Filtek P90 Technical Profile for Latin America/Asia Pacificof sports equipment like tennis rackets...

Filtek™ P90Low Shrink Posterior Restorative

P90 System AdhesiveSelf-Etch Primer & Bond

Filtek P90

TM

Table of ContentsIntroductIon ............................................................................................................... 1

History ............................................................................................................................. 1

Rationale ......................................................................................................................... 3

overvIew of MaterIals ........................................................................................... 4

Filtek™ P90 Low Shrink Posterior Restorative .............................................................. 4Chemistry of Resin System ........................................................................................ 4Ring-Opening Polymerization.................................................................................... 5Initiator System .......................................................................................................... 6Filler Technology ....................................................................................................... 6

P90 System Adhesive Self-Etch Primer and Bond .......................................................... 7Chemical Background ................................................................................................ 7P90 System Adhesive Self-Etch Primer ..................................................................... 8P90 System Adhesive Bond ....................................................................................... 9

test results ............................................................................................................... 10

Polymerization Shrinkage ............................................................................................. 10

Polymerization Stress .................................................................................................... 12

Cusp Displacement ....................................................................................................... 15

Adhesion ........................................................................................................................ 16

Marginal Quality of the Restoration ............................................................................. 17

Wear .............................................................................................................................. 18

Flexural Fatigue Limit .................................................................................................. 18

Compressive Strength and Flexural Strength ............................................................... 19

Flexural Modulus .......................................................................................................... 19

Fracture Toughness (KIC) ............................................................................................. 20

Depth of Cure ................................................................................................................ 20

Ambient Light Stability ................................................................................................. 21

Water Sorption and Exogenic Staining ......................................................................... 22

Clinical Studies ............................................................................................................ 22

3M esPe aPPlIcatIon test .................................................................................... 23

clInIcal case ............................................................................................................ 24

Clinical Application of the Filtek™ P90 System ........................................................... 24

technIque GuIde ...................................................................................................... 26

Filtek™ P90 Low Shrink Posterior Restorative ............................................................ 26

P90 System Adhesive Self-Etch Primer and Bond ........................................................ 26

IndIcatIons .............................................................................................. 27

shades ........................................................................................................................... 27

coMPosItIon ............................................................................................................... 27

questIons and answers ...................................................................................... 28

suMMary ....................................................................................................................... 33

lIterature.................................................................................................................... 34

technIcal data .......................................................................................................... 36

table of contents

IntroductionFiltek™ P90 Low Shrink Posterior Restorative and P90 System Adhesive Self-Etch Primer and Bond is a complete system for Class I and II direct posterior restorations.

Filtek P90 restorative is offered in 4 radiopaque shades (A2, A3, B2, C2) with one opacity. This restorative is based on a new resin chemistry – silorane technology – which has achieved the lowest shrinkage currently available. The reduced shrinkage leads to greatly reduced polymerization stress.

Filtek P90 Posterior Restorative is used with P90 System Adhesive. The dedicated adhesive is an advanced self-etching formulation delivered in vials. The formulation of P90 System Adhesive specifically fits the chemistry of the Filtek P90 restorative.

The specially-adapted P90 adhesive and the reduced shrinkage of the Filtek P90 composite lead

to restorations with excellent marginal integrity.

HistoryComposite materials have been used in dental practices to restore teeth since 3M first introduced a composite to the dental market in 1964. Composites consist of fillers embedded in a chemically-reactive organic resin matrix. Fillers are typically inorganic materials like glass or quartz which are generally functionalized on the surface (silanization), enabling chemical linkage to the resin matrix.

The early materials were chemically-cured, two-component systems. These tooth-colored materials provided better esthetics than amalgam. However, much had to be learned about the chemical and physical properties that were required to withstand the aggressive oral environment. High shrinkage, high wear, color changes and lack of bonding to tooth

surfaces were the issues associated with these early materials.

Significant improvements have been made since then (Table 1). On the one hand, adhesive systems have been developed that adhere well not only to enamel, but even to moist dentin. On the other hand, composites have been made stronger, with higher wear resistance and color stability. And, both composites and adhesives have been modified to be curable on demand by exposure to light.

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1901 Synthesis and polymerization of methyl methacrylate

1930 Use of PMMA as denture base resin (Germany)

1944 First acrylic filling material

1951 Addition of inorganic fillers (non-bonded) to direct filling materials (Knock and Glenn)

1955 Investigation of epoxy resins as direct filling materials

1955 Acid-etch technique introduced (Buonocore)

1958 Dimethacrylates (Bis-GMA) and silanized inorganic filler investigated as direct filling material (Bowen)

1964 Bis-GMA composites marketed

1968 Development of polymeric coatings on fillers (Dental Fillings Ltd)

1973 UV-cured dimethacrylate composite resins

1977 Visible light-cured dimethacrylate composite resins

2007 Introduction of Filtek™ P90 System to the market

IntroductIon

Table 1: History of major developments in composite resins (From 1901 – 2007)

Improvements on the composite side were achieved, to a great extent, by optimizing the fillers – while the chemistry behind the organic resin matrix remained essentially the same since the pioneering work of R. L. Bowen in the 1960s. Practically all composites employ dimethacrylates such as TEGDMA, Bis-GMA or UDMA, which are radically polymerized as the primary resin (Fig. 1).

It is striking, that during these decades of improvement, polymerization shrinkage was only incrementally reduced to a somewhat lower level. Reducing the polymerization shrinkage of composite materials without compromising physical and handling properties remained the major challenge for material scientists.

Shrinkage is one of the major drawbacks of composite materials. Shrinkage results in a built-in polymerization stress which challenges the tooth/composite interface. To achieve long-term marginal integrity of restorations, technically-perfect bonding to enamel and dentin with high bond strength is necessary to counteract the shrinkage and polymerization stress.

Polymerization shrinkage is an intrinsic property of the resin matrix. Upon curing, the single resin molecules move towards each other and are linked by chemical bonds to form a polymer network. This reaction leads to a significant volume contraction.

To date, the main strategy to reduce shrinkage focused on increasing the filler load, thereby reducing the proportion of the methacrylate resin (Fig. 2). Since the shrinkage is caused by the resin, the lower the proportion of resin in a composite, the lower the shrinkage will be. However, the shrinkage intrinsic to the methacrylate resin has remained a major challenge. Therefore, exchanging the resin seems the most promising pathway to solve the shrinkage problem.

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Filler Content (wt %)

SiloraneMethacrylate

60 65 70 75 80 85 90 95 100

Figure 2: Simulated dependency of the volumetric shrinkage of composites on the filler content in weight percent plotted for typical methacrylate-based resins and the Silorane resin

Source: 3M ESPE internal data

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IntroductIon

Figure 1: Methacrylate resin chemistry

It’s time to face the next challenge: the fundamental improvement of the resin matrix by advancing beyond the current methacrylate resin systems.

Filtek™ P90 Low Shrink Posterior Restorative resin is based on silorane chemistry and does not contain methacrylates. The silorane ring-opening monomers provide for low polymerization shrinkage.

The new silorane platform provides a fundamental solution to the long-standing customer need for low shrinkage.

