Wear and marginal breakdown of composites with various degrees of cure

Restoration of Severely Compromised Teeth With Modern Operative Techniques

This case report illustrates how to restore severely compromised teeth with direct composite restorations. The size of the restorations presented is often considered by dentists as being a contraindication for direct composites. Hence, the technique is explained step by step, addressing the crucial points.

Simulated Wear of Self-Adhesive Resin Cements

One of the primary areas of concern with luting agents is marginal gap erosion and attrition. The purpose of this laboratory study was to evaluate bulk and marginal slit (gap) generalized wear of self-adhesive resin cements. Three self-adhesive resin cements were used in this study: G-CEM LinkAce (LA), Maxcem Elite (ME), and RelyX Unicem2 Automix (RU). A custom stainless-steel fixture with a cavity 4.5 mm in diameter and 4 mm deep was used for simulated generalized (bulk) wear. For simulated marginal gap wear, a two-piece stainless-steel custom fixture was designed with a slit (gap) 300 μm wide and 3 mm in length. For both wear models, 20 specimens each for each of the three adhesive cements were made for both light-cure and chemical-cure techniques. The cured cements were polished with a series of carbide papers to a 4000-grit surface and subjected to 100,000 cycles using the slit (gap) wear model and 400,000 cycles for generalized (bulk) wear in a Leinfelder-Suzuki (Alabama machine) wear simulator (maximum load of 78.5 N). Flat-ended stainless-steel antagonists were used in a water slurry of poly(methylmethacrylate) beads for simulation of generalized contact-free area wear with both wear models. Before and after the wear challenges, the specimens were profiled with a Proscan 2100 noncontact profilometer, and wear (volume loss [VL] and mean facet depth [FD]) was determined using AnSur 3D software. Two-way analysis of variance (ANOVA) and Tukey post hoc tests were used for data analysis for the two wear models. Scanning electron microscopy (SEM) was used to examine polished surfaces of the resin cements and the worn surfaces after the wear challenges. The two-way ANOVA of VL using the generalized (bulk) wear model showed a significant effect among the three resin cement materials for the factor of resin cement (p<0.001) and the interaction of the cement and cure method (p<0.001), but not for the cure method (p=0.465). The two-way ANOVA for FD also found a significant difference for the factor of resin cement (p<0.001) and the interaction of the resin cement and cure method (p<0.001), but not for the cure method (p=0.277). The simulated generalized (bulk) wear for the light-cure groups was as follows: VL (mm(3)): RU 0.631 (0.094), LA 0.692 (0.112), and ME 1.046 (0.141) and FD (μm): RU 43.6 (6.5), LA 47.0 (7.7), and ME 72.5 (9.9). The simulated generalized (bulk) wear for the chemical-cure groups was as follows: VL (mm(3)): LA 0.741 (0.105), RU 1.231 (0.234), and ME 1.305 (0.143) and FD (μm): LA 50.7 (7.2), RU 84.5 (16.1), and ME 91.7 (10.2). Simulated wear using the slit (gap) model for the light-cure groups was as follows: VL (mm(3)): RU 0.030 (0.006), LA 0.031 (0.006), and ME 0.041 (0.009) and FD (μm): RU 49.6 (5.7), LA 57.2 (8.4), and ME 70.9 (10.7). The wear values for the chemical-cure slit (gap) groups were as follows: VL (mm(3)): LA 0.031 (0.004), ME 0.038 (0.007), and RU 0.045 (0.009) and FD (μm): LA 53.9 (6.7), ME 63.5 (9.1), and RU 74.2 (12.9). Pearson correlation tests revealed a strong relationship between the two wear models for the light-cure groups and a good relationship for the chemical-cure groups. The observations using SEM showed differences in filler particle shape and size among the cements and the resultant effect of the wear challenges. The worn surfaces of each cement were essentially the same for both light-cure and chemical-cure methods. The bulk wear model and new slit (gap) model for evaluation of simulated generalized wear of luting agents demonstrated significant differences (p<0.05) in relative wear among three self-adhesive resin cements and between visible light- and chemical-cure techniques.

Effect of mold type, diameter, and uncured composite removal method on depth of cure

OBJECTIVE

This study compared the effects of mold material and diameter on the thickness of cured composite remnants and depth of cure (DOC) of resin-based composites (RBC).

MATERIAL AND METHODS

One Polywave® curing light was used to photo-cure two shades of the same "bulk-fill" RBC in 4, 6, or 10-mm internal diameter metal or white Delrin® molds. For 60 specimens, the uncured RBC was manually scraped away as described in the ISO 4049 depth of cure test. The remaining 60 specimens were immersed in tetrahydrofuran for 48 hours in the dark. Maximum lengths of remaining hard RBC and their DOC values were compared using analysis of variance (ANOVA) and Tukey-Kramer post hoc multiple comparison tests (α = 0.05).

