Color stability of experimental composites containing different photoinitiators

Influence of Cementation on the Aesthetical Appearance of Full-Ceramic Restorations

The use of dental ceramics as restorative materials requires corresponding luting materials (cements) that, in turn, influence the visual appearance of the restoration. Due to the high light transmission through the ceramics, the cements can affect the color perception of the dental restoration. This study aims to investigate the optical effects of various cements on the visual appearance of full-ceramic restorations. Three fixing polymer resins (Bifix SE (VOCO GmbH, Cuxhafen, Germany), Breeze^TM (Pentron Clinical, West Collins Orange, CA, USA), and Panavia^TM F. 2.0 (Kuraray, Noritake, Osaka, Japan)), with layer thicknesses of 50, 100, 200, and 250 µm, were applied onto a ceramic base model (0.4 mm thick), and irradiated with laser light of wavelengths 532, 632.8, and 1064 nm. Light intensities and scattering effects of light of various wavelengths were angle-dependent, analyzed using a goniophotometer with perpendicular light incidence on the sample specimen (base model plus luting material). In addition, the transmitted power of the light through the sample specimen was determined as a function of the layer thickness. With increasing layer thickness, power losses of respectively 30% for Bifix SE and Breeze^TM in the visible spectral range were comparable, whereas Panavia^TM F. 2.0 showed a power loss of ca. 44% here. For the near-infrared range, the power losses for all cements were 25%. This could be confirmed by the interpretation of the line widths. Moreover, the line widths for thin cement layer thicknesses (50 and 100 µm) in the visible spectral range displayed only a redistribution of light by scattering, which does not affect color perception at all. In addition, at 200 and 250 µm, absorption occurred which causes a change in color perception. Within the scope of this study, it could be shown that for thin-layer thicknesses of the cement applied here, there is no adverse optical effect on the aesthetic visual appearance of the restoration.

Effect of ceramic and resin cement type on color stability and translucency of ceramic laminate veneers for diastema closure: an in vitro study

To investigate the effect of resin cements on the color stability and translucency of ceramic laminate veneers used for diastema closure. Sixty resin abutments were prepared for ceramic laminate veneers and divided into six groups according to the ceramic type (lithium disilicate, zirconia-reinforced lithium silicate, and translucent zirconia) and the cement type (Variolink Esthetic LC and RelyX Veneer). Color coordinates and translucency were analyzed after cementation and after soaking in the coffee solution. Differences in color and translucency were estimated, and results were statistically assessed (α = 0.05). Ceramic materials showed a significant impact on color changes after soaking in coffee within Variolink Esthetic groups. Translucent zirconia showed the highest color change, followed by zirconia reinforced lithium silicate and lithium disilicate. Ceramic materials showed a significant impact among the RelyX Veneer groups. A significant interaction in color changes was found between ceramic types and cement types after cementation, and after soaking in coffee was found. All groups showed a clinically acceptable difference in translucency parameters after soaking in coffee. The resin cement affects the color and translucency of ceramic laminate veneers used for diastema closure, and ceramic laminate veneers bonded with Variolink Esthetic LC resin cement are more translucent, while ceramic laminate veneers bonded with RelyX Veneer resin are more resistant to coffee staining. The lithium disilicate laminate veneer is more resistant to coffee staining than zirconia reinforced lithium silicate and translucent zirconia laminate veneers used for diastema closure.

Color Change Evaluation of Three Universal Resin Composites after Storage in Water: An In Vitro Study

Aim:

The aim of this in vitro study was to evaluate the color changes of three different universal resin composites after immersion in distilled water for one month.

Materials and Methods:

Omnichroma, Estelite Σ Quick, and Filtek Universal Restorative were investigated. Ten disk shaped specimens (6 mm diameter, 2 mm thickness) were prepared according to the manufacturers’ instructions for each material. After polishing, initial color measurements were taken followed by individual storage of the specimens in distilled water at 37 °C for one month when color measurements were repeated. The change in the color of each resin composites (Δ E00) was calculated with a digital method, using the CIEDE2000 color difference formula. The data were analyzed using one-way ANOVA followed by Tukey post-hoc test ( P < .05).

Results:

All resin composites exhibited acceptable color change after one month. Omnichroma exhibited the highest color change (2.26 ± 0.48) value while Filtek Universal Restorative showed the lowest (1.14 ± 0.38) value. All color parameters influenced the Δ E00 values in all groups except Filtek Universal for Δ L* and Δ b values.

Conclusion:

When performing composite resin restorations, especially for esthetic purposes, polymerization may lead to change in the color of restorative material over time, but it should be considered whether this is within acceptable limits.

Mechanical Properties of Experimental Composites with Different Photoinitiator

Objective  The effect of different photoinitiators on mechanical properties of experimental composites was evaluated.

