Multiple correlations of material parameters of light-cured dental composites

Application of near-infrared-to-blue upconversion luminescence for the polymerization of resin cements through zirconia discs

OBJECTIVES

To investigate a near-infrared-to-blue luminescence upconversion curing method for polymerizing resin cements under zirconia discs.

METHODS

Lava zirconia discs of different thicknesses (0.5-2.0 mm) were manufactured. First, the transmittances of the NIR and two blue lights (BLs) (LED and halogen lights) through these discs were measured. Second, NaYF4:Yb3+/Tm3+ upconversion phosphor (UP) powder was milled into 0.5-μm particle sizes. A light-curable resin cement VariolinkII base was chosen as the control (UP0), and an experimental cement (UP5) was prepared by adding 5 % UPs. These two cements were examined using multiphoton excitation microscopy for particle distribution. UP5 and UP0 were polymerized with or without zirconia shielding then subjected to a microhardness test. A multifold analysis was performed to examine the effects of zirconia thickness, curing protocols (pure BL or combined BL and NIR curing), and cement type.

RESULTS

The transmittance of NIR was superior to that of BL through zirconia discs of all thicknesses. UP particles were homogeneously distributed in UP5 and emitted blue luminescence under 980-nm NIR excitation. UP5 showed higher microhardness values than UP0 under any curing protocol or zirconia shielding condition. The combination of 20-s BL and 40-s NIR curing yielded the highest microhardness in uncovered UP5. However, combining 40-s BL and 20-s NIR curing surpassed the other groups when the zirconia discs were thicker than 0.5 mm.

SIGNIFICANCE

NIR exhibits higher transmission through zirconia than BL. UP particles work as strengthen fillers and photosensitizers in cements. NIR upconversion curing could be a new strategy for polymerizing resin cements under thick zirconia restorations.

Surface hardness and flexural strength of dual-cured bulk-fill restorative materials after solvent storage

BACKGROUND

This study aimed to evaluate the surface hardness (VHN) and biaxial flexural strength (BFS) of dual-cured bulk-fill restorative materials after solvent storage.

METHODS

Two dual-cured bulk-fill composites (Surefil One® and Activa™ Bioactive), a light-cured bulk-fill composite (Filtek One Bulk-Fill) and a resin-modified glass ionomer (Fuji II LC) were investigated. Surefil One and Activa were used in the dual-cure mode, all materials were handled according to manufacturer's instructions. For VHN determination, 12 specimens were prepared from each material and measured after 1 h (baseline), 1 d, 7 d and 30 d of storage in either water or 75% ethanol-water. For BFS test, 120 specimens were prepared (n = 30/material) and stored in water for either 1, 7 or 30 d before testing. Repeated measures MANOVA, two-way and one-way ANOVA followed by the Tukey post hoc test (p ≤ 0.05) were used to analyze the data.

RESULTS

Filtek One had the highest VHN, while Activa had the lowest. All materials exhibited a significant increase in VHN after 1d of storage in water, except for Surefil One. After 30 d of storage, VHN increased significantly in water except for Activa, while ethanol storage caused a significant time-dependent reduction in all tested materials (p ≤ 0.05). Filtek One showed the highest BFS values (p ≤ 0.05). All the materials, except for Fuji II LC, exhibited no significant differences between 1 and 30 d BFS measurements (p > 0.05).

CONCLUSIONS

Dual-cured materials had significantly lower VHN and BFS compared to the light-cured bulk-fill material. The low results of Activa VHN and Surefil One BFS, indicate that these materials should not be recommended in posterior stress-bearing areas.

Effect of Hydrothermal Factors on the Microhardness of Bulk-Fill and Nanohybrid Composites

This study evaluates the effect of aging in artificial saliva and thermal shocks on the microhardness of the bulk-fill composite compared to the nanohybrid composite. Two commercial composites, Filtek Z550 (3M ESPE) (Z550) and Filtek Bulk-Fill (3M ESPE) (B-F), were tested. The samples were exposed to artificial saliva (AS) for one month (control group). Then, 50% of the samples from each composite were subjected to thermal cycling (temperature range: 5-55 °C, cycle time: 30 s, number of cycles: 10,000) and another 50% were put back into the laboratory incubator for another 25 months of aging in artificial saliva. The samples' microhardness was measured using the Knoop method after each stage of conditioning (after 1 month, after 10,000 thermocycles, after another 25 months of aging). The two composites in the control group differed considerably in hardness (HK = 89 for Z550, HK = 61 for B-F). After thermocycling, the microhardness decrease was for Z550 approximately 22-24% and for B-F approximately 12-15%. Hardness after 26 months of aging decreased for Z550 (approximately 3-5%) and B-F (15-17%). B-F had a significantly lower initial hardness than Z550, but it showed an approximately 10% lower relative reduction in hardness.

An Enamel Based Biopolymer Prosthesis for Dental Treatment with the Proper Bond Strength and Hardness and Biosafety

Although dental prosthesis materials such as metal alloys, ceramics, and cured resin composite have long been utilized to restore teeth, their bond strength and hardness values are not well matched to human enamel. Prosthesis detachment and opposing enamel wear are major concerns in restorative dentistry. An experimental biopolymer, hybridized enamel, was synthesized and utilized as a dental prosthesis to compare hardness and tensile bond strength (TBS) with those of commercial materials. Vickers hardness (VHN) with a 100 g loading for 15 s at eight indentations on each specimen (n = 20) was measured. TBSs between prostheses and two types of resin luting agents (n = 10), Super-Bond C&B and All-Bond2 + Duo-Link, were tested. Fractured surfaces and the luting resin-prosthesis interface were examined under a stereomicroscope or a scanning electron microscope (SEM). Statistically significant differences in the TBS and hardness were revealed (p < 0.05). The experimental biopolymer provided a hardness value comparable with human enamel and the highest TBS for both luting agent types. The SEM micrograph demonstrated a honeycomb-like pattern interface between the experimental biopolymer and luting resin. These results suggest that this experimental biopolymer may be a better restorative material to protect from natural enamel loss from tooth reduction or attrition and prevent prosthesis detachment during mastication.

