The relationship between composition and properties of posterior resin composites

Microstructural investigation of hybrid CAD/CAM restorative dental materials by micro-CT and SEM

OBJECTIVES

An increasing number of CAD/CAM (computer-aided design/computer-aided manufacturing) hybrid materials have been introduced to the dental market in recent years. In addition, CAD/CAM hybrid materials for additive manufacturing (AM) are becoming more attractive in digital dentistry. Studies on material microstructures using micro-computed tomography (µ-CT) combined with scanning electron microscopy (SEM) have only been available to a limited extent so far.

METHODS

One CAD/CAM three-dimensional- (3D-) printable hybrid material (VarseoSmile Crown plus) and two CAD/CAM millable hybrid materials (Vita Enamic; Voco Grandio), as well as one direct composite material (Ceram.x duo), were included in the present study. Cylindrical samples with a diameter of 2 mm were produced from each material and investigated by means of synchrotron radiation µ-CT at a voxel size of 0.65 µm. Different samples from the same materials, obtained by cutting and polishing, were investigated by SEM.

RESULTS

The 3D-printed hybrid material showed some agglomerations and a more irregular distribution of fillers, as well as a visible layered macrostructure and a few spherical pores due to the printing process. The CAD/CAM millable hybrid materials revealed a more homogenous distribution of ceramic particles. The direct composite material showed multiple air bubbles and microstructural irregularities based on manual processing.

SIGNIFICANCE

The µ-CT and SEM analysis of the materials revealed different microstructures even though they belong to the same class of materials. It could be shown that µ-CT and SEM imaging are valuable tools to understand microstructure and related mechanical properties of materials.

Physical Properties and Clinical Performance of Short Fiber Reinforced Resin-based Composite in Posterior Dentition: Systematic Review and Meta-analysis

OBJECTIVE

This study compares the physical properties and clinical performance of short fiber reinforced composites (SFRC) to those of particulate-filled resin-based composites (PFRC) for class I and II direct restorations in permanent dentition.

METHODS

Systematic review and meta-analysis was conducted using PubMed, Embase (Elsevier), and Dentistry and Oral Sciences Source (EBSCO) databases. The outcomes evaluated were physical properties including flexural strength, flexural modulus, elastic modulus, microhardness, shrinkage, fracture toughness, degree of conversion, and depth of cure. Clinical performance was evaluated with a systematic review.

RESULTS

The meta-analyses favored SFRC for flexural strength and fracture toughness compared to every PFRC subgroup, with a high quality of evidence. For all other properties, the meta-analyses favored SFRC to overall PFRC, with some non-significant differences with certain PFRC subgroups. The most recent clinical trial showed SFRC performed similarly to PFRC, however older studies suggest inferior surface texture and discoloration of SFRC compared to PFRC.

CONCLUSION

This study can aid dental professionals in clinical decision making, supporting that SFRC offers improved physical properties, especially fracture resistance and flexural strength, compared to PFRC.

Influence of Instrument Lubrication on Properties of Dental Composites

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

Influence of Various Desensitizing Mouthrinses and Simulated Toothbrushing on Surface Roughness and Microhardness of Tetric N-Ceram Bulk-Fill Resin Composite: An In Vitro Study and Scanning Electron Microscope Analysis

OBJECTIVES

 Bulk-filled composite resins are popularly used for posterior restorations due to various advantages. Routine oral hygiene measures like toothbrushing and the use of various mouthrinses can influence the mechanical properties of composite resins. Desensitizing mouthrinses are widely used as well, to manage dentinal hypersensitivity. Studies on the influence of desensitizing mouthrinses on bulk-filled composites are limited. Hence, the objective of the present in vitro study was to evaluate the influence of toothbrushing and various desensitizing mouthrinses on the surface roughness and microhardness of Tetric N-Ceram bulk-fill composite resin.

MATERIALS AND METHODS

 Fifty Tetric N-Ceram bulk-fill composite resin disks were prepared and were randomly divided into five groups (n = 10). Group 1 (Control): no toothbrushing and no mouthrinse; Group 2: toothbrushing only; Group 3: toothbrushing + HiOra-K mouthrinse; Group 4: toothbrushing + Listerine Sensitive mouthrinse; and Group 5: toothbrushing + Shy-OR mouthrinse. The specimens were brushed with a soft bristle brush using a toothpaste slurry and immersed in respective mouthrinse twice daily for 1 month. The mean surface roughness (average roughness) and microhardness (Vickers Pyramid number) values were determined and the data were tabulated. Data were analyzed using one-way analysis of variance, Post-hoc Tukey test, and Pearson correlation test. A p-value less than 0.05 was considered statistically significant.

RESULTS

 Specimens treated with HiOra-K mouthrinse exhibited maximum surface roughness (p < 0.05) and specimens treated with Listerine Sensitive exhibited the least microhardness (p < 0.05). A weak negative correlation was found between surface roughness and microhardness for groups 1, 2, and 5, while a weak positive correlation was found for groups 3 and 4.

CONCLUSIONS

 It is suggested that desensitizing mouthrinses containing alcohol or essential oils can lead to increased surface roughness and reduction in microhardness of bulk-fill composites, which could have an undesirable effect on their clinical performance.

Printable and Machinable Dental Restorative Composites for CAD/CAM Application-Comparison of Mechanical Properties, Fractographic, Texture and Fractal Dimension Analysis

Thanks to the continuous development of light-curing resin composites it is now possible to print permanent single-tooth restorations. The purpose of this study was to compare resin composites for milling -Gandio Blocks (GR), Brilliant Crios (CR) and Enamic (EN) with resin composite for 3D printing-Varseo Smile Crown plus (VSC). Three-point bending was used to measure flexural strength (σ_f) and flexural modulus (E_f). The microhardness was measured using a Vickers method, while fractographic, microstructural, texture and fractal dimension (FD) analyses were performed using SEM, optical microscope and picture analysis methods. The values of σ_f ranged from 118.96 (±2.81) MPa for EN to 186.02 (±10.49) MPa for GR, and the values of E_f ranged from 4.37 (±0.8) GPa for VSC to 28.55 (±0.34) GPa for EN. HV01 ranged from 25.8 (±0.7) for VSC to 273.42 (±27.11) for EN. The filler content ranged from 19-24 vol. % for VSC to 70-80 vol. % for GR and EN. The observed fractures are typical for brittle materials. The correlation between FD of materials microstructure and E_f was observed. σ_f of the printed resin depends on layers orientation and is significantly lower than σ_f of GR and CR. E_f of the printed material is significantly lower than E_f of blocks for milling.

