Effect of monomer type on the C C degree of conversion, water sorption and solubility, and color stability of model dental composites

Effects of Color Modifier on Degree of Monomer Conversion, Biaxial Flexural Strength, Surface Microhardness, and Water Sorption/Solubility of Resin Composites

Color modifiers can be mixed with resin composites to mimic the shade of severely discolored tooth. The aim of this study was to assess the effects of a color modifier on the physical and mechanical properties of a resin composite. The composite was mixed with a color modifier at 0 wt% (group 1), 1 wt% (group 2), 2.5 wt% (group 3), or 5 wt% (group 4). The degree of monomer conversion (DC) was examined after light curing for 20 or 40 s. Biaxial flexural strength (BFS)/modulus (BFM), surface microhardness (SH), and water sorption (W_sp)/solubility (W_sl) were also tested. The DC of group 1 was significantly higher than that of groups 3 and 4. The increase in curing time from 20 to 40 s increased the DC by ~10%. The BFS, BFM, W_sp, and W_sl of all the groups were comparable. A negative correlation was detected between the concentration of color modifier and the BFS and DC, while a positive correlation was observed with W_sp. In conclusion, the color modifier reduced the DC of composites, but the conversion was improved by extending the curing time. The increase in color modifier concentration also correlated with a reduction in strength and the increase in the water sorption of the composites.

Effect of curing mode on the conversion and IIT-derived mechanical properties of core build-up resin composites

The aim of the study was to evaluate the degree of conversion and the mechanical properties of five composite core build-up materials polymerized in dual-curing and self-curing modes. The materials tested were: Clearfil DC Core Plus (CF), Gradia Core (GC), Luxacore-Z Dual Smartmix (LX), Multicore Flow (MC) and Paracore (PC). Disk-shaped specimens were prepared from each material; half the specimens were light-cured, whereas the rest were only self-cured. After a 3-week storage period (dark/dry/37 °C) the Martens Hardness, Indentation Modulus, and Elastic Index were determined by instrumented indentation testing (IIT), while the degree of conversion was assessed by ATR-FTIR spectroscopy. Statistical analysis was performed by 2-way ANOVA and post-hoc testing (α = 0.05). The dual-curing mode resulted in statistically higher Martens Hardness and Elastic Index than the self-curing mode in most materials but showed insignificant differences in Indentation Modulus. MC and PC demonstrated significantly higher degree of conversion in both curing modes. Overall, the self-curing mode was inferior to the dual-curing in conversion and mechanical properties for most products, despite their differences in monomer composition and filler loading.

Effect of combining photoinitiators on cure efficiency of dental resin-based composites

BACKGROUND

Camphorquinone is the most conventionally used photoinitiator in Dentistry. Although different alternative photoinitiators have been proposed, no photoinitiator was capable of completely substituting camphorquinone. The combination of photoinitiators has been considered the best alternative.

OBJECTIVES

To evaluate the effect of combining Norrish type I and II photoinitiators on the cure efficiency of dental resin-based composites.

METHODOLOGY

Experimental composites were produced containing different photoinitiator systems: Norrish type I-only, mono-alkyl phosphine oxide (TPO); Norrish type II-only, camphorquinone (CQ); or its combination, CQ and TPO, in a 1: 1 molar ratio. UV-vis absorption spectrophotometry was performed to assess the consumption of each photoinitiator after curing (n=3). A multi-wave LED (Bluephase® G2, Ivoclar Vivadent) was pre-characterized and used with a radiant exposure of 24 J/cm2. The degree of conversion was evaluated by Raman spectrometry, and the elution of the monomers by nuclear magnetic resonance analysis (n=3). Data were analyzed using ANOVA and Tukey's test (α=0.05; β=0.2).

RESULTS

The combination of CQ and TPO increased the consumption of the photoinitiator system compared to CQ-only (p=0.001), but presented similar consumption compared to TPO-only (p=0.52). There was no significant difference in the degree of conversion between the composites regardless of the photoinitiator system (p=0.81). However, the elution of the monomers was reduced when both photoinitiators were combined. TPO-based material presented the highest elution of monomers.

CONCLUSIONS

The combination of the photoinitiator systems seems to be beneficial for the cure efficiency of dental resin-based composites.

Enhancing Toughness and Reducing Volumetric Shrinkage for Bis-GMA/TEGDMA Resin Systems by Using Hyperbranched Thiol Oligomer HMDI-6SH

In order to improve the toughness and reduce polymerization shrinkage of traditional bisphenol A-glycidyl methacrylate (Bis-GMA)/triethylene glycol dimethacrylate (TEGDMA) based dental resin system, a hyperbranched thiol oligomer (HMDI-6SH) was synthesized via thiol-isocyanate click reaction using pentaerythritol tetra(3-mercaptopropionate (PETA) and dicyclohexylmethane 4,4′-diisocyanate (HMDI) as raw materials. Then HMDI-6SH was mixed with 1,3,5-Triallyl-1,3,5-Triazine-2,4,6(1H,3H,5H)-Trione (TTT) to prepare thiol-ene monomer systems, which were added into Bis-GMA/TEGDMA resins with different mass ratio from 10 wt% to 40 wt% to serve as anti-shrinking and toughening agent. The physicochemical properties of these thiol-ene-methacrylate ternary resins including functional groups conversion, volumetric shrinkage, flexural properties, water sorption, and water solubility were evaluated. The results showed that the incorporation of HMDI/TTT monomer systems into Bis-GMA/TEGDMA based resin could improve C=C double bond conversion from 62.1% to 82.8% and reduced volumetric shrinkage from 8.53% to 4.92%. When the mass fraction of HMDI/TTT monomer systems in the resins was no more than 20 wt%, the flexural strength of the resin was higher or comparable to Bis-GMA/TEGDMA based resins (p > 0.05). The toughness (it was measured from the stress–strain curves of three-point bending test) of the resins was improved. Water sorption and water solubility tests showed that the hydrophobicity of resin was enhanced with increasing the content of thioester moiety in resin.

