Effect of two artificial aging protocols on color and gloss of single-shade versus multi-shade resin composites

Color Stability of Single-Shade Resin Composites in Direct Restorations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

The objective was to compare the color match and color stability behavior of single- and multi-shade resin-based composites (RBCs) used for direct restorations. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized clinical trials evaluating the shade performance of single-shade RBCs in direct restorations were included. A search of the scientific literature was performed in five databases (April 2024). The meta-analysis was performed using RevMan 5.4, calculating the risk difference (RD) and 95% confidence interval (CI) of the dichotomous outcome using a random effects model. Bias was assessed using the RoB 2.0 tool, and certainty of evidence was assessed using the GRADEpro tool. Four studies were selected, with 263 restorations analyzed. The results showed comparable performance between single-shade RBCs and multi-shade RBCs in terms of color match and color stability over 12 months. Three studies had a low risk of bias with all expected results, and one study had some concerns. The certainty of evidence for color stability was considered low for all follow-up periods due to the small number of events and sample size. According to the United States Public Health Service Evaluation (USPHS) and the World Dental Federation (FDI), there is comparable clinical color performance between single-shade and multi-shade RBCs over 12 months.

Assessing one-shade composite resin color stability in response to everyday drinks

OBJECTIVE

The aim of our study was to measure the color changes in one-shade composite resins when exposed to common drinks, such as tea, cola and coffee.

MATERIALS/METHODS

In our study, Omnichroma, Vitrra APS Unique, GC A'chord and Charisma Diamond One composite resins were used. Composite resins were placed in stainless steel molds with depths of 2 mm and diameters of 5 mm. Ten specimens were immersed in tea, 10 specimens were immersed in coffee, 10 specimens were immersed in cola and 10 specimens were immersed in distilled water in an incubator at 37 °C for 14 days. Color measurements were performed at the beginning of the study and after 24 h and 14 days. Color values ​​were measured using a CIE L*a*b* system with a spectrophotometer device. Color and translucency changes were calculated and data analyzed using one-way ANOVA, two-way ANOVA, and post-hoc Tukey test (p < 0.05).

RESULTS

The greatest color changes occurred in the tea and coffee groups; the smallest color change occurred in the control group. After 14 days, the greatest color change was observed in the Charisma + Coffee group; the smallest color change was observed in the Omnichroma + Water group. The transparency and contrast ratios changed in all groups, and the smallest change occurred in the Omnichroma control group.

CONCLUSION

Significant differences were found in the composite color changes after immersion in beverages. The color variations significantly differed depending on the beverage in which the specimens were immersed. The initial contrast ratio was markedly different from the examined materials.

CLINICAL SIGNIFICANCE

The study emphasizes the significance of common beverages on the color stability of one-shade composite resins, underlining the need of appropriate material selection for long-term aesthetic effects in one-shade composite resin restorations.

Color change of tooth-colored restorative materials bonded to silver diamine fluoride-treated dentine: a systematic review

BACKGROUND

The desirable properties of silver diamine fluoride (SDF) make it an effective agent for managing dental caries and tooth hypersensitivity. There are several clinical instances that SDF application might precede the placement of direct tooth-colored restorations. On the other hand, SDF stains demineralized/carious dental tissues black, which might affect the esthetic outcomes of such restorations. Color is a key parameter of esthetics in dentistry. Therefore, this study aims to systematically review dental literature on color/color change of tooth-colored restorations placed following the application of SDF on dentine.

METHODS

Comprehensive search of PubMed, Embase, Scopus and ISI Web of Science databases (until August 2023) as well as reference lists of retrieved studies was performed. In vitro studies reported color or color change of tooth-colored restorative materials applied on SDF-treated dentine were included. Methodological quality assessment was performed using RoBDEMAT tool. Pooled weighted mean difference (WMD) and 95% confidence interval (95% CI) was calculated.

RESULTS

Eleven studies/reports with a total of 394 tooth-colored restorations placed following a) no SDF (control) or b) SDF with/without potassium iodide (KI)/glutathione dentine pre-treatments were included. Color change was quantified using ∆E formulas in most reports. The pooled findings for the comparison of resin-based composite (RBC) restorations with and without prior 38% SDF + KI application revealed no statistically significant differences in ∆E values at short- and long-term evaluations (~ 14 days: WMD: -0.56, 95% CI: -2.09 to 0.96; I2: 89.6%, and ~ 60 days: WMD: 0.11; 95% CI: -1.51 to 1.72; I2: 76.9%). No studies provided sufficient information for all the items in the risk of bias tool (moderate to low quality).

CONCLUSIONS

The limited evidence suggested comparable color changes of RBC restorations with and without 38% SDF + KI pre-treatment up to 60 days. The included studies lacked uniformity in methodology and reported outcomes. Further studies are imperative to draw more definite conclusions.

PROTOCOL REGISTRATION

The protocol of this systematic review was registered in PROSPERO database under number CRD42023485083.

In vitro comparison of one-step, two-step, and three-step polishing systems on the surface roughness and gloss of different resin composites

OBJECTIVES

This laboratory study evaluated the effect of three polishing systems on the surface roughness and gloss of resin composites.

