Effect of bleaching on the elution of monomers from modern dental composite materials

The effect of hydrogen peroxide and subsequent resveratrol application to CAD-CAM blocks on the cell viability of fibroblasts

The aim is to assess viability of fibroblasts exposed to 2 CAD-CAM blocks and a nanohybrid resin after application of hydrogen peroxide (HP) and resveratrol with 2 extraction media at 24 h, 48 h, and 72 h. Eighteen specimens were obtained from Lava Ultimate (LU), Vita Enamic (VE), and Grandio (GR). Specimens of each material were divided into 3 groups (material only, bleached, resveratrol applied) for 2 extraction media as artificial saliva (AS) and phosphate buffer saline (PBS) (n = 3). For bleached group, 40% HP was applied to specimens for 20 min twice. For resveratrol group, 0.5 µM resveratrol was applied after bleaching for 10 min. Mouse fibroblast cells were exposed to extracts of each group. The viability of cells was determined with MTT assay at 24 h, 48 h, and 72 h. Cell viability data (%) were analyzed statistically using one-way ANOVA, and post hoc Tukey test. Bleached materials showed the lowest cell viability (PBS; p < 0.01/ AS; p < 0.001). There is no statistically significant difference between resveratrol applied and bleached groups (PBS; p = 0.14/ AS; p = 0.072). Regardless of period of time and procedure, GR showed lower viable cell numbers than LU and VE (p < 0.001). Viable cell numbers were higher at 24 h than at 72 h (p < 0.001). There was no statistically difference between AS and PBS (p > 0.05). For all materials, the application of resveratrol did not affect the cell viability which decreased after bleaching over time. The decrease in nanohybrid resin was more critical than hybrid CAD-CAM blocks. The type of extraction media had no effect on cell viability results.

Evaluation of the Impact of Irradiance Lamps and Storage Media on Elution of TEGDMA from Dental Composites

OBJECTIVES

 The aim of this study was to evaluate and compare the effect of irradiance light and storage media on the elution of triethylene glycol dimethacrylate (TEGDMA) from conventional Filtek Z350XT 3M ESPE and two bulk-fill composites Shofu Beautifil-Bulk and Filtek Bulk fill flowable 3M ESPE using high-performance liquid chromatography (HPLC).

MATERIALS AND METHODS

 Shofu Beautifil-Bulk, Filtek Bulk fill flowable 3M ESPE, and Filtek Z350XT 3M ESPE were the three types of composites used in this study. Disk shaped samples of 4-mm thickness and 10-mm diameter were fabricated using a stainless steel mold and were polymerized using light emitting diode (LED) and quartz tungsten halogen (QTH) lamps. After polymerization, the samples were immersed in ethanol, artificial saliva with betel quid extract, and distilled water for 1, 7, and 30 days, respectively. The elution of monomer TEGDMA was evaluated using HPLC.

STATISTICAL ANALYSIS

 To evaluate the mean concentration difference, mixed way analysis of variance (ANOVA) was applied. Between different light, materials, and within the time duration, Tukey's post hoc test was used. A p value of 0.05 was considered significant.

RESULTS

 During the first day of storage, a significant amount of monomer TEGDMA elution was seen in all the materials. The highest values observed to be in the disks cured with QTH lamp. However, the highest elution was seen when the disks were immersed in ethanol/water solution. While the most stable medium was distilled water, artificial saliva with betel nut extract also had a significant effect on the elution of TEGDMA. The highest value obtained was of Filtek Bulk fill flowable 3M ESPE after 30 days of immersion in both LED and QTH cured disks.

CONCLUSION

 Filtek Bulk fill flowable 3M ESPE shows better properties in relation to the release of monomer TEGDMA as it releases less amount of monomer in the storage media. The release of monomer was highest in ethanol as compared to artificial saliva and distilled water with the passage of time.

