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Soares BM, Barbosa MP, de Almeida RV, Jardim RN, da Silva EM. Marginal integrity and physicomechanical properties of a thermoviscous and regular bulk-fill resin composites. Clin Oral Investig 2024; 28:496. [PMID: 39177835 DOI: 10.1007/s00784-024-05887-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 08/13/2024] [Indexed: 08/24/2024]
Abstract
OBJECTIVES To evaluate the marginal integrity (MI%) and to characterize specific properties of a thermoviscous bulk-fill resin composite, two regular bulk-fill resin composites, and a non-bulk-fill resin composite. MATERIALS AND METHODS VisCalor bulk (VBF), Filtek One Bulk Fill (OBF), and Aura Bulk Fill (ABF) were evaluated. Filtek Z250 XT (ZXT) was used as non-bulk-fill control. MI% was evaluated in standardized cylindrical cavities restored with the composites by using a 3D laser confocal microscope. The following properties were characterized: volumetric polymerization shrinkage (VS%), polymerization shrinkage stress (Pss), degree of conversion (DC%), microhardness (KHN), flexural strength (FS), and elastic modulus (EM). Data were analyzed by one-way and two-way ANOVA, and Tukey HSD post-hoc test (α = 0.05). RESULTS VBF presented the highest MI% and the lowest VS% and Pss (p < 0.05). DC% ranged from 59.4% (OBF) to 71.0% (ZXT). ZXT and VBF presented similar and highest KHN than OBF and ABF (p < 0.05). ABF presented the lowest FS (p < 0.05). EM ranged from 5.5 GPa to 7.7 GPa, with the values of ZXT and VBF being similar and statistically higher than those of OBF and ABF (p < 0.05). CONCLUSIONS Thermoviscous technology employed by VisCalor bulk was able to improve its mechanical behavior comparatively to regular bulk-fill resin composites and to contribute to a better marginal integrity in restorations built up in cylindrical cavities with similar geometry to a class I cavity as well. Although presenting overall better physicomechanical properties, Z250 XT presented the worst MI%. CLINICAL RELEVANCE The marginal integrity, which is pivotal for the success of resin composite restorations, could be improved using VisCalor bulk-fill. The worst MI% presented by Z250 XT reinforces that non-bulk-fill resin composites shall not be bulk-inserted in the cavity to be restored.
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Affiliation(s)
- Bárbara Monteiro Soares
- Analytical Laboratory of Restorative Biomaterials - LABiom-R, School of Dentistry, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Marianna Pires Barbosa
- Analytical Laboratory of Restorative Biomaterials - LABiom-R, School of Dentistry, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Rayane Velloso de Almeida
- Analytical Laboratory of Restorative Biomaterials - LABiom-R, School of Dentistry, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Renata Nunes Jardim
- Analytical Laboratory of Restorative Biomaterials - LABiom-R, School of Dentistry, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Eduardo Moreira da Silva
- Analytical Laboratory of Restorative Biomaterials - LABiom-R, School of Dentistry, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil.
- Universidade Federal Fluminense/Faculdade de Odontologia -Rua Mário Santos Braga, nº 30 - Campus Valonguinho, Centro, Niterói, RJ, CEP 24040, Brazil.
