Fiber-reinforced composites in dentistry - An insight into adhesion aspects of the material and the restored tooth construct

Effects of different surface treatments on surface topography and bond strength in the repair of fiber-reinforced dentin composite

OBJECTIVE

This study aimed to evaluate the effects of different surface treatments on the repair bond strength between a fiber-reinforced dentin composite and a posterior composite.

METHODS

Forty fiber-reinforced dentin composite resin blocks (4 mm × 4 mm × 4 mm) were separated into eight groups (n = 5) according to the surface preparation methods: (G1) negative control group, (G2) adhesive application, (G3) 50% dimethylsulfoxide (DMSO) application, (G4) 50% DMSO + adhesive application, (G5) 37% phosphoric acid etch + adhesive application, (G6) air abrasion + adhesive application, (G7) 37% phosphoric acid etch + 50% DMSO application + adhesive application, and (G8) air abrasion +50% DMSO application + adhesive application group. The composite surfaces were repaired in two layers with a posterior composite. Composite sticks were subjected to a micro tensile bond strength (μTBS) test. Fractured surfaces were evaluated using a stereomicroscope (×25). Short fiber-reinforced composite samples' surfaces were investigated by scanning electron microscope (SEM). Shapiro Wilk, one-way ANOVA, and Tukey HSD tests were used for statistical evaluation.

RESULTS

The highest average (μTBS) values were observed in G8, whereas the lowest mean μTBS values were evident in the G1 group. Statistically significant μTBS values were found in all adhesive-applied groups when compared with the negative control group. Notably, the application of 50% DMSO without adhesive did not lead to a statistically significant increase in μTBS values. SEM images demonstrated that acid etching partially eliminated residues on the composite surface, while air abrasion had a detrimental effect on the integrity of fiber structures.

CONCLUSION

In the repair of fiber-reinforced dentin composite with a posterior composite, adhesive application is an effective approach. The treatment of 50% DMSO without adhesive did not confer a statistically significant advantage, and the supplemental use of acid etch or air abrasion did not show an additional benefit compared to adhesive-only repairs.

CLINICAL SIGNIFICANCE

Adhesive application emerges as a potent and effective strategy for the repair of bur-roughened fiber-reinforced dentin composites. With its limitations, the study highlights the efficacy of adhesive-only repairs without the necessity for additional surface treatments.

Shear Bond Strength to Enamel, Mechanical Properties and Cellular Studies of Fiber-Reinforced Composites Modified by Depositing SiO2 Nanofilms on Quartz Fibers via Atomic Layer Deposition

Introduction

Poor interfacial bonding between the fibers and resin matrix in fiber-reinforced composites (FRCs) is a significant drawback of the composites. To enhance the mechanical properties of FRC, fibers were modified by depositing SiO2 nanofilms via the atomic layer deposition (ALD) technique. This study aims to evaluate the effect of ALD treatment of the fibers on the mechanical properties of the FRCs.

Methods

The quartz fibers were modified by depositing different cycles (50, 100, 200, and 400) of SiO2 nanofilms via the ALD technique and FRCs were proposed from the modified fibers. The morphologies, surface characterizations of nanofilms, mechanical properties, and cytocompatibility of FRCs were systematically investigated. Moreover, the shear bond strength (SBS) of FRCs to human enamel was also evaluated.

Results

The SEM and SE results showed that the ALD-deposited SiO2 nanofilms have good conformality and homogeneity. According to the results of FTIR and TGA, SiO2 nanofilms and quartz fiber surfaces had good chemical combinations. Three-point bending tests with FRCs showed that the deposited SiO2 nanofilms effectively improved FRCs' strength and Group D underwent 100 deposition cycles and had the highest flexural strength before and after aging. Furthermore, the strength of the FRCs demonstrated a crescendo-decrescendo tendency with SiO2 nanofilm thickness increasing. The SBS results also showed that Group D had outstanding performance. Moreover, the results of cytotoxicity experiments such as cck8, LDH and Elisa, etc., showed that the FRCs have good cytocompatibility.

Conclusion

Changing the number of ALD reaction cycles affects the mechanical properties of FRCs, which may be related to the stress relaxation and fracture between SiO2 nanofilm layers and the built-up internal stresses in the nanofilms. Eventually, the SiO2 nanofilms could enhance the FRCs' mechanical properties and performance to enamel by improving the interfacial bonding strength, and have good cytocompatibility.

Assessing color stability of orthodontic esthetic wires in different staining solutions

BACKGROUND

Esthetic orthodontic wires are preferred for their ease to fit in with natural tooth color, but their susceptibility to staining in the oral environment poses a concern. Various Coatings such as Teflon and Epoxy aim to enhance appearance and biocompatibility but may still result in discoloration. Understanding the color stability of these wires under different staining conditions is crucial for a better and enhanced treatment plan.

OBJECTIVE

This study intended to assess the color stability of esthetic orthodontic wires under various staining solutions that are often used in daily life.

