Mechanical properties and degree of conversion of resin-based core build-up materials and short fiber-reinforced flowable resin-based composite

To evaluate the degree of conversion (DC), surface hardness (SH), and flexural strength (FS) of resin-based core build-up materials. Core build-up materials used were: MultiCore Flow (MCF); Activa (ACT); Core-X Flow (CXF); and everX flow (EVX), and DC, SH and FS were measured. An increase of DC was identified for all materials post-cure, except for EVX. The DC change percentage ranged from 5%-33%, and EVX was displayed the greatest DC rate. All materials displayed an SH increase after 30 days and the greatest increase was observed in ACT. At 1 h, the SH of EVX and CXF was different from the other materials. At 30 days, MCF displayed the greatest SH. All materials displayed an increase in their FS after 30 days except for EVX, and ranging 3%-36% were noticed. Differences observed between materials, thus clinician should be acquainted mechanical properties of these materials to ensure the success of the restorations.

Temperature rise in photopolymerized adhesively-bonded resin composite: A thermography study

OBJECTIVES

To assess visually and quantitatively the contributions of the adhesive layer photopolymerization and the subsequent resin composite increment to spatio-temporal maps of temperature at five different cavity locations, subjected to two irradiance curing protocols: standard and ultra-high.

METHODS

Caries-free molars were used to obtain 40, 2 mm thick dentin slices, randomly assigned to groups (n = 5). These slices were incorporated within 3D-printed model cavites, 4 mm deep, restored with Adhese® Universal bonding agent and 2 mm thick Tetric® Powerfill resin composite, and photocured sequentially, as follows: G1: control-empty cavity; G2: adhesive layer; G3 composite layer with no adhesive; and G4 composite layer with adhesive. The main four groups were subdivided based on two curing protocols, exposed either to standard 10 s (1.2 W/cm2) or Ultra high 3 s (3 W/cm2) irradiance modes using a Bluephase PowerCure LCU. Temperature maps were obtained, via a thermal imaging camera, and numerically analyzed at 5 locations. The data were analyzed using two-way ANOVA followed by multiple one-way ANOVA, independent t-tests and Tukey post-hoc tests (α = 0.05). Tmax, ΔT, Tint (integrated area under the curve) and time-to-reach-maximum-temperature were evaluated.

RESULTS

Two-way ANOVA showed that there was no significant interaction between light-curing time and location on the measured parameters (p > 0.05), except for the time-to-reach-maximum-temperature (p < 0.05). Curing the adhesive layer alone with the 10 s protocol resulted in a significantly increased pulpal roof temperature compared to 3 s cure (p < 0.05). Independent T-tests between G3 and G4, between 3 s and 10 s, confirmed that the adhesive agent caused no significant increases (p > 0.05) on the measured parameters. The ultra-high light-curing protocol significantly increased ΔT in composite compared to 10 s curing (p < 0.05).

SIGNIFICANCE

When the adhesive layer was photocured alone in a cavity, with a 2 mm thick dentin floor, the exothermal release of energy resulted in higher temperatures with a 10 s curing protocol, compared to a 3 s high irradiance. But when subsequently photocuring a 2 mm layer of composite, the resultant temperatures generated at pulpal roof location from the two curing protocols were similar and therefore there was no increased hazard to the dental pulp from the immediately prior adhesive photopolymerization, cured via the ultra-high irradiation protocol.

A comprehensive review of resin luting agents: Bonding mechanisms and polymerisation reactions

The field of dentistry is constantly evolving and increasingly embracing minimally invasive approaches. One such approach, which is bonding to the tooth structure, particularly enamel, has been shown to offer the most predictable outcomes. However, there are instances where significant tooth loss may limit treatment options for a restorative dentist. In these scenarios, indirect restoration might be the preferred treatment option. This literature review provides a comprehensive examination of the currently available resin luting agents and their bonding requirements. It provides valuable insights for dental professionals seeking an in-depth understanding of the current state of the field and the future prospects of dental adhesion.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

SIGNIFICANCE

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

Assessment of Erosive Effect of Various Beverages on Esthetic Restorative Materials Used in Primary Teeth: An In Vitro Study

AIM

The purpose of the current study was to evaluate the erosive impact of various beverages on the esthetic restorative materials utilized in primary teeth.

