Qualitative and quantitative characterization of monomers of uncured bulk-fill and conventional resin-composites using liquid chromatography/mass spectrometry

Evaluation of the Impact of Irradiance Lamps and Storage Media on Elution of TEGDMA from Dental Composites

OBJECTIVES

 The aim of this study was to evaluate and compare the effect of irradiance light and storage media on the elution of triethylene glycol dimethacrylate (TEGDMA) from conventional Filtek Z350XT 3M ESPE and two bulk-fill composites Shofu Beautifil-Bulk and Filtek Bulk fill flowable 3M ESPE using high-performance liquid chromatography (HPLC).

MATERIALS AND METHODS

 Shofu Beautifil-Bulk, Filtek Bulk fill flowable 3M ESPE, and Filtek Z350XT 3M ESPE were the three types of composites used in this study. Disk shaped samples of 4-mm thickness and 10-mm diameter were fabricated using a stainless steel mold and were polymerized using light emitting diode (LED) and quartz tungsten halogen (QTH) lamps. After polymerization, the samples were immersed in ethanol, artificial saliva with betel quid extract, and distilled water for 1, 7, and 30 days, respectively. The elution of monomer TEGDMA was evaluated using HPLC.

STATISTICAL ANALYSIS

 To evaluate the mean concentration difference, mixed way analysis of variance (ANOVA) was applied. Between different light, materials, and within the time duration, Tukey's post hoc test was used. A p value of 0.05 was considered significant.

RESULTS

 During the first day of storage, a significant amount of monomer TEGDMA elution was seen in all the materials. The highest values observed to be in the disks cured with QTH lamp. However, the highest elution was seen when the disks were immersed in ethanol/water solution. While the most stable medium was distilled water, artificial saliva with betel nut extract also had a significant effect on the elution of TEGDMA. The highest value obtained was of Filtek Bulk fill flowable 3M ESPE after 30 days of immersion in both LED and QTH cured disks.

CONCLUSION

 Filtek Bulk fill flowable 3M ESPE shows better properties in relation to the release of monomer TEGDMA as it releases less amount of monomer in the storage media. The release of monomer was highest in ethanol as compared to artificial saliva and distilled water with the passage of time.

The Effect of Plaque Detectors on the Color Stability of Two Types of Restorative Materials

OBJECTIVE

To investigate the color stability of a one-shade resin-based composite material (RC) and a glass-ionomer cement (GIC) after staining with plaque detectors (PDs) with different formulations and delivery forms.

MATERIALS AND METHODS

Rectangular-shaped specimens (7 × 3 × 2 mm) were produced with RC (Venus Diamond One, Kulzer) and GIC (Fujy IX GP, GC) (n = 30). Further, the following PDs were used on the specimens: (1) tablets (T; Plaq-Search, TePe); (2) mouthwash (M; Plaque Agent, Miradent); and (3) light-curing liquid (L; Plaque test, Ivoclar). The PDs were removed with dedicated toothbrushes (T1) and the specimens were repolished (T2). The protocol was repeated after 1 week of storage in artificial saliva (staining-T3 and repolishing-T4). Color measurement were performed at baseline (T0) and all testing times (T1-T4) using a recently introduced digital colorimeter (SmartColor, Smart Vision). Color changes (ΔEab) compared to T0 were automatically recorded by the digital instrument. The data were statistically analyzed (p < 0.05).

RESULTS

The type of PD, the polishing procedure and their interactions influenced the color stability of both restorative materials (p < 0.05). Particularly, after the second PDs application, M and L produced the highest color changes (p < 0.05), with GIC showing higher color variability than RC. Although repolishing reduced the color changes of RC (p < 0.05), it could not reestablish the initial color of GIC, irrespective of the PD used (p < 0.05). Except for RC associated with T, all materials exhibited discoloration above the clinical perceptibility (1.77) and acceptability (2.66) thresholds.

CONCLUSIONS

The influence of PDs on the color stability of RC and GIC was material-dependent. GIC showed higher color instability than RC. Repolishing could not reestablish the original color of GIC and only attenuated the color changes of the one-shade RC. The newly introduced digital colorimeter was an important tool to standardize and simplify color measurement evaluations.

CLINICAL SIGNIFICANCE

PDs can pose a potential risk to the color stability of restorative materials. Dental practitioners should be careful when recommending the frequency of at-home application of PDs, taking into consideration the material properties and the position of the restorations of each patient.