Novel Polymerization of Dental Composites Using Near-Infrared-Induced Internal Upconversion Blue Luminescence

Blue light (BL) curing on dental resin composites results in gradient polymerization. By incorporating upconversion phosphors (UP) in resin composites, near-infrared (NIR) irradiation may activate internal blue emission and a polymerization reaction. This study was aimed to evaluate the competency of the NIR-to-BL upconversion luminance in polymerizing dental composites and to assess the appropriate UP content and curing protocol. NaYF₄ (Yb³⁺/Tm³⁺ co-doped) powder exhibiting 476-nm blue emission under 980-nm NIR was adapted and ball-milled for 4–8 h to obtain different particles. The bare particles were assessed for their emission intensities, and also added into a base composite Z100 (3M EPSE) to evaluate their ability in enhancing polymerization under NIR irradiation. Experimental composites were prepared by dispensing the selected powder and Z100 at different ratios (0, 5, 10 wt% UP). These composites were irradiated under different protocols (BL, NIR, or their combinations), and the microhardness at the irradiated surface and different depths were determined. The results showed that unground UP (d50 = 1.9 μm) exhibited the highest luminescence, while the incorporation of 0.4-μm particles obtained the highest microhardness. The combined 20-s BL and 20–120-s NIR significantly increased the microhardness on the surface and internal depths compared to BL correspondents. The 5% UP effectively enhanced the microhardness under 80-s NIR irradiation but was surpassed by 10% UP with longer NIR irradiation. The combined BL-NIR curing could be an effective approach to polymerize dental composites, while the intensity of upconversion luminescence was related to specific UP particle size and content. Incorporation of 5–10% UP facilitates NIR upconversion polymerization on dental composites.

A Comparative Study of the Mechanical Properties of Selected Dental Composites with a Dual-Curing System with Light-Curing Composites

Dual-curing composites have a wide spectrum of use in practice (rebuilding, reconstruction, and luting). The characterization of this type of material and comparative study of selected mechanical properties with light-cured materials were carried out for this paper. In this study, we used six materials with a dual-cure system—Bulk EZ, Fill-Up!, StarFill 2B, Rebilda DC, MultiCore Flow, Activa Bioactive-Restorative—and three light-cured materials—Filtek Bulk Fill Posterior, Charisma Classic, and G-aenial Universal Flo. The materials were conditioned for 24 h in water at 37 °C before testing. Selected material properties were determined: three-point bending flexural strength, diametral tensile strength, hardness, microhardness, and shrinkage stress. The highest three-point bending flexural strength (TPB) was 137.0 MPa (G-aenial Universal Flo), while the lowest amounted to 86.5 MPa (Activa Bioactive). The diametral tensile strength (DTS) values were in a range from 39.2 MPa (Rebilda DC) to 54.1 MPa (Charisma Classic). The lowest hardness (HV) value of 26 was obtained by the Activa Bioactive material, while the highest values were recorded for Filtek Bulk Fill Posterior and Charisma Classic-53. The shrinkage stress of the tested materials ranged from 6.3 MPa (Charisma Classic) to 13.2 MPa (G-aenial Universal Flo). Dual-curing composites were found to have similar properties to light-cured composites.

Digital image correlation in dental materials and related research: A review

OBJECTIVE

Digital image correlation (DIC) is a non-contact image processing technique for full-field strain measurement. Although DIC has been widely used in engineering and biomechanical fields, it is in the spotlight only recently in dental materials. Therefore, the purpose of this review paper is introducing the working principle of the DIC technique with some modifications and providing further potential applications in various dental materials and related fields.

METHODS

The accuracy of the algorithm depending on the environmental characteristics of the DIC technique, as well as the advantages and disadvantages of strain measurement using optical measurements, have been elaborated in dental materials and related fields. Applications to those researches have been classified into the following categories: shrinkage behavior of light-cured resin composite, resin-tooth interface, mechanical properties of tooth structure, crack extension and elastic properties of dental materials, and deformation of dental restoration and prosthesis. This classification and discussion were performed using literature survey and review based on numerous papers in the international journals published over the past 20 years. The future directions for predicting the precise deformation of dental materials under various environments, as well as limitations of the DIC technique, was presented in this review.

RESULTS

The DIC technique was demonstrated as a more effective tool to measure full-field polymerization shrinkage of composite resin, even in a simulated clinical condition over the existing methods. Moreover, the DIC combined with other technologies can be useful to evaluate the mechanical behavior of material-tooth interface, dentine structure and restorative and prosthetic materials with high accuracy. Three-dimensional DIC using two cameras extended the measurement range in-plane to out-of-plane, enabling measure of the strain directly on the surface of dental restorations or prosthesis.

SIGNIFICANCE

DIC technique is a potential tool for measuring and predicting the full-field deformation/strain of dental materials and actual prostheses in diverse clinical conditions. The versatility of DIC can replace the existing complex sensor devices in those studies.

Evaluation of F, Ca, and P release and microhardness of eleven ion-leaching restorative materials and the recharge efficacy using a new Ca/P containing fluoride varnish

OBJECTIVES

The objectives of this study were to evaluate fluoride (F), calcium (Ca), and phosphate (P) release of ion-leaching restorative materials (ILMs), their recharge efficacy with a Ca/P-containing F varnish, and relative microhardness.

