Evaluation of the filler packing structures in dental resin composites: From theory to practice

Synthesis of mPEG-functionalized betulin-based maleic derivatives and unraveling the effect of PEGylation on dental restorative resins

As a derivative of bisphenol A (BPA), bisphenol A glycidyl dimethacrylate (Bis-GMA) is questioned regarding its endocrine-disrupting properties. We previously reported a plant-derived monomer, betulin-based maleic diester derivative (MABet), as a substitute for Bis-GMA, but its yellow powdery appearance greatly affected the viscosity and aesthetics of dental resins. Herein, we synthesized three novel types of mPEG-functionalized MABet (PnMABet) by leveraging the active carboxylic acid groups of MABet to undergo a DCC coupling reaction with mPEG variants with diverse repeating ethylene glycol units (n = 7, 12, and 16). Their chemical structures were validated using 1H and 13C NMR spectroscopy, FT-IR spectroscopy, and HR-MS. Afterwards, the PnMABet were incorporated into Bis-GMA-based resins at 10, 30, and 50 wt%. The mechanical performance was firstly evaluated to determine the optimal monomer content. The results showed that all PnMABet monomers were light-yellow liquids. Increasing their concentration from 10, 30, to 50 wt% and the number of repeating units of mPEG from 7, 12, to 16 significantly reduced the mechanical property of resins. Of all groups, 10 wt% addition of P7MABet endowed the resulting 1P7M4B5T resin with the highest flexural and compressive strength (123.2 ± 10.3 MPa; 296.6 ± 27.5 MPa) than the 5B5T control (70.0 ± 6.4 MPa; 230.5 ± 22.5 MPa). This resin also exhibited comparable viscosity, polymerization conversion, cytotoxicity to 5B5T without antibacterial activity. The developed PnMABet have the potential to modulate resin viscosity. Exploring the structure-property relationship is beneficial to realize monomer design and regulate resin properties.

Comparative study of the shrinkage behavior of three bulk-fill resin-based composites using the aluminium tooth model with a MOD cavity

This study evaluated the cusp tip deflection of aluminium tooth models with a mesial-occlusal-distal (MOD) cavity filled with three bulk-fill resin-based composites (RBCs), Aura Ultra Universal (Aura), Admira Fusion x-tra Universal (Admira), and Filtek One shade A2 (Filtek One), to assess the level of shrinkage stress they could produce. The models were prepared using a primer, adhesive and a single RBC increment photo-cured for 20 s at a radiance exitance 1.25 W/cm2. The RBC axial shrinkage strain (ε) and stress (S) were also measured. Micro-computed tomography in combination with silver nitrate infiltration showed no interfacial debonding. The mean cusp tip deflection for Admira was found to be smaller than those for the other two RBCs. Although ε and S for Aura were higher than those for Filtek One, their mean cusp tip deflections were not significantly different. These results could be explained by the temporal behavior of their elastic modulus.

3D micro-CT and O-PTIR spectroscopy bring new understanding of the influence of filler content in dental resin composites

BACKGROUND

Dental resin composites' performance is intricately linked to their polymerisation shrinkage characteristics. This study compares polymerisation shrinkage using advanced 3D micro-computed tomography (micro-CT) and traditional 2D linear assessments. It delves into the crucial role of filler content on shrinkage and the degree of conversion in dental resin composites, providing valuable insights for the field.

METHODS

Five experimental dental composite materials were prepared with increasing filler contents (55-75 wt%) and analysed using either 3D micro-CT for volumetric shrinkage or a custom-designed linometer for 2D linear shrinkage. The degree of conversion was assessed using Optical Photothermal Infrared (O-PTIR) and Fourier-Transform Infrared (FTIR) spectroscopy. Light transmittance through a 2-mm layer was evaluated using a NIST-calibrated spectrometer. Scanning Electron Microscopy (SEM) and Energy-Dispersive X-ray Spectroscopy (EDX) examined surface morphology and elemental distribution. Correlation between the investigated parameters was determined using Spearman correlation analyses.

RESULTS

The study found significant differences in polymerisation-related properties among different filler content categories, with volumetric shrinkage consistently demonstrating higher mean values than linear shrinkage across most groups. Volumetric shrinkage decreased with increasing curing depth, showing no direct correlation between filler content and shrinkage levels at different curing depths. The results highlighted a strong negative correlation between filler content and degree of conversion, volumetric and linear shrinkage, as well as maximum shrinkage rate. Light transmittance showed a moderate correlation with the filler content and a weak correlation with other tested parameters.

CONCLUSIONS

This study underscores the importance of considering both volumetric and linear shrinkage in the design and analysis of dental composite materials. The findings advocate optimising filler content to minimise shrinkage and enhance material performance. Integrating micro-CT and O-PTIR techniques offers novel insights into dental composites' polymerisation behaviour, providing a foundation for future research to develop materials with improved clinical outcomes.

Characterization of dental light-curing resin composites incorporating multiple modified low-shrink monomers

OBJECTIVE

Polymerization shrinkage poses a significant challenge in dental resin composites. The objective of this study is to introduce spiroorthocarbonate monomer 3,9-dimethylene-1,3,5,7-tetraoxa-spiro[5,5]undecane (BMSOC) and epoxy resin monomer 3,4-epoxycyclohexylmethyl-3,4-epoxycyclohexane carboxylate (ECHM-ECHC) into bisphenol-S-bis(3-methacrylato-2-hydroxy propyl)ether (BisS-GMA) based resin composites to develop composites with reduced shrinkage properties.

