Polymerization shrinkage and polymerization shrinkage stress in polymer-based restoratives

Microleakage of Nanofilled Resin-modified Glass-ionomer/Silorane- or Methacrylate-based Composite Sandwich Class II Restoration: Effect of Simultaneous Bonding

Objectives

Microleakage of composite restorations at the cervical margin placed apically to the cementoenamel junction (CEJ) is still a concern. This study evaluated the effect of simultaneous bonding application on cervical sealing of nano-ionomer/silorane- or methacrylate-based composite open sandwich Class II restorations in the modified technique compared with that of conventional bonding.

Methods and Materials

In 60 sound maxillary premolars, two standardized Class II cavities were prepared with cervical margins 1 mm below the CEJ. The teeth were randomly divided into six groups of 10 teeth each. In the first three groups (groups 1-3), Clearfil SE Bond and Clearfil APX (Kuraray) were used for restoration in the total bonding technique (group 1), conventional open sandwich technique associated with a nano-ionomer (Ketac N100, 3M ESPE) (group 2), and modified open sandwich technique with simultaneous bonding application for both nano-ionomer and composite (group 3). In the second three groups (groups 4-6), Silorane Adhesive and Filtek Silorane composite (3M ESPE) were used in the same manner as in the first three groups, respectively.

Results

The simultaneous bonding application in the modified sandwich restorations (with SE Bond or Silorane Adhesive) resulted in a significant reduction of the cervical microleakage compared with that of the conventional bonding (p<0.05). However, microleakage of the modified technique was similar to that of the total bonding (with SE Bond or Silorane Adhesive) (p>0.05), both showing good marginal seal.

Histological evaluation to study the effects of dental amalgam and composite restoration on human dental pulp: an in vivo study

OBJECTIVE

To study and compare the effects of dental amalgam and composite restorations on human dental pulp.

MATERIALS AND METHODS

One hundred sound premolars scheduled for orthodontic extraction were divided equally into two groups: group A, teeth restored with silver amalgam, and group B, teeth restored with composite resin. Each group was equally subdivided into two subgroups [extracted after 24 h (A-1 and B-1) or 7 days (A-2 and B-2)], and the histological changes in the pulp related to the two different materials at the two different intervals were studied.

RESULTS

It was found that after 24 h, the inflammatory response of the pulp in teeth restored with amalgam and composite was similar (p = 1.00). However, after 7 days, the severity of the inflammatory response of the pulp in teeth restored with amalgam was less compared to that in teeth restored with composite (p = 0.045).

CONCLUSION

This study confirmed that amalgam continues to be the mechanically as well as biologically more competent restorative material. Composite could be a promising restorative material to satisfy esthetic needs for a considerable period of time. However, its biological acceptance is still in doubt.

Physical Property Evaluation of Four Composite Materials

Purpose

The purpose of this study was to evaluate the physical properties of current formulations of composite resins for polymerization shrinkage, surface hardness, and flexural strength. In addition, a comparison of Knoop and Vickers hardness tests was made to determine if there was a correlation in the precision between the two tests.

Materials and Methods

Four composite resin materials were used: Filtek LS (3M-ESPE), Aelite LS (Bisco), Kalore (GC America), and Empress Direct (Ivoclar). Ten samples of each composite (shade Vita A2) were used. Polymerization shrinkage was measured with the Kaman linometer using 2-mm-thick samples, cured for 40 seconds and measured with digital calipers for sample thickness. Surface microhardness samples were prepared (2-mm thick × 12-mm diameter) and sequentially polished using 600-grit silicone carbide paper, 9 μm and 1 μm diamond polishing solutions. After 24 hours of dry storage, Knoop (200 g load, 15 seconds dwell time) and Vickers (500 g load, 15 seconds dwell time) hardness tests were conducted. Flexural strength test samples (25 × 2 × 2 mm) were stored in 100% relative humidity and analyzed using a three-point bending test with an Instron Universal Testing Machine (Instron 5565, Instron Corp) applied at a crosshead speed of 0.75 ± 0.25 mm/min. Maximum load at fracture was recorded. One-way analysis of variance and Tukey multiple comparison tests were used to determine significant differences in physical properties among materials.

Results

Filtek LS had significantly lower shrinkage (0.45 [0.39] vol%). Aelite LS demonstrated the greatest Knoop surface hardness (114.55 [8.67] KHN), followed by Filtek LS, Kalore, and Empress Direct (36.59 [1.75] KHN). Vickers surface hardness was significantly greater for Aelite LS (126.88 [6.58] VH), followed by Filtek LS, Kalore, and Empress Direct (44.14 [1.02] VH). Flexural strength (MPa) was significantly higher for Aelite LS and Filtek LS (135.75 [17.35]; 129.42 [9.48]) than for Kalore and Empress Direct (86.84 [9.04]; 92.96 [9.27]). There is a strong correlation between results obtained using Knoop and Vickers hardness tests (r=0.99), although Vickers values were significantly greater for each material.