Effect of Bleaching on Resin-Infiltration-Masked Artificial White Spots In Vitro

Resin infiltration is an effective method to mask vestibular white spots. If needed, external bleaching is usually recommended before infiltration, whilst in clinical practice, this sequence may not always be feasible. This in vitro study evaluated the effect of bleaching after resin infiltration regarding surface roughness and color using bovine incisors. Unlike for the untreated specimens (control, n = 25), artificial caries lesions were created within the test group (n = 25) using a demineralization solution at 37 °C for five days (pH = 4.95). The lesions were subsequently infiltrated using a resin infiltrant (Icon, DMG, Hamburg, Germany), followed by polishing. Afterwards, all specimens were bleached with a 10% carbamide peroxide gel (Opalescence, Ultradent, South Jordan, UT, USA) for 8 h/day over a ten-day period. Between bleaching treatments, specimens were stored in an opaque container with moistened paper tissues at 37 °C. Surface roughness was measured using a profilometer, and color in the L*a*b* space was assessed spectrophotometrically before and after bleaching. Bleaching increased the L*-values of both infiltrated (mean ± SD; ΔL* = 3.52 ± 1.98) and untreated (control) specimens (ΔL* = 3.53 ± 2.30) without any significant difference between the groups (p = 0.983). Bleaching also induced a significant increase in the mean surface roughness of both infiltrated (p < 0.001) and untreated (p = 0.0134) teeth. In terms of clinical relevance; it can be concluded that bleaching resin-infiltrated enamel is as effective as bleaching sound enamel.

Effect of Different Bleaching Methods on Monomer Release from Aged Microhybrid and Nanohybrid Resin Composites

Introduction

Recently, the application of laser-assisted bleaching has increased in dental practice. This method might affect the physical and chemical properties of resin composite and its monomer release. This study aimed to evaluate the effect of in-office, at-home, and laser-assisted bleaching on the monomer release (bisphenol A diglycidyl dimethacrylate (BisGMA), triethylene glycol dimethacrylate (TEGDMA), and urethane dimethacrylate (UDMA)) from aged nanohybrid (Grandio, Voco) and microhybrid (Clearfil AP-X Esthetics, Kuraray) resin composites.

Methods

Thirty-two samples of each composite were prepared. The samples underwent aging procedure with UV light at 65°C for 100 hr. The samples were divided into 4 groups: OB: conventional in-office bleaching with Opalescence Boost PF 40% gel; HB: home bleaching with Opalescence PF 15% gel; LB: bleaching with JW Power bleaching gel followed by diode laser application; and C: control group without bleaching. Then, the samples were immersed in a solution containing 75% ethanol + 25% distilled water. The medium was renewed after 8, 16, 24 hr, and 7 days and was analyzed using high-performance liquid chromatography method to evaluate the monomer release. The data were analyzed using Two-way ANOVA and Post hoc Tukey test.

Results

The bleaching method had no effect on TEGDMA and BisGMA release in both composites while it affected UDMA release in nanohybrid composite; UDMA release was significantly higher in LB compared to control and also higher in OB and LB compared to HB. No difference was observed in the microhybrid composite in this regard.

Conclusion

Laser-assisted bleaching did not affect monomer release from microhybrid composite while it increased UDMA release from nanohybrid composite. The bleaching method had no effect on TEGDMA and BisGMA release.

Monomers Release from Direct and Indirect Resin-Based Restorations after Immersion in Common Beverages

Impurities or degradation of the components of resin-based materials have been throughout investigated by the dental scientific community. The aim of this study is to examine if there is a release of monomers from resin-based materials when they are immersed in common beverage materials which are consumed by the population in large quantities. Three representative dental materials were used for this study, one resin composite indicated for direct restorations and two Computer Aided Design and Computer Aided Manufacturing (CAD/CAM) materials with different methods of fabrication. Forty specimens were fabricated from each material using a low-speed precision sectioning blade 12 × 14 × 2 mm in size and immersed in wine, coffee or cola for 48 h and 12 days, equivalent to 1 month and 1 year of consumption. The materials released more monomers when the materials were immersed in the wine solution (p < 0.05). CAD/CAM materials release less monomers compared to the resin composite material indicated for direct restorations (p < 0.05). The CAD/CAM materials leach a limited quantity of monomers when they are immersed in common beverages due to the manufacturing process which includes high-temperature/high-pressure polymerization.