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2
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Hatipoğlu Ö, Par M, Pertek Hatipoğlu F. Comparison of degree of conversion performance of bulk-fill resin composites: A systematic review and network meta-analysis of in vitro studies. J Dent 2024; 149:105289. [PMID: 39103073 DOI: 10.1016/j.jdent.2024.105289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 07/13/2024] [Accepted: 08/02/2024] [Indexed: 08/07/2024] Open
Abstract
OBJECTIVES To systematically compile data on the degree of conversion (DC) for bulk-fill composites using a network meta-analysis. METHODS A systematic search for in vitro studies of DC of bulk-fill composites was performed in PubMed, Web of Science, Scopus, and Open Grey. Risk of bias within studies and due to missing evidence was assessed using the Joanna Briggs Institute scoring system and ROB-MEN tool, respectively. The primary outcome was the DC of bulk-fill composites. Surface Under the Cumulative Ranking curve (SUCRA) was used to rank relative performance. Inconsistencies in the model were investigated to ensure its validity and the level of confidence in the network meta-analysis (CINeMA) was assessed. RESULTS A total of 28 studies were included in the quantitative analysis. The average DC values (%) for 0-h/top, 0-h/bottom, 24-h/top, and 24-h/bottom were 59.09, 57.14, 66.73, and 63.87, respectively. According to their SUCRA ranking, the best-performing composites were: SonicFill, Venus Bulk Fill, and SDR (0-h/top), Reveal HD, i-Flow Bulk Fill, and Venus Bulk- Fill (0-h/bottom), Venus Bulk Fill, SDR, and QuiXfil (24-h/top), and Venus Bulk Fill, Aura Bulk Fill, and i-Flow Bulk Fill (24-h/bottom). Incoherence between direct and indirect evidence was identified as the most significant factor affecting confidence. CONCLUSIONS DC values of bulk-fill composites were within the range commonly reported for previous generations of "conventional" composites, with flowable composites tending to perform better than sculptable composites. High variability in DC data was observed, which may be attributed to incompletely understood methodological differences. CLINICAL SIGNIFICANCE DC is a fundamental parameter that influences multiple mechanical and biological properties of resin composites and is particularly relevant for the group of bulk-fill composites that are designed for use in thick layers.
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Affiliation(s)
- Ömer Hatipoğlu
- Department of Restorative Dentistry, Nigde Ömer Halisdemir University, Niğde, Turkey
| | - Matej Par
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, Zagreb, Croatia.
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3
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Santos M, Fidalgo-Pereira R, Torres O, Carvalho O, Henriques B, Özcan M, Souza JCM. The impact of inorganic fillers, organic content, and polymerization mode on the degree of conversion of monomers in resin-matrix cements for restorative dentistry: a scoping review. Clin Oral Investig 2024; 28:454. [PMID: 39066793 PMCID: PMC11283416 DOI: 10.1007/s00784-024-05829-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 07/13/2024] [Indexed: 07/30/2024]
Abstract
PURPOSE The main aim of the present study was to carry out a scoping review on the differences in degree of conversion of monomers regarding several types resin cements, indirect restorative materials, and light-curing procedures used in dentistry. METHOD A bibliographic review was performed on PubMed using the following search items: "degree of conversion" OR "filler" AND "resin cement" OR "inorganic cement" AND "organic" OR "radiopacity" OR "refractive" OR "transmittance" OR "type" AND "resin composite." The search involved articles published in English language within the last thirteen years. A research question has been formulated following the PICO approach as follow: "How different is the degree of conversion of monomers comparing several types of resin-matrix cements?". RESULTS Within the 15 selected studies, 8 studies reported a high degree of conversion (DC) of the organic matrix ranging from 70 up to 90% while 7 studies showed lower DC values. Dual-cured resin-matrix cements revealed the highest mean values of DC, flexural strength, and hardness when compared with light- and self-polymerized ones. DC mean values of resin-matrix cements light-cured through a ceramic veneer with 0.4 mm thickness were higher (~ 83%) than those recorded for resin-matrix cements light-cured through a thicker ceramic layer of 1.5 mm (~ 77%). CONCLUSIONS The highest percentage of degree of conversion of monomers was reported for dual-cured resin-matrix cements and therefore both chemical and light-induced pathways promoted an enhanced polymerization of the material. Similar degree of conversion of the same resin-matrix cement were recorded when the prosthetic structure showed a low thickness. On thick prosthetic structures, translucent materials are required to allow the light transmission achieving the resin-matrix cement. CLINICAL RELEVANCE The chemical composition of resin-matrix cements and the light-curing mode can affect the polymerization of the organic matrix. Thus, physical properties of the materials can vary leading to early clinical failures at restorative interfaces. Thus, the analysis of the polymerization pathways of resin-matrix cements is significantly beneficial for the clinical performance of the restorative interfaces.