MATERIALS AND METHODS

One hundred and twenty primary molars indicated for serial extraction or over-retention reason with sound buccal surfaces were collected. One millimeter above the cemento-enamel junction, standard Class V cavities were prepared. Following cavity preparation, all teeth were randomly assigned (20 samples per group for each beverage) to one of the three experimental groups based on the type of filling materials: group I: resin-modified glass ionomer cement (GC), group II: nanocomposite resin and group III nanohybrid ormocer-based composite. The samples were kept suspended in various containers containing 250 mL of each orange juice and cola at a temperature of 37°C for three hours per day and rest of day in distilled water. This procedure was repeated for 15 days. Using a 3D optical profilometer, a profilometric reading was recorded for each specimen.

RESULTS

The minimum surface roughness was found in nanohybrid ormocer‑based composite (1.816 ± 0.16 and 1.302 ± 0.08) followed by resin-modified glass ionomer cement (3.101 ± 0.12 and 2.946 ± 0.09) and nanocomposite resin (5.242 ± 0.20 and 4.488 ± 0.16) after immersed in the cola and orange juice, respectively. And there was a statistically significant difference found between the different esthetic restorative materials in both media.

CONCLUSION

On conclusion, the current investigation demonstrates that when exposed to both beverages, the erosive effect was much lesser in nanohybrid ormocer-based composite, followed by resin-modified glass ionomer cement and nanocomposite resin.

CLINICAL SIGNIFICANCE

Consuming high-calorie, low pH acidic foods and beverages such as carbonated beverages and fruit juices can lead to erosion, a frequent condition that results in irreparable damage to dental hard tissues and early deterioration of dental restorations.

Dental Fiber-Post Systems: An In-Depth Review of Their Evolution, Current Practice and Future Directions

The field of dental medicine is constantly evolving and advancing toward minimally invasive techniques. Several studies have demonstrated that bonding to the tooth structure, particularly enamel, yields the most predictable results. In some instances, however, significant tooth loss, pulpal necrosis, or irreversible pulpitis may limit the options available to the restorative dentist. In these cases, placement of a post and core followed by a crown is the preferred treatment option, provided all requirements are met. This literature review provides an overview of the historical development of dental FRC post systems as well as a comprehensive examination of the currently available posts and their bonding requirements. In addition, it offers valuable insights for dental professionals seeking to understand the current state of the field and the prospects of dental FRC post systems.

No-Cap Flowable Bulk-Fill Composite: Physico-Mechanical Assessment

(1) Background: A newer class of flowable bulk-fill resin-based composite (BF-RBC) materials requires no capping layer (Palfique Bulk flow, PaBF, Tokuyama Dental, Tokyo, Japan). The objective of this study was to assess the flexural strength, microhardness, surface roughness, and color stability of PaBF compared to two BF-RBCs with different consistencies. (2) Methods: PaBF, SDR Flow composite (SDRf: Charlotte, NC, USA) and One Bulk fill (OneBF: 3M, St. Paul, MN, USA) were evaluated for flexural strength with a universal testing machine, surface microhardness using a pyramidal Vickers indenter, and surface roughness using a high-resolution three-dimensional non-contact optical profiler, a and clinical spectrophotometer to measure the color stability of each BF-RBC material. (3) Results: OneBF presented statistically higher flexural strength and microhardness than PaBF or SDRf. Both PaBF and SDRf presented significantly less surface roughness compared with OneBF. Water storage significantly reduced the flexural strength and increased the surface roughness of all tested materials. Only SDRf showed significant color change after water storage. (4) Conclusions: The physico-mechanical properties of PaBF do not support its use without a capping layer in the stress bearing areas. PaBF showed less flexural strength compared with OneBF. Therefore, its use should be limited to a small restoration with minimal occlusal stresses.

Post-irradiation surface viscoelastic integrity of photo-polymerized resin-based composites

OBJECTIVE

A class of ultra-rapid-cure resin-based composites (RBCs) exhibited immediate post-irradiation surface viscoelastic integrity using an indentation-creep/recovery procedure. The aim of this study was to determine whether such behavior is more generally characteristic of a wider range of RBCs.

