Effects of adhesive used as modeling liquid on the stability of the color and opacity of composites

The Impact of Modeling Liquids on Surface Roughness and Color Properties of Bulkfill Resin Composites After Simulated Tooth Brushing: An in Vitro Study. Part I

OBJECTIVE

To evaluate the effect of different modeling agents on color changes, surface roughness, and translucency parameters over time in Bulkfill resin composites.

MATERIAL AND METHODS

Sixty specimens were prepared using three Bulkfill resin composites (Tetric N-Ceram Bulkfill, Filtek One Bulkfill and Opus Bulkfill) and three modeling agents (Wetting Resin, Optibond FL and Ambar APS). All specimens were subjected to a simulated tooth-brushing (Baseline, 50.000 cycles, 100.000 cycles), and surface roughness was measured at each interval. Surface topography was evaluated. The translucency parameter and color changes were assessed after 24-h, 7-, 14- and 30-day immersion in water, wine, and coffee. Data was analyzed using ANOVA and Bonferroni test.

RESULTS

All specimens increased roughness after simulated tooth-brushing (p < 0.05). Wetting Resin decreased roughness on Tetric N-Ceram Bulkfill (p < 0.05). The translucency parameter remained unaltered for all groups. All groups changed color after 30-days of immersion in wine and coffee (p < 0.05). Ambar APS and Wetting Resin on Tetric N-Ceram Bulkfill showed higher color changes when immersed in coffee (p < 0.05).

CONCLUSION

The use of modeling agents does not jeopardize translucency properties but may affect surface roughness and color properties of Bulkfill resin composites depending on their composition.

CLINICAL SIGNIFICANCE

The findings of this study suggest that surface roughness and color properties are affected by the differences in the composition between modeling agents and Bulkfill resins composites.

The Influence of Modeling Liquid on Microhardness of Single-Shade Composite Resins: An In-Vitro Study

Aim

To assess the effect of modeling liquid on the microhardness of single-shade universal composites.

Materials and Methods

A total of 60 disk-shaped samples were prepared in six groups [Omnichroma (OM), Essentia Universal (EU), Vittra APS Unique (VA), OM + Signum, EU + Signum, and VA + Signum] for surface microhardness measurements. Samples were stored in a coffee solution for 7 days and after that bleached with an Office bleaching agent (Total Blanc Office). Surface microhardness was measured for baseline, after staining, and after bleaching. A two-way analysis of variance test was used for statistical analysis (P < 0.05).

Results

In terms of microhardness, there is a statistically significant difference (P < 0.05) between the two categories with and without modeling liquid. The alterations in microhardness measurements at baseline, after staining, and after bleaching are statistically significant (P < 0.05). The Essentia groups showed the lowest microhardness findings at all measurement times. Microhardness values decreased significantly more when EU was applied along with modeling liquid than when it was not applied at different intervals.

Conclusions

Modeling liquid affects the microhardness of single-shade composites. Microhardness is reduced when modeling liquid is used for all three single-shade universal composite resins at three different times.

Reliability of the color measurement of resin composites using images obtained using a stereoscopic loupe

This study assessed the reliability of a color measurement method using images obtained from a charge-coupled device (CCD) camera and a stereoscopic loupe. Disc-shaped specimens were created using the composite Filtek Z350 XT (shades DA1, DA2, DA3, and DA4) (n = 3). CIELAB color coordinates of the specimens were measured using the spectrophotometer SP60 over white and black backgrounds. Images of the same specimens were taken using a CCD camera attached to a stereoscopic loupe. The color of the image was measured (red-green-blue [RGB]) using an image processing software and converted to CIELAB coordinates. For each color coordinate, data from images were adjusted using linear regressions predicting those values from SP60. The whiteness index for dentistry (WID) and translucency parameter (TP00) of the specimens as well as the color differences (ΔE00) among pairwise shades were calculated. Data were analyzed via repeated-measures analysis of variance and Tukey's post hoc test (α = 0.05). Images obtained using the loupe tended to be darker and redder than the actual color. Data adjustment resulted in similar WID, ΔE00, and TP00 values to those observed for the spectrophotometer. Differences were observed only for the WID of shade DA3 and ΔE00 for comparing DA1 and DA3 over the black background. However, these differences were not clinically relevant. The use of adjusted data from images taken using a stereoscopic loupe is considered a feasible method for color measurement.

