Inorganic Fillers for Dental Resin Composites: Present and Future

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.

Flexural Properties, Wear Resistance, and Microstructural Analysis of Highly Filled Flowable Resin Composites

OBJECTIVE

This study aimed to evaluate the flexural properties and two-body wear resistance of nine highly filled flowable resin composites relative to those of viscous and conventional low-filled flowable composites. In addition, scanning electron microscopy (SEM) analysis of the microstructures was performed.

METHODS AND MATERIALS

For each resin composite group (n=12), 12 specimen bars (25 mm × 2 mm × 2 mm) were fabricated using a silicon mold for performing flexural strength (FS), flexural modulus (E), flexural toughness (FT), Weibull modulus (m) tests, and SEM microstructural analysis. For each group, ten bars were tested using a three-point flexural test on a universal testing machine, while the other two were embedded in acrylic resin before being observed by SEM for structural analysis. During the two-body wear test with a chewing simulator, 8 specimens (12 groups, n=8) of each resin composite group were manufactured in a specific mold and subjected to 120,000 cycles of wear against a steatite ball, and the depth loss was measured. Three one-way ANOVA tests followed by Tukey's post hoc tests were conducted to compare the flexural and wear properties among the different groups.

RESULTS

The majority of highly filled composites tested in this study exhibited similar flexural strengths (between 105.68 MPa and 135.49 MPa) and superior wear resistance to those of viscous composites. The flexural moduli (between 5.12 GPa and 9.62 GPa) of these composites were in between those of the viscous and low-filled composites tested in this study.

CONCLUSIONS

The highly filled flowable composites tested in this study exhibited different in vitro properties but were often superior to those of viscous resin composite suggesting their possible use for posterior restorations.

Microscopic and Color Changes in Direct Dental Restorative Composite Resins upon Immersion in Beverages: Characterization by Scanning Electron Microscopy (SEM) and Energy-Dispersive X-ray Spectroscopy (EDS)

This study aimed to evaluate the staining sensitivity and surface changes in recent composite resins (Herculite Ultra XRV (Kerr, Bolzano, Italy), G-ænial A'CHORD (GC Corp, Tokyo, Japan), and Omnichroma (Yamaguchi, Japan)) when exposed to common beverages such as coffee, red wine, and Coca-Cola. A total of 60 disk-shaped specimens were prepared from three different resin composites (n = 20 each). The specimens were exposed to coffee, red wine, and Coca-Cola for 10 days. Color measurements were taken using a spectrophotometer, and surface morphology and elemental composition were analyzed using SEM and EDS. The SEM and EDS analyses revealed significant changes in the surface morphology and elemental composition of the composites after immersion. Coffee and wine caused significant surface degradation, whereas Coca-Cola resulted in the greatest degree of surface and elemental variations. Color changes (ΔE = 4 ± 0.52) were most notable in Coca-Cola for Herculite Ultra XRV (Kerr, Italy), in red wine for G-ænial A'CHORD (GC Corp, Japan) (ΔE = 12.51 ± 0.38), and in coffee for Omnichroma (Yamaguchi, Japan) (ΔE = 10.85 ± 1.03). The tested beverages significantly affected both the surface condition and the chemical composition of the resin at the surface level. These findings highlight the importance of understanding the effects of common dietary beverages on dental composites.

Growing three-dimensional objects with light

Vat photopolymerization (VP) additive manufacturing enables fabrication of complex 3D objects by using light to selectively cure a liquid resin. Developed in the 1980s, this technique initially had few practical applications due to limitations in print speed and final part material properties. In the four decades since the inception of VP, the field has matured substantially due to simultaneous advances in light delivery, interface design, and materials chemistry. Today, VP materials are used in a variety of practical applications and are produced at industrial scale. In this perspective, we trace the developments that enabled this printing revolution by focusing on the enabling themes of light, interfaces, and materials. We focus on these fundamentals as they relate to continuous liquid interface production (CLIP), but provide context for the broader VP field. We identify the fundamental physics of the printing process and the key breakthroughs that have enabled faster and higher-resolution printing, as well as production of better materials. We show examples of how in situ print process monitoring methods such as optical coherence tomography can drastically improve our understanding of the print process. Finally, we highlight areas of recent development such as multimaterial printing and inorganic material printing that represent the next frontiers in VP methods.

A Historical Perspective on Dental Composite Restorative Materials

This review article will discuss the origin of resin-based dental composite materials and their adoption as potentially useful adjuncts to the primary material used by most dentists for direct restorations. The evolution of the materials, largely driven by the industry's response to the needs of dentists, has produced materials that are esthetic, strong, and versatile enough to be used in most areas of the oral cavity to replace or restore missing tooth structures. Significant advancements, such as the transition from chemical to light-curing materials, refinements in reinforcing particles to produce optimum polishing and wear resistance, formulating pastes with altered viscosities to create highly flowable and highly stiff materials, and creating materials with enhanced depth of cure to facilitate placement, will be highlighted. Future advancements will likely reflect the movement away from simply being a biocompatible material to one that is designed to produce some type of beneficial effect upon interaction within the oral environment. These new materials have been called "bioactive" by virtue of their potential effects on bacterial biofilms and their ability to promote mineralization of adjacent tooth structures.

Comparative Assessments of Dental Resin Composites: A Focus on Dense Microhybrid Materials

The performance of dental resin composites is crucially influenced by the sizes and distributions of inorganic fillers. Despite the investigation of a variety of functional particles, glass fillers and nanoscale silica are still the predominant types in dental materials. However, achieving an overall improvement in the performance of resin composites through the optimization of their formulations remains a challenge. This work introduced a "dense" microhybrid filler system with 85 wt % filler loading, leading to the preparation of self-developed resin composites (SRCs). Comparative evaluations of these five SRCs against four commercial products were performed, including mechanical property, polymerization conversion, and shrinkage, along with water sorption and solubility and wear resistance. The results showed that among all SRC groups, SRC3 demonstrated superior mechanical performance, high polymerization conversion, reduced shrinkage, low water absorption and solubility, and acceptable wear resistance. In contrast to commercial products, this optimal SRC3 material was comparable to Z350 XT in flexural and diametral tensile strength and better in flexural modulus and surface hardness. The use of a "dense" microhybrid filler system in the development of resin composites provides a balance between physicochemical property and wear resistance, which may be a promising strategy for the development of composite products.

Next-generation all-organic composites: A sustainable successor to organic-inorganic hybrid materials

This Review presents an overview of all-organic nanocomposites, a sustainable alternative to organic-inorganic hybrids. All-organic nanocomposites contain nanocellulose, nanochitin, and aramid nanofibers as highly rigid reinforcing fillers. They offer superior mechanical properties and lightweight characteristics suitable for diverse applications. The Review discusses various methods for preparing the organic nanofillers, including top-down and bottom-up approaches. It highlights in situ polymerization as the preferred method for incorporating these nanomaterials into polymer matrices to achieve homogeneous filler dispersion, a crucial factor for realizing desired performance. Furthermore, the Review explores several applications of all-organic nanocomposites in diverse fields including food packaging, performance-advantaged plastics, and electronic materials. Future research directions-developing sustainable production methods, expanding biomedical applications, and enhancing resistance against heat, chemicals, and radiation of all-organic nanocomposites to permit their use in extreme environments-are explored. This Review offers insights into the potential of all-organic nanocomposites to drive sustainable growth while meeting the demand for high-performance materials across various industries.

