Evaluation of the effect of water on three different light cured composite restorative materials stored in water: an in vitro study

Characterization of the Mechanical Properties, Water Sorption, and Solubility of Antibacterial Copolymers of Quaternary Ammonium Urethane-Dimethacrylates and Triethylene Glycol Dimethacrylate

The use of dental composites based on dimethacrylates that have quaternary ammonium groups is a promising solution in the field of antibacterial restorative materials. This study aimed to investigate the mechanical properties and behaviors in aqueous environments of a series of six copolymers (QA:TEG) comprising 60 wt.% quaternary ammonium urethane-dimethacrylate (QAUDMA) and 40 wt.% triethylene glycol dimethacrylate (TEGDMA); these copolymers are analogous to a common dental copolymer (BG:TEG), which comprises 60 wt.% bisphenol A glycerolate dimethacrylate (Bis-GMA) and 40 wt.% TEGDMA. Hardness (HB), flexural strength (FS), flexural modulus (E), water sorption (WS), and water solubility (SL) were assessed for this purpose. The pilot study of these copolymers showed that they have high antibacterial activity and good physicochemical properties. This paper revealed that QA:TEGs cannot replace BG:TEG due to their insufficient mechanical properties and poor behavior in water. However, the results can help to explain how QAUDMA-based materials work, and how their composition should be manipulated to produce the best performance. It was found that the longer the N-alkyl chain, the lower the HB, WS, and SL. The FS and E increased with the lengthening of the N-alkyl chain from eight to ten carbon atoms. Its further extension, to eighteen carbon atoms, caused a decrease in those parameters.

Synthesis of Novel Dental Nanocomposite Resins by Incorporating Polymerizable, Quaternary Ammonium Silane-Modified Silica Nanoparticles

Diverse approaches dealing with the reinforcement of dental composite resins with quaternary ammonium compounds (QAC) have been previously reported. This work aims to investigate the physicochemical and mechanical performance of dental resins containing silica nanofillers with novel QAC. Different types of quaternary ammonium silane compounds (QASiC) were initially synthesized and characterized with proton nuclear magnetic resonance (¹H-NMR) and Fourier transform infrared (FTIR) spectroscopy. Silica nanoparticles were surface modified with the above QASiC and the structure of silanized products (S.QASiC) was confirmed by means of FTIR and thermogravimetric analysis. The obtained S.QASiC were then incorporated into methacrylate based dental resins. Scanning electron microscopy images revealed a satisfactory dispersion of silica nanoclusters for most of the synthesized nanocomposites. Curing kinetics disclosed a rise in both the autoacceleration effect and degree of conversion mainly induced by shorter QASiC molecules. Polymerization shrinkage was found to be influenced by the particular type of S.QASiC. The flexural modulus and strength of composites were increased by 74% and 19%, while their compressive strength enhancement reached up to 19% by adding 22 wt% S.QASiC nanoparticles. These findings might contribute to the proper design of multifunctional dental materials able to meet the contemporary challenges in clinical practice.

Effect of argon plasma on repair bond strength using nanofilled and microhybrid composites

OBJECTIVES

To evaluate the effect of atmospheric pressure plasma (PLA), sandblasting (SAN), silanization (SIL) and hydrophobic bonding resin (HBR) on the micro-shear bond strength (MSBS) of fresh nanofilled (NF) or microhybrid (MH) composites to water-aged nanofilled composite.

MATERIALS AND METHODS

NF plates were fabricated and stored in distilled water for 4 months. The aged plates were assigned to the groups (n = 6): 1- untreated; 2- SAN + SIL + HBR; 3- HBR; 4- PLA + HBR; 5- SAN + HBR; 6- SAN + PLA + HBR; and 7- PLA. Two fresh composite cylinders were constructed on each plate with NF or MH composites and tested after 24 h or 1 year of water-storage, using the MSBS testing. Data were analyzed by three-way ANOVA and Tukey test (α = 0.05).

RESULTS

NF yielded better outcomes than MH at 24 h, which was not observed at 1 year. HBR showed the highest MSBS results, while untreated and PLA groups yielded the lowest one. MSBS reduced for all groups after 1 year.

