Polymerization shrinkage stress of resin-based dental materials: A systematic review and meta-analyses of composition strategies

Antibacterial Properties of an Experimental Dental Resin Loaded with Gold Nanoshells for Photothermal Therapy Applications

This study explored the chemical and antibacterial properties of a dental resin loaded with gold nanoshells (AuNPs) in conjunction with photothermal therapy (PTT) as a novel method against Streptococcus mutans (S. mutans) to prevent secondary caries. First, a 20-h minimum inhibitory concentration (MIC) assay was performed on solutions of AuNPs with planktonic S. mutans under an LED device and laser at 660 nm. Next, resin blends containing 0, 1 × 1010, or 2 × 1010 AuNPs/mL were fabricated, and the degree of conversion (DC) was measured using an FTIR spectroscopy. Lastly, a colony forming unit (CFU) count was performed following 24 h growth of S. mutans on 6 mm diameter resin disks with different light treatments of an LED device and a laser at 660 nm. The MIC results only showed a reduction in S. mutans at AuNP concentrations less than 3.12 µg/mL under a laser illumination level of 95.5 J/cm2 compared to the dark treatment (p < 0.010 for each). CFU and DC results showed no significant dependence on any light treatment studied. The AuNPs expressed antibacterial effects following PPT against planktonic S. mutans but not in a polymerized dental adhesive resin. Future studies should focus on different shapes, structure, and concentrations of AuNPs loaded in a resin blend.

From Unregulated Networks to Designed Microstructures: Introducing Heterogeneity at Different Length Scales in Photopolymers for Additive Manufacturing

Photopolymers have been optimized as protective and decorative coating materials for decades. However, with the rise of additive manufacturing technologies, vat photopolymerization has unlocked the use of photopolymers for three-dimensional objects with new material requirements. Thus, the originally highly cross-linked, amorphous architecture of photopolymers cannot match the expectations for modern materials anymore, revealing the largely unanswered question of how diverse properties can be achieved in photopolymers. Herein, we review how microstructural features in soft matter materials should be designed and implemented to obtain high performance materials. We then translate these findings into chemical design suggestions for enhanced printable photopolymers. Based on this analysis, we have found microstructural heterogenization to be the most powerful tool to tune photopolymer performance. By combining the chemical toolbox for photopolymerization and the analytical toolbox for microstructural characterization, we examine current strategies for physical heterogenization (fillers, inkjet printing) and chemical heterogenization (semicrystalline polymers, block copolymers, interpenetrating networks, photopolymerization induced phase separation) of photopolymers and put them into a material scientific context to develop a roadmap for improving and diversifying photopolymers' performance.

Polymerization shrinkage stress of contemporary dental composites: Comparison of two measurement methods

The aim of this study was to compare two testing methodologies employed for assessing the polymerization shrinkage stress of dental resin composites. Ten commercial resin composites were investigated (EverX Posterior & Flow; G-ænial Anterior, Posterior, A'CHORD & Universal Injectable; Filtek One Bulk Fill & Universal Restorative; SDR flow+ and Aura Bulk Fill). Photoelastic and contraction forces measurement methods were performed. The slope of the linear trendline and C-factor of specimens were calculated. The shrinkage stress values (range between: 6.4-13.4 MPa) obtained by the photoelastic method were higher for all resin composites than the values obtained by contraction forces measurements (range between 1.2-4.8 MPa). However, there was a strong linear correlation between these methods (r=0.8). The use of both investigated methods revealed important information about the shrinkage behavior of the restorative resin composites.

Toothbrushing effects on the surface roughness and cement volume loss of bonded enamel-ceramic interface

This study evaluated the effect of toothbrushing on enamel-cementing material-ceramic bonded interfaces, using different cementing materials.

MATERIALS AND METHODS

Thirty enamel and thirty ceramic blocks were bonded with cementing materials to produce the samples that were bonded with three types of cementing materials: 1- RelyX Ultimate resin cement (REXU), 2- RelyX Unicem 2 self-adhesive resin cement (REU2) and 3- heated Z100 restorative composite (60°C). Bonded interfaces of the samples were toothbrushed and the surfaces of the 3 cementing materials were evaluated for roughness (RG, in µm), roughness profile (RP, in µm), and volume loss (VL, in µm3) (baseline and after 20,000 and 60,000 toothbrushing cycles). Data were evaluated by Generalized Linear Analysis (two factors: "material" and "toothbrushing cycle") and Bonferroni test (α=0.05).

RESULTS

REXU and Z100 exhibited lower RG than that presented by REU2, except after 60,000 toothbrushing cycles when only Z100 differed from REU2. The increase in toothbrushing cycles increased the RG and RP for all materials. REU2 also showed higher RP than those showed by REXU and Z100 when it was analyzed regarding the enamel. The VL of Z100 was the lowest with 20,000 toothbrushing cycles, regarding the enamel and ceramic. For 60,000 cycles, REXU showed the lowest VL regarding the ceramic, and REU2 had the highest VL regarding the enamel and ceramic.

CONCLUSION

In general, REXU and Z100 showed the best results regarding the evaluations performed and the REU2 exhibited the highest RG, RP, and VL.

5-year clinical performance of posterior bulk-filled resin composite restorations: A double-blind randomized controlled trial

OBJECTIVES

The aim of this double-blind, and randomized controlled clinical trial was to evaluate the 5-year clinical performance of posterior resin composite restorations placed with the incremental filling technique [IF] or the bulk-fill technique [BF]. Two different adhesive systems were used: etch-&-rinse (ER) or self-etch (SE).

METHODS

Posterior dental teeth of 72 participants (n = 236), with a cavity depth of at least 3 mm, were randomly divided into four groups. Restorations were applied with either Tetric N-Bond or Tetric N-Bond SE. The composite resin Tetric N-Ceram Bulk-Fill was placed either with IF or BF. Restorations were evaluated using FDI criteria at baseline and after 1, 2, 3, 4, and 5 years. Statistical analysis was performed using the Wilcoxon Signed rank test (a=0.05).

RESULTS

Two hundred and four restorations were evaluated after 5 years. Eleven restorations were considered 'failed', ten due to fracture (4 IF and 6 BF) and one due to secondary caries (IF). The annual failure rate was 1.2% for BF and 1% for IF (p = 0.35). When comparing BF and IF, no significant differences were found for any of the parameters evaluated (p > 0.05). Regarding the adhesive systems, 44 and 51 restorations showed minor problems in terms of marginal adaptation and staining, with significantly more marginal discoloration when the self-etch adhesive was used (p = 0.002).

SIGNIFICANCE

The bulk-fill restorative technique showed good clinical behavior compared to the incremental filling technique, especially when using an etch-&-rinse adhesive, after 5 years of clinical evaluation.

Application and limitations of configuration factor (C-factor) in stress analysis of dental restorations

OBJECTIVE

The configuration factor (C-factor) is an index used to evaluate the relationship between cavity configuration and the development of polymerization shrinkage stress in dental restorations. Although C-factor has been widely researched, its correlation with stress analysis in dental restorations remains controversial. This review aims to discuss the application and limitations of C-factor and define the restricted conditions under which the C-factor "rule of thumb" is applicable.