METHODS

BMSOC and BisS-GMA were synthesized and thoroughly mixed with ECHM-ECHC, followed by inorganic fillers and photoinitiators. Based on the composition of the resin matrix, five groups of experimental composites were prepared, with traditional bisphenol A-dimethacrylate glycidyl ester (Bis-GMA)/triethylene glycol dimethacrylate (TEGDMA) based composite serving as the control. The polymerization properties, including degree of conversion (DC) and polymerization shrinkage (PS), as well as marginal microleakage, wettability, flexural strength (FS), flexural modulus (FM), and biocompatibility were evaluated.

RESULTS

The results demonstrated that compared with the control group, the PS of BisS-GMA based composites containing BMSOC and ECHM-ECHC were significantly reduced (P < 0.05), and the lowest PS (0.96 ± 0.08 %) was observed when the ratio of BisS-GMA: (Epoxy + BMSOC) was 4:6. Additionally, the experimental composites also exhibited improved DC, minimal microleakage, low hydrophilicity, enhanced mechanical properties, qualified in vivo biocompatibility, and slight/moderate in vitro biocompatibility.

SIGNIFICANCE

The resin composites incorporating multiple modified low-shrink monomers are promising for dental applications to prevent various clinical problems caused by PS and extend restoration longevity.

Comparison of selective laser melting and stereolithography etching templates for guided endodontics

Background

With the increasing application of guided endodontics to treat complex root canal treatment, the entire process of root canal treatment has become more precise, reducing damage to tooth structure and improving success rates. However, due to the limitations of the operating space, the use of guided endodontic templates in posterior root canal treatment is less common. This study aims to compare the accuracy and reliability of selective laser melting (SLM) and traditional stereolithography etching (SLA) guided endodontic templates for posterior root canals, providing better treatment strategies for posterior root canal treatment.

Methods

The teeth were randomly assigned to either SLM or SLA group. Preoperative cone-beam computed tomography (CBCT) and a three-dimensional (3D) scanner were used to establish the 3D root canal system and the accurate occlusal models of the teeth. The virtual access to the canal access was designed using Mimics 19.0 and 3-Matic 11.0. The endodontic access was performed based on either SLM or SLA templates. The accuracy of endodontic preparation was measured in three-dimensions by calculating deviations from planned accesses. The template height and tooth substance loss rates in each group were measured.

Results

SLM-guided templates have a low average deviation at the entry point and apical portion of the bur of total posterior teeth (including premolars and molars) and individual molars (P < 0.05). Moreover, there was a significant difference in angular deviations and height of template in total posterior teeth and individual molars (P < 0.05). The mean substance loss rate of the SLA group was slightly greater than that of the SLM group, but the difference was not statistically (P > 0.05).

Conclusions

SLM-guided endodontics provides a more predictable and precise location of root canal orifice for the treatment of posterior teeth.

A Historical Perspective on Dental Composite Restorative Materials

This review article will discuss the origin of resin-based dental composite materials and their adoption as potentially useful adjuncts to the primary material used by most dentists for direct restorations. The evolution of the materials, largely driven by the industry's response to the needs of dentists, has produced materials that are esthetic, strong, and versatile enough to be used in most areas of the oral cavity to replace or restore missing tooth structures. Significant advancements, such as the transition from chemical to light-curing materials, refinements in reinforcing particles to produce optimum polishing and wear resistance, formulating pastes with altered viscosities to create highly flowable and highly stiff materials, and creating materials with enhanced depth of cure to facilitate placement, will be highlighted. Future advancements will likely reflect the movement away from simply being a biocompatible material to one that is designed to produce some type of beneficial effect upon interaction within the oral environment. These new materials have been called "bioactive" by virtue of their potential effects on bacterial biofilms and their ability to promote mineralization of adjacent tooth structures.

Comparative Assessments of Dental Resin Composites: A Focus on Dense Microhybrid Materials

The performance of dental resin composites is crucially influenced by the sizes and distributions of inorganic fillers. Despite the investigation of a variety of functional particles, glass fillers and nanoscale silica are still the predominant types in dental materials. However, achieving an overall improvement in the performance of resin composites through the optimization of their formulations remains a challenge. This work introduced a "dense" microhybrid filler system with 85 wt % filler loading, leading to the preparation of self-developed resin composites (SRCs). Comparative evaluations of these five SRCs against four commercial products were performed, including mechanical property, polymerization conversion, and shrinkage, along with water sorption and solubility and wear resistance. The results showed that among all SRC groups, SRC3 demonstrated superior mechanical performance, high polymerization conversion, reduced shrinkage, low water absorption and solubility, and acceptable wear resistance. In contrast to commercial products, this optimal SRC3 material was comparable to Z350 XT in flexural and diametral tensile strength and better in flexural modulus and surface hardness. The use of a "dense" microhybrid filler system in the development of resin composites provides a balance between physicochemical property and wear resistance, which may be a promising strategy for the development of composite products.

