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Torres CRG, Mailart MC, Moecke SE, Matuda AGN, Veloso SM, da Silva Ávila DM, Nicoló RD, Borges AB. Flowable bulk-fill versus layering restorative material on Class II restorations: A randomized clinical trial. J Dent 2024; 148:105154. [PMID: 38942111 DOI: 10.1016/j.jdent.2024.105154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 06/20/2024] [Accepted: 06/22/2024] [Indexed: 06/30/2024] Open
Abstract
OBJECTIVE This study evaluated the clinical performance of Class II restorations made with flowable bulk-fill base versus conventional layering ORMOCER-based restorative material in a split-mouth randomized clinical trial. METHODS Thirty patients received two class II restorations (n = 60) performed with different strategies. All preparations received the application of the universal self-etching adhesive system according to the manufacturer's recommendation, followed by the placement of a sectional matrix, wooden wedge, and separation ring. The first restoration was performed using 4 mm of flowable bulk-fill material covered by 2 mm of conventional viscosity restorative material (Bulk-fill technique). The second restoration was performed only with the conventional viscosity material, with a maximum of 2 mm thick increments, up to fill the cavity (Layering technique). After occlusal adjustment, the same polishing system was used for all restorations. Evaluations using the FDI criteria were conducted after 7 days, 12, and 24 months. Data were analyzed with the Fisher's Exact test (α=0.05). RESULTS From 30 participants, 24 attended the 24-month recall, and 48 restorations were evaluated. All restorations received acceptable overall scores for esthetic and biological properties after this period, while only 6.66 % of the restorations exhibited unacceptable overall scores for the functional properties in both groups. No significant differences between the tested restorative materials and techniques were found for each FDI criterion assessed. The success rate after 2 years was 93.33 % for both groups. CONCLUSION Both restorative materials exhibited good clinical performance for the parameters analyzed with no differences between them after 24-month follow-up. CLINICAL RELEVANCE Flowable bulk-fill ORMOCER-based material is a suitable alternative for direct Class II restorations, providing good clinical outcomes and simplifying the restorative procedure. CLINICAL TRIAL REGISTRATION NUMBER RBR-6mvp9w.
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Affiliation(s)
- Carlos Rocha Gomes Torres
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University - UNESP, Brazil. Av. Engenheiro Francisco Jose Longo, 777, Jardim Sao Dimas, Sao Jose dos Campos, SP, CEP 12245-000, Brazil.
| | - Mariane Cintra Mailart
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University - UNESP, Brazil. Av. Engenheiro Francisco Jose Longo, 777, Jardim Sao Dimas, Sao Jose dos Campos, SP, CEP 12245-000, Brazil
| | - Sabrina Elise Moecke
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University - UNESP, Brazil. Av. Engenheiro Francisco Jose Longo, 777, Jardim Sao Dimas, Sao Jose dos Campos, SP, CEP 12245-000, Brazil
| | - Amanda Guedes Nogueira Matuda
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University - UNESP, Brazil. Av. Engenheiro Francisco Jose Longo, 777, Jardim Sao Dimas, Sao Jose dos Campos, SP, CEP 12245-000, Brazil
| | - Sheyla Mamede Veloso
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University - UNESP, Brazil. Av. Engenheiro Francisco Jose Longo, 777, Jardim Sao Dimas, Sao Jose dos Campos, SP, CEP 12245-000, Brazil
| | - Daniele Mara da Silva Ávila
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University - UNESP, Brazil. Av. Engenheiro Francisco Jose Longo, 777, Jardim Sao Dimas, Sao Jose dos Campos, SP, CEP 12245-000, Brazil
| | - Rebeca Di Nicoló
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University - UNESP, Brazil. Av. Engenheiro Francisco Jose Longo, 777, Jardim Sao Dimas, Sao Jose dos Campos, SP, CEP 12245-000, Brazil
| | - Alessandra Bühler Borges
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University - UNESP, Brazil. Av. Engenheiro Francisco Jose Longo, 777, Jardim Sao Dimas, Sao Jose dos Campos, SP, CEP 12245-000, Brazil
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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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Miletic V, Komlenic V, Bajuk-Bogdanović D, Stasic J, Petrovic V, Savic-Stankovic T. Preheating and "snow-plow" composite application technique affect double bond conversion but not bond strength to dentine. J ESTHET RESTOR DENT 2024; 36:951-961. [PMID: 38497672 DOI: 10.1111/jerd.13218] [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: 01/08/2024] [Revised: 02/12/2024] [Accepted: 02/29/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVE To measure degree of conversion (DC) of a flowable composite, microtensile bond strength (MTBS) to dentine in the snow-plow technique with/without preheating and temperature in the preheated composite. MATERIALS AND METHODS For DC, snow-plow specimens of Filtek Ultimate Flowable (Flow) and Filtek Bulk Fill (Bulk) (3M) were prepared by light-curing composites simultaneously in standardized molds while in control groups light-curing was separate. DC of Flow was measured using micro-Raman spectroscopy. For MTBS, specimens were prepared on dentine of human extracted molars by simultaneous (snow-plow) or separate (control) light-curing. MTBS was measured using a universal testing machine after 24 h and 6 months. Data were analyzed using ANOVA with Tukey's post hoc (α = 0.05). RESULTS Increased curing time significantly increased DC in snow-plow from 13.4% ± 11.6% (10 s) to 31.8% ± 4.4% (40 s) albeit significantly lower than controls (p < 0.05). Preheated Bulk improved conversion in snow-plow (44.3% ± 1.7%) and control (50.5% ± 2.6%) (p < 0.05). No significant differences occurred in MTBS between groups (p > 0.05). MTBS values ranged between 66.7 ± 8.4 MPa (snow-plow group_21°C_baseline) and 54.1 ± 15.8 MPa (control_21°C_long-term). Temperature in the preheated Bulk dropped to ~38°C after 30 s. CONCLUSIONS Snow-plow technique, irrespective of preheating, resulted in lower DC of Flow than separate light-curing of composite increments. Snow-plow, irrespective of preheating, resulted in similar initial and long-term MTBS to dentine. CLINICAL SIGNIFICANCE Clinicians with preference for flowable composite liners in Class II restorations should be aware that the snow-plow technique of simultaneous light-curing of flowable and bulk-fill composite increments affects monomer-to-polymer conversion, albeit no effect on immediate, and long-term bonding to dentine was detected. Preheating sculptable bulk-fill composite improves conversion of the flowable liner in the snow-plow technique but has no detectable effect on bond strength to dentine.