RationalePolymerization shrinkage and the resulting shrinkage stress, lead to microleakage which is among the major factors for composite material failures in the oral environment. Moreover, shrinkage stress can lead to tooth deformation, enamel cracks and stress-induced post-operative sensitivity (Fig. 3).

Materials which remain dimensionally stable upon polymerization, coupled with an advanced bonding to the enamel and dentin, will markedly enhance the stability of the restoration under functional stress.

Filtek P90 Low Shrink Posterior Restorative is designed to minimize shrinkage and polymerization stress.

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Figure 3: Clinical challenges associated with high shrinkage and polymerization stress

IntroductIon

Filler 76%

Initiator 0.9%Stabilizer 0.13%

Pigments 0.005%

Siloraneresin 23%

Figure 5: Composition of Filtek™ P90 Low Shrink Posterior Restorative

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Overview of MaterialsFiltek™ P90 Low Shrink Posterior RestorativeChemistry of the Resin System The development of dental restorative composites began in the late 1940s. Since then many technological developments have significantly improved the clinical performance of dental resin composites. However, the common chemical basis for all restorative composites remained the radical polymerization of methacrylates or acrylates. The low-shrinking Filtek P90 restorative is based on the new ring-opening silorane chemistry.

Siloranes are a totally new class of compounds for the use in dentistry. The name silorane derives from its chemical building blocks siloxanes and oxiranes (Fig. 4).

Siloxanes are well known in industrial applications for their distinct hydrophobicity. By incorporating the siloxanes into the dental silorane resin, this property was transferred to the Filtek P90 composite.

Oxiranes have been used for a very long time in many technical fields, especially where high forces and a challenging physical environment are expected, such as in the manufacture of sports equipment like tennis rackets or skis, or in the automotive and aviation industries and many more. The oxirane polymers are known for their low shrinkage and the outstanding stability toward many physical and chemophysical forces and influences.

The combination of the two chemical building blocks of siloxanes and oxiranes provides the biocompatible, hydrophobic and low-shrinking silorane base of Filtek P90 Low Shrink Posterior Restorative. This innovative resin matrix represents the major difference of Filtek P90 restorative compared to conventional methacrylates. Also, the initiating system and the filler were adapted in order to provide the best performance of the new technology (Fig. 5).

overvIew of MaterIals

Figure 4: Silorane chemistry

Ring-Opening Polymerization The polymerization process of Filtek P90 restorative occurs via a cationic ring-opening reaction which results in a lower polymerization contraction, compared to the methacrylate-based resins which polymerize via a radical addition reaction of their double bonds.

The ring-opening step in the polymerization of the silorane resin significantly reduces the amount of polymerization shrinkage which occurs in the curing process. The reduced amount of shrinkage is illustrated schematically in Fig. 6. During the polymerization process, molecules have to approach their “neighbors” to form chemical bonds. This process results in a loss of volume, namely polymerization shrinkage. In contrast to the linear-reactive groups of methacrylates, the ring-opening chemistry of the siloranes starts with the cleavage and opening of the ring systems. This process gains space and counteracts the loss of volume which occurs in the subsequent step, when the chemical bonds are formed. In total, the ring-opening polymerization process yields a reduced volumetric shrinkage.

Besides shrinkage, another parameter of paramount importance to the performance of a restorative material is polymerization stress. Polymerization stress is generated when composites are cured in the bonded state and the polymerization shrinkage develops forces within the cavity walls. The rigid tooth structure will withstand this force to a certain degree, however, these tensions can lead to marginal gaps or to damage of healthy tooth structure by its deformation. These forces or tensions are summarized under the term “polymerization stress.”

From the restorative material perspective, polymerization stress is mainly determined by three factors: 1) the polymerization shrinkage, 2) the internal flowability of the material, and 3) the polymerization kinetics (polymerization speed). A highly-shrinking material with a small, internal flowability and very fast curing speed in the first few seconds, will exhibit the highest polymerization stress.

Silorane technology was developed to minimize shrinkage, and is thus also predestined for low stress development. Moreover, the kinetics of the initiation and polymerization of the Filtek P90 resin were optimized to provide very low polymerization stress, as will be shown in the Test Result chapter.

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Figure 6: Reactive sites of silorane and methacrylates and corresponding shrinkage reduction upon polymerization

1 <1% volumetric shrinkage tested by bonded disc method

Initiator System One component of the initiating system is camphorquinone, which matches the light spectrum of conventional dental polymerization light sources. 3M™ ESPE™ Filtek™ P90 Low Shrink Posterior Restorative can be cured with halogen, as well as LED devices.

Further components of the initiating system are iodonium salts and electron donors, which generate the reactive cationic species that start the ring-opening polymerization process (Fig. 7).

The initiating system of Filtek P90 restorative was tailored so that the resulting polymerization kinetics leads to a minimized polymerization stress. A unique property of the three-component initiating system is that a “critical mass” of initiating reactive cationic species has to be generated to start the polymerization. This threshold behavior brings one major advantage: it allows the practitioner to work longer under full operatory light than with any conventional methacrylate-based composite.

While developing low stress and being stable against ambient light, the curing times for 2.5 mm increments of Filtek P90 restorative could be kept at a level comparable to conventional composites:

Halogen light devices Exposure time

Wave length spectrum 400-500 nm Output 500–1400 mW/cm2,

40 sec, standard mode

LED light devices Exposure time

Wave length spectrum 430-480 nm Output 500-1000 mW/cm2, 40 sec, standard mode Output 1000-1500 mW/cm2, 20 sec, standard mode (e.g., Elipar™ FreeLight 2, manufactured by 3M ESPE)

However, the threshold behavior of the Filtek P90 restorative initiator system requires a minimum curing time of 20 seconds, which can not be compensated by higher intensities. Very high intensity light sources like plasma arc lamps and lasers do not allow sufficiently-long curing times due to heating of the tooth. Therefore, plasma arc lamps, lasers and other light sources with very high intensities are contraindicated to be used with Filtek P90 restorative.

Filler Technology Filtek P90 restorative is filled with a combination of fine quartz particles and radiopaque yttrium fluoride. From the filler side, Filtek P90 restorative is to be classified as a microhybrid composite. The quartz surface is modified with a silane layer which was specifically matched to the silorane technology in order to provide the proper interface of the filler to the resin for long-term, excellent mechanical properties (Fig. 8).

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Quartz Particle Size (µm)

0.01 0.1 10001 10 100

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Figure 7: Initiation chemistry for siloranes

Figure 8: Filler-size distribution of Filtek™ P90 Low Shrink Posterior Restorative


P90 System Adhesive Chemical Background Recently, self-etch adhesives have gained increasing popularity among dentists. Their success is mainly based on their ease of use, low technique sensitivity and ability to reduce post-operative sensitivity as compared to total-etch adhesives.

P90 System Adhesive Self-Etch Primer and Bond is a new member of the 3M ESPE family of successful self-etch adhesive materials. P90 System Adhesive has been specially designed to provide strong and long-lasting bonding of Filtek P90 Low Shrink Posterior Restorative to enamel and dentin, providing the basis for excellent marginal integrity of the restorations.

