Fiber-Reinforced Composites for Dental Applications

Clinical performance of polyethylenefiber reinforced resin composite restorations in endodontically treated teeth: (a randomized controlled clinical trial)

AIM

The purpose of this study was to evaluate the performance of polyethylene fiber reinforced resin composite fillings compared to bulk fill resin composite fillings in endodontically treated teeth over a two-year monitoring period.

METHOD

A total of 240 individuals with endodontically treated lower molars and a moderate amount of tooth structure were divided into two equal groups of 120 each. One group received polyethylene fiber reinforced bulk fill resin composite restorations while the other group received only bulk fill resin composite restorations, both applied as per manufacturer guidelines. Two proficient experienced blinded assessors assessed the restorations using modified USPHS criteria at baseline, 6, 12, and 24 months.

STATISTICAL ANALYSIS USED

Data analysis involved the utilization of Mann-Whitney U, Friedman's test, and Nemenyi post hoc test, with age data being displayed as mean and standard deviation. The significance level was established as p < 0.05, and R software was utilized for statistical analysis.

RESULTS

There were no notable distinctions in any parameters or scores between the intervention and comparator groups at various time points. Alpha scores were present for retention, gross fracture, and secondary caries at all follow up intervals.

CONCLUSION

Both direct resin composite restorations reinforced with polyethylene fibers and direct bulk fill resin composite restorations placed in endodontically treated molars with moderate remaining tooth structure demonstrated satisfactory clinical outcomes during a 24-month follow-up period.

CLINICAL RELEVANCE

Bulk fill resin composites directly placed in endodontically treated molars with moderate remaining tooth structure showed promise as a treatment option over a two-year period.

CLINICAL TRIAL REGISTRATION

(06-01-2022) on https://ClinicalTrials.gov with the ID (NCT05180903).

Effect of cleaning solution on surface properties of 3D-printed denture materials

PURPOSE

To evaluate the effect of cleaning solutions on surface properties of 3D-printed resins.

MATERIALS AND METHODS

Seven different resin materials for denture base and teeth were used in the form of 280 half-disks. Samples were randomly assigned to two cleaning groups (FD, FreshDent; PO, Polydent), with daily 2- or 3-min immersion followed by water storage, repeated for 30 days. Samples were then cleaned in an ultrasonic bath with water and analyzed for surface roughness (Keyence, VHX-7000N) and hardness (Shimadzu, HMV-2 series). The pH of cleaning solutions was analyzed over 5-min and the surface morphology of specimens was analyzed via scanning electron microscopy (SEM). Statistical analysis used two-way ANOVA (α = 0.05).

RESULTS

Surface roughness of base materials was significantly affected (p < 0.001), whereas roughness of teeth materials was not. As for hardness, there was a significant interaction between materials and cleaning solution for both, base (p < 0.001) and teeth (p < 0.001). For teeth materials, PO significantly increased Denture's (Dentca) hardness and decreased that of Rodin's (Pac Dent), while PO significantly increased Rodin's Base (Pac Dent) hardness. The hardness of Flexcera Ultra (Envision Tec), Glidewell (Glidewell), Lucitone (Dentsply Sirona), and NextDent (NextDent) teeth and base materials were not affected by the cleaning solution. Overall, the pH of FD averaged 7.3 and PO averaged 6.6. All the SEM images indicated surface irregularities after immersion in either FD or PO.

CONCLUSIONS

One-month of storage and cyclic cleaning of 3D- printed resins did not affect surface roughness but had a significant impact on hardness. The cleaning solutions' effect was not homogeneous among materials.

Effects of aligner activation and power arm length and material on canine displacement and periodontal ligament stress: a finite element analysis

BACKGROUND

This study aimed to assess the impact of aligner activation and power arm length and material on canine and aligner displacement, von Mises stress in the power arm, and principal stress in the periodontal ligament (PDL) during canine tooth distalization using finite element analysis (FEA). The effects of aligner activation and power arm length were primary outcomes, while the effect of the power arm material was a secondary outcome.

METHODS

Aligner activation (0.1 mm or 0.2 mm) was applied without using a power arm in two models. The effects of aligner activation, power arm length (12, 13, or 14 mm) and power arm material (stainless steel [SS] or fiber-reinforced composite [FRC]) on canine distalization were investigated in 12 models by evaluating displacement and stress via ALTAIR OptiStruct analysis.

RESULTS

Greater canine displacement was observed in all models with 0.2 mm than 0.1 mm of aligner activation. When models with the same aligner activation were compared, reduced mesiodistal tipping, increased palatal tipping, and increased extrusion of the canine cusp were observed with increasing power arm length. Moreover, the von Mises stress increased as the power arm length increased. Increasing the aligner activation and power arm length increased the maximum principal stress in the PDL. Power arms of the same length in both materials showed the same results in terms of canine displacement, clear aligner displacement, and maximum principal stress in the PDL. However, under conditions of equal length and aligner activation, the von Mises stress of the SS power arm was higher than that of the FRC power arm.

CONCLUSION

Using a power arm in canine distalization reduced mesiodistal tipping but increased palatal tipping and extrusion of the canine cusp. Aligner activation and additional force increased tooth movement and principal stress in the canine PDL. FRC power arms exhibited less von Mises stress than SS power arms.

Fracture Resistance of Fiber-Reinforced Composite Restorations: A Systematic Review and Meta-Analysis

Composite resin is universally used for posterior teeth restorations. Fibers have been suggested for the mechanical improvement of the restorations. This study assessed the fracture resistance of class II fiber-reinforced composite restorations and compared it with the fracture resistance of three control groups: (1) healthy teeth, (2) non-fiber-reinforced restorations and (3) unrestored cavities. A search was performed using PubMed, Web of Science and Google Scholar from 15 May to 12 June 2023. Only in vitro studies from the last 10 years were included for this systematic analysis. This study was registered in the PROSPERO database, it followed PRISMA guidelines and the risk of bias was assessed using the QUIN tool. Fracture resistance median values, in Newtons (N), were calculated for the experimental and control groups (95% confidence interval). For pairwise comparison, nonparametric tests (p < 0.05) were applied. Twenty-four in vitro studies met the inclusion criteria. The fracture resistance of the experimental group was 976.0 N and differed (p < 0.05) from all controls. The experimental group showed lower values of fracture resistance than healthy teeth (1459.9 N; p = 0.048) but higher values than non-fiber-reinforced restorations (771.0 N; p = 0.008) and unrestored cavities (386.6 N; p < 0.001). In vitro systematic outcomes evidenced that glass and/or polyethylene fibers improved the fracture resistance of composite restorations.

