Color adjustment potential of single-shade resin composite to various-shade human teeth: Effect of structural color phenomenon

Assessing color mismatch in single-shade composite resins for enamel replacement

STATEMENT OF PROBLEM

Shade selection is a challenge in restorative dentistry. While single-shade composite resins may simplify this process, whether the color mismatch between this composite resin and the substrate is within acceptable levels to ensure successful outcomes is unclear.

PURPOSE

The purpose of this in vitro study was to assess the influence of background and surrounding shade, thickness, and proximity to the surrounding on color mismatch when shaded and single-shade composite resins are used in the center of an enamel layer.

MATERIAL AND METHODS

Two-layer specimens mimicking dentin (the background) and enamel (the surrounding and center) were prepared. Two shades were used for the background and the surrounding layer (OA1/A1 and OA3/A3). At the Ø3-mm center, 2 single-shade composite resins were placed, Omnichroma (OM) and Admira Fusion x-tra (FU), and also shaded composite resins A1, WE, A3, and C2. For the OA1/A1 background and surrounding, shades A1 and WE served as positive controls, while the A3 and C2 were negative controls. For OA3/A3, these controls were reversed. Two enamel layer thicknesses were evaluated (0.5- and 1.0-mm). Reflectance measurements were made at 0.0, 1.0, 2.0, and 2.5 mm from the center. Color differences were calculated between those at 2.5 mm and at other distances (ΔE0, ΔE1, and ΔE2). Data analysis employed a 4-way repeated measure ANOVA with Bonferroni corrections for the pair-wise comparisons (α=.05).

RESULTS

Background and surrounding shade, central shade, distance, and thickness affected color mismatch (P<.05). For the OA1/A1 specimens, single-shade color mismatch values were found between both the positive and negative controls (P<.05). For the OA3/A3 specimens, the color mismatch did not differ significantly from that of negative controls (P>.05). No difference was found between ΔE0 and ΔE1, but each was distinct from ΔE2. Thickness did not affect the color mismatch of the single-shade composite resins (P<.05).

CONCLUSIONS

Single-shade composite resins for enamel replacement showed higher color mismatches compared with positive controls.

The effect of different liquids on the surface roughness and color stability of single shade and nanohybrid resin composites: An AFM and SEM analysis

The aim of this study is to evaluate the surface roughness (SR) and color changes of single-shade and nanohybrid resin-based restorative materials (RBC) after immersion in liquids at different pH values. For RBCs, a total of 120 specimens, 30 for each material, were prepared using 10 mm diameter and 2 mm thick molds. For flowable bulk fill RBC, a total of 40 specimens, 10 for each material, were prepared using 10 mm diameter and 4 mm thick molds (n = 10). After initial color and SR measurements, samples were stored in the liquids for 14 days and all of the measurements were repeated on 14th days. Scanning electron microscopy and atomic force microscopy analyzes were performed in all groups. When SR results are examined; among all liquids, the highest SR value was observed in the Carisma Diamond One (CDO) group, while the lowest SR value was observed in the Omnichroma Flow Bulk (OMF) group (p < .05). When the color changes (ΔE) results are examined; it was observed that CDO group had highest color change and OMF group had the lowest values. It has been observed that among the liquids, the liquids that affect the ΔE values of the materials the most are coffee and cola. When the ΔE values of the subgroups of the materials were examined, there was a statistically significant difference in all subgroups of RBCs (p < .05). While acidic liquids increased the SR of RBCs, coffee more affected the color change of RBCs. RESEARCH HIGHLIGHTS: Clinicians should keep in mind that the RBCs tested may change their surface properties and colors when exposed to various liquids. People who have RBCs should pay attention to the consumption of acidic and highly pigmented liquids.

The color-matching ability of single-shade universal composites in extracted human teeth

OBJECTIVES

To evaluate the color-match with extracted natural teeth of three single-shade universal composites, a group-shade universal composite, and a highly translucent-shade conventional composite.

METHODS

Twenty extracted human teeth were divided into light- and dark-shade groups (n = 10, LSG and DSG). A preparation was restored with the 3 single-shade universal composites, OMNICHROMA (OMC), Admira Fusion x-tra U (AFU), and Essentia U (ESU); a highly translucent-shade conventional composite, Tetric EvoCeram T (TEC-T); and two shades of a group-shade universal composite-Filtek Universal Restorative (FUR A1 and A4). Composites were photopolymerized, polished, and stored in water for 24 h. The ΔE00 value between the unprepared and restored surfaces was obtained using a spectrophotometer. Composite placement and measurements were repeated three times per tooth. Color differences were statistically analyzed with the within-between-subjects t-test and repeated-measures analysis of variance (ANOVA), followed by post hoc pairwise comparisons with a Bonferroni adjustment (α = 0.05).

RESULTS

There were no statistically significant differences between OMC and FUR (A1 and A4). AFU and ESU showed significantly higher ΔE00 values than OMC and TEC-T (p < 0.05). Single-shade composites exhibited significantly higher ΔE00 values in the DSG than in the LSG except ESU (p < 0.05). None of the composites satisfied the criteria for an acceptable match (ΔE00 >1.8).

CONCLUSION

OMC showed the same color matching ability as a group-shade universal composite. A highly translucent-shade conventional composite and OMC exhibited better color matching ability than other single-shade composites. Overall, single-shade universal composites performed better in lighter-shaded teeth.

CLINICAL SIGNIFICANCE

Single-shade universal composites have the potential to reduce chair time by eliminating shade selection in cavities with lighter-shade teeth. Highly translucent incisal conventional composites also may be used if the appropriate shade of composite is not available.

Evaluation of the effects of temperature and centrifugation time on elimination of uncured resin from 3D-printed dental aligners

The study investigated the effects of temperature and centrifugation time on the efficacy of removing uncured resin from 3D-printed clear aligners. Using a photo-polymerizable polyurethane resin (Tera Harz TC-85, Graphy Inc., Seoul, Korea), aligners were printed and subjected to cleaning processes using isopropyl alcohol (IPA) or centrifugation (g-force 27.95g) at room temperature (RT, 23 °C) and high temperature (HT, 55 °C) for 2, 4, and 6 min. The control group received no treatment (NT). Cleaning efficiency was assessed through rheological analysis, weight measurement, transparency evaluation, SEM imaging, 3D geometry evaluation, stress relaxation, and cell viability tests. Results showed increased temperature and longer centrifugation times significantly reduced aligner viscosity, weight (P < 0.05), and transmittance. IPA-cleaned aligners exhibited significantly lower transparency and rougher surfaces in SEM images. All groups met ISO biocompatibility standards in cytotoxicity tests. The NT group had higher root mean square (RMS) values, indicating greater deviation from the original design. Stress relaxation tests revealed over 95% recovery in all groups after 60 min. The findings suggest that a 2-min HT centrifugation process effectively removes uncured resin without significantly impacting the aligners' physical and optical properties, making it a clinically viable option.