The extraordinary low shrinkage and polymerization stress of Filtek P90 restorative have been achieved by developing the new silorane resin system. Curing of this resin system involves chemical mechanisms different from conventional methacrylate-based composites. From a scientific standpoint, it is obvious that a new adhesive is needed. Adhesives currently available on the market have been developed for traditional methacrylate materials and will, therefore, lead to insufficient results in combination with Filtek P90 restorative.

Due to its siloxane backbone, the silorane resin is more hydrophobic than conventional methacrylate resins, so it results in reduced water uptake and related phenomena, as described in the Test Results section. That means this adhesive has to bridge a larger difference between the hydrophilic tooth substrate and the hydrophobic silorane material as compared to conventional methacrylate materials. Therefore, P90 System Adhesive has been designed as a two-step adhesive (Fig. 9):

• P90SystemAdhesiveSelf-EtchPrimer is rather hydrophilic, and ensures strong and durable adhesion to the tooth.

• P90SystemAdhesiveBond is optimized for wetting and adhering to the hydrophobic Filtek P90 Posterior Restorative.

P90System Adhesive

Primer

P90System Adhesive

Bond

HydrophobicHydrophilic

Tooth Filtek™ P90

Figure 9: Different regimes of hydrophilicity/ hydrophobicity at the interface between the tooth and Filtek™ P90 Low Shrink Posterior Restorative

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P90 System Adhesive Self-Etch Primer In principle, self-adhesion is generated by acidic monomers that etch dental substrates and thus create a retention pattern for micromechanical interlocking of the cured adhesive with the tooth. Furthermore, they provide chemical bonding to the calcium-containing hydroxyapatite of the mineralized tissue. Most of today’s self-etch adhesives contain phosphorylated methacrylates as acidic monomers; some contain carboxylic acid functionalized monomers, or a combination of both.

P90 System Adhesive Self-Etch Primer contains phosphorylated methacrylates, as well as the Vitrebond™ copolymer with its carboxylic acid functionality used in many 3M™ ESPE™ resin-modified glass ionomers, and adhesives for adhesion to enamel and dentin. Furthermore, comonomers like BisGMA and HEMA, a solvent system consisting of water and ethanol for wetting and penetrating the dental substrates, and a photoinitiator system based on camphorquinone for thorough and fast curing are included. A silane-treated silica filler with a primary particle size of about 7 nm has been added for improving the mechanical strength and film-forming properties of P90 System Adhesive Self-Etch Primer. This filler is very finely dispersed in order to prevent settling.

Special attention has been devoted to providing a stable formulation that combines acidic monomers and the water/ethanol solvent system. Refrigeration is required in order to prevent loss of ethanol or water by evaporation.

With a pH of about 2.7, P90 System Adhesive Self-Etch Primer provides rather mild etching and demineralization of the tooth structure, yet strong and durable bonding through its nanoetching pattern, as well as chemical bonding to the hydroxyapatite. If P90 System Adhesive is to be applied to uncut enamel, a separate etching of the unprepared tooth structure is recommended. It is not required to etch prepared enamel but it may be done if desirable.

On dentin, well-defined resin tags are visible and penetration of the dentin structure by P90 System Adhesive Self-Etch Primer (Fig. 10).

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Figure 10: SEM micrograph of the composite/adhesive/ dentin interface after consecutive etching with hydrochloric acid and sodium hypochlorite solution


P90 System Adhesive Bond P90 System Adhesive Bond is also based on methacrylate chemistry. As a main component, it contains a unique 3M™ ESPE™ hydrophobic bifunctional monomer in order to match the hydrophobic silorane resin. An immediate result of this feature is the easy adaptation of Filtek™ P90 Low Shrink Posterior Restorative on cured P90 System Adhesive Bond. Other components include acidic monomers that initiate the ring-opening cationic cure of Filtek P90 restorative, thus providing chemical bonding to Filtek P90 (Fig. 11). The photoinitiator system is based on camphorquinone.

Figure 11: Mechanism of chemical bonding between P90 System Adhesive Bond and Filtek™ P90 Low Shrink Posterior Restorative

Acidic Monomerof P90 SystemAdhesive Bond

Curingof Adhesive Application

and Curingof Filtek™ P90

RestorativeChemical Bond

Between Adhesiveand Composite

OxiraneGroup

P90 System Adhesive Bond contains a silane-treated silica filler that not only improves the mechanical strength of the material, but also allows for carefully adjusted viscosity properties. P90 System Adhesive Bond may appear very viscous at first glance – you may have to flick it to the tip of the vial in order to dispense it. However, once you apply it with the brush or air-thin it, the viscosity drops by several orders of magnitude (Fig. 12), and it can be very easily dispersed as an even, uniform film. This phenomenon is called shear thinning. The benefits are obvious: it does not drop from the brush; and you can direct it with the air stream where you want it to be and it stays there – especially on the cavity walls and preparation margins – and it does not pool. With P90 System Adhesive Bond, the resulting film thickness is in the range of other two-step self-etch adhesives, despite the apparently higher viscosity.

Viscosity At Rest1000

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Figure 12: Viscosity of P90 System Adhesive Bond at low shear and under application conditions. Application and air thinning reduces the viscosity by several orders of magnitude, thus allowing for formation of an even and homogeneous film


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Test ResultsFiltek™ P90 Low Shrink Posterior Restorative has been tested extensively, both in-house as well as at renowned universities worldwide – and many results have been published in peer-reviewed journals. In this evaluation care was taken to address the most important quality parameters for composite restorations.

Polymerization ShrinkagePolymerization shrinkage is still a major concern. Prof. Swift and co-workers stated only recently that “although composites are now the material of choice for most restorations, their polymerization shrinkage remains a problem. The contraction stress associated with this shrinkage can cause debonding at the composite/tooth interface and can contribute to post-operative sensitivities, enamel fracture, recurrent caries marginal staining and eventually failure of the restoration.” (Yamazaki, Bedran, Russo, Pereira and Swift, 2006)

Filtek P90 restorative has been developed to minimize polymerization shrinkage and polymerization stress, while providing a high-performance bond to the tooth. Extensive testing of polymerization shrinkage has been conducted which shows Filtek P90 restorative to have a significantly lower shrinkage than all methacrylate composites tested, irrespective of the method employed (Fig. 13, Fig. 14, Fig. 15).

Most common measurements for polymerization shrinkage are the bonded-disc method, also referred to as Watts method (Watts & Cash 1991), and the Archimedes method which was recently developed into a German Standard (DIN 13907/2005). The bonded-disc method results in lower shrinkage values since only the linear shrinkage of a bonded composite disc is measured and then converted into % of volume. Whereas the Archimedes method measures the actual shrinkage in volume according to the buoyant force principle. However, both methods show a high correlation (Weinmann et al., 2005).

The bonded-disc method revealed shrinkage values for Filtek P90 restorative of 0.9 % (Fig. 13), while the polymerization shrinkage is about 1% when measured with the Archimedes method (Fig. 14).

