Direct Esthetic Restorative Materials

There are four types of direct esthetic restorative materials currently in use. They are:

1. Composites
2. Compomers
3. Hybrid Ionomers
4. Glass Ionomers

Composites are dominating the materials used for direct esthetic restorations. Glass ionomers are primarily used for restorations of cervical eroded areas. Hybrid ionomers provide better esthetics than glass ionomers. Compomers provide improved handling and fluoride release when compared with composites.

Composites are esthetically better, strong and wear resistant but low or lack fluoride release. Compomers are less wear resistant, are esthetically pleasing and release fluoride. Hybrid ionomers, when compared to compomers, release more fluoride but are less wear resistant, hence not used in posterior restorations. Glass ionomers release the maximum fluoride, best for restoration in patients with high caries risk in low stress bearing areas.

Uses of Composites, Compomers, Hybrid Ionomers, and Glass Ionomers

Microfilled composite: Class III and IV

Nanofilled composite: Class I, II, III, IV, and V

All purpose composite: Class I, II, III, IV and V, patient with low risk of caries.

Packable composite: Class I, II and VI (mesial, occlusal, distal=MOD).

Flowable composite: Cervical restorations, paediatric restorations, small-low stress bearing restorations.

Laboratory composite: Class II restorations, three unit bridge with fibre reinforcement.

Compomer: Class III and V restorations, Cervical lesions, primary teeth, class I and II restorations in children, sandwich technique in class II, and patients with medium risk of caries.

Hybrid ionomer: Class III and V restorations, Cervical lesions, primary teeth, class I restorations in children, sandwich technique in class II, and patients with high risk of caries.

Glass ionomer: Class V restorations in adults who do not give priority to esthetics, and patients with high risk of caries, cervical lesions.