Conclusion

Results suggest that Aelite LS possesses superior hardness and flexural strength, while Filtek LS has significantly less shrinkage compared with the other composites tested.

Thermo-mechanical degradation of composite restoration photoactivated by modulated methods-a SEM study of marginal and internal gap formation

OBJECTIVE

To evaluate the influence of thermal-mechanical degradation on superficial and internal gap formation of composite restorations photoactivated using modulated methods.

MATERIALS AND METHODS

An experimental composite was prepared using a resin matrix containing 65wt% Bis-GMA and 35wt% TEGDMA. Camphorquinone (0.5wt%) and dimethylaminoethyl-methacrylate (0.5wt%) were dissolved in the resin as a photo-initiator system and 65wt.% silanized glass fillers were added to the matrix. Ground buccal surfaces of bovine lower incisors were used to make 160 preparations (3 mm × 3 mm × 2 mm in depth). An adhesive system (Adper Single Bond 2) was applied and the specimens were assigned into 16 groups (n = 10), according to the photoactivation method [high intensity (HI), low intensity (LI), soft-start (SS) and pulse-delay (PD)] and the degradation protocol [(control/no degradation; thermal cycling (TC); mechanical loading (ML); thermo-mechanical loading (TC+ML)]. Marginal and internal interfaces of bonded restorations were replicated in epoxy resin and analyzed by SEM. Gaps were expressed as a percentage of the total length of the margins. Data were submitted to 2-way ANOVA and Tukey's test (α = 0.05).

RESULTS

For the control group no significance was noted among the photoactivation methods. TC had no effect in gap formation. ML and TC+ML increased the incidence of superficial gaps for both HI and SS groups as well as increased the internal gaps for all groups.

CONCLUSION

Although photoactivation methods do not influence gap formation at first, composite restoration photoactivated by low intensity or modulated methods showed improved resistance to thermo-mechanical degradation. Mechanical loading is determinant for interfacial degradation of composite restorations, while thermal cycling has no effect on gap formation.

Properties of composite materials used for bracket bonding

The purpose of this study was to evaluate in vitro the shear bond strength to enamel, flexural strength, flexural modulus, and contraction stress of one orthodontic composite and two flowable composites. Orthodontic brackets were bonded to 45 human maxillary premolars with the composites Transbond XT, Filtek Z-350 flow and Opallis flow and tested for shear bond strength. For measurement of flexural strength and flexural modulus, specimens were fabricated and tested under flexion. For the contraction stress test, cylindrical specimens were tested and an extensometer determined the height of the specimens. The data were subjected to one-way ANOVA and Tukey's test (α=0.05). The shear bond strength values were significantly lower (p<0.05) for the flowable composites compared with the orthodontic composite. For the flexural strength, no statistically significant difference was found among the composites (p>0.05) while the flexural modulus was significantly higher (p<0.05) for Transbond XT than for Filtek Z-350 flow and Opallis flow. The orthodontic composite presented significantly lower contraction stress values than the flowable composites (p<0.05). The light-activated orthodontic composite material presented higher flexural modulus and shear bond strength and lower contraction stress than both flowable composites.

Influence of resin cement polymerization shrinkage on stresses in porcelain crowns

OBJECTIVE

The aim of this study was to analyze the influence of polymerization shrinkage of the cement layer on stresses within feldspathic ceramic crowns, using experimentally validated FEA models for (1) increasing occlusal cement thickness; and, (2) bonded versus non-bonded ceramic-cement interfaces.

METHODS

2-D axial symmetric models simulated stylized feldspathic crowns (1.5mm occlusal thickness) cemented with resin-cement layers of 50-500μm on dentin preparations, being loaded (500N) or not. Ceramic-cement interface was either bonded or not. Cement was bonded to the dentin in all models. Maximum axial shrinkage of 0%, 1%, 2%, 3%, 4% and 4.65% were simulated. The first principal stresses developing in the cementation surface at the center and at the occluso-axial line-angle of the crown were registered.

RESULTS

Polymerization shrinkage of the cement increased tensile stresses in the ceramic, especially in loaded non-bonded crowns for thicker cement layers. Stresses in loaded non-bonded crowns increased as much as 87% when cement shrinkage increased from 0% to 4.65% (100-187MPa), for a 500μm-thick cement. Increasing polymerization shrinkage strain raised the tensile stresses, especially at the internal occlusal-axial line-angle, for bonded crowns.

SIGNIFICANCE

Changes in the polymerization shrinkage strain (from 0% to 4.65%) have little effect on the tensile stresses generated at the cementation surface of the ceramic crowns, when the occlusal cement thickness is thin (approx. 50μm for bonded crowns). However, as the cement becomes thicker stresses within the ceramic become significant.