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Figure 14: Polymerization shrinkage (Archimedes method) of Filtek™ P90 Low Shrink Posterior Restorative and methacrylate composites


A third method to determine volumetric shrinkage is employing video imaging to determine dimensional changes. The so-called AccuVol method (J. Burgess, U.S.A.) results in a value of 0.66 % volumetric shrinkage for Filtek P90 (Fig. 15) and confirms Filtek P90 restorative to be the lowest shrinking material among all composites tested.

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Figure 15: Polymerization shrinkage (AccuVol method) of Filtek™ P90 Low Shrink Posterior Restorative and methacrylate composite

Source: J. Burgess, U.S.A.

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test results

Polymerization StressPolymerization stress builds up during polymerization as a consequence of polymerization shrinkage when the gel point is reached, and further contraction cannot be compensated for by additional flow of the material.

Filtek™ P90 Low Shrink Posterior Restorative develops a very low polymerization stress compared to methacrylate composites, with all methods employed (Fig. 16, Fig. 17, Fig. 18).

A wide range of shrinkage-stress data are available for a tensilometer method developed at ACTA (University of Amsterdam). Here a composite sample is luted between a glass and a metal plate. The metal plate is attached to a load cell. While the composite is cured through the glass plate, the height of the composite sample is held constant by the testing device. The force needed to keep the height constant is recorded.

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Str

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Time (sec)

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Filtek™ P90Tetric® CeramSpectrum® TPH® Quixfil™ Filtek™ Z250 Filtek™ Supreme

Figure 16: Polymerization stress (Tensilometer method) of Filtek™ P90 Low Shrink Posterior Restorative compared to several methacrylate composites

Source: Dr. DeGee and Prof. Feilzer, University of Amsterdam (ACTA)

Watts et al. (2003) developed a method to determine the photopolymerization shrinkage-stress kinetics in resin composites with the Bioman device. Filtek P90 restorative shows significantly lower polymerization stress than the methacrylate composites tested (Fig. 17).

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Figure 17: Polymerization stress (Bioman method) of Filtek™ P90 Low Shrink Posterior Restorative and methacrylate composites

Source: Prof. Watts, University of Manchester

test results

Another method for the evaluation of shrinkage stress was performed by Prof. Ernst (University of Mainz) by means of a photoelastic investigation. Composite specimens were bonded in Araldit plates and cured with a halogen curing light. The strain forces induced by the polymerization shrinkage of the composites into the Araldit plate can be visualized as isochromatic rings in a polarizing microscope. The polymerization stress was calculated from the diameter of the first order isochromatic rings, at 4 minutes and again at 24 hours after exposure.

The results reveal that Filtek P90 restorative generated the lowest polymerization stress among all composites tested (Fig. 18). Additionally, all methacrylate-based materials continued to build up stress: the values measured after 24 hours are always higher than after 5 minutes. Filtek P90 restorative was the only material which maintained the same low-stress value observed after 5 minutes and did not continue to build up stress (Ernst et al. 2004).

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Source: Prof. Ernst, University of Mainz

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test results

The correlation between polymerization shrinkage and polymerization stress can be seen in Fig. 20, which shows the unique position of Filtek silorane restorative made possible through silorane technology.

The low stress development of Filtek™ P90 Low Shrink Posterior Restorative can be visualized by Finite Element Analysis. Dr. Versluis (University of Minnesota) simulated the spatial distribution and the intensity of polymerization stress compared to a low-shrink methacrylate (Fig. 19). Note that the Filtek P90 restoration shows an absence of “gray” high-stress areas where enamel cracks and leakage in the margin can occur.

Figure 19: Finite Element Analysis of Polymerization Stress

Source: Dr. Versluis, University of Minnesota

Filtek™ P90

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test results

Figure 20: Correlation between polymerization shrinkage and polymerization stress of Filtek™ P90 Low Shrink Posterior Restorative and methacrylate composites (Shrinkage method: Bonded disc method; Stress method: Bioman)

Source: Prof. Watts, University of Manchester

Cusp DisplacementA clinical implication of high polymerization stress and polymerization shrinkage is cusp displacement, which can result in the damage of healthy tooth structure (e.g., enamel cracks) and strain-induced hypersensitivities. Prof. Bouillaguet (University of Geneva) showed that Filtek P90 Low Shrink Posterior Restorative generates a much lower cusp displacement compared to methacrylate-based composites (Bouillaguet et al. 2006, Fig. 21).

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p D

isp

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men

t (m

icro

ns)

Time (sec)0 50 100 150 200

Filtek™ P90Tetric® FlowPremise™ Tetric® Ceram QuiXfil™

8 Figure 21: Time resolved cusp displacement of teeth with Filtek™ P90 and methacrylate composites placed in Class II MOD cavities. [Electronic speckle pattern interferometry (ESPI)]

Source: Prof. Bouillaguet, University of Geneva

15

test results

Figure 22: Tensile bond strength of the Filtek™ P90 System and methacrylate systems

Source: Prof. Powers, University of Michigan

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Filte

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eram

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m

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il™Figure 23: Shear bond strength

of the Filtek™ P90 System and methacrylate systems


Prof. Fischer (University of Zurich) investigated the durability of the adhesive interface by thermocycling and subsequent determination of shear bond strength. Filtek P90 System showed a significantly higher bond strength after thermocycling compared to a leading methacrylate system (Fig. 24).

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She

ar B

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Str

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(MP

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Tetric EvoCeram/AdheSE

Filtek Silorane/Silorane Adhesive

Dentin Enamel Dentin Enamel

35

30

25

20

15

10

5

0

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ar B

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Str

eng

th a

fter

TC

(MP

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Tetric EvoCeram®/AdheSE®

Filtek™ P90/P90 Adhesive

Dentin Enamel Dentin Enamel

Figure 24: Bond strength after thermocycling of Filtek™ P90 System as compared to a leading methacrylate system

Source: Prof. Fischer, University of Zurich

16

AdhesionAdhesion with sufficient high-bond strength is a key factor determining the seal of a filling and the stabilization of the restored tooth. To ensure optimal linkage of Filtek™ P90 Low Shrink Posterior Restorative to the tooth, a dedicated P90 System Adhesive has been developed.

Bond strength of the P90 System Adhesive in combination with Filtek P90 restorative was evaluated with the widely-used tensile bond test where load is applied perpendicular to the tooth surface, and shear bond testing where load is applied parallel to the tooth surface. Prof. Powers (University of Michigan) determined tensile bond strengths to enamel and dentin for the Filtek P90 System to be higher than a variety of clinically successful bonding systems (Fig. 22).

Similarly, shear bond strength of P90 System Adhesive revealed bond strength values similar to or better than current adhesive systems (Fig. 23).

test results

17

Marginal Quality of the Restoration Due to the low shrinkage and low polymerization stress of the Filtek P90 Restorative System, a smaller portion of the bond strength has to be invested to counteract forces resulting from shrinkage. Thus, more effective bond strength remains to counteract mastication forces and forces resulting from temperature changes. The low polymerization shrinkage of Filtek P90 restorative, in combination with the excellent bond strength, leads to excellent marginal integrity of the restoration (Fig. 25).