Instrumental and Visual Evaluation of the Chameleon Effect of Single-shaded Composite Resins

OBJECTIVE

To evaluate the shade-matching ability of single-shade resin-based composite restorations in different thicknesses using both instrumental and visual techniques.

METHODS AND MATERIALS

Cavities with 4 mm diameter and 2 mm (n=96) or 3 mm (n=96) depth were prepared in acrylic incisor teeth of shades A2, A3, B3, and C2 and restored with three single-shade resin composites, Omnichroma (Tokuyama Dental America, Encinitas, CA, USA [OM]), Vittra APS Unique (FGM Dental Group, Joinville, SC, Brazil [VU]), Zenchroma (President Dental, Allershausen, Germany [ZC]), and a microhybrid resin composite (Filtek 3M Z250 3M ESPE, St Paul, MN, USA [FZ]) of A2, A3, B3, and C2 shades. Readings were obtained using VITA Easyshade V spectrophotometer for the teeth and restorations. The CIEDE2000 (ΔE00) color difference formula was used, and the values were assessed using three-way analysis of variance (ANOVA). Forty-eight evaluators graded the shade match of 32 different specimens visually as (A) best shade match, (B) intermediate shade match, and (C) poor shade match.

RESULTS

FZ material achieved satisfactory matches for both thicknesses, across all shades, and OM material demonstrated statistically significant lower shade matches than the ZC and the FZ materials (p<0.05). VU exhibited poor shade match with the highest ΔE00 value on C2 shade. According to the visual examination, the best shade matches were observed for FZ on A3-shade and ZC on C2-shade teeth.

CONCLUSIONS

Shade matching for 2 mm and 3 mm-thick composite resin restorations is material- and tooth-shade dependent.

Influence of cavity wall thickness on the color adjustment potential of single-shade resin composites

BACKGROUND

The color adjustment potential of resin composites depends on the specific characteristics of the surrounding structures. The authors evaluated the influence of cavity wall thickness on CIEDE2000 color adjustment potential (CAP00) of single-shade composites using the CIEDE2000 color difference (ΔE00) formula.

METHODS

Two types of specimens were produced: single, using Vittra APS color DA3 (FGM Dental), Vittra APS Unique (VU) (FGM Dental), and Omnichroma (Tokuyama Dental) composites; and dual, using Vittra APS color DA3, but with cavity wall thicknesses of 3, 2, or 1 mm, restored with VU or Omnichroma. CIEL∗a∗b∗ color coordinates were obtained from digital photographs of the specimens at different locations, and ΔE00 and CAP00 were calculated. Statistical analysis included 2-way analysis of variance, Kruskal-Wallis, Holm-Sidak, Student-Newman-Keuls, Wilcoxon signed rank, and paired t tests (α = 5%).

RESULTS

Cavity walls 1-mm-thick had higher ΔE00 values and lower CAP00 values, particularly for VU (P < .05). Restorations matched better with the control at the periphery than the central area (P < .001). Overall ΔE00 means exceeded the color perceptibility threshold (ie, 0.8) and the acceptability threshold (ie, 1.8). Color differences (between center of restoration and control composite) were moderately unacceptable for 3-mm and 2-mm thicknesses and extremely unacceptable for 1-mm thickness. Both composites had a ΔE00 color shift predominately determined by means of the lightness difference. Positive CAP00 values were found for VU and Omnichroma.

CONCLUSIONS

Wall thickness, especially at 1 mm, negatively impacted the color of single- shade composites. This effect was more pronounced for VU, affecting mainly the restoration's central area.

PRACTICAL IMPLICATIONS

Color matching ability depends on the structural and material characteristics, and clinicians should be attentive to these factors when using single-shade resin composites.

Flexural strength and degree of conversion of universal single shade resin-based composites

Background/purpose

Recently, a group of universal single-shade resin-based composites (RBCs) has been developed to simplify the process of shade selection. Excellent mechanical and physical properties are crucial for the ultimate success and clinical longevity of restorations. Therefore, evaluating the properties of the single-shaded RBCs is imperative. This study aimed to determine the flexural strength (FS) and degree of conversion (DC) of universal single-shade RBCs.

Materials and methods

In this study, four commercial RBCs were used; three universal single-shade RBCs; Omnichroma (OC), Charisma® Diamond ONE (CD), and Vittra APS Unique (VU), and a conventional nanohybrid composite Filtek™ Z250 XT (FT) which was used as a control. Sixty composite beams and 40 composite discs were used for FS and DC, respectively. A universal test machine with a three-point bending test was used to measure the FS, whereas the DC was measured using a Fourier-transform infrared spectrometer (FTIR). Three fractured specimens from each resin composite group were qualitatively analyzed using scanning electron microscopy.

Results

ANOVA was used to compare the mean values of FS and DC among the four RBCs (OC, CD, VU, and FT). Highly significant differences were observed in the mean FS and DC values (F = 673.043, p < 0.001 and F (=782.4, p < 0.0001), respectively. The highest FS was observed in the CD group, followed by FT and VU groups; the lowest value was observed in the OC group. In addition, a statistically significant difference was identified in DC values. The highest DC value was observed in VU, followed by OC and CD, and the lowest DC value was observed in FT.

Conclusion

Universal single-shade RBCs demonstrated a good FS, except for OC, which exhibited a significantly low FS. The DC of the universal single-shade RBCs was higher than that of the conventional nanohybrid composite restorative material.

Effect of aging and fiber-reinforcement on color stability, translucency, and microhardness of single-shade resin composites versus multi-shade resin composite

OBJECTIVE

The purpose of this study was to evaluate the effect of aging and fiber-reinforcement on the color stability, translucency, and microhardness of single-shade resin composites versus multi-shade resin composite.

