Leached components from dental composites in oral simulating fluids and the resultant composite strengths

Are S-PRG composites able to resist against erosive and abrasive challenges and protect surrounding enamel in situ?

OBJECTIVES

This study evaluated the resistance of S-PRG (Surface Pre-Reacted Glass-ionomer) composites and other restorative materials against erosive and abrasive challenges and their protective effect on enamel adjacent to the restorations.

MATERIALS AND METHODS

Bovine enamel blocks were prepared and randomized into 12 groups, including 6 types of material, each of them subjected to erosion_e or erosion+abrasion_ea: Beautifil II (S-PRG); Beautifil Bulk Restorative (S-PRG); Filtek Z250 XT; Filtek Bulk Fill; EQUIA Forte; Riva Light Cure. Cavities were prepared in the middle of enamel blocks and restored with the materials. Initial profiling measurement was performed on the material and on adjacent enamel (100, 200, 300, 600 and 700 μm from the restoration margin). Palatal intraoral appliances with the restored enamel blocks were used by the volunteers (n = 10). During 5 days appliances were immersed in 2.5 % citric acid for 2 min; 6 × /day (erosion_e). For ea condition, blocks were brushed for 1 min after each acid immersion. Final profile assessment was performed. Data were analysed by two and three way ANOVA followed by Tukey's test (p < 0.05).

RESULTS

Material wear: Riva Light Cure showed the highest wear followed by EQUIA Forte and then all resin composites, including the ones with S-PRG (p = 0.000). Enamel wear: there was significant interaction among type of restorative material, wear condition and distance (p = 0.014), enamel around materials showed similar wear (p = 0.983) and the enamel subjected to ea exhibited highest wear (p = 0.000).

CONCLUSION

SPRG based composites showed resistance against erosive and abrasive challenges but were not able to protect enamel adjacent to the restorations.

CLINICAL SIGNIFICANCE

S-PRG composites exhibit resistance to material wear comparable to resin composites. However, they have shown an inability to effectively protect the adjacent enamel under in situ erosive-abrasive conditions, despite the presence of mineral-loss-preventing ions surrounding materials.

Do mouthwashes affect the optical properties of resin cement?

OBJECTIVES

The objective of this study was to evaluate the effect of mouthwashes on the optical properties of resin cement.

MATERIALS AND METHODS

One hundred and 60 resin cement discs (6x2mm) were produced from 4 different brands of resin cement (Panavia V5, Estecem II, RelyX Veneer, NX3) with the help of a Teflon mould. The discs were divided into 4 subgroups, 1 of which served as the control group, to be immersed in mouthwashes after measuring the initial L, a, and b values on white and black backgrounds. Colour measurements were repeated after the 1st and 7th days. The collected data were used to calculate the ∆E00 value to measure colour stability, the translucency parameter (TP00), and the contrast ratio parameter (CR) to compare translucency change. Data were statistically analysed using mixed-design analysis of ANOVA and the Bonferroni-Dunn test. Repeated measures ANOVA was used for dependent results (α = 0.05).

RESULTS

On the ∆E00, TP00, and CR parameters; the joint effect of resin groups, mouthwash groups, and measurement times were found to be statistically significant. The ∆E00 (colour difference) parameter; the joint effect of resin groups, mouthwash groups, and measurement times was found to be statistically significant. The TP00; the joint effect of resin groups, mouthwash groups, and measurement times were found to be statistically significant. The CR parameter; the joint effect of resin groups, mouthwash groups, and measurement times was found to be statistically significant. In the Estecem II (Tokuyama) group, the means of Listerine Cool Mint (Johnson & Johnson) was above acceptable limits in both time periods. In the Panavia V5 (Kuraray Noritake) group, the color change was above acceptable limits in all time periods and in all mouthwash groups. Among the resin materials used, Estecem II (Tokuyama) shows the most color change. Listerine Cool Mint (Johnson & Johnson) caused more color change than other mouthwashes at all times.

CONCLUSIONS

Within the limitations of this study; the colour stability and translucency value of resin cement depend on both the resin cement content and the mouthwash. Long-term use of mouthwash may adversely affect the optical properties of the resin cement.

CLINICAL RELEVANCE

Clinicians should take into account the fact that mouthwash use and the composition of the resin cement employed will have an impact on the colour of laminate veneers.

Effect of Fibres on Physico-Mechanical Properties of Bulk-Fill Resin Composites

OBJECTIVE

To measure the flexural strength (FS) of bulk-fill resin composites and assess their long-term water absorption and solubility properties with and without the inclusion of short glass fibres.

METHODS

One resin composite, everX Flow with fibres, and four commercially available bulk-fill composites without fibres, namely, PALFIQUE, Activa, SDR Plus, and Filtek Bulk Fill One, were tested. Six specimens (2 × 2 × 25 mm) were fabricated for each material and stored in water for 1 day and 30 days to measure the flexural strength using a three-point bending test. To evaluate water absorption and solubility, circular disks measuring 15 × 2 mm (n = 5) were immersed in water for 60 days, and their weights were recorded periodically. After 60 days, the specimens were dried for an additional 21 days to determine solubility.

RESULTS

Flexural strength values ranged from 101.7 to 149.1 MPa. Significant distinctions were observed among the resin composites at the onset of the study (p < 0.05). The highest FS value was identified in everX Flow, while ACT exhibited the lowest (p < 0.05). However, the flexural strength values exhibited a significant decrease with increased storage time (p < 0.05), except for ACT, which demonstrated a noteworthy increase. Concerning water absorption and solubility, ACT displayed the highest absorption, while the range of solubility varied from -0.88 to 5.8 μg/mm3. ACT also had the highest solubility, whereas everX Flow exhibited negative solubility.

SIGNIFICANCE

The addition of short fibres, along with potential differences in matrix composition, enhanced the flexural strength of everX Flow. However, the substantial reduction in flexural strength observed in everX Flow and SDR following exposure to water corroborates the manufacturers' recommendation to apply a conventional resin composite cap on these materials.

Surface degradation and biofilm formation on hybrid and nanohybrid composites after immersion in different liquids

PURPOSE

This study evaluated the association of surface degradation and formation of Streptococcus mutans (S. mutans) biofilm in resin-based composites (RBCs) after storage in different acidic liquids.

METHODS

To evaluate microhardness and surface micromorphology, hybrid and nanohybrid RBC discs were stored in artificial gastric acid, cola drink, orange juice, artificial saliva, and distilled water for three intervals of 15 min per day for 7, 15, and 30 days. After 30 days of storage, surface roughness was analyzed, and the RBC discs were placed in a biofilm reactor inoculated with S. mutans to evaluate surface biofilm formation.

RESULTS

As compared with nanohybrid RBCs, roughness and surface microhardness values were significantly lower (P < 0.05) for hybrid RBCs stored in artificial gastric acid, followed by specimens stored in cola drink and orange juice. Artificial gastric acid caused greater surface degradation, which increased the biomass of S. mutans on the surface of both RBC types.

