Academy of Dental Materials guidance-Resin composites: Part I-Mechanical properties

Biaxial flexural strength of hydrothermally aged resin-based materials

PURPOSE

The strength of temporary restorations plays a vital role in full-mouth reconstruction, and it can be impacted by the aging process. The aim of this in vitro study was to evaluate the biaxial flexural strength and fractographic features of different resin-based materials submitted to thermal aging.

MATERIAL AND METHODS

One hundred and ninety-two resin disc-shaped specimens (6.5 mm in diameter and 0.5 mm in thickness) were fabricated and divided into six experimental groups according to the resin-based materials (Filtek Bulk-Fill flowable resin; J-Temp temporary resin; and Fuji Lining glass ionomer cement) and aging process (before and after thermal cycling). Biaxial flexural strength test was performed using a universal testing machine at a crosshead speed of 0.5 mm/min before and after thermal cycling (5 °C and 55 °C, 5760 cycles, 30 s). The mechanical properties were assessed using Weibull parameters (characteristic strength and Weibull modulus) (n = 30). Fractured specimens were examined under a polarized light stereomicroscope to identify crack origin and propagation direction. The surface microstructure of the resin-based materials was assessed by scanning electron microscopy (n = 2). The Weibull modulus (m), characteristic strength, and reliability properties were calculated, and a contour plot was used to detect differences among groups (95% confidence interval).

RESULTS

The Weibull modulus (m), characteristic strength, and reliability of the resin-based compounds were influenced by material type and thermal aging (p < 0.05). Weibull modulus (m) revealed no differences when comparing the materials and aging process (p > 0.05), except for the preceding aging period where Filtek Bulk-Fill exhibited higher values compared to J-Temp (p < 0.05). Filtek Bulk-Fill demonstrated superior characteristic strength and reliability compared to J-Temp and Fuji Lining before and after thermal cycling (p < 0.05). Fractography of the resin-based materials showed fractures originating from surface defects exposed to tensile side and their propagation toward the compressive side. Generally, no differences in surface microstructure were observed on micrographs before and after thermal aging for Filtek Bulk-Fill and Fuji Lining. However, the aging process developed flaws in J-Temp.

CONCLUSION

Resin-based material composition resulted in different flexural strength performance, impacting the Weibull modulus (m), characteristic strength, and reliability of the resin-based restorations.

Awareness of possible complications associated with direct composite restorations: A multinational survey among dentists from 13 countries with meta-analysis

OBJECTIVES

Resin-based composites (RBCs) evolved into favoured materials for teeth restorations, marking a significant change in dental practice. Despite many advantages, RBCs exhibit various limitations in their physical and chemical properties. Therefore, we assessed the dentists' awareness of possible complications after direct composite restorations and their opinions about this material.

METHODS

The online questionnaire was created in English in May 2023. A 16-item survey was dedicated to general dentists and specialists. The first section included four questions related to demographic characteristics. The second section comprised twelve questions and focused on awareness of potential side effects of composite restorations, the most crucial advantages and disadvantages of composite resins, and the frequency of experienced clinical complications after the application of composite materials.

RESULTS

A total of 1830 dentists from 13 countries took part in the survey. Dentists most often declared awareness of low adhesion to the dentine (77.5 %) and, most rarely, solubility in oral fluids (42.6 %). Aesthetics was identified as the main advantage of composite fillings (79 %), followed by the possibility of repair (59 %) and adhesion to enamel (57 %). Polymerisation shrinkage was a major disadvantage for most countries (70 % overall). Analysing the declared potential clinical complications for all countries, statistically significant findings were obtained for marginal discolouration (OR=2.982, 95 % CI: 1.321-6.730, p-value=0.009) and borderline significance for secondary caries (OR=1.814, 95 % CI: 0.964-3.415, p-value=0.065).

CONCLUSIONS

Dentists value aesthetics and repairability but are aware of shrinkage and experience discolouration. The issue of toxicity and solubility seems to be the least known to dentists.

CLINICAL SIGNIFICANCE

Dentists should use RBCs with critical caution due to possible side effects. Despite the undoubted aesthetics of direct composite restorations, it is necessary to remember potential clinical complications such as marginal discolouration or secondary caries.

Mechanical properties and degree of conversion of resin-based core build-up materials and short fiber-reinforced flowable resin-based composite

To evaluate the degree of conversion (DC), surface hardness (SH), and flexural strength (FS) of resin-based core build-up materials. Core build-up materials used were: MultiCore Flow (MCF); Activa (ACT); Core-X Flow (CXF); and everX flow (EVX), and DC, SH and FS were measured. An increase of DC was identified for all materials post-cure, except for EVX. The DC change percentage ranged from 5%-33%, and EVX was displayed the greatest DC rate. All materials displayed an SH increase after 30 days and the greatest increase was observed in ACT. At 1 h, the SH of EVX and CXF was different from the other materials. At 30 days, MCF displayed the greatest SH. All materials displayed an increase in their FS after 30 days except for EVX, and ranging 3%-36% were noticed. Differences observed between materials, thus clinician should be acquainted mechanical properties of these materials to ensure the success of the restorations.

Dental restorative materials and halitosis: a preliminaryin-vitrostudy

Despite the widespread use of dental restorative materials, little information exists in the literature regarding their potential impact on bad breath. This in vitro study aims to fill this gap by investigating the influence of different restorative materials on the release of hydrogen sulfide (H2S). Thirteen diverse dental restorative materials, including composites, flowable composites, glass ionomer restorative materials, high-copper amalgam, and CAD-CAM blocks, were examined. Cellulose Sponge models were used as negative and positive control. All samples were prepared with a diameter of 5 mm and a height of 2 mm. Except for the negative control group, all samples were embedded into Allium cepa L., and the emitted H2S was measured using the Wintact W8802 hydrogen sulfide monitor. Surface roughness's effect on emission was explored by roughening the surfaces of CAD-CAM material samples, and gas emission was measured again. The data were statistically analyzed using the Kruskal-Wallis test and DSCF pairwise comparison tests. Fiber-reinforced flowable composite (EverX Flow), amalgam (Nova 70-caps), and certain composite materials (IPS Empress Direct, Tetric Evoceram, Admira Fusion X-tra) released higher H2S concentrations compared to the negative control. The H2S release period lasted longer in the same materials mentioned above, along with G-aenial Universal Injectable. Indirectly used materials, such as GC Cerasmart, Vita Enamic, and Vita YZ HT, demonstrated significantly lower emissions compared to other direct restoratives. Importantly, the surface roughness of indirect materials did not significantly affect peak H2S concentrations or release times. The study reveals variations in H2S release among restorative materials, suggesting potential advantages of indirect restorative materials in reducing H2S-induced halitosis. This comprehensive understanding of the relationship between restorative materials and halitosis can empower both dental professionals and patients to make well-informed treatment choices. Notably, there is evidence supporting the enhanced performance of indirect restorative materials for individuals affected by halitosis.

The accuracy and precision of wear testing and wear facet analyses: The two sides of the story

A critical examination of the literature for dental wear publications highlighted three distinct areas, clinical data, laboratory data and the simulation of the clinical situation data. The imprecision of the clinical data values from direct and indirect in vivo methods renders the clinical data compromised at best. Laboratory data showed a focus on finding a correlation between simplistic laboratory abrasive wear resistance studies and established materials science laboratory techniques, but with no actual correlation identified. Replication of the masticatory cycle in the mouth in the form of an oral wear simulator has focussed more on the wear testing devices rather than the wear quantification methods. As a result, the data acquisition variables in the x- and y-planes need to be examined to consider how they can influence the accuracy and precision of the laboratory wear measurements recorded in the dental literature. The current approach was undertaken using the teaching tool outlined in "The First Three Questions".

The mechanical, wear, antibacterial properties and biocompatibility of injectable restorative materials under wet challenge

OBJECTIVES

To evaluate the mechanical, wear, antibacterial properties, and biocompatibility of injectable composite materials.

METHODS

Two injectable composite resins (GU and BI), one flowable composite resin (FS), and one flowable compomer (DF), in A2 shade, were tested. Mechanical properties were tested via three-point bending test immediately after preparation and after 1-day, 7-day, 14-day, and 30-day water storage. Under water-PMMA slurry immersion, specimens were subjected to a 3-body wear test (10,000 cycles) against stainless steel balls, while the roughness, wear depth, and volume loss were recorded. After 1-day and 3-day MC3T3-E1 cell culture, cell viability was evaluated with CCK-8 test kits, while the cell morphology was observed under CLSM and SEM. Antibacterial properties on S. mutans were assessed via CFU counting, CLSM, and SEM observation. SPSS 26.0 was used for statistical analysis (α = 0.05).

RESULTS

The mechanical properties were material-dependent and sensitive to water storage. Flexural strength ranked GU > FS > BI > DF at all testing levels. Three nanocomposites had better wear properties than DF. No significant difference on 1-day cell viability was found, but DF showed significantly lower cell proliferation than nanocomposites on 3-day assessment. GU and FS had more favourable cell adhesion and morphology. CFU counting revealed no significant difference, while FS presented a slightly thicker biofilm and BI showed relatively lower bacteria density.

CONCLUSIONS

Injectable nanocomposites outperformed the compomer regarding mechanical properties, wear resistance, and biocompatibility. The tested materials presented comparable antibacterial behaviours. Flowable resin-based composites' performances are affected by multiple factors, and their compositions can be attributed.

CLINICAL SIGNIFICANCE

A profound understanding of the mechanical, wear, and biological properties of the restorative material is imperative for the clinical success of dental restorations. The current study demonstrated superior properties of highly filled injectable composite resins, which imply their wider indications and better long-term clinical performances.