Monomer Release from Dental Resins: The Current Status on Study Setup, Detection and Quantification for In Vitro Testing

Improvements in mechanical properties and a shift of focus towards esthetic dentistry led to the application of dental resins in various areas of dentistry. However, dental resins are not inert in the oral environment and may release monomers and other substances such as Bisphenol-A (BPA) due to incomplete polymerization and intraoral degradation. Current research shows that various monomers present cytotoxic, genotoxic, proinflammatory, and even mutagenic effects. Of these eluting substances, the elution of BPA in the oral environment is of particular interest due to its role as an endocrine disruptor. For this reason, the release of residual monomers and especially BPA from dental resins has been a cause for public concern. The assessment of patient exposure and potential health risks of dental monomers require a reliable experimental and analytical setup. However, the heterogeneous study design applied in current research hinders biocompatibility testing by impeding comparative analysis of different studies and transfer to the clinical situation. Therefore, this review aims to provide information on each step of a robust experimental and analytical in vitro setup that allows the collection of clinically relevant data and future meta-analytical evaluations.

Marginal Adaptation and Depth of Cure of Flowable versus Packable Bulk-fill Restorative Materials: An In Vitro StudyMarginal Adaptation and Depth of Cure of Flowable versus Packable Bulk-fill Restorative Materials: An In Vitro Study

Aim: To investigate the marginal adaptation and depth of cure of a flowable bulk-fill giomer (BEAUTIFIL Flow Plus X [BFP]), a flowable bulk-fill resin composite (PALFIQUE BULK FLOW [PBF]) bulk-fill resin composite, a packable bulk-fill giomer (BEAUTIFL-Bulk Restorative [BBR]), and two packable bulk-fill resin composites (X-tra fil [XF]) and (Filtek™ One Bulk Fill Restorative [FOB]). Materials and Methods: Twenty-five standardized class II cavities were prepared in the occlusomesial surfaces of maxillary premolars. A self-etching dental adhesive was used. All restorative materials were applied, and light cured according to their manufacturer's instructions. The teeth were subjected to 2500 thermal cycles between 5° C and 55° C. Epoxy resin replicas were obtained to examine the marginal by calculating the percentage of the continuous margin over the total margin length. using SEM at 200× magnification. For assessing the depth of cure, fifty specimens with 4 mm height were prepared. Vickers microhardness testing was used to assess the depth of cure was calculating the bottom-to-top ratio of each specimen. If this ratio reaches 0.80 or more, an adequate depth of cure is achieved. Results: Regarding marginal adaptation, there was no significant difference between different groups before (p=0.398) and after (p=0.644) thermocycling. Within all groups, there was a significant decrease in marginal adaptation after thermocycling (p<0.001). Regarding the depth of cure, all restorative materials achieved the required 0.8 bottom-to-top ratio.  There was a significant difference between different groups (p<0.001).  The highest value was found in BFP group (0.97±0.02), while the lowest value was found in BBR group (0.81±0.11). Conclusions: The marginal adaptation and depth of cure of bulk-fill giomer restorative materials are acceptable. Therefore, their use in restoration of 4-mm deep class II cavities is appealing.

Utilizing a degradation prediction pathway system to understand how a novel methacrylate derivative polymer with flipped external ester groups retains physico-mechanical properties following esterase exposure

OBJECTIVE

The region of failure for current methacrylates (i.e. derivatives of acrylates) are ester bond linkages that hydrolyze in the presence of salivary and bacterial esterases that break the polymer network backbone. This effect decreases the mechanical properties of methacrylate-based materials.

METHODS

The ethylene glycol dimethacrylate (EGDMA) or novel ethylene glycol ethyl methacrylate (EGEMA) discs were prepared using 40 µL of the curing mixture containing photo/co-initiators for 40 s in a PTFE mold at 1000 mW/cm². The degree of conversion was used as a quality control measure for the prepared discs, followed by physical, mechanical, and chemical characterization of discs properties before and after cholesterol esterase treatment.

RESULTS

After 9 weeks of standardized cholesterol esterase (CEase) exposure, EGDMA discs showed exponential loss of material (p = 0.0296), strength (p = 0.0014) and increased water sorption (p = 0.0002) compared to EGEMA discs. We integrated a degradation prediction pathway system to LC/MS and GC/MS analyses to elucidate the degradation by-products of both EGEMA and EGDMA polymers. GC/MS analysis demonstrated that the esterase catalysis was directed to central polymer backbone breakage, producing ethylene glycol, for EGDMA, and to side chain breakage, producing ethanol, for EGEMA. The flipped external ester group linkage design is attributed to EGEMA showing higher resistance to esterase biodegradation and changes in mechanical and physical properties than EGDMA.

