Modulated photoactivation methods—Effect on marginal and internal gap formation of restorations using different restorative composites

Influence of Acid Etching and Universal Adhesives on the Bond Strength to Dentin

Abstract The purpose of this study was to evaluate the influence of the application mode of three universal adhesive systems on interfacial physical properties of indirect composite restorations adhesively cemented to dentin cavities. Seventy-eight bovine lower incisors were selected and a slice of dentin (thickness: 2 mm) between the buccal surface and pulp chamber was obtained for each tooth. Conical cavities were made on this surface. The internal walls of the cavities were then coated with a hydrophilic gel, filled with composite resin and photopolymerized. The dentin/cone sets were divided into 6 groups (n=10) according to type of universal adhesive (TETRI: Tetric N Bond, FUT: Futura Bond U, SBU: Single Bond Universal) and acid etching on dentin (A: with acid etching; WA: without acid etching). The acid etching and the adhesive systems were applied to the surface of the dentin. All composite resin cones were sandblasted (Al2O3, 20 s) and silanized. After surface treatment, the cones were cemented (RelyX Ultimate) into the dentin cavity and photopolymerized. After thermocycling (10,000 cycles), samples were submitted to marginal adaptation analysis (using caries detector dye), push-out test (0.5 mm/min), and failure mode analysis. Additional samples were prepared for nanoleakage analysis (SEM). The data (MPa) were analyzed by two-way ANOVA and Tukey’s post-test (5%). The groups in which the dentin was acid etched showed significantly lower bond strength values in the push-out test (p<0.01). Dentin acid etching significantly reduced the bond strength between universal adhesive systems and dentin in indirect restorative procedures.

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.

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.

Effects of curing mode and moisture on nanoindentation mechanical properties and bonding of a self-adhesive resin cement to pulp chamber floor

OBJECTIVE

This study aimed to investigate the effect of dentin surface moisture and curing mode on microtensile bond strength (MTBS) and nanoindentation characteristics of a self-adhesive resin cement.

METHODS

Forty-four extracted human molars were distributed into four groups according to dentin surface moisture (dry or wet) and curing mode of the resin cement (light or chemical). Clearfil SA Cement (Kuraray Noritake Dental, Japan) was used for cementation of composite cores to the pulp chamber dentin. The specimens were sectioned into beams for MTBS test at the pulpal floor. Nanoindentation hardness and creep of the cement layer were measured under 100 mN load with 30s hold segment. Data were statistically analyzed using two-way ANOVA and Weibull distribution of MTBS (α=0.05).

RESULTS

Moisture, curing mode or their interaction did not significantly affect mean MTBS values that ranged 17.6-22.6 MPa (p>0.05); however, the lowest characteristic strength was found in moist chemically cured group. Hardness ranged 437-512 MPa, and was not affected by the experimental factors (p>0.05). Nanoindentation creep ranged 9.3-10.9% with the chemically cured groups showing the highest values, indicating lower cross-linking and deformation resistance of their polymer network.

SIGNIFICANCE

Additional moisture on dentin surface did not contribute to adhesion of the anhydrous self-adhesive resin cement to dentin. Light-curing, despite attenuation through the composite core, was beneficial and improved nanoindentation creep resistance of the cement. The difference was not, however, reflected in the mean bond strength or hardness values.

Impact of adhesive and photoactivation method on sealant integrity and polymer network formation

We evaluated the influence of photoactivation method and hydrophobic resin (HR) application on the marginal and internal adaptation, hardness (KHN), and crosslink density (CLD) of a resin-based fissure sealant. Model fissures were created in bovine enamel fragments (n = 10) and sealed using one of the following protocols: no adhesive system + photoactivation of the sealant using continuous light (CL), no adhesive system + photoactivation of the sealant using the soft-start method (SS), HR + CL, or HR + SS. Marginal and internal gaps and KHN were assessed after storage in water for 24 h. The CLD was indirectly assessed by repeating the KHN measurement after 24 h of immersion in 100% ethanol. There was no difference among the samples with regard to marginal or internal adaptation. The KHN and CLD were similar for samples cured using either photoactivation method. Use of a hydrophobic resin prior to placement of fissure sealants and curing the sealant using the soft-start method may not provide any positive influence on integrity or crosslink density.