A Finite Element Method Study on a Simulation of the Thermal Behaviour of Four Methods for the Restoration of Class II Cavities

The possibility of dental pulp damage during dental procedures is well known. According to studies, during finishing and polishing without cooling, temperatures of up to 140 °C or more can be generated. There are many studies that have analysed the influence of the finishing and polishing of fillings on the mechanical parameters, but the analysis of thermal parameters has led to uncertain results due to the difficulty of performing this in vivo. Background: We set out to conduct a study, using the finite element method, to determine the extent to which the type of class II cavity and the volume of the composite filling influence the duration of heat transfer to the pulp during finishing and polishing without cooling. Materials and Methods: A virtual model of an upper primary molar was used, with a caries process located on the distal aspect, in which four types of cavities were digitally prepared: direct access, horizontal slot, vertical slot and occlusal-proximal. All four cavity types were filled using a Filtek Supreme XT nanocomposite. Results: The study showed that the filling volume almost inversely proportionally influences the time at which the dental pulp reaches the critical temperature of irreversible damage. The lowest duration occurred in occlusal-distal restorations and the highest in direct access restorations. Conclusions: based on the results of the study, a working protocol can be issued so that finishing and polishing restorations without cooling are safe for pulpal health.

Effects of solvent type and UV post-cure time on 3D-printed restorative polymers

OBJECTIVES

This study evaluated the impact of different solvents and UV post-curing times on properties of 3D printing resins for provisional restorations.

METHODS

The post-processing methods were tested using two solvents (isopropyl alcohol or absolute ethanol) and three UV times (5, 10, or 30 min). The resins tested were Resilab 3D Temp, Printax Temp, and Prizma Bioprov. Microhardness (kgf/mm2), fracture toughness (KIC, MPa√m), surface roughness (Ra, µm), gloss (gloss units), and degree of CC conversion (%DC) were measured (n = 8). All response variables were collected from the same specimen. The specimens were 3D printed using an SLA/LCD printer (150° angulation, 50 µm layer thickness). Light exposure times were adjusted for each material, and the post-processing methods were applied using an all-in-one machine immediately after printing. Data were analyzed using Three-Way ANOVA (α = 0.05).

RESULTS

Microhardness was affected by UV post-cure time and 3D resin. Resilab showed higher microhardness with isopropyl alcohol and 30-min UV time, while Printax had higher microhardness with absolute ethanol. KIC was influenced by solvent type, UV time, and 3D resin, with varying effects on different resins. Roughness was affected by 3D resin and UV time, but no significant differences were seen for Resilab or Prizma. Gloss was influenced by 3D resin, and for Prizma, it was lower with specific solvent/UV time combinations. DC was influenced by 3D resin, with each resin behaving differently.

SIGNIFICANCE

Tailoring the combination of 3D resin, solvent washing type, and UV post-curing time is important to achieve optimal mechanical and aesthetic outcomes for restorations.

POSS hybrid bioactive glass dental composite resin materials: Synthesis and analysis

INTRODUCTION

This study create a dental composite by hybirding polyhedral oligo-sesquioxide nano monomers and bioactive glass BG 45S5.

METHODS

Make an experimental composite resin material with a 60 % filler content overall by substituting 20 % of the filler with BG 45S5. The experimental resins are grouped and named P0, P2, P4, P6 and P8 based on the reactive nanomonomer methacrylic acid-based multifaceted oligomeric sesquisiloxane (POSS) added by 2 %-8 % in the resin matrix portion of each group. Utilize a universal testing machine to analyze and compare the mechanical properties of these, then perform Fourier infrared spectrum analysis, double bond conversion analysis, and scanning electron microscope analysis. Based on this, after soaking the experimental materials artificial saliva solution or lactic acid solution for a while, the pH changes of the solution, the release of Ca2+ and PO43- ions, and the precipitation of apatite on the resin material's surface were tested and analyzed. Cell viability tests were used to assess sample cell viability and quantify the cytotoxicity of biological cells. The independent sample t-test was used to examine the group comparisons, and a difference was considered statistically significant at P<0.05.

RESULTS

Outstanding mechanical and the double bond conversion are demonstrated by the nanocomposites when the POSS concentration hits 4 wt%. Agglomeration will cause the performance to deteriorate if the concentration beyond this threshold. In the P4 group, the double bond conversion, CS, and FS rose by a large margin, respectively, in comparison to the blank control group P0. Thankfully, the data demonstrate that adding POSS increases adhesive ability when compared to the blank group P0, however, there is no discernible difference between the other experimental groups. The acid neutralization capacity of the P4 group is essentially the same as that of the control group (P0). Ca2+ and PO43- ions are released in significant amounts following treatment with lactic acid solution, although this tendency is clearly less pronounced in artificial saliva. SEM and EDX data indicate that when the experimental resin is soaked in lactic acid solution and artificial saliva, apatite precipitation will happen on its surface. The results of the cell viability test indicated that there was no statistically significant difference between the experimental groups, and the viability of the cells increased after 24hours and 48 hours.

CONCLUSIONS

POSS was included into the composite resin along with 20% bioactive glass as a filler. When the proportion of POSS is less than 4%, the indices of composite resin materials rise in a dose-dependent way. When this value is surpassed, performance begins to deteriorate. The inclusion of POSS has no influence on the biological activity of the composites, which means that the hybrid composite resin is capable of acid neutralization, ion release, and apatite precipitation.

CLINICAL SIGNIFICANCE

The experimental composite resin can be used as an intelligent material in clinical treatment. It has the clinical application potential of preventing demineralization of tooth hard tissue, promoting remineralization, and improving edge sealing through apatite precipitation.

Influence of surface sealants on the quality of posterior restorations with bulk-fill composites: A 4-year randomized clinical trial

OBJECTIVES

The aim of this study was to evaluate the clinical performance of surface sealants associated with a bulk-fill composite in posterior restorations after 4 years.

METHODS

A total of 174 posterior restorations were performed on 57 participants using a self-etch adhesive system and a bulk-fill composite. The groups were then divided into the following categories: 1) without surface sealant (NoS), 2) with surface sealant Biscover (Bisco, SBi), and 3) with surface sealant Permaseal (Ultradent, SPe). Restorations were evaluated using FDI criteria at baseline and after 1 and 4 years. Statistical analysis was conducted using Kaplan-Meier survival analysis and the Chi-square test (α = 0.05).

RESULTS

After 4 years, only one restoration was lost (1 in the NoS group). The fracture/retention rate (with 95% confidence interval) was 98% for NoS and 100% for both SBi and SPe (p = 0.76). The majority of secondary outcomes showed minor defects, with no significant differences among the groups (p > 0.05). However, significant differences were observed among the groups in terms of marginal staining and marginal adaptation (p = 0.03). In both items, twelve restorations (nine in NoS, one in SBi, and two in SPe) showed minor marginal discrepancies favoring the sealant groups (SBi and SPe).

SIGNIFICANCE

Regardless of the use of surface sealants, the bulk-fill composite restorations showed excellent clinical performance after 4 years. However, the groups that received sealants showed better marginal adaptation and less marginal discoloration compared to those that did not receive sealants.

CAD-CAM resin composites: Effective components for further development

OBJECTIVE

This paper summarizes the effective components of computer-aided design and computer-aided manufacturing (CAD-CAM) resin composites that contribute to achieving greater mechanical properties and further development.

METHODS

In silico multi-scale analysis, in silico nonlinear dynamic finite element analysis (FEA), and artificial intelligence (AI) were used to explore the effective components of CAD-CAM resin composites. The effects of the filler diameter and silane coupling ratio on the mechanical properties of CAD-CAM resin composites have been clarified through multi-scale analysis. The effects of the filler contents, and filler and monomer compositions have been investigated by AI algorithms. The fracture behavior of CAD-CAM composite crown was analyzed using in silico non-linear dynamic FEA. The longevity of CAD-CAM composite crown was assessed through step-stress accelerating life testing (SSALT).

RESULTS

As the filler diameter decreases, there is an increase in elastic moduli and compressive strengths at the macroscale. At the nanoscale, a decrease in the filler diameter results in a decrease in the maximum value of the maximum principal strain. When the silane coupling ratio decreases, there is a decrease in the elastic modulus and compressive strength. According to the exhaustive search and feature importance analysis based on the AI algorithm, the combination of certain components was narrowed down to achieve a flexural strength of 269.5 MPa. The in silico non-linear FEA successfully detected the sign of the initial crack of the CAD-CAM composite molar crown. The SSALT revealed that CAD-CAM resin composite molar crowns containing nanofillers with a high fraction of resin matrix demonstrated great longevity.

SIGNIFICANCE

This paper summarized the effective components of CAD-CAM resin composites for their further development. The integration of in vitro and in silico approaches will expedite the advancement of CAD-CAM resin composites, offering benefits such as time efficiency and reduction of material waste for researchers and manufacturers.

Effect of thermocycling on surface topography and fracture toughness of milled and additively manufactured denture base materials: an in-vitro study

BACKGROUND

Studies investigating thermocycling effect on surface topography and fracture toughness of resins used in digitally manufactured denture bases are few. The study aimed to assess the impact of thermocycling on surface topography and fracture toughness of materials used for digitally manufactured denture bases.

METHODS

Water sorption, solubility, hardness, surface roughness, and fracture toughness of both three-dimensional (3D)-printed and computer-aided design, computer-aided manufacturing (CAD-CAM) milled specimens (n = 50) were assessed both prior to and following 2000 thermocycles, simulating 2 years of clinical aging. Surface hardness (n = 10) was measured using a Vickers hardness testing machine, surface roughness (n = 10) was determined by a contact profilometer, and fracture toughness (n = 20) was measured using the 3-point bend test, then studying the fractured surfaces was done via a scanning electron microscope (SEM). Prior to and following thermocycling, water sorption and solubility (n = 10) were assessed. Normally distributed data was tested using two-way repeated ANOVA and two-way ANOVA, while Mann Whitney U test and the Wilcoxon signed ranks test were used to analyze data that was not normally distributed (α < 0.05).