Influence of flowable composite and restorative technique on microleakage of class II restorations

AIM

The aim of the present study was to evaluate the microleakage in class II cavities restored with dental composite by varying the thickness of two flowable composite resins and the restorative technique.

METHODS

A total of 130 cavities were prepared on proximal surfaces of bovine teeth and randomly divided in 13 groups. Twelve experimental groups were performed using flowable composite resin as the liner, and they were divided according to the type of flowable composite resin (Filtek Z350 Flow-Z350F and SureFil SDR Flow-SUR), the thickness of the flowable composite (0.5, 1, or 2 mm), and the restorative technique (flowable composite applied at the cavosurface angle or amelodentinal junction) (n = 10). A control group was performed without using a flowable composite. Following restorative procedures and thermocycling, the samples were immersed in Methylene Blue for 2 h, and prepared for analysis in an absorbance spectrophotometer. All results were statistically analyzed (α = 0.05).

RESULTS

There was no significant difference between the flowable composites (P > 0.05). The restorative techniques influenced microleakage and were flowable composite dependent (P ≤ 0.05). The lower thickness of the flowable composite provided less microleakage (P ≤ 0.05).

CONCLUSION

The use a lower thickness of a flowable composite resin provided less microleakage, suggesting a better sealing tooth-restoration interface.

Synthesis of glycerol-derived diallyl spiroorthocarbonates and the study of their antishrinking properties in acrylic dental resins

In this work was evaluated the efficiency of an antishrinkage additive in a dental resin. This additive was a mixture 1:1 of five and six-membered ring spiroorthocarbonates functionalized with allylic groups (SOC DA). The aim of this study was to reduce the shrinkage of a typical dental resin composed of a blend of the dimethacrylates, Glycerolate bisphenol A dimethacrylate (Bis-GMA)/2-[(3,5,5-trimethyl-6-[2-(2-methyl prop-2-enoyloxy) ethoxycarbonylamino] hexyl) carbamoyloxy] ethyl, 2-methyl prop-2-enoate, (UDMA)/triethyleneglycol dimethacrylate (TEGDMA) in a 50:30.20 molar ratio, and silicon dioxide as filler. SOC DA was added at 5, 10 and 20 mol% to the already mentioned formulation. It was found that the addition of 20 mol% of SOC DA decreased 53 % the shrinkage of the cured composite material, in comparison with a formulation where it was not added the antishrinkage additive. Besides, the kinetics of photopolymerization determined by Real-Time infrared spectroscopy, demonstrated that the addition of increasing concentration of SOC DA improved the conversion of double bonds of dimethacrylates. Additionally, the presence of SOC DA at 10 % mol, helped to increase the flexural strength and the compressive strength of the composite, as a consequence of the augment of the crosslink density, induced by the ring opening polymerization of SOC DA.

Influence of fiber inserts, type of composite, and gingival margin location on the microleakage in Class II resin composite restorations

This study evaluated the influence of fiber inserts, type of composites, and location of the gingival seat on microleakage in Class II resin composite restorations. Fifty noncarious human third molars were selected for the study. Standardized Class II box type cavities were prepared on the mesial and distal side of 45 teeth. The gingival margin was placed above the cementoenamel junction (CEJ) on the mesial side and below the CEJ on the distal side. The remaining five teeth received no cavity preparations. The prepared samples were divided randomly on the basis of type of composite and presence or absence of fiber inserts, into four experimental groups of 10 teeth each and two control groups of five teeth each. The groups were defined as follows: group I (n=10) - Z350 XT; group II (n=10) - Z350 XT with fibers; group III (n=10) - P90; group IV (n=10) - P90 with fibers; and group V (n=5) - positive controls, cavities were not restored; group VI (n=5) - negative controls, no cavities were prepared. The samples were stored in distilled water in incubator at 37°C for 24 hours and then subjected to 500 cycles of thermocycling (5°C and 55°C) with a dwell time of 15 seconds. They were then placed in a 2% methylene blue dye solution for 24 hours at 37°C. Samples were sectioned longitudinally and evaluated for microleakage at the occlusal and gingival margin under a stereomicroscope at 20× magnification. Kruskal-Wallis and Mann-Whitney U-tests were used to compare the mean leakage scores. Restorations with gingival margins in enamel showed significantly less microleakage. Significant reduction in microleakage was observed in groups restored with P90 composite than those restored with Z350 XT. No improvement in microleakage was observed with the use of fiber inserts (p>0.05).

Post-curing conversion kinetics as functions of the irradiation time and increment thickness

Objective:

This study evaluated the variation of conversion degree (DC) in the 12 hours following initial photoactivation of a low-shrinkage composite resin (Venus Diamond).