A Comprehensive Narrative Review of Nanomaterial Applications in Restorative Dentistry: Demineralization Inhibition and Remineralization Applications (Part I)

Nanotechnology is extensively employed in various aspects of dentistry, including restorative dentistry, because of its substantial improvement and promising potential in the clinical efficacy of restorative materials and procedures. The main purpose of this review is to explore the different uses of nanomaterials in restorative dentistry. The review is divided into two parts: the current review (Part 1) focuses on the prevention of demineralization and promotion of remineralization, while the upcoming review (Part 2) will discuss the reinforcement of restorative materials and their therapeutic applications. Nanofillers are added to dental materials to boost their antibacterial, anticaries, and demineralization inhibitory capabilities. Additionally, they improve remineralization and enhance both mechanical properties and therapeutic features. The nanoparticles (NPs) used to increase antibacterial and remineralization inhibitions can be classified into two main groups: inorganic and organic NPs. Examples of inorganic NPs include silver, zinc oxide, titanium oxide, and gold. Examples of organic NPs include silica, quaternary ammonium salt monomers, and chitosan NPs. Furthermore, the nanofillers utilized to enhance the process of remineralization include various types such as metals, nano-hydroxyapatite, nano-amorphous calcium phosphate (ACP), dicalcium phosphate NPs, casein phosphopeptide-ACP (CPP-ACP), and calcium fluoride NPs. These uses underscore the potential applications of NPs in restorative dentistry, although there are still some limitations to address.

Stretchable Magneto-Mechanical Configurations with High Magnetic Sensitivity Based on "Gel-Type" Soft Rubber for Intelligent Applications

"Gel-type" soft and stretchable magneto-mechanical composites made of silicone rubber and iron particles are in focus because of their high magnetic sensitivity, and intelligence perspective. The "intelligence" mentioned here is related to the "smartness" of these magneto-rheological elastomers (MREs) to tune the "mechanical stiffness" and "output voltage" in energy-harvesting applications by switching magnetic fields. Hence, this work develops "gel-type" soft composites based on rubber reinforced with iron particles in a hybrid with piezoelectric fillers such as barium titanate. A further aspect of the work relies on studying the mechanical stability of intelligence and the stretchability of the composites. For example, the stretchability was 105% (control), and higher for 158% (60 per 100 parts of rubber (phr) of barium titanate, BaTiO3), 149% (60 phr of electrolyte iron particles, EIP), and 148% (60 phr of BaTiO3 + EIP hybrid). Then, the magneto-mechanical aspect will be investigated to explore the magnetic sensitivity of these "gel-type" soft composites with a change in mechanical stiffness under a magnetic field. For example, the anisotropic effect was 14.3% (60 phr of EIP), and 4.4% (60 phr of hybrid). Finally, energy harvesting was performed. For example, the isotropic samples exhibit ~20 mV (60 phr of BaTiO3), ~5.4 mV (60 phr of EIP), and ~3.7 mV (60 phr of hybrid). However, the anisotropic samples exhibit ~5.6 mV (60 phr of EIP), and ~8.8 mV (60 phr of hybrid). In the end, the composites prepared have three configurations, namely one with electro-mechanical aspects, another with magnetic sensitivity, and a third with both features. Overall, the experimental outcomes will make fabricated composites useful for different intelligent and stretchable applications.

Novel low-shrinkage dental resin containing microcapsules with antibacterial and self-healing properties

Dental resin restorations commonly fail because of fractures and secondary caries. The aim of this research was to synthesize a novel low-shrinkage dental resin with antibacterial and self-healing properties. The low-shrinkage dental resin was obtained by incorporating a 20 wt% anti-shrinkage mixture of an expanding monomer 3,9-diethyl-3,9-dimethylol -1,5,7,11-tetraoxaspiro[5,5] undecane and an epoxy resin monomer diallyl bisphenol A diglycidyl ether (1:1, referred as "UE") and different mass fractions of self-healing antibacterial microcapsules (0%, 2.5%, 5%, 7.5%, and 10%) were incorporated into the matrix to prepare multifunctional dental resin. Polymerization shrinkage, mechanical properties, antibacterial activity, self-healing ability, and cytotoxicity of this dental resin were evaluated. The polymerization volumetric shrinkage of resin containing 20 wt% UE and 7.5 wt% microcapsules was reduced by 30.12% (4.13% ± 0.42%) compared with control. Furthermore, it exhibited high antibacterial activity and a good self-healing efficiency of 71% without adversely affecting the mechanical property and cell viability. This novel multifunctional dental resin with low polymerization shrinkage and excellent antibacterial activity and self-healing capability has potential application as a dental resin material to decrease the incidence of fractures and secondary caries.

An in vitro assessment of biaxial flexural strength, degree of monomer conversion, color stability, and ion release in provisional restorations containing Sr-bioactive glass nanoparticles

This study examined the mechanical and chemical properties of an experimental provisional restoration containing Sr-bioactive glass nanoparticles (Sr-BGNPs) compared to commercial provisional materials. The experimental material (TempS10) contained dimethacrylate monomers with added 10 wt% Sr-BGNPs. The degree of monomer conversion (DC) of self-curing (n = 5), biaxial flexural strength (BFS)/modulus (BFM) (n = 5), and color changes (ΔE*00) of materials in red wine (n = 5) were determined. Additionally, ion release (Ca, P, and Sr) in water at 2 weeks was examined (n = 3). The commercial materials tested included polymethyl methacrylate-based provisional material (Unifast) and bis-acrylic materials (Protemp4 and Cooltemp). TempS10 exhibited a comparable degree of monomer conversion (49%) to that of Protemp4 (60%) and Cooltemp (54%) (p > 0.05). The DC of Unifast (81%) was significantly higher than that of other materials (p < 0.05). TempS10 showed a BFS (126 MPa) similar to Cooltemp (102 MPa) and Unifast (123 MPa), but lower than Protemp4 (194 MPa). The immersion time for 2 weeks exhibited no detrimental effect on the strength and modulus of all materials. The highest ΔE*00 at 24 h and 2 weeks was observed with TempS10, followed by Cooltemp, Unifast, and Protemp4. Only TempS10 showed a detectable amount of Ca (0.69 ppm), P (0.12 ppm), and Sr (3.01 ppm). The experimental provisional resin restoration containing Sr-BGNPs demonstrated polymerization and strength comparable to those of bis-acryl provisional restorations but with the added benefit of ion-releasing properties. However, the experimental material demonstrated unsatisfactory color stability.