MATERIALS AND METHODS

Thirty specimens (6 mm Ø × 8 mm) were fabricated from each of three resin composites: Z 350 XT (nanofill), Harmonize (nanohybrid), and Estelite Omega (supranonofill). All specimens were photopolymerized using a multi-peak LED curing unit (VALO-Standard mode), having a exitance irradiance of approximately 1000 mW/cm2 against a polyester strip (PS). 2 mm was then removed from the irradiated end (finished) using #320 abrasive paper (F). Specimens were then randomly polished (P) using a one-step (1S) (OneGloss), two-step (2S) (EVE Diacomp Twist Basic CA), or 3-step (3S) (Astropol P) system (n = 10). For PS, F, and P groups, surface roughness (Ra) was measured using a surface roughness tester, and surface gloss was measured with a glossmeter. For each specimen, the percent recovery to the PS value (%R) of surface roughness and surface gloss were calculated. Data were analyzed using two-way ANOVA, followed by Tukey's test. Surface roughness and gloss values were submitted to Pearson's correlation test (α = 0.05). All statistical testing was performed using a pre-set alpha of 0.05.

RESULTS

The interaction term [resin composite × polishing system] was significant for both surface roughness (p = 0.001) and gloss (p = 0.0001). For all resin composites, the 2S and 3S systems provided a higher %R of surface roughness and gloss compared to those of the 1S system. There was a negative correlation between surface roughness and gloss, but only a few combinations showed strong correlations.

CONCLUSIONS

The 2S and 3S polishing systems provided surfaces having greater smoothness and gloss compared to the 1S system. The ability to recover surface roughness and gloss was dependent on type of resin composite filler classification.

CLINICAL SIGNIFICANCE

The 3S and 2S polishing systems were more effective in achieving PS values than was the 1S system for all tested resin composites. However, individual polishing systems performed differently depending on type of resin composite.

In Vitro Comparison of Optical Properties Between Single-Shade and Conventional Composite Resin Restorations

INTRODUCTION

The recently developed single-shade composite resin (using the concept of structural coloring) is a promising option to eliminate the process and subjectivity of shade selection. However, current evidence of its performance is still insufficient. This study aimed to evaluate the color matching, color stability, and refractive index (RI) of single-shade restorations compared with conventional composite resin.

METHODS

This in vitro study was conducted on 48 extracted maxillary premolars. The teeth were sorted into three tooth shade groups (B2, A3, and A3.5). Each group included two subgroups based on the materials used: Omnichroma (OM; Tokuyama Dental, Tokyo, Japan) and Filtek Z350 (FT; 3M ESPE, St. Paul, MN, USA). Buccal and lingual Class V round cavities were prepared and restored according to the randomly assigned subgroups, with the test single-shade material (OM) on one surface and the matching conventional control material (FT) of the proper shade on the other surface of each tooth. Color matching was evaluated by visual assessment and a spectrophotometer. All specimens were distributed into four staining groups and immersed in various staining beverages (black coffee, Arabic coffee, Coca-Cola, and distilled water) for four weeks. Color changes were assessed using a spectrophotometer. Four groups of disc-shaped specimens (single-shade, B2, A3, and A3.5) were fabricated to evaluate the RI using a refractometer. Statistical analyses were performed to compare the materials.

RESULTS

The mean value of the color difference (ΔE) of single-shade restorations was significantly higher than that of paired conventional restorations in all shade groups. The highest mean ΔE was in subgroup A3.5-OM (8.84 ± 2.39) and showed significantly less color matching than other OM subgroups (p=0.009). The visual assessment showed comparable and acceptable color matching in all subgroups except A3.5-OM (p=0.006). There was a significant color change after the staining test within and across staining groups, but the color change was comparable between the OM and FT subgroups. The RI of single-shade material was significantly higher than conventional material (p<0.05).

CONCLUSION

The color matching of single-shade restorations was affected by tooth shade. Its color stability was influenced by various staining substances but was similar to conventional restorations.

Staining and bleaching susceptibility of zirconia-reinforced lithium silicate glass-ceramics with different thicknesses, translucencies, and fabrication methods

STATEMENT OF PROBLEM

The influence of different thicknesses, translucencies, and fabrication methods on the spectrophotometric and topographical properties of zirconia-reinforced lithium silicate glass-ceramics (ZLSs) for dental restorations remains unclear.

PURPOSE

The purpose of this in vitro study was to investigate the effect of thicknesses, translucencies, and fabrication methods on the color stability, translucency parameter, opalescence parameter, whiteness stability, transmitted irradiance, light transmittance, opacity, gloss, and roughness of ZLSs exposed to coffee staining and bleaching treatments.

MATERIAL AND METHODS

Two pressable ZLSs (VITA AMBRIA, VA and Celtra Press, CP) and 2 machinable ZLSs (VITA Suprinity, VS and Celtra Duo, CD) were examined at high translucency (HT) and low translucency (LT) levels in 2 thicknesses (n=160). The specimens were evaluated at baseline, after coffee staining, and after bleaching. The color stability (ΔE2000), translucency parameter (TP), opalescence parameter (OP), whiteness index (WID), and whiteness stability (ΔWID) were measured with a spectrophotometer. Transmitted irradiance (It), light transmission (T), and opacity (O) were obtained from a light-polymerizing unit and a polymerization light collection device. Roughness stability (ΔSa%) was determined with an optical profilometer, and gloss stability (ΔGU%) was recorded with a gloss meter. Data of ΔCIE2000, ΔWID, ΔSa%, and ΔGU% were analyzed by 4-way ANOVA, and data of the TP, OP, WID, It, T, and O were analyzed by repeated 4-way ANOVA (α=.05).