METHODS

A thorough literature review was conducted on the application and limitations of C-factor in stress analysis of dental restorations. This was principally based on MEDLINE/PubMed and Web of Science databases and a review of the relevant studies and publications in scientific papers in international peer-reviewed journals for the specific topic of C-factor and polymerization shrinkage.

RESULTS

The C-factor alone cannot provide an accurate prediction of the shrinkage stress of restorations and the mechanical behavior of material-tooth interfaces. C-factor is only applicable under one condition not typically seen in clinical practice: low, near-rigid compliance.

SIGNIFICANCE

Conditions for the application of C-factor have been explicitly defined. A more accurate and precise understanding and utilization of the C-factor is of benefit as it contributes to better understanding of polymerization shrinkage behavior of restorations.

Assessment of internal porosities for different placement techniques of bulk-fill resin-based composites: a micro-computed tomography study

OBJECTIVES

The aim was to compare the porosity of different bulk-fill resin-based composites (RBCs) placement techniques to the conventional incremental technique using microcomputed tomography (μ-CT).

MATERIAL AND METHODS

Occlusal cavities were prepared on extracted human molars, divided into five groups based on the placement technique (n = 10/group). Techniques examined were Monoblock-two-step (SureFil SDR flow + Ceram.X), Monoblock-two-step (Tetric EvoFlow Bulk-Fill + Tetric EvoCeram Bulk-Fill), Monoblock-one-step (Tetric EvoCeram Bulk-Fill), Monoblock with sonic activation (SonicFill2), and incremental technique (Filtek Z250). μ-CT scanning (SkyScan, Bruker, Belgium) assessed the number, volume of closed pores, and total porosity. Analysis of variance on ranks was used (Student-Newman-Keuls method and Mann-Whitney rank-sum test), to determine the significance of RBC viscosity and the sonication placement technique. The Spearman correlation method assessed the correlation between porosity characteristics (α = 0.05).

RESULTS

The SonicFill2 presented a higher number of closed pores than the other groups (p < 0.05). The overall porosity within the restoration seemed greater in this order: Filtek Z250 > SonicFill2 > Tetric EvoFlow Bulk-Fill + Tetric EvoCeram Bulk-Fill > Tetric EvoCeram Bulk-Fill > SureFil SDR Flow + Ceram.X. Sonication was associated with increased number (p = 0.005) and volume (p = 0.036) of closed pores. A strong correlation was observed between the number and volume of closed pores (R2 = 0.549, p < 001).

CONCLUSIONS

The monoblock technique with sonic activation showed significantly more internal porosity than the other placement techniques. Sonication during application contributed to the higher number and volume of closed pores than the passive bulk-fill application.

CLINICAL RELEVANCE

Using bulk-fill materials enhances efficiency, yet void formation remains an issue, depending on viscosity and active/passive delivery of materials. Clinicians must familiarize themselves with effective placement techniques to reduce void formation and optimizing treatment outcomes.

Biocompatibility of bulk-fill resins in vitro

OBJECTIVES

This study aims to evaluate the cytotoxicity and genotoxicity of three different extracts obtained from Filtek™ One Bulk Fill, Tetric Evoceram® Bulk Fill and Coltene Fill-Up! resins.

MATERIALS AND METHODS

The cytotoxicity was determined on 3T3 fibroblast cells using the MTT and crystal violet assays. The genotoxicity was determined using a cytokinesis-block micronucleus assay.

RESULTS

The cytotoxicity of the resin extracts on 3T3 mouse fibroblasts was found to be dose-dependent with both the MTT and crystal violet assays. Extracts concentrated above 1% were cytotoxic according to the MTT assay. The Filtek™ One Bulk Fill, Tetric Evoceram® Bulk Fill, and Coltene Fill-Up! resins reached the LD50 at concentrations of 60%, 50%, and 20%, respectively, and showed genotoxicity rates that were 2-5 times, 3-8 times, and 4-15 times higher than the negative control, respectively.

CONCLUSIONS

Coltene Fill-Up! resin extracts were the most cytotoxic and genotoxic, followed by Tetric Evoceram® Bulk Fill and Filtek™ One Bulk Fill.

CLINICAL RELEVANCE

The analyzed bulk-fill resins showed differences in in vitro biocompatibility, and the Filtek™ One Bulk Fill was found to be the safest for clinical use.

Brief Narrative Review on Commercial Dental Sealants-Comparison with Respect to Their Composition and Potential Modifications

The scope of this paper is to compare different dental sealants and flow materials indicated for sealing pits and fissures considering their chemical formula. The narrative review aims to address the following questions: What is the essence of different dental sealants' activity, how does their chemical formula affect their mechanisms of caries prevention, and what makes a dental sealant efficient mean of caries prevention? Another vital issue is whether the sealants that contain fluoride, or any other additions, have potentially increased antimicrobial properties. An electronic search of the PubMed, Cochrane, Web of Science, and Scopus databases was performed. The following keywords were used: (dental sealants) AND (chemical composition). Additionally, information about composition and indications for clinical use provided by manufacturers were utilized. All of the considered materials are indicated for use both in permanent and primary dentition for sealing fissures, pits, and foramina caeca. The selection of suitable material should be made individually and adjusted to conditions of the sealing procedure and patient's needs. Cariostatic mechanisms increasing sealants' effectiveness such as fluoride release are desired in modern dentistry appreciating preventive approach. The review aims are to find crucial elements of sealants' composition which affect their cariostatic mechanisms.

Marginal Adaptation of In Vitro Class II Restorations Made Out of Bulk or Conventional Composite Using Single- or Multi-Layered Techniques

Objective: Testing the influence of various restorative materials (conventional or bulkfill composites) and filling techniques (single- or multi-layered techniques) on the in vitro marginal adaptation of large class II direct composites with supra and sub-gingival margins subjected to thermomechanical loading (TML). Methods: A total of 40 prepared teeth were attributed randomly to five experimental groups. In Group 1, restorations were made of multi-layered high-viscosity conventional composite (Tetric EvoCeram); in Groups 2 and 3, restorations were made of a high viscosity bulkfill composite (Tetric EvoCeram Bulk Fill) applied in one (Group 2) or three layers (Group 3); in Groups 4 and 5, restorations were made of a flowable bulkfill composite (SDR flow) applied in one (Group 4) or two layers (Group 5), covered with a layer of high-viscosity conventional composite (Ceram-X Universal). A single adhesive (OptiBond FL) was used in all groups. All specimens were submitted to a staged TML comprising three phases (2 × 500,000 and 1,000,000 cycles) at 50 N with 3350 thermal cycles (5 to 55 °C) every 500,000 cycles. The tooth-restoration interfaces on proximal surfaces were evaluated quantitatively by scanning electron microscopy, before and after each TML phase, hence at three timepoints (T0, T1, T2 and T3). The following segments were considered for evaluation: proximal, vertical enamel margins (assessed individually on both restoration sides), cervical enamel (restoration side above CEJ) and cervical dentin margin (restoration side below the CEJ). Results: TML induced a significant reduction in continuous adaptation at both enamel and dentin margins in all groups, with percentages of continuous margins ranging from 75.2 to 91.8% at T0, and decreasing to values ranging from 21.3 to 73.9% at T3. Both composite systems and layering protocols had a significant influence on marginal adaptation of the restorations, with statistical associations depending on the restoration group and the timepoint considered. Defective margins in enamel were all of a cohesive nature with micro-fractures, while in dentin, interfacial gaps were the main defect observed. Conclusions/Clinical significance: The present results highlighted significant degradation of marginal adaption after long-term in vitro fatigue test using materials even with high-viscosity conventional resin composites, applied with a proper layering approach in medium-large sub-gingival cavities. While no significant differences were observed at the dentin cervical margins, there was a tendency for better adaptation at the enamel margin when using a higher modulus material with a multi-layered technique.