Unlocking Endocrown Restoration Expertise Among Dentists: Insights from a Multi-Center Cross-Sectional Study

BACKGROUND This study, employing an online questionnaire, aimed to assess and contrast the awareness, knowledge, and perceptions of dentists in Saudi Arabia (SA) regarding endocrowns (EC) as post-endodontic restorations with those of dentists educated in various other countries. MATERIAL AND METHODS We conducted a cross-sectional survey among dental interns and practicing dentists in government facilities, private dental centers, and dental colleges in SA, including participants of diverse nationalities. We disseminated validated, closed-ended questionnaires through WhatsApp via Google Forms. The Chi-square test was applied to assess associations between categorical variables, with a P-value of ≤0.05 indicating statistical significance. RESULTS The majority of participants (61.2%) indicated that EC restorations are best suited for molar teeth. Furthermore, 69.6% asserted that the primary objective of employing EC is to accomplish minimally invasive preparations while preserving the existing tooth structure. Among the responses, 68.3% pinpointed debonding of ECs as a significant cause of failure. Notably, substantial differences were observed in responses concerning the knowledge or practice of EC across various factors such as gender, educational attainment, country of graduation, and workplace. CONCLUSIONS The findings reveal a comparatively low adoption of ECs among the participants, irrespective of experience or country of education. This underscores the need for incorporating ECs into dental curricula through theoretical and clinical discussions or considering them as a subject for post-graduate continuing education programs.

Biocompatibility of fiber-reinforced composite (FRC) and woven-coated FRC: an in vivo study

OBJECTIVES

To investigate biocompatibility and bone contact area of FRC and woven-coated FRC (FRC-C) in rats.

MATERIALS AND METHODS

Sixty rats were allocated to three groups: FRC (n=20), FRC-C (n=20), and control group (n=20). Subgroups were determined as 4th (n=10) and 12th weeks (n=10). The specimens were placed in the femur of rats. In the control group, the bone defects were left empty and sutured. Four and 12 weeks after implantation, the rats were sacrificed. Histopathological examinations were performed in a semi-quantitative manner. Twenty rats (n=20) were used for scanning electron microscopy (SEM) examination. Bone contact surfaces were calculated in SEM analysis. A chi-square test was performed to analyze the data.

RESULTS

No statistical difference was detected between the 4th and 12th weeks in the quality of bone union. Quality of bone union was lower in FRC compared to the control group in the 4th week (p=0.012) and the 12th week (p=0.017). The periosteal reaction at the 12th week was lower in FRC than in the control group (p=0.021). Bone contact of FRC and FRC-C was 85.5% and 86.3%, respectively.

CONCLUSIONS

FRC and FRC-C were biocompatible and showed no inflammation. The woven coating did not increase the quality of bone union and bone contact area, while not reducing biocompatibility.

CLINICAL RELEVANCE

The biocompatibility and good bone response of the woven glass fiber net were demonstrated to have the potential as a scaffold for the augmentation of alveolar bone deficiencies and the reconstruction of maxillofacial defects.

Reconstruction of Natural Smile and Splinting with Natural Tooth Pontic Fiber-Reinforced Composite Bridge

Teeth replacement is challenging in old patients with severe periodontal disease, limiting prosthetics treatment options. Here, we report a fiber-reinforced composite (FRC) resin bridge using natural tooth pontic in a patient with severe periodontitis. A 60-year-old lady complaining of teeth mobility was diagnosed with severe periodontitis, recession, bone loss, and crowding in the anterior maxillary teeth. Due to a hopeless periodontal prognosis, lateral incisors were extracted and sectioned using a cylindrical diamond bur. The pulp chamber was debrided and filled with self-adhesive flowable composite resin. After three weeks, the pontics were fixed in proximal contact areas, and the FRC bridge was fabricated directly using the resin fiber strip followed by occlusion adjustment, finishing, and polishing. Esthetic, occlusion, and periodontal status were re-evaluated after six months. Here, FRC using natural pontic could successfully reconstruct a natural smile, splint the adjacent teeth, eliminate crowding, and provide stable occlusion. Therefore, this method may be considered for similar cases.

Post Placement and Restoration of Endodontically Treated Canines: A Finite Element Analysis Study

The purpose of this study was to show the improved outcomes of restoring endodontically treated teeth with fiberglass posts compared to restorations using metal posts. In our study, we used the Finite Element Method (FEM), which is based on the principle that a physical model that supports a given load distributes the stress throughout its volume. We sought to assess what stress results in a tooth when it is restored using a fiberglass post compared to restoration using a metal post. The finite element analysis showed that a system consisting of a tooth with a fiberglass post is more stable in terms of the maximum stress than a system consisting of a tooth with a metal post. The maximum displacements and deformations were obtained in the case of a canine restored with a fiberglass post, which showed that this system had a high elasticity, therefore, higher strength than a canine restored with a metal post, which had high rigidity.