Analysis of Monomer Release from Different Composite Resins after Bleaching by HPLC

(1) Background: This study aimed to examine the effect of bleaching agents on the release of triethylenae glycol dimethacrylate, 2-hydroxyethyl methacrylate, bisphenol A, urethane dimethacrylate, and bisphenol A-glycidyl methacrylate monomers, which are released from different composite resins, using the high-performance liquid chromatography (HPLC) method. (2) Methods: Ninety disc-shaped specimens were produced and immersed in artificial saliva. After different bleaching applications [office type bleaching (OB) and home type bleaching (HB)], the specimens were immersed in a 75 wt% ethanol/water solution, and the released monomers were analyzed by HPLC at predefined time intervals: 1, 7, and 28 days. The Kruskal−Wallis and Mann−Whitney U tests were conducted for statistical analysis (p = 0.05). (3) Results: The monomers were released at all times from all composite specimens. The monomer release was increased over time. The highest monomer release was detected on day 28. Bleaching applications affected monomer release. No statistical difference was found between OB and HB applications (p > 0.05). The most released monomer was Bisphenol-A in all composites. (4) Conclusion: Given that a residual monomer release from composite resins has a toxic effect and that bleaching treatments increase this release, a treatment protocol should be made in accordance with the manufacturer’s instructions.

Monomer release from dental restorative materials containing dimethacrylate resin after bleaching

OBJECTIVE

The aim of this study is to determine the type and amount of monomer released over time after bleaching was applied to dental restorative materials containing dimethacrylate resin.

MATERIALS AND METHODS

Thirteen different restorative materials containing dimethacrylate resin were used in this study. Twenty samples were prepared from each material and the samples were randomly divided into 4 subgroups, namely, office bleaching, home bleaching, and separate control group for each of the bleaching methods. After bleaching, the samples were stored in 75% ethanol solution for 1, 14, and 28 days. Analysis of the samples collected to determine the type and amount of residual monomer released from the materials was performed using a liquid chromatography-tandem mass/mass spectrometer (LC-MS/MS). Data were analyzed using Friedman and Kruskal-Wallis tests. Statistical significance level was taken as p < 0.05.

RESULTS

In terms of bleaching groups, mostly no significant difference was found between the groups in each time period in restorative materials (p > 0.05). In terms of time periods, it was determined that the amount of release of all monomers was decreased over time. In terms of restorative materials, the highest monomer release was detected in composite resin groups and the least monomer release was detected in CAD/CAM blocks.

CONCLUSION

Although monomers were released from all materials, bleaching did not affect the amount of released monomer. Amounts of released monomers were generally below toxic limits.

CLINICAL RELEVANCE

Within the limits of this study, bleaching does not significantly affect monomer release in restorative materials containing dimethacrylate resin.

Evaluation of Monomer Elution and Surface Roughness of a Polymer-Infiltrated Ceramic Network CAD-CAM Material After Er,Cr:YSGG Laser-assisted Tooth Bleaching

PURPOSE

The aim of this in vitro study was to examine the effect of Er,Cr:YSGG laser-assisted tooth bleaching treatment on the elution of monomers and surface roughness of a hybrid computer-aided design-computer-aided manufacturing (CAD-CAM) material, and to compare it with a resin composite for direct restorations.