Low-temperature flow-synthesis-assisted urethane-grafted zinc oxide-based dental composites: physical, mechanical, and antibacterial responses

A novel way was adopted to graft zinc oxide (ZnO) with urethane-modified dimethacrylate (UDMA) in order to utilize them as reinforcing agents in resin-based dental composites. Experimental novel composites were synthesized having UDMA-grafted and nongrafted ZnO, at a concentration of 0 wt.%, 5 wt.%, and 10 wt.%. The same concentrations of ZnO were also incorporated in Filtek Z250 XT (3 M ESPE, USA). The antibacterial behavior was evaluated against Streptococcus mutans by direct-contact test at one, three, and seven days of incubation. The compressive strength and Vickers microhardness were tested as per ISO 9917 and ISO/CD6507-1, respectively. For abrasive wear resistance, mass loss and roughness average after tooth-brushing cycles of 24,000 at custom-made tooth-brushing simulator were evaluated using noncontact profilometer. Data analysis was carried out using post hoc Tucky's test and nonparametric Kruskal-Wallis test. Direct contact test revealed that the antibacterial potential of novel and commercial composites was increased with an increase in the concentration of grafted ZnO as compared with nongrafted, whereby the potential was the highest at day seven. There was a significant decrease in compressive strength and Vickers hardness of commercial composites on addition of grafted ZnO while there was no significant difference in the strength of experimental novel composite. The abrasive wear of commercial and experimental composites was within clinical limits. Low-temperature flow-synthesis method was successfully employed to synthesize grafted and nongrafted ZnO. The UDMA-grafted ZnO can be incorporated into dental composites without decreasing their strength and these composites can be used to combat secondary caries.

The effect of different storage media on the monomer elution and hardness of CAD/CAM composite blocks

OBJECTIVE

This study aimed to assess the effect of different storage media on the hardness and monomer elution of CAD/CAM composite blocks.

METHODS

Five resin-composite blocks (RCB), one polymer-infiltrated ceramic network (PICN) block (Enamic (EN)), one ceramic-filled poly ether ether ketone (PEEK) block (Dentokeep (DK)), and one feldspathic ceramic block. Microhardness was measured using a Vickers indenter tester (FM-700, Future Tech Corp., Japan). In addition 4 conventional resin-composites were investigated for monomer elution using high performance liquid chromatography (HPLC) after storage in different media for 3 months. The data were analysed by three-way ANOVA, two-way ANOVA, one-way ANOVA, Tukey's post hoc test and the independent t-test (α=0.05 for all tests).

RESULTS

The specimens stored in the water had a hardness reduction ranging from 0.9% to 24.4%. In artificial saliva, the specimens had a hardness reduction ranging from 2.8% to 23.2%. The hardness reduction percentage in 75% Ethanol/Water (E/W) ranged between 3.8% and 35.3%. All materials, except GR (resin-composite block) and DK (Polyetheretherketone (PEEK)), showed a variable extent of monomer elution into 75% E/W with significantly higher amounts eluted from conventional composites. GRA and GND (conventional resin-composites) eluted TEGDMA in artificial saliva and GRA eluted TEGDMA in water.

SIGNIFICANCE

The hardness of CAD/CAM composite blocks was affected by different storage media, and they were not as stable as ceramic, with PICN exhibited superior hardness stability to all of the resin-composite blocks in all the storage media and was comparable to ceramic block. The hardness reduction percentage of the CAD/CAM composite blocks was influenced by the filler loading and resin-matrix composition.Minimal or no monomer elution from CAD/CAM blocks was detected.

A novel CAD/CAM resin composite block with high mechanical properties

OBJECTIVE

To determine the mechanical properties of a newly-developed CAD/CAM resin composite block and compare with other resin composite blocks and a polymer-infiltrated ceramic block.

METHODS

Experimental composite block was formulated by our proprietary resin and filler technologies and cured via Hot Isostatic Pressing (HIP). Bar-shaped specimens (1 × 4×12 - 13 mm, n = 10) for flexural strength, flexural modulus and modulus of resilience were sectioned from block materials and measured in accordance to modified ISO-6872. Cylinder specimens for compressive strength (2 × 4 mm, n = 8) and for diametral tensile strength (6 × 3 mm, n = 8) were milled from the block materials and tested according to ASTM-D695 and ANSI/ADA-Specification #27, respectively. Block specimens (5 mm, n = 3) for Vickers hardness were polished and measured for five indentations on each specimen. The data was analyzed by one-way ANOVA and post-hoc Tukey tests (p ≤ 0.05).

RESULTS

Experimental composite block showed higher or significantly higher flexural strength, flexural modulus, modulus of resilience, compressive strength, diametral tensile strength and Vickers hardness than the other commercially available block materials except Vita Enamic for flexural modulus and hardness and Cerasmart for modulus of resilience. Some positive correlations were observed among the different mechanical properties.

SIGNIFICANCE

New composite block exhibited higher mechanical properties as compared to commercially available composite block materials. Superior mechanical properties for resin composite block materials were obtained by composite and curing processing technologies. Resin composite blocks with higher mechanical properties are good options for the fabrication of CAD/CAM indirect restorations.

Effect of surface sealant on the surface roughness of different composites and evaluation of their microhardness

Purpose:

The aim of this study was to evaluate the effect of a surface sealant on the surface roughness of different composites and compare their microhardness values.

Materials and methods:

Sixty disc-shaped specimens were prepared and assigned to 6 groups (n =10). Groups were prepared as follows; Group 1 (Herculite XRV Ultra), Group 2 (Beautifil Bulk Restorative) and Group 3 (Filtek Bulk Fill Posterior Restorative). Groups 4, 5, and 6 were prepared by applying a surface sealant (BisCover LV) on the specimens in groups 1, 2 and 3. Surface hardness of the discs in group 1, 2, and 3 and surface roughness of the discs in all groups were measured using the Vickers hardness test and a profilometer, respectively. One-way ANOVA was used to test for differences among the groups.

Results:

No significant differences were observed in the microhardness and roughness between the experimental and control groups for each restorative materials. Group 3 showed the highest surface hardness and group 4 showed the lowest surface roughness values.