RESULTS

Following thermocycling, Vickers hardness and fracture toughness of both groups declined, with a significant reduction in values of the 3D-printed resin (P < .001). The 3D-printed denture base resins had a rougher surface following thermocycling with a significant difference (P < .001). The sorption and solubility of water of both materials were not affected by thermocycling.

CONCLUSIONS

Before and after thermocycling, milled specimens had lower surface roughness and a greater degree of hardness and fracture toughness than 3D-printed specimens. Thermocycling lowered hardness and fracture toughness, and increased surface roughness in both groups, but had no effect on water sorption and solubility.

Comparative study of two bioactive dental materials

OBJECTIVES

New bioactive materials were introduced to not only restore the lost dental hard tissue but also to release fluoride that inhibits demineralization and occurrence of secondary caries. The current study thus aims to assess Fluoride release as well as the mechanical and physical properties of two new commercially available bioactive restorative materials.

METHODS

Two materials, Cention® Forte (CF) (Ivoclar Vivadent), Surefil one™ (SO) (Denstply Sirona), were evaluated in terms of fracture toughness (FT), flexural strength (FS), flexural modulus (FM) (ISO 4049), compressive strength (CS), and Vickers hardness (VH). In addition, thermogravimetric analysis (TGA) was performed, as well as pH measurements and quantification of Fluoride release after immersion in distilled water at times of 0, 7, 14 and 21 days. The sealing ability was evaluated using silver nitrate dye penetration on natural teeth. Finally, Energy-Dispersive X-Ray Spectroscopy (EDX) was used to investigate the surface composition of the two studied material surfaces. The data were statistically analyzed using Independent T-Tests; the chosen significance level was α = 0.05.

RESULTS

CF had significantly higher FT values compared to SO (p = 0.001). Also the FS results showed that CF had significantly higher values (90.11 MPa), followed by SO (22.15 MPa). The CS values showed the same order with significantly higher values for CF (231.79 MPa). While the FM and VH showed the reverse order with SO having significantly higher values than CF. pH measurements showed that CF evolved towards significantly higher pH values after 3 weeks in distilled water, while thermal properties showed more stability and higher resistance to degradation for CF compared to SO. The silver nitrate penetration results showed significantly better sealing ability for CF compared to the self-adhesive SO. Finally, EDX surface analysis results were consistent with the release profiles and confirmed the composition of the two tested materials.

SIGNIFICANCE

Both materials, demonstrated enhanced Fluoride release ability, and hence good remineralisation potential in vitro that could prevent recurrent carious lesions in vivo. The composition based on acrylic polymerization showed better mechanical resistance to bending and fracture, and higher sealing ability than those based on acid base reaction.

Mechanical properties of 3D-printed and milled composite resins for definitive restorations: An in vitro comparison of initial strength and fatigue behavior

OBJECTIVE

To evaluate the flexural strength and fatigue behavior of a novel 3D-printed composite resin for definitive restorations.

MATERIALS AND METHODS

Fifty disc-shaped specimens were manufactured from each of a nanohybrid composite resin (NHC), polymer-infiltrated ceramic network (PICN), and 3D-printed composite resin (3D) with CAD-CAM technology. Biaxial flexural strength (σin ) (n = 30 per group) and biaxial flexural fatigue strength (σff ) (n = 20 per group) were measured using piston-on-three-balls method, employing a staircase approach of 105  cycles. Weibull statistics, relative-strength degradation calculations, and fractography were performed. The results were analyzed with 1-way ANOVA and Games-Howell post hoc test (α = 0.05).

RESULTS

Significant differences in σin and σff among the groups (p < 0.001) were detected. The NHC group provided the highest mean ± standard deviation σin and σff (237.3 ± 31.6 MPa and 141.3 ± 3.8 MPa), followed by the PICN (140.3 ± 12.9 MPa and 73.5 ± 9.9 MPa) and the 3D (83.6 ± 18.5 MPa and 37.4 ± 23.8 MPa) groups. The 3D group exhibited significantly lower Weibull modulus (m = 4.7) and up to 15% higher relative strength degradation with areas of nonhomogeneous microstructure as possible fracture origins.

CONCLUSIONS

The 3D-printed composite resin exhibited the lowest mechanical properties, where areas of nonhomogeneous microstructure developed during the mixing procedure served as potential fracture origins.

CLINICAL SIGNIFICANCE

The clinical indications of the investigated novel 3D-printed composite resin should be limited to long-term provisional restorations. A cautious procedure for mixing the components is crucial before the 3D-printing process, since nonhomogeneous areas developed during the mixing could act as fracture origins.

A low-shrinkage-stress and anti-bacterial adherent dental resin composite: physicochemical properties and biocompatibility

Polymerisation shrinkage and biofilm accumulation are the two main problems associated with dental resin composites (DRCs) that induce secondary caries, which can cause restoration failure. Polymerisation shrinkage can lead to microleakage gaps between the tooth and the DRCs, causing the aggregation of bacteria and development of secondary caries. Reducing the shrinkage stress (SS) and improving the resistance to bacterial adhesion have always been the focus of this field in modifying DRCs. A thiol-ene resin system can effectively reduce the polymerisation SS via its step-growth mechanism for delaying the gel point. Fluorinated compounds can reduce the surface free energies, thereby reducing bacterial adhesion. Thus, in this study, a range of mass fractions (0, 10, 20, 30, and 40 wt%) of a fluorinated thiol-ene resin system were added to a fluorinated dimethacrylate resin system/tricyclo decanedimethanol diacrylate to create a fluorinated methacrylate-thiol-ene ternary resin matrix. DRCs were prepared using the obtained ternary resin matrix, and their physical and chemical properties, effect on bacterial adhesion, and biocompatibility were investigated. The results demonstrated that the volumetric shrinkage and SS of the DRCs were reduced with no reduction in conversion degree even after the thiol-ene resin system was added. All DRC-based fluorinated resin systems exhibited an excellent anti-bacterial adhesion effect, as evidenced by the colony-forming unit counts, live/dead bacterial staining, and crystal violet staining tests against Streptococcus mutans (S. mutans). The genetic expressions associated with the bacterial adhesion of S. mutans were substantially affected after being cultured with fluorinated DRCs. All fluorinated DRCs demonstrated good biocompatibility through the in vitro cytotoxicity test and live/dead staining images of the L-929 cells. The above results illustrate that the DRCs based on the fluorinated methacrylate-thiol-ene resin matrix can be potentially applied in clinical practice due to their low SS and anti-bacterial adhesion effect.

The flexural strength of 3D-printed provisional restorations fabricated with different resins: a systematic review and meta-analysis

BACKGROUND

Three-dimensional (3D) printing technology has revolutionized dentistry, particularly in fabricating provisional restorations. This systematic review and meta-analysis aimed to thoroughly evaluate the flexural strength of provisional restorations produced using 3D printing while considering the impact of different resin materials.

METHODS

A systematic search was conducted across major databases (ScienceDirect, PubMed, Web of Sciences, Google Scholar, and Scopus) to identify relevant studies published to date. The inclusion criteria included studies evaluating the flexural strength of 3D-printed provisional restorations using different resins. Data extraction and quality assessment were performed using the CONSORT scale, and a meta-analysis was conducted using RevMan 5.4 to pool results.

RESULTS

Of the 1914 initially identified research articles, only 13, published between January 2016 and November 2023, were included after screening. Notably, Digital Light Processing (DLP) has emerged as the predominant 3D printing technique, while stereolithography (SLA), Fused Deposition Modeling (FDM), and mono-liquid crystal displays (LCD) have also been recognized. Various printed resins have been utilized in different techniques, including acrylic, composite resins, and methacrylate oligomer-based materials. Regarding flexural strength, polymerization played a pivotal role for resins used in 3D or conventional/milled resins, revealing significant variations in the study. For instance, SLA-3D and DLP Acrylate photopolymers displayed distinct strengths, along with DLP bisacrylic, milled PMMA, and conventional PMMA. The subsequent meta-analysis indicated a significant difference in flexure strength, with a pooled Mean Difference (MD) of - 1.25 (95% CI - 16.98 - 14.47; P < 0.00001) and a high I2 value of 99%, highlighting substantial heterogeneity among the studies.

CONCLUSIONS

This study provides a comprehensive overview of the flexural strength of 3D-printed provisional restorations fabricated using different resins. However, further research is recommended to explore additional factors influencing flexural strength and refine the recommendations for enhancing the performance of 3D-printed provisional restorations in clinical applications.

Mechanical properties of materials for 3D printed orthodontic retainers

AIM

The purpose of this study was to compare the mechanical properties of materials used for orthodontic retainers made by direct 3D printing and thermoforming.

Making graphene oxide (GO)-cladded SiO2 spheres (SiO2 @GO) as inorganic fillers for dental restorative resin composites

OBJECTIVE

Graphene oxide (GO) is of great interest in dentistry as the functional filler, mainly owing to its ability to inhibit the formation of cariogenic bacteria and possess low cytotoxicity to different cells, such as human dental pulp cells, HeLa cells, etc. However, its typical brown color limits the practical application.

METHODS

Here, the refractive-index-matched monodisperse SiO2 were used as the supporting substrates to synthesize GO-cladded SiO2 spheres (xSiO2 @ yGO) through a mild electrostatic self-assembly process, where x and y represent the amount of SiO2 and GO in the reaction mixture, respectively. The morphology and the optical performance of the obtained xSiO2 @ yGO particles were modulated by varying the mass ratio of SiO2 and GO (5:1, 10:1, 50:1, and 100:1). All developed hybrid particles were silanized and formulated with dimethacrylate-based resins. These were tested for curing depth, polymerization conversion, mechanical performance, in vitro cell viability, and antibacterial activity.