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Affiliation(s)
- Vesna Miletic
- School of Dental Medicine, DentalNet Research Group, University of Belgrade, Belgrade, Serbia
- Faculty of Medicine and Health, Sydney Dental School, The University of Sydney, Surry Hills, New South Wales, Australia
| | - Vojislav Komlenic
- School of Dental Medicine, DentalNet Research Group, University of Belgrade, Belgrade, Serbia
| | | | - Jovana Stasic
- School of Dental Medicine, DentalNet Research Group, University of Belgrade, Belgrade, Serbia
| | - Violeta Petrovic
- School of Dental Medicine, DentalNet Research Group, University of Belgrade, Belgrade, Serbia
| | - Tatjana Savic-Stankovic
- School of Dental Medicine, DentalNet Research Group, University of Belgrade, Belgrade, Serbia
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Loguercio AD, Ñaupari-Villasante R, Gutierrez MF, Gonzalez MI, Reis A, Heintze SD. 5-year clinical performance of posterior bulk-filled resin composite restorations: A double-blind randomized controlled trial. Dent Mater 2023; 39:1159-1168. [PMID: 37839995 DOI: 10.1016/j.dental.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/07/2023] [Accepted: 10/08/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVES The aim of this double-blind, and randomized controlled clinical trial was to evaluate the 5-year clinical performance of posterior resin composite restorations placed with the incremental filling technique [IF] or the bulk-fill technique [BF]. Two different adhesive systems were used: etch-&-rinse (ER) or self-etch (SE). METHODS Posterior dental teeth of 72 participants (n = 236), with a cavity depth of at least 3 mm, were randomly divided into four groups. Restorations were applied with either Tetric N-Bond or Tetric N-Bond SE. The composite resin Tetric N-Ceram Bulk-Fill was placed either with IF or BF. Restorations were evaluated using FDI criteria at baseline and after 1, 2, 3, 4, and 5 years. Statistical analysis was performed using the Wilcoxon Signed rank test (a=0.05). RESULTS Two hundred and four restorations were evaluated after 5 years. Eleven restorations were considered 'failed', ten due to fracture (4 IF and 6 BF) and one due to secondary caries (IF). The annual failure rate was 1.2% for BF and 1% for IF (p = 0.35). When comparing BF and IF, no significant differences were found for any of the parameters evaluated (p > 0.05). Regarding the adhesive systems, 44 and 51 restorations showed minor problems in terms of marginal adaptation and staining, with significantly more marginal discoloration when the self-etch adhesive was used (p = 0.002). SIGNIFICANCE The bulk-fill restorative technique showed good clinical behavior compared to the incremental filling technique, especially when using an etch-&-rinse adhesive, after 5 years of clinical evaluation.
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Affiliation(s)
- Alessandro D Loguercio
- Department of Restorative Dentistry, School of Dentistry, Ponta Grossa State University, Ponta Grossa, PR, Brazil
| | - Romina Ñaupari-Villasante
- Department of Restorative Dentistry, School of Dentistry, Ponta Grossa State University, Ponta Grossa, PR, Brazil
| | - Mario F Gutierrez
- Universidad de los Andes, Chile, Facultad de Odontologia, Chile; University of Chile, Department of Restorative Dentistry, Faculty of Dentistry, Chile
| | | | - Alessandra Reis
- Department of Restorative Dentistry, School of Dentistry, Ponta Grossa State University, Ponta Grossa, PR, Brazil
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Derigi LP, Barros LS, Sugii MM, Turssi CP, França F, Basting RT, Vieira WF. Effect of Commercial Mouth Rinses on Physical Properties of Conventional and Bulk-fill Resin Composites. Oper Dent 2023; 48:720-731. [PMID: 37881067 DOI: 10.2341/23-041-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE To evaluate the effects of commercial mouth rinses on color, roughness, sorption (SR), and solubility (SL) of resin composites. METHODS AND MATERIALS Disc-shaped specimens (stage I: 6 mm × 2 mm; stage II: 10 mm × 1.5 mm) were made from the following resin composites (n=10): conventional nanofilled (Filtek Z350XT, 3M Oral Care), conventional nanohybrid (Luna, SDI), bulk-fill nanofilled (Filtek One Bulk-Fill, 3M Oral Care), and bulk-fill nanohybrid (Aura Bulk-Fill, SDI) exposed to distilled water (control), blue mouth rinse without alcohol (Colgate Total 12 Clean Mint, Colgate-Palmolive), or blue mouth rinse with alcohol and essential oil (Listerine Tartar Control, Johnson & Johnson). In stage I, tests were performed at the baseline, and after the immersion in solution time points to evaluate coordinates of the CIEL*a*b* system (ΔL*, Δa*, Δb*), general color change (ΔEab, ΔE00, and ΔSGU), and surface roughness (Ra). In stage II, SR and SL were evaluated (ISO 4049:2019) after immersion in the solutions for 7 days. The results were evaluated by generalized linear models (Ra, SR), Kruskal-Wallis, and Dunn tests (color, SL), with α = 0.05. RESULTS There were no significative differences for Ra between the solutions. Both mouth rinses promoted significantly negative ΔL* (Luna), Δa* (Filtek One Bulk-fill), and Δb* (all materials except conventional nanofilled resin composite). Mouth rinse without alcohol promoted significantly negative Δa* on all resin composites tested. Both mouth rinses promoted higher ΔEab and ΔE00 for bulk-fill resin composites compared to control. Mouth rinse with alcohol caused higher ΔSGU for bulk-fill nanofilled resin composite. It also promoted greater SR in all the resin composites compared with mouth rinse without alcohol and higher SR in nanohybrid resin composites compared with control. Both mouth rinses promoted higher SL values in Luna and differed significantly from control. CONCLUSIONS The physical properties were manufacturer dependent and mediated by mouth rinses. The mouth rinses promoted color changes in the resin composites, pointing out that bulk-fill resin composites were more affected by these effects, especially when the mouth rinse contained essential oil and alcohol.