RESULTS

Specimen thickness and DOC were always greater using the white Delrin® molds compared to metal molds (p < 0.001). Increase in mold diameter significantly increased specimen thickness and DOC when made in the metal molds and in the 6-mm diameter Delrin® molds (p < 0.01). Increasing the diameter of the Delrin® molds to 10-mm did not increase specimen thickness or DOC. Sectioning and staining of specimens revealed an internal, peripheral transition zone of porous RBC in the solvent-dissolved specimens only.

CONCLUSION

Mold material and internal diameter significantly influenced cured composite remnant thickness as well as depth of cure. The existence of an outer region of RBC that is hard, yet susceptible to solvent dissolution, requires further investigation.

CLINICAL RELEVANCE

The depth of cure results obtained from a 4-mm diameter metal mold may not represent the true potential for evaluating composite depth of cure. A universally acceptable mold material and diameter size need to be established if this type of testing is to be useful for evaluating the relative performance of a given type of LCU and RBC.

Effect of Curing Light Barriers and Light Types on Radiant Exposure and Composite Conversion

PURPOSE

Previous research investigated the effects of curing tip barriers on light output and composite properties, but no study has measured the effect of a wide variety of barriers and curing light types on delivered radiant exposure and the resulting composite cure 2 mm below the radiated surface.

MATERIALS AND METHODS

Six barrier materials and six curing light types were tested. Spectroradiometry was used to measure irradiance with and without barriers for each light type, and radiant exposure values were determined for a commercial camphorquinone-based dental composite material. Composite monomer conversion was measured at 10 minutes following exposure for each light type/barrier condition (N = 5) using infrared spectroscopy. Results were subjected to one-way analyses of variance for radiant exposure and conversion among barrier types within a given curing light: preset alpha 0.05.

RESULTS

All barriers significantly reduced radiant exposure compared with the uncovered tip, but the use of the two polywave LEDs covered with a latex-based barrier demonstrated significantly lower conversion values.

CONCLUSIONS

Although light-curing barriers reduce radiant exposure to a restorative material over a recommended exposure, this reduction is not sufficient to cause significant reduction in composite cure, except when using a latex-based barrier and a polywave LED curing light.

CLINICAL SIGNIFICANCE

Clinicians need to be aware of the possible interaction between curing light barriers and curing light type in order to optimally photocure restorative materials.

Light-Curing Units

For improved interstudy reproducibility, reduced risk of premature failures, and ultimately better patient care, researchers and dentists need to know how to accurately characterize the electromagnetic radiation (light) they are delivering to the resins they are using. The output from a light-curing unit (LCU) is commonly characterized by its irradiance. If this value is measured at the light tip, it describes the radiant exitance from the surface of the light tip, and not the irradiance received by the specimen. The value quoted also reflects only an averaged value over the total measurement area and does not represent the irradiance that the resin specimen is receiving locally or at a different moment in time. Recent evidence has reported that the spectral emission and radiant exitance beam profiles from LCUs can be highly inhomogeneous. This can cause nonuniform temperature changes and uneven photopolymerization within the resin restoration. The spectral radiant power can be very different between different brands of LCUs, and the use of irradiance values derived from dental radiometers to describe the output from an LCU for research purposes is discouraged. Manufacturers should provide more information about the light output from the LCU and the absorption spectrum of their resin-based composite (RBC). Ideally, future assessments and research publications should include the following information about the curing light: 1) radiant power output throughout the exposure cycle and the spectral radiant power as a function of wavelength, 2) analysis of the light beam profile and spectral emission across the light beam, and 3) measurement and reporting of the light the RBC specimen received as well as the output measured at the light tip.

Impact of the distance of light curing on the degree of conversion and microhardness of a composite resin

OBJECTIVE

This study evaluated the impact of the distance between the light guide tip of the curing unit and material surface on the degree of conversion and Knoop microhardness of a composite resin.

MATERIALS AND METHODS

Circular samples were carried out of a methacrylate micro-hybrid resin-based composite and light cured at 0, 2 and 4 mm distance. Monomer conversion rate was measured using a Fourier-transform Raman spectrometer and Knoop hardness number was obtained using a microhardness tester on the top and bottom surfaces. Data were statistically analyzed by analysis of variance and Tukey's test (α=0.05).

RESULTS

Overall, the increase of curing distance reduced the microhardness (p≤0.05), but did not influence the carbon double bond conversion rate (p>0.05) of the composite resin tested; and the top surface showed better properties compared to the bottom (p≤0.05).

