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

Does the Type of Resin Luting Material Affect the Bonding of CAD/CAM Materials to Dentin?

Background/Objectives: This study aimed to investigate the microtensile bond strength (µTBS) of composite-based (Cerasmart), polymer-infiltrated (Vita Enamic), and feldspathic (Cerec) CAD/CAM blocks luted to dentin using a dual-cure resin cement (LinkForce), as well as micro-hybrid (G-aenial) and flowable composites (G-aenial Universal Flo), and evaluate the microhardness (HV) of luting materials through the CAD/CAM blocks. Methods: Cerasmart, Enamic, and Cerec were luted to dentin using three luting materials; LinkForce, G-aenial, and Universal Flo (n = 5). For HV, 117 disk-shaped specimens from LinkForce, G-aenial, and Universal Flo (n = 13) were polymerized through 3 mm thick CAD/CAM. Thirty-nine light-cured specimens without CAD/CAM were used as control. Following 24 h storage, the µTBS and HV were evaluated. Data were analyzed using the two-way ANOVA and post hoc Tukey tests (p < 0.05). Results: The µTBS to dentin and HV were significantly influenced by the type of luting material and CAD/CAM material. With all the CAD/CAM materials, LinkForce and Universal Flo exhibited a significantly similar µTBS to that of dentin (p > 0.05). Compared with the control group, all the HV values of the luting materials decreased significantly (p < 0.05). Conclusions: Heavily filled flowable composites exhibit a bonding effectiveness similar to that of dual-cure resin cements. All the luting materials showed similar HV when polymerized through the polymer-infiltrated CAD/CAM material.

Effect of thiourethane on the polymerization and mechanical properties of composite resin: A systematic review

STATEMENT OF PROBLEM

Thiourethane has high chemical affinity with polymeric materials and its addition has been suggested for improving adhesives and composite resin. However, a systematic review of thiourethane addition is lacking.

PURPOSE

The purpose of this systematic review was to analyze the articles in the dental literature that studied the effect of thiourethane added to the resin matrix of dental materials related to polymerization shrinkage and mechanical properties.

MATERIAL AND METHODS

The systematic review was prepared in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and was registered in the Open Science Framework (osf.io/sb9my). The population, intervention, comparison, outcome, and study design (PICOS) were the following: composite resin, thiourethane addition, composite resin without addition, evaluation of polymerization and mechanical properties, and in vitro experimental studies. Initially, 204 articles were found, 150 of which were excluded because of duplication. After reading the titles and abstracts based on the application of eligibility criteria, 21 articles were selected for reading in full, and all were included in the systematic review. Three reviewers evaluated the articles independently in 2 phases based on the eligibility criteria (selection of the title and reading of the article in full), with the reviewers' doubts and discrepancies being analyzed and resolved in a meeting with the authors.

RESULTS

Most of the articles reported a significant improvement in the polymerization shrinkage and mechanical properties of experimental polymeric materials with the addition of oligomers.

CONCLUSIONS

Thiourethane added to resin dental materials improved their polymerization shrinkage values and mechanical properties.

The impact of inorganic fillers, organic content, and polymerization mode on the degree of conversion of monomers in resin-matrix cements for restorative dentistry: a scoping review

PURPOSE

The main aim of the present study was to carry out a scoping review on the differences in degree of conversion of monomers regarding several types resin cements, indirect restorative materials, and light-curing procedures used in dentistry.

METHOD

A bibliographic review was performed on PubMed using the following search items: "degree of conversion" OR "filler" AND "resin cement" OR "inorganic cement" AND "organic" OR "radiopacity" OR "refractive" OR "transmittance" OR "type" AND "resin composite." The search involved articles published in English language within the last thirteen years. A research question has been formulated following the PICO approach as follow: "How different is the degree of conversion of monomers comparing several types of resin-matrix cements?".

RESULTS

Within the 15 selected studies, 8 studies reported a high degree of conversion (DC) of the organic matrix ranging from 70 up to 90% while 7 studies showed lower DC values. Dual-cured resin-matrix cements revealed the highest mean values of DC, flexural strength, and hardness when compared with light- and self-polymerized ones. DC mean values of resin-matrix cements light-cured through a ceramic veneer with 0.4 mm thickness were higher (~ 83%) than those recorded for resin-matrix cements light-cured through a thicker ceramic layer of 1.5 mm (~ 77%).