MATERIALS AND METHODS

Four resin composites (Filtek Z250, Omnichroma, Vittra APS Unique, Zenchroma) were tested. Three subgroups of specimens were prepared for each of the composites: control, polyethylene fiber-reinforcement, and glass fiber-reinforcement- groups (n = 10/per group). The samples were subjected to aging for 10,000 thermal cycles. Color differences (ΔE00 ) were calculated after aging. Relative translucency parameter (RTP00 ) and microhardness values were calculated before and after aging. A two-way analysis of variance and the generalized linear model was used (p < 0.05).

RESULTS

The lowest and highest ΔE00 values were found for Filtek Z250 (0.6 ± 0.2) and Omnichroma resin composites (1.6 ± 0.4), respectively. The ΔE00 value of the polyethylene fiber-reinforcement group (1.2 ± 0.6) was significantly higher than the ΔE00 value of the glass fiber-reinforcement group (1.0 ± 0.4, p < 0.001). The RTP00 value of the glass fiber-reinforcement group (1.92 ± 0.78) was significantly higher than the RTP00 value of the polyethylene fiber-reinforcement group (1.72 ± 0.77, p < 0.001). The highest microhardness values were found in glass fiber-reinforcement group (76.48 ± 17.07, p < 0.001).

CONCLUSION

Single-shade resin composites were more translucent, had higher color change, and lower hardness than multi-shade resin composite. For relative translucency and microhardness, statistical significance was found in the material and fiber type interaction. The glass fiber-reinforcement provided higher translucency, lower color change and higher microhardness values than polyethylene fiber-reinforcement group after aging. Thermocycling had a significant impact on the color stability, translucency parameter, and microhardness of the tested resin composite materials.

CLINICAL SIGNIFICANCE

Single-shade resin composite materials have greater color-changing potential. The glass fiber-reinforcement optimize resin material mechanical properties and color stability more than polyethylene fiber-reinforcement.

Optical behavior and marginal discoloration of a single shade resin composite with a chameleon effect: a randomized controlled clinical trial

OBJECTIVE/AIM

Evaluating the optical behavior and marginal discoloration of a Single-shade universal resin composite over 12 months. To achieve this, a split-mouth with a double-blinded randomized strategy was employed.

MATERIALS AND METHODS

Twenty adult patients, each presenting with at least two caries lesions in their posterior teeth, were selected and randomly subdivided into two identical groups: Group I received Single-shade universal resin composite (Omnichroma), and Group II received multi-shade nanohybrid resin composite (Tetric®N-Ceram). Color measurements and marginal discoloration were assessed visually by three blinded operators at baseline followed after 1,3,6,9, and 12‑month periods utilizing the Modified United States Public Health Services (USPHS) criteria. Statistical analysis was adopted utilizing the Wilcoxon test with a 0.05 significance level.

RESULTS

The two groups revealed non-statistically significant differences up to 6 months regarding color match and color stability. After 9 and 12 months, the multi-shade group demonstrated a statistically significant higher prevalence of color match (Alpha) scores than the single-shade universal group. Regarding marginal discoloration, all restorations in the two groups had no discoloration (Alpha scores).

DISCUSSION/CONCLUSION

Since the percentage of Alpha and Bravo scores was considered clinical success, both the single-shade universal and the multi-shade nanohybrid resin composites demonstrated satisfactory optical performance and marginal discoloration as posterior restorations after a 12-month follow-up period.

Color Match of a Universal-shade Composite Resin for Restoration of Non-carious Cervical Lesions: An Equivalence Randomized Clinical Trial

PURPOSE

The objective of this double-blind, split-mouth, randomized clinical trial was to evaluate the color match of a single-shade composite resin Admira Fusion X-tra in comparison with a multi-shade composite resin Admira Fusion in non-carious cervical lesion restorations (NCCLs).

METHODS AND MATERIALS

One hundred and twenty restorations were performed on NCCLs with two restorative materials (n=60). After prophylaxis, the teeth were isolated with a rubber dam, and one universal adhesive was applied in the selective enamel etching strategy. For both groups, the restorations were inserted incrementally and light-cured. The values of the coordinates L*, a*, and b* in the cervical third before vs after the restorations and cervical vs middle third after the restorations were evaluated using a digital spectrophotometer after the coordinate values were used to calculate the CIEDE (ΔE00). The restorations were evaluated at baseline and after 7 days of clinical performance according to the FDI criteria. Statistical analysis was performed using the Chi-square test for all parameters. Color change was analyzed by Student t-test for paired samples (α=0.05).

RESULTS

All restorations were evaluated after 7 days. Regarding the color measurement, no significant difference was observed when Admira Fusion was compared to Admira Fusion X-tra for any of the comparisons performed (p>0.05). However, the values of ΔE00 in the cervical third before vs after the restorations were higher when compared with ΔE00 observed when the cervical vs middle third after restorations were compared. All restorations received the score "clinically very good" after 7 days for all outcomes, including the subjective color match, when evaluated for FDI criterion.

CONCLUSIONS

The single-shade composite resin used achieves the same color match when compared to a multi-shade composite resin after 7 days in NCCLs.

Color match analysis of single-shade and multi-shade composite resins using spectrophotometric and visual methods after bleaching

The aim of this study is to evaluate the color match of the materials after the staining and bleaching procedures applied to the teeth restored with single-shade and multi-shade composite resins. Cavities prepared on the facial surface of human incisors were restored with two different composite resins. After 24 h, the color matching parameters between the initial filling-tooth of the samples were recorded. Then, the color measurements of the samples subjected to the coloring process were repeated. Each composite resin group was randomly divided into 2 subgroups and home and office bleaching methods were applied to the samples. After bleaching, color measurements were repeated. In terms of periods, a statistically significant difference was found in ΔE values 1 day and 28 days after bleaching (p<0.05). In addition, it was found that the color match between filling-tooth was generally weaker in Omnichroma material and after home bleaching.