CONCLUSIONS

The light curing at distance can reduce mechanical properties and could affect long-term durability of the composite restorations. Thus, the use of a curing device with high irradiance is recommended.

Effect of temperature, curing time, and filler composition on surface microhardness of composite resins

Aim:

The aim of this study was to evaluate the microhardness of two composite resins when subjected to three different temperatures and three different light-curing times.

Materials and Methods:

Two composites were used; Filtek Z250 and Grandio. Three different temperatures (23, 37, and 55^oC) were used, utilizing a composite warmer. The heated samples were immediately injected into cylindrical molds (6 mm × 2 mm) and the top surface of the specimens was polymerized for 10, 20, and 40 sec, using a Quartz-Tungsten-Halogen light-curing unit (QTH LCU). Vickers microhardness measurements were performed from both the top and bottom surface of the specimens, following dry storage for 24 hours in the dark. Statistical analysis were performed using one-way analysis of variance (ANOVA) and Tukey post-hoc test at a level of significance of a = 0.05.

Results:

The results indicated that there was an increase in microhardness as the temperature of the composite was increased for either the top or the bottom surface (P < 0.05). Furthermore, there was a general increase in microhardness for both composites as curing time increased (P < 0.05). The type of composites did not influence the surface microhardness (P > 0.05).

Conclusions:

Temperature of composites affects their surface microhardness. Also, light-curing time influence microhardness values of the composites tested.

Examining exposure reciprocity in a resin based composite using high irradiance levels and real-time degree of conversion values

OBJECTIVE

Exposure reciprocity suggests that, as long as the same radiant exposure is delivered, different combinations of irradiance and exposure time will achieve the same degree of resin polymerization. This study examined the validity of exposure reciprocity using real time degree of conversion results from one commercial flowable dental resin. Additionally a new fitting function to describe the polymerization kinetics is proposed.

METHODS

A Plasma Arc Light Curing Unit (LCU) was used to deliver 0.75, 1.2, 1.5, 3.7 or 7.5 W/cm(2) to 2mm thick samples of Tetric EvoFlow (Ivoclar Vivadent). The irradiances and radiant exposures received by the resin were determined using an integrating sphere connected to a fiber-optic spectrometer. The degree of conversion (DC) was recorded at a rate of 8.5 measurements a second at the bottom of the resin using attenuated total reflectance Fourier Transform mid-infrared spectroscopy (FT-MIR). Five specimens were exposed at each irradiance level. The DC reached after 170s and after 5, 10 and 15 J/cm(2) had been delivered was compared using analysis of variance and Fisher's PLSD post hoc multiple comparison tests (alpha=0.05).

RESULTS

The same DC values were not reached after the same radiant exposures of 5, 10 and 15 J/cm(2) had been delivered at an irradiance of 3.7 and 7.5 W/cm(2). Thus exposure reciprocity was not supported for Tetric EvoFlow (p<0.05).

SIGNIFICANCE

For Tetric EvoFlow, there was no significant difference in the DC when 5, 10 and 15J/cm(2) were delivered at irradiance levels of 0.75, 1.2 and 1.5 W/cm(2). The optimum combination of irradiance and exposure time for this commercial dental resin may be close to 1.5 W/cm(2) for 12s.

The influence of finishing/polishing time and cooling system on surface roughness and microhardness of two different types of composite resin restorations

Objective:

The aim of this study was to evaluate the effect of finishing time and polishing time on surface roughness and microhardness of nanofilled and hybrid resin composites.

Materials and Methods:

Hundred disk composite specimens from micro hybrid composite and nanohybrid composite were prepared, 50 for each type of composite. The specimens were divided into five groups according to the time of finishing and polishing (immediate, 15 min, 24 h and dry). Composite under the Mylar strip without finishing and polishing was taken as the control group. Surface roughness was measured with environmental scanning electronic microscope (ESEM) and microhardness was determined using Vickers Microhardness Tester. Data collected were statistically analyzed by t-test and one-way analysis of variance (ANOVA) followed by Turkey's post hoc test.

Results:

Smooth surface with low hardness was obtained for the group under Mylar strip without finishing and polishing. The highest roughness was recorded for delayed finishing and polishing for both composites. Immediate finishing and polishing increased the surface hardness more than that in the control group in both types of composites. Dry finishing reduced the hardness significantly for micro hybrid composite, but resulted in the highest surface hardness for nanofilled composite.

Conclusion:

Immediate finishing and polishing under coolant resulted in the best surface smoothness and hardness values in micro hybrid composite; however, immediate dry finishing and polishing gave the best smoothness and hardness values in nanohybrid composite.