Comparison of a Nanofiber-Reinforced Composite with Different Types of Composite Resins

The aim of this study was a comprehensive evaluation and comparison of the physical and mechanical properties of a newly developed nano-sized hydroxyapatite fiber-reinforced composite with other fiber-reinforced and particle-filled composites. Commercially available eight composite resins (3 fiber-reinforced and 5 particle-filled) were used: Fiber-reinforced composites: (1) NovaPro Fill (Nanova): newly developed nano-sized hydroxyapatite fiber-reinforced composite (nHAFC-NF); (2) Alert (Pentron): micrometer-scale glass fiber-reinforced composite (µmGFC-AL); (3) Ever X Posterior (GC Corp): millimeter-scale glass fiber-reinforced composite (mmGFC-EX); Particle-filled composites: (4) SDR Plus (Dentsply) low-viscosity bulk-fill (LVBF-SDR); (5) Estelite Bulk Fill (Tokuyama Corp.) low-viscosity bulk-fill (LVBF-EBF); (6) Filtek Bulk Fill Flow (3M ESPE) low-viscosity bulk-fill (LVBF-FBFF); (7) Filtek Bulk Fill (3M ESPE) high-viscosity bulk-fill (HVBF-FBF); and (8) Filtek Z250 (3M ESPE): microhybrid composite (µH-FZ). For Vickers microhardness, cylindrical-shaped specimens (diameter: 4 mm, height: 2 mm) were fabricated (n = 10). For the three-point bending test, bar-shaped (2 × 2 × 25 mm) specimens were fabricated (n = 10). Flexural strength and modulus elasticity were calculated. AcuVol, a video image device, was used for volumetric polymerization shrinkage (VPS) evaluations (n = 6). The polymerization degree of conversion (DC) was measured on the top and bottom surfaces with Fourier Transform Near-Infrared Spectroscopy (FTIR; n = 5). The data were statistically analyzed using one-way ANOVA, Tukey HSD, Welsch ANOVA, and Games-Howell tests (p < 0.05). Pearson coefficient correlation was used to determine the linear correlation. Group µH-FZ displayed the highest microhardness, flexural strength, and modulus elasticity, while Group HVBF-FBF exhibited significantly lower VPS than other composites. When comparing the fiber-reinforced composites, Group mmGFC-EX showed significantly higher microhardness, flexural strength, modulus elasticity, and lower VPS than Group nHAFC-NF but similar DC. A strong correlation was determined between microhardness, VPS and inorganic filler by wt% and vol% (r = 0.572-0.877). Fiber type and length could affect the physical and mechanical properties of fibers containing composite resins.

Effect of monomer composition and filler fraction on surface microhardness and depth of cure of experimental resin composites

This study evaluated microhardness profiles and calculated depths of cure at 80% of the surface microhardness of experimental dental resin composites having different base monomer compositions and different filler fractions. Composites were prepared using four different base monomers (bisphenol A-glycidyl methacrylate [Bis-GMA], urethane dimethacrylate [UDMA], ethoxylated bisphenol-A dimethacrylate [Bis-EMA], and Fit-852) with triethylene glycol dimethacrylate (TEGDMA) used as a co-monomer at three filler:resin matrix weight percent fractions (50:50, 60:40, and 70:30). Uncured material was placed in 3D printed molds and light cured for 40 s from the top surface only. Knoop microhardness was measured at the top of the specimen, and at every 0.5 mm up to 4 mm in depth. Microhardness at the surface increased in all experimental composites as the filler fraction increased. When comparing base monomers, microhardness was the highest in UDMA-based composites, while Bis-GMA-based composites showed the lowest values. When comparing depth of cure as a function of base monomer type, both Bis-GMA and Bis-EMA showed significantly lower values than UDMA or Fit-852. Composites having 50 wt% filler showed a significantly higher depth of cure than those with 60 and 70 wt% filler. Base monomer and filler fraction significantly influence microhardness and depth of cure in these experimental composites.

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.

Application of Nanomaterials in Restorative Dentistry

Dental composite resins are widely popular restoratives, as, when using these tools to restore the tooth, only the infected and affected carious structures are removed. This allows the patient to retain a greater quantity of their natural tooth structure than they would have using conventional principles of cavity preparation. Nanomaterials are a new concept concerning the manipulation of materials on an atomic or molecular level. However, on a nanoscale, the chemical, biological, and physical properties of an atom vary compared to the properties of its naturally occurring compound form. The main idea of shifting focus to the inclusion of nanomaterials is to aid in the detection, treatment, and prevention of the recurrence of a pathology (secondary caries). The primary aim of using nanomaterials in composites is to augment their strength, wear resistance, and microhardness. This usage also reduces polymerization shrinkage. Nanomaterials are capable of enhancing mechanical properties, life, and bond strength between dentin and restoration. This review aims to highlight different research studies and experiments that have been conducted on the use of nanomaterials in restorative dentistry in order to understand the versatility of these materials and their viability in practice.

