Comparing microleakage and the layering methods of silorane-based resin composite in wide Class II MOD cavities

Influence of curing mode and aging on the bonding performance of universal adhesives in coronal and root dentin

BACKGROUND

This study aims to evaluate the microtensile bond strength (µTBS) of different resin composite restorations bonded to mid-coronal dentin and proximal root dentin using light-cured, chemical-cured, and dual-cured adhesives immediately and after aging. Nanoleakage and degree of cure were also assessed.

METHODS

Eighty-four molars were divided into mid-coronal dentin and proximal root dentin. Each group was further subdivided into three subgroups based on the restorative systems used, which involved the utilization of light-cured, chemical-cured, and dual-cured adhesives. Half of the specimens underwent µTBS testing after 24 h, while the other half after aging. Representative specimens were analyzed for nanoleakage. The degree of cure of the tested adhesive systems was also assessed.

RESULTS

Aging showed a significant negative effect on µTBS results and led to increased nanoleakage (p < 0.001). Furthermore, in all subgroups, the µTBS values of proximal root dentin were lower compared to mid-coronal dentin, except in the aged subgroup for the system utilizing the dual-cured adhesive. The restorative systems with chemical and dual-cured adhesives demonstrated comparable bonding properties. However, the system with the light-cured adhesive exhibited the worst bonding properties after aging when bonded to proximal root dentin and cured at a large distance (p < 0.05).

CONCLUSIONS

All tested restorative systems were negatively affected by aging, and the regional dentin had variable effects on the bonding properties. Clinicians should exercise caution when using the tested light-cured adhesive in areas where the curing distance exceeds 3 mm.

The Effect of Gravity on Marginal Integrity of Different Flowable Bulk-Fill Resin Composites

Background and Objectives: The aim of this quantitative research was to investigate the effect of gravitational forces on the marginal integrity of different bulk-fill composites by micro-CT imaging. Materials and Methods: Fifty caries-free human third molars extracted for prophylactic purposes were used in this study. Each tooth was prepared with two proximal box cavities, with dimensions of 3 mm × 3 mm × 5 mm. Five distinct groups, each comprising 20 cavities, thus totaling 100 cavities for this study: (1, Group CON): Clearfil Majesty Flow + Clearfil Majesty Esthetic (as the control); (2, Group FBR): Filtek Bulk-fill Flowable Restorative + Clearfil Majesty Esthetic; (3, Group XTB): Voco Extrabase + Clearfil Majesty Esthetic; (4, Group SDR): SDR + Clearfil Majesty Esthetic; and (5, Group SNC): Sonicfill. When restoring the mesial cavities, the occlusal surfaces of the teeth in the mold were positioned upwards, counteracting the force of gravity. In contrast, for the restoration of the distal cavities, the occlusal surfaces were aligned downwards, to be parallel with the gravitational pull. After restorative procedures, each tooth was treated with 5000 thermal cycles. A solution of ammoniacal silver nitrate (AgNO3) was employed as a tracing agent. The micro-CT scans were conducted and the total volume of silver nitrate and the total volume of restorations within the relevant region of interest were calculated in "mm3" with software. Two-way ANOVA and Tukey tests were performed at a significance level of p = 0.05 with Graphpad Prism v 8.2.1 software. Results: Both gravity effect and interaction showed no statistical differences (p > 0.05). Statistically significant differences were observed in the restorative materials (p < 0.05). Conclusions: Gravitational forces do not emerge as a major factor affecting the marginal integrity of flowable bulk-fill composites in class II restorations. The chemical composition of the composites plays a more crucial role, with the XTB composite showing higher microleakage ratios compared to the others.

Is Deep margin elevation a reliable tool for cervical margin relocation? - A comparative review

The permanence of deep subgingival restorations are questionable both functionally and biologically. Crown lengthening is one of the traditionally performing procedures to visualize and relocate the deep margins, but the limitations of the invasive surgical procedure are anatomical complications like exposure of root concavities or furcation, violation of biological width, post operative discomfort because of sutures or periodontal packs; and less patient compliance. Other than crown lengthening, researchers tried some other techniques like modified matrix adaptation technique, using retraction cord, making holes in matrix band and flowing resin modified glass ionomer cement (RMGIC) to the root or cervical caries, orthodontic extrusion. But most of these procedures are failed to give adequate clinical success. Deep margin elevation (DME) is one of the minimally invasive and successful procedure performing in deep subgingival caries. But the evidences and knowledge in this technique is limited among practitioners. This review is to evaluate the applicability of DME, the current clinical concepts, techniques and materials for DME; and a comparison with traditionally used various techniques for cervical margin relocation also concluding that currently available various clinical parameters with this technique.

Comparison of Microleakage in Nanocomposite and Amalgam as a Crown Foundation Material Luted with Different Luting Cements under CAD-CAM Milled Metal Crowns: An In Vitro Microscopic Study

Microleakage is a persistent problem despite advancement in materials and techniques in fixed prosthodontics. This leads to the importance of sound crown foundation material and luting agents used to maintain the marginal seal. The literature is deficient with studies, comparing microleakage under various crown foundation materials and luting agents, especially with CAD-CAM (computer-aided design and computer-aided manufacturing) metal crowns. This study was aimed to compare microleakage in a nanocomposite/dentinal bonding agent and amalgam/cavity varnish as crown foundation materials luted with two different luting cements: resin-reinforced glass ionomer cement and self-adhesive resin cement, under both dry and contaminated conditions. A hundred intact, caries-free human molars were prepared to receive crown foundation material and extra coronal restorations. Amalgams with cavity varnish and nanocomposites with dentinal bonding agent in both ideal and contaminated conditions were used as crown foundation materials. After restoration, each sample was cemented with a CAD-CAM milled metal crown using two different luting agents—resin-reinforced glass ionomer cement and self-adhesive resin cements both in ideal and contaminated conditions. Cementation was followed by thermocycling of samples, immersion in erythrosine B dye, embedding in clear auto polymerizing acrylic resin and sectioning to evaluate microleakage using stereomicroscope. The mean microleakage between different luting cements on the experimental side of the facial surface was 137.64 μm and 211.01 μm for resin-reinforced GIC and for self-adhesive resin cement was 119.78 μm and 150.42 μm, under ideal and contaminated condition, respectively. There was a significant difference in mean micro-leakage between different crown foundation material and cement groups used in the study. The composites and amalgam, both when used as crown foundation material and luted with use of technically advanced CAD-CAM metal crown with self-adhesive resin cement (in both ideal or contaminated condition), showed less microleakage than in resin-reinforced glass ionomer cement. Overall, the self-adhesive resin cement showed comparatively reduced microleakage in all combinations with different crown foundations. Thus, this combination can be used in daily clinical practice to provide better protection from further decay.

Microleakage Evaluation of Expired and Non-expired Resin Composites and Bonding Agents: In Vitro Study

Aim:

Although the shelf life is a key property of dental composites and bonding agents, these materials may often be used in simple procedures after expiration. In this study, the microleakage of two year expired and non-expired dental composites (Filtek Ultimate Universal A2 Enamel, 3M ESPE, USA, and Tetric N Ceram A2, Ivoclar Vivadent, Schaan, Liechtenstein) and a universal bonding system (Single Bond Universal, 3M ESPE, USA) was examined.

Materials and Methods:

In 40 freshly extracted human molars, two standardized Class II cavities (buccolingual and mesiodistal width of 3 mm and 4 mm, respectively) were prepared (80 cavity preparations). The teeth were thermocycled in distilled water for 1000 cycles in a 5°C to 55°C water bath. Next, the teeth and their apical foramens were coated with water resistant nail varnish, except for 1 mm around the restoration–tooth interface, and retained in a 1% methylene blue solution. After 24 h, the specimens were cut into two halves and analyzed using a stereomicroscope. Scanning electron microscopy images of two samples of the groups were obtained.