METHODS AND MATERIALS

Forty specimens of a hybrid CAD-CAM material (Enamic) and forty of a conventional resin composite (Tetric) were fabricated and randomly divided into four groups (n=10). Half of the specimens of each material were stored in distilled water and the other half in artificial saliva for 7 days. At the end of this period, the storage medium was analyzed by high-performance liquid chromatography (HPLC), and the surface roughness parameters of the specimens were evaluated by optical imaging noncontact interferometric profilometry. Afterwards, half of the specimens of each tested material received a conventional in-office tooth bleaching treatment and the other half an Er,Cr:YSGG laser-assisted bleaching treatment, and then they were again incubated in distilled water and artificial saliva for an additional 7-day time period. At the end of this period, the effect of the bleaching treatments on elution of monomers and surface roughness of the tested materials was evaluated.

RESULTS

Bisphenol A (BPA), urethane dimethacrylate (UDMA), triethylene glycol dimethacrylate (TEGDMA), and bisphenol A-glycidyl dimethacrylate (BisGMA) were eluted from the conventional resin composite into both the solutions tested. Only TEGDMA was eluted from the hybrid CAD-CAM material. However, no statistically significant differences were found among the surface roughness parameters of both materials. Both the conventional and Er,Cr:YSGG laser-assisted tooth bleaching treatments affected the monomer elution from the composite resin. However, there were no statistically significant differences (p<0.05) between the treatments.

CONCLUSIONS

According to the results of this study, tooth bleaching with Er,Cr:YSGG laser or conventional technique is safe, even if the bleaching agent comes in contact with hybrid CAD-CAM restorations.

An integrative review on the toxicity of Bisphenol A (BPA) released from resin composites used in dentistry

The main aim of this study was to perform an integrative review on the release of bisphenol A (BPA) from resin-matrix composites and potential toxic effects. A bibliographic search was performed on the PubMed platform using the following keywords: "Bisphenol A" OR "BPA" AND "resin composite" OR "composite resin" AND "toxicity" OR "cytotoxicity" OR "release". Inclusion criteria involved in vitro and in vivo studies on the release and toxicity of BPA. Results highlighted the release of BPA from resin-matrix composites due to insufficient polymerization and/or degradation of the polymeric matrix. BPA is part of the organic matrix of resin-matrix composites and may be hydrolysed in human saliva, although studies report that low doses might not be detected by traditional chemical analysis. Studies exposing zebrafish embryos to different concentrations of Bis-GMA, showed 55% mortality at 10 μM Bis-GMA while 30% mortality was recorded at 1 μM Bis-GMA. In patients, a BPA concentration of around 2.09 × 10^-2 μg/ml was found in the saliva after placement of lingual orthodontic retainers with resin-matrix composites. Also, the BPA molecule can be swallowed and absorbed by the oral/gastrointestinal mucosa, which might result in systemic toxicity. The degradation of resin-matrix composites and release of BPA in oral environment are dependent on the organic matrix content and on the polymerization method. A increased release of BPA can lead to the absorption into oral and gastrointestinal mucosa with high risks of local and systemic toxicity.

Influence of a new polishing system on changes in gloss and surface roughness of resin composites after polishing and brushing

This study aimed to compare the change of surface roughness (Ra) and gloss units (GU) of five dental composites (Filtek Z250, Filtek Z350XT, Metafil CX, Ceram X one, and Venus Diamond) polished with three systems (Sof-Lex XT, Enhance/Pogo, and Sof-Lex Diamond) before/after simulated brushings and to determine the amount of time required to achieve maximum gloss. Ninety rectangular specimens (n=18 per composite) were prepared. Six specimens of each composite were assigned to one of the polishing systems. The Ra and GU of each specimen were measured after each polishing step. Five polished specimens per composite were brushed with a toothbrush machine, and the Ra and GU values were determined. Filtek Z350XT exhibited the most stable and lowest Ra during the brushing cycles regardless of polishing system. When using the Sof-Lex Diamond and Enhance/Pogo systems, the highest gloss and the smoothest surfaces were achieved after polishing and brushing.

Do resin-based composite CAD/CAM blocks release monomers?

OBJECTIVE

The present study aimed to identify and quantify the elution of monomers of five different resin-based CAD/CAM blocks (RCBs) using HPLC.