Color discrepancy of single-shade composites at different distances from the interface measured using cell phone images

Objectives

This study aimed to evaluate the impact of substrate color and interface distance on the color adjustment of 2 single-shade composites, Vittra APS Unique and Charisma Diamond One.

Materials and Methods

Dual disc-shaped specimens were created using Vittra APS Unique or Charisma Diamond One as the center composite, surrounded by shaded composites (A1 or A3). Color measurements were taken with a spectrophotometer against a gray background, recording the color coordinates in the CIELAB color space. Illumination with a light-correcting device and image acquisition using a polarizing filter-equipped cell phone were performed on specimens over the same background. Image processing software was used to measure the color coordinates in the center and periphery of the inner composite and in the outer composite. The color data were then converted to CIELAB coordinates and adjusted using data from the spectrophotometer. Color differences (ΔE00) between the center/periphery of single-shade and outer composites were calculated, along with color changes in single-shade composites caused by different outer composites. Color differences for the inner composites surrounded by A1 and A3 were also calculated. Data were analyzed using repeated-measures analysis of variance (α = 0.05).

Results

The results showed that color discrepancies were lowest near the interface and when the outer composite was whiter (A1). Additionally, Charisma Diamond One exhibited better color adjustment ability than Vittra APS Unique.

Conclusions

Color discrepancies between the investigated single-shade composites diminished towards the interface with the surrounding composite, particularly when the latter exhibited a lighter shade.

Impact of combining dental composite brushes with modeling resins on the color stability and topographic features of composites

This study explores the effect of using dental brushes with or without metacrylate-based modeling resins on long-term color stability and surface topographies of resin-based composites. This study examined the effects of two variables: (1) the type of brush used (Art brush, Micro-brush, or Mylar strip) and (2) the application of a modeling resin (applied or not applied). The specimens were artificially aged through 10,000 cycles of thermocycling and subsequently immersed in coffee for 30 days. Measurements of color and surface roughness were taken at baseline and after the aging, using a non-contact profilometer for surface roughness and a spectrophotometer for color. Data were analyzed using paired t-tests and one-way ANOVA. Resin-based composites smoothed with dental brushes or micro brushes without modeling resins exhibited lower color change (ΔE) than other groups. Paired t-tests revealed significant differences in average surface roughness (Ra) and valley depth (Rv) for each surfacing technique before and after aging (p ⩽ 0.01). The root means square average of the profile heights (Rq) significantly increased in the control and micro-brush groups (p ⩽ 0.01). In conclusion, the use of brushes in resin-based composites placement does not increase the susceptibility to staining. Instead, the inclusion of resin modeling contributes to discoloration over time.

The role of interface distance and underlying substrate on the color adjustment potential of single-shade composites

OBJECTIVE

This study assessed how the distance from the composite interface and the underlying chromatic substrate affect the color adjustment potential (CAP) of two single-shade composites.

MATERIALS AND METHODS

Cylinder-shaped specimens were created using Vittra APS Unique (VU), Charisma Diamond One (DO), and a shaded (A3) composite. Some single-shade specimens were surrounded by the A3 composite, forming dual specimens. Color measurements of simple specimens were taken against a gray background using a spectrophotometer. All specimens were positioned at a 45° angle in a viewing booth under illuminant D65, and images were captured with a DSLR camera against gray or A3 backgrounds. Image colors were measured using image processing software and converted to CIELAB coordinates. Color differences (ΔE00 ) between the single-shade composites and the A3 composite were calculated. CAP was determined by comparing data from simple and dual specimens.

RESULTS

No clinically significant differences were observed between color measurements obtained from images and the spectrophotometer. CAP was higher for DO compared to VU and increased as the distance from the composite interface decreased and when specimens were positioned against an A3 background.

CONCLUSION

The color adjustment potential increased with decreased distance from the composite interface and against a chromatic background.

CLINICAL SIGNIFICANCE

Achieving satisfactory color match in restorations using single-shade composites is crucial, and selecting an appropriate underlying substrate is essential. The color adjustment gradually decreases from the restoration margins towards its center.

Full analysis of the effects of modeler liquids on the properties of direct resin-based composites: a meta-analysis review of in vitro studies

OBJECTIVES

This study systematically revised the literature to answer the following question: do modeler liquids (MLs) affect the properties of direct resin-based composites (RBCs)?

