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

Properties of model E-glass fiber composites with varying matrix monomer ratios

OBJECTIVE

To evaluate properties of fiber-reinforced-composites (FRC) containing Bis-EMA/UDMA monomers but identical dispersed phase (60% wt BaSi glass power +10% wt E-glass fibre).

METHODS

A control (Group A), monomer mixture comprising 60% Bis-GMA, 30% TEGDMA, and 10% PMMA (typical FRC monomers) was used. The following monomer mass fractions were mixed: 50% bis-GMA plus 50% of different ratios of Bis-EMA+UDMA to produce consistent formulations (Groups B-E) of workable viscosities was also studied. Flexural strength (FS), fracture toughness (KIC), water sorption (SP), solubility (SL) and hygroscopic expansion (HE) were measured. FS and KIC specimens were stored for 1, 7 d, and 30 d in water at 37 °C. SP/SL specimens were water-immersed for 168d, weighed at intervals, then dried for 84 d at 37 °C. To analyze differences in FS, and KIC, a two-way ANOVA and Tukey post-hoc tests (α = 0.05) were conducted. For SP/SL, and HE, one-way ANOVA with subsequent Tukey post-hoc tests (α = 0.05) were utilized.

RESULTS

FS and KIC for groups A, D, E decreased progressively after 1 d. Groups B and C (highest amounts of Bis-EMA) did not decrease significantly. The modified matrix composites performed significantly better than the control group for SP and HE. The control group outperformed the experimental composites only for SL with up to 250% higher SL for group E (6.9 μg/mm) but still below the maximum permissible threshold of 7.5 μg/mm.

SIGNIFICANCE

EXPERIMENTAL: composites with highest amounts of Bis-EMA showed improved hydrolytic stability and overall enhancement in several clinically-relevant properties. This makes them potential candidates for alternative matrices to a semi-interpenetrating network in fiber-reinforced composites.

Investigation of aging resistance for dental resin composites with and without glass flakes

OBJECTIVES

Outstanding physical-mechanical properties and aging resistance are key requirements for dental resin composite since it will be placed in the oral environment for a long time. In this work, a new dental resin composite mainly modified by glass flakes was fabricated, and the aging resistance was evaluated by comparing with commercial composites without glass flakes.

MATERIALS AND METHODS

The new dental resin composite was produced through hand blending of inorganic glass flakes/Si-Al-borosilicate glass (58wt%:7wt% of dental resin composite), POSS-MA (5wt% of resin matrix), Bis-GMA/TEGDMA(64.4wt%:27.6wt% of resin matrix), and CQ/EDMAB (0.9wt%:2.1wt% of resin matrix) together. The flexural strength, elasticity modulus, and hardness, as well as wear were tested for evaluating the aging resistance of different dental resin composite.

RESULTS

Among 6 kinds of commercial composites in this study, after 6-month water storage, the maximum percentage of performance degradation is that the flexural strength decreased 39.96%, elasticity modulus decreased 51.53% and hardness decreased 12.52%. In contrast, the new synthesized material decreased 14.53%, 20.88%, and 0.61%, respectively, and performed lesser wear depth compared to some other groups (P < 0.05).

CONCLUSIONS

It was observed that the new dental resin composite performed better performance stability and wear resistance when compared with commercial dimethacrylate-based or low shrinkage dental resin composite tested in this study.

CLINICAL RELEVANCE

This possibly paves a path for designing tailored dental composite for practical application. Since the aging resistance of dental resin composite modified by glass flakes is superior, it has the potential to be used for promoting the durability of dental resin composite.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

SIGNIFICANCE

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

Time-lapse submicrometer particle motion reveals residual strain evolution and damaging stress relaxation in clinical resin composites sealing human root canals

Polymer based composites are widely used for treatment, for example as biofilm resistant seals of root canal fillings. Such clinical use, however, fails more frequently than other dental composite restorations, due to stress-related misfits. The reason for this is that the biomaterials used are inserted as viscous masses that may bond to the substrate, yet shrinkage stresses arising during setting of the cross-linking polymer, work against durable adhesion. Here we combine phase contrast enhanced time-lapse radiography (radioscopy), digital image correlation (DIC) and submicrometer resolution phase-contrast enhanced microtomography (PCE-CT), to reveal the spatial and temporal dynamics of composite polymerization and strain evolution. Radioscopy of cavities located in the upper part of human root canals demonstrates how the composite post-gelation "densification" is dominated by viscous flow with quantifiable motion of both particles and entrapped voids. Thereafter, these composites enter a "stress-relaxation" stage and exhibit several structural adaptations, induced by residual shrinkage stresses. Consequently critical alterations to the final biomaterial geometry emerge: (i) entrapped bubbles expand; (ii) microscopic root filling pull-out occurs; (iii) the cavity walls deform inwards, and (iv) occasionally delamination ensues, propagating out from the root canal filling along buried restoration-substrate interfaces. Our findings shed new light on the interactions between confined spaces and biomedical composites that cross-link in situ, highlighting the crucial role of geometry in channeling residual stresses. They further provide new insights into the emergence of structural flaws, calling attention to the need to find new treatment options. STATEMENT OF SIGNIFICANCE: This work quantifies recurring spatial and temporal material redistribution in composites used clinically to fill internal spaces in teeth. This knowledge is important for both promoting biomaterial resistance against potentially pathologic biofilms and for improving structural capacity to endure years of mechanical function. Our study demonstrates the significant role of geometry and the need for improved control over stress raisers to develop better treatment protocols and new space filling materials. The use of high-brilliance X-rays for time-lapse imaging at submicrometer resolution provides dynamic information about the damaging effects of stress relaxation due to polymerization shrinkage.