RESULTS

VS-HT exceeded the ΔCIE2000 acceptability threshold after coffee staining and bleaching protocols. Pressable ZLSs exhibited greater color stability than machinable ZLSs. The 1-mm-thick VA, CP, and CD materials exceeded the ΔWID perceptibility threshold after bleaching. The highest TP and OP was displayed by the 1-mm-thick CP after bleaching. ΔGU increased after water storage and decreased after coffee staining and bleaching. ΔSa% significantly increased after bleaching (P<.05).

CONCLUSIONS

The color stability and other spectrophotometric properties of ZLSs depended on material thickness. The effects of ZLS fabrication methods and translucency levels on their measured properties were inconsistent. Subjecting 1-mm-thick ZLS materials to acidic media adversely impacted their stainability and surface texture.

Influence of Thickness on the Translucency Parameter and Whiteness Index of Single-Shade Resin Composites

The study aimed to evaluate the effect of thickness on the translucency parameter (TP) and whiteness index for dentistry (WID) of single-shade resin composites compared with a multi-shade resin composite after thermocycling. A total of 100 resin composite samples of five brands (Filtek Z250, Omnichroma, Vittra APS Unique, Zenchroma, and Charisma Diamond One) with thicknesses of 2 mm and 4 mm were prepared (n=10). CIE L*a*b* coordinates were obtained using a spectrophotometer. The resin composite samples were subjected to 10,000 thermocycles. Before and after thermocycling, TP values were calculated with the CIEDE2000 formula, and whiteness values were calculated using the WID. The influence of thickness, resin composite, and aging on these variables was analyzed using the generalized linear model (p<0.05). Omnichroma and Filtek Z250 exhibited, respectively, the highest and the lowest TP00 values compared with the other resin materials (p<0.001). The TP00 values of Zenchroma and Diamond One were similar (p>0.05). Vittra APS Unique had a lower TP than Zenchroma and Diamond One (p<0.001). Before thermocycling, the highest WID showed the combination of Vittra APS Unique with thicknesses of 2 mm (48.33±1.18). After thermocycling, the highest WID was shown in the combination of Vittra APS Unique with thicknesses of 2 mm (45.33±0.55) and 4 mm (46.23±0.94) (p<0.001). After thermocycling, the lowest WID was for the combination of Filtek Z250 with thicknesses 2 mm (21.16±0.93) and 4 mm (20.70±0.91) (p<0.001). The TP and WID values of the resin composites varied across different composites and thicknesses. Single-shade resin composites of different thicknesses demonstrated higher translucency and whiteness values than multi-shade resin composite, both before and after thermocycling.

Assessment of Prevalence and Causative Factors for Replacement of Composite and Amalgam Restorations: An Observational Study

Aim

This study intends to evaluate the frequency and causes of replacement for failed amalgam and composite dental restorations.

Methodology

A cross-sectional study comprising female patients with failed permanent composite and amalgam restorations aged 15-60 years old was carried out at the dental clinics of Qassim University. Using a self-structured proforma, demographic data and causes for restoration failure were recorded. The effectiveness of the restorations was assessed by using the Ryge criteria after performing clinical and radiographic examinations. The Statistical Package for Social Science was used for the statistical analysis.

Results

It is found that 84.6% of the 299 unsuccessful restorations examined were composite, and 15.4% were amalgam. The main reason for dental failure for both amalgam (95.6%) and composite (93.28%) restorations was secondary caries. Failure of amalgam restoration was largely caused by poor marginal adaptation. With varied incidences between amalgam and composite restorations, typical complaints included discomfort, sensitivity, pain, and food impaction with soreness. The main justification for replacement in amalgam restorations was sensitivity. Repair and replacement rates were similar for amalgam, composite, and mandibular/maxillary restorations. Moreover, 21.1% of individuals overall reported no symptoms, with 8.7% in the amalgam group and 23.3% in the composite group with significant differences (χ2 = 34.28, P = 0.001).

Conclusion

According to the current study, secondary caries was found to be the main reason for both amalgam and composite restoration failure. The main problems reported were sensitivity, discomfort, and pain with amalgam showing more sensitivity-related failures.