Preparation of Silica Aerogel/Resin Composites and Their Application in Dental Restorative Materials

As the most advanced aerogel material, silica aerogel has had transformative industrial impacts. However, the use of silica aerogel is currently limited to the field of thermal insulation materials, so it is urgent to expand its application into other fields. In this work, silica aerogel/resin composites were successfully prepared by combining silica aerogel with a resin matrix for dental restoration. The applications of this material in the field of dental restoration, as well as its performance, are discussed in depth. It was demonstrated that, when the ratio of the resin matrix Bis-GMA to TEGDMA was 1:1, and the content of silica aerogel with 50 μm particle size was 12.5%, the composite achieved excellent mechanical properties. The flexural strength of the silica aerogel/resin composite reached 62.9546 MPa, which was more than five times that of the pure resin. Due to the presence of the silica aerogel, the composite also demonstrated outstanding antibacterial capabilities, meeting the demand for antimicrobial properties in dental materials. This work successfully investigated the prospect of using commercially available silica aerogels in dental restorative materials; we provide an easy method for using silica aerogels as dental restorative materials, as well as a reference for their application in the field of biomedical materials.

The Effectiveness of Dental Protection and the Material Arrangement in Custom-Made Mouthguards

Experimental research studies have shown that wearing a mouthguard (MG) is an effective way to prevent tooth or maxillofacial trauma. However, there is a lack of scientific information regarding how the material arrangement within the mouthguard can modify its mechanical response during an impact. Hence, this study aimed to evaluate the influence of material arrangement within custom-made mouthguards on stress transmitted to anterior teeth, bone, and soft tissue after impact. Four 3D finite element models of a human maxilla were reconstructed based on the CBCT of a young patient and analyzed according to the presence or absence of a mouthguard and the type of material arrangement within those with a mouthguard: model NMG with no mouthguard; model CMG representing the conventional arrangement with a single 4 mm-thick ethylene-vinyl acetate (EVA) foil; model FMG presenting layer arrangement with two 1 mm-thick foils of EVA in the outer shell and one 2 mm-thick foil of EVA foam in the core; model HMG presenting a 1 mm-thick compact inner and outer shell of EVA and a 2 mm wide air-filled zone in the core. Linear quasi-static analysis and frontal load were used to simulate an impact with an energy of 4.4 J. Isotropic linear elastic properties were assumed for the bone and teeth but not for the mouthguard protection and oral soft tissues. The results were evaluated and compared in terms of displacement, stretches, and stresses. All the mouthguards analyzed reduced the risk of injury to teeth and bone, reducing the displacement and stress of these structures. However, the implementation of a honeycomb structured layer allowed more significant displacement and deformation of the mouthguard’s external layer, thus promoting higher protection of the anatomic structures, namely the root dentin and the bone tissue. Nevertheless, the results also indicate that improving the mouthguard flexibility might increase the soft tissue injuries.

Efficient prediction of the packing density of inorganic fillers in dental resin composites for excellent properties

OBJECTIVE

The purpose of this study is to develop a mathematical model for efficient prediction of the packing density of different filler formulations in dental resin composites (DRCs), and to study properties of DRCs at the maximum filler loading (MFL), thereby providing an effective guidance for the design of filler formulations in DRCs to obtain excellent properties.

METHODS

The packing density data generated by discrete element model (DEM) simulation were used to re-derive the parameters of 3-parameter model. The modifier effect was also induced to modify the 3-parameter model. DRCs with 10 filler formulations were selected to test properties at the MFL. The packing densities of binary and ternary mixes in DRCs were calculated by 3-parameter model to explore the regularity of composite packing.

RESULTS

The predicted packing density was validated by simulation and experimental results, and the prediction error is within 1.40 vol%. The optimization of filler compositions to obtain a higher packing density is beneficial to enhancing the mechanical properties and reducing the polymerization shrinkage of DRCs. In binary mixes, the maximum packing density occurs when the volume fraction of small fillers is 0.35-0.45, and becomes higher with the reduction of particle size ratio. In ternary mixes, the packing density can reach the maximum value when the volume fractions of large and small fillers are in the 0.5-0.75 and 0.15-0.4 ranges, respectively.

SIGNIFICANCE

The modified 3-parameter model can provide an effective method to design the multi-level filler formulations of DRCs, thereby improving the performance of the materials.

Synthesis and Characterization of Methacrylate-Functionalized Betulin Derivatives as Antibacterial Comonomer for Dental Restorative Resins

Secondary caries is the primary cause of composite restoration failures, resulting from marginal leakage and bacterial accumulation in the oral environment. Antibacterial dental composites, especially antibacterial monomers, have emerged as a promising strategy to inhibit secondary caries, which is pivotal to prolonging the lifespan of dental restorations. In this work, monomethacrylate- and dimethacrylate-functionalized betulin derivatives (M₁Bet and M₂Bet) were synthesized via an esterification reaction and served as antibacterial comonomers to develop novel dental resin formulations, in which M₁Bet and M₂Bet were incorporated to partially or completely replace bisphenol A glycerolate dimethacrylate (Bis-GMA). The control resin was a mixture based on Bis-GMA and tri(ethyleneglycol) dimethacrylate (TEGDMA) with a weight ratio of 50:50 (5B5T). The effect of the resin compositions and the chemical structures of M₁Bet and M₂Bet on the rheology behavior, optical property, polymerization kinetics, mechanical performance, cell viability, and antibacterial activity of dental resins were systematically investigated. Among all materials, the 1M₂Bet4B5T resin with 10 wt % substitution of Bis-GMA by M₂Bet exhibited comparable viscosity, higher light transmittance, improved degree of conversion, and mechanical properties compared with 5B5T. After incubation for 24 h, this optimal resin also possessed the best antibacterial activity against Streptococcus mutans, which had a significantly lower bacterial concentration (1.53 × 10⁹ CFU/mL) than 5B5T (9.03 × 10⁹ CFU/mL). Introducing betulin-based comonomers into dental resins is a potential strategy to develop antibacterial dental materials without sacrificing physical-mechanical properties.