In vitro studies on the cytotoxic potential of surface sealants

OBJECTIVE

The objective of this in vitro study was an initial screening of the cytotoxic potential of widely used smooth enamel surface sealants.

MATERIALS AND METHODS

A total of 20 products were allocated to four groups based on their chemical composition: (1) filled resin-based sealants, (2) unfilled resin-based sealants, (3) a resin-modified, glass ionomer-based sealant, and (4) silicone-based sealants. All materials were applied to human enamel slices both in accordance with manufacturers' instructions and in additional experiments applying 50% undercuring and 50% overcuring. An agar overlay assay was then used to test the specimens following ISO 10933. The cytotoxic potential of each material was interpreted based on a reaction index that summarized the decolorization and lysis scores obtained.

RESULTS

The cytotoxic potential decreased as follows: unfilled resin-based sealants > filled resin-based sealants > resin-modified, glass ionomer-based sealant > silicone-based sealants. In 75% of the resin-based products, deliberate undercuring was associated with more extensive decolorization zones, leading to higher rates of cytotoxic potential in two of those products. Overcuring, by contrast, was associated with a tendency for smaller decolorization zones in 50% of the resin-based products.

CONCLUSION

Surface sealants derived from resin monomers exhibited cytotoxic potential in the agar overlay assay. There is also evidence of a possible association with curing, as undercuring can increase the cytotoxic potential, whereas normal curing (as per manufacturers' instructions) or overcuring may help minimize such effects. More research into the biological implications of these materials is needed, especially with regard to their potential impact on the adjacent gingiva.

Effect of ionizing radiation on polymer brackets

OBJECTIVE

The purpose of this study was to investigate whether the mechanical properties of polymer brackets can be improved without discoloration by electron beam (EB) irradiation applied with a Rhodotron electron accelerator using standard high-energy parameters including a 10 MV acceleration voltage and 100 kGy of energy. We analyzed polymer samples and several commercially available brackets.

MATERIALS AND METHODS

The first group included three polymeric base materials (polyoxymethylene, polycarbonate, polyurethane) currently used in various bracket systems. The second group included five bracket types, three of which are on the market (Aesthetik-Line and Brillant by Forestadent; Envision by Ortho Organizers) while the other two were experimental brackets containing urethane dimethacrylate as a monomer matrix and functional silane-treated SiO2 fillers with a filler content of 10 or 40 vol%. Each category included 40 specimens previously irradiated by a commercial provider (Beta-Gamma-Service, Bruchsal, Germany) and another 40 nonirradiated controls. The polymer specimens were analyzed for fracture toughness, Vickers hardness, and wear resistance, and the bracket specimens for Vickers hardness and color stability. The Wilcoxon-Mann-Whitney U test was used for pairwise comparison to identify significant differences (p ≤ 0.05).

RESULTS

Significant increases in fracture toughness and Vickers hardness were observed in polycarbonate and polyurethane after EB irradiation, while EB irradiation of polyoxymethylene resulted in a significant decrease in these parameters. The polyurethane samples demonstrated significantly less postirradiation wear. All the commercially available brackets except for Brillant revealed significant increases in Vickers hardness. Significant discoloration was observed in all brackets after irradiation.

CONCLUSION

Although our evaluation of polymer brackets revealed considerable improvements in mechanical properties after EB irradiation, this benefit was marred by very obvious discoloration. We cannot therefore recommend industrial scale EB irradiation for any polymer bracket currently on the market.

Polymerization shrinkage and depth of cure of bulk-fill resin composites and highly filled flowable resin

The aim of this study was to evaluate the polymerization behavior and depth of cure (DOC) of recently introduced resin composites for posterior use: highly filled flowable composite and composites for bulk fill. A highly filled flowable (G-aenial Universal Flo [GUF]), two bulk-fill flowables (Surefil SDR Flow [SDR] and Venus Bulk fill [VBF]), and a bulk-fill nonflowable composite (Tetric N-Ceram Bulk fill [TBF]) were compared with two conventional composites (Tetric Flow [TF], Filtek Supreme Ultra [FS]). Linear polymerization shrinkage and polymerization shrinkage stress were each measured with custom-made devices. To evaluate DOC, the composite specimen was prepared using a mold with a hole of 4 mm depth and 4 mm internal diameter. The hole was bulk filled with each of the six composites and light cured for 20 seconds, followed by 24 hours of water storage. The surface hardness was measured on the top and the bottom using a Vickers microhardness (HV) indenter. The linear polymerization shrinkage of the composite specimens after photo-initiation decreased in the following order: TF and GUF > VBF > SDR > FS and TBF (p<0.05). The polymerization shrinkage stress of the six composite groups decreased in the following order: GUF > TF and VBF > SDR > FS and TBF (p<0.05). The mean bottom surface HV of SDR and VBF exceeded 80% of the top surface HV (HV-80%). However, the bottom of GUF and TBF failed to reach HV-80%. A highly filled flowable (GUF) revealed limitations in polymerization shrinkage and DOC. Bulk-fill flowables (SDR and VBF) were properly cured in 4-mm bulk, but they shrank more than the conventional nonflowable composite. A bulk-fill nonflowable (TBF) showed comparable shrinkage to the conventional nonflowable composite, but it was not sufficiently cured in the 4-mm bulk.