Results:

The Kruskal–Wallis test indicated no significant differences between the groups ( P < .05). The occlusal median scores were not significant ( P = .99). Moreover, the gingival median scores were not significant ( P = .48). No difference was found between the occlusal and gingival values in any group ( P > .05).

Conclusion:

These findings indicated that two-year-expired dental composites and bonding agent, which were maintained under proper conditions, do not have any significant difference in terms of the microleakage.

An In-Vitro Evaluation of Microleakage in Resin-Based Restorative Materials at Different Time Intervals

A vital feature of conservative dentistry is the adhesion of the restorative material to the tooth structure for restoration of the tooth substance lost due to dental decay, trauma, or dental imperfections. In a perfect world, a restorative material should generate a lasting adhesion by bonding the restoration with tooth tissues. The ingress of micro-organisms, oral fluids, molecules, and ions through microscopic spaces due to faulty adhesion between restoration and tooth structure is known as microleakage. This study is focuses on the evaluation of adhesive failures between the restorative materials. In the past, studies have focused more on the bonding potential of a restorative material with the tooth surface. Therefore, there is need to carry out a study that compares the microleakage between resin-based restorative materials in a sandwich manner with and without the intermediate bonding layer after immersion in 2% methylene blue dye at different time intervals. The restorative materials used were composite Ceram X Mono plus (DENTSPLY) and Z350 (3M ESPE), Vitremer resin modified glass ionomer cement (RMGIC) (3M ESPE), smart dentine replacement SDR (3M ESPE), Bond NT (DENTSPLY), and Universal Bond (3M ESPE). A light emitting diode (LED) was used to cure the specimens. Artificial saliva was used as a storage medium for the specimens. Thermocycling of specimens was carried out at 500 cycles/30 s and 1000 cycles/30 s. The world health organization (WHO) grading tool for microleakage was used to analyze fluid ingress in the specimens through disclosing by 2% methylene blue dye. The statistical analysis was carried out with one-way analysis of variance (ANOVA) and Tukey post hoc test, keeping the level of significance at p ≤ 0.05. In Grade 0 = 85 samples, Grade 1 = 10 samples, Grade 2 = 7 samples, Grade 3 = 16 samples, and in Grade 4 = 2 samples were identified. This study describes that no microleakage was observed in SDR and resin composite groups as compared to Vitremer and resin composite groups.

Novel Polymerization of Dental Composites Using Near-Infrared-Induced Internal Upconversion Blue Luminescence

Blue light (BL) curing on dental resin composites results in gradient polymerization. By incorporating upconversion phosphors (UP) in resin composites, near-infrared (NIR) irradiation may activate internal blue emission and a polymerization reaction. This study was aimed to evaluate the competency of the NIR-to-BL upconversion luminance in polymerizing dental composites and to assess the appropriate UP content and curing protocol. NaYF₄ (Yb³⁺/Tm³⁺ co-doped) powder exhibiting 476-nm blue emission under 980-nm NIR was adapted and ball-milled for 4–8 h to obtain different particles. The bare particles were assessed for their emission intensities, and also added into a base composite Z100 (3M EPSE) to evaluate their ability in enhancing polymerization under NIR irradiation. Experimental composites were prepared by dispensing the selected powder and Z100 at different ratios (0, 5, 10 wt% UP). These composites were irradiated under different protocols (BL, NIR, or their combinations), and the microhardness at the irradiated surface and different depths were determined. The results showed that unground UP (d50 = 1.9 μm) exhibited the highest luminescence, while the incorporation of 0.4-μm particles obtained the highest microhardness. The combined 20-s BL and 20–120-s NIR significantly increased the microhardness on the surface and internal depths compared to BL correspondents. The 5% UP effectively enhanced the microhardness under 80-s NIR irradiation but was surpassed by 10% UP with longer NIR irradiation. The combined BL-NIR curing could be an effective approach to polymerize dental composites, while the intensity of upconversion luminescence was related to specific UP particle size and content. Incorporation of 5–10% UP facilitates NIR upconversion polymerization on dental composites.

Effect of proximal box elevation on fracture resistance and microleakage of premolars restored with ceramic endocrowns

Background

Restoration of endodontically treated premolar is in high risk for biomechanical failure, and often presents with subgingival margins. Proximal box elevation (PBE) has been used to relocate subgingival cavity outlines.

Objective

To evaluate the influence of PBE on fracture resistance and gingival microleakage of premolars with endodontic access cavities following ceramic endocrown.

Methods

Eighty sound maxillary premolars with standardized Class II cavities on mesial surfaces were randomly assigned to four groups (n = 20 in each group). Groups E1, E2 and E3, with proximal margins located in dentin/cementum, 2 mm below the cemento-enamel junction (CEJ), simulated subgingival location. Group E4 (supragingival group), with proximal margins located in enamel, 1 mm above the CEJ, was used as the positive control. For margin elevation of the proximal cavities, bulk-fill Smart Dentin Replacement (SDR), a visible light cured resin composite, was applied in group E1, and conventional resin composite (3M Z350 XT, a light-activated composite) was placed in group E2. Group E3 was only treated with a ceramic crown and served as the negative control. In all groups, computer-aided design (CAD) ceramic endocrowns were adhesively inserted, and fracture resistance, failure mode and microleakage were evaluated.

Results

A higher fracture resistance value was observed in PBE groups E1 and E2, regardless of the materials used (P = 0.038, and 0.010, respectively, vs E3), and fracture resistance in group E1 was higher than that in group E2. In teeth without PBE, the percentage of catastrophic failures reached 70%. Compared to group E3, a lower frequency distribution of microleakage was detected in supragingival group E4 (P = 0.031). No increased percentage of microleakage was observed in groups treated with PBE.

Conclusion

For endodontically treated maxillary premolars restored with ceramic endocrowns, PBE increases fracture resistance but not microleakage.

Marginal Adaptation and Micropermeability of Class II Cavities Restored with Three Different Types of Resin Composites-A Comparative Ten-Month In Vitro Study

The development of composite materials is subject to the desire to overcome polymerization shrinkage and generated polymerization stress. An indicator characterizing the properties of restorative materials, with specific importance for preventing secondary caries, is the integrity and durability of marginal sealing. It is a reflection of the effects of polymerization shrinkage and generated stress. The present study aimed to evaluate and correlate marginal integrity and micropermeability in second-class cavities restored with three different types of composites, representing different strategies to reduce polymerization shrinkage and stress: nanocomposite, silorane, and bulk-fill composite after a ten-month ageing period. Thirty standardized class ΙΙ cavities were prepared on extracted human molars. Gingival margins were 1 mm apical to the cementoenamel junction. Cavities were randomly divided into three groups, based on the composites used: FiltekUltimate-nanocomposite; Filtek Silorane LS-silorane; SonicFill-bulk-fill composite. All specimens were subjected to thermal cycles after that, dipped in saline for 10-mounds. After ageing, samples were immersed in a 2% methylene blue. Thus prepared, they were covered directly with gold and analyzed on SEM for assessment of marginal seal. When the SEM analysis was completed, the teeth were included into epoxy blocks and cut longitudinally on three slices for each cavity. An assessment of microleakage on stereomicroscope followed. Results were statistically analyzed. For marginal seal evaluation: F.Ultimate and F.Silorane differ statistically with more excellent results than SonicFill for marginal adaptation to the gingival margin, located entirely in the dentin. For microleakage evaluation: F.Ultimate and F.Silorane differ statistically with less microleakage than SonicFill. Based on the results obtained: a strong correlation is found between excellent results for marginal adaptation to the marginal gingival ridge and micropermeability at the direction to the axial wall. We observe a more significant influence of time at the gingival margin of the cavities. There is a significant increase in the presence of marginal fissures (p = 0.001). A significant impact of time (p < 0.000) and of the material (p < 0.000) was found in the analysis of the microleakage.