Toward esthetically and biomechanically reliable anterior resin composite restorations: Current clinical experiences among dental practitioners in Saudi Arabia

Background: Esthetic anterior composite restorations are very challenging. They constitute a main part of the clinical practice of restoring teeth with resin composites. Distinctive variations in composite material selection and technique of application in anterior teeth exist when compared to the practice of restoring posterior teeth with resin composites. In a continuation of a previous assessment of class II resin composite practice,  a cross-sectional survey study was performed to determine the awareness of general dental practitioners in Saudi Arabia about resin composite restorations in anterior teeth and to provide evidence-based recommendations to improve their practice. Methods: A total of 500 dental practitioners from different provinces in Saudi Arabia were invited to participate in an online questionnaire which comprised four domains and included a total of sixteen questions addressing aspects regarding the selection of resin composites, cavity configuration, etching protocol, light-curing technique, liner application, application of poly-chromatic composite, as well as finishing and polishing procedures. Chi square testing and descriptive statistics were used to analyze the attained data. Results: From 250 respondents, the greatest participation was from the Eastern and Middle provinces of Saudi Arabia. Female dentists participated less than males. There was no general agreement between participants regarding the resin composite material or the employed technique of application in restoring anterior tooth defects. Respondents indicated that discoloration and hypersensitivity were the most common reasons for patient's dissatisfaction with resin composites in anterior teeth. Conclusions: Dental practitioners are highly encouraged to improve their clinical practice of restoring anterior teeth using resin composites with the focus upon continuous education programs, online webinars, and workshops.

Evaluation of Single-Shade Composite Resin Color Matching on Extracted Human Teeth

Introduction

Universal single-shade composite resins are characterized by a property that enables the creation of restorations that mimic tooth structure to the extent possible with fewer shades of color.

Objectives

This study aimed to instrumentally and visually evaluate the color correspondence of two single-shade composite resins in extracted human teeth multishade composite resins.

Methods

Upper central incisors and upper and/or lower molars with intact buccal surfaces were selected. The study consisted of a control group (n = 20): Z250 XT (3M ESPE) (G1) multishade composite resin in colors A1 to A4, and a test group (n = 20) divided further into two equal groups, consisting of single-shade composite resin Omnichroma (Tokuyama Dental) (G2) and single-shade composite resin Vittra APS Unique from (FGM) (G3). Instrumental evaluation was performed using a spectrophotometer, and visual evaluation was performed by three observers. Descriptive measurements related to the differences in color obtained through instrumental means were analyzed using mean and standard deviation, wherein the means were compared using ANOVA, applying the Bonferroni post hoc test.

Results

A statistically significant difference was observed among the groups (G1, G2, and G3) (ANOVA: p < 0.001). For the visual assessment, regardless of the assessment group, 77.49% of the teeth were within the acceptable color-match classification, with the single-shade resins showing better correspondence than the multishade resins.

Conclusion

Single-shade composite resins showed different color-matching results when compared to multishade resins, both in spectrophotometry and visual evaluations. Clinical Significance. Single-shade composite resins simplify the shade-selection process and are promising materials for use in dental practice.

Color and Translucency Variation of a One-Shaded Resin-Based Composite after Repeated Heating Cycles and Staining

(1) Background: This study aimed to determine the effect of repeated pre-polymerization heating on the color and translucency of a one-shaded resin-based composite and to evaluate whether the heating cycles affect its color stability. (2) Methods: Fifty-six samples of 1-mm thickness were fabricated from Omnichroma (OM) after applying different heating cycles (for one, five, and ten times at 45 °C) before polymerization (n = 14/group) and afterwards were stained with a yellow dye solution. CIE L*, a*, b*, C*, h° coordinates were recorded, and color differences, whiteness, and translucency were calculated, before and after staining. (3) Results: Heating cycles significantly influenced the color coordinates, WID₀₀, and TP₀₀ of OM being higher after one heating cycle and decreasing as the number of heating cycles increased. The color coordinates, WI_D, and TP₀₀ after staining significantly differed for each group. The color and whiteness differences calculated after staining exceeded the acceptability thresholds for all groups. The color and whiteness variations after staining were clinically unacceptable. (4) Conclusions: Repeated pre-polymerization heating induces a clinically acceptable color and translucency change to OM. Although the color changes resulting after staining are clinically unacceptable, increasing the number of heating cycles up to ten times slightly reduces the color differences.

Assessment of Microhardness of Conventional and Bulk-Fill Resin Composites Using Different Light-Curing Intensity

(1) Background: This study evaluates the effect of a conventional/low-voltage light-curing protocol (LV protocol) (10 s with 1340 mW/cm²) and high-voltage light-curing protocol (HV protocol) (3 s with 3440 mW/cm²) on the microhardness (MH) of dental resin-based composites (RBCs). Five resin composites were tested: conventional Evetric (EVT), Tetric Prime (TP), Tetric Evo Flow (TEF), bulk-fill Tetric Power Fill (PFL), and Tetric Power Flow (PFW). (2) Materials and Methods: Two tested composites (PFW and PFL) were designed for high-intensity light curing. The samples were made in the laboratory in specially designed cylindrical molds; diameter = 6 mm and height = 2 or 4 mm, depending on the type of composite. Initial MH was measured on the top and bottom surfaces of composite specimens 24 h after light curing using a digital microhardness tester (QNESS 60 M EVO, ATM Qness GmbH, Mammelzen, Germany). The correlation between the filler content (wt%, vol%) and the MH of the RBCs was tested. For the calculation of depth-dependent curing effectiveness, the bottom/top ratio for initial MH was used. (3) Conclusions: MH of RBCs is more dependent on material composition than on light-curing protocol. Filler wt% has a greater influence on MH values compared to filler vol%. The bottom/top ratio showed values over 80% for bulk composites, while for conventional sculptable composites, borderline or suboptimal values were measured for both curing protocols.

Accelerated versus Slow In Vitro Aging Methods and Their Impact on Universal Chromatic, Urethane-Based Composites

Structural coloring of dental resin-based composites (RBC) is used to create universal chromatic materials designed to meet any aesthetic need, replacing the mixing and matching of multiple shades. The microstructural adjustments to create this desideratum involve nanoscale organic-inorganic core-shell structures with a particular arrangement. The generally higher polymer content associated with these structures compared to universal chromatic RBCs colored by pigments, which in their microstructure come close to regularly shaded RBCs, can influence the way the material ages. Accelerated and slow aging up to 1.2 years of immersion in artificial saliva at 37 °C were therefore compared in relation to their effects on the materials described above and in relation to the immersion conditions prescribed by standards. Quasi-static and viscoelastic parameters were assessed to quantify these effects by a depth-sensing indentation test equipped with a DMA module. The microstructure of the materials was characterized by scanning electron microscopy. The results convincingly show a differentiated influence of the aging protocol on the measured properties, which was more sensitively reflected in the viscoelastic behavior. Accelerated aging, previously associated with the clinical behavior of RBCs, shows a 2- to 10-fold greater effect compared to slow aging in artificial saliva of up to 1.2 years, highly dependent on the microstructure of the material.

