Direct and indirect monomer elution from an RBC product family

Light-curing dental resin-based composites: How it works and how you can make it work

Aim

Clinicians may become quite familiar with the rapid transformation of composite pastes to rigid solids as a routine phenomenon in operative dentistry. But they may still lack scientific understanding of how and why this happens. Efforts to learn scientifically about the interaction between light beams and resin-composites can significantly promote effective clinical placement of restorations. Neglect of such study can result in practical procedures of light curing that are inadequate or even seriously defective.

Method

This review addresses the underlying science and technology to elucidate how light curing works for dental resin-based composites, including-but not limited to-bulk fill types. This involves questions concerning: (a) the particle-wave understanding of light; (b) how photons can penetrate sufficiently deeply into bulk fill composites; (c) the necessary technology of LED light-curing units (LCUs); (d) the criteria for absorption of photons by photoinitiators to initiate free-radical addition polymerisation.

Conclusions

The implications for clinical practice are surveyed. These include design variables and selection criteria for LED-LCUs and guidelines on their use. This is to guide practitioners towards safe and effective light-curing procedures so that they can achieve optimal result for their patients.

Ability of short exposures from laser and quad-wave curing lights to photo-cure bulk-fill resin-based composites

OBJECTIVE

This study investigated the ability of a laser, and a 'quad-wave' LCU, to photo-cure paste and flowable bulk-fill resin-based composites (RBCs).

METHODS

Five LCUs and nine exposure conditions were used. The laser LCU (Monet) used for 1 s and 3 s, the quad-wave LCU (PinkWave) used for 3 s in the Boost and 20 s in the Standard modes, the the multi-peak LCU (Valo X) used for 5 s in the Xtra and 20 s in the Standard modes, were compared to the polywave PowerCure used in the 3 s mode and for 20 s in the Standard mode, and to the mono-peak SmartLite Pro used for 20 s. Two paste consistency bulk-fill RBCs: Filtek One Bulk Fill Shade A2 (3 M), Tetric PowerFill Shade IVA (Ivoclar Vivadent), and two flowable RBCs: Filtek Bulk Fill Flowable Shade A2 (3 M), Tetric PowerFlow Shade IVA (Ivoclar Vivadent) were photo-cured in 4-mm deep x 4-mm diameter metal molds. The light received by these specimens was measured using a spectrometer (Flame-T, Ocean Insight), and the radiant exposure delivered to the top surface of the RBCs was mapped. The immediate degree of conversion (DC) at the bottom, and the 24-hour Vickers Hardness (VH) at the top and bottom of the RBCs were measured and compared.

RESULTS

The irradiance received by the 4-mm diameter specimens ranged from 1035 mW/cm² (SmartLite Pro) to 5303 mW/cm² (Monet). The radiant exposures between 350 and 500 nm delivered to the top surface of the RBCs ranged from 5.3 J/cm² (Monet in 1 s) to 26.4 J/cm² (Valo X), although the PinkWave delivered 32.1 J/cm² in 20 s 350 to 900 nm. All four RBCs achieved their maximum DC and VH values at the bottom when photo-cured for 20 s. The Monet used for 1 s and the PinkWave used for 3 s on the Boost setting delivered the lowest radiant exposures between 420 and 500 nm (5.3 J/cm² and 3.5 J/cm² respectively), and they produced the lowest DC and VH values.

CONCLUSIONS

Despite delivering a high irradiance, the short 1 or 3-s exposures delivered less energy to the RBC than 20-s exposures from LCUs that deliver> 1000 mW/cm². There was an excellent linear correlation (r > 0.98) between the DC and the VH at the bottom. There was a logarithmic relationship between the DC and the radiant exposure (Pearson's r = 0.87-97) and between the VH and the radiant exposure (Pearson's r = 0.92-0.96) delivered in the 420-500 nm range.