Conclusion:

Using the BisCover LV resin after the polishing step has no significant effect on the surface roughness. The highest hardness values were obtained for the Filtek Bulk Fill Posterior Restorative after the polishing step. The smoothest surfaces were obtained for all experimental groups using the BisCover LV resin after the polishing step, Herculite XRV Ultra showed lower average roughness values than the other materials.

Three-body wear of 3D printed temporary materials

OBJECTIVE

The aim of this study was to investigate the three-body wear of different additively manufactured temporary materials, one temporary PMMA material for CAD/CAM milling and one resin-based composite for direct restorations as a control group by using an ACTA machine.

METHODS

Specimens (n=8) of the 3D printing materials 3Delta temp, NextDent C&B, Freeprint temp were additively manufactured by DLP 3D printer. Postprocessing was carried out according to the manufacturer's specifications. Telio CAD were cut out of blocks, Tetric EvoCeram was applied directly and light cured. Three-body wear was simulated with an ACTA machine. Data were statistically analysed (ANOVA, post hoc test: Tukey, p<0.05). The worn surfaces of the specimens were examined with a FE-SEM.

RESULTS

The average mean wear was 50±15μm for Tetric EvoCeram<62±4μm for 3Delta temp<236±31μm for Telio CAD<255±13μm for NextDent C&B<257±24μm for Freeprint temp. After 200,000 cycles, the wear and wear rates for Tetric EvoCeram and 3Delta temp were significantly lower than those for the other materials. SEM revealed that 3Delta temp has a higher filler proportion than the other 3D printing materials but less than Tetric EvoCeram.

SIGNIFICANCE

The filler content influences the wear behaviour of additively manufactured materials as well as dental restorative composite materials. While most 3D printing materials have a low inorganic filler load, which qualifies the materials for temporary use only, one 3D printing material has an optimized composition that would qualify the material for longer clinical service time if wear is considered as the outcome variable.

In vitro aging behavior of dental composites considering the influence of filler content, storage media and incubation time

Objective

Over time dental composites age due to mechanical impacts such as chewing and chemical impacts such as saliva enzymes and food ingredients. For this research, the focus was placed on chemical degradation. The objective of this study was to simulate hydrolysis by using different food simulating liquids and to assess their impact on the mechanical parameter Vickers microhardness (MHV) and the physicochemical parameter contact angle (CA).

Methods

Specimen of three composites (d = 6 mm, h = 2 mm; n = 435) classified with respect to their filler content (wt%), namely low-filled, medium-filled and highly-filled, were stored for 0, 14, 30, 90 and 180 days in artificial saliva (pH 7), citric acid (pH 3; pH 5), lactic acid (pH 3; pH 5) and ethanol (40%vol; 60%vol) and assessed regarding to MHV and CA. Statistics: Kruskal-Wallis test, stepwise linear regression, bivariate Spearman Rank Correlation (p < 0.05).

Results

While stored in artificial saliva, acid and ethanol the CA decreased especially for the low- and medium-filled composites. It was shown that rising the filler content caused less surface changes in the CA. Storage in ethanol led to a significant decrease of MHV of all composites. Regression analysis showed that the effect of in vitro aging on MHV was mainly influenced by the composite material and therefore by filler content (R² = 0.67; p < 0.05). In contrast, the CA is more influenced by incubation time and filler content (R² = 0.2; p < 0.05) leading to a higher risk of plaque accumulation over time. Significance: In vitro aging showed significant changes on the mechanical and physicochemical properties of dental composites which may shorten their long-term functionality. In conclusion, it can be stated, that the type of composite material, especially rising filler content seems to improve the materials’ resistance against the processes of chemical degradation.

Influences of Light-emitting Diode Illumination Bleaching Technique on Nanohardness of Computer-aided Design and Computer-aided Manufacturing Ceramic Restorative Materials

AIM

This study evaluated the effect of light-emitting diode (LED) illumination bleaching technique on the surface nanohardness of various computer-aided design and computer-aided manufacturing (CAD/CAM) ceramic materials.

MATERIALS AND METHODS

Twenty disk-shaped samples (width, length, and thickness = 10, 15, and 2 mm) were prepared from each of the ceramic materials for CAD/CAM, including Lava™ Ultimate (L_V), Vita Enamic® (E_n) IPS e.max® CAD (M_e), inCoris® TZI (I_C), and Prettau® zirconia (P_r). The samples from each type of ceramic were randomly divided into two groups based on the different bleaching techniques to be used on them, using 35% hydrogen peroxide with and without LED illumination. The ceramic disk samples were bleached according to the manufacturer's instruction. Surface hardness test was performed before and after bleaching using nanohardness tester with a Berkovich diamond indenter.

RESULTS

The respective Vickers hardness number upon no bleaching and bleaching without or with LED illumination [mean ± standard deviation (SD)] for each type of ceramic were as follows: 102.52 ± 2.09, 101.04 ± 1.18, and 98.17 ± 1.15 for L_V groups; 274.96 ± 5.41, 271.29 ± 5.94, and 268.20 ± 7.02 for E_n groups; 640.74 ± 31.02, 631.70 ± 22.38, and 582.32 ± 33.88 for M_e groups; 1,442.09 ± 35.07, 1,431.32 ± 28.80, and 1,336.51 ± 34.03 for I_C groups; and 1,383.82 ± 33.87, 1,343.51 ± 38.75, and 1,295.96 ± 31.29 for P_r groups. The results indicated surface hardness reduction following the bleaching procedure of varying degrees for different ceramic materials. Analysis of variance (ANOVA) revealed a significant reduction in surface hardness due to the effect of bleaching technique, ceramic material, and the interaction between bleaching technique and ceramic material (p < 0.05).

CONCLUSION

Bleaching resulted in a diminution of the surface hardness of dental ceramic for CAD/CAM. Using 35% hydrogen peroxide bleaching agent with LED illumination exhibited more reduction in surface hardness of dental ceramic than what was observed without LED illumination.

CLINICAL SIGNIFICANCE

Clinicians should consider protection of the existing restoration while bleaching.

Mechanical and Physical Properties of Two Different Resin-based Materials: A Comparative Study

AIM

The purpose of this study was to evaluate the degree of conversion (DC) of two different resin-based composite materials (nanofill composite and ormocer) and correlate it with some mechanical properties of these two restorative materials.

