Flexural strength and microhardness of bulk-fill restorative materials

The effect of depth of cure on microhardness between bulk-fill and hybrid composite resin material

Background

Functional properties should be considered when selecting composites for restorations. With bulk-fill resin composites, the disadvantages of conventional composites were overcome regarding the increments necessitating the application of a 2 mm thick layer of resin and the amount of polymerization. The most significant advantage of bulk-fill resin composite is the possibility of applying the material in 4 mm layers. Multiple studies have examined the polymerization, mechanical, and adhesive properties of bulk-fill resin composites and proven them successful.

Objective

This study aimed to compare the effect of the depth of cure on the microhardness between different bulk-fill composites and a hybrid composite material by following the manufacturer's instructions.

Methods

In this in vitro study, five composite types obtained from different companies were used: two high-viscosity bulk-fill composites, Filtek and OPUS bulk; two low-viscosity bulk-fill flowable composites, Any-com and OPUS flow; one light-cure hybrid composite, Cavex, totaling 25 samples. The composite was applied at a depth of 4 mm in the bulk-fill composite and 2 mm in the hybrid composite and light-cured. The microhardness was measured at three different times. The first time was performed immediately after light-curing, the second time was evaluated 24 h after polymerization, and the third time was after thermocycling.

Result

A total of 25 samples showed that the microhardness increased the first and second times and decreased the third time after thermocycling on the top and bottom sides of Filtek, OPUS bulk-fill, OPUS flow, and Any-com bulk. The Cavex microhardness at the bottom was equal at all three-time points. Two-way repeated measures ANOVA showed that the microhardness between all types of composite resin materials was significantly different at different times when p = 0.00.

The Depth of Cure, Sorption and Solubility of Dual-Cured Bulk-Fill Restorative Materials

This study aimed to examine depth of cure (DoC), mass change, water sorption and solubility of dual-cured bulk-fill restorative materials (Surfil One and Activa) in comparison with a light-cured bulk-fill composite (Filtek One Bulk-Fill) and a resin-modified glass ionomer (Fuji II LC). Twenty specimens were prepared of each material using stainless steel molds designed with a slot (8 × 4 × 2 mm) and irradiated for either 20 or 40 s. The Vickers hardness (VHN) was measured at every 0.5 mm to assess the DoC after 24 h of storage at 37 °C. The depth of cure was reported as the depth corresponding to 80% of the maximum Vickers hardness. Disc-shaped specimens were prepared of each material (n = 5) to investigate mass change, sorption and solubility after 4 months of water storage. The data were analyzed using a two-way and one-way analysis of variance (ANOVA) followed by the Tukey post hoc test (p ≤ 0.05). Fuji II LC had the greatest DoC while Activa had the lowest. The two different irradiation times did not demonstrate a significant difference in DoC for all dual-cured materials (p > 0.05). Fuji II LC had the highest sorption while Filtek One showed the lowest. Surefil One and Fuji II LC had a negative solubility. This study concluded that dual-cured materials showed different depth of cure values despite having the same setting reaction. Both materials exhibited a high water sorption, which might jeopardize their dimensional stability and effect their clinical performance.

Surface hardness and flexural strength of dual-cured bulk-fill restorative materials after solvent storage

BACKGROUND

This study aimed to evaluate the surface hardness (VHN) and biaxial flexural strength (BFS) of dual-cured bulk-fill restorative materials after solvent storage.

METHODS

Two dual-cured bulk-fill composites (Surefil One® and Activa™ Bioactive), a light-cured bulk-fill composite (Filtek One Bulk-Fill) and a resin-modified glass ionomer (Fuji II LC) were investigated. Surefil One and Activa were used in the dual-cure mode, all materials were handled according to manufacturer's instructions. For VHN determination, 12 specimens were prepared from each material and measured after 1 h (baseline), 1 d, 7 d and 30 d of storage in either water or 75% ethanol-water. For BFS test, 120 specimens were prepared (n = 30/material) and stored in water for either 1, 7 or 30 d before testing. Repeated measures MANOVA, two-way and one-way ANOVA followed by the Tukey post hoc test (p ≤ 0.05) were used to analyze the data.

RESULTS

Filtek One had the highest VHN, while Activa had the lowest. All materials exhibited a significant increase in VHN after 1d of storage in water, except for Surefil One. After 30 d of storage, VHN increased significantly in water except for Activa, while ethanol storage caused a significant time-dependent reduction in all tested materials (p ≤ 0.05). Filtek One showed the highest BFS values (p ≤ 0.05). All the materials, except for Fuji II LC, exhibited no significant differences between 1 and 30 d BFS measurements (p > 0.05).