Material and Methods:

The conversion degree was monitored for 12 hours using Attenuated Total Reflection (ATR) F-TIR Spectroscopy. The composite was placed in 1 or 2 mm rings and cured for 10 or 20 seconds with a LED lamp. ATR spectra were acquired from the bottom surface of each sample immediately after the initial photoactivation (P=0), 30 minutes (P=0.5) and 12 hours after photoactivation (P=12) in order to obtain the DC progression during the post-curing period. Interactions between thickness (T), irradiation time (I) and post-curing (P) on the DC were calculated through ANOVA testing.

Results:

All the first order interactions were statistically significant, with the exception of the T-P interaction. Furthermore, the shift from P=0 to P=0.5 had a statistically higher influence than the shift from P=0.5 to P=12. The post-curing period played a fundamental role in reaching higher DC values with the low-shrinkage composite resin tested in this study. Moreover, both the irradiation time and the composite thickness strongly influenced the DC.

Conclusions:

Increased irradiation time may be useful in obtaining a high conversion degree (DC) with a low-shrinkage nano-hybrid composite resin, particularly with 2 mm composite layers.

Five-year retrospective clinical study of indirect composite restorations luted with a light-cured composite in posterior teeth

OBJECTIVES

The purpose of this study was to evaluate the clinical performance of indirect composite onlays-overlays bonded with a light-cured composite on vital molars.

MATERIALS AND METHODS

Forty-one patients were restored with 79 indirect composite restorations. The restorations were studied for an observation time of 5 years. Marginal adaptation, marginal discolouration, secondary caries, colour match and anatomic form were clinically examined following modified United States Public Health Service criteria. Each restoration was also examined for fractures and debonding. Endodontic complications were registered. Survival rate, based just on failures that required a replacement, and success rate that included also failures that required a repair intervention were statistically determined using a restoration and a patient-related analysis.

RESULTS

After 5 years, using each restoration as a statistical unit, the survival rate was 91.1% and the success rate 84.8%, with a high Kaplan-Meier estimated success probability of 0.852. Using the patient as the statistical unit, the survival rate was 90.2% and the success rate 85.4%, corresponding to a Kaplan-Meier estimated success probability of 0.857. On the basis of the criteria used, most of the restorations rated Alpha. Regarding marginal adaptation and marginal discolouration, 5 and 10.1% of the restorations, respectively, revealed Bravo ratings

CONCLUSIONS

Indirect composite restorations offer a predictable and successful treatment modality giving an optimal preservation of sound tooth tissue.

CLINICAL RELEVANCE

The preparation, cementation and finishing procedures are considered key factors for the long-term success of the indirect composite restorations.

Effect of light polymerization time, mode, and thermal and mechanical load cycling on microleakage in resin composite restorations

This study evaluated the effect of polymerization mode and time and thermal and mechanical loading cycling (TMC) on microleakage in composite resin restorations. One hundred and eighty cavities were prepared and randomly divided according to the light curing time (20, 40, or 60 s), modes (quartz-tungsten-halogen (QTH)-420 mW/cm(2), LED 2 (2nd degree generation)-1,100 mW/cm(2), or LED 3 (3rd degree generation)-700 mW/cm(2)), and TMC. Following standard restorative procedures, the samples were prepared for analysis in an absorbance spectrophotometer. All results were statistically analyzed using the three-way ANOVA and Tukey test (p ≤ 0.05). The results revealed that the groups QTH and LED 3 submitted to TMC showed higher microleakage than those that were not submitted to TMC. Only for LED 3, 60 s showed higher microleakage than 20 s. For LED 2 and QTH, there were no differences between the times. QTH showed lower microleakage means than LED 2, when photoactivated for 20 s, without TMC. When photoactivated for 60 s, QTH showed lower microleakage means than LED 3, for the groups with or without TMC. It was concluded that TMC, the increase in polymerization time, and the irradiance were factors that may increase the marginal microleakage of class II cavities.

Effect of energy density on low-shrinkage composite resins: diode-pumped solid state laser versus quartz-tungsten-halogen light-curing unit

OBJECTIVE

The purpose of the present study was to evaluate the effect of energy density on the polymerization of low-shrinkage composite resins.

BACKGROUND DATA

The number of photons needs to initiate the polymerization process can be controlled by light intensity and curing time through the form of energy density.

MATERIALS AND METHODS

For the study, two methacrylate-based (Premise [PR] and Venus Diamond [VE]) and one silorane-based (Filtek LS [LS]) composite resins were light cured using a quartz-tungsten-halogen (QTH) light-curing unit (LCU) and a 473 nm diode-pumped solid state (DPSS) laser. Degree of conversion (DC), microhardness, refractive index, and polymerization shrinkage were evaluated under different energy densities. Through the study, the feasibility of DPSS laser as a light source was tested as well.

RESULTS

LS showed the highest DC and refractive index both on the top and bottom surfaces, and the least polymerization shrinkage among the tested specimens. For the same or similar energy density, QTH and DPSS showed insignificant DC difference (p>0.05). On the other hand, for microhardness, except for one case at the bottom surface, QTH and DPSS showed significant difference (p<0.001). DPSS generated slightly lower polymerization shrinkage than that by QTH.