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Affiliation(s)
- L P Derigi
- Leonardo Pinheiro Derigi, MSc student, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
| | - L S Barros
- Leonardo Santos Barros, MSc student, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
| | - M M Sugii
- Mari Miura Sugii, DDS, MSc, PhD, professor, Groningen University Medical Center, University of Groningen, Groningen, Netherlands
| | - C P Turssi
- Cecilia Pedroso Turssi, DDS, MSc, PhD, professor, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
| | - Fmg França
- Fabiana Mantovani Gomes França, DDS, MSc, PhD, professor, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
| | - R T Basting
- Roberta Tarkany Basting, DDS, MSc, PhD, professor, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
| | - W F Vieira
- *Waldemir Francisco Vieira-Junior, DDS, MSc, PhD, professor, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
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Leinonen KM, Leinonen J, Bolstad NL, Tanner T, Al-Haroni M, Johnsen JAK. Procedure time and filling quality for bulk-fill base and conventional incremental composite techniques-A randomised controlled in vitro trial. J Dent 2023; 138:104725. [PMID: 37742811 DOI: 10.1016/j.jdent.2023.104725] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/12/2023] [Accepted: 09/21/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVES The aims of this randomised controlled laboratory trial were to determine the procedure time and immediate quality (surface porosity and marginal gaps) of fillings placed using the bulk-fill base technique and the conventional incremental technique in simulated clinical settings. METHODS Forty-two dentists and dental students were randomly allocated to use either the bulk-fill base technique or the conventional incremental technique to fill an identical class II disto-occlusal cavity in a maxillary left first molar typodont tooth. We recorded the time the participants used to fill the cavity and evaluated the surface porosity and marginal gaps on the approximal surfaces of the fillings using a stereomicroscope and specific probes according to the FDI criteria for restoration evaluation. Data were analysed using the Mann-Whitney U, Kruskal-Wallis, and chi-square tests. RESULTS The median time ± interquartile range was 186 ± 80 s for the bulk-fill base technique and 463 ± 156 s for the conventional incremental technique (p < 0.001). The quality of the fillings was better for the bulk-fill base technique than for the conventional incremental technique (X2 = 9.5, p = 0.002). Neither operator experience nor the usual technique of choice were associated with the procedure time or the quality of the fillings. CONCLUSIONS Compared to the conventional incremental technique, the use of the bulk-fill base technique shortened the time to fill a cavity by 59.8 % or 4 min and 36 s, and it improved the immediate surface and marginal quality of the fillings, regardless of the operator's experience or technique preference. CLINICAL SIGNIFICANCE The use of the bulk-fill base technique instead of the conventional incremental technique leads to significant time-savings when placing large class II composite fillings. Additionally, the use of the bulk-fill base technique instead of the conventional incremental technique improves the immediate quality of large class II composite fillings.
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Affiliation(s)
- Kaisa M Leinonen
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway; Institute of Dentistry, School of Medicine, University of Eastern Finland, Yliopistonrinne 3, 70210 Kuopio, Finland.
| | - Jukka Leinonen
- Institute of Dentistry, School of Medicine, University of Eastern Finland, Yliopistonrinne 3, 70210 Kuopio, Finland
| | - Napat L Bolstad
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway
| | - Tarja Tanner
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.Box 8000, FI-90014 Oulu, Finland
| | - Mohammed Al-Haroni
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway
| | - Jan-Are K Johnsen
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway
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Dietschi D, Askari M, Rossier I, Caseiro L, Krejci I, Leprince JG, Di Bella E, Ardu S. Marginal Adaptation of In Vitro Class II Restorations Made Out of Bulk or Conventional Composite Using Single- or Multi-Layered Techniques. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6325. [PMID: 37763602 PMCID: PMC10533156 DOI: 10.3390/ma16186325] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023]
Abstract
Objective: Testing the influence of various restorative materials (conventional or bulkfill composites) and filling techniques (single- or multi-layered techniques) on the in vitro marginal adaptation of large class II direct composites with supra and sub-gingival margins subjected to thermomechanical loading (TML). Methods: A total of 40 prepared teeth were attributed randomly to five experimental groups. In Group 1, restorations were made of multi-layered high-viscosity conventional composite (Tetric EvoCeram); in Groups 2 and 3, restorations were made of a high viscosity bulkfill composite (Tetric EvoCeram Bulk Fill) applied in one (Group 2) or three layers (Group 3); in Groups 4 and 5, restorations were made of a flowable bulkfill composite (SDR flow) applied in one (Group 4) or two layers (Group 5), covered with a layer of high-viscosity conventional composite (Ceram-X Universal). A single adhesive (OptiBond FL) was used in all groups. All specimens were submitted to a staged TML comprising three phases (2 × 500,000 and 1,000,000 cycles) at 50 N with 3350 thermal cycles (5 to 55 °C) every 500,000 cycles. The tooth-restoration interfaces on proximal surfaces were evaluated quantitatively by scanning electron microscopy, before and after each TML phase, hence at three timepoints (T0, T1, T2 and T3). The following segments were considered for evaluation: proximal, vertical enamel margins (assessed individually on both restoration sides), cervical enamel (restoration side above CEJ) and cervical dentin margin (restoration side below the CEJ). Results: TML induced a significant reduction in continuous adaptation at both enamel and dentin margins in all groups, with percentages of continuous margins ranging from 75.2 to 91.8% at T0, and decreasing to values ranging from 21.3 to 73.9% at T3. Both composite systems and layering protocols had a significant influence on marginal adaptation of the restorations, with statistical associations depending on the restoration group and the timepoint considered. Defective margins in enamel were all of a cohesive nature with micro-fractures, while in dentin, interfacial gaps were the main defect observed. Conclusions/Clinical significance: The present results highlighted significant degradation of marginal adaption after long-term in vitro fatigue test using materials even with high-viscosity conventional resin composites, applied with a proper layering approach in medium-large sub-gingival cavities. While no significant differences were observed at the dentin cervical margins, there was a tendency for better adaptation at the enamel margin when using a higher modulus material with a multi-layered technique.