MATERIALS AND METHODS

The review followed the PRISMA statement, and the search was conducted in PubMed, Scopus, Web of Science, Embase, and Lilacs databases. Studies were included if they investigated the properties of RBCs prepared using the restorative dental modeling insertion technique (RDMIT). The risk of bias was performed with the RoBDEMAT tool. Statistical analyses were conducted using Review Manager, and heterogeneity was assessed with the Cochran Q test and I² statistics.

RESULTS

From 309 studies identified, 25 met the eligibility criteria, and 23 were meta-analyzed. In total, 27 MLs and 23 RBCs were evaluated. Modeled and non-modeled RBCs showed similar results in terms of cohesive strength, flexural strength, load-to-fracture, modulus of elasticity, work of fracture, degree of conversion, solubility, weight change, microhardness, and color change. Sorption and roughness benefited from the use of MLs, whereas translucency and whitening index were more adequate in the non-modeled RBCs. Aging affected similarly the modeled and non-modeled RBCs. Most studies showed a moderate risk of bias.

CONCLUSIONS

Modeled and non-modeled RBCs performed similarly in most of the properties, and the use of non-solvated lubricants offered beneficial effects in some cases.

CLINICAL RELEVANCE

When a balance has to be made between the RDMIT and the conventional technique, our review supports the safe application of modeler liquids for the handling of composite increments during the sculpting fabrication of direct resin-based restorations.

Effect of Activated Charcoal Toothpaste on Color Stability of Bleached Teeth Immersed in Different Drinks

OBJECTIVE

This study aimed to evaluate the effect of activated charcoal toothpaste on the color stability of teeth subjected to tooth bleaching and pigmenting agents.

METHODS

A total of 120 bovine crowns were randomly divided into 12 groups (n=10) according to two study factors: staining solutions (three levels): saliva (control), coffee, and red wine; and toothpaste (four levels): BPC, Bianco Pro Clinical (Bianco Oral Care) (Control); BIW, Black is White (Curaprox); BCA, Bianco Carbon (Bianco Oral Care); and NAT, Natural Suavetex (Suavetex). The samples were subjected to office bleaching with a 35% hydrogen peroxide-based gel (Whiteness HP Blue, FGM), followed by immersion in the solution for 45 minutes per day and daily toothbrushing for 7 days. The color (ΔE) and luminosity changes (ΔL*) were measured using reflectance spectroscopy (Vita EasyShade). The CIE values (L*, a*, b*) were measured at baseline after bleaching (T0) and immediately after immersion in solution each day (Ti1-Ti7) and after all toothbrushing cycles (Tb1-Tb7). ΔE and ΔL were analyzed using a two-way analysis of variance and Tukey's test (α=0.05). The clinically unacceptable level of ΔE > 3.3 was used to evaluate the color change.

RESULTS

The color change was significantly influenced by the staining solutions and toothpastes (p<0.001). The color change (ΔE) was significantly higher when immersed in wine than in coffee, and lower ΔE values were observed for artificial saliva (control), irrespective of the toothpaste used. In artificial saliva, BPC, BIW, and BCA resulted in significantly lower ΔE values than NAT, which presented a clinically unacceptable level of dental color change (ΔE>3.3). Coffee resulted in a lower (L*) reduction than wine, irrespective of the toothpaste used.

CONCLUSION

Charcoal toothpastes resulted in a color change on the surface of the tooth enamel (ΔE). The bleaching effect of the charcoal toothpastes and control evaluated in this study partially reduced the color changes on the surface of the tooth enamel caused by staining solutions but was unable to reestablish the measured values to the baseline. For teeth immersed in artificial saliva, the color change was not noticeable in BCA, BIW, and control-BPC (ΔE≥3.3), except for NAT, which showed a significant color change.