CONCLUSIONS

DC, microhardness, refractive index, and polymerization shrinkage were linearly correlated with energy density. In most cases, there was a strong linear correlation among DC, mirohardness, and refractive index. The DPSS laser of 473 nm could polymerize low-shrinkage composite resins to the level that was achieved by the conventional QTH unit.

Water sorption, solubility, and resultant change in strength among three resin-based dental composites

OBJECTIVE

To determine the water sorption, solubility, and resultant change in strength of one microhybrid and two nanofilled resin-based composites (RBCs).

METHODS

Water sorption, solubility, and three-point bending strength (TPBS) characteristics of a microhybrid RBC Filtek(™) Z250 (Z250; batch 8MA; shade A3) and two nanofilled RBCs, namely Filtek(™) Supreme XT "body" (FSB; batch 8NU; shade A3) and "translucent" shades (FST; batch 6C; shade YT) (3M ESPE Dental Products, St Paul, MN, USA) were investigated following 1 and 13 weeks storage regimes.

RESULTS

FSB displayed a significant increase in water sorption compared with Z250 and FST (P < 0.001), however, the latter demonstrated no significant difference between them following 1 week and 13 weeks immersion periods (P > 0.001). Following the 13-week immersion period, FSB showed greater water solubility compared with Z250 and FST (P < 0.001). FSB exhibited greater TPBS compared with FST in dry control specimens (P < 0.05), but no significant difference among TPBS of all RBCs was identified following the 1-week immersion period (P = 0.290). The TPBS of FSB decreased significantly compared with Z250 and FST following the 13-week immersion period (P < 0.001).

CONCLUSION

Since the FSB exhibited greater water sorption, solubility, and resulting strength degradation compared with Z250 and FST, a poor clinical performance may be expected.

Effect of a DPSS laser on the shear bond strength of ceramic brackets with different base designs

This study evaluated the shear bond strength (SBS) and adhesive remnant index (ARI) of ceramic brackets with different base designs using a 473-nm diode-pumped solid-state (DPSS) laser to test its usefulness as a light source. A total of 180 caries-free human premolars were divided into four groups according to the base designs: microcrystalline, crystalline particle (CP), dovetail, and mesh. For each base design, teeth were divided into three different subgroups for light curing using three different light-curing units (LCUs) (quartz-tungsten-halogen unit, light-emitting diode unit, and a DPSS laser of 473 nm). Applied light intensities for the DPSS laser and the other LCUs were approximately 630 and 900 mW/cm(2), respectively. Stainless steel brackets with a mesh design served as controls. The failure modes of debonded brackets were scored using ARI. As a result, brackets bonded using the DPSS laser had the highest SBS values (16.5-27.3 MPa) among the LCUs regardless of base design. Regarding base designs, the CP groups showed the highest SBS values (22.9-27.3 MPa) regardless of LCU. Furthermore, stainless steel brackets with a mesh design had the lowest SBS values regardless of LCU. In many cases, brackets bonded using the DPSS laser had higher ARI scores and had more adhesive on their bases than on tooth surfaces. The study shows that the 473-nm DPSS laser has considerable potential for bonding ceramic brackets at lower light intensities than the other light-curing units examined.

Influence of resin-based composite restoration technique and endodontic access on cuspal deflection and cervical microleakage scores

OBJECTIVES

To assess cuspal deflection and cervical microleakage of mesio-occlusal-distal cavities in standardised premolar teeth restored incrementally with resin-based composite (RBC) placed horizontally or obliquely and with endodontic access cavities (with and without gutta percha and epoxy resin sealer obturation).

MATERIALS AND METHODS

Thirty-two teeth were allocated to four groups (n=8) and RBC restored in eight horizontal (Group A) or oblique increments (Groups B-D) using a quartz-tungsten-halogen light curing unit. The dependent variable for Groups B-D was endodontic access (none (Group B), obturated without (Group C) and with gutta percha and epoxy resin sealer (Group D)). Cuspal deflections were recorded post-irradiation using a twin channel deflection measuring gauge. Following restoration, the teeth were thermocycled, immersed in fuchsin dye, sectioned and examined for cervical microleakage.

RESULTS

Tukey's post hoc tests identified a significant decrease in total cuspal deflection for the horizontal (p=0.015) compared with the oblique placement technique. No significant difference in total cuspal deflection was evident between Groups B and D restored teeth (p>0.318) or in cervical microleakage score between Groups A and D (p=0.575).

SIGNIFICANCE

Deformation is proportional to the cubed power of the length of a uniform cantilever beam and although a crude approximation of cuspal deformation, the reduction in the effective cusp length therefore significantly reduced the deflection in the MOD cavities when the horizontal rather than the oblique incremental restoration technique was employed.