METHODS

Thirteen groups of materials were investigated. Cylindrical-shaped specimens were fabricated. Deionised water or lactic-acid solution were used as the storage media. Solutions were changed after 1d, 4d, 7d, and 14d of ion release and at the same periods after recharge with MI Varnish (7 -h storage). F, Ca, and P measurements were accomplished using a fluoride-ion selective electrode, atomic absorption spectrometry, and colourimetric method by spectrophotometer, respectively. Relative Vickers hardness was proceeded with similar specimens used in the F assay (4 periods). SEM/EDS was additionally performed. Statistical analyses were calculated in each parameter (p < 0.05).

RESULT

Hardness of several ILMs immediately increased after recharge. After 28d, Ketac Universal [a high-viscosity glass-ionomer cement (HVGIC)] showed the highest hardness similar to the resin composite control. Although 2 HVGICs (Zirconomer and Equia Forte Fil) ranked as first and second for F release/re-release, some HVGICs had inferior or comparable F capacity to RMGICs (Fuji VIII and Fuji II LC) and a resin-based (RB) ILM (Cention N). Cention N, Activa-Restorative (RB-ILM), and Zirconomer were the top-3 ranking for Ca release/re-release. Activa-Restorative showed the highest P release, whereas Cention N displayed the greatest recharge ability for P.

CONCLUSIONS

Zirconomer showed a versatile performance for ion-release/re-release, especially for F. Cention N had excellent capacity in relation to Ca release and recharge ability of Ca/P.

CLINICAL SIGNIFICANCE

With the F varnish recharge protocol, Zirconomer, Equia Forte, and Fuji VIII seems to have an ability to inhibit initial caries initiation. Cention N is a promising resin-based material that could be an alternative for high caries risk patients due to the high Ca release/recharge with acceptable F release.

Vickers Hardness and Shrinkage Stress Evaluation of Low and High Viscosity Bulk-Fill Resin Composite

The aim of this in vitro study was to evaluate the hardness and shrinkage stress (SS) of six bulk-fill resin composites. To evaluate microhardness (MH), ten 6 mm specimens were prepared using a metal mold for each selected bulk-fill resin composite and irradiated from the top side for 40 s using an LED light. After 24 h of storage, Vickers MH was evaluated on the upper, lower and lateral sides of the specimens. SS evaluation was then performed with a universal machine, which evaluated the contraction force generated by a bulk-fill composite specimen placed between two metal cylinders during and after light curing. The results were evaluated with a one-way ANOVA test with a post-hoc Bonferroni test and linear regression analysis (p < 0.05). All materials showed a significant MH decrease between the top and bottom surfaces. However, the bulk-fill materials tested performed differently when considering lateral depth progression. ANOVA tests for SS evaluation showed that both SDR and Venus Bulk Fill had significantly lower stress during irradiation than other tested materials. Further, MH decrease became significantly lower from the top surface at different depths in each tested group. Among the different resins, Venus Bulk Fill and SDR showed not only inferior hardness, but also a significant reduction in SS.

Limited reciprocity in curing efficiency of bulk-fill resin-composites

OBJECTIVE

The aim of the study was to identify experimental limits of the general reciprocity hypothesis that the same photo-cure outcomes will result from applying essentially constant energy densities, despite reciprocal variations in the irradiance and irradiation time-period, for a representative set of bulk fill (BF) and non-BF resin composites.

METHODS

Six BF and two non-BF resin-composites were selected. The unset pastes were inserted into white acetal molds (5mm id) with (n=6) depths (1, 2, 3, 4, 5 and 6mm). Three light curing units (LCUs) of increasing radiant emittance capability: 1200, 2000 and 3200mW/cm² were used. Composite specimen groups (n=3, per depth, per LCU) were irradiated on the upper surface only. For each specific composite, the irradiation times for each LCU were reduced reciprocally, as the LCU irradiance increased, to deliver a constant energy density (J/cm²) to that composite. However, the required energy density for a given composite differed in accordance with each composite manufacturer recommendations. After storing for 24h at 37°C, light transmission measurements were made through each specimen and re-expressed as Apparent Absorbance (A'). Vickers hardness (H_V) measurements (n=10) were made on both top and bottom surfaces, for each specimen, and H_Vversus "depth" profile plots created. From the top-surface data, a Depth-of-Cure parameter could be derived. Data were statistically evaluated for differences between top and bottom H_V values and for other predefined variables of interest.

RESULTS

Irradiation with the LCU of 1200mW/cm² generally gave the highest H_V/depth for most materials tested compared to the other curing lights with higher power output, regardless of top and bottom measurements (p<0.001). However, this difference was material-dependent. With one BF composite, 1200 and 2000mW/cm² irradiance did not show a significant difference between top and bottom H_V. Composites with higher translucency showed reduced differences in top/bottom H_V than more opaque composites.

SIGNIFICANCE

Reciprocity was found to be limited with most materials examined, such that irradiance periods of 10s, gave generally better H_V outcomes than by using LCUs of superior radiant emittance while reciprocally reducing irradiance time to maintain constant dose of energy density.

Hardness and Wear Resistance of Dental Biomedical Nanomaterials in a Humid Environment with Non-Stationary Temperatures

This study discusses a quantitative fatigue evaluation of polymer-ceramic composites for dental restorations, i.e., commercial material (Filtek Z550) and experimental materials Ex-nano (G), Ex-flow (G). Their evaluation is based on the following descriptors: microhardness, scratch resistance, and sliding wear. In order to reflect factors of environmental degradation conditions, thermal fatigue was simulated with a special computer-controlled device performing algorithms of thermocycling. Specimens intended for the surface strength and wear tests underwent 10⁴ hydrothermal fatigue cycles. Thermocycling was preceded by aging, which meant immersing the specimens in artificial saliva at 37 °C for 30 days. Microhardness tests were performed with the Vickers hardness test method. The scratch test was done with a Rockwell diamond cone indenter. Sliding ball-on-disc friction tests were performed against an alumina ball in the presence of artificial saliva. A direct positive correlation was found between thermocycling fatigue and microhardness. The dominant mechanism of the wear of the experimental composites after thermocycling is the removal of fragments of the materials in the form of flakes from the friction surface (spalling). Hydrothermal fatigue is synergistic with mechanical fatigue.