Materials and Methods  Resin composites were formulated by using a blend of bisphenol A-glycidyl and triethylene glycol (50/50 wt%) dimethacrylate monomers, and 65 wt% of barium aluminium silicate and silica filler particles. Photoinitiators used were 0.2% camphorquinone (CQ) and 0.8% co-initiator (DMAEMA); 0.2% phenyl-propanedione and 0.8% DMAEMA; 0.1% CQ + 0.1% phenyl propanedione and 0.8% DMAEMA; 0.42% mono(acyl)phosphine oxide (MAPO); and 0.5% bis(acyl)phosphine oxide (BAPO). Specimens ( n = 10) were light cured by using a multiple-emission peak light-emitting diode for 20 seconds at 1,200 mW/cm ² of irradiance and Knoop hardness and plasticization, depth of cure, flexural strength, and elastic modulus were evaluated. Data were statiscally analyzed at significance level of α = 5%.

Results  Experimental composites containing MAPO and BAPO photoinitiators showed the highest values of flexural strength, elastic modulus, top surface hardness, and lower hardness reduction caused by alcohol compared with CQ. Composites containing CQ and PPD showed similar results, except for depth of cure and hardness of bottom surface.

Conclusion  BAPO and MAPO showed higher flexural strength, elastic modulus, hardness on top surface, and lower polymer plasticization to CQ.

Utilizing Light Cure Units: A Concise Narrative Review

The use of photo-curable resin composite restorations is an essential treatment modality in modern dental practice. The success and longevity of these restorations depend on achieving predictable and effective polymerization. Understanding the dynamics of the polymerization and the effect of light cure units (LCUs) on this process is paramount. The goal of this concise narrative review is to provide a simplified presentation of basic principles of composite chemistry, polymerization reactions, and photo-curing with relevant terminologies. Clinical guidelines for choosing and maintaining LCUs, as well as safety precautions and factors under the control of the clinician are listed. Finally, clinical recommendations of LCUs’ usage and monitoring are included to aid practitioners in achieving predictable polymerization during the placement of direct resin composite restorations.

The Photoinitiators Used in Resin Based Dental Composite-A Review and Future Perspectives

The presented paper concerns current knowledge of commercial and alternative photoinitiator systems used in dentistry. It discusses alternative and commercial photoinitiators and focuses on mechanisms of polymerization process, in vitro measurement methods and factors influencing the degree of conversion and hardness of dental resins. PubMed, Academia.edu, Google Scholar, Elsevier, ResearchGate and Mendeley, analysis from 1985 to 2020 were searched electronically with appropriate keywords. Over 60 articles were chosen based on relevance to this review. Dental light-cured composites are the most common filling used in dentistry, but every photoinitiator system requires proper light-curing system with suitable spectrum of light. Alternation of photoinitiator might cause changing the values of biomechanical properties such as: degree of conversion, hardness, biocompatibility. This review contains comparison of biomechanical properties of dental composites including different photosensitizers among other: camphorquinone, phenanthrenequinone, benzophenone and 1-phenyl-1,2 propanedione, trimethylbenzoyl-diphenylphosphine oxide, benzoyl peroxide. The major aim of this article was to point out alternative photoinitiators which would compensate the disadvantages of camphorquinone such as: yellow staining or poor biocompatibility and also would have mechanical properties as satisfactory as camphorquinone. Research showed there is not an adequate photoinitiator which can be as sufficient as camphorquinone (CQ), but alternative photosensitizers like: benzoyl germanium or novel acylphosphine oxide photoinitiators used synergistically with CQ are able to improve aesthetic properties and degree of conversion of dental resin.

Mechanical properties of experimental resin cements containing different photoinitiators and co-initiators

Aim

The aim of this study was to evaluate the influence of different concentrations of two photoinitiators and one co-initiator on the flexural strength (FS) and elastic modulus (E) of experimental resin cements.

Materials and methods

A mixture containing BisGMA, TEGDMA, and barium-aluminum-silicate (BaAlSi) and silanized colloidal silica (SiO₂) filler particles was prepared with two photoinitiators, viz. camphorquinone (CQ) and bisacylphosphine oxide (BAPO). Dimethylaminoethyl methacrylate (DMAEMA) was used as co-initiator. Thirty groups (n=10) were formulated with different photoinitiator systems (CQ/DMAEMA and BAPO/DMAEMA) and concentrations (wt%) of photoinitiator and co-initiator. The photoactivation was carried out for 20 s with a light-emitting diode (LED, Bluephase, Ivoclar Vivadent) with irradiance of 1200 mW/cm². The FS and E were obtained in a three-point bending test on a universal testing machine (0.5 mm/min). Data were subjected to the Kolmogorov-Smirnov normality test, followed by two-way ANOVA and Tukey’s test (α=0.05).