RESULTS

Of all xSiO2 @ yGO materials, increasing the mass ratio to 100:1 made the 100SiO2 @GO particles appear light brown and possess the lowest light absorbance from 300 to 800 nm. The results of CIEL*a*b* system showed that all these hybrid particles exhibited obvious discoloration compared with SiO2 and GO, where 100SiO2 @GO possessed the smallest color difference. Furthermore, following the results of curing depth, polymerization conversion, and mechanical performance of dental composites, the optimal filler composition was 100SiO2 @GO at 5 wt% filler loading. The resultant 100SiO2 @GO-filled composite produced the highest flexural strength (115 ± 12 MPa) and the lowest bacterial concentration (6.7 × 108 CFU/mL) than those of the resin matrix (78 ± 11 MPa; 9.2 × 108 CFU/mL) and 5 wt% SiO2-filled composite (106 ± 9 MPa; 9.1 × 108 CFU/mL), respectively, without affecting in vitro cell viability.

SIGNIFICANCE

The facile and mild synthesis of xSiO2 @ yGO hybrid particles provided a convenient way to tune their optical property. The optimal 100SiO2 @GO particles could be considered as the promising antibacterial filler to be applied in dental care and therapy.

Investigation of aging resistance for dental resin composites with and without glass flakes

OBJECTIVES

Outstanding physical-mechanical properties and aging resistance are key requirements for dental resin composite since it will be placed in the oral environment for a long time. In this work, a new dental resin composite mainly modified by glass flakes was fabricated, and the aging resistance was evaluated by comparing with commercial composites without glass flakes.

MATERIALS AND METHODS

The new dental resin composite was produced through hand blending of inorganic glass flakes/Si-Al-borosilicate glass (58wt%:7wt% of dental resin composite), POSS-MA (5wt% of resin matrix), Bis-GMA/TEGDMA(64.4wt%:27.6wt% of resin matrix), and CQ/EDMAB (0.9wt%:2.1wt% of resin matrix) together. The flexural strength, elasticity modulus, and hardness, as well as wear were tested for evaluating the aging resistance of different dental resin composite.

RESULTS

Among 6 kinds of commercial composites in this study, after 6-month water storage, the maximum percentage of performance degradation is that the flexural strength decreased 39.96%, elasticity modulus decreased 51.53% and hardness decreased 12.52%. In contrast, the new synthesized material decreased 14.53%, 20.88%, and 0.61%, respectively, and performed lesser wear depth compared to some other groups (P < 0.05).

CONCLUSIONS

It was observed that the new dental resin composite performed better performance stability and wear resistance when compared with commercial dimethacrylate-based or low shrinkage dental resin composite tested in this study.

CLINICAL RELEVANCE

This possibly paves a path for designing tailored dental composite for practical application. Since the aging resistance of dental resin composite modified by glass flakes is superior, it has the potential to be used for promoting the durability of dental resin composite.

An In Vitro Study regarding the Wear of Composite Materials Following the Use of Dental Bleaching Protocols

Composite materials used in dental restorations are considered resistant, long-lasting and aesthetic. As the wear of restorations is an important element in long-term use, the aim of this study was to evaluate the surface condition of nanohybrid and microfilled composite resins, after being subjected to the erosive action of dental bleaching protocols. This paper reflects a comparative study between one nanofilled composite and three microfilled composites used in restorations. For each composite, three sets of samples (under the form of composite discs) were created: a control group, an "office bleach" group with discs bleached with 40% hydrogen peroxide gel, and a "home bleach" group with discs bleached with 16% carbamide peroxide gel. Wear was numerically determined as the trace and the coefficients of friction obtained using a tribometer, the ball-on-disk test method, and two balls: alumina and sapphire. For all composite groups, there were statistically significant differences between the wear corresponding to the control and bleaching groups, for both testing balls. Regarding the composite type, the largest traces were recorded for GC Gradia direct anterior, for all groups, using the alumina ball. In contrast, for the sapphire ball, 3M ESPE Filtek Z550 was characterized by the largest traces. With respect to the friction coefficients, the "office bleach" group recorded the largest values, no matter the composite or the ball type used. The 3M ESPE Valux Plus composite recorded the largest friction coefficients for the alumina ball, and 3M ESPE Filtek Z550 for the sapphire ball. Overall, the "office bleach" group was characterized by higher composite wear, compared to the "home bleach" protocol or control group. Nanofilled composite resins showed superior wear resistance to microfilled resins after undergoing a bleaching protocol.

Effect of Two Different Ultrafast Curing Exposure Durations on the Surface Hardness of Bulk Fill Composite - An In-Vitro Study

AIM

The aim of the present study is to assess the microhardness of resin-based composites (RBCs) cured with ultrafast curing mode at two different exposure durations.

STUDY DESIGN

This is an experimental in-vitro study. Forty-five cylindrical composite specimens were prepared to a dimension of 5 mm height and 4 mm diameter. Curing was done using three different exposure modes and duration with dual mode LED curing light as follows: Group I: Ultrafast curing mode for 1 second at 2300 mW/cm2 (n = 15); Group II: Ultrafast curing mode for 3 second at 2300 mW/cm2 (n = 15) and Group III: Standard exposure mode for 20 second at 1000 mW/cm2 (n = 15). Vicker's microhardness measurement was done on both the curing and non-curing sides of the specimen using a motorised diamond-faced micro-indenter (Wilson Wolpwert, Germany) using a load of 50 gram and a dwell time of 30 second.

STATISTICAL ANALYSIS

Kruskal Wallis ANOVA was used to test for difference between the three groups followed by Mann-Whitney U test for post-hoc analysis.

RESULTS

The microhardness values of the composite cured with a conventional curing unit were significantly higher than the ultrafast cured specimens.

CONCLUSION

Low-intensity conventional curing lights were found to perform better than the high-intensity ultrafast curing units.

Probing the micro- and nanoscopic properties of dental materials using infrared spectroscopy: A proof-of-principle study

The preservation of oral health over a person's lifespan is a key factor for a high quality of life. Sustaining oral health requires high-end dental materials with a plethora of attributes such as durability, non-toxicity and ease of application. The combination of different requirements leads to increasing miniaturization and complexity of the material components such as the composite and adhesives, which makes the precise characterization of the material blend challenging. Here, we demonstrate how modern IR spectroscopy and imaging from the micro- to the nanoscale can provide insights on the chemical composition of the different material sections of a dental filling. We show how the recorded IR-images can be used for a fast and non-destructive porosity determination of the studied adhesive. Furthermore, the nanoscale study allows precise assessment of glass cluster structures and distribution within their characteristic organically modified ceramic (ORMOCER) matrix and an assessment of the interface between the composite and adhesive material. For the study we used a Fourier-Transform-IR (FTIR) microscope and a quantum cascade laser-based IR-microscope (QCL-IR) for the microscale analysis and a scattering-type scanning near-field optical microscopy (s-SNOM) for the nanoscale analysis. The paper ends with an in-depth discussion of the strengths and weaknesses of the different imaging methods to give the reader a clear picture for which scientific question the microscopes are best suited for. STATEMENT OF SIGNIFICANCE: Modern resin-based composites for dental restoration are complex multi-compound materials. In order to improve these high-end materials, it is important to investigate the molecular composition and morphology of the different parts. An emergent method to characterize these materials is infrared spectroscopic imaging, which combines the strength of infrared spectroscopy and an imaging approach known from optical microscopy. In this work, three state of the art methods are compared for investigating a dental filling including FTIR- and quantum cascade laser IR-imaging microscopy for the microscale and scattering-type scanning near-field optical microscopy for the nanoscale.

Do nanofillers provide better physicomechanical properties to resin-based pit and fissure sealants? A systematic review

The purpose of this study was to systematically review the impact of nanofillers on the physicomechanical properties of resin-based pit and fissure sealants (RBS). This review included in vitro studies with full-length English-language articles reporting on the physicomechanical properties of nanofilled RBS until February 2023. PubMed, Web of Sciences, Scopus, and LILACS databases were accessed for literature searches. The review was formulated based on the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and used the Consolidated Standards of Reporting Trials (CONSORT) guidelines and risk of bias Cochrane tool for quality assessment. The search resulted in 539 papers, of which 22 were eligible to be included in the review. Inorganic, polymeric, core-shell, and composite nanomaterials were used to reinforce the studied RBS. The inherent nature of the nanomaterial used, its morphology, concentration, and volume used were the primary parameters that determined the nanomaterial's success as a filler in RBS. These parameters also influenced their interaction with the resin matrix, which influenced the final physicomechanical properties of RBS. The use of nanofillers that were non-agglomerated and well dispersed in the resin matrix enhanced the physicomechanical properties of RBS.

In vitro evaluation of CAD/CAM composite materials

OBJECTIVES

The purpose of this in vitro study was to evaluate the microstructural, elemental and mechanical properties of contemporary computer-aided-design/computer-aided manufacturing (CAD/CAM) resin based composite (RBC) materials.

METHODS

Six CAD/CAM RBC materials [Brilliant CRIOS (Coltene Whaledent AG), Cerasmart (GC), Lava Ultimate (3M ESPE), Tetric CAD (Ivoclar Vivadent), Shofu Block HC (Shofu), Grandio Blocs (VOCO GmbH)] were tested. Ten rectangular blocks (14 Χ 12 Χ 18 mm) for each material, after metallographic grinding and polishing, were subjected to Instrumented Indentation Testing (ΙIT). Martens Hardness (HM), Indentation Elastic Modulus (EIT), Elastic (ηIT) and Creep indices (CIT) were determined according to formulas provided by ISO 14577. The diagonal length of each indentation was measured and HV was determined. The results of HM, EIT, ηΙΤ, HV, and CIT were statistically analyzed by one-way ANOVA and Tukey post hoc test employing the material as a discriminating variable (a = 0.05), while the possible correlations were determined by Spearman's correlation test. One specimen from each group was examined by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX).