Dentin Bonding Performance of Universal Adhesives in Primary Teeth In Vitro

(1) Background: The aim of this in vitro study was to evaluate the micro-tensile bond strength (µ-TBS) of universal adhesives to primary tooth dentin after different storage periods. (2) Methods: Dentin of 100 extracted primary molars was exposed. Dentin surfaces were bonded with six universal adhesives (Adhese®Universal [AU], All-Bond Universal® [ABU], G-Premio Bond [GPB], iBond®Universal [IBU], Prime&Bond active™ [PBa], and Prime&Bond®NT as control [PBN]) and restored with a resin composite build-up (Filtek™ Z250). After 24 h, 6 months, and 12 months of water storage, specimens were cut into sticks, and µ-TBS was measured and analyzed using one-way ANOVA (p < 0.05) for normal distributions and the Mann-Whitney U-test (p < 0.05) for non-normal distribution. Pretesting failures were recorded as 0 MPa. Fracture modes were analyzed under a fluorescence microscope; interfaces were visualized with SEM/TEM. (3) Results: Compared with the reference group (PBN: 32.5/31.2 MPa after 6/12 months), two adhesives showed a significantly higher bond strength after 6 months (AU: 44.1 MPa, ABU: 40.9 MPa; p < 0.05) and one adhesive after 12 months (AU: 42.9 MPa, p < 0.05). GPB revealed significantly lower bond strengths in all storage groups (16.9/15.5/10.9 MPa after 24 h/6 months/12 months; p < 0.05). AU and IBU did not suffer pre-test-failures [PTF]. (4) Conclusions: After 12 months, PBN, IBU, AU, and GPB showed significantly lower results compared ithw initial µ-TBS, whereas AU revealed the highest µ-TBS and no PTF.

Novel Bioactive Nanocomposites Containing Calcium Fluoride and Calcium Phosphate with Antibacterial and Low-Shrinkage-Stress Capabilities to Inhibit Dental Caries

OBJECTIVES

Composites are commonly used for tooth restorations, but recurrent caries often lead to restoration failures due to polymerization shrinkage-stress-induced marginal leakage. The aims of this research were to: (1) develop novel low-shrinkage-stress (L.S.S.) nanocomposites containing dimethylaminododecyl methacrylate (DMADDM) with nanoparticles of calcium fluoride (nCaF2) or amorphous calcium phosphate (NACP) for remineralization; (2) investigate antibacterial and cytocompatibility properties.

METHODS

Nanocomposites were made by mixing triethylene glycol divinylbenzyl ether with urethane dimethacrylate containing 3% DMADDM, 20% nCaF2, and 20% NACP. Flexural strength, elastic modulus, antibacterial properties against Streptococcus mutans biofilms, and cytotoxicity against human gingival fibroblasts and dental pulp stem cells were tested.

RESULTS

Nanocomposites with DMADDM and nCaF2 or NACP had flexural strengths matching commercial composite control without bioactivity. The new nanocomposite provided potent antibacterial properties, reducing biofilm CFU by 6 logs, and reducing lactic acid synthesis and metabolic function of biofilms by 90%, compared to controls (p < 0.05). The new nanocomposites produced excellent cell viability matching commercial control (p > 0.05).

CONCLUSIONS

Bioactive L.S.S. antibacterial nanocomposites with nCaF2 and NACP had excellent bioactivity without compromising mechanical and cytocompatible properties. The new nanocomposites are promising for a wide range of dental restorations by improving marginal integrity by reducing shrinkage stress, defending tooth structures, and minimizing cariogenic biofilms.

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.

Micromechanical interlocking structure at the filler/resin interface for dental composites: a review

Dental resin composites (DRCs) are popular materials for repairing caries or dental defect, requiring excellent properties to cope with the complex oral environment. Filler/resin interface interaction has a significant impact on the physicochemical/biological properties and service life of DRCs. Various chemical and physical modification methods on filler/resin interface have been introduced and studied, and the physical micromechanical interlocking caused by the modification of fillers morphology and structure is a promising method. This paper firstly introduces the composition and development of DRCs, then reviews the chemical and physical modification methods of the filler/resin interface, mainly discusses the interface micromechanical interlocking structures and their enhancement mechanism for DRCs, finally give a summary on the existing problems and development potential.

Effect of the Combination of Restorative Material and the Etching Protocol in Enamel Microleakage in Class II Cavities after Thermocycling

This study is aimed at evaluating the marginal microleakage of bulk-fill class II restorations after thermocycling. Thirty-two human third molars received class II cavities prepared on mesial and distal faces. The cavities were bonded according to the adhesive protocol (total or self-etching). The cavities were then restored with composite and divided into 8 groups based on the composite combination: layering technique with Filtek Z350XT (G1 and G5), first layer with Filtek Z350 XT Flowable Restorative and then Filtek Z350XT (G2 and G6), bulk-fill technique with Filtek One Bulk Fill (G3 and G7), and first layer with Filtek One Bulk Fill Flow and Filtek Z350 XT (G4 and G8). The restorations were then subjected to thermocycling (2000 cycles, 5°C and 55°C, dwell time of 30 s). After aging, the restored teeth were immersed in methylene blue for 48 hours. The restorations (n = 32) were sectioned in the middle (two sections). The microleakage results were analyzed by two-way ANOVA followed by Tukey's post hoc test (α = 0.05). The groups did not differ statistically from each other in terms of marginal microleakage (p = 0.295). It can be concluded that there is no difference in the percentage of microleakage between conventional and bulk-fill resins on both consistencies, as well as there is also no statistically significant difference when the adhesive system is used in a conventional or self-etching mode.

Tailoring the monomers to overcome the shortcomings of current dental resin composites - review

Dental resin composites (DRCs) have become the first choice among different restorative materials for direct anterior and posterior restorations in the clinic. Though the properties of DRCs have been improved greatly in recent years, they still have several shortcomings, such as volumetric shrinkage and shrinkage stress, biofilm development, lack of radio-opacity for some specific DRCs, and estrogenicity, which need to be overcome. The resin matrix, composed of different monomers, constitutes the continuous phase and determine the performance of DRCs. Thus, the chemical structure of the monomers plays an important role in modifying the properties of DRCs. Numerous researchers have taken to design and develop novel monomers with specific functions for the purpose of fulfilling the needs in dentistry. In this review, the development of monomers in DRCs were highlighted, especially focusing on strategies aimed at reducing volumetric shrinkage and shrinkage stress, endowing bacteriocidal and antibacterial adhesion activities as well as protein-repelling activity, increasing radio-opacity, and replacing Bis-GMA. The influences of these novel monomers on the properties of DRCs were also discussed.