CONCLUSIONS

The highest percentage of degree of conversion of monomers was reported for dual-cured resin-matrix cements and therefore both chemical and light-induced pathways promoted an enhanced polymerization of the material. Similar degree of conversion of the same resin-matrix cement were recorded when the prosthetic structure showed a low thickness. On thick prosthetic structures, translucent materials are required to allow the light transmission achieving the resin-matrix cement.

CLINICAL RELEVANCE

The chemical composition of resin-matrix cements and the light-curing mode can affect the polymerization of the organic matrix. Thus, physical properties of the materials can vary leading to early clinical failures at restorative interfaces. Thus, the analysis of the polymerization pathways of resin-matrix cements is significantly beneficial for the clinical performance of the restorative interfaces.

Relaxation mechanisms in low-stress polymer networks with alternative chemistries

Background

Low-stress resin-based composites (RBCs) are available to the clinician, some using stress relaxation mechanisms on the basis of network reconfiguration, modulated photopolymerization, or chain transfer reactions. This study investigated those materials in terms of their overall stress relaxation and their relationship with polymerization kinetics and compared them with an experimental low-stress thiourethane (TU) material.

Methods

Experimental composites (bisphenol-A-diglycidyl dimethacrylate, urethane dimethacrylate, and triethylene glycol dimethacrylate [50:30:20 mass ratio]; 70% barium aluminosilicate filler; camphoroquinone, ethyl-4-dimethylaminobenzoate, and 2,6-di-tert-butyl-4-methylphenol [0.2:0.8:0.2% by mass]) with or without TU oligomer (synthesized in-house) and commercial composites (SureFil SDR Flow+ Posterior Bulk Fill Flowable Base [SDR Flow+] [Dentsply Sirona], Filtek Bulk Fill Posterior Restorative [3M ESPE], and Filtek Supreme Ultra Universal Restorative [3M ESPE]) were tested. Polymerization kinetics (near-infrared) and polymerization stress (Bioman) were evaluated during light-emitting diode photoactivation at 100 mW/cm2 for 20 seconds. Stress relaxation was assessed using dynamic mechanical analysis. Data were analyzed with a 1-way analysis of variance and Tukey test (α = 0.05).

Results

The kinetic profiles of all materials differed substantially, including more than a 2-fold difference in the rate of polymerization between TU-modified composites and SDR Flow+. TU-modified RBCs also showed more than a 2-fold higher conversion at the onset of deceleration vs the experimental control and commercial materials. RBCs that used stress reduction mechanisms showed at least a 34% reduction in polymerization stress compared with the controls and significantly reduced the amount of early-onset stress buildup. SDR Flow+ and the TU-modified RBCs showed the greatest amount of viscoelastic stress relaxation postpolymerization.

Conclusions

The novel TU-modified materials showed similar or improved performance compared with commercial low-stress RBCs, showing that chain transfer may be a promising strategy for stress reduction, both during polymerization and after polymerization.

Optical effects of graphene addition on adhesives for orthodontic lingual retainers

The objective of this study was to determine the effects on the colour of adding increasing concentrations of graphene to orthodontic fixed retainer adhesives and to evaluate changes in optical transmission during light curing and the resultant degree of conversion. Two different types of adhesives commonly used for fixed retainers were investigated: A packable composite (Transbond) and a flowable composite (Transbond Supreme). Graphene was added to the adhesives in three different concentrations (0.01, 0.05, and 0.1 wt%). Adhesives without graphene addition were set as control groups. A Minolta colourimeter was used to measure the colour and translucency parameters. Irradiance transmitted during curing was quantified using MARC Light Collector. Fourier-transform infrared spectroscopy was used to record degree of conversion. Data were statistically analysed with the Student's t-test and one-way ANOVA with Tukey's tests (α = 0.05). The findings showed that incorporating graphene darkened the adhesive colour significantly and reduced translucency. As the graphene concentration reached 0.1 wt%, samples became opaque; yet, no adverse effect on degree of conversion was observed. The addition of graphene reduces optical transmission of lingual retainer adhesives; the effect increases with graphene concentration.