Light transmittance and micro-mechanical properties of bulk fill vs. conventional resin based composites

OBJECTIVES

The aim of this study was to quantify the blue light that passes through different incremental thicknesses of bulk fill in comparison to conventional resin-based composites (RBCs) and to relate it to the induced mechanical properties.

MATERIALS AND METHODS

Seven bulk fill, five nanohybrid and two flowable RBCs were analysed. Specimens (n = 5) of three incremental thicknesses (2, 4 and 6 mm) were cured from the top for 20 s, while at the bottom, a spectrometer monitored in real time the transmitted irradiance. Micro-mechanical properties (Vickers hardness, HV, and indentation modulus, E) were measured at the top and bottom after 24 h of storage in distilled water at 37 °C. Electron microscope images were taken for assessing the filler distribution and size.

RESULTS

Bulk fill RBCs (except SonicFill) were more translucent than conventional RBCs. Low-viscosity bulk fill materials showed the lowest mechanical properties. HV depends highly on the following parameters: material (ηp (2) = 0.952), incremental thickness (0.826), filler volume (0.747), filler weight (0.746) and transmitted irradiance (0.491). The bottom-to-top HV ratio (HVbt) was higher than 80 % in all materials in 2- and 4-mm increments (except for Premise), whereas in 6-mm increments, this is valid only in four bulk fill materials (Venus Bulk Fill, SDR, x-tra fil, Tetric EvoCeram Bulk Fill).

CONCLUSIONS

The depth of cure is dependent on the RBC's translucency. Low-viscosity bulk fill RBCs have lower mechanical properties than all other types of analysed materials. All bulk fill RBCs (except SonicFill) are more translucent for blue light than conventional RBCs.

SIGNIFICANCE

Although bulk fill RBCs are generally more translucent, the practitioner has to follow the manufacturer's recommendations on curing technique and maximum incremental thickness.

Post-cure depth of cure of bulk fill dental resin-composites

OBJECTIVES

To determine the post-cure depth of cure of bulk fill resin composites through using Vickers hardness profiles (VHN).

METHODS

Five bulk fill composite materials were examined: Tetric EvoCeram(®) Bulk Fill, X-tra base, Venus(®) Bulk Fill, Filtek™ Bulk Fill, SonicFill™. Three specimens of each material type were prepared in stainless steel molds which contained a slot of dimensions (15 mm × 4 mm × 2 mm), and a top plate. The molds were irradiated from one end. All specimens were stored at 37°C for 24h, before measurement. The Vickers hardness was measured as a function of depth of material, at 0.3mm intervals. Data were analysed by one-way ANOVA using Tukey post hoc tests (α=0.05).

RESULTS

The maximum VHN ranged from 37.8 to 77.4, whilst the VHN at 80% of max.VHN ranged from 30.4 to 61.9. The depth corresponding to 80% of max.VHN, ranged from 4.14 to 5.03 mm. One-way ANOVA showed statistically significant differences between materials for all parameters tested. SonicFill exhibited the highest VHN (p<0.001) while Venus Bulk Fill the lowest (p≤0.001). SonicFill and Tetric EvoCeram Bulk Fill had the greatest depth of cure (5.03 and 4.47 mm, respectively) and was significant's different from X-tra base, Venus Bulk Fill and Filtek Bulk Fill (p≤0.016). Linear regression confirmed a positive regression between max.VHN and filler loading (r(2)=0.94).

SIGNIFICANCE

Bulk fill resin composites can be cured to an acceptable post-cure depth, according to the manufacturers' claims. SonicFill and Tetric EvoCeram Bulk Fill had the greatest depth of cure among the composites examined.

Localised irradiance distribution found in dental light curing units

OBJECTIVE

To measure the localised irradiance and wavelength distributions from dental light curing units (LCUs) and establish a method to characterise their output.