MATERIALS AND METHODS

Two different resin-based materials (Filtek Supreme XT and Admira) were tested. A total of 30 samples of each type of selected composite were prepared. Specimens were immersed in distilled water for 24 hours. Then, the specimens were subjected to DC, hardness, and diametral tensile strength (DTS) measurements. The data obtained were tabulated for statistical analysis. The t-test was used to detect the significant difference among the variables tested in this study. Furthermore, the interrelationship between the studied parameters was investigated using a simple correlation coefficient statistical test.

RESULTS

Statistically significant differences were observed regarding DC, hardness, and DTS. Filtek Supreme XT presented the highest values. There was a positive correlation between DC and hardness. Also there was a correlation between DC and DTS, but it was not significant.

CONCLUSION

Under the tested experimental conditions, the DC of Filtek Supreme XT was higher than that of ormocer. Accordingly, Filtek Supreme XT showed better mechanical properties.

CLINICAL SIGNIFICANCE

Filtek Supreme XT showed superior mechanical properties. Therefore, orthodontic bracket-based composite combinations may also be expected to perform well clinically over the lifetime of a bonded orthodontic appliance.

Impact of Polishing Systems on the Surface Roughness and Microhardness of Nanocomposites

AIM

The aim of this article is to evaluate the influence of finishing and polishing techniques on the surface roughness and microhardness of two composite resins with two different types of polishing systems.

MATERIALS AND METHODS

A total of 30 disk-shaped specimens of nanocomposite Filtek™ Z350 and Ceram-X® were prepared. They were divided into three groups. The control group (n = 10) received no finishing and polishing. The remaining specimens were divided into two groups, and they received polishing and finishing either with PoGo or Sof-Lex system. After the polishing procedures, average surface roughness (Ra) was assessed with a surface profilometer. The microhardness was determined using a Vickers hardness test. The data were tabulated and analyzed.

RESULTS

The smoothest surfaces were noticed with the control group (Mylar strips) in both composite materials tested. The PoGo one-step polishing system showed significantly better surface roughness compared with the Sof-Lex polishing system. The microhardness did not show any significant variations after finishing and polishing.

CONCLUSION

It can be concluded that the use of PoGo® one-step polishing system resulted in smoother surface with both composite materials studied compared with the Sof-Lex system. The finishing and polishing system had little influence on the surface microhardness.

CLINICAL SIGNIFICANCE

The finishing procedure and polishing system can affect the physical properties and performance of resin composites.

Changes in surface characteristics of two different resin composites after 1 year water storage: An SEM and AFM study

To evaluate changes in surface characteristics of two different resin composites after 1 year of water storage using a profilometer, Vickers hardness, scanning electron microscopy (SEM), and atomic force microscopy (AFM). A total of 46 composite disk specimens (10 mm in diameter and 2 mm thick) were fabricated using Clearfil Majesty Esthetic and Clearfil Majesty Posterior (Kuraray Medical Co, Tokyo, Japan). Ten specimens from each composite were used for surface roughness and microhardness tests (n = 10). For each composite, scanning electron microscope (SEM, n = 2) and atomic force microscope (AFM, n = 1) images were obtained after 24 h and 1 year of water storage. The data were analyzed using two-way analysis of variance and a post-hoc Bonferroni test. Microhardness values of Clearfil Majesty Esthetic decreased significantly (78.15-63.74, p = 0.015) and surface roughness values did not change after 1 year of water storage (0.36-0.39, p = 0.464). Clearfil Majesty Posterior microhardness values were quite stable (138.74-137.25, p = 0.784), and surface roughness values increased significantly (0.39-0.48, p = 0.028) over 1 year. One year of water storage caused microhardness values for Clearfil Majesty Esthetic to decrease and the surface roughness of Clearfil Majesty Posterior increased. AFM and SEM images demonstrated surface detoration of the materials after 1 year and ensured similar results with the quantitative test methods. SCANNING 38:694-700, 2016. © 2016 Wiley Periodicals, Inc.

Surface and bulk properties of dental resin- composites after solvent storage

OBJECTIVES

To investigate the surface micro-hardness and the diametral tensile strength (DTS) of bulk-fill and conventional resin-composites after storage in food simulating solvents.

METHODS

Eight materials were investigated. For the micro-hardness measurement, Teflon mould with an internal dimensions of 10mm and 2mm (n=15). For the DTS measurement, Split stainless steel moulds were used to make disk-shaped specimens of 6mm diameter and 2mm thickness (n=15). Materials were subdivided in to three groups (water, 75% ethanol/water and MEK). Micro-hardness measurements were made under a load of 300gm with a dwell time of 15s at 7, 30, and 90ds after storage. DTS was measured after 30ds at a cross head speed of 0.5mm/min.

RESULTS

The storage time and type of solvent had a significant influence on the micro-hardness. MEK showed more drastic reduction in the material micro-hardness with an exception of G-aenial universal flo (GA-F) which showed similar results in water/ethanol and MEK. DTS values of materials stored in water ranged from 48.7MPa for the GA-F and 30.6MPa for Ever X posterior (EXP). Generally, the results are observed to decrease with increasing solvent power, except for GA-F.

SIGNIFICANCE

Bulk-fill materials showed no superior results compared with the other materials. For the bulk-fill materials that are designed to be used as a base, their penetration by the solvents may be shielded and thus the changes observed in this study may not be of clinical importance.

From Artisanal to CAD-CAM Blocks

Indirect composites have been undergoing an impressive evolution over the last few years. Specifically, recent developments in computer-aided design–computer-aided manufacturing (CAD-CAM) blocks have been associated with new polymerization modes, innovative microstructures, and different compositions. All these recent breakthroughs have introduced important gaps among the properties of the different materials. This critical state-of-the-art review analyzes the strengths and weaknesses of the different varieties of CAD-CAM composite materials, especially as compared with direct and artisanal indirect composites. Indeed, new polymerization modes used for CAD-CAM blocks—especially high temperature (HT) and, most of all, high temperature–high pressure (HT-HP)—are shown to significantly increase the degree of conversion in comparison with light-cured composites. Industrial processes also allow for the augmentation of the filler content and for the realization of more homogeneous structures with fewer flaws. In addition, due to their increased degree of conversion and their different monomer composition, some CAD-CAM blocks are more advantageous in terms of toxicity and monomer release. Finally, materials with a polymer-infiltrated ceramic network (PICN) microstructure exhibit higher flexural strength and a more favorable elasticity modulus than materials with a dispersed filler microstructure. Consequently, some high-performance composite CAD-CAM blocks—particularly experimental PICNs—can now rival glass-ceramics, such as lithium-disilicate glass-ceramics, for use as bonded partial restorations and crowns on natural teeth and implants. Being able to be manufactured in very low thicknesses, they offer the possibility of developing innovative minimally invasive treatment strategies, such as “no prep” treatment of worn dentition. Current issues are related to the study of bonding and wear properties of the different varieties of CAD-CAM composites. There is also a crucial need to conduct clinical studies. Last, manufacturers should provide more complete information regarding their product polymerization process, microstructure, and composition, which significantly influence CAD-CAM material properties.

