Clinical evaluation of Giomer and self-etch adhesive compared with nanofilled resin composite and etch-and-rinse adhesive - Results at 8 years

OBJECTIVE

This study aimed to evaluate the long-term clinical performance of Giomer and a self-etch adhesive system compared with a nanofilled resin composite and etch-and-rinse adhesive system in Class I and Class II restorations.

METHOD

The study was designed to be double-blinded with intra-individual control. 48 patients with 54 pairs of cavities (class I or class II) were recruited. Each pair of restorations was placed with either BEAUTIFIL II (BF) and FL-BOND II (FL) or Filtek Z350 (Z350) and Scotchbond Multi-Purpose (SMP). Clinical evaluation was performed at baseline, 6-month, 18-month, 4-year and 8-year after placement according to modified USPHS criteria. Kaplan-Meier survival analysis and log rank tests were performed (SPSS 20.0, IBM Corporation, US) to compare the survival probability of different restorations.A generalized linear mixed model (GLMM) was adopted to assess the performance of the materials. The McNemar test was used to show significant changes for all the evaluation criteria and difference between them.

RESULTS

At the eight-year recall, 32 patients with 67 restorations were present. There were twelve restorations in total recorded as failure due to loss of retention, restoration fracture, secondary caries, tooth fracture or endodontic treatment due to pulp necrosis. The survival probabilities and calculated annual failure rate(AFR) of BF and Z350 restorations at 8-year were 87.2 % vs 87.8 % and 1.6 % vs 1.5 % respectively with no significant difference (p > 0.05)between the two materials. Over the recall time range of eight years, decreased possibility of alpha rating was observed for retention, marginal adaptation, marginal staining and surface roughness for both materials (p < 0.05). Decreased possibility of alpha rating was observed for surface staining and secondary caries for Z350 (p < 0.05) and restoration fracture for BF (p < 0.05), respectively. Comparing the two restorative systems over eight years, no significant difference was seen for linear decline of the possibility of alpha rating for any of the criteria evaluated (p > 0.05).

CONCLUSION

Giomer material and the self-etch adhesive system had comparable clinical performance with nanofilled resin composite and etch-and-rinse adhesive system over the observation period of eight years.

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.

Analysis of color stability and degree of conversion of different types of resin composites

Resin composites containing surface pre-reacted glass (S-PRG) have been introduced to reduce demineralization and improve remineralization of the tooth structure. However, water diffusion within the material is necessary for its action, which can impair its overall physicomechanical properties over time, including color stability. This study aimed to evaluate the color stability and related degree of conversion (DC) of four resin composites. Discs (6 x 4 mm, n = 5/group) of microhybrid (MH), nanofilled (NF), nanohybrid (NH), and S-PRG-based nanohybrid (S-PRG-NH) composites with two opacities (A2/A2E and A2O/A2D) were prepared. Color (CIELab and CIEDE2000) was evaluated with a spectrophotometer after aging in grape juice (2 x 10 min/10mL/7days). The DC was analyzed by using Fourier transform infrared spectroscopy before and after light-curing. Data were statistically analyzed by using two-way analysis of variance and post-hoc least significant difference tests (p<0.05). In the color stability analysis, the interaction between filler type and opacity was significant (CIELab, p = 0.0015; CIEDE2000, p = 0.0026). NH presented the highest color stability, which did not differ from that of MH. The greatest color alteration was observed for S-PRG-NH. S-PRG fillers also influenced DC (p < 0.05). The nanohybrid resin composite presented favorable overall performance, which is likely related to its more stable organic content. Notwithstanding the benefits of using S-PRG-based nanohybrid resins, mostly in aesthetic procedures, professionals should consider the susceptibility of such resins to color alteration, probably due to the water-based bioactive mechanism of action.

Effect of a demineralization model on the microhardness, surface roughness and topography of giomers: An in vitro study

The purpose of this study is to compare the effect of a demineralization model on the microhardness, surface roughness, and topography of giomers.Seventy-two discs of six different dental materials in three different presentations (pit and fissure sealant (PFS), flowable and restorative materials) were divided into six groups (n = 12 p/g). Three experimental groups (giomers) consisted of BeautiSealant, Beautifil Flow Plus, and Beautifil II, and three control groups (resin-based materials) were formed using ClinproTM, FiltekTM Z350 XT Flow, and Filtek™ Bulk Fill materials. Vickers microhardness, surface roughness, and topographic analysis with atomic force microscopy were measured at the beginning (0) after four (1) and 7 days (2) of immersion in a demineralizing model. Statistical analysis was performed using One-way and Repeated Measures ANOVA and Pearson's correlation coefficient (p ≤ .05). The microhardness values showed significant variations, except for the G_RM group. All the groups presented significant increases in roughness through the experiment stages, except for RB_PFS in the Ra parameter. The topographic analysis showed variations in the micromorphology, especially in the experimental group at the end of the demineralization model. Finally, there was no correlation between microhardness and surface roughness. The demineralization model decreased the microhardness, with the lowest reductions in the giomers groups. The effect of the demineralizing model on the surface roughness and topography showed an increase in specific patterns for the experimental and control groups. Therefore, their clinical use is recommended. RESEARCH HIGHLIGHTS: The demineralization model decreased the microhardness property of the evaluated materials, with better performance for the giomer groups. The effect of the demineralizing model on surface roughness showed an increase with specific patterns for the experimental and control groups. Although the materials presented changes in their microhardness, roughness, and topography, their clinical use is recommended.