Filtek P90 Restorations were challenged in a chewing-simulation test device which combined 450,000 cycles of loading with 50 N per load and thermocycling for 1,550 cycles between 5°C and 55°C. The results showed that Filtek P90 System provides better marginal integrity before and after chewing simulation, as compared to leading methacrylate systems (Fig. 26).

100

80

60

40

20

0Tetric EvoCeram®/

AdheSE®

QuiXfil™/Xeno® III

Filtek™ P90/P90 System

Adhesive

% C

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us M

arg

in (E

nam

el a

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BeforeChewing

AfterChewing

BeforeChewing

AfterChewing

BeforeChewing

AfterChewing

Figure 26: Marginal integrity of the Filtek™ P90 System as compared to leading methacrylate systems


Conventional composite: adhesive and shrinkage forces work in strong opposition.

The Filtek™ P90 System ensures marginal quality due to reduced shrinkage forces combined with excellent adhesive force values.

Polymerization stress

Bond strength

Polymerization stress

Bond strength

Figure 25: Bond strength and polymerization stress act in opposite directions

test results

WearThe wear rate of Filtek™ P90 Low Shrink Posterior Restorative was determined in a three-body abrasion test according to the ACTA method. In this test, a sample wheel filled with composites (Body 1) is rotated against a structured stainless steel wheel (Body 2) in a millet suspension (Body 3). As the stainless steel wheel is narrower than the sample wheel, it leaves an abrasion mark on the samples, the depth of which can be determined by means of a profilometer. The deeper the abrasion mark, the less resistant the material is to wear. The three-body wear of Filtek P90 restorative corresponds to that of the clinically-tried and proven composites (Fig. 27).

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Figure 27: Three-body wear for Filtek™ P90 Low Shrink Posterior Restorative and methacrylate composite


18

Flexural Fatigue LimitRestoration fracture due to material fatigue is one of the main reasons for failure of direct restorations. To obtain insight into the fatigue behavior of the Filtek P90 restorative its flexural fatigue limit was determined and compared with conventional methacrylate composites. In this test 10,000 cycles of 3-point loading were applied with the frequency of 2 Hz, which is the upper limit of chewing frequency, under wet conditions and a constant temperature of 35°C. Several tests were done for each material, increasing the stress compared to the previous test if a material did not fail, and decreasing the stress if the material broke under loading. This procedure is referred to as the staircase approach.

The flexural fatigue limit of Filtek P90 restorative under wet conditions reaches top level, indicating a long-term durability of Filtek P90 restorative under clinical conditions (Fig. 28).

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80

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60

50

40

30

20

10

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CeramFiltek™ Z250 SureFil® Prodigy®

Condensable®Solitaire® 2 Filtek™ P90

She

ar F

lexu

ral F

atig

ue L

imit

(MP

a)

Figure 28: Flexural fatigue limit of Filtek™ P90 Low Shrink Posterior Restorative and methacrylate composites

Source: Prof. Braem, University of Antwerp

test results

19

Compressive Strength and Flexural StrengthA high compressive strength and a high flexural strength of the restoration material protects from fractures and stabilizes the tooth at the same time, especially when used in posterior restorations. The compressive strength of Filtek P90 restorative was determinded by increasing the load on specimens of 3x3x5 mm until fracture. Flexural strength was determined using the a three-point bending test. In this test the material is fixed at two points and stress is applied to a third point until fracture. During the test, compressive forces built up on the upper side and tensile forces at the lower side.

Both the compressive strength and flexural strength of Filtek P90 restorative rank within the range of clinically proven composites and are substantially above the ISO 4049 limit of 80 MPa (flexural strength) (Fig. 29).

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Compressive Strength

Flexural Strength

Figure 29: Compressive strength and flexural strength of Filtek™ P90 Low Shrink Posterior Restorative and methacrylate composites


Flexural ModulusThe flexural modulus defines the rigidity of a material and is determined on the basis of the same experimental set-up as flexural strength. There are no standard values indicating how high the flexural modulus of a restoration material should be. If the flexural modulus is too high, the material is more brittle and filling fractures are more likely. If the flexural modulus is too low, the tooth would not be provided with adequate stability. The flexural modulus of Filtek P90 restorative ranks within the range of clinically-proven composites (Fig. 30).

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20000

15000

10000

5000

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Figure 30: Flexural modulus of Filtek™ P90 Low Shrink Posterior Restorative and methacrylate composites


test results

20

Fracture Toughness (KIC)Fracture toughness is a measure of the resistance of a material to crack formation. A notch is sawed into rod-shaped test bodies, which are then pulled apart with increasing energy until the notch propagates as a crack and the specimen breaks. The fracture toughness of Filtek™ P90 Low Shrink Posterior Restorative is in the range of clinically proven methacrylate composites (Fig. 31).

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2.5

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250

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eram

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Filte

k™ P

90

Figure 31: Fracture toughness of Filtek™ P90 Low Shrink Posterior Restorative and methacrylate composites

Source: Prof. Kunzelmann, University of Munich

Depth of CureThe depth of cure was determined by a scratch test in accordance with ISO 4049:1999. For the test, composite cylinders are light cured in a brass mold. After polymerization, the brass mold is removed and the non-polymerized soft composite is scraped off with a spatula. The height of the remaining composite cylinder is measured. On the basis of these measurements Filtek P90 restorative may be placed in increments of up to 2.5 mm (Fig. 32).

9

8

7

6

5

4

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Dep

th o

f C

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(mm

)

Prod

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®

Filte

k™ Z

250

Tetri

c® C

eram

Hel

iom

olar

®

Filte

k™ P

90Figure 32: Depth of cure in metal

molds according to ISO 4049:1999

Source: Dr. Ilie, University of Munich

test results

21

Ambient Light StabilityAmbient light stability contributes to the convenience of handling of a composite material. The ambient light stability of Filtek P90 restorative was evaluated according to ISO 4049, which requires stability of a composite to be at least 60 seconds at 8000 Lux illumination (Fig. 33).

The silorane technology of Filtek P90 restorative offers the dentist up to 9 minutes to place and shape the restoration under operatory light illumination.

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Figure 33: Ambient light stability of Filtek™ P90 Low Shrink Posterior Restorative and methacrylate composite at 8000 Lux (Method based on ISO 4049)


test results

22

Clinical StudiesProf. Ernst, Johannes Gutenberg University of Mainz, Germany

Filtek P90 restorative is being studied in Class II restorations with an experimental adhesive, together with QuiXfil posterior restorative and Xeno III adhesive, in a split-mouth design. 102 restorations were placed in 46 patients. At baseline and at one year, the restorations were evaluated according to the Ryge/CDA criteria. After one year, all restorations showed clinically excellent and acceptable results. No Charlie or Delta scores were documented (Schattenberg et al. 2007).

Prof. Eliasson, University of Iceland

In this study the clinical performance of Filtek P90 restorative is being tested with an experimental adhesive system, and is compared to Tetric Ceram and a self-etching adhesive, AdheSE. At least one pair of restorations was placed in each patient according to research protocol. At one year, 53 restoration pairs in 31 patients were examined using the modified Ryge/CDA scale. No Charlie and Delta scores were seen. Color match was unchanged. One Tetric Ceram restoration was removed because of sensitivity. At one year, both materials appeared to be clinically acceptable and comparable.