Fiber Post Removal Using a Conservative Fully Guided Approach: A Dental Technique

This report describes the usefulness of an endodontic template for the removal of a fiber post. A 40-year-old man presented with discomfort in the maxillary left canine. Clinical and radiographic examinations showed tooth #23 with a permanent core material retained with fiber post along with a persistent apical radiolucency. Among the various treatment modalities, nonsurgical root canal retreatment with fiber post removal using a conservative fully guided approach was proposed. After obtaining both the cone-beam computed tomographic images and the cast surface scan, their data were merged using implant planning software (ImplaStation for Windows x64 Bit Beta Version, ProDigiDent, Miami, Florida, USA) and superimposed. The drilling space was planned based on the location, diameter, and apical extent of the fiber post and was virtually overlapped and transferred clinically using a resin template to drill through the fiber post. With guides in position over the rubber dam, drilling was made with increments of 2 mm using a size 4 long-shank round bur (Thomas, Bourges, France) until it exposed the coronal gutta-percha. As soon as the canal was located, K3 rotary files (Sybron Endo, Orange, USA) were used along with chloroform to remove the old obturating materials. Then, additional shaping and cleaning were done with ProTaper Next rotary files (Dentsply Sirona, Ballaigues, Switzerland), sizes X2 and X3, and 5.25% NaOCl irrigation, respectively. The root canal was then dried with paper points and obturated with gutta-percha and AH Plus sealer (Dentsply Sirona, Ballaigues, Switzerland) using the continuous-wave compaction technique. Finally, the tooth was temporarily restored using the double seal technique with zinc oxide and zinc sulfate-based temporary material (Cavit W; 3M ESPE, St. Paul, MN, USA) and resin-modified glass ionomer material (Photac Fil; ESPE, Norristown, PA, USA) filling materials and referred for the final restoration.

Influence of Stress Level and Fibre Volume Fraction on Fatigue Performance of Glass Fibre-Reinforced Polyester Composites

Fibre-reinforced polymeric composite materials are becoming substantial and convenient materials in the repair and replacement of traditional metallic materials due to their high stiffness. The composites undergo different types of fatigue loads during their service life. The drive to enhance the design methodologies and predictive models of fibre-reinforced polymeric composite materials subjected to fatigue stresses is reliant on more precise and reliable techniques for assessing their fatigue life. The influences of fibre volume fraction and stress level on the fatigue performance of glass fibre-reinforced polyester (GFRP) composite materials have been studied in the tension–tension fatigue scenario. The fibre volume fractions for this investigation were set to: 20%, 35%, and 50%. The tensile testing of specimens was performed using a universal testing machine and the Young’s modulus was validated with four different prediction models. In order to identify the modes of failure as well as the fatigue life of composites, polyester-based GFRP specimens were evaluated at five stress levels which were 75%, 65%, 50%, 40%, and 25% of the maximum tensile stress until either a fracture occurred or five million fatigue cycles was reached. The experimental results showed that glass fibre-reinforced polyester samples had a pure tension failure at high applied stress levels, while at low stress levels the failure mode was governed by stress levels. Finally, the experimental results of GFRP composite samples with different volume fractions were utilized for model validation and comparison, which showed that the proposed framework yields acceptable correlations of predicted fatigue lives in tension–tension fatigue regimes with experimental ones.

An Interdisciplinary Study Regarding the Characteristics of Dental Resins Used for Temporary Bridges

Background and Objectives: The surface condition of the materials that are used for temporary prostheses influences their microbial colonization, with a direct impact on the oral tissues. This study aims at a comparative analysis of three types of resins for temporary bridges using conventional and digital technologies. The attention was focused on the analysis of the surface characteristics and mechanical strength of these materials. Materials and Methods: The surface condition was assessed for three distinct materials both before and after polishing- heat-curing resin Superpont C + B (SpofaDental, Jicin, Czech Republic) used unconventional technology, Zotion dental milling polymethyl methacrylate (PMMA) block (Zotion, Chongqing, China) for provisional crowns/bridges used in digital subtractive technologies and Freeprint Temp (Detax GmbH & Co. KG, Ettlingen, Germany) resin for temporary crowns and bridges that are used in 3D printing technologies. The two-way ANOVA analysis indicated that polishing leads to a statistically significant increase in roughness coefficients for all the three resins that were tested (p < 0.001). While the highest roughness coefficients were displayed in the 3D cured sample, the largest decrease was reported by the milled sample Results: The results revealed that surface roughness was significantly influenced by both the type of resin that was used (p < 0.001) and the treatment that was induced by finishing and polishing (p < 0.001). Similar p-values were obtained for each of the three resins. Conclusions: The results demonstrated a significant optimization of the surfaces after finishing and polishing and statistically significant differences between the surface parameters and the mechanical properties of the samples. The low values of the roughness and the acceptable values of the mechanical resistance for the conventional samples indicate these materials for the long-term temporary bridge’s realization, allowing the correct restoration of the functions and the rehabilitation at the oral level.

Accuracy of Digital Impression Taking with Intraoral Scanners and Fabrication of CAD/CAM Posts and Cores in a Fully Digital Workflow

Current intraoral scanners (IOS) enable direct impression taking for computer-aided de-sign/computer-aided manufacturing (CAD/CAM) posts and cores (P+C) with subsequent milling out of monolithic materials. The aim of this in vitro study was to systematically investigate the accuracy of CAD/CAM-P+C in a fully digital workflow, considering different IOS impression methods (Primescan (PRI), Trios4 without (TRI) and with scanpost (TRI+SP)) (Part A), and CAD/CAM milling of zirconium dioxid (ZIR) and resin composite (COM)-P+C (Part B). Five human models were developed in this study. Micro-CT imaging was used as a reference (REF). For Part A, the models were scanned 12 times for each impression method. Then, IOS datasets (n = 180) were superimposed with REF, and scan accuracy was determined using 3D software (GOMInspect). For Part B, one CAD/CAM-P+C (n = 30) was milled for each model, impression method, and material. The triple-scan method was applied using an industrial scanner (ATOS) to determine the accuracy of the fit. Statistical analysis was performed using analysis of variance (ANOVA, p < 0.05). Part A showed for PRI significantly lower accuracy than TRI and TRI+SP (p < 0.05). The data of Part B revealed significantly higher accuracy for ZIR than for COM (p < 0.05). Within the limitations of this study, CAD/CAM-P+C of the ZIR can be recommended for fabrication in a fully digital workflow regarding the accuracy of fit.