Surface Properties and Wear Resistance of Injectable and Computer-Aided Design/Computer Aided Manufacturing-Milled Resin Composite Thin Occlusal Veneers

OBJECTIVES

 This study was conducted to investigate the microhardness, surface roughness (Ra), and wear behavior of thin occlusal veneers (TOV) fabricated from different injectable composite materials and compare them to a Computer-Aided Design (CAD)/Computer-Aided Manufacturing (CAM) resin-based material.

MATERIALS AND METHODS

 A 1-mm occusal veneer preparation was done in a mandibular right second molar typodont tooth. The prepared model was duplicated to fabricate 32 replicas and divided into four groups (n = 8). Standard TOV were fabricated either indirectly from Cerasmart blocks, Cerasmart, GC (CS), or directly from Beautifil Injectable X, Shofu (BF), G-ænial Universal injectable, GC (GU), or SonicFill 2, Kerr (SF) using the injection molding technique. All the specimens were subjected to both thermomechanical cyclic loading (TMC) in a chewing simulator. Wear measurement was conducted by three-dimensional (3D) scanning of the veneered models before and after TMC, and the difference in the volume of the sample was recorded as the volumetric material loss due to wear. Ra before and after TMC and Vickers microhardness (VHN) of the tested materials were measured using standardized samples (n = 8). Representative samples from each group were investigated under a stereomicroscope and a scanning electron microscope.

STATISTICAL ANALYSIS

 One-way analysis of variance (ANOVA) was applied to detect the effect of material on VHN and wear. Two-way ANOVA was utilized to examine the impact of material and TMC on Ra. Multiple comparisons between the groups were conducted using Tukey's post hoc test (α = 0.05). The Pearson's correlation coefficient was used to determine the relationship between hardness and wear and between roughness and wear (α = 0.05).

RESULTS

 CS exhibited the highest mean VHN (p ≤ 0.001), followed by GU and SF which were statistically similar (p = 0.883) but significantly higher than BF (p < 0.001). After TMC, GU revealed the lowest Ra and volumetric wear (VW), followed by CS, BF, and SF (p < 0.5). A highly significant correlation existed between Ra and VW (p = 0.001, R 2 = 0.9803).

CONCLUSION

 The effect of TMC on the surface properties and wear resistance of the investigated TOV is material-dependent. GU injectable TOV are less influenced by TMC than CS milled TOV. In contrast, BF and SF demonstrated significant VW and Ra which might limit their clinical use as TOV.

Effects of in vitro erosion on surface texture, microhardness, and color stability of resin composite with S-PRG fillers

OBJECTIVES

To evaluate the effect of acid erosion on different physical properties of resin composite with S-PRG (surface pre-reacted glass) fillers, by conducting simulations of intrinsic and extrinsic sources.

MATERIALS AND METHODS

Cylindrical samples (Ø6 vs. 2 mm) of a conventional nanohybrid resin composite (Forma, Ultradent) and of a nanohybrid resin composite with S-PRG filler (Beautifil II, Shofu) were exposed to erosive cycling (5 days), based on (n=12) remineralizing solution (control); 0.3% citric acid (pH=2.6); or 0.01 M hydrochloric acid (pH=2). Roughness (Ra), microhardness (KHN), and color (CIEL*a*b*, CIEDE2000, and Vita scale (SGU)) factors were analyzed at the initial and final time points, and the general color changes (ΔE_ab, ΔE₀₀, ΔSGU) were calculated. Final images were obtained using scanning electron microscopy (SEM). The data were evaluated by generalized models, Mann-Whitney, Wilcoxon, Kruskal-Wallis, and Dunn tests (α=0.05).

RESULTS

Regarding KHN, there was no difference between the groups or the time periods (p = 0.74). As for Ra, there was a significant increase in the Ra of both composites after cycling with hydrochloric acid, but only the resin composite with S-PRG filler showed a change in Ra after cycling with citric acid (p = 0.003). After cycling with citric and hydrochloric acid, the highest Ra values were found for the resin composite with S-PRG filler (p < 0.0001), corroborating the result of images (SEM) indicating loss of filler and porosities in this material. The resin composite with S-PRG filler showed higher ΔE_ab and ΔE₀₀, in addition to more negative ΔSGU values and lower L* values after exposure to both acids, compared to the control (p < 0.05).