METHODS

Five different RCBs were used in the study: GC Cerasmart (CS), Voco Grandio blocs (GR), 3M Lava Ultimate (LU), Shofu Block (SB), and Vita Enamic (VE). Fifteen samples from each material were prepared using a low-speed precision diamond saw (ISOMET Buehler, Lake Bluff, IL, USA) at 5 × 5 × 4 mm size. After the preparation of samples, an extraction solution was mixed with %75/%25 ethanol/water. The samples were stored in the amber-colored bottles during three different immersed periods as 1 h, 24 h, and 90 days (n = 5). After immersion, 0.5 ml solutions were taken from each bottle and analyzed using HPLC.

RESULTS

A total of 16.7 μg/ml of monomers from SB, 13.4 μg/ml of monomers from GR, 13.2 μg/ml of monomers from CS, and 6.7 μg/ml of monomers from LU were found after 3-m immersion. TEGDMA after 3-m of immersion was only released from the SB group, and also BisEMA was released from the CS group. Among the specimens immersed for 1 h, UDMA was released the least from the LU group and the most from the GR group (p < 0.05). Correspondingly, 24 h and 3 m after immersion, the highest release of monomers was found in the GR (p < 0.05).

CONCLUSIONS

When the monomer release from RCBs was evaluated, it was shown that these materials released methacrylate-based monomers except VE, especially if they were kept in a solvent solution for a long time such as 3 m.

CLINICAL SIGNIFICANCE

The novel resin-based CAD/CAM blocks might monomer release, which may cause cytotoxic effects. But, the detected amount of monomer release is below the estimated daily limit.

Influence of Bleaching and Aging Procedures on Color and Whiteness of Dental Composites

Bleaching can cause perceptible color changes on resin-based composite (RBC) restorations that may not be stable with aging. The objective of this study was to evaluate color stability and whiteness variations of RBCs after bleaching and aging procedures. Discs (10 mm in diameter and 1 mm thick) of shades A2 and A3 were fabricated from two RBCs (Filtek Z250 and Filtek Z350 XT) and divided into three subgroups (for each composite and shade) (n=5) as follows: control (no bleaching), at-home bleaching, and in-office bleaching. All specimens underwent an accelerated artificial aging up to 450 KJ/m2 and 900 KJ/m2 in an aging chamber (Suntest XXL+). A spectroradiometer (SpectraScan PR-670) was used to obtain CIE L*a*b* coordinates. CIEDE2000 color difference (ΔE00) and whiteness index for dentistry (WID) were used to evaluate color stability. Color and whiteness differences data were analyzed considering the 50:50% visual color difference thresholds (perceptibility [PT] and acceptability [AT]) and 50:50% whiteness thresholds (whiteness perceptibility [WPT] and whiteness acceptability [WAT]). Analysis of variance and Tukey tests (α=0.05) were used to statistically analyze the data. After bleaching, all specimens showed ΔE00 and ΔWID values below their corresponding acceptability thresholds (AT and WAT, respectively). After aging, L* and WID values decreased while b* values increased (p≤0.05), resulting in ΔE00 and ΔWID values above AT and WAT, respectively. Color changes after bleaching RBCs were clinically acceptable, while aging provoked clinically perceptible color changes.

Monomer release from nanohybrid composites after bleaching

The evaluation of the effect of bleaching on monomer release from two composite resins was performed by bleaching two nanohybrid composite resins Filtek Z550 and Tetric N-Ceram using two bleaching products Whiteness HP Maxx and Vivastyle. In total, 20 samples were made from each composite resin from which four groups were fabricated (two for each bleaching product). The samples were stored in a 75% ethanol solution, and the solutions were renewed after 1, 7, and 28 days. The monomer release was analyzed using high performance liquid chromatography. The data were analyzed using repeated measures analysis of variance and least significant difference multiple comparison test (α = 0.05). Monomers were found to be released from both composite resins. The amounts of monomer released were found to decrease over time (P < 0.05); however, the resins were not affected by bleaching, and the released monomers were well below toxic doses.