Effect of Ceramic Thickness and Technician Variability on the Shade Duplication of Dental Ceramo-Metallic Restorations

Ceramic thickness and technicians' manipulative variables are critical factors affecting the resultant shade of dental ceramo-metallic restorations. This study investigated the effect of the following variables on shade duplication of ceramo-metallic specimens: (a) ceramic thickness; (b) differences between several technicians (inter-technician variability); and (c) the ability of each technician to repeat the resultant shade (intra-technician variability). Ninety ceramo-metallic specimens were prepared and divided into three main groups (n = 30/gp) according to the different technicians who built up the veneering ceramic of the specimens. Each group was further subdivided into three subgroups (n = 10/subgroup) according to the thickness of the ceramic (1, 1.5, and 2 mm built over a 0.5 mm-thick metal substructure). Three different technicians were asked to follow the same protocol as regards the same ceramic batch (Shade 3M2, Vita VM13, Zahnfabrik, Germany), firing temperature, and number of firing cycles. Meanwhile, each technician followed his own protocol with regard to other ceramic manipulative variables. The duplicated shades of the specimens were investigated using the Vita Easyshade spectrophotometer by using the verify shade mode. Color difference (∆E) values were calculated between the target shade (3M2) and the duplicated shades of the specimens automatically by the Vita Easyshade spectrophotometer (Vita, Zahnfabrik, Germany). The effect of ceramic thickness and inter- and intra-technician variability on the duplication of the target shade was investigated. The results showed that the effect of ceramic thickness on the duplicated shades depended on inter-technician variability. High inter-technician variability (∆E = 2-6.4) was noticed in contrast to low intra-technician variability (∆E = 0.2-1.5). It could be concluded that proper shade-duplication of ceramo-metallic restoration was a cumulative technique intimately related to manipulative variables and ceramic thickness.

Effects of background color and restoration depth on color adjustment potential of a new single-shade resin composite versus multi-shade resin composites

The objectives of this study was to evaluate the effects of background color and restoration depth on color adjustment potential of a new single-shade resin composite versus multi-shade resin composites. Two multi-shade resin composites (Spectrum TPH3 and Clearfil AP-X) marked A2 shade and a new single-shade resin composite (Charisma Diamond One) were tested. Four base shades (A1, A2, A3, and A3.5) of the same resin composite (Filtek Z250) were selected as different background colors. Dual specimens with 1-, 2-, and 3-mm restoration depth and single specimens of all materials were fabricated. CIE color coordinates were measured using a spectrophotometer, then color differences (∆E00) and translucency parameter (TP00) were calculated using the CIEDE2000 formula. Independent observers performed visual scoring. CAP-I and CAP-V values were calculated according to ΔE00 and visual scoring. The results revealed that CAP-I and CAP-V were significantly affected by resin composite type, background color, and restoration depth. CAP-I and CAP-V decreased as restoration depth increased at the same background color for all materials. Charisma Diamond One had the highest CAP-I and CAP-V values at all background colors and restoration depths, with the highest TP00 value. These findings demonstrated that color adjustment potential was dependent on resin composite type, background color, and restoration depth, so shade selection is indispensable for multi-shade resin composites. Charisma Diamond One exhibited the highest color adjustment potential and the most pronounced color shifting, contributing to simplifying the process of shade selection and improving the efficiency of clinical work.

Evaluation of compressive strength, surface microhardness, solubility and antimicrobial effect of glass ionomer dental cement reinforced with silver doped carbon nanotube fillers

BACKGROUND

Conventional glass ionomer cements (GICs) are currently the most widely used dental cements due to their chemical bonding into tooth structure, release of fluoride, and ease of manipulation and usage. One of their drawbacks is their low mechanical properties and high solubility. Carbon nanotubes (CNTs) could be utilized in dentistry due to their several potential applications. CNTs can be used as fillers to reinforce polymers or other materials. Additionally, silver (Ag) nanoparticles are highly effective at preventing dental biofilm and enhancing mechanical properties.

OBJECTIVES

The aim of the present in vitro study is to evaluate the compressive strength, surface microhardness, solubility, and antimicrobial effect of the conventional GIC reinforced with manual blending of 0.01 wt.% Ag doped CNT fillers.

METHODS

The control group was prepared by mixing dental GIC powder with their liquid. The innovatively reinforced dental GIC group was prepared by incorporating 0.01 wt.% Ag doped CNT fillers into the GIC powder prior to liquid mixing. Chemical characterization was performed by XRF. While, physical characterization was done by measuring film thickness and initial setting time. The compressive strength, surface microhardness, solubility, and antimicrobial effect against Streptococcus mutans bacteria using an agar diffusion test were measured. The data was statistically analyzed using independent sample t-tests to compare mean values of compressive strength, surface microhardness, solubility, and antimicrobial activity (p ≤ 0.05).

RESULTS

The results revealed that innovative reinforced GIC with 0.01 wt.% Ag doped CNT fillers showed higher mean compressive strength, surface microhardness, and antimicrobial effect values than the conventional GIC control group; there was no significant difference between different groups in relation to the solubility test (P ≤ 0.05).

CONCLUSION

The innovatively reinforced GIC with 0.01 wt.% Ag doped CNT fillers had the opportunity to be used as an alternative to conventional GIC dental cements.

Color behavior of composite resin enhanced with different shapes of new antimicrobial polymer coated nanoparticles

BACKGROUND

Zein-coated magnesium oxide nanoparticles (zMgO NPs) demonstrate a potent antimicrobial effect, endorsing it as a compelling additive to dental materials formulations for oral health care advances. However, currently there is no data on the imprint of zMgO NPs on the color permanence of dental composites. The objective of this study is to evaluate the color stability of different types of composite enhanced with antimicrobial zein-coated magnesium oxide nanoparticles (zMgO NPs) of different shapes before and after thermocycling.