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.

Effects of surrounding and underlying shades on the color adjustment potential of a single-shade composite used in a thin layer

Objectives

This study aimed to evaluate the surrounding and underlying shades' effect on the color adjustment potential (CAP) of a single-shade composite used in a thin layer.

Materials and Methods

Cylinder specimens (1.0 mm thick) were built with the Vittra APS Unique composite, surrounded (dual specimens) or not (simple specimens) by a control composite (shade A1, A2, or A3). Simple specimens were also built only with the control composites. Each specimen's color was measured against white and black backgrounds or the simple control specimens with a spectrophotometer (CIELAB system). The whiteness index for dentistry (WI_D) and translucency parameters (TP₀₀) were calculated for simple specimens. Differences (ΔE₀₀) in color between the simple/dual specimens and the controls were calculated. The CAP was calculated based on the ratios between data from simple and dual specimens.

Results

The Vittra APS Unique composite showed higher WI_D and TP₀₀ values than the controls. The highest values of ΔE₀₀ were observed among simple specimens. The color measurements of Vittra APS Unique (simple or dual) against the control specimens presented the lowest color differences. Only surrounding the single-shade composite with a shaded composite barely impacted the ΔE₀₀. The highest CAP values were obtained using a shaded composite under simple or dual specimens.

Conclusions

The CAP of Vittra APS Unique was strongly affected by the underlying shade, while surrounding this composite with a shaded one barely affected its color adjustment.

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.

The influence of inorganic fillers on the light transmission through resin-matrix composites during the light-curing procedure: an integrative review

PURPOSE

The objective of this study was to perform an integrative review on the effect the inorganic fillers on the light transmission through the resin-matrix composites during the light-curing procedure.

METHOD

A bibliographic review was performed on PubMed using the following search terms: "fillers" OR "particle" AND "light curing" OR "polymerization" AND "light transmission" OR "light absorption" OR "light irradiance" OR "light attenuation" OR "light diffusion" AND "resin composite." The search involved articles published in English language in the last 10 years.

RESULTS

Selected studies reported a decrease in biaxial strength and hardness in traditional resin-matrix composites in function of the depth of polymerization. However, there were no significant differences in biaxial strength and hardness recorded along the polymerization depth of Bulk-Fill™ composites. Strength and hardness were enhanced by increasing the size and content of inorganic fillers although some studies revealed a progressive decrease in the degree of conversion on increasing silica particle size. The translucency of glass-ceramic spherical fillers promoted light diffusion mainly in critical situations such as in the case of deep proximal regions of resin-matrix composites.

CONCLUSIONS

The amount of light transmitted through the resin-matrix composites is influenced by the size, content, microstructure, and shape of the inorganic filler particles. The decrease of the degree of conversion affects negatively the physical and mechanical properties of the resin-matrix composites.

CLINICAL RELEVANCE

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

Engineering a new generation of thermoset self-healing polymers based on intrinsic approaches

Objectives

The development of thermosetting polymers with autonomic reparability has become an important research topic since it has the potential to benefit several fields such as biomaterials, tissue engineering, paint and coating technologies, electronics, and soft robotics. In dentistry, the development of restorative materials capable of inhibiting the propagation of microcracks caused by masticatory forces and thermal stress may represent a crucial expansion of the limited clinical lifespan of dental restorations, which is a pressing challenge. Biological systems have inspired the underlying concepts and designs of synthetic polymeric self-healing systems, and different strategies have been used to impart autonomous repair capability in polymers. In this review, the most relevant intrinsic strategies are categorized based on the reaction mechanisms. In general, these strategies rely on the incorporation of latent functionalities capable of undergoing reversible chemical bonds within the polymeric structure (chemically or compositionally tuned).

Search Strategy

The searches were conducted in the databases Scopus, PubMed, and Google Scholar and limited to articles that were written in English and published during the last ten years. A few additional articles were included by complementing the database searches with manual review of the reference lists.