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Affiliation(s)
- Didier Dietschi
- Division of Cariology and Endodontology, Section of Dental Medicine, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland; (D.D.); (M.A.); (I.R.); (L.C.); (I.K.); (J.G.L.)
| | - Mustafa Askari
- Division of Cariology and Endodontology, Section of Dental Medicine, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland; (D.D.); (M.A.); (I.R.); (L.C.); (I.K.); (J.G.L.)
| | - Isaline Rossier
- Division of Cariology and Endodontology, Section of Dental Medicine, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland; (D.D.); (M.A.); (I.R.); (L.C.); (I.K.); (J.G.L.)
| | - Luciana Caseiro
- Division of Cariology and Endodontology, Section of Dental Medicine, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland; (D.D.); (M.A.); (I.R.); (L.C.); (I.K.); (J.G.L.)
| | - Ivo Krejci
- Division of Cariology and Endodontology, Section of Dental Medicine, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland; (D.D.); (M.A.); (I.R.); (L.C.); (I.K.); (J.G.L.)
| | - Julian Gregoire Leprince
- Division of Cariology and Endodontology, Section of Dental Medicine, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland; (D.D.); (M.A.); (I.R.); (L.C.); (I.K.); (J.G.L.)
| | - Enrico Di Bella
- Department of Political and International Studies, University of Genoa, 16126 Genoa, Italy;
| | - Stefano Ardu
- Division of Cariology and Endodontology, Section of Dental Medicine, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland; (D.D.); (M.A.); (I.R.); (L.C.); (I.K.); (J.G.L.)
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8
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Silva G, Marto CM, Amaro I, Coelho A, Sousa J, Ferreira MM, Francisco I, Vale F, Oliveiros B, Carrilho E, Paula AB. Bulk-Fill Resins versus Conventional Resins: An Umbrella Review. Polymers (Basel) 2023; 15:2613. [PMID: 37376259 DOI: 10.3390/polym15122613] [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: 05/14/2023] [Revised: 06/02/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Currently, composite resins have become the material of choice for the restoration of posterior teeth. Although bulk-fill resins represent a tempting alternative due to their lower complexity and faster use, some dentists are reluctant to use this material. The objective is to compare the performance of bulk-fill resins and conventional resins in direct restorations of posterior teeth based on the literature. The databases that were used to carry out the research were PubMed/MEDLINE, Embase, the Cochrane Library and the WOS. This umbrella literature review complies with PRISMA standards and assesses the quality of studies using the AMSTAR 2 tool. With the application of the criteria of the AMSTAR 2 tool, the reviews were considered low to moderate. The overall meta-analysis, although without statistical significance, favours mostly the use of conventional resin, as it is about five times more likely to obtain a favourable result than bulk-fill resin. Bulk-fill resins result in a simplification of the clinical process of posterior direct restorations, which is an advantage. The performance in terms of several properties of bulk-fill resins and conventional resins showed that they present similar behaviour.