METHODS

Eight representative RBCs were selected based on different clinical categories: three bulkfills (OBF, Filtek One Bulk Fill; VBF, Venus Bulkfill; EBF, Estelite Bulkfill), three conventional non-flowables (XTE, Filtek Supreme XTE; GSO, GrandioSo; HRZ, Harmonize) and conventional flowables (XTF, Filtek Supreme XTE Flow; GSF, GrandioSo Flow). Stainless steel split molds were used to fabricate cylindrical specimens (4mm (dia)×4mm). These were irradiated (1.2W/cm²) for 20s on the top surface. Post-irradiation specimens (n=3), within their molds, were centrally loaded with a flat-ended 1.5mm diameter indenter under 14MPa stress: either immediately (<2min) or after 24h delayed indentation. Stress was maintained for 2h, then - after removal - recovery measurements continued for a further 2h. Indentation depth (%) versus time was measured continuously to an accuracy of <0.1μm. Data were analyzed by One-way ANOVA and Tukey post-hoc tests (α=0.05).

RESULTS

Time-dependent viscoelastic indentation was observed for all RBCs. For immediate indentation, the maximum indentation range was 1.43-4.92%, versus 0.70-2.22% for 24h delayed indentation. Following 2h recovery, the residual indentation range was 0.86-3.58% after immediate indentation, reducing to 0.22-1.27% for delayed indentation. The greatest immediate indentation was shown by VBF followed by XTF and GSF. OBF, HRZ, XTE and GSO had significantly lower indentations (greater hardness). XTE showed a significantly reduced indentation maximum compared to OBF (p<0.05). Indentations delayed until 24h post-irradiation were reduced (p<0.05) for most materials.

SIGNIFICANCE

The indentation-creep methodology effectively characterized resin-based composites within several categories. Viscoelastic properties evaluated by the indentation-creep method confirmed that highly filled RBCs were more resistant to indentation. Indentations were reduced after 24h post-irradiation due to further matrix-network development.

Spatio-temporal temperature fields generated coronally with bulk-fill resin composites: A thermography study

OBJECTIVE

This study aimed to investigate the effects of (i) a high-irradiance (3s) light-curing protocol versus (ii) two standard-irradiance (10s) protocols on 2D temperature maps during intra-dental photo-irradiation within a molar cavity restored with either Ultra-Rapid Photo-Polymerized Bulk Fill (URPBF) composites or a pre-heated thermo-viscous bulk-fill composite, compared to a standard bulk-fill resin-based-composite (RBC). The specific objectives included visual assessment of the temperature maps and quantitative assessment of several temperature/time plots at four different locations.

METHODS

A caries-free lower first molar cavity served as a natural tooth mold. Resin composites were placed without intermediary adhesive. Two URPBF composites (PFill; PFlow) and one pre-heated thermo-viscous bulk-fill composite (Viscalor: VC) were compared to a contemporary bulk-fill composite (One Bulk Fill: OBF). Two LED-LCU devices were used: Bluephase PowerCure (PC) and Elipar S10 (S10), with three light-irradiation protocols (PC-3s, PC-10s and S10-10s). 2D temperature maps over the entire coronal area were recorded for 120 s during and after irradiation using a thermal imaging camera. Changes at four different levels were selected from the data sets: (0, 2 and 4 mm from the cavity top and at 1 mm below the dentin cavity floor). The maximum temperature attained (T_max), the mean temperature rise (ΔT), the time (s) to reach maximum temperature and the integrated areas (°C s) under the temperature/time (T/t) plots were identified. Data were analysed via three-way ANOVA, One-way ANOVA, independent t-tests and Tukey post-hoc tests (p < 0.05).

RESULTS

All RBCs showed qualitatively similar temperature-time profiles. PFlow reached T_max in the shortest time. PC-3s (3000 mW/cm²) generated comparable ΔT to S10-10s, except with PFill, where ΔT was greater. Despite the same irradiance (1200 mW/cm²), Elipar S10 led to higher T_max and ΔT compared to PC-10s. The highest T_max and ΔT were observed at the 2 mm level, and the lowest were at 1 mm depth into the underlying dentin.