RESULTS

Backscattered Electron images and EDX analysis demonstrated differences in size, shape and type of fillers along with elemental composition among materials tested. Statistical significant differences were identified for all mechanical properties tested. Grandio Blocs had the significantly higher HM (953±7 N/mm2), HV (136±1) and EIT (23±1 GPa) followed by Lava Ultimate (ΗM=674±25 N/mm2, HV=105±2, EIT=15±1 GPa). Elastic index ranged from 41% to 52%, with Shofu Block demonstrating the significantly highest ηIT (52 ± 1%) values. Cerasmart had significantly higher CIT value (8.4 ± 0.1%) than all other materials tested, while Grandio Blocs and Lava Ultimate had the lowest ones. Spearman's correlation revealed that all mechanical properties tested exhibited correlations with each other, apart from ηΙΤ.

CONCLUSIONS

The results showed that the CAD/CAM materials tested have differences in their microstructure, elemental composition and mechanical properties.

CLINICAL SIGNIFICANCE

The RBCs tested showed significant differences in mechanical properties and thus differences in clinical performance are anticipated. RBCs with increased filler loading had the most favorable combination of hardness, elastic modulus and creep index indicating that these materials may have better clinical performance under intraoral loading conditions.

Effect of inorganic fillers on the light transmission through traditional or flowable resin-matrix composites for restorative dentistry

OBJECTIVES

The aim of this in vitro study was to evaluate the light transmission through five different resin-matrix composites regarding the inorganic filler content.

METHODS

Resin-matrix composite disc-shaped specimens were prepared on glass molds. Three traditional resin-matrix composites contained inorganic fillers at 74, 80, and 89 wt. % while two flowable composites revealed 60 and 62.5 wt. % inorganic fillers. Light transmission through the resin-matrix composites was assessed using a spectrophotometer with an integrated monochromator before and after light curing for 10, 20, or 40s. Elastic modulus and nanohardness were evaluated through nanoindentation's tests, while Vicker's hardness was measured by micro-hardness assessment. Chemical analyses were performed by FTIR and EDS, while microstructural analysis was conducted by optical microscopy and scanning electron microscopy. Data were evaluated using two-way ANOVA and Tukey's test (p < 0.05).

RESULTS

After polymerization, optical transmittance increased for all specimens above 650-nm wavelength irradiation since higher light exposure time leads to increased light transmittance. At 20- or 40-s irradiation, similar light transmittance was recorded for resin composites with 60, 62, 74, or 78-80 wt. % inorganic fillers. The lowest light transmittance was recorded for a resin-matrix composite reinforced with 89 wt. % inorganic fillers. Thus, the size of inorganic fillers ranged from nano- up to micro-scale dimensions and the high content of micro-scale inorganic particles can change the light pathway and decrease the light transmittance through the materials. At 850-nm wavelength, the average ratio between polymerized and non-polymerized specimens increased by 1.6 times for the resin composite with 89 wt. % fillers, while the composites with 60 wt. % fillers revealed an increased ratio by 3.5 times higher than that recorded at 600-nm wavelength. High mean values of elastic modulus, nano-hardness, and micro-hardness were recorded for the resin-matrix composites with the highest inorganic content.

CONCLUSIONS

A high content of inorganic fillers at 89 wt.% decreased the light transmission through resin-matrix composites. However, certain types of fillers do not interfere on the light transmission, maintaining an optimal polymerization and the physical properties of the resin-matrix composites.

CLINICAL SIGNIFICANCE

The type and content of inorganic fillers in the chemical composition of resin-matrix composites do affect their polymerization mode. As a consequence, the clinical performance of resin-matrix composites can be compromised, leading to variable physical properties and degradation.

Effect of Fibres on Physico-Mechanical Properties of Bulk-Fill Resin Composites

OBJECTIVE

To measure the flexural strength (FS) of bulk-fill resin composites and assess their long-term water absorption and solubility properties with and without the inclusion of short glass fibres.

METHODS

One resin composite, everX Flow with fibres, and four commercially available bulk-fill composites without fibres, namely, PALFIQUE, Activa, SDR Plus, and Filtek Bulk Fill One, were tested. Six specimens (2 × 2 × 25 mm) were fabricated for each material and stored in water for 1 day and 30 days to measure the flexural strength using a three-point bending test. To evaluate water absorption and solubility, circular disks measuring 15 × 2 mm (n = 5) were immersed in water for 60 days, and their weights were recorded periodically. After 60 days, the specimens were dried for an additional 21 days to determine solubility.

RESULTS

Flexural strength values ranged from 101.7 to 149.1 MPa. Significant distinctions were observed among the resin composites at the onset of the study (p < 0.05). The highest FS value was identified in everX Flow, while ACT exhibited the lowest (p < 0.05). However, the flexural strength values exhibited a significant decrease with increased storage time (p < 0.05), except for ACT, which demonstrated a noteworthy increase. Concerning water absorption and solubility, ACT displayed the highest absorption, while the range of solubility varied from -0.88 to 5.8 μg/mm3. ACT also had the highest solubility, whereas everX Flow exhibited negative solubility.

SIGNIFICANCE

The addition of short fibres, along with potential differences in matrix composition, enhanced the flexural strength of everX Flow. However, the substantial reduction in flexural strength observed in everX Flow and SDR following exposure to water corroborates the manufacturers' recommendation to apply a conventional resin composite cap on these materials.

Innovative Nanostructured Fillers for Dental Resins: Nanoporous Alumina and Titania Nanotubes

The possibility of improving dental restorative materials is investigated through the addition of two different types of fillers to a polymeric resin. These fillers, consisting of porous alumina and TiO₂ nanotubes, are compared based on their common physicochemical properties on the nanometric scale. The aim was to characterize and compare the surface morphological properties of composite resins with different types of fillers using analytical techniques. Moreover, ways to optimize the mechanical, surface, and aesthetic properties of reinforced polymer composites are discussed for applications in dental treatments. Filler-reinforced polymer composites are the most widely used materials in curing dental pathologies, although it remains necessary to optimize properties such as mechanical resistance, surface characteristics, and biocompatibility. Anodized porous alumina nanoparticles prepared by electrochemical anodization offer a route to improve mechanical properties and biocompatibility as well as to allow for the controlled release of bioactive molecules that can promote tissue integration and regeneration. The inclusion of TiO₂ nanotubes prepared by hydrothermal treatment in the resin matrix promotes the improvement of mechanical and physical properties such as strength, stiffness, and hardness, as well as aesthetic properties such as color stability and translucency. The surface morphological properties of composite resins with anodized porous alumina and TiO₂ nanotube fillers were characterized by Atomic Force Microscopy (AFM), Scanning Electron Microscopy (SEM), and X-ray chemical analysis. In addition, the stress-strain behavior of the two composite resins is examined in comparison with enamel and dentin.

Surface Analysis of a Universal Resin Composite and Effect of Preheating on its Physicochemical Properties

This study was aimed at analyzing the surface properties of a universal resin composite and evaluating the effect of preheating on its physicochemical properties. Two commercial resin composites were used under two conditions: Filtek Universal Restorative (UR); UR preheated (URH); Filtek Supreme (FS) and FS preheated (FSH). The film thickness (FT) test (n = 10) was done using two glass slabs under compression. Flexural strength (FLS) and modulus (FLM) were evaluated using a three-point flexion test (n = 10). Polymerization shrinkage stress (PSS) was evaluated in a universal testing machine (n = 5). Gap width (GW) between composite and mold was measured in internally polished metallic molds (n = 10). The degree of conversion (DC) was evaluated by Fourier Transform Infrared spectroscopy (n = 3). The morphology of the filler particles was checked by scanning electron microscope (SEM) and EDX analysis. Surface gloss (SG) and surface roughness (SR) were evaluated before and after mechanical brushing (n = 10). The outcomes were submitted to 2-way ANOVA and Tukey's test (α = 0.05). Lower mean values of FT were observed for the preheated groups when compared to the non-preheated groups. URH and FSH showed higher mean values of FLS and FLM when compared with UR and FS. No differences were observed between groups in the PSS test. The GW was higher for the UR and FS groups when compared with URH and FSH. The DC was higher for preheated resin composites when compared to the non-preheated groups. The SR of the UR composite was higher than the FS after mechanical brushing, while the SG was higher for the FS groups. In conclusion, the universal resin composite tested generally presented similar physicochemical properties compared with the nanofilled resin composite and either similar or slightly inferior surface properties. The preheating improved or maintained all properties evaluated.

Evaluation of a biobased polycarbonate interpenetrated network in a dental resin composite

Silanization of filler particles in a dental resin composite is achieved by the formation of Si-O-Si bonds, however, these bonds are especially vulnerable to hydrolysis because this covalent bond has a significant ionic character due to the electronegativity differences between the atoms. The objective of this study was to evaluate the use of an interpenetrated network (IPN) as alternative of silanization reaction and to assess its effect in selected properties of experimental photopolymerizable resin composites. The interpenetrate network was obtained during the photopolymerization reaction of organic matrix (BisGMA/TEGDMA) with a biobased polycarbonate. Its characterization was performed via FTIR, flexural strength, flexural modulus, depth of cure, sorption water and solubility. A resin composite formulated with non-silanized filler particles was used as control. The IPN with a biobased polycarbonate was successfully synthesized. The results showed that the IPN based resin composite had higher values of flexural strength, flexural modulus, and degree of double bond conversion than the control (p < 0.05). Polymerization shrinkage, water sorption and solubility were statistically significantly lower than the control resin (p < 0.05). Finally, this study shows there were no statistically significant differences for the biocompatibility outcomes (p > 0.05). The biobased IPN replaces the silanization reaction in resin composites, improving physical and chemical properties. Therefore, IPN with a biobased polycarbonate could be potentially useful in the formulation of dental resin composites.

