Conversion, shrinkage, water sorption, flexural strength and modulus of re-mineralizing dental composites

3D micro-CT and O-PTIR spectroscopy bring new understanding of the influence of filler content in dental resin composites

BACKGROUND

Dental resin composites' performance is intricately linked to their polymerisation shrinkage characteristics. This study compares polymerisation shrinkage using advanced 3D micro-computed tomography (micro-CT) and traditional 2D linear assessments. It delves into the crucial role of filler content on shrinkage and the degree of conversion in dental resin composites, providing valuable insights for the field.

METHODS

Five experimental dental composite materials were prepared with increasing filler contents (55-75 wt%) and analysed using either 3D micro-CT for volumetric shrinkage or a custom-designed linometer for 2D linear shrinkage. The degree of conversion was assessed using Optical Photothermal Infrared (O-PTIR) and Fourier-Transform Infrared (FTIR) spectroscopy. Light transmittance through a 2-mm layer was evaluated using a NIST-calibrated spectrometer. Scanning Electron Microscopy (SEM) and Energy-Dispersive X-ray Spectroscopy (EDX) examined surface morphology and elemental distribution. Correlation between the investigated parameters was determined using Spearman correlation analyses.

RESULTS

The study found significant differences in polymerisation-related properties among different filler content categories, with volumetric shrinkage consistently demonstrating higher mean values than linear shrinkage across most groups. Volumetric shrinkage decreased with increasing curing depth, showing no direct correlation between filler content and shrinkage levels at different curing depths. The results highlighted a strong negative correlation between filler content and degree of conversion, volumetric and linear shrinkage, as well as maximum shrinkage rate. Light transmittance showed a moderate correlation with the filler content and a weak correlation with other tested parameters.

CONCLUSIONS

This study underscores the importance of considering both volumetric and linear shrinkage in the design and analysis of dental composite materials. The findings advocate optimising filler content to minimise shrinkage and enhance material performance. Integrating micro-CT and O-PTIR techniques offers novel insights into dental composites' polymerisation behaviour, providing a foundation for future research to develop materials with improved clinical outcomes.

The development of resin-coating materials for enhancing elemental release of coated glass ionomer cements

This study aimed to develop resin coatings containing monocalcium phosphate monohydrate (MCPM), Sr/F-doped bioactive glass (Sr/F-BAGs), and pre-reacted glass ionomer fillers (SPG) that enhance ion release without detrimentally affecting the mechanical properties of GIC. The objective of this study was to evaluate the degree of monomer conversion (DC), biaxial flexural strength, surface microhardness, and ion release of the GICs coated with experimental coating materials compared to a commercial product (EQUIA Coat, EC). Four experimental resin coating materials containing 10-20 wt% of MCPM with Sr/F-BAGs and 5-10 wt% SPG were prepared. The DC of the coating material was determined using ATR-FTIR. The flexural strength and surface microhardness of the coated GICs were assessed. Fluoride and elemental (Ca,P,Sr,Si,Al) release were measured using fluoride-specific electrodes and ICP-OES. The DC of the experimental coating material (60-69 %) was higher than that of EC (55 %). The strength of GICs coated with experimental materials (35-40 MPa) was comparable to EC (37 MPa). However, their surface microhardness (13-24 VHN) was lower than EC (44 VHN). The experimental coating materials reduced fluoride release by ∼43 %, similar to EC (∼40 %). However, experimental coating materials promoted higher P and Sr release than EC. In conclusion, GICs coated with the experimental resin coating containing ion-releasing additives exhibited mechanical properties similar to those of the commercial product. The new coating materials promoted a higher level of ion release for GICs. These properties could potentially enhance remineralizing actions for the coated GICs.

Ion release mechanisms in composites containing CaP particles and hydrophilic monomers

OBJECTIVE

To investigate the effect of hydrophilic/permeable polymer matrices on water sorption/solubility (WS/SL), Ca2+ release, mechanical properties and hydrolytic degradation of composites containing dicalcium phosphate dihydrate (DCPD) particles.

METHODS

Six composites were tested, all with 10 vol% of glass particles and either 30 vol% or 40 vol% DCPD. Composites containing 1BisGMA:1TEGDMA in mols (at both inorganic levels) were considered controls. Four materials were formulated where 0.25 or 0.5 of the BisGMA/TEGDMA was replaced by pyromellitic dianhydride glycerol dimethacrylate (PMGDM)/ polyethylene glycol dimethacrylate (PEGDMA). Composites were tested for degree of conversion (FTIR spectroscopy), WS/SL (ISO 4049) and Ca2+ release (inductively coupled plasma optical emission spectroscopy). Fracture toughness (FT) and biaxial flexural strength/modulus (BFS/FM) were determined after 24 h and 60 days in water. The contributions of diffusional and relaxational mechanisms to Ca2+ release kinetics were analyzed using the semi-empirical Salim-Peppas model. Data were analysed by ANOVA/Tukey test (alpha: 0.05).

RESULTS

WS/SL was higher for composites containing PMGDM/PEGDMA compared to the controls (p < 0.001). Only at 40% DCPD the 0.5 PMGDM/PEGDMA composite showed statistically higher Ca2+ release than the control. Relaxation diffusion was the main release mechanism. Initial FT was not negatively affected by matrix composition. BFS (both DCPD fractions) and FM (30% DCPD) were lower for composites with hydrophilic/permeable networks (p < 0.01). After 60 days in water, composites with PMGDM/PEGDMA presented significant reductions in FT, while all composites had reductions in BFS/FM.

SIGNIFICANCE

Increasing matrix hydrophilicity/permeability significantly increased Ca2+ release only at a high DCPD fraction.

Polymerization shrinkage of contemporary dental resin composites: Comparison of three measurement methods with correlation analysis

The aim of this study was to evaluate a novel approach for measuring the polymerization shrinkage of dental resin composites - measurement of sample depth variation. This new method was compared with two testing methodologies used for assessing the polymerization shrinkage (buoyancy and strain gauge methods). Eleven commercial resin composites were investigated (EverX Posterior; EverX Flow Bulk & Dentin; G-aenial Anterior, Posterior, A'chord & Universal Injectable; Filtek One Bulk Fill & Universal Restorative; SDR + Flow and Aura Bulk Fill). In addition, filler content (wt. %), flexural modulus, and the degree of conversion were evaluated. Shrinkage values, obtained by the buoyancy method, are greater than shrinkage evaluated by the strain gauge. There are significant differences in polymerization shrinkage among the tested resin composite materials. There is a strong correlation between the newly proposed method of shrinkage measurement and the buoyancy method (r2 = 0.8; p < 0.01). There is no correlation between volumetric shrinkage measurement (depth changes and buoyancy method) and linear strain measurement. Volumetric filler amount correlates with shrinkage values evaluated by all three methods. The degree of conversion for the tested resin composites ranges from 36 % to 52 %. There are some differences (around 10 %) between the filler content (wt. %) measured by the ashing-in-air method and the data given by the manufacturers. The highest flexural modulus is 14.8 GPa and the lowest 6.6 GPa. New formulations may introduce unknown relationships between the fundamental properties of dental resin composites.

Synthesis, monomer conversion, and mechanical properties of polylysine based dental composites

OBJECTIVE

The aim of this study was to synthesize a new bioactive and antibacterial composite by incorporating reactive calcium phosphate and antibacterial polylysine into a resin matrix and evaluate the effect of these fillers on structural analysis, degree of monomer conversion, mechanical properties, and bioactivity of these newly developed polypropylene based dental composites.

METHODOLOGY

Stock monomers were prepared by mixing urethane dimethacrylate and polypropylene glycol dimethacrylate and combined with 40 wt% silica to make experimental control (E-C). The other three experimental groups contained a fixed percentage of silica (40 wt%), monocalcium phosphate monohydrate, and β-tri calcium phosphate (5 wt% each) with varying amounts of polylysine (PL). These groups include E-CCP0 (0 wt% PL), E-CCP5 (5 wt% PL) and E-CCP10 (10 wt% PL). The commercial control used was Filtek™ Z250 3M ESPE. The degree of conversion was assessed by using Fourier transform infrared spectroscopy (FTIR). Compressive strength and Vicker's micro hardness testing were evaluated after 24 h of curing the samples. For bioactivity, prepared samples were placed in simulated body fluid for 0, 1, 7, and 28 days and were analyzed using a scanning electron microscope (SEM). SPSS 23 was used to analyze the data and one-way ANOVA and post hoc tukey's test were done, where the significant level was set ≤0.05.

RESULTS

Group E-C showed better mechanical properties than other experimental and commercial control groups. Group E-C showed the highest degree of conversion (72.72 ± 1.69%) followed by E-CCP0 (72.43 ± 1.47%), Z250 (72.26 ± 1.75%), E-CCP10 (71.07 ± 0.19%), and lowest value was shown by E-CCP5 (68.85 ± 7.23%). In shear bond testing the maximum value was obtained by E-C. The order in decreasing value of bond strength is E-C (8.13 ± 3.5 MPa) > Z250 (2.15 ± 1.1 MPa) > E-CCP10 (2.08 ± 2.1 MPa) > E-CCP5 (0.94 ± 0.8 MPa) > E-CCP0 (0.66 ± 0.2 MPa). In compressive testing, the maximum strength was observed by commercial control i.e., Z250 (210.36 ± 18 MPa) and E-C (206.55 ± 23 MPa), followed by E-CCP0 (108.06 ± 19 MPa), E-CCP5 (94.16 ± 9 MPa), and E-CCP10 (80.80 ± 13 MPa). The maximum number of hardness was shown by E-C (93.04 ± 8.23) followed by E-CCP0 (38.93 ± 9.21) > E-CCP10 (35.21 ± 12.31) > E-CCP5 (34.34 ± 12.49) > Z250 (25 ± 2.61). SEM images showed that the maximum apatite layer as shown by E-CCP10 and the order followed as E-CCP10 > E-CCP5 > E-CCP0 >Z250> E-C.