CONCLUSION

The acidic conditions altered the roughness and color stability of the materials tested, pointing out that the resin composite containing S-PRG filler showed greater degradation of its physical properties than the conventional resin composite.

CLINICAL RELEVANCE

Bioactive materials are relevant, considering that their properties interact with dental hard tissues; however, the S-PRG-based resin composite showed greater degradation under acidic conditions than the conventional resin composite.

Comparison of the shear bond strength in Giomer and resin-modified glass ionomer in class V lesions

Introduction

There are several cosmetic, restorative materials to restore non-carious Cervical Lesions (NCCLs). The aim of this study was to specify and compare the shear bond strength of Giomer and resin-modified glass ionomer in Class V lesions so that whether Giomer showed a better shear bond strength, it could be used instead of RMGI to restore NCCLs because of its better esthetic.

Method

ology: 20 maxillary and 20 mandibular intact premolars were collected. Each group of 20 samples was divided into two 10-tooth subgroups of A and B. A class V preparation was made on the buccal surface of the samples with 2*2*3 mm dimensions using a diamond bur. Also, the crossing path of the universal machine chisel was prepped with 2 mm depth up to incisal edge. For group A, after applying BeautiBond and curing it, Beautifil II Giomer was placed in nylon cylinders and the cylinders were placed in the middle cervical region and cured for 20 s. For group B, 1 spoon powder of Fuji II RMGI was mixed with two drops of its liquid and transported to nylon cylinders and placed in the middle cervical region, then cured for 20 s. The nylon cylinders were removed from all 40 samples. Then, all teeth were thermocycled and then tested using a universal machine with the force of 20 MPa and the speed of 1 mm/min until they fractured to assess their shear bond strength. The obtained data was analyzed using SPSS v.26. The significance level was considered 0.05.

Results

There was no significant difference between Giomer (4.97 ± 2.36) and the resin-modified glass ionomer (3.41 ± 2.71) groups as regards their shear strength (p = 0.059). Likewise, there was no significant difference in shear bond strength between Giomer and RMGI groups as regards jaw type (P = 0.326).

Conclusion

The paper suggests that Giomer and resin-modified glass ionomer groups did not differ significantly in terms of their shear bond strength and that both can be utilized to treat Class V lesions. Furthermore, there was no significant difference between the shear bond strength in terms of jaw type.

Flexural Properties of Contemporary Bioactive Restorative Materials: Effect of Environmental pH

This study investigated the effects of environmental pH on the flexural properties of ion-releasing restorative materials (IRMs), including giomer (Beautifil-Bulk Restorative - BB), alkasite (Cention N - CN), bioactive composite (Activa - AB) and resin-modified glass ionomer (Riva Light Cure -RV) restoratives. A bio-inert resin-based composite (Filtek Bulk-fill Posterior - FB) served as the control. Stainless steel molds were used to fabricate 40 beam-shaped specimens (12mm × 2mm × 2mm) for each material. The specimens were finished, measured, and randomly distributed into four groups (n=10) and immersed in aqueous solutions of pH 3.0, pH 5.0, pH 6.8, and pH 10.0 at 37°C for 28 days. Specimens were then subjected to a uniaxial three-point bending flexural test with a load cell of 5 KN and a fixed deformation rate of 0.5 mm/min until fracture occurred. Flexural modulus and strength were statistically analyzed using analysis of variance/Dunnet T3's test (p=0.05). Mean flexural modulus varied from (2.40±0.41 to 9.65±1.21 GPa), while mean flexural strength ranged from (21.56±2.78 to 163.86±13.13 MPa). Significant differences in flexural properties were observed among the various pH values and materials. All materials immersed in artificial saliva (pH 6.8) presented the highest flexural properties, except AB. The flexural strength of AB was significantly better when exposed to acidic environments. FB had better flexural properties than IRMs after exposure to a range of environmental pH values.

Five-year clinical performance of two fluoride-releasing giomer resin materials in occlusal restorations

OBJECTIVE

To evaluate and compare the clinical performance of two nano-hybrid giomer restorative composite materials after 5 years.

MATERIALS AND METHODS

Forty-four pairs of restorations (total n = 88) of a flowable giomer (Beautifil Flow Plus F00; Shofu Inc., Kyoto, Japan) and a conventional nano-hybrid giomer restorative material (Beautifil II; Shofu Inc.) were placed in Class I cavities after the application of a dentin adhesive (FL-Bond II; Shofu Inc.) and a flowable liner (Beautifil Flow Plus F03; Shofu Inc). After 5 years, 32 pairs of restorations were assessed using the modified United States Public Health Service criteria. Both tested materials were compared using Fisher's exact test and each tested clinical criterion for each material was analyzed separately with respect to different follow-up periods using Friedman's test (a = 0.05).