Antibacterial Activity of Dental Composite with Ciprofloxacin Loaded Silver Nanoparticles

Resin composites have been widely used in dental restoration. However, polymerization shrinkage and resultant bacterial microleakage are major limitations that may lead to secondary caries. To overcome this, a new type of antibacterial resin composite containing ciprofloxacin-loaded silver nanoparticles (CIP-AgNPs) were synthesized. The chemical reduction approach successfully produced CIP-AgNPs, as demonstrated by FTIR, zeta potential, scanning electron microscopy, and ultraviolet-visible (UV-vis) spectroscopy. CIP-AgNPs were added to resin composites and the antibacterial activity of the dental composite discs were realized against Enterococcus faecalis, Streptococcus mutans, and the Saliva microcosm. The biocompatibility of modified resin composites was assessed and mechanical testing of modified dental composites was also performed. The results indicated that the antibacterial activity and compressive strength of resin composites containing CIP-AgNPs were enhanced compared to the control group. They were also biocompatible when compared to resin composites containing AgNPs. In short, these results established strong ground application for CIP-AgNP-modified dental composite resins.

Antibacterial dental resin composites (DRCs) with synthesized bis-quaternary ammonium monomethacrylates as antibacterial agents

Three bi-quaternary ammonium methacrylates (biQAMA-12, biQAMA-14, and biQAMA-16) with different alkyl chain length were synthesized with the purpose of endowing dental resin composites (DRCs) with antibacterial activity without sacrificing physicochemical properties of DRCs. All of biQAMAs were confirmed by ¹H-NMR spectra and incorporated into Bis-GMA/TEGDMA (60 wt/40 wt) resin matrix with a mass fraction of 5 wt% as antibacterial agent. The obtained resin matrixes were mixed with commercial silaned glass fillers at a mass ratio of 30 wt/70 wt to prepare antibacterial DRCs. The double bond conversion (DC), antibacterial activity against S. mutans., surface charge density, water contact angle, water sorption (WS) and solubility (SL), mechanical properties, and cytotoxicity of biQAMAs containing DRCs were investigated. The DRC without biQAMAs was used as control. The results showed that all biQAMAs containing DRCs had antibacterial rate higher than 90%, and DRC with biQAMA-12 had the highest antibacterial rate due to its highest surface charge density. Adding 5 wt% of biQAMAs would not bring out negative effect on physicochemical properties of DRCs, except for increasing WS, but the resultant WS still met the ISO requirement on WS of restorative materials. Both biQAMA-14 and biQAMA-16 containing DRCs showed higher cytotoxicity than control, thus biQAMA-12 was considered as the optimal antibacterial agent in this research.

Comparison of polymerization shrinkage of a new bulk-fill flowable composite with other composites: An in vitro study

OBJECTIVE

Since composites still face a critical problem called polymerization shrinkage and bulk-fill composites have reported acceptable results for this issue, this study aims to assess the polymerization shrinkage of a new bulk-fill flowable composite (G-aenial bulk injectable [GBI]) and compare it to other bulk-fill and conventional composites.

MATERIALS AND METHODS

In this in vitro study, 25 composite discs were fabricated using three bulk-fill and two conventional composites. They were bonded to a microscopic slide and were covered by a coverslip. This assembly was transferred to a linear variable differential transformer and composite samples were cured from underneath the slides. Dimensional changes formed in composite samples were recorded. Data were analyzed using analysis of variance followed by post hoc Tukey's and Dunnett's tests.

RESULTS

The groups were significantly different regarding polymerization shrinkage. G-aenial bulk injectable and G-aenial universal flo showed significantly higher polymerization shrinkage than other composites at 30, 60, and 1800 s after light irradiation, while X-tra fil and Filtek Z250 showed the lowest polymerization shrinkage at the aforementioned time points.

CONCLUSION

According to the results, the new composite had polymerization shrinkage similar to the conventional one. Bulk-fill composites reported similar or lower shrinkage to conventional composites.

Raman Spectroscopy as Spectral Tool for Assessing the Degree of Conversion after Curing of Two Resin-Based Materials Used in Restorative Dentistry

(1) Background: The treatment of dental cavities and restoration of tooth shape requires specialized materials with specific clinical properties, including being easy to model, light-cured, having a natural color, reduced shrinkage, a hardness similar to hydroxyapatite, and no leakage. The dimensional stability of resin composite materials is affected by polymerization shrinkage, degree of conversion (number of π carbon bonds converted into σ ones), thermal contraction and expansion, and interactions with an aqueous environment. (2) Methods: The materials used in our investigation were two composite resins with similar polymer matrices, but different filler (micro/nano filler). To evaluate the properties of samples, we employed the pycnometer technique (pycnometer from Paul Marienfeld Gmbh, Lauda-Königshofen, Germany), RAMAN spectroscopy technique (MiniRam Equipment from B&W Tek Inc., Plainsboro Township, NJ, USA; 785 nm laser source), SEM and EDX (FEI Inspect S.). (3) Results: The size of the filler plays an important role in the polymerization: for the pycnometric results, the larger particle filler (Sample 1) seems to undergo a rapid polymerization during the 45 s curing, while the nanoparticle filer (Sample 2) needs additional curing time to fully polymerize. This is related to a much larger porosity, as proved by SEM images. The lower degree of conversion, as obtained by Raman spectroscopy, in the same geometry means that the same volume is probed for both samples, but Sample 1 is more porous, which means less amount of polymer is probed for Sample 1. (4) Conclusions: For the two composites, we obtained a degree of conversion of 59% for Sample 1 and 93% for Sample 2, after 45 s of curing.

Characterization of Contemporary Conventional, Bulk-fill, and Self-adhesive Resin Composite Materials

OBJECTIVE

To evaluate the physical and biological properties of different types of flowable resin composites and their bonding ability to dentin, comparing the performance of self-adhesive and bulk-fill materials with a conventional control.

METHODS AND MATERIALS

Four flowable resin composites were tested: two self-adhesive (Y-flow [SA_YF]; and Dyad Flow [SA_DF]); one bulk-fill (Filtek Bulk Fill Flow [BF]); and one conventional composite (Opallis Flow [OF]). The microshear bond strength (μSBS) to dentin (bovine samples) was investigated at 24 hours and 6 months of storage. The materials were also characterized by degree of conversion, cross-link density, water contact angle, color stability, and cell viability (ISO 10993-5/2009) analyses. Data were analyzed using Analysis of Variance and Tukey tests (α=0.05).

RESULTS

The μSBS values were higher for control specimens at 24 hours, whereas the resin-dentin bonds were similarly distributed among the groups after aging. Adhesive failure was the most frequent pattern observed at both time intervals. SA_YF was the only material that increased the bond strength over time. Degree of conversion increased in the following order: SA_YF (28.6±1.4%) < BF (49.7±0.8%) < OF (60.0±2.0%) = SA_DF (63.6±2.3%). Cross-link density was similar among all materials. The self-adhesive composites were more hydrophilic than the other types, with BF showing the lowest water contact angle and the greatest color alteration. All resin composites had a biocompatible behavior.