CONCLUSION

Surface degradation of hybrid and nanohybrid RBCs correlated with the pH of the liquid, while S. mutans biofilm formation was associated with increased surface roughness in hybrid RBCs.

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.

Evaluation of the microhardness of different resin-based dental restorative materials treated with gastric acid: Scanning electron microscopy-energy dispersive X-ray spectroscopy analysis

The aim of this study is to evaluate the microhardness, relative surface roughness, and elemental changes of resin-based dental restorative materials (RDRMs) after gastric acid treatment. Five different RDRMs (Group 1 [Filtek Z550], Group 2 [Beautifil II], Group 3 [Vertise Flow], Group 4 [Dyract XP], Group 5 [Fuji II LC]) were used. Samples were formed by using plexiglass molds of 10 mm diameter and 2 mm thickness. A total of 50 samples (n = 10) for microhardness tests and a total of 15 samples (n = 3) for scanning electron microscopy (SEM)-energy dispersive X-ray spectroscopy (EDX) analysis were prepared. All samples of each group were treated to gastric acid, simultaneously. A Vickers microhardness tester was used to evaluate the microhardness of the upper surfaces of each sample. SEM-EDX system was used for microstructure and elemental composition detection. The SEM-EDX, microhardness and relative surface roughness analysis were made prior to treatment in gastric acid for 14 days and analysis were repeated on the 14th day. As the difference in the microhardness values of RDRMs was compared, the time-dependent variation in all RDRMs was found to be statistically significant. It was observed that a drastic decrease in microhardness values was in Beautifil II, Filtek Z550, Vertise Flow, Fuji II LC, and Dyract XP, respectively. Average decrease rate of microhardness values compared to the initial state can be listed from high to low as Beautifil II (%35.72), Vertise Flow (% 28.88), Fuji II LC (% 21.09), Dyract XP (%17.60), and Filtek Z550 (% 16.58). As a result, in in-vitro conditions gastric acid decreased microhardness while increasing the relative surface roughness of RDRMs.

Effect of water storage and thermocycling on light transmission properties, translucency and refractive index of nanofilled flowable composites

The effect of 1-week water storage and subsequent 10,000 thermal cycles on light transmission properties (straight-line transmission (G0), diffusion (DF), the amount of transmitted light (AV)), translucency parameter (TP) and refractive index (RI) of four nanofilled flowable composites was examined. The composites included Filtek Supreme Ultra Flowable Restorative (FSU), Estelite Flow Quick (EFQ), Estelite Universal Flow, (EUF), and Clearfil Majesty ES Flow (ESF), all of A3 shade. For composites with lower filler load (FSU, EFQ), water storage increased G0, AV and TP, but subsequent thermocycling decreased them. An opposite tendency was found for DF. Materials with higher filler load (EUF, ESF) were not significantly affected by aging conditions. RI of EFQ and EUF containing bisphenol A polyethoxy methacrylate (Bis-MPEPP) increased significantly after thermocycling. Additionally, morphological changes were observed using scanning electron microscopy which revealed cracks within nanocluster fillers and dislocation of particles in FSU and EFQ after thermocycling.

5-year retrospective evaluation of direct composite restorations in orthodontically treated patients

OBJECTIVES

In patients affected by dimensional discrepancy between size of anterior maxillary and mandibular teeth, orthodontic therapy could be necessary to solve occlusal problems. However, anterior restorations are indicated to finalize the aesthetic aspect of the therapy. The aim of the present retrospective clinical study was to evaluate the long-term outcomes of direct additive composite restorations performed to correct anterior teeth discrepancies persisting after orthodontic treatment.

METHODS

Patients with dimensional teeth discrepancy, subjected to a combined orthodontic-restorative treatment, between January 2009 and January 2019, were recalled for the present retrospective evaluation and divided in two groups according to the restoration performed: G1) diastema closure; G2) tooth shape modification. All patients, after ortho therapy, were subjected to a standardized restorative rehabilitation of the anterior area. All restorations were performed by a single experienced operator employing the same materials. During recall visits, two calibrated examiners evaluated the restorations and recorded USPHS data. Kaplan-Meier estimator and Cox-regression analysis were performed. Statistical significance was set for p < 0.05.

RESULTS

53 patient were included, with a total of 169 restoration (G1:110;G2:59). The mean study time period was 5 year (ranging from 6 month to 10 years). The overall survival rate of additive restoration was 2,59% (G1:2,07%; G2:0,47 p < 0.05). Chipping of the material was the most frequent adverse event (G1:13,64%; G2:1,69), followed by composite wear (G1:9,09%; G2:5,17).

CONCLUSIONS

Based on the obtained results, good clinical performances were shown at a 5-year interval. A low number of failures were collected and most of them were classified as reparable. Only few cases needed complete reintervention.

CLINICAL SIGNIFICANCE

Showing that a direct approach in restoring anterior teeth for diastema closure or shape modification is a valid alternative in terms of durability and aesthetics to more invasive procedure such as indirect restorations.

Degradation of Computer-aided Design/Computer-aided Manufacturing Composites by Dietary Solvents: An Optical Three-dimensional Surface Analysis

CLINICAL RELEVANCE

Computer-aided design/computer-aided manufacturing (CAD/CAM) composite resins are susceptible to degradation by dietary solvents. Dietary counselling is prudent when placing such CAD/CAM restorations.

SUMMARY

This study determined the effect of dietary solvents on the surface roughness (Ra) of direct, indirect, and computer-aided design/computer-aided manufacturing (CAD/CAM) dental composites. The materials evaluated were a direct composite (Filtek Z350 XT [FZ]), an indirect composite (Shofu Ceramage [CM]), and four CAD/CAM composites (Lava Ultimate [LU], Shofu Block HC [HC], Cerasmart [CS], and Vita Enamic [VE]). Specimens (12×14×1.5 mm) of each material were prepared, measured for baseline Ra, ranked, divided into six groups (n=12), and conditioned in the following media for 1 week at 37°C: air (control), distilled water, 0.02 N citric acid, 0.02 N lactic acid, heptane, and 50% ethanol-water solution. The composite specimens were then subjected to postconditioning Ra testing using an optical three-dimensional surface analyzer (G4e, Alicona Imaging GmbH, Raaba, Austria). Inter-medium and inter-material comparisons were performed with one-way analysis of variance and post hoc Bonferroni test at a significance level of α=0.05. Mean Ra values ranged from 0.086 ± 0.004 μm to 0.153 ± 0.005 μm for the various material/medium combinations. For all materials, conditioning in air (control) and distilled water generally resulted in significantly lower mean Ra than exposure to other dietary solvents. Conditioning in citric acid presented the roughest surfaces for FZ, CM, and CS. For LU, HC, and VE, exposure to lactic acid, heptane, and ethanol solution resulted in the highest mean Ra. Regardless of conditioning media, FZ had the highest and VE the lowest mean Ra compared with other composites. The CAD/CAM composites remained susceptible to surface degradation by dietary solvents despite their industrial polymerization.