CONCLUSIONS

Only HBR can obtain good MSBS results, while PLA alone was not beneficial. After 1 year, a reduction in repair MSBS was observed and the type of composite did not influence the results.

CLINICAL RELEVANCE

The repair technique can be simplified with the use of only an adhesive and macromechanical retentions in the old composite, regardless the type of fresh composite.

Effect of water storage and thermocycling on light transmission properties, translucency and refractive index of nanofilled flowable composites

The effect of 1-week water storage and subsequent 10,000 thermal cycles on light transmission properties (straight-line transmission (G0), diffusion (DF), the amount of transmitted light (AV)), translucency parameter (TP) and refractive index (RI) of four nanofilled flowable composites was examined. The composites included Filtek Supreme Ultra Flowable Restorative (FSU), Estelite Flow Quick (EFQ), Estelite Universal Flow, (EUF), and Clearfil Majesty ES Flow (ESF), all of A3 shade. For composites with lower filler load (FSU, EFQ), water storage increased G0, AV and TP, but subsequent thermocycling decreased them. An opposite tendency was found for DF. Materials with higher filler load (EUF, ESF) were not significantly affected by aging conditions. RI of EFQ and EUF containing bisphenol A polyethoxy methacrylate (Bis-MPEPP) increased significantly after thermocycling. Additionally, morphological changes were observed using scanning electron microscopy which revealed cracks within nanocluster fillers and dislocation of particles in FSU and EFQ after thermocycling.

Discoloration of Resin Composites Induced by Coffee and Tomato Sauce and Subjected to Surface Polishing: An In Vitro Study

BACKGROUND The purpose of this study is to evaluate and compare color stability of 3 resin based restorative materials when immersed into staining media at 0, 3, 30, 45, 60, and 75 days, and to assess the efficacy of surface polishing in reducing possible discoloration. MATERIAL AND METHODS Ninety composite discs were prepared in a custom-made mold (5 mm diameter and 2 mm thick) from 3 different light cured composites (Filtek™ Z250, Harmonize™, and G-aenial). Color differences of all specimens were measured by a spectrophotometer according to the CIE L*a*b* system. After baseline color measurements, 30 discs from each composite group were randomly divided into 3 subgroups of 10 specimens each. Subgroups (n=10) were immersed for 75 days into different staining solutions: coffee, tomato sauce, and distilled water (control). Solutions were changed every week and color measurements were repeated every 15 days. At day 75, color measurements of the specimens were performed before and after surface polishing with aluminum oxide discs. The experimental data were statistically evaluated using repeated measures one-way ANOVA test followed by Tukey's multiple pairwise comparison with a significance level of 5%. RESULTS Of the 3 composites, G-aenial reported the highest color change deviation when immersed into coffee (ΔE=8.674), and tomato sauce (ΔE=7.737) at day 75, followed by Harmonize that also exhibited a significant difference for coffee (ΔE=4.7) and tomato sauce (ΔE=3.8) when compared to distilled water. While Filtek™ Z250 did not show any significant difference between the 3 storage solutions (P>0.05). Only G-aenial had significant color change (P<0.05) after polishing with aluminum oxide discs for all tested samples, whereas Filtek™ Z250 and Harmonize presented no significant difference after surface polishing (P>0.05). CONCLUSIONS Under the tested experimental conditions, Filtek™ Z250, among the 3 resin-based composites, exhibited the highest color stability when subjected to coffee and tomato sauce as well. Whereas, G-aenial presented the highest color deviation when immersed in both staining media. Surface polishing effectively reduced coffee and tomato sauce discolorations for G-aenial's specimens and had no significant effect regarding Filtek™ Z250 and Harmonize.

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.

