Polymerization contraction stress in light-cured packable composite resins

Temperature Changes in the Pulp Chamber During Orthodontic Bonding Using a High-Power Light-Emitting Diode Device With Two Different Exposure Times and Intensities: An In-Vitro Study

OBJECTIVE

This study used a high-power light-emitting diode (LED) device to evaluate the effects of two exposure times and intensities on pulp chamber temperature and cooling time during bracket bonding.

MATERIALS AND METHODS

Sixty upper premolars were used in the sample in this study. These premolars were split into two main groups based on the exposure time and intensity: the first group employed a traditional curing mode (TCG) for 20 seconds with an intensity of 1200 mw/cm2, whereas the second group had a quick curing mode (QCG) for 3 seconds with an intensity of 2500 mw/cm2. The pulp chamber's temperature variations and cooling times were recorded using a thermal imaging camera. The Mann-Whitney U test was used to find differences between the two-group comparison of the pulp chamber's temperature and cooling time.

RESULTS

The two groups had statistically significant differences regarding the temperature increase in the pulp chamber and cooling time (p > 0.001). The mean temperature increase in the traditional curing group was 3.52°C, which is greater than that in the quick curing group (i.e., a mean value of 1.28°C). The mean cooling time in the traditional curing group was 38.83 seconds, which is greater than that in the quick curing group (9.97 seconds).

CONCLUSIONS

Reducing the exposure time to 3 seconds and increasing the intensity to 2500 mw/cm2 is considered safer for the pulp chamber during and after the curing process.

Two-year clinical performance of dual- and light-cure bulk-fill resin composites in Class ӀӀ restorations: a randomized clinical trial

OBJECTIVE

This study aimed to compare the clinical performance of dual- and light-cure bulk-fill resin composites (BFRCs) in Class ӀӀ restorations after 2 years.

MATERIALS AND METHODS

A double-blinded, prospective, randomized clinical trial (RCT) was conducted following the CONSORT (Consolidated Standard of Reporting Trials) guidelines. Forty patients were enrolled in the study. Each patient received three compound Class ӀӀ restorations. One dual-cure (Fill-Up; Coltene Waledent AG) and two light-cure (QuiXfil; Dentsply, and Tetric N-Ceram Bulk Fill; Ivoclar Vivadent) BFRCs were used for 120 Class ӀӀ restorations. A universal adhesive (ONE COAT 7 UNIVERSAL; Coltene Waledent AG) was used with all restorations. Restorations were clinically evaluated after 1 week (baseline), 6 months, 12 months, 18 months, and finally after 24 months using the FDI World Dental Federation (FDI) criteria. The Kruskal-Wallis test was used for comparison between BFRCs groups at baseline and at each recall period, and the Wilcoxon signed-rank test was used for comparing different follow-up times of each BFRC to baseline. The level of significance was set at p < 0.05.

RESULTS

All BFRCs restorations showed only minor changes and revealed no statistically significant differences between their clinical performance for all evaluated parameters at all recall periods; also, there was no statistically significant difference between all recall periods and baseline for all evaluated parameters.

CONCLUSION

The two-year clinical performance of dual-cure BFRC was comparable to light-cure BFRCs in Class ӀӀ restorations.

CLINICAL RELEVANCE

Dual- and light-cure BFRCs showed excellent clinical performance in Class ӀӀ restorations after a 2-year clinical follow-up.

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.

Mechanical and Biomimetic Characteristics of Bulk-Fill Resin Dental Composites Following Exposure in a Simulated Acidic Oral Environment

During the last 10 years, various companies have marketed different "bulk-fill" resin dental composites for the restoration of posterior stress-bearing teeth; however, the impact of acidic conditions on these relatively newer materials has not been thoroughly investigated. Therefore, an attempt was made to evaluate the effect of acidic beverages on the mechanical biomimetic characteristics of four bulk-fill and one conventional nanohybrid resin-based dental composites (RBCs). The specimens of each RBC were stored in two acidic beverages namely 'Orange Juice' and 'Coca-Cola', whereas 'dry' and 'distilled water' storage of specimens served as controls. After 1 week of storage, flexural and surface hardness properties of specimens were determined using a universal testing machine and Vickers hardness tester, respectively. In general, the 'Coca-Cola' beverage caused the greatest degradation of flexural strength, flexural modulus, and surface hardness characteristics in all RBCs in contrast to the 'dry', 'distilled water' controls and 'Orange Juice' storage conditions. However, the overall mechanical biomimetic performance of nanohybrid RBCs was relatively better than all other bulk-fill RBCs and may, therefore, be considered a suitable candidate for the restoration of posterior stress-bearing permanent dentition.

Bond strength of bulk-fill resin composites

 Aim: Evaluating the resin-dentin bond strength of Class II conventional and bulk-fill composite restorations, using different cavity sizes before and after aging. Methods: Seventy-five human molars were distributed into groups according to the buccolingual width of the cavities, conservative (n=25) and extended (n=50). They were divided according to the restorative material: conventional (Z100/control group) or bulk-fill resin composites (Filtek Bulk Fill/FBF; Tetric N Ceram Bulk Fill/TNCBF; Filtek Bulk Fill Flow/FBFF; Surefill SDR flow/SDR). The restored teeth were sectioned on sticks (n=50 per restorative materials + width cavities group), half were stored in Water/Ethanol 75% for 30 days and the other half were submitted to the immediate microtensile bond strength (μTBS) test. Data were analyzed applying the Three-Way Analysis of Variance (ANOVA), Bonferroni test, test t, and Weibull analyses (p<0.05). Results: SDR and FBF presented lower μTBS values for extended preparation when compared to the conservative preparation, before aging. After aging, only for the FBFF, a decrease in the μTBS values was observed. Comparing the μTBS values, before and after aging, the SDR demonstrated lower μTBS values after aging when the conservative cavity was used. A decrease in the μTBS values was observed for the Z100, the FBF and, the FBFF, after aging, when the extended cavity was used. Conclusion: The effect of cavity preparation and aging on the resin-dentin of Class II is material dependent. Most of the bulk-fill resin composites evaluated presented a similar performance to the conventional resin composites for all the conditions of this study.