Flexural Strength of Dental Fiber Composite Post Manufactured with a Novel Approach

Thermoplastic resin fiber composites have an easy fabrication process, good mechanical properties, and compatible stiffness to tooth dentin. However, they have not yet attracted much interest in the field of dentistry. The current study was carried out to test a new proposed approach to manufacture a fiber reinforced composite endodontic post and evaluate its flexural strength through a two-point inclined loading test. The proposed fiber post manufacture approach depends upon a braiding technique of the glass fibers’ (GF) reinforcing component with thermoplastic polypropylene (PP) resin fibers that will later represent the resin matrix after thermal melting. Posts were made of different core (70%) and sheath (30%) construction (PP/GF ratios) using three different GF types and seizing pre-treatment to both fiber types. Two-point inclined loading test at 45 °C applied force angle was used to test the posts’ flexural strength. Fiber posts (1.6 mm in diameter) with pure GF (de-sized starch E-GF and pre-silanized S-GF) core, and sheath construction with higher PP/GF ratios, showed the significantly highest two-point bending strength (56.67 ± 4.89 and 53.96 ± 1.81 MPa, respectively), among experimental posts groups (except for the commercial control posts). However, posts with PP core type showed the lowest values (21.59 ± 1.86 and 16.54 ± 1.94 MPa for de-sized and E-glass sheath fibers, respectively). Based on these findings, the proposed approach was reliable in producing fiber-reinforced composite post with the desired dimensions and fiber distribution. Post construction with a pure GF core and higher PP/GF ratio showed considerably higher flexural strength and GF volume fraction comparable to commercial available post types.

Utilization of a 3D Printed Orthodontic Distalizer for Tooth-Borne Hybrid Treatment in Class II Unilateral Malocclusions

This paper introduces a novel method of 3D designing and 3D printing of a hybrid orthodontic tooth-borne personalized distalizer for treatment of unilateral Class II malocclusion. Research objectives were to clinically utilize 3D printed distalizers, appraise feasibility of this technique and compare two different biocompatible photopolymers (white and transparent). Frequency of distalizers’ debonding and patients’ aesthetical perception was evaluated on the set of 12 complete orthodontic treatments. The mean duration of treatment period with a bonded distalizer was 6.4 months. All cases were adults with unilateral Class II malocclusion managed with a hybrid approach as a part of Invisalign® comprehensive treatment. Results showed that such perspective practice is feasible for 3D design and in-office 3D printing of a personalized distalizer. Results also showed no clinically significant differences between both studied biopolymers. The paper discusses an evaluation of such personalized distalizer functionality with regard to the current state of the art and compares to conventional prefabricated alternatives like a Carriere® Distalizer™ appliance. Research showed a preference of patients towards transparent biocompatible photopolymer instead of the white A2 shade. The paper concludes that additive manufacturing from dental resins is a viable method in personalization and in-office 3D printing of orthodontic auxiliaries, particularly distalizers. New materials for orthodontic 3D printing endow enhanced individualization, thus more efficient treatment.

A Comparison of the Ligation Torque Expression of a Ribbonwise Bracket-Archwire Combination and a Conventional Combination: A Primary Study

OBJECTIVE

To assess the effect of the third-order mechanics of a new ribbonwise bracket-archwire combination using an orthodontic torque simulator. Material and Methods. An orthodontic torque simulator was used to measure the third-order moment of a maxillary central incisor as it changed from a neutral position to a 40° rotation in 1° increment. A new ribbonwise bracket (Xinya, China) was compared with a conventional ligation bracket (American Orthodontic, U.S.A.). The effects of different archwire sizes (i.e., 0.017″ × 0.025″ and 0.019″ × 0.025″) and materials (i.e., nickel-titanium, titanium-molybdenum alloy, and stainless steel) were analyzed. Paired sample t-tests were conducted to compare the moments between the two bracket types corresponding to each of the archwires. The effects of the stiffness of the bracket-archwire complexes were also assessed.

RESULTS

Statistically significant differences (P=0.05) between the moments from the two brackets were found. The ribbonwise bracket-archwire complex generated larger moments when the rotation angle was lower than 30°. The ribbonwise brackets produced moments that could reach a threshold of 5 Nmm more quickly as the angle was increased. The higher the stiffness of the complex, the larger the moment.

CONCLUSION

The ribbonwise bracket-archwire complex reached the moment threshold limits earlier than the conventional complex. When the rotation angle is less than 30°, the ribbonwise bracket-archwire complex generated a greater torque moment in comparison with the conventional complex.

A Comprehensive Review on Natural Fibers: Technological and Socio-Economical Aspects

Asian countries have abundant resources of natural fibers, but unfortunately, they have not been optimally utilized. The facts showed that from 2014 to 2020, there was a shortfall in meeting national demand of over USD 2.75 million per year. Therefore, in order to develop the utilization and improve the economic potential as well as the sustainability of natural fibers, a comprehensive review is required. The study aimed to demonstrate the availability, technological processing, and socio-economical aspects of natural fibers. Although many studies have been conducted on this material, it is necessary to revisit their potential from those perspectives to maximize their use. The renewability and biodegradability of natural fiber are part of the fascinating properties that lead to their prospective use in automotive, aerospace industries, structural and building constructions, bio packaging, textiles, biomedical applications, and military vehicles. To increase the range of applications, relevant technologies in conjunction with social approaches are very important. Hence, in the future, the utilization can be expanded in many fields by considering the basic characteristics and appropriate technologies of the natural fibers. Selecting the most prospective natural fiber for creating national products can be assisted by providing an integrated management system from a digitalized information on potential and related technological approaches. To make it happens, collaborations between stakeholders from the national R&D agency, the government as policy maker, and academic institutions to develop national bioproducts based on domestic innovation in order to move the circular economy forward are essential.

Evaluation of the Behavior of Two CAD/CAM Fiber-Reinforced Composite Dental Materials by Immersion Tests

Fiber-reinforced composites are used as restorative materials for prosthetic oral rehabilitation. Gastroesophageal reflux disease (GERD) is an accustomed affection with various oral manifestations. This study aimed to evaluate the behavior of two high-performance CAD/CAM milled reinforced composites (Trinia™, TriLor) in artificial saliva at different pH levels through immersion tests, and to determine if changes in mass or surface morphology at variable pH, specific for patients affected by GERD, appear. After investigating the elemental composition and surface morphology, the specimens were immersed in Carter Brugirard artificial saliva for 21 days at different pH values (5.7, 7.6, and varying the pH from 5.7 to 3). The values of the weighed masses during the immersion tests were statistically processed in terms of mean and standard deviation. Results suggested that irrespective of the medium pH, the two composites presented a similar mass variation in the range of −0.18 (±0.01)–1.82 (±0.02) mg after immersion, suggesting their stability when in contact with artificial saliva, an aspect which was also highlighted by scanning electron microscope (SEM) analysis performed on the immersed surfaces. Novel composite biomaterials can be a proper alternative for metal alloys used for prosthetic frameworks in patients suffering from GERD.