Bonding and sealing ability of a new self-adhering flowable composite resin in class I restorations

OBJECTIVES

The aim of this study is to assess by means of shear bond strength tests (SBS), microleakage analysis (μLKG), and scanning electron microscopy (SEM) the bonding potential and sealing ability of a new self-adhering composite resin.

MATERIALS AND METHODS

SBS and μLKG of Vertise Flow (VF, Kerr) were measured and compared to the all-in-one adhesive systems G-Bond (GB, GC), AdheSE One (AO, Ivoclar Vivadent), Adper Easy Bond (EB, 3M ESPE), Xeno V (XV, Dentsply), and iBOND (iB, Heraeus Kulzer). For each system, 20 molars were tested for SBS on dentin (n = 10) and enamel (n = 10). For μLKG assessment, 12 premolars per group were selected and small, box-shaped cavities were made. After restoration, the teeth were immersed in 50 wt% silver nitrate solution for 24 h. For each group, 10 randomly selected specimens were processed for leakage calculations, while two of the specimens were examined under SEM. Between-group differences in SBS to dentin and μLKG were assessed using Kruskal-Wallis analysis of variance followed by the Dunn's Multiple Range test. Enamel SBS data were analyzed with one-way ANOVA, followed by the Tukey test.

RESULTS

On dentin and enamel, VF recorded the lowest SBS values that were statistically comparable to those measured by GB, iB, and AO. μLKG analysis showed the lowest percentage of stained interface for VF. Significantly greater extent of infiltration was seen for iB and EB.

CONCLUSIONS

Although VF resulted in lower bond strengths values on either dental substrate, better marginal sealing ability was visualized in comparison with all-in-one adhesive systems.

CLINICAL RELEVANCE

The results of the present study demonstrated satisfactory in vitro outcome of the self-adhering flowable composite resin VF when used to restore class I cavities.

Effect of water temperature on the fit of provisional crown margins during polymerization: An in vitro study

AIM

To evaluate the effect of water temperature on the marginal fit of bis-acrylic composite provisional crown during resin polymerization.

MATERIALS AND METHODS

Precisely machined 10 brass master dies were designed to simulate molar teeth. Five brass dies were selected and precisely machined to simulate all ceramic crown preparation. An acrylic jaw replica was made in which brass dies were arranged equidistant from each other. A custom-made metallic tray was fabricated on the acrylic jaw replica to make polyvinyl siloxane impression matrix. Bis-acrylic composite resin provisional crowns were made using polyvinyl siloxane impression matrix. Provisional crowns were polymerized at room temperature (Group I direct technique, on dental stone cast; Group I indirect technique crowns) and at different water temperatures (Group II direct technique crowns). The vertical marginal gap between all the provisional crown margins and the finish line of brass dies was measured using a Research Stereomicroscope System.

RESULTS

The results were statistically analyzed using one-way analysis of variance (ANOVA) test and Newman-Keul's test. The results showed that crowns polymerized in 20°C and 30°C water had marginal gap approximately three times smaller than those polymerized in 30°C air, due to the reduced polymerization shrinkage.

CONCLUSION

This study shows that crowns polymerized in 20°C and 30°C water had mean vertical marginal gap approximately three times smaller than those polymerized in 30°C air. It was approximately closer to that of crowns fabricated by indirect technique. Warmer water also supposedly hastens polymerization.

Fiber post placement with core build-up materials or resin cements-an evaluation of different adhesive approaches

OBJECTIVE

To compare push-out bond strength of fiber-posts luted with different adhesive approaches to root canal dentin.

MATERIALS AND METHODS

Forty maxillary first incisors were decoronated and endodontically treated. Specimens were randomly distributed into five groups (n = 8) and fiber-posts (DentinPost coated, Komet) were inserted using five different luting materials: etch-and-rinse adhesive systems and corresponding core-and-post material in groups 1 (DentinBond/DentinBuild, Komet) and 2 (XP Bond + SCA/Core-X flow, Densply), self-adhesive resin cements in groups 3 (RelyX Unicem, 3M Espe) and 4 (SmartCem 2, Dentsply) and a self-etch adhesive/resin cement in group 5 (ED-Primer II/Panavia F 2.0, Kuraray). The roots were sectioned into eight 1 mm thick serial slices and within 48 h push-out bond strength was investigated. Statistical analyses were performed using non-parametrical Kruskal-Wallis H-test and Mann-Whitney U-test for differences between experimental groups at p < 0.05. The failure modes were analyzed using Chi square test.

RESULTS

The bond strength [MPa] (mean/min-max) for groups 3 (12.35/3.60-32.44), 4 (13.52/4.48-30.69) and 2 (11.15/5.23-35.58) were significantly higher (p < 0.001) compared to groups 1 (6.66/2.34-24.89) and 5 (7.41/0.28-34.18). Adhesive failure between dentin and luting agent was the most frequent failure mode.