Mechanical properties, accuracy, and cytotoxicity of UV-polymerized 3D printing resins composed of Bis-EMA, UDMA, and TEGDMA

STATEMENT OF PROBLEM

Three-dimensional printing has the potential for clinical applications, and additive manufacturing materials for dental use merit further investigation.

PURPOSE

The purpose of this in vitro study was to evaluate the properties of materials formulated with ethoxylated bisphenol A-dimethacrylate (Bis-EMA), urethane dimethacrylate (UDMA), and triethylene glycol dimethacrylate (TEGDMA) as 3D printing resins for ultraviolet digital light processing (UV-DLP) 3D printers and to characterize the mechanical and biological properties and accuracy of the printed objects.

MATERIAL AND METHODS

Ten different light-polymerized resins were formulated using Bis-EMA, UDMA, and TEGDMA. Their viscosities were measured, and only 7 resins with viscosities lower than 1500 centipoise (cP) were selected for 3D printing and further material characterization. The light-polymerized resins were printed into representative shapes using a custom-made 3D printer equipped with a 405-nm UV-DLP projector as the light source. The printed specimens were subjected to biologic, mechanical, and accuracy tests, and the data were submitted to 1-way ANOVA and Tukey post hoc comparisons (α=.05).

RESULTS

Photopolymerizable resins made of Bis-EMA, UDMA, and TEGDMA were successfully formulated for 3D printing to fabricate objects of various shapes and sizes. TEGDMA served as the diluent to reduce the viscosity and increase the degree of conversion, while UDMA and Bis-EMA provided strength as demonstrated by the mechanical testing. All the printed objects passed cytotoxicity testing. The flexural strengths of the printed specimens ranged between 60 MPa and 90 MPa; flexural modulus ranged between 1.7 GPa and 2.1 GPa; and surface hardness ranged between 14.5 HV and 24.6 HV. These represent similar mechanical properties to those of currently used clinical resin materials. In the accuracy test, the resin mixture composed of 80% Bis-EMA, 10% UDMA, and 10% TEGDMA had the highest accuracy, with a 0.051-mm deviation from the original design.

CONCLUSIONS

Bis-EMA, UDMA, and TEGDMA are good candidates for the formulation of 3D printing resins for dental use. The printed objects demonstrated favorable biological and mechanical properties. Further, the accuracy of the printed specimens showed potential for clinical application.

The Influence of Distance on Radiant Exposure and Degree of Conversion Using Different Light-Emitting-Diode Curing Units

Objectives:

To investigate the influence of curing distance on the degree of conversion (DC) of a resin-based composite (RBC) when similar radiant exposure was achieved using six different light-curing units (LCUs) and to explore the correlation among irradiance, radiant exposure, and DC.

Methods and Materials:

A managing accurate resin curing-resin calibrator system was used to collect irradiance data for both top and bottom specimen surfaces with a curing distance of 2 mm and 8 mm while targeting a consistent top surface radiant exposure. Square nanohybrid-dual-photoinitiator RBC specimens (5 × 5 × 2 mm) were cured at each distance (n=6/LCU/distance). Irradiance and DC (micro-Raman spectroscopy) were determined for the top and bottom surfaces. The effect of distance and LCU on irradiance, radiant exposure, and DC as well as their linear associations were analyzed using analysis of variance and Pearson correlation coefficients, respectively (α=0.05).

Results:

While maintaining a similar radiant exposure, each LCU exhibited distinctive patterns in decreased irradiance and increased curing time. No significant differences in DC values (63.21%-70.28%) were observed between the 2- and 8-mm distances, except for a multiple-emission peak LCU. Significant differences in DC were detected among the LCUs. As expected, irradiance and radiant exposure were significantly lower on the bottom surfaces. However, a strong correlation between irradiance and radiant exposure did not necessarily result in a strong correlation with DC.

Conclusions:

The RBC exhibited DC values &gt;63% when the top surface radiant exposure was maintained, although the same values were not reached for all lights. A moderate-strong correlation existed among irradiance, radiant exposure, and DC.

Creep, Hardness, and Elastic Modulus of Lingual Fixed Retainers Adhesives

The aims of this study were twofold: a) to characterize a wide array of time-independent and -dependent properties and b) to find possible correlations among the properties tested. Seven commercially available orthodontic adhesives were included in this study and ten cylindrical specimens were prepared from each material. Five specimens from each material were used for the characterization of Martens Hardness (HM), indentation modulus (E_IT), and elastic index (η_IT), and the remaining five for the determination of indentation creep (C_IT). Al the aforementioned properties were identified by employing an Instrumented Indentations Testing (IIT) device with a Vickers indenter. The results of HM, E_IT, η_IT, and C_IT were statistically analyzed by one way ANOVA and Tukey post hoc test, while the possible correlations among the aforementioned properties were determined by Spearman correlation test. Statistical significant differences were identified for all properties among the materials tested. Spearman correlation reveals that HM has a positive correlation with E_IT. Both properties demonstrated a negative correlation with η_IT and C_IT, while no correlation was identified between η_IT and C_IT. Significant differences in the mechanical properties tested may also imply differences in their clinical behavior and efficacy.

Polymerization pattern characterization within a resin-based composite cured using different curing units at two distances

OBJECTIVES

To investigate the relationship of the irradiance-beam-profile areas from six different light-curing units (LCUs) with the degree of conversion (DC), microhardness (KH), and cross-link density (CLD) throughout a resin-based composite (RBC) cured at two clinically relevant distances, and to explore the correlations among them.