Effect of modeling liquids on resin composite roughness and color parameters after staining and toothbrushing

This study evaluated surface roughness, color stability, whitening index, and opacity of different types of modeling liquids for resin composite coating after exposure to staining and toothbrushing. Disc-shaped resin composite (Vittra APS, FGM) specimens were fabricated and divided into four groups (n = 10 each): control group, Composite Wetting resin (Ultradent Products), Adper Scotchbond Multipurpose adhesive (3M ESPE), and Adper Universal adhesive (3M ESPE). Surface roughness (Ra) was measured using a rugosimeter, while color stability (∆E00), whitening index (WI), and opacity (%) were measured using a spectrophotometer. Assessments were made at four time points: after polishing (baseline, T1), after immersion in red wine for 24 h (T2), and after 5,000 (T3) and 10,000 (T4) cycles of toothbrushing. Scanning electron microscopy images were captured to analyze the scratches created. The data were statistically analyzed by two-way repeated-measures analysis of variance and Tukey's honestly significant difference tests (α = .05). Modeling with the Wetting resin resulted in higher surface roughness (p < 0.05) and low color stability, which were attributable to porosities. Higher color change values were observed in the control group after staining. Both adhesives showed the lowest mean ΔE00 values (p < 0.005). WI decreased after staining, except with the use of the Universal adhesive (p < 0.005). The lowest opacity values were observed at baseline for all groups (p < 0.005). The Universal and Scotchbond adhesives had lower surface roughness, better color stability, higher WI, and the lowest opacity values after staining with red wine and toothbrushing.

Physicochemical, Mechanical, and Esthetic Properties of the Composite Resin Manipulated with Glove Powder and Adhesive as a Modeling Liquid

Composite resins with low flowability are usually handled and manipulated before insertion into the tooth preparation with gloved hands and/or using an instrument covered with a little amount of adhesive to facilitate modeling. We investigated if the modeling techniques (combined or not) affected physicochemical and esthetic properties of a composite resin. Specimens were fabricated and divided into groups according to the handling/modeling technique: Gloved-hands (composite was hand-manipulated with powdered latex gloves); Adhesive (adhesive was used in between the composite layers); Gloved-hands + Adhesive; Control (no adhesive and no touch with gloved-hands). The highest values for flexural strength (MPa), modulus of elasticity (GPa), and fracture toughness (MPa.m0.5) were obtained for Adhesive and Gloved-hands + Adhesive (p < 0.05); the lowest values were obtained for Control and Gloved-hands (p < 0.05). The Control group had the highest sorption. The Gloved-hands (p < 0.05) group had the highest solubility. Adhesive and Gloved-hands + Adhesive had a similar solubility (p > 0.05). The Control group (p < 0.05) had the lowest solubility. There was no statistical interaction between translucency vs. handling/modeling techniques and color stability vs. handling/modeling techniques. Adhesive as a modeling liquid protected the composite against sorption and solubility (if powdered gloves were used) and improved its physical/mechanical properties. Translucency and color stability were not correlated with modeling techniques.

Modeling Liquids and Resin-Based Dental Composite Materials—A Scoping Review

Several lubricant materials can be used to model resin-based composites (RBCs) during restorative procedures. Clinically, instruments or brushes are wet with bonding agents (BAs) or modeling liquids (MLs) for sculpturing purposes. However, a knowledge gap exists on their effects on the mechanical properties of RBCs, requiring greater insight. Five databases were searched, including 295 in vitro studies on the use of lubricant materials for modeling RBCs during restorative procedures. Only articles in the English language were included, with no limits on the publication date. The last piece of research was dated 24 March 2022. In total, 16 studies were included in the review process, together with a paper retrieved after screening references. A total of 17 BAs and 7 MLs were investigated. Tensile (n = 5), flexural strength (n = 2), water sorption (n = 2), color stability (n = 8) and translucency (n = 3), micro-hardness (n = 4), roughness (n = 3), degree of conversion (n = 3), and monomer elution (n = 2) tests were carried out. In general, a maximum of 24 h of artificial storage was performed (n = 13), while four papers tested the specimens immediately. The present review identifies the possibilities and limitations of modeling lubricants used during restorative procedures on the mechanical, surface, and optical properties of RBCs. Clinicians should be aware that sculpturing RBCs with modeling resins might influence the composite surface properties in a way that is material-dependent.

Color stability of resin-based composites: Staining procedures with liquids-A narrative review

OBJECTIVE

The objective of this study was to review the experimental staining procedures performed in in-vitro studies for evaluating color stability of resin-based composites used for direct restorations.