Effects of hybrid inorganic-organic nanofibers on the properties of enamel resin infiltrants - An in vitro study

This in vitro study aimed to evaluate the overall mechanical properties of resin infiltrants doped with bioactive nanofibers and their ability in inhibiting enamel demineralization or achieving remineralization of the adjacent enamel to white spots. A commercial resin infiltrant (ICON, DMG) was doped with hybrid inorganic-organic nanofibers and analyzed for degree of conversion (DC, n = 3) and surface hardness (SH, n = 6). Subsequently, enamel specimens (6 × 4 × 2 mm³) were prepared and submitted to a demineralizing/remineralizing process to produce a subsurface caries-like lesion. The specimens were treated with one of the following materials: ICON infiltrant, DMG (control); ICON + nanofibers of poly-lactic acid (PLA)-filled with silica (PLA-SiO₂); ICON + nanofibers of (PLA)-filled with calcium incorporated into a silica network (SiO₂-CaP). Then, the specimens were subjected to a pH-cycling demineralizing/remineralizing model for 7 days at 37 °C. The %ΔSH change (after treatment), %SH loss and %SH recovery (after pH-cycling regimen) were calculated after SH evaluation (n = 9/group). The Ca/P weight ratio before and after pH-cycling regimen was evaluated through SEM/EDX. The results of DC were analyzed through the T-test (p < 0.05). ANOVA followed by Tukey's test (p < 0.05) was performed for hardness and EDX. A significant SH increase was observed in the ICON/SiO₂CaP group (p < 0.05). The ICON/PLA-SiO₂ presented higher DC values than the control group (p = 0.043). All groups presented significant difference in %ΔSH (p < 0.05), although the specimens treated with ICON/SiO₂CaP presented greater values. Regarding the %SHL and %SHR, the ICON/SiO₂CaP and ICON/PLA-SiO₂ were significantly different compared to the control group (p < 0.001). However, no difference was observed between the ICON/SiO₂CaP and ICON/PLA-SiO_2. The Ca/P ratio showed that the ICON/SiO₂CaP and ICON/PLA-SiO₂ after the pH-cycling regimen differed from sound enamel and modified infiltrants before pH-cycling. In conclusion, tailored hybrid nanofibers may be incorporated into enamel resin infiltrants without compromise the mechanical properties of such experimental materials. These latter can inhibit the demineralization of enamel and increase its hardness during pH-clycling challange.

Effect of Different Application Techniques of Universal Bonding System on Microtensile Bond Strength of Bulk-Fill Composites to Primary and Permanent Dentin

Objectives

This study aimed to determine the microtensile bond strength (μTBS) of a bulk-fill composite to permanent and primary coronal dentin using a universal adhesive in self-etch and total-etch modes.

Materials and Methods

This in-vitro study was performed on 52 occlusal dentinal surfaces of human primary and permanent teeth. The crowns were cut to the gingival level. The 48 prepared dentin sections were randomly assigned to the following groups (n=13): A: Primary/Total-etch, B: Primary/Self-etch, C: Permanent/Total-etch, and D: Permanent/Self-etch. In groups A and C, after etching for 15 seconds, two layers of a universal bonding (Futurabond U) were applied and cured for 10 seconds. All samples were filled with a bulk-fill composite (x-trafil; VOCO) and cured for 40 seconds. The samples were cut to a bar-shaped dentin block with the dimensions of 1×1×1 mm³, and after 10,000 thermocycles, the μTBS test was accomplished at a crosshead speed of 1 mm/minute. The mean and standard deviation (SD) of μTBS were calculated, and the data were analyzed using two-way analysis of variance (ANOVA) and Fisher's exact test.

Results

The mean μTBS was as follows: A: 15.03±2.0279, B: 11.11±2.4423, C: 23.50±4.8165, and D: 16.26±6.3200 MPa. Futurabond U showed a higher μTBS in the total-etch mode (P<0.001). The permanent teeth had greater μTBS than the primary teeth (P<0.001). Similar percentages of failure modes were observed in the total-etch groups but in the self-etch groups, most failures were in the form of adhesive and mixed.

Conclusion

Greater μTBS was observed in the permanent teeth with the total-etch technique.

Shrinkage vectors in flowable bulk-fill and conventional composites: bulk versus incremental application

OBJECTIVES

Sufficient depth of cure allows bulk-fill composites to be placed with a 4-mm thickness. This study investigated bulk versus incremental application methods by visualizing shrinkage vectors in flowable bulk-fill and conventional composites.

MATERIALS AND METHODS

Cylindrical cavities (diameter = 6 mm, depth = 4 mm) were prepared in 24 teeth and then etched and bonded with OptiBond FL (Kerr, Italy). The composites were mixed with 2 wt% radiolucent glass beads. In one group, smart dentin replacement (SDR, Dentsply) was applied in bulk "SDR-bulk" (n = 8). In two groups, SDR and Tetric EvoFlow (Ivoclar Vivadent) were applied in two 2-mm-thick increments: "SDR-incremental" and "EvoFlow-incremental." Each material application was scanned with a micro-CT before and after light-curing (40 s, 1100 mW/cm²), and the shrinkage vectors were computed via image segmentation. Thereafter, linear polymerization shrinkage, shrinkage stress and gelation time were measured (n = 10).

RESULTS

The greatest shrinkage vectors were found in "SDR-bulk" and "SDR-increment2," and the smallest were found in "SDR-increment1-covered" and "EvoFlow-increment1-covered." Shrinkage away from and toward the cavity floor was greatest in "SDR-bulk" and "EvoFlow-increment2," respectively. The mean values of the shrinkage vectors were significantly different between groups (one-way ANOVA, Tamhane's T2 test, p < 0.05). The linear polymerization shrinkage and shrinkage stress were greatest in Tetric EvoFlow, and the gelation time was greatest in "SDR-bulk."

CONCLUSIONS

The bulk application method had greater values of shrinkage vectors and a higher debonding tendency at the cavity floor.

CLINICAL RELEVANCE

Incremental application remains the gold standard of composite insertion.