RESULTS

None of the restorations showed complete retention loss, post-operative sensitivity, secondary caries or color change. There were no significant changes to any of the clinical criteria for each material during the 5-year evaluation period (p > 0.05) and no significant differences between the two materials in all clinical parameters after 5 years (p > 0.05).

CONCLUSIONS

Five-year clinical performance of both two nano-hybrid giomer restorative materials was comparably acceptable and not significantly different for any of the parameters evaluated.

CLINICAL SIGNIFICANCE

Nano-hybrid giomer-based materials are clinically acceptable for the restoration of occlusal cavities as they demonstrate excellent performance after 5 years.

Effects of staining and artificial aging on optical properties of gingiva-colored resin-based restorative materials

Objectives

To evaluate CIEDE2000/CIELAB differences in color (ΔE₀₀/ΔE_ab), and translucency parameter (ΔTP₀₀/ΔTP_ab), and gloss of gingiva-colored resin-based restorative materials upon staining/aging.

Materials and methods

Disc-shaped, 10 mm in diameter, and 2-mm-thick samples (n = 5/group) were made from giomer (Beautifil II gingiva), oligomer-based (crea.lign GUM gel), CAD/CAM polymethyl-methacrylate-based (IvoBase CAD), PMMA-based (ProBase Hot), and dimethacrylate-based (SR Nexco Paste Gingiva). Color and gloss were recording using a benchtop spectrophotometer and gloss meter, respectively, at baseline (T0), and upon staining in coffee or red wine for 60 (T1) and 120 h (T2), or artificial aging of 150 kJ/m² (T1) and 300 kJ/m² (T2). Three-way analysis of variance (materials x staining conditions x time intervals), Tukey’s test (α = 0.05), and Pearson’s correlation test were used in analytical statistics.

Results

CIEDE2000 color differences ranged from 1.0 to 4.4 (coffee), 1.5 to 5.3 (wine), and 0.9 to 2.0 after artificial aging, with ΔE₀₀ values being significantly higher for Beautifil than other materials (p < 0.05). ΔTP₀₀ values ranged from 0.2 to 0.7 and were statistically higher upon staining in wine compared to artificial aging (p < 0.05). Gloss values at T0 were 76.7–87.0. Beautifil exhibited the lowest gloss retention (50.8–60.2%) after staining, compared to > 90% of other materials (p < 0.05). ΔE₀₀/ΔE_ab and ΔTP₀₀/ΔTP_ab were positively correlated (p < 0.0001).

Conclusions

Color, translucency, and gloss changes of gingiva-colored restorative materials were material- and staining/aging-dependent. Generally, wine caused greatest changes in color (with IvoBase CAD being the most color stable) and translucency parameter. All materials except Beautifil gingiva II exhibited staining- and aging-dependent gloss retention greater than 90% for all compared time intervals.

Clinical relevance

Optical properties of resin-based gingiva-colored restorative materials depend on material, staining/aging conditions, and exposure time. Certain materials should be avoided in individuals with high consumption of red wine and coffee.

Antibacterial Activity and Biofilm Inhibition of New-Generation Hybrid/Fluoride-Releasing Restorative Materials

The antibacterial activity, and the effect of the application of additional topical fluoride on the bacterial activity, biofilm formation, and surface roughness of new-generation hybrid/fluoride-releasing materials were investigated. Two hundred and forty specimens were prepared in split Teflon molds (8 × 2 mm) from a resin composite (as negative control: G-aenial A’Chord/GC), Equia Forte HT Fil(GC), Equia Forte HT Fil+Equia Forte Coat, Riva Self-Cure (SDI), Riva Self-Cure+Equia Forte Coat, Zirconomer (Shofu), Beautifil II (Shofu), and Riva Silver (Shofu). Penicillin G,1U was used as positive control. The antibacterial activity was evaluated by the agar diffusion test immediately after the materials set using Streptococcus mutans (S. mutans) and Lactobacillus casei (L. casei), and repeated after application of 0.20% w/w (900 ppm) topical fluoride. The biofilm formation of S. mutans on each material was quantified by crystal violet staining. Surface roughness of the specimens was measured by a profilometer. The data were analyzed by Kruskal–Wallis, Dunn’s, one-way ANOVA, and Tukey’s HSD tests (p < 0.05). None of the tested restorative materials showed antibacterial activity and no inhibition zones were observed after treatment of the restoratives with additional topical fluoride. There were significant differences among the groups in terms of biofilm formation (p < 0.005). Equia Forte HT Fil with and without coating showed the lowest, while Riva self-cure without coating and Zirconomer showed the highest biofilm accumulation. None of the new-generation hybrid/fluoride-releasing materials demonstrated antibacterial activity and additional topical fluoride application did not make any change. Biofilm formation of the tested materials differed. All tested materials showed different surface roughness values (p < 0.005). Characteristics and compositions of the materials seemed to be more effective than the surface roughness.