MATERIALS AND METHODS

A mapping approach was used to measure DC using micro-Raman spectroscopy, KH using a Knoop indentor on a hardness tester, and %KH reduction after ethanol exposure, as an indicator for CLD within a nano-hybrid RBC increment (n = 3) at various depths. These sample composites were cured from two distances while maintaining the radiant exposure, using six different light-curing units: one quartz-tungsten-halogen; two single and three multiple-emission-peak light-emitting-diode units. Irradiance beam profiles were generated for each LCU at both distances, and localized irradiance values were calculated. Points across each depth were analyzed using repeated measures ANOVA. Correlations across multiple specimen locations and associations between beam uniformity corresponding with polymerization measurements were calculated using linear mixed models and Pearson correlation coefficients.

RESULTS

Significant non-uniform polymerization patterns occurred within the specimens at various locations and depths. At 2-mm curing distance, the localized DC = 52.7-76.8%, KH = 39.0-66.7 kg/mm², and %KH reduction = 26.7-57.9%. At 8-mm curing distance, the localized DC = 50.4-78.6%, KH = 40.3-73.7 kg/mm², and %KH reduction = 28.2-56.8%. The localized irradiance values were weakly correlated with the corresponding DC, KH, and %KH reduction, with only a few significant correlations (p < 0.05).

CONCLUSIONS

Although significant differences were observed at each depth within the specimens, the localized irradiance values for all LCUs did not reflect the polymerization pattern and did not seem to have a major influence on polymerization patterns within the RBC, regardless of the curing distance.

CLINICAL RELEVANCE

Commonly used LCUs do not produce uniform polymerization regardless of the curing distance, which may contribute to the risk of RBC fracture.

Characterization of fluoride releasing restorative dental materials

This study aimed to evaluate and compare certain mechanical properties, Vickers-hardness, water sorption, fluoride-release, shrinkage-stress and wear of five commercial fluoride-releasing restorative materials (Dyract, CompGlass, BEAUTIFIL II, ACTIVA-Restorative, and GC Fuji II LC), in relation to their microstructural characteristics. Mechanical properties were determined for each material following ISO standards. A wear test was conducted with 15,000 chewing cycles using a dual-axis chewing simulator. Daily fluoride-release was measured during the first 10 days by using a fluoride ion selective electrode. Scanning electron microscopy (SEM) was used to evaluate the microstructure of each material. Results were statistically analysed using ANOVA followed by post hoc Tukey's test. ACTIVA-Restorative exhibited the highest fracture toughness (1.1 MPa m^1/2) among the materials tested. BEAUTIFIL II presented the highest flexural strength (145 MPa) which was not significantly different (p>0.05) from CompGlass and Dyract. Highest fluoride-release measurement was located for GC Fuji II LC among other tested materials.

Mechanical properties of contemporary orthodontic adhesives used for lingual fixed retention

Objective:

The aim of the present study was to test the mechanical properties of different adhesives used in orthodontics for fixed retainers and to investigate their possible interrelations.

Materials and methods:

Specimens of six different adhesive resins were prepared: Transbond XT, Transbond LR and an experimental BPA-free orthodontic adhesive, as well as IPS Empress Direct (IPS-ED), ZNano and Accolade. The mechanical properties tested were Martens hardness (HM), indentation modulus (E

Results:

Significant differences were identified among all the materials tested for HM, with Transbond LR presenting the highest value. This resin presented the highest E

Conclusions:

The materials tested demonstrated significant differences in their mechanical properties, and thus differences in their clinical performance are anticipated.

Correlation between the beam profile from a curing light and the microhardness of four resins

OBJECTIVE

To demonstrate the effect of localized irradiance and spectral distribution inhomogeneities of one LED-based dental light-curing unit (LCU) on the corresponding microhardness values at the top, and bottom surfaces of four dental resin-based composites (RBCs), which contained either camphorquinone (CQ) alone or a combination of CQ and monoacylphosphine oxide (TPO) as photoinitiators.

METHODS

Localized irradiance beam profiles from a polywave LED-based LCU were recorded five times using a laser beam analyzer, without and with either a 400 nm or 460 nm narrow bandpass filter placed in front of the camera lens. Five specimens of each of the four RBCs (two containing CQ/TPO and two containing CQ-only) were exposed for 5-, 10-, or 30-s with the light guide directly on the top surface of the RBC. After 24 h, Knoop microhardness values were measured at 45 locations across the top and bottom surfaces of each specimen. Microhardness readings for each RBC surface and exposure time were correlated with localized patterns of the LCU beam profile, measured using the 400 nm and 460 nm bandpass filters. Spearman rank correlation was used to avoid relying on an assumption of a bivariate normal distribution for the KHN and irradiance.

RESULTS

The local irradiance and spectral emission values were not uniformly distributed across the light tip. There was a strong significant positive correlation with the irradiance beam profile values from the LCU taken through bandpass filters and the microhardness maps of the RBC surfaces exposed for 5 and 10 s. The strength of this correlation decreased with increasing exposure time for the RBCs containing CQ only, and increased for the RBCs containing both CQ and TPO.

CONCLUSIONS

Localized beam and spectral distributions across the tip end of the light guide strongly correlated with corresponding areas of microhardness in both the top and bottom surfaces among four RBCs with different photoinitiator contents. Significance: A light-curing unit with a highly inhomogeneous light output can adversely affect localized microhardness of resin-based composites and this may be a contributing factor for premature failure of a restoration.

Self-adhesive resin cements: pH-neutralization, hydrophilicity, and hygroscopic expansion stress

OBJECTIVES

The objective of the study was to investigate the relationship between pH-neutralization, hydrophilicity, and free hygroscopic expansion stress of self-adhesive resin cements (SARCs) after storage in artificial saliva.