CONCLUSIONS

Dual-cured materials had significantly lower VHN and BFS compared to the light-cured bulk-fill material. The low results of Activa VHN and Surefil One BFS, indicate that these materials should not be recommended in posterior stress-bearing areas.

The stamp technique for direct restoration in a ICDAS 4 carious lesion: A 4-year follow-up

OBJECTIVE

This case report described the use of a stamping technique associated with a bulk fill composite to restore an ICDAS 4 carious lesion on a posterior tooth. The 4-year follow-up is also presented.

CLINICAL CONSIDERATIONS

A 32-year-old patient presented a carious lesion on tooth 36 with an underlying dark shadow at the dentin seen from the noncavitated enamel occlusal surface, which was compatible with an ICDAS 4 carious lesion. The lesion was radiographically detected and the caries disease was treated with dietary and hygiene habits orientations. Before accessing the lesion and selectively removing the carious tissue, an occlusal stamp was made by applying a flowable resin composite to copy the anatomy of the noncavitated enamel surface. The cavity was restored using a bulk fill resin composite (Opus Bulk Fill, FGM) with 4-mm-thick increments. Before curing the last increment, a Teflon band was adapted at the uncured bulk fill composite surface and the occlusal stamp made with the flowable composite was pressed against it to reproduce the natural characteristics and initial occlusal anatomy. The top surface was light-activated for 40 s. After 4 years, small wear could be seen in the restoration, but still within clinically acceptable levels.

CONCLUSION

The occlusal stamp technique allows reproduction of the natural anatomy of teeth affected by ICDAS 4 carious lesions with good clinical longevity over 4 years.

CLINICAL SIGNIFICANCE

This case report presents the use of the stamp technique to restore a tooth affected by an ICDAS 4 lesion, in which a carious process reached the dentin and the enamel anatomy was still preserved. The bulk fill resin composite associated with the occlusal stamp was chosen to quickly restore the cavity with clinical predictability. Bulk fill composites allow the insertion of up to 4-mm-thick increments and offer lower shrinkage stress, good clinical longevity and a less time-consuming procedure in cases of posterior teeth, especially if associated with the stamp technique.

Color alterations, flexural strength, and microhardness of 3D printed resins for fixed provisional restoration using different post-curing times

OBJECTIVES

To evaluate the effect of post-curing times on the color change, flexural strength (FS), modulus (FM) and microhardness at different depths of four 3D printed resins.

MATERIALS AND METHODS

A characterization of the light emitted by 3D-resin post-curing unit (Wash and Cure 2.0, Anycubic) was performed. The tested 3D printed resins were Cosmos Temp3D (COS), SmartPrint BioTemp (SM) Resilab3D Temp (RES) and Prizma3D BioProv (PRI) were evaluated under five different post-curing conditions (no post-curing or 5-, 10-, 15, and 20 min of post-curing). For color change analysis, 10 mm diameter x 1 mm thick discs (n = 7) were printed, and the luminosity, color and translucency were measured before post-curing as control, and repeatedly after 5 min cycles of post-curing until a total of 20 min was reached for ΔE₀₀ [CIED2000 (1:1:1)] calculation. For FS and FM, 25 × 2×2 mm (n = 10, for each post-curing time) 3D printed bars were subjected to a 3-point being test. Knoop microhardness (KHN) was measured transversally on 5 × 5×5 mm blocks (n = 10, for each post-curing time). Color results were analyzed by one-way repeated measures ANOVA (factor: color change). FS and FM were analyzed by two-way ANOVA (factors: Material*Post-Curing Time). KHN was analyzed individually for each material by two-way ANOVA (factors: Depth*Post-Curing Time).

RESULTS

The post-curing time significantly influenced the ΔE_00, FS, FM and KHN of all the evaluated materials. COS and SMA presented ΔE₀₀ values above the acceptability threshold after 5 and 10 min of post-curing, respectively. The FS of RES reached a plateau after 5 min of post-curing, and for PRI and SMA, the FS stabilized after 10 min of post-curing. The post-curing process improved the KHN of the tested materials, and longer exposure periods were associated to higher KHN values at all the evaluated depths.

