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Pires PM, de Almeida Neves A, Lukomska-Szymanska M, Farrar P, Cascales ÁF, Sauro S. Bonding performance and interfacial adaptation of modern bulk-fill restorative composites after aging in artificial saliva: an in vitro study. Clin Oral Investig 2024; 28:132. [PMID: 38308668 DOI: 10.1007/s00784-024-05525-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/21/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVES This study aimed at comparing the microtensile bond strength (MTBS) and interfacial adaptation of a modern self-curing and a light-curing restorative bulk-fill composite to a conventional composite applied with the layering technique. METHODS Forty-eight occlusal cavities were divided in three main groups (16/group) based on tested materials: (i) STELA, bulk-fill self-curing restorative (STELA, SDI Ltd.); (ii) 3 M-BULK, bulk-fill composite (Filtek One Bulk-Fill, 3 M Oral Care); and (iii) 3 M-CTR, a conventional composite (Filtek Supreme XTE, 3 M Oral Care). These were used in combination with their adhesives in self-etch (SE) or etch-and-rinse (ER) mode. Specimens stored in artificial saliva (24 h or 12 months) were evaluated for MTBS and fractography. The interfacial analysis was performed through confocal microscopy. ANOVA and Fisher's LSD post hoc tests were performed with a level of significance of 5%. RESULTS All the tested materials applied in ER mode presented (24 h) greater bond strength than in SE mode. Although all materials showed a significant drop in the bond strength after prolonged storage, STELA showed the highest bonding performance and interfaces with few gaps. 3 M-BULK had the lowest bond strength and an interface with several voids and gaps. CONCLUSIONS All materials were affected by interface degradation and bonding reduction over prolonged aging. However, their use in combination with adhesives applied in ER mode may offer greater immediate bonding performance. CLINICAL RELEVANCE The use of restorative light-curing bulk-fill composites may generate gaps at the bonding interface and voids. STELA may represent a suitable alternative to avoid such issues.
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Affiliation(s)
- Paula Maciel Pires
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil
- Dental Biomaterials & Minimally Invasive Dentistry, Departamento de Odontología, Facultad de Ciencias de La Salud, Universidad CEU Cardenal Herrera, Alfara del Patriarca, 46115, Valencia, Spain
| | - Aline de Almeida Neves
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Paul Farrar
- Research & Development, SDI Limited, Bayswater, Australia
| | - Álvaro Ferrando Cascales
- Department of Biomaterials Engineering, Faculty of Medicine, UCAM, Universidad Católica de Murcia, Campus Los Jerónimos 135, 30107, Guadalupe, Murcia, Spain
| | - Salvatore Sauro
- Dental Biomaterials & Minimally Invasive Dentistry, Departamento de Odontología, Facultad de Ciencias de La Salud, Universidad CEU Cardenal Herrera, Alfara del Patriarca, 46115, Valencia, Spain.
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Burrer P, Par M, Fürer L, Stübi M, Marovic D, Tarle Z, Attin T, Tauböck TT. Effect of polymerization mode on shrinkage kinetics and degree of conversion of dual-curing bulk-fill resin composites. Clin Oral Investig 2023; 27:3169-3180. [PMID: 36869923 PMCID: PMC10264464 DOI: 10.1007/s00784-023-04928-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
OBJECTIVES To assess the behavior of dual-cure and conventional bulk-fill composite materials on real-time linear shrinkage, shrinkage stress, and degree of conversion. MATERIALS AND METHODS Two dual-cure bulk-fill materials (Cention, Ivoclar Vivadent (with ion-releasing properties) and Fill-Up!, Coltene) and two conventional bulk-fill composites (Tetric PowerFill, Ivoclar Vivadent; SDR flow + , Dentsply Sirona) were compared to conventional reference materials (Ceram.x Spectra ST (HV), Dentsply Sirona; X-flow; Dentsply Sirona). Light curing was performed for 20 s, or specimens were left to self-cure only. Linear shrinkage, shrinkage stress, and degree of conversion were measured in real time for 4 h (n = 8 per group), and kinetic parameters were determined for shrinkage stress and degree of conversion. Data were statistically analyzed by ANOVA followed by post hoc tests (α = 0.05). Pearson's analysis was used for correlating linear shrinkage and shrinkage force. RESULTS Significantly higher linear shrinkage and shrinkage stress were found for the low-viscosity materials compared to the high-viscosity materials. No significant difference in degree of conversion was revealed between the polymerization modes of the dual-cure bulk-fill composite Fill-Up!, but the time to achieve maximum polymerization rate was significantly longer for the self-cure mode. Significant differences in degree of conversion were however found between the polymerization modes of the ion-releasing bulk-fill material Cention, which also exhibited the significantly slowest polymerization rate of all materials when chemically cured. CONCLUSIONS While some of the parameters tested were found to be consistent across all materials studied, heterogeneity increased for others. CLINICAL RELEVANCE With the introduction of new classes of composite materials, predicting the effects of individual parameters on final clinically relevant properties becomes more difficult.