An Evaluation of the Mechanical Properties of a Hybrid Composite Containing Hydroxyapatite

There is currently a lack of scientific reports on the use of composites based on UDMA resin containing HAp in conservative dentistry. The aim of this study was therefore to determine the effect of hydroxyapatite content on the properties of a hybrid composite used in conservative dentistry. This paper compares a commercial hybrid composite with experimental composites treated with 2% by weight (b/w), 5% b/w, and 8% b/w hydroxyapatite. The composites were subjected to bending strength, compression, and diametrical compression tests, as well as those for impact strength, hardness, and tribological wear. The obtained results were subjected to statistical analysis. Increased hydroxyapatite was found to weaken the mechanical properties; however, 2% b/w and 5% b/w hydroxyapatite powder was found to achieve acceptable results. The statistical analysis showed no significant differences. HAp is an effective treatment for composites when applied at a low concentration. Further research is needed to identify an appropriate size of HAp particles that can be introduced into a composite to adequately activate the surface and modification its composition.

Influence of Restorative Material on the Distribution of Loads to the Bone in Hybrid Abutment Crowns-In Vitro Study

Background: The objective of this study was to evaluate the load transmitted to the peri-implant bone by seven different restorative materials in single-unit rehabilitations with morse taper implants using a strain gauge. Materials: In a polyurethane block that simulated type III bone, a morse taper platform implant was installed (3.5 × 11 mm) in the center and 1 mm below the test base surface, and four strain gauges were installed around the implant, simulating the mesial, distal, buccal and lingual positions. Seven similar hybrid abutment crowns were crafted to simulate a lower premolar using different materials: 1-PMMA; 2-glass ceramic over resin matrix; 3-PEEK + lithium disilicate; 4-metal-ceramic; 5-lithium disilicate; 6-zirconia + feldspathic; 7-monolithic zirconia. All groups underwent axial and oblique loads (45 degrees) of 150 N from a universal testing machine. Five measurements (n = 5) were performed with each material and for each load type; the microdeformation data underwent statistical analysis. The data were obtained in microdeformation (με), and the significance level was set at p ≤ 0.05. Results: There was no statistically significant difference in the evaluation among the materials under either the axial load or the oblique load at 45 degrees. In turn, in the comparison between axial load and oblique load, there was a difference in load for all materials. Conclusion: The restorative material did not influence the load transmitted to the bone. Furthermore, the load transmitted to the bone was greater when it occurred obliquely at 45° regardless of the material used. In conclusion, it appeared that the different elastic modulus of each material did not influence the load transmission to the peri-implant bone.

Validation of the Orr theory in dental resin-based composites: A fractographic approach

OBJECTIVES

The present study aimed to assess the applicability of Orr's equation on light-cured resin-based composites (RBCs) tested in 3- and 4-point bending tests, as well as assess the operator reliability of this method.

METHODS

Fracture mirrors of 320 specimens (n = 320) made of four RBCs that had failed in the two tests were analyzed microscopically and consequently two radii of each specimen were measured by two operators, each measuring twice. The mirror constant A was calculated using Orr's equation. The results of the two operators were compared using a t-Test and further assessment of the data was performed using a MANOVA, Tukey's post hoc test and regression analysis.

RESULTS

With the exception of 11 specimens, the measurement of the fracture mirror radii was carried out successfully. The calculation of the mirror constant proved successful with a high coefficient of determination (R² > 0.98). The calculated mirror constants were operator-independent if the results of more than one measurement was taken into consideration. The ratio of the mirror constant A to the fracture toughness K_Ic lay between 2.1 and 2.4 for three of the four RBC. The fourth RBC had a ratio of 1.6 and was the only one where different mirror constants were observed as a function of the testing method.

SIGNIFICANCE

The present study proves the applicability of brittle fracture mechanics on RBCs despite them often being regarded as not brittle due to their also plastic behavior.

12-Month flexural mechanical properties of conventional and self-adhesive flowable resin composite materials

The aim of this study was to investigate the 12-month flexural mechanical properties of 23 flowable resin-based composites (FRBC) that included 5 self-adhesive FRBC materials. Specimens were evaluated following ISO 4049:2019 guidelines, but additionally stored in physiologic 0.2M phosphate buffered saline solution being tested at 24 h, 1 week, 1 month, and at 3-, 6-, 9-, and 12-months. While some deviation and degradation were noted at testing intervals, conventional FRBC materials overall demonstrated greater flexural strength than the self-adhesive and compomer materials. Three self-adhesive materials and the compomer were below recommended ISO 4049:2019 flexural strength values at 24 h with another after 6 months storage. Conventional FRBC materials, except at 1 month, overall demonstrated increased flexural modulus than the self-adhesive FRBC materials. Although results were material dependent, conventional FRBC materials demonstrated overall greater flexural mechanical properties as compared to the self-adhesive FRBC materials and the compomer evaluated.

Bulk-Fill Resins versus Conventional Resins: An Umbrella Review

Currently, composite resins have become the material of choice for the restoration of posterior teeth. Although bulk-fill resins represent a tempting alternative due to their lower complexity and faster use, some dentists are reluctant to use this material. The objective is to compare the performance of bulk-fill resins and conventional resins in direct restorations of posterior teeth based on the literature. The databases that were used to carry out the research were PubMed/MEDLINE, Embase, the Cochrane Library and the WOS. This umbrella literature review complies with PRISMA standards and assesses the quality of studies using the AMSTAR 2 tool. With the application of the criteria of the AMSTAR 2 tool, the reviews were considered low to moderate. The overall meta-analysis, although without statistical significance, favours mostly the use of conventional resin, as it is about five times more likely to obtain a favourable result than bulk-fill resin. Bulk-fill resins result in a simplification of the clinical process of posterior direct restorations, which is an advantage. The performance in terms of several properties of bulk-fill resins and conventional resins showed that they present similar behaviour.

Surface hardness and flexural strength of dual-cured bulk-fill restorative materials after solvent storage

BACKGROUND

This study aimed to evaluate the surface hardness (VHN) and biaxial flexural strength (BFS) of dual-cured bulk-fill restorative materials after solvent storage.

METHODS

Two dual-cured bulk-fill composites (Surefil One® and Activa™ Bioactive), a light-cured bulk-fill composite (Filtek One Bulk-Fill) and a resin-modified glass ionomer (Fuji II LC) were investigated. Surefil One and Activa were used in the dual-cure mode, all materials were handled according to manufacturer's instructions. For VHN determination, 12 specimens were prepared from each material and measured after 1 h (baseline), 1 d, 7 d and 30 d of storage in either water or 75% ethanol-water. For BFS test, 120 specimens were prepared (n = 30/material) and stored in water for either 1, 7 or 30 d before testing. Repeated measures MANOVA, two-way and one-way ANOVA followed by the Tukey post hoc test (p ≤ 0.05) were used to analyze the data.

RESULTS

Filtek One had the highest VHN, while Activa had the lowest. All materials exhibited a significant increase in VHN after 1d of storage in water, except for Surefil One. After 30 d of storage, VHN increased significantly in water except for Activa, while ethanol storage caused a significant time-dependent reduction in all tested materials (p ≤ 0.05). Filtek One showed the highest BFS values (p ≤ 0.05). All the materials, except for Fuji II LC, exhibited no significant differences between 1 and 30 d BFS measurements (p > 0.05).

CONCLUSIONS

Dual-cured materials had significantly lower VHN and BFS compared to the light-cured bulk-fill material. The low results of Activa VHN and Surefil One BFS, indicate that these materials should not be recommended in posterior stress-bearing areas.

The Influence of a Novel, Crenelated Design of CAD-CAM Ceramic Veneers on the Debonding Strength

(1) Background: Aesthetic dentistry has become one of the most dynamic fields in modern dental medicine. Ceramic veneers represent the most appropriate prosthetic restorations for smile enhancement, due to their minimal invasiveness and highly natural appearance. For long-term clinical success, accurate design of both tooth preparation and ceramic veneers is of paramount importance. The aims of this in vitro study were to assess the stress in anterior teeth restored with Computer-Aided Design (CAD) and Computer-Aided Manufacturing (CAM) ceramic veneers and compare the resistance to detachment and the fracture of ceramic veneers prepared using two different designs. (2) Methods: Sixteen lithium disilicate ceramic veneers were designed and milled using the CAD-CAM technology and divided into two groups according to the preparations (n = 8): Group 1, conventional (CO), with linear marginal contour and Group 2, crenelated (CR), the latter with our novel (patented) sinusoidal marginal design. All samples were bonded to anterior natural teeth. The mechanical resistance to detachment and fracture was investigated by applying bending forces on the incisal margin of the veneers in order to determine which type of preparation leads to better adhesion. An analytic method was employed, as well, and the results of the two approaches were compared. (3) Results: The mean values of the maximum force recorded at the veneer detachment were 78.82 ± 16.55 N for the CO group and 90.20 ± 29.81 N for the CR group. The relative increase, equal to 14.43%, demonstrated that the novel CR tooth preparation provided higher adhesive joints. In order to determine the stress distribution within the adhesive layer, a finite element analysis (FEA) was performed. The statistical t-test showed that the mean value of the maximum normal stresses is higher for the CR-type preparations. (4) Conclusions: The patented CR veneers represent a practical solution to augment the adhesion and mechanical properties of ceramic veneers. The obtained results demonstrated that CR adhesive joints triggered higher mechanical and adhesive forces, which subsequently led to a higher resistance to detachment and fracture.