Filler Mixed Into Adhesives Does Not Necessarily Improve Their Mechanical Properties

OBJECTIVES

To investigate the influence of filler type/loading on the micro-tensile fracture strength (μTFS) of adhesive resins, as measured 'immediately' upon preparation and after 1-week water storage ('water-stored').

METHODS

The morphology and particle-size distribution of three filler particles, referred to as 'Glass-S' (Esschem Europe), 'BioUnion' (GC), and 'CPC_Mont', were correlatively characterized by SEM, TEM, and particle-size analysis. These filler particles were incorporated into an unfilled adhesive resin ('BZF-29unfilled', GC) in different concentrations to measure the 'immediate' μTFS. After 1-week water storage, the 'water-stored' μTFS of the experimental particle-filled adhesive resins with the most optimum filler loading, specific for each filler type, was measured. In addition, the immediate and water-stored μTFS of the adhesive resins of three experimental two-step universal adhesives based on the same resin matrix but varying for filler type/loading, coded as 'BZF-21' (containing silica and bioglass), 'BZF-29' (containing solely silica), and 'BZF-29_hv' (highly viscous with a higher silica loading than BZF-29), and of the adhesive resins of the gold-standard adhesives OptiBond FL ('Opti-FL', Kerr) and Clearfil SE Bond 2 ('C-SE2', Kuraray Noritake) was measured along with that of BZF-29unfilled (GC) serving as control/reference. Statistics involved one-way and two-way ANOVA followed by post-hoc multiple comparisons (α<0.05).

RESULTS

Glass-S, BioUnion, and CPC_Mont represent irregular fillers with an average particle size of 8.5-9.9 μm. Adding filler to BZF-29unfilled decreased μTFS regardless of filler type/loading. One-week water storage reduced μTFS of all adhesive resins except BZF-21, with the largest reduction in μTFS recorded for BZF-29unfilled. Among the three filler types, the μTFS of the 30 wt% Glass-S and 20 wt% BioUnion filled adhesive resin was not significantly different from the μTFS of BZF-29unfilled upon water storage.

CONCLUSIONS

Adding filler particles into adhesive resin did not enhance its micro-tensile fracture strength but appeared to render it less sensitive to water storage as compared to the unfilled adhesive resin investigated.

Experimental characterization and finite element investigation of SiO2 nanoparticles reinforced dental resin composite

In this study, a commercial dental resin was reinforced by SiO2 nanoparticles (NPs) with different concentrations to enhance its mechanical functionality. The material characterization and finite element analysis (FEA) have been performed to evaluate the mechanical properties. Wedge indentation and 3-point bending tests were conducted to assess the mechanical behavior of the prepared nanocomposites. The results revealed that the optimal content of NPs was achieved at 1% SiO2, resulting in a 35% increase in the indentation reaction force. Therefore, the sample containing 1% SiO2 NPs was considered for further tests. The morphology of selected sample was examined using field emission scanning electron microscopy (FE-SEM), revealing the homogeneous dispersion of SiO2 NPs with minimal agglomeration. X-ray diffraction (XRD) was employed to investigate the crystalline structure of the selected sample, indicating no change in the dental resin state upon adding SiO2 NPs. In the second part of the study, a novel approach called iterative FEA, supported by the experiment wedge indentation test, was used to determine the mechanical properties of the 1% SiO2-dental resin. Subsequently, the accurately determined material properties were assigned to a dental crown model to virtually investigate its behavior under oblique loading. The virtual test results demonstrated that most microcracks initiated from the top of the crown and extended through its thickness.

Mechanical and Antimicrobial Properties of Boron Nitride/Methacrylic Acid Quaternary Ammonium Composites Reinforced Dental Flowable Resins

Dental resin composites (DRCs) are commonly used to restore teeth affected by dental caries or defects. These materials must possess excellent properties to withstand the complex oral environment. The objective of this study was to prepare and characterize Boron nitride nanosheets (BNN)/ dimethyl amino hexadecyl methacrylate (DMAHDM) composites (BNN/DMA), and to evaluate them as functional fillers to enhance the mechanical and antimicrobial properties of dental resins. The BNN/DMA composites were successfully prepared under the theoretical guidance of molecular dynamics (MD), and then the physicochemical and morphological characterization of the BNN/DMA composites were carried out by using various test methods, such as FT-IR, XRD, UV-vis spectroscopy, SEM, TEM, and AFM. It was doped into the dental flowable resin in a certain proportion, and the results showed that the flexural strength (FS), elastic modulus (EM), compressive strength (CS), and microhardness (MH) of the modified resin composites were increased by 53.29, 47.8, 97.59, and 37.1%, respectively, with the addition of 0.8 wt % of BNN/DMA composite fillers. It has a good inhibition effect on Streptococcus mutans, with an inhibition rate as high as 90.43%. Furthermore, this effect persists even after one month of aging. In conclusion, the modification of flowable resins with low-concentration BNN/DMA composites favorably integrates the mechanical properties and long-term antimicrobial activity of dental resins. At the same time, they have good biocompatibility and do not affect the aesthetics. The BNN/DMA composite modified flowable resin has the potential to become a new type of antimicrobial dental restorative material.

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.

Degree of conversion and physicomechanical properties of newly developed flowable composite derived from rice husk using urethane dimethacrylate monomer

This study evaluated the use of urethane dimethacrylate (UDMA) as a base monomer to prepare the newly developed flowable composite (FC) using nanohybrid silica derived from rice husk in comparison to bisphenol A-glycidyl methacrylate (Bis-GMA) on the degree of conversion and physicomechanical properties. The different loadings of base monomer to diluent monomer were used at the ratio of 40:60, 50:50, and 60:40. The bonding analysis confirmed the presence of nanohybrid silica in the newly developed FC. Independent t-test revealed a statistically significant increase in the degree of conversion, depth of cure and Vickers hardness of the UDMA-based FC, while surface roughness showed comparable results between the two base monomers. In conclusion, UDMA-based FC demonstrated superior performance with 60%-65% conversions, a significantly higher depth of cure exceeding 1 mm which complies with the Internal Standard of Organization 4049 (ISO 4049), and a substantial increase in Vickers hardness numbers compared to Bis-GMA-based FC, making UDMA a suitable alternative to Bis-GMA as a base monomer in the formulation of this newly developed FC derived from rice husk.