CONCLUSION

The experimental formulation showed an optimal degree of conversion with compromised mechanical properties when the polylysine percentage was increased. Apatite layer formation and polylysine at the interface may result in remineralization and ultimately lead to the prevention of secondary caries formation.

Influence of Specimen Dimension, Water Immersion Protocol, and Surface Roughness on Water Sorption and Solubility of Resin-Based Restorative Materials

The evaluation of water sorption and solubility is pivotal for the development of new resin-based restorative materials with the potential for clinical application. The purpose of the present study was to evaluate the influence of the specimen dimension, water immersion protocol, and surface roughness on the water sorption and solubility of three resin-based restorative materials. Disk-shaped specimens of 15 mm × 1 mm, 10 mm × 1 mm, and 6 mm × 1 mm were produced with a composite resin (Z100), a resin cement (RelyX ARC), and an adhesive system (Single Bond 2-SB2). The specimens were immersed in distilled water according to four protocols: ISO (all the specimens for each group were vertically immersed in 50 mL); IV-10 (the specimens were individually and vertically immersed in 10 mL); IH-10 (the specimens were individually and horizontally immersed in 10 mL); and IH-2 (the specimens were individually and horizontally immersed in 2 mL). The surface roughness (Sa and Sp) was evaluated using an atomic force microscope, and the degree of conversion was determined using FT-IR spectrometry. The specimen dimension and water immersion protocol had no effect on water sorption and solubility. For the three resin-based restorative materials, Sp was higher than Sa. The degree of conversion was not influenced by the specimen dimension. The variations in the specimen dimension and water immersion protocol compared to those determined by ISO 4049 did not prevent the comparison between the values of water sorption and solubility obtained for a given resin-based restorative material.

Assessment of Degree of Conversion and Volumetric Shrinkage of Novel Self-Adhesive Cement

The degree of monomer conversion and polymerization shrinkage are two of the main reasons for potential adhesion failure between the tooth structure and the restoration substrate. To evaluate the degree of conversion and polymerization shrinkage of a newly developed self-adhesive resin cement, the degree of conversion (DC) was measured using FTIR under different activation modes, temperatures, and times. Volumetric shrinkage was tested using the AcuVol video imaging method. The experimental cement showed a higher DC than other cements under self-curing. The DC of the experimental cement was higher than that of other cements, except SpeedCem Plus under light curing. The experimental cement had a higher DC than other cements, except SpeedCem Plus in some conditions under dual curing. All self-adhesive cements had a higher DC at 37 °C than at 23 °C under self-curing, and there was no statistical difference between 23 °C and 37 °C under light curing. All self-adhesive cements showed a significantly higher DC at 10 min than at 5 min under self-curing. There was no statistical difference between 5 min and 10 min for most cements under dual curing. All self-adhesive cements statistically had the same volumetric shrinkage under light curing and self-curing. The newly developed self-adhesive resin cement exhibited a higher degree of conversion and similar volumetric shrinkage compared to these commercial self-adhesive resin cements.

Modifying dental composites to formulate novel methacrylate-based bone cements with improved polymerisation kinetics, and mechanical properties

OBJECTIVES

The aim was to develop bone composites with similar working times, faster polymerisation and higher final conversion in comparison to Cortoss™. Additionally, low shrinkage/heat generation and improved short and longer-term mechanical properties are desirable.

METHODS

Four urethane dimethacrylate based composites were prepared using tri-ethylene-glycol dimethacrylate (TEGDMA) or polypropylene dimethacrylate (PPGDMA) diluent and 0 or 20 wt% fibres in the glass filler particles. FTIR was used to determine reaction kinetics, final degrees of conversions, and polymerisation shrinkage/heat generation at 37 °C. Biaxial flexural strength, Young's modulus and compressive strength were evaluated after 1 or 30 days in water.

RESULTS

Experimental materials all had similar inhibition times to Cortoss™ (140 s) but subsequent maximum polymerisation rate was more than doubled. Average experimental composite final conversion (76%) was higher than that of Cortoss™ (58%) but with less heat generation and shrinkage. Replacement of TEGDMA by PPGDMA gave higher polymerisation rates and conversions while reducing shrinkage. Early and aged flexural strengths of Cortoss™ were 93 and 45 MPa respectively. Corresponding compressive strengths were 164 and 99 MPa. Early and lagged experimental composite flexural strengths were 164-186 and 240-274 MPa whilst compressive strengths were 240-274 MPa and 226-261 MPa. Young's modulus for Cortoss™ was 3.3 and 2.2 GPa at 1 day and 1 month. Experimental material values were 3.4-4.8 and 3.0-4.1 GPa, respectively. PPGDMA and fibres marginally reduced strength but caused greater reduction in modulus. Fibres also made the composites quasi-ductile instead of brittle.

SIGNIFICANCE

The improved setting and higher strengths of the experimental materials compared to Cortoss™, could reduce monomer leakage from the injection site and material fracture, respectively. Lowering modulus may reduce stress shielding whilst quasi-ductile properties may improve fracture tolerance. The modified dental composites could therefore be a promising approach for future bone cements.

Enhanced anti-bacterial adhesion effect of FDMA/SR833s based dental resin composites by using 1H,1H-heptafluorobutyl methacrylate as partial diluent

With the purpose of further reducing surface free energy to achieve better anti-bacterial adhesion effect of fluorinated dimethacrylate (FDMA)/tricyclo (5.2.1.0) decanedimethanol diacrylate (SR833s) based dental resin composites (DS), 1H,1H-heptafluorobutyl methacrylate (FBMA) was used to partially replace SR933s as reactive diluent. According to the degree of substitution, the obtained resin composites were marked as DSF-1 (20 wt.% of SR833s was replaced by FBMA), DSF-2 (40 wt.% of SR833s was replaced by FBMA), and DSF-3 (60 wt.% of SR833s was replaced by FBMA). Bisphenol A glycidyl dimethacrylate (Bis-GMA)/triethylene glycol dimethacrylate (TEGDMA) based resin composite (BT) was used as control. The influence of FBMA concentration on double bond conversion (DC), contact angle, surface free energy, anti-bacterial adhesion effect against Streptococcus mutans (S. mutans), volumetric shrinkage (VS) and shrinkage stress (SS), flexural strength (FS) and modulus (FM), water sorption (WS) and solubility (SL) were investigated. The results showed that FBMA addition could reduce surface free energy from 44.6 mN/m for DS to 32.9 mN/m for DSF-3, and lead to better anti-bacterial adhesion effect (the amounts of adherent bacteria decreased from 2.03 × 105 CFU/mm2 for DS to 6.44 × 104 CFU/mm2 for DSF-3). The FBMA had no negative effects on DC, VS, SS, WS, and SL. Too high a concentration of FBMA reduced FS and FM before water immersion, but the values were still higher than those of BT.

Novel Remineralizing and Antibiofilm Low-Shrinkage-Stress Nanocomposites to Inhibit Salivary Biofilms and Protect Tooth Structures

Recurrent caries remain a persistent concern, often linked to microleakage and a lack of bioactivity in contemporary dental composites. Our study aims to address this issue by developing a low-shrinkage-stress nanocomposite with antibiofilm and remineralization capabilities, thus countering the progression of recurrent caries. In the present study, we formulated low-shrinkage-stress nanocomposites by combining triethylene glycol divinylbenzyl ether and urethane dimethacrylate, incorporating dimethylaminododecyl methacrylate (DMADDM), along with nanoparticles of calcium fluoride (nCaF2) and nanoparticles of amorphous calcium phosphate (NACP). The biofilm viability, biofilm metabolic activity, lactic acid production, and ion release were evaluated. The novel formulations containing 3% DMADDM exhibited a potent antibiofilm activity, exhibiting a 4-log reduction in the human salivary biofilm CFUs compared to controls (p < 0.001). Additionally, significant reductions were observed in biofilm biomass and lactic acid (p < 0.05). By integrating both 10% NACP and 10% nCaF2 into one formulation, efficient ion release was achieved, yielding concentrations of 3.02 ± 0.21 mmol/L for Ca, 0.5 ± 0.05 mmol/L for P, and 0.37 ± 0.01 mmol/L for F ions. The innovative mixture of DMADDM, NACP, and nCaF2 displayed strong antibiofilm effects on salivary biofilm while concomitantly releasing a significant amount of remineralizing ions. This nanocomposite is a promising dental material with antibiofilm and remineralization capacities, with the potential to reduce polymerization-related microleakage and recurrent caries.