Mechanical Properties of Poly(Alkenoate) Cement Modified with Propolis as an Antiseptic

Background: We assessed the effect of propolis on the antibacterial, mechanical, and adhesive properties of a commercial poly(alkenoate) cement. Methods: The cement was modified with various concentrations of propolis, and antibacterial assays were performed against S. mutans by both MTT assays and agar diffusion tests. The compressive, flexural, and adhesive properties were also evaluated. Results: the modified cement showed activity against S. mutans in both assays, although reductions in compressive (from 211.21 to 59.3 MPa) and flexural strength (from 11.1 to 6.2 MPa) were noted with the addition of propolis, while adhesive strength (shear bond strength and a novel pull-out method) showed a statistical difference (p < 0.05). Conclusion: the antiseptic potential of modified material against S. mutans will allow this material to be used in cases in which low mechanical resistance is required (in addition to its anti-inflammatory properties) when using atraumatic restorative techniques, especially in deep cavities.

3D Printing of CNT- and YSZ-Added Dental Resin-Based Composites by Digital Light Processing and Their Mechanical Properties

This study demonstrates the successful 3D printing of dental resin-based composites (DRCs) containing ceramic particles using the digital light processing (DLP) technique. The mechanical properties and oral rinsing stability of the printed composites were evaluated. DRCs have been extensively studied for restorative and prosthetic dentistry due to their clinical performance and aesthetic quality. They are often subjected to periodic environmental stress, and thus can easily undergo undesirable premature failure. Here, we investigated the effects of two different high-strength and biocompatible ceramic additives, carbon nanotube (CNT) and yttria-stabilized zirconia (YSZ), on the mechanical properties and oral rinsing stabilities of DRCs. Dental resin matrices containing different wt.% of CNT or YSZ were printed using the DLP technique after analyzing the rheological behavior of slurries. Mechanical properties such as Rockwell hardness and flexural strength, as well as the oral rinsing stability of the 3D-printed composites, were systematically investigated. The results indicated that a DRC with 0.5 wt.% YSZ exhibits the highest hardness of 19.8 ± 0.6 HRB and a flexural strength flexural strength of 50.6 ± 6 MPa, as well as reasonable oral rinsing steadiness. This study provides a fundamental perspective for designing advanced dental materials containing biocompatible ceramic particles.

Cytotoxic, Elastic-Plastic and Viscoelastic Behavior of Aged, Modern Resin-Based Dental Composites

The development of resin-based composites (RBCs) is a delicate balance of antagonistic properties with direct clinical implications. The clear trend toward reducing filler size in modern RBCs solves esthetic deficiencies but reduces mechanical properties due to lower filler content and increases susceptibility to degradation due to larger filler-matrix interface. We evaluated a range of nano- and nano-hybrid RBCs, along with materials attempting to address shrinkage stress issues by implementing an Ormocer matrix or pre-polymerized fillers, and materials aiming to provide caries-protective benefit by incorporating bioactive fillers. The cytotoxic response of human gingival fibroblast (HGF) cells after exposure to the RBC eluates, which were collected for up to six months, was analyzed using a WST-1 assay. The microstructural features were characterized using a scanning electron microscopy and were related to the macroscopic and microscopic mechanical behaviors. The elastic-plastic and viscoelastic material behaviors were evaluated at the macroscopic and microscopic levels. The data were supplemented with fractography, Weibull analysis, and aging behavioral analysis. The results indicate that all RBCs are non-cytotoxic at adequate exposure. The amount of inorganic filler affects the elastic modulus, while only to a limited extent the flexural strength, and is well below the theoretical estimates. The nanoparticles and the agglomeration of nanoparticles in the RBCs help generate good mechanical properties and excellent reliability, but they are more prone to deterioration with aging. The pre-polymerized fillers lower the initial mechanical properties but are less sensitive to aging. Only the Ormocer retains its damping ability after aging. The strength and modulus of elasticity on the one hand and the damping capacity on the other are mutually exclusive and indicate the direction in which the RBCs should be further developed.

Wear behavior of materials for additive manufacturing after simulated occlusion of deciduous dentition

OBJECTIVES

To evaluate wear characteristics of materials for additive manufacturing (AM) after a simulated occlusal test in primary teeth. Wear was simulated by means of impacting - sliding wear testing (ISWT) between specimens prepared from materials for AM against enamel derived from deciduous teeth.

METHODS

The prepared hemispherical upper specimens were subjected to impacting-sliding wear test (ISWT) machine against the flattened enamel of deciduous molars on lower specimens. The samples were subjected to 20,000 load cycles using a contact force of 30 N between the opposing surfaces under controlled conditions. In the upper specimens, five groups (n=9): four types of additively manufactured materials Dima, Zenith, Detax, Veltz and a deciduous enamel groups were tested in this study. The enamel-to-enamel group was used as the control. Wear characteristics comprised wear surface area, wear depth, wear volumetric loss, and surface roughness were measured with a confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). Data obtained were statistically analyzed by Kruskal-Wallis test and Dunn's test with Bonferroni correction (p < 0.05).

RESULTS

Dima showed significantly higher worn surface area (p = 0.009, 0.001, and < 0.001 for Zenith, Detax, and control enamel, respectively), volumetric loss (p = 0.027, 0.007, and < 0.001 for Zenith, Detax, and control enamel, respectively), and damaged opposing enamel (p = 0.002, 0.001, and 0.01 for Detax, Veltz, and control enamel, respectively). There was no significant difference among the volumetric loss in Zenith and Detax. However, SEM revealed that Zenith showed rough worn surfaces and chipping, Detax showed rather a smooth circular worn surface. The worn area of Veltz was smaller than Detax and Zenith at 5,000 cycles, but higher at 15,000 and 20,000 cycles, and SEM showed detachment.

CONCLUSION

Wear behavior was different among different materials for AM. In the upper specimens, DM and VZ showed large wear. In the lower specimens, DM caused largest enamel wear and damage. In contrast, ZT and DX showed lower wear and caused less damage to the antagonistic primary enamel. SEM image of ZT showed large losses due to chipping, whereas DX showed the rather smooth. DX was confirmed to have lowest wear and caused least damage to the opposing deciduous enamel, which might be applicable as restorative treatments in deciduous dentition.

SIGNIFICANCE

Additive manufactured dental materials could be considered as a treatment modality in deciduous teeth.

Fiber-reinforced composites in dentistry - An insight into adhesion aspects of the material and the restored tooth construct

OBJECTIVE

This review aimed to highlight the insight into adhesion aspects within the components of the glass FRC (i.e., fiber and matrix) and between resin luting material and the glass FRC construction.

METHODS

The fundamentals of semi-interpenetrating polymer network (semi-IPN) based FRCs and their advantages in forming a solid adhesive interface with indirect FRC restoration, dental adhesive, and luting cement are elaborated. The important resin matrix systems and glass fibers used in FRCs are discussed. This is principally based on a survey of the literature over Medline/PubMed, Web of Science, and Scopus databases and a review of the relevant studies and publications in scientific papers in international peer-reviewed journals for the specific topic of biomaterials science. The keywords used for the search approach were: adhesion, fiber-reinforced composite, glass fiber, and semi-interpenetrating polymer network.

RESULTS

The polymer matrix systems of semi-IPN-based FRCs and formation of secondary-IPN layer are pivotal for bonding of multiphasic indirect dental constructs and repair. Additionally, describing areas of indication for FRCs in dentistry, explaining the adhesion aspects of FRC for the cohesion of the material itself, and for obtaining durable adhesion when the FRC construct is luted to tooth and remaining dentition. Current progress in the field of FRC research and future directions are summarized and presented.

SIGNIFICANCE

By understanding the isotropic-anisotropic nature of fibers and the interfacial adhesion within the components of the FRC; between resin cement and the FRC construction, the clinically successful FRC-based multiphasic indirect tooth construct can be achieved. The interfacial adhesion within the components of the FRC and between resin luting material and the FRC construction play a key role in adhesion-based unibody dental restorations.

Effect of pre-heating methods and devices on the mechanical properties, post-gel shrinkage, and shrinkage stress of bulk-fill materials

This study evaluated the effect of using two different pre-heating methods on the three resin-based composite (RBCs). Three paste viscosity bulk-fill RBCs (VisCalor Bulk [VC]; VOCO; x-tra fil Caps [XF], VOCO; Filtek One Bulk Fill [FO], 3 M) were pre-heated using either a VisCalor Dispenser (VOCO) to 65 °C, or the Caps Warmer (VOCO) to 37 °C, 54 °C, or 68 °C. The temperature inside the capsules and cavity was monitored before and after insertion into the matrix. Within 30 s of inserting the RBC, they were light-activated using a VALO (Ultradent) curing light for 20 s. The post-gel shrinkage (Shr - %), Flexural Strength (FS - MPa), Elastic Modulus (E - MPa), degree of conversion (DC - %), Knoop Hardness (KH - N/mm²), diametral tensile strength (DTS - MPa), and compressive strength (CS - MPa) of the RBCs were measured (10 specimens per group). The shrinkage stress was calculated using three-dimensional finite element analysis. Data were analyzed using one-way, two-way ANOVA and Tukey's test (α = 0.05). The temperature fell rapidly after the RBC was inserted into the cavity. Pre-heating the RBCs did not affect the mechanical properties. FO had the lowest E, DC, and KH values, VC had intermediate values, and XF achieved the highest values. The DTS and CS values were not affected by the various pre-heating methods, the temperature, or RBC. Pre-heating methods at 37 °C produced higher shrinkage for all RBCs. VC pre-heated to 65 °C produced the lowest stress when measured at 10 min after light activation.

Materials informatics for developing new restorative dental materials: A narrative review

Materials informatics involves the application of computational methodologies to process and interpret scientific and engineering data concerning materials. Although this concept has been well established in the fields of biology, drug discovery, and classic materials research, its application in the field of dental materials is still in its infancy. This narrative review comprehensively summarizes the advantages, limitations, and future perspectives of materials informatics from 2003 to 2022 for exploring the optimum compositions in developing new materials using artificial intelligence. The findings indicate that materials informatics, which is a recognized and established concept in the materials science field, will accelerate the process of restorative materials development and contribute to produce new insights into dental materials research.