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Affiliation(s)
- Gonçalo Silva
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
| | - Carlos Miguel Marto
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Laboratory for Evidence-Based Sciences and Precision Dentistry (LACBE-MDP), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Institute of Experimental Pathology, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3000-354 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotecnhology (CIBB), 3000-354 Coimbra, Portugal
| | - Inês Amaro
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Laboratory for Evidence-Based Sciences and Precision Dentistry (LACBE-MDP), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3000-354 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotecnhology (CIBB), 3000-354 Coimbra, Portugal
| | - Ana Coelho
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Laboratory for Evidence-Based Sciences and Precision Dentistry (LACBE-MDP), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3000-354 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotecnhology (CIBB), 3000-354 Coimbra, Portugal
| | - José Sousa
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Laboratory for Evidence-Based Sciences and Precision Dentistry (LACBE-MDP), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
| | - Manuel Marques Ferreira
- Laboratory for Evidence-Based Sciences and Precision Dentistry (LACBE-MDP), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3000-354 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotecnhology (CIBB), 3000-354 Coimbra, Portugal
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
| | - Inês Francisco
- Laboratory for Evidence-Based Sciences and Precision Dentistry (LACBE-MDP), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3000-354 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotecnhology (CIBB), 3000-354 Coimbra, Portugal
- Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
| | - Francisco Vale
- Laboratory for Evidence-Based Sciences and Precision Dentistry (LACBE-MDP), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3000-354 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotecnhology (CIBB), 3000-354 Coimbra, Portugal
- Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
| | - Bárbara Oliveiros
- Laboratory for Evidence-Based Sciences and Precision Dentistry (LACBE-MDP), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3000-354 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotecnhology (CIBB), 3000-354 Coimbra, Portugal
- Laboratory of Biostatistics and Medical Informatics (LBIM), Faculty of Medicine, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Eunice Carrilho
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Laboratory for Evidence-Based Sciences and Precision Dentistry (LACBE-MDP), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3000-354 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotecnhology (CIBB), 3000-354 Coimbra, Portugal
| | - Anabela Baptista Paula
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Laboratory for Evidence-Based Sciences and Precision Dentistry (LACBE-MDP), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3000-354 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotecnhology (CIBB), 3000-354 Coimbra, Portugal
- Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
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9
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Brosh T, Davidovitch M, Berg A, Shenhav A, Pilo R, Matalon S. Influence of Practitioner-Related Placement Variables on the Compressive Properties of Bulk-Fill Composite Resins-An In Vitro Clinical Simulation Study. MATERIALS 2022; 15:ma15124305. [PMID: 35744363 PMCID: PMC9227906 DOI: 10.3390/ma15124305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022]
Abstract
Aims: To determine if restoration location and/or execution behavior force parameters have an influence on the mechanical properties of bulk-fill composite dental restorations. Methods: Pressure transducers were placed within each quadrant of dental mannequin jaws. Cylindrical molds were placed above the transducers and filled with two bulk-fill composite materials, Filtek and Tetric, by four experienced dentists. Each dentist prepared five specimens per quadrant and material. The total placement time, mean force, number of peak forces (above 25 N), and mean peak(s) force during placement were measured. Then, the stiffness and maximal compressive strength of the specimens were determined while loading the specimens up to failure using a universal loading machine. Results: Placement time was affected by jaw (p < 0.004) and side (p < 0.029), with the shortest time demonstrated for the left side of the mandible. Force exerted during restoration placement was not normally distributed without differences in location (jaw) or material. A higher application force was found on the right side (p < 0.01). The number of peak forces was affected by side (p < 0.03), with less peaks on the left side. No significant differences were found in compressive strength when correlated to restoration location, participant, or material (p = 0.431). The stiffness values of Filtek (3729 ± 228 N/mm) were found to be 15% higher than Tetric (3248 ± 227 N/mm) (p < 0.005). No correlations were found between the compressive strength or stiffness and the amount of force applied during placement. Conclusions: The individual restoration material placement parameters did influence practitioner performance; however, these differences did not affect the mechanical properties of the final restoration.
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Affiliation(s)
- Tamar Brosh
- The Department of Oral Biology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
- Correspondence:
| | - Moshe Davidovitch
- Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel;
| | - Avi Berg
- Department of Oral Rehabilitation, The Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv 6997801, Israel; (A.B.); (A.S.); (S.M.)
| | - Aviran Shenhav
- Department of Oral Rehabilitation, The Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv 6997801, Israel; (A.B.); (A.S.); (S.M.)
| | - Raphael Pilo
- The Department of Oral Biology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Shlomo Matalon
- Department of Oral Rehabilitation, The Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv 6997801, Israel; (A.B.); (A.S.); (S.M.)
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10
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de Melo TP, Delgado A, Martins R, Lassila L, Garoushi S, Caldeira J, Azul AM, Vallittu P. Can Specular Gloss Measurements Predict the Effectiveness of Finishing/Polishing Protocols in Dental Polymers? A Systematic Review and Linear Mixed-effects Prediction Model. Oper Dent 2022; 47:E131-E151. [PMID: 35776960 DOI: 10.2341/21-027-lit] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE The current gold standard measure to assess polishing efficacy is surface roughness (SR) assessed in laboratory research. Specular gloss (SG) has been negatively correlated to SR, which raises the following question: Can SG be used to accurately determine the effectiveness of a finishing/polishing procedure in direct resin composites? METHODS A systematic approach and search strategy, following Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, was developed and conducted in five electronic databases: PubMed/Medline, Scopus, Web of Science, EMBASE (Ovid), and SciELO/LILACS to identify laboratory studies that assessed SR and SG, simultaneously, of resin composites, without date or language restriction. Risk of bias assessment was carried out by two reviewers, independently. From the extracted quantitative data of SG/SR, regression analyses were performed, and a linear mixed-effects prediction model was derived using the nimble package in R (v4.0.3). RESULTS A total of 928 potential studies were found, out of which, 13 were eligible after criterion screening. Experimental groups featured 31 resin composites of six different filler types, with the most common being microhybrids followed by nanohybrids. More than half of the studies initially reported a linear correlation between SR and SG, which ranged from r2 = 0.34-0.96. Taking into account the regression analysis and prediction model posteriorly performed, the corresponding SG threshold for 0.2 μm is estimated to be >55 GU. Most of the evidence was classified as moderate or high risk of bias. CONCLUSION SG is universally correlated to SR in polymers, and a reference value of >55 GU is proposed, above which samples are considered well polished.