METHOD

Color changes of Teflon and Epoxy-coated esthetic orthodontic wires were meticulously measured at baseline, 7, 14, and 21-day intervals utilizing the precise CIE Lab* color measurement system. A total of thirty-two samples of wires from each brand were prepared (n= 8/group) and immersed in staining solutions (coffee, tea, cola, and saffron). The color change within and between the groups was statistically evaluated (p< 0.05).

RESULTS

Significant variations in color stability were observed across different staining solutions. Saffron emerged as the most potent agent, inducing the most pronounced color changes, whereas cola demonstrated the least impact. Furthermore, Epoxy-coated wires consistently exhibited superior color stability compared to their Teflon-coated counterparts across all staining solutions and time intervals.

CONCLUSION

This study underlines the significance for orthodontists to consider staining agents' possible effects on orthodontic wires into account when selecting the orthodontic wires. The findings suggest that Epoxy-coated wires hold promise in mitigating discoloration issues during orthodontic therapy.

Considerations about Cytotoxicity of Resin-Based Composite Dental Materials: A Systematic Review

The dental material industry is rapidly developing resin-based composites (RBCs), which find widespread use in a variety of clinical settings. As such, their biocompatibility has gained increasing interest. This literature review presents a summary of research into the cytotoxicity of methacrylate-based composites published from 2017 to 2023. Subject to analysis were 14 in vitro studies on human and murine cell lines. Cytotoxicity in the included studies was measured via MTT assay, LDH assay, and WST-1 assay. The QUIN Risk of Bias Tool was performed to validate the included studies. Included studies (based entirely on the results of in vitro studies) provide evidence of dose- and time-dependent cytotoxicity of dental resin-based composites. Oxidative stress and the depletion of cellular glutathione (GSH) were suggested as reasons for cytotoxicity. Induction of apoptosis by RBCs was indicated. While composites remain the golden standard of dental restorative materials, their potential cytotoxicity cannot be ignored due to direct long-term exposure. Further in vitro investigations and clinical trials are required to understand the molecular mechanism of cytotoxicity and produce novel materials with improved safety profiles.

Effects of aligner activation and power arm length and material on canine displacement and periodontal ligament stress: a finite element analysis

BACKGROUND

This study aimed to assess the impact of aligner activation and power arm length and material on canine and aligner displacement, von Mises stress in the power arm, and principal stress in the periodontal ligament (PDL) during canine tooth distalization using finite element analysis (FEA). The effects of aligner activation and power arm length were primary outcomes, while the effect of the power arm material was a secondary outcome.

METHODS

Aligner activation (0.1 mm or 0.2 mm) was applied without using a power arm in two models. The effects of aligner activation, power arm length (12, 13, or 14 mm) and power arm material (stainless steel [SS] or fiber-reinforced composite [FRC]) on canine distalization were investigated in 12 models by evaluating displacement and stress via ALTAIR OptiStruct analysis.

RESULTS

Greater canine displacement was observed in all models with 0.2 mm than 0.1 mm of aligner activation. When models with the same aligner activation were compared, reduced mesiodistal tipping, increased palatal tipping, and increased extrusion of the canine cusp were observed with increasing power arm length. Moreover, the von Mises stress increased as the power arm length increased. Increasing the aligner activation and power arm length increased the maximum principal stress in the PDL. Power arms of the same length in both materials showed the same results in terms of canine displacement, clear aligner displacement, and maximum principal stress in the PDL. However, under conditions of equal length and aligner activation, the von Mises stress of the SS power arm was higher than that of the FRC power arm.

CONCLUSION

Using a power arm in canine distalization reduced mesiodistal tipping but increased palatal tipping and extrusion of the canine cusp. Aligner activation and additional force increased tooth movement and principal stress in the canine PDL. FRC power arms exhibited less von Mises stress than SS power arms.

Evaluation of the Shear Bond Strength of Immediate and Delayed Restorations of Various Calcium Silicate-Based Materials with Fiber-Reinforced Composite Resin Materials

Due to significant tissue loss in teeth requiring pulp treatments, hermetic restoration of the remaining dental tissues is one of the most crucial factors in determining the treatment's success. The adhesion of composite resins to calcium silicate cements (CSCs) is considered challenging. Consequently, it is crucial to identify the optimal method for obtaining optimal adhesion. The aim of the present study is to evaluate the shear bond strength (SBS) values of immediate and delayed restorations with fiber-reinforced composites on powder-liquid, premixed, and resin-containing flowable CSCs. In the present study, the SBS values obtained after immediate (14 min) and delayed (7 days) restorations of three different CSCs (NeoMTA2, NeoPutty, and TheraCal PT) with three different resin composite materials (EverX FlowTM, EverX PosteriorTM, and Filtek Z550) were compared. The fracture types were evaluated using a stereomicroscope and SEM. TheraCal PT had the highest SBS values for both immediate and delayed restorations, and the comparison with other materials showed a statistically significant difference (p = 0.001). In contrast, there was no statistically significant difference between the SBS values of NeoMTA and NeoPutty (p > 0.05). In both immediate and delayed restorations, there was no statistically significant difference between nanohybrid and fiber-reinforced composites (p > 0.05). The simple use and strong bonding ability of TheraCal PT with composite resins may provide support for the idea that it is suitable for pulpal interventions. Nevertheless, due to the in vitro nature of this study, additional in vitro and clinical studies are required to investigate the material's physical, mechanical, and biological properties for use in clinical applications.