OVERVIEW

A review was performed with the purpose to identify in vitro procedures carried out to establish staining and color stability of resin-based composites used for direct restorations. A literature search was performed on four online databases (PubMed, Scopus, Embase and Web of Science) for articles published from January 1st 2001 till March 20th 2021, using a combination of free words and Medical Subject Headings (MESH) terms: "Composite Resins" AND "Color Stability" OR "Staining." Two reviewers screened titles and/or abstracts of 1728 unique studies. In total, 208 studies were selected for full-text reading, from which 178 were included in the review. The assessed variables were specimen dimensions, shape, and surface finishing; time before immersion; staining media type, dwell time, temperature and renewal interval; type of composite; color and translucency assessment parameters and measuring system. One hundred and seventy-eight articles analyzed color stability with staining liquids. Coffee was the most used staining medium (n = 102), followed by tea (n = 61), and red wine (n = 55). A disc-shaped specimen was used in most studies (n = 170) with a 2 mm thickness (n = 116). Spectrophotometers were the most used color assessment devices (n = 154), followed by colorimeters (n = 17). Color differences were quantified with ΔE (n = 154), ΔE00 (n = 23). Acceptability and or perceptibility thresholds were also taken into consideration (n = 126).

CONCLUSIONS

The large variety of staining procedure suggests the need for standardization.

CLINICAL SIGNIFICANCE

Aesthetic failure due to discoloration is a relevant clinical problem. Evaluating benefits and drawbacks of resin based composites artificial staining procedures will improve to predict materials clinical performances.

Influence of Instrument Lubrication on Properties of Dental Composites

Resin composites are one of the most commonly used materials in restorative dentistry. To improve their handling and facilitate restoration sculpting, clinicians began to lubricate modeling instruments with various substances like alcohol, unfilled resins, or even bonding agents. Although the technique is commonly present in daily clinical practice, it has not been precisely described in the literature and both application methods and lubricating materials vary across the available studies. This study aims to summarize the currently available knowledge about influence of instrument lubrication on properties of dental composites. Literature selection was conducted within MEDLINE, SCOPUS, and EBSCO databases. Instrument lubrication seems not to be indifferent for composite mechanical and optical properties. Moreover, various lubricants can differently affect the composite material, so the choice of lubricating agent should be deliberate and cautious. Available in vitro studies suggest possible incorporation of lubricant into the composite structure. Unfilled resins based on bisphenol A-glycidyl methacrylate (Bis-GMA) seem to be the best choice for the lubricant, as bonding agents containing hydrophilic molecules and alcohols carry a bigger risk of altering the composite properties. Further research is necessary to evaluate lubricants' influence in clinical practice conditions.

Effects of Immediate Coating on Unset Composite with Different Bonding Agents to Surface Hardness

OBJECTIVES

 This study evaluated the surface microhardness of composite, affected by surface coating with different dental adhesive systems.

MATERIALS AND METHODS

 A total of 100 composite discs were divided into five groups. Group 1 was uncoated (control group C), and groups 2 to 5 were coated with different adhesive systems (OptiBond FL: FL, OptiBond SOLO Plus: SOLO, OptiBond XTR: XTR, and OptiBond All in one: AIO, respectively). The Vickers microhardness (VHN) was measured without and with 500 thermocycles.

STATISTICAL ANALYSIS

 The data were analyzed using two-way ANOVA and Tukey's posthoc test at the 95% confidence level.

RESULTS

 At 24 hours, the VHN of C (59.96 ± 3.68) and FL (59.83 ± 4.54) were significantly higher than SOLO (51.73 ± 4.63) and AIO (51.45 ± 4.11). The VHN of XTR (54.96 ± 3.68) was not significant compared with that of C and all other groups. After thermocycling, VHN were significantly decreased in all groups. However, there were no significant differences among all groups.

CONCLUSIONS

 At 24 hours, composite coated with different adhesive systems have different effects to VHN. Thermocycling all adhesive resin systems coated on composite surface significantly decreased the VHN.

Effect of Modeling Resins on Microhardness of Resin Composites

Objectives  This study was aimed to determine the effects of modeling resins on the surface microhardness of composites.