Overall Conclusions

Although intrinsic approaches remain underexplored in dentistry, a wide variety of elegant chemistries with tremendous translational potential employed in other fields to promote autonomic repair are highlighted in this review.

Toughening and polymerization stress control in composites using thiourethane-treated fillers

Filler particle functionalization with thiourethane oligomers has been shown to increase fracture toughness and decrease polymerization stress in dental composites, though the mechanism is poorly understood. The aim of this study was to systematically characterize the effect of the type of filler surface functionalization on the physicochemical properties of experimental resin composites containing fillers of different size and volume fraction. Barium glass fillers (1, 3 and 10 µm) were functionalized with 2 wt% thiourethane-silane (TU-Sil) synthesized de novo and characterized by thermogravimetric analysis. Fillers treated with 3-(Trimethoxysilyl)propyl methacrylate (MA-Sil) and with no surface treatment (No-Sil) served as controls. Fillers (50, 60 and 70 wt%) were incorporated into BisGMA-UDMA-TEGDMA (5:3:2) containing camphorquinone/ethyl-4-dimethylaminobenzoate (0.2/0.8 wt%) and 0.2 wt% di-tert-butyl hydroxytoluene. The functionalized particles were characterized by thermogravimetric analysis and a representative group was tagged with methacrylated rhodamine B and analyzed by confocal laser scanning microscopy. Polymerization kinetics were assessed by near-IR spectroscopy. Polymerization stress was tested in a cantilever system, and fracture toughness was assessed with single edge-notched beams. Fracture surfaces were characterized by SEM. Data were analyzed with ANOVA/Tukey's test (α = 0.05). The grafting of thiourethane oligomer onto the surface of the filler particles led to reductions in polymerization stress ranging between 41 and 54%, without affecting the viscosity of the composite. Fracture toughness increased on average by 35% for composites with the experimental fillers compared with the traditional methacrylate-silanized groups. SEM and confocal analyses demonstrate that the coverage of the filler surface was not homogeneous and varied with the size of the filler. The average silane layer for the 1 µm particle functionalized with the thiourethane was 206 nm, much thicker than reported for traditional silanes. In summary, this study systematically characterized the silane layer and established structure–property relationships for methacrylate and thiourethane silane-containing materials. The results demonstrate that significant stress reductions and fracture toughness increases are obtained by judiciously tailoring the organic–inorganic interface in dental composites.

Thiourethane filler functionalization for dental resin composites: Concentration-dependent effects on toughening, stress reduction and depth of cure

OBJECTIVES

The aim of this study was to modify the surface of fillers used in dental composites by the synthesis of two novel thiourethane oligomeric silanes, used to functionalize the silica-containing inorganic particles. Several thiourethane silane concentrations were tested during the silanization process to systematically assess the effect of silane coverage on experimental composite conversion, polymerization stress and fracture toughness.

MATERIALS AND METHODS

Two different thiourethane silanes were synthesized based either on 1,6-hexanediol-diissocynate (HDDI), or 1,3-bis(1-isocyanato-1-methylethyl) benzene (BDI). Conventional 3-(Trimethoxysilyl)propyl methacrylate was used as the control. Glass fillers were silanized with 1, 2 or 4 wt% of each thiourethane silane, then evaluated by thermogravimetrical analysis. Photopolymerizable resin composites were prepared with Bis-GMA/UDMA/TEGDMA and 50 wt% silanized glass filler. Polymerization kinetics and degree of conversion were tested using Near-IR. Bioman was used to test polymerization stress. Data were analyzed with two-way ANOVA/Tukey's test (α = 5%).

RESULTS

The mass of silane coupled to the filler increased with the concentrations of thiourethane in the silanizing solution, as expected. Thiourethane-containing groups exhibited significantly higher degree of conversion compared to control groups, except for BDI 4%. HDDI 4%, BDI 2% and BDI 4% showed significantly lower polymerization stress than control groups. HDDI 4% exhibited significantly higher fracture toughness.