Utilizing an Oxidized Biopolymer to Enhance the Bonding of Glass Ionomer Luting Cement Particles for Improved Physical and Mechanical Properties

This study aimed to determine the reinforcing effect of two weight ratios of Gum Arabic (GA) natural biopolymer, i.e., 0.5% and 1.0% in the powdered composition of glass ionomer luting cement. GA powder was oxidized and GA-reinforced GIC in 0.5 and 1.0 wt.% formulations were prepared in rectangular bars using two commercially available GIC luting materials (Medicem and Ketac Cem Radiopaque). The control groups of both materials were prepared as such. The effect of reinforcement was evaluated in terms of microhardness, flexural strength (FS), fracture toughness (FT), and tensile strength (TS). The internal porosity and water contact angle formation on the study samples were also evaluated. Film thickness was measured to gauge the effect of micron-sized GA powder in GA-GIC composite. Paired sample t-tests were conducted to analyze data for statistical significance (p < 0.05). The experimental groups of both materials containing 0.5 wt.% GA-GIC significantly improved FS, FT, and TS compared to their respective control groups. However, the microhardness significantly decreased in experimental groups of both cements compared to their respective control groups. The addition of GA powder did not cause a significant increase in film thickness and the water contact angle of both 0.5 and 1.0 wt.% GA-GIC formulations were less than 90o. Interestingly, the internal porosity of 0.5 wt.% GA-GIC formulations in both materials were observed less compared to their respective control groups. The significantly higher mechanical properties and low porosity in 0.5 wt.% GA-GIC formulations compared to their respective control group indicate that reinforcing GA powder with 0.5 wt.% in GIC might be promising in enhancing the mechanical properties of GIC luting materials.

Oxidized Natural Biopolymer for Enhanced Surface, Physical and Mechanical Properties of Glass Ionomer Luting Cement

This laboratory investigation aimed to synthesize and characterize micron-sized Gum Arabic (GA) powder and incorporate it in commercially available GIC luting formulation for enhanced physical and mechanical properties of GIC composite. Oxidation of GA was performed and GA-reinforced GIC in 0.5, 1.0, 2.0, 4.0 & 8.0 wt.% formulations were prepared in disc-shaped using two commercially available GIC luting materials (Medicem and Ketac Cem Radiopaque). While the control groups of both materials were prepared as such. The effect of reinforcement was evaluated in terms of nano hardness, elastic modulus, diametral tensile strength (DTS), compressive strength (CS), water solubility and sorption. Two-way ANOVA and post hoc tests were used to analyze data for statistical significance (p < 0.05). FTIR spectrum confirmed the formation of acid groups in the backbone of polysaccharide chain of GA while XRD peaks confirmed that crystallinity of oxidized GA. The experimental group with 0.5 wt.% GA in GIC enhanced the nano hardness while 0.5 wt.% and 1.0 wt.% GA in GIC increased the elastic modulus compared to the control. The CS of 0.5 wt.% GA in GIC and DTS of 0.5 wt.% and 1.0 wt.% GA in GIC demonstrated elevation. In contrast, the water solubility and sorption of all the experimental groups increased compared to the control groups. The incorporation of lower weight ratios of oxidized GA powder in GIC formulation helps in enhancing the mechanical properties with a slight increase in water solubility and sorption parameters. The addition of micron-sized oxidized GA in GIC formulation is promising and needs further research for improved performance of GIC luting composition.

Adhesion of individually formed fiber post adhesively luted with flowable short fiber composite

This laboratory study aimed to measure the push-out bond strength of individually formed fiber-reinforced composite (FRC) post luted with flowable short fiber-reinforced composite (SFRC) and to evaluate the influence of post coating with light-cured adhesive. Post spaces (Ø 1.7 mm) were drilled into 20 single-rooted decoronated premolar teeth. Post spaces were etched and treated with light-cured universal adhesive (G-Premio Bond). Individually formed FRC posts (Ø 1.5 mm, everStick) were luted either with light-cured SFRC (everX Flow) or conventional particulate-filled (PFC) dual-cure luting cement (G-CEM LinkForce). Half of the posts from each group were treated with dimethacrylate adhesive resin (Stick Resin) for 5 min before luting. After storage in water for two days, the roots were sectioned into 2 mm thick disks (n = 10/per group). Then, a push-out test-setup was used in a universal testing machine to measure the bond strength between post and dentin. The interface between post and SFRC was inspected using optical and scanning electron microscopy (SEM). Data were statistically analyzed using analysis of variance ANOVA (p = .05). Higher bond strength values (p < .05) were obtained when flowable SFRC was used as a post luting material. Resin coating of a post showed no significant effect (p > .05) on bond strength values. Light microscope images showed the ability of discontinuous short fibers in SFRC to penetrate into FRC posts. The use of flowable SFRC as luting material with individually formed FRC posts proved to be a promising method to improve the interface adhesion.