MATERIALS AND METHODS

The SARCs RelyX Unicem Automix 2 (RX2, 3 M ESPE), iCEM (iCEM, Heraeus) and Maxcem Elite (MCE, Kerr) were under investigation in this study. Cylinders (height × diameter, 6 × 4mm) were prepared from each material and stored in artificial saliva (7d at 37 °C). Cylinder height was measured at baseline and after 7 days. After storage, the compression modulus was measured to calculate the free hygroscopic expansion stress. For pH-neutralization and hydrophilicity assessment, disks (height × diameter, 1 × 1.5 mm) were prepared, covered with electrolyte, and monitored over 24 h at 37 °C. Hydrophilicity was assessed using the static sessile drop technique at baseline and at different time intervals up to 24 h. Data were analyzed using one-way ANOVA and post hoc Student-Newman-Keuls test (S-N-K, α = 0.05).

RESULTS

After 24 h, RX2 (pH_24h 4.68) had a significantly higher (p < 0.05) pH-value than MCE (pH_24h 4.2) and iCEM (pH_24h 3.23). iCEM showed the significantly highest hydrophilicity (p < 0.05) after 24 h (θ_24h 85.02°), while MCE resulted lower (θ_24h 113.01°) in comparison with RX2 (θ_24h 108.11°). The resulting hygroscopic expansion stress of iCEM (29.15 MPa) was significantly higher (p < 0.05) compared to RX2 (14.5 MPa) and MCE (21.02 MPa).

CONCLUSIONS

The material with lowest pH-neutralization capacity displayed higher hydrophilicity after 24 h and higher hygroscopic expansion stress after 7 days compared to those with high pH-neutralization.

CLINICAL SIGNIFICANCE

Remnant hydrophilicity due to low pH-neutralization of SARCs could lead to cement interface stress build-up and long-term failure of silicate ceramic restorations.

Novel rechargeable calcium phosphate dental nanocomposite

OBJECTIVES

Calcium phosphate (CaP) composites with Ca and P ion release can remineralize tooth lesions and inhibit caries. But the ion release lasts only a few months. The objectives of this study were to develop rechargeable CaP dental composite for the first time, and investigate the Ca and P recharge and re-release of composites with nanoparticles of amorphous calcium phosphate (NACP) to achieve long-term inhibition of caries.

METHODS

Three NACP nanocomposites were fabricated with resin matrix of: (1) bisphenol A glycidyl dimethacrylate (BisGMA) and triethylene glycol dimethacrylate (TEGDMA) at 1:1 mass ratio (referred to as BT group); (2) pyromellitic glycerol dimethacrylate (PMGDM) and ethoxylated bisphenol A dimethacrylate (EBPADMA) at 1:1 ratio (PE group); (3) BisGMA, TEGDMA, and Bis[2-(methacryloyloxy)ethyl] phosphate (BisMEP) at 2:1:1 ratio (BTM group). Each resin was filled with 20% NACP and 50% glass particles, and the composite was photo-cured. Specimens were tested for flexural strength and elastic modulus, Ca and P ion release, and Ca and P ion recharge and re-release.

RESULTS

NACP nanocomposites had strengths 3-fold of, and elastic moduli similar to, commercial resin-modified glass ionomer controls. CaP ion recharge capability was the greatest for PE group, followed by BTM group, with BT group being the lowest (p<0.05). For each recharge cycle, CaP re-release reached similarly high levels, showing that CaP re-release did not decrease with more recharge cycles. After six recharge/re-release cycles, NACP nanocomposites without further recharge had continuous CaP ion release for 42 d.

SIGNIFICANCE

Novel rechargeable CaP composites achieved long-term and sustained Ca and P ion release. Rechargeable NACP nanocomposite is promising for caries-inhibiting restorations, and the Ca and P ion recharge and re-release method has wide applicability to dental composites, adhesives, cements and sealants to achieve long-term caries-inhibition.

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

OBJECTIVE

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

MATERIAL AND METHODS

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

RESULTS

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

CONCLUSION

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

CLINICAL RELEVANCE

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

Effect of a broad-spectrum LED curing light on the Knoop microhardness of four posterior resin based composites at 2, 4 and 6-mm depths

OBJECTIVE

To measure the Knoop microhardness at the bottom of four posterior resin-based composites (RBCs): Tetric EvoCeram Bulk Fill (Ivoclar Vivadent), SureFil SDR flow (DENTSPLY), SonicFill (Kerr), and x-tra fil (Voco).

METHODS

The RBCs were expressed into metal rings that were 2, 4, or 6-mm thick with a 4-mm internal diameter at 30°C. The uncured specimens were covered by a Mylar strip and a Bluephase 20i (Ivoclar Vivadent) polywave(®) LED light-curing unit was used in high power setting for 20s. The specimens were then removed and placed immediately on a Knoop microhardness-testing device and the microhardness was measured at 9 points across top and bottom surfaces of each specimen. Five specimens were made for each condition.

RESULTS

As expected, for each RBC there was no significant difference in the microhardness values at the top of the 2, 4 and 6-mm thick specimens. SureFil SDR Flow was the softest resin, but was the only resin that had no significant difference between the KHN values at the bottom of the 2 and 4-mm (Mixed Model ANOVA p<0.05). Although the KHN of SureFil SDR Flow was only marginally significantly different between the 2 and 6-mm thickness, the bottom at 6-mm was only 59% of the hardness measured at the top.

CLINICAL SIGNIFICANCE

This study highlights that clinicians need to consider how the depth of cure was evaluated when determining the depth of cure. SureFil SDR Flow was the softest material and, in accordance with manufacturer's instructions, this RBC should be overlaid with a conventional resin.

Effect of High Irradiance on Depth of Cure of a Conventional and a Bulk Fill Resin-based Composite

OBJECTIVES

This study evaluated the effect of using three commercial light curing units (LCUs) delivering a range of irradiance values, but delivering similar radiant exposures on the depth of cure of two different resin-based composites (RBCs).