SIGNIFICANCE

EGEMA is a potential substitute for common macromer diluents, such as EGDMA, based on its resistance to biodegradation effects. This work inspires the flipped external group design to be applied to analogs of current larger, hydrophobic strength bearing macromers used in future dental material formulations.

Comparative analysis of leaching residual monomer and biological effects of four types of conventional and CAD/CAM dental polymers: an in vitro study

OBJECTIVES

The objective of this study is to investigate leaching residual monomer and biological effects of four types of conventional and computer-aided design/computer-aided manufacturing (CAD/CAM) dental polymers on human gingival fibroblasts (HGFs).

MATERIALS AND METHODS

A total of 540 disk-shaped specimens were fabricated from four different materials (n=135 per group): compression-molding polymethylmethacrylate (PMMA) (conventional denture polymer), CAD/CAM PMMA (CAD/CAM denture polymer), bis-acrylic composite resin (conventional temporary polymer), and CAD/CAM PMMA (CAD/CAM temporary polymer). Specimens were eluted in cell culture medium for 72 h at 37°C, and the residual monomer in eluates subsequently was measured by high-performance liquid chromatography (HPLC). The biological effects of material eluates on HGFs were analyzed by CCK-8 assay, flow cytometry, real-time quantitative PCR, Western blotting, and enzyme-linked immunosorbent assay (ELISA) to identify cell death patterns and its biological mechanism.

RESULTS

Methyl methacrylate (MMA) was detected only in compression-molding PMMA, and by-products were detected in bis-acrylic composite resin. The cell proliferation of CAD/CAM denture polymer or CAD/CAM temporary polymer was greater than that of compression-molding PMMA or bis-acrylic composite resin at 72 h in culture. No apoptosis and necrosis were detected in CAD/CAM dental polymers. Apoptosis was detected only in bis-acrylic composite resin and further confirmed by the upregulation of Bax and cleaved Caspase-3, as well as the downregulation of Bcl-2 gene. And no significant variation in inflammatory cytokines secretion was observed in all materials.

CONCLUSIONS

CAD/CAM dental polymers (including temporary and denture polymers) have favorable biocompatibility due to lower residual monomer, which provides scientific evidence to the controversy of biocompatibility of conventional and CAD/CAM dental polymers.

CLINICAL RELEVANCE

The use of CAD/CAM dental polymers is recommended in the fabrication of temporary restorations and dentures due to their favorable biocompatibility.

Antimicrobial agents in dental restorative materials: Effect on long-term drug release and material properties

The present study reports on the long-term drug release and mechanical properties of bioactive dental filling materials based on chlorhexidine diacetate (CHX) or octinidine (di)hydrochloride (ODH) incorporated in a composite based on dimethacrylates or an ormocer. CHX or ODH were added to a nano-hybrid ormocer (O) and a nano-hybrid composite (C) with the amount of 2 wt% to achieve four matrix-drug combinations: O-CHX, O-ODH, C-CHX, and C-ODH. Drug extraction and release were measured using high-performance liquid chromatography with diode-array detection (HPLC-DAD), while drug distribution was assessed by using energy dispersive X-ray spectroscopy (EDX). Drug release in water at 37°C was observed over 87 d. To determine the material properties, the water absorption, water solubility, flexural strength and hardness were measured and compared to the reference materials. Persistent drug release over 87 d was observed for both ODH-based systems and both ormocer-systems, with the longest duration of activity seen for the O-ODH combination. Persistent drug release was achieved via the loosening of the polymer network indicated via decreasing polymerization enthalpies, enhanced water absorption, and water solubility. As a consequence, the flexural strengths of the materials were reduced. However, surface hardness was hardly reduced. ODH seems to be more adequate than CHX for the design of bioactive dental filling materials based on nano-hybrid ormocer and composites.

Effects of Monomer Composition of Urethane Methacrylate Based Resins on the C=C Degree of Conversion, Residual Monomer Content and Mechanical Properties