METHODS

Using a laboratory grade integrating sphere spectrometer system (Labsphere and Ocean Optics) the power, irradiance, and spectral emission were measured at the light tips of four LCUs: one plasma-arc (PAC) unit, one single peak blue light-emitting diode (blue-LED) unit, and two polywave LED (poly-LED) units. A beam profiler camera (Ophir Spiricon) was used to record the localised irradiance across the face of the light tips. The irradiance-calibrated beam profile images were then divided into 45 squares, each 1mm(2). Each square contained the irradiance information received from approximately 3200 pixels. The mean irradiance value within each square was calculated, and the distribution of irradiance values among these 45 squares across the tip-ends was examined. Additionally, the spectral emission was recorded at various regions across each light tip using the integrating sphere with a 4-mm diameter entrance aperture.

RESULTS

The localised irradiance distribution was inhomogeneous in all four lights. The irradiance distribution was most uniformly distributed across the PAC tip. Both the irradiance and spectral emission from the poly-LED units were very unevenly distributed.

CONCLUSIONS

Reporting a single irradiance value or a single spectral range to describe the output from a curing light is both imprecise and inappropriate. Instead, an image of both the irradiance distribution and the distribution of the spectral emission across the light tip should be provided.

CLINICAL SIGNIFICANCE

The localised beam irradiance profile at the tip of dental LCUs is not uniform. Poly-LED units may deliver spectrally inhomogeneous irradiance profiles. Depending on the photoinitiator used in the RBC and the orientation of the LCU over the tooth, this non-uniformity may cause inadequate and inhomogeneous resin polymerisation, leading to poor physical properties, and premature failure of the restoration.

Quantification of incisal tooth wear in upper anterior teeth: conventional vs new method using toolmakers microscope and a three-dimensional measuring technique

OBJECTIVES

This study aimed to quantify tooth wear in upper anterior teeth using a new CAD-CAM Laser scanning machine, tool maker microscope and conventional tooth wear index.

METHODS

Fifty participants (25 males and 25 females, mean age = 25 ± 4 years) were assessed for incisal tooth wear of upper anterior teeth using Smith and Knight clinical tooth wear index (TWI) on two occasions, the study baseline and 1 year later. Stone dies for each tooth were prepared and scanned using the CAD-CAM Laser Cercon System. Scanned images were printed and examined under a toolmaker microscope to quantify tooth wear and then the dies were directly assessed under the microscope to measure tooth wear. The Wilcoxon Signed Ranks Test was used to analyze the data.

RESULTS

TWI scores for incisal edges were 0-3 and were similar at both occasions. Score 4 was not detected. Wear values measured by directly assessing the dies under the toolmaker microscope (range = 113 - 150 μm, mean = 130 ± 20 μm) were significantly more than those measured from Cercon Digital Machine images (range=52-80 μm, mean = 68 ± 23 μm) and both showed significant differences between the two occasions.

CONCLUSIONS

Wear progression in upper anterior teeth was effectively detected by directly measuring the dies or the images of dies under toolmaker microscope. Measuring the dies of worn dentition directly under tool maker microscope enabled detection of wear progression more accurately than measuring die images obtained with Cercon Digital Machine. Conventional method was the least sensitive for tooth wear quantification and was unable to identify wear progression in most cases.

Contemporary issues in light curing

This review article will help clinicians understand the important role of the light curing unit (LCU) in their offices. The importance of irradiance uniformity, spectral emission, monitoring the LCU, infection control methods, recommended light exposure times, and learning the correct light curing technique are reviewed. Additionally, the consequences of delivering too little or too much light energy, the concern over leachates from undercured resins, and the ocular hazards are discussed. Practical recommendations are provided to help clinicians improve their use of the LCU so that their patients can receive safe and potentially longer lasting resin restorations.

Influence of the curing mode on the degree of conversion of a dual-cured self-adhesive resin luting cement beneath ceramic

OBJECTIVE

To evaluate the effect of the delayed photoactivation and ceramic barrier on the degree of conversion (DC) of self-adhesive resin cement.

MATERIALS AND METHODS

Circular specimens (5 mm in diameter × 1 mm in thickness) of the RelyX U-100 resin cement were made using the following curing protocols (n = 10): (G1) 40 s beneath a IPS Empress II ceramic; (G2) 40 s of direct photocuring; (G3) 80 s beneath the ceramic; (G4) 80 s of direct photocuring; (G5) self-curing; (G6) 5 min in the absence of light (self-curing) followed by transceramic photocuring for 40 s; (G7) 5 min in the absence of light (self-curing) followed by transceramic photocuring for 80 s. All the specimens were photoactivated by LED (800 mW/cm(2)). After 24 h of dry storage, the DC was measured by FTIR, on the top surface of the specimens. Data were submitted to one-way ANOVA and Tukey test (p ≤ 0.05).