CONCLUSIONS AND CLINICAL SIGNIFICANCE

Novel filler functionalization with thiourethane silanes may be a promising alternative for improving dental composites properties by significantly increasing the degree of conversion, fracture toughness and reducing the polymerization stress.

Effects of systematically varied thiourethane-functionalized filler concentration on polymerization behavior and relevant clinical properties of dental composites

Introduction of thiourethane (TU) oligomer to resin-based dental restorative materials reduces stress and improves fracture toughness without compromising conversion. Localization of TU at the resin-filler interface via silanization procedures may lead to more substantial stress reduction and clinical property enhancements. The objective of this study was to evaluate composite properties as a function of TU-functionalized filler concentration. TU oligomers were synthesized using click-chemistry techniques and subsequently silanized to barium glass filler. Resin-based composites were formulated using varying ratios of TU-functionalized filler and conventional methacrylate-silanized barium filler. Material property testing included thermogravimetric analysis, real-time polymerization kinetics and depth of cure, polymerization stress, stress relaxation and fracture toughness. Clinical property testing included water sorption/solubility, composite paste viscosity, and gloss and surface roughness measured before and after subjecting the samples to 6 h of continuous tooth brushing in a custom-built apparatus using a toothpaste/water mixture. Increasing TU-filler in the composite resulted in as much as a 78% reduction in stress, coupled with an increase in fracture toughness. Conversion was similar for all groups. After simulated tooth brushing, gloss reduction was lower for TU-containing composites and surface roughness was less than or equal to the control.

Development of dual-cured resin cements with long working time, high conversion in absence of light and reduced polymerization stress

OBJECTIVE

This study evaluated the properties of experimental dual-cured cements containing thiourethane (TU) and low concentrations of p-Tolyldiethanolamnie (DHEPT) and benzoyl peroxide (BPO) as chemical initiators.

METHODS

BisGMA/TEGDMA-based dual-cured cement was formulated with 1.0 wt% DHEPT and 0.75 wt% BPO as initiators and used as control. The concentration of BPO was adjusted to 0.1 wt% in catalyst paste of experimental cements, and two base pastes containing TU and 0.5 wt% or 0.25 wt% of DHEPT were formulated. The rheological behavior and kinetics of polymerization of cements were assessed in the absence of light activation. The kinetics of polymerization was also evaluated for cements light-activated immediately or 5 min after the start of mixing. Polymerization stress, flexural strength and elastic modulus (n = 5) were also evaluated under these conditions.

RESULTS

Cements with TU presented lower viscosity than the control, improved working time (0.25% DHEPT > 0.5% DHEPT) and higher conversion in the absence of light-activation. Delaying the light-activation reduced the maximum rate of polymerization (Rpmax) but did not affect the conversion or stress. The addition of TU increased the Rpmax and conversion, and reduced the stress when compared to the control, without affecting the flexural strength. Except for the control with delayed light-activation (highest values), the other experimental conditions yielded similar modulus.

SIGNIFICANCE

Adding TU and using a low concentration of DHEPT/BPO resulted in dual-cured cements with longer working time, reduced polymerization stress and increased conversion even in the absence of light, with no significant effect on the mechanical properties.

Impact of thiourethane filler surface functionalization on composite properties

Thiourethane oligomers added to methacrylate matrices improve fracture toughness and reduce polymerization stress. In this study, the oligomers are added to the surface of inorganic fillers in the formulation of resin composites. Systematically varied fillers treated either with the thiourethane or a methacrylate silane control are tested. Thiourethane reduces the rate of polymerization of light-cured composites but does not affect the final degree of conversion (DC). Filler functionalization with thiourethane increases the depth of polymerization, in filler type-dependent fashion. Thiourethane reduces the polymerization stress for all fillers. The findings suggest that this approach results in the same general effects with the addition of thiourethanes directly to the matrix. This is accomplished with a lower overall concentration of thiourethane, and with no prejudice to the handling characteristics of the material.

