Effect of immersion into solutions at various pH on the color stability of composite resins with different shades

Effects of different antiviral mouthwashes on the surface roughness, hardness, and color stability of composite CAD/CAM materials

OBJECTIVE

To evaluate the effect of COVID-19 preventive mouthwashes on the surface hardness, surface roughness (Ra), and color change (ΔE) of three different polymer-based composite CAD/CAM materials (Vita Enamic (ENA), Grandio Block (GB), Lava Ultimate (LU)).

METHODS

A total of 100 rectangular-shaped specimens with dimensions of 2 mm × 7 mm × 12 mm were obtained by sectioning three different CAD/CAM blocks and randomly divided into five subgroups according to the 30 days of mouthwash immersion protocol as follows: Control: artificial saliva, PVP-I: 1% povidone-iodine, HP: 1.5% hydrogen peroxide, CPC: mouthwash containing 0.075% cetylpyridinium chloride, EO: mouthwash containing essential oils. Microhardness, Ra, and ΔE values were measured at baseline and after 30 days of immersion protocols. Data were analyzed using the Wald Chi-square, two-way ANOVA, and post hoc Tukey tests.

RESULTS

The independent factors (materials and solutions) significantly influenced the microhardness and color (p < 0.001). Ra of the materials was not affected by any of the mouthwashes (p > 0.05). The microhardness and color of each material varied significantly after immersion in PvP-I and HP (p < 0.05). The highest percentage change in microhardness, Ra, and ΔE was found in LU immersed in PvP-I and HP mouthwashes, while the lowest change was found in ENA groups (p < 0.05).

CONCLUSION

Within the limitations of this study, it was found that the surface hardness and color of tested polymer-based composite CAD/CAM materials are susceptible to degradation and change after 30 days of immersion in 1% PvP-I and 1.5% HP mouthwashes.

Understanding the Mechanical, Surface, and Color Behavior of Oral Bioactive Prosthetic Polymers under Biodegradation Processes

Changes in the properties of resin-based polymers exposed to the oral environment can emerge when chlorhexidine (CHX) is incorporated to develop bioactive systems for treating denture stomatitis. Three reline resins loaded with CHX were prepared: 2.5 wt% in Kooliner (K), 5 wt% in Ufi Gel Hard (UFI), and Probase Cold (PC). A total of 60 specimens were submitted to physical aging (1000 cycles of thermal fluctuations, 5-55 °C) or chemical aging (28 days of pH fluctuations in artificial saliva, 6 h at pH = 3, 18 h at pH = 7). Knoop microhardness (30 s, 98 mN), 3-point flexural strength (5 mm/min), and surface energy were tested. Color changes (ΔE) were determined using the CIELab system. Data were submitted to non-parametric tests (α = 0.05). After aging, bioactive K and UFI specimens were not different from the controls (resins without CHX) in mechanical and surface properties. Thermally aged CHX-loaded PC specimens showed decreased microhardness and flexural strength but not under adequate levels for function. The color change was observed in all CHX-loaded specimens that underwent chemical aging. The long-term use of CHX bioactive systems based on reline resins generally does not impair removable dentures' proper mechanical and aesthetic functions.

Can Modification with Urethane Derivatives or the Addition of an Anti-Hydrolysis Agent Influence the Hydrolytic Stability of Resin Dental Composite?