Flexural Properties of Contemporary Bioactive Restorative Materials: Effect of Environmental pH

This study investigated the effects of environmental pH on the flexural properties of ion-releasing restorative materials (IRMs), including giomer (Beautifil-Bulk Restorative - BB), alkasite (Cention N - CN), bioactive composite (Activa - AB) and resin-modified glass ionomer (Riva Light Cure -RV) restoratives. A bio-inert resin-based composite (Filtek Bulk-fill Posterior - FB) served as the control. Stainless steel molds were used to fabricate 40 beam-shaped specimens (12mm × 2mm × 2mm) for each material. The specimens were finished, measured, and randomly distributed into four groups (n=10) and immersed in aqueous solutions of pH 3.0, pH 5.0, pH 6.8, and pH 10.0 at 37°C for 28 days. Specimens were then subjected to a uniaxial three-point bending flexural test with a load cell of 5 KN and a fixed deformation rate of 0.5 mm/min until fracture occurred. Flexural modulus and strength were statistically analyzed using analysis of variance/Dunnet T3's test (p=0.05). Mean flexural modulus varied from (2.40±0.41 to 9.65±1.21 GPa), while mean flexural strength ranged from (21.56±2.78 to 163.86±13.13 MPa). Significant differences in flexural properties were observed among the various pH values and materials. All materials immersed in artificial saliva (pH 6.8) presented the highest flexural properties, except AB. The flexural strength of AB was significantly better when exposed to acidic environments. FB had better flexural properties than IRMs after exposure to a range of environmental pH values.

Bond strength of bulk fill composite to teeth prepared with Er

Aim: The present in vitro study aimed to evaluate the bond strength of a bulk fill composite on dentin surfaces prepared with the Er: YAG laser. Methods: Twenty-four permanent third molars were selected and divided into 2 groups: CP - Conventional preparation with high-speed handpiece (control) and LA (laser) - Preparation with Er: YAG laser. The occlusal surface was removed to expose coronal dentin, which was subsequently prepared with a high-speed handpiece or Er: YAG laser (350mJ, 4Hz, 1.5 ml/min water flow). Both groups were restored with Filtek One Bulk Fill (3M ESPE) composite resin. After 24 hours, the samples were evaluated for microtensile bond strength (μTBS), fracture pattern, and scanning electron microscopy (SEM). Results: The data obtained in the μTBS test were submitted to t-test (α=0.05). The results showed no difference in μTBS when the different types of cavity preparation were compared (ρ=0.091). Fracture patterns revealed the prevalence of cohesive fracture in composite resin in CP (83.3%) and adhesive fracture in LA (92.1%). In the SEM analysis, the LA group demonstrated the presence of gaps between the composite resin and the irradiated dentin surface. The hybrid layer exhibited more regularity with the presence of longer and uniform resin tags in the CP group. Conclusion: The type of cavity preparation did not influence the values of bulk fill composite resin μTBS to dentin. Fracture patterns and scanning electron microscopy analyses suggested less interference at the adhesive interface in preparations performed using CP.

Evaluation of the Effect of the Addition of Hydroxyapatite on Selected Mechanical and Tribological Properties of a Flow-Type Composite

(1) Background: The aim of the study was to determine the effect of modification with sintered hydroxyapatite (HAp) on selected mechanical and tribological properties of a flow-type composite. (2) Methods: Samples in the shapes of cuboidal beams (n = 120) and cylinders (n = 120) with the proper dimensions were prepared from a standard flow-type composite and others with the addition of 2% wt., 5% wt., and 8% wt. sintered hydroxyapatite. The bending strength, compression strength, diametral compression strength, impact resistance, hardness, and tribological properties were compared. (3) Results: In all cases, it was established that an increase in the amount of HAp caused a reduction in the bending, compression, and diametral compression strength. Increasing the amount of added HAp also reduced the impact strength, hardness, and wear resistance. However, the differences were statistically insignificant. (4) Conclusions: The addition of hydroxyapatite to a flow-type composite material worsened its mechanical and tribological properties; however, the obtained values were acceptable with 2% wt. and 5% wt. HAp.

Assessment of Physical/Mechanical Performance of Dental Resin Sealants Containing Sr-Bioactive Glass Nanoparticles and Calcium Phosphate

The aim of this study was to assess the chemical/mechanical properties of ion-releasing dental sealants containing strontium-bioactive glass nanoparticles (Sr-BGNPs) and monocalcium phosphate monohydrate (MCPM). Two experimental sealants, TS1 (10 wt% Sr-BGNPs and 2 wt% MCPM) and TS2 (5 wt% Sr-BGNPs and 4 wt% MCPM), were prepared. Commercial controls were ClinproXT (CP) and BeautiSealant (BT). The monomer conversion (DC) was tested using ATR−FTIR (n = 5). The biaxial flexural strength (BFS) and modulus (BFM) were determined (n = 5) following 24 h and 7 days of immersion in water. The Vickers surface microhardness (SH) after 1 day in acetic acid (conc) versus water was tested (n = 5). The bulk and surface calcium phosphate precipitation in simulated body fluid was examined under SEM-EDX. The ion release at 4 weeks was analyzed using ICP-MS (n = 5). The DC after 40 s of light exposure of TS1 (43%) and TS2 (46%) was significantly lower than that of CP (58%) and BT (61%) (p < 0.05). The average BFS of TS1 (103 MPa), TS2 (123 MPa), and BT (94 MPa) were lower than that of CP (173 MPa). The average BFM and SH of TS1 (2.2 GPa, 19 VHN) and TS2 (2.0 GPa, 16 VHN) were higher than that of CP (1.6 GPa, 11 VHN) and BT (1.3 GPa, 12 VHN). TS1 showed higher Ca, P, and Sr release than TS2. Bulk calcium phosphate precipitation was detected on TS1 and TS2 suggesting some ion exchange. In conclusion, the DC of experimental sealants was lower than that of commercial materials, but their mechanical properties were within the acceptable ranges. The released ions may support remineralizing actions.

Polymerization and shrinkage kinetics and fracture toughness of bulk-fill resin-composites

OBJECTIVES

To determine degree of conversion (DC), maximum polymerization rate (RPmax), polymerization shrinkage (PS), maximum shrinkage rate (PS Rmax) and fracture toughness (KIC) of different types of bulk-fill (BF) composites plus the effect of viscosity reduction techniques.

METHODS

BF specimens were created in 2 mm deep molds: SonicFill 3 (SF3), Viscalor (VC), One Bulk Fill (OBF) and Beautifil Bulk (BBR). SF3 was applied via sonic insertion using a SonicFill handpiece (Kerr Corp. USA). Viscalor was pre-heated in a Caps Warmer in T3 mode (at 68 °C) for 30 s (T3-30 s) and 3 min (T3-3 min), respectively. Specimens were irradiated at zero distance from the upper surface with an Elipar S10 LED unit (3 M ESPE, USA) of mean irradiance 1200 mW/cm2 for 40 s. Real-time polymerization kinetics and DC at 5 min and 24 h post-irradiation (DC5 min and DC24 h) were measured using ATR-FTIR (n = 3). PS was measured up to 1 h on 1 mm thick discs via the bonded-disk technique (n = 3) and PS Rmax obtained by numerical differentiation (n = 3). For fracture toughness, single-edge-notched specimens (32 × 6 ×3 mm) of each BF composite were prepared and measured by three-point bending after 7 d water storage (n = 5). Data were analysed using One-way ANOVA, independent T-tests and Tukey post-hoc tests (p < 0.05).

RESULTS

SF3 showed the significantly highest DC5 min, DC24 h and RPmax (p < 0.05), followed by OBF (p < 0.05). Regardless of pre-heating, VC showed comparable conversion kinetics to BBR (p > 0.05). There was no significant difference in PS of these BF composites, except OBF had the highest PS (p > 0.05). However, PS Rmax significantly varied among materials (p = 0.047) and SF3 had the highest PS Rmax. Regarding fracture toughness, BBR had the lowest KIC (p < 0.05), whereas other composites showed similar KIC (p > 0.05). Strong correlations of filler content (wt%)-PS/KIC were found. Different pre-heating times had no significant influences on DC %, RPmax, PS, PS Rmax and KIC of VC (p > 0.05).

SIGNIFICANCE

Different types of bulk-fill composites showed comparable shrinkage. A highly filled BF giomer composite (BBR) had the lowest fracture toughness, whereas others had similar KIC. Pre-heating had no adverse effects on Viscalor properties. Sonication and pre-heating are beneficial techniques to enhance composite flowability without either increasing shrinkage or reducing fracture toughness.

Monomers Release from Direct and Indirect Resin-Based Restorations after Immersion in Common Beverages

Impurities or degradation of the components of resin-based materials have been throughout investigated by the dental scientific community. The aim of this study is to examine if there is a release of monomers from resin-based materials when they are immersed in common beverage materials which are consumed by the population in large quantities. Three representative dental materials were used for this study, one resin composite indicated for direct restorations and two Computer Aided Design and Computer Aided Manufacturing (CAD/CAM) materials with different methods of fabrication. Forty specimens were fabricated from each material using a low-speed precision sectioning blade 12 × 14 × 2 mm in size and immersed in wine, coffee or cola for 48 h and 12 days, equivalent to 1 month and 1 year of consumption. The materials released more monomers when the materials were immersed in the wine solution (p < 0.05). CAD/CAM materials release less monomers compared to the resin composite material indicated for direct restorations (p < 0.05). The CAD/CAM materials leach a limited quantity of monomers when they are immersed in common beverages due to the manufacturing process which includes high-temperature/high-pressure polymerization.