S-PRG-based composites erosive wear resistance and the effect on surrounding enamel

This study evaluated Surface Pre-Reacted Glass-ionomer (S-PRG)-based-composites' surface resistance against erosive wear and their protective effect on surrounding enamel. Bovine enamel was randomized into 12 groups (n = 10/group) [erosion (e) or erosion + abrasion (a)]: nanohybrid-S-PRG-based composite (SPRGe/SPRGa), nanohybrid-S-PRG-based bulk-fill (SPRGBFe/SPRGBFa), nanoparticle-composite (RCe/RCa), nanohybrid-bulk-fill (BFe/BFa), Glass Hybrid Restorative System (GHRSe/GHRSa), and resin-modified glass-ionomer-cement (RMGICe/RMGICa). Cavities were prepared and restored. Initial profile assessment was performed on material and on adjacent enamel at distances of 100, 200, 300, 600, and 700 μm from margin. Specimens were immersed in citric acid (2 min; 6×/day for 5 days) for erosion. Erosion + abrasion groups were brushed for 1 min after erosion. Final profile assessment was performed. Two-way ANOVA and Tukey-test showed: for erosion, the GHRSe and RMGICe presented greater material wear compared to the other groups (p = 0.001); up to 300 μm away from restoration, GHRSe and SPRGBFe were able to prevent enamel loss compared to RMGICe and other composite groups (p = 0.001). For erosion + abrasion, none of the materials exhibited a significant protective effect and S-PRG-based groups showed lower wear than RMGICa and GHRSa, and higher wear than composites (p = 0.001). S-PRG-based-composites can diminish surrounding enamel loss only against erosion alone, similarly to GIC, with advantage of being a more resistant material.

Three-year Clinical Performance of Two Giomer Restorative Materials in Restorations

CLINICAL RELEVANCE

The clinical performance of both conventional and flowable giomer restorative materials was particularly good in Class I restorations after three years of service.

SUMMARY

This study evaluated and compared the clinical performance of a flowable and a conventional giomer restorative material after three years. Forty-four pairs of restorations (total n=88) were placed in Class I cavities with either a flowable giomer (Beautifil Flow Plus F00; Shofu Inc, Kyoto, Japan) or a conventional giomer restorative material (Beautifil II; Shofu Inc) after the application of a dentin adhesive (FL-Bond II; Shofu Inc) and a flowable liner (Beautifil Flow Plus F03; Shofu Inc). After 3 years, 39 pairs of restorations were evaluated with the modified United States Public Health Service criteria, and digital color photographs of restorations were taken at each patient visit. The evaluation parameters were as follows: color match, marginal integrity, marginal discoloration, retention, secondary caries formation, anatomic form, surface texture, and postoperative sensitivity. Evaluations were recorded as a clinically ideal situation (Alpha), a clinically acceptable situation (Bravo), or a clinically unacceptable situation (Charlie). Data were analyzed with Fisher's exact and McNemar tests (α=0.05).None of the restorations showed retention loss, postoperative sensitivity, secondary caries, or color change. The performance of Beautifil II in terms of marginal integrity, marginal discoloration, and surface anatomic form was significantly lower at the 36-month follow-up than at baseline (p=0.007). There were no significant differences between the baseline and 36-month follow-up scores for the other criteria for Beautifil II (p>0.05). No differences were found between the baseline and the 36-month follow-up scores for any of the criteria for Beautifil Flow Plus F00 (p>0.05). No statistically significant difference in overall clinical performance was found between the 2 materials after 36 months (p>0.05).The three-year clinical performance of both restorative materials (Beautifil Flow Plus F00 and Beautifil II) was very good and not significantly different for any of the parameters evaluated.

The Effects of Food-Simulating Liquids on Surface Roughness, Surface Hardness, and Solubility of Bulk-Fill Composites

Aim:

To investigate the surface roughness, surface hardness, and solubility of bulk-fill composites after exposure to food-simulating liquids (FSLs).

Materials and Methods:

A total of 200 disc-shaped samples (8 mm diameter × 4 mm depth) were prepared using four bulk-fill composites (SonicFillTM, Tetric® EvoCeram Bulk Fill, Beautifil-Bulk Restorative, FiltekTM Bulk Fill Posterior Restorative) and a microhybrid composite (FiltekTM Z250) ( n = 40). Following the measurement of initial weights of the samples ( m1), the surface roughness measurements were gauged using a contact-profilometer. The samples were stored in four different FSLs for 7 days, and then the second surface roughness values were recorded. The samples were stored in a desiccator to reach the constant mass and the values were recorded as m2, then the solubility levels were calculated. The Vickers microhardness values of the samples were determined. A total of 20 specimens were evaluated in terms of surface morphology with a scanning electron microscope (SEM). Data were statistically analyzed with the two-way ANOVA and Bonferroni tests ( P < .05).

