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SDR

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Resin komposit merupakan bahan restorasi direct dengan nilai estetik yang paling baik.
Berbagai jenis komposit terdapat dipasaran tergantung dari jenis filler dan kegunaannya.
Perkembangan teknologi dalam bidang kedokteran gigi saat ini menghasilkan suatu inovasi
baru dari resin komposit yang digunakan sebagai base/liner pada restorasi komposit
konvensional. Resin komposit tersebut yaitu komposit SDR.
Komposit SDR dapat berikatan secara kimia dengan semua resin yang memiliki
komposisi methacrylate. Ukuran partikel rata-rata komposit SDR adalah 4,2µm, dengan
persentase bahan pengisi 68% dari beratnya dan 44% dari volumenya. Indikasi komposit SDR
adalah sebagai base pada penambalan gigi posterior (kelas I dan kelas II). Komposit SDR dapat
digunakan untuk daerah yang memiliki tekanan yang besar karena ukuran partikelnya yang
cukup besar sehingga memiliki kekuatan yang lebih baik. Compressive strength komposit SDR
sebesar 242MPa. Konsistensi komposit SDR lebih dapat mengalir, sehingga cara aplikasi resin
komposit ini lebih mudah dengan teknik bulkfill hingga kedalaman 4 mm yang kemudian akan
dipolimerisasi dengan light curing unit LED. Namun, polymerization shrinkage tetap terjadi
yaitu sekitar 3,5%
SDR technology is based on a unique chemical structure of the organic phase which includes
a polymerisation modulator. A component- urethane dimetacrylate resin is a kind of a monomer
which controls the course of polymerisation by being a so called chemical ‘soft start’.
DR has low polymerisation stress and effective hardening in the whole 4mm layer and is
resistant to fracture and fissure in the perigingival region (12)
A significant change of this parameter led to decreased patient’s pain stimuli one week after
the treatment. The problem of post-operative sensitivity also frequently occurs in restoration
of hard tissues with traditional composite material. In case of SDR, it is connected with the
preparation and filling very big and deep carious lesions. The presence of sensitivity can be
connected with hard tissues damage or inappropriate application of etching applicator (
asil penelitian sendiri menunjukkan efektivitas dan keamanan penggunaan SDR sebagai
lapisan dasar 4mm
untuk pengisian rongga kelas I dan II selama satu tahun pengamatan. Dinyatakan bahwa SDR
adalah
netral untuk jaringan parodontal dan memungkinkan pemulihan titik kontak yang normal
gigi tetangga
In addition, this technique may result in less color stability over time compared with
conventional resin systems [31, 32], affecting the final esthetic result.
The results of own studies show the effectiveness and safety of SDR use as the 4mm base layer
for fillings of class I and II cavities during one year observation. It was stated that SDR is
neutral for parodontal tissues and allows normal restoration of contact point between
neighboring teeth.
Another system recently, introduced in the field of dentistry, Smart dentin replacement (SDR)
(Dentsply, Konstanz, Germany), includes a photoactive group in a modified urethane
dimethacrylate resin. Activated resin has demonstrated a relatively slow radical polymerization
rate, suggesting that the photo initiator incorporated into the resin affects the polymerization
process; moreover, the incorporation of activated resin results in 60-70% less shrinkage stress
when compared to conventional methacrylate-based resins.[7,8] SDR was initially marketed as
a flowable composite resin whose reduced polymerization stress allowed it to be applied in
bulk in a single layer up to 4 mm thick, followed by a mandatory 2-mm cover layer of
conventional composite resin. However, despite ongoing debates regarding, the use of flowable
composite resin material to relieve stress, and promote adaptation, its aforementioned usages
have yet to be confirmed in any clinical study. In the only study, conducted to date that
describes the relevant parameters for SDR, the polymerization stress level of SDR was reported
to be considerably lower than that of conventional flowable materials.[7,9]
Micro-leakage is defined as the clinically undetectable passage of bacteria, fluids, molecules,
or ions between a restorative material and the cavity wall to, which it is applied.[12] Microleakage at the tooth-restoration interface is considered a major factor in the longevity of dental
restorations. It may lead to staining and a hastening of the breakdown at the restoration margins,
as well as hypersensitivity, recurrent caries, and pulpal pathology.[13]
Yazici et al.[20] found a combination of flowable and hybrid composites to yield the most
effective reduction in micro-leakage. Simi and Suprabha[3] showed that the marginal
adaptation of a composite improved when used in conjunction with a flowable composite
lining. Furthermore, Chuang et al.[21] concluded that a 0.5-1.0 mm layer of flowable
composite liner used under packable composite restorations resulted in a significant reduction
in micro-leakage. It is possible that the relatively thin layer of the liner minimized the effects
of the polymerization shrinkage in the present study.
SDR, a flowable composite resin with a filler load of 68% weight that has recently been
introduced on the market, claims to possess a lower modulus of elasticity, as well as lower
levels of polymerization stress in comparison to traditional flowable composite, without
compromising on depth of cure. The material is marketed as a resin composite for bulk
application in direct composite resin restorations.[9,28,29]
A recent study, comparing SDR with two traditional flowable methacrylate-based composites
found that SDR had the lowest level of shrinkage stress, the longest pre-gel time, and the lowest
shrinkage rate.[7] Koltisko et al.[30] found the polymerization stress of SDR to be lower than
that of other flowable composites, whereas no differences were found in flexural modulus and
volumetric shrinkage (3.5% volume) of the composites tested. According to, Burgess et al.,[29]
the chemistry of SDR is designed to slow the polymerization rate, thereby reducing
polymerization shrinkage stress without affecting polymerization shrinkage levels. Jin et al.[8]
found that the new SDR resin system in unfilled, as well as in various differently filled
formulations, exhibited less curing stress than conventional resin. Although SDR had the
lowest shrinkage stress, in the present study, no differences were observed in micro-leakage
between teeth restorated in SDR and in the conventional flowable composite resin.
he combinations of packable composite with SDR and with conventional flowable composite
resin tested in the present in vitro study in order to, demonstrate micro-leakage in Class V
composite restorations. It can be concluded that the use of new-generation and conventional
flowable composite resins as an intermediate layer between restoration and dental substrate
does not reduce micro-leakage.
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