Water Sorption and Exogenic StainingThe water sorption of composite restorations leads to swelling and possibly reduction in material properties – and it also facilitates exogenic discoloration. Filtek™ P90 Low Shrink Posterior Restorative was compared to methacrylate systems regarding water uptake according to ISO 4049 and its tendency to acquire staining in a coffee-stain test. In the course of this test specimens are immersed in a coffee solution over extended periods of time and the resulting discoloration is expressed as a Delta E-value (Fig. 34).

Water sorption for Filtek P90 restorative is very low due to the hydrophobicity of the silorane matrix, which results in a very low tendency for exogenic staining.

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2

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0

Del

ta E

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ffee

sta

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g

5

Water uptake (µg/mm3) ISO 4049

Filtek™ P90

CeramX™

Venus™

Grandio®

Premise™

TetricEvoCeram® Estelite®

Sigma

1510 20

Figure 34: Water uptake (ISO 4049) and exogenic staining (coffee-stain test) Delta-E values of Filtek™ P90 Low Shrink Posterior Restorative and methacrylate composites


test results

23

3M ESPE Application TestTo evaluate the handling of the Filtek P90 system, an in-vivo application test with 43 general practitioners in five European countries was conducted.

Dentists were asked to rate several handling criteria of the Filtek™ P90 Low Shrink Posterior Restorative. On a 5-point scale, rating 1 stands for an excellent performance and rating 5 for a poor performance (Fig. 35).

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2

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5

Stic

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Excellent

Poor

With over 1,100 fillings placed during the 6-week trial period, this application test confirmed the convenient handling of Filtek P90 restorative.

In a second in vivo application test, 1,145 fillings were placed by 43 general practitioners in Germany. No cases of post-operative sensitivity were reported. 86% stated they were satisfied with the overall handling of the Filtek P90 System, and 84% found the system easy to use.

3M esPe aPPlIcatIon test

Figure 35: General practitioners rate the handling characteristics of Filtek™ P90 Low Shrink Posterior Restorative


24

Clinical Case

Clinical Application of Filtek™ P90 SystemThe direct restorative filling with the Filtek P90 System requires no special technique. It works just like state-of-the-art composite/adhesive systems with one substantial improvement. Due to its greatly reduced sensitivity to ambient light, Filtek™ P90 Low Shrink Posterior Restorative can be placed, shaped and modeled under full operatory light illumination for as long as 9 minutes.

The case shown is typical: A Class II composite filling had to be replaced due to the occurrence of secondary caries after marginal gap formation.

Initial situation Shade selection Prepared cavity with rubber dam, wedge and matrix after removal of old filling and excavation of secondary caries.

Application of P90 System Adhesive Self-Etch Primer

Application of P90 System Adhesive Self-Etch Primer for 15 seconds with black microbrush, followed by gentle air dispersion and 10 seconds of light curing.

Application of P90 System Adhesive Bond

Application of P90 System Adhesive Bond with green microbrush, followed by gentle air dispersion and 10 seconds of light curing.

clInIcal case

25

Application of Filtek P90 Low Shrink Posterior Restorative

Placement and shaping of Filtek™ P90 Low Shrink Posterior Restorative under full operatory light conditions.

20 seconds light curing (Elipar™ FreeLight 2).

Finishing and Polishing (Sof-Lex™). Final Filtek™ P90 Low Shrink Posterior Restorative filling after rehydration of the teeth.

clInIcal case

26

Technique GuideFiltek™ P90 Low Shrink Posterior Restorative

P90 System Adhesive Self-Etch Primer and Bond

technIque GuIde

Filtek™ Silorane Low Shrink Posterior Restorative Niedrig schrumpfendes Seitenzahn-Füllungsmaterial

Silorane System Adhesive Self-Etch Primer and Bond Selbstätzender Primer und Bond

Use only as a system!

1 2

3 4

5 6

7 8

9 10

3M ESPE Filtek Silorane

Made in U.S.A. by 3M ESPE Dental Products St. Paul, MN 55144-1000

EC REP 3M ESPE AG Dental Products D-82229 Seefeld – Germany

Silorane System Adhesive

Made in Germany by 3M ESPE AG Dental Products D-82229 Seefeld - Germany

3M, ESPE and Filtek are trademarks of 3M or 3M ESPE AG. © 3M 2007 All rights reserved. 44-0007-4505-7

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27

IndicationsFiltek™ P90 Low Shrink Posterior Restorative, together with P90 System Adhesive Self-Etch Primer and Bond, is a system for direct, posterior restorative filling. It can be used for the following posterior restorations:

•ClassI •ClassII

Filtek P90 restorative and P90 system adhesive may be used together with glass ionomer cements or resin-modified glass ionomer cements, as cavity liners or bases.

Composites and compomers (including flowable composites and compomers), which are bonded to the tooth substance using an adhesive, may not be used as a liner or base under a Filtek P90 filling.

ShadesFiltek P90 posterior restorative is offered in the shades A2, A3, B2 and C2. All shades are radiopaque.

CompositionFiltek P90 Low Shrink Posterior Restorative:

• Siloraneresin • Initiatingsystem:camphorquinone,iodoniumsalt,electrondonor •Quartzfiller •Yttriumfluoride •Stabilizers •Pigments

P90 System Adhesive Self-Etch Primer:

• Phosphorylatedmethacrylates •Vitrebond™ copolymer •BisGMA •HEMA •Water •Ethanol •Silane-treatedsilicafiller • Initiators •Stabilizers

P90 System Adhesive Bond:

•Hydrophobicdimethacrylate •Phosphorylatedmethacrylates •TEGDMA •Silane-treatedsilicafiller • Initiators •Stabilizers

IndIcatIons, shades and coMPosItIon

28

Questions and Answers• What is the difference between Filtek™ P90 Low Shrink Posterior Restorative and

conventional composites currently on the market?

Filtek P90 restorative is based on the new silorane technology which allows shrinkage of <1% – which is exceptionally low compared to conventional methacrylate composites. (Volumetric shrinkage tested by bonded disc method) The new resin matrix technology requires a dedicated adhesive.

• HowcanItrusta“new”chemistrylikesilorane?Hasitbeenthoroughlytested?

Yes, the Filtek P90 System has been thoroughly tested and evaluated. The data shows that the Filtek P90 System performs well in both in vitro and in vivo studies and is biocompatible.

• ForwhatindicationscanIusetheFiltekP90restorative/P90adhesivesystem?

Filtek P90 restorative and P90 System Adhesive form a system for direct posterior filling procedures: Class I and II.

• DoIneedanyspecialmoisture-controlprecautionswhenplacingfillingswiththe Filtek P90 System?

With the Filtek P90 restorative/P90 System adhesive you can place your fillings like with any other composite/adhesive system; i.e., under dry conditions with rubber dam being recommended, but not mandatory.

• DoIneedtopreparethecavityinaspecialwayforFiltekP90fillings?