Effect of varying functional monomers in experimental self-adhesive composites: polymerization kinetics, cell metabolism influence and sealing ability

The aim was to evaluate the effects of adding different functional monomers to experimental self-adhesive composites (SACs) on polymerization kinetics, cell metabolic activity, and sealing ability. SACs were formulated using urethane dimethacrylate as the base monomer and triethylene glycol dimethacrylate. Additionally, 10 wt.% of distinct functional monomers were added - 10-methacryloyloxydecyl dihydrogen phosphate, glycerol phosphate dimethacrylate (GPDM), 2-hydroxyethyl methacrylate (HEMA) or hydroxyethyl acrylamide (HEAA). ATR-FTIR was used to determine real-time polymerization kinetics (20 min,n= 3). The final extrapolated conversion and polymerization rates were determined (DC,max;Rp,max). TheDC,maxvalues were employed to calculate volumetric shrinkage. The MTT assay was performed on MDPC-23 cells using disc extracts at different concentrations (n= 8). Class V cavities were prepared in 60 sound human molars, assigned to six groups (n= 10), depending on the composite used and aging type (T0 or TC, if thermocycled for 10 000 cycles). One-way ANOVA, two-way, andKruskal-Wallistests were employed to treat the data (ɑ= 0.05). Varying the functional monomers had a large impact on DC,max, as confirmed by one-way ANOVA (p<0.001). The highest was obtained for HEMA (64 ± 3%). The HEMA and HEAA formulations were found to be significantly more toxic at concentrations below 100%. For microleakage, having a functional monomer or not did not show any improvement, irrespective of margin or aging period (Mann-Whitney U,p> 0.05). Larger functional monomers MDP and GPDM affected polymerization properties. Conversely, their acidity did not seem to be detrimental to cell metabolic activity. Regarding sealing ability, it seems that the functional monomers did not bring an advantage to the composites. Varying the functional monomer in SACs had a clear impact on the polymerization kinetics as well as on their cytotoxic potential. However, it did not confer better microleakage and sealing. Claiming self-adhesiveness based only on functional monomers seems dubious.

The effect of varying monocalcium phosphate and polylysine levels on dental composite properties

OBJECTIVES

The aim was to quantify effects of polylysine (PLS, 2 or 5 wt%) and monocalcium phosphate (MCP, 4 or 8 wt%) on properties of dental composites.

METHODS

Light-activated, lower surface polymerisation kinetics versus sample depth (1-4 mm) of 4 formulations were quantified using ATR-FTIR. Water sorption and solubility (at 1 week) were assessed following ISO/4049. PLS release (over 1 month) and biaxial flexural strength (over 6 months) of fully-cured, water-immersed, 1 mm thick discs were determined. Surface mineral precipitation, following immersion in simulated body fluid (SBF), was assessed by SEM. Z250 was used as a conventional composite comparator.

RESULTS

With 40s light exposure, increasing depth (from 1 to 4 mm) led to enhanced delay before polymerisation (from 3 to 17s) and decreased final conversion (72-66%) irrespective of PLS and MCP level. Increasing PLS and MCP raised solubility (4-13 μg/mm3). Water sorption (between 32 and 55 μg/mm3) and final PLS release (8-13% of disc content) were raised primarily by increasing PLS. Higher PLS also reduced strength. Strength reached minimum values (69-94 MPa) at 3 months. Surface mineral deposition was enhanced by increased MCP. For Z250, polymerisation delays (3-6s) and final conversions (55-54%) at 1-4 mm depth, solubility (0 μg/mm3), water sorption (16 μg/mm3) and strength (180 MPa) were all significantly different.

CONCLUSION

Delay time increased whilst final conversion decreased with thicker samples. Higher PLS enhances its percentage release, but lower level is required to keep water sorption, solubility and mechanical properties within ISO 4049 recommendations. Doubling MCP raises solubility and enhances minerals reprecipitation with minimal mechanical property compromise.

Effect of inorganic fillers on the light transmission through traditional or flowable resin-matrix composites for restorative dentistry

OBJECTIVES

The aim of this in vitro study was to evaluate the light transmission through five different resin-matrix composites regarding the inorganic filler content.

METHODS

Resin-matrix composite disc-shaped specimens were prepared on glass molds. Three traditional resin-matrix composites contained inorganic fillers at 74, 80, and 89 wt. % while two flowable composites revealed 60 and 62.5 wt. % inorganic fillers. Light transmission through the resin-matrix composites was assessed using a spectrophotometer with an integrated monochromator before and after light curing for 10, 20, or 40s. Elastic modulus and nanohardness were evaluated through nanoindentation's tests, while Vicker's hardness was measured by micro-hardness assessment. Chemical analyses were performed by FTIR and EDS, while microstructural analysis was conducted by optical microscopy and scanning electron microscopy. Data were evaluated using two-way ANOVA and Tukey's test (p < 0.05).

RESULTS

After polymerization, optical transmittance increased for all specimens above 650-nm wavelength irradiation since higher light exposure time leads to increased light transmittance. At 20- or 40-s irradiation, similar light transmittance was recorded for resin composites with 60, 62, 74, or 78-80 wt. % inorganic fillers. The lowest light transmittance was recorded for a resin-matrix composite reinforced with 89 wt. % inorganic fillers. Thus, the size of inorganic fillers ranged from nano- up to micro-scale dimensions and the high content of micro-scale inorganic particles can change the light pathway and decrease the light transmittance through the materials. At 850-nm wavelength, the average ratio between polymerized and non-polymerized specimens increased by 1.6 times for the resin composite with 89 wt. % fillers, while the composites with 60 wt. % fillers revealed an increased ratio by 3.5 times higher than that recorded at 600-nm wavelength. High mean values of elastic modulus, nano-hardness, and micro-hardness were recorded for the resin-matrix composites with the highest inorganic content.

CONCLUSIONS

A high content of inorganic fillers at 89 wt.% decreased the light transmission through resin-matrix composites. However, certain types of fillers do not interfere on the light transmission, maintaining an optimal polymerization and the physical properties of the resin-matrix composites.

CLINICAL SIGNIFICANCE

The type and content of inorganic fillers in the chemical composition of resin-matrix composites do affect their polymerization mode. As a consequence, the clinical performance of resin-matrix composites can be compromised, leading to variable physical properties and degradation.

Novel Bioactive Nanocomposites Containing Calcium Fluoride and Calcium Phosphate with Antibacterial and Low-Shrinkage-Stress Capabilities to Inhibit Dental Caries

OBJECTIVES

Composites are commonly used for tooth restorations, but recurrent caries often lead to restoration failures due to polymerization shrinkage-stress-induced marginal leakage. The aims of this research were to: (1) develop novel low-shrinkage-stress (L.S.S.) nanocomposites containing dimethylaminododecyl methacrylate (DMADDM) with nanoparticles of calcium fluoride (nCaF2) or amorphous calcium phosphate (NACP) for remineralization; (2) investigate antibacterial and cytocompatibility properties.

METHODS

Nanocomposites were made by mixing triethylene glycol divinylbenzyl ether with urethane dimethacrylate containing 3% DMADDM, 20% nCaF2, and 20% NACP. Flexural strength, elastic modulus, antibacterial properties against Streptococcus mutans biofilms, and cytotoxicity against human gingival fibroblasts and dental pulp stem cells were tested.

RESULTS

Nanocomposites with DMADDM and nCaF2 or NACP had flexural strengths matching commercial composite control without bioactivity. The new nanocomposite provided potent antibacterial properties, reducing biofilm CFU by 6 logs, and reducing lactic acid synthesis and metabolic function of biofilms by 90%, compared to controls (p < 0.05). The new nanocomposites produced excellent cell viability matching commercial control (p > 0.05).

CONCLUSIONS

Bioactive L.S.S. antibacterial nanocomposites with nCaF2 and NACP had excellent bioactivity without compromising mechanical and cytocompatible properties. The new nanocomposites are promising for a wide range of dental restorations by improving marginal integrity by reducing shrinkage stress, defending tooth structures, and minimizing cariogenic biofilms.

Novel Dental Low-Shrinkage-Stress Composite with Antibacterial Dimethylaminododecyl Methacrylate Monomer

OBJECTIVES

Current dental resins exhibit polymerization shrinkage causing microleakage, which has the potential to cause recurrent caries. Our objectives were to create and characterize low-shrinkage-stress (LSS) composites with dimethylaminododecyl methacrylate (DMADDM) as an antibacterial agent to combat recurrent caries.

METHODS

Triethylene glycol divinylbenzyl ether and urethane dimethacrylate were used to reduce shrinkage stress. DMADDM was incorporated at different mass fractions (0%, 1.5%, 3%, and 5%). Flexural strength, elastic modulus, degree of conversion, polymerization stress, and antimicrobial activity were assessed.

RESULTS

The composite with 5% DMADDM demonstrated higher flexural strength than the commercial group (p < 0.05). The addition of DMADDM in BisGMA-TEGDMA resin and LSS resin achieved clinically acceptable degrees of conversion. However, LSS composites exhibited much lower polymerization shrinkage stress than BisGMA-TEGDMA composite groups (p < 0.05). The addition of 3% and 5% DMADDM showed a 6-log reduction in Streptococcus mutans (S. mutans) biofilm CFUs compared to commercial control (p < 0.001). Biofilm biomass and lactic acid were also substantially decreased via DMADDM (p < 0.05).

CONCLUSIONS

The novel LSS dental composite containing 3% DMADDM demonstrated potent antibacterial action against S. mutans biofilms and much lower polymerization shrinkage-stress, while maintaining excellent mechanical characteristics. The new composite is promising for dental applications to prevent secondary caries and increase restoration longevity.