Cytotoxicity of Different Nano Composite Resins on Human Gingival and Periodontal Ligament Fibroblast Cell Lines: An In Vitro Study

The aim of this study is to determine the cytotoxicity of three different nano composite resins (CRs) on human gingival fibroblast (hGF) and periodontal ligament fibroblast (hPDLF) cell lines. These CRs selected were nanohybrid organic monomer-based Admira Fusion (AF), nanohybrid Bis-(acryloyloxymethyl) tricyclo [5.2.1.0.sup.2,6] decane-based Charisma Topaz (CT), and supra nano filled resin-based Estelite Quick Sigma (EQS). MTT assay was performed to assess the cytotoxicity of CRs at 24 h and one week. AF and EQS applied on hGF cells at 24 h and one week demonstrated similar cytotoxic outcomes. Cytotoxicity of CT on hGF cells at one week was higher than 24 h (p = 0.04). Cytotoxicity of CT on hGF cells was higher at 24 h (p = 0.002) and one week (p = 0.009) compared to control. All composites showed higher cytotoxicity on hPDLF cells at one week than the 24 h (AF; p = 0.02, CT; p = 0.02, EQS; p = 0.04). AF and EQS demonstrated lower cytotoxicity on hPDLF cells than the control group at 24 h (AF; p = 0.01, EQS; p = 0.001). CT was found more cytotoxic on hPDLF cells than the control (p = 0.01) and EQS group (p = 0.008) at one week. The cytotoxicity of CRs on hGF and hPDLF cells vary, according to the type of composites, cell types, and exposure time.

Evaluating the effects of different beverages with daily consumption habits on the wear of restorative materials

The aim of this study was to investigate the cumulative effects of fruit juices and/or alcoholic beverages on wear track area of the restorative materials by simulating the oral environment in vitro. A microhybrid, a sub-microhybrid, a nanofill resin composite, and a giomer material were used. A daily exposure habits model was created to simulate consumption frequency of acidic and/or alcoholic beverages. Two-body wear tests were carried out using a reciprocating wear tester. ANOVA and Tukey's HSD tests were used for statistical analyses (p < 0.05). When considering experimental groups related to daily exposure habits, statistical difference was found between restorative materials in terms of wear track area (p < 0.01). Joint effect of rmaterial and exposure on wear track area was statistically significant (p < 0.01). Giomer was found to be more affected by acidic and alcoholic beverages. Microhybrid resin composites showed less wear than the other restorative materials. Cumulative effects of alcoholic beverages and fruit juice on wear track area of materials could be related to material's composition and frequency of consumption of acid or ethanol-containing beverages. Daily cumulative effect of acidic and alcoholic beverages was found to be stronger than only acidic fruit juice consumption in terms of wear track area. The plasticizing effect and the concentration of ethanol in the alcoholic beverages provided the basis for the increased wear track area on the restorative materials.

Multifunctional monomer acts as co-initiator and crosslinker to provide autonomous strengthening with enhanced hydrolytic stability in dental adhesives

OBJECTIVE

The purpose of this study was to evaluate a new synthesized multifunctional monomer, aminosilane functionalized methacrylate (ASMA), containing polymerizable methacrylate, tertiary amine, and methoxysilane functionalities in dental adhesive formulations, and to investigate the polymerization kinetics, leachates, thermal and mechanical properties of copolymers.

METHODS

Adhesive contained HEMA/BisGMA (45/55, w/w) was used as a control, and mixtures based on HEMA/BisGMA/ASMA at the mass ratio of 45/(55-x)/x were used as experimental adhesive. Adhesives were characterized with regard to water miscibility, photo-polymerization behavior (Fourier transform infrared spectroscopy, FTIR), leached co-monomers (high performance liquid chromatography, HPLC), thermal properties (modulated differential scanning calorimeter, MDSC), and mechanical properties (dynamic mechanical analyzer, DMA). Stress relaxation times and the corresponding moduli, obtained from stress relaxation tests, are used in a simulated linear loading case.

RESULTS

As compared to the control, ASMA-containing adhesives showed higher water miscibility, lower viscosity, improved monomer-to-polymer conversion, significantly greater T_g and rubbery modulus. HPLC results indicated a substantial reduction of leached HEMA (up to 85wt%) and BisGMA (up to 55wt%) in ethanol. The simulation reveals that the ASMA-containing adhesive becomes substantially stiffer than the control.

SIGNIFICANCE

ASMA monomer plays multiple roles, i.e. it serves as both a co-initiator and crosslinker while also providing autonomous strengthening and enhanced hydrolytic stability in the adhesive formulations. This multifunctional monomer offers significant promise for improving the durability of the adhesive at the composite/tooth interface.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

SIGNIFICANCE

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

Changes in the physical properties and color stability of aesthetic restorative materials caused by various beverages

This study investigates the effects of various beverages on the wettability, microhardness, and color stability of aesthetic dental restorative materials. A contact angle analyzer, Vickers hardness tester, and spectrophotometer were used to characterize the properties of the materials and a total of 225 specimens were prepared: 75 each for a resin composite, compomer, and giomer. Ingestion of energy drinks and cola caused the greatest deterioration in wettability and microhardness, and coffee caused the most significant color change. In addition, the change in the resin composite was lower than that of the other restorative materials. The extent of change in the restorative materials increased with duration and frequency of contact with the beverages, so a reduction in the frequency of ingestion of these beverages is recommended.

New silyl-functionalized BisGMA provides autonomous strengthening without leaching for dental adhesives

Resin-based composite has overtaken dental amalgam as the most popular material for direct restorative dentistry. In spite of this popularity the clinical lifetime of composite restorations is threatened by recurrent decay. Degradation of the adhesive leads to gaps at the composite/tooth interface-bacteria, bacterial by-products and fluids infiltrate the gaps leading to recurrent decay and composite restoration failure. The durability of resin-dentin bonds is a major problem. We address this problem by synthesizing silyl-functionalized BisGMA (e.g., silyl-BisGMA), formulating dental adhesives with the new monomer and determining the physicochemical properties and leaching characteristics of the silyl-BisGMA adhesives. Silyl-BisGMA was synthesized by stoichiometric amounts of BisGMA and 3-isocyanatopropyl trimethoxysilane (IPTMS). The control adhesive was a mixture based on HEMA/BisGMA (45/55, w/w). In the experimental formulations, BisGMA was partially or completely replaced by silyl-BisGMA. Water miscibility, polymerization behavior (Fourier transform infrared spectroscopy, FTIR), thermal property (modulated differential scanning calorimetry, MDSC), mechanical properties in dry and wet conditions (dynamic mechanical analysis, DMA), and leached species (HPLC) were investigated. Data from all tests were submitted to appropriate statistical analysis (α = 0.05). Silyl-BisGMA-containing adhesives exhibited comparable water miscibility, lower viscosities, and significantly improved degree of conversion of CC bond as compared to the control. After 4 weeks aqueous aging, the glass transition temperature and rubbery moduli of the experimental copolymers were significantly greater than the control (p < 0.05). HPLC results indicated a substantial reduction of leached HEMA (up to 99 wt%) and BisGMA (up to 90 wt%). By introducing silyl-functional group, the new BisGMA derivative exhibited potential as a monomer that can lead to dental adhesives with improved mechanical properties and reduced leaching under conditions relevant to the oral environment. STATEMENT OF SIGNIFICANCE: The low-viscosity adhesive that bonds the composite to the tooth (enamel and dentin) is intended to seal and stabilize the composite/tooth interface, but it degrades leading to a breach at the composite/tooth margin. As the most popular crosslinking monomer in adhesives, Bisphenol A-glycerolate dimethacrylate (BisGMA) has limitations, e.g. susceptible to hydrolysis and concomitant property degradation. A methoxysilyl-functionalized BisGMA derivative (silyl-BisGMA) was introduced in this work to respond to these limitations. Our results indicated that by introducing silyl-BisGMA, higher crosslinked networks were obtained without sacrificing the homogeneity, and the leached amount of HEMA was reduced up to 99%. This novel resin offers potential benefits including prolonging the functional lifetime of dental resin materials.