Vickers Hardness and Shrinkage Stress Evaluation of Low and High Viscosity Bulk-Fill Resin Composite

The aim of this in vitro study was to evaluate the hardness and shrinkage stress (SS) of six bulk-fill resin composites. To evaluate microhardness (MH), ten 6 mm specimens were prepared using a metal mold for each selected bulk-fill resin composite and irradiated from the top side for 40 s using an LED light. After 24 h of storage, Vickers MH was evaluated on the upper, lower and lateral sides of the specimens. SS evaluation was then performed with a universal machine, which evaluated the contraction force generated by a bulk-fill composite specimen placed between two metal cylinders during and after light curing. The results were evaluated with a one-way ANOVA test with a post-hoc Bonferroni test and linear regression analysis (p < 0.05). All materials showed a significant MH decrease between the top and bottom surfaces. However, the bulk-fill materials tested performed differently when considering lateral depth progression. ANOVA tests for SS evaluation showed that both SDR and Venus Bulk Fill had significantly lower stress during irradiation than other tested materials. Further, MH decrease became significantly lower from the top surface at different depths in each tested group. Among the different resins, Venus Bulk Fill and SDR showed not only inferior hardness, but also a significant reduction in SS.

Improved mechanical performance of self-adhesive resin cement filled with hybrid nanofibers-embedded with niobium pentoxide

OBJECTIVES

In this study hybrid nanofibers embedded with niobium pentoxide (Nb₂O₅) were synthesized, incorporated in self-adhesive resin cement, and their influence on physical-properties was evaluated.

METHODS

Poly(D,L-lactide), PDLLA cotton-wool-like nanofibers with and without silica-based sol-gel precursors were formulated and spun into submicron fibers via solution blow spinning, a rapid fiber forming technology. The morphology, chemical composition and thermal properties of the spun fibers were characterized by field emission scanning electron microscopy (FE-SEM), energy dispersive X-ray spectroscopy (EDS) and Fourier-transform infrared spectroscopy (FTIR), and differential scanning calorimetry (DSC), respectively. Produced fibers were combined with a self-adhesive resin cement (RelyX U200, 3M ESPE) in four formulations: (1) U200 resin cement (control); (2) U200+1wt.% PDLLA fibers; (3) U200+1wt.% Nb₂O₅-filled PDLLA composite fibers and (4) U200+1wt.% Nb₂O₅/SiO₂-filled PDLLA inorganic-organic hybrid fibers. Physical properties were assessed in flexure by 3-point bending (n=10), Knoop microhardness (n=5) and degree of conversion (n=3). Data were analyzed with One-way ANOVA and Tukey's HSD (α=5%).

RESULTS

Composite fibers formed of PDLLA-Nb₂O₅ exhibited an average diameter of ∼250nm, and hybrid PDLLA+Nb₂O₅/SiO₂ fibers were slightly larger, ∼300nm in diameter. There were significant differences among formulations for hardness and flexural strength (p<0.05). Degree of conversion of resin cement was not affected for all groups, except for Group 4 (p<0.05).

SIGNIFICANCE

Hybrid reinforcement nanofibers are promising as fillers for dental materials. The self-adhesive resin cement with PDLLA+Nb₂O₅ and PDLLA+Nb₂O₅/SiO₂ presented superior mechanical performance than the control group.

Influence of water aging on surface hardness of low-shrinkage light-cured composite resins

This study evaluated the microhardness of four types of low-shrinkage composite resins and two types of universal composite resins with either 12 or 16 J/cm² light power energy. Three disks were made for each group (n = 3) for a total of 36 specimens. The specimens were prepared by condensing the composite resin into a circular copper mold (diameter: 6 mm; height: 2 mm) and polymerizing with 700 mW/cm² light power density. The microhardness values of the resin specimens were measured using a Vickers hardness tester after different storage durations. Z250 and Clearfil Majesty Posterior composites showed softer subsurfaces when comparing the 24 h samples for all six types. Conversely, Kalore GC and Admira (AD) composites showed harder subsurfaces during the 24 h samples. All the composite resins showed significant differences (P < 0.05) in microhardness values at one of the aging times when they were polymerized with either 12 or 16 J/cm² light power energy. Composite resin AD had a higher microhardness value after polymerization with 12 J/cm² than with 16 J/cm². The results indicated that low-shrinkage composite resins have better subsurface characteristics, and the light power energy of 16 J/cm² is better for the polymerization of most composites.

Contraction and Hydroscopic Expansion Stress of Dental Ion-Releasing Polymeric Materials

Ion-releasing polymeric restorative materials seem to be promising solutions, due to their possible anticaries effect. However, acid functional groups (monomers) and glass filler increase hydrophilicity and, supposedly, water sorption. The purpose of the study was to evaluate the influence of water sorption of polymeric materials on the stress state at the restoration-tooth interface. Beautifil Bulk Fill Flow, Beautifil Flow Plus F00, Beautifil Flow F02, Dyract eXtra, Compoglass Flow, Ionosit, Glasiosite, TwinkiStar, Ionolux and Fuji II LC were used for the study. The stress state was measured using photoelastic analysis after: 0.5, 24, 72, 96, 168, 240, 336, 504, 672, 1344 and 2016 h. Moreover, water sorption, solubility and absorption dynamic were assessed. The water sorption, solubility and absorption dynamic of ion-releasing restorative materials are material dependent properties. The overall results indicated that the tested restorative materials showed significant stress decrease. The total reduction in contraction stress and water expansion stress was not observed for materials with low value of water sorption (Beautifil Bulk Fill, Dyract eXtra, Glasionosit and Twinky Star). The photoelastic method turned out to be inadequate to evaluate stress changes of resin modified glass-ionomer cement (RMGI, Fuji II LC and Ionolux).

Effect of fiber incorporation on the contraction stress of composite materials

OBJECTIVES

This study aimed to assess the effects of fiber incorporation on the contraction stress (CS), time to gelation (TG), and temperature rise (TR) features of two experimental resin-based composites (RBCs) in comparison to those of bulk-fill RBCs and conventional RBCs in simulated, clinically relevant cavities.

MATERIALS AND METHODS

CS over 300 s, TG and TR were assessed by a stress-strain analyzer (SSA T80) in two cavity configurations (2 × 4 × 4 mm³/4 × 4 × 4 mm³/configuration value [Formula: see text] and [Formula: see text]) for two experimental RBCs, eight bulk-fill RBCs (EverX Posterior, Filtek Bulk Fill, SDR, SonicFill, Tetric EvoCeram Bulk Fill, Venus Bulk Fill, X-tra base, and X-tra Fill) and one RBC (Filtek Supreme XTE) by light curing (1200 mW/cm²) (n = 10). The experimental materials used were based on EverX Posterior with modifications made to the fiber and filler content. Statistical analyses were performed via ANOVA; multiple pair-wise comparisons were performed via Tukey's test, and homogeneous subsets were identified ("multcomp" package, R).