Water-Induced Changes in Experimental Resin Composites Functionalized with Conventional (45S5) and Customized Bioactive Glass

The aim of the study was to evaluate microhardness, mass changes during 1-year water immersion, water sorption/solubility, and calcium phosphate precipitation of experimental composites functionalized with 5-40 wt% of two types of bioactive glass (BG): 45S5 or a customized low-sodium fluoride-containing formulation. Vickers microhardness was evaluated after simulated aging (water storage and thermocycling), water sorption and solubility were tested according to ISO 4049, and calcium phosphate precipitation was studied by scanning electron microscopy, energy dispersive X-ray spectroscopy, and Fourier-transform infrared spectroscopy. For the composites containing BG 45S5, a significant reduction in microhardness was observed with increasing BG amount. In contrast, 5 wt% of the customized BG resulted in statistically similar microhardness to the control material, while higher BG amounts (20 and 40 wt%) resulted in a significant improvement in microhardness. Water sorption was more pronounced for composites containing BG 45S5, increasing 7-fold compared to the control material, while the corresponding increase for the customized BG was only 2-fold. Solubility increased with higher amounts of BG, with an abrupt increase at 20 and 40 wt% of BG 45S5. Calcium phosphate was precipitated by all composites with BG amounts of 10 wt% or more. The improved properties of the composites functionalized with the customized BG indicate better mechanical, chemical, and dimensional stability without compromising the potential for calcium phosphate precipitation.

Bioactive Inorganic Materials for Dental Applications: A Narrative Review

Over time, much attention has been given to the use of bioceramics for biomedical applications; however, the recent trend has been gaining traction to apply these materials for dental restorations. The bioceramics (mainly bioactive) are exceptionally biocompatible and possess excellent bioactive and biological properties due to their similar chemical composition to human hard tissues. However, concern has been noticed related to their mechanical properties. All dental materials based on bioactive materials must be biocompatible, long-lasting, mechanically strong enough to bear the masticatory and functional load, wear-resistant, easily manipulated, and implanted. This review article presents the basic structure, properties, and dental applications of different bioactive materials i.e., amorphous calcium phosphate, hydroxyapatite, tri-calcium phosphate, mono-calcium phosphate, calcium silicate, and bioactive glass. The advantageous properties and limitations of these materials are also discussed. In the end, future directions and proposals are given to improve the physical and mechanical properties of bioactive materials-based dental materials.

Novel antibacterial low-shrinkage-stress resin-based cement

OBJECTIVE

A low-shrinkage-stress resin-based cement with antibacterial properties could be beneficial to create a cement with lower stress at the tooth-restoration interface, which could help to enhance the longevity of the fixed dental restoration by reducing microleakage and recurrent caries. To date, there has been no report on the development of a low-shrinkage-stress and bio-interactive cement. Therefore, the objectives of this study were to develop a novel low-shrinkage-stress resin-based cement containing dimethylaminohexadecyl methacrylate (DMAHDM) and investigate the mechanical and antibacterial properties for the first time.

METHODS

The monomers urethane dimethacrylate (UDMA) and triethylene glycol divinylbenzyl ether (TEG-DVBE) were combined and denoted as UV resin. Three cements were fabricated: (1) UV+ 0%DMAHDM (experimental control); (2) UV+ 3%DMAHDM, (3) UV+ %5DMAHDM. RelyX Ultimate cement was used as commercial control. Mechanical properties and Streptococcus mutans (S. mutans) biofilms growth on cement were evaluated.

RESULTS

The novel bio-interactive cement demonstrated excellent antibacterial and mechanical properties. Compared to commercial and experimental controls, adding DMAHDM into the UV cement significantly reduced colony forming unit (CFU) counts by approximately 7 orders of magnitude, metabolic activities from 0.29 ± 0.03 A₅₄₀/cm² to 0.01 ± 0.01 A₅₄₀/cm², and lactic acid production from 22.3 ± 0.74 mmol/L to 1.2 ± 0.27 mmol/L (n = 6) (p < 0.05). The low-shrinkage-stress cement demonstrated a high degree of conversion of around 70 %, while reducing the shrinkage stress by approximately 60%, compared to a commercial control (p < 0.05).

CONCLUSIONS

The new antibacterial low-shrinkage-stress resin-based cement provides strong antibacterial action and maintains excellent mechanical properties with reduced polymerization shrinkage stress.

CLINICAL SIGNIFICANCE

A low-shrinkage-stress resin-based cement containing DMAHDM was developed with potent antibacterial effects and promising mechanical properties. This cement may potentially enhance the longevity of fixed dental restoration such as a dental crown, inlay, onlay, and veneers through its excellent mechanical properties, low shrinkage stress, and strong antibacterial properties.

Effects of Sr/F-Bioactive Glass Nanoparticles and Calcium Phosphate on Monomer Conversion, Biaxial Flexural Strength, Surface Microhardness, Mass/Volume Changes, and Color Stability of Dual-Cured Dental Composites for Core Build-Up Materials

This study prepared composites for core build-up containing Sr/F bioactive glass nanoparticles (Sr/F-BGNPs) and monocalcium phosphate monohydrate (MCPM) to prevent dental caries. The effect of the additives on the physical/mechanical properties of the materials was examined. Dual-cured resin composites were prepared using dimethacrylate monomers with added Sr/F-BGNPs (5 or 10 wt%) and MCPM (3 or 6 wt%). The additives reduced the light-activated monomer conversion by ~10%, but their effect on the conversion upon self-curing was negligible. The conversions of light-curing or self-curing polymerization of the experimental materials were greater than that of the commercial material. The additives reduced biaxial flexural strength (191 to 155 MPa), modulus (4.4 to 3.3), and surface microhardness (53 to 45 VHN). These values were comparable to that of the commercial material or within the acceptable range of the standard. The changes in the experimental composites' mass and volume (~1%) were similar to that of the commercial comparison. The color change of the commercial material (1.0) was lower than that of the experimental composites (1.5-5.8). The addition of Sr/F-BGNPs and MCPM negatively affected the physical/mechanical properties of the composites, but the results were satisfactory except for color stability.

Physical/mechanical and antibacterial properties of orthodontic adhesives containing Sr-bioactive glass nanoparticles, calcium phosphate, and andrographolide

White spot lesions around orthodontic brackets are the major complication during fixed orthodontic treatment. This study prepared orthodontic adhesives for promoting mineral precipitation and reducing bacterial growth. Adhesives with added calcium phosphate monohydrate/Sr-bioactive glass nanoparticles (Sr/CaP) and andrographolide were prepared. The physical/mechanical and antibacterial properties of the adhesives were tested. The additives reduced the monomer conversion of the materials (62 to 47%). The addition of Sr/CaP and andrographolide increased the water sorption (from 23 to 46 μg/mm³) and water solubility (from 0.2 to 5.9 μg/mm³) but reduced the biaxial flexural strength (from 193 to 119 MPa) of the adhesives. The enamel bond strengths of the experimental adhesives (19–34 MPa) were comparable to that of the commercial material (p > 0.05). The Sr/CaP fillers promoted Ca, Sr, and P ion release and the precipitation of calcium phosphate at the debonded interface. An increase in the Sr/CaP concentration enhanced the inhibition of S. mutans by 18%, while the effect of andrographolide was not detected. The abilities of the adhesives to promote ion release, calcium phosphate precipitation, and the growth inhibition of cariogenic bacteria were expected to reduce the occurrence of white spot lesions. The additives reduced the physical/mechanical properties of the materials, but the corresponding values were within the acceptable range.

Preparation of Ca doped wrinkled porous silica (Ca-WPS) for the improvement of apatite formation and mechanical properties of dental resins

The purpose of this work was to fabricate and characterize Ca doped wrinkled porous silica (Ca-WPS), and evaluate their effect on the mineralization and mechanical properties of resin composites as functional fillers. Ca-WPS were prepared by sol-gel method and characterized by scanning electron microscopy, transmission electron microscopy and N₂ adsorption-desorption measurements. The mineralization properties of the prepared Ca-WPS particles and the resin composites with different amount of Ca-WPS were evaluated by simulated body fluid (SBF) immersion method. The mechanical properties (flexural strength, flexural modulus, compressive strength and microhardness) of the dental resins containing unimodal Ca-WPS fillers and bimodal Ca-WPS fillers with nonporous silica were evaluated by a universal testing machine. Results showed that after immersing in SBF for 5 d, apatite formed on the surface of Ca-WPS and composites containing Ca-WPS fillers, indicating the excellent mineralization property of the prepared Ca-WPS. The mechanical properties of the dental resins increase with the increase of the proportion of unimodal Ca-WPS fillers. The dental resins with bimodal Ca-WPS fillers showed better mechanical properties than the group with only nonporous fillers at the same filler loading (60 wt%). Among all the samples, the dental composites filled with bimodal fillers (mass ratio of Ca-WPS: nonporous silica = 10:50, total filler loading 60 wt%) exhibited the best mechanical performance. The flexural strength, flexural modulus, compressive strength and microhardness of these samples were 26.96%, 42.75%, 16.04% and 54.1% higher than the composites with solid silica particles alone, respectively. Thus, the prepared Ca-WPS could effectively improve the apatite formation and mechanical properties of resin composites.

Influence of curing modes on conversion and shrinkage of dual-cure resin-cements

OBJECTIVE

To explore the effect of curing modes of dual-cure resin cements on their degree of conversion (DC) and polymerization shrinkage (PS) over specific post-activation periods.

METHODS

Five self-adhesive (PANAVIA SA, RelyX Universal Resin, RelyX Unicem 2, Bifix SE, and SpeedCEM Plus) and three conventional (PANAVIA V5, Nexus Third Generation, and RelyX Ultimate Universal) dual-cure resin cements were studied. Four specimens (n = 4) were made per curing mode (light/self-cure) to measure either DC or PS. FTIR was utilized to measure real-time DC (%) over 24 h. The Bonded Disk method was used to measure shrinkage at 23 °C over 1 h. The data were analyzed using one-way ANOVA, Tukey post-hoc tests and independent/ paired sample t-tests (a = 0.05).