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Affiliation(s)
- T P de Melo
- *Teresa Pinheiro de Melo, DDS, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Monte de Caparica, Portugal
| | - Ahs Delgado
- António HS Delgado, DDS, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Monte de Caparica, Portugal; 2 Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, London, UK
| | - R Martins
- Rui Martins, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Monte de Caparica, Portugal
| | - L Lassila
- Lippo Lassila, Department of Biomaterials Science and TCBC, Institute of Dentistry, University of Turku, Turku, Finland
| | - S Garoushi
- Sufyan Garoushi, Department of Biomaterials Science and TCBC, Institute of Dentistry, University of Turku, Turku, Finland
| | - J Caldeira
- Jorge Caldeira, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Monte de Caparica, Portugal; UCIBIO and LAQV Requimte Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, 2829-516 Caparica, Portugal
| | - A M Azul
- Ana Mano Azul, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Monte de Caparica, Portugal
| | - P Vallittu
- Pekka Vallittu, Department of Biomaterials Science and TCBC, Institute of Dentistry, University of Turku, Turku, Finland; Division of Welfare, City of Turku, Turku, Finland
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11
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Abdelwahed AG, Essam S, Abdelaziz MM. Marginal Adaptation and Depth of Cure of Flowable versus Packable Bulk-fill Restorative Materials: An In Vitro StudyMarginal Adaptation and Depth of Cure of Flowable versus Packable Bulk-fill Restorative Materials: An In Vitro Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: To investigate the marginal adaptation and depth of cure of a flowable bulk-fill giomer (BEAUTIFIL Flow Plus X [BFP]), a flowable bulk-fill resin composite (PALFIQUE BULK FLOW [PBF]) bulk-fill resin composite, a packable bulk-fill giomer (BEAUTIFL-Bulk Restorative [BBR]), and two packable bulk-fill resin composites (X-tra fil [XF]) and (Filtek™ One Bulk Fill Restorative [FOB]).
Materials and Methods: Twenty-five standardized class II cavities were prepared in the occlusomesial surfaces of maxillary premolars. A self-etching dental adhesive was used. All restorative materials were applied, and light cured according to their manufacturer's instructions. The teeth were subjected to 2500 thermal cycles between 5° C and 55° C. Epoxy resin replicas were obtained to examine the marginal by calculating the percentage of the continuous margin over the total margin length. using SEM at 200× magnification. For assessing the depth of cure, fifty specimens with 4 mm height were prepared. Vickers microhardness testing was used to assess the depth of cure was calculating the bottom-to-top ratio of each specimen. If this ratio reaches 0.80 or more, an adequate depth of cure is achieved.
Results: Regarding marginal adaptation, there was no significant difference between different groups before (p=0.398) and after (p=0.644) thermocycling. Within all groups, there was a significant decrease in marginal adaptation after thermocycling (p<0.001). Regarding the depth of cure, all restorative materials achieved the required 0.8 bottom-to-top ratio. There was a significant difference between different groups (p<0.001). The highest value was found in BFP group (0.97±0.02), while the lowest value was found in BBR group (0.81±0.11).
Conclusions: The marginal adaptation and depth of cure of bulk-fill giomer restorative materials are acceptable. Therefore, their use in restoration of 4-mm deep class II cavities is appealing.
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12
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FRANK L, VIEIRA JUNIOR WF, BASTING RT, TURSSI CP, AMARAL FLBD, FRANÇA FMG. Effect of acid challenge and photoactivation distance on microhardness and roughness of flow bulk-fill composite resins. REVISTA DE ODONTOLOGIA DA UNESP 2022. [DOI: 10.1590/1807-2577.03222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract Introduction composite resins are indicated to the reconstruction of proximal walls and the evaluation of properties of flow bulk-fill composite resins exposed to acid challenge is necessary. Objective to evaluate the microhardness and roughness at different depths of photoactivation of bulk-fill flow composites (Filtek Bulk Fill Flow; SureFil SDR Flow; Tetric N Ceram Bulk fill) and conventional composite resin (control, Filtek Z350 XT) subjected to acid challenge. Material and method forty composites brick shaped specimens (3x3x4 mm) were made using a polyacetal matrix. To simulate pH challenges, the samples were immersed in a demineralizing solution. Each sample had Knoop microhardness (KHN) and roughness (Ra) evaluated at three depths (superficial, medium, and cervical), considering the lateral surface of the sample. Data were submitted to Kruskal-Wallis, Friedman's and Dunn's tests with a significance level of 5%. Result comparing the composites among themselves, in superficial (p=0.693), medium (p=0.053) and cervical (p=0.176) regions, there was no difference in the KHN values. There were also no differences in roughness between the composites in superficial (p=0.356), medium (p=0.734) and cervical (p=0.207) regions. Only the Filtek Z350 XT (p=0.027) showed less difference in KHN in the middle region caused by acid challenge. Changes in roughness showed that the greatest difference was at the cervical region for Bulk Fill Flow SDR (p=0.014) and Tetric N-Ceram Bulk Fill (p = 0.003) with an increase after acid challenge. Conclusion after acid challenge, bulk-fill flow composites showed alterations similar to those presented by the conventional nanoparticulate resin composite.
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Affiliation(s)
- Luana FRANK
- Instituto de Pesquisas São Leopoldo Mandic, Brasil
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13
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Kaisarly D, ElGezawi M, Haridy R, Elembaby A, Aldegheishem A, Alsheikh R, Almulhim KS. Reliability of Class II Bulk-fill Composite Restorations With and Without Veneering: A Two-year Randomized Clinical Control Study. Oper Dent 2021; 46:491-504. [PMID: 35486510 DOI: 10.2341/19-290-c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 11/23/2022]
Abstract
Bulk-fill composites are increasingly used in stress-bearing areas in posterior teeth, with a diversity of reports concerning their effectiveness and clinical reliability. The objective of this randomized clinical control study was to investigate the effectiveness of bulk-fill versus veneered bulk-fill Class II composite restorations. A double-blind split-mouth technique was employed in 80 subjects recruited for restoring Class II caries in one molar bilaterally in the same arch following respective inclusion and exclusion criteria and after obtaining written consent. While one molar was randomly restored with bulk-fill composite using the sealed-envelope technique, Tetric N-Ceram Bulk Fill (TBF), the contralateral was restored with a bulk-fill composite veneered with an increment of a heavy-body microhybrid composite-Tetric-Ceram HB (TBF/V). Box-only cavities were prepared and received etch-and-rinse adhesive bonding and Tetric N-Bond treatment before composite insertion. Restorations were assessed at 24 hours, 2 weeks, 6 months, 12 months, and 24 months for esthetic, functional, and biological quality employing the FDI ranking criteria. Friedman repeated-measures analysis of variance, the McNemar test, and the Cohen's kappa statistical test were used for statistical analysis. Over a 24-month interval, none of the test restorations were ranked as clinically unsatisfactory. In terms of functional criteria, clinically excellent restorations were significantly more prevalent in TBF/V than in TBF (p<0.05). For long-term satisfactory performance of Class II bulk-fill composites, an occlusal veneering increment of conventional heavy body microhybrid composite appears to be favorable.