Toxicology of Pre-heated Composites Polymerized Directly and Through CAD/CAM Overlay

Objectives

The aim was to compare cytotoxicity/genotoxicity of pre-heated composites polymerized through CAD/CAM overlays on isolated human peripheral blood lymphocytes.

Material and Methods

A microhybrid (Z100, 3M ESPE) and nanofilled composite (Filtek Supreme Ultra, 3M ESPE) were heated in a heating unit (Calset, AdDent Inc.) at different temperatures: 37 ^oC, 54 ^oC, and 68 ^oC. A small amount of heated composite was placed in a cylindrical mold (6mm diameter; 0.65mm thick), covered with a Mylar sheet, pressed and light-cured directly and through 2 mm thick CAD/CAM ceramic-reinforced polymer (CRP)(LAVA Ultimate, 3M ESPE) or CAD/CAM lithium disilicate ceramic (LDC)(e.max, Ivoclar/Vivadent) overlay. After curing, the specimens were immediately placed in a prepared lymphocyte cell culture. Cytotoxicity was assessed using a dye exclusion method by simultaneous staining with ethidium bromide and acridine orange, aimed to determine percentages of viable, apoptotic and necrotic cells. Genotoxicity was studied using alkaline comet assay.

Results

For Z100, the highest percentage of viable cells is recorded at T1 (93.7%) after direct light curing, followed by light curing through CRP (92.3%) and through LDC (91.7%T1,T3). For Filtek Supreme Ultra, the highest percentage of viable cells is recorded while curing through CRP (91.0% T2), followed by LDC (90% T1,T3) and direct light curing (88.7%T2).

Conclusion

For both tested materials, preheating the procedure at T1 and T2 may be the procedure of choice. In terms of genotoxicity, preheating at T3 may not be suggested.

Effect of Staining and Bleaching on Color stability and Surface Roughness of Three Resin Composites: An in vitro study

Aim:

This study evaluated the effect of staining and subsequent bleaching on the color stability and surface roughness of three resin composites.

Materials and Methods:

One hundred and eight customized plastic disks from a plastic mold with an outer diameter of 10 mm and thickness of 1.02 mm were fabricated. Samples were divided into three groups of 36 specimens each – Group I (Estelite^® α – Supranano), Group II (Filtek™ Z250 XT – Nanohybrid), and Group III (Filtek™ P90–Silorane). Subsequently, baseline surface color and roughness values were tabulated using spectrophotometer and profilometer, respectively. The specimens were then subjected to staining with coffee and turmeric for a period of 3 h/day for 40 days and following this, bleaching of the samples was done using a bleaching agent carbamide peroxide gel 15% for 8 h/day for 14 consecutive days.

Results:

Estelite^® α performed better by maintaining color stability with minimal roughness compared to Filtek™ P90 and Filtek™Z250 XT. Turmeric had a greater potential to stain composites compared to coffee in all the groups.

In vitro aging behavior of dental composites considering the influence of filler content, storage media and incubation time

Objective

Over time dental composites age due to mechanical impacts such as chewing and chemical impacts such as saliva enzymes and food ingredients. For this research, the focus was placed on chemical degradation. The objective of this study was to simulate hydrolysis by using different food simulating liquids and to assess their impact on the mechanical parameter Vickers microhardness (MHV) and the physicochemical parameter contact angle (CA).

Methods

Specimen of three composites (d = 6 mm, h = 2 mm; n = 435) classified with respect to their filler content (wt%), namely low-filled, medium-filled and highly-filled, were stored for 0, 14, 30, 90 and 180 days in artificial saliva (pH 7), citric acid (pH 3; pH 5), lactic acid (pH 3; pH 5) and ethanol (40%vol; 60%vol) and assessed regarding to MHV and CA. Statistics: Kruskal-Wallis test, stepwise linear regression, bivariate Spearman Rank Correlation (p < 0.05).

Results

While stored in artificial saliva, acid and ethanol the CA decreased especially for the low- and medium-filled composites. It was shown that rising the filler content caused less surface changes in the CA. Storage in ethanol led to a significant decrease of MHV of all composites. Regression analysis showed that the effect of in vitro aging on MHV was mainly influenced by the composite material and therefore by filler content (R² = 0.67; p < 0.05). In contrast, the CA is more influenced by incubation time and filler content (R² = 0.2; p < 0.05) leading to a higher risk of plaque accumulation over time. Significance: In vitro aging showed significant changes on the mechanical and physicochemical properties of dental composites which may shorten their long-term functionality. In conclusion, it can be stated, that the type of composite material, especially rising filler content seems to improve the materials’ resistance against the processes of chemical degradation.

Effect of mouthrinses on color stability of monolithic zirconia and feldspathic ceramic: an in vitro study

BACKGROUND

Patients susceptible to periodontal disease and dental caries, including those who undergo fixed prosthodontic treatments use chemical plaque control agents. However, these mouthrinses may result in adverse effects such as discoloration of the restorative materials. The aim of this study was to compare the color stability of monolithic zirconia and feldspathic porcelain after immersion in two different mouthrinses: 0.2% Chlorhexidine digluconate (CHX), or Listerine®. Color change was evaluated by color spectrophotometer and according to the Commission Internationale de l'Eclairage (CIELab) system.

METHODS

We prepared 72 disc-shaped porcelains (n = 36) as follows: Group A consisted of dental direkt cube X2 discs (49% translucency) as the monolithic zirconia and group B consisted of VITA VMK 95 as a feldspathic porcelain. Groups A and B were divided into three subgroups (n = 12 per group). Each subgroup was immersed in one of the following three solutions: distilled water (control), CHX, or Listerine® for 2 min, once per day. We recorded the samples' baseline color values according to the CIELab system by using a color spectrophotometer operated by an experienced operator. Color measurements were subsequently obtained following 7 days of immersion, and after the samples were rinsed with distilled water and allowed to dry. We measured CIE L*, a*, and b*and calculated the color difference (ΔE*ab). All data were analyzed by the Mann-Whitney and Kruskal-Wallis tests.