RESULTS

After 1 h post-activation, the DC of light-cured (LC) specimens ranged between 66.6% and 77.4%, whereas for self-cured (SC) specimens DC ranged between 44.4% and 73.2%. After 24 h, the DC of LC specimens ranged between 74.8% and 82.4% and between 62.7% and 81.7% for SC specimens. After 24 h, the DC of three cements (BSE, PV5, and RXU) were comparable between their curing modes (p > 0.05), whereas five cements (CEM, NX3, PSA, RXU2, RXL) had significantly lower DC for SC compared to LC specimens (p < 0.05). After 1 h post-activation, shrinkage ranged between 5.9% and 8.5% for LC and between 4.9% and 8.3% for SC specimens. Most cements were not significantly different between curing modes. However, light-cured PAS, RXL and RXU2 had significantly higher shrinkage (p < 0.05). After 1 h post-activation, a strong positive correlation existed between conversion and shrinkage (LC: r² = 0.95 and SC: r² = 0.93).

SIGNIFICANCE

Whenever light access is possible, light-curing of resin-cements remains beneficial to the overall efficacy of their conversion and thus all factors that depend on that. Conversion and shrinkage behavior are intrinsically important factors in clinical selection of resin-cement products.

Physical/Mechanical and Antibacterial Properties of Orthodontic Adhesives Containing Calcium Phosphate and Nisin

Enamel demineralization around orthodontic adhesive is a common esthetic concern during orthodontic treatment. The aim of this study was to prepare orthodontic adhesives containing monocalcium phosphate monohydrate (MCPM) and nisin to enable mineralizing and antibacterial actions. The physicomechanical properties and the inhibition of S. mutans growth of the adhesives with added MCPM (5, 10 wt %) and nisin (5, 10 wt %) were examined. Transbond XT (Trans) was used as the commercial comparison. The adhesive containing a low level of MCPM showed significantly higher monomer conversion (42–62%) than Trans (38%) (p < 0.05). Materials with additives showed lower monomer conversion (p < 0.05), biaxial flexural strength (p < 0.05), and shear bond strength to enamel than those of a control. Additives increased water sorption and solubility of the experimental materials. The addition of MCPM encouraged Ca and P ion release, and the precipitation of calcium phosphate at the bonding interface. The growth of S. mutans in all the groups was comparable (p > 0.05). In conclusion, experimental orthodontic adhesives with additives showed comparable conversion but lesser mechanical properties than the commercial material. The materials showed no antibacterial action, but exhibited ion release and calcium phosphate precipitation. These properties may promote remineralization of the demineralized enamel.

In Vitro and In Vivo Efficacy of New Composite for Direct Pulp Capping

Objectives

To investigate physicochemical properties, dentin bonding, cytotoxicity, and in vivo pulp response of experimental self-adhesive composites tailored to direct pulp capping.

Materials and Methods

Experimental composites were prepared with beta-tricalcium phosphate and hydroxyapatite nanoparticles adsorbed with simvastatin and glutathione added at 0% (control resin), 1 wt% (Res 1%), and 10 wt% (Res 10%). A commercial light-curable calcium hydroxide (Ca(OH)₂) (Ultra-Blend Plus) was used as control material. The physicochemical properties investigated were flexural strength and modulus, calcium release, and degree of conversion. Dentin bonding was assessed by the push-out test. Proliferation and cell counting assays were performed to evaluate in vitro cytotoxicity using fluorescence microscopy. In vivo pulp capping was performed on molars of Wistar rats, which were euthanized after 14 days and evaluated by histological analysis.

Results

No statistical difference was observed in flexural strength and cell viability (p > 0.05). Res 10% presented higher modulus than control resin and Ca(OH)₂. Also, Res 10% attained statistically higher degree of conversion when compared to other experimental composites. Ca(OH)₂ showed higher calcium release after 28 and 45 days of storage, with no statistical difference at 45 days to Res 10%. All experimental composites achieved significantly higher bond strength when compared to Ca(OH)₂. While no significant difference was observed in the cell proliferation rates, resins at lower concentrations showed higher cell viability. In vivo evaluation of pulp response demonstrated no pulp damage with experimental composites.

Conclusions

The experimental composite investigated in this study achieved adequate physicochemical properties with minor in vivo pulpal inflammation and proved to be a valuable alternative for direct pulp capping.

Effects of Color Modifier on Degree of Monomer Conversion, Biaxial Flexural Strength, Surface Microhardness, and Water Sorption/Solubility of Resin Composites

Color modifiers can be mixed with resin composites to mimic the shade of severely discolored tooth. The aim of this study was to assess the effects of a color modifier on the physical and mechanical properties of a resin composite. The composite was mixed with a color modifier at 0 wt% (group 1), 1 wt% (group 2), 2.5 wt% (group 3), or 5 wt% (group 4). The degree of monomer conversion (DC) was examined after light curing for 20 or 40 s. Biaxial flexural strength (BFS)/modulus (BFM), surface microhardness (SH), and water sorption (W_sp)/solubility (W_sl) were also tested. The DC of group 1 was significantly higher than that of groups 3 and 4. The increase in curing time from 20 to 40 s increased the DC by ~10%. The BFS, BFM, W_sp, and W_sl of all the groups were comparable. A negative correlation was detected between the concentration of color modifier and the BFS and DC, while a positive correlation was observed with W_sp. In conclusion, the color modifier reduced the DC of composites, but the conversion was improved by extending the curing time. The increase in color modifier concentration also correlated with a reduction in strength and the increase in the water sorption of the composites.

Determination of Dental Adhesive Composition throughout Solvent Drying and Polymerization Using ATR-FTIR Spectroscopy

The of this study aim was to develop a rapid method to determine the chemical composition, solvent evaporation rates, and polymerization kinetics of dental adhesives. Single-component, acetone-containing adhesives One-Step (OS; Bisco, Anaheim, CA, USA), Optibond Universal (OU; Kerr, Brea, CA, USA), and G-Bond (GB; GC, Tokyo, Japan) were studied. Filler levels were determined gravimetrically. Monomers and solvents were quantified by comparing their pure Attenuated Total Reflectance-Fourier Transform Infra-Red (ATR-FTIR) spectra, summed in different ratios, with those of the adhesives. Spectral changes at 37 °C, throughout passive evaporation for 5 min, then polymerisation initiated by 20 s, and blue light emitting diode (LED) (600 mW/cm²) exposure (n = 3) were determined. Evaporation and polymerisation extent versus time and final changes were calculated using acetone (1360 cm^-1) and methacrylate (1320 cm^-1) peaks. OS, OU, and GB filler contents were 0, 9.6, and 5.3%. FTIR suggested OS and OU were Bis-GMA based, GB was urethane dimethacrylate (UDMA) based, and that each had a different diluent and acidic monomers and possible UDMA/acetone interactions. Furthermore, initial acetone percentages were all 40-50%. After 5 min drying, they were 0% for OS and OU but 10% for GB. Whilst OS had no water, that in OU declined from 18 to 10% and in GB from 25 to 20% upon drying. Evaporation extents were 50% of final levels at 23, 25, and 113 s for OS, OU, and GB, respectively. Polymerisation extents were all 50 and 80% of final levels before 10 and at 20 s of light exposure, respectively. Final monomer polymerisation levels were 68, 69, and 88% for OS, OU, and GB, respectively. An appreciation of initial and final adhesive chemistry is important for understanding the properties. The rates of evaporation and polymerisation provide indications of relative required drying and light cure times. UDMA/acetone interactions might explain the considerably greater drying time of GB.

Novel low-shrinkage-stress bioactive nanocomposite with anti-biofilm and remineralization capabilities to inhibit caries

Background/purpose

A common reason for dental composite restoration failure is recurrent caries at the margins. Our objectives were to: (1) develop a novel low-shrinkage-stress, antibacterial and remineralizing resin composite; (2) evaluate the effects of dimethylaminohexadecyl methacrylate (DMAHDM) on mechanical properties, biofilm inhibition, calcium (Ca) and phosphate (P) ion release, degree of conversion, and shrinkage stress on the new low-shrinkage-stress resin composite for the first time.

Material and methods

The resin consisted of urethane dimethacrylate (UDMA) and triethylene glycol divinylbenzyl ether (TEG-DVBE) with high resistance to salivary hydrolytic degradation. Composites were made with 0%–8% of DMAHDM for antibacterial activity, and 20% of nanoparticles of amorphous calcium phosphate (NACP) for remineralization. Mechanical properties and Streptococcus mutans biofilm growth on composites were assessed. Ca and P ion releases, degree of conversion and shrinkage stress were evaluated.

Results

Adding 2–5% DMAHDM and 20% NACP into the low-shrinkage-stress composite did not compromise the mechanical properties (p > 0.05). The incorporation of DMAHDM greatly reduced S. mutans biofilm colony-forming units by 2–5 log and lactic acid production by 7 folds, compared to a commercial composite (p < 0.05). Adding 5% DMAHDM did not compromise the Ca and P ion release. The low-shrinkage-stress composite maintained a high degree of conversion of approximately 70%, while reducing the shrinkage stress by 37%, compared to a commercial control (p < 0.05).

Conclusion

The bioactive low-shrinkage-stress composite reduced the polymerization shrinkage stress, without compromising other properties. Increasing the DMAHDM content increased the antibacterial effect in a dose-dependent manner.