RESULTS

Direct photocuring with no ceramic interposition, regardless of the curing time (40 s and 80 s) promoted the highest conversion mean (56.79 ± 1.19 and 59.98 ± 2.93, respectively) and the 5 min delay time for the transceramic photocuring presented a similar mean compared to the immediate transceramic photocuring. The DC was influenced by the ceramic barrier, decreasing the conversion values (49.72 ± 1.91 for 40 s and 52.36 ± 2.50 for 80 s), with no statistical difference from the groups with the previous 5 min of photoactivation delay. The self-cure only showed the worst DC values.

CONCLUSION

Direct photocuring provided a higher degree of conversion for the self-adhesive resin cement. The delayed light activation did not influence the degree of conversion for the resin cement tested.

Terahertz time-domain spectroscopy for monitoring the curing of dental composites

We apply terahertz (THz) time-domain spectroscopy for monitoring the curing process of three different light-curing dental composites. Exact knowledge of the sample thickness is required for a precise determination of the THz dielectric parameters, as the materials exhibit shrinkage when they are cured. We find very small but significant changes of the THz refractive index and absorption coefficient during stepwise light exposure. The changes in the refractive index are correlated with changes in the density of the materials. Furthermore, the refractive index and the sample thickness are found to give the most reliable result for monitoring the curing process of the dental composites.

Resin-based composite performance: are there some things we can't predict?

OBJECTIVE

The objective of this manuscript is to address the following questions: Why do direct dental composite restorative materials fail clinically? What tests may be appropriate for predicting clinical performance? Does in vitro testing correlate with clinical performance?

METHODS

The literature relating to the clinical and laboratory performance of dental composite restorative materials was reviewed. The main reasons for failure and replacement of dental composite restorations provided the guidance for identifying specific material's properties that were likely to have the greatest impact on clinical outcomes.

RESULTS

There are few examples of studies showing correlation between laboratory tests of physical or mechanical properties and clinical performance of dental composites. Evidence does exist to relate clinical wear to flexure strength, fracture toughness and degree of conversion of the polymer matrix. There is evidence relating marginal breakdown to fracture toughness. Despite the fact that little confirmatory evidence exists, there is the expectation that clinical fracture and wear relates to resistance to fatigue. Only minimal evidence exists to correlate marginal quality and bond strength in the laboratory with clinical performance of bonded dental composites.

SIGNIFICANCE

The use of clinical trials to evaluate new dental composite formulations for their performance is expensive and time consuming, and it would be ideal to be able to predict clinical outcomes based on a single or multiple laboratory tests. However, though certain correlations exist, the overall clinical success of dental composites is multi-factorial and therefore is unlikely to be predicted accurately by even a battery of in vitro test methods.

Correlation between surface roughness and microhardness of experimental composites with varying filler concentration

AIM

The purpose of this study was to investigate the influence of the surface roughness on the surface microhardness of experimental composites with varying filler concentration.

MATERIALS AND METHODS

Experimental resin composites were formulated by mixing Bis-GMA and TEGDMA in a 50/50% weight ratio and CQ/EDAB were added to make the material photosensitive. Silanized glass particles were incorporated in the resin blend in two concentrations: C50 with 50% and C75 with 75% in weight ratio. The surface roughness and the surface microhardness measurements were determined after every three finishing procedures with #280-, #600- and #1200-grit wet sandpapers, respectively. The data were analyzed statistically by Two Way ANOVA and Tukey's test, and comparisons were conducted using the Spearman's correlation test (p > 0.05).

RESULTS

The surface roughness and surface microhardness were negatively associated (r = - 0.68) and the finishing procedures of both composites resulted in harder and smoother surfaces than the initial ones. Additionally, in a smooth circumstance, the higher content of fillers has not resulted in a composite with better microhardness and smoothness.

CONCLUSION

Finishing procedures decreased the surface roughness and consequently improved the surface microhardness of the composites evaluated.

CLINICAL SIGNIFICANCE

Finishing and polishing procedures are effectives in reducing the surface roughness amplitude of composite materials and in improving their surface microhardness. Thus a microhardness test and any hardness evaluation must be conducted only after a properly finished and polished surface is achieved.

General dental practitioners' knowledge of polymerisation of resin-based composite restorations and light curing unit technology

OBJECTIVE

Clinical successful use of resin-based composite restorations (RBCs) depends on knowledge of material and light curing unit (LCU) related factors. The purpose of this study was to evaluate general dental practitioners' knowledge of polymerisation of RBCs and LCU technology.