Size-controllable synthesis of dendritic porous silica as reinforcing fillers for dental composites

OBJECTIVE

Porous materials, especially porous silica particles are of great interest in different areas, and have applied in dental composites as inorganic fillers, due to their potential in constructing micromechanical interlocking at the filler-resin matrix interfaces. However, the facile and precise synthesis of hierarchical porous silica with graded sizes is still a great challenge.

METHODS

Here, we synthesized dendritic porous silica (DPS) with center-radial hierarchical pores and controllable size ranging from 75 to 1000nm by varying simultaneously the amounts of silica precursor and template in the microemulsion. A plausible nucleation-growth mechanism for the structural formation and the size tunability of the DPS particles was further put forward. These DPS particles were then formulated with Bis-GMA/TEGDMA resin.

RESULTS

The particle size and morphology influenced the mechanical properties of dental composites. Particularly, DPS-500 particles (average size: 500nm) exhibited the superior reinforcing effect, giving large improvements of 32.0, 96.7, 51.9, and 225.6% for flexural strength (S_F), flexural modulus (E_Y), compressive strength (S_C), and work of fracture (WOF), respectively, over the DPS-75 filled composite. All DPS filler sized exhibited similar degree of conversions and curing depths. Furthermore, the DPS-500 filled composite presented better cytocompatibility than commercial Z250 XT.

SIGNIFICANCE

The facile synthesis of DPS particles developed here and the understanding of the influence of the filler size and morphology on the composite properties provide a shortcut to design porous silica with precise size control and dental composites with superior performance. These DPS particles could also have promising applications in biomedicine, catalysis, adsorption, and cancer therapy.

Functional fillers for dental resin composites

Dental resin composites (DRCs) are popular materials to repair caries. Although various types of DRCs with different characteristics have been developed, restoration failures still exist. Bulk fracture and secondary caries have been considered as main causes for the failure of composites restoration. To address these problems, various fillers with specific functions have been introduced and studied. Some fillers with specific morphologies such as whisker, fiber, and nanotube, have been used to increase the mechanical properties of DRCs, and other fillers releasing ions such as Ag⁺, Ca²⁺, and F^-, have been used to inhibit the secondary caries. These functional fillers are helpful to improve the performances and lifespan of DRCs. In this article, we firstly introduce the composition and development of DRCs, then review and discuss the functional fillers classified according to their roles in the DRCs, finally give a summary on the current research and predict the trend of future development.

Effect of APTES- or MPTS-Conditioned Nanozirconia Fillers on Mechanical Properties of Bis-GMA-Based Resin Composites

To investigate the effects of 3-aminopropyltriethoxysilane (APTES)- or (3-mercaptopropyl)trimethoxysilane (MPTS)-conditioned nanozirconia fillers on the mechanical properties of Bis-GMA-based resin composites. The conditioned fillers were characterized by Fourier transform infrared (FTIR) spectroscopy, X-ray photoelectron spectroscopy (XPS), and thermodynamic calculations. They were then used to prepare Bis-GMA-based resin composites, whose flexural strength and elastic modulus were evaluated. The Cell Counting Kit-8 (CCK-8) assessed the composites' cytotoxicity. The FTIR spectra of the conditioned fillers showed new absorption bands at 1569 and 1100 cm-1, indicating successful grafting of APTES or MPTS onto nanozirconia. XPS confirmed the Zr-O-Si bonds in the APTES- or MPTS-conditioned fillers at contents of 2.02 and 6.98%, respectively. Thermodynamic calculations reaffirmed the chemical binding between the two silanes and nanozirconia fillers. Composites containing the conditioned nanozirconia fillers had significantly greater flexural strengths (APTES, 121.02 ± 8.31 MPa; MPTS, 132.80 ± 15.80 MPa; control, 94.84 ± 9.28 MPa) and elastic moduli (8.76 ± 0.52, 9.24 ± 0.60, and 7.44 ± 0.83 GPa, respectively) than a control with untreated fillers. The cytotoxicity assay identified no significant cytotoxicity by composites containing the conditioned fillers. Silanes were previously considered to be unable to chemically condition zirconia to bond with resin. Inclusion of APTES- or MPTS-conditioned nanozirconia fillers can improve the mechanical properties of Bis-GMA-based resin composites without obvious cytotoxicity in this study.

Mechanical Properties of Nanohybrid Resin Composites Containing Various Mass Fractions of Modified Zirconia Particles

PURPOSE

The aim of this study was to investigate the effect of various mass fractions of 10-methacry-loyloxydecyl dihydrogen phosphate (MDP)-conditioned or unconditioned zirconia nano- or micro-particles with different initiator systems on the mechanical properties of nanohybrid resin composites.