Monomer Conversion, Dimensional Stability, Biaxial Flexural Strength, Ion Release, and Cytotoxicity of Resin-Modified Glass Ionomer Cements Containing Methacrylate-Functionalized Polyacids and Spherical Pre-Reacted Glass Fillers

The aim of this study was to prepare RMGICs for pulp protection that contain polyacids functionalized with methacrylate groups (CMs) to enable light-activated polymerization without the need for toxic 2-hydroxyethyl methacrylate (HEMA) monomers. The effects of using CM liquids with 0 or 5 wt% HEMA on the physical/mechanical properties and cytotoxicity of the experimental RMGICs were assessed. Spherical pre-reacted glass fillers (SPG) were used as the powder phase. The experimental RMGICs were prepared by mixing SPG with CM liquid (0 wt% HEMA, F1) or CMH liquid (5 wt% HEMA, F2). Commercial materials (Vitrebond, VB; TheraCal LC, TC) were used for the comparisons. The degree of monomer conversion and fluoride release of both F1 and F2 were significantly lower than those of VB. F1 showed comparable biaxial flexural strength with VB but higher strength than TC. The dimensional stability (mass/volume changes) of the experimental materials was comparable with that of the commercial materials. F1 and F2 exhibited higher Sr/Ca ion release and relative cell viability than VB. The use of CMH liquid reduced the strength but enhanced the fluoride release of the experimental RMGICs. In conclusion, the experimental RMGICs showed comparable strength but lower cytotoxicity compared to the commercial RMGICs. These novel materials could be used as alternative materials for pulp protection.

Rheological Properties, Surface Microhardness, and Dentin Shear Bond Strength of Resin-Modified Glass Ionomer Cements Containing Methacrylate-Functionalized Polyacids and Spherical Pre-Reacted Glass Fillers

The aim of this study was to prepare experimental resin-modified glass ionomer cements (RMGICs) containing low levels of hydroxyethyl methacrylate (HEMA) for pulp protection. Liquid and powder phases of the experimental RMGICs were polyacid functionalized with methacrylate groups and spherical pre-reacted glass fillers (SPG). Two types of liquid phase containing 0 wt. % HEMA (CM liquid) or 5 wt. % HEMA (CMH liquid) were formulated. The experimental RMGICs were prepared by mixing SPG fillers with CM liquid (F1) or CMH liquid (F2). Rheological properties were examined using a strain-controlled rheometer (n = 5). The Vickers microhardness (n = 5) and dentin shear bond strength (SBS) (n = 10) of the materials were tested. Commercial pulp protection materials (Vitrebond and TheraCal LC) were used as comparisons. The viscosity and surface microhardness of F1 (22 m Pa·s, 18 VHN) and F2 (18 m Pa·s, 16 VHN) were significantly higher than those of Vitrebond (6 mPa·s, 6 VHN) and TheraCal (0.1 mPa·s, 7 VHN). The SBS of F1 (10.7 MPa) and F2 (11.9 MPa) was comparable to that of Vitrebond (15.4 MPa) but higher than that of TheraCal LC (5.6 MPa). The addition of 5 wt. % HEMA showed no significant effect on viscosity, surface microhardness, or SBS of the experimental RMGICs. The experimental materials showed higher viscosity and microhardness but similar SBS when compared with the commercial RMGIC.

Flexural Properties of Bioactive Restoratives in Cariogenic Environments

This study determined the mechanical performance of bioactive restoratives in cariogenic environments and compared the flexural properties of various bioactive materials. The materials evaluated included a conventional resin-based composite (Filtek Z350 [FZ]) and 3 bioactive restoratives, namely an alkasite (Cention N [CN]), a giomer (Beautifil-bulk Restorative [BB]), and an enhanced resin-modified glass ionomer (Activa Bioactive Restorative [AV]). Beam-shaped specimens (12 x 2 x 2 mm) were produced, randomly allocated to 4 groups (n=10), and conditioned in deionized solution, remineralizing solution, demineralizing solution (DE), or pH cycled for 14 days at 37°C. After conditioning/pH cycling, the specimens were subjected to 3-point flexural testing. Flexural data were subjected to statistical analysis using analysis of variance or Tukey's test (α=0.05). Mean flexural modulus and strength ranged from 3.54 ± 0.33 to 7.44 ± 0.28 GPa, and 87.07 ± 8.99 to 123.54 ± 12.37 MPa, respectively. While the flexural modulus of the bioactive restoratives was not affected by cariogenic/acidic conditions, flexural strength usually decreased, with the exception of CN. The strength of BB was significantly reduced by DE and pH cycling, while that of AV was lowered by DE. For all conditioning mediums, AV had a significantly lower modulus than the other materials. Apart from conditioning in DE, where differences in flexural strength was insignificant, FZ and AV were generally significantly stronger than BB and CN. The effect of cariogenic environments on flexural strength was found to be material dependent, and aside from the alkasite material (CN), cariogenic conditions were observed to significantly decrease the strength of bioactive restoratives.

Varying 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) level improves polymerisation kinetics and flexural strength in self-adhesive, remineralising composites

OBJECTIVES

To assess the influence of systematically varying concentrations of 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) versus 3% 4-META on the polymerisation kinetics and shrinkage, biaxial flexural strength (BFS) and modulus of remineralising composites.

METHODS

Composites were prepared by adding poly(propylene glycol) dimethacrylate (24 wt%), camphorquinone (1 wt%) and MDP (0%, 5%, 10%, 15% and 20 wt%) or 4-META (3%) to urethane dimethacrylate. These were mixed with glass fillers containing 8 wt% monocalcium phosphate and 4 wt% polylysine (powder-liquid ratio of 3:1). Continuous spectral changes, following 20 s light exposure (37 °C), were assessed with an ATR-FTIR to monitor polymerisation kinetics (n = 3). Final extrapolated conversions (D_C,max) were employed to calculate polymerisation shrinkage. BFS and modulus of 24-h dry stored disc specimens (10 × 1 mm; n = 10) were determined using a ball-on-ring jig setup.

RESULTS

Maximum rate of polymerisation and D_C,max increased linearly from 2.5 to 3.5% s^-1 and 67 to 83%, respectively, upon increasing MDP from 0 to 20 wt%. Values with 3% 4-META were 2.6% s^-1 and 78%. Shrinkage was 3.8 ± 0.3% for all formulations. Raising 4-META or MDP from 0 to 3 versus 5%, respectively, increased strength from 106 to 145 versus 136 MPa. A decreasing trend with higher MDP concentrations was noted. Elastic modulus showed no specific trend upon MDP increase.

SIGNIFICANCE

Whilst final conversion levels were enhanced by 3% 4-META or >5% MDP, trends did not correlate with strength. Peak strengths with 3% 4-META or 5% MDP may therefore be due to acidic monomers providing linkage between the hydrophilic, non-silane treated particles and the polymer matrix.

Methacrylate peak determination and selection recommendations using ATR-FTIR to investigate polymerisation of dental methacrylate mixtures

Investigation of polymerisation kinetics using ATR-FTIR systems is common in many dental studies. However, peak selection methods to calculate monomer-polymer conversion can vary, consequently affecting final results. Thus, the aim of this study is to experimentally confirm which method is less prone to systematic errors. Three commercial restorative materials were tested-Vertise Flow (VF), Constic and Activa Bioactive Restorative Kids. Firstly, Attenuated Total Reflectance Fourier Transform Infra-Red (ATR-FTIR) (Spectrum One, Perkin-Elmer, UK) spectra of monomers were acquired-10-methacryloyloxy decyl dihydrogen phosphate (10-MDP), bisphenol-A glycidyl dimethacrylate (Bis-GMA), 2-hydroxyethyl methacrylate (HEMA), triethyelene glycol dimethacrylate (TEGDMA) and urethane dimethacrylate (UDMA) to investigate proportionality of methacrylate peak heights versus concentration. Spectral changes upon light exposure of 2 mm discs of the restorative materials (irradiated for 20 s, LED curing unit 1100-1330 mW/cm2) were assessed to study polymerisation kinetics (n = 3), with continuous acquisition of spectra, before, during and after light exposure. Peak differences and degrees of conversion (DC %) were calculated using 1320/1336, 1320/1350 and 1636/1648 cm-1 as reaction/reference peaks. Inferential statistics included a MANOVA and within-subjects repeated measures ANOVA design (5% significance level). Proportionality of methacrylate peak height to concentration was confirmed, with the 1320/1352 cm-1 peak combination showing the lowest coefficient of variation (8%). Difference spectra of the polymerisation reaction showed noise interference around the 1500-1800 cm-1 region. Across the different materials, DC % results are highly dependent upon peak selection (p<0.001), with higher variability associated to the 1636 cm-1. Significant differences in the materials were only detected when the 1320 cm-1 peak was used (p<0.05). Within the same materials, methods were significantly different for Constic and Activa (p<0.05). It is possible to conclude that the 1320 cm-1 peak is more adequate to assess polymerisation of methacrylates and is therefore recommended.