The Effect of Occlusal Loading on Gingival Microleakage of Bulk Fill Composites Compared with a Conventional Composite

Statement of the Problem:

Bulk fill composites have been introduced over the recent years in order to accelerate the process of tooth restoration by inserting composite in bulk up to 4mm thickness. Occlusal loading may influence the gingival microleakage of this composite.

Purpose:

This in vitro study aims to evaluate the effect of occlusal loading on the gingival microleakage of bulk fill composites compared with a conventional composite.

Materials and Method:

In this experimental study, box only class II cavities with gingival margins placed 1mm below the cemento-enamel junction were prepared on the mesial and distal surfaces of 36 maxillary premolars (72 cavities). The samples were divided into three groups and restored as follows: Group 1 (Tetric N-Ceram, incremental filling), Group 2 (X-tra fill, bulk filling), Group 3 (Tetric N-Ceram Bulk Fill, bulk filling). All restorations were thermocycled for 2000 cycles (5-50̊C) and then half of the samples were subjected to 200,000 cycles of loading. All the specimens were immersed in 0.5% basic fuchsin for 48 hours, then, sectioned, and evaluated for microleakage with a stereomicroscope. Data were analyzed using Kruskal-Wallis and Mann-Whitney U-tests. p< 0.05 was considered significant.

Results:

There were no significant differences among the gingival microleakage of three composites in both unloaded and loaded groups. In addition, no statistically significant difference was found between the microleakage of unloaded and loaded groups in all materials.

Conclusion:

Occlusal loading did not affect the gingival microleakage of bulk fill composites, and the microleakage of class II cavities restored with the bulk filling technique was similar to that of restored with the incremental technique.

Effect of rinsing time and surface contamination on the bond strength of silorane-based and dimethacrylate-based composites to enamel

Background

The aim of this study was to assess whether saliva contamination and rinsing time for 15, 30, and 60 seconds, affects the shear bond strength of silorane and methacrylate-based composites to enamel.

Material and Methods

Two light cure resin, P60 (3M ESPE) and Filtek LS Silorane were tested. 120 sound premolars were randomly divided into four groups of 30 teeth based on composite type with or without saliva contamination after etching and rinsing. Each group was further divided into three subgroups according to their rinsing time. Then a cylinder of the composite was bonded to the enamel and Shear bond strength was assessed. To determine the failure mode, the bonded surfaces were then observed under SEM. In addition, the DC of each group was measured at pH levels of 4 and 7 using FTIR spectroscopy. The data were analyzed with one-way ANOVA and post hoc analysis followed by Fisher’s least significant difference.

Results

The bond strength of the non-contaminated methacrylate group was significantly higher than the other groups (p< 0.0001). In addition, there was no significant deference between the methacrylate subgroups. In the silorane groups, the shear bond strength was higher in the rinsing time of 15 seconds. Failure pattern was mainly adhesive. The DC of the Methacrylates had no significant difference at pH 4 and pH 7, but was significantly higher than that of siloranes (p< 0.0001). While the DC of the siloranes at pH 4 was significantly higher than at pH 7 (p< 0.0001).

Conclusions

Saliva contamination in both composites reduces bond strength. Increasing rinsing time in Methacrylates proves ineffective. In non-contaminated siloranes, excessive rinsing time reduced bond strength. The best-recommended rinsing time for both composite is 15 seconds.

Key words:Composite resins, silorane composite resin, methacrylates, shear strength.

The evaluation of surface sealants' effect on the surface roughness of Nano-hybrid composite after polishing with One-Step system (in-vitro)

Background

The clinical use of composite resins has increased substantially due to increased esthetic demands by patients, improvements in formulation, and simplification of bonding procedures. Use of surface sealants is recommended to improve surface smoothness of composite restorations. The aim of this study was to evaluate the effect of surface sealants on the surface roughness of nano-hybrid composite after polishing with One-Step system.

Material and Methods

Using a silicon mold, 56 specimens of 10 mm diameter and 2 mm height were prepared from Grandio nano-hybrid composite (Voco, Cuxhaven, Germany) with A2 shade. Specimens were randomly divided in 2 groups. The surface of specimens were polished with VOCO One-step system. One group of specimens assigned as control group and received no more surface treatment. Surface sealant PermaSeal (Ultradent, USA) was applied on the surface of specimens of the other group as experimental group. Specimens were stored in Ringer’s solution at 37°C for 24 hours. The specimens were subjected to artificial accelerated aging with thermocycling method (3000 cycles, between 5 and 55°C) and then 100000 cycles of tooth brushing. A Profilometer was used to measuring the surface roughness of specimens before and after aging procedures.

Results

The surface roughness changes of control group were significant before and after aging (P<0.05). The mean final surface roughness of control group was unacceptable clinically while it was acceptable in experimental group.

Conclusions

The use of surface sealants on nano-hybrid composite causes noticeable reduces in surface roughness of composite.

Key words:Surface-penetrating sealant, surface roughness, nano-hybrid, composites, one-step polishing.

The effect of repeated preheating of dimethacrylate and silorane-based composite resins on marginal gap of class V restorations

Background. One of the problems with composite resin restorations is gap formation at resin‒tooth interface. The present study evaluated the effect of preheating cycles of silorane- and dimethacrylate-based composite resins on gap formation at the gingival margins of Class V restorations.

Methods. In this in vitro study, standard Class V cavities were prepared on the buccal surfaces of 48 bovine incisors. For restorative procedure, the samples were randomly divided into 2 groups based on the type of composite resin (group 1: di-methacrylate composite [Filtek Z250]; group 2: silorane composite [Filtek P90]) and each group was randomly divided into 2 subgroups based on the composite temperature (A: room temperature; B: after 40 preheating cycles up to 55°C). Marginal gaps were measured using a stereomicroscope at ×40 and analyzed with two-way ANOVA. Inter- and intra-group comparisons were analyzed with post-hoc Tukey tests. Significance level was defined at P < 0.05.

Results. The maximum and minimum gaps were detected in groups 1-A and 2-B, respectively. The effects of composite resin type, preheating and interactive effect of these variables on gap formation were significant (P<0.001). Post-hoc Tukey tests showed greater gap in dimethacrylate compared to silorane composite resins (P< 0.001). In each group, gap values were greater in composite resins at room temperature compared to composite resins after 40 preheating cycles (P<0.001).

Conclusion. Gap formation at the gingival margins of Class V cavities decreased due to preheating of both composite re-sins. Preheating of silorane-based composites can result in the best marginal adaptation.

Effect of cyclic loading on microleakage of silorane based composite compared with low shrinkage methacrylate-based composites

Background:

There are many concerns regarding the marginal seal of composite restorations, especially when composite restorations are subjected to cyclic loading. The aim of this study was to evaluate the effect of cyclic loading on the microleakage of silorane based composite compared with low shrinkage methacrylate-based composites in class V cavities.

Materials and Methods:

In this in vitro study, class V cavities were prepared on the facial and lingual surfaces of 48 human premolars (96 cavities). The teeth were randomly divided into four groups of 12 teeth (24 cavities) each and restored as follows: Group 1 (Siloran System Adhesive + Filtek P90), Group 2 (All Bond SE + Aelite LS Posterior), Group 3 (Futurabond NR + Grandio), and Group 4 (G-Bond + Kalore-GC). All the specimens were thermocycled for 2000 cycles (5-55°C) and then half of the specimens from each group, were Load cycled. All teeth were immersed in 0.5% basic fuchsine dye, sectioned, and observed under a stereomicroscope. Data were analyzed using Wilcoxon test, Kruskal–Wallis, and Mann–Whitney U-tests. P < 0.05 was considered as significant.

