were failing like that. Now, the resins are more durable and the fillers come in all shapes, sizes and dimensions.”

    One major benefit of composite resins and glass ionomers (and the combinations in between), aside from nicer looking teeth and happier patients, is that those materials have inspired innovation in the field of restorative dentistry. Today, restorative materials have evolved to be “more esthetic and wear resistant, easy to use and place, feature superior wear resistance and more accurately match natural dentition,” says Brendan Steidle, product marketing manager at GC America. “Typically, the dentist and patient want something that matches natural dentition so as not to indicate that there were any caries or damage to the tooth. So, anything that helps the restoration look more like natural teeth is something that both the dentist and the patient are going to be interested in. That’s where the industry has been going — dentists want that combination of esthetics and strength. Resin composites are able to offer both of those and blend in with the natural dentition, so it doesn’t stand out.”

    Dental materialsThe improvements made to resins in the last decade include the ability to bond to the fillers so that they don’t come out of the tooth. “After that, it’s about controlling shrinkage and being able to have less water absorption,” Clark says.

    “In the last few years, smarter filler compositions have significantly impacted handling, the gloss properties and the wear resistance of the materials,” adds Melanie Dietrich, restorative business unit manager at COLTENE.
    The solution to the finicky restorations of the past was twofold: to improve the physical properties of the fillers and adhesives and to identify the best techniques for use, says John Fundingsland, professional services manager at 3M Oral Care.

    “Over the last decades, composites have developed immensely and are today’s material of choice in minimally invasive, direct restorative therapy,” Dietrich adds.

    While there are many factors that determine the long-term health of the restoration, they are theoretically designed to last a lifetime, according to Steidle.

    “Dental professionals really like resin composites because of that adaptability and esthetic,” he says. “Over time, resins tend to shrink, but technological advances in development of composites provides less polymerization shrinkage over time. So, you have better adaptation at placement, and then when you have a recall a year later or even five years later, these restorations often look as good as when they were placed.”

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