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Affiliation(s)
- Marcionilia Santos
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS), CESPU, 4585-116, Gandra PRD, Portugal
| | - Rita Fidalgo-Pereira
- Center for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine (FMD), Universidade Católica Portuguesa (UCP), 3504-505, Viseu, Portugal
| | - Orlanda Torres
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS), CESPU, 4585-116, Gandra PRD, Portugal
| | - Oscar Carvalho
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Campus Azurém, 4800-058, Guimarães, Portugal
- Associate Laboratory (LABBELS), University of Minho, 4710-057, Guimarães, Braga, Portugal
| | - Bruno Henriques
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Campus Azurém, 4800-058, Guimarães, Portugal
- Associate Laboratory (LABBELS), University of Minho, 4710-057, Guimarães, Braga, Portugal
- Ceramic and Composite Materials Research Group (CERMAT), Federal University of Santa Catarina (UFSC), Campus Trindade, Florianópolis, SC, 88040-900, Brazil
| | - Mutlu Özcan
- Clinic for Masticatory Disorders and Dental Biomaterials, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - Júlio C M Souza
- Center for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine (FMD), Universidade Católica Portuguesa (UCP), 3504-505, Viseu, Portugal.
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Campus Azurém, 4800-058, Guimarães, Portugal.
- Associate Laboratory (LABBELS), University of Minho, 4710-057, Guimarães, Braga, Portugal.
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Odum NC, Ross JT, Citrin NS, Tantbirojn D, Versluis A. Fast Curing with High-power Curing Lights Affects Depth of Cure and Post-gel Shrinkage and Increases Temperature in Bulk-fill Composites. Oper Dent 2023; 48:98-107. [PMID: 36445972 DOI: 10.2341/21-160-l] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2022] [Indexed: 12/02/2022]
Abstract
OBJECTIVES High-power LED curing lights and bulk-fill resin composites are intended to reduce chair time. This study investigated depth of cure, post-gel shrinkage (responsible for shrinkage stress), and heat generation in bulk-fill composites when cured according to minimum curing times recommended by manufacturers of curing lights and composites. METHODS A regular LED curing light (Demi Ultra, 1350 mW/cm2, Kerr Dental) and two LED curing lights with high-power modes (VALO Grand, 3117 mW/cm2 Xtra Power, Ultradent; and Bluephase PowerCure, 2435 mW/cm2 Turbo and 3344 mW/cm2 3sCure, Ivoclar Vivadent) were tested on three bulk-fill composites (Filtek One Bulk Fill, 3M Oral Care Solutions; Tetric EvoCeram Bulk Fill, Ivoclar Vivadent; Tetric Powerfill, Ivoclar Vivadent). Using minimum times recommended by manufacturers (3, 5, 6, 10, or 20 seconds), depth of cure was determined by Vickers hardness of specimens cured in a slot (n=10). Post-gel polymerization shrinkage was measured using a strain gauge (n=10) and temperature with a thermocouple (n=5). Results were analyzed using two- and one-way analysis of variance (ANOVA) followed by pairwise comparisons or Student-Newman-Keuls post hoc tests (α=0.05). RESULTS Curing lights and curing protocols significantly affected depth of cure, post-gel shrinkage, and temperature rise (p<0.001). Cure decreased with depth whereby best overall curing performance was achieved by the 20 second exposure at lowest irradiance (Demi Ultra). Fast curing (3-5 seconds) at high irradiance resulted in lesser depth-of-cure performance, except for the BluePhase-Tetric PowerFill combination. Post-gel shrinkage was higher in all composites when cured at high irradiance (p<0.001), while heat generated also tended to be higher. CONCLUSIONS Although the high-power LED curing lights advertise time savings, not all manufacturer recommended minimum curing times cured bulk-fill materials to the same extent. Moreover, these time savings came at a cost of higher post-gel shrinkage and generated more heat in the bulk-fill composites than the lower irradiance curing protocol.