Results:

In both unloaded and loaded groups, no statistically significant differences were observed among four composites at the occlusal margin, but a significant difference in gingival microleakage was found between Aelite and silorane. Occlusal and gingival microleakage was not affected by cyclic loading in none of the four restorative materials.

Conclusion:

Silorane did not provide better marginal seal than the low shrinkage methacrylate-based composites (except Aelite). In addition, cyclic loading did not affect the marginal microleakage of evaluated composite restorations.

In-vitro comparison of the effect of different bonding strategies on the micro-shear bond strength of a silorane-based composite resin to dentin

Background:

The current study evaluated the micro-shear bond strengths of a new low-shrinkage composite resin to dentin.

Materials and Methods:

In this in-vitro study, 70 extracted premolars were assigned to one of seven groups (n = 10): Group 1: OptiBond Solo Plus (Opt; Kerr); Group 2: SE Bond (SE; Kuraray); Group 3: Silorane System Adhesive (SSA; 3M ESPE); Group 4: OptiBond Solo Plus + LS Bond (Opt LS); Group 5: SE Bond + LS Bond (SE LS); Group 6: OptiBond Solo Plus (Opt Po); and Group 7: SE Bond (SE Po). Occlusal dentin was exposed and restored with Filtek LS (3M ESPE) in groups 1 to 5 and Point 4 (Kerr) in groups 6 and 7. After thermocycling (1000 cycles at 5/55΀C), micro-shear bond test was carried out to measure the bond strengths. The results were submitted to analysis of variance and post hoc Tukeytests (P < 0.05).

Results:

Two-way ANOVA showed no significant differences between the two types of composite resin (P = 0.187), between bonding agents (P = 0.06) and between composite resin and bonding agents (P = 0.894). Because P value of bonding agents was near the significance level, one-way ANOVA was used separately between the two composite groups. This analysis showed significant differences between silorane composite resin groups (P = 0.045) and Tukey test showed a significant difference between Groups 4 and 5 (P = 0.03).

Conclusion:

The application of total-etch and self-etch methacrylate-based adhesives with and without use of a hydrophobic resin coating resulted in acceptable bond strengths.

Role of TiF4 in Microleakage of Silorane and Methacrylate-based Composite Resins in Class V Cavities

AIM

This study investigated the effect of TiF4 solution pretreat-ment on microleakage of silorane and nanofilled methacrylate-based composites in class V cavities.

MATERIALS AND METHODS

Forty-eight intact premolar teeth were randomly allocated to four groups of 12 teeth. Restorative techniques after standard class V tooth preparations were as follows: Group 1, Filtek P90 composite; group 2, Filtek Z350 XT; group 3, TiF4 solution pretreatment and Filtek P90 composite; group 4, TiF4 solution pretreatment and Filtek Z350 XT. After storing the specimens in distilled water at 37°C for 24 hours and followed by immersion of the specimens in a 0.5% basic-fuchsin solution for 24 hours, they were sectioned buccolingually to obtain four surfaces for each specimen for analysis of microleakage using a stereomicroscope. Data analysis was performed using Kruskal-Wallis test to compare the four groups and the Mann-Whitney test for paired comparisons with Statistical Package for the Social Sciences (SPSS) version 17 software.

RESULTS

At the enamel margins, microleakage score of the Filtek Z350 XT group was lower than those of the Filtek P90 with and without the application of the TiF4 (p = 0.009 and p = 0.031 respectively). At the dentin margins, groups 3 and 4 (TiF4+Filtek P90 and TiF4+Filtek z350 XT respectively) showed significantly lower microleakage than group 1 (Filtek P90). However, there was no significant difference between other groups (p > 0.05).

CONCLUSION

At the enamel margins, microleakage score of the silorane-based composite was more than that of the nanofilled composite. No significant differences were observed between the other groups. At the dentin margins, for the silorane-based composite restorations, TiF4 solution pretreatment resulted in significantly lower microleakage. However, the similar result was not observed for Filtek Z350 XT. Also, no significant difference was observed between microleakage scores of Filtek P90 and Filtek Z350 XT with or without TiF4 pretreatment.

CLINICAL SIGNIFICANCE

In spite of better mechanical and physical properties of modern composites than earlier methacrylate-based composites, polymerization shrinkage has been remaining as one of the main shortcomings of them. Different methods, such as using new low shrinkage resin composites and different dentin pretreatments, have been suggested to overcome this problem. This study evaluated the effect of TiF4 as pretreatment on microleakage of class V tooth preparations restored with a nanocomposite and a silorane-based resin composite.

Effect of Instrument Lubricants on the Surface Degree of Conversion and Crosslinking Density of Nanocomposites

PURPOSE

The surface degree of conversion and crosslink density of composites should not be affected by the use of instrument lubricants in order to provide long-lasting tooth restorations. This study aimed to analyze the effect of instrument lubricants on the degree of conversion and crosslink density of nanocomposites.

MATERIALS AND METHODS

Samples (N = 10) were fabricated according to the composites (Filtek Z350 XT, 3M ESPE, St. Paul, MN, USA; and IPS Empress Direct, Ivoclar Vivadent AG, Schaan, Liechtenstein and lubricants used (Adper Single Bond 2 and Scotchbond Multi-Purpose bonding agent adhesive systems, 3M ESPE; 70% ethanol, absolute ethanol, and no lubricant). Single composite increments were inserted into a Teflon mold using the same dental instrument. The composite surface was then modeled using a brush wiped with each adhesive system and a spatula wiped with each ethanol. The control group was fabricated with no additional modeling. The surface degree of conversion and crosslink density were measured by Fourier transform infrared spectroscopy and the hardness decrease test, respectively. Data were analyzed using two-way analysis of variance and the Tukey's test (p < 0.05).

RESULTS

Filtek Z350 XT showed statistically similar degree of conversion regardless of the lubricant used, whereas the use of adhesive systems and 70% ethanol decreased the degree of conversion for IPS Empress Direct. Only Scotchbond Multi-Purpose bonding agent decreased crosslink density for Filtek Z350 XT, whereas both adhesive systems decreased crosslink density for IPS Empress Direct.

CONCLUSION

Filtek Z350 XT appeared to be less sensitive to the effects of lubricants, and absolute ethanol did not affect the degree of conversion and crosslink density of the nanocomposites tested.

CLINICAL SIGNIFICANCE

Although the use of lubricants may be recommended to minimize the stickiness of dental instruments and composite resin, dentists should choose materials that do not have a negative effect on the surface properties of composites. Only the use of absolute ethanol safely maintains the surface integrity of nanocomposites in comparison with adhesive system and 70% ethanol.

Surface Roughness, Microhardness, and Microleakage of a Silorane-Based Composite Resin after Immediate or Delayed Finishing/Polishing

Objective. This study evaluated the effect of immediate or delayed finishing/polishing using different systems on the surface roughness, hardness, and microleakage of a silorane-based composite. Material and Methods. Specimens were made with silorane-based composite (Filtek P90, 3M ESPE) and assigned to the treatments: control (light-cured); aluminum oxide discs (Sof-Lex, 3M ESPE); diamond-impregnated silicone tips (Astropol, Ivoclar Vivadent); aluminum oxide-impregnated silicone tips (Enhance, Dentsply). Half of the specimens were finished/polished immediately and the rest after 7 days. Surface roughness (Ra, μm; n = 20) and Vickers microhardness (50 g; 45 s; n = 10) were measured. Cavities were prepared in bovine incisors and filled with Filtek P90. The fillings received immediate or delayed finishing/polishing (n = 10) and were subjected to dye penetration test (0.5% basic fuchsin, 24 h). Data were analyzed by ANOVA and Scheffe, Kruskal-Wallis, and Mann-Whitney tests (p < 0.05). Results. The finishing/polishing system significantly influenced roughness and microhardness (p < 0.0001). For enamel, microleakage was not affected by the finishing/polishing system (p = 0.309). For dentin, Sof-Lex discs and Astropol points promoted greater microleakage than Enhance points (p = 0.033). Conclusion. Considering roughness, microhardness, and microleakage together, immediate finishing/polishing of a silorane-based composite using aluminum oxide discs may be recommended.