Light and viscosity effects on the curing potential of bulk-fill composites placed in deep cavities

To determine the influence of light curing units (LCUs) and material viscosity on the degree of conversion (DC) of bulk-fill (BF) resin-based composites (RBCs) placed in deep cavity preparations. Four LCUs were tested: Valo cordless, Bluephase-G2, Poly wireless and Radii-cal. Light irradiance was determined at 0 mm and 6 mm distance to the reading sensor. The following RBCs were considered: Filtek BF, Filtek BF Flow, Opus BF, Opus BF Flow, Tetric N-Ceram BF and Surefil SDR Flow. Sirius-Z was used with the incremental technique. DC (n = 3) was evaluated by spectroscopy both at top and bottom regions of deep preparations with 6 mm depth. The data were submitted to ANOVA and Tukey's test (α = 0.05). Pearson's correlation (95%) was used to verify the relation between the LCUs and the curing potential of RBCs. The DC at 6 mm depth was reduced when Opus BF, Opus BF Flow and Tetric N-Ceram BF were activated with Radii-cal. There was a positive correlation between the LCU irradiance and the bottom/top conversion ratios. The materials' viscosities did not affect the curing potential. Bulk-fill composites did not present higher curing potential than the conventional composite used with the incremental technique; the most important aspect of the LCU was the irradiance ratio; and the materials' viscosity did not affect the curing potential as a function of depth. Radii-cal negatively impacted the degree of conversion at 6 mm depth for most bulk-fill resin composites. Depending on the brand, bulk-fill composites may present reduced curing potential due to the light source when placed in deep cavities. Dentists should avoid LCU with acrylic tips to photoactivate bulk-fill resin-based composites.

Synthesis of an urushiol derivative and its use for hydrolysis resistance in dentin adhesive

Hydrolysis resistance is essential to the durability of the dentin bonding interface. Urushiol is a natural monomer that has been used in different fields over thousands of years but has the disadvantage of a long drying time. In this study, we evaluated a novel photocurable derivative of urushiol as the main monomer for polymerization in dentin adhesive and its effect on hydrolysis resistance. The derivative was characterized by Fourier transform infrared spectroscopy and ¹H nuclear magnetic resonance spectroscopy. Compared with the Adper Single Bond 2, the experimentally synthesized adhesives had higher contact angles. In particular, the water sorption/solubility of the experimental samples were significantly lower than that of Adper Single Bond 2. The microtensile bond strengths of the test groups were higher than that of the control group, even after 5000 thermocycles. Cytotoxicity test results showed that adhesives based on the original derivative induced low toxicity to L929 cells. The results of this study may shift the focus of future research to natural monomers and even their derivatives which may perform well in dentistry.

Modified POSS nano-structures as novel co-initiator-crosslinker: Synthesis and characterization

OBJECTIVE

To synthesize an amine-modified polyhedral oligomeric silsesquioxane (POSS) nano-structure as a novel co-initiator-crosslinker (co-Ini-Linker) and to determine the effect of the co-Ini-linker on the physical and mechanical behavior of an experimental dental composite.

METHODS

The amine-methacrylate POSS nano-structures (AMA-POSS) were chemically synthesized by anchoring a tertiary amine functionality on the methacrylate POSS (MA-POSS) branches. Three types of AMA-POSS, having different amine branches in their structures, were synthesized through the Aza Michael reaction. The chemical structure of AMA-POSSs were evaluated by¹H-NMR spectroscopy. Afterward, the AMA-POSS was incorporated into a dental resin system composed of Bis-GMA, TEGDMA, and photo-initiator. Three resin systems with different AMA-POSS types were then prepared, and their properties were compared with a resin containing DMAEMA as a conventional co-initiator. The degree of conversion evaluated by FTIR spectroscopy and the shrinkage kinetics of the resins were determined through the bonded-disk technique. The flexural properties of the photopolymerized resins were also investigated. The distribution of nano-structures in the matrix resin was analyzed using EDX analysis.

RESULTS

The modified POSS structure and the number of amine branches were confirmed with¹H-NMR spectroscopy. The resin containing 8 amine branches (P8) showed the same degree of conversion (DC%) as the resin containing DMAEMA (P > 0.05). Decreasing the amine branches in the POSS structure, however, revealed an increasing trend in DC%. The resin containing P8 showed the lowest shrinkage strain. By incorporating AMA-POSS into the resin system, the water sorption significantly decreased (P < 0.05). The flexural strength and modulus increased by adding P3 into the resin system (P < 0.05). EDX Si-map revealed that the co-Ini-linker was well dispersed in the resin matrix.

SIGNIFICANCE

The synthesized novel amine-methacrylate POSS nanostructures not only act as an amine co-initiator but also work as a reinforcing filler and a cross-linking agent.

Effect of finishing and polishing systems on the surface roughness and color change of composite resins

Background

This study is to examine the surface roughness and color changes occurring on composite resins following the application of different finishing and polishing systems.

Material and Methods

In our study, a total of 200 samples were prepared from composites resin (6×2 mm) containing supra-nano, submicron hybrid, nanohybrid, nano-ceramic and microhybrid filler. They were polished with diamond, aluminum oxide, silicon carbide finishing and polishing systems. The initial color values of composite samples were measured with a spectrophotometer and surface roughness values with a profilometer. After that, samples were immersed of coffee solution and color measurements were repeated on the 1st and 7th day. The differences between surface roughness (Ra) and color change values (∆Eab) were evaluated using two-way analysis of variance (ANOVA) test (p<0.05).

Results

Finishing and polishing systems produced a statistically significant difference between the surface roughness values of nano-ceramic, submicron hybrid and microhybrid composite resin samples (p<0.05). Supra nano composite, which showed the lowest surface roughness after all finishing and polishing systems, showed the least color change after 7 days compared to other composite groups (p<0.05). The microhybrid composite with the highest surface roughness was the most color changing composite group (p<0.5).

Conclusions

The spiral finishing and polishing system containing diamond particles was the system to provide the least color difference on all composite groups. However, color differences of all composite resin groups were found to exceed the perceptibility threshold (PT) and acceptability threshold (AT).

Key words:Composite resin, color stability, surface roughness.