METHODS

Two hundred composite samples were divided into four groups: Gp1: Tetric N-Flow with zMgO nanowires, Gp2: Tetric N-Flow with zMgO nanospheres, Gp3: Tetric N-Ceram with zMgO nanowires; Gp4: Tetric N-Ceram with zMgO nanospheres. Each group was subdivided into 5 subgroups (n = 10) with concentrations of zMgO NPs 0%, 0.3%, 0.5%, 1% and 2%. The characterization of the modified composite containing the zMgO was done via X-ray Diffraction, Field Emission Scanning Electron Microscopy (FESEM), and Fourier Transform Infrared Spectroscopy (FTIR). Colorimetric evaluation was performed through spectrophotometry with a white background. Samples underwent color assessment using a spectrophotometer, followed by thermocycling, and then another color assessment.

RESULTS

FESEM analysis showed a uniform distribution of the zMgO nanoparticles in the composite and FTIR illustrated no change in the spectra. However, the XRD spectra exhibited an amorphous pattern in the composite enhanced with zMgO NPs. There was no compelling discrepancy in color variation ΔE among the different groups before and after thermocycling (p > 0.05). A statistically notable variation in ΔL was found amid the control and N-Flow and N-Ceram with 2% zMgO nanospheres before and after thermocycling respectively (p < 0.05). While after thermocycling, there was a statistically significant difference in Δa in N-Flow and N-Ceram wires amid the control and the different groups (p < 0.05). Additionally, after thermocycling there was a statistically significant difference in Δb in N-Flow and N-Ceram wires between the control and the different groups (p < 0.05). The Tukey test exhibited no variation among the groups with different zMgO concentrations (p > 0.05).

CONCLUSION

Enhancing N-Flow and N-Ceram composite with antimicrobial zMgO nanowires and nanospheres did not alter the total color stability of the materials before and after thermocycling.

The Effect of Different Finishing and Polishing Systems on Surface Properties of New Flowable Bulk-fill Resin Composite

AIM

The purpose of this research was to explore how various finishing and polishing techniques affect the surface roughness (Ra) and gloss of flowable bulk-fill injectable resin composite utilized for posterior teeth restoration, following exposure to a range of food-simulating liquids (FSLs) over three months.

MATERIALS AND METHODS

This study comprised fifty-six disk specimens of G-aenial™ Bulk Injectable flowable resin composite which were created using a Teflon mold (10 × 4 mm). Two techniques of finishing and polishing (F/P) were employed: The two-step 3M™ Sof-Lex™ F/P spiral wheels system and the multiple-step 3M™ Sof-Lex™ XT finishing disks supplemented by the Ultradent Jiffy HiShine polisher cup system. The Ra and gloss of the prepared specimens were measured using an interference microscope system and Horiba gloss checker respectively, immediately post-finishing and polishing and then reassessed after three months in artificial saliva and Coca-Cola.

RESULTS

The two-step system showed a statistically significant difference, exhibiting greater "surface roughness (Ra)" and lower "surface gloss (GU)" mean values compared to the multiple-step system under different storage conditions, particularly after 3 months of storage (p = 0.001).

CONCLUSION

The multiple-step polishing system improved the "Ra" and "GU" of resin composite, suggesting their suitability for posterior resin composite restorations. Acidic media had a deleterious impact on the "Ra" and "GU" of resin composite restoration.

CLINICAL SIGNIFICANCE

The quality of resin composite restorations can be significantly improved with the correct use of finishing and polishing systems, particularly in complex areas of posterior teeth restorations, leading to successful dental procedures.

Colour Parameters and Changes of Tea-Stained Resin Composite Exposed to Whitening Pen (In Vitro Study)

BACKGROUND

One of the crucial factors influencing the longevity of anterior aesthetic dental restorations is the colour stability of resin composites. Bleaching and whitening have become popular methods for enhancing dental aesthetics. Home whitening techniques, such as special pens, are widely available commercially. This in vitro study aimed to determine the efficiency of a whitening pen in removing tea stains from resin composite by measuring colour differences (ΔE₀₀). Additionally, the study aimed to evaluate the variations in colour parameters measured by extra-oral and intra-oral spectrophotometers.

METHODS

A total of 45 disc-shaped resin composite specimens were randomly divided into three groups; Group 1: stored in artificial saliva (control), Group 2: stored in artificial saliva followed by a whitening pen application, and Group 3: stored in tea followed by a whitening pen application. Colour measurements were taken three times for each specimen using two spectrophotometers (extra-oral and intra-oral devices); T1: before storage (baseline), T2: after storage in artificial saliva or tea for 6 days; and T3: after one week of whitening pen application in groups 2 and 3. The data were statistically analyzed using one-way ANOVA followed by the Tukey post hoc test (p ≤ 0.05). The independent sample t-test was also employed. The equation of CIEDE2000 (ΔE₀₀) was used to calculate the colour difference between the dry, as-prepared specimens (baseline), and those after storage or bleaching. The colour changes exceeding the acceptability threshold (∆E₀₀ = 1.8) were considered unacceptable.