Filtek P90 restorative/P90 System adhesive requires no special cavity preparation. Preparation has to follow the usual guidelines for adhesive restorations; i.e., minimal invasive treatment, no special undercuts and beveled margins as needed.

questIons and answers

29


• WhydoIneedadedicatedadhesive?CanIuseFiltekP90restorativewith other adhesives than P90 System adhesive?

All adhesives on the market today have been developed for conventional methacrylate-based filling materials. As the Filtek P90 resin system is based on a completely new chemistry, an adhesive is needed that takes into account the different curing mechanism. P90 System adhesive is the only adhesive that reliably delivers excellent bond strength with Filtek P90 restorative. The use of a different adhesive will lead to insufficient bond strength.

•CantheP90SystemAdhesivebeusedwithconventionalmethacrylatecomposites?

P90 System Adhesive has been specially developed for the use with Filtek™ P90 Low Shrink Posterior Restorative. We recommend its use solely with Filtek P90 restorative.

•Whydidn’t3MESPEmakeP90SystemAdhesivea5thgenerationadhesive? I don’t believe in self-etch adhesives.

With more than 70 million fillings placed worldwide today, using 3M ESPE self-etch adhesives, 6th generation adhesives are clinically-proven and well accepted in the market. This is also due to their ease of use.

One major goal of silorane technology is reduced shrinkage and polymerization stress, which can result in reduced post-operative sensitivity. In order to provide a truly low-sensitivity system, we decided to provide Filtek P90 restorative with a self-etch adhesive, as these adhesives are known for their reduced risk of post-op sensitivity compared to total-etch systems. In case you would like to etch enamel selectively, this can be done.

•WhathappensifIseparatelyetchenameland/ordentinbeforeapplyingthe P90 System Adhesive?

On dentin and prepared enamel, the self-etching P90 System Adhesive needs no additional etching step. However, due to its rather mild etching, it is recommended to use phosphoric acid on uncut enamel prior to application of P90 System Adhesive and you can optionally also do so on cut enamel.

30

•WhatkindofbondstrengthsdoIgetwithP90SystemAdhesive?

Studies by Dr. John Powers, Prof. Jens Fischer, and 3M ESPE in-house measurements using different techniques, show that the bond strength of P90 self-etch adhesive is comparable to that obtained with clinically-proven, state-of-the-art, self-etch adhesives for methacrylate composites. Therefore, with the exceptionally low polymerization shrinkage and stress of Filtek P90, the P90 system provides excellent results.

•CanIwetmyinstrumentwithP90SystemAdhesiveforplacingandmodeling of Filtek P90 restorative?

Using an adhesive to lubricate an instrument for placing Filtek P90 restorative is not recommended. The bonding agent or adhesive will penetrate the composite and will change the composition of the material at the wetted surface. This compromises the mechanical properties of the material. The interface between increments placed with a wetted instrument is also believed to be less strong than when placed “dry.”

•CanIuseaflowablecompositeasaliner?

As of now, flowable composites and compomers may not be used as a liner or base under a Filtek P90 filling. These materials require usage of an adhesive other than P90 System self-etch adhesive, which in turn is not compatible with the Filtek P90 Low Shrink Posterior Restorative. P90 System Adhesive offers handling properties which allow proper placement without using a flowable as a liner. The stress-relief properties of a flowable liner are not important for a silorane restoration due to the low stress developed by the Filtek P90 restorative.

•CanIusetheFiltekP90Systemina“sandwich”techniquewithGIC/RMGIC on the bottom?

Yes, Filtek P90 restorative and P90 System adhesive may be used together with self-adhesive materials such as glass ionomer cements or resin modified-glass ionomer cements as a cavity liner or base.

• CanIuseFiltekP90restorativeasabasefillingandcoveritwith a methacrylate composite?

Yes, conventional adhesives can be used to bond methacrylate composites to cured Filtek P90 restorative.


31


•CanFiltekP90fillingsberepairedwithaconventionalmethacrylate composite system?

Yes, conventional adhesives can be used to bond methacrylate composites to cured Filtek P90 restorative.

•WhyisFiltekP90restorativeemployingaquartzfiller?

The silorane resin matches with the surface chemistry and the refractive index of quartz.

• CanIusea“bulkplacement”techniquewithFiltekP90restorative? What is the depth of cure?

Filtek P90 restorative has to be used with a conventional layering technique with a layer thickness of 2.5 mm or less in order to obtain perfect results.

• DoIneedtodimtheoperatorylightduringplacementandmodelingof Filtek P90 restorative?

No, Filtek P90 restorative has an outstanding ambient light stability and offers up to 9 minutes of working time under full operatory light conditions.

• WhyamInotallowedtousehigh-powercuringlights,likeplasmaarclamps orlasers,for curing Filtek™ P90 Low Shrink Posterior Restorative?

In the first few seconds, the ring-opening polymerization reaction of Filtek P90 restorative is somewhat slower than the radical polymerization of methacrylates. However, after 20 seconds, the cure has proceeded to a degree equivalent to that of methacrylate composites. This difference in cure time for Filtek P90 restorative is due to its different chemistry and cannot be compensated by a higher intensity; e.g., of a plasma curing light.

•“Lowshrinkage”isaratheracademicterm.HowcanIseethebenefits in my everyday work?

The low shrinkage of Filtek P90 restorative results directly in low-polymerization stress. The latter potentially reduces the risk of post-operative sensitivity, cusp deflection and enamel cracks.

32

•Whydodifferentmethodsofshrinkagemeasurementgivedifferentresults?

One method that measures the volume difference upon curing is the Archimedes method, based on the buoyancy principle. Other methods, like the Watts bonded disc, yield different results, because here several approximations have to be made. More fruitful than discussing absolute numbers is to compare numbers received within one method. Filtek™ P90 Low Shrink Posterior Restorative provides the lowest shrinkage compared to methacrylates with the Archimedes method, the Watts bonded-disk method, the AccuVol device and the ACTA linometer.

•WhyisFiltekP90restorativenota0%shrinkagecomposite?

Filtek P90 restorative represents a balance of shrinkage versus swelling due to water uptake. Even though the water uptake is very low for Filtek P90 restorative, a 0% shrinkage material could lead to pressure on the tooth structure caused by hydrolytical expansion.

•IfIcarefullylayermymethacrylatecomposite,don’tIcompensatefortheshrinkage?

The layering technique does compensate for shrinkage to a certain degree. However, even when applying a sophisticated layering technique, methacrylate composites will produce a significantly higher polymerization stress compared to the low-shrink and low-stress optimized Filtek P90 System.

•Lowshrinkageisnice,butwhataboutstress?

The Filtek P90 System also provides for an exceptionally low polymerization stress. The benefits for patient and dentist are reduced risk of post-op sensitivity, reduced cusp displacement and, thus, less enamel cracks and improved margins.

•What’sthedifferencebetweenshrinkageandstress?

Shrinkage is the process of volumetric contraction upon curing of the composite. Stress is the force that the shrinking composite exerts on the surrounding tooth structure, and which has been related to post-operative sensitivity, marginal gaps, cusp deflection or enamel cracks.

•AtthemomentIamusingauniversalcompositeforanteriorandposterior restorations.WhyshouldIswitchtoa“posterioronly”system?