RESULTS

Color changes occurred in the experimental groups. The ΔE*ab values were significantly greater in VMK 95 porcelain compared to cube X2 (both p < 0.001) following immersion in CHX and Listerine® mouthrinses. However no significant difference was founded when distilled water was used (p = 0.630). For the two materials, the ΔE values were highest in CHX, followed by the Listerine® and distilled water.

CONCLUSION

Both monolithic zirconia and feldspathic porcelain were susceptible to color changes following immersion in CHX and Listerine® mouthrinses.

Retrieval analysis of lingual fixed retainer adhesives

INTRODUCTION

Our objective was to analyze the surface and bulk properties alterations of clinically aged composites used for fixed retention.

METHODS

Twenty-six lingual retainers bonded for different time periods (2.2-17.4 years) were retrieved from postorthodontic patients. Fifteen lingual retainers had been cemented by a chemically cured adhesive (Maximum Cure, Reliance Orthodontic Products, Itasca, Ill), and 11 were treated with a photo-cured adhesive (Flow-Tain, Reliance Orthodontic Products). The first group was in service for 2.8 to 17.4 years and the second for 2.2 to 5.4 years. Five specimens from each material were prepared and used as the control (or reference) group. The debonded surfaces from enamel were studied by attenuated total reflectance Fourier transform infrared spectroscopy (n = 3 per material per group), low-vacuum scanning electron microscopy, and energy dispersive x-ray microanalysis (n = 3 per material per group). All specimens were used for the assessment of Vickers hardness, indentation modulus, and elastic index with the instrumented indentation testing method. The values of Vickers hardness, indentation modulus, and elastic index were compared between the retrieved and the reference groups with 1-way analysis of variance and the Student-Newman-Keuls multiple comparison test (α = 0.05).

RESULTS

The attenuated total reflectance Fourier transform infrared spectroscopy analysis showed that both retrieved composites demonstrated reduced unsaturation in comparison with the corresponding reference specimens. Some bonded surfaces showed development of organic integuments. All retrieved specimens showed reduced silicon content. Barium was identified only in the photo-cured group. No significant differences were found between the reference and retrieved groups in Vickers hardness, indentation modulus, and elastic index.

CONCLUSIONS

Despite the changes in composition, the mechanical properties of the materials tested remained unaffected by intraoral aging.

The Survival of Class V Composite Restorations and Analysis of Marginal Discoloration

The aims of this retrospective clinical study were to analyze the longevity of class V composite restorations and compare the results obtained from clinical and laboratory evaluation of marginal discoloration. A total of 186 restorations were evaluated with modified US Public Health Service criteria. Longevity and associated variables were analyzed with the Kaplan-Meier method and a Cox proportional hazard model. Restorations with marginal discoloration were additionally evaluated using digital photographs and epoxy resin replicas under a stereomicroscope. The mean survival time was 15.0 years, with five- and 10-year survival rates of 95.5% and 83.1%, respectively. Z250 had a higher risk of failure (hazard ratio=7.01, 95% confidence interval=2.07-23.72) than Z100. In addition, the presence of occlusal wear facets and bleeding on probing were associated with an increased risk of failure of the restorations. However, the use of an adhesive system (Scotchbond Multi-Purpose or Clearfil SE Bond) did not affect the longevity of the restorations. The results of laboratory evaluation were significantly different from clinical evaluation (p&lt;0.001, McNemar test). Among 55 restorations rated as Bravo in the clinical evaluation, 24 restorations (43.6%) were determined to have penetrating discoloration on laboratory evaluation. When evaluating aged composite restorations, surface refurbishment and the use of a microscope are recommended, which will be helpful in determining the need for timely repair or replacement.

Elution of monomer from different bulk fill dental composite resins

OBJECTIVE

The purpose of this study was to evaluate the elution of Bis-GMA, TEGDMA, HEMA, and Bis-EMA monomers from six bulk fill composite resins over four different time periods, using HPLC.

METHODS

Six different composite resin materials were used in the present study: Tetric Evo Ceram Bulk Fill (Ivoclar Vivadent, Amherst, NY), X-tra Fill (VOCO, Cuxhaven, Germany), Sonic Fill (Kerr, Orange, CA, USA), Filtek Bulk Fill (3M ESPE Dental Product, St. Paul, MN), SDR (Dentsply, Konstanz, Germany), EQUIA (GC America INC, Alsip, IL). The samples (4mm thickness, 5mm diameter) were prepared and polymerized for 20s with a light emitted diode unit. After fabrication, each sample was immediately immersed in 75wt% ethanol/water solution used as extraction fluid and stored in the amber colored bottles at room temperature. Ethanol/water samples were taken (0.5mL) at predefined time intervals:10m (T1), 1h (T2), 24h (T3) and 30 days (T4). These samples were analyzed by HPLC. The obtained data were analyzed with one-way ANOVA and Tukey HSD at significance level of p<0.05.

RESULTS

Amount of eluted Bis-EMA and Bis-GMA from Tetric Evo Ceram Bulk Fill and amount of eluted TEGDMA and HEMA from X-tra Fill higher than others composites (p<0.05).

SIGNIFICANCE

Residual monomers were eluted from bulk fill composite resins in all time periods and the amount of eluted monomers was increased with time.

Influence of Resin Monomers on Growth of Oral Streptococci

Ethyleneglycol dimethacrylate monomers have been previously reported to stimulate the growth of certain caries-associated bacteria on the basis of turbidity measurements. To elucidate the detail of this effect, we examined the influence of resin monomers on the growth of Streptococcus sobrinus and Streptococcus sanguis by determination of bacterial numbers (colony-forming units), morphological observation, and chemical analysis. Although the absorbance values in the stationary phase of bacterial suspension were increased in the presence of ethyleneglycol monomers, no significant differences were observed for bacterial numbers throughout the incubation period. Scanning electron microscopy observation revealed the formation of sparse vesicular material surrounding bacterial cells when incubated with ethyleneglycol monomers, and these products were proved to be resin polymers. The results demonstrate that the apparent biomass increase during incubation with ethyleneglycol monomers is due not to promotion of bacterial multiplication, but to the polymerization of resin monomers to form vesicular structures attached to cells.

Mouthrinses affect color stability of composite

Aim:

The aim of this study is to evaluate the effect of alcohol and nonalcohol containing mouth rinses on the color stability of a nanofilled resin composite restorative material.

Materials and Methods:

A total of 120 samples of a nanofilled resin composite material (Tetric N-Ceram, Ivoclar Vivadent AG, FL-9494 Schaan/Liechtenstein) were prepared and immersed in distilled water for 24 h. Baseline color values were recorded using Color Spectrophotometer 3600d (Konica Minolta, Japan). Samples were then randomly distributed into six groups: Group I - distilled water (control group), Group II - Listerine, Group III - Eludril, Group IV - Phosflur, Group V - Amflor, and Group VI - Rexidin. The postimmersion color values of the samples were then recorded, respectively.

Results:

Significant reduction in the mean color value (before and after immersion) was observed in nonalcohol containing mouth rinses (P < 0.001).