Due to the questionable durability of dental restorations, there is a need to increase the lifetime of composite restoration. The present study used diethylene glycol monomethacrylate/4,4'-methylenebis(cyclohexyl isocyanate) (DEGMMA/CHMDI), diethylene glycol monomethacrylate/isophorone diisocyanate (DEGMMA/IPDI) monomers, and bis(2,6-diisopropylphenyl)carbodiimide (CHINOX SA-1) as modifiers of a polymer matrix (40 wt% urethane dimethacrylate (UDMA), 40 wt% bisphenol A ethoxylateddimethacrylate (bis-EMA), and 20 wt% triethyleneglycol dimethacrylate (TEGDMA)). Flexural strength (FS), diametral tensile strength (DTS), hardness (HV), sorption, and solubility were determined. To assess hydrolytic stability, the materials were tested before and after two aging methods (I-7500 cycles, 5 °C and 55 °C, water and 7 days, 60 °C, 0.1 M NaOH; II-5 days, 55 °C, water and 7 days, 60 °C, 0.1 M NaOH). The aging protocol resulted in no noticeable change (median values were the same as or higher than the control value) or a decrease in the DTS value from 4 to 28%, and a decrease in the FS value by 2 to 14%. The hardness values after aging were more than 60% lower than those of the controls. The used additives did not improve the initial (control) properties of the composite material. The addition of CHINOX SA-1 improved the hydrolytic stability of composites based on UDMA/bis-EMA/TEGDMA monomers, which could potentially extend the service life of the modified material. Extended studies are needed to confirm the possible use of CHINOX SA-1 as an antihydrolysis agent in dental composites.

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.

Effect of Mouthwashes for COVID-19 Prevention on Surface Changes of Resin Composites

OBJECTIVE

The aim of this research was to investigate the effect of various mouthwashes for COVID-19 prevention on surface hardness, roughness, and colour changes of bulk-fill and conventional resin composites and determine the pH and titratable acidity of mouthwashes.

METHODS

Four hundred eighty specimens were fabricated in cylindrical moulds (10 mm in diameter and 2 mm in thickness). Before immersion, baseline data of surface hardness, roughness, and colour values were recorded. Each product of specimens (Filtek Z350XT, Premise, Filtek One Bulk Fill Restorative, SonicFil 2) were divided into 4 groups for 0.2% povidone iodine, 1% hydrogen peroxide, 0.12% chlorhexidine, and deionised water (serving as a control). The specimens were immersed in mouthwashes for 1 minute and then stored in artificial saliva until 24 hours. This process was repeated for 14 days. After immersion, surface hardness, roughness, and colour values of specimens were measured at 7 and 14 days. The data were statistically analysed by 2-way repeated analysis of variance, Tukey honestly significant difference, and t test (P < .05).

RESULTS

After immersion, all mouthwashes caused significantly lower surface hardness and greater roughness and colour values (P < .05) on all resin composites tested.

CONCLUSIONS

Mouthwashes had an effect on all resin composites evaluated leading to a significant decreased surface hardness and an increased roughness and colour values (P < .05).

Evaluation of the Color Stability, Water Sorption, and Solubility of Current Resin Composites

This study aims to assess the color stability, water sorption, and solubility of 11 resin composites as commercially available dental products. Twenty samples (10 mm in diameter and 2 mm in thickness) of each material were fabricated using a customized silicone mold, followed by immersion in each of curry, coffee, wine, and distilled water for 28 days (n = 5). Baseline shade and color changes (ΔE) were measured using a reflection spectrophotometer. The CIE L*, a*, b* system was used to evaluate the color changes. Five samples of each resin composite were applied to test water sorption and solubility according to ISO 4049:2009. As a result, the ∆E values were significantly influenced by each of the three factors (composition of material, solution, time) and the interactions between them (p < 0.001). Highest resistance to discoloration was achieved by Ceram.X One Universal (CXU), followed by Magnafill Putty (MP). Generally, microhybrid composites showed fewer color changes than nanohybrid composites and giomers. DX. Universal and Filtek Z350 XT showed the highest ΔE values in all colorants. All materials tested in this study fulfilled the criteria of ISO 4049:2009; CXU and MP had the lowest water sorption and solubility. The Pearson test showed statistically significant positive correlations between water sorption and ΔE and between solubility and ΔE.