The Influence of Water Sorption of Dental Light-Cured Composites on Shrinkage Stress

The contraction stress generated during the photopolymerization of resin dental composites is the major disadvantage. The water sorption in the oral environment should counteract the contraction stress. The purpose was to evaluate the influence of the water sorption of composite materials on polymerization shrinkage stress generated at the restoration-tooth interface. The following materials were tested: Filtek Ultimate, Gradia Direct LoFlo, Heliomolar Flow, Tetric EvoCeram, Tetric EvoCeram Bulk Fill, Tetric EvoFlow, Tetric EvoFlow Bulk Fill, X-tra Base, Venus BulkFil, and Ceram.X One. The shrinkage stress was measured immediately after curing and after: 0.5 h, 24 h, 72 h, 96 h, 168 h, 240 h, 336 h, 504 h, 672 h, and 1344 h by means of photoelastic study. Moreover, water sorption and solubility were evaluated. Material samples were weighted on scale in time intervals to measure the water absorbency and the dynamic of this process. The tested materials during polymerization generated shrinkage stresses ranging from 6.3 MPa to 12.5 MPa. Upon water conditioning (56 days), the decrease in shrinkage strain (not less than 48%) was observed. The decrease in value stress in time is material-dependent.

Effect of Surface Treatment, Silane, and Universal Adhesive on Microshear Bond Strength of Nanofilled Composite Repairs

Purpose: The aim of this study was to evaluate the effect of surface treatment and universal adhesive on the microshear bond strength of nanoparticle composite repairs.

Methods: One hundred and forty-four specimens were built with a nanofilled composite (Filtek Supreme Ultra, 3M ESPE). The surfaces of all the specimens were polished with SiC paper and stored in distilled water at 37°C for 14 days. Half of the specimens were then air abraded with Al2O3 particles and cleaned with phosphoric acid. Polished specimens (P) and polished and air-abraded specimens (A), respectively, were randomly divided into two sets of six groups (n=12) according to the following treatments: hydrophobic adhesive only (PH and AH, respectively), silane and hydrophobic adhesive (PCH, ACH), methacryloyloxydecyl dihydrogen phosphate (MDP)–containing silane and hydrophobic adhesive (PMH, AMH), universal adhesive only (PU, AU), silane and universal adhesive (PCU, ACU), and MDP-containing silane and universal adhesive (PMU, AMU). A cylinder with the same composite resin (1.1-mm diameter) was bonded to the treated surfaces to simulate the repair. After 48 hours, the specimens were subjected to microshear testing in a universal testing machine. The failure area was analyzed under an optical microscope at 50× magnification to identify the failure type, and the data were analyzed by three-way analysis of variance and the Games-Howell test (α=0.05).

Results: The variables “surface treatment” and “adhesive” showed statistically significant differences for p&lt;0.05. The highest mean shear bond strength was found in the ACU group but was not statistically different from the means for the other air-abraded groups except AH. All the polished groups except PU showed statistically significant differences compared with the air-abraded groups. The PU group had the highest mean among the polished groups. Cohesive failure was the most frequent failure mode in the air-abraded specimens, while mixed failure was the most common mode in the polished specimens.

Conclusions: While air abrasion with Al2O3 particles increased the repair bond strength of the nanoparticle composite, the use of MDP-containing silane did not lead to a statistically significant increase in bond strength. Silane-containing universal adhesive on its own was as effective as any combination of silane and adhesive, particularly when applied on air-abraded surfaces.

The effect of instrument lubricant on the diametral tensile strength and water uptake of posterior composite restorative material

OBJECTIVES

This in-vitro study investigated the effect of 'instrument lubricants' used during placement of composite restorative material, on the diametral tensile strength (DTS) and water uptake of composite specimens.

METHODS

300 posterior composite cylindrical specimens were manufactured: 60 with each instrument lubricant (ethanol, 3-step, 2-step and 1-step 'bonding agent') and 60 with no lubricant (controls). Each set of 60 specimens was evenly allocated to one of the following test groups (n=100/group): Group 1 - tested for DTS immediately after manufacture; Groups 2 and 3 - tested for DTS after immersion in phosphate-buffered saline (PBS) for 1 and 12-weeks respectively, using a Universal Instron machine. Water uptake was assessed gravimetrically. Data were statistically analysed with two-way ANOVA and Tukey's post hoc test (α=0.05).

RESULTS

The mean DTS and percentage weight change of composite specimens ranged between 32.49-53.14MPa and 0.51-1.36% and varied with lubricant used and time incubated in PBS. All control groups exhibited significantly higher DTS (MPa) (groups 1-3: 53.17±1.78; 50.64±1.85; 45.17±1.77) and lower percentage weight change (groups 2-3: 0.51±0.03; 0.61±0.01) than specimens placed with an instrument lubricant, with significant differences between certain lubricant groups.