Effect of Bleaching Agents on the Nanohardness of Tooth Enamel, Composite Resin, and the Tooth-Restoration Interface

This in vitro study aimed to evaluate the nanohardness of tooth enamel, composite resin, dental adhesive, and enamel hybrid layer exposed to 35% hydrogen peroxide-based bleaching agents and analyze the tooth-restoration interface using scanning electron microscopy (SEM). This study used 40 crowns of bovine incisors, which were embedded in epoxy resin. A 2 × 2 × 2-mm cavity was prepared in the medial third of the flattened buccal surface of each tooth and restored (two-step etch-and-rinse Adper Single Bond 2 + nanocomposite resin Filtek Z350 XT). The specimens were polished and divided into four groups (n=10), corresponding to each bleaching agent used (TB: Total Blanc Office, pH=7.22–6.33; HPB: Whiteness HP Blue, pH=8.89–8.85; HP: Whiteness HP, pH=6.65–6.04; PO: Pola Office, pH=3.56–3.8), applied in accordance with manufacturer protocols. The nanohardness of the substrates was measured before and immediately after the bleaching procedure and after 7-day storage in artificial saliva with an Ultra-Microhardness Tester (DUH-211S, Shimadzu). Loads used were 100 mN for tooth enamel and composite resin and 10 mN for adhesive and enamel hybrid layer. For SEM analysis, epoxy replicas were prepared through high-precision impressions of the specimens. For nanohardness, the statistical tests two-way analysis of variance and Tukey (p&lt;0.05) revealed that the agent with the lowest pH value (PO) was the only one to decrease the nanohardness of enamel and the enamel hybrid layer immediately after its application; however, after 7-day storage in artificial saliva, the nanohardness levels of these substrates returned to their original values. SEM analysis revealed small gaps between tooth enamel and adhesive after the exposure to all bleaching agents; however, the most evident gap in the tooth-restoration interface was observed immediately after application of agent PO. No bleaching agent used changed the nanohardness of the composite resin and adhesive layer.

Gene expression analysis of conventional and interactive human gingival cell systems exposed to dental composites

OBJECTIVES

The aim of this study was the detection of putative gene expression-related effects of dental composites in conventional and interactive gingival cell systems.

METHODS

Conventional monoculture (MC) and interactive cell systems (ICS) comprising human gingival fibroblast (HGF) and immortalized human gingival keratinocytes (IHGK) were exposed for 24h and 7 days according to ISO10993-12:2012 manufactured eluates of different composites (Ceram X(®), Filtek™ Supreme XT, Filtek™ Silorane, Fusio™ Liquid Dentin, and Vertise™ Flow). qRT-PCR-based mRNA analysis for biomarkers indicating cell proliferation, differentiation, apoptosis, inflammation, and adhesion was performed. Apoptotic cells were quantified by annexin-V labeling.

RESULTS

Due to low RNA amounts, qPCR could not be performed for Vertise™ Flow and Fusio™ Liquid Dentin at day 7. At 24h, flowables yielded increased transcription for biomarkers of inflammation and apoptosis in IHGK, irrespective of the cell system. HGF cultures displayed lower transcription for cell adhesion markers in both cell systems. Filtek™ Supreme XT showed increased differentiation by elevated filaggrin gene expression in both cell systems for IHGK at day 7, while Filtek™ Silorane and Ceram X(®) yielded elevation of inflammation biomarkers in both cell types. Annexin-V labeling revealed high apoptosis rates for both flowables and Filtek™ Supreme XT for IHGK, while low rates were detected for Filtek™ Silorane and Ceram X(®).

SIGNIFICANCE

Among the composites evaluated, exposition of IHGK and HGF in conventional and interactive cell systems demonstrated most pronounced gene expression alterations in response to flowables, coinciding with elevated levels of apoptosis.

Elution of Monomers from Provisional Composite Materials

The aim of this study was to evaluate the elution of substances from different materials used for the manufacturing of temporary indirect restorations, after storage in saliva and ethanol 75%. 10 samples of three chemically cured materials (Protemp 3 Garant, Systemp.c&b, and Trim) and one light-cured material (Clip F) were stored in saliva and ethanol 75% for 24 h, 7, and days 28 days. From the storage media at each time period, samples were prepared and analysed by LC-MS/MS, in order to access the elution of monomers. The results differed among the materials (P≤ 0.05). No monomers were detected in the samples of Protemp 3 Garant and Clip F. Substances were detected only in ethanol samples of Systemp.c&b and Trim. The amount of BisGMA, TEGDMA, and UDMA 2 released from Systemp.c&b was higher compared to Trim. Storage time affected the release of substances (P≤ 0.05). The highest release was observed within the first 24 h. It can be concluded that provisional resin composite materials do not show high release of monomers and this release is material dependent. However, the detection of additional peaks during the analysis, suggesting the formation of by-products of the eluted substances, may not be in favour of these materials with respect to their toxicity.

Investigation of the correlation between the different mechanical properties of resin composites

The aim of this study was to investigate the relationship between the different mechanical properties with the filler fraction of various resin composites. Mechanical properties of eighteen different resin composites were investigated in this study; flexural strength (FS), flexural modulus (FM), fracture toughness (FT), compressive strength (CS), diametral tensile strength (DTS), Barcol hardness (BH), Vickers hardness (HV), and Knoop hardness (HK). The mean values of mechanical properties and the filler fractions (V(f )) obtained from the literature and the manufacturer were analyzed using Pearson's correlation test at p<0.01. The relationships were compared with the data retrieved from previous studies. Strong correlations between Vf and BH/HV/HK and V(f) and FM were evident in the results of the present study and these results were supported by the retrieved data from previous studies. The other relationships between mechanical properties, such as that between FS and FM and between CS and HV were not significant.