Materials and Methods  Six resin-based composites (Charisma Smart, Estellite Asteria, CeramX-One SphereTEC, Admira Fusion, Filtek Ultimate, and Clearfil Majesty Es-2) and three wetting agents (Modeling Liquid, Composite Primer, and Modeling Resin) were investigated. In all, 240 specimens were prepared, and wetting agents were applied prior to light curing in the experimental groups. After 24 hours, specimens were polished and Vickers microhardness (VHN) values were measured.

Statistical Analysis  Shapiro–Wilk and two-way analysis of variance (ANOVA) were used for analyses ( p < 0.05).

Results  Both modeling resin and composites were determined to be effective factors ( p < 0.001). The control group showed the highest VHN (70.37 ± 7.94), followed by Modeling Liquid (64.68 ± 12.07), Composite Primer (59.84 ± 6.33), and Modeling Resin (58 ± 3.52 ^b ; p < 0.001). Filtek Ultimate showed the highest VHN (76.62 ± 9.78 ^c ), whereas Charisma Smart (58.87 ± 7.95), and Clearfil Majesty (67.27 ± 2.58) showed the lowest ( p < 0.001). Clearfil Majesty–Modeling Liquid (46.62 ± 5.33) and Charisma Smart–Composite Primer (50.81 ± 0.39) combinations showed the lowest VHN, whereas Filtek Ultimate–control (87.15 ± 2.12) and Filtek Ultimate–Modeling Liquid (84.24 ± 3.11) showed the highest ( p < 0.001).

Conclusion  All tested modeling resins decreased VHN value, and the amount of reduction varied among composites and wetting agents. It might be safer not to use wetting agents unless they are necessary.

Oxygen Inhibition of Surface Composites and Its Correlation with Degree of Conversion and Color Stability

This study investigated the effects of oxygen inhibition and finishing/polishing procedures on the composite resin properties. One bulk-fill and two conventional composite resins (nanoparticle and microhybrid) were evaluated. Specimens were prepared using 4 surface treatments: control, no treatment; Gly, oxygen inhibition with glycerin; FP, finishing and polishing; Gly + FP, glycerin followed by finishing and polishing. The degree of conversion (DC) was measured using Fourier Transformed Infrared Spectroscopy (FTIR) immediately and after 15 days (n=5). Color stability (ΔEab, and ΔE00) and opacity were evaluated using a spectrophotometer after 15 days of immersion in coffee, using the CIELAB system (n=5). Data were analyzed by two-way ANOVA and Tukey tests (α=0.05) and opacity by two-way repeated-measures ANOVA. Glycerin usage increased significantly the DC however had no influence on the ΔEab, ΔE00 and, opacity values. Finishing and polishing reduced ΔEab and ΔE00 values, regardless of composite resins. Microhybrid showed higher opacity, followed by the nanoparticle and bulk fill, regardless of surface treatment. Post-polymerization polishing procedures resulted in lower conversion than using an oxygen inhibitor agent (Gly condition), but similar staining caused by coffee.

Influence of modeling agents on the surface properties of an esthetic nano-hybrid composite

Objective

The aim of this study was to evaluate the influence of different modeling agents on the surface microhardness (Vickers hardness number; VHN), roughness (Ra), and color change (ΔE) of a nano-hybrid composite with or without exposure to discoloration by coffee.

Materials and Methods

Sixty-four cylinder-shaped nano-hybrid composite specimens were prepared using a Teflon mold. The specimens' surfaces were prepared according to the following groups: group 1, no modeling agent; group 2, Modeling Liquid; group 3, a universal adhesive (G-Premio Bond); and group 4, the first step of a 2-step self-adhesive system (OptiBond XTR). Specimens were randomly allocated into 2 groups (n = 8) according to the storage medium (distilled water or coffee). VHN, Ra, and ΔE were measured at 24 hours, 1 week, and 6 weeks. The Kruskal-Wallis test followed by the Bonferroni correction for pairwise comparisons was used for statistical analysis (α = 0.05).

Results

Storage time did not influence the VHN of the nano-hybrid composite in any group (p > 0.05). OptiBond XTR Primer application affected the VHN negatively in all investigated storage medium and time conditions (p < 0.05). Modeling Liquid application yielded improved Ra values for the specimens stored in coffee at each time point (p < 0.05). Modeling Liquid application was associated with the lowest ΔE values in all investigated storage medium and time conditions (p < 0.05).

Conclusion

Different types of modeling agents could affect the surface properties and discoloration of nano-hybrid composites.