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Affiliation(s)
- D Kaisarly
- *Dalia Kaisarly, BDS, MDSc, PhD, University of Munich, Munich, Germany; Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Saudi Arabia
| | - M ElGezawi
- Moataz ElGezawi, BDS, MDSc, DDSc, Department of Restorative Dental Sciences, College of Dentistry, Imam Abdul Rahman Bin Faisal University, Dammam, Saudi Arabia
| | - R Haridy
- Rasha Haridy, BDS, MScD, PhD, Department of Clinical Dental Sciences, Princess Nourah Bint Abdel Rahman University, Saudi Arabia
| | - A Elembaby
- Abeer Elembaby, BDS, MScD, PhD, Department of Restorative Dental Sciences, College of Dentistry, Imam Abdul Rahman Bin Faisal University, Dammam, Saudi Arabia
| | - A Aldegheishem
- Alhanooof Aldegheishem, BDS, MScD, PhD, Department of Clinical Dental Sciences, Princess Nourah Bint Abdel Rahman University, Saudi Arabia
| | - R Alsheikh
- Rasha Alsheikh, BDS, MScD, PhD, Department of Clinical Dental Sciences, Princess Nourah Bint Abdel Rahman University, Saudi Arabia
| | - K S Almulhim
- Khalid S. Almulhim BDS, MScD, PhD, Department of Clinical Dental Sciences, Princess Nourah Bint Abdel Rahman University, Saudi Arabia
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14
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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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15
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Six-year clinical evaluation of bulk-fill and nanofill resin composite restorations. Clin Oral Investig 2021; 26:417-426. [PMID: 34110494 DOI: 10.1007/s00784-021-04015-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This study aims to compare the performance of a bulk-fill and a nanofill resin composite in class II restorations after 6 years. MATERIALS AND METHODS Fifty patients having at least two class II carious lesions were recruited for the study. One lesion in each patient was randomly assigned to be restored using either the Tetric EvoCeram Bulk Fill (TB) or Filtek Ultimate (FU) resin composites with their respective adhesives. One hundred four restorations were placed by two calibrated operators. Restorations were evaluated at baseline and annually over the course of 6 years by two examiners using modified USPHS criteria. Data were statistically analyzed using the Chi-square and Cochran Q tests (p < 0.05). RESULTS Sixty-six restorations in 33 patients were evaluated after 6 years. Only one restoration was lost from FU group at 5 years. At the end of 6 years, marginal discoloration was observed in three (9.1%) TB and eight (36.4%) FU restorations creating a significant difference between the groups (p < 0.05). The FU group showed a significant increase in marginal discoloration at 6 years from the baseline (p < 0.05). Marginal adaptation was rated as Bravo for 9.1% and 24.2% of TB and FU restorations, respectively (p > 0.05). Significant degradation was observed within each group in terms of marginal adaptation (p < 0.05). There were no statistically significant differences between the groups for the other criteria tested (p > 0.05). CONCLUSIONS Bulk-fill restorations performed better for marginal discoloration. The remaining clinical performance criteria of bulk-fill and nanofill resin composite restorations were similar after 6 years. CLINICAL RELEVANCE Bulk-fill resin might be a better alternative to incrementally placed restorative in terms of marginal discoloration under clinical conditions.
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16
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Kaisarly D, Meierhofer D, El Gezawi M, Rösch P, Kunzelmann KH. Effects of flowable liners on the shrinkage vectors of bulk-fill composites. Clin Oral Investig 2021; 25:4927-4940. [PMID: 33506426 PMCID: PMC8342399 DOI: 10.1007/s00784-021-03801-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 01/19/2021] [Indexed: 01/08/2023]
Abstract
Objectives This investigation evaluated the effect of flowable liners beneath a composite restoration applied via different methods on the pattern of shrinkage vectors. Methods Forty molars were divided into five groups (n = 8), and cylindrical cavities were prepared and bonded with a self-etch adhesive (AdheSe). Tetric EvoCeram Bulk Fill (TBF) was used as the filling material in all cavities. The flowable liners Tetric EvoFlow Bulk Fill (TEF) and SDR were used to line the cavity floor. In gp1-TBF, the flowable composite was not used. TEF was applied in a thin layer in gp2-fl/TEF + TBF and gp3-fl/TEF + TBFincremental. Two flowable composites with a layer thickness of 2 mm were compared in gp4-fl/TEF + TBF and gp5-fl/SDR + TBF. TEF and SDR were mixed with radiolucent glass beads, while air bubbles inherently present in TBF served as markers. Each material application was scanned twice by micro-computed tomography before and after light curing. Scans were subjected to image segmentation for calculation of the shrinkage vectors. Results The absence of a flowable liner resulted in the greatest shrinkage vectors. A thin flowable liner (gp2-fl/TEF + TBFbulk) resulted in larger overall shrinkage vectors for the whole restoration than a thick flowable liner (gp4-fl/TEF + TBF). A thin flowable liner and incremental application (gp3-fl/TEF + TBFincremental) yielded the smallest shrinkage vectors. SDR yielded slightly smaller shrinkage vectors for the whole restoration than that observed in gp4-fl/TEF + TBF. Conclusions Thick flowable liner layers had a more pronounced stress-relieving effect than thin layers regardless of the flowable liner type. Clinical relevance It is recommended to apply a flowable liner (thin or thick) beneath bulk-fill composites, preferably incrementally.