Comparison of physical and biological properties of a flowable fiber reinforced and bulk filling composites

OBJECTIVE

To evaluate in vitro the mechanical, biological, and polymerization behavior of a flowable bulk-fill composite with fibers as a dispersed phase.

METHODS

EverX Flow™ (GC Corporation) (EXF), one conventional bulk-fill composite (Filtek™ Bulk Fill Posterior Restorative, 3 M (FBF)), and one flowable bulk composite without fibers (SDR® flow+, Dentsply (SDR)) were tested. Samples were characterized in terms of flexural strength (ISO 4049), fracture toughness (ISO 20795-1), and Vickers hardness. Polymerization stress and volumetric shrinkage were evaluated. The in vitro biological assessment was achieved on cultured primary Human Gingival Fibroblast cells (HGF). The cell metabolic activity was evaluated using Alamar Blue assay at 1, 3, and 5 days of contact to the 3 tested composite extracts (ISO 10993) and cell morphology was evaluated by confocal microscopy. Data were submitted to One-Way analysis of variance (ANOVA) and independent t-test (α = 0.05).

RESULTS

FBF showed statistically higher Vickers hardness and flexural modulus than EXF and SDR. However, EXF showed statistically higher K_IC than FBF and SDR. EXF had the statistically highest shrinkage stress values and FBF the lowest. Archimedes volumetric shrinkage showed significantly lower values for FBF as compared to the other two composites. Slight cytotoxic effect was observed for the three composites at day one. An enhancement of metabolic activity at day 5 was observed in cells treated with EXF extracts.

SIGNIFICANCE

EXF had a significantly higher fracture toughness validating its potential use as a restorative material in stress bearing areas. EXF showed higher shrinkage stress values, and less cytotoxic effect. Fiber reinforced flowable composite is mainly indicated for deep and large cavities, signifying the importance for assessing its shrinkage stress and biological behavior.

A novel methacrylate derivative polymer that resists bacterial cell-mediated biodegradation

This study tests biodegradation resistance of a custom synthesized novel ethylene glycol ethyl methacrylate (EGEMA) with ester bond linkages that are external to the central polymer backbone when polymerized. Ethylene glycol dimethacrylate (EGDMA) with internal ester bond linkages and EGEMA discs were prepared in a polytetrafluoroethylene (PTFE) mold using 40 μl macromer and photo/co-initiator mixture cured for 40 s at 1000 mW/cm² . The discs were stored in the constant presence of Streptococcus mutans (S. mutans) in Todd Hewitt Yeast + Glucose (THYE+G) media up to 9 weeks (n = 8 for each macromer type) and physical/mechanical properties were assessed. Initial measurements EGEMA versus EGDMA polymer discs showed equivalent degree of conversion (45.69% ± 2.38 vs. 46.79% ± 4.64), diametral tensile stress (DTS; 8.12± 2.92 MPa vs. 6.02 ± 1.48 MPa), and low subsurface optical defects (0.41% ± 0.254% vs. 0.11% ± 0.074%). The initial surface wettability (contact angle) was slightly higher (p ≤ .012) for EGEMA (62.02° ± 3.56) than EGDMA (53.86° ± 5.61°). EGDMA showed higher initial Vicker's hardness than EGEMA (8.03 ± 0.88 HV vs. 5.93 ± 0.69 HV; p ≤ .001). After 9 weeks of S. mutans exposure, EGEMA (ΔDTS-1.30 MPa) showed higher resistance to biodegradation effects with a superior DTS than EGDMA (ΔDTS-6.39 MPa) (p = .0039). Visible and scanning electron microscopy images of EGEMA show less surface cracking and defects than EGDMA. EGDMA had higher loss of material (18.9% vs. 8.5%, p = .0009), relative changes to fracture toughness (92.5% vs. 49.2%, p = .0022) and increased water sorption (6.1% vs. 1.9%, p = .0022) compared to EGEMA discs. The flipped external ester group linkage design is attributed to EGEMA showing higher resistance to bacterial degradation effects than an internal ester group linkage design methacrylate.

Effect of Streptococcus mutans on the flexural strength of resin-based restorative materials

BACKGROUND

There are a limited number of studies about the effects of microbial aging on the mechanical properties of restorative materials. Therefore, this study aimed to evaluate the effect of simulated aging with Streptococcus mutans on the flexural strength of different resin-based materials.