Results:

Beautifil-Bulk Restorative was affected at most in terms of surface roughness after storage in FSLs and citric acid caused the highest values in this group ( P < .005). Beautifil-Bulk Restorative and Filtek Z250 showed the highest surface hardness values, while the Tetric EvoCeram group had the lowest. The highest solubility values were found in Beautifil-Bulk Restorative, and citric acid and ethanol yielded the highest solubility values for all of the composites.

Conclusion:

Beautifil-Bulk Restorative is the most affected group in all parameters evaluated and also affected overly by citric acid among the FSLs in consequence of its prereacted glass ionomer fillers.

Characterization of low-cost Brazilian resin composites submitted to tooth brushing

This in vitro study aimed to evaluate surface microhardness, roughness, color, gloss and topography of low-cost Brazilian resin composites, compared with an international one. All 120 samples (8mm ø x 2mm height) were prepared and divided into 5 groups: Ultrafill (Biodinâmica), Llis (FGM), Fill Magic (Coltene), Applic (Makira), and Filtek Z250XT (3M Oral Care). Surface microhardness (KHN) (n=10) was analyzed at two time periods: before and after simulated tooth brushing (STB). Other standardized samples of each group (n=10) were analyzed for surface roughness (Ra), color (ΔL, Δa, Δb, ΔE, ΔE00) and gloss unit (GU) at the same two periods. The topography of non-brushed and brushed samples of each group (n=4) was evaluated by scanning electron microscopy. Data were analyzed statistically by two-way repeated measures ANOVA with Bonferroni post-hoc test (KHN, Ra, GU), and one-way ANOVA with Tukey post-hoc test (ΔL, Δa, Δb, ΔE, ΔE00) (α=0.05). Topographic images were submitted to descriptive analysis. The low-cost Brazilian resin composites investigated were compared with the international one and revealed: lower KHN, regardless of before or after STB; statistically similar Ra before STB, except Ultrafill, which presented higher values; lower Ra after STB, except Ultrafill, which presented statistically similar values; statistically similar color change in ΔL, Δa, Δb parameters; statistically similar color change in ΔE, ΔE00 parameters, except Fill Magic, which presented lower values; lower gloss before STB; lower gloss after STB, except Ultrafill, which presented statistically similar values. In a situation of scarce resources, low-cost Brazilian composites might be an acceptable cost-effective restorative alternative.

Bioactive Materials Subjected to Erosion/Abrasion and Their Influence on Dental Tissues

OBJECTIVE

The objective of this study was to evaluate the effect of erosion or erosion-abrasion on bioactive materials and adjacent enamel/dentin areas.

METHODS AND MATERIALS

Enamel and dentin blocks (4×4×2 mm) were embedded side by side in acrylic resin, and a standardized cavity (1.2×4×1.5 mm) was prepared between them. Preparations were restored with the following materials: composite resin (Filtek Z350, control); experimental composite containing di-calcium phosphate dihydrate particles (DCPD); Giomer (Beautifil II), high viscosity glass ionomer cement (GIC, Fuji IX); and a resin-modified GIC (Fuji II LC). The specimens were submitted to two cycling models (n=10): erosion or erosion-abrasion. The challenges consisted of five-minute immersion in 0.3% citric acid solution, followed by 60-minute exposure to artificial saliva. Toothbrushing was carried out twice daily, 30 minutes after the first and last exposures to acid. Dental and material surface loss (SL, in μm) were determined by optical profilometry. Data were analyzed with Kruskal-Wallis and Dunn tests (α=0.05).

RESULTS

Under erosion, for enamel, only the GIC groups presented lower SL values than Z350 (p<0.001 for Fuji IX and p=0.018 for Fuji II LC). For dentin, none of the materials showed significantly lower SL values than Z350 (p>0.05). For material, the GICs had significantly higher SL values than those of Z350 (p<0.001 for Fuji IX and p=0.002 for Fuji II LC). Under erosion-abrasion, the enamel SL value was significantly lower around Fuji II LC compared with the other materials (p<0.05). No significant differences were observed among groups for dentin SL (p=0.063). The GICs and Giomer showed higher SL values than Z350 (p<0.001 for the GICs and p=0.041 for Giomer).

CONCLUSION

Both GIC-based materials were susceptible to erosive wear; however, they promoted the lowest erosive loss of adjacent enamel. Against erosion-abrasion, only Fuji II LC was able to reduce enamel loss. For dentin, none of the materials exhibited a significant protective effect.