Conclusion:

All mouthrinses tested in the present in-vitro study caused a color shift in the nanofilled resin composite restorative material, but the color shift was dependent on the material and the mouthrinse used. Group VI (Rexidin) showed maximum color change.

In vitro biocompatibility of ICON(®) and TEGDMA on human dental pulp stem cells

OBJECTIVES

Resin infiltrants have been successfully used in dental medicine preventing the progression of tooth decay in an early phase of caries development. ICON(®) is an infiltrant of low-viscosity which penetrates via dentinal tubules into the lesion in dependence of the demineralization depth. Hence, we performed an in vitro study to determine the effect of ICON(®) on human dental pulp stem cells (hDPSCs).

METHODS

Using explant technique, primary hDPSCs were collected from extracted teeth. Characterization and isolation were performed with typical mesenchymal stem cell markers (Stro-1, CD73, CD90, CD105) and hDPSCs differentiation was validated by immunofluorescence and flow cytometry. HDPSCs were stimulated with light-cured ICON(®) (lc) and non-light-cured ICON(®) (nc) conditioned media as well as different TEGDMA concentrations followed by the analysis of cytotoxicity, pro- and anti-inflammatory responses and differentiation using XTT assay, RT-PCR and ELISAs, respectively.

RESULTS

Initial analysis demonstrated that hDPSCs express characteristic mesenchymal stem cell markers and differentiate into adipocytes, chondrocytes and osteoblasts. Notably, ICON(®) nc dramatically reduced cell viability (up to 98.9% after 48h), whereas ICON(®) lc showed only a modest cytotoxicity (10%). Data were in line with cytokine expression demonstrating increased levels of IL-6 and IL-8 as well as decreased IL-10 after ICON(®) nc exposure compared to ICON(®) lc. ICON(®) lc caused almost no alterations of DSPP, whereas ICON(®) nc markedly elevated DSPP mRNA levels (130.3-times). A concentration-dependent effect was observed in TEGDMA challenged hDPSCs.

SIGNIFICANCE

ICON(®) is a successful minimal invasive technique. However, clinicians should strictly follow manufacturer's instructions to prevent adverse effects.

Effects of acrylic resin monomers on porcine coronary artery reactivity

The purpose of the present investigation was to assess the reactivity of porcine coronary arteries under in vitro conditions following their exposure to methyl methacrylate (MMA) and hydroxyethyl methacrylate (HEMA) monomers. Confirming previous studies using rat aortas, both MMA and HEMA induced acute/direct relaxation of coronary ring preparations, which was partly dependent on the endothelium. With prolonged tissue exposure, both monomers caused time- and concentration-dependent inhibition of receptor-mediated contraction of the vascular smooth muscle caused by prostaglandin F2∝ (PGF2∝), with HEMA causing more inhibition than MMA. Hydroxyethyl methacrylate, but not MMA, also produced impairment of non-receptor-mediated contraction of the coronary smooth muscle induced by KCl. On the other hand, neither HEMA nor MMA altered relaxation of the smooth muscle produced by the direct-acting pharmacological agent, sodium nitroprusside (SNP). While exposure to HEMA impaired endothelium-dependent vasorelaxation caused by bradykinin (BK), MMA markedly enhanced this endothelial-mediated response of the arteries. The enhanced endothelial response produced by MMA was linked to nitric oxide (NO) release. In conclusion, with prolonged tissue exposure, MMA causes less pronounced effects/adverse consequences on coronary smooth muscle function relative to the effect of HEMA, while enhancing vasorelaxation associated with release of NO from the endothelium. Accordingly, MMA-containing resin materials appear to be safer for human applications than materials containing HEMA.

Solubility of two resin composites in different mouthrinses

AIM

This study aimed to compare the solubility of a universal restorative resin composite (Filtek Z250; FZ250) and a silorane-based resin composite (Filtek Silorane; FS) after immersion in alcohol-containing mouthrinse, alcohol-free mouthrinse, and artificial saliva.

METHODS

30 discs (10 mm × 1 mm) were prepared from each material and desiccated until a constant mass was obtained. Specimens were immersed in the test solutions for two days and desiccated again. Solubility was calculated based on the change in weight of each specimen before and after immersion. Data was analyzed using two-way ANOVA and Tukey's Post Hoc test (P < 0.05).

RESULTS

Solubility values for both resin composites were the highest in the alcohol-containing mouthrinse. FZ250 showed greater solubility than FS; the difference was only significant in artificial saliva.

CONCLUSION

Both resin-composite materials tested exhibited some degree of solubility in each of the test solutions. The use of an alcohol-free mouthrinse may be preferable for patients with extensive composite restorations.

Effect of extraction media and storage time on the elution of monomers from four contemporary resin composite materials

Introduction:

The purpose of this study was to examine the effect of different extraction media, including culture media, as well as storage times on the elution of monomers from modern dental composites.

Materials and Methods:

Four contemporary composite materials were tested: (a) Clearfil Majesty Esthetic (Kuraray), (b) Esthet X (DENTSPLY), (c) Filtek Silorane (3M ESPE), and (d) Admira (Voco). Forty-eight specimens were made. The specimens were stored in 1 ml of (a) artificial saliva, (b) Dulbecco's Modified Eagle Medium (DMEM), (c) DMEM plus 10% fetal bovine serum (FBS), and (d) ethanol 75%. The specimens were analyzed after 24 hours and after 1 week of storage. HPLC Liquid Chromatography was performed to analyze the extracted solutions. The statistical package SPSS 18 was used for the statistical analysis of the results.

Results:

All the materials tested released monomers that were consistent with the base composition of their resin matrix. Bisphenol-A (BPA) was detected in Clearfil Esthetic and EsthetX when ethanol 75% was used for storage. TEGDMA was released at a faster rate compared to the other monomers with most of the monomer eluted in the first 24 hours. The effect of storage solution and storage time on the elution of the same monomers varied between materials.

Conclusions:

There was a significant effect of time, storage solution, and material on the elution of the detectable unbound monomers. Unbound monomers were detected in culture media, which may lead to false-negative results in cytotoxicity tests of resin composite materials. BPA was detected in two of the tested materials.

Effect of Acidic Solutions on the Surface Degradation of a Micro-Hybrid Composite Resin

Composite resins may undergo wear by the action of chemical substances (e.g., saliva, alcohol, bacterial acids) of the oral environment, which may affect the material's structure and surface properties. This study evaluated the effect of acidic substances on the surface properties of a micro-hybrid composite resin (Filtek Z-250). Eighty specimens were prepared, and baseline hardness and surface roughness (KMN0 and Ra0, respectively) were measured. The specimens were subjected to sorption (SO) and solubility (SL) tests according to ISO 4049:2009, but using different storage solutions: deionized water; 75/25 vol% ethanol/water solution; lactic acid; propionic acid; and acetic acid. The acids were used in two concentrations: PA and 0.02 N. pH was measured for all solutions and final hardness (KMN1) and surface roughness (Ra1) were measured. Data were analyzed with paired t-tests and one-way ANOVA and Tukey's test (a=5%). All solutions decreased hardness and increased the Ra values, except for the specimens stored in water and 0.02 N lactic acid, which maintained the hardness. All solutions produced similar SO and SL phenomena, except for the 0.02 N lactic acid, which caused lower solubility than the other solutions. Ethanol showed the highest pH (6.6) and the 0.02 N lactic acid the lowest one (2.5). The solutions affected negatively the surface properties of the composite resin; in addition, an acidic pH did not seem to be a significant factor that intensifies the surface degradation phenomena.