Posterior restorations have to function under very tough conditions. Filtek P90 restorative with P90 System adhesive is a specially-designed posterior restorative system providing the lowest shrinkage and exceptionally low polymerization stress.


33

SummaryManaging polymerization shrinkage, especially in the posterior region, is one of the most pressing challenges that is still not fully addressed with state-of-the-art composite filling materials. Over the last ten years several attempts were made to gain a low-shrinking material, but today still the vast majority of composites on the market show volume shrinkage values in the range of 2-3%.

3M™ ESPE™ Filtek™ P90 Low Shrink Posterior Restorative is part of a revolutionary new filling system that will herald a new era in restorative dentistry. In contrast to conventional, methacrylate-based composites, Filtek P90 restorative is polymerized in a ring-opening polymerization reaction. Filtek P90 restorative is characterized by the lowest polymerization shrinkage on the market. Featuring a polymerization shrinkage of less than 1% also contributed greatly in reduction of polymerization stress. Lower polymerization stresses potentially reduce the risk of post-operative sensitivity, cusp deflection and, therefore, enamel cracks.

Furthermore, low polymerization shrinkage and stress, in combination with excellent adhesive properties of the 3M™ ESPE™ P90 System Adhesive Self-Etch Primer and Bond, result in an excellent marginal integrity of Filtek P90 restorations.

The P90 system adhesive is a dedicated adhesive leveraging 3M ESPE̓s long-term experience on self-etch adhesives. The composition of P90 System adhesive especially addresses the technological needs of adhesive bonding of the new Filtek P90 resin to enamel and dentin.

Filtek P90 restorative and P90 System Adhesive represent the next generation of restorative filling materials, combining esthetics and mechanical properties you know for conventional hybrid composites with low polymerization shrinkage due to a revolutionary new resin system. The system is well proven by scientific researchers all over the world, confirming the mechanical strength and convenient clinical handling of the Filtek P90 system.

suMMary

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Literature

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Bouillaguet S., Gamba J., Forchelet J., Krejci I., Wataha J. C. (2006), Dynamics of composite polymerization mediates the development of cuspal strain. Dent Mater 22:896-902.

Braga R. R. and Ferracane J. L. (2004), Alternatives in Polymerization Contraction Stress Management. Crit Rev Oral Biol Med 15(3):176-184.

Brandenbusch M., Meyer G. R., Canbek K., Willershausen B., Ernst C. P. (2007),One year performance of an innovative silorane posterior composite. IADR 2007, Abstract #1581.

Cook W. D., Beech D. R., Tyas M. J. (1985), Structure and properties of methacrylate based dental restorative materials. Biomaterials 6:362-368.

DeGee A. J., Feilzer A. J., Davidson C. L. (1993), True linear polymerization shrinkage ofunfilledresinsandcompositesdeterminedwithalinometer.DentMater9:11-14.

De Munck J., Van Landuyt K., Peumans M., Poitevin A., Lambrechts P., Braem M.,Van Meerbeek B. (2005), A Critical Review of the Durability of Adhesion to Tooth Tissue: Methods and Results. J Dent Res 84(2):118-132.

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Ernst C. P., Meyer G. R., Klöcker K., Willershausen B. (2004), Determination of polymerization shrinkage stress by means of a photoelastic investigation. Dent Mater 20, 313-321.

Guggenberger R., Weinmann W., Kappler O., Fundingsland J., Thalacker C. (2007), Historical Evolution of Volumetric Polymerization Shrinkage of Restorative Composites. IADR 2007, Abstract #0403.

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Palin W. M., Fleming G. J. P., Nathwani H., Burke F. J. T., Randall R. C. (2005), In vitro cuspaldeflectionandmicroleakageofmaxillarypremolarsrestoredwithnovellow-shrinkdental composites. Dent Mater 21:324-335.

Palmer T. M., Gessel T. F., Christensen C. C., Melonakos S. J., Ploeger B. J. (2005),Volumetric Shrinkage of “Low Shrinkage” Composite Resins. IADR 2005, Abstract 0296.

Schattenberg A., Meyer G. R., Willershausen B., Ernst C. P. (2007), Shrinkage stress of new experimental low-shrinkage resin composites. IADR 2007, Abstract #0412.

Schweikl H., Schmalz G., Weinmann W. (2004), The Induction of Gene Mutations and Micronuclei by Oxiranes and Siloranes in Mammalian Cells in vitro. J Dent Res 83:17-21.

Watts D. C. and Cash A. J. (1991), Determination of polymerization shrinkage kinetics in visible-light-cured materials: methods development. Dental Materials 7:281-287.

Watts D. C., Marouf A. S., Al-Hindi A. M. (2003), Photo-polymerization shrinkage-stress kinetics in resin-composites: methods development. Dental Materials 19:1-11.

Watts D. C. (2005), Shrinkage-Stress Kinetics of Silorane versus Dimethacrylate Resin-Composite. IADR 2005, Abstract #2680.

Weinmann W., Thalacker C., Guggenberger R. (2004), Siloranes in dental composites. Dent Mater 21:68-74.

Yamazaki P. C. V., Bedran-Russo A. K. B., Pereira P. N. R., Swift E. J. Jr. (2006), Microleakage Evaluation of a New Low-shrinkage Composite Restorative Material. Operative Dentistry 31-6, 670-676.

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Technical DataFiltek™ P90 Low Shrink Posterior Restorative

Property Resin Matrix Siloranes

Filler Quartz and Yttrium fluoride

Filler Load by Weight (%) 76%

Average Particle Size (µm) 0.47

Curing Time (seconds) Halogen light devices:

Output 500 – 1400 mW/cm2, 40 sec, standard mode

LED light devices:



Increment Thickness (mm) 2.5

Volumetric Shrinkage (Bonded disc method) 0.9%

Fracture Toughness (K1C) 1.6

Flexural Fatigue Limit (MPa) 77

Compressive Strength (MPa) 394

Flexural Strength (MPa) 123

Flexural Modulus (GPa) 9.6

In vitro Wear (3-body wear in µm/cycles) 65/200,000

Number of Shades 4

technIcal data

37

Name

Vskd AsklkfgajerFayhin Sieklt HainetyAsklk Sieklt HainetyCountry

Name

Vskd AsklkfgajerFayhin Sieklt HainetyAsklk Sieklt HainetyCountry

3M, ESPE, Adper, Elipar, Filtek, L-Pop, Prompt, Sof-Lex, Vitrebond and Z100 are trademarks of 3M or 3M ESPE. AdheSE, Aelite, Alert, APX, Charisma, CeramX, Clearfil, Definite, ELS, Estelite, EsthetX, EvoCeram, Futurabond NR, Glacier, Gradia, Grandio, Heliomolar, Herculite, Herculite XRV, iBond, InTen-S, Miris, Optibond, Point 4, Premise, Prime & Bond NT, Prodigy, Prodigy Condensable, QuiXfil, Renamel, Saremco ELS, Solitaire, Spectrum, Spectrum TPH, SureFil, Tetric, Tetric EvoCeram, TPH, TPH3, Venus, Xeno and XtraFil are not trademarks of 3M.

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