Performance of the experimental resins and dental nanocomposites at varying deformation rates

AIM

The aim of the present study was to evaluate the bi-axial flexural strength of experimental unfilled resins and resin-based composites at varying deformation rates following 1-week dry, 1-week wet, and 13-week wet storage regimes.

METHODS

A total of 270 disc-shaped specimens (12 mm diameter, 1 mm thickness) of either unfilled resins or experimental resin-based composites comprising of three groups (n = 90) were fabricated. Three groups of each unfilled resin and resin-based composites (n = 90) were stored for 1 week under dry conditions, and at 1 and 13 weeks under wet conditions (37 ± 1°C) before testing. The bi-axial flexural strength of each unfilled resin and resin-based composites group was determined at a 0.1, 1, and 10 mm/min deformation rate (n = 30).

RESULTS

The unfilled resins revealed a deformation rate dependence following all storage regimes; however, the addition of fillers in the unfilled resins modified such reliance following the 1-week dry and 13-week wet storage regimes. In contrast, a lower bi-axial flexural strength of the 1-week wet resin-based composites specimens at a 0.1 mm/min deformation rate was identified.

CONCLUSION

A lower bi-axial flexural strength of the 1-week wet resin-based composites specimens at a low deformation rate suggests that premature failure of resin-based composites restorations might occur in patients with parafunctional habits, such as bruxism.

Effect of repeated preheating cycles on flexural strength of resin composites

The aim of this study was to assess the flexural strengths of three resin composites prepared at room temperature or cured after 20 or 40 cycles of preheating to a temperature of 45°C. Three resin composites were evaluated: Enamel Plus HFO (Micerium) (HFO), Enamel Plus HRi (Micerium) (HRi), Opallis + (FGM) (OPA). One group of specimens for each composite was fabricated under ambient laboratory conditions, whereas in the other groups, the composites were cured after 20 or 40 preheating cycles to a temperature of 45°C in a preheating device. Ten specimens were prepared for each group. A three-point bending test was performed using a universal testing machine at a crosshead speed of 0.5 mm/min. Data were analyzed with a two-way analysis of variance (ANOVA) test and a Games-Howell test (α = 0.05). The two-way ANOVA showed that both the material and the number of heating cycles were significant factors, able to influence the flexural strength values (p<0.05). However, there was not a statistically significant interaction (p>0.05). For all three composites flexural strengths were not affected after 20 preheating cycles in comparison with the control groups (0 preheating cycles) but were, however, significantly decreased when 40 prewarming cycles were conducted. The HRi and OPA groups had the highest flexural strengths, with no statistically significant differences among them. HFO presented significantly lower flexural strengths in comparison with HRi.

Human gingival keratinocyte response to substances eluted from silorane composite material reveal impact on cell behavior reflected by RNA levels and induction of apoptosis

OBJECTIVES

The aim of this study was the characterization of siloran-derived composite eluates in conjunction with their putative impact on human gingival keratinocytes (HGK), i.e. levels of total RNA and induction of apoptosis compared to a methacrylate-based material.

METHODS

Standardized Filtek™ Silorane specimens (n = 20) were subjected to scanning ion monitoring to detect monomer masses between 100 and 1000, after storage in human saliva, and 75% ethanol for up to 28 days. In order to evaluate the effect on cells, HGK were exposed to eluates from Filtek™ Silorane, Filtek™ Supreme XT and control medium for 1 and 4 days, prior to isolation of total RNA, and Annexin-5 fluorescence labeling indicating induction of apoptosis.

RESULTS

Irrespective of the mode and storage time, SIM identified discrete peaks, corresponding to masses of "393" and "337". In response to both composite eluates, an effect on HGK was reflected by drastically reduced levels of isolated total RNA at each time period (after 1 day: control: 302 ng/μl; Filtek™ Silorane: 128 ng/μl, Filtek™ Supreme XT: 129 ng/μl and after 4 days: control: 528 ng/μl; Filtek™ Silorane: 162 ng/μl, Filtek™ Supreme XT: 166 ng/μl). Exposure to eluates from both composite materials yielded apoptosis induction in HGK, as demonstrated by a significant increase of cells exhibiting Annnexin-5 fluorescence.

SIGNIFICANCE

Two distinct peaks were identified, which indicated the presence of corresponding substances. The composite-derived effects on HGK strongly suggest a negative impact on cells, as revealed by a clear reduction of total RNA levels, and significant increase in induction of apoptosis.

Correlation between surface roughness and microhardness of experimental composites with varying filler concentration

AIM

The purpose of this study was to investigate the influence of the surface roughness on the surface microhardness of experimental composites with varying filler concentration.

MATERIALS AND METHODS

Experimental resin composites were formulated by mixing Bis-GMA and TEGDMA in a 50/50% weight ratio and CQ/EDAB were added to make the material photosensitive. Silanized glass particles were incorporated in the resin blend in two concentrations: C50 with 50% and C75 with 75% in weight ratio. The surface roughness and the surface microhardness measurements were determined after every three finishing procedures with #280-, #600- and #1200-grit wet sandpapers, respectively. The data were analyzed statistically by Two Way ANOVA and Tukey's test, and comparisons were conducted using the Spearman's correlation test (p > 0.05).

RESULTS

The surface roughness and surface microhardness were negatively associated (r = - 0.68) and the finishing procedures of both composites resulted in harder and smoother surfaces than the initial ones. Additionally, in a smooth circumstance, the higher content of fillers has not resulted in a composite with better microhardness and smoothness.

CONCLUSION

Finishing procedures decreased the surface roughness and consequently improved the surface microhardness of the composites evaluated.

CLINICAL SIGNIFICANCE

Finishing and polishing procedures are effectives in reducing the surface roughness amplitude of composite materials and in improving their surface microhardness. Thus a microhardness test and any hardness evaluation must be conducted only after a properly finished and polished surface is achieved.

The effect of ceramic restoration shade and thickness on the polymerization of light- and dual-cure resin cements

OBJECTIVES

Inadequately polymerized resin cements may negatively affect the clinical performance of cemented all-ceramic restorations. The purpose of this in vitro study was to evaluate the effect of ceramic thickness and shade on the microhardness of various light-cured (LC) and dual-cured (DC) resin cements. The amount of light transmission through the restoration was also evaluated to correlate the results.