An Evaluation of the Hydrolytic Stability of Selected Experimental Dental Matrices and Composites

Materials with potential use as dental restoration should be evaluated in an aggressive environment. Such accelerated aging is widely used in other industries and allows the assessment of service life. In the presented study, three neat resins (UDMA/Bis-GMA/TEGDMA 70/10/20 wt.%, UDMA/Bis-GMA/TEGDMA 40/40/20 wt.% and UDMA/Bis-EMA/TEGDMA 40/40/20 wt.%) and three composites based on these matrices were tested before and after aging protocols (I-7500 cycles, 5 °C and 55 °C, water and 7 days, 60 °C, 0.1 M NaOH; II-5 days, 55 °C, water and 7 days, 60 °C, 0.1 M NaOH). Flexural strength (FS), diametral tensile strength (DTS) and hardness (HV) were determined. Applied aging protocols resulted in a decrease in the value of the FS, DTS and HV. Larger changes were noticed for the neat resins. Materials in which the content of bis-GMA was lower or substituted by bis-EMA showed better resistance to degradation. The choice of mixtures with monomers characterized by lower sorption values may favorably affect hydrolytic stability. It was shown that for composites there was a drastic decrease in hardness, which suggests a more superficial effect of the used protocols. However, degradation of the surface layer can result in a growing problem over time given that the mastication processes are an inherent element in the oral environment.

Comparison of instrumental methods for color change assessment of Giomer resins

Objectives

The aim of this study was to compare the color change of the Giomer resin composite (Beautifil-Bulk) by using photographs obtained with a smartphone (iPhone 6S) associated with Adobe Photoshop software (digital method), with the spectrophotometric method (Vita Easyshade) after immersion in different pigment solutions.

Materials and Methods

Twenty resin composite samples with a diameter of 15.0 mm and thickness of 1.0 mm were confectioned in A2 color (n = 5). Photographs and initial color readings were performed with a smartphone and spectrophotometer, respectively. Then, samples were randomly divided and subjected to cycles of immersion in distilled water (control), açai, Coke, and tomato sauce, 3 times a day, 20 minutes for 7 days. Later, new photographs and color readings were taken.

Results

The analysis (2-way analysis of variance, Holm-Sidak, p < 0.05) demonstrated no statistical difference (p < 0.005) between the methods in all groups. Similar color changes were observed for all pigment solutions when using the spectrophotometric method. For the digital method, all color changes were clinically unacceptable, with distilled water and tomato sauce similar to each other and with statistical differences (p < 0.005) for Coke and açai.

Conclusions

Only the tomato sauce produced a color change above the acceptability threshold using both methods of color assessment. The spectrophotometric and digital methods produce different patterns of color change. According to our results, the spectrophotometric method is more recommended in color change assessment.

Color stability of an artificially aged nanofilled composite resin post-cured with different techniques

Background. Post-cured composite resins exhibit improvements in physical and mechanical properties due to additional polymerization conversion. However, the post-curing techniques might influence the color stability of composite resin materials. Thus, this study evaluated the color stability of a nanofilled composite resin (Filtek Z350 XT - 3M ESPE) subjected to different post-curing techniques.

Methods. Sixty samples (color A2) were randomly allocated to six experimental groups (n=10): G1: photoactivation (P) (control); G2: P + microwave oven with distilled water; G3: P + microwave oven without distilled water; G4: P + conventional oven; G5: P + dry-heat sterilizer; G6: P + steam autoclave. All the groups were stored in distilled water for 60 days and immersed daily in 5 mL of a coffee solution for 3 minutes. The color readings (CIEL*a*b* system) were performed at two different time intervals, initially and after 60 days, in a reflectance spectrophotometer (UV-2600; Shimadzu). The colorimetric readings were performed using the Color Analysis software (CIEL*a*b* system).

Results. Group G6 exhibited significantly low values of total color change (ΔE=13.16). The control (ΔE=15.32) and G5 (ΔE=15.49) groups exhibited intermediate values, with no difference between them. In turn, the groups in which the resin was heated in a microwave (G2 ΔE=18.55 and G3 ΔE=19.45) exhibited the most significant color changes (one-way ANOVA and Tukey test, P ≤0.05).