Instrumental and visual evaluation of the color adjustment potential of different single-shade resin composites to human teeth of various shades

OBJECTIVE

The study aims to evaluate the color adjustment potential (CAP-I, CAP-V) of different single-shade resin composites.

MATERIALS AND METHODS

The shades of 40 human incisors were determined using a spectrophotometer, with the teeth divided into four groups of the same shade (n = 10). The following single-shade resin composites were tested: Omnichroma, Charisma Diamond One, Vittra Unique, and Essentia Universal. The specimens were prepared as "dual" and "single." Standardized cavity preparations (diameter, 7 mm; depth, 2 mm) were prepared in human incisor teeth and then restored for dual specimens. Composite duplicates of human incisors were prepared with resin composites for single specimens (n = 10). The color match of these specimens to that of unrestored human incisors was compared, and the color difference (ΔE*) was calculated. Independent observers conducted a visual evaluation of the specimens and scored them. CAP-I and CAP-V values were determined. A one-way analysis of variance test was used for statistical analysis (p < 0.05).

RESULTS

There was no statistically significant difference between the CAP-V and CAP-I values of the tested single-shade resin composites (p > 0.05). All the materials tested had acceptable color-matching potential.

CONCLUSIONS

In terms of color matching, there were no significant differences between the different tooth shades of all the tested resin composites.

CLINICAL RELEVANCE

Single-shade resin composites have acceptable CAP. The use of single-shade resin composites can reduce in-chair clinical times by minimizing the time spent on shade selection.

Effects of surrounding and underlying shades on the color adjustment potential of a single-shade composite used in a thin layer

Objectives

This study aimed to evaluate the surrounding and underlying shades' effect on the color adjustment potential (CAP) of a single-shade composite used in a thin layer.

Materials and Methods

Cylinder specimens (1.0 mm thick) were built with the Vittra APS Unique composite, surrounded (dual specimens) or not (simple specimens) by a control composite (shade A1, A2, or A3). Simple specimens were also built only with the control composites. Each specimen's color was measured against white and black backgrounds or the simple control specimens with a spectrophotometer (CIELAB system). The whiteness index for dentistry (WI_D) and translucency parameters (TP₀₀) were calculated for simple specimens. Differences (ΔE₀₀) in color between the simple/dual specimens and the controls were calculated. The CAP was calculated based on the ratios between data from simple and dual specimens.

Results

The Vittra APS Unique composite showed higher WI_D and TP₀₀ values than the controls. The highest values of ΔE₀₀ were observed among simple specimens. The color measurements of Vittra APS Unique (simple or dual) against the control specimens presented the lowest color differences. Only surrounding the single-shade composite with a shaded composite barely impacted the ΔE₀₀. The highest CAP values were obtained using a shaded composite under simple or dual specimens.

Conclusions

The CAP of Vittra APS Unique was strongly affected by the underlying shade, while surrounding this composite with a shaded one barely affected its color adjustment.

Effect of filler load on structural coloration and color adjustment potential of resin composites

The color-matching ability of single-shade composites Omnichroma (OMN) and Omnichroma Flow (OCF) is ensured by structural color, which arises from monodisperse 260 nm spherical fillers. This study evaluated how filler load influences the color adjustment potential of composite restorations to human teeth of various shades. The performance of composites containing the 260 nm spherical fillers -OMN (79 wt%), OCF (71 wt%), and experimental composites R1 (65 wt%), and R2 (60 wt%)- was compared to two conventional A2-shade composites and a transparent composite. Additionally, the translucency parameter, spectral reflectance, and light transmission properties were assessed. Composites with a lower load of the 260 nm spherical fillers exhibited lower light diffusion and lower reflectance in the yellow-to-red range (580-650 nm), which is characteristic for the structural color of OMN and OCF. The best color adjustment was achieved with OCF, presumably due to its high translucency and uniform spectral reflectance.

Does the thickness of universal-shade composites affect the ability to reflect the color of background dentin?

The recently introduced resin composites with a universal shade are claimed to match any tooth color. In this study, it was examined how composite thickness affects the color adjustment of conventional and universal-shade composites to background dentin. Thirty sound human central incisors of various shade were used, and color differences between their intact labial surfaces, exposed dentin surfaces and composite restorations (thickness 1-3 mm) were evaluated. In addition, the translucency, light transmission characteristics, and spectral reflectance of the composites were measured. The results showed that universal-shade composites outperformed conventional composites of A2 shade in the adjustment of hue and chroma (p<0.05) but not in lightness (p>0.05). The color adjustment potential of all composites significantly decreased as their thickness increased (p<0.05). The effect of thickness on Omnichroma and Omnichroma Flow was less marked, presumably because of their higher translucency (p<0.05) and structural coloration which induces light reflectance in the yellow-to-red range.

Shade matching potential of one-shade resin composites used for restoration repair

To evaluate shade matching ability of one-shade composites used for repair of different resin-based restorative materials. Two one-shade composites or one layering composite of 1 mm thickness were placed over non-aged or aged 3 different base materials of 1 mm thickness to simulate repair. Two millimeters thick base samples were prepared and used for reference (n=12). Shade measurements of reference and repair groups were performed with dental spectrophotometer and color difference (ΔE₀₀) were calculated according to CIEDE2000. Data were analyzed using three-way ANOVA followed by Tukey's test (α=0.05). Regardless of aging and base materials, repairing with layering composite yielded lower ΔE₀₀ than repair of one-shade composites (p<0.05). Repair of non-aged and aged GrandioDisc with any repair composite led to higher ΔE₀₀ values than repair of other base materials (p<0.05). Shade matching performance of one-shade composites for repair of different non-aged or aged resin-based material was not clinically acceptable.