Physical-Chemical and Microhardness Properties of Model Dental Composites Containing 1,2-Bismethacrylate-3-eugenyl Propane Monomer

A new eugenyl dimethacrylated monomer (symbolled BisMEP) has recently been synthesized. It showed promising viscosity and polymerizability as resin for dental composite. As a new monomer, BisMEP must be assessed further; thus, various physical, chemical, and mechanical properties have to be investigated. In this work, the aim was to investigate the potential use of BisMEP in place of the BisGMA matrix of resin-based composites (RBCs), totally or partially. Therefore, a list of model composites (CEa0, CEa25, CEa50, and CEa100) were prepared, which made up of 66 wt% synthesized silica fillers and 34 wt% organic matrices (BisGMA and TEGDMA; 1:1 wt/wt), while the novel BisMEP monomer has replaced the BisGMA content as 0.0, 25, 50, and 100 wt%, respectively. The RBCs were analyzed for their degree of conversion (DC)-based depth of cure at 1 and 2 mm thickness (DC1 and DC2), Vickers hardness (HV), water uptake (WSP), and water solubility (WSL) properties. Data were statistically analyzed using IBM SPSS v21, and the significance level was taken as p < 0.05. The results revealed no significant differences (p > 0.05) in the DC at 1 and 2 mm depth for the same composite. No significant differences in the DC between CEa0, CEa25, and CEa50; however, the difference becomes substantial (p < 0.05) with CEa100, suggesting possible incorporation of BisMEP at low dosage. Furthermore, DC1 for CEa0-CEa50 and DC2 for CEa0-CEa25 were found to be above the proposed minimum limit DC of 55%. Statistical analysis of the HV data showed no significant difference between CEa0, CEa25, and CEa50, while the difference became statistically significant after totally replacing BisGMA with BisMEP (CEa100). Notably, no significant differences in the WSP of various composites were detected. Likewise, WSL tests revealed no significant differences between such composites. These results suggest the possible usage of BisMEP in a mixture with BisGMA with no significant adverse effect on the DC, HV, WSP, and degradation (WSL).

Glass-Ceramic Fillers Based on Zinc Oxide-Silica Systems for Dental Composite Resins: Effect on Mechanical Properties

The potential of glass ceramics as applicable materials in various fields including fillers for dental restorations is our guide to present a new procedure for improvements of the mechanical properties of dental composites. This work aims to use Zn2SiO4 and SiO2-ZnO nano-materials as fillers to improve the mechanical properties of Bis-GMA/TEGDMA mixed dental resins. Zn2SiO4 and SiO2-ZnO samples were prepared and characterized by using XRD, FE-SEM, EDX, and FT-IR techniques. The XRD pattern of the SiO2-ZnO sample shows that ZnO crystallized in a hexagonal phase, while the SiO2 phase was amorphous. Similarly, the Zn2SiO4 sample crystallized in a rhombohedral crystal system. The prepared samples were used as fillers for the improvement of the mechanical properties of Bis-GMA/TEGDMA mixed dental resins. Five samples of dental composites composed of Bis-GMA/TEGDMA mixed resins were filled with 2, 5, 8, 10, and 15 wt% of SiO2-ZnO, and similarly, five samples were filled with Zn2SiO4 samples (2, 5, 8, 10, and 15 wt%). All of the 10 samples (A1-A10) were characterized by using different techniques including FT-IR, FE-SEM, EDX, and TGA analyses. According to the TGA analysis, all samples were thermally stable up to 200 °C, and the thermal stability increased with the filler percent. Next, the mechanical properties of the samples including the flexural strength (FS), flexural modulus (FM), diameter tensile strength (DTS), and compressive strength (CS) were investigated. The obtained results revealed that the samples filled with 8 wt% of SiO2-ZnO and 10 wt% of Zn2SiO4 had higher FS values of 123.4 and 136.6 MPa, respectively. Moreover, 8 wt% of both fillers displayed higher values of the FM, DTS, and CS parameters. These values were 8.6 GPa, 34.2 MPa, and 183.8 MPa for SiO2-ZnO and 11.3 GPa, 41.2 MPa, and 190.5 MPa for the Zn2SiO4 filler. Inexpensive silica-based materials enhance polymeric mechanics. Silica-metal oxide nanocomposites improve dental composite properties effectively.

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.

Synthesis of Pore-Size-Tunable Porous Silica Particles and Their Effects on Dental Resin Composites

The filler/resin matrix interface interaction plays a vital role in the properties of dental resin composites (DRCs). Porous particles are promising fillers due to their potential in constructing micromechanical interlocking at filler/resin matrix interfaces, therefore improving the properties of the resulting DRCs, where the pore size is significantly important. However, how to control the pore size of porous particles via a simple synthesis method is still a challenge, and how their pore sizes affect the properties of resulting DRCs has not been studied. In this study, porous silica (DPS) with a dendritic structure and an adjustable pore size was synthesized by changing the amounts of catalyst in the initial microemulsion. These synthesized DPS particles were directly used as unimodal fillers and mixed with a resin matrix to formulate DRCs. The results showed that the DPS pore size affects the properties of DRCs, especially the mechanical property. Among various DPS particles with different pore sizes, DPS6 resulted in 19.5% and 31.4% improvement in flexural strength, and 24.4% and 30.7% enhancement in compression strength, respectively, compared to DPS1 and DPS9. These DPS particles could help to design novel dental restorative materials and have promising applications in biomedicine, catalysis, and adsorption.

Bioactive Dental Resin Composites with MgO Nanoparticles

Photoactivating dental resin composites have been the most prevailing material for repairing dental defects in various clinical scenarios due to their multiple advantages. However, compared to other restorative materials, the surface of resin-based composites is more susceptible to plaque biofilm accumulation, which can lead to secondary caries and restoration failure. This study introduced different weight fractions (1, 2, 5, 10, and 15%) of magnesium oxide nanoparticles (MgONPs) as antibacterial fillers into dental resin composites. Multifarious properties of the material were investigated, including antibacterial activity against a human salivary plaque-derived biofilm, cytotoxicity on human gingival fibroblasts, mechanical and physicochemical properties as well as the performance when subjected to thermocycling aging treatment. Results showed that the incorporation of MgONPs significantly improved the composites' anti-biofilm capability even at a low amount of 2 wt % without compromising the mechanical, physicochemical, and biocompatibility performances. The results of the thermocycling test suggested certain of aging resistance. Moreover, a small amount of MgONPs possibly made a difference in enhancing photoactivated polymerization and increasing the curing depth of experimental resin composites. Overall, this study highlights the potential of MgONPs as an effective strategy for developing antibacterial resin composites, which may help mitigating cariogenic biofilm-associated secondary caries.

Micromechanical interlocking structure at the filler/resin interface for dental composites: a review

Dental resin composites (DRCs) are popular materials for repairing caries or dental defect, requiring excellent properties to cope with the complex oral environment. Filler/resin interface interaction has a significant impact on the physicochemical/biological properties and service life of DRCs. Various chemical and physical modification methods on filler/resin interface have been introduced and studied, and the physical micromechanical interlocking caused by the modification of fillers morphology and structure is a promising method. This paper firstly introduces the composition and development of DRCs, then reviews the chemical and physical modification methods of the filler/resin interface, mainly discusses the interface micromechanical interlocking structures and their enhancement mechanism for DRCs, finally give a summary on the existing problems and development potential.