Conclusion. Steam autoclave post-polymerization increased the color stability of the nanofilled resin subjected to artificial aging and coffee immersion.

Ageing of Dental Composites Based on Methacrylate Resins-A Critical Review of the Causes and Method of Assessment

The paper reviews the environmental factors affecting ageing processes, and the degradation of resins, filler, and the filler-matrix interface. It discusses the current methods of testing materials in vitro. A review of literature was conducted with the main sources being PubMed. ScienceDirect, Mendeley, and Google Scholar were used as other resources. Studies were selected based on relevance, with a preference given to recent research. The ageing process is an inherent element of the use of resin composites in the oral environment, which is very complex and changes dynamically. The hydrolysis of dental resins is accelerated by some substances (enzymes, acids). Bonds formed between coupling agent and inorganic filler are prone to hydrolysis. Methods for prediction of long-term behaviour are not included in composite standards. Given the very complex chemical composition of the oral environment, ageing tests based on water can only provide a limited view of the clinical performance of biomaterial. Systems that can reproduce dynamic changes in stress (thermal cycling, fatigue tests) are better able to mimic clinical conditions and could be extremely valuable in predicting dental composite clinical performance. It is essential to identify procedure to determine the ageing process of dental materials.

Effect of different cement systems and aging on the bond strength of chairside CAD-CAM ceramics

STATEMENT OF PROBLEM

The bond strength of different chairside computer-aided design and computer-aided manufacturing (CAD-CAM) restorative materials to dentin with different resin cements needs to be evaluated.

PURPOSE

The purpose of this in vitro study was to investigate the effect of 3 different cementation systems after thermal aging on the shear bond strength of different CAD-CAM materials.

MATERIAL AND METHODS

The occlusal surfaces of 63 molar teeth of similar size were removed, and 21 zirconia-reinforced lithium disilicate (Vita Suprinity-VS), 21 polymer infiltrated ceramic (Vita Enamic-VE), and 21 resin nanoceramic (GC Cerasmart-GC) rectangular specimens of 2.5 mm in thickness were obtained. The ceramics were cemented using total etch (TE), self-etch (SE), and self-adhesive (SA) cement systems. Half of the specimens were subjected to thermal aging with 5000 cycles. The shear bond strength test of all the specimens was measured. Fractured ceramic surfaces were examined by scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDX) analysis. The Shapiro-Wilk test, 3-way analysis of variance (ANOVA), and Fisher Least Significant Difference (LSD) tests were used to analyze the shear bond strength test data (α=.05).

RESULTS

The highest bond strength value was found in the nonthermal aged VS-TE and the lowest in the thermal aged VE-TE. Significant interaction was found between TE and SE cemented ceramics (P<.001). For specimens cemented with the SA system, significant interaction was found among ceramics with thermal aged specimens (P<.001). Thermal aging significantly decreased the mean bond strength (P<.05).

CONCLUSIONS

Differences in bond strength were observed in chairside CAD-CAM ceramics when cemented with TE, SE, and SA systems. Additionally, thermal aging significantly reduced the bond strength values of all the ceramic materials, regardless of the cementation procedure. Clinicians should consider these variables and choose the most suitable cementation systems for the material used.

O uso do gel de glicerina melhora a estabilidade de cor de resinas compostas?