CONCLUSION

Chemical composition appeared to be an influential factor affecting the physicomechanical and biological behavior of the materials tested.

Impact of Copper-Doped Mesoporous Bioactive Glass Nanospheres on the Polymerisation Kinetics and Shrinkage Stress of Dental Resin Composites

We embedded copper-doped mesoporous bioactive glass nanospheres (Cu-MBGN) with antibacterial and ion-releasing properties into experimental dental composites and investigated the effect of Cu-MBGN on the polymerisation properties. We prepared seven composites with a BisGMA/TEGDMA (60/40) matrix and 65 wt.% total filler content, added Cu-MBGN or a combination of Cu-MBGN and silanised silica to the silanised barium glass base, and examined nine parameters: light transmittance, degree of conversion (DC), maximum polymerisation rate (R_max), time to reach R_max, linear shrinkage, shrinkage stress (PSS), maximum PSS rate, time to reach maximum PSS rate, and depth of cure. Cu-MBGN without silica accelerated polymerisation, reduced light transmission, and had the highest DC (58.8 ± 0.9%) and R_max (9.8 ± 0.2%/s), but lower shrinkage (3 ± 0.05%) and similar PSS (0.89 ± 0.07 MPa) versus the inert reference (0.83 ± 0.13 MPa). Combined Cu-MBGN and silica slowed the R_max and achieved a similar DC but resulted in higher shrinkage. However, using a combined 5 wt.% Cu-MBGN and silica, the PSS resembled that of the inert reference. The synergistic action of 5 wt.% Cu-MBGN and silanised silica in combination with silanised barium glass resulted in a material with the highest likelihood for dental applications in future.

Development of low-shrinkage dental adhesives via blending with spiroorthocarbonate expanding monomer and unsaturated epoxy resin monomer

Polymerization shrinkage is one of the main drawbacks of dental resin adhesives. In this study, spiroorthocarbonate expanding monomer 3,9-diethyl-3,9-dimethylol -1,5,7,11-tetraoxaspiro-[5,5] undecane (DDTU) and unsaturated epoxy resin monomer Diallyl bisphenol A diglycidyl ether (DBDE) were synthesized and utilized as anti-shrinkage-coupling additive of methacrylate-based adhesives. Polymerization process and physicochemical properties including double bond conversion, polymerization shrinkage, compatibility, mechanical performance, thermal stability, contact angle, shear bond strength and cytotoxicity were characterized. Results indicated that adhesives containing anti-shrinkage-coupling additive had reduced volume shrinkage, improved compatibility and enhanced shear bond strength. When the amount of additive was 20 wt%, the volume shrinkage was decreased by 45.8% (4.17 ± 0.32%) and the shear bond strength was increased by 49.6% (19.64 ± 0.99 MPa). The results also showed that the use of additive had no adversely affect on double bond conversion and cytotoxicity. Therefore, novel low-shrinkage resin adhesives were prepared via blending with spiroorthocarbonate expanding monomer and unsaturated epoxy resin monomer.

Developments in resin-based composites

With the phasing down of dental amalgam use in response to the Minamata Convention, it is likely that resin-based composite restoratives will be the dental material of choice for the direct restoration of compromised dentition in the UK, at least for the foreseeable future. The current materials have a finite lifespan, with failures predominately due to either secondary caries or fracture. Consequently, there is considerable in vitro research reported each year with the intention of producing improved materials. This review describes the recent research in materials designed to have low polymerisation shrinkage and increased mechanical properties. Also described is research into materials that are either antimicrobial or are designed to release ions into the surrounding oral environment, with the aim of stimulating remineralisation of the surrounding dental tissues. It is hoped that by describing this recent research, clinicians will be able to gain some understanding of the current research that will potentially lead to new products that they can use to improve patient treatment in the future.

Provides an overview of recent research developments aimed at improving the performance of resin-based composites.

Details the recent developments in monomers and fillers to produce resin-based composites that either have lower polymerisation shrinkage or better mechanical properties compared to current commercially available products.

Describes recent research on developing resin-based composites that can act as potential sources of antimicrobial or remineralising agents.

Low-Shrinkage Resin Matrices in Restorative Dentistry-Narrative Review

Dimethacrylate-based resin composites restorations have become widely-used intraoral materials in daily dental practice. The increasing use of composites has greatly enhanced modern preventive and conservative dentistry. They have many superior features, especially esthetic properties, bondability, and elimination of mercury and galvanic currents. However, polymeric materials are highly susceptible to polymerization shrinkage and stresses that lead to microleakage, biofilm formation, secondary caries, and restoration loss. Several techniques have been investigated to minimize the side effects of these shrinkage stresses. The primary approach is through fabrications and modification of the resin matrices. Therefore, this review article focuses on the methods for testing the shrinkage, as well as formulations of resinous matrices available to reduce polymerization shrinkage and its associated stress. Furthermore, this article reviews recent cutting-edge developments on bioactive low-shrinkage-stress nanocomposites to effectively inhibit the growth and activities of cariogenic pathogens and enhance the remineralization process.

Effect of thickness on shrinkage stress and bottom-to-top hardness ratio of conventional and bulk-fill composites

This study evaluated the effect of the material thickness on shrinkage stress and bottom-to-top hardness ratio of conventional and bulk-fill composites. Six commercial composites were selected based on their different technologies: Two conventional (C1, C2), two high-viscosity bulk-fill (HVB1, HVB2), and two low-viscosity bulk-fill (LVB1, LVB2). Shrinkage stress was analyzed for five specimens with 2 mm thickness (C-factor 0.75 and volume 24 mm³ ) and five specimens with 4 mm thickness (C-factor 0.375 and volume 48 mm³ ) for 300 s in a universal testing machine. Bottom-to-top hardness ratio values were obtained from Knoop microhardness measurements in specimens with 2- and 4-mm thickness (n = 5). Thickness increase resulted in significantly higher shrinkage stress for all materials with the exception of HVB2 and LVB1. C1, C2, HVB2, and LVB1 showed lower bottom-to-top hardness ratios at 4 mm than at 2 mm. Only LVB2 presented a bottom-to-top hardness ratio lower than 80% at 2 mm, while HVB1 surpassed this threshold at 4 mm of depth. The results suggest that the increase of composite thickness affected the shrinkage stress values. Also, thickness increase resulted in lower bottom-to-top hardness ratio. HVB1 showed better behavior than other bulk-fill materials, with low stress and adequate bottom-to-top hardness ratio at 4 mm thickness.

Mechanical Properties of Experimental Composites with Different Photoinitiator

Objective  The effect of different photoinitiators on mechanical properties of experimental composites was evaluated.