Hydrophobically Modified Isosorbide Dimethacrylates as a Bisphenol-A (BPA)-Free Dental Filling Material

A series of bio-based hydrophobically modified isosorbide dimethacrylates, with para-, meta-, and ortho- benzoate aromatic spacers (ISBGBMA), are synthesized, characterized, and evaluated as potential dental restorative resins. The new monomers, isosorbide 2,5-bis(4-glyceryloxybenzoate) dimethacrylate (ISB4GBMA), isosorbide 2,5-bis(3-glyceryloxybenzoate) dimethacrylate (ISB3GBMA), and isosorbide 2,5-bis(2-glyceryloxybenzoate) dimethacrylate (ISB2GBMA), are mixed with triethylene glycol dimethacrylate (TEGDMA) and photopolymerized. The resulting polymers are evaluated for the degree of monomeric conversion, polymerization shrinkage, water sorption, glass transition temperature, and flexural strength. Isosorbide glycerolate dimethacrylate (ISDGMA) is synthesized, and Bisphenol A glycerolate dimethacrylate (BisGMA) is prepared, and both are evaluated as a reference. Poly(ISBGBMA/TEGDMA) series shows lower water sorption (39-44 µg/mm³) over Poly(ISDGMA/TEGDMA) (73 µg/mm³) but higher than Poly(BisGMA/TEGDMA) (26 µg/mm³). Flexural strength is higher for Poly(ISBGBMA/TEGDMA) series (37-45 MPa) over Poly(ISDGMA/TEGDMA) (10 MPa) and less than Poly(BisGMA/TEGDMA) (53 MPa) after immersion in phosphate-buffered saline (DPBS) for 24 h. Poly(ISB2GBMA/TEGDMA) has the highest glass transition temperature at 85 °C, and its monomeric mixture has the lowest viscosity at 0.62 Pa·s, among the (ISBGBMA/TEGDMA) polymers and monomer mixtures. Collectively, this data suggests that the ortho ISBGBMA monomer is a potential bio-based, BPA-free replacement for BisGMA, and could be the focus for future study.

Influence of resin matrix on the rheology, translucency, and curing potential of experimental flowable composites for bulk-fill applications

OBJECTIVE

To propose monomer formulations that show an optimal degree of conversion as a function of depth for bulk-fill applications.

METHODS

Four resin blends were formulated with methacrylate-based monomers: BisGMA + TEGDMA (control); BisEMA + BisGMA + TEGDMA (BisEMA-based); UDMA + BisGMA + TEGDMA (UDMA-based) and BisEMA + UDMA + BisGMA + TEGDMA (BisEMA + UDMA-based). For each material, a photoinitiating system and silanized filler particles were added. The rheological analyses were performed with a rotational rheometer using the cone/plate geometry. CIELab coordinates were assessed over black and white backgrounds using a bench spectrophotometer (SP60, X-Rite) to calculate the translucency parameter (TP) for samples with 0.5, 4, and 6 mm thickness. The degree of CC conversion (DC) was determined by infrared spectroscopy (FTIR/ATR) at 0.05 mm (top), 4, and 6 mm depths (bottom), and the bottom-to-top ratio was considered. A broad spectrum-based LED was used for light activation. Analysis of variance and Tukey's test (95%) were performed on the results.

RESULTS

The materials tested showed pseudoplastic and thixotropic behavior and a predominance of viscous effects over elastics. The control resin yielded the lowest viscosity for the entire shear rate investigated, followed by the BisEMA-based, BisEMA + UDMA-based, and UDMA-based group, which had the highest viscosity. The UDMA-based material showed the lowest TP as a function of thickness. Both the materials' formulations and depths significantly influenced the DC. The UDMA-based group promoted the highest DC ​​on the top (71 ± 1%) and 4 mm depth (68 ± 1%) but exhibited lower bottom-to-top DC ratio. The BisEMA + UDMA-based material promoted the highest bottom-to-top DC ratio at 4 mm (99%) and 6 mm (97%).

SIGNIFICANCE

The resin matrix interferes in the rheological behavior, translucency parameter, and polymerization capacity as a function of depth. The material formulated with the addition of UDMA and BisEMA demonstrated the highest curing potential as a function of depth and can be useful for bulk-fill applications.

Dimensional stability of short fibre reinforced flowable dental composites

Fibre-reinforced dental composites are proven to have superior mechanical properties in comparison with micro/nano/hybrid filled composites. However, the addition of small quantities of short glass fibres could affect the dimensional stability of the restoration both during initial stages as well as through the life of the restoration. This in-vitro study aims at evaluating the physical properties of short S-Glass reinforced flowable dental composites. Two S-Glass short fibre-particulate reinforced (5 wt% of aspect ratios 50 and 70) and one particulate only reinforced flowable dental composites were prepared with UDMA-TEGDMA based dental monomer systems. Samples were photopolymersied for 60 s and stored in distilled water at 37 °C for 24 h before testing. Depth of cure (through-thickness microhardness), volumetric shrinkage (Archimedes technique), polymerisation stress (cantilever based tensometer), curing exotherm (thermocouple), water sorption and solubility (ISO 4049) and thermal expansion coefficient (dilatometer) were determined. The test results were statistically analysed using one-way ANOVA (p < 0.05). Depth of cure increased by 41%, volumetric shrinkage increased by 8.3%, shrinkage stress increased by 37.6%, exotherm increased by 20.2%, and thermal expansion reduced by 6.4% while water sorption and solubility had a negligible effect with the inclusion of short glass fibres. The study demonstrates that within the same organic resin system and quantity, a small replacement of fillers with short fibres could significantly affect the dimensional stability of the composite system. In conjunction with mechanical properties, this study could help clinicians to gain confidence in fibre reinforced dental composite restorative system.

Effects of Different Amine Activators on the Monomer Conversion, Biaxial Flexural Strength, and Color Stability of Experimental Provisional Dental Restorations

Objective  The aim was to assess the effect of different amine activators including N, N-dimethyl-p-toluidine (DMPT) or Na-N-tolyglycine glycidyl methacrylate (NTGGMA) on chemical-activated monomer conversion, biaxial flexural strength (BFS), and color stability of composites for provisional dental restorations.