METHODS

Three different brands of resin cements (Appeal/Ivoclar; Calibra/Dentsply; Nexus 2/Kerr) were used in LC and DC forms to prepare disk-shaped samples (0.5-mm thickness × 5-mm diameter) (n=15). Study group samples were light-cured for 40 seconds (Flashlite 1401/Discus Dental) through four shades (ETC1, ETC2, ETC3, ETC4) and four thicknesses (1 mm, 2 mm, 3 mm, 4 mm) of all-ceramic ingot discs (IPS Empress Esthetic/Ivoclar). Control samples were directly cured without the presence of ceramic. The light transmission through various shades and thicknesses of ceramics was measured using a hand-held radiometer (Demetron, Kerr). Vickers microhardness measurements were performed (Micromet/Buehler) at 24 hours following dark storage in 37°C water. Correlation between ceramic shade, thickness, and light intensity readings (mW/cm2) with respect to microhardness was statistically evaluated using analysis of variance (p=0.05).

RESULTS

Ceramic thickness of 3 mm and/or above significantly decreased the microhardness values in all LC and DC groups (p<0.0001). Ceramic shade had a significant effect only on Calibra in both LC and DC groups (p<0.0001). Microhardness values of LC groups were significantly lower than DC groups (p<0.0001). Control groups had significantly higher hardness values in all cement groups (p<0.0001). There was a significant correlation between the amount of light transmitted and hardness (p=0.000).

CONCLUSION

The ceramic thickness has a more intense effect on polymerization compared to the ceramic shade. Overlying ceramic thickness of 3 mm and above was found to adversely affect the polymerization of LC and DC resin cements and therefore a 3-mm thickness was considered the critical threshold.

Effect of light sources on nanohardness, elastic modulus and water sorption of a composite resin

The aim of this study was to evaluate the effect of a light source on nanohardness, elastic modulus, water sorption and solubility of a composite resin. Four curing units were used, three of which had an LED and another had a halogen source. The resin composite Z250 (3M ESPE) was used for all tests. For water sorption and solubility, five resin disks were made (15 mm in diameter and 1 mm thick), and these were polymerized for 20 seconds at nine different points (1 in the center and 8 around). For nanohardness and elastic modulus evaluation, 20 cylinders (5 for each group) were made with a bipartite steel matrix (6.0 mm diameter and 4.0 mm thick). The results of this study showed that the group polymerized with the Radii light-curing unit presented less water sorption than other curing units (p < 0.05). No statistical difference between units was found in nanohardness in 1mm-thick specimens. However, decreased nanohardness was shown at higher resin composite depth (p < 0.05). A Pearson correlation showed a strong positive relationship between nanohardness and elastic modulus for all groups and depths. The light source affects the water sorption, nanohardness and elastic modulus of composite resins.

Effect of Bleaching on Microhardness of Esthetic Restorative Materials

High-concentration carbamide peroxide containing home bleaching may cause a varying influence on the microhardness of esthetic restorative materials.

Indirect resin composites

Aesthetic dentistry continues to evolve through innovations in bonding agents, restorative materials, and conservative preparation techniques. The use of direct composite restoration in posterior teeth is limited to relatively small cavities due to polymerization stresses. Indirect composites offer an esthetic alternative to ceramics for posterior teeth. This review article focuses on the material aspect of the newer generation of composites. This review was based on a PubMed database search which we limited to peer-reviewed articles in English that were published between 1990 and 2010 in dental journals. The key words used were 'indirect resin composites,' composite inlays,' and 'fiber-reinforced composites.'

Depth of cure of dental composites submitted to different light-curing modes

Objective:

This study evaluated the depth of cure of five dental composites submitted to different light-curing modes.

Material and Methods:

Canal-shaped cavities with 5mm of length were prepared on the buccal surfaces of extracted third molars, and restored using P-60, A-110, Admira, Z-250 and Supreme resin composites. Materials were light-cured from the top, according to three modes (Group 1- Conventional (C): 500 mW/cm²/ 40 s; Group 2 – Soft-Start (SS):250 mW/cm²/ 20 s + 500 mW/cm²/ 20 s + 500 mW/cm²/ 10 s and Group 3 – LED: 250 mW/cm²/ 40 s). After that, cavity longitudinal surfaces were polished and marked with a millimeter scale of 4mm of length. Depth of cure was evaluated by means of Knoop hardness number (KHN), so that five indentations were performed at each millimeter. Original data were submitted to three-way ANOVA and Fisher's LSD test (α = 0.01).

Results:

All materials presented a significant reduction on KHN from first to third millimeter. Regarding depth of cure, the results obtained for Conventional and Soft-Start modes were similar, but statistically superiors to those found for group 3 (LED). Conclusion: This performance may be related to the differences among energy densities obtained with different light-curing modes.

Flexural strength and hardness of direct and indirect composites

The objective of this study was to evaluate the flexural strength (sigma f) and hardness (H) of direct and indirect composites, testing the hypotheses that direct resin composites produce higher sigma f and H values than indirect composites and that these properties are positively related. Ten bar-shaped specimens (25 mm x 2 mm x 2 mm) were fabricated for each direct [D250 - Filtek Z250 (3M-Espe) and D350 - Filtek Z350 (3M-Espe)] and indirect [ISin - Sinfony (3M-Espe) and IVM - VitaVM LC (Vita Zahnfabrik)] materials, according to the manufacturer's instructions and ISO4049 specifications. The sigma f was tested in three-point bending using a universal testing machine (EMIC DL 2000) at a crosshead speed of 0.5 mm/min (ISO4049). Knoop hardness (H) was measured on the specimens' fragments resultant from the sigma f test and calculated as H = 14.2P/l(2), where P is the applied load (0.1 kg; dwell time = 15 s) and l is the longest diagonal of the diamond shaped indent (ASTM E384). The data were statistically analyzed using Anova and Tukey tests (alpha = 0.05). The mean sigma f and standard deviation values (MPa) and statistical grouping were: D250 - 135.4 +/- 17.6a; D350 - 123.7 +/- 11.1b; ISin - 98.4 +/- 6.4c; IVM - 73.1 +/- 4.9 d. The mean H and standard deviation values (kg/mm(2)) and statistical grouping were: D250 - 98.12 +/- 1.8a; D350 - 86.5 +/- 1.9b; ISin - 28.3 +/- 0.9 c; IVM - 30.8 +/- 1.0 c. The direct composite systems examined produce higher mean sigma f and H values than the indirect composites, and the mean values of these properties were positively correlated (r = 0.91), confirming the study hypotheses.

Effect of LED Light-curing on the Relative Hardness of Tooth-colored Restorative Materials

The use of high intensity LED curing units will result in the polymerization of tooth-colored restoratives using shorter times.