Bisphenol A in dental materials - existence, leakage and biological effects

OBJECTIVE

Recently, questions have been raised concerning the potential endocrine disrupting effects of bisphenol A (BPA). This substance is a constituent in many different products which we frequently come into contact with, such as food containers and receipts. Resin-based dental filling materials are another source of exposure, although according to previous studies the amount and potential risks are not clear. Thus, the aims of the present study were (1) to identify if direct dental filling materials are liable to leak BPA and (2) to investigate if this leakage could lead to any adverse effects on health.

MATERIALS AND METHODS

A literature search was made with PubMed as the primary source, subsequently complemented with reference tracking.

RESULTS

A total of 26 articles were included, 24 of which were used for the first aim (leakage) and 2 for the second aim (health risks). The majority of studies, including all in vivo studies, showed leakage of BPA from dental materials in various amounts and during different time intervals. The findings showed a contradiction in results regarding the connection between dental materials and adverse health effects.

CONCLUSIONS

There is leakage of BPA from some dental materials, but critical levels are not evident. Bis-DMA contents might convert to BPA in the oral cavity. There is a contradiction between in vitro and in vivo studies concerning BPA leakage and finally, there is a lack of studies investigating the association between BPA exposure and its adverse effects on human health.

Effect of Laser-assisted and Conventional In-office Bleaching on Monomer Release from Microhybrid and Nanohybrid Composite

BACKGROUND AND AIMS

Bleaching might affect structural properties of composite materials, and lead to monomer release. This study aimed to evaluate the effect of Laser-assisted and conventional in-office bleaching on the release of BIS-GMA, TEGDMA, and UDMA monomers from a nanohybrid and a microhybrid BIS-GMA based composite.

MATERIALS AND METHODS

32 samples of each composite, were divided into 4 subgroups; subgroup 1: Conventional in-office bleaching (CIB) with the Opalescence Boost PF 38% gel, subgroup 2: Laser-assisted bleaching (LBO) with the Opalescence Boost PF 38% gel, subgroup 3: Laser-assisted bleaching (LBH) with the JW Power bleaching gel, subgroup 4: (CO) control without bleaching. All the samples were immersed in tubes of 2cc Ethanol 75% medium. The released monomers were analyzed using the high performance liquid chromatography (HPLC) method 24 h, 7, and 28 days. Data's were analyzed by Univariate Analysis of Variance test followed by Tukeys HSD.

RESULTS

The amount of TEGDMA monomer released was not significant. However, nanohybrid composites showed significantly more monomer release than microhybrid composites (P < 0.05). For UDMA the interaction was significant only after 1 week. In microhybrid composites, the CO subgroup showed more monomer release than LBH and LBO. In nanohybrid composites, LBH showed more monomer release than CIB and CO subgroups. For BIS-GMA monomers the interaction was significant at all time periods and the LBH subgroup of nanohybrid composite had significantly more BIS_GMA release in comparison to other subgroups.

CONCLUSION

Bleaching by laser with JW Power Bleaching gel led to more monomer release in nanohybrid composite.

Effects of bleaching agent on physical and aesthetic properties of restorative materials

To investigate the effects of bleaching agent on microhardness, color and light transmission of different restorative materials. Specimens (n=20) of Tetric EvoCeram (TEC), Tetric EvoCeram Bulk Fill (TECBF) and Equia Fill (EQUIA) were treated with either 40% hydrogen peroxide Opalesence Boost or destilled water for 45 min. Specimens were stained in tea solution or stored in deionized water for one and two weeks. Color, microhardness and light transmission were monitored at the baseline, after the bleaching and after the tea immersion or storage in deionized water. After the bleaching a significant reduction in surface microhardness (p<0.001) was recorded for all materials. Clinically visible color change (ΔE>3) was observed after the bleaching and after treatment in tea solution, but only in EQUIA samples. The absorption coefficient was the largest for the samples stained in tea solution. Bleaching can affect the microhardness and color of fillings; therefore, they should be sometimes replaced.