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Affiliation(s)
- Phoebe Burrer
- Department of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
| | - Matej Par
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000, Zagreb, Croatia
| | - Leo Fürer
- Department of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Michelle Stübi
- Department of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Danijela Marovic
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000, Zagreb, Croatia
| | - Zrinka Tarle
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000, Zagreb, Croatia
| | - Thomas Attin
- Department of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Tobias T Tauböck
- Department of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
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Ilie N. Cytotoxic, Elastic-Plastic and Viscoelastic Behavior of Aged, Modern Resin-Based Dental Composites. Bioengineering (Basel) 2023; 10:bioengineering10020235. [PMID: 36829729 PMCID: PMC9952265 DOI: 10.3390/bioengineering10020235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
The development of resin-based composites (RBCs) is a delicate balance of antagonistic properties with direct clinical implications. The clear trend toward reducing filler size in modern RBCs solves esthetic deficiencies but reduces mechanical properties due to lower filler content and increases susceptibility to degradation due to larger filler-matrix interface. We evaluated a range of nano- and nano-hybrid RBCs, along with materials attempting to address shrinkage stress issues by implementing an Ormocer matrix or pre-polymerized fillers, and materials aiming to provide caries-protective benefit by incorporating bioactive fillers. The cytotoxic response of human gingival fibroblast (HGF) cells after exposure to the RBC eluates, which were collected for up to six months, was analyzed using a WST-1 assay. The microstructural features were characterized using a scanning electron microscopy and were related to the macroscopic and microscopic mechanical behaviors. The elastic-plastic and viscoelastic material behaviors were evaluated at the macroscopic and microscopic levels. The data were supplemented with fractography, Weibull analysis, and aging behavioral analysis. The results indicate that all RBCs are non-cytotoxic at adequate exposure. The amount of inorganic filler affects the elastic modulus, while only to a limited extent the flexural strength, and is well below the theoretical estimates. The nanoparticles and the agglomeration of nanoparticles in the RBCs help generate good mechanical properties and excellent reliability, but they are more prone to deterioration with aging. The pre-polymerized fillers lower the initial mechanical properties but are less sensitive to aging. Only the Ormocer retains its damping ability after aging. The strength and modulus of elasticity on the one hand and the damping capacity on the other are mutually exclusive and indicate the direction in which the RBCs should be further developed.
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Affiliation(s)
- Nicoleta Ilie
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, D-80336 Munich, Germany
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Ilie N. Resin-Based Bulk-Fill Composites: Tried and Tested, New Trends, and Evaluation Compared to Human Dentin. MATERIALS (BASEL, SWITZERLAND) 2022; 15:8095. [PMID: 36431581 PMCID: PMC9694352 DOI: 10.3390/ma15228095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
A more-and-more-accepted alternative to the time-consuming and technique-sensitive, classic, incremental-layering technique of resin-based composites (RBCs) is their placement in large increments. The so-called bulk-fill RBCs had to be modified for a higher polymerization depth and already have a 20-year history behind them. From the initial simple mechanisms of increasing the depth of cure by increasing their translucency, bulk-fill RBCs have evolved into complex materials with novel polymerization mechanisms and bioactive properties. However, since the materials are intended to replace the tooth structure, they must be comparable in mechanical behavior to the substance they replace. The study compares already established bulk-fill RBCs with newer, less-studied materials and establishes their relationship to dentin with regard to basic material properties such as hardness and indentation modulus. Instrumented indentation testing enables a direct comparison of tooth and material substrates and provides clinically relevant information. The results underline the strong dependence of the measured properties on the amount of filler in contrast to the small influence of the material classes into which they are classified. The main difference of RBCs compared to dentin is a comparable hardness but a much lower indentation modulus, emphasizing further development potential.