Resumo Introdução A camada superficial de resina composta não polimerizada, em função da presença do oxigênio, ocasiona problemas clínicos, como alteração de cor por absorção de pigmentos. Objetivo Determinar o efeito de diferentes técnicas usadas no controle da formação da camada de dispersão sobre as propriedades ópticas de uma resina composta comercial. Material e método Espécimes foram produzidos com a resina composta Estelite Sigma. A fotoativação foi conduzida com uma fonte de luz LED Bluephase G2 (1.200 mW/cm2 por 40 s). Os grupos foram determinados em função de três técnicas distintas: 1) sem tratamento (controle); 2) fotoativação com gel de glicerina; 3) polimento com lixa abrasiva após a fotoativação. A estabilidade de cor (ΔE) e o parâmetro de translucidez foram determinados pelo método de espectroscopia de reflectância (Easyshade Compac, Vita) empregando o parâmetro CIELab. As análises foram realizadas imediatamente após a fotoativação e repetidas após 7 dias de armazenamento em água ou em café. Os resultados foram submetidos à análise de variância e ao teste de Tukey (α = 0,05). Resultado Não houve diferença para ΔE nos grupos envelhecidos em água. Quando armazenados em café, o grupo controle apresentou o maior valor de ΔE, enquanto o grupo polido gerou a menor alteração de cor. A aplicação do gel de glicerina produziu resultados intermediários. O parâmetro de translucidez não foi afetado pelos tratamentos testados. Conclusão O uso do gel de glicerina minimiza a alteração de cor nas regiões de difícil acesso aos instrumentos de acabamento e de polimento.

Discoloration Effects of Traditional Turkish Beverages on different Composite Restoratives

AIM

The aim of this study was to evaluate the discoloring effects of five beverages including, especially, traditional Turkish ones on five commonly used dental composites by using a spectrophotometer device.

MATERIALS AND METHODS

Five methacrylate-based composites (shade A2) were selected to evaluate their color stability (175 disk samples). Four of them (Filtek Ultimate Universal, Clearfil Majesty ES-2, Tetric EvoCeram, and Cavex Quadrant Universal LC) were nanofilled universal composites for both anterior and posterior restorations, and one (Clearfil Majesty Posterior) was nano-superfilled for posterior restorations. The tested beverages were tamarind syrup, ottoman syrup, turnip juice, pomegranate juice, and distilled water (control). All samples were kept in an incubator at 37°C for 12 days (measured at 3rd, 6th, 12th day intervals) in immersion solutions which was equivalent to 1 year in vivo. Color measurements were made with VITA Easyshade Advance (Vident, Brea, CA) spectrophotometer device according to CIE L*a*b* system. Statistical analysis was performed with analysis of variance and least significant difference test to analyze differences in L*a*b* and ΔE values.

RESULTS

All materials showed significant discoloration (p < 0.05) when compared with the control group. The highest ΔE was observed in turnip juice, whereas ottoman syrup had the lowest ΔE. Tetric EvoCeram showed the lowest ΔE, while Clearfil Majesty ES-2 showed the highest ΔE.

CONCLUSION

In all the groups tested, clinically unacceptable ΔE values were obtained. Although color stability of methacrylate-based composites has been widely investigated, this has not been done before with these kinds of immersion solutions.

CLINICAL SIGNIFICANCE

Potential discoloration might be limited by dietary adjustments based on in vitro evaluations.

The effect of red and white wine on color changes of nanofilled and nanohybrid resin composites

Objectives

This study investigated the effect of red and white wine on color changes of nanofilled and nanohybrid resin composite.

Materials and Methods

Sixty specimens of each resin composite were prepared. Baseline data color values were recorded using a spectrophotometer. Three groups of discs (n = 20) were then alternately immersed in red, white wine, and deionized water (as a control) for twenty five minutes and artificial saliva for five minutes for four cycles. Specimens were then stored in artificial saliva for twenty two hours. This process was repeated for five days following immersion in artificial saliva for two days. Subsequently, the process was repeated again. Data were analyzed by two-way repeated ANOVA, one-way ANOVA, and Tukey's HSD.

Results

Red wine caused significantly higher color change (ΔE^* > 3.3) than did white wine and deionized water (p < 0.05). Nanohybrid resin composites had significantly more color changes than nanofilled resin composite (p < 0.05).

Conclusions

The effect of red and white wine on the color changes of resin composite restorative materials depended upon the physical and chemical composition of the restorative materials and the types of wine.