RESULTS

After whitening, the colour of the specimens stored in brewed tea (Group 3) remained unacceptable, as indicated by both the extra-oral and intra-oral spectrophotometers (ΔE₀₀ = 4 and 2.9, respectively). Groups 1 and 2 exhibited lower ΔE₀₀ values than Group 3 (p = 0.01 *). No significant difference was observed between Group 1 (stored in artificial saliva) and Group 2 (stored in artificial saliva and then bleached) (p = 0.3). Significant differences were consistently observed between the data obtained from the extra-oral spectrophotometer and the intra-oral one.

CONCLUSIONS

The whitening pen proved ineffective in removing tea stains from resin composites. Although significant differences were found between the values obtained by the two spectrophotometers (extra-oral and intra-oral), both devices confirmed the unacceptable colour of the tea-stained resin composites after whitening.

Effect of immersion and thermocycling in different beverages on the surface roughness of single- and multi-shade resin composites

BACKGROUND

Resin composite restorations are highly esthetic restorations, which should have and maintain high surface polish. However, esthetic restorations are subjected to different beverages at variable temperatures, which may affect their surface roughness. This study aimed to evaluate the surface roughness of single-shade (Omnichroma) and multi-shade (Filtek Z350XT) composite materials, following aging by immersion and thermocycling in different beverages, simulating one year of clinical service.

METHODS

Thirty specimens of each material were prepared and divided into 6 subgroups (n = 5). In each material, the grouping of the specimens was as follows: the first subgroup was the as-prepared specimens stored dry without immersion or thermocycling. The second, third, and fourth subgroups were immersed in saliva, tea, and red wine, respectively, for 12 days at 37 °C. The fifth and sixth subgroups were thermocycled for 10,000 cycles, in tea (the fifth between 37 and 57 °C) and in red wine (the sixth between 37 °C and12°C). The resultant surface roughness was measured by two different methods, stylus profilometer and atomic force microscopy (AFM). Intergroup comparison was performed using independent t test, while intragroup comparison was performed using one-way analysis of variance (ANOVA) followed by Tukey's post-hoc test.

RESULTS

Intergroup comparison between both composites showed no statistically significant differences in all groups using the stylus profilometer roughness measurements (P>0.05), while the AFM measurements showed significant difference (P ≤ 0.05) within all storage media except the as-prepared control (P = 0.0645), where nanofilled Filtek Z350 XT showed lower nano-roughness. Intragroup comparison data were variable, depending on the material, aging conditions, and roughness assessment tool. However, the resultant average surface roughness (R_a) values in all groups did not exceed the threshold value of R_a 0.2 μm.

CONCLUSIONS

Both resin composites attained and retained a clinically acceptable surface finish after immersion and thermocycling in different beverages.

Effects of Polishing and Artificial Aging on Mechanical Properties of Dental LT Clear® Resin

Three-dimensional printing has become incorporated into various aspects of everyday life, including dentistry. Novel materials are being introduced rapidly. One such material is Dental LT Clear by Formlabs, a resin used for manufacturing occlusal splints, aligners, and orthodontic retainers. In this study, a total of 240 specimens, comprising two shapes (dumbbell and rectangular), were evaluated through compression and tensile tests. The compression tests revealed that the specimens were neither polished nor aged. However, after polishing, the compression modulus values decreased significantly. Specifically, the unpolished and nonaged specimens measured 0.87 ± 0.02, whereas the polished group measured 0.086 ± 0.03. The results were significantly affected by artificial aging. The polished group measured 0.73 ± 0.05, while the unpolished group measured 0.73 ± 0.03. In contrast, the tensile test proved that the specimens showed the highest resistance when the polishing was applied. The artificial aging influenced the tensile test and reduced the force needed to damage the specimens. The tensile modulus had the highest value when polishing was applied (3.00 ± 0.11). The conclusions drawn from these findings are as follows: 1. Polishing does not change the properties of the examined resin. 2. Artificial aging reduces resistance in both compression and tensile tests. 3. Polishing reduces the damage to the specimens in the aging process.

Color and Translucency Variation of a One-Shaded Resin-Based Composite after Repeated Heating Cycles and Staining

(1) Background: This study aimed to determine the effect of repeated pre-polymerization heating on the color and translucency of a one-shaded resin-based composite and to evaluate whether the heating cycles affect its color stability. (2) Methods: Fifty-six samples of 1-mm thickness were fabricated from Omnichroma (OM) after applying different heating cycles (for one, five, and ten times at 45 °C) before polymerization (n = 14/group) and afterwards were stained with a yellow dye solution. CIE L*, a*, b*, C*, h° coordinates were recorded, and color differences, whiteness, and translucency were calculated, before and after staining. (3) Results: Heating cycles significantly influenced the color coordinates, WID₀₀, and TP₀₀ of OM being higher after one heating cycle and decreasing as the number of heating cycles increased. The color coordinates, WI_D, and TP₀₀ after staining significantly differed for each group. The color and whiteness differences calculated after staining exceeded the acceptability thresholds for all groups. The color and whiteness variations after staining were clinically unacceptable. (4) Conclusions: Repeated pre-polymerization heating induces a clinically acceptable color and translucency change to OM. Although the color changes resulting after staining are clinically unacceptable, increasing the number of heating cycles up to ten times slightly reduces the color differences.