Evaluation of Wear Properties of Four Bulk-Fill Composites: Attrition, Erosion, and Abrasion

Purpose

Wear and increased surface roughness are among the reasons for failure of posterior composite restorations. Considering the widespread use of bulk-fill composites in the posterior region, information about their wear resistance is imperative. The aim of this study was to compare the wear and surface roughness of four bulk-fill composite resins with a conventional composite.

Methods

Thirty composite discs (4 mm × 10 mm) were fabricated from EverX Posterior (GC), X-tra fil (Voco), Filtek Bulk-Fill Posterior (3M, USA), SonicFill 2 (Kerr), and Z250 (3M) composites. The baseline weight and surface roughness of specimens were measured. For the assessment of the attrition wear, the specimens were placed in a chewing simulator (Mechatronik). pH cycling was performed to erode the composite discs. They were then placed in a tooth brushing simulator machine (Dorsa) for abrasion wear. Finally, the weight and surface roughness of the specimens were measured. Data were compared using one-way ANOVA (alpha ≤ 0.05).

Results

One-way ANOVA showed that the mean weight changes were significant after attrition, abrasion, and erosion (P = 0.019), but changes in surface roughness were not significant (P ≥ 0.05). The results of Tukey's test showed no significant difference between the bulk-fill composites and Z250 regarding weight loss (P ≥ 0.05), but the weight loss of X-tra fil was significantly greater than that of EverX (P = 0.007) and Filtek Bulk-Fill (P = 0.005).

Conclusions

Considering the limitations of this study, it appears that the wear and surface roughness of bulk-fill composites are within the acceptable range and are not different from those of a conventional composite.

Universal Adhesive for Fixed Retainer Bonding: In Vitro Evaluation and Randomized Clinical Trial

This study aims to assess the efficacy of a universal adhesive (Scotchbond Universal, 3M ESPE) (SB) in total-etch mode, compared to a traditional orthodontic primer (Transbond XT Primer, 3M ESPE) (XT Primer), to perform bonding of orthodontic fixed retainers along with the Transbond XT Light Cure Adhesive Paste (3M ESPE). For the in vitro study, a round section wire (Ortosmail Krugg) was bonded using XT Primer for 20 bovine incisors (Group 1) and SB for other 20 (Group 2). Samples were debonded in a universal testing machine applying a tangential force to specimens (crosshead speed of 1 millimeter per minute). Shear bond strength (SBS) and adhesive remnant index (ARI) scores were calculated. For the in vivo study, 100 patients needing upper and lower canine-to-canine fixed retainers after orthodontic treatment were randomly assigned to two groups of 50 participants each, i.e., group 1 (retainer bonding with XT Primer) and group 2 (retainer bonding with SB). Over two years, examinations were carried out monthly, and detachments were registered by considering the teeth and arches affected. In vitro, no statistically significant differences in SBS and ARI scores were demonstrated between the two groups, both showing a mean bond strength of about 12 MPa and major frequency of ARI "2" (>50% remnant adhesive on the enamel). Conversely, a significantly lower failure rate over 2 years was assessed clinically for group 2 in both arches. Independently of the adhesive and arch, incisors reported a significantly higher failure rate than canines. Scotchbond Universal used in total-etch mode could be a valid alternative to the traditional orthodontic Transbond XT Primer.

Structural Behavior Evaluation of Reinforced Concrete Using the Fiber-Reinforced Polymer Strengthening Method

Reinforced concrete (RC) structures age with time, which results in performance degradation and cracks. These performance degradations do not recover easily, but a performance higher than the existing structures can be expected through reinforcement. There are various reinforcement methods for RC structures. This study selected four reinforcement methods: near-surface mounting (NSM), external prestressing (EP), external bonding (EB), and section enlargement (SE). In the past, steel bars were often used as reinforcements. However, this study uses fiber-reinforced polymer (FRP), which is an alternative to steel bars owing to its high tensile strength, and its non-corrosive and lightweight properties. It is a basic strengthening material, along with a carbon-fiber-reinforced polymer (CFRP) and glass-fiber-reinforced polymer (GFRP) in bar and sheet forms. Various strengthening materials such as a CFRP, GFRP, and prestressing (PS) strand are applied to the NSM, EP, EB, and SE methods, followed by flexural experiments. In addition, changes in the ductility of the RC structures were examined. The concrete EP and near-surface mounting prestressing (NSM(P)) methods have a stiffness that is almost double the non-strengthened specimen. However, because the EP and EB methods are brittle, the NSM(P) method with ductile behavior is considered the most effective.

Exposure of Biomimetic Composite Materials to Acidic Challenges: Influence on Flexural Resistance and Elastic Modulus

Acidic conditions of the oral cavity, including soft drinks and cariogenic bacteria, represent a damage for restorative biomimetic composite materials. The aim of this study is to assess the influence of two different acidic challenges on the flexural strength and elastic modulus of five composites: x-tra fil (Group 1, XTF), GrandioSO x-tra (Group 2, GXT), Admira Fusion x-tra (Group 3, AFX), VisCalor bulk (Group 4, VCB), and Enamel Plus HRi (Group 5, EPH). Thirty samples for each group were randomly divided and assigned to three different treatments: storage in distilled water as the controls (subgroups 1a-5a), 3 weeks distilled water + 1 week Coca-Cola (subgroups 1b-5b), and 4 weeks Coca-Cola (subgroups 1c-5c). For each subgroup, the flexural strength and elastic modulus were measured using an Instron universal testing machine, and data were submitted to statistical analysis. Considering subgroups B, no material showed a significant difference in the flexural strength with the controls (p > 0.05), whereas for subgroups C, only GXT and VCB showed significantly lower values (p < 0.05). AFX reported the lowest flexural strength among the materials tested. As regards the elastic modulus, no material showed a significant variation after acidic storages when compared with the respective control (p > 0.05). AFX and EPH reported the lowest elastic modulus compared to the other materials. All composites tested showed adequate flexural properties according to the standards, except for AFX. This biomimetic material, along with EPH, might be indicated for V class (cervical) restorations considering the lowest values of elasticity reported.

