Correlating cytotoxicity to elution behaviors of composite resins in term of curing kinetic

Quality of Cure in Depth of Commercially Available Bulk-fill Composites: A Layer-by-layer Mechanical and Biological Evaluation

Despite their popularity, the use of bulk-fill composites remains controversial, both in terms of their properties and their in-depth development. The objectives of the present work were (1) to provide a more comprehensive evaluation of the quality of cure in depth of commercially available bulk-fill composites by combining various key mechanical and biological characterization methods, (2) to evaluate the inter-material differences when optimally cured, and (3) to evaluate the efficiency of an antioxidant-N-acetyl-cysteine (NAC)-to restrain the adverse effects of the leached components on cell viability. Nine bulk-fill composites (including flowable and high-viscosity materials) were investigated and compared to two conventional resin-based composites, one flowable and one high-viscosity restorative material. The materials were injected or packed into Teflon molds of various configurations, up to 6 mm material thickness. They were then light-cured from the top for 20 seconds with Bluephase G2 (Ivoclar Vivadent, irradiance = 1050 mW/cm2). The following physicomechanical properties were measured for the upper (0-2 mm), intermediate (2-4 mm), and lower (4-6 mm) layers: degree of conversion using Raman Spectrometry (DC, in %), microhardness using a Vickers micro-indenter before (VHN dry) and after 24 hours of storage in ethanol (VHN EtOH), and flexural strength (in MPa) and flexural modulus (in GPa) using a three-point bend test. Each composite layer and an uncured layer were also stored for one week in a standard cell growth medium to generate conditioned media. Human dental pulp cells were then cultured for 24 hours with the latter and cell viability was measured using an MTS assay. A similar experiment was repeated with conditioned media produced in contact with uncured composites, with and without the addition of 4 mM NAC. The data were subjected to a Shapiro-Wilk test, then one-way ANOVA or Kruskal-Wallis test, followed either by Tukey's test (inter-material comparison) or by Dunnett's or Dunn's test (comparison between layers relative to the upper one). The level of statistical significance was set at 0.05. Some materials (EverX, X-traF, VenusBF, X-traB) did not show any significant differences (p>0.05) for any of the properties considered between the intermediate layers compared to the upper one (considered as reference). Others displayed significant differences, at least for some properties, highlighting the value of combining various key mechanical and biological characterization methods when investigating the quality of cure in depth. Significant inter-material differences (p<0.05) were observed when comparing the properties of their upper layer, considered as "optimally" polymerized. Hence, one needs to consider the absolute property values, not only their relative evolution concerning layer thickness. Finally, the use of NAC appeared as beneficial to reduce the risk of harmful effects to dental pulp cells, especially in case of excessive thickness use, and may therefore be of potential interest as an additive to composites in the future.

Effect of Adhesive Resin as a Modeling Liquid on Elution of Resin Composite Restorations

Background

Adhesive resin is increasingly used as a modeling liquid for composite. Based on previous studies, elution of some components from the composite mass negatively affects the oral tissues. Since few studies have focused on the effect of adhesive resin on composite mass, this study aimed to investigate the effect of dental adhesion factors as modeling liquid on the elution of substances from composite restorations.

Materials and Methods

Sixty-four composite specimens (6 × 2 mm diameter × height) were prepared in four groups (n = 16) by using a Teflon ring. Composite mass was incrementally applied in four layers (0.5 mm). The control group contained no material between the layers, but other groups had one of the single bond, SE bond, and wetting resin adhesives between the layers. Specimens were immersed in distilled water and methanol. The amount of released triethylene glycol dimethacrylate (TEGDMA), urethane dimethacrylate (UDMA), and camphorquinone (CQ) was monitored by gas chromatography after 24 hours and 7 days. Data were analyzed with SPSS software through Kruskal–Wallis and Mann–Whitney U tests (α = 0.05).

Results

The highest rate of released TEGDMA comonomer was seen in the wetting resin group in the water medium. The highest rate of released UDMA monomer was seen in SE bond and wetting resin groups in the methanol medium after 24 hours. The highest amount of released CQ in the methanol medium was observed in the SE bond group after 7 days.

Conclusion

Single bond adhesive can be used as modeling liquid since it has no significant effect on the elution of components from composite mass. Whereas, wetting resin and SE bond adhesives are not suitable to be used as modeling liquid due to the high amounts of released TEGDMA and UDMA.