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Affiliation(s)
- N C Odum
- Nicholas C Odum, BS, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - J T Ross
- Jason T Ross, BS, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - N S Citrin
- Nechama S Citrin, DMD, MS, Department of General Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - D Tantbirojn
- Daranee Tantbirojn, DDS, MS, PhD, Department of General Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - A Versluis
- *Antheunis Versluis, PhD, Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
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Gehlot PM, Sudeep P, Manjunath V, Annapoorna BM, Prasada LK, Nandlal B. Influence of Various Desensitizing Mouthrinses and Simulated Toothbrushing on Surface Roughness and Microhardness of Tetric N-Ceram Bulk-Fill Resin Composite: An In Vitro Study and Scanning Electron Microscope Analysis. Eur J Dent 2022; 16:820-827. [PMID: 35176786 DOI: 10.1055/s-0041-1739547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES Bulk-filled composite resins are popularly used for posterior restorations due to various advantages. Routine oral hygiene measures like toothbrushing and the use of various mouthrinses can influence the mechanical properties of composite resins. Desensitizing mouthrinses are widely used as well, to manage dentinal hypersensitivity. Studies on the influence of desensitizing mouthrinses on bulk-filled composites are limited. Hence, the objective of the present in vitro study was to evaluate the influence of toothbrushing and various desensitizing mouthrinses on the surface roughness and microhardness of Tetric N-Ceram bulk-fill composite resin. MATERIALS AND METHODS Fifty Tetric N-Ceram bulk-fill composite resin disks were prepared and were randomly divided into five groups (n = 10). Group 1 (Control): no toothbrushing and no mouthrinse; Group 2: toothbrushing only; Group 3: toothbrushing + HiOra-K mouthrinse; Group 4: toothbrushing + Listerine Sensitive mouthrinse; and Group 5: toothbrushing + Shy-OR mouthrinse. The specimens were brushed with a soft bristle brush using a toothpaste slurry and immersed in respective mouthrinse twice daily for 1 month. The mean surface roughness (average roughness) and microhardness (Vickers Pyramid number) values were determined and the data were tabulated. Data were analyzed using one-way analysis of variance, Post-hoc Tukey test, and Pearson correlation test. A p-value less than 0.05 was considered statistically significant. RESULTS Specimens treated with HiOra-K mouthrinse exhibited maximum surface roughness (p < 0.05) and specimens treated with Listerine Sensitive exhibited the least microhardness (p < 0.05). A weak negative correlation was found between surface roughness and microhardness for groups 1, 2, and 5, while a weak positive correlation was found for groups 3 and 4. CONCLUSIONS It is suggested that desensitizing mouthrinses containing alcohol or essential oils can lead to increased surface roughness and reduction in microhardness of bulk-fill composites, which could have an undesirable effect on their clinical performance.
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Affiliation(s)
- Paras Mull Gehlot
- Department of Conservative Dentistry and Endodontics, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, SS Nagara, Mysuru, Karnataka, India
| | - Parvathi Sudeep
- Department of Conservative Dentistry and Endodontics, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, SS Nagara, Mysuru, Karnataka, India
| | - Vinutha Manjunath
- Department of Conservative Dentistry and Endodontics, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, SS Nagara, Mysuru, Karnataka, India
| | - B M Annapoorna
- Department of Conservative Dentistry and Endodontics, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, SS Nagara, Mysuru, Karnataka, India
| | - L Krishna Prasada
- Department of Conservative Dentistry and Endodontics, KVG Dental College and Hospital, Dakshina Kannada, Karnataka, India
| | - Bhojraj Nandlal
- Department of Pedodontics and Preventive Dentistry, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, SS Nagara, Mysuru, Karnataka, India
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6
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Cardoso IO, Machado AC, Fernandes LDO, Soares PV, Raposo LHA. Influence of Tip Diameter and Light Spectrum of Curing Units on the Properties of Bulk-Fill Resin Composites. Eur J Dent 2021; 16:360-366. [PMID: 34905778 PMCID: PMC9339921 DOI: 10.1055/s-0041-1735799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective
The aim of this study was to evaluate the influence of different light-curing units (LCUs) with distinct tip diameters and light spectra for activating bulk-fill resins.
Materials and Methods
The specimens (
n
= 10) were made from a conventional composite (Amaris, VOCO) and bulk-fill resins (Aura Bulk Fill, SDI; Filtek One, 3M ESPE; Tetric Bulk Fill, Ivoclar Vivadent) with two diameters, 7 or 10 mm, × 2 mm thickness. Following 24 hours of specimen preparation, the degree of conversion (DC) was evaluated using the Fourier-transform infrared unit. Knoop hardness (KHN) readings were performed on the center and periphery of the specimens. Data were assessed for homoscedasticity and submitted to one-way and three-way analysis of variance followed by the Tukey's and Dunnett's tests, depending on the analysis performed (α = 0.05).