Antibacterial and physical properties of resin cements containing MgO nanoparticles

Cariogenic bacteria and dental plaque biofilm at prosthesis margins are considered a primary risk factor for failed restorations. Resin cement containing antibacterial agents can be beneficial in controlling bacteria and biofilm. This work aimed to evaluate the impact of incorporating magnesium oxide nanoparticles (MgONPs) as an antibacterial filler into dual-cure resin cement on bacteriostatic activity and physical properties, including mechanical, bonding, and physicochemical properties, as well as performance when subjected to a 5000-times thermocycling regimen. Experimental resin cements containing MgONPs of different mass fractions (0, 2.5%, 5%, 7.5% and 10%) were developed. Results suggested that the inclusion of MgONPs markedly improved the materials' bacteriostatic effect against Streptococcus mutans without compromising the physical properties when its addition reached 7.5 wt%. The mechanical properties of the specimens did not significantly decline after undergoing aging treatment, except for the flexural properties. In addition, the cements displayed good bonding performance and the material itself was not prone to cohesive fracture in the failure mode analysis. Furthermore, MgONPs possibly have played a role in decelerating material aging during thermocycling and enhancing bonding fastness in the early stage of cementation, which requires further investigation. Overall, developing MgONPs-doped resin cements can be a promising strategy to improve the material's performance in inhibiting cariogenic bacteria at restoration margins, in order to achieve a reduction in biofilm-associated secondary caries and a prolonged restoration lifespan.

Impact of silanization of different bioactive glasses in simplified adhesives on degree of conversion, dentin bonding and collagen remineralization

OBJECTIVE

To analyze simplified adhesive containing pure or silanized bioglass 45S5 (with calcium) or Sr-45S5 (strontium-substituted) fillers applied on dentin and to evaluate the microtensile bond strength (µTBS), interface nanoleakage, degree of conversion of adhesive, collagen degradation and remineralization.

METHODS

Ambar Universal adhesive (FGM) was doped with 10 wt% bioactive glasses to form following groups: Control (no bioglass), 45S5 (conventional bioglass 45S5), Sr-45S5 (Sr-substituted bioglass 45S5), Sil-45S5 (silanized bioglass 45S5) and Sil-Sr-45S5 (silanized bioglass Sr-45S5). Adhesives were applied after dentin acid-etching using phosphoric acid at extracted human molars. Resin-dentin sticks were obtained and tested for µTBS, nanoleakage at 24 h or 6 months. Degree of conversion was measured using micro-Raman spectroscopy. Dentin remineralization was assessed by FTIR after 6-month storage in PBS. Hydroxyproline (HYP) release was surveyed by UV-Vis spectroscopy. Statistical analysis was performed using ANOVA and Tukey's test (p < 0.05).

RESULTS

Regarding µTBS, Sr-45S5 and 45S5 presented higher and stable results (p > 0.05). Control (p = 0.018) and Sil-Sr-45S5 (p < 0.001) showed µTBS reduction after 6-month aging. Sil-Sr-45S5 showed higher HYP release than that obtained in the 45S5 group. Sil-45S5 showed mineral deposition and increase in µTBS (p = 0.028) after 6-months. All experimental adhesives exhibited higher degree of conversion compared to Control group, except for 45S5. All adhesives created gap-free interfaces, with very low silver impregnation, except for Sil-Sr-45S5.

SIGNIFICANCE

The incorporation of silanized 45S5 bioglass into the universal adhesive was advantageous in terms of dentin remineralization, bonding performance and adhesive polymerization. Conversely, Sil-Sr-45S5 compromised the µTBS, interface nanoleakage and had a negative impact on HYP outcomes.

Zirconia Nanoparticles as Reinforcing Agents for Contemporary Dental Luting Cements: Physicochemical Properties and Shear Bond Strength to Monolithic Zirconia

Nanofillers in resin materials can improve their mechanical and physicochemical properties. The present work investigated the effects of zirconia nanoparticles (NPs) as fillers in commercial dental luting cements. Two dual-cured self-adhesive composites and one resin modified glass ionomer (RMGI) luting cement were employed. Film thickness (FT), flexural strength (FS), water sorption (W_sp), and shear bond strength (SBS) to monolithic zirconia were evaluated according to ISO 16506:2017 and ISO 9917-2:2017, whereas polymerization progress was evaluated with FTIR. Photopolymerization resulted in double the values of DC%. The addition of 1% wt NPs does not significantly influence polymerization, however, greater amounts do not promote crosslinking. The sorption behavior and the mechanical performance of the composites were not affected, while the film thickness increased in all luting agents, within the acceptable limits. Thermocycling (TC) resulted in a deteriorating effect on all composites. The addition of NPs significantly improved the mechanical properties of the RMGI cement only, without negatively affecting the other cements. Adhesive primer increased the initial SBS significantly, however after TC, its application was only beneficial for RMGI. The MDP containing luting cement showed higher SBS compared to the RMGI and 4-META luting agents. Future commercial adhesives containing zirconia nanoparticles could provide cements with improved mechanical properties.

Tailoring the monomers to overcome the shortcomings of current dental resin composites - review

Dental resin composites (DRCs) have become the first choice among different restorative materials for direct anterior and posterior restorations in the clinic. Though the properties of DRCs have been improved greatly in recent years, they still have several shortcomings, such as volumetric shrinkage and shrinkage stress, biofilm development, lack of radio-opacity for some specific DRCs, and estrogenicity, which need to be overcome. The resin matrix, composed of different monomers, constitutes the continuous phase and determine the performance of DRCs. Thus, the chemical structure of the monomers plays an important role in modifying the properties of DRCs. Numerous researchers have taken to design and develop novel monomers with specific functions for the purpose of fulfilling the needs in dentistry. In this review, the development of monomers in DRCs were highlighted, especially focusing on strategies aimed at reducing volumetric shrinkage and shrinkage stress, endowing bacteriocidal and antibacterial adhesion activities as well as protein-repelling activity, increasing radio-opacity, and replacing Bis-GMA. The influences of these novel monomers on the properties of DRCs were also discussed.

How the Duration and Mode of Photopolymerization Affect the Mechanical Properties of a Dental Composite Resin

Composite materials are the most common materials in use in modern dentistry. Over the years, the methods of photopolymerization of composite materials have been improved with the use of various devices, such as quartz tungsten halogen lamps (QTHs), light-emitting diode units (LEDs), plasma-arc lamps and argon-ion lasers. This study aimed to compare the mechanical properties of a composite material, depending on the time and mode of photopolymerization. One hundred and forty rectangular specimens (25 × 2 × 2 mm) and forty-two disc-shaped samples (5 mm diameter and 2 mm thickness) were prepared from shade A2 Boston composite resin. Samples were cured using the following seven photopolymerization protocols: four fast-cure modes (full power for 3, 5, 10, and 20 s), two pulse-cure modes (5 and 10 shots of 1 s exposures at full power), and one step-cure mode (soft start with a progressive cycle lasting 9 s). Specimens were subjected to a flexural strength test, Vickers microhardness test, and FTIR spectroscopy test. A 2-factor ANOVA and post-hoc tests were carried out to assess the differences in the flexural strength parameter between the tested groups of samples before and after aging. A mixed-model ANOVA was carried out to assess the differences in the Vickers microhardness parameter between the tested groups of samples before and after aging. The lowest values of flexural strength (p < 0.001) and Vickers microhardness (p < 0.001) were obtained for the 3 s mode for the pre- and post-aging groups. The FTIR mapping tests showed a much more homogeneous chemical structure of the composite after 20 s of continuous irradiation, compared to the sample irradiated for 5 s in the continuous mode. The mode and cure time affects the mechanical properties of the composite resin. Appropriate selection of the cure mode and time ensures better mechanical properties of composite resin. This suggests that the survival of dental restorations within the oral cavity could be extended by using longer photopolymerization durations.