RESULTS

CS values ranged from 1.00 to 4.07 MPa (2 × 4 × 4 mm³) and from 0.97 to 2.49 MPa (4 × 4 × 4 mm³); TG values ranged from 1.31 to 4.05 s (2 × 4 × 4 mm³) and from 1.39 to 3.84 s (4 × 4 × 4 mm³). SDR values showed lowest stress values in both cavity configurations. The experimental composite with fibers presented significantly higher stress values than did the experimental composite without fibers.

CONCLUSION

Bulk-fill RBCs showed lower levels of stress than did conventional RBCs. The incorporation of fibers had no positive impact on the CS and TG.

CLINICAL RELEVANCE

Appropriate material selection may be essential to clinical success because certain RBCs exhibit higher CS, TG, and TR values.

Polymerization shrinkage and shrinkage force kinetics of high- and low-viscosity dimethacrylate- and ormocer-based bulk-fill resin composites

The aim of the present study was to investigate polymerization shrinkage, shrinkage force development, and degree of monomer conversion of high- and low-viscosity dimethacrylate- and ormocer-based bulk-fill resin composites. Two flowable bulk-fill composites (SDR, x-tra base), two high-viscosity bulk-fill composites (Bulk Ormocer, SonicFill), and two conventional composite materials (Esthet X flow, Esthet X HD) were photoactivated for 20 s at 1275 mW/cm². Linear polymerization shrinkage and shrinkage force were recorded in real time using custom-made devices, and the force rate and time to achieve maximum force rate were determined. Degree of conversion was measured using Fourier-transform infrared spectroscopy. Data were analyzed with one-way ANOVA and Tukey's HSD post-hoc test, and bivariate correlations were computed (α = 0.05). The category of high-viscosity bulk-fill resin composites showed the significantly lowest polymerization shrinkage and force development. Within the tested flowable composite materials, SDR bulk-fill generated the significantly lowest shrinkage forces during polymerization and attained the significantly highest degree of conversion. Strong positive correlations were revealed between shrinkage force and both linear polymerization shrinkage (r = 0.902) and maximum force rate (r = 0.701). Linear shrinkage and shrinkage force both showed a negative correlation with filler volume content (r = - 0.832 and r = - 0.704, respectively). Bulk-fill resin composites develop lower shrinkage forces than their conventional flowable and high-viscosity counterparts, respectively, which supports their use for restoring high C-factor posterior cavities. Overall, bulk-fill composites with high filler amount and low force rate showed the most favorable shrinkage force characteristics.

Marginal Gap Formation in Approximal “Bulk Fill” Resin Composite Restorations After Artificial Ageing

The aim of this in vitro study was to investigate the marginal gap formation of a packable “regular” resin composite (Filtek Supreme XTE [3M ESPE]) and two flowable “bulk fill” resin composites (Filtek Bulk Fill [3M ESPE] and SDR [DENTSPLY DeTrey]) along the approximal margins of Class II restorations. In each of 39 extracted human molars (n=13 per resin composite), mesial and distal Class II cavities were prepared, placing the gingival margins below the cemento-enamel junction. The cavities were restored with the adhesive system OptiBond FL (Kerr) and one of the three resin composites. After restoration, each molar was cut in half in the oro-vestibular direction between the two restorations, resulting in two specimens per molar. Polyvinylsiloxane impressions were taken and “baseline” replicas were produced. The specimens were then divided into two groups: At the beginning of each month over the course of six months' tap water storage (37°C), one specimen per molar was subjected to mechanical toothbrushing, whereas the other was subjected to thermocycling. After artificial ageing, “final” replicas were produced. Baseline and final replicas were examined under the scanning electron microscope (SEM), and the SEM micrographs were used to determine the percentage of marginal gap formation in enamel or dentin. Paramarginal gaps were registered. The percentages of marginal gap formation were statistically analyzed with a nonparametric analysis of variance followed by Wilcoxon-Mann-Whitney tests and Wilcoxon signed rank tests, and all p-values were corrected with the Bonferroni-Holm adjustment for multiple testing (significance level: α=0.05). Paramarginal gaps were analyzed descriptively. In enamel, significantly lower marginal gap formation was found for Filtek Supreme XTE compared to Filtek Bulk Fill (p=0.0052) and SDR (p=0.0289), with no significant difference between Filtek Bulk Fill and SDR (p=0.4072). In dentin, significantly lower marginal gap formation was found for SDR compared to Filtek Supreme XTE (p&lt;0.0001) and Filtek Bulk Fill (p=0.0015), with no significant difference between Filtek Supreme XTE and Filtek Bulk Fill (p=0.4919). Marginal gap formation in dentin was significantly lower than in enamel (p&lt;0.0001). The percentage of restorations with paramarginal gaps varied between 0% and 85%, and for all three resin composites the percentages were markedly higher after artificial ageing. The results from this study suggest that in terms of marginal gap formation in enamel, packable resin composites may be superior to flowable “bulk fill” resin composites, while in dentin some flowable “bulk fill” resin composites may be superior to packable ones.

Effect of Zirconia Nanoparticles in Epoxy-Silica Hybrid Adhesives to Join Aluminum Substrates

This research presents the interaction of the epoxy polymer diglicydil ether of bisphenol-A (DGEBA) with silica (SiO₂) nanoparticles plus zirconia (ZrO₂) nanoparticles obtained via the sol-gel method in the synthesis of an epoxy-silica-zirconia hybrid adhesive cured with polyamide. ZrO₂ nanoparticles were added to the epoxy-silica hybrid adhesive produced in situ to modify the apparent shear strength of two adhesively bonded aluminum specimens. The results showed that the addition of different amounts of ZrO₂ nanoparticles increased the shear strength of the adhesively bonded aluminum joint, previously treated by sandblasting, immersion in hot water and silanized with a solution of hydrolyzed 3-glycidoxipropyltrimethoxysilane (GPTMS). The morphology and microstructure of the nanoparticles and aluminum surfaces were examined by scanning electron microscopy (SEM), and elemental analysis was performed with the Energy-dispersive X-ray spectroscopy (EDS) detector; the chemical groups were investigated during the aluminum surface modification using Fourier transform infrared spectroscopy (FTIR).