Results

No polymerization occurred in the CQ groups without DMAEMA (0 wt%). DMAEMA 0.5 %wt and 1 %wt groups showed statistically similar FS and E results for CQ and BAPO, except for CQ 0.3 wt% (FS), CQ 0.9wt% (E) and BAPO 1.76 wt% (FS and E) for DMAEMA 0.5 %wt. No significant difference was found for FS and E values for different concentrations of photoinitiators, except for CQ 0.25 wt% (FS and E) and BAPO 0.25 wt% (E) that showed the lowest values.

Conclusion

The wt% of the photoinitiators and co-initiator influenced the mechanical properties and the performance of CQ was dependent on the DMAEMA concentration. BAPO can be used as substitute for the conventional CQ/DMAEMA photoinitiator system.

The influence of simulated aging on the color stability of composite resin cements

STATEMENT OF PROBLEM

Data for the color stability of dual-polymerized and light-polymerized resin cements used in esthetic dentistry are lacking.

PURPOSE

The purpose of this in vitro study was to evaluate the color stability of 4 types of composite resin cements after water aging.

MATERIAL AND METHODS

Specimens (n=30) of each resin cement (Variolink Esthetic LC, RelyX Ultimate DC, Nexus 3 DC, Nexus 3 LC) were prepared. The shade selected was Light+ for Variolink Esthetic, B 0.5 for RelyX Ultimate, and White for both Nexus 3 DC and LC. All 120 specimens were aged by water for 30 days at 37°C under dark conditions, using a thermocycling machine. The specimens' color characteristics (L*, luminosity; a*, red-green; b*, yellow-blue) and color differences (ΔE) were measured with a spectrophotometer before day 0, after day 1, and after 30 days of immersion. Statistical analysis used ANOVA and Tukey post hoc tests (α=.05).

RESULTS

Considering ΔE<3.3 as clinically acceptable, results showed significant color variations for all cements (RelyX Ultimate=3.69; Nexus 3 LC=3.76; Nexus 3 DC=5.34), except for Variolink Esthetic (0.88). However, this variation was significantly less when day 1 was considered the baseline measurement, showing clinically acceptable ΔE values for all types of cement.

CONCLUSIONS

Water aging had a significant effect on color stability; most color variations occurred in the first 24 hours of polymerization, with relatively nonsignificant variations afterwards.

Evaluation of phenyl-propanedione on yellowing and chemical-mechanical properties of experimental dental resin-based materials

Objective

To evaluate the influence of phenyl-propanedione on yellowing and chemical-mechanical properties of experimental resin-based materials photoactivated using different light curing units (LCUs).

Material and Methods

Experimental resin-based materials with the same organic matrix (60:40 wt% BisGMA:TEGDMA) were mechanically blended using a centrifugal mixing device. To this blend, different photoinitiator systems were added in equimolar concentrations with aliphatic amine doubled by wt%: 0.4 wt% CQ; 0.38 wt% PPD; or 0.2 wt% CQ and 0.19 wt% PPD. The degree of conversion (DC), flexural strength (FS), Young's modulus (YM), Knoop hardness (KNH), crosslinking density (CLD), and yellowing (Y) were evaluated (n=10). All samples were light cured with the following LCUs: a halogen lamp (XL 2500), a monowave LED (Radii), or a polywave LED (Valo) with 16 J/cm2. The results were analysed by two-way ANOVA and Tukey's test (α=0.05).

Results

No statistical differences were found between the different photoinitiator systems to KNH, CLS, FS, and YM properties (p≥0.05). PPD/CQ association showed the higher DC values compared with CQ and PPD isolated systems when photoactivated by a polywave LED (p≤0.05). Y values were highest for the CQ compared with the PPD systems (p≤0.05).

Conclusion

PPD isolated system promoted similar chemical and mechanical properties and less yellowing compared with the CQ isolated system, regardless of the LCU used.

Effect of 4-(N,N-dimethylamino)phenethyl alcohol on degree of conversion and cytotoxicity of photo-polymerized CQ-based resin composites