Evaluation of a novel fixed-space maintainer made of light-cured acrylic resin: an in vitro study

To evaluate a fixed-space maintainer made of light-cure acrylic resin (LCAR) for its flexural and shear bond strength using different bonding systems to the enamel. 45 extracted primary teeth were selected. They were randomly divided into three equal groups (n = 15) along with the type of adhesive system (Tetric Flow, Transbond XT, and Fuji Ortho LC) used for bonding (LCAR) to the tooth surface. Surfaces were treated; LCAR was attached to the treated surfaces using a split Teflon mold. For flexural strength testing, ten bars of LCAR were made using another Teflon-split mold. Shear bond strength and mean flexural strength values were evaluated by a universal testing machine. The highest values of bond strength were recorded for Transbond XT, followed by Tetric Flow, while the lowest values were for Fuji Ortho LC. Various groups had a significant difference as investigated by ANOVA. ARI scores showed no significant difference in debond sites. Mean value and standard deviation of flexural strength for LCAR were 82.83  ± 5.2. LCAR has superior mechanical properties and could be an alternative to currently-in-use space maintainer though in vivo and in vitro trials are needed to progress the ultimate design of LCAR.

Fracture Resistance of Three Post Types in the Restoration of Anterior Primary Teeth

Background:

Extensive restorative treatments of anterior primary teeth are challenging in pediatric dentistry.

Objective:

This study aimed to compare the fracture resistance of three post types for restoring the anterior primary teeth.

Methods:

This in-vitro study was carried out on 90 extracted maxillary anterior primary teeth with intact roots. They were randomly allocated into six groups to be restored with conventional composite resin post, X-tra fill composite resin post, Tetric N Ceram composite resin post, prefabricated glass fiber post with conventional composite build-up, prefabricated glass fiber post with X-tra fill composite build-up, and prefabricated glass fiber post with Tetric N Ceram composite build up. The samples were polished and placed in acrylic resin blocks with 1 mm of part of cervical root being out, thermocycled (×5000) and tested for fracture resistance. Intra-class correlation test, Kruskal-Wallis test and one-way ANOVA were used for statistical analyses (α=0.05).

Results:

The mean fracture resistance was significantly different among the six groups. It was the highest in prefabricated glass fiber post with conventional composite build-up (418.64 N), prefabricated glass fiber post with X-tra fill composite build-up (403.63 N) and prefabricated glass fiber post with Tetric N Ceram composite build up (361.63 N); and the lowest in Tetric N Ceram group (280.65 N). The groups were significantly different concerning the fracture strength and fracture state.

Conclusion:

Since the anterior teeth restored with prefabricated glass fiber posts were far more fracture resistant, and prefabricated glass fiber posts can be promisingly used for the restoration of anterior primary teeth.

Toughening Mechanism of Mullite Matrix Composites: A Review

Mullite has high creep resistance, low thermal expansion coefficient and thermal conductivity, excellent corrosion resistance and thermal shock resistance, and plays an important role in traditional ceramics and advanced ceramic materials. However, the poor mechanical properties of mullite at room temperature limit its application. In order to improve the strength and toughness of mullite, the current research focuses on the modification of mullite by using the second phase. The research status of discontinuous phase (particle, whisker, and chopped fiber) and continuous fiber reinforced mullite matrix composites is introduced, including preparation process, microstructure, and its main properties. The reinforcement mechanism of second phase on mullite matrix composites is summarized, and the existing problems and the future development direction of mullite matrix composites are pointed out and discussed.

Fear of the Relapse: Effect of Composite Type on Adhesion Efficacy of Upper and Lower Orthodontic Fixed Retainers: In Vitro Investigation and Randomized Clinical Trial

The aim of this laboratory and clinical study is to determine the reliability of the flowable nanocomposite Filtek Supreme XTE (FL) for the adhesion of orthodontic retainers, compared to highly filled orthodontic resin Transbond XT (XT). Portions of a round section multistranded wire (Ortosmail Krugg) were bonded to 40 bovine incisors with Scotchbond Universal in total-etch modality. For group one (XT, 20 samples), the orthodontic resin was used, whereas in group two (FL, 20 samples), the flowable one. Specimens were placed into a universal testing machine which applied a shear force on retainers with a crosshead speed of one/minute. Shear bond strength (SBS) and adhesive remnant index (ARI) scores were calculated. In the clinical trial, 100 patients requiring a canine-to-canine palatal and lingual retainer were randomly divided into two groups, according to the resin used for bonding procedure: the orthodontic in group one (XT, 50 participants) and the flowable in group two (FL, 50 participants). Monthly visits were carried out over a 24-month follow up to assess any detachment occurring on teeth of both arches. All data were submitted to statistical analysis. In vitro, FL reported a significant lower mean SBS, whereas no significant differences in ARI were reported between the two groups which both showed a major frequency of scores “1” and “2”. At the end of the 24-month follow up, FL reported significantly higher failure rates in both arches besides a significantly lower survival rate starting from the sixth month after retainers bonding. According to the results assessed in vitro and clinically, XT would be preferable to FL when performing retainers bonding procedure.

Novel Methodology for Football Rebound Test Method

Assessing and keeping control of the mechanical properties of sport surfaces is a relevant task in sports since it enables athletes to train and compete safely and under equal conditions. Currently, different tests are used for assessing athlete- and ball-surface interactions in artificial turf pitches. In order to make these evaluations more agile and accessible for every facility, it is important to develop new apparatus that enable to perform the tests in an easier and quicker way. The existing equipment for determining the vertical ball behavior requires a complex and non-easily transportable device in which the ball must be fixed to the upper part of the frame in a very precise position by means of a magnet. The rebound height is determined by capturing the acoustic signal produced when the ball bounces on the turf. When extended tests are conducted, the time required to evaluate a single field is too high due to the non-valid trials. This work proposes a novel methodology which allows to notoriously decrease the time of testing fields maintaining the repeatability and accuracy of the test method together with a compact device for improving its mobility and transport. Simulations and experiments demonstrates the repeatability and accuracy of the results obtained by the proposed device, which decreases the non-valid trials and notoriously reduces the time for field evaluation.

