Restoration of posterior teeth with indirect and direct solutions, using ORMOCER and nanohybrid composite technology

Abstract

Composites are complex materials that have undergone significant development in recent decades. In addition to changing
the particle size of the fillers, the manufacturers also targeted to further improve the resin matrix. The Organically
Modified Ceramics or ORMOCERs can be considered such a promising development. Their uniqueness lies in the fact
that the frame of the resin matrix is the inorganic -Si-O-Si chemical bond to which high molecular weight unsaturated organic
side groups are connected. In contrast to the classical composites, the ormocers are in polymer state even before
light curing, so an inorganic-organic copolymer is the backbone of the resin matrix. Admira Fusion (VOCO, Germany)
is a highly filled (84% w/w) composite based on ORMOCER technology, in which, in addition to the above-mentioned
chemical innovation, the nanohybrid filler is also completely silanized, so the -Si-O-Si bond will form the entire backbone
of the filler, making it a purely ceramic based composite. Thanks to its unique chemical structure, that does not contain
classical bis-GMA monomers, it has excellent biocompatibility, low shrinkage (1.25%) and a wide range of uses. In the
case presentation a direct and indirect restoration solution of a premolar and molar is presented. The final cuspal coverage
of the endodontically treated tooth #45 was preceded by the filling replacement on the adjacent tooth #46. An anatomical
and aesthetic restoration was created with the Admira Fusion composite family and the Final Touch characterization
system. Centripetal technique was used to build up the tooth and the occlusal surface was rebuilt with layering
technique. After completion of the direct filling indirect restoration of #45 was executed using CAD-CAM technology from
nanohybrid restoration material Grandio blocs (VOCO, Germany). The advantages of composite blocs beside the fact
that they are antagonist friendly is that they can be easily individualised and repaired if needed and do not require firing,
making the whole process faster. In conclusion, ORMOCER technology is a reliable, biocompatible, low-shrinkage
alternative to traditional composites. The nanohybrid Grandio blocs are suitable materials for creating fracture-resistant,
aesthetic indirect restorations.