CONCLUSIONS

Bond strength of fiber-posts adhesively luted to root canal dentin was significantly higher when self-adhesive resin cements were used. One (group 2) of the tested core-and-post materials/etch-and-rinse adhesive achieved comparable bond strength values.

Advances in light-curing units: four generations of LED lights and clinical implications for optimizing their use: Part 2. From present to future

The first part of this series of two described the history of light curing in dentistry and developments in LED lights since their introduction over 20 years ago. Current second- and third-generation LED light units have progressively replaced their halogen lamp predecessors because of their inherent advantages. The background to this, together with the clinical issues relating to light curing and the possible solutions, are outlined in the second part of this article. Finally, the innovative features of what may be seen as the first of a new fourth-generation of LED lights are described and guidance is given for the practitioner on what factors to consider when seeking to purchase a new LED light activation unit.

CLINICAL RELEVANCE

Adequate curing in depth is fundamental to clinical success with any light-activated restoration. To achieve this goal predictably, an appropriate light source needs to be combined with materials knowledge, requisite clinical skills and attention to detail throughout the entire restoration process. As dentists increasingly use light-cured direct composites to restore large posterior restorations they need to appreciate the issues central to effective and efficient light curing and to know what to look for when seeking to purchase a new light-curing unit.

Using hyperbranched oligomer functionalized glass fillers to reduce shrinkage stress

OBJECTIVE

Fillers are widely utilized to enhance the mechanical properties of polymer resins. However, polymerization stress has the potential to increase due to the higher elastic modulus achieved upon filler addition. Here, we demonstrate a hyperbranched oligomer functionalized glass filler UV curable resin composite which is able to reduce the shrinkage stress without sacrificing mechanical properties.

METHODS

A 16-functional alkene-terminated hyperbranched oligomer is synthesized by thiol-acrylate and thiol-yne reactions and the product structure is analyzed by (1)H NMR, mass spectroscopy, and gel permeation chromatography. Surface functionalization of the glass filler is measured by thermogravimetric analysis. Reaction kinetics, mechanical properties and shrinkage stress are studied via Fourier transform infrared spectroscopy, dynamic mechanical analysis and a tensometer, respectively.

RESULTS

Silica nanoparticles are functionalized with a flexible 16-functional alkene-terminated hyperbranched oligomer which is synthesized by multistage thiol-ene/yne reactions. 93% of the particle surface was covered by this oligomer and an interfacial layer ranging from 0.7 nm to 4.5 nm thickness is generated. A composite system with these functionalized silica nanoparticles incorporated into the thiol-yne-methacrylate resin demonstrates 30% reduction of shrinkage stress (from 0.9 MPa to 0.6 MPa) without sacrificing the modulus (3100 ± 300 MPa) or glass transition temperature (62 ± 3°C). Moreover, the shrinkage stress of the composite system builds up at much later stages of the polymerization as compared to the control system.

SIGNIFICANCE

Due to the capability of reducing shrinkage stress without sacrificing mechanical properties, this composite system will be a great candidate for dental composite applications.

Cervical Margin Integrity of Class II Resin Composite Restorations in Laser- and Bur-Prepared Cavities Using Three Different Adhesive Systems

One of the challenges in durability of posterior tooth-colored restorative materials is polymerization shrinkage, which results in gap formation between the restoration and tooth structure. The aim of the present study was to investigate marginal adaptation of Class II composite restorations using a self-etching and two etch-and-rinse adhesive systems in cavities prepared either with bur or Er,Cr:YSGG laser. A total of 45 extracted sound human premolars were selected. In each tooth, mesial and distal Class II cavities were prepared either by a diamond bur or by Er,Cr:YSGG laser with the margins 1 mm apical to the cemento-enamel junction. Then the teeth were randomly divided into three groups of 15 each, according to the type of the adhesive system used (Single Bond, Single Bond 2, and Adper Easy One adhesive systems). Subsequent to restoring the teeth, the specimens were subjected to thermal cycling between 5 ± 2°C and 55 ± 2°C for 500 cycles and were then cut longitudinally into two halves using a diamond disk. Marginal adaptation was evaluated using a stereomicroscope, and the values for gap widths were obtained in micrometers. Data were analyzed using two-factor analysis of variance and post hoc tests. There were statistically significant differences in mean marginal gap widths between the adhesive type and preparation groups (p&lt;0.05). The interfacial gap width in bur-prepared cavities was significantly less than that in laser-prepared cavities, and the lowest gap width was observed in Adper Easy One regardless of the type of the preparation.

Influence of polymerization mode and C-factor on cohesive strength of dual-cured resin cements

OBJECTIVES

The aim of this study is to determine the influence of the C-factor and the mode of polymerization on the cohesive strength of various dual-cure resin cements.