The Influence of Polishing and Artificial Aging on BioMed Amber® Resin's Mechanical Properties

Currently, 3D print is becoming more common in all branches of medicine, including dentistry. Some novel resins, such as BioMed Amber (Formlabs), are used and incorporated to more advanced techniques. The aims of the study were to check whether or not polishing and/or artificial aging influences the properties of the 3D-printed resin. A total of 240 specimens of BioMed Resin were printed. Two shapes (rectangular and dumbbell) were prepared. Of each shape, 120 specimens were divided into four groups each (with no influence, after polishing only, after artificial aging only, and after both polishing and artificial aging). Artificial aging took place in water at the temperature of 37 °C for 90 days. For testing, the universal testing machine (Z10-X700, AML Instruments, Lincoln, UK) was used. The axial compression was performed with the speed of 1mm/min. The tensile modulus was measured with the constant speed of 5 mm/min. The highest resistance to compression and tensile test were observed in the specimens that were neither polished nor aged (0.88 ± 0.03 and 2.88 ± 0.26, respectively). The lowest resistance to compression was observed in the specimens that were not polished, but aged (0.70 ± 0.02). The lowest results of the tensile test were observed when specimens were both polished and aged (2.05 ± 0.28). Both polishing and artificial aging weakened the mechanical properties of the BioMed Amber resin. The compressive modulus changed much with or without polishing. The tensile modulus differed in specimens that were either polished or aged. The application of both did not change the properties when compared to the polished or aged probes only.

In Vitro Optical and Physical Stability of Resin Composite Materials with Different Filler Characteristics

The objective of this study was to compare the physical and optical stability of resin composite materials with different filler characteristics. Ninety-six resin composite blocks (6 mm × 6 mm × 2 mm) were prepared using four different types of resin composite, divided into four groups. Specimens from the same material were randomly divided into four groups (n = 6) and allocated for Vickers hardness (VH), water sorption, solubility (WS/SL), and staining and aging challenges tests. One-way ANOVA showed significant differences in microhardness (p = 0.0001), WS (p = 0.0001), and SL (p = 0.003) among the tested groups. Beautifil II LS recorded the highest hardness, and CharmFil^®Flow had the lowest value. Beautifil Injectable X and II LS showed negative WS, whereas the other groups had positive values. All groups showed positive SL. Repeated measures ANOVA showed significant color parameter alteration in the tested groups (p = 0.0001). All groups showed significant color shifting after one week of the staining challenge. Repeated measures ANOVA showed a significant color parameter (p = 0.0001) and weight (p = 0.001) alteration after the aging challenge. The optical and physical stability of resin composites may vary according to filler characteristics. Clinicians should choose the composite as per the desired outcome.

The Toothbrushing Effects on Surface Properties and Color Stability of CAD/CAM and Pressable Ceramic Fixed Restorations-An In Vitro Study

Pressable ceramic restorations have been introduced and investigated, and found comparable to CAD/CAM ceramic in terms of mechanical properties; however, the effect of toothbrushing on the pressable ceramic has not been thoroughly investigated. The objective of the current study was to assess the effect of artificial toothbrushing simulation on the surface roughness, microhardness, and color stability of different ceramic materials. Three lithium disilicate-based ceramics (IPS Emax CAD [EC], IPS Emax Press [EP]; (Ivoclar Vivadent AG), and LiSi Press [LP] (GC Corp, Tokyo, Japan)) were examined. For each ceramic material, eight bar-shaped specimens were prepared and subjected to 10,000 brushing cycles. Surface roughness, microhardness, and color stability (∆E) were measured before and after brushing. Scanning electron microscopy (SEM) was used for surface profile analysis. The results were analyzed using one-way ANOVA, Tukey's post hoc test, and paired sample t-test α = 0.05. The findings revealed a non-significant decrease in the surface roughness of EC, EP, and LP groups (p > 0.05), and both LP and EP have the lowest surface roughness values (0.64 ± 0.13, 0.64 ± 0.08 µm) after brushing, respectively. Toothbrushing showed a decrease in the microhardness of the three groups: EC and LP, p < 0.001; EP, p = 0.012). EP showed the lowest hardness value after brushing (862.45 ± 273.83). No significant changes (∆E) were observed in all groups (p > 0.05); however, the EC group was found to be considerably affected by color changes, in comparison to the EC and LP groups. Toothbrushing had no effect on surface roughness and color stability of all tested materials, but it decreased the microhardness. Material type, surface treatments, and glazing of ceramic materials contributed to the surface changes in the ceramic materials, necessitating further investigations in terms of the toothbrushing effect with different glazing as variables.

Effect of Different Mouthwashes on the Surface Microhardness and Color Stability of Dental Nanohybrid Resin Composite

BACKGROUND

Surface microhardness and color stability of dental restorative material should be sustained throughout its functional lifetime to maintain the esthetic quality of the restoration. However, the frequent application of mouthwash may affect their surface microhardness and color stability. The aim of this study was to evaluate the effects of different types of mouthwashes with different contents on surface microhardness and color stability of dental nanohybrid resin-based composite.