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Affiliation(s)
- Dalia Kaisarly
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Goethestrasse 70, 80336, Munich, Germany. .,Biomaterials Department, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.
| | - D Meierhofer
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Goethestrasse 70, 80336, Munich, Germany
| | - M El Gezawi
- Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - P Rösch
- University of Applied Sciences, Augsburg, Germany
| | - K H Kunzelmann
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Goethestrasse 70, 80336, Munich, Germany
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17
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Par M, Marovic D, Attin T, Tarle Z, Tauböck TT. Effect of rapid high-intensity light-curing on polymerization shrinkage properties of conventional and bulk-fill composites. J Dent 2020; 101:103448. [DOI: 10.1016/j.jdent.2020.103448] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/12/2020] [Accepted: 08/04/2020] [Indexed: 12/17/2022] Open
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18
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Evaluation of the Bond Strength and Cytotoxicity of Alkasite Restorative Material. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10186175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cention N (CN; Ivoclar Vivadent, Schaan, Liechtenstein), advertised as an alkasite, is a bioactive bulk-fill resin-based composite (BF-RBC) with alkaline fillers. This study evaluated the resin-dentin micro-tensile bond strength (μTBS) and cytotoxicity of CN. Methods: Flat dentin surfaces were obtained, bonded with a universal adhesive, and randomly distributed into two groups. CN (group I) and a flowable BF-RBC, namely, Tetric N-Flow Bulk Fill, Ivoclar Vivadent, Schaan, Liechtenstein (group II), were used. After thermocycling, bonded samples were sectioned into micro-beams for μTBS evaluation. Resin-based composite (RBC) discs with a thickness of 2 and 4 mm were tested on human gingival fibroblast cells (HGFCs). Cytotoxicity was assessed by cell viability and growth using AlamarBlue® (Biosource, Camarillo, CA, USA) over a seven-day period. Independent t-test was utilized to statistically analyze μTBS data, while one- and two-way analysis of variance (ANOVA) and Tukey’s post-hoc tests were utilized to analyze the cell viability data. Results: There was no statistically significant difference (p > 0.05) in the μTBS between the flowable BF-RBC and CN. For both materials, the HGFCs were viable, with constant growing over the seven-day period. Conclusion: CN provided a resin-dentin μTBS that was comparable to that provided by the flowable BF-RBC. Both materials showed acceptable cytotoxicity over the seven-day period at a thickness of both 2 and 4 mm.
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Rodrigues MDP, Soares PBF, Gomes MAB, Pereira RA, Tantbirojn D, Versluis A, Soares CJ. Direct resin composite restoration of endodontically-treated permanent molars in adolescents: bite force and patient-specific finite element analysis. J Appl Oral Sci 2020; 28:e20190544. [PMID: 32348440 PMCID: PMC7185981 DOI: 10.1590/1678-7757-2019-0544] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 02/20/2020] [Indexed: 12/14/2022] Open
Abstract
Objective To evaluate the influence of three levels of dental structure loss on stress distribution and bite load in root canal-treated young molar teeth that were filled with bulk-fill resin composite, using finite element analysis (FEA) to predict clinical failure. Methodology Three first mandibular molars with extensive caries lesions were selected in teenager patients. The habitual occlusion bite force was measured using gnathodynamometer before and after endodontic/restoration procedures. The recorded bite forces were used as input for patient-specific FEA models, generated from cone-beam computed tomographic (CT) scans of the teeth before and after treatment. Loads were simulated using the contact loading of the antagonist molars selected based on the CT scans and clinical evaluation. Pre and post treatment bite forces (N) in the 3 patients were 30.1/136.6, 34.3/133.4, and 47.9/124.1. Results Bite force increased 260% (from 36.7±11.6 to 131.9±17.8 N) after endodontic and direct restoration. Before endodontic intervention, the stress concentration was located in coronal tooth structure; after rehabilitation, the stresses were located in root dentin, regardless of the level of tooth structure loss. The bite force used on molar teeth after pulp removal during endodontic treatment resulted in high stress concentrations in weakened tooth areas and at the furcation. Conclusion Extensive caries negatively affected the bite force. After pulp removal and endodontic treatment, stress and strain concentrations were higher in the weakened dental structure. Root canal treatment associated with direct resin composite restorative procedure could restore the stress-strain conditions in permanent young molar teeth.
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Affiliation(s)
- Monise de Paula Rodrigues
- Departamento de Dentística e Materiais Odontológicos, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
| | - Priscilla Barbosa Ferreira Soares
- Departamento de Periodontia e Implantologia, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
| | - Márcio Alex Barros Gomes
- Departamento de Dentística e Materiais Odontológicos, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
| | - Renata Afonso Pereira
- Departamento de Dentística e Materiais Odontológicos, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
| | - Daranee Tantbirojn
- Department of Restorative Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Antheunis Versluis
- Department of Memphis, College of Dentistry, University of Tennessee Health Science Center, Tennessee, USA
| | - Carlos Jose Soares
- Departamento de Dentística e Materiais Odontológicos, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
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