CONCLUSION

Data from the present study suggest that the use of instrument lubricant may adversely effect the DTS and water uptake of composite restorative material.

CLINICAL SIGNIFICANCE

The use of instrument lubricants to aid composite placement is widespread however based on the data obtained it is suggested that discontinuing or limiting the use of instrument lubricants, and if necessary using the 'bonding agent' from a 3-step adhesive system is recommended as results suggest this has the least deleterious effect upon material properties.​.

Evaluation of Flexural, Diametral Tensile, and Shear Bond Strength of Composite Repairs

Objective

Repairing composite restorations may be a more conservative treatment than replacing the entire restoration. The objective of this in vitro study was to determine the best repair method by measuring flexural, diametral tensile, and shear bond strength of repaired composites in which the surfaces were treated with chemical primers (Add & Bond or Silane Bond Enhancer), a bonding agent (Optibond Solo Plus [OBSP]), or mechanical retention with a bonding agent.

Methods

Filtek Supreme Ultra shade B1B was placed in special molds to fabricate specimens that served to test the flexural, diametral tensile, or shear strength of the inherent resin substrate. The same molds were modified to make specimens for testing repair strength of the resin. Repairs were made immediately or after aging in deionized water at 37°C for seven days. All repair sites were finished with coarse Sof-Lex discs to simulate finishing new restorations or partially removing aged restorations. Repair surfaces were treated with one of the following: 1) phosphoric-acid etching and OBSP; 2) Add & Bond; 3) phosphoric-acid etching, Silane Bond Enhancer, and OBSP; or 4) quarter round bur, phosphoric-acid etching, and OBSP. Specimens were placed back in the original molds to fabricate specimens for diametral tensile or flexural testing or in an Ultradent jig to make specimens for shear bond testing. Composite resin in shade B5B was polymerized against the treated surfaces to make repairs. Two negative control groups for the three testing methods consisted of specimens in which repairs were made immediately or after aging without any surface treatments. Controls and experimental repairs were aged (water 37°C, 24 hours) before flexural, diametral tensile, or shear testing in an Instron Universal testing machine at a crosshead speed of 0.5 mm/min.

Results

Experimental flexural repair strengths ranged from 26.4% to 88.6% of the inherent substrate strength. Diametral tensile repair strengths ranged from 40% to 80% of the inherent substrate strength, and shear bond strength repairs ranged from 56% to 102%. Geometric means were statistically analyzed with two-way analysis of variance on their log-transformed values. Significant differences were determined using Tukey honestly significant difference (p&lt;0.05).

Conclusions

Depending on the mechanical property being tested, surface treatments produced different results. OBSP produced more consistent results than chemical primers.

Short fiber reinforced composite in restoring severely damaged incisors

OBJECTIVE

To evaluate the static-load-bearing capacity of severely damaged endodontically-treated incisors restored with short fiber composite (SFC) as a direct post-core-crown complex and to investigate the effect of SFC on the failure mode of the restorations.

MATERIALS AND METHODS

The clinical crowns of 40 maxillary incisors were prepared by cutting 2/3 parts of the crown horizontally. Five groups were fabricated (n = 8) using the direct technique; Group A: Crown restorations from conventional composite (CC); Group B: FRC-posts with core-crown restorations from CC; Group C: Crown restorations from SFC; Group D: FRC-posts and core-crown restorations from SFC; Group E: Post-core-crown restorations from SFC. The posts were cemented with dual-cure resin cement. The restorations were polymerized with a hand-light curing unit. All restored teeth were stored in distilled water at 37°C for 5 days before they were statically loaded. Initial fracture (IF) and final fracture (FF) were recorded. Failure modes were visually examined.

RESULTS

ANOVA revealed that SFC restorations had greater IF (469.8 N) and FF load values (515.8 N) (p < 0.05) than the CC restorations (164.8 N). No significant difference for both IF and FF was observed among groups C, D and E. Group E revealed a more favorable fracture mode than any other material combination used.

CONCLUSION

The use of SFC as a restorative material for fabricating the direct composite post-core-crown restorations of severely damaged incisors provided improved load-bearing capacity than CC used alone or with FRC post reinforcement.