Materials and Methods  Two formulations of composites containing either DMPT (D-temp) or NTGGMA (N-temp) were prepared. The degree of monomer conversion was assessed. The BFS of the materials was tested using the ball-on-ring testing jig. The color difference (∆E ₀₀ ) of the materials after immersion in water was also determined. The commercial comparisons were Unifast (UF), Protemp (PT), Luxacrown, and Luxatemp (LT).

Results  The monomer conversion of D-temp (57.4 ± 1.3%) was comparable to that of N-temp (59.0 ± 1.3%). The conversion of both D-temp and N-temp were higher than that of PT (48.1 ± 3.4%) and LT (48.0 ± 1.6%). BFS of both D-temp (164.2 ± 18.1 MPa) and N-temp (168.6 ± 8.9 MPa) were comparable but higher than that of UF (119.8 ± 13.6 MPa). ∆E ₀₀ of D-temp (2.7 ± 0.7) and N-temp (2.5 ± 0.8) were comparable but higher than that of other commercial materials (0.6–1.2).

Conclusion  The use of DMPT or NTGGMA showed negligible effect on monomer conversion, BFS, and color stability of the experimental provisional restorations. The conversion and BFS of the experimental materials were in the range of that obtained from commercial bis-acryl-based materials. However, the color stability of the experimental materials was lower than that of commercial materials.

New method to differentiate surface damping behavior and stress absorption capacities of common CAD/CAM restorative materials

OBJECTIVES

To assess energy dissipation capacities and surface damping abilities of different CAD/CAM restorative materials (CRMs) to characterize stress resistance during load peaks.

METHODS

Using instrumented indentation testing (IIT), Martens hardness (HM) together with its elastic (η_IT) and plastic index (η_ITdis) and Leeb hardness (HLD) together with its deduced energy dissipation (HLD_dis) were determined for eight ceramic, eight composite, and four polymer-based materials as well as three metals. The results were compared to those of bovine enamel. Ten indentations per material were performed at room temperature (23 ± 1 °C) on two separate specimens (12.0 × 12.0 × 3.5 mm³) after water storage (24 h; 37.0 ± 1.0 °C). Hardness parameters were recorded, and data were analyzed with one-way MANOVA (Games-Howell post hoc tests, α = 0.05). Correlations between different parameters were tested (Pearson, α = 0.05).

RESULTS

Independently determined HLD_dis, and η_ITdis values substantiated different energy dissipation characteristics of CRM, whereby a strong correlation was observed for the two datasets (r = 0.956, p = 0.011). Ceramics had the significantly lowest values (p < 0.001) while both parameters revealed the highest surface damping effects for metals (p < 0.001), followed in both cases by bovine enamel. Energy dissipation of polymer and composite CRM was in between ceramics and bovine enamel (p < 0.001), whereas only for HLD_dis did both show no significant difference (p > 0.05).

SIGNIFICANCE

Promising new HLD_dis and η_ITdis data allow a reliable differentiation of energy dissipation and surface damping capacities of CRMs. Previously published rankings of edge chipping and loss tangent results were perfectly reproduced, especially by HLD_dis.

Evaluation of physico-mechanical properties and filler particles characterization of conventional, bulk-fill, and bioactive resin-based composites

OBJECTIVE

This study evaluated physical and mechanical properties and characterized the filler particles of seven composites.

MATERIALS AND METHODS

Filtek Supreme (FS, 3M Oral Care), Forma (FO, Ultradent), Charisma Diamond (CD, Kulzer), Spectra Smart (SS, Dentsply), Filtek Bulk Fill (FB, 3M Oral Care), Tetric N-Ceram Bulk Fill (TB, Ivoclar), and Cention N (Ivoclar) in self- (CNSC) or dual-curing (CNDC) were evaluated. Fillers size, shape, and content were analyzed by scanning electron microscopy (SEM) and X-ray dispersive energy spectroscopy (EDX). Disk-shaped specimens (n = 5) were prepared for sorption (SP) and solubility (SL). Flexural strength and elastic modulus were tested at 24 h and 12 months (n = 10). Degree of conversion (DC%) and maximum rate of polymerization (Rp^max) were evaluated using micro-Raman spectroscopy. SP and SL results were submitted to Kruskal-Wallis one-way ANOVA and Dunn's pairwise test (α = 0.05). Mechanical properties were analyzed by 2-way ANOVA and Tukey's test (α = 0.05). DC% of CNSC and CNDC was compared by independent t-test (α = 0.05). Rp^max results were analyzed by 1-way ANOVA and Tukey's test (α = 0.05).

RESULTS

The composites differed regarding filler size, shape, and content. CD and CNSC showed lower SP than FS. SS had lower SL than CNSC and CNDC. CNDC presented higher DC% than CNSC. CD, TB, and CNDC showed the highest Rp^max. TB, CNSC, and CNDC showed the lowest 24-h flexural strengths. Mechanical properties of CD did not decrease, while FO, TB, and CNSC showed a significant reduction after storage.

CONCLUSIONS

Monomer composition and fillers characteristics greatly influenced the physico-mechanical properties of the tested composites.

Clinical Performance of Bulk-Fill Resin Composite Restorations Using the United States Public Health Service and Federation Dentaire Internationale Criteria: A 12-Month Randomized Clinical Trial

Objective  This study was aimed to compare the 12-month clinical performance of two full-body bulk-fill resin composites Filtek bulk fill/3M ESPE (FBF) and Tetric EvoCeram bulk fill/Ivoclar Vivadent (TBF) and a conventional microhybrid resin composite Filtek Z250/3M ESPE (Z250) using the modified the United States Public Health Service (USPHS) and Federation Dentaire Internationale (FDI) criteria. Also, the agreement between the two evaluation criteria was evaluated at baseline and after 12 months of follow-up.

Materials and Methods  A total of 138 class I and II restorations were placed in posterior teeth (split-mouth design) of 46 volunteers following manufacturer’s instructions and bonded with a self-etching bonding agent (Clear fill SE Bond/Kuraray). The restorations were evaluated at baseline and after 12 months of follow-up by three previously calibrated dentists (Cohen’s K = 0.84).