METHODS

A conventional hybrid RBC (Z100 shade A2, 3M ESPE) or a bulk fill RBC (Tetric EvoCeram Bulk Fill shade IVA, Ivoclar Vivadent) was packed into a 10-mm deep semicircular metal mold with a 2-mm internal radius. The RBC was exposed to light from a plasma-arc-curing (PAC) light (Sapphire Plus, DenMat) for five seconds, a quartz-tungsten-halogen (QTH) light (Optilux 501, Kerr) for 40 seconds, or a light-emitting-diode (LED) light (S10, 3M ESPE) for 20 seconds and 40 seconds (control). The Knoop microhardness was then measured as soon as possible at the top surface and at three points every 0.5 mm down from the surface. For each RBC, a repeated measures analysis of variance (ANOVA) model was used to predict the Knoop hardness in a manner analogous to a standard regression model. This predicted value was used to determine at what depth the RBC reached 80% of the mean hardness achieved at the top surface with any light.

RESULTS

The PAC light delivered an irradiance and radiant exposure of 7328 mW/cm(2) and 36.6 J/cm(2), respectively, to the RBCs; the QTH light delivered 936 mW/cm(2) and 37.4 J/cm(2) and in 20 seconds the LED light delivered 1825 mW/cm(2) and 36.5 J/cm(2). In 40 seconds, the control LED light delivered a radiant exposure of 73.0 J/cm(2). For Z100, using 80% of the maximum hardness at the top surface as the criteria for adequate curing, all light exposure conditions achieved the 2.0-mm depth of cure claimed by the manufacturer. The LED light used for 40 seconds achieved the greatest depth of cure (5.0 mm), and the PAC light used for five seconds, the least (2.5 mm). Tetric EvoCeram Bulk Fill achieved a 3.5-mm depth of cure when the broad-spectrum QTH light was used for 40 seconds delivering 37.4 J/cm(2). It required a 40-second exposure time with the narrow-spectrum LED, delivering approximately 73 J/cm(2) to reach a depth of cure of 4 mm.

CONCLUSIONS

When delivering a similar radiant exposure of 37 J/cm(2), the QTH (40 seconds) and LED (20 seconds) units achieved a greater depth of cure than the PAC (five seconds) light. For both resins, the greatest depth of cure was achieved when the LED light was used for 40 seconds delivering 73 J/cm(2) (p<0.05).

Effect of the irradiance distribution from light curing units on the local micro-hardness of the surface of dental resins

OBJECTIVE

An inhomogeneous irradiance distribution from a light-curing unit (LCU) can locally cause inhomogeneous curing with locally inadequately cured and/or over-cured areas causing e.g. monomer elution or internal shrinkage stresses, and thus reduce the lifetime of dental resin based composite (RBC) restorations. The aim of the study is to determine both the irradiance distribution of two light curing units (LCUs) and its influence on the local mechanical properties of a RBC.

METHODS

Specimens of Arabesk TOP OA2 were irradiated for 5, 20, and 80s using a Bluephase® 20i LCU in the Low mode (666mW/cm(2)), in the Turbo mode (2222mW/cm(2)) and a Celalux® 2 (1264mW/cm(2)). The degree of conversion (DC) was determined with an ATR-FTIR. The Knoop micro-hardness (average of five specimens) was measured on the specimen surface after 24h of dark and dry storage at room temperature.

RESULTS

The irradiance distribution affected the hardness distribution across the surface of the specimens. The hardness distribution corresponded well to the inhomogeneous irradiance distributions of the LCU. The highest reaction rates occurred after approximately 2s light exposure. A DC of 40% was reached after 3.6 or 5.7s, depending on the LCU. The inhomogeneous hardness distribution was still evident after 80s of light exposure.

SIGNIFICANCE

The irradiance distribution from a LCU is reflected in the hardness distribution across the surface. Irradiance level of the LCU and light exposure time do not affect the pattern of the hardness distribution--only the hardness level. In areas of low irradiation this may result in inadequate resin polymerization, poor physical properties, and hence premature failure of the restorations as they are usually much smaller than the investigated specimens. It has to be stressed that inhomogeneous does not necessarily mean poor if in all areas of the restoration enough light intensity is introduced to achieve a high degree of cure.

Simultaneous measurement of polymerization stress and curing kinetics for photo-polymerized composites with high filler contents

OBJECTIVES

Photopolymerized composites are used in a broad range of applications with their performance largely directed by reaction kinetics and contraction accompanying polymerization. The present study was to demonstrate an instrument capable of simultaneously collecting multiple kinetics parameters for a wide range of photopolymerizable systems: degree of conversion (DC), reaction exotherm, and polymerization stress (PS).

METHODS

Our system consisted of a cantilever beam-based instrument (tensometer) that has been optimized to capture a large range of stress generated by lightly-filled to highly-filled composites. The sample configuration allows the tensometer to be coupled to a fast near infrared (NIR) spectrometer collecting spectra in transmission mode.

RESULTS

Using our instrument design, simultaneous measurements of PS and DC are performed, for the first time, on a commercial composite with ≈80% (by mass) silica particle fillers. The in situ NIR spectrometer collects more than 10 spectra per second, allowing for thorough characterization of reaction kinetics. With increased instrument sensitivity coupled with the ability to collect real time reaction kinetics information, we show that the external constraint imposed by the cantilever beam during polymerization could affect the rate of cure and final degree of polymerization.

SIGNIFICANCE

The present simultaneous measurement technique is expected to provide new insights into kinetics and property relationships for photopolymerized composites with high filler content such as dental restorative composites.

Addition of benzalkonium chloride to self-adhesive resin-cements: some clinically relevant properties

OBJECTIVE

The clinical survival rates of the adhesive restorations are limited due to the deterioration of resin-dentin bonds over time, partly due to the endogenous enzymatic activity of dentin. Recently, benzalkonium chloride (BAC) has been shown to effectively inhibit endogenous protease activity of dentin. This study evaluated the effect of different concentrations of benzalkonium chloride (BAC) on the degree of conversion (DC), vickers hardness (VH), setting time (ST) and biaxial flexural strength (FS) of two self-adhesive resin luting cements (RC).