Effect of fiber reinforcement on microleakage of class II cavities restored with a novel G-aenial posterior composite, silorane composite, and nanohybrid composite: an in vitro comparative study

AIM

The aim of the present study was to compare G-aenial, silorane, and nanoceramic composites and the effect of polyethylene fiber inserts in reducing gingival microleakage in class II composite restorations placed apical to the cementoenamel junction.

METHODS

Standardized class II cavities were prepared on extracted molars and randomly divided into six groups (n = 20 each): group 1, Ceram X mono; group 2, Ceram X mono + Ribbond; group 3, Filtek P90; group 4, Filtek P90 + Ribbond; group 5, G-aenial posterior; and group 6, G-aenial posterior + Ribbond. All specimens were subjected to a thermocycling regime, immersed in 2% methylene blue dye for 24 h, sectioned longitudinally, and examined under a stereomicroscope to assess dye penetration on a six-point scale. The score data were subjected to statistical analysis, whereby the Kruskal-Wallis analysis of variance was used for multiple group comparisons and the Mann-Whitney test for groupwise comparisons at a significance level of P ≤ 0.05.

RESULTS

A statistically-significant decrease in microleakage was found when Ribbond fiber was used: group 2 vs group 1 (P < 0.001), group 4 vs group 3 (P < 0.001), and group 6 vs group 5 (P < 0.001). A significant decrease in microleakage scores was found in the silorane and G-aenial posterior composites when compared to the nanoceramic composite (P < 0.001).

CONCLUSION

The use of polyethylene fiber, silorane composite, and G-aenial posterior composite reduces microleakage in class II composite restorations with gingival margins below the cementoenamel junction.

Effect of organic acids in dental biofilm on microhardness of a silorane-based composite

OBJECTIVES

This study evaluated the effect of lactic acid and acetic acid on the microhardness of a silorane-based composite compared to two methacrylate-based composite resins.

MATERIALS AND METHODS

Thirty disc-shaped specimens each were fabricated of Filtek P90, Filtek Z250 and Filtek Z350XT. After measuring of Vickers microhardness, they were randomly divided into 3 subgroups (n = 10) and immersed in lactic acid, acetic acid or distilled water. Microhardness was measured after 48 hr and 7 day of immersion. Data were analyzed using repeated measures ANOVA (p < 0.05). The surfaces of two additional specimens were evaluated using a scanning electron microscope (SEM) before and after immersion.

RESULTS

All groups showed a reduction in microhardness after 7 day of immersion (p < 0.001). At baseline and 7 day, the microhardness of Z250 was the greatest, followed by Z350 and P90 (p < 0.001). At 48 hr, the microhardness values of Z250 and Z350 were greater than P90 (p < 0.001 for both), but those of Z250 and Z350 were not significantly different (p = 0.095). Also, the effect of storage media on microhardness was not significant at baseline, but significant at 48 hr and after 7 day (p = 0.001 and p < 0.001, respectively). Lactic acid had the greatest effect.

CONCLUSIONS

The microhardness of composites decreased after 7 day of immersion. The microhardness of P90 was lower than that of other composites. Lactic acid caused a greater reduction in microhardness compared to other solutions.

Evaluation of Microleakage and Marginal Ridge Fracture Resistance of Primary Molars Restored with Three Restorative Materials: A Comparative in vitro Study

Composite restorations are popular because of their superior esthetics and acceptable clinical performance. But shrinkage is still a drawback. Polymerization shrinkage results in volumetric contraction, leading to deformation of the cusps, microleakage, decrease of marginal adaptation, enamel micro-cracks and postoperative sensitivity. A new class of ring opening resin composite based on silorane chemistry has been introduced with claims of less than 1% shrinkage during polymerization. The present study was conducted to evaluate and compare the ability of low shrink silorane based material, a packable composite and a compomer to resist microleakage in class II restorations on primary molars and evaluate marginal ridge fracture resistance of these materials. Sixty human primary molars were selected. Class II cavities were prepared and the teeth were divided into three groups of twenty each. Groups were as follows group I: low shrink composite resin (Filtek P90). Group II: packable composite (Filtek P60) and Group III: compomer (Compoglass F). Half of the teeth were used for microleakage and the rest for marginal ridge fracture resistance. For microleakage testing, dye penetration method was used with 1% methylene blue dye. Followed by evaluation and grading under stereomicroscope at 10* magnification. Fracture resistance was tested with universal testing machine. It was concluded that low shrink silorane based composite resin showed the least amount of microleakage, whereas compomer showed the highest microleakage. Packable composite resisted fracture of marginal ridge better than other composite resins. Marginal ridge fracture resistance of packable composite was comparable to the intact side. How to cite this article: Yeolekar TS, Chowdhary NR, Mukunda KS, Kiran NK. Evaluation of Microleakage and Marginal Ridge Fracture Resistance of Primary Molars Restored with Three Restorative Materials: A Comparative in vitro Study. Int J Clin Pediatr Dent 2015;8(2):108-113.

Microleakage of Class I and II Composite Resin Restorations Using a Sonic-resin Placement System

OBJECTIVES

To determine microleakage of posterior Class I and II restorations using the SonicFill composite resin system.

METHODS AND MATERIALS

Eighty previously extracted third molars were randomly assigned to four preparation/restoration groups (n=20): Group A: Class I preparations restored with SonicFill system/bulk fill; Group B: Class II preparations restored with SonicFill system/bulk fill; Group C: Class I preparations restored with Herculite Ultra composite resin/incremental technique; and Group D: Class II preparations restored with Herculite Ultra composite resin/incremental technique. Class I preparations were approximately 3.0 mm in width buccolingually and 3.0 mm in depth. Class II preparations were approximately 3.0 mm in width buccolingually, 1.5 mm in axial depth, and 4.0 mm in gingival depth. In all groups, the enamel and dentin surfaces were conditioned with Kerr 37.5% phosphoric acid, followed by application of Optibond Solo Plus adhesive system. Following restoration, the specimens were thermocycled, immersed in methylene blue dye, and embedded in acrylic resin. Specimen blocks were sectioned in the mesiodistal direction, with marginal dye penetration (microleakage) examined using a 20× binocular microscope. Class I and II restoration microleakage was scored separately using a 0-3 ordinal ranking system. Statistical analyses were conducted using nonparametric testing at the p < 0.05 level of significance.

RESULTS

Significantly less microleakage was associated with both Class I restorative groups (A and C), SonicFill bulk fill and Herculite Ultra incremental fill, compared to the Class II restorative groups (B and D), SonicFill/bulk fill and Herculite Ultra/incremental fill.

CONCLUSIONS

According to the results of this study, the materials (SonicFill vs Herculite Ultra), C-factors, and insertion techniques (bulk vs incremental) did not appear to be significant influences with regard to marginal microleakage; however, the type of preparation cavity (Class I vs Class II) and the subsequent bonding surface (enamel vs dentin [cementum]) proved to be significant factors.