The aim of this study was to evaluate the degree of conversion (DC) and the cytotoxicity of photo-cured experimental resin composites containing 4-(N,N-dimethylamino)phenethyl alcohol (DMPOH) combined to the camphorquinone (CQ) compared with ethylamine benzoate (EDAB). The resin composites were mechanically blended using 35 wt% of an organic matrix and 65 wt% of filler loading. To this matrix was added 0.2 wt% of CQ and 0.2 wt% of one of the reducing agents tested. 5x1 mm samples (n=5) were previously submitted to DC measurement and then pre-immersed in complete culture medium without 10% (v/v) bovine serum for 1 h or 24 h at 37 °C in a humidifier incubator with 5% CO2 and 95% humidity to evaluate the cytotoxic effects of experimental resin composites using the MTT assay on immortalized human keratinocytes cells. As a result of absence of normal distribution, the statistical analysis was performed using the nonparametric Kruskal-Wallis to evaluate the cytotoxicity and one-way analysis of variance to evaluate the DC. For multiple comparisons, cytotoxicity statistical analyses were submitted to Student-Newman-Keuls and DC analysis to Tukey's HSD post-hoc test (=0.05). No significant differences were found between the DC of DMPOH (49.9%) and EDAB (50.7%). 1 h outcomes showed no significant difference of the cell viability between EDAB (99.26%), DMPOH (94.85%) and the control group (100%). After 24 h no significant difference were found between EDAB (48.44%) and DMPOH (38.06%), but significant difference was found compared with the control group (p>0.05). DMPOH presented similar DC and cytotoxicity compared with EDAB when associated with CQ.

Transmitted irradiance through ceramics: effect on the mechanical properties of a luting resin cement

OBJECTIVES

The study aims to characterise the curing behaviour of a light-curing luting composite (Variolink® Aesthetic LC, Ivoclar Vivadent) polymerised at different exposure times (10 s, 20 s) through different ceramics (IPS Empress CAD and IPS e.max CAD, Ivoclar Vivadent) and ceramic thicknesses (no ceramic, 0.5, 1, 1.5 and 2 mm).

MATERIAL AND METHOD

Curing units' (Bluephase Style, Ivoclar Vivadent) variation in irradiance delivered up to 10-mm exposure distance as well as the incident and transmitted irradiance and radiant exposure up to 6-mm ceramic thickness were assessed on a laboratory-grade spectrometer. A total of 216 (18 groups, n = 12) thin and flat luting composite specimens of 500-μm thickness were prepared and stored after curing in a saturated vapour atmosphere for 24 h at 37 °C. Micro-mechanical properties (Vickers hardness, HV and indentation modulus, Y_HU) were determined by means of an automatic micro-hardness indenter.

RESULTS

Within the study design, the radiant exposure received by the luting composite varied from 2.56 to 24.75 J/cm², showing a high impact on the measured properties. Comparing the effect of the parameters exposure time, ceramic thickness and type, the highest influence on the micro-mechanical parameters was identified for exposure time, while this influence was stronger on HV (p < 0.001, η _P² = 0.452) than on Y_HU (p < 0.001, η _P² = 0.178). The influence of ceramic type was significant but low (η _P² = 0.161 on HV and 0.113 on Y_HU), while the influence of ceramic thickness was the lowest (η _P² = 0.04 and 0.05, respectively).

CONCLUSIONS

Slightly higher irradiance values were transmitted through Empress CAD up to a ceramic thickness of 3 mm (p < 0.001), while being comparable with e.max for thicker slices. Differences in translucency between ceramics were reflected in the micro-mechanical properties of the luting composite.

CLINICAL RELEVANCE

The radiant exposure reaching the luting composite is determined by the incident irradiance, exposure time, ceramic type and ceramic thickness. At the analysed incident irradiance, exposure time was the most consistent parameter affecting the micro-mechanical properties of the luting composite, and this effect was strongly reflected in the more translucent ceramic Empress CAD. Within the curing conditions, an exposure time of 20 s is recommended.

Evaluation of Discoloration Removal by Polishing Resin Composites Submitted to Staining in Different Drink Solutions

The aim of this study was to evaluate the discoloration effects of water, cola-based soft drink, coffee, and wine on resin composites used in restorative dentistry and the possibility of removing the stain with chair side manual polishing. The A2 shade of three materials was tested. Disc specimens were prepared. A spectrophotometer was used to measure the baseline CIE-Lab color parameters of each material (n=10) 24 hours after sample preparation. Samples were then immersed in a cola-based soft drink, coffee, or wine for 1 hour every day, for 30 days. For the remaining hours, the specimens were stored in distilled water. In the control group, the specimens were immersed in water for the whole period. The color differences (ΔE) were calculated after 7 and 30 days of storage, and after polishing with coarse Sof-Lex discs, and analyzed by two-way ANOVA with repeated measures and Tukey's HSD test (α=0.05). Luna presented higher ΔE values (3.41)^a followed by Durafill (2.82)^b and Herculite (2.24)^c. For the drink solutions, ΔE values were higher for wine (4.40)^a followed by coffee (2.59)^b and for cola-based soft drink (2.23)^c and water (2.13)^c which were statistically similar. For time, ΔE values were higher for 30 days (3.97)^a and then for 7 days (2.48)^b and after polishing (2.04)^c. The results indicate that color stability is material dependent. The types of drinks that patients consume also influence the color stability of restorative materials.