(1) Background: This study investigated the influence of Bis-GMA, TEGDMA, UDMA, and two different polyethylene glycol (PEG)-containing, UDMO-based co-monomers on the Young’s modulus and flexural strength, degree of methacrylate C=C double bond conversion and residual monomer elution of experimental dental resins. (2) Methods: Urethane methacrylate-based monomer was synthesised via a radical chain growth polymerization mechanism using PEG in order to improve the mechanical properties. Dental resins were formulated using Bis-GMA, UDMA, or UDMO as base monomers combined with TEGDMA as a dilution monomer and DMAEM + CQ as the photo-initiator system. Degree of conversion (DC), mechanical properties, and residual monomer content of light-activated methacrylate resin formulations were evaluated and statistically analysed by ANOVA and a Tukey’s test. (3) Results: PEG-containing UDMO resins had lower Young’s modulus and elastic strength than UDMA-derived resin for all irradiation times. The highest DC (67,418%) was observed for the PEG-containing UDMO-based resin formulation when light cured for 40 s. For all samples, DC increased with the photo-polymerization time. The amount of residual monomer decreased after increasing the light-curing period from 20 to 40 s, resin with UDMO content 0.01 mol of PEG having the smallest amount of free eluted monomer. (4) Conclusions: A strong structure–property relationship exists in photo-cured dimethacrylate-based dental resins. The time and quantity of the photochemical initiation system can influence the physical–mechanical properties of the resins but also the monomers in their composition.

Bisphenol A release from short-term degraded resin-based dental materials

OBJECTIVES

There is still much debate about the release of bisphenol A (BPA) from resin-based dental materials. Therefore, this study aimed to quantify BPA present as an impurity and to evaluate whether their degradation by salivary, bacterial, and chemical challenges could increase its release.

METHODS

BPA was determined in three different amounts (300, 400, and 500 µg) of eight unpolymerized resin-based materials (four composites, one fissure sealant, two adhesives and one root canal sealer). Next, polymerized samples (n = 5) of each material were immersed in 1 mL of whole human pooled saliva collected from adults, Streptococcus mutans (2 × 10⁷ CFU/mL), and acidic (0.1 M HCl), alkaline (0.1 M NaOH), and control media, respectively. The amount of BPA was quantified using an UPLC-MS/MS method including derivatization of BPA by pyridine-3-sulfonyl chloride.

RESULTS

Only the composites contained trace amounts of BPA above the limit of quantification (ranging from 301±32 pg PBA/mg to 1534±62 pg BPA/mg), most likely as impurity from the synthesis of the monomers. The amounts of BPA released from polymerized materials upon salivary and bacterial degradation were too low for accurate quantification, but in water, quantifiable amounts of BPA were released from all materials. In alkaline media, the BPA release from two composites was significantly decreased, while the release from one adhesive was significantly increased, compared to water.

CONCLUSIONS

BPA already present in unpolymerized resin-based materials may account for the release of BPA after polymerization. There was no clear indication that short-term material degradation leads to increased release of BPA.

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.

Bisphenol A as degradation product of monomers used in resin-based dental materials

OBJECTIVE

There is still much debate about the release of bisphenol-A (BPA) from dental materials. Therefore, this study aimed to quantify BPA present as an impurity in both BPA-based and non-BPA-based monomers and to evaluate whether these monomers may degrade to BPA upon salivary, bacterial, and chemical challenges.

METHODS

BPA was determined in three different amounts (1, 2, and 3 μmol) of each monomer (TEGDMA, UDMA, mUDMA, BisGMA, BisEMA-3, -6, -10, -30, BisPMA, EBPADMA urethane, BADGE, and BisDMA). Next, the monomers (3 μmol) were immersed in whole human pooled saliva collected from adults, Streptococcus mutans (2 × 10⁷ CFU/mL), and acidic (0.1 M HCl), alkaline (0.1 M NaOH), and control media. The amount of BPA was quantified using a specific and highly sensitive UPLC-MS/MS method including derivatization of BPA by pyridine-3-sulfonyl chloride.

RESULTS

The monomers BisGMA and BisEMA-3 contained trace amounts (0.0006% and 0.0025%, respectively) of BPA as impurities of their synthesis process. BPA concentrations increased when the monomers BisGMA, BisEMA-3, BisEMA-6, BisEMA-10, BisPMA and BADGE were exposed to saliva and S. mutans, indicating degradation of a small amount of monomer into BPA. In addition, BisPMA and BADGE degraded into BPA under alkaline conditions. The conversion rate of the monomers into BPA ranged between 0.0003% and 0.0025%.

SIGNIFICANCE

Impurities and degradation of BPA-based monomers may account for the release of BPA from resin-based dental materials. Even though the detected amounts of BPA due to monomer impurity were small, manufacturers of dental materials can reduce the BPA content by using only monomers of the highest purity. Considering the overall current trend towards BPA-free materials, it may be recommendable to investigate whether non-BPA based monomers can be used in dental resin-based materials.

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.