An In-Vitro Comparison of Micro Leakage Between Two Posterior Composites Restored with Different Layering Techniques Using Two Different LED Modes

AIM

Composite resins have undergone various advances since their introduction, but their polymerization shrinkage remains a problem. Shrinkage can cause debonding of the restoration and can contribute to postoperative sensitivity, secondary caries, marginal staining and eventual failure of the restoration. So, our aim is to compare the effect of two different placement techniques and two different curing modes in reducing the marginal microleakage of two different composites in Class II cavities, where oblique and horizontal placement techniques and ramp & pulse curing modes of LED are used during the restoration.

MATERIALS AND METHODS

Standardized slot preparations were prepared in 80 human multi-rooted teeth. The teeth were randomly divided into four groups. Group A and B: Restored with Filtek P60 (3M, ESPE), Group C and D: Restored with Filtek P90 (3M, ESPE). All groups were further divided into sub-groups on basis of placement technique and curing mode. The samples were stored in distilled water, followed by thermocycling and immersed in 2% methylene blue. The samples were sectioned and evaluated for microleakage at the gingival margin with an optical stereomicroscope.

RESULTS

P60 composite when placed in the cavity with oblique incremental technique and cured with ramp mode of LED showed highest mean microleakage. There is no significant difference between horizontal and oblique placement technique (p=0.80); Pulse-curing and the ramp-curing mode (p=0.62).

CONCLUSION

In restoring deep class II cavities, the use of a low-shrink composite with the oblique placement technique and ramp curing mode of LED is recommended to overcome the problem of marginal microleakage.

Resin composite repair: Quantitative microleakage evaluation of resin-resin and resin-tooth interfaces with different surface treatments

Objective:

The aim was to evaluate the effect of different adhesive systems and surface treatments on the integrity of resin-resin and resin-tooth interfaces after partial removal of preexisting resin composites using quantitative image analysis for microleakage testing protocol.

Materials and Methods:

A total of 80 human molar teeth were restored with either of the resin composites (Filtek Z250/GrandioSO) occlusally. The teeth were thermocycled (1000×). Mesial and distal 1/3 parts of the restorations were removed out leaving only middle part. One side of the cavity was finished with course diamond bur and the other was air-abraded with 50 μm Al₂O₃. They were randomly divided into four groups (n = 10) to receive: Group 1: Adper Single Bond 2; Group 2: All Bond 3; Group 3: ClearfilSE; Group 4: BeautiBond, before being repaired with the same resin composite (Filtek Z250). The specimens were re-thermocycled (1000×), sealed with nail varnish, stained with 0.5% basic fuchsin, sectioned mesiodistally and photographed digitally. The extent of dye penetration was measured by image analysis software (ImageJ) for both bur-finished and air-abraded surfaces at resin-tooth and resin-resin interfaces. The data were analyzed statistically.

Results:

BeautiBond exhibited the most microleakage at every site. Irrespective of adhesive and initial composite type, air-abrasion showed less microleakage except for BeautiBond. The type of initial repaired restorative material did not affect the microleakage. BeautiBond adhesive may not be preferred in resin composite repair in terms of microleakage prevention.

Conclusions:

Surface treatment with air-abrasion produced the lowest microleakage scores, independent of the adhesive systems and the pre-existing resin composite type. Pre-existing composite type does not affect the microleakage issue. All-in-one adhesive resin (BeautiBond) may not be preferred in resin composite repair in terms of microleakage prevention.

The use of micro-CT with image segmentation to quantify leakage in dental restorations

OBJECTIVE

To develop a method for quantifying leakage in composite resin restorations after curing, using non-destructive X-ray micro-computed tomography (micro-CT) and image segmentation.

METHODS

Class-I cavity preparations were made in 20 human third molars, which were divided into 2 groups. Group I was restored with Z100 and Group II with Filtek LS. Micro-CT scans were taken for both groups before and after they were submerged in silver nitrate solution (AgNO3 50%) to reveal any interfacial gap and leakage at the tooth restoration interface. Image segmentation was carried out by first performing image correlation to align the before- and after-treatment images and then by image subtraction to isolate the silver nitrate penetrant for precise volume calculation. Two-tailed Student's t-test was used to analyze the results, with the level of significance set at p<0.05.

RESULTS

All samples from Group I showed silver nitrate penetration with a mean volume of 1.3 ± 0.7mm(3). In Group II, only 2 out of the 10 restorations displayed infiltration along the interface, giving a mean volume of 0.3 ± 0.3mm(3). The difference between the two groups was statistically significant (p<0.05). The infiltration showed non-uniform patterns within the interface.

SIGNIFICANCE

We have developed a method to quantify the volume of leakage using non-destructive micro-CT, silver nitrate infiltration and image segmentation. Our results confirmed that substantial leakage could occur in composite restorations that have imperfections in the adhesive layer or interfacial debonding through polymerization shrinkage. For the restorative systems investigated in this study, this occurred mostly at the interface between the adhesive system and the tooth structure.

Effect of different monomer-based composites and acid etching pre-treatment of enamel on the microleakage using self-etch adhesives systems

OBJECTIVE

To evaluate quantitatively the marginal microleakage of restorations carried out with self-etching adhesives with or without prior phosphoric enamel acid etching of silorane or methacrylate resin-based composite restorations subjected to thermal cycling.

MATERIALS AND METHODS

Forty cavities were prepared at the proximal surface of bovine incisors and randomly divided according to the etching of the enamel and restorative system used. The groups were restored with methacrylate [Adper SE Plus adhesive (3M ESPE) + Filtek Z250 (3M ESPE)] or silorane [Filtek LS adhesive (3M ESPE) + Filtek LS composite (3M ESPE)] restorative systems, light-cured using a LED unit (Bluephase 16i, Vivadent). After restorative procedure and thermocycling (1000 cycles), the specimens were immersed in methylene blue for 2 h. The specimens were triturated and the powder was used for analysis in an absorbance spectrophotometer. Data were statistically analyzed by 2-way ANOVA (alpha = 0.05).

RESULTS

No statistical difference between the restorative materials tested with or without previous acid etching of enamel in Class II marginal microleakage was observed (p > 0.05).

CONCLUSIONS

The use of acid etching prior to self-etching adhesives did not interfere on the microleakage of methacrylate- or silorane-based restorations.

Effect of 38% carbamide peroxide on the microleakage of silorane-based versus methacrylate-based composite restorations

OBJECTIVES

This study aimed to assess the effect of 38% carbamide peroxide on the microleakage of class V cavities restored with either a silorane-based composite or two methacrylate-based composites.

MATERIALS AND METHODS

A total of 96 class V cavities were prepared on the buccal surface of extracted human teeth with both enamel and dentin margins and were randomly assigned into three groups of Filtek P90 (3M-ESPE) + P90 system adhesive (3M-ESPE)(group A), Filtek Z250 (3M-ESPE) + Adper Prompt L-Pop (3M-ESPE)(group B) and Filtek Z350XT (3M-ESPE) + Adper Prompt L-Pop (group C). Half of the teeth were randomly underwent bleaching (38% carbamide peroxide, Day White, Discus Dental, applying for 15 min, twice a day for 14 day) while the remaining half (control) were not bleached. Dye penetration was measured following immersion in basic fuchsine. Data were statistically analyzed using Kruskal-Wallis and Mann-Whitney U tests at a level of 0.05.

RESULTS

No significant differences were found between composites in the control groups in enamel (p = 0.171) or dentin (p = 0.094) margins. After bleaching, microleakage of Z250 (in enamel [p = 0.867] or dentin [p = 0.590] margins) and Z350 (in enamel [p = 0.445] or dentin [p = 0.591] margins) did not change significantly, but the microleakage of P90 significantly increased in both enamel (p = 0.042) and dentin (p = 0.002) margins.