Surface roughness and filler particles characterization of resin-based composites

The purpose of this study was to evaluate the surface roughness (Ra), and the morphology and composition of filler particles of different composites submitted to toothbrushing and water storage. Disc-shaped specimens (15 mm × 2 mm) were made from five composites: two conventional (Z100™, and Filtek™ Supreme Ultra Universal, 3M), one "quick-cure" (Estelite ∑ Quick, Tokuyama), one fluoride-releasing (Beautiful II, Shofu), and one self-adhering (Vertise Flow, Kerr) composite. Samples were finished/polished using aluminum oxide discs (Sof-Lex, 3M), and their surfaces were analyzed by profilometry (n = 5) and scanning electron microscopy (SEM; n = 3) at 1 week and after 30,000 toothbrushing cycles and 6-month water storage. Ra data were analyzed by two-way analysis of variance and Tukey's test (α = 0.05). Filler particles morphology and composition were analyzed by SEM and X-ray dispersive energy spectroscopy, respectively. Finishing/polishing resulted in similar Ra for all the composites, while toothbrushing and water storage increased the Ra of all the tested materials, also changing their surface morphology. Beautifil II and Vertise Flow presented the highest Ra after toothbrushing and water storage. Filler particles were mainly composed of silicon, zirconium, aluminum, barium, and ytterbium. Size and morphology of fillers, and composition of the tested composites influenced their Ra when samples were submitted to toothbrushing and water 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.

Impact of dietary solvents on flexural properties of bulk-fill composites

OBJECTIVE

This study investigated the effect of dietary solvents on flexural strength and modulus of bulk-fill composites.

MATERIALS AND METHODS

One conventional composite (Filtek Z350 [FZ]), two bulk-fill composites (Filtek Bulk-fill [FB] and Tetric N Ceram [TN]) and a bulk-fill giomer (Beautifil-Bulk Restorative [BB]) were evaluated. Specimens (12 × 2 × 2 mm) were fabricated using customized stainless steel molds. Specimens were light-cured, removed from their molds, finished, measured and randomly divided into six groups. The groups (n = 10) were conditioned in the following mediums for 7 days at 37 °C: air (control), artificial saliva (SAGF), distilled water, 0.02 N citric acid, heptane, 50% ethanol-water solution. After conditioning, the specimens were rinsed, blotted dry, measured and subjected to flexural testing using a universal testing machine. Representative SEM images of the intact surfaces were obtained to appraise the degradation mechanism by dietary solvents. Data was subjected to statistical analysis using ANOVA/Tukey's tests at significance level p < 0.05.

RESULTS

Significant differences in flexural properties were observed between materials and conditioning mediums. The highest flexural properties were usually obtained with conditioning in air (control) or heptane. Exposure to aqueous solutions generally reduced flexural properties of bulk-fill composites.

CONCLUSION

The effect of dietary solvents on flexural properties of bulk-fill composites was material and medium dependent.

A Deep Morphological Characterization and Comparison of Different Dental Restorative Materials

Giomer is a relatively new class of restorative material with aesthetics, handling and physical properties of composite resins, and benefits of glass ionomers: high radiopacity, antiplaque effect, fluoride release, and recharge. To verify the superior properties of Giomers, in this study, a deep morphological characterization has been performed with an in vitro comparative study among a Giomer (Beautifil® II by Shofu Dental Corporation, Osaka, Japan), a Compomer (Dyract Extra by Dentsply, Caulk, Germany), glass ionomer cement (Ketac fil plus by 3M ESPE), and a composite resin (Tetric Evoceram by Ivoclar). In particular, mechanical and optical properties and ageing effects have been compared to investigate materials similarities and differences. Indentation tests, UV-Visible spectroscopy, Raman spectroscopy, and weight loss after storage in saliva or sugary drink have been carried out to analyze materials behavior in real conditions. The results confirm the high quality of Giomer material and indicate possible improvements in their usage.

Dynamic analysis of bulk-fill composites: Effect of food-simulating liquids

This study investigated the effect of food simulating liquids on visco-elastic properties of bulk-fill restoratives using dynamic mechanical analysis. One conventional composite (Filtek Z350 [FZ]), two bulk-fill composites (Filtek Bulk-fill [FB] and Tetric N Ceram [TN]) and a bulk-fill giomer (Beautifil-Bulk Restorative [BB]) were evaluated. Specimens (12 × 2 × 2mm) were fabricated using customized stainless steel molds. The specimens were light-cured, removed from their molds, finished, measured and randomly divided into six groups. The groups (n = 10) were conditioned in the following mediums for 7 days at 37°C: air (control), artificial saliva (SAGF), distilled water, 0.02N citric acid, heptane, 50% ethanol-water solution. Specimens were assessed using dynamic mechanical testing in flexural three-point bending mode and their respective mediums at 37°C and a frequency range of 0.1-10Hz. The distance between the supports were fixed at 10mm and an axial load of 5N was employed. Data for elastic modulus, viscous modulus and loss tangent were subjected to ANOVA/Tukey's tests at significance level p < 0.05. Significant differences in visco-elastic properties were observed between materials and mediums. Apart from bulk-fill giomer, elastic modulus was the highest after conditioning in heptane. No apparent trends were noted for viscous modulus. Generally, loss tangent was the highest after conditioning in ethanol. The effect of food-simulating liquids on the visco-elastic properties of bulk-fill composites was material and medium dependent.