Toughening of Dental Composites with Thiourethane-Modified Filler Interfaces

Stress of polymerization is one of the most significant drawbacks of dental resin composites, since it is related to poor marginal adaptation, postoperative pain, and secondary caries. Previous studies have shown that thiourethane oligomers incorporated into the organic matrix represents a promising strategy to reduce stress and increase fracture toughness in dental composites. However, this strategy promotes a significant increase of the viscosity system, which may represent a challenge for clinical application. The objective of this study was to functionalize the surface of inorganic filler particles with thiouretanes and evaluate the impact on mechanical properties and kinetics of polymerization. Our results showed that composites filled with thiourethane-silanized inorganic fillers showed up to 35% lower stress while doubling mechanical properties values. This was achieved with no prejudice to the viscosity of the material and following a clinically acceptable photoactivation protocol.

The Combination of CQ-amine and TPO Increases the Polymerization Shrinkage Stress and Does Not Improve the Depth of Cure of Bulk-fill Composites

OBJECTIVES

To evaluate the effect of combining camphorquinone (CQ) and diphenyl(2,4,6-trimethylbenzoyl)phosphine oxide (TPO) on the depth of cure and polymerization shrinkage stress of bulk-fill composites.

METHODS AND MATERIALS

Experimental bulk-fill composites were produced containing equal molar concentrations of either CQ-amine or CQ-amine/TPO. The degree of in-depth conversion through each millimeter of a 4-mm-thick bulk-fill increment was evaluated by Fourier transform near-infrared microspectroscopy using a central longitudinal cross section of the increment of each bulk-fill composite (n=3). Light-transmittance of the multi-wave light-emitting diode (LED) emittance used for photoactivation (Bluephase G2, Ivoclar Vivadent) was recorded through every millimeter of each bulk-fill composite using spectrophotometry. The volumetric shrinkage and polymerization shrinkage stress were assessed using a mercury dilatometer and the Bioman, respectively. The flexural modulus was also assessed by a three-point bend test as a complementary test. Data were analyzed according to the different experimental designs (α=0.05 and β=0.2).

RESULTS

Up to 1 mm in depth, adding TPO to CQ-based bulk-fill composites increased the degree of conversion, but beyond 1 mm no differences were found. The light-transmittance of either wavelengths emitted from the multi-wave LED (blue or violet) through the bulk-fill composites were only different up to 1 mm in depth, regardless of the photoinitiator system. Adding TPO to CQ-based bulk-fill composites did not affect volumetric shrinkage but did increase the flexural modulus and polymerization shrinkage stress.

CONCLUSION

Adding TPO to CQ-based bulk-fill composites did not increase the depth of cure. However, it did increase the degree of conversion on the top of the restoration, increasing the polymerization shrinkage stress.

Color Changes Caused by Reduction on the Dentin Shade Composite Thickness

This study determined the reduction threshold in thickness of the dentin shade composite necessary to result in perceptible and acceptable color changes on simulated restorations. Three composite systems (Charisma Diamond, IPS Empress Direct, and Filtek Z350 XT) were evaluated using cylinder-shaped specimens built-up with dentin and enamel shades. The opacity of the composites was assessed using 1.0 mm thick specimens over black and white backgrounds. A baseline color was established for each system by combining 1.0 mm thick enamel shade with 3.0 mm of dentin shade cylinders over a dark background (n = 9). Then, the color changes (∆E00) caused by sequential 0.1 mm reductions on dentin shade cylinders were calculated. Opacity changes on dentin shade cylinders and combined enamel-dentin pair cylinders were also assessed after each thickness reduction. Polynomial regression was performed with averages of ∆E00 as a function of thickness of dentin shade cylinders; and acceptability (∆E = 1.77) and perceptibility (∆E = 0.81) thresholds were calculated. Linear regressions were also performed for ∆E00 as function of opacity of dentin shade cylinders and combined enamel-dentin pair of cylinders. Except for Charisma, enamel shades presented the lowest opacity than dentin one. Perceptible and acceptable color changes were observed for dentin shade cylinders thinner than 2.0-2.4 mm and 1.1-1.4 mm, respectively, were used. No difference among the composite systems was observed. In conclusion, reductions on dentin shade composite lower than 0.6-mm did not yield perceptible color changes, and clinically significant color changes only were observed within reductions higher than 1.6-mm.