CONCLUSIONS

No significant differences were noted between the bleached and control subgroups of two methacrylate-based composites in enamel or dentin margins. Microleakage of silorane-based composite significantly increased after bleaching.

The effect of an erbium, chromium: yttrium-scandium-gallium-garnet laser on the microleakage and bond strength of silorane and micro-hybrid composite restorations

Objective:

The aim of this in vitro study was to compare the microleakage and bond strength of Class V silorane-based and universal micro-hybrid composite restorations prepared either with diamond bur or with an erbium, chromium: yttrium-scandium-gallium-garnet (Er, Cr:YSGG) laser.

Materials and Methods:

A total of 160 molar teeth were used for microleakage assessment and shear bond strength (SBS) test. The specimens were prepared using either diamond bur or 3 W-, 4 W- and 5 W-20 Hz Er, Cr:YSGG laser irradiation. All specimens were subjected to thermocycling (500 times at 5 ± 2°C to 55 ± 2°C, dwell time 15 s and transfer time 10 s). Microleakage was assessed using a 0.5% basic-fuchsin solution. The bond strengths were determined using a microtensile tester at a crosshead speed of 0.5 mm/min. The Kruskal Wallis test was used for the analysis of microleakage and a one-way analysis of variance test was used to analyze the SBS (P < 0.05).

Results:

No statistically significant differences were found (P > 0.05) between Er, Cr:YSGG laser and bur preparation methods regarding microleakage and bond strength values.

Conclusion:

Irradiation with Er, Cr:YSGG laser was confirmed to be as effective as conventional methods for preparing cavities before adhesive restorations.

Polymerization shrinkage of different types of composite resins and microleakage with and without liner in class II cavities

AIM

To determine the volumetric polymerization shrinkage of four different types of composite resin and to evaluate microleakage of these materials in class II (MOD) cavities with and without a resin-modified glass ionomer cement (RMGIC) liner, in vitro.

MATERIALS AND METHODS

One hundred twenty-eight extracted human upper premolar teeth were used. After the teeth were divided into eight groups (n=16), standardized MOD cavities were prepared. Then the teeth were restored with different resin composites (Filtek Supreme XT, Filtek P 60, Filtek Silorane, Filtek Z 250) with and without a RMGIC liner (Vitrebond). The restorations were finished and polished after 24 hours. Following thermocycling, the teeth were immersed in 0.5% basic fuchsin for 24 hours, then midsagitally sectioned in a mesiodistal plane and examined for microleakage using a stereomicroscope. The volumetric polymerization shrinkage of materials was measured using a video imaging device (Acuvol, Bisco, Inc). Data were statistically analyzed with Kruskal-Wallis and Mann-Whitney U-tests.

RESULTS

All teeth showed microleakage, but placement of RMGIC liner reduced microleakage. No statistically significant differences were found in microleakage between the teeth restored without RMGIC liner (p>0.05). Filtek Silorane showed significantly less volumetric polymerization shrinkage than the methacrylate-based composite resins (p<0.05).

CONCLUSION

The use of RMGIC liner with both silorane- and methacrylate-based composite resin restorations resulted in reduced microleakage. The volumetric polymerization shrinkage was least with the silorane-based composite.

Evaluation of bond strength of silorane and methacrylate based restorative systems to dentin using different cavity models

OBJECTIVE

The aim of this in vitro study was to evaluate the microtensile bond strength (µTBS) to dentin of two different restorative systems: silorane-based (P90), and methacrylate-based (P60), using two cavity models.

MATERIAL AND METHODS

Occlusal enamel of 40 human third molars was removed to expose flat dentin surface. Class I cavities with 4 mm mesial-distal width, 3 mm buccal-lingual width and 3 mm depth (C-factor=4.5) were prepared in 20 teeth, which were divided into two groups (n=10) restored with P60 and P90, bulk-filled after dentin treatment according to manufacturer's instructions. Flat buccal dentin surfaces were prepared in the 20 remaining teeth (C-factor=0.2) and restored with resin blocks measuring 4x3x3 mm using the two restorative systems (n=10). The teeth were sectioned into samples with area between 0.85 and 1.25 mm2 that were submitted to µTBS testing, using a universal testing machine (EMIC) at speed of 0.5 mm/min. Fractured specimens were analyzed under stereomicroscope and categorized according to fracture pattern. Data were analyzed using ANOVA and Tukey Kramer tests.

RESULTS

For flat surfaces, P60 obtained higher bond strength values compared with P90. However, for Class I cavities, P60 showed significant reduction in bond strength (p<0.05). No statistical difference between restorative systems was shown for Class I cavity model (p>0.05), or between Class I Cavity and Flat Surface group, considering P90 restorative system (p>0.05). Regarding fracture pattern, there was no statistical difference among groups (p=0.0713) and 56.3% of the fractures were adhesive.

CONCLUSION

It was concluded that methacrylate-based composite µTBS was influenced by cavity models, and the use of silorane-based composite led to similar bond strength values compared to the methacrylate-based composite in cavities with high C-factor.

Effect of configuration factor on gap formation in hybrid composite resin, low-shrinkage composite resin and resin-modified glass ionomer

AIM

Polymerization shrinkage is one of the important factors in creation of gap between dental structure and composite resin restorations. The aim of this study was to evaluate the effect of configuration factor (C-factor) on gap formation in a hybrid composite resin, a low shrinkage composite resin and a resin modified glass ionomer restorative material.

METHODS

Cylindrical dentin cavities with 5.0 mm diameter and three different depths (1.0, 2.0 and 3.0 mm) were prepared on the occlusal surface of 99 human molars and the cavities assigned into three groups (each of 33). Each group contained three subgroups depend on the different depths and then cavities restored using resin modified glass ionomer (Fuji II LC Improved) and two type composite resins (Filtek P90 and Filtek Z250). Then the restorations were cut into two sections in a mesiodistal direction in the middle of restorations. Gaps were measured on mesial, distal and pulpal floor of the cavities, using a stereomicroscope.

RESULTS

Data analyses using Kruskal-Wallist and Mann-Whitney tests. Increasing C-factor from 1.8 to 3.4 had no effect on the gap formation in two type composite resins, but Fuji II LC Improved showed significant effect of increasing C-factor on gap formation. Taken together, when C-factor increased from 1.8 up to 3.4 had no significant effect on gap formation in two tested resin composites. Although, Filtek P90 restorations showed smaller gap formation in cavities walls compared to Filtek Z250 restorations.

CONCLUSIONS

High C-factor values generated the largest gap formation. Silorane-based composite was more efficient for cavity sealing than methacrylate-based composites and resin modified glass ionomer.

Microleakage of Nanofilled Resin-modified Glass-ionomer/Silorane- or Methacrylate-based Composite Sandwich Class II Restoration: Effect of Simultaneous Bonding

Objectives

Microleakage of composite restorations at the cervical margin placed apically to the cementoenamel junction (CEJ) is still a concern. This study evaluated the effect of simultaneous bonding application on cervical sealing of nano-ionomer/silorane- or methacrylate-based composite open sandwich Class II restorations in the modified technique compared with that of conventional bonding.

Methods and Materials

In 60 sound maxillary premolars, two standardized Class II cavities were prepared with cervical margins 1 mm below the CEJ. The teeth were randomly divided into six groups of 10 teeth each. In the first three groups (groups 1-3), Clearfil SE Bond and Clearfil APX (Kuraray) were used for restoration in the total bonding technique (group 1), conventional open sandwich technique associated with a nano-ionomer (Ketac N100, 3M ESPE) (group 2), and modified open sandwich technique with simultaneous bonding application for both nano-ionomer and composite (group 3). In the second three groups (groups 4-6), Silorane Adhesive and Filtek Silorane composite (3M ESPE) were used in the same manner as in the first three groups, respectively.