Glass Fiber Reinforced Composite Orthodontic Retainer: In Vitro Effect of Tooth Brushing on the Surface Wear and Mechanical Properties

Fiber reinforced composites (FRCs) are metal free materials that have many applications in dentistry. In clinical orthodontics, they are used as retainers after active treatment in order to avoid relapse. However, although the modulus of the elasticity of FRCs is low, the rigidity of the material in the form of a relatively thick retainer with a surface cover of a flowable resin composite is known to have higher structural rigidity than stainless steel splints. The aim of the present study is to measure load and bending stress of stainless steel wires, as well as flowable resin composite covered and spot‑bonded FRC retainer materials after tooth brushing. These materials were tested with a three point bending test for three different conditions: no brushing, 26 min of brushing, and 60 min of brushing. SEM images were taken before and after different times of tooth brushing. Results showed that stainless steel was not significantly affected by tooth brushing. On the other hand, a significant reduction of values at maximum load at fracture was reported for both FRC groups, and uncovered FRCs were most affected. Concerning maximum bending stress, no significant reduction by pretreatment conditions was reported for the materials tested. SEM images showed no evident wear for stainless steel. Flowable resin composite covered FRCs showed some signs of composite wear, whereas spot‑bonded FRCs, i.e., without the surface cover of a flowable resin composite, showed signs of wear on the FRC and exposed glass fibers from the FRC's polymer matrix. Because of the significant changes of the reduction of maximum load values and the wear for spot‑bonded FRCs, this technique needs further in vitro and in vivo tests before it can be performed routinely in clinical practice.

Coronal Restorations and Temporomandibular Joint (TMJ) Dysfunction: A Survey Among General Practitioners of the Town of Abidjan

Background:

The paper surveyed the knowledge of general practitioners to coronal restorations and temporomandibular dysfunction. The specific aim of this study was to evaluate the knowledge and therapeutic approaches of the general practitioners in terms of restoring occlusion, aesthetics and function after restorative treatments in other to make recommendations to prevent potential dysfunction of the temporomandibular joint.

Methodology:

A cross sectional descriptive survey was used. It was carried out on 86 dentists out of the entire population size of 152 dentists practicing within Abidjan’s center municipality, randomly selected from the database provided by the National College of Dental Surgeons of Ivory Coast. A structured questionnaire was administered to collect data, which was subsequently collated and analysed.

Results:

The majority of the practitioners (95.4%) knew how to diagnose TMJ dysfunction. The etiological factors were stress for 55.2% of the practitioners and amalgam overhang for 49.4% of them. The precautions used to avoid TMJ disorders consisted of good control of the occlusion after having performed a restoration (55%) and taking into account the occlusal morphology (32%) at the time of shaping. Fifty-four percent of the practitioners systematically reevaluated the restorations undertaken.

Conclusion:

Impairment of occlusion results in improper muscular responses and leads to changes in pressure at the level of the temporomandibular joint. This study revealed that the general practitioners of the town of Abidjan have a good level of knowledge of the consequences of poorly carried out restorations on the initiation of masticatory apparatus disorders.

Magnetic Resonance Imaging and Its Effects on Metallic Brackets and Wires: Does It Alter the Temperature and Bonding Efficacy of Orthodontic Devices?

Magnetic resonance imaging (MRI) is a widely used diagnostic technique. Patients wearing orthodontic appliances are often requested to remove their appliances, even when the MRI exam involves anatomical areas far from mouth, in order to avoid heating of the metal and detachment of the appliance. The purpose of the present investigation was to measure and compare temperature changes and orthodontic appliances' adhesion to enamel after different MRIs. A total of 220 orthodontic brackets were bonded on bovine incisors and wires with different materials (stainless steel and nickel titanium). Moreover, various sizes (0.014″ and 0.019″ × 0.025″) were engaged. Appliances were submitted to MRI at two different powers (1.5 T and 3 T). The temperatures of brackets and wires were measured before and after MRI. Subsequently, the shear bond strength (SBS) and adhesive remnant index (ARI) scores were recorded. Statistical analysis was performed. After MRI, a significant increase in the temperature was found for both the brackets and wires in some groups, even if the mean temperature increase was clinically insignificant, as the temperature ranged between 0.05 °C and 2.4 °C for brackets and between 0.42 °C and 1.74 °C for wires. The MRI did not condition bracket adhesion in any group. No differences were reported when comparing the 1.5 T with 3 T groups. The ARI Scores were also significantly lower after MRI. The results of the present report show that, under MRI, orthodontic appliances present a low temperature rise and no debonding risk. Therefore, the removal of orthodontic appliance is not recommended routinely, but is suggested only in the case of a void risk or potential interference in image quality.

Effect of Long-Term Brushing on Deflection, Maximum Load, and Wear of Stainless Steel Wires and Conventional and Spot Bonded Fiber-Reinforced Composites

Fiber-reinforced composite (FRC) retainers are an aesthetic alternative to conventional Stainless Steel splints. They are generally used with a full bonded technique, but some studies demonstrated that they could be managed with a spot bonding technique to significantly decrease their rigidity. In order to propose this FRC spot bonding technique for clinical use, the aim of this study was to evaluate mechanical properties and surface wear of fibers left uncovered. Tests were made by simulating tooth brushing, comparing FRC spot bonding technique splints with stainless steel and FRC traditional technique splints. Specimens were tested both at 0.1 mm of deflection and at maximum load, showing higher values of rigidity for the FRC full bonded technique. After tooth brushing, no significant reduction in values at 0.1 mm deflection was reported, while we found a similar reduction in these values for the Stainless Steel and FRC spot bonding technique at maximum load, and no significant variation for the FRC full bonded technique. SEM images after tooth brushing showed wear for FRC fibers left uncovered, while no relevant wear signs in metal and conventional FRC fibers were noticed. Results showed that FRC spot bonding technique has advantages in mechanical properties when compared to the FRC traditional full bonding technique, also after tooth brushing. However, the surface wear after tooth brushing in the FRC spot bonding technique is considerable and other tests must be performed before promoting this technique for routine clinical use.