Cuspal Deflection of Premolars Restored with Bulk-Fill Composite Resins

OBJECTIVE

This in vitro study compared cuspal deflection of premolars restored with three bulk-fill composite resins to that of incrementally-restored ones with a low-shrinkage silorane-based restorative material.

MATERIALS AND METHODS

Forty freshly-extracted intact human upper premolars were used. Reference points at buccal and palatal cusp tips were acid-etched and composite rods were horizontally bonded to them (TPH-Spectra-HV, Dentsply). Two acrylic resin guiding paths were made for each premolar to guide beaks of a digital micrometer used for cuspal deflection measurements. Standardized MOD cavities, 3 mm wide bucco-lingually and 3.5 mm deep, were prepared on each premolar. Prepared teeth were then equally divided into four groups (n = 10) and each group was assigned to one of four composite resin (QuiXX, Dentsply; X-tra fil, Voco; Tetric EvoCeram Bulk Fill, Ivoclar Vivadent; low-shrinkage Filtek LS, 3M/ESPE). Adper Single Bond-Plus, 3M/ESPE was used with all bulk-fill restoratives. LS-System Adhesive, 3M/ESPE was used with Filtek LS. For each prepared premolar, cuspal deflection was measured in microns as the difference between two readings between reference points before and after restoration completion. Means and SDs were calculated and data statistically-analyzed using One-way ANOVA and Tukey's test.

RESULTS

Filtek LS showed the lowest mean cuspal deflection value 6.4(0.84)μm followed by Tetric EvoCeram Bulk Fill 10.1(1.2) μm and X-tra fil 12.4(1.35)μm, while QuiXX showed the highest mean 13(1.05)μm. ANOVA indicated significant difference among mean values of groups (p < 0.001). Tukey's test indicated no significant difference in mean values between QuiXX and X-tra fil (p = 0.637).

CONCLUSIONS

Tetric EvoCeram Bulk Fill had significantly lower mean cuspal deflection compared with the two other bulk-fill composite resins tested. Filtek LS had the lowest significant mean cuspal deflection in comparison to all tested bulk-fill restoratives.

CLINICAL SIGNIFICANCE

The use of Tetric EvoCeram Bulk fill composite resin restorative for class II MOD cavities resulted in reduced cuspal deflection in comparison to the two other bulk-fill composite resins tested. The silorane-based Filtek LS restorative resulted in the least cuspal deflection in comparison to all tested bulk-fill composite restoratives.

The effect of bonding and surface sealant application on postoperative sensitivity from posterior composites

PURPOSE

The purpose of the study was to evaluate the postoperative sensitivity of posterior Class I composite restoration at short-term, restorated with two different all-in-one self-etch adhesives with or without surface sealant application.

MATERIALS AND METHODS

44 restorations were inserted in 11 patients who required Class I restorations in their molars. Each patient received 4 restorations, thus four groups were formed; (1) G-Aenial Bond (GC, Japan); (2) Clearfil S3 Bond (Kuraray, Japan); (3) G-Aenial Bond+Fortify Plus (Bisco, USA), (4) Clearfil S3 Bond+Fortify Plus. Sensitivity was evaluated at 24h, 7, 15, and 30 days using cold air, ice, and pressure stimuli using a visual analog scale. Comparisons of continuous variables between the sensitivity evaluations were performed using the Friedman's One-Way Analysis of Variance with repeated measures test (p<0.05).

RESULTS

The type of adhesive used and the application of a surface sealant had no significant effects in postoperative sensitivity (p>0.05). The use of Clearfil S3 Bond resulted in almost the same level of postoperative sensitivity as did the use of G-Aenial Bond. The highest sensitivity scores were observed for the surface sealant applied teeth without any statistical significance (p>0.05).

CONCLUSION

Self etch adhesives displayed postoperative sensitivity. The sensitivity scores slightly decreased at the end of 30 days (p>0.05). Surface sealant application did not result in a decrease in sensitivity scores for either dentin adhesives.

Polymerization Shrinkage Stress Kinetics and Related Properties of Bulk-fill Resin Composites

The present study assessed the polymerization shrinkage stress kinetics of five low-shrinkage light-cured bulk-fill resin composites: Surefil SDR flow (SF, Dentsply), Tetric EvoCeram Bulkfil (TE, Ivoclar Vivadent), Venus Bulk Fill (VB, Heraeus Kulzer), x-tra fil (XF, Voco), and experimental bulk fill (FB, 3M ESPE). Filtek Z250 (FZ, 3M ESPE) was used as a control. Real-time shrinkage stress of investigated composites was measured using a tensometer; maximum shrinkage stress, stress rate (Rmax), and time to reach maximum stress rate (tmax) were recorded. Flexural strength and modulus were measured using a standard procedure, and curing efficiency of 4-mm long specimens was determined using bottom/top percentage Knoop microhardness. Data were analyzed using one-way analysis of variance and Bonferroni multiple range tests at a significance level of α=0.05. Results of shrinkage stress, Rmax, and tmax of all bulk-fill materials were significantly lower (p&lt;0.05) than those of the control except for XF. All tested bulk-fill materials were able to achieve acceptable curing efficiency (≥80% bottom/top percentage) at 4-mm depth. In conclusion, this study reports a significant reduction in polymerization shrinkage stress while maintaining comparable curing efficiency at 4 mm for some bulk-fill composites and supports their potential use in posterior clinical situations.

The effect of time between handling and photoactivation on self-adhesive resin cement properties

PURPOSE

To evaluate the degree of conversion, absorption, and solubility in water of self-adhesive resin cements subjected to different time intervals between material preparation and the photoactivation procedure.

MATERIALS AND METHODS

Two dual self-adhesive resin cements were tested: RelyX Unicem and SmartCem2. The degree of conversion as a function of time was evaluated by Fourier-transformed infrared spectroscopy using the attenuated total reflectance technique. Three time intervals between handling and photoactivation were applied: Group 1 = immediately; Group 2 = a 1-minute interval; Group 3 = a 4-minute interval. All specimens were irradiated with a light-emitting diode source for 40 seconds. Thirty discs of each cement (1 mm thick × 6 mm diameter, n = 10) were prepared for the absorption and solubility tests. These specimens were stored in distilled water at 37°C for 90 days. The results were subjected to ANOVA with two factors (material and activation time intervals) and Tukey's test (95% significance).