METHODS

Both light-cured (L) and dual-cured (D) resin composites were prepared. When the mass fraction of the nano- or micro-zirconia fillers reached 55 wt%, resin composites were equipped with dual-cured initiator systems. We measured the three-point bending-strength, elastic modulus, Weibull modulus and translucency parameter of the nanohybrid resin composites containing various mass fractions of MDP-conditioned or unconditioned zirconia nano- or micro-particles (0%, 5 wt%, 10 wt%, 20 wt%, 30 wt% and 55 wt%). A Cell Counting Kit (CCK)-8 was used to test the cell cytotoxicity of the experimental resin composites. The zirconia nano- or micro-particles with MDP-conditioning or not were characterized by transmission electron microscopy (TEM), Fourier infrared spectroscopy (FTIR), and X-ray photoelectron spectroscopy (XPS).

RESULTS

Resin composites containing 5-20 wt% MDP-conditioned or unconditioned nano-zirconia fillers exhibited better three-point bending-strength than the control group without zirconia fillers. Nano- or micro-zirconia fillers decreased the translucence of the nanohybrid resin composites. According to the cytotoxicity classification, all of the nano- or micro-zirconia fillers containing experimental resin composites were considered to have no significant cell cytotoxicity. The FTIR spectra of the conditioned nano- or micro-fillers showed new absorption bands at 1719 cm-1 and 1637 cm-1, indicating the successful combination of MDP and zirconia particles. The XPS analysis measured Zr-O-P peak area on MDP-conditioned nano- and micro-zirconia fillers at 39.91% and 34.89%, respectively.

CONCLUSION

Nano-zirconia filler improved the mechanical properties of nanohybrid resin composites, but cannot be the main filler to replace silica filler. The experimental dual-cured composites can be resin cements with better opacity effects and a low viscosity.

A new method for predicting the maximum filler loading of dental resin composites based on DEM simulations and experiments

OBJECTIVE

The inorganic fillers in dental resin composites can enhance their mechanical properties and reduce polymerization shrinkage. When the usage amount of inorganic fillers is closed to maximum filler loading (MFL), the composites will usually achieve optimal performances. This study aims to develop a method that can predict the MFL of dental resin composites for the optimization of filler formulations.

METHODS

A method based on discrete element method (DEM) simulations and experiments was firstly developed to predict the MFL of spherical silica particles for single-level and multi-level filling.

RESULTS

The results indicate that the presence of modifier can increase the MFL, and the MFL increment can be exponentially changed with the content of the modifier. Compared with the single-level filling, the addition of secondary fillers is beneficial to increase the MFL, and the increment can be affected by the particle size and size ratio. The prediction results show a good agreement with the experiment results.

SIGNIFICANCE

The accuracy of prediction results indicates a great potential of DEM simulations as a numerical experimental method in studying the MFL, and provides an effective method for the optimization of filler formulations.

Influence of the organic matrix composition on the polymerization behavior and bulk properties of resin composites containing thiourethane-functionalized fillers

OBJECTIVES

The incorporation of thiourethane-based oligomeric additives into resin composite formulations leads to improvement in mechanical properties and reduction in polymerization stress, but may increase viscosity. The objective of this study was to functionalize filler particle surfaces with thiourethane silane molecules and determine the impact of the inorganic filler loading and surface treatment on the behavior of experimental resin composites with systematically-varied organic matrices.

METHODS

Thiourethane oligomer was synthesized de novo, and grafted to the surface of 0.7um barium glass. BisGMA and TEGDMA (BT) were combined (at 30:70, 50:50 or 70:30 wt%) to 50 or 75 wt% of methacrylate (MA-Sil - control) or thiourethane-silanized (TU-Sil) particles. Composites were made polymerizable by the addition of 0.2 wt% BAPO and 0.05 wt% BHT was added as inhibitor. A mercury arc lamp (320-500 nm) at 800 mW/cm2 was used for all curing procedures. Kinetics of polymerization was assessed by near-IR spectroscopy in real time. Polymerization stress was determined with a cantilever system in real time (Bioman). Flexural modulus and strength were determined in 3-point bending (25x2x2 mm). Water sorption and solubility and film thickness were tested according to ISO 4049. Polymeric network characteristics were analyzed by dynamic mechanical analysis (DMA). Data was analyzed with two-way ANOVA/Tukey's test (95%).

RESULTS

Viscosity increased with the increase in BisGMA and/or filler amounts. Overall, TU-Sil containing composites showed delayed vitrification and higher final DC. Filler concentration did not affect DC neither flexural strength. DC decreased with increasing BisGMA content. Polymerization stress reduced and flexural modulus increased for higher filler content, especially for formulations containing TU-Sil particles. The water stability was positively affected by the increase in amount of BisGMA and inorganic filler particles. In terms of polymeric network, the addition of TU-Sil particles increased the Tg and decreased the E' and cross-link density.

CONCLUSIONS

With the exception of flexural modulus, all tested properties were significantly impacted by the matrix viscosity and/or the addition of TU-Sil filler particles. In general, the use of thiourethane oligomers as a silane coupling agent was able to reinforce the materials and reduce the polymerization stress without negatively affecting the viscosity of the system.

Preparation of Zn doped mesoporous silica nanoparticles (Zn-MSNs) for the improvement of mechanical and antibacterial properties of dental resin composites

OBJECTIVE

The purpose of this work was to explore the enhancement effect of zinc doped mesoporous silica nanoparticles (Zn-MSNs), which could form micromechanical interlocking with resin matrix and sustainably release Zn²⁺, on the mechanical and antibacterial properties of the dental resin composites.

