A critical evaluation of tribological interaction for restorative materials in dentistry

Comparison of Flexural Strength and Wear of Injectable, Flowable and Paste Composite Resins

(1) Objectives: This study investigated and compared the wear and flexural strength of two highly filled (injectable), one flowable and one paste composite. (2) Methods: Two highly filled flowable composites (G-aenial Universal Injectable and Beautifil Plus F00), a paste composite (Empress Direct) and a conventional flowable (Tetric EvoFlow) were tested. A two-body wear test was carried out using 10 disc-shaped samples from each group, which were subjected to 200,000 wear machine cycles to simulate wear, followed by Scanning Electron Microscope analysis. Flexural strength was tested using a three-point bend test using 15 beam samples for each of the four groups. Values were statistically compared using one-way analysis of variance (ANOVA) for flexural strength and a Kruskal-Wallis test for wear. (3) Results: The median volume loss for G-aenial Universal Injectable and Beautifil Plus F00 was statistically lower than that of both Empress Direct and Tetric EvoFlow. For flexural strength the two highly filled flowable composites both exhibited statistically higher mean flexural strength values compared to Empress Direct (p < 0.004) and Tetric Evoflow (p < 0.001). There were no statistically significant differences in the values of wear and flexural strength between the two highly filled flowable composites. (4) Conclusions/significance: Highly filled flowable composite resins with nano filler particles outperformed a conventional flowable and a paste composite resin in terms of wear resistance and flexural strength, and may be suitable to use in occlusal, load-bearing areas.

Clinical Effectiveness of Ion-Releasing Restorations versus Composite Restorations in Dental Restorations: Systematic Review and Meta-Analysis

BACKGROUND

To compare the clinical effectiveness of ion-releasing restorations (IRR) vs. composite resin (CR) in dental restorations.

METHODS

A systematic search was carried out from articles published until January 2024, in the biomedical databases: PubMed, Cochrane Library, Scielo, Scopus, Web of Science and Google Scholar. Randomized clinical trials were included, with a follow-up time greater than or equal to 1 year, without time and language limits and which reported the clinical effect of IRR compared to CR in dental restorations. The RoB 2.0 tool was used to assess the risk of bias of the included studies and the GRADEPro GDT tool was used to assess the quality of evidence and the strength of recommendation of the results.

RESULTS

The search yielded a total of 1109 articles. After excluding those that did not meet the selection criteria, 29 articles remained for the quantitative synthesis. The analysis found no statistically significant difference when comparing the dental restorations with IRRs or CRs.

CONCLUSION

The literature reviewed suggests that there are no differences between the IRRs and CRs in dental restorations.

An In Vitro Study regarding the Wear of Composite Materials Following the Use of Dental Bleaching Protocols

Composite materials used in dental restorations are considered resistant, long-lasting and aesthetic. As the wear of restorations is an important element in long-term use, the aim of this study was to evaluate the surface condition of nanohybrid and microfilled composite resins, after being subjected to the erosive action of dental bleaching protocols. This paper reflects a comparative study between one nanofilled composite and three microfilled composites used in restorations. For each composite, three sets of samples (under the form of composite discs) were created: a control group, an "office bleach" group with discs bleached with 40% hydrogen peroxide gel, and a "home bleach" group with discs bleached with 16% carbamide peroxide gel. Wear was numerically determined as the trace and the coefficients of friction obtained using a tribometer, the ball-on-disk test method, and two balls: alumina and sapphire. For all composite groups, there were statistically significant differences between the wear corresponding to the control and bleaching groups, for both testing balls. Regarding the composite type, the largest traces were recorded for GC Gradia direct anterior, for all groups, using the alumina ball. In contrast, for the sapphire ball, 3M ESPE Filtek Z550 was characterized by the largest traces. With respect to the friction coefficients, the "office bleach" group recorded the largest values, no matter the composite or the ball type used. The 3M ESPE Valux Plus composite recorded the largest friction coefficients for the alumina ball, and 3M ESPE Filtek Z550 for the sapphire ball. Overall, the "office bleach" group was characterized by higher composite wear, compared to the "home bleach" protocol or control group. Nanofilled composite resins showed superior wear resistance to microfilled resins after undergoing a bleaching protocol.

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.

Polymer–Metal Composite Healthcare Materials: From Nano to Device Scale

Metals have been investigated as biomaterials for a wide range of medical applications. At nanoscale, some metals, such as gold nanoparticles, exhibit plasmonics, which have motivated researchers’ focus on biosensor development. At the device level, some metals, such as titanium, exhibit good physical properties, which could allow them to act as biomedical implants for physical support. Despite these attractive features, the non-specific delivery of metallic nanoparticles and poor tissue–device compatibility have greatly limited their performance. This review aims to illustrate the interplay between polymers and metals, and to highlight the pivotal role of polymer–metal composite/nanocomposite healthcare materials in different biomedical applications. Here, we revisit the recent plasmonic engineered platforms for biomolecules detection in cell-free samples and highlight updated nanocomposite design for (1) intracellular RNA detection, (2) photothermal therapy, and (3) nanomedicine for neurodegenerative diseases, as selected significant live cell–interactive biomedical applications. At the device scale, the rational design of polymer–metallic medical devices is of importance for dental and cardiovascular implantation to overcome the poor physical load transfer between tissues and devices, as well as implant compatibility under a dynamic fluidic environment, respectively. Finally, we conclude the treatment of these innovative polymer–metal biomedical composite designs and provide a future perspective on the aforementioned research areas.