METHODS

Disc specimens of nanohybrid resin composite (Luna Nano-Hybrid Composite) were prepared according to manufacturing instructions; specimens were incubated for 24 h in three types of mouthwash (Chlorohexidine, Listerine Green Tea, and Colgate Optic White Whitening Mouthwash). Artificial saliva was used as a control group. Surface microhardness was evaluated using Vickers microhardness device. Color stability after and before immersion in the different mouthwashes was evaluated using extra-oral spectrophotometer; the values of color change (ΔE₀₀) were subsequently calculated. Data were analyzed using one-way ANOVA and post hoc test (p ≤ 0.05).

RESULTS

There was no significant difference between microhardness of resin composite immersed in artificial saliva, CHX, and Green Tea mouthwashes (78.5, 78.4, and 73.5, respectively) (p ≥ 0.1), while the bleaching mouthwash led to the lowest microhardness of resin composite, with significant difference compared to the three previous immersion media (p = 0.002). Moreover, there were significant differences in the color changes (ΔE₀₀) of resin composite exposed to the various immersion media (p = 0.0001).

CONCLUSIONS

The bleaching mouthwash led to a significant reduction in nanohybrid resin composite's microhardness compared to the chlorohexidine and Green Tea containing mouthwashes. The resin composite's color change was accepted in bleaching mouthwash but unaccepted in chlorohexidine and Green Tea containing mouthwashes.

Shear Bond Strength and Color Stability of Novel Antibacterial Nanofilled Dental Adhesive Resins

Experimental adhesives containing co-doped metaloxide nanoparticles were demonstrated to display strong and long-term antibacterial properties against Streptococcus mutans biofilms. The present study represents an effort to characterize the shear-bond strength (SBS) and color stability (CS) of these novel biomaterials. Experimental adhesives were obtained by dispersing nitrogen and fluorine co-doped titanium dioxide nanoparticles (NF_TiO2, 10%, 20% or 30%, v/v%) into OptiBond Solo Plus (OPTB). Dentin surfaces were wet-polished (600-Grit). Specimens (n = 5/group) of Tetric EvoCeram were fabricated and bonded using either OPTB or experimental (OPTB + NF_TiO2) adhesives. Specimens were stored in water (37 °C) for twenty-four hours (T1), three months (T2), and six months (T3). At T1, T2, or T3, specimens were removed from water storage and were tested for SBS. Disc-shaped specimens (n = 10/group; d = 6.0 mm, t = 0.5 mm) of adhesives investigated were fabricated and subjected to thermocycling (10,000 cycles, 5−55 °C, 15 s dwell time). Specimens’ colors were determined with a VITA Easyshade® V spectrophotometer (after every 1000 cycles). SBS data was analyzed using two-way ANOVA and post-hoc Tukey tests, while CS data was analyzed using one-way ANOVA and post-hoc Tukey tests (α = 0.05). Mean values of SBS ranged from 16.39 ± 4.20 MPa (OPTB + 30%NF_TiO2) to 19.11 ± 1.11 MPa (OPTB), from 12.99 ± 2.53 MPa (OPTB + 30% NF_TiO2) to 14.87 ± 2.02 (OPTB) and from 11.37 ± 1.89 (OPTB + 20% NF_TiO2) to 14.19 ± 2.24 (OPTB) after twenty-four hours, three months, and six months of water storage, respectively. Experimental materials had SBS values that were comparable (p > 0.05) to those from OPTB independently of nanoparticle concentration or time-point considered. Experimental materials with higher NF_TiO2 concentrations had less intense color variations and were more color stable than OPTB even after 10,000 thermocycles. In combination, the results reported have demonstrated that experimental adhesives can establish strong and durable bonds to human dentin while displaying colors that are more stable, thereby suggesting that the antibacterial nanotechnology investigated can withstand the harsh conditions within the oral cavity without compromising the esthetic component of dental restorations.

Translucency and Color Stability of a Simplified Shade Nanohybrid Composite after Ultrasonic Scaling and Air-Powder Polishing

We aimed to assess the influence of professional dental prophylaxis on the translucency and color stability of a novel simplified shade nanohybrid composite material. Sixty composite disks (5 mm in diameter and 2 mm thick) of light (n = 30) and dark (n = 30) shades were prepared. The specimens were randomly divided into the following three groups (n = 10) according to the prophylaxis procedure used: ultrasonic scaling, air-powder polishing with sodium bicarbonate, and controls. The specimens were submitted to translucency and color analysis based on the CIELab system. Two measurements were performed before and after 48-h storage in coffee. Translucency values of untreated light and dark specimens were 9.15 ± 0.38 and 5.28 ± 1.10, respectively. Air-powder polishing decreased the translucency of the light composite specimens. Storage in coffee resulted in color changes (∆E) ranging between 2.69 and 12.05 and a mean translucency decrease ranging between -0.88 and -6.91. The samples in the light group tended to exhibit greater staining; the treatment method had no effect on ∆E. It can be concluded that light-shade composite restorations are more prone to translucency and color changes resulting from air-powder polishing and contact with staining media. However, further research using other composites and powders is required.