Modelling ATR-FTIR Spectra of Dental Bonding Systems to Investigate Composition and Polymerisation Kinetics

Component ratios and kinetics are key to understanding and optimising novel formulations. This warrants investigation of valid methods. Attenuated Total Reflectance Fourier Transform Infra-Red (ATR)-FTIR spectra of separate primers/adhesives were modelled using summed spectra of solvents (water, ethanol), methacrylate monomers (HEMA (hydroxyethyl methacrylate), Bis-GMA (bisphenol A glycidyl methacrylate), and 10-MDP (10-methacryloyloxydecyl dihydrogen phosphate)), and fillers, multiplied by varying fractions. Filler loads were obtained following their separation from the adhesives, by analysing three repetitions (n = 3). Spectral changes during light exposure at 37 °C (20 s, LED 1100-1330 mW/cm2) were used to determine polymerisation kinetics (n = 3). Independent samples T-test was used for statistical analysis (significance level of 5%). FTIR modelling suggested a primer solvent percentage of OBFL (Optibond FL) (30%) was half that of CFSE (Clearfil SE 2) (60%). OBFL included ethanol and water, while CFSE included only water. Monomer peaks were largely those of HEMA with lower levels of phosphate monomers. OBFL/CFSE adhesive model spectra suggested that both contained equal volumes of Bis-GMA/HEMA, with CFSE having 10-MDP. Filler levels and spectra from OBFL (48 wt.%) and CFSE (5 wt.%) were different. Both systems reached a 50% conversion rate within seconds of light exposure. The final conversion for OBFL (74 ± 1%) was lower compared to CFSE (79 ± 2%) (p < 0.05). ATR-FTIR is a useful method to investigate relative levels of main components in bonding systems and their polymerisation kinetics. Such information is valuable to understanding such behaviour.

Monomer conversion, biaxial flexural strength, apatite forming ability of experimental dual-cured and self-adhesive dental composites containing calcium phosphate and nisin

The aim was to develop dual-cured, self-adhesive composites containing monocalcium phosphate monohydrate (MCPM, 8 or 4 wt%) and nisin (6 or 3 wt%) with added adhesive monomer. The effect of additives on monomer conversion (MC), biaxial flexural strength (BFS), dentin shear bond strength (SBS), and surface apatite formation were examined. All experimental composites showed light-activated MC (70-75%) higher than the commercial self-adhesive composite (Vertise Flow; VF, 65%). The additives reduced BFS of the composites from 217 to 133 MPa. SBS of the experimental composites (2-6 MPa) was lower than that of VF (12 MPa). Rising MCPM level enabled apatite-like crystals precipitated on the surface of composites after immersion in simulated body fluid for 4 weeks. The additives showed negligible effect on MC and SBS. Rising level of additives reduced strength of the composites but the values were still higher than that required by the standard.

Early Polylysine Release from Dental Composites and Its Effects on Planktonic Streptococcus mutans Growth

The study aim was to assess the effect of incorporating polylysine (PLS) filler at different mass fractions (0.5, 1 and 2 wt%) on PLS release and Streptococcus mutans planktonic growth. Composite containing PLS mass and volume change and PLS release upon water immersion were assessed gravimetrically and via high-performance liquid chromatography (HPLC), respectively. Disc effects on bacterial counts in broth initially containing 8 × 10⁵ versus 8 × 10⁶ CFU/mL Streptococcus mutans UA159 were determined after 24 h. Survival of sedimented bacteria after 72 h was determined following LIVE/DEAD staining of composite surfaces using confocal microscopy. Water sorption-induced mass change at two months increased from 0.7 to 1.7% with increasing PLS concentration. Average volume increases were 2.3% at two months whilst polylysine release levelled at 4% at 3 weeks irrespective of composite PLS level. Early percentage PLS release, however, was faster with higher composite content. With 0.5, 1 and 2% polylysine initially in the composite filler phase, 24-h PLS release into 1 mL of water yielded 8, 25 and 93 ppm respectively. With initial bacterial counts of 8 × 10⁵ CFU/mL, this PLS release reduced 24-h bacterial counts from 10⁹ down to 10⁸, 10⁷ and 10² CFU/mL respectively. With a high initial inoculum, 24-h bacterial counts were 10⁹ with 0, 0.5 or 1% PLS and 10⁷ with 2% PLS. As the PLS composite content was raised, the ratio of dead to live sedimented bacteria increased. The antibacterial action of the experimental composites could reduce residual bacteria remaining following minimally invasive tooth restorations.

Novel low-shrinkage-stress nanocomposite with remineralization and antibacterial abilities to protect marginal enamel under biofilm

OBJECTIVES

Polymerization shrinkage stress may lead to marginal damage, microleakage and failure of composite restorations. The objectives of this study were to : (1) develop a novel nanocomposite with low-shrinkage-stress, antibacterial and remineralization properties to reduce marginal enamel demineralization under biofilms; (2) evaluate the mechanical properties of the composite and calcium (Ca) and phosphate (P) ion release; and (3) investigate the cytotoxicity of the new low-shrinkage-stress monomer in vitro.

METHODS

The low-shrinkage-stress resin consisted of urethane dimethacrylate (UDMA) and triethylene glycol divinylbenzyl ether (TEG-DVBE), and 3 % dimethylaminohexadecyl methacrylate (DMAHDM) and 20 % calcium phosphate nanoparticles (NACP) were added. Mechanical properties, polymerization shrinkage stress, and degree of conversion were evaluated. The growth of Streptococcus mutans (S. mutans) on enamel slabs with different composites was assessed. Ca and P ion releases and monomer cytotoxicity were measured.

RESULTS

Composite with DMAHDM and NACP had flexural strength of 84.9 ± 10.3 MPa (n = 6), matching that of a commercial control composite. Adding 3 % DMAHDM did not negatively affect the composite ion release. Under S. mutans biofilm, the marginal enamel hardness was 1.2 ± 0.1 GPa for the remineralizing and antibacterial group, more than 2-fold the 0.5 ± 0.07 GPa for control (p < 0.05). The polymerization shrinkage stress of the new composite was 40 % lower than that of traditional composite control (p < 0.05). The new monomers had fibroblast viability similar to that of traditional monomer control (p > 0.1).

CONCLUSION

A novel low-shrinkage-stress nanocomposite was developed with remineralizing and antibacterial properties. This new composite is promising to inhibit recurrent caries at the restoration margins by reducing polymerization stress and protecting enamel hardness.

Fabrication and characterization of remineralizing dental composites containing hydroxyapatite nanoparticles

The aim of this study was to fabricate and characterize dental composites containing hydroxyapatite nanoparticles (HApNPs). Four dental composites were produced from the same organic matrix (70 wt% Bis-GMA and 30 wt% TEGDMA), with partial replacement of BaBSi particles (65 wt%) by HApNPs in the following concentrations (wt%): E0 (0) - control, E10 (10), E20 (20) and E30 (30). Ca²⁺ and PO₄^3- release was evaluated in solutions with different pHs (4, 5.5, and 7) using atomic emission spectroscopy with microwave-induced nitrogen plasma while the enamel remineralization potential was evaluated in caries-like enamel lesions induced by S. mutans biofilm using micro-CT. The following properties were characterized: degree of conversion (DC%), microhardness (KHN), flexural strength (FS), elastic modulus (EM) and translucency (TP). The higher the HApNPs content, the higher the Ca²⁺ and PO₄^3- release. The ions release was influenced by pH (4 > 5.5 > 7) (p < 0.05). All composites loaded with HApNPs were able to remineralize the enamel (E30 = E20 > E10) (p < 0.05). Contrarily, E0 was not able of recovering the enamel mineral loss. E0 and E10 presented highest DC%, while E20 and E30 showed similar and lowest DC%. KHN and FS were decreased with the addition of HApNPs, while EM was not influenced by the incorporation of HApNPs. E10 presented statistically similar TP to E0, while this property decreased for E20 and E30 (p < 0.05). Incorporation of HApNPs into dental composites promoted enamel remineralization, mainly at potentially cariogenic pH (= 4), while maintained their overall performance in terms of physicomechanical properties.

Monomer conversion, dimensional stability, biaxial flexural strength, and fluoride release of resin-based restorative material containing alkaline fillers

The aim of this study was to assess monomer conversion, dimensional stability (mass and volume changes), biaxial flexural strength (BFS), and fluoride release of recently developed resin composites containing alkaline fillers (Cention N; CN) compared with resin-modified glass ionomer cements (RMGICs: Riva LC; RL and Fuji II LC; FL), and conventional composite (Z350). FL showed highest monomer conversion (88±2%) followed by RL (73±10%), CN (59±2%), and Z350 (50±2%). RL exhibited highest mass and volume increase (10.22±0.04 wt% and 19.4±0.2 vol%). CN exhibited higher BFS (180±20 MPa) than RMGICs but lower than Z350 (248±27 MPa). The highest cumulative fluoride release at 6 weeks was observed with RL (136±22 ppm) followed by CN (36±4 ppm) and FL (30±3 ppm). CN exhibited monomer conversion higher than the composite. CN also released fluoride in the range of that observed with RMGICs but with higher flexural strength.

Polymerization kinetics stability, volumetric changes, apatite precipitation, strontium release and fatigue of novel bone composites for vertebroplasty

PURPOSE

The aim was to determine effects of diluent monomer and monocalcium phosphate monohydrate (MCPM) on polymerization kinetics and volumetric stability, apatite precipitation, strontium release and fatigue of novel dual-paste composites for vertebroplasty.

MATERIALS AND METHODS

Polypropylene (PPGDMA) or triethylene (TEGDMA) glycol dimethacrylates (25 wt%) diluents were combined with urethane dimethacrylate (70 wt%) and hydroxyethyl methacrylate (5 wt%). 70 wt% filler containing glass particles, glass fibers (20 wt%) and polylysine (5 wt%) was added. Benzoyl peroxide and MCPM (10 or 20 wt%) or N-tolyglycine glycidyl methacrylate and tristrontium phosphate (15 wt%) were included to give initiator or activator pastes. Commercial PMMA (Simplex) and bone composite (Cortoss) were used for comparison. ATR-FTIR was used to determine thermal activated polymerization kinetics of initiator pastes at 50-80°C. Paste stability, following storage at 4-37°C, was assessed visually or through mixed paste polymerization kinetics at 25°C. Polymerization shrinkage and heat generation were calculated from final monomer conversions. Subsequent expansion and surface apatite precipitation in simulated body fluid (SBF) were assessed gravimetrically and via SEM. Strontium release into water was assessed using ICP-MS. Biaxial flexural strength (BFS) and fatigue properties were determined at 37°C after 4 weeks in SBF.

