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Operative Dentistry - Best Practices

Resin-based Composite

(last modified September 25, 2014)

Direct resin-based composites (RBC) comprise an increasingly utilized direct esthetic restorative material, which now involves the majority of direct restorations placed both in the anterior and posterior part of the mouth. RBC is the material of first choice for small- to moderately-sized primary coronal lesions when adequate field control is obtainable.

Advantages:

  • Restorations are extremely esthetic mimicking lost tooth structure
  • Restorations may utilize bonding to enamel and dentin for achieving their retention to tooth structure resulting in minimal tooth structure removal
  • Preparations can be defect specific, that is, RBC does not require the preparation to extend beyond the extent of the defect for clinical success, with the exception of the¬†enamel cavosurface margin
  • Restorations are viewed as more biocompatible than dental amalgam
  • Through bonding, restorations may reinforce lost tooth structure
  • Restorations are not as thermally conductive as dental amalgam
  • Good longevity when properly placed

Disadvantages:

  • Restorative material is quite technique sensitive
  • Material is hydrophobic
  • Material must be polymerized properly to achieve maximum physical properties
  • May produce more wear and microleakage than other direct restorative materials
  • Placement techniques must be tailored to the material
  • May discolor over time

Indications

  • Isolation must be achieved
  • Any anterior restoration with adequate enamel and dentin for bonded retention
  • Class V restorations where fluoride release is not necessary
  • Posterior restorations with adequate remaining tooth structure
  • Class II restorations where the gingival margin is located in enamel

Relative Contraindications

  • Large cusp coverage posterior restorations
  • Any restoration which does not have sufficient tooth structure for bonding support
  • High risk caries patients, rampant or root caries situations
  • Subgingival margins in dentin (* RMGI)

Contraindications

  • Any preparation where proper field control cannot be achieved