Application of Tribology Concept in Dental Composites Field: A Scoping Review

Tribology is the discipline concerning the application of friction, lubrication, and wear concepts of interacting surfaces in relative motion. A growing interest has developed in tribology application in medical biomaterials, such as resin composites used in restorative dentistry. Yet, the keywords "tribology" and "biotribology" are little applied in the pertinent publications. The aim of this scoping review was to offer an overview of tribology application in dental composites research and to identify knowledge gaps and address future research. A literature search was conducted on Pubmed and Scopus databases and the studies investigating the tribological behavior of resin composites were included for qualitative synthesis. The majority of studies on dental tribology were published in the research areas of mechanical engineering/nanotechnology and differed in several methodological aspects. The preponderant engineering approach and the lack of standardized testing make the laboratory findings poorly informative for clinicians. Future research should focus on the tribological behavior of dental materials composites by means of an integrated approach, i.e., engineering and clinical, for improving development and advancement in this field of research.

Influence of filler material on properties of fiber-reinforced polymer composites: A review

The current day target for material scientists and researchers is developing a wholesome material to satisfy the parameters such as durability, manufacturability, low cost, and lightweight. Extensive research studies are ongoing on the possible application of polymer matrix composites in engineering and technology, since these materials have an edge over conventional materials in terms of performance. Hybridization of reinforcements is considered to be a better option to enhance the efficiency and performance of composite materials. Accordingly, research studies focus on the surface treatment of natural fibers and the addition of nanofillers (natural or synthetic) by industry and academia to take the properties and application of composites to the next level. This review purely focuses on the influence of fillers on the properties of composites along with the probable application of filler-based polymer composites.

Comparison of polymerization shrinkage of a new bulk-fill flowable composite with other composites: An in vitro study

OBJECTIVE

Since composites still face a critical problem called polymerization shrinkage and bulk-fill composites have reported acceptable results for this issue, this study aims to assess the polymerization shrinkage of a new bulk-fill flowable composite (G-aenial bulk injectable [GBI]) and compare it to other bulk-fill and conventional composites.

MATERIALS AND METHODS

In this in vitro study, 25 composite discs were fabricated using three bulk-fill and two conventional composites. They were bonded to a microscopic slide and were covered by a coverslip. This assembly was transferred to a linear variable differential transformer and composite samples were cured from underneath the slides. Dimensional changes formed in composite samples were recorded. Data were analyzed using analysis of variance followed by post hoc Tukey's and Dunnett's tests.

RESULTS

The groups were significantly different regarding polymerization shrinkage. G-aenial bulk injectable and G-aenial universal flo showed significantly higher polymerization shrinkage than other composites at 30, 60, and 1800 s after light irradiation, while X-tra fil and Filtek Z250 showed the lowest polymerization shrinkage at the aforementioned time points.

CONCLUSION

According to the results, the new composite had polymerization shrinkage similar to the conventional one. Bulk-fill composites reported similar or lower shrinkage to conventional composites.

Analytical Methods for Determination of BPA Released from Dental Resin Composites and Related Materials: A Systematic Review

Knowing the impacts of bisphenol A (BPA) on human health, this systematic review aimed to gather the analytical methods for the quantification of BPA release of BPA in dental materials in in vitro and in vivo (biological fluids) studies. A brief critical discussion of the impacts of BPA on human health and the possible association with BPA in dental materials was also presented. The research was carried out by three independent researchers, (according to PRISMA guidelines) in PUBMED and SCOPUS databases, by searching for specific keywords and articles published between January 2011 and February 2022. Seventeen articles met the eligibility criteria and were included in this systematic review: 10 in vitro and 7 in vivo. In in vitro studies, the highest amounts of BPA released were from flowable to conventional resins, followed by resin-modified glass ionomer. In contrast, the smallest amount was released from "BPA-free" composites and CAD-CAM blocks. Regarding in vivo studies, a higher concentration of BPA were found in saliva than urine or blood. The best analytical method for trace quantifying BPA is LC-MS/MS (Liquid Chromatography with Tandem Mass Spectrometry) due to its selectivity, low quantification limits, and the unequivocal identification. However, further studies are required to develop faster and more sensitive methods, in order to obtain more reliable results.

Multi-scale Modeling of Polymeric Composites Including Nanoporous Fillers of Milled Anodic Alumina

A polymer composite based on an innovative filler consisting of microscale powder of nanoporous alumina is modeled. The passing-through nanoscale pores in this system—roughly columnar cylindrical, with diameter of the order of 100 nm—are fully penetrated by the resin, which is not bonded to the inner pore walls by any chemical agent. This system, previously assessed by laboratory experiments, is modeled here for the first time, based on a computational multi-scale hierarchical approach. First, microscale representative volume element (RVE) is modeled in two steps using finite element modeling. Then, the macro-scale RVE is characterized, using a combination of micromechanical rules. The elastic response of the composite is simulated to predict its Young’s modulus. This simulation confirms the former experimental results and helps to shed light on the response of the investigated material, which may represent a novel system for use in disparate composite applications. In particular, the nanoporous microfillers composite is compared with a composite material containing the fillers of the same material yet nonporous, bonded to the matrix. It appears that, with respect to this standard concept of three-phase composites, the presence of the nanopores can compensate for the absence of the bonding agent.

The influence of inorganic fillers on the light transmission through resin-matrix composites during the light-curing procedure: an integrative review

PURPOSE

The objective of this study was to perform an integrative review on the effect the inorganic fillers on the light transmission through the resin-matrix composites during the light-curing procedure.

METHOD

A bibliographic review was performed on PubMed using the following search terms: "fillers" OR "particle" AND "light curing" OR "polymerization" AND "light transmission" OR "light absorption" OR "light irradiance" OR "light attenuation" OR "light diffusion" AND "resin composite." The search involved articles published in English language in the last 10 years.

RESULTS

Selected studies reported a decrease in biaxial strength and hardness in traditional resin-matrix composites in function of the depth of polymerization. However, there were no significant differences in biaxial strength and hardness recorded along the polymerization depth of Bulk-Fill™ composites. Strength and hardness were enhanced by increasing the size and content of inorganic fillers although some studies revealed a progressive decrease in the degree of conversion on increasing silica particle size. The translucency of glass-ceramic spherical fillers promoted light diffusion mainly in critical situations such as in the case of deep proximal regions of resin-matrix composites.

CONCLUSIONS

The amount of light transmitted through the resin-matrix composites is influenced by the size, content, microstructure, and shape of the inorganic filler particles. The decrease of the degree of conversion affects negatively the physical and mechanical properties of the resin-matrix composites.

CLINICAL RELEVANCE

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

Dental Poly(methyl methacrylate)-Based Resin Containing a Nanoporous Silica Filler

Poly(methyl methacrylate) (PMMA)-based resins have been conventionally used in dental prostheses owing to their good biocompatibility. However, PMMA-based resins have relatively poor mechanical properties. In the present study, a novel nanoporous silica filler was developed and introduced into PMMA-based resins to improve their mechanical properties. The filler was prepared by sintering a green body composed of silica and an organic binder, followed by grinding to a fine powder and subsequent silanization. The filler was added to photocurable PMMA-based resin, which was prepared from MMA, PMMA, ethylene glycol dimethacrylate, and a photo-initiator. The filler was characterized by scanning electron microscopy (SEM), X-ray diffraction analysis, nitrogen sorption porosimetry, and Fourier transform infrared (FT-IR) spectroscopy. The PMMA-based resins were characterized by SEM and FT-IR, and the mechanical properties (Vickers hardness, flexural modulus, and flexural strength) and physicochemical properties (water sorption and solubility) were evaluated. The results suggested that the filler consisted of microparticles with nanopores. The filler at 23 wt % was well dispersed in the PMMA-based resin matrix. The mechanical and physicochemical properties of the PMMA-based resin improved significantly with the addition of the developed filler. Therefore, such filler-loaded PMMA-based resins are potential candidates for improving the strength and durability of polymer-based crown and denture base.