Materials and Methods  Resin composites were formulated by using a blend of bisphenol A-glycidyl and triethylene glycol (50/50 wt%) dimethacrylate monomers, and 65 wt% of barium aluminium silicate and silica filler particles. Photoinitiators used were 0.2% camphorquinone (CQ) and 0.8% co-initiator (DMAEMA); 0.2% phenyl-propanedione and 0.8% DMAEMA; 0.1% CQ + 0.1% phenyl propanedione and 0.8% DMAEMA; 0.42% mono(acyl)phosphine oxide (MAPO); and 0.5% bis(acyl)phosphine oxide (BAPO). Specimens ( n = 10) were light cured by using a multiple-emission peak light-emitting diode for 20 seconds at 1,200 mW/cm ² of irradiance and Knoop hardness and plasticization, depth of cure, flexural strength, and elastic modulus were evaluated. Data were statiscally analyzed at significance level of α = 5%.

Results  Experimental composites containing MAPO and BAPO photoinitiators showed the highest values of flexural strength, elastic modulus, top surface hardness, and lower hardness reduction caused by alcohol compared with CQ. Composites containing CQ and PPD showed similar results, except for depth of cure and hardness of bottom surface.

Conclusion  BAPO and MAPO showed higher flexural strength, elastic modulus, hardness on top surface, and lower polymer plasticization to CQ.

Relationships between Flexural and Bonding Properties, Marginal Adaptation, and Polymerization Shrinkage in Flowable Composite Restorations for Dental Application

To evaluate the flexural and bonding properties, marginal adaptation, and polymerization shrinkage in flowable composite restorations and their relationships, four new generation flowable composites, one conventional, and one bulk-fill flowable composite were used in this study. Flexural properties of the composites and shear bond strength to enamel and dentin for flowable restorations were measured immediately and 24 h after polymerization. Marginal adaptation, polymerization shrinkage, and stress were also investigated immediately after polymerization. The flexural properties, and bond strength of the flowable composites to enamel and dentin were much lower immediately after polymerization than at 24 h, regardless of the type of the composite. Polymerization shrinkage and stress varied depending on the material, and bulk-fill flowable composite showed much lower values than the others. The marginal adaptation and polymerization shrinkage of the composites appeared to have a much stronger correlation with a shear bond strength to dentin than to enamel. The weak mechanical properties and bond strengths of flowable composites in the early stage after polymerization must be taken into account when using them in the clinic. In addition, clinicians should be aware that polymerization shrinkage of flowable composites can still lead to the formation of gaps and failure of adaptation to the cavity regardless of the type of composite.

Shrinkage Stress and Temperature Variation in Resin Composites Cured via Different Photoactivation Methods: Insights for Standardisation of the Photopolymerisation

The literature has shown that there is no consensus regarding the best resin composite photoactivation protocol. This study evaluated the efficiency of the conventional, soft-start, pulse-delay and exponential protocols for photoactivation of resin composites in reducing the shrinkage stress and temperature variation during the photopolymerisation. The photoactivation processes were performed using a photocuring unit and a smartphone app developed to control the irradiance according each photoactivation protocol. These photoactivation methods were evaluated applying photoactivation energies recommended by the resins manufactures. Three brands of resin composites were analysed: Z-250, Charisma and Ultrafill. The cure effectiveness was evaluated through depth of cure experiments. All results were statistically evaluated using one-way and multi-factor analysis of variance (ANOVA). The use of exponential and pulse-delay methods resulted in a significant reduction of the shrinkage stress for all evaluated resins; however, the pulse-delay method required too long a photoactivation time. The increases on the temperature were lower when the exponential photoactivation was applied; however, the temperature variation for all photoactivation protocols was not enough to cause damage in the restoration area. The evaluation of the depth of cure showed that all photoactivation protocols resulted in cured resins with equivalent hardness, indicating that the choice of an alternative photoactivation protocol did not harm the polymerisation. In this way, the results showed the exponential protocol as the best photoactivation technique for practical applications.

The Bond Strength and Antibacterial Activity of the Universal Dentin Bonding System: A Systematic Review and Meta-Analysis

Streptococcus mutans (S. mutans) is a group of viridans mostly located in oral flora among the wide and biodiverse biofilm. It plays a significant role not only in caries formation but also triggering intracerebral haemorrhage. The durable and stable bond interface, besides bacteria elimination, is one of the crucial factors influencing the resin composite restoration performance. This study aimed to evaluate universal adhesives (UAs) with regard to in vitro bond strength to dentin, and the inhibition of the S. mutans growth and compare them with UAs modified with antimicrobial agents through a systematic review and meta-analysis. Two reviewers performed a literature search up to April 2021 in 5 electronic databases: PubMed MedLine, Scielo, ISI Web of Science, Scopus, and EMBASE. Only in vitro studies reporting the effect of modifying UAs with antimicrobial agents on the bond strength to dentin and/or on the inhibition of the S. mutans were included. Analyses were carried out using Review Manager Software version 5.3.5 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). The methodological quality of each in vitro study was evaluated following the parameters of a previous systematic review. A total of 1716 potentially relevant publications were recognized. After reviewing the title and abstract, 16 studies remained in the systematic review. From these, a total of 3 studies were included in the meta-analysis. Since data from the studies included in the antimicrobial outcome included zero values, they could not be meta-analysed. Including 0 values in the analysis will lead to several biases in the analysis, so these data were discarded. The antibacterial effect against S. mutans of UAs modified with antimicrobial agents was higher than the non-modified adhesive systems. Within the limitations of the present study, the bond strength of UAs to dentin could be improved by using antimicrobial agents. The UAs modified with antibacterial agents showed a decrease in the viability of S. mutans biofilm, among the adhesives tested. However, there are not enough valid data on antibacterial properties of modified UAs; therefore, more well-designed research on these materials is needed.

24 hour polymerization shrinkage of resin composite core materials

PURPOSE

The study's purpose was to evaluate the 24-hour polymerization shrinkage of resin composite core materials.

MATERIAL AND METHODS

Eleven resin composite core material samples (n = 12) were evaluated using a non-contact imaging device with measurements obtained over 24 h. Shrinkage values were determined corresponding to proposed times involved with CAD/CAM same-day treatment and at 24 h. Shrinkage data was statistically compared using Friedman/Dunn's test for intragroup analysis and Kruskal Wallis/Dunn's test for intergroup analysis, all at a 95% level of confidence (α = 0.05).

RESULTS

Mean results identified a wide volumetric shrinkage range with considerable similarity overlap. Inconsistent shrinkage behavior was evident and all materials reached maximum values before 24 h. No significant difference was observed during proposed digital same day all ceramic crown procedures, but some differences were noted at 24 h.

CONCLUSIONS

Under this study's conditions results were material specific, at times inconsistent, with wide variation. Shrinkage consistently increased for all products and it is not known if the continued shrinkage magnitude may compromise the stability and fit of all-ceramic crowns at 24 h.