Evaluation of monomer leaching from a dual cured resin cement

PURPOSE

An increasing number of inlay cavities is restored with tooth-colored materials, especially ceramics are cemented with resin cements. The comonomer TEGDMA and other monomers Bis-GMA and UDMA have been identified as the main compounds released from polymerized resin cements into aqueous media. The present investigation was conducted to clarify the leaching behavior of the monomers of dual polymerized resin cement.

MATERIAL AND METHODS

Ten freshly extracted caries and restoration free molar teeth were used in this study. Standardized Class I preparations were prepared in all teeth. Lithium disilicate based (IPS Empress Esthetic) ceramic inlays were cemented with dual polymerized resin cement (Variolink II). After cementation, specimens were stored in 75% ethanol solution. High-performance liquid chromatography (HPLC) was used to analyze the amounts of three monomers in the solution (after 10 min, 1 h, 24 h, 3, 7, 14, and 21 days). Two-way ANOVA and Tukey HSD tests were used to evaluate the results (p < 0.05).

RESULTS

There were statistically significant differences among the amounts of the monomers (p < 0.01) and also among time periods (p < 0.01). While the TEGDMA resulted in significantly higher amount than Bis-GMA and UDMA, there were no statistically significant differences between amounts of Bis-GMA, UDMA (p = 0.06). The cumulative amount of monomers was the highest after 21 days (p < 0.01).

CONCLUSION

In the case of resin cement, leaching of TEGDMA was the highest and the cumulative amount of leaching monomers from resin cement was influenced by the time.

The Influence of One-step Polishing Systems on the Surface Roughness and Microhardness of Nanocomposites

One-step polishing systems exhibited similar or better surface roughness values when compared to multi-step polishing systems. In all groups, mylar-strip created surfaces showed lower microhardness values than polished surfaces. Different polishing procedures did not effect the microhardness of nanocomposites. One-step polishing systems may be a good choice for polishing nanocomposites, resulting in reduced chair time.

Influence of Light-polymerization Modes on the Degree of Conversion and Mechanical Properties of Resin Composites: A Comparative Analysis Between a Hybrid and a Nanofilled Composite

The nanofilled composite presented a lower degree of conversion, flexural modulus and flexural strength than the hybrid composite. On the other hand, the two materials had a similar hardness. The light polymerization mode influenced only the degree of conversion and the hardness of composites.

Evaluation of the curing depth of two translucent composite materials using a halogen and two LED curing units

This in vitro study evaluated the influence of one halogen and two light-emitting diode (LED) curing units on the curing depth of a conventional hybrid and two translucent resin composites by measuring the Knoop microhardness. In the first part of the study, a conventional hybrid resin composite and three curing units (one halogen: 40 s polymerization time, two LEDs: 10 and 20 s) were used. Ten cylindrical resin composite samples were prepared for each curing unit and each polymerization time tested. After polymerization, the soft part of the samples was removed. The samples were embedded in a polyacrylic resin and separated in the middle towards the direction, top-bottom. On the section plane, Knoop microhardness measurements were performed every 1 mm, starting at 0.5 mm under the surface. In the second part of the study, two translucent resin composites and a conventional hybrid composite resin were cured with the three curing units, and the microhardness was measured as mentioned above. The difference between the curing units tested was found statistically significant (p = 0.0009), as well as the difference between the materials concerning curing depth (p = 0.0001). Both translucent materials achieved microhardness values equal to the 80% of the surface values, in depths 3.5-5.5 mm, depending on the curing units used.

Shrinkage behaviour of flowable resin-composites related to conversion and filler-fraction

OBJECTIVES

To evaluate the shrinkage-strain, degree of conversion (DC) and percent filler of a range of flowable resin-composites.

METHODS

Several commercially available flowable resin-composites were selected. The bonded-disk technique was used to measure shrinkage-strain kinetics. Measurements were obtained continuously for 60min by irradiation for 40s at 750mW/cm(2) at two initial temperatures of 23 and 37 degrees C. Three repetitions (n=3) were made at each temperature per material. The DC was measured by FTIR spectroscopy immediately post-cure. The percent filler was determined by combustion of specimens for 1h at 400 degrees C.

RESULTS

The final values of shrinkage-strain ranged from 2.61 to 6.25% at 23 degrees C and from 3.88 to 6.56% at 37 degrees C. Statistically significant differences (p<0.05) were found in shrinkage-strain between the flowable resin-composites at both temperatures 23 and 37 degrees C. Significantly higher values were obtained at 37 degrees C (p<0.05). A strong inverse correlation was found between the percent filler and the shrinkage-strain at 37 and 23 degrees C (r(2)=0.94 and 0.87, respectively). No correlation was found between shrinkage-strain and DC (p>0.05).

CONCLUSIONS

Flowable resin-composites vary widely in shrinkage-strain magnitude and the inverse relationship between filler percent and shrinkage-strain is explained by the corresponding decrease in volume fraction of monomers present to undergo polymerisation.

Diametral tensile strength of composite resins submitted to different activation techniques

The aim of this study was to evaluate the diametral tensile strength (DTS) of composite resins submitted to different curing techniques. Four composite resins were tested in this study: Targis (Ivoclar), Solidex (Shofu), Charisma (Heraeus-Kulzer) and Filtek Z250 (3M Espe). Sixty-four cylindrical specimens were prepared and divided into eight groups according to each polymerization technique (n = 8). The indirect composite resins (Targis and Solidex) were polymerized with their respective curing systems (Targis Power and EDG-lux); Charisma and Filtek Z250 were light-cured with conventional polymerization (halogen light) and additionally, with post-curing systems. Specimens were stored in artificial saliva at 37 degrees C for one week. DTS tests were performed in a Universal Testing Machine (0.5 mm/min). The data were statistically analyzed by ANOVA and Duncan tests. The results were (MPa): Z250/EDG-lux: 69.04 feminine; Z250/Targis Power: 68.57 feminine; Z250/conventional polymerization: 60.75b; Charisma/Targis Power: 52.34c; Charisma/conventional polymerization: 49.17c; Charisma/EDG-lux: 47.98c; Solidex: 36.62d; Targis: 32.86d. The results reveal that the post-cured Z250 composite resin showed the highest DTS means. Charisma composite presented no significant differences when activation techniques were compared. Direct composite resins presented higher DTS values than indirect resins.