RESULTS

Polymerization profiles all exhibited an inhibition time before polymerization as predicted by free radical polymerization mechanisms. Initiator paste inhibition times and maximum reaction rates were described well by Arrhenius plots. Plot extrapolation, however, underestimated lower temperature paste stability. Replacement of TEGDMA by PPGDMA, enhanced paste stability, final monomer conversion, water-sorption induced expansion and strontium release but reduced polymerization shrinkage and heat generation. Increasing MCPM level enhanced volume expansion, surface apatite precipitation and strontium release. Although the experimental composite flexural strengths were lower compared to those of commercially available Simplex, the extrapolated low load fatigue lives of all materials were comparable.

CONCLUSIONS

Increased inhibition times at high temperature give longer predicted shelf-life whilst stability of mixed paste inhibition times is important for consistent clinical application. Increased volumetric stability, strontium release and apatite formation should encourage bone integration. Replacing TEGDMA by PPGDMA and increasing MCPM could therefore increase suitability of the above novel bone composites for vertebroplasty. Long fatigue lives of the composites may also ensure long-term durability of the materials.

Mechanical properties of experimental composites containing bioactive glass after artificial aging in water and ethanol

OBJECTIVES

To evaluate the effect of bioactive glass 45S5 (BG) in experimental composites on flexural strength (FS), flexural modulus (FM), modulus of resilience (MR), and material reliability after artificial aging in water for 1, 7, and 30 days, and an additional accelerated aging for 3 days in a 75 vol% ethanol-water solution.

MATERIALS AND METHODS

Five experimental light-curable composites were prepared with 0-40 wt% of BG and a total filler load of 70 wt%. The resinous matrix was Bis-GMA/TEGDMA in 60:40 by weight. Mechanical properties were evaluated using a three-point bending test (ISO/DIN 4049:1998) with n = 20. Weibull statistics were used to assess material reliability. Additionally, the degree of conversion (DC) was assessed 24 h post-cure using FT-Raman spectroscopy.

RESULTS

FS and FM decreased linearly as the amount of BG was increased. The ISO 4049 requirement for a minimum FS of 80 MPa was fulfilled in experimental composites with up to 20 wt% of BG. Degradation of FS and FM with artificial aging was more extensive in materials with higher BG amounts. MR decreased as a function of BG amount and artificial aging. Material reliability (Weibull modulus) was stable through aging for composites with up to 10 wt% of BG. DC was negatively influenced by the BG amount and ranged from 64 to 81%.

CONCLUSION

Increasing the amount of unsilanized BG fillers from 0 to 40 wt% resulted in a progressive decline in mechanical properties and a more extensive degradation during artificial aging.

CLINICAL RELEVANCE

Bioactive fillers diminished the mechanical properties in a dose-dependent manner.

Curing potential of experimental resin composites with systematically varying amount of bioactive glass: Degree of conversion, light transmittance and depth of cure

OBJECTIVES

The aim of this work was to investigate the curing potential of an experimental resin composite series with the systematically varying amount of bioactive glass 45S5 by evaluating the degree of conversion, light transmittance and depth of cure.

METHODS

Resin composites based on a Bis-GMA/TEGDMA resin with a total filler load of 70 wt% and a variable amount of bioactive glass (0-40 wt%) were prepared. The photoinitiator system was camphorquinone and ethyl-4-(dimethylamino) benzoate. The degree of conversion and light transmittance were measured by Raman spectroscopy and UV-vis spectroscopy, respectively. The depth of cure was evaluated according to the classical ISO 4049 test.

RESULTS

The initial introduction of bioactive glass into the experimental series diminished the light transmittance while the further increase in the bioactive glass amount up to 40 wt% caused minor variations with no clear trend. The curing potential of the experimental composites was similar to or better than that of commercial resin composites. However, unsilanized bioactive glass fillers demonstrated the tendency to diminish both the maximum attainable conversion and the curing efficiency at depth.

CONCLUSIONS

Experimental composite materials containing bioactive glass showed a clinically acceptable degree of conversion and depth of cure. The degree of conversion and depth of cure were diminished by bioactive glass fillers in a dose-dependent manner, although light transmittance was similar among all of the experimental composites containing 5-40 wt% of bioactive glass.

CLINICAL SIGNIFICANCE

Reduced curing potential caused by the bioactive glass has possible consequences on mechanical properties and biocompatibility.

Effects of deformation rate variation on biaxial flexural properties of dental resin composites

Objectives

This study aimed to determine the biaxial flexural strength (BFS) of resin composite materials at distinct deformation rates.

Methods

Two micro-hybrid [Filtek Z100™ Restorative (Z100), Filtek™ Z250 (Z250)] and two nano-filled [Filtek™ Supreme XT Body (FSB), Filtek™ Supreme Translucent (FST)] composite resins were selected. Disc-shaped (12 × 1 mm) specimens were fabricated using nylon split moulds. Bar-shaped specimens (25 × 2 × 2 mm) were fabricated from each material to determine the flexural modulus. The specimens were tested for BFS and flexural modulus under dry and wet conditions after 1, 13, and 52 weeks.

Results

The highest BFS was recorded for Z250 (162 ± 19 MPa), followed by FST (154 ± 16 MPa), Z100 (150 ± 18 MPa), and FSB (136 ± 18 MPa). The materials exhibited a clear trend of increase in BFS with deformation rate. Following immersion for 1 week, the BFS was 126 ± 18 MPa for Z100, and 124 ± 17 MPa for Z250, which were higher than those of FSB (99 ± 16 MPa) and FST (115 ± 19 MPa) under comparable conditions. There was a remarkable reduction in the flexural moduli of the specimens immersed for 1 week compared to those of the dry specimens: Z100 (from 18.3 ± 1.2 GPa for dry specimen to 15.7 ± 0.8 GPa after immersion for 1 week), Z250 (from 16.7 ± 0.8 GPa to 13.3 ± 1.4 GPa), FSB (from 13.7 ± 0.6 GPa to 11.0 ± 2.1 GPa) and FST (from 12.7 ± 2.3 GPa to 10.4 ± 1.0 GPa).

Conclusion

This study concludes that the BFS and flexural moduli of resin-based dental restoratives decline when they are immersed in an aqueous medium until saturation with water. However, after equilibrium is established, the immersion medium does not affect the restorative materials further. Variations in deformation rate did not have a significant effect on the BFS of resin-based dental restoratives.

Real-time Temperature Monitoring During Light-Curing of Experimental Composites

OBJECTIVE

To investigate the real-time temperature rise during light-curing of experimental composite materials containing bioactive glass 45S5 (BG) and compare it to the temperature rise in three commercial composites.

MATERIALS AND METHODS

Five light-curable composite materials containing 0-40 wt% of BG and a total filler load of 70 wt% were prepared. Cylindrical composite specimens 6 mm in diameter and 2 mm thick were cured using Bluephase G2 (Ivoclar Vivadent) at 1200 mW/cm2 for 30 s. The rise in temperature during light-curing was measured at the bottom of the specimens using a T-type thermocouple at the data collection rate of 20 s -1. An additional illumination for 30 s was performed after the specimen temperature returned to the baseline in order to record the temperature rise due to the heating from the curing unit. Statistical analysis was performed using the one-way ANOVA and Pearson correlation analysis with α=0.05.

RESULTS

Temperature rise during light-curing of experimental composites amounted to 12.2-14.0 °C and was comparable to that of the flowable commercial composite (12.5 °C) but higher than that of nano- and micro-hybrid commercial composites (9.6-10.3 °C). The temperature rise during the second illumination was similar for all composites (7.8-9.1 °C). In experimental composites, the temperature rise which was attributable to the polymerization exotherm amounted to 3.1-5.8 °C and was negatively correlated to the BG fraction (R2=0.94). Times at which temperature reached maximum values were in the range of 6.5-19.8 s and were positively correlated to the BG fraction (R2=0.98).

CONCLUSIONS

Temperature rise during light-curing of experimental composites was comparable to that of commercial composites, suggesting that the amount of heat released is tolerable by dental pulp.

Effect of cusp coverage and water storage on compressive strength of composite restorations of premolars

Background

The aim of this study was to assess the effect of cusp coverage and water storage on compressive strength of composite restorations.

Material and Methods

This in vitro experimental study was conducted on 40 extracted human maxillary premolar teeth, which were randomly divided into four groups of 10. Mesio-occluso-distal (MOD) cavities were prepared in all teeth. The thickness of composite for cusp coverage was 1.5 mm in groups 1 and 3 and 2.5 mm in groups 2 and 4. Compressive strength (CS) was measured after 24 hours in groups 1 and 2 and after six months of water storage in groups 3 and 4. Two-way ANOVA was used to statistically analyze the data.

Results

The mean and standard error (SE) of compressive strength was 795.23 ± 35.18N in Group 1, 1232.52 ± 78.01N in Group 2, 617.18 ± 40.19N in Group 3 and 963.22 ± 50.05N in Group 4.

Conclusions

Statistical analysis showed a significant difference in compressive strength measured after 24 hours (groups 1 and 3) and after six months of water storage (groups 2 and 4). The compressive strength of groups with 2.5 mm cusp coverage was significantly greater than that of groups with 1.5 mm cusp coverage.

Key words:Fracture strength, cusp coverage, water absorption, composite resin, compressive strength.