Results
LCUs and specimen diameter significantly affected the DC. The
Tetric Bulk Fill
provided increased DC results when light-cured with
Valo
(54.8 and 53.5%, for 7 and 10 mm, respectively) compared with
Radii Xpert
(52.1 and 52.9%, for 7 and 10 mm, respectively). No significant differences in KHN results were noted for the conventional resin composite (
Amaris
) compared with LCUs (
p
= 0.213) or disc diameters (
p
= 0.587), but the center of the specimen exhibited superior KHN (
p
≤ 0.001) than the periphery.
Conclusion
The light spectrum of the multipeak LCU (
Valo
) significantly increased the DC and KHN of the bulk-fill resin composite with additional initiator to camphorquinone (
Tetric Bulk Fill
) compared with the monowave LCU (
Radii Xpert
). The tip size of the LCUs influenced the performance of some of the resin composites tested.
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Affiliation(s)
- Igor Oliveiros Cardoso
- Department of Occlusion, Fixed Prosthodontics and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
| | | | - Luísa de Oliveira Fernandes
- Department of Occlusion, Fixed Prosthodontics and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
| | - Paulo Vinícius Soares
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
| | - Luís Henrique Araújo Raposo
- Department of Occlusion, Fixed Prosthodontics and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
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Zotti F, Falavigna E, Capocasale G, De Santis D, Albanese M. Microleakage of Direct Restorations-Comparisonbetween Bulk-Fill and Traditional Composite Resins:Systematic Review and Meta-Analysis. Eur J Dent 2021; 15:755-767. [PMID: 34450679 PMCID: PMC8630972 DOI: 10.1055/s-0041-1724155] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Since the bulk-fill composites were produced, there was a progressive diffusion of their use for direct conservative treatment in posterior teeth. Their chemical structure increases the depth of cure and decreases the polymerization contraction; in this manner, bulk-fill composites can be placed in 4 mm single layers and the treatment times are considerably reduced. However, aesthetic and mechanical properties and impact on microleakage of bulk-fill resins are still unclear. This systematic review and meta-analysis aimed to assess the risk of microleakage of direct posterior restorations made of bulk-fill versus conventional composite resins. Researches were performed on PubMed and Scopus databases. Eligible in vivo studies, published since 2006, were reviewed. Outcomes of marginal discoloration, marginal adaptation, and recurrent caries were considered to conduct the systematic review and meta-analysis. Secondary data were examined to implement additional analysis and assess the risk of bias. Eight randomized clinical trials were analyzed, involving 778 direct restorations. The summary of RCTs led to significant but inconsistent results; the marginal discoloration and recurrent caries were found to be improved respectively by 5.1 and 1.4%, whereas the marginal adaptation was reduced of 6.5%. Secondary analyses revealed that follow-up periods, the adhesive system used and the class of carious lesions evaluated are confounding factors, and they result in a risk of bias across studies. Bulk-fill composites are innovative materials for conservative dentistry and they can be used to reduce treatment steps and duration of operative times. There are insufficient data to explore the relationship between bulk-fill composites and microleakage and further investigations are needed.
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Affiliation(s)
- Francesca Zotti
- Department of Surgical Sciences, Paediatrics and Gynaecology, University of Verona Policlinico G. B. Rossi, Verona, Italy
| | - Edoardo Falavigna
- Department of Surgical Sciences, Paediatrics and Gynaecology, University of Verona Policlinico G. B. Rossi, Verona, Italy
| | - Giorgia Capocasale
- Department of Surgical Sciences, Paediatrics and Gynaecology, University of Verona Policlinico G. B. Rossi, Verona, Italy
| | - Daniele De Santis
- Department of Surgical Sciences, Paediatrics and Gynaecology, University of Verona Policlinico G. B. Rossi, Verona, Italy
| | - Massimo Albanese
- Department of Surgical Sciences, Paediatrics and Gynaecology, University of Verona Policlinico G. B. Rossi, Verona, Italy
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