Elution of Monomers from Provisional Composite Materials

The aim of this study was to evaluate the elution of substances from different materials used for the manufacturing of temporary indirect restorations, after storage in saliva and ethanol 75%. 10 samples of three chemically cured materials (Protemp 3 Garant, Systemp.c&b, and Trim) and one light-cured material (Clip F) were stored in saliva and ethanol 75% for 24 h, 7, and days 28 days. From the storage media at each time period, samples were prepared and analysed by LC-MS/MS, in order to access the elution of monomers. The results differed among the materials (P≤ 0.05). No monomers were detected in the samples of Protemp 3 Garant and Clip F. Substances were detected only in ethanol samples of Systemp.c&b and Trim. The amount of BisGMA, TEGDMA, and UDMA 2 released from Systemp.c&b was higher compared to Trim. Storage time affected the release of substances (P≤ 0.05). The highest release was observed within the first 24 h. It can be concluded that provisional resin composite materials do not show high release of monomers and this release is material dependent. However, the detection of additional peaks during the analysis, suggesting the formation of by-products of the eluted substances, may not be in favour of these materials with respect to their toxicity.

Effect of 38% carbamide peroxide on the microleakage of silorane-based versus methacrylate-based composite restorations

OBJECTIVES

This study aimed to assess the effect of 38% carbamide peroxide on the microleakage of class V cavities restored with either a silorane-based composite or two methacrylate-based composites.

MATERIALS AND METHODS

A total of 96 class V cavities were prepared on the buccal surface of extracted human teeth with both enamel and dentin margins and were randomly assigned into three groups of Filtek P90 (3M-ESPE) + P90 system adhesive (3M-ESPE)(group A), Filtek Z250 (3M-ESPE) + Adper Prompt L-Pop (3M-ESPE)(group B) and Filtek Z350XT (3M-ESPE) + Adper Prompt L-Pop (group C). Half of the teeth were randomly underwent bleaching (38% carbamide peroxide, Day White, Discus Dental, applying for 15 min, twice a day for 14 day) while the remaining half (control) were not bleached. Dye penetration was measured following immersion in basic fuchsine. Data were statistically analyzed using Kruskal-Wallis and Mann-Whitney U tests at a level of 0.05.

RESULTS

No significant differences were found between composites in the control groups in enamel (p = 0.171) or dentin (p = 0.094) margins. After bleaching, microleakage of Z250 (in enamel [p = 0.867] or dentin [p = 0.590] margins) and Z350 (in enamel [p = 0.445] or dentin [p = 0.591] margins) did not change significantly, but the microleakage of P90 significantly increased in both enamel (p = 0.042) and dentin (p = 0.002) margins.

CONCLUSIONS

No significant differences were noted between the bleached and control subgroups of two methacrylate-based composites in enamel or dentin margins. Microleakage of silorane-based composite significantly increased after bleaching.

Effect of extraction media and storage time on the elution of monomers from four contemporary resin composite materials

Introduction:

The purpose of this study was to examine the effect of different extraction media, including culture media, as well as storage times on the elution of monomers from modern dental composites.

Materials and Methods:

Four contemporary composite materials were tested: (a) Clearfil Majesty Esthetic (Kuraray), (b) Esthet X (DENTSPLY), (c) Filtek Silorane (3M ESPE), and (d) Admira (Voco). Forty-eight specimens were made. The specimens were stored in 1 ml of (a) artificial saliva, (b) Dulbecco's Modified Eagle Medium (DMEM), (c) DMEM plus 10% fetal bovine serum (FBS), and (d) ethanol 75%. The specimens were analyzed after 24 hours and after 1 week of storage. HPLC Liquid Chromatography was performed to analyze the extracted solutions. The statistical package SPSS 18 was used for the statistical analysis of the results.