SIGNIFICANCE

Coronal 2D temperature maps showed rises largely confined within the bulk-fill RBC materials, with maxima at 2 mm rather than 4 mm depth indicating some extent of thermal insulation for the underlying dentin and pulp. RBCs polymerized via different irradiation protocols showed similar temperature changes. With the PC-3s protocol - also with pre-heated VC - minimal temperature rises at 1 mm within dentin suggest their clinical safety when sufficient remaining dentin thickness is present.

Material behavior of resin composites with and without fibers after extended water storage

The objective of this study was to determine the long-term water sorption, solubility and hygroscopic expansion of resin composites with and without incorporated short fibers. Three resin composites incorporating fibers were examined: everX Posterior (EVX), NovoPro Universal (NPU) and NovoPro Flow (NPF). Four Particulate filled composites were used as controls: Filtek bulk Fill (FBF), Filtek one bulkfill (FBO), Filtek Supreme XTE (XTE), and Filtek Supreme Flow (XTEF). For sorption and solubility measurements, specimens were immersed in water for140 days, weighed at intervals, then dried for a further 42 days at 37±1°C. Laser micrometer measured diametral expansion. XTEF exhibited the highest sorption. The solubility range was between -1.4 to 4.1 μg/mm; XTEF had the highest solubility, with EVX demonstrating negative solubility. Hygroscopic expansion ranged between 1.4% for hydroxyapatite fiber reinforced composite (NPU) and 2.2% for E-glass fiber reinforced composite (EVX). A nano-fiber containing composite (NPU) had the most favorable outcomes compared to a range of composites.

Characterizing surface viscoelastic integrity of ultra-fast photo-polymerized composites: Methods development

OBJECTIVE

Resin-Composites are now available designed for polymerization using 3 s of intense light irradiation. The aim was to develop an experimental method to probe their surface viscoelastic integrity immediately following such rapid photo-cure via macroscopic surface indentation under constant stress as a function of time.

METHODS

Two bulk-fill composites (Ivoclar AG) were studied: Tetric PowerFill (PFill) and PowerFlow (PFlow). Split molds were used to fabricate cylindrical {4 mm (dia) × 4 mm} paste specimens, irradiated at 23 °C at 0 mm from the top surface with a BluephasePowerCure LED-LCU, with 3 s or 5 s modes, emitting 3 and 2 W/cm², respectively. Post-irradiation specimens were immediately transferred to an apparatus equipped with a flat-ended indentor of 1.5 mm diameter. 14 MPa compressive stress at the indentor tip was applied centrally in < 2 min and maintained constant for 2 h. Indentation (I) magnitudes were recorded in real-time (t), with I(t) data re-expressed as % indentation relative to the 4 mm specimen height. After 2 h, the indentor was unloaded and indentation recovery was monitored for a further 2 h. Parallel sets of measurements were made where indentation was delayed for 24 h. Further measurements were made with more conventional composites: EvoCeram Bulk Fill (ECeram) and Tetric EvoFlow Bulk Fill (EFlow). These were irradiated for 20 s at 1.2 W/cm². Kinetic data were curve-fitted to exponential growth functions and key parameters analyzed by ANOVA and post-hoc tests (α = 0.05).

RESULTS

I(t) plots looked initially similar to bulk creep/recovery: rapid deformation plus viscoelastic response; then, upon unloading: rapid (elastic) recovery followed by partial viscoelastic recovery. However, unlike multiply irradiated and stored bulk-creep specimens, the present specimens were exposed to only 3 or 5 s "occlusal" irradiation; generating "hard" surfaces. Subsequently, during the 2 h indentation, the polymer matrix network continued to harden and consolidate. Upon initial loading, I(t) reached 2-3% indentation, depending upon the formulation. Upon unloading at 2 h, elastic recovery was only ca. 1 %. Delayed loading for 24 h, generated I(t) plots of significantly reduced magnitude. Most importantly, however, the I(t) plots for ECeram and EFlow, after 20 s irradiation, showed I(t) magnitudes quite comparable to the PFill and PFlow rapid-cure composites.

SIGNIFICANCE

Macroscopic indentation creep has been shown to be a workable procedure that can be applied to rapid-cure materials to assess their immediate surface integrity and developing viscoelastic characteristics. The applied stress of 14 MPa was relatively severe and the indentation/recovery profiles of PowerFill materials with only 3 or 5 s irradiation demonstrated comparability with their established 20 s cure siblings, evidencing the suitability of the PowerCure system for clinical application.