Background and surrounding colors affect the color blending of a single-shade composite

This study evaluated the background and effect of surrounding colors on the color blending of a single-shade composite used in a thin layer. Disc-shaped specimens (1.0 mm thickness) were built with the Vittra APS Unique composite surrounded (dual specimens) or not surrounded (simple specimens) by a control composite (shade A1, A2, or A3). Simple specimens were also built with only control composites. The specimen color was measured against white and black backgrounds with a spectrophotometer (CIELAB system). The whiteness index for dentistry (WID) was calculated for simple specimens. Differences (ΔE00) in color and translucency parameters (ΔTP00) between the simple/dual specimens and the controls were calculated. The translucency adjustment potential (TAP) and color adjustment potential (CAP) were estimated based on the ratios between data from simple and dual specimens. The Vittra APS Unique composite showed higher WID values than the controls. No differences between ΔTP00_SIMPLE and ΔTP00_DUAL were observed for any of the shades. The composite shade did not affect TAP values. The lowest values of ΔE00_SIMPLE and ΔE00_DUAL were observed for shade A1 regardless of the background color. For the white background, ΔE00_SIMPLE values did not differ from those of ΔE00_DUAL for all shades. Only A1 showed ΔE00_DUAL values lower than ΔE00_SIMPLE when the black background was used. The highest modulus of CAP (negative values for the white background) was observed when shade A1 surrounded the Vittra APS Unique composite. The color blending ability of the single-shade resin composite used in a thin layer was affected by both the surrounding shade and background color.

Two‐year retrospective evaluation of monoshade universal composites in direct veneer and diastema closure restorations

OBJECTIVES

The aim of this retrospective evaluation was to assess the short-term outcome of two monoshade universal resin composites with high chameleon effect in anterior direct veneer and diastema closure restorations, and to investigate the possible reasons for failure.

MATERIAL AND METHODS

Patients subjected to veneer and diastema closure restorations with two monoshade universal resin composites (Essentia Universal Shade; EU, GC Corp., and Omnichroma; OC, Tokuyama) operated between January 2018 and March 2019 were selected for the present retrospective evaluation. A total of 159 composite restorations (78 veneers and 81 diastema closure restorations) performed by a single operator in 44 patients (mean age: 33.6) were included in the study. Two blinded and calibrated examiners performed 1- and 2-year assessments of the restorations with respect to FDI criteria, using medical/clinical history and dental photography records. Data were analyzed using Pearson Chi-square with Continuity Correction, Fisher's Exact tests, and Cox regression (a < 0.05).

RESULTS

The cumulative overall survival rates of EU and OC restorations were 94.6% (97.3% for the first year) and 88.6% (95.3% for the first year), respectively, with no significant difference from each other (p = 0.316). The cumulative overall survival rates of direct veneer and diastema closure restoration types were 90.2% (95.1% for the first year) and 92.4% (97.4% for the first year), respectively, with no significant difference (p = 0.559). The reasons for failure were evaluated as fracture of the restoration, failure in esthetic anatomical form, and color mismatch. All the failed direct veneer restorations were due to fractures (FDI score of 5.4), whereas 5 of 6 failed diastema closure restorations were due to color mismatch (FDI score of 3.4). Regarding the composite materials, there were no significant differences between the success rates of the restoration types (p = 0.442 for EU, p = 1.000 for OC). With respect to the restoration types, there were also no significant differences between the success rates of the resin-based composites (p = 1.000 for direct veneer restorations and p = 0.228 for the diastema closure restorations). In addition, no significant difference was observed between male and female patients regarding the acceptable and unacceptable scores (p = 1.000).

CONCLUSIONS

The 2-year clinical performance of the two monoshade universal composites in anterior veneer and diastema closure restorations were both considered successful and similar. Despite the lack of shade selection, both monoshade universal composites presented a successful color match. However, the diastema closure restorations might be more prone to color mismatch compared to the veneers over time, while veneer restorations presented more fractures than the diastema closure restorations.

CLINICAL SIGNIFICANCE

Monoshade universal composites presented successful short-term clinical outcomes regarding both function and esthetics in anterior direct veneer and diastema closure restorations.

Effect of two artificial aging protocols on color and gloss of single-shade versus multi-shade resin composites

The long-term color stability and gloss retention of resin composites are among the crucial factors that affect the clinical longevity of esthetic restorations, especially in anterior teeth. This study evaluated the effect of artificial aging by immersion in different storage media and thermocycling on color and gloss of dental single-shade resin composite (Omnichroma) versus multi-shade one (Filtek Z350XT). One hundred resin-composite disc-shaped specimens were used, 50 from each group, Omnichroma and Filtek Z350XT. Ten specimens from each material acted as control group (incubated in saliva). For each material, 40 specimens were divided according to the artificial-aging protocol (immersion at 37 °C for 12 days or thermocycling for 10,000 cycles) and storage media (tea, red wine). Color and gloss were measured before and after artificial aging. Color difference (∆E₀₀) was compared with perceptibility threshold and acceptability threshold. Data were statistically analyzed; independent t test was used to compare results between two tested materials, while two-way ANOVA was used to compare results among the different immersion media within the same material. Artificial aging (immersion or thermocycling) in tea and red wine led to significant color changes and gloss reduction in both materials (P < 0.05), in contrast to control group. Red wine produced highest color differences. Both dental resin-composites; the single-shade (Omnichroma) and multi-shade (Filtek Z350XT) displayed unacceptable discoloration and gloss reduction after artificial-aging in tea and red-wine by immersion or thermocycling simulating one-year clinical-service.

Assessment of Micro-Hardness, Degree of Conversion, and Flexural Strength for Single-Shade Universal Resin Composites

Single-shade universal resin composites (SsURC) are preferred in clinical practice to reduce time for shade selection and obtain good esthetic results. In this study, the static mechanical properties of seven new SsURCs were investigated, their spectral analyzes were performed and scanning electron microscopy (SEM) evaluations were presented. Charisma Diamond One/DO, Admira Fusion x-tra/AFX, Omnichroma/OC, OptiShade/OS, Essentia Universal/EU, Zenchroma/ZC, Vittra APS Unique/VU were used in a three-point bending test to determine flexural strength (FS) and elastic modulus (EM); Vickers micro-hardness (VHN) and hardness-ratio (HR) were performed with a micro-hardness tester from top/bottom after 24-h/15-days of storage in distilled water at 37 °C (±1 °C). The degree of conversion (DC) was assessed by using Fourier transform infrared spectroscopy (FTIR). The structure of the resin matrix and filler content were assessed by SEM. Data were analyzed using IBM SPSS V23 and the R program and the significance level was taken as p < 0.05. The main effect of the tested SsURCs was found to be statistically significant on FS, EM, VHN, and DC values (p < 0.001). Bis-GMA free SsURCs (AFX, DO, VU) showed better DC and HR except for OC. All seven tested SsURCs conform to the requirements of ISO standards for dental resin composites for all tested categories.