RESULTS

The 4-minute interval significantly reduced the degree of conversion of SmartCem2 (30.6% ± 8.3%). No other significant changes were observed for the degree of conversion; however, the time intervals before photoactivation interfered significantly in the water absorption of the RelyX Unicem specimens but not the SmartCem2 specimens. The time intervals did not affect the solubility of either cement. In all cases, SmartCem2 had higher solubility than RelyX Unicem.

CONCLUSION

The time interval between handling and photoactivation significantly influenced the degree of conversion and water sorption of the resin-based cements. In general, one can say that the self-adhesive resin cements should be photoactivated as soon as possible after the material handling process.

Cytotoxicity of a silorane-based dental composite on human gingival fibroblasts

AIM: To evaluate the direct and indirect biocompatibility of Filtek Silorane on human gingival fibroblastic cells.

METHODS: Sixty-three standardized cylindrical specimens (8 mm diameter and 2 mm thickness) of restorative material were prepared using a light emitting diode-curing unit. The sample were built up in one increment and divided in 2 groups. In the first group, 21 samples (unpolished samples) were left without a specific polishing procedure; in the second one, 42 samples (polished samples) were polished with 4 different grains of discs. Fibroblast cultures, obtained from gingiva of 2 subjects without systemic and oral disease, were used to assess the direct and indirect biocompatibility. Cells cultured for 48 h in normal culture medium were used as a control.

RESULTS: The scanning electron microscope observations of fibroblasts cultured on the silorane samples, either polished or unpolished, confirmed the good biocompatibility of the material, favouring the cellular spreading. 3-dimethylthiazol-2, 5-diphenyltetrazolium bromide tests showed a significant reduction (P < 0.01) of gingival fibroblasts viability cultured both in polished samples (90.05% ± 19.00%) and unpolished samples (78.15% ± 11.00%) compared with the control. Cells growth in medium conditioned with the samples for 1 wk showed a significant viability reduction (P < 0.01) compared to the control. A reduction of cell viability was observed even in the groups containing the material for 3 wk (polished: 89.45% ± 10.00%; unpolished: 65.97% ± 10.00%), even if the cytotoxicity was reduced after this long time exposure.

CONCLUSION: Although the poor chromatic availability of this material remains a big limit that restricts its use to posterior sectors, the silorane-based material can be considered an option to perform restorations when aesthetic demands are not the priority, such as the class II restorations

Alternatives in polymerization contraction stress management

Polymerization contraction stress of dental composites is often associated with marginal and interfacial failure of bonded restorations. The magnitude of the stress depends on the composite's composition (filler content and matrix composition) and its ability to flow before gelation, which is related to the cavity configuration and curing characteristics of the composite. This article reviews the variations found among studies regarding the contraction stress testing method, contraction stress values of current composites, and discusses the validity of contraction stress studies in relation to results from microleakage tests. The effect of lower curing rates and alternative curing routines on contraction stress values is also discussed, as well as the use of low elastic modulus liners. Moreover, studies with experimental Bis-GMA-based composites and recent developments in low-shrinkage monomers are described.

Comparative evaluation of microleakage in class II cavities restored with Ceram X and Filtek P-90: An in vitro study

Context:

Polymerization shrinkage in composite resins is responsible for microleakage. Methacrylate-based composite resins have linear reactive groups resulting in high polymerization shrinkage. A recently introduced composite resin Filtek P90 is based on siloxanes and oxiranes which polymerize by cationic “ring opening” polymerization resulting in reduced polymerization shrinkage.

Objectives:

Aim of this study was to compare microleakage in class II cavities restored with a nanoceramic restorative (Ceram X) and a silorane composite (Filtek P90).

Materials and Methods:

Standardized class II box type cavities were prepared on mesial (Groups Ia and IIa) and distal (Groups Ib and IIb) surfaces of twenty extracted permanent molar teeth with gingival floor ending 1 mm coronal and apical to the cementoenamel junction, respectively. The teeth in Group Ia and Ib were restored with Ceram X and Group IIa and IIb with Filtek P90. The specimens were thermocycled and microleakage evaluated.

Statistical Analysis Used:

The data were statistically analyzed using Wilcoxon Signed-Rank test at the 0.05 level of significance.

Results:

Mean microleakage score of group la and lb was 1 ± 2.260 and 2.8 ± 1.229, respectively. And that of group Ila and llb was 0.2 ± .869 and 0.3 ± .588, respectively. When groups I and II were compared, results were statistically significant (P<0.05).

Conclusion:

It was concluded that silorane-based composite may be a better substitute for methacrylate-based composites.

Microleakage of silorane- and methacrylate-based class V composite restorations

The marginal integrity of class V restorations in a silorane- and a group of methacrylate-based composite resins with varying viscosities was tested in the present study. Different adhesives (OptiBond FL, KerrHawe; AdheSE One, Vivadent; or Silorane System Adhesive, 3M ESPE) were applied to 168 standardized class V cavities. The cavities (n = 12) were filled with a wide range of different viscous composite resins: Filtek Silorane, 3M ESPE; els and els flow, Saremco; Tetric EvoCeram and Tetric EvoFlow, Vivadent; Grandio, Voco; and Ultraseal XT Plus, Ultradent. Microleakage of the restoration was assessed by dye penetration (silver staining) on multiple sections with and without thermocycling and mechanical loading (TCML: 5,000 × 5-55°C; 30 s/cycle; 500,000 × 72.5 N, 1.6 Hz). Data were statistically analyzed with the Mann-Whitney U test and the Error Rates Method (ERM). The silorane-based composite resin yielded the lowest dye penetration after TCML. Microleakage of methacrylate-based composite restorations, in general (ERM), was statistically significantly influenced by the adhesive system, Moreover, dye penetration at enamel margins was significantly lower than dye penetration at dentin margins. The chemical basis of composite resins and adjacent tooth substance seems to strongly influence marginal sealing of class V restorations for methacrylate-based materials. Moreover, the steps of dental adhesives used affected marginal integrity. The silorane-based composite resin evaluated in the present study exhibits the best marginal seal. The three-step adhesive yielded better marginal sealing than the one-step adhesive for methacrylate-based class V composite restorations.