Statistical Analysis  Fisher’s exact test and Pearson’s Chi-squared test were used to evaluating the homogeneity of distribution of the clinical characteristics. Friedman’s test was applied to evaluate differences among the resin composites. The results obtained for the USPHS and FDI criteria at the different observation times were compared using the Wilcoxon test. A level of significance of 0.05 was adopted for all tests.

Results  After 12 months (recall rate, 78.3%, n = 36 patients), the overall success rate was 99.07% for both criteria. Only one failed restoration (0.93%) was detected for each system during follow-up in the TBF group.

Conclusion  The bulk-fill resin composites showed satisfactory clinical performance compared with conventional resin composite after 12 months. The percentage of the acceptable scores was significantly higher for the USPHS criteria, due to discrepancies in the score description for each criterion.

Multifactorial analysis of optical properties, sorption, and solubility of sculptable universal composites for enamel layering upon staining in colored beverages

OBJECTIVE

To analyze the effects of factors 'composite,' 'medium,' and 'time' on color, translucency, and sorption/solubility of sculptable universal composites for enamel layering upon immersion in colored beverages.

MATERIALS AND METHODS

Disk-shaped specimens, 10 mm in diameter and 2 mm thick (n = 5/group), of ultrafine, hybrid composite Essentia (GC), microhybrid Gaenial Anterior (GC), nanofilled Filtek Ultimate Enamel and Body ( 3M ESPE) were immersed in red wine, coffee, or distilled water for 15 days. CIELab color coordinates were measured and CIEDE2000 (∆E₀₀ ) and Translucency Parameter differences (∆TP₀₀ ) were calculated. Sorption and solubility were determined according to ISO 4049:2009. Data were analyzed using the analyses of variance and Tukey's post-hoc test (α = 0.05).

RESULTS

Essentia and Gaenial exhibited the lowest and the highest staining-dependent color differences, with mean ∆E₀₀ range of 1.7-6.1 and 5.1-11.3, respectively (p < 0.05). ∆TP₀₀ was more pronounced in wine than in coffee (p < 0.05). Sorption and solubility varied between 9.8 and 15.3 μg/mm³ and -1.6 and -5.4 μg/mm³ , respectively, with positive correlation between ∆TP₀₀ and sorption (p = 0.005).

CONCLUSIONS

Total color and translucency differences of sculptable composites for enamel layering were material-, time- and medium-dependent. Translucency differences positively correlated with sorption. Overall, the ultrafine, hybrid composite exhibited the best results in terms of color stability, sorption and solubility.

CLINICAL SIGNIFICANCE

Clinicians should be aware of differences in color stability of sculptable composites for enamel layering as these are directly exposed to discoloration in the oral environment and are directly related to patients' long-term satisfaction and restoration longevity. Ultrafine, hybrid composite may be preferred due to better color stability, lower sorption and solubility compared to nanofilled and microhybrid composites evaluated in this study.

Effect of Green, Tulsi, and Areca Teas on the Color Stability of Two Composite Resin Materials - an in vitro Spectrophotometric Analysis

Objective

To compare the effect of Green, Tulsi, and Areca teas on the color stability of two composite materials on the 30th and 60th days.

Materials and Methods

Two light cure composite restorative materials, Brilliant EverGlow (Group 1) and Brilliant NG, (Group 2) with different resin and filler characteristics were selected. The test solutions selected were Green tea, Tulsi tea, Areca tea, and artificial saliva (control group). In total, 104-disc shaped specimens were fabricated using a custom made brass mold as per the manufacturer instructions. All specimens were put in storage for rehydration and complete polymerization at 37°C in distilled water for 24 hours. Specimens of each composite material were randomly divided into four subgroups of 13 samples. Tea solutions were freshly prepared, and specimens were immersed in the respective solutions every day for 15 minutes for 60 days. Specimens were stored in artificial saliva after the immersion regimen. The color evaluation was done before immersion, on the 30th and 60th day, using a digital reflectance spectrophotometer.

Results

At 30 days, Group 1 specimens immersed in Areca and Green teas showed significantly higher mean values than those in control and Tulsi tea. At 60 days in Group 1, specimens in Areca tea showed significantly higher mean value, followed by Green tea, Tulsi tea, and control. At 30 and 60 days in group 2, specimens in control had significantly lower mean values than other tea preparations. Group 1 showed a higher mean difference in ΔE than Group 2 specimens immersed in Green and Areca teas at 30 days (P=0.001 and 0.001) and 60 days (P=0.001 and <0.001), respectively.

Conclusion

All herbal tea preparations exhibited staining potential, which increased over time, and Areca tea showed the highest staining potential. Understanding the staining potential of newer tea preparations on recent composite materials helps the clinician to choose the right restorative materials.

Niobium silicate as a filler for an experimental photopolymerizable luting agent

PURPOSE

To synthesize niobium silicate particles (SiNb) and incorporate into resin-based luting agents.

METHODS

SiNb particles were synthesized and characterized by x-ray diffraction, FTIR spectroscopy, particle size, and specific surface area. Luting agents were formulated with 50 wt% BisGMA, 30 wt% TEGDMA and 20 wt% UDMA. BAPO was used as a photoinitiator in 1mol%. The SiNb particles were incorporated into the agents at concentrations of 50 wt% (SiNb50%) or 65% wt% (SiNb65%). Barium glass particles at the same concentrations were used as controls (SiBa50% and SiBa65%). Refractive index, degree of conversion (DC), polymerization kinetics, softening in solvent, radiopacity, film thickness, color stability, flexural strength (FS) and micro shear bond strength (µSBS) were evaluated.

RESULTS

SiNb particles were successfully synthesized with an adequate structure to be applied as inorganic fillers. SiNb groups had higher DC, lower %ΔKHN, greater film thickness and greater radiopacity than the SiBa groups. Color stability was greater for SiNb50% and SiNb65% after six months of storage, as demonstrated by ΔE00. ΔWID values were lower for the SiBa groups. FS results decreased over time, and lower values were found for SiNb. In µSBS, the values of SiNb65% were higher at 24 h (45.22 MPa) and at six months (36.83 MPa), with statistically differences from values for the SiBa groups.