Influence of the LED curing source and selective enamel etching on dentin bond strength of self-etch adhesives in class I composite restorations

The aim of this study was to evaluate the influence of the LED curing unit and selective enamel etching on dentin microtensile bond strength (μTBS) for self-etch adhesives in class I composite restorations. On 96 human molars, box-shaped class I cavities were made maintaining enamel margins. Self-etch adhesives (Clearfil SE - CSE and Clearfil S(3) - S3) were used to bond a microhybrid composite. Before adhesive application, half of the teeth were enamel acid-etched and the other half was not. Adhesives and composites were cured with the following light curing units (LCUs): one polywave (UltraLume 5 - UL) and two single-peak (FlashLite 1401 - FL and Radii Cal - RD) LEDs. The specimens were then submitted to thermomechanical aging and longitudinally sectioned to obtain bonded sticks (0.9 mm(2)) to be tested in tension at 0.5 mm/min. The failure mode was then recorded. The μTBS data were submitted to a three-way ANOVA and Tukey's (α = 0.05). For S3, the selective enamel-etching provided lower μTBS values (20.7 ± 2.7) compared to the non-etched specimens (26.7 ± 2.2). UL yielded higher μTBS values (24.1 ± 3.2) in comparison to the photoactivation approach with FL (18.8 ±3.9) and RD (19.9 ±1.8) for CSE. The two-step CSE was not influenced by the enamel etching (p ≥ 0.05). Enamel acid etching in class I composite restorations affects the dentin μTBS of the one-step self-etch adhesive Clearfil S(3), with no alterations for Clearfil SE bond strength. The polywave LED promoted better bond strength for the two-step adhesive compared to the single-peak ones.

Effect of the curing method and composite volume on marginal and internal adaptation of composite restoratives

The aim of the present study was to evaluate the influence of curing methods and composite volumes on the marginal and internal adaptation of composite restoratives. Two cavities with different volumes (Lower volume: 12.6 mm(3); Higher volume: 24.5 mm(3)) were prepared on the buccal surface of 60 bovine teeth and restored using Filtek Z250 in bulk filling. For each cavity, specimens were randomly assigned into three groups according to the curing method (n=10): 1) continuous light (CL: 27 seconds at 600 mW/cm(2)); 2) soft-start (SS: 10 seconds at 150 mW/cm(2)+24 seconds at 600 mW/cm(2)); and 3) pulse delay (PD: five seconds at 150 mW/cm(2)+three minutes with no light+25 seconds at 600 mW/cm(2)). The radiant exposure for all groups was 16 J/cm(2). Marginal adaptation was measured with the dye staining gap procedure, using Caries Detector. Outer margins were stained for five seconds and the gap percentage was determined using digital images on a computer measurement program (Image Tool). Then, specimens were sectioned in slices and stained for five seconds, and the internal gaps were measured using the same method. Data were submitted to two-way analysis of variance and Tukey test (p<0.05). Composite volume had a significant influence on superficial and internal gap formation, depending on the curing method. For CL groups, restorations with higher volume showed higher marginal gap incidence than did the lower volume restorations. Additionally, the effect of the curing method depended on the volume. Regarding marginal adaptation, SS resulted in a significant reduction of gap formation, when compared to CL, for higher volume restorations. For lower volume restorations, there was no difference among the curing methods. For internal adaptation, the modulated curing methods SS and PD promoted a significant reduction of gap formation, when compared to CL, only for the lower volume restoration. Therefore, in similar conditions of the cavity configuration, the higher the volume of composite, the greater the gap formation. In addition, modulated curing methods (SS and PD) can improve the interfacial quality of composite restorations through the reduction of internal gaps in lower volume composite restoratives.

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.

Influence of the curing method on the post-polymerization shrinkage stress of a composite resin

The aim of this study was to evaluate the effect of different curing methods on the stress generated by the polymerization shrinkage of a restorative composite in two moments: immediately after light exposure and after 5 min. Photoactivation was performed using two different light sources: (1) xenon plasma arc (PAC) light (1,500 mW/cm² – 3s) and (2) a quartz-tungsten-halogen (QTH) light with three light-curing regimens: continuous exposure (40 s at 800 mW/cm² – CL); soft-start (10 s at 150 mW/cm² and 30 s at 800 mW/cm² - SS) and intermittent light [cycles of 4 s (2 s with light on at 600 mW/cm² and 2 s of light off), for 80s – IL]. The composite resin was applied between two 5-mm diameter metallic rods, mounted in a servohydraulic machine. The maximum stress was recorded immediately after light exposure (FF) and after 5 min (5F). The results were submitted to ANOVA and Tukey's test (5%). For each method, the results obtained in FF and 5F were, respectively: CL (3.58 and 4.46 MPa); SS (2.99 and 4.36 MPa); IL (3.11 and 4.32 MPa) and PAC (0.72 and 3.27 MPa). The stress generated by the polymerization shrinkage during light exposure can be associated with the photoactivation method used. A significant increase in the stress level was observed during the post-curing period up to 5 min, for all evaluated methods.

Transdental Photo-activation Technique: Hardness and Marginal Adaptation of Composite Restorations Using Different Light Sources

The association of transdental and direct photo-activation of composite restorations might improve marginal adaptation, while not being detrimental to composite hardness.