Developments in resin-based composites

With the phasing down of dental amalgam use in response to the Minamata Convention, it is likely that resin-based composite restoratives will be the dental material of choice for the direct restoration of compromised dentition in the UK, at least for the foreseeable future. The current materials have a finite lifespan, with failures predominately due to either secondary caries or fracture. Consequently, there is considerable in vitro research reported each year with the intention of producing improved materials. This review describes the recent research in materials designed to have low polymerisation shrinkage and increased mechanical properties. Also described is research into materials that are either antimicrobial or are designed to release ions into the surrounding oral environment, with the aim of stimulating remineralisation of the surrounding dental tissues. It is hoped that by describing this recent research, clinicians will be able to gain some understanding of the current research that will potentially lead to new products that they can use to improve patient treatment in the future.

Provides an overview of recent research developments aimed at improving the performance of resin-based composites.

Details the recent developments in monomers and fillers to produce resin-based composites that either have lower polymerisation shrinkage or better mechanical properties compared to current commercially available products.

Describes recent research on developing resin-based composites that can act as potential sources of antimicrobial or remineralising agents.

Influence of curing modes on monomer elution, sorption and solubility of dual-cure resin-cements

OBJECTIVE

To explore the effect of two curing modes, for dual-cure resin cements, on their monomer elution, water sorption and solubility after 30 d water storage and 30 d dry reconditioning.

METHODS

Eight dual-cure resin-cements were investigated (Bifix SE, Nexus Third Generation, PANAVIA SA, PANAVIA V5, RelyX Ultimate Universal, RelyX Unicem 2, RelyX Universal and SpeedCEM Plus). Six disk-shaped specimens were made per curing mode: light-cure (LC) versus self-cure (SC) to measure amounts of eluted monomers after 30 d of water storage at 37 °C. Ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC MS/MS) was performed to identify and quantify three eluted monomers (Bis-GMA, UDMA and TEGDMA). Water sorption/ solubility specimens were prepared according to ISO 4049. Specimens from each curing mode (LC/SC) were immersed separately in distilled water for 30 d and then reconditioned for 30 d; all at 37 °C. Mass change was measured at different time intervals. Data were analyzed via one-way ANOVA, Tukey post-hoc tests and independent sample t-tests (α = 0.05).

RESULTS

After 30 d of water storage, the three monomers Bis-GMA, UDMA and TEGDMA were detected in water. All monomers showed a variable extent of elution into water and were significantly higher (p < 0.0001) with SC compared to LC curing modes. BSE had the highest quantity of eluted monomers. After 30 d of water sorption (μg/mm³), all rein-cements showed significantly higher sorption (p < 0.05) of SC compared to LC curing modes except for PV5, RXU and CEM (p > 0.05). After 30 d of water solubility (μg/mm³), all resin-cements showed significantly higher solubility (p < 0.0001) of SC compared to LC curing mode. BSE had the highest water sorption and solubility. The total amounts of eluted monomers correlated positively with solubility: r² = 0.95 for LC and r² = 0.93 for SC.

SIGNIFICANCE

Whenever light access is possible, light curing remains beneficial to reduce the extent of resin degradation and related properties of dual-cure resin cements. BSE showed statistically the highest extent of eluted monomers, sorption and solubility.

Meta-analytical analysis on components released from resin-based dental materials

OBJECTIVES

Resin-based materials are applied in every branch of dentistry. Due to their tendency to release substances in the oral environment, doubts have been raised about their actual safety. This review aims to provide a comprehensive analysis of the last decade literature regarding the concentrations of elutable substances released from dental resin-based materials in different type of solvents.

MATERIALS AND METHODS

All the literature published on dental journals between January 2010 and April 2022 was searched using international databases (PubMed, Scopus, Web of Science). Due to strict inclusion criteria, only 23 papers out of 877 were considered eligible. The concentration of eluted substances related to surface and volume of the sample was analyzed, considering data at 24 h as a reference. The total cumulative release was examined as well.

RESULTS

The most eluted substances were HEMA, TEGDMA, and BPA, while the less eluted were Bis-GMA and UDMA. Organic solvents caused significantly higher release of substances than water-based ones. A statistically significant inverse correlation between the release of molecules and their molecular mass was observed. A statistically significant positive correlation between the amount of released molecule and the specimen surface area was detected, as well as a weak positive correlation between the release and the specimen volume.

CONCLUSIONS

Type of solvent, molecular mass of eluates, and specimen surface and volume affect substances release from materials.

CLINICAL RELEVANCE

It could be advisable to rely on materials based on monomers with a reduced elution tendency for clinical procedures.