Effect of C-factor on microtensile bond strengths of low-shrinkage composites

This study evaluated the microtensile bond strength (μ-TBS) of low-shrinkage composites with their corresponding adhesive systems, Filtek Silorane/Silorane adhesive (SIL, 3M ESPE AG, Seefeld, Germany) and Aelite LS/One-Step Plus (AL, BISCO Inc, Schaumburg, IL, USA) in cavities with different C-factors. Filtek Z250/Adper Single Bond Plus (Z, 3M ESPE, St Paul, MN, USA) was used as a control.

METHOD

Standardized Class I cavities were prepared in extracted human molars after removing occlusal enamel. Cavities were assigned into six different C-factors by applying nail polish to four walls, three walls, two walls adjacent to each other, two walls opposite to each other, one wall, or no walls. Resin composites with their corresponding adhesive systems were applied according to manufacturer instructions. Specimens were sectioned to obtain four rectangular beams from the center of the restorations and μ-TBS was measured. Data were analyzed by Weibull survival analysis. Shrinkage stresses of the resin composites were determined after 30 minutes from the start of light-curing using a tensometer testing machine. Flexure elastic modulus was determined using standard procedures, in accordance with ISO 4049. Data for shrinkage stress and elastic modulus were analyzed by one-way analysis of variance followed by a Tukey multiple-comparisons test (p<0.05).

RESULTS

μ-TBS of both SIL and AL were not affected by different C-factors; however, the bond strength of Z decreased significantly when the C-factor increased. Shrinkage stress results were 0.94 ± 0.1, 1.79 ± 0.18, and 2.14 ± 0.23 MPa for SIL, AL, and Z, respectively. The flexural modulus of both the SIL and the AL was significantly lower than that of Z.

CONCLUSIONS

Increasing C-factor did not negatively affect the bond strength of low-shrinkage composites.

Contraction stresses in dental composites adjacent to and at the bonded interface as measured by crack analysis

The objective of this study was to calculate stresses produced by polymerization contraction in regions surrounding a dental resin composite restoration. Initial cracks were made with a Vickers indenter at various distances from the edge of a cylindrical hole in a soda-lime glass disk. Indentation crack lengths were measured parallel to tangents to the hole edge. Resin composites (three brands) were placed in the hole and polymerized (two light irradiation protocols) at equal radiation exposures. The crack lengths were re-measured at 2 and 10 min after irradiation. Radial tensile stresses due to polymerization contraction at the location of the cracks (σ(crack)) were calculated from the incremental crack lengths and the fracture toughness K(c) of the glass. Contraction stresses at the composite-glass bonded interface (σ(interface)) were calculated from σ(crack) on the basis of the simple mechanics of an internally pressurized thick-walled cylinder. The greater the distance or the shorter the time following polymerization, the smaller was σ(crack). Distance, material, irradiation protocol and time significantly affected σ(crack). Two-step irradiation resulted in a significant reduction in the magnitude of σ(interface) for all resin composites. The contraction stress in soda-lime glass propagated indentation cracks at various distances from the cavity, enabling calculation of the contraction stresses.

Curing efficiency of high-intensity light-emitting diode (LED) devices

We evaluated the curing efficiency of 4 high-intensity light-emitting diode (LED) devices by assessing percentage of residual C=C (%RDB), surface microhardness (SM), depth of cure (DC), percentage of linear shrinkage-strain (%LS), and percentage of wall-to-wall contraction (%WWC). The light-curing units tested were a QTH light, the Elipar TriLight (3M/ESPE), and 4 LED devices - the Allegro (Denmat), the Bluephase (Ivoclar/Vivadent), the FreeLight2 (3M/ESPE), and The Cure TC-01 (Spring Health Products). The %RDB was measured by microFTIR spectroscopy. Microhardness measurements (Vickers) were performed at the surface (H0) and at depths of 3 mm (H3) and 5 mm (H5) of cylindrical specimens. Depth of cure was expressed as the ratio of microhardness at each depth, relative to the corresponding surface value (H3/H0 and H5/H0). The bonded disc method was used to evaluate %LS. For the %WWC evaluation, cylindrical resin restorations were imaged by high resolution micro-CT and the %WWC was calculated at depths of 0 mm and 2 mm. There were no statistical differences among the LEDs in %RDB or %LS. The Bluephase and Allegro had the highest SM values. As compared with the other LEDs, the Bluephase and The Cure TC-01 had lower values for depth of cure at depths of 3 mm and 5 mm. There were no significant differences in %WWC among the LEDs at either depth, and the QTH had the lowest %WWC at both depths.

Post-gel shrinkage strain and degree of conversion of preheated resin composite cured using different regimens

OBJECTIVES

This study investigated the influence of resin composite preheating temperature, light curing regimen (mode and duration) on post-gel shrinkage strain (PGSS) and degree of conversion (DC) of a restorative resin composite.

METHODS

A hybrid resin composite preheated to three different temperatures (37 degrees C, 54 degrees C and 68 degrees C) was cured using a high intensity light emitting diode (LED) curing unit. The light source was used in 40- and 20-second continuous mode as well as soft start mode. The resin composite was monitored for PGSS during curing and 10 minutes following light irradiation using strain gauges. DC was measured using FTIR spectrometer. The results were analyzed using two-way ANOVA followed by the Duncan's Multiple Range Test for pairwise comparisons. The significance level was set at p < or = 0.05.

RESULTS

Preheating of the resin composite significantly increased its PGSS and DC. The soft start groups revealed significantly lower PGSS values compared to the 20- and 40-second groups without altering the DC.

CONCLUSIONS

Preheating of resin composite prior to curing increased its DC but also increased its PGSS. The soft-start mode decreased the PGSS of resin composite without altering the DC.