Optical properties and colorimetric evaluation of resin cements formulated with thio-urethane oligomers

OBJECTIVE

The aim of this study was to evaluate the color parameters and optical properties of resin cements (RCs) formulated with thio-urethanes (TUs).

MATERIALS AND METHODS

Six TUs were synthesized by combining thiols (pentaerythritol tetra-3-mercaptopropionate [PETMP] or trimethylol-tris-3-mercaptopropionate [TMP]) with di-functional isocyanates (1,6-Hexanediol-diissocyante [HDDI] [aliphatic-AL] or 1,3-bis(1-isocyanato-1-methylethyl) benzene [BDI] [aromatic-AR] or Dicyclohexylmethane 4,4'-Diisocyanate [HMDI] [cyclic-CC]). TUs (20 wt%) were added to a BisGMA/UDMA/TEGDMA matrix. Filler was introduced at 60 wt%. Fluorescence was evaluated through an UV-light emitting equipment. Coordinates L*, a*, and b* were obtained in the black and white reflectance to evaluate the contrast ratio (CR) and translucency parameter (TP₀₀ ). The coordinates obtained from transmittance were used to evaluate lightness (L*), chroma (C*), color difference (ΔE₀₀ ) after 6 month, and whiteness index for Dentistry (WI_D ).

RESULTS

RCs formulated with TUs presented significantly higher CR, and fluorescence (with T_AR). Significantly lower C*, L*, and TP₀₀ (except for P_AR and T_AL) were also observed in RCs containing TUs. ΔE₀₀ were not significant among the materials. WI_D was not influenced.

CONCLUSION

RCs composed by TU oligomers present higher CR and lower translucency. The material also present higher fluorescence depending on the oligomer used.

CLINICAL SIGNIFICANCE

The use of thio-urethanes to formulate resin cements can ensure a luting material with improved potential to mask colored substrates due to the higher contrast ratio and lower translucency obtained. A final higher fluorescence of restoration is also expected with the use of specific oligomer.

Effect of thiourethane filler surface functionalization on stress, conversion and mechanical properties of restorative dental composites

OBJECTIVES

This study evaluated the efficacy of a thiourethane(TU)-modified silane agent in improving properties in filled composites.

METHODS

The TU-silane agent was synthesized by combining 1,3-bis(1-isocyanato-1-methylethyl)benzene and 3-(triethoxysilyl)propyl isocyanate with trimethylol-tris-3-mercaptopropionate (TMP), at 1:2 isocyanate:thiol, leaving pendant thiol and alkoxy silane groups. Barium glass fillers (1μm average particle size) were functionalized with 5wt% TU-silane in an acidic ethanol solution. Commercially available 3-(trimethoxysilyl)propyl methacrylate (MA-silane) and (3-mercaptopropyl)trimethoxysilane (SH-silane), as well as no silane treatment (NO-silane), were used as controls. Composites were made with BisGMA-UDMA-TEGDMA (5:3:2), camphorquinone/ethyl-4-dimethylaminobenzoate (0.2/0.8wt%) and di-tert-butyl hydroxytoluene (0.3wt%) and 70wt% silanated inorganic fillers. Polymerization stress (PS) was measured using a cantilever beam apparatus (Bioman). Methacrylate conversion (DC) and rate of polymerization (RP) during photoactivation (800mW/cm²) were followed in real-time with near-IR. Flexural strength/modulus (FS/FM) were evaluated in three-point bending with 2×2×25 mm.

STATISTICAL ANALYSIS

2-way ANOVA/Tukey's test (α=5%).

RESULTS

DC, Rp_max and E were similar for all groups tested. FS was similar for the TU- and MA-silane, which were statistically higher than the untreated and SH-silane groups. Stress reductions in relation to the MA-silane were observed for all groups, but statistically more markedly for the TU-silane material. This is likely due to stress relaxation and/or toughening provided at the filler interface by the oligomeric TU structure.

SIGNIFICANCE

TU-silane oligomers favorably modified conventional dimethacrylate networks with minimal disruption to existing curing chemistry, in filled composites. For the same conversion values, stress reductions of up to 50% were observed, without compromise to mechanical properties or handling characteristics.