SIGNIFICANCE

A fine adjustment of the post-curing time is crucial to produce adequate mechanical properties in 3D-printed restorative resins, while minimizing the color alterations on the restorations. For the evaluated resins, 5-10 min of post-curing will result in adequate mechanical properties, without affecting the acceptability in the color of the material. However, the results are material-dependent, and evaluation of each specific resin is advised.

Evaluation of color stability and microhardness of contemporary bulk-fill composite resins with different polymerization properties

OBJECTIVES

To determine the color stability and microhardness of three bulk-fill composites with different polymerization characteristics, after immersion in four different solutions.

MATERIALS AND METHODS

Color measurements of three bulk fill (Viscalor (VIS), Tetric PowerFill (TPF), Fill Up! (FUP)) and a microhyrid composite resin (G-aenial posterior [GCP]) were performed after polymerization. The specimens were immersed in coffee, cola, red wine and distilled water. Discolorations were recorded after 24 h (T1), 10 days (T2) and 30 days (T3) of immersion. ΔE (CIEDE2000) values were calculated. Vickers microhardness (VHN) was measured from top and bottom surfaces at T0 and T3. Data was analyzed with Two-way ANOVA, One-way ANOVA and Tukey post hoc tests.

RESULTS

The highest discoloration was seen in wine and the lowest in distilled water and cola. At T3, there was no difference in distilled water groups, while the statistically highest ΔE₀₀ were obtained in TPF and GCP in coffee, cola and wine. VIS groups had the highest VHN values at T0 and T3 in all solutions.

CONCLUSIONS

Samples immersed in coffee and wine showed discoloration beyond clinically acceptable limits. After 30 days, discoloration occurred in all materials immersed in all solutions. At T3, VIS microhardness generally decreased, while TPF did not.

CLINICAL SIGNIFICANCE

After 30 days, all bulk-fill composites immersed in distilled water, coffee and wine showed clinically unacceptable ΔE₀₀ .

Effect of extended light activation and increment thickness on physical properties of conventional and bulk-filled resin-based composites

OBJECTIVES

To evaluate the biaxial flexural strength (BFS), flexural modulus (BFM), and Knoop microhardness (KHN) of incremental and bulk-filled resin-based composites (RBCs) using extended curing exposure times.

MATERIALS AND METHODS

Disc specimens (n = 8; 6-mm diameter) were fabricated using three stacked molds (0.5-mm thick for the top and bottom molds, and a 1-mm-thick center mold for the conventional and 3-mm thick for the bulk-fill RBCs). Conventional (Tetric EvoCeram/TCE and Filtek Z250/FIZ) and bulk-fill RBCs (Tetric EvoCeram Bulk Fill/TBF and Filtek One Bulk Fill Restorative/FOB) were evaluated. The stacked RBC-filled molds were light-cured for (1) the manufacturer-recommended exposure (MRE) duration; (2) 50%, and (3) 100% extension of the MRE. The BFS, BFM, and KHN of the top and bottom discs were measured. BFS and BFM were analyzed by three-way ANOVA (material*curing time*depth) and Tukey's post hoc (α = 0.05). KHN was analyzed by two-way ANOVA (curing time*depth) and Tukey's post hoc (α = 0.05).

RESULTS

Extending the exposure duration did not change the BFS and BFM on the top of the RBCs, but the BFS and KHN increased at the bottom of bulk-fill RBCs. For the conventional RBCs, TCE showed the highest increase on BFS at the bottom, going from 53.6 MPa at T1 to 69.9 at T3. Among the bulk-fill RBCs, FOB presented the highest increase on the bottom BFS (T1: 101.0 ± 19.9 MPa, T3: 147.6 ± 12.9 MPa). For all RBCs and exposure times, BFS and KHN were lower at the bottom. Only FIZ and FOB reached a bottom-to-top hardness ratio of 80%, at T3 and T2.

CONCLUSION

A significant increase on the BFS and KHN on the bottom of bulk-fill RBCs can be observed when the time of exposure to the curing light is double the MRE. However, extended exposure does not eliminate differences on the BFS and KHN between the shallow and deep regions of RBCs. TCE and TBF failed to reach an acceptable B/T hardness ratio at all evaluated exposure times.

CLINICAL RELEVANCE

Mechanical properties of RBCs can be affected by insufficient polymerization, specially at deeper regions of the increment. Therefore, clinicians should consider applying twice the MRE to curing-light to polymerize the maximal increment thickness of bulk-fill RBCs.