MATERIALS AND METHODS

This experimental study was performed on the blocks of different types of restorative materials including composite resin, giomer, and a resin-modified glass ionomer (RMGI). Moreover, three types of aging, such as 30-day storage in distilled water, S. mutans, and germ-free culture medium, were used in this study. The three-point bending flexural strength of the specimens before and after aging was measured according to the International Organization for Standardization-4049 standard. Data were analyzed by two-way ANOVA and post hoc Tukey's tests. A P < 0.05 was considered statistically significant.

RESULTS

Results showed that the 30-day aging with the S. mutans significantly reduced the flexural strength of all three types of materials (P = 0.00). In all restorative materials, storage in a bacteria-free culture medium acted the same as distilled water, and there was no significant difference between these two solutions in terms of the flexural strength of the material, compared to the before-aging strength (P > 0.05). Furthermore, no significant difference was observed between S. mutans-based aging and distilled water aging regarding RMGI (P = 0.75).

CONCLUSION

It can be concluded that aging by S. mutans reduced the flexural strength in all three restorative materials.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

SIGNIFICANCE

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

Interface analysis after fatigue loading of adhesively luted bundled fiber posts to human root canal dentin

OBJECTIVES

The aim of this study was to assess the fatigue loading behavior and fracture resistance of endodontically treated teeth restored with adhesively luted bundled fiber posts in comparison to solid fiber posts. Image analysis (2D and 3D) was applied to evaluate modes of failure and to characterize susceptible parts of the post-and-core interface.

METHOD

Crowns of 72 human similar-sized central upper incisors were removed and roots received a conventional root canal filling prior to establishing 4 groups of core build-up: No Post group (nP) received a 4 mm deep filling made of composite inside the canal with no dental post, fiber post group (FP) received a conventional solid post, and two experimental groups received bundles of 6 (FB6) or 12 (FB12) 0.3 mm thin fiber posts, respectively. Posts were placed adhesively inside the root canal using a dual-curing build-up composite in combination with a self-etch adhesive, the latter was also used for nP group. Upon completion of core build-ups, all teeth received full-ceramic crowns that recreated the original tooth form. Samples were subjected in a 135° angle to thermo-mechanical loading (TML) for 1.2 Mill. chewing cycles followed by static load tests (fracture resistance). Fracture modes as well as intracanal failure modes with respect to failed interfaces were analyzed using optical and electron microscopy (SEM). Microcomputer tomography (μCT) was used to exemplary compare pre and post TML geometries.

RESULTS

Static load test was significantly different between groups (p < 0.0005; Kruskal-Wallistest). Pairwise comparison showed that the nP group (221 ± 103N) failed at significantly lower forces compared to the FP (454 ± 184N), FB6 (477 ± 250N) and FB12 (478 ± 260N) groups (p ≤ 0,001; Mann-Whitney-U-test). Fracture modes were significantly affected by the presence or absence of a post (p ≤ 0,016; Chi-square test) revealing increased incidence of restorable fractures at the cervical region for nP group. Microscopic analysis revealed more intracanal failures at interfaces between post surfaces and composite for solid posts, whereas fiber bundled posts mostly failed at the interfaces between composite and dentin. Micro-CT analysis showed no alterations of the root-post-and-core structure after TML except slight deformations of occasionally entrapped voids.

CONCLUSION

Fracture resistance and fracture modes were significantly affected by the presence or absence of a post, whereas the investigated post groups did not differ from each other. However intracanal failure revealed differences in adhesive failures between solid fiber posts and bundled fiber posts. Deformations of entrapped voids, revealed by micro-Ct analyses after TML, lead to the assumption that applied forces result in alterations in the regions of voids.

Flexural Performance of Direct Resin Composite Restorative Materials Past Expiration Date

Objective  This study' s purpose was to examine the flexural properties of five direct restorative resin composites stored up to 30 months after the expiration date.

Materials and Methods  Ambient-stored materials had pre-expiration date baseline flexure strength values as per ISO 4049 ( n = 20). All materials were used per manufacturer guidelines, photopolymerized on both sides using a LED-based visible light curing unit, and stored in 0.2M phosphate buffered saline. At 24 hours, specimens were stressed to failure in three-point bend at a 0.5 mm/min cross head speed. Additional samples were made at 3, 6, 9, 12, 15, 18, 24, and 30 months past expiration date. Young’s modulus (flexural) was ascertained using the linear slope of the stress-stain curve.

Statistical Analysis  The mean data was found to contain a non-normal distribution and irregular variance which was compared using Kruskal–Wallis with Dunn’s posthoc testing.

Also, Pearson’s correlation analysis was used to identify possible similar degradation behavior between products within both flexure strength and modulus determinations. A 95% level of confidence (α = 0.05) was used.

Results  Materials maintained similar to baseline flexure strength and modulus for up to 15 months past expiration date with two materials being similar at 30 months. However, clinicians were still advised to follow expiration dates, as resin composite degradation mechanisms are complex and vital constituents might degrade that are not overtly identified by clinical handling characteristics. No dental shelf life standards exist and manufacturers are requested to provide protocol information used in determining shelf life expiration.