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

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

Effects of alternatively used thermal treatments on the mechanical and fracture behavior of dental resin composites with varying filler content

The purpose of this study was two-fold: (i) to investigate whether the thermal treatment of direct dental resin composites (RCs) using microwave or autoclave heating cycles would modify the materials' strength as compared to the protocol without heating (control); and (ii) to compare the mechanical performance of direct and indirect RCs. Three RCs (from 3M ESPE) were tested: one indirect (Sinfony); and two direct materials (microhybrid - Filtek Z250; and nanofilled - Filtek Z350). Specimens from the direct RCs were prepared and randomly allocated into three groups according to the thermal treatment (n = 10): Control - no thermal treatment was performed; Microwave - the wet heating was performed using a microwave oven; and Autoclave - the wet heating was performed in an autoclave oven. The indirect RC was prepared following the instructions of the manufacturer. All materials were tested using flexural strength, elastic modulus, work of fracture (Wf), microhardness, and scanning electron microscopy (SEM) analyses. Data were analyzed with ANOVA and Tukey as well as Weibull analysis (α = 0.05). The thermal treatments tended to produce slight changes in the topography of direct RCs, especially by the autoclave' wet heating. Overall, the physico-mechanical properties changed after thermal treatment, although this effect was dependent on the type of RC and on the heating protocol. Sinfony showed the lowest modulus and hardness of the study, although it was the most compliant system (higher work of fracture). The load-deflection ability was also greater for the indirect RC. Reliability of the tested materials was similar among each other (p > 0.05). In conclusion, the alternative thermal treatments suggested here may significantly influence some aspects of the mechanical behavior of dental resin composites, with negative effects relying on both the chemical composition of the restorative material as well as on the wet heating protocol used. Clinicians should be aware of the possible effects that additional wet heating of direct resin composites using microwave or autoclave thermal protocols as performed here could have on the overall fracture and mechanical responses during loading circumstances.

One-Year Clinical Aging of Low Stress Bulk-Fill Flowable Composite in Class II Restorations: A Case Report and Literature Review

Bulk-fill flowable composites provide functional and aesthetic restorations while eliminating incremental composite layering and saving time. The degradation of the adhesive interface with subsequent gap formation is a concern when adhesively luted restorations are placed. Moreover, the number of adhesive interface failures increases when they are exposed to long-term water storage. The aim of the present study was to evaluate the morphological characteristics of the tooth-composite interface in class II cavities restored with a low stress bulk-fill flowable composite after aging in an oral environment. We describe a case of a patient with class II cavities in four premolars restored with a low stress bulk-fill flowable composite Surefil SDR (Dentsply DeTrey GmbH, Konstanz, Germany). The occlusal part was restored with nano-hybrid resin composite Ceram X Mono (Dentsply DeTrey GmbH). After one year of clinical function, the teeth were extracted and examined in a scanning electron microscope (SEM). It can be concluded that the application of bulk-fill covered with conventional composite seems to provide the homogeneous and stable bond to tooth structure after one year of aging in an oral environment. However, some defects within the dentin-resin composite interface were observed.

OpenMandible: An open-source framework for highly realistic numerical modelling of lower mandible physiology

OBJECTIVE

Computer modeling of lower mandible physiology remains challenging because prescribing realistic material characteristics and boundary conditions from medical scans requires advanced equipment and skill sets. The objective of this study is to provide a framework that could reduce simplifications made and inconsistency (in terms of geometry, materials, and boundary conditions) among further studies on the topic.

METHODS

The OpenMandible framework offers: 1) the first publicly available multiscale model of the mandible developed by combining cone beam computerized tomography (CBCT) and μCT imaging modalities, and 2) a C++ software tool for the generation of simulation-ready models (tet4 and hex8 elements). In addition to the application of conventional (Neumann and Dirichlet) boundary conditions, OpenMandible introduces a novel geodesic wave propagation - based approach for incorporating orthotropic micromechanical characteristics of cortical bone, and a unique algorithm for modeling muscles as uniformly directed vectors. The base intact model includes the mandible (spongy and compact bone), 14 teeth (comprising dentin, enamel, periodontal ligament, and pulp), simplified temporomandibular joints, and masticatory muscles (masseter, temporalis, medial, and lateral pterygoid).

RESULTS

The complete source code, executables, showcases, and sample data are freely available on the public repository: https://github.com/ArsoVukicevic/OpenMandible. It has been demonstrated that by slightly editing the baseline model, one can study different "virtual" treatments or diseases, including tooth restoration, placement of implants, mandible bone degradation, and others.

SIGNIFICANCE

OpenMandible eases the community to undertake a broad range of studies on the topic, while increasing their consistency and reproducibility. At the same time, the needs for dedicated equipment and skills for developing realistic simulation models are significantly reduced.

One-year clinical evaluation of two high-viscosity glass-ionomer cements in class II restorations of primary molars

BACKGROUND

Little information exists on the clinical performance of restorative materials on primary teeth of preschool children. This study aimed to evaluate clinical performance of compomer, glass-hybrid-added high-viscosity glass-ionomer cement and zinc-added high-viscosity glass-ionomer cement materials in class ΙΙ restorations of primary molars.

METHODS

The study included 251 teeth of 57 patients aged 4-7 years with proximal caries in primary molars. The teeth were divided into three groups, and each restorative material was randomly distributed. Dyract XP, Equia Forte and ChemFil Rock materials were placed after cavity preparation and clinically evaluated at 3, 6, 9 and 12 months using modified United States Public Health Service criteria. Statistical analyses were performed using chi-square and z tests.

RESULTS

At the end of 12 months, a total of three restorations in Dyract XP group, 22 in Equia Forte group and 11 in ChemFil Rock group failed in retention criteria. No statistically significant difference existed between retention, colour match and surface texture criteria of all groups at 3 and 6 months, but a statistically significant difference was found at 12 months (P < 0.05).

CONCLUSION

For class ΙΙ restorations of primary molars, the success of compomer material was superior to high-viscosity glass-ionomer materials.

Effect of Layering Techniques on Polymerization Shrinkage Stress of High- and Low-viscosity Bulk-fill Resins

CLINICAL RELEVANCE

The use of layering techniques is still advisable with many bulk-fill resins and should be the default unless a particular resin is known to not need it.

SUMMARY

Objective: The purpose of this study was to investigate how layering techniques affect polymerization shrinkage stresses of high-and low-viscosity bulk-fill resins.Method: Six high-viscosity and six low-viscosity bulk-fill resins were evaluated. Aluminum blocks with a mesial-occlusal-distal (MOD) cavity were machined and randomly divided into groups for different filling techniques (bulk-fill vs horizontal layering vs oblique layering) and further subdivided according to type of resin (high- vs low-viscosity). The cuspal deflection resulting from the polymerization of bulk-fill resin bonded to a MOD cavity within an aluminum block was measured with a digimatic micrometer. Scanning electron microscopy analyses of tested resins were also conducted.Results: In the high-viscosity bulk-fill resins, cuspal deflection of the MOD cavity ranged from 11.2 to 18.2 μm with the bulk-filling technique, from 10.7 to 15.5 μm with the horizontal layering technique, and from 10.9 to 15.2 μm with the oblique layering technique. In the low-viscosity bulk-fill resins, cuspal deflection of the material ranged from 9.2 to 19.8 μm with the bulk-filling technique, from 8.2 to 15.7 μm with the horizontal layering technique, and from 8.4 to 16.4 μm with the oblique layering technique.Conclusion: Cuspal deflections for some high-and low-viscosity bulk-fill resins were significantly reduced by using layering techniques, but the resultant improvement of layering techniques was not applicable to all the bulk-fill resins used in this study.