METHODS

Two RC SpeedCEM (Ivoclar-Vivadent) and BisCem (Bisco) were modified by addition of 0.1, 0.5, 1, 1.5, 2 wt% BAC. The luting cements without the addition of BAC served as control. The DC (FT-IR/ATR from the bottom of the resin disc), vickers hardness (from top and bottom of the light-cured specimen), setting time (ISO 4049) and biaxial flexural strength (0.6 × 6 mm discs) of the specimens were tested. Data were analyzed using ANOVA and Tukeys HSD.

RESULTS

DC results were in the range of 70-80%, with some significant changes in BisCem (p < 0.05). VH values of both materials increased significantly compared to control, with no significant change as the BAC percentage increases. BAC addition influenced the ST differently for both materials. For BisCem, a gradual decrease (p < 0.05) was observed whereas, for SpeedCEM, a gradual increase was observed until 1% BAC (p < 0.05). For FS values, a gradual decrease was observed for both materials with increased amounts of BAC (p < 0.05), compared to the control group.

CONCLUSIONS

BAC addition of up to 1% seems to be acceptable considering the properties tested. Clinical significance. Incorporation of benzalkonium chloride to self-adhesive resin luting cements during the mixing procedure does not significantly affect the degree of conversion or flexural strength of the luting agent and may be a good option to improve the durability of adhesive interface.

Shrinkage stress development in dental composites--an analytical treatment

OBJECTIVES

The aim of this paper is to develop a comprehensive mathematical model for shrinkage stress development in dental composites that can account for the combined effect of material properties, specimen geometry and external constraints.

METHODS

A viscoelastic model that includes the composite's elastic, creep and shrinkage strains, and their interaction with the sample's dimensions and the external constraint is developed. The model contains two dimensionless parameters. The first one represents the compliance of the external constraint relative to that of the composite sample, and the second controls the rate of shrinkage stress decay through creep. The resulting differential equation is solved for two special cases: zero compliance and zero creep. Predictions for shrinkage stress measurements are then made using the analytical solutions for instruments with different compliances, samples with different thicknesses and composites with different filler fractions.

RESULTS

The model correctly predicts how shrinkage stress increases with time, its dependence on the interaction between the entire system's compliance and the material properties, and the effect of the filler fraction on its maximum value. Comparisons with reported shrinkage stress measurements have provided very good agreement between theory and experiments.

SIGNIFICANCE

The results provided by the model can help to resolve most, if not all, of the seemingly conflicting experimental observations reported in the literature. They can also provide some useful guidelines for optimizing the mechanical performance of dental composite restorations. The compliance ratio, a new parameter derived from the model, represents a fuller description of the constraints of the system.

Kinetics of polymerization and contraction stress development in self-adhesive resin cements

OBJECTIVES

The aim of the study was to evaluate the contraction stress, microhardness and polymerization kinetics of three self-adhesive cements vs. conventional dual-cure resin cement.

METHODS

Cements tested were: RelyX Unicem (3M ESPE, St. Paul, MN, USA), MaxCem Elite (Kerr, Orange, CA, USA), Clearfil SA Cement (Kuraray, Tokyo, Japan) and Duolink (Bisco Inc., Schaumburg, IL, USA). Cements were irradiated with a LED-curing unit (bluephase, IvoclarVivadent) for 20 or 40 s and the contraction forces (N) generated during polymerization were continuously recorded for 6 h with a universal testing machine. Polymerization kinetics were monitored using micro-Raman spectroscopy and degree of conversion was calculated. Vickers microhardness was also recorded. All measurements were performed at 10 min and 6h. Data were statistically analyzed by three-way ANOVA with repeated measures and Tukey's post hoc test (α=0.05).

RESULTS

Irrespective of exposure time, stress analysis ranked in the following order: Clearfil SA Cement<MaxCem<RelyX Unicem≤Duolink (p<0.05). Stress was correlated with microhardness values (p<0.05). Kinetic curves showed that maximum degree of conversion was attained more quickly than maximum stress after light activation.

SIGNIFICANCE

The conventional resin-based cement showed higher stress values than the self-adhesive cements. The results were material-dependent and probably correlated to the composition of each material.

The effect of specimen temperature on the polymerization of a resin-composite

OBJECTIVE

To use rapid scan FT-IR and Knoop microhardness to determine the effect of specimen temperature on the rate and extent of polymerization of a dental resin.

METHODS

Two-millimeter thick specimens of shade A2 Tetric EvoCeram were light cured for 20s at 22, 26, 30, and 35°C. The IR spectrum was obtained at the bottom of the specimens at a rate of 3 measurements per second for the first 5 min, and then again 2h later. The Knoop microhardness was measured at the bottom of the samples in the region where the IR spectrum was recorded at 5 min and 2h after light curing. Data were statistically analyzed using mixed model ANOVA (with Fisher's PLSD) to examine the effect of temperature, time and their interaction. The rate of conversion was determined using first differences and smoothed using a cubic spline procedure.

RESULTS

The bottom surfaces of the samples light cured at 22, 26, 30 and 35°C were all significantly different from each other (p<0.05). The higher temperature resulted in higher degree of conversion and Knoop microhardness values, and faster maximum rate of polymerization, which also occurred sooner. One second after the light was turned on, the rate of conversion was 106% faster at 35°C than at 22°C (p=0.003). Regression analysis showed a positive linear correlation between the degree of conversion and Knoop microhardness (r²=0.93).

SIGNIFICANCE

A relatively small difference in temperature can have a large and significant effect on the rate and extent of polymerization of dental resin. Consequently laboratory studies comparing the performance of resins should be conducted at clinically relevant temperatures.