Effect of light-curing units and activation mode on polymerization shrinkage and shrinkage stress of composite resins

The aim of this study was to evaluate the polymerization shrinkage and shrinkage stress of composites polymerized with a LED and a quartz tungsten halogen (QTH) light sources. The LED was used in a conventional mode (CM) and the QTH was used in both conventional and pulse-delay modes (PD). The composite resins used were Z100, A110, SureFil and Bisfil 2B (chemical-cured). Composite deformation upon polymerization was measured by the strain gauge method. The shrinkage stress was measured by photoelastic analysis. The polymerization shrinkage data were analyzed statistically using two-way ANOVA and Tukey test (p≤0.05), and the stress data were analyzed by one-way ANOVA and Tukey's test (p≤0.05). Shrinkage and stress means of Bisfil 2B were statistically significant lower than those of Z100, A110 and SureFil. In general, the PD mode reduced the contraction and the stress values when compared to CM. LED generated the same stress as QTH in conventional mode. Regardless of the activation mode, SureFil produced lower contraction and stress values than the other light-cured resins. Conversely, Z100 and A110 produced the greatest contraction and stress values. As expected, the chemically cured resin generated lower shrinkage and stress than the light-cured resins. In conclusion, The PD mode effectively decreased contraction stress for Z100 and A110. Development of stress in light-cured resins depended on the shrinkage value.

Flowability of composites is no guarantee for contraction stress reduction

OBJECTIVES

The purpose of this study was to measure the contraction stress development of three flowable resin-composite materials (Grandio Flow, VOCO GmbH, Cuxhaven, Germany; Tetric Flow, Ivoclar Vivadent, Schaan, Liechtenstein; Filtek Supreme XT Flowable Restorative, 3M ESPE, ST. Paul, MN, USA) and an universal micro-hybrid composite resin (Filtek Z250, 3M ESPE, St. Paul, MN, USA) during photopolymerization with a halogen curing light, using a novel stress-measuring gauge.

METHODS

Curing shrinkage stress was measured using a stress-analyzer. Composites were polymerized with a halogen curing unit (VIP, Bisco Inc., Schaumburg, IL, USA) for 40s. The contraction force (N) generated during polymerization was continuously recorded for 180s after photo-initiation. Contraction stress (MPa) was calculated at 20s, 40s, 60s, 120s and 180s. Data were statistically analyzed.

RESULTS

Filtek Supreme XT Flowable Restorative exhibited the highest stress values compared to other materials (p<0.05), while the lowest values were recorded with Tetric Flow (p<0.05). Tetric Flow was also the only flowable composite showing stress values lower than the conventional composite Filtek Z250 (p<0.05).

SIGNIFICANCE

Flowable composites investigated with this experimental setup showed shrinkage stress comparable to conventional resin restorative materials, thus supporting the hypothesis that the use of flowable materials do not lead to marked stress reduction and the risk of debonding at the adhesive interface as a result of polymerization contraction is similar for both type of materials.

Influence of the curing method on the post-polymerization shrinkage stress of a composite resin

The aim of this study was to evaluate the effect of different curing methods on the stress generated by the polymerization shrinkage of a restorative composite in two moments: immediately after light exposure and after 5 min. Photoactivation was performed using two different light sources: (1) xenon plasma arc (PAC) light (1,500 mW/cm² – 3s) and (2) a quartz-tungsten-halogen (QTH) light with three light-curing regimens: continuous exposure (40 s at 800 mW/cm² – CL); soft-start (10 s at 150 mW/cm² and 30 s at 800 mW/cm² - SS) and intermittent light [cycles of 4 s (2 s with light on at 600 mW/cm² and 2 s of light off), for 80s – IL]. The composite resin was applied between two 5-mm diameter metallic rods, mounted in a servohydraulic machine. The maximum stress was recorded immediately after light exposure (FF) and after 5 min (5F). The results were submitted to ANOVA and Tukey's test (5%). For each method, the results obtained in FF and 5F were, respectively: CL (3.58 and 4.46 MPa); SS (2.99 and 4.36 MPa); IL (3.11 and 4.32 MPa) and PAC (0.72 and 3.27 MPa). The stress generated by the polymerization shrinkage during light exposure can be associated with the photoactivation method used. A significant increase in the stress level was observed during the post-curing period up to 5 min, for all evaluated methods.

Contraction stress determinants in dimethacrylate composites

The influence of composite organic content on polymerization stress development remains unclear. It was hypothesized that stress was directly related to differences in degree of conversion, volumetric shrinkage, elastic modulus, and maximum rate of polymerization encountered in composites containing different BisGMA (bisphenylglycidyl dimethacrylate) concentrations and TEGDMA (triethylene glycol dimethacrylate) and/or BisEMA (ethoxylated bisphenol-A dimethacrylate) as co-monomers. Stress was determined in a tensilometer. Volumetric shrinkage was measured with a mercury dilatometer. Elastic modulus was obtained by flexural test. We used fragments of flexural specimens to determine degree of conversion by FT-Raman spectroscopy. Reaction rate was determined by differential scanning calorimetry. Composites with lower BisGMA content and those containing TEGDMA showed higher stress, conversion, shrinkage, and elastic modulus. Polymerization rate did not vary significantly, except for the lower value of the 66% TEGDMA composite. We used linear regressions to evaluate the association between polymerization stress and conversion (R(2)=0.905), shrinkage (R(2)=0.825), and modulus (R(2)=0.623).

Kinetic model for the coupled volumetric and thermal behavior of dental composites

OBJECTIVE

The volume and thermal behavior of dental composites during the curing reaction was analyzed for different modes of initiation using a combination of experiments and models for polymerization kinetics.

METHODS

The volume behavior of four dental composites (Venus, Tetric Ceram, Ceram X mono and Filtek Supreme) was studied with buoyancy measurements during the initiation and dark phase of the curing process. The volume and temperature development of the composites were described for different intensities of the photo-initiation with a mathematical model based on the "mixed termination model" for the polymerization reaction.

RESULTS

A good agreement between volumetric data and the model function was achieved. A non-linear regression of the experimental data with the model yields results for the adjustable parameters describing the kinetics of the polymerization reaction which are typical for comparable polymerization reactions. Using kinetic models of the polymerization reaction for analyzing the volume behavior of radically crosslinking curing dental composites, thermal and polymerization-specific components of the overall shrinkage of the composites can be distinguished and compared for different materials.

SIGNIFICANCE

With the developed methodology, a more detailed insight into the curing process can be achieved which can contribute to the understanding of the build-up of internal stresses in dental fillings. These stresses can negatively affect the marginal integrity of the filling, which is a relevant precondition of long-term chemical, biological and mechanical stability.