CONCLUSIONS

SiNb particles were successfully synthesized using the sol-gel method, and their incorporation into luting agents at a concentration of up to 65% improved the physicomechanical characteristics and color stability of these agents.

Curing potential and color stability of different resin-based luting materials

PURPOSE

To determine the curing potential and color stability of resin-based luting materials for aesthetic restorations.

MATERIAL AND METHODS

Four resin-based luting agents were tested: traditional dual-activated resin cement (RelyX ARC, ARC), amine-free dual-activated resin cement (RelyX Ultimate, ULT), light-activated resin cement (RelyX Veneer, VEN), and pre-heated restorative resin composite (Filtek Supreme, PHC). Degree of C=C conversion was determined by infrared spectroscopy (n=3) with direct light exposure or with interposition of 1.5-mm-thick ceramic (e.max Press HT) between the luting material and light. The curing potential considered the ratio between these two scenarios. Color difference (n=6) was determined by CIELAB (ΔE_ab) and CIEDE2000 (ΔE₀₀) methods, by spectrophotometer measurements made 24h after photoactivation and 90 days after storage in water. Data was submitted to ANOVA and Tukey's test (α=0.05).

RESULTS

The luting agents affected both conversion and color stability. With ceramic, ARC produced the highest conversion among the tested groups (75±1%) and the pre-heated composite (PHC) the lowest one (51±3%), but the curing potential was similar for all materials. ULT produced lower ΔE_ab than ARC. PHC presented the lowest color difference when considered both CIELAB and CIE2000 methods (ΔE_ab 2.1±0.4; ΔE₀₀ 1.6±0.2).

SIGNIFICANCE

All luting strategies presented high curing potential. Amine-free dual-activated material was able to reduce color difference than that formulated with the amine component. Pre-heated composite produced the least color variation after storage.

Surface Characteristics and Color Stability of Gingiva-Colored Resin Composites

The purpose of this study was to investigate the surface characteristics and color stability of gingiva-colored composite restorative materials (Anaxgum—ANG, Ceramage—CMG and Gradia Gum—GRG). The microstructure, composition, degree of conversion (DC %) and 3D roughness (Sa, Sz, Sdr, Sc) were examined by LV-SEM/EDS, ATR-FTIR and optical profilometry, respectively. For the color stability (CIE L*, a*, b* system) and hardness (HV), measurements were performed at baseline and after 30 days storage in distilled water, coffee and red wine. The ANG and GRG contain prepolymerized particles in aromatic and aliphatic resin matrices, respectively, whereas CMG contains inorganic zirconia silicate/silica particles, in an aromatic resin matrix, with a smaller particle size and a higher surface area fraction. Urethane monomers were mainly identified in CMG and GRG. The DC% showed statistically insignificant differences between the materials. The same applied for the roughness parameters, except for the greatest Sdr in CMG. ANG showed a color difference (ΔE) of > 3.3 after immersion in all media, CMG in coffee and wine and GRG only in coffee. Sc was the only roughness parameter demonstrating correlations with the ΔL*, Δb* and ΔE*. The HV values showed insignificant differences between the storage conditions per material. There are important differences in the color stability of the materials tested, which were mostly affected by the roughness parameters due to variations in their microstructure.

Influence of exposure to phosphoric and polyacrylic acids on selected microscopic and physical/chemical properties of calcium hydroxide cements

Purpose:

This study aimed to evaluate if the contact of calcium hydroxide cements with polyacrylic and phosphoric acids would alter selected microscopic and physical and chemical properties.

Materials and methods:

Chemically activated (Hydro C and Dycal Advanced Formula II) and resin-modified photoactivated (Ultra-blend Plus) calcium hydroxide cements were examined after exposure to the following different strategies: contact with no substance (control group); rinsing with water and drying; contact with polyacrylic acid, rinsing with water, and drying; and contact with phosphoric acid, rinsing with water, and drying. Surface morphology, determined by scanning electron microscopy (SEM), water sorption and solubility, and the release of hydroxyl ions were evaluated.

Results:

SEM showed a greater impact of the conditioning acids on the surface of the chemically activated cements. Ultra-blend Plus obtained the highest value of sorption (516.8 μg/mm3) and solubility (381.1 μg/mm3) and Hydro C had the lowest values 251.9 μg/mm3 and 206.3 μg/mm3 respectively. Considering the release of hydroxyl ions in comparison with time, Hydro C and Ultra-blend Plus presented significant statistical difference for polyacrylic and phosphoric acid subgroups.

Conclusion:

Hydro C and Dycal presented intensification of surface irregularities after contact with conditioning acids. The chemically activated materials suffered a decrease in sorption and solubility. The action of the conditioning acids promotes greater increase of the release of hydroxyl ions for Hydro C and Dycal.

Effect of pH Cycling Followed by Simulated Toothbrushing on the Surface Roughness and Bacterial Adhesion of Bulk-fill Composite Resins

The aim was to evaluate, in vitro, quantitatively and qualitatively, the effect of pH cycling and simulated toothbrushing on surface roughness (Ra) and bacterial adhesion (Cn) of bulk-fill composite resins. Thirty specimens of each composite resin, 5 mm wide and 4 mm high, were obtained: group 1 (control): Filtek Z250 (Z250); group 2: Filtek Bulk-Fill (FTK); group 3: Tetric N-Ceram Bulk-Fill (TTC); and group 4: Aura Bulk-Fill (AUR). After 24 hours, the specimens were polished and then alternated with demineralization/remineralization solutions for 15 cycles of 24 hours each at 37°C. Then the specimens were submitted to simulated toothbrushing. The Ra and Cn measurements were quantitatively analyzed in three stages: after polishing (Ra0 and Cn0), after pH cycling (Ra1 and Cn1), and after simulated toothbrushing (Ra2 and Cn2). The Ra values were submitted to two-way analysis of variance, followed by the Tukey test (α=0.05). The Kruskal-Wallis test, followed by multiple comparisons, was applied for Cn analysis. Surface topography and bacterial adhesion were observed by scanning electron microscopy (SEM). Z250, FTK, and TTC showed no significant change in Ra regardless of the treatment performed; AUR obtained increased Ra at Ra2 (p&lt;0.05). FTK differed from the others at Cn0 and Cn1 (p&lt;0.05). At Cn2, there was no difference among the composite resins. SEM images showed the exposure of fillers and microcavities at Ra1 and Ra2. There was greater bacterial adhesion at Cn1 for Z250 and FTK. It was concluded that the pH cycling caused surface degradation of all composite resins, which was potentiated by simulated toothbrushing. However, only AUR presented an increased Ra. Bacterial adhesion occurred on all composite resins after pH cycling; however, after simulated toothbrushing, adhesion of dispersed bacteria was similar for all the composite resin groups.