The effect of different beverages on the color and translucency of flowable composites

This study examined the changes in color and translucency of flowable composites after immersion in different beverages. Thirty composite samples were prepared from four flowable composites (G-aenial Universal Flo, Filtek Ultimate, Esthelite Flow Quick, and Clearfil Majesty ES Flow) and a microhybrid composite (Filtek Z-250) and stored in distilled water at 37°C for 24 h. The samples were randomly divided into seven groups and then immersed in different beverages (Red Bull, coffee, black tea, Pepsi Cola, orange juice, and distilled water) for 7 days. The CIE L*a*b* values of each sample were measured against white and black backgrounds using a spectrophotometer before and after immersion. Data were analyzed using two-way analysis of variance and Tukey's post-hoc test (p < 0.05). The color changes were significantly different among the composite materials after immersion in beverages (p < 0.05). Filtek Ultimate and Esthelite Flow Quick exhibited less discoloration than did G-aenial Universal Flo and Clearfil Majesty ES Flow. No significant difference was found between Filtek Z-250 and either Filtek Ultimate or Esthelite Flow Quick (p > 0.05). Among the beverages, black tea and coffee caused the highest discoloration of all the materials. Immersion in coffee and black tea resulted in the highest negative changes in the translucency of the materials. The degree of discoloration for the composite resins depended on the material used and drinking beverage. SCANNING 38:701-709, 2016. © 2016 Wiley Periodicals, Inc.

Effect of Beverages on Color and Translucency of New Tooth-Colored Restoratives

This investigation examined the susceptibility to staining and translucency changes of some new tooth-colored restorative materials after immersion in different beverages. The materials studied were 3M Filtek Z350XT (ZT), 3M Filtek 350XT Flowable Restorative (ZF), Shofu Beautifil Flow Plus (BF), Shofu Beautifil II (B2), 3M Ketac Nano (N100), and 3M Photac Fil (PF). Following the manufacturers' instructions, 42 samples were made from each material and placed in an incubator at 100% humidity and 37°Celsius for 24 hours. Baseline L*, a*, b* readings were taken against white and black backgrounds using a photospectrometer. The samples were then randomly assigned to be immersed in seven beverages, namely cola drink, orange juice, red wine, vodka, black coffee, green tea, and distilled water for a period of seven days. Color readings were taken again by recording the L*, a*, b* values. Data was analyzed using t-tests, one-way analysis of variance with Tukey post hoc and Pearson's correlation (p&lt;0.05). BF generally performed as well as the conventional composite resin materials (ZT and ZF) but N100 and B2 did not. PF had the largest staining and translucency changes. Coffee, red wine, and tea resulted in the most staining and negative translucency changes. An inverse correlation between ΔE and ΔTP was observed for all materials and beverages with the exception of orange juice.

Water Sorption, Solubility, and Color Stability of Giomer Restoratives

OBJECTIVES

This study compared the color stability, water sorption, and solubility of a giomer composite and two nanohybrid composite resins.

MATERIALS AND METHODS

Disc-shaped specimens (1-mm thickness × 15-mm diameter) of a giomer (Beautifil II, Shofu, Kyoto, Japan) and two nanohybrid (Filtek Z550, 3M ESPE, St. Paul, MN, USA; Tetric N-Ceram, Ivoclar Vivadent, Schaan, Liechtenstein) composites (N = 10) were prepared. Baseline color measurements were taken, and specimens were immersed in water for 28 days. Following immersion, color values were remeasured, and color-change values (ΔE) were calculated. Water sorption and solubility were assessed by mass gain or loss after storage in water for 28 days. Data were analyzed with one-way analysis of variance and Tukey's post-hoc tests (p = 0.05). Pearson's correlation test was used to assess possible correlations between water sorption and solubility, water sorption and color stability, and solubility and color stability (p = 0.05).

RESULTS

Water sorbtion (%) and color change (ΔE) varied significantly among groups, with Beautifil II exhibiting the highest values (p < 0.001). No statistically significant differences were observed in water solubility values among the groups (p = 0.661); however, a linear, positive correlation was detected between solubility and discoloration (r = 0.368, p = 0.046).

CONCLUSION

Water sorption and discoloration values of the giomer composite group were significantly higher than those of the nanohybrids tested.

CLINICAL SIGNIFICANCE

The high levels of water sorption and discoloration of giomer composites are likely to have an adverse effect on esthetic restorations.

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.