Smart Monochromatic Composite: A Literature Review

Over the previous years of the 20th and 21st centuries, there has been a progression in the field of bonded esthetic restorations. At the present time, the inclination of dentists toward the smart monochromatic shade of composite is flourishing owing to the fact that it decreases the requirement of a range of composite shades, curtails the waste of unconsumed composite shades, lessens chair side interval, abolishes the shade selection, and decreases dependency on shade-selecting methods. Smart monochromatic composite is known to obtain the color of the adjacent tooth structure in which it is placed. Therefore, the current literature elucidates the several features of innovative and revolutionary monochromatic composites including color stability, mechanical and optical properties, and shade-matching capability that could have a positive impact potentially over other resin composites.

The Effects of Selected Mouthwashes on the Surface Microhardness of a Single-shade Universal Resin Composite: In Vitro Study

Aim:

To investigate the effects of selected alcohol-free mouthwashes with different formulations (zinc-hydroxyapatite, hydrogen peroxide, and sodium fluoride) on the surface microhardness of a single-shade universal resin composite.

Materials and Methods:

Forty disc-shaped specimens (8 × 2 mm) from the universal resin composite (Omnichroma®), and a nano-hybrid composite (Tetric® N-Ceram) were prepared. After polymerization, baseline surface microhardness values were recorded using Vickers microhardness tester. The samples from each material were randomly assigned to 4 groups ( n = 10) and immersed in 20 ml of the mouthwashes: Biorepair®, Listerine®, Colgate® Optic White, and distilled water (control). The samples were kept in the immersion solutions for 24 hours, and post-immersion microhardness values were recorded. Data were analyzed with one-way ANOVA and paired sample t-tests at p < .05.

Results:

Significant reduction in microhardness was observed in all resin composite groups after immersion in the mouthwashes compared to baseline values ( p < .0001). The highest microhardness reduction in Omnichroma® group was observed after immersion in Colgate® Optic White; and Tetric® N-Ceram group after immersion in Listerine® mouthwash. For both materials, the least reduction in microhardness was observed after immersion in Biorepair®. Microhardness values for Omnichroma were significantly higher than Tetric® N-Ceram ( p < .0001). However, Omnichroma exhibited a significantly greater reduction in microhardness after immersion in the tested mouthwashes.

Conclusion:

In vitro simulated use of the investigated mouthwashes negatively affected the surface microhardness of both tested resin composites. The observed effects were both mouthwash and material dependent.

Resin-Based Composites for Direct and Indirect Restorations: Clinical Applications, Recent Advances, and Future Trends

Continuous advancements in resin-based composites can make selection of the appropriate system a daunting task for the clinician. This review aims to simplify this process and clarify some new or controversial topics. Various types of composites for direct and indirect applications are discussed, including microfilled and microhybrid composites, nanocomposites, single shade, bulk fill, fiber-reinforced, high temperature/high pressure processed, CAD/CAM, and three-dimensional printable composites. Recent material advancements that lead to improved seal and toughness, degradation resistance, antimicrobial and self-healing capabilities are presented. Future directions are highlighted, such as the development of "smart" materials that are able to interact with the host environment.

Effect of surrounded shade and specimen`s thickness on color adjustment potential of a single-shade composite

Abstract This study evaluated the effect of surrounded shade and specimens` thickness on the color adjustment potential (CAP) of a single-shade composite. The composite Vittra APS Unique was surrounded (dual specimens) or not (simple specimens) by a control composite (shade A1, A2, or A3). Simple specimens of the control composite were also confectioned. Opacity and whiteness index for dentistry (WID) were calculated for simple specimens. Color differences between the simple (ΔE*SIMPLE)/ dual specimens (ΔE*DUAL) and the controls were calculated. CAP was calculated based on the ratio between ΔE* SIMPLE and ΔE* DUAL. The tested composite presented lower opacity (53 to 62% vs. 80 to 93%) and higher WID (≈ 42 vs. 18 to 32) than controls. Irrespective of the specimens’ thickness (1.0/ 1.5 mm), the lowest values of ΔE* SIMPLE (11.1/ 10.8) and ΔE*DUAL (7.2/ 6.1) were observed using the surrounding shade A1. The shade A3 yielded higher ΔE*SIMPLE (16.4/ 17.1) and ΔE* DUAL (11.3/ 12.3) than the A2 (ΔE*SIMPLE = 13.4/ 14.6; and ΔE* DUAL = 9.7/ 10.3). The specimen`s thickness significantly affected the CAP (0.35 and 0.44 for 1.0 and 1.5 mm, respectively) only for shade A1, which had the highest CAP values. The shade A3 resulted in higher CAP values (0.31) than A2 (0.27) when 1.0-mm thick specimens were used, but similar values were observed for 1.5 thick specimens (≈ 0.29). In conclusion, both surrounding shade and specimen thickness can affect the CAP of a single-shade resin composite.

The Effect of Additional Finishing and Polishing Sequences on Hardness and Roughness of Two Different Dental Composites: An In Vitro Study

Aim:

The aim of this study was to evaluate the effect of additional finishing and polishing sequences on a new structural colored (Omnichroma) and a conventional dental composite (Estelite Sigma Quick).

Materials and Method:

Forty disk-shaped dental composite specimens were prepared from each dental composite and assigned to four groups in terms of additional finishing polishing sequences. Group 1: Mylar strip (control). Group 2: Abrasive disks. Group 3: After abrasive disks, application of a felt brush with abrasive paste. Group 4: After abrasive disks, application of a felt brush with abrasive paste. Then, a single-bottle adhesive was applied as a surface sealer. Hardness and surface roughness were measured using the Vickers hardness test and a profilometer, respectively. SEM images of one of each group were captured at 500x, 1500x, and 3500x magnifications. Two-way analysis of variance, Tukey HSD, and Shapiro–Wilk tests were used for the statistical analysis.