Synthesis, characterization, and aging resistance of the polyurethane dimethacrylate layer for dental restorations

In this study, polyurethane dimethacrylate (PUDMA) was synthetized from different components and incorporated into a direct resin composite restoration system with the aim to buffer tooth-resin interfacial stresses and maintain the marginal adaptation. The tensile strength, elongation at fracture (ε), and thermal stability of the PUDMA layer were characterized, showing a tensile strength of 22 MPa, an ε of 112%, and a thermal decomposition temperature of about 282°C. In addition, the degree of conversion, water sorption/solubility, hydrophobicity, microtensile bond strength (μTBS), marginal leakage, and cytotoxicity in vitro were evaluated for the PUDMA layer. The data were analyzed using one-way ANOVA, except for leakage depths (which were analyzed using the Wilcoxon paired-rank test). The level of significance was set at 0.05. Compared with dental adhesives, PUDMA displayed a higher degree of conversion, lower water sorption/solubility, and improved hydrophobicity and biocompatibility in vitro. After thermocycling, the μTBS of the restoration system containing PUDMA had increased compared with the μTBS at 24 h. Restorations containing PUDMA showed lower leakage depths than those which did not contain PUDMA. In conclusion, because of its hydrophobic and elastic nature, the PUDMA layer, when used as an intermediate between tooth and resin restoratives, may buffer interfacial stresses, improve the stability and durability of the bonding interface, and reduce microleakage.

Depth-Dependent Cellular Response from Dental Bulk-Fill Resins in Human Dental Pulp Stem Cells

The proper choice of dental composite resins is necessary based on the minimal cytotoxicity and antiodontogenesis on human dental pulp stem cells for dental pulp-dentin tissue repair and regeneration. The aim of this study was to evaluate the cytotoxicity and antidifferentiation effects of dental bulk-fill resins, able to be polymerized as a bulk status for filling deep cavity of a tooth by single light curing, against human dental pulp stem cells (hDPSCs) from three compartments corresponding to depth (0-2, 2-4, and 4-6 mm) from the light-curing site. Three bulk-fill composite resins (SDR, Venus bulk-fill (VBF), and Beautifil Bulk Flowable (BBF)) and a conventional flowable composite resin (Filtek Z350 XT flowable restorative (ZFF)) were individually filled into a cylindrical hole (h = 2 mm, Ф = 10 mm), and three compartments (total ~6 mm of height) were combined as a single assembly for light curing. The resin samples from the three layers were separated and eluted in the culture medium. The extracts were exposed to hDPSCs, and cytotoxicity and differentiation capability were evaluated. Depth of cure and surface hardness according to depth were determined. All bulk-fill resins except BBF revealed cytotoxicity from 4 to 6 or 2 to 4 mm, while ZFF was cytotoxic at over 2 mm. Depth of cure was detected from 3.55 to 4.02 mm in the bulk-fill resins (vs. ~2.25 mm in conventional resin), and 80% hardness compared with that of a fully polymerized top surface was determined from 4.2 to 6 mm in the bulk-fill resin (vs. 2.4 mm in conventional resin). Antidifferentiation was revealed at a depth of 4-6 mm in the bulk-fill resin. There was a difference in depth of cytotoxicity and antidifferentiation between the bulk-fill composite resins, which was mainly due to different cure depths and ingredients. Therefore, careful consideration of choice of bulk-fill resins is necessary especially for restoration of deep cavities for maintaining the viability and differentiation ability of dental pulp stem cells.

Polymerisation Shrinkage Profiling of Dental Composites using Optical Fibre Sensing and their Correlation with Degree of Conversion and Curing Rate

Traditional polymerisation shrinkage (PS) measurement systems measure average PS of dental composites, but the true local PS varies along the length and breadth of the composite. The PS depends on the curing light intensity distribution, resultant degree of conversion (DOC) and the curing rate. In this paper, optical fibre Bragg grating (FBG) sensing based technology is used to measure the linear post-gel PS at multiple locations within dental composite specimens, and is correlated with DOC and curing rate. A commercial dental composite is used, and its post-gel PS and DOC are mapped using embedded fibre Bragg grating sensors at different curing conditions. The distance between the curing lamp and the composite specimen is varied which resulted in different intensity distribution across the specimen. The effect of curing light intensity distribution on PS, curing rate and DOC are investigated for demonstrating a relationship among them. It is demonstrated that FBG sensing method is an effective method to accurately profiling post-gel PS across the specimen.

Influence of preheating and post-curing on a novel fiber-reinforced composite post material

The aim of this study was to investigate the influence of preheating and post-curing methods on diametral tensile strength (DTS), flexural strength (FS), knoop microhardness (KHN), and degree of conversion (DC) of an experimental fiber-reinforced composite (FRC). Specimens (30 wt% of 3-mm-short E-glass fiber, 22.5 wt% of methacrylated-based resin and 47.5 wt% of filler particles) were subjected to: P - photocuring at 1500 mW/cm2 for 40 s (control); P/M - photocuring and microwave post-curing (540W/5 minutes); P/A - photocuring and autoclave post-curing (120°C/15 minutes); PH-P - preheating (60°C) and photocuring; PH-P/M - preheating, photocuring and microwave post-curing; and PH-P/A - preheating, photocuring and autoclave post-curing. Specimens for DTS (Ø 3 x 6 mm) and FS (25 x 2 x 2 mm) were tested at Instron 5965. KHN employed a 50g load for 30s. DC was measured using FTIR spectroscopy. Statistical analysis employed: factorial analysis, normality test, one-way ANOVA and Tukey's HSD test, independent T-test and the Dunnett test. Interaction between factors was not significant (P>0.05). Preheating promoted significantly higher values of FS and KHN (p = 0.0001). Post-curing promoted significantly higher values for KHN (p = 0.0001). For DTS (p = 0.066) and DC (p= 0.724) no statistical difference was found between groups. SEM images showed that preheating promoted better interaction between glass fibers and resin matrix. Preheating increased FS, KHN and DTS, and post-curing increased KHN. DC was not affected by both methods. Preheating and post-curing methods can be used to improve some mechanical properties of FRCs' but degree of conversion remains unaffected.