METHODS

Members of the Active Research Group of the Faculty of General Dental Practice (UK) in England, Scotland and Wales engaged in primary dental care were sent a letter introducing the study and asking for their cooperation, followed by an email containing a link to the online survey questionnaire, hosted on Surveymonkey.com. The questionnaire enquired about current LCUs, and asked a series of questions on material science.

RESULTS

Sixty-six percent of the 274 members contacted responded. Fifty-seven percent used LED units, 25% quartz tungsten halogen (QTH), and 1% plasma arc (missing: 17%). Thirty percent reported having access to a radiometer. Appropriate responses regarding the degree of conversion of composite and adhesive materials were given by 32% and 23% respectively, and 22% agreed that LED and QTH LCUs had comparable efficiency in polymerising composites. Thirty-three percent were aware that RBCs eluted substances that may have adverse local or systemic consequences. Fifty-eight percent stated that if polymerisation of RBC is slowed down, polymerisation stress will be lower, and 43% said that polymerisation shrinkage will be reduced if the degree of conversion is reduced. Knowledge (measured by appropriate responses to these questions) was not related to years since qualification (r=-0.05, n=168, p=0.53).

CONCLUSION

The study suggests that dentists' knowledge of curing RBC restorations and LCUs is poor. This indicates that there is a need for training and guidance in this aspect of primary dental care.

Wear model simulating clinical abrasion on composite filling materials

The aim of this study was to establish a wear model for testing composite filling materials with abrasion properties closer to a clinical situation. In addition, the model was used to evaluate the effect of filler volume and particle size on surface roughness and wear resistance. Each incisor tooth was prepared with nine identical standardized cavities with respect to depth, diameter, and angle. Generic composite of 3 different filler volumes and 3 different particle sizes held together with the same resin were randomly filled in respective cavities. A multidirectional wet-grinder with molar cusps as antagonist wore the surface of the incisors containing the composite fillings in a bath of human saliva at a constant temperature of 37°C. The present study suggests that the most wear resistant filling materials should consist of medium filling content (75%) and that particles size is not as critical as earlier reported.

Curing Efficiency of Three Different Curing Modes at Different Distances for Four Composites

Doubling the exposure time of a high-intensity light-emitting diode curing light with a turbo tip and autofocus capability does not predictably compensate for distance in deep cavities.

State-of-the-art: dental photocuring--a review

Light curing in dentistry has truly revolutionized the practice of this art and science. With the exception bonding to tooth structure, there is perhaps no single advancement that has promoted the ease, efficiency, productivity, and success of performing dentistry. Like most every major advancements in this profession, the technology underlying the successful application of light curing in dentistry did not arise from within the profession, but instead was the result of innovative adaptations in applying new advances to clinical treatment. One cannot appreciate the current status of dental photocuring without first appreciating the history and innovations of the science and industry underlying the advances from which it developed. This review will place the current status of the art within the context of its historical progression, enabling a better appreciation for the benefits and remaining issues that photocuring has brought us. Lastly, the manuscript will present thoughts for future considerations in the field, offering suggestions as to how current advances in light-generating science might yet be adapted for dental use.

The effect of curing light and chemical catalyst on the degree of conversion of two dual cured resin luting cements

The aim of this study was to evaluate the influence of different curing lights and chemical catalysts on the degree of conversion of resin luting cements. A total of 60 disk-shaped specimens of RelyX ARC or Panavia F of diameter 5 mm and thickness 0.5 mm were prepared and the respective chemical catalyst (Scotchbond Multi-Purpose Plus or ED Primer) was added. The specimens were light-cured using different curing units (an argon ion laser, an LED or a quartz-tungsten-halogen light) through shade A2 composite disks of diameter 10 mm and thickness 2 mm. After 24 h of dry storage at 37°C, the degree of conversion of the resin luting cements was measured by Fourier-transformed infrared spectroscopy. For statistical analysis, ANOVA and the Tukey test were used, with p ≤ 0.05. Panavia F when used without catalyst and cured using the LED or the argon ion laser showed degree of conversion values significantly lower than RelyX ARC, with and without catalyst, and cured with any of the light sources. Therefore, the degree of conversion of Panavia F with ED Primer cured with the quartz-tungsten-halogen light was significantly different from that of RelyX ARC regardless of the use of the chemical catalyst and light curing source. In conclusion, RelyX ARC can be cured satisfactorily with the argon ion laser, LED or quartz-tungsten-halogen light with or without a chemical catalyst. To obtain a satisfactory degree of conversion, Panavia F luting cement should be used with ED Primer and cured with halogen light.