Effect of Surface Polishing on Nano-Hardness and Elastic Modulus of Different Resin Composites after Immersion in Alcoholic Medium

There has been a great tendency toward using resin composite in dentistry and exploring nano-hardness, elastic modulus, and effect of polishing on its mechanical properties after its artificial ageing. This study aimed to evaluate the effect of surface polishing of four different resin composites on their nano-hardness and elastic modulus. This effect was tested right after light curing of composite resin and after its artificial ageing (immersion in alcoholic medium). Nanoindentation test preparations, surface roughness, surface hardness, and scanning electron microscope were conducted across the four different resin composites: Clearfil AP-X (APX), Estelite Sigma Quick (ESQ), Beautifil II (BE2), and FiltekTM Supreme Ultra Universal restorative (FSU). We found that difference in fillers load and particle size are amongst the factors influencing hardness and modulus of elasticity. The APX is the highest in term of hardness due to fillers load and size while the ESQ is the lowest because all fillers in nano size and distributed homogenously. The significance of surface polishing of the studied resin composite restorations was highlighted. Future research may focus on exploring survival rate of polished and non-polished composite surfaces with emphasis on measuring degree of conversion and impacts of polished and non-polished surfaces on the individuals’ oral health quality of life.

Sol-Gel Synthesis and Characterization of YSZ Nanofillers for Dental Cements at Different Temperatures

BACKGROUND

Yttria-stabilized zirconia nanoparticles can be applied as fillers to improve the mechanical and antibacterial properties of luting cement. The aim of this study was to synthesize yttria-stabilized zirconia nanoparticles by the sol-gel method and to investigate their composition, structure, morphology and biological properties.

METHODS

Nanopowders of ZrO₂ 7 wt% Y₂O₃ (nY-ZrO) were synthesized by the sol-gel method and were sintered at three different temperatures: 800, 1000 and 1200 °C, and their composition, size and morphology were investigated. The biocompatibility was investigated with human gingival fibroblasts (hGFs), while reactive oxygen species (ROS) production was evaluated through fluorescence analysis.

RESULTS

All synthesized materials were composed of tetragonal zirconia, while nanopowders sintered at 800 °C and 1000 °C additionally contained 5 and 20 wt% of the cubic phase. By increasing the calcination temperature, the crystalline size of the nanoparticles increased from 12.1 nm for nY-ZrO800 to 47.2 nm for nY-ZrO1200. Nano-sized particles with good dispersion and low agglomeration were received. Cell culture studies with human gingival fibroblasts verified the nanopowders' biocompatibility and their ROS scavenging activity.

CONCLUSIONS

the obtained sol-gel derived nanopowders showed suitable properties to be potentially used as nanofillers for dental luting cement.

The Effect of Different Dietary and Therapeutic Solutions on the Color Stability of Resin-Matrix Composites Used in Dentistry: An In Vitro Study

The purpose of this study was to evaluate the color stability of aesthetic restorative resin-matrix materials after their immersion in different dietary and therapeutic solutions. Thirty disc-shaped specimens (10 × 2 mm) were prepared from three different types of resin-matrix composites used in dentistry (BE, FS, AF). The color coordinates (L*a*b*, ΔL*, Δa*, Δa*, Δb* and ΔE*) were measured using a VITA Easyshade 3D-Master (VITA Zahnfabrik, Bad Säckingen, Germany) before and after the immersion of the specimens in coffee, red wine, Coca-Cola^®, Eludril Care^®, and distilled water solutions for 40 h. The color change (ΔE*) was calculated and analyzed by the Kolmogorov -Smirnov test and the Kruskal -Wallis multiple-comparison test. All the restorative materials showed significant color (ΔE*) changes after their exposure to red wine, followed by coffee and Coca-Cola^®; however, one nanohybrid resin-matrix composite showed a high color stability in such colored test solutions. The chemical composition and content of the organic matrix played a key role in the color stability of the resin-matrix composites. Clinicians should advise their patients about the chemical interaction between dietary substances and different resin-matrix composites.

Efficient prediction of the packing density of inorganic fillers in dental resin composites for excellent properties

OBJECTIVE

The purpose of this study is to develop a mathematical model for efficient prediction of the packing density of different filler formulations in dental resin composites (DRCs), and to study properties of DRCs at the maximum filler loading (MFL), thereby providing an effective guidance for the design of filler formulations in DRCs to obtain excellent properties.

METHODS

The packing density data generated by discrete element model (DEM) simulation were used to re-derive the parameters of 3-parameter model. The modifier effect was also induced to modify the 3-parameter model. DRCs with 10 filler formulations were selected to test properties at the MFL. The packing densities of binary and ternary mixes in DRCs were calculated by 3-parameter model to explore the regularity of composite packing.

RESULTS

The predicted packing density was validated by simulation and experimental results, and the prediction error is within 1.40 vol%. The optimization of filler compositions to obtain a higher packing density is beneficial to enhancing the mechanical properties and reducing the polymerization shrinkage of DRCs. In binary mixes, the maximum packing density occurs when the volume fraction of small fillers is 0.35-0.45, and becomes higher with the reduction of particle size ratio. In ternary mixes, the packing density can reach the maximum value when the volume fractions of large and small fillers are in the 0.5-0.75 and 0.15-0.4 ranges, respectively.

SIGNIFICANCE

The modified 3-parameter model can provide an effective method to design the multi-level filler formulations of DRCs, thereby improving the performance of the materials.

The Development of Filler Morphology in Dental Resin Composites: A Review

Dental resin composites (DRCs) with diverse fillers added are widely-used restorative materials to repair tooth defects. The addition of fillers brings an improvement in the mechanical properties of DRCs. In the past decade, diverse fillers have emerged. However, the change of emerging fillers mainly focuses on the chemical composition, while the morphologic characteristics changes are often ignored. The fillers with new morphologies not only have the advantages of traditional fillers (particles, fibrous filler, etc.), but also endow some additional functional characteristics (stronger bonding ability to resin matrix, polymerization resistance, and wear resistance, drug release control ability, etc.). Moreover, some new morphologies are closely related to the improvement of traditional fillers, porous filler vs. glass particles, core-sheath fibrous vs. fibrous, etc. Some other new morphology fillers are combinations of traditional fillers, UHA vs. HA particles and fibrous, tetrapod-like whisker vs. whisker and fibrous filler, mesoporous silica vs. porous and silica particles. In this review, we give an overall description and a preliminary summary of the fillers, as well as our perspectives on the future direction of the development of novel fillers for next-generation DRCs.