Results:

All the materials tested released monomers that were consistent with the base composition of their resin matrix. Bisphenol-A (BPA) was detected in Clearfil Esthetic and EsthetX when ethanol 75% was used for storage. TEGDMA was released at a faster rate compared to the other monomers with most of the monomer eluted in the first 24 hours. The effect of storage solution and storage time on the elution of the same monomers varied between materials.

Conclusions:

There was a significant effect of time, storage solution, and material on the elution of the detectable unbound monomers. Unbound monomers were detected in culture media, which may lead to false-negative results in cytotoxicity tests of resin composite materials. BPA was detected in two of the tested materials.

Tooth-bleaching procedures and their controversial effects: A literature review

AIM

This review article will help clinicians improve their understanding of the history of bleaching procedures, bleaching types, components, mechanisms, and their effects on soft tissue, tooth structures, resin composite, and bonding.

METHODS

The controversial issues about bleaching procedures and their effects are reviewed. Additionally, the consequences of pre- and post-bleaching on the bonding potential of composite resin restorations to tooth structure are discussed.

CONCLUSION

The overall goal of the paper is to help reduce risks for patients.

Human gingival keratinocyte response to substances eluted from silorane composite material reveal impact on cell behavior reflected by RNA levels and induction of apoptosis

OBJECTIVES

The aim of this study was the characterization of siloran-derived composite eluates in conjunction with their putative impact on human gingival keratinocytes (HGK), i.e. levels of total RNA and induction of apoptosis compared to a methacrylate-based material.

METHODS

Standardized Filtek™ Silorane specimens (n = 20) were subjected to scanning ion monitoring to detect monomer masses between 100 and 1000, after storage in human saliva, and 75% ethanol for up to 28 days. In order to evaluate the effect on cells, HGK were exposed to eluates from Filtek™ Silorane, Filtek™ Supreme XT and control medium for 1 and 4 days, prior to isolation of total RNA, and Annexin-5 fluorescence labeling indicating induction of apoptosis.

RESULTS

Irrespective of the mode and storage time, SIM identified discrete peaks, corresponding to masses of "393" and "337". In response to both composite eluates, an effect on HGK was reflected by drastically reduced levels of isolated total RNA at each time period (after 1 day: control: 302 ng/μl; Filtek™ Silorane: 128 ng/μl, Filtek™ Supreme XT: 129 ng/μl and after 4 days: control: 528 ng/μl; Filtek™ Silorane: 162 ng/μl, Filtek™ Supreme XT: 166 ng/μl). Exposure to eluates from both composite materials yielded apoptosis induction in HGK, as demonstrated by a significant increase of cells exhibiting Annnexin-5 fluorescence.

SIGNIFICANCE

Two distinct peaks were identified, which indicated the presence of corresponding substances. The composite-derived effects on HGK strongly suggest a negative impact on cells, as revealed by a clear reduction of total RNA levels, and significant increase in induction of apoptosis.

Changes in surface roughness and color stability of two composites caused by different bleaching agents

The objective of this study was to evaluate the effect of two bleaching agents (10% and 35% hydrogen peroxide) on the color stability and surface roughness of two composites, one nanohybrid and one nanoparticle. Specimens were polished, aged, stained, bleached and polished again. The action of the bleaching agents on the composites was analyzed using a profilometer (surface roughness) and a spectrophotometer (color stability). The effect of polishing the composites on the surface roughness and the resumption of the composite color was also evaluated. The results were analyzed statistically by ANOVA and Tukey's test at 5% significance level. The analysis indicated that the nanohybrid composite was more affected by staining. The bleaching agents were not able to promote bleaching of either composite over the evaluation period. Surface polishing returned nanohybrid composite to its original color condition, which did not occur for the nanoparticle composite. Additionally, polishing did not return the surface roughness of either composite to its original value. It may be concluded that polishing surface after bleaching should not be the treatment of choice, as it was not possible to reverse the roughness of the composites to their original values, suggesting that a more extensive and irreversible degradation might have occurred.