Evaluation of physical-mechanical properties, antibacterial effect, and cytotoxicity of temporary restorative materials

The objective of this study was to compare selective physical-mechanical properties, antibacterial effects and cytotoxicity of seven temporary restorative materials (TRM): five resin-based materials [Bioplic (B), Fill Magic Tempo (FM), Fermit inlay (F), Luxatemp LC (L) and Revotek LC (R)], and zinc oxide-eugenol cement (IRM) and glass ionomer cement (GIC) as the controls. Material and methods The physical-mechanical properties were evaluated by determining microleakage (ML), ultimate tensile strength (UTS) and Shore D hardness (SDH). In addition, the polymerization rate (Pr-1), depth of cure (DC), water sorption and solubility (WS/SL) were evaluated. The antimicrobial effects of the materials were assessed by biofilm accumulation of Streptococcus mutans (BT) and the direct contact test (DCT) by exposure to Enterococcus faecalis for 1 and 24 h, and cytotoxicity by MTT assay. The data were analyzed by ANOVA or Kruskall-Wallis tests, and a complementary post-hoc method (p<0.05). Results Group B, followed by FM and GIC had significantly lower percentages of microleakage in comparison with the other groups; Groups FM and L showed the highest WS, while Groups R and FM showed the significantly lowest SL values (p<0.05). Group R showed the statistically highest UTS mean and the lowest DC mean among all groups. Group F showed the lowest S. mutans biofilm accumulation (p=0.023). Only the Group L showed continued effect against E. faecalis after 1 h and 24 h in DCT. The L showed statistically lower viability cell when compared to the other groups. Conclusions These findings suggest the antibacterial effect of the temporary materials Fill Magic and Bioplic against S. mutans, while Luxatemp showed in vitro inhibition of S. mutans biofilm accumulation and E. faecalis growth. Regarding the cell viability test, Luxatemp was the most cytotoxic and Fill Magic was shown to be the least cytotoxic.

Does translucency influence cure efficiency and color stability of resin-based composites?

OBJECTIVE

To determine if material's translucency influences the cure efficiency and color stability of resin-based composites (RBCs).

METHODS

Four commercially-available RBCs indicated for aesthetic restorations were selected in different translucent/opaque shades: IPS Empress Direct (IED) A3 Dentin, A3 Enamel, Trans 20, and Trans 30; Filtek Z350 XT (FZX) A3D, A3B, A3E, and CT; Estelite ∑ Quick (EQ) OA3, A3, and CE; and Opallis (OP) DA3, EA3, and T-Neutral. Color was obtained in the L'C'h' system at three distinct periods: 24h after photoactivation (baseline), after 30d of water storage (WS), and after 30d of coffee storage (CS). The translucency parameter (TP) of each RBC was calculated at baseline. The degree of CC conversion (DC) was obtained by Fourier-transform infrared spectroscopy at 0.05mm (top) and 2mm (bottom) surfaces; the cure efficiency considered the bottom/top ratio. The CIEDE2000 color difference (ΔE₀₀) was calculated considering the WS-baseline and CS-baseline values. Data were submitted to two-way ANOVA and Tukey's post-hoc test (α=0.05). Pearson's tests were used to analyze the correlations between TP and DC, and between TP and ΔE₀₀.

RESULTS

For all RBCs, cure efficiency was not affected by materials' translucency. A positive, significant correlation was observed between TP and DC at the bottom surface for FZX only. For all RBCs, the higher the TP, the higher the ΔE₀₀. The ΔE₀₀ was higher after CS than after WS, except for EQ A3. Positive correlation between TP and ΔE₀₀ were observed for all materials.

CONCLUSION

The translucency did not influence the cure efficiency but affected the color stability for all RBCs.

CLINICAL SIGNIFICANCE

High-translucent RBCs presented lower color stability and should be used carefully.

Repair bond strength of nanohybrid composite resins with a universal adhesive

Objective: To investigate the repair bond strength of fresh and aged nanohybrid and hybrid composite resins using a universal adhesive (UA).

Materials and methods: Fresh and aged substrates were prepared using two nanohybrid (Venus Pearl, Heraus Kulzer; Filtek Supreme XTE, 3 M ESPE) and one hybrid (Z100, 3 M ESPE) composite resin, and randomly assigned to different surface treatments: (1) no treatment (control), (2) surface roughening with 320-grit (SR), (3) SR + UA (iBOND, Heraus Kulzer), (4) SR + Silane (Signum, Ceramic Bond I, Heraeus Kulzer) + UA, (5) SR + Sandblasting (CoJet, 3 M ESPE) + Silane + UA. After surface treatment, fresh composite resin was added to the substrates at 2 mm layer increments to a height of 5 mm, and light cured. Restored specimens were water-stored for 24 h and sectioned to obtain 1.0 × 1.0 mm beams (n = 12), and were either water-stored for 24 h at 37 °C, or water-stored for 24 h, and then thermocycled for 6000 cycles before microtensile bond strength (µTBS) testing. Data were analyzed with ANOVA and Tukey’s HSD tests (p = .05).

Results: Combined treatment of SR, sandblasting, silane and UA provided repair bond strength values comparable to the cohesive strength of each tested resin material (p < .05). Thermocycling significantly reduced the cohesive strength of the composite resins upto 65% (p < .05). Repair bond strengths of UA-treated groups were more stable under thermocycling.

Conclusions: Universal adhesive application is a reliable method for composite repair. Sandblasting and silane application slightly increases the repair strength for all substrate types.