Results

The simultaneous bonding application in the modified sandwich restorations (with SE Bond or Silorane Adhesive) resulted in a significant reduction of the cervical microleakage compared with that of the conventional bonding (p&lt;0.05). However, microleakage of the modified technique was similar to that of the total bonding (with SE Bond or Silorane Adhesive) (p&gt;0.05), both showing good marginal seal.

Marginal sealing ability of silorane and methacrylate resin composites in class II cavities: A scanning electron microscopic study

Aim and Objectives:

To comparatively evaluate the microleakage and microgap formation along the gingival margin in class II cavities restored with silorane resin composite and methacrylate resin composite with and without flowable resin liner.

Materials and Methods:

Sixty human mandibular premolars were distributed into three groups, each group containing 20 teeth (n = 20). Mesial (subgroup A) and distal (subgroup B) box cavities were prepared with gingival margin above and below cemento enamel junction (CEJ), respectively, in each tooth and restored as follows — Group I — Silorane resin composite with self-etch primer and bond (Filtek P90, 3M ESPE MN, USA). Group II — Methacrylate resin composite (Filtek P60, 3M ESPE MN, USA) and self-etch adhesive (Adper Easy one, 3M ESPE MN, USA). Group III — Methacrylate resin composite with self-etch adhesive and a flowable resin liner (Filtek Z350 XT, 3M ESPE MN, USA). The teeth were thermocycled and immersed in 50% silver nitrate solution before sectioning. The specimens were observed under scanning electron microscope for dye penetration and microgap formation. The data was subjected to statistical analysis using Kruskal-Wallis test and Mann-Whitney U test using SPSS version 18.

Results:

Subgroup A in all the three groups showed significantly less microleakage and microgap formation compared to subgroup B with P < 0.05.

Intergroup comparison of subgroup A did not show statistically significant difference, whereas subgroup B showed statistically significant difference for microleakage between group I and group II (P = 0.003), group III and group II (P = 0.002).

Conclusion:

Silorane resin composite and methacrylate resin with liner showed significantly less microleakage in class II cavities along the gingival margin placed below CEJ compared to methacrylate resin without liner. All the study groups showed less microleakage and microgap formation along the gingival margin placed above CEJ.

Marginal leakage of class V cavities restored with silorane-based and methacrylate-based resin systems

The aim of this study was to compare the microleakage of class V cavities restored by silorane resin with those restored by the methacrylate resin system. Sixty standardized class V cavities were prepared on premolars. The teeth were restored with Filtek(TM) Silorane and Silorane(TM) System Adhesive, Filtek(TM) Silorane and Adper(TM) Easy One and Filtek(TM) Supreme XT and Adper(TM) Easy One. The area and the depth of dye leakage were measured. Considering dye leakage area, the best results were achieved in group I (mean-M=0.114±0.083 mm(2)), then in group III (M=0.384±0.480 mm(2)) and finally in group II (M=5.389±6.587 mm(2)). Considering the depth of dye leakage, there was a significant difference between group I (mean rank-m.r.=1.23±0.44 mm) and II (1.98±0.83 mm), group II and III (1.23±0.40 mm). In this study silorane composite and its adhesive showed less microleakage than the methacrylate composite, and it showed compatibility only with its assigned adhesive.

CLINICAL SIGNIFICANCE

Less microleakage of silorane restorations could provide better and long lasting composite fillings.

The effect of LED curing mode on microleakage of Class V cavity restored by silorane-based composite

OBJECTIVE

This in vitro study evaluated the effect of soft-start curing mode by LED unit on the marginal microleakage of silorane composite restoration.

MATERIALS AND METHODS

Class V cavities were prepared on the buccal surfaces of 80 extracted molars at the cementoenamel junction and randomly divided into eight groups. In groups 1-4, four adhesive/composite combinations (silorane/silorane, silorane/Z250, Adper Single Bond/Z250, Clearfil SE Bond/Clearfil AP-X) were applied and the composites were cured under standard mode at 1500 mW/cm(2) for 20 s. In the other four groups, after applying the same adhesive/composite combinations, the composites were cured at 550 mW/cm(2) for 10 s followed at 1500 mW/cm(2) for 15 s. After 24 h of water storage and thermocycling, the specimens were placed in 1% methylene blue solution. The dye penetration was assessed under a stereomicroscope. The data were analysed using non-parametric tests.

RESULTS

There were no significant differences among four groups for two curing modes at the occlusal and gingival margins (p > 0.05). The soft-start curing had a positive effect on the gingival marginal sealing of group 1 (p < 0.05), but not for the other three groups (p > 0.05).

CONCLUSION

The beneficial effect of relatively high soft-start curing on marginal sealing of Class V restoration depends on a combination of the adhesive and composite types, having a positive effect on silorane adhesive/silorane-based composite at the gingival margin.

In Vitro Performance of Class I and II Composite Restorations: A Literature Review on Nondestructive Laboratory Trials—Part I

Posterior adhesive restorations are a basic procedure in general dental practices, but their application remains poorly standardized as a result of the number of available options. An abundant number of study hypotheses corresponding to almost unlimited combinations of preparation techniques, adhesive procedures, restorative options, and materials have been described in the literature and submitted to various evaluation protocols. A literature review was thus conducted on adhesive Class I and II restorations and nondestructive in vitro tests using the PubMed/Medline database for the 1995-2010 period. The first part of this review discusses the selected literature related to photoelasticity, finite element analysis (FEM), and microleakage protocols. Based on the aforementioned evaluation methods, the following parameters proved influential: cavity dimensions and design, activation mode (light or chemical), type of curing light, layering technique, and composite structure or physical characteristics. Photoelasticity has various limitations and has been largely (and advantageously) replaced by the FEM technique. The results of microleakage studies proved to be highly inconsistent, and the further use of this technique should be strictly limited. Other study protocols for adhesive Class II restorations were also reviewed and will be addressed in part II of this article, together with a tentative relevance hierarchy of selected in vitro methods.

Influence of an intermediary base on the microleakage of simulated class II composite resin restorations

The aim of this in vitro study was to qualitatively and quantitatively evaluate the microleakage of Class II cavities restored with a methacrylate-based composite (Filtek Z250, 3M ESPE) or silorane-based composite (Filtek LS, 3M ESPE), varying the application of an intermediary base, using a low-viscosity composite resin (Filtek Z350 Flow, 3M ESPE) or resin-modified glass ionomer cement (RMGIC) (Vitrebond, 3M ESPE) and no intermediary base (control groups). Sixty cavities were prepared on the proximal surfaces of bovine teeth and were randomly divided according to the experimental groups (n=10). Following the restorative procedures and thermocycling, the samples were immersed in methylene blue for two hours. The qualitative evaluation was made using a stereomicroscope, whereby two observers analyzed the infiltration level of the dye within the tooth/filling. Microleakage scores among the groups were compared using the Kruskal-Wallis test followed by the Mann-Whitney test (p≤0.05). The samples were then ground and the powder was prepared for quantitative analysis in an absorbance spectrophotometer. The results were statistically analyzed by analysis of variance and the Tukey test (p≤0.05). Results from the quantitative analysis showed that LS presented higher values of microleakage than did Z250. There was a significant difference between both composites concerning the intermediary materials, with the lowest values obtained using RMGIC as an intermediary base. Results from the qualitative analysis showed that there were no statistically significant differences between composites; however, there were significant differences for both composites concerning the intermediary materials, with the lowest values obtained using RMGIC as an intermediary. It