Effect of food stimulated liquids and thermocycling on the monomer elution from a nanofilled composite

The present study was aimed to evaluate the effects of food simulating liquids and thermocycling on the elution of monomers from a nanofilled resin composite in different immersion times. Five Specimen discs were made from a nano-hybrid composite (Supreme 3M) for each group (Total = 180) and immersed in distilled water (control), citric acid, lactic acid, and 75% aqueous ethanol solution. The discs were removed after 24 h, 48 h, 72 h, 1 wk, 4 wk, and 12 wk. Three groups of samples underwent thermocycling for 1000, 2000 and 3000 cycles. The solutes were analyzed with HPLC for detection of eluted monomers. The results showed that the amount of released TEGDMA was significantly higher than that of Bis-GMA; however, there were not any significant differences between the amount of released Bis-GMA and UDMA. Moreover, the highest amount of monomers was released from samples immersed in ethanol solution; samples immersed in citric acid and lactic acid significantly released more monomers than those immersed in distilled water. Furthermore, the immersion time in aqueous ethanol solution had an increasing effect on the release of monomers. In addition, the higher amounts of monomers were release from samples immersed in ethanol and citric acid which underwent a higher number of thermal cycles. In conclusion, food and drink stimulated liquids used in this study increased the amount of some of the monomers released from composite resin. Thermal shocks and storage time are other factors that increased the release of monomers from the composite resin

FT-Raman spectroscopy study of organic matrix degradation in nanofilled resin composite

This in vitro study evaluated the effect of light curing unit (LCU) type, mouthwashes, and soft drink on chemical degradation of a nanofilled resin composite. Samples (80) were divided into eight groups: halogen LCU, HS--saliva (control); HPT--Pepsi Twist®; HLC--Listerine®; HCP--Colgate Plax®; LED LCU, LS--saliva (control); LPT--Pepsi Twist®; LLC--Listerine®; LCP--Colgate Plax®. The degree of conversion analysis and the measure of the peak area at 2,930 cm-1 (organic matrix) of resin composite were done by Fourier-transform Raman spectroscopy (baseline, after 7 and 14 days). The data were subjected to multifactor analysis of variance (ANOVA) at a 95% confidence followed by Tukey's HSD post-hoc test. The DC ranged from 58.0% (Halogen) to 59.3% (LED) without significance. Differences in the peak area between LCUs were found after 7 days of storage in S and PT. A marked increase in the peak intensity of HLC and LLC groups was found. The soft-start light-activation may influence the chemical degradation of organic matrix in resin composite. Ethanol contained in Listerine® Cool Mint mouthwash had the most significant degradation effect. Raman spectroscopy is shown to be a useful tool to investigate resin composite degradation.

Infrared spectroscopic analysis of restorative composite materials' surfaces and their saline extracts

This study aims at finding out if multiple attenuated internal reflection-infrared (MAIR-IR) spectroscopic analysis can be used as a tool to differentiate commercial resin composite brands and to find out if different resin composites will have different abilities of leaching materials that are cytotoxic to human gingival fibroblasts (HGFs) Tooth-colored resin fillings have become increasingly popular as restorative materials, which make it important to differentiate the commercial brands for forensic and biological purposes. Fourteen resin composite brands were used in the study. MAIR-IR spectroscopic analysis was used for surface characterization of the organic and inorganic parts of the resin composite samples which were studied as is and after 2 weeks of saline incubation. IR spectroscopy was also done on the saline extracts to find out if different resin composite materials would have different leaching abilities. The saline extracts were also used for the viability testing of HGF cell cultures. One-way analysis of variance test statistics was used to analyze the results. It was found that the resin composite brands have different spectra after saline soaking. It was also found that these resin composite brands possess different leaching abilities with regard to the amount and type of materials and different cytotoxic effects, which were found to be threshold dependent, meaning there is a critical or threshold value of leaching material at or above which the toxic effect will be significant and below which there is no toxic effect. Therefore, IR spectroscopy might be considered as a useful tool for dental resin composite characterization. However, more oral simulating environmental testing methods, different surface characterization methods, and more cell viability testing methods and assays must be considered for more specific results which relate more to the behavior of these dental resin composites in the oral environment.

Microhardness of dual-polymerized resin cement around a translucent fiber post in the intraradicular environment

Aim:

In this study, we evaluated the effect of photopolymerization on Vickers microhardness of dual-polymerized resin cement at three locations when a translucent quartz fiber post was used.

Materials and Methods:

Single-rooted bovine teeth received quartz fiber post systems (length: 12 mm) using a dual-polymerized resin cement. In Group 1, the posts were cemented but not photopolymerized, and in Group 2, the posts were both cemented and photopolymerized. After cementation, approximately 1.5-mm thick sections were obtained (two cervical, two middle, and two apical) for regional microhardness evaluations.

Statistical Analysis:

Statistical analyses were performed using the SPSS software (ver. 11.0 for Windows; SPSS, Inc., Chicago, IL, USA). Microhardness (kg/mm²) data were submitted to two-way analysis of variance (two-way ANOVA) and repeated measures with microhardness values as the dependent variable and polymerization status (two levels: with and without) and root region (three levels: cervical, middle, and apical) as independent variables. Multiple comparisons were made using Dunnett's T3 post-hoc test. P values of <0.05 were considered to indicate statistical significance in all tests.

Results:

Photopolymerization did not significantly change the microhardness values when compared with no photopolymerization. Microhardness values also showed no significant difference between the three regions in the root canals in both groups.

Conclusions:

The mode of polymerization of the cement tested in combination with the translucent quartz fiber post system did not affect the microhardness of the cement at the cervical, middle, or apical regions of the root.

Effect of alcoholic and non-alcoholic beverages on color stability and surface roughness of resin composites: An in vitro study

Background:

Consumption of certain beverages may affect the esthetic and physical properties of the resin composite, thereby undermining the quality of restorations.

Aim:

To analyze the effect of three beverages (Whiskey, Coca-Cola, and Nimbooz) on color stability and surface roughness of two different types of resin composites at various time intervals in vitro.

Materials and Methods:

A methacrylate-based nanofilled composite and a silorane-based microhybrid composite were used. Each material was randomly divided into four equal subgroups of 10 samples each according to the beverages used (Whiskey, Coca-Cola, Nimbooz, and Distilled water). The samples were immersed in each beverage for 10 minutes each day for 56 days. Color change and surface roughness measurements were noted at the baseline — the seventh, fourteenth, twenty-eighth, and fifty-sixth day.

Statistical Analysis Used:

RANOVA and Bonferroni tests were used to find the difference in color change and surface roughness in the two resin composites when immersed in different beverages. The Pearson Correlation test was carried out to test if any correlation existed between color change and surface roughness.