The effect of aging methods on the fracture toughness and physical stability of an oxirane/acrylate, ormocer, and Bis-GMA-based resin composites

PURPOSE

To determine the effect of aging methods on the fracture toughness of a conventional Bis-GMA-based resin composite (Filtek Supreme), an ormocer-based resin composite (Admira), and an experimental hydrophobic oxirane/acrylate interpenetrating network resin system (OASys)-based composite.

METHODS

A 25 × 5 × 2.8-mm stainless-steel mold with 2.5 mm single-edge center notch, following ASTM standards [E399-90], was used to fabricate 135 specimens (n = 15) of the composite materials and randomly distributed into groups. For the baseline group, specimens were fabricated and then tested after 24-h storage in water. For the biofilm challenge, specimens were randomly placed in a six-well tissue culture plate and kept at 37 °C with bacterial growth media (Brain Heart Infusion (BHI); Streptococcus mutans) changed daily for 15 days. For the water storage challenge, specimens were kept in 5 ml of deionized distilled autoclaved water for 30 days at 37 °C. μCT evaluation by scanning the specimens was performed before and after the proposed challenge. Fracture toughness (K_Ic) testing was carried out following the challenges.

RESULTS

μCT surface area and volume analyses showed no significant changes regardless of the materials tested or the challenge. Filtek and Admira fracture toughness was significantly lower after the biofilm and water storage challenges. OASys mean fracture toughness values after water aging were significantly higher than that of baseline. Toughness values for OASys composites after biofilm aging were not statistically different when compared to either water or baseline values.

CONCLUSION

The fracture toughness of Bis-GMA and ormocer-based dental resin composites significantly decreased under water and bacterial biofilm assault. However, such degradation in fracture toughness was not visible in OASys-based composites.

CLINICAL SIGNIFICANCE

Current commercial dental composites are affected by the oral environment, which might contribute to the long-term performance of these materials.

Microcomputed Tomography Evaluation of Volumetric Shrinkage of Bulk-Fill Composites in Class II Cavities

PURPOSE

This study aimed to quantify polymerization shrinkage of one conventional and three bulk-fill composites, under bonded and unbonded conditions, in Class II preparations using 3D microcomputed tomography (μCT) and report its location.

MATERIALS AND METHODS

Preparations (2.5 mm occlusal depth × 4 mm wide × 4 mm mesial box and 1 mm beyond the CEJ distal box depth) were made in 48 human extracted molars (n = 6). Four composites were tested, one regular (Vitalescence/VIT) and three bulk-fill: SureFil SDR Flow (SDR), Tetric EvoCeram Bulk Fill (TET), and Filtek flowable Bulk Fill (FIL). Teeth were divided into four groups according to restorative material used and subdivided into two subgroups, according to the presence of an adhesive system (XP Bond) application (bonded [-B]) or its absence (unbonded [-U]). Each tooth was scanned three times: (1) after cavity preparation, (2) before and (3) after composite light-curing. Acquired μCT images were imported into 2D and 3D software for analysis.

RESULTS

Significantly different volumetric shrinkage between bonded and unbonded conditions was observed only for TET group (p < 0.05), unbonded presenting significantly higher volumetric shrinkage. Among the bonded groups, TET-B presented significantly lower shrinkage than both SDR-B and FIL-B but not significantly different from VIT-B. Generally, shrinkage occurred at occlusal and distal surfaces.

CONCLUSIONS

When applied to bonded Class II cavities, TET exhibited significantly lower volumetric shrinkage compared to the other bulk-fill composites. However, it also exhibited the highest difference of volumetric shrinkage values between unbonded and bonded cavities.

CLINICAL SIGNIFICANCE

Volumetric polymerization shrinkage occurred with all composites tested, regardless of material type (conventional or bulk-fill) or presence or absence of bonding. However, volumetric shrinkage has been reduced or at least maintained when bulk-fill composites were used compared to a conventional composite resin, which makes them a potential time saving alternative for clinicians. (J Esthet Restor Dent 29:118-127, 2017).