METHODS

Zn-MSNs were prepared by a sol-gel method, and characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM) and N₂ adsorption/desorption. The mechanical properties of the dental composites reinforced by Zn-MSNs were measured by a universal mechanical testing machine. Antibacterial activities of dental composites were evaluated by both qualitative and quantitative analysis using Streptococcus mutans (S. mutans). The cytotoxicity of the Zn-MSNs filled dental composites was investigated by osteoblasts (OBs).

RESULTS

The synthesized Zn-MSNs possessed good monodispersity with an average particle size of about 138nm. The mechanical properties of the composites gradually increased with the increase of the content of Zn-MSNs. The flexural strength, flexural modulus, compressive strength and micro-hardness of the composites containing 15wt% Zn-MSNs were 31.21%, 50.47%, 53.83% and 26.79% higher than the samples with no Zn-MSNs, respectively. The antibacterial performance was significantly improved by the addition of Zn-MSNs and the antibacterial rate of the composite with 15wt% of Zn-MSNs reached 100%. Cytotoxicity tests revealed that all the composites were biocompatible during OBs incubation.

SIGNIFICANCE

The prepared Zn-MSNs can effectively improve the mechanical and antibacterial properties of the dental resin composites.

Surface Treatment Of Nanozirconia Fillers To Strengthen Dental Bisphenol A-Glycidyl Methacrylate-Based Resin Composites

Purpose

To investigate the effects of nanozirconia fillers conditioned with 10-methacryloyloxydecyl dihydrogen phosphate (MDP) with or without zirconium hydroxide precoating on bending strength, Vickers hardness, and translucence of dental resin composites.

Methods

We obtained nanozirconia fillers coated with different concentrations of Zr(OH)₄ using wet-chemical synthesis. We analyzed coating quality by observing electron-diffraction patterns using transmission electron microscopy. We conditioned zirconia fillers, with or without prior Zr(OH)₄-coating, using MDP-containing primers and evaluated the formation of chemical bonds using nuclear magnetic resonance (NMR) and X-ray photoelectron spectroscopy (XPS). We then performed three-point bending-strength tests, Weibull analysis, Vickers hardness, and translucence-parameter analysis with or without addition of different concentrations of zirconia using untreated zirconia fillers as controls.

Results

We achieved desirable Zr(OH)₄ coating using 5 mmol/L zirconium chloride. NMR and XPS analysis detected stronger Zr–O–P peaks on MDP-conditioned zirconia fillers with prior Zr(OH)₄-coating compared with MDP-conditioned fillers alone, suggesting that MDP bonding with zirconia was enhanced by zirconium hydroxide. Our three-point bending-strength tests revealed that increasing levels of untreated zirconia fillers decreased the three-point bending strength of the resin composites, while MDP-conditioned zirconia fillers with or without prior Zr(OH)₄ coating improved three-point bending strengths. Adding 5 wt% and 7.5 wt% MDP-conditioned zirconia fillers with prior Zr(OH)₄ coating achieved the highest three-point bending strength. Furthermore, addition of zirconia fillers decreased the translucence of silica-based resin composites.

Conclusion

MDP conditioning with prior Zr(OH)₄ coating is recommended for treating nanozirconia fillers of resin composites.

Hardness and fracture toughness of resin-composite materials with and without fibers

OBJECTIVE

To investigate the surface micro-hardness (VHN) and fracture toughness (K_IC) of resin-composites, with and without incorporated short fibers, after solvent storage.

METHODS

Three resin-composites incorporating fibers, additional to particle reinforcement, were examined: everX™, NovoPro Fill™ and NovoPro Flow™. Four composites were used as controls, with only particle reinforcement: Filtek bulk Fill™, Filtek bulk one™, Filtek XTE™, and Filtek Flow XTE™. For hardness measurement, materials were cured in 2mm thick molds for 20s by a LED source of average irradiance 1.2W/cm². Specimens (n=6/group) were stored dry for 1h and then in either water or 75% ethanol/water for 1h, 1 day and 30 days at 37±1°C. Vickers hardness was measured under a load of 300g for 15s. For fracture toughness (K_IC) measurements, single-edge-notched specimens (n=6/group) were prepared: (32×6×3mm) for 3-point bending and stored for 1 and 7 days in water at 37°C. Fractured surfaces of fiber-reinforced composite were examined by scanning electron microscopy (SEM). VHN data were analyzed using three-way ANOVA, one-way ANOVA and the Tukey post hoc test (p≤0.05). K_IC data were analyzed by two-way ANOVA and one-way ANOVA and the Tukey post hoc test (p≤0.05). An independent t-test was used to detect differences (α=0.05) in K_IC between stored groups for each material.

RESULTS

VHN decreased for all composites with storage time in both solvents, but more appreciably in 75% ethanol/water (an average of 20%). K_IC ranged from 2.14 (everX Posterior) to 0.96 NovoPro Flow) MPa.m^0.5. The longer storage period (7 days) had no significant effect on this property relative to 1 day storage.

SIGNIFICANCE

Reinforcement with short fibers, and possibly matrix compositional differences, significantly enhanced the fracture toughness of EVX. However, for nano-fiber containing composites, there were no evident beneficial effects upon either their fracture toughness or hardness compared to a range of control composites. Water storage for 7 days of all these resin-composites produced no significant change in their K_IC values, relative to 1 day storage.