METHODS

Three curing conditions were tested; chemical curing with free shrinkage conditions (C=0), and constraint shrinkage conditions (C=25), and dual-curing with free shrinkage conditions (C=0). Opaque polyethylene, brass (pretreated with Clearfil SE bond), and transparent polyethylene tubes respectively, were filled with the different cements. The tubes were 20mm long with an inner diameter of 1.6 or 1.8mm. Five cements, DC Core Automix, Panavia F 2.0, Maxcem, Multilink, and RelyX Unicem, were tested with ten specimens per group. The specimens were trimmed to an hour-glass shape with a neck diameter of 1mm, stored in water (37°C, 24h), and subjected to microtensile testing (1mmmin(-1)). SEM analysis was carried out on chemically cured samples of DC Core Automix C=0 and C=25. Data were statistically analyzed (Two-way ANOVA, Tukey's post hoc test, p<0.05).

RESULTS

Most cements showed no significant differences between the curing modes. A high C-factor negatively influences the cohesive strength of some cements. SEM analysis shows that chemical curing of DC Core Automix in a high C-factor environment leads to more and larger microvoids in the cement.

SIGNIFICANCE

Constraint shrinkage conditions, i.e. a high C-factor, can negatively influence the physical properties of a dual-cured resin cement, which would clinically be the case in the confined space of a root canal or post space preparation.

Effect of resin-composite filler particle size and shape on shrinkage-stress

OBJECTIVES

The aim of this study was to investigate the effect of variations in filler particle size and shape on the polymerization shrinkage-stress kinetics of resin-composites.

METHODS

A model series of 12 VLC resin-composites were studied. The particulate dispersed phase volume fraction was 56.7%: these filler particles were systematically graded in size, and further were either spherical or irregular. A Bioman instrument (cantilever beam method) was employed to determine the shrinkage-stress kinetics following 40s irradiation (600 mW/cm(2)) at 23°C (n=3). All data were captured for 60 min and the final shrinkage-stress calculated.

RESULTS

Shrinkage-stress varied between 3.86 MPa (SD 0.14) for S3 (spherical filler particles of 500 nm) and 8.44 MPa (SD 0.41) for I1 (irregular filler particles of 450 nm). The shrinkage-stress values were generally lower for those composites with spherical filler particles than those with irregular filler particles. The differences in shrinkage-stress with filler particle size and shape were statistically significant (p<0.001).

SIGNIFICANCE

Composites with spherical filler particles exhibit lower shrinkage-stress values compared to those with irregular filler particles. Shrinkage-stress and shrinkage-stress rate vary in a complex manner with variations in the size of the dispersed phase particles: a hypothesized explanation for the effect of filler particle size and shape is presented.

Reparability of Aged Silorane With Methacrylate-Based Resin Composite: Micro-Shear Bond Strength and Scanning Electron Microscopy Evaluation

Aged silorane composite restorations can be repaired with a methacrylate-based resin composite by using a phosphate-methacrylate–based adhesive as the intermediate layer.

Effect of conventional and resin-modified glass-ionomer liner on dentin adhesive interface of Class I cavity walls after thermocycling

OBJECTIVE

The aim of this in vitro study was to analyze the effect of glass-ionomer cement as a liner on the dentin/resin adhesive interface of lateral walls of occlusal restorations after thermocycling.

MATERIALS AND METHODS

Occlusal cavities were prepared in 60 human molars, divided into six groups: no liner (1 and 4); glass-ionomer cement (GIC, Ketac Molar Easymix, 3M ESPE) (2 and 5); and resin-modified glass-ionomer cement (RMGIC, Vitrebond, 3M ESPE) (3 and 6). Resin composite (Filtek Z250, 3M ESPE) was placed after application of an adhesive system (Adper Single Bond 2, 3M ESPE) that was mixed with a fluorescent reagent (Rhodamine B) to allow confocal microscopy analysis. Specimens of groups 4, 5 and 6 were thermocycled (5°C-55°C) with a dwell time of 30 seconds for 5000 cycles. After this period, teeth were sectioned in approximately 0.8-mm slices. One slice of each tooth was randomly selected for confocal microscopy analysis. The other slices were sectioned into 0.8 mm × 0.8 mm beams, which were submitted to microtensile testing (MPa). Data were analyzed using two-way ANOVA and Tukey test (p<0.05).

RESULTS

There was no detectedstatistical difference on bond strength among groups (α<0.05). Confocal microscopy analysis showed a higher mean gap size in group 4 (12.5 μm) and a higher percentage of marginal gaps in the thermocycled groups. The RMGIC liner groups showed the lowest percentage of marginal gaps.

CONCLUSIONS

Lining with RMGIC resulted in less gap formation at the dentin/resin adhesive interface after artificial aging. RMGIC or GIC liners did not alter the microtensile bond strength of adhesive system/resin composite to dentin on the lateral walls of Class I restorations.