Results:

Mean hardness values differ in terms of finishing-polishing sequences ( P < .001), dental composites ( P < .001), and interaction of finishing-polishing sequences-dental composites ( P < .001). Mean roughness values differ in terms of finishing-polishing ( P = .002). The main effect of composites on roughness values was not found statistically significant ( P = .990). Also, there is no difference between the mean roughness values in terms of the interactions of finishing-polishing and composites ( P = .967).

Conclusion:

Finishing-polishing with abrasive disks and abrasive paste are important steps for these dental composites. However, the application of a single-bottle adhesive as a surface sealant on these composites decreases the hardness of the materials.

Toward a Clinically Reliable Class II Resin Composite Restoration: A Cross-Sectional Study into the Current Clinical Practice among Dentists in Saudi Arabia

Objective

The aim of this study was to evaluate the current clinical practice of general dentists in Saudi Arabia in restoring class II cavities using direct resin composites and to set evidence-based practice recommendations of concern.

Methods

An online survey formed of 20 questions and classified into four domains was developed. 500 dentists in 5 Saudi provinces were invited to join the survey anonymously and voluntarily using poster announcements and e-mail invitations. Descriptive statistics were used to analyze participants' responses.

Results

343 responses were received. Dentists in Saudi Arabia vary in their clinical practices and techniques of insertion of resin composite in class II cavities. 67% of participants use cotton rolls for isolating the field while 32% use rubber dam isolation. 33% and 28% of respondents use circumferential matrix (Tofflemire) and AutoMatrix, respectively. Fracture, followed by recurrent caries and open proximal contacts, was the received main reason of failure of class II direct resin composite restorations.

Conclusion

Diversity of class II resin composite practices exists among dentists in Saudi Arabia. For ensuring optimum quality outcomes and high standards of restorative dentistry healthcare, several dentists in Saudi Arabia need to reconsider their clinical practice and modify their clinical procedures of direct class II resin composites. Several evidence-based practice guidelines are recommended to dentists in this article to improve their practice and enhance the clinical reliability and longevity of class II direct resin composite restorations.

Universal Chromatic Resin-Based Composites: Aging Behavior Quantified by Quasi-Static and Viscoelastic Behavior Analysis

Universal chromatic dental resin-based composites were recently developed in an attempt to speed up the restoration process with the aim of making it easier for the practitioner to decide on a suitable shade and to avoid time-consuming matching and mixing of materials. The way in which color is created in the analyzed universal chromatic materials is innovative, as it is not only induced by selective light absorption via pigments (Venus Diamond ONE, Venus Pearl ONE), as is usual in regular composites (Charisma Classic, Charisma Topaz, Venus, Venus Diamond), but also by selective light reflection via particularized microstructures (Omnichroma). Material properties were assessed at 24 h post-polymerization and after artificial aging. Flexural strength (n = 20) and modulus were measured in a 3-point-bending test and complemented with fractography and Weibull analysis. Quasi-static (Martens, Vickers, and indentation hardness; elastic and total indentation work; creep, indentation depth) and viscoelastic (storage, loss, and indentation moduli; loss factor) behavior (n = 6) was measured by a depth-sensing indentation test equipped with a DMA module. The nanoscale silica/zirconia polymer core-shell structure in the structural-colored material induces similar or poorer mechanical properties compared with pigment-colored materials, which is related to the higher polymer content. For all materials, aging shows a clear influence on the measured properties, with the degree of degradation depending on the measurement scale.

Long-term mechanical stability and light transmission characteristics of one shade resin-based composites

OBJECTIVE

The study aims to investigate the long-term mechanical characteristics, reliability, and light transmission of novel, one shade resin-based composites (RBC).

METHODS

120 Specimens (n = 20) of three RBCs (Venus Diamond/VD, Venus Pearl/VP, Omnichroma/OC) were used in a three-point bending test, to determine flexural modulus (E) and flexural strength (σ). Testing ensued after 24 h or thermocycling (TC/10,000 cycles, 5/55 °C). Each fracture mechanism and filler system were documented, using light and scanning electron microscopy. A depth-sensing indentation test (n = 6) quantified the indentation modulus (Y), Martens/Vickers hardness (HM, HV) and creep (Cr). Incident (I₀) and transmitted irradiance (I_T) plus radiant exposure (RE_T) per RBC were measured employing a USB4000 spectrometer (n = 3) to calculate spectral absorbance. Data was tested for significant differences (α = 0.05) utilizing Student's t-tests, one- and multiple-way analysis of variance (ANOVA) and Tukey's post-hoc tests along with Pearson's correlational and Weibull analysis.

RESULTS

Initially, σ, E and Weibull modulus m were the highest for VP. After TC σ was comparable for VP and VD, E was higher for VD and m higher for VP. Maximum Y, HM, HV and Cr were always measured for VD. Inferior parameters, except Cr, were always recorded for OC. I_T, RE_T and absorbance differed marginally, with OC on top.

CONCLUSIONS

The variation in long-term mechanical stability and light transmission is significantly dependent on RBC formulation, most notably due to filler system and resin matrix.

CLINICAL SIGNIFICANCE

One shade RBCs vary substantially in their material composition and characteristics, facilitating the diversity present in RBC direct restoratives.

Evaluation of the Repolished Surface Properties of a Resin Composite Employing Structural Coloration Technology

Resin composites employing structural coloration have recently been developed. These resins match to various tooth shades despite being a single paste. To accomplish this, the filler and base resin are tightly bonded, which is thought to provide excellent discoloration resistance. Here, we investigated the surface properties of one of these resins, including the discoloration of the repolished surface. We developed an innovative in vitro method to adjust the repolished surface, in which structural degradation is removed according to scanning electron microscopy (SEM) observation rather than by the naked eye. The resin samples (20 mm (length) × 10 mm (width) × 4 mm (depth)) were manufactured using this resin material. After accelerated aging of the resin by alkaline degradation, the resin was repolished and the discoloration (ΔE*ab), surface roughness (the arithmetic mean roughness (Ra)), and glossiness (the 60° specular) were measured. SEM observation showed that the appearance of the bond between the organic composite filler and base resin on the repolished surface was different from that on the mirror-polished surface. This revealed that according to our in vitro method it was difficult to make the repolished surface structurally identical to the mirror-polished surface. Among the properties of the repolished surface, the degree of discoloration did not change despite the rougher and less glossy surface. It can be concluded that the factors that induce discoloration in this resin composite are independent of the surface roughness and glossiness.