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Affiliation(s)
- Nicoleta Ilie
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig Maximilian University of Munich, Goethestr. 70, 80336 Munich, Germany
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Universal Chromatic Resin-Based Composites: Aging Behavior Quantified by Quasi-Static and Viscoelastic Behavior Analysis. Bioengineering (Basel) 2022; 9:bioengineering9070270. [PMID: 35877321 PMCID: PMC9312272 DOI: 10.3390/bioengineering9070270] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022] Open
Abstract
Universal chromatic dental resin-based composites were recently developed in an attempt to speed up the restoration process with the aim of making it easier for the practitioner to decide on a suitable shade and to avoid time-consuming matching and mixing of materials. The way in which color is created in the analyzed universal chromatic materials is innovative, as it is not only induced by selective light absorption via pigments (Venus Diamond ONE, Venus Pearl ONE), as is usual in regular composites (Charisma Classic, Charisma Topaz, Venus, Venus Diamond), but also by selective light reflection via particularized microstructures (Omnichroma). Material properties were assessed at 24 h post-polymerization and after artificial aging. Flexural strength (n = 20) and modulus were measured in a 3-point-bending test and complemented with fractography and Weibull analysis. Quasi-static (Martens, Vickers, and indentation hardness; elastic and total indentation work; creep, indentation depth) and viscoelastic (storage, loss, and indentation moduli; loss factor) behavior (n = 6) was measured by a depth-sensing indentation test equipped with a DMA module. The nanoscale silica/zirconia polymer core-shell structure in the structural-colored material induces similar or poorer mechanical properties compared with pigment-colored materials, which is related to the higher polymer content. For all materials, aging shows a clear influence on the measured properties, with the degree of degradation depending on the measurement scale.
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Veček NN, Par M, Sever EK, Miletić I, Krmek SJ. The Effect of a Green Smoothie on Microhardness, Profile Roughness and Color Change of Dental Restorative Materials. Polymers (Basel) 2022; 14:polym14102067. [PMID: 35631949 PMCID: PMC9145769 DOI: 10.3390/polym14102067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/12/2022] [Accepted: 05/17/2022] [Indexed: 11/16/2022] Open
Abstract
Acidic drinks are known to exert negative effects on the surface properties of dental restorative materials. However, the effect of increasingly popular green smoothie drinks has not been addressed so far. The present study investigated the effect of cyclic immersions (5 min daily over 30 days) in a green smoothie drink on the surface properties of contemporary dental restorative materials, including resin composites, an alkasite, and a glass hybrid. Vickers microhardness, profile roughness, and perceptible color change in the CIE L* a* b* color space were evaluated as clinically relevant properties of the material surface. After 30-day green smoothie immersion, microhardness values either decreased by 8–28% (for resin composites) or increased by up to 91% (for glass hybrid). The increase in profile roughness (Ra parameter) of smoothie-immersed specimens was 7–26 times higher compared to the control group. The perceptible color change (ΔE*) in the smoothie group was 3–8 times higher compared to the control group. Overall, this study demonstrated that daily exposure of dental restorations made from resin composites, alkasites, and glass hybrid materials to a green smoothie drink can significantly accelerate material degradation, which is reflected as surface softening, as well as higher roughness and higher perceptible color change.
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Affiliation(s)
| | - Matej Par
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia; (E.K.S.); (I.M.); (S.J.K.)
- Correspondence:
| | - Eva Klarić Sever
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia; (E.K.S.); (I.M.); (S.J.K.)
| | - Ivana Miletić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia; (E.K.S.); (I.M.); (S.J.K.)
| | - Silvana Jukić Krmek
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia; (E.K.S.); (I.M.); (S.J.K.)
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Rathke A, Pfefferkorn F, McGuire MK, Heard RH, Seemann R. One-year clinical results of restorations using a novel self-adhesive resin-based bulk-fill restorative. Sci Rep 2022; 12:3934. [PMID: 35273277 PMCID: PMC8913631 DOI: 10.1038/s41598-022-07965-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/28/2022] [Indexed: 11/18/2022] Open
Abstract
This prospective study assessed the dual-curing self-adhesive bulk-fill restorative Surefil one. The restorations were placed and reviewed by dental practitioners who are members of a practice-based research network in the United States. Seven practitioners filled 60 cavities (20 class I, 19 class II and 21 class V) in 41 patients with Surefil one without adhesive, according to the manufacturer’s instructions. The restorations were evaluated using modified USPHS criteria at baseline, 3 months, and 1 year. Patients were also contacted to report postoperative hypersensitivity one to four weeks after placement. The only patient that showed moderate hypersensitivity after 1 year had previously reported symptoms that were unlikely associated to the class I molar restoration. One class II restoration in a fractured maxillary molar was partially lost. The remaining restorations were found to be in clinically acceptable condition resulting in an annual failure rate of 2%. Color match showed the lowest number of acceptable scores (88%) revealing significant changes over time (P = 0.0002). No significant differences were found for the other criteria (P > 0.05). The novel self-adhesive bulk-fill restorative showed clinically acceptable results in stress-bearing class I and II as well as non-retentive class V cavities at 1-year recall.
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Affiliation(s)
- Andreas Rathke
- Dentsply Sirona, Konstanz, Germany. .,University of Ulm, Faculty of Dentistry, Ulm, Germany.
| | | | | | | | - Rainer Seemann
- Dentsply Sirona, Konstanz, Germany.,Department of Restorative, Preventive and Pediatric Dentistry, zmk Bern, University of Bern, Bern, Switzerland
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