Introducing Bioinspired Initiator into Resins for In Situ Repairing of 3D-Printed Metallic Structures

Delicate metal parts with superior electrical, mechanical, and thermal properties have attracted a lot of interest, but it is yet challenging to fabricate. Herein, a strategy of making complex metallic structures is developed in this research through integrating a bioinspired catechol-based initiator, dopamine, as an example, into the three-dimensional (3D) printing process followed by the assistance of surface modification. The wealthy catechol groups growing on the polymer enable the metal coating with a high adhesion stability. A series of complex metallic structures were fabricated, such as Ni-Co, Cu, and Ni Eiffel towers, Ag micro-stretching-dominated architecture, and Au auxetic structure. The introduced metal coating enables the 3D-printed objects with multiple classes of functionalities, such as magnetism or high conductivity. In particular, this method allows in situ repairing of the damaged metallic structures, which not only prolongs the lifespan of products but also solves the long-lasting challenge of repairing 3D printing parts. The detailed fabrication and repairing processes of functional metallic parts are presented and discussed. The proposed strategy has great potential in practical applications related to electronics, energy storage, healthcare, and so on.

Simulated Cuspal Deflection and Flexural Properties of Bulk-Fill and Conventional Flowable Resin Composites

CLINICAL RELEVANCE

Some bulk-fill flowable resin composites produce less cuspal deflection than a conventional incrementally filled flowable resin composites.

SUMMARY

Objective: This study investigated simulated cuspal deflection and flexural properties of bulk-fill and conventional flowable resin composites.Methods and Materials: Five bulk-fill and six conventional flowable resin composites were evaluated. Aluminium blocks with a mesio-occlusal-distal cavity were prepared and randomly divided into groups for each of the different measurement techniques and were further subdivided according to the type of flowable resin composite. The simulated cuspal deflection caused by the polymerization of resin composite within an aluminium block was measured using a highly accurate submicron digimatic micrometer or a confocal laser scanning microscope (CLSM). In addition, the flexural properties of tested resin composites were measured to investigate the relation between cuspal deflection and flexural properties, and the resin composites were observed using scanning electron microscopy.Results: Simulated cuspal deflection of some bulk-fill flowable resin composites was found to be significantly lower than or similar to those for conventional counterparts, regardless of the measurement method. There were statistically significant differences in flexural properties depending on the material, regardless of the type of flowable resin composite. Pearson correlation analysis did not reveal a statistically significant relationship between flexural properties and cuspal deflection.Conclusion: These results indicate that some bulk-fill flowable resin composites exhibit lower cuspal deflection with the bulk-filling technique than is shown by conventional flowable resin composites using the incremental filling technique. Simulated cuspal deflection can be measured using either a micrometer or CLSM, but this experiment failed to show a significant relationship between cuspal deflection and flexural properties of flowable resin composites.

Dynamic Viscoelastic Characterization of Bulk-fill Resin-based Composites and Their Conventional Counterparts

This study compared the viscoelastic properties of restorative and flowable bulk-fill resin-based composites (RBCs) with their conventional counterparts and evaluated the impact of aqueous solutions on viscoelastic properties. The materials examined included three conventional RBCs (Filtek Z350, Tetric N Ceram, and Beautifil II), three restorative bulk-fill RBCs (Filtek Bulk-Fill Restorative, Tetric N Ceram Bulk-Fill, and Beautifil Bulk-Fill Restorative) in addition to three flowable bulk-fill RBCs (Filtek Bulk-Fill Flowable, Tetric N Flow Bulk-Fill, and Beautifil Bulk-Fill Flowable). Beam-shaped specimens (12×2×2 mm) were fabricated using customized stainless-steel molds, finished, and measured. The specimens were randomly divided into four groups and conditioned in air (control), artificial saliva, 0.02 N citric acid, and 50% ethanol-water solution for seven days at 37°C. They were then subjected to dynamic mechanical analysis (n = 10) in flexure mode at 37°C with a frequency of 0.1 to 10 Hz. Storage modulus, loss modulus, and loss tangent data were subjected to statistical analysis using one-way analysis of variance/Tukey post hoc test at a significance level of α = 0.05. Viscoelastic properties of the RBCs were found to be product and conditioning medium dependent. For most RBCs, exposure to aqueous solutions, particularly an ethanol-water solution, degraded viscoelastic properties. With the exception of Filtek Bulk-Fill Restorative, bulk-fill restorative and flowable RBCs generally had significantly lower storage and loss modulus than their conventional counterparts regardless of conditioning medium. Conventional RBCs are thus favored over their bulk-fill counterparts, particularly for high-stress-bearing areas.

Which materials would account for a better mechanical behavior for direct endocrown restorations?

PURPOSE

To investigate the mechanical performance and fracture behavior of endocrown restorations prepared using different composite materials and following a direct technique.

METHODS

Sound molars were cut at 2 mm above the cementoenamel junction, endodontically treated, and allocated according to the type of restoration (n = 7): without post (endocrowns) or with post (post-retained restorations). Endocrowns were fabricated with conventional composite (Filtek Z350); bulk fill composite (Filtek Bulk Fill); conventional composite modeled using resin adhesives (SBMP: Scotchbond Multipurpose Adhesive; or SBU: Scotchbond Universal Adhesive); and lithium disilicate ceramic (E.max; Positive control). The post-retained restorations were fabricated with glass-fiber post combined with conventional or bulk fill composites. All restorations were bonded following an etch-and-rise adhesive approach or self-adhesive resin cement. The teeth were submitted to fatigue (Byocycle) and compression (EMIC DL500) testing at a crosshead speed of 1 mm/min. Data were analyzed with ANOVA and Tukey (p < 0.05) and Weibull analysis was carried out in order to evaluate the reliability of restorations.

RESULTS

The bulk-fill-based endocrown showed a stronger performance than the control. The presence of SBMP or the use of bulk-fill composite resulted in the occurrence of less aggressive fractures than the other restorative systems. Endocrowns bonded directly to the tooth seemed to produce similar fracture strength properties as compared to endocrowns bonded using self-adhesive resin cementation. The bulk-fill-based endocrown showed the greatest reliability of study.

CONCLUSION

Resin-based restorative materials seem to be interesting alternative options to fabricate large dental restorations in lieu of the more traditionally used glass ceramics or root canal post systems.

Study on a novel antibacterial light-cured resin composite containing nano-MgO

A new type of photocurable resin composite containing nano-MgO was synthesized in order to reduce the occurrence of secondary caries. Different mass ratios (0 %, 1 %, 2 %, 4 %, 8 %) of nano-MgO were added into resin composites. The antibacterial properties of nano-MgO powder and modified resin composites against Streptococcus mutans (S. mutans) were detected by antibacterial ring test and film contact test, respectively. Compressive strength (CS) and wear resistance were determined by a universal testing machine and an abrasion test machine. The results indicated that antibacterial activity and wear resistance of resin composites containing nano-MgO were superior to the control group (p < 0.05). The antibacterial rate reached as high as 99.4 % when the mass ratio of nano-MgO was 8 %. However, the CS values tended to decline as the content of nano-MgO increase. Hence, the addition of nano-MgO showed excellent antibacterial property to resin composites and enhanced wear resistance, but was detrimental to their mechanical properties.