Rheological and Mechanical Properties of Resin-Based Materials Applied in Dental Restorations

Resin-based materials have been prevalent for dental restorations over the past few decades and have been widely used for a variety of direct and indirect procedures. Typically, resin-based dental materials are required to be flowable or moldable before setting and can provide adequate mechanical strength after setting. The setting method may include, but is not limited to, light-curing, self-curing or heating. In this review, based on different indications of resin-based dental materials (e.g., dental filling composite, dental bonding agent, resin luting cement), their rheological and mechanical properties were reviewed. Viscous and flexible properties were focused on for materials before setting, while elastic properties and mechanical strength were focused on for materials after setting. At the same time, the factors that may affect their rheological and mechanical properties were discussed. It is anticipated that the insightful information and prospections of this study will be useful to the future development and fabrication of resin-based dental restorative materials.

Shrinkage Stress and Temperature Variation in Resin Composites Cured via Different Photoactivation Methods: Insights for Standardisation of the Photopolymerisation

The literature has shown that there is no consensus regarding the best resin composite photoactivation protocol. This study evaluated the efficiency of the conventional, soft-start, pulse-delay and exponential protocols for photoactivation of resin composites in reducing the shrinkage stress and temperature variation during the photopolymerisation. The photoactivation processes were performed using a photocuring unit and a smartphone app developed to control the irradiance according each photoactivation protocol. These photoactivation methods were evaluated applying photoactivation energies recommended by the resins manufactures. Three brands of resin composites were analysed: Z-250, Charisma and Ultrafill. The cure effectiveness was evaluated through depth of cure experiments. All results were statistically evaluated using one-way and multi-factor analysis of variance (ANOVA). The use of exponential and pulse-delay methods resulted in a significant reduction of the shrinkage stress for all evaluated resins; however, the pulse-delay method required too long a photoactivation time. The increases on the temperature were lower when the exponential photoactivation was applied; however, the temperature variation for all photoactivation protocols was not enough to cause damage in the restoration area. The evaluation of the depth of cure showed that all photoactivation protocols resulted in cured resins with equivalent hardness, indicating that the choice of an alternative photoactivation protocol did not harm the polymerisation. In this way, the results showed the exponential protocol as the best photoactivation technique for practical applications.

Synthesis and Characterization of Methacrylate-Functionalized Betulin Derivatives as Antibacterial Comonomer for Dental Restorative Resins

Secondary caries is the primary cause of composite restoration failures, resulting from marginal leakage and bacterial accumulation in the oral environment. Antibacterial dental composites, especially antibacterial monomers, have emerged as a promising strategy to inhibit secondary caries, which is pivotal to prolonging the lifespan of dental restorations. In this work, monomethacrylate- and dimethacrylate-functionalized betulin derivatives (M₁Bet and M₂Bet) were synthesized via an esterification reaction and served as antibacterial comonomers to develop novel dental resin formulations, in which M₁Bet and M₂Bet were incorporated to partially or completely replace bisphenol A glycerolate dimethacrylate (Bis-GMA). The control resin was a mixture based on Bis-GMA and tri(ethyleneglycol) dimethacrylate (TEGDMA) with a weight ratio of 50:50 (5B5T). The effect of the resin compositions and the chemical structures of M₁Bet and M₂Bet on the rheology behavior, optical property, polymerization kinetics, mechanical performance, cell viability, and antibacterial activity of dental resins were systematically investigated. Among all materials, the 1M₂Bet4B5T resin with 10 wt % substitution of Bis-GMA by M₂Bet exhibited comparable viscosity, higher light transmittance, improved degree of conversion, and mechanical properties compared with 5B5T. After incubation for 24 h, this optimal resin also possessed the best antibacterial activity against Streptococcus mutans, which had a significantly lower bacterial concentration (1.53 × 10⁹ CFU/mL) than 5B5T (9.03 × 10⁹ CFU/mL). Introducing betulin-based comonomers into dental resins is a potential strategy to develop antibacterial dental materials without sacrificing physical-mechanical properties.

Recent Progress in Antimicrobial Strategies for Resin-Based Restoratives

Repairing tooth defects with dental resin composites is currently the most commonly used method due to their tooth-colored esthetics and photocuring properties. However, the higher than desirable failure rate and moderate service life are the biggest challenges the composites currently face. Secondary caries is one of the most common reasons leading to repair failure. Therefore, many attempts have been carried out on the development of a new generation of antimicrobial and therapeutic dental polymer composite materials to inhibit dental caries and prolong the lifespan of restorations. These new antimicrobial materials can inhibit the formation of biofilms, reduce acid production from bacteria and the occurrence of secondary caries. These results are encouraging and open the doors to future clinical studies on the therapeutic value of antimicrobial dental resin-based restoratives. However, antimicrobial resins still face challenges such as biocompatibility, drug resistance and uncontrolled release of antimicrobial agents. In the future, we should focus on the development of more efficient, durable and smart antimicrobial dental resins. This article focuses on the most recent 5 years of research, reviews the current antimicrobial strategies of composite resins, and introduces representative antimicrobial agents and their antimicrobial mechanisms.

An integrative review on the toxicity of Bisphenol A (BPA) released from resin composites used in dentistry

The main aim of this study was to perform an integrative review on the release of bisphenol A (BPA) from resin-matrix composites and potential toxic effects. A bibliographic search was performed on the PubMed platform using the following keywords: "Bisphenol A" OR "BPA" AND "resin composite" OR "composite resin" AND "toxicity" OR "cytotoxicity" OR "release". Inclusion criteria involved in vitro and in vivo studies on the release and toxicity of BPA. Results highlighted the release of BPA from resin-matrix composites due to insufficient polymerization and/or degradation of the polymeric matrix. BPA is part of the organic matrix of resin-matrix composites and may be hydrolysed in human saliva, although studies report that low doses might not be detected by traditional chemical analysis. Studies exposing zebrafish embryos to different concentrations of Bis-GMA, showed 55% mortality at 10 μM Bis-GMA while 30% mortality was recorded at 1 μM Bis-GMA. In patients, a BPA concentration of around 2.09 × 10^-2 μg/ml was found in the saliva after placement of lingual orthodontic retainers with resin-matrix composites. Also, the BPA molecule can be swallowed and absorbed by the oral/gastrointestinal mucosa, which might result in systemic toxicity. The degradation of resin-matrix composites and release of BPA in oral environment are dependent on the organic matrix content and on the polymerization method. A increased release of BPA can lead to the absorption into oral and gastrointestinal mucosa with high risks of local and systemic toxicity.

Adhesion of Flowable Resin Composites in Simulated Wedge-Shaped Cervical Lesions: An In Vitro Pilot Study

The resin composite restoration of non-carious cervical lesions (NCCLs) still faces some drawbacks mostly related to the quality of the marginal seal. This study attempts to evaluate the adhesive capacities of two flowable and two conventional hybrid resin composite restorations of NCCLs having two types of cervical margins. Our null hypothesis assumes the same adhesive behavior of different materials. The relative composition of dental–restoration structures was also measured. Thus, restored wedge-shaped cervical cavities were realized on both the buccal and oral surfaces of extracted teeth. After immersion in dye solution, sectioning of the teeth was performed. We proposed an optical microscopy method to quantify the dye penetration along the restoration–tooth interface and scanning electron microscopy (SEM) and energy-dispersive X-ray analysis (EDX) to evaluate the quality of the peripheral seal. The data obtained revealed an amount of dentinal microleakage for all tested materials, despite the favorable results of the restoration peripheral seal. Therefore, data from this study failed to reject the null hypothesis. The adhesion is not influenced by the position of cervical margins. The SEM revealed occasional disruptions of the adhesive interface. EDX sustains the qualitative compositions as provided by the manufacturers. Conclusions: The four experimental composites are recommended to restore NCCLs in clinic.