Surface Characteristics of Esthetic Nickel⁻Titanium and Beta-Titanium Orthodontic Archwires Produced by Plasma Electrolytic Oxidation (PEO)-Primary Results

Background/Aim: There is continuing interest in engineering esthetic labial archwires. The aim of this study was to coat nickel–titanium (NiTi) and beta-titanium (β-Ti), also known as titanium molybdenum (TMA), archwires by plasma electrolytic oxidation (PEO) and to analyze the characteristics of the PEO-surfaces. Materials and Methods: PEO-coatings were generated on 0.014-inch NiTi and 0.19 × 0.25-inch β-Ti archwires. The surfaces were analyzed by scanning electron microscopy and stereomicroscopy. Cytocompatibility testing was performed with ceramized and untreated samples according to EN ISO 10993-5 in XTT-, BrdU- and LDH-assays. The direct cell impact was analyzed using LIVE-/DEAD-staining. In addition, the archwires were inserted in an orthodontic model and photographs were taken before and after insertion. Results: The PEO coatings were 15 to 20 µm thick with a whitish appearance. The cytocompatibility analysis revealed good cytocompatibility results for both ceramized NiTi and β-Ti archwires. In the direct cell tests, the ceramized samples showed improved compatibility as compared to those of uncoated samples. However, bending of the archwires resulted in loss of the PEO-surfaces. Nevertheless, it was possible to insert the β-Ti PEO-coated archwire in an orthodontic model without loss of the PEO-ceramic. Conclusion: PEO is a promising technique for the generation of esthetic orthodontic archwires. Since the PEO-coating does not resist bending, its clinical use seems to be limited so far to orthodontic techniques using straight or pre-bent archwires.

Vickers Micro-Hardness of New Restorative CAD/CAM Dental Materials: Evaluation and Comparison after Exposure to Acidic Drink

CAD/CAM (computer-aided design/computer-aided manufacturing) for indirect restorative materials has been recently introduced in dentistry. The purpose of this study was to evaluate the change of the surface micro-hardness of different restorative CAD/CAM materials after exposure to a carbonated acidic drink (Coca-Cola, Coca-Cola Company, Milan, Italy). One hundred and eighty specimens of identical size (2 mm thickness) were obtained by sectioning each tested CAD/CAM block of four materials: a hybrid ceramic (CERASMART™, GC Corporation, Tokyo, Japan), a resin nano ceramic (Lava™ Ultimate, 3M, Monrovia, CA, USA), a nanohybrid composite (Grandio blocs, VOCO GmbH, Cuxhaven, Germany), and a zirconia-reinforced lithium silicate glass ceramic (VITA SUPRINITY® PC; VITA Zahnfabrik, Bad Sackingen, Germany). Forty-five specimens of each material were tested. Micro-hardness was measured at baseline, after 7 days and after 28 days. The data were analyzed. The micro-hardness of each material varied significantly after immersion in Coca-Cola. The nanohybrid composite had a high initial micro-hardness and the greatest percentage loss after acid exposure. The hybrid ceramic and the resin nano ceramic had similar percentage losses of micro-hardness values even if the second material had higher initial values. The zirconia-reinforced lithium silicate glass ceramic had the highest baseline values and the lowest percentage loss of micro-hardness. The different CAD/CAM materials presented different micro-hardness values before and after acid exposure.

The Influence of Non-Uniformities on the Mechanical Behavior of Hemp-Reinforced Composite Materials with a Dammar Matrix

As a result of manufacture, composite materials can appear to have variations to their properties due to the existence of structural changes. In this paper, we studied the influence of material irregularity on the mechanical behavior of two categories of bars for which we have used hemp fabric as a reinforcing material. The common matrix is a hybrid resin based on Dammar and epoxy resin. We molded two types of bars within each of the previously mentioned categories. The first type, also called "ideal bar", was made of layers in which the volume proportion and the orientation of the reinforcing material was the same in each section. The ideal bar does not show variations of mechanical properties along it. The second type of bar was molded to have one or two layers where, between certain sections, the reinforcing material was interrupted in several segments. We have determined some mechanical properties, the characteristic curves (strain-stress), the tensile strength, and elongation at break for all the sample sets on trial. Moreover, we have studied the influence of the non-uniformities on the mechanical behavior of the composites by entering certain quality factors that have been calculated after experimental determinations.

A Review of Recent Advances in Nanoengineered Polymer Composites

This review paper initially summarizes the latest developments in impact testing on polymer matrix composites collating the various analytical, numerical, and experimental studies performed since the year 2000. Subsequently, the scientific literature investigating nanofiller reinforced polymer composite matrices as well as self-healing polymer matrix composites by incorporating core-shell nanofibers is reviewed in-depth to provide a perspective on some novel advances in nanotechnology that have led to composite developments. Through this review, researchers can gain a representative idea of the state of the art in nanotechnology for polymer matrix composite engineering, providing a platform for further study of this increasingly industrially significant material, and to address the challenges in developing the next generation of advanced, high-performance materials.

Chitosan as a Coupling Agent for Phosphate Glass Fibre/Polycaprolactone Composites

This study shows that chitosan (CS) could be highly useful as a coupling agent in phosphate glass fibre/polycaprolactone (PGF/PCL) composites, as it improved the interfacial shear strength by up to 78%. PGFs of the composition 45P2O5–5B2O3–5Na2O–24CaO–10MgO–11Fe2O3 were dip-coated with CS (with a degree of deacetylation >80%) dissolved in acetic acid solution (2% v/v). Different CS concentrations (3–9 g L−1) and coating processes were investigated. Tensile and fragmentation tests were conducted to obtain the mechanical properties of the single fibres and interfacial properties of the PGF/PCL composites, respectively. It was observed that post-cleaning, the treated fibres had their tensile strength reduced by around 20%; however, the CS-coated fibres experienced strength increases of up to 1.1–11.5%. TGA and SEM analyses were used to confirm the presence of CS on the fibre surface. FTIR, Raman, and X-ray photoelectron spectroscopy (XPS) analyses further confirmed the presence of CS and indicated the protonation of CS amine groups. Moreover, the nitrogen spectrum of XPS demonstrated a minimum threshold of CS coating required to provide an improved interface.