Biophysical and Fluoride Release Properties of a Resin Modified Glass Ionomer Cement Enriched with Bioactive Glasses

The aim of this study was to evaluate the bond strength, microleakage, cytotoxicity, cell migration and fluoride ion release over time from a resin-modified glass-ionomer cement (RMGIC) enriched with bioactive glasses (BAGs) and a nanohybrid restorative polymer resin agent used as adhesion material in the cemented brackets. One hundred and twenty bovine lower incisors were divided into three groups: (Transbond Plus Self Etching Primer (TSEP)/Transbond XT (TXT), TSEP/ACTIVA, orthophosphoric acid gel/ACTIVA) and brackets were bonded. A bond strength test and microleakage test were applied. A fluoride release test was applied after 60 days for the TXT and ACTIVA group. To evaluate cytotoxicity and cell migration, a cell viability and scratch migration assay were done for each group. p values < 0.05 were considered significant. Regarding bond strength and microleakage test, no significant differences were found between TSEP/TXT and TSEP/ACTIVA. At 6.4 pH, ACTIVA showed a higher degree of fluoride ion release, which increased with acid pH (3.5), with a maximum fluoride secretion at 30 days. MTT assay revealed that TXT reduces the viability of gingival cells with significant differences (p < 0.001) compared to the untreated cells (control group). ACTIVA provides optimal adhesive and microfiltration properties, releases substantial amounts of fluoride ions in both acid and neutral media, and its biocompatibility is greater than that of traditional composite resin adhesive systems.

The effects of extended polymerization time for different resin composites on reactive oxygen species production and cell viability

PURPOSE

The present study was conducted to determine oxidative stress and cell viability after contact with resin composites polymerized for different times.

METHODS

Disk-shaped specimens of Admira Fusion, Ceram X One Universal, Solare x and Filtek Z550 (n = 12) were prepared, and two subgroups with polymerization times of 20 and 40 s were employed. The specimens were incubated with mouse fibroblast cells for 48 and 72 h, and changes in reactive oxygen species (ROS) production and cellular viability were determined by an assay with a cell-permeable fluorescent dye, 2',7'-dichlorodihydrofluorescein diacetate (H₂DCF-DA), and the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay, respectively.

RESULTS

At 72 h, ROS production in the presence of Admira Fusion polymerized for 40 s was reduced relative to that in the presence of Admira Fusion polymerized for 20 s (P < 0.05). Cell viability was maximal in the Admira Fusion and Solare x groups and there was no difference relative to the control group at 48 h. Cell viability was higher in the Admira Fusion and Solare x groups polymerized for 40 s than for the same materials polymerized for 20 s at 72 h (P < 0.05).

CONCLUSION

Extension of the polymerizaton time has a material-specific effect and may be used as a strategy to increase the biocompability of resin composites.

Effect of Camphorquinone Concentration in Physical-Mechanical Properties of Experimental Flowable Resin Composites

The aim of this study was to evaluate the effect of camphorquinone concentration in physical-mechanical properties of experimental flowable composites in order to find the concentration that results in maximum conversion, balanced mechanical strength, and minimum shrinkage stress. Model composites based on BISGMA/TEGDMA with 70% wt filler loading were prepared containing different concentrations of camphorquinone (CQ) on resin matrix (0.25%, 0.50%, 1%, 1.50%, and 2% by weight). Degree of conversion was determined by FTIR. Surface hardness was assessed before and after 24 h ethanol storage and softening rate was determined. Depth of cure was determined by Knoop hardness evaluation at different depths. Color was assessed by reflectance spectrophotometer, employing the CIE-Lab system. Flexural strength and elastic modulus were determined by a three-point bending test. Shrinkage stress was determined in a Universal Testing Machine in a high compliance system. Data were submitted to ANOVA and Tukey's test (α = 0.05). The increase in CQ concentration caused a significant increase on flexural strength and luminosity of composites. Surface hardness was not affected by the concentration of CQ. Composite containing 0.25% wt CQ showed lower elastic modulus and shrinkage stress when compared to others. Depth of cure was 3 mm for composite containing 1% CQ and 2 mm for the other tested composites. Degree of conversion was inversely correlated with softening rate and directly correlated with elastic modulus and shrinkage stress. In conclusion, CQ concentration affects polymerization characteristics and mechanical strength of composites. The concentration of CQ in flowable composite for optimized polymerization and properties was 1% wt of the resin matrix, which allows adequate balance among degree of conversion, depth of cure, mechanical properties, and color characteristics of these materials.