Improving the Physical-Mechanical Property of Dental Composites by Grafting Methacrylate-Polyhedral Oligomeric Silsesquioxane onto a Filler Surface

Endowing dental composites with excellent interfacial bonding through filler surface modification is pivotal to improve the physical-mechanical property and prolong the life of composite fillings. In this study, methacrylate-polyhedral oligomeric silsesquioxane (MA-POSS) acts as a "molecular bridge" between the commonly used SiO₂ particles and the methacrylate-based resin matrix via a thiol-ene click reaction to construct MA-POSS/SiO₂ (p-SiO₂) hybrid particles. Synthesized p-SiO₂ exhibited the roughest surface morphology and had more polymerizable groups, in comparison with SiO₂ and silanized SiO₂. Furthermore, the p-SiO₂ particles were used as a reinforcement to fabricate bisphenol A glycerolate dimethacrylate/tri(ethyleneglycol) dimethacrylate-based dental composites, where the SiO₂- and silanized SiO₂-filled composites served as the control groups, and the filler loading was fixed at 65 wt %. Results of the mechanical properties indicated that the hybrid p-SiO₂ particles significantly improved the flexural strength, flexural modulus, compressive strength, and work of fracture of dental composites, giving improvements of 251.2, 17.89, 122.3, and 1094%, respectively, over the SiO₂-filled composites due to the strong interfacial interaction between the resin matrix and p-SiO₂. Additionally, this optimal p-SiO₂-loaded composite also presented better polymerization shrinkage, acceptable degree of conversion, curing depth, and cell viability. Grafting of MA-POSS onto a filler surface is a promising filler surface modification to improve the resin matrix/filler interfacial interaction, leading to the enhanced overall performance of composites.

Biopolymers Hybrid Particles Used in Dentistry

This literature review provides an overview of the fabrication and application of biopolymer hybrid particles in dentistry. A total of 95 articles have been included in this review. In the review paper, the common inorganic particles and biopolymers used in dentistry are discussed in general, and detailed examples of inorganic particles (i.e., hydroxyapatite, calcium phosphate, and bioactive glass) and biopolymers such as collagen, gelatin, and chitosan have been drawn from the scientific literature and practical work. Among the included studies, calcium phosphate including hydroxyapatite is the most widely applied for inorganic particles used in dentistry, but bioactive glass is more applicable and multifunctional than hydroxyapatite and is currently used in clinical practice. Today, biopolymer hybrid particles are receiving more attention as novel materials for several applications in dentistry, such as drug delivery systems, bone repair, and periodontal regeneration surgery. The literature published on the biopolymer gel-assisted synthesis of inorganic particles for dentistry is somewhat limited, and therefore, this article focuses on reviewing and discussing the biopolymer hybrid particles used in dentistry.

Functional fillers for dental resin composites

Dental resin composites (DRCs) are popular materials to repair caries. Although various types of DRCs with different characteristics have been developed, restoration failures still exist. Bulk fracture and secondary caries have been considered as main causes for the failure of composites restoration. To address these problems, various fillers with specific functions have been introduced and studied. Some fillers with specific morphologies such as whisker, fiber, and nanotube, have been used to increase the mechanical properties of DRCs, and other fillers releasing ions such as Ag⁺, Ca²⁺, and F^-, have been used to inhibit the secondary caries. These functional fillers are helpful to improve the performances and lifespan of DRCs. In this article, we firstly introduce the composition and development of DRCs, then review and discuss the functional fillers classified according to their roles in the DRCs, finally give a summary on the current research and predict the trend of future development.

The use of bioactive glass (BAG) in dental composites: A critical review

OBJECTIVE

In recent years, numerous studies have analyzed the role of bioactive glass (BAG) as remineralizing additives in dental restorative composites. This current review provides a critical analysis of the existing literature, particularly focusing on BAGs prepared via the melt-quench route that form an "apatite-like" phase when immersed in physiological-like solutions.

METHODS

Online databases (Science Direct, PubMed and Google Scholar) were used to collect data published from 1962 to 2020. The research papers were analyzed and the relevant papers were selected for this review. Sol-gel BAGs were not included in this review since it is not a cost-effective manufacturing technique that can be upscaled and is difficult to incorporate fluoride.

RESULTS

BAGs release Ca²⁺, PO₄^3- and F^- ions, raise the pH and form apatite. There are numerous published papers on the bioactivity of BAGs, but the different glass compositions, volume fractions, particle sizes, immersion media, time points, and the characterization techniques used, make comparison difficult. Several papers only use certain characterization techniques that do not provide a full picture of the behavior of the glass. It was noted that in most studies, mechanical properties were measured on dry samples, which does not replicate the conditions in the oral environment. Therefore, it is recommended that samples should be immersed for longer time periods in physiological solutions to mimic clinical environments.

SIGNIFICANCE

BAGs present major benefits in dentistry, especially their capacity to form apatite, which could potentially fill any marginal gaps produced due to polymerization shrinkage.

Thiourethane filler functionalization for dental resin composites: Concentration-dependent effects on toughening, stress reduction and depth of cure

OBJECTIVES

The aim of this study was to modify the surface of fillers used in dental composites by the synthesis of two novel thiourethane oligomeric silanes, used to functionalize the silica-containing inorganic particles. Several thiourethane silane concentrations were tested during the silanization process to systematically assess the effect of silane coverage on experimental composite conversion, polymerization stress and fracture toughness.

MATERIALS AND METHODS

Two different thiourethane silanes were synthesized based either on 1,6-hexanediol-diissocynate (HDDI), or 1,3-bis(1-isocyanato-1-methylethyl) benzene (BDI). Conventional 3-(Trimethoxysilyl)propyl methacrylate was used as the control. Glass fillers were silanized with 1, 2 or 4 wt% of each thiourethane silane, then evaluated by thermogravimetrical analysis. Photopolymerizable resin composites were prepared with Bis-GMA/UDMA/TEGDMA and 50 wt% silanized glass filler. Polymerization kinetics and degree of conversion were tested using Near-IR. Bioman was used to test polymerization stress. Data were analyzed with two-way ANOVA/Tukey's test (α = 5%).

RESULTS

The mass of silane coupled to the filler increased with the concentrations of thiourethane in the silanizing solution, as expected. Thiourethane-containing groups exhibited significantly higher degree of conversion compared to control groups, except for BDI 4%. HDDI 4%, BDI 2% and BDI 4% showed significantly lower polymerization stress than control groups. HDDI 4% exhibited significantly higher fracture toughness.

CONCLUSIONS AND CLINICAL SIGNIFICANCE

Novel filler functionalization with thiourethane silanes may be a promising alternative for improving dental composites properties by significantly increasing the degree of conversion, fracture toughness and reducing the polymerization stress.