Results:

Silorane-based resin composites were more stable in different beverages over time.

Conclusion:

The effect of interaction of different resin composites, various beverages, and time depended on a multitude of factors.

Effect of light sources and curing mode techniques on sorption, solubility and biaxial flexural strength of a composite resin

Adequate polymerization plays an important role on the longevity of the composite resin restorations.

In Vitro Evaluation of Surface Roughness and Microhardness of Restorative Materials Submitted to Erosive Challenges

The effects of dental erosion caused by acidic solutions on the surface of restorative dental materials could be minimized by the application of a surface sealant.

Effect of Biofilm on the Repair Bond Strengths of Composites

Composite restorations degrade during wear, but it is unknown how wear affects the composite surface and influences composite-to-composite bonding in minimally invasive repair. Here, it is hypothesized that in vitro exposure of composites to oral biofilm yields clinically relevant degradation of composite surfaces, and its influence on composite-to-composite bonding is determined. Biofilms on composite surfaces in vitro increased their roughness and decreased filler particle exposure, except for a microhybrid composite, similar to effects of clinical wear in palatal appliances. Failure shear stresses after intermediate-adhesive-resin application were significantly lower after aging by in vitro exposure to biofilms, while silica-coating maintained the same failure stress levels as in non-aged composites. Failure modes were predominantly cohesive after silica-coating, while intermediate-adhesive-resin application yielded more adhesive failure. It is concluded that in vitro exposure to oral biofilm is a clinically relevant aging condition, and that silica-coating is to be preferred for the repair of aged composites.

Real-time xCELLigence impedance analysis of the cytotoxicity of dental composite components on human gingival fibroblasts

OBJECTIVES

Aim of this study was by continuous monitoring to assay the proliferative capacity of human gingival fibroblasts (HGFs), to investigate cytotoxicity of the most common monomers/comonomers in dental resin composites: bisphenol-A-glycidylmethacrylate (BisGMA), hydroxyethylenemethacrylate (HEMA), triethyleneglycoldimethacrylate (TEGDMA), and urethanedimethacrylate (UDMA) in HGFs during 24h exposure using the xCELLigence system.

METHODS

xCELLigence cell index (CI) impedance measurements were performed according to the instructions of the supplier. HGFs were resuspended in medium and subsequently adjusted to 400,000, 200,000, 100,000, and 50,000 cells/mL. After seeding 100 microL of the cell suspensions into the wells of the E-plate 96, HGFs were monitored every 15 min for a period of up to 18 h by the xCELLigence system.

RESULTS

Half maximum effect concentrations (EC(50)) were determined based on the dose-response curves derived by xCELLigence measurements. Following real-time analysis, significantly increased EC(50) values of HGFs exposed for 24h to the following substances were obtained: HEMA(a), TEGDMA(b), UDMA(c). The EC(50) values (mean [mmol/L]+/-S.E.M.; n=5) were: HEMA 11.20+/-0.3, TEGDMA(a) 3.61+/-0.2, UDMA(a,b) 0.20+/-0.1, and BisGMA(a,b,c) 0.08+/-0.1. These results are similar to the EC(50) values previously observed with the XTT end-point assay.

SIGNIFICANCE

Our data suggests that the xCELLigence live cell analysis system offers dynamic live cell monitoring and combines high data acquisition rates with ease of handling. Therefore, the xCELLigence system can be used as a rapid monitoring tool for cellular viability and be applied in toxicity testing of xenobiotics using in vitro cell cultures.

The Effect of Mouthrinses on Salivary Sorption, Solubility and Surface Degradation of a Nanofilled and a Hybrid Resin Composite

The use of alcohol-containing mouth rinses with a low pH may increase the sorption and solubility of resin composites. The nanofilled resin composite underwent more surface degradation than the hybrid type.

Bond strength of resin-resin interfaces contaminated with saliva and submitted to different surface treatments

The purpose of this study was to investigate the effect of different surface treatments on shear bond strength of saliva-contaminated resin-resin interfaces. Flat resin surfaces were fabricated. In the control group, no contamination or surface treatment was performed. The resin surfaces of the experimental groups were contaminated with saliva and air-dried, and then submitted to: (G1) rinsing with water and drying; (G2) application of an adhesive system; (G3) rinsing and drying, abrasion with finishing disks, etching and application of adhesive system; (G4) rinsing and drying, etching, application of silane and adhesive system. Resin cylinders were placed over the treated surfaces. The specimens were stored in water or ethanol. Shear bond strength tests were performed and the mode of failure was evaluated. Data were submitted to two-way ANOVA and Dunnett T3 test. Contamination of resin-resin interfaces with saliva significantly reduced shear strength, especially after prolonged storage (p<0.05). Similar values to the original bond strength were obtained after abrasion and application of adhesive (G3) or etching and application of silane and adhesive (G4). If contamination occurs, a surface treatment is required to guarantee an adequate interaction between the resin increments.

HPLC analysis of HEMA released from two different adhesive systems

OBJECTIVES

The aim of this study was to evaluate in vitro elution of 2-Hydroxyethyl methacrylate (HEMA) from two different adhesive systems, used in two dual polymerized resin cements for bonding of ceramic restoration by high performance liquid chromatography (HPLC).

METHODS

Twenty freshly extracted caries and restoration free molar teeth used in this study. Standardized Class I preparations were prepared in all teeth. A lithium disilicate based (IPS Empress Esthetic; Ivoclar) ceramic inlays were cemented with one of the dual polymerized resin cements (RelyX ARC; 3M ESPE or Nexus 2; Kerr) that have two different adhesive systems (Single Bond; 3M ESPE, Optibond Solo Plus; Kerr). After cementation, specimens were stored in 75% ethanol solution. HPLC was used to analyze the amount of HEMA in the solution (after 10 min, 1 h, 24 h, 3, 7, 14, and 21 days). Two-way analysis of variance and Tukey HSD tests were used to evaluate the results (p < 0.05).

RESULTS

There were statistically significant differences between adhesive systems according to the amount of released HEMA (p < 0.01) and also among time periods (p < 0.01). The amount of HEMA eluted from Optibond Solo Plus was significantly higher than Single Bond. The total amount of monomers was the highest after 21 days (p < 0.01).

CONCLUSIONS

In the case of adhesive systems, Optibond Solo Plus showed the highest amount of HEMA. The amount of HEMA eluted from adhesive systems influenced by the time.

Molecular toxicology of substances released from resin-based dental restorative materials

Resin-based dental restorative materials are extensively used today in dentistry. However, significant concerns still remain regarding their biocompatibility. For this reason, significant scientific effort has been focused on the determination of the molecular toxicology of substances released by these biomaterials, using several tools for risk assessment, including exposure assessment, hazard identification and dose-response analysis. These studies have shown that substances released by these materials can cause significant cytotoxic and genotoxic effects, leading to irreversible disturbance of basic cellular functions. The aim of this article is to review current knowledge related to dental composites' molecular toxicology and to give implications for possible improvements concerning their biocompatibility.