Material behavior of resin composites with and without fibers after extended water storage

The objective of this study was to determine the long-term water sorption, solubility and hygroscopic expansion of resin composites with and without incorporated short fibers. Three resin composites incorporating fibers were examined: everX Posterior (EVX), NovoPro Universal (NPU) and NovoPro Flow (NPF). Four Particulate filled composites were used as controls: Filtek bulk Fill (FBF), Filtek one bulkfill (FBO), Filtek Supreme XTE (XTE), and Filtek Supreme Flow (XTEF). For sorption and solubility measurements, specimens were immersed in water for140 days, weighed at intervals, then dried for a further 42 days at 37±1°C. Laser micrometer measured diametral expansion. XTEF exhibited the highest sorption. The solubility range was between -1.4 to 4.1 μg/mm; XTEF had the highest solubility, with EVX demonstrating negative solubility. Hygroscopic expansion ranged between 1.4% for hydroxyapatite fiber reinforced composite (NPU) and 2.2% for E-glass fiber reinforced composite (EVX). A nano-fiber containing composite (NPU) had the most favorable outcomes compared to a range of composites.

Effects of Bisphenol A Released From Composite Fillings on Reproductive Hormone Levels in Men

Objectives

Composite resins are the most preferred filling material because of their excellent aesthetic qualities. However, a filling material should also be biocompatible as well as aesthetic. The aim of this study was to determine the serum and saliva bisphenol-A (BPA) levels and to examine the effects of serum BPA on reproductive hormone levels after healthy men were treated with composite fillings.

Methods

Eighteen healthy males each received 2 composite restorations. Saliva and blood samples of subjects were collected before resin application and 1 day and 1, 3, and 5 weeks after the resin was applied. BPA amounts in samples were detected using high-performance liquid chromatography (HPLC). Serum gonadotropins, testosterone, sex hormone binding globulin, free androgen index, and oestrogen levels were measured with radioimmunological assay kits. Statistical analysis of data was made using Friedman, Wilcoxon signed ranks and Mann-Whitney U tests (α = 0.05).

Results

The amount of BPA released from composite resins over time was not significantly elevated in either saliva or serum (P > 0.5). In addition, serum BPA levels were significantly higher than saliva BPA levels for both composites (P < .05), but saliva and serum BPA levels were not statistically different when comparing the 2 composites (P > .05).

Conclusions

BPA from composite resins used in this study did not significantly alter serum hormone levels.

Cytotoxicity of Different Nano Composite Resins on Human Gingival and Periodontal Ligament Fibroblast Cell Lines: An In Vitro Study

The aim of this study is to determine the cytotoxicity of three different nano composite resins (CRs) on human gingival fibroblast (hGF) and periodontal ligament fibroblast (hPDLF) cell lines. These CRs selected were nanohybrid organic monomer-based Admira Fusion (AF), nanohybrid Bis-(acryloyloxymethyl) tricyclo [5.2.1.0.sup.2,6] decane-based Charisma Topaz (CT), and supra nano filled resin-based Estelite Quick Sigma (EQS). MTT assay was performed to assess the cytotoxicity of CRs at 24 h and one week. AF and EQS applied on hGF cells at 24 h and one week demonstrated similar cytotoxic outcomes. Cytotoxicity of CT on hGF cells at one week was higher than 24 h (p = 0.04). Cytotoxicity of CT on hGF cells was higher at 24 h (p = 0.002) and one week (p = 0.009) compared to control. All composites showed higher cytotoxicity on hPDLF cells at one week than the 24 h (AF; p = 0.02, CT; p = 0.02, EQS; p = 0.04). AF and EQS demonstrated lower cytotoxicity on hPDLF cells than the control group at 24 h (AF; p = 0.01, EQS; p = 0.001). CT was found more cytotoxic on hPDLF cells than the control (p = 0.01) and EQS group (p = 0.008) at one week. The cytotoxicity of CRs on hGF and hPDLF cells vary, according to the type of composites, cell types, and exposure time.

Effect of thermocycling on the amount of monomer released from bulk fill composite resins

The goal of this study was to examine the effect of thermal cycling on the amount of monomer released from bulk fill composites. Five bulk fill composite resins were used in the study. Extraction solutions were obtained at the end of the time/thermal cycle periods: 0-1 day/0-1,500, 1-3 days/1,500-4,500 and 3-7 days/4,500-10,000. The monomers in the extractions samples taken at each time point were measured on an HPLC instrument. The obtained data were analyzed by repeated measures of variance analysis and tukey multiple comparison tests (p<0.05). The thermocycling increased the amount of monomer released from all composites at 0-1 day (p<0.05). At 0-1 and 1-3 days, Venus Bulk Fill and Filtek Bulk Fill composite resins were more affected. Polymer networks with high molecular weight monomers such as Bis-GMA and UDMA can be less affected by thermal changes compared to polymers with low molecular weight monomers.

Monomer release from nanohybrid composites after bleaching

The evaluation of the effect of bleaching on monomer release from two composite resins was performed by bleaching two nanohybrid composite resins Filtek Z550 and Tetric N-Ceram using two bleaching products Whiteness HP Maxx and Vivastyle. In total, 20 samples were made from each composite resin from which four groups were fabricated (two for each bleaching product). The samples were stored in a 75% ethanol solution, and the solutions were renewed after 1, 7, and 28 days. The monomer release was analyzed using high performance liquid chromatography. The data were analyzed using repeated measures analysis of variance and least significant difference multiple comparison test (α = 0.05). Monomers were found to be released from both composite resins. The amounts of monomer released were found to decrease over time (P < 0.05); however, the resins were not affected by bleaching, and the released monomers were well below toxic doses.

Hydrolytic and Biological Degradation of Bulk-fill and Self-adhering Resin Composites

OBJECTIVES

This study aimed to evaluate the hydrolytic degradation (in vitro) and biodegradation (in situ) of different resin composites: bulk-fill (XTra Fill, XTF/VOCO; Tetric EvoCeram Bulk Fil, TBF/ Ivoclar Vivadent), self-adhering (Vertise Flow, VTF/ Kerr; Fusio Liquid Dentin, FUS/ Pentron Clinical), and a conventional resin composite (Filtek Z250, Z250/ 3M ESPE), which was used as a control.

METHODS AND MATERIALS

Seventy-five cylindrical specimens (7 × 1 mm) were desiccated and immersed into distilled water (DW), artificial saliva (AS), and 0.1 M lactic acid (LA) (n=5) for 180 days. Specimens were weighed after 180 days, after which they were desiccated again. The sorption (μg/mm³) and solubility (μg/mm³) were calculated based on ISO 4049. For the in situ phase, an intraoral palatal device containing five cylindrical specimens (5 × 1.5 mm) was used by 20 volunteers for seven days. Surface roughness was evaluated before and after this period to analyze the superficial biodegradation. Sorption and solubility data were submitted to Kruskal-Wallis and Mann-Whitney tests. The Wilcoxon signed-rank test was used to compare roughness at different observation times. The statistical significance for all tests was considered α=0.05.

RESULTS

For in vitro, self-adhering resin composites (VTF and FUS) showed, respectively, higher sorption values independent of the solution (62.55 and 50.81 μg/mm³ in DW, 67.26 and 50.46 μg/mm³ in AS, and 64.98 and 59.86 μg/mm³ in LA). Self-adhering VTF also had a greater solubility value in DW (22.18 μg/mm³) and FUS in LA (65.87 μg/mm³). In AS, the bulk-fill resin composite XTF showed higher solubility (22.13 μg/mm³). All resins were biodegraded, but the XTF specimens were more resistant (p=0.278) to chemical attack.

CONCLUSIONS

The self-adhering resin composites showed the highest hydrolytic degradation, and the bulk-fill resin composites exhibited comparable or superior results to the conventional resin composites. Not all resin composites underwent biodegradation in the in situ environment. The storage environment influenced the final characteristics of each material tested.

Analysis of Base Monomer Elution from 3 Flowable Bulk-Fill Composite Resins Using High Performance Liquid Chromatography (HPLC)

Background

The aim of this study was to evaluate the elution of BisGMA, UDMA, TEGDMA, and HEMA monomers from flowable bulk fill composite resins with different resin matrix compositions, polymerized in 4-mm-thick layers, into 3 elution media.

Material/Methods

Three bulk-fill (SDR^® (SDR), X-tra base (XB) and BEAUTIFIL-Bulk Flowable (BF)) resin-composites were tested. Cylindrical samples were immersed in 100% ethanol, 75% ethanol, and distilled water. The concentrations of the monomers were measured using the HLPC method (Agilent Technologies 1200 Series) after 1 and 24 h, as well as after 3, 7, 14, and 21 days.

Results

After polymerization of the tested resins, there was elution of the BisGMA, UDMA, TEGDMA, and HEMA monomers from the SDR and BF composites, but none of the tested monomers could be detected eluting from XB. The highest penetrations of the polymerized SDR and BF composites were observed in the 100% ethanol solution. This extraction medium eluted the highest amounts of free monomers. Some eluted monomers were not described in the composites Material Safety Data Sheets.

Conclusions

The elution of the residual monomers depended on the resin composition and the materials filler/resin matrix ratio. In composite materials, toxicity assessment should be carried out, and should consider both the material composition as given by the manufacturer, and also the residual monomers that elute from the polymerized material. The elution concentration and time of monomers from composites depended on the solvent used. The highest penetrations of the polymerized SDR and BF composites were observed in the 100% ethanol solution, and this extraction medium eluted the highest amounts of free monomers. The 75% ethanol was a more aggressive medium than water in terms of monomer elution from bulk fill composites.

Impact of Material Shade and Distance from Light Curing Unit Tip on the Depth of Polymerization of Composites

Abstract This study aimed to evaluate the effect of the composite shade and distance from the light-curing unit (LCU) tip on the irradiance reaching the bottom of composite disks and on the depth of polymerization. Composites of three shades (opaque - OXDC, bleach - BXL, and A2) were inserted into molds with 3-mm of thickness positioned over a spectrometer and photo-activated with the LCU (Bluephase) tip placed at 0 or 1 cm from the composite surface. The mean irradiance reaching the bottom of composite was recorded during the entire photo-activation (30 s). Specimens (2 x 2 x 4 mm) were polymerized and used to map the degree of conversion achieved in different depths from irradiated surface. Specimens were sectioned into slices that were positioned over the platform of the infra-red microscope connected to the spectrometer to map the conversion. The conversion was measured in eight different depths every 500-µm. Increasing the distance of LCU tip reduced the irradiance only for A2. Interposing OXDC disks resulted in lowest values of irradiance and A2 the highest one. A tendency to decrease the conversion was observed towards the bottom of specimens for all experimental conditions, and the slope was more accentuated for OXDC. Differences among shades and distances from LCU tip were evident only beyond 1.5-2.0 mm of depth. In conclusion, both composite shade and distance from LCU tip might affect the light-transmission and depth of polymerization, while the effect of last was more pronounced.

Polymerization shrinkage stress of composite resins and resin cements - What do we need to know?

Polymerization shrinkage stress of resin-based materials have been related to several unwanted clinical consequences, such as enamel crack propagation, cusp deflection, marginal and internal gaps, and decreased bond strength. Despite the absence of strong evidence relating polymerization shrinkage to secondary caries or fracture of posterior teeth, shrinkage stress has been associated with post-operative sensitivity and marginal stain. The latter is often erroneously used as a criterion for replacement of composite restorations. Therefore, an indirect correlation can emerge between shrinkage stress and the longevity of composite restorations or resin-bonded ceramic restorations. The relationship between shrinkage and stress can be best studied in laboratory experiments and a combination of various methodologies. The objective of this review article is to discuss the concept and consequences of polymerization shrinkage and shrinkage stress of composite resins and resin cements. Literature relating to polymerization shrinkage and shrinkage stress generation, research methodologies, and contributing factors are selected and reviewed. Clinical techniques that could reduce shrinkage stress and new developments on low-shrink dental materials are also discussed.

Impact of thio-urethane additive and filler type on light-transmission and depth of polymerization of dental composites

OBJECTIVE

This study evaluated the effects of filler type and the addition of thio-urethane oligomers on light-transmission, polymerization kinetics and depth of cure of resin composites.

METHODS

BisGMA:UDMA:TEGMA (5:3:2wt%) were mixed with 0 (control) or 20wt% thio-urethane. Fillers with various sizes and refractive indices were included and refractive index (RI) measured. Unfilled resins were used as controls. The RIs of materials were measured before and after polymerization. The irradiance reaching the bottom of 3-mm thick specimens was measured during the polymerization. Degree of conversion to a depth of 5mm was mapped. An optical bench was used to simultaneously follow conversion and light transmission.

RESULTS

The addition of thio-urethane increased the RI for all composites. As expected, RI also increased with conversion for all materials. The one exception was for the material filled with OX-50, in which the RI of the composite decreased with conversion. In this case, the irradiance at the bottom of the 3mm specimen was also the lowest among all groups. The addition of thio-urethanes had only minimal effect on light transmission within a filler type, but led to increased conversion in depth for all groups. The filler type itself had a greater effect on light transmission, and that correlated well with the degree of conversion.

SIGNIFICANCE

The effect of the thio-urethane addition on degree of conversion in depth was dependent on filler type. The additive can be tailored to improve the RI match with the filler to optimize light transmission in dental composites.

Genotoxic potential of dental bulk-fill resin composites

OBJECTIVE

To investigate both genotoxicity and hardening of bulk-fill composite materials applied in 4-mm layer thickness and photo-activated for different exposure times.

METHODS

Three flowable bulk-fill materials and one conventional flowable composite were filled in molds (height: 4mm) and irradiated for 20 or 30s. The top (0mm) and bottom (4mm) specimen surface were mechanically scraped, and eluates (0.01g composite in 1.5ml RPMI 1640 cell culture media) prepared for each material, surface level and irradiation time. Genotoxicity was assessed in human leukocytes using both the alkaline comet assay and cytokinesis-blocked micronucleus assay, and Knoop hardness (KHN) was measured at the top and bottom specimen surface (n=8).

RESULTS

At both irradiation times, none of the bulk-fill composites significantly affected comet assay parameters used in primary DNA damage assessment or induced significant formation of any of the scored chromatin abnormalities (number of micronuclei, nuclear buds, nucleoplasmic bridges), whether eluates were obtained from the top or bottom surface. Furthermore, no decrease in KHN from the top to the bottom surface of the bulk-fill materials was observed. On the other hand, the conventional composite irradiated for 20s showed at 4-mm depth a significant increase in the percentage of DNA that migrated in the tail and a significant increase in the number of nuclear buds, as well as a significant decrease in KHN relative to the top surface.

SIGNIFICANCE

Bulk-fill resin composites, in contrast to conventional composite, applied in 4-mm thickness and photo-activated for at least 20s do not induce relevant genotoxic effects or mechanical instability.

The Influence of Irradiation Time and Layer Thickness on Elution of Triethylene Glycol Dimethacrylate from SDR® Bulk-Fill Composite

Objective. This study aimed to evaluate triethylene glycol dimethacrylate (TEGDMA) elution from SDR bulk-fill composite. Methods. Three groups of samples were prepared, including samples polymerized in a 4 mm layer for 20 s, in a 4 mm layer for 40 s, and in a 2 mm layer for 20 s. Elution of TEGDMA into 100% ethanol, a 75% ethanol/water solution, and distilled water was studied. The TEGDMA concentration was measured using HPLC. Results. The TEGDMA concentration decreased in the following order: 100% ethanol > 75% ethanol > distilled water. Doubling the energy delivered to the 4 mm thick sample caused decrease (p < 0.05) in TEGDMA elution to distilled water. In ethanol solutions, the energy increase had no influence on TEGDMA elution. Decreasing the sample thickness resulted in decrease (p < 0.05) in TEGDMA elution for all the solutions. Conclusions. The concentration of eluted TEGDMA and the elution time were both strongly affected by the hydrophobicity of the solvent. Doubling the energy delivered to the 4 mm thick sample did not decrease the elution of TEGDMA but did decrease the amount of the monomer available to less aggressive solvents. Elution of TEGDMA was also correlated with the exposed sample surface area. Clinical Relevance. Decreasing the SDR layer thickness decreases TEGDMA elution.

Degree of Conversion and BisGMA, TEGDMA, UDMA Elution from Flowable Bulk Fill Composites

The degree of conversion (DC) and the released bisphenol A diglycidyl ether dimethacrylate (BisGMA), triethylene glycol dimethacrylate (TEGDMA) and urethane dimethacrylate (UDMA) monomers of bulk-fill composites compared to that of conventional flowable ones were assessed using micro-Raman spectroscopy and high performance liquid chromatography (HPLC). Four millimeter-thick samples were prepared from SureFil SDR Flow (SDR), X-tra Base (XB), Filtek Bulk Fill (FBF) and two and four millimeter samples from Filtek Ultimate Flow (FUF). They were measured with micro-Raman spectroscopy to determine the DC% of the top and the bottom surfaces. The amount of released monomers in 75% ethanol extraction media was measured with HPLC. The differences between the top and bottom DC% were significant for each material. The mean DC values were in the following order for the bottom surfaces: SDR_4mm_20s > FUF_2mm_20s > XB_4mm_20s > FBF_4mm_20s > XB_4mm_10s > FBF_4mm_10s > FUF_4mm_20s. The highest rate in the amount of released BisGMA and TEGDMA was found from the 4 mm-thick conventional flowable FUF. Among bulk-fills, FBF showed a twenty times higher amount of eluted UDMA and twice more BisGMA; meanwhile, SDR released a significantly higher amount of TEGDMA. SDR bulk-fill showed significantly higher DC%; meanwhile XB, FBF did not reach the same level DC, as that of the 2 mm-thick conventional composite at the bottom surface. Conventional flowable composites showed a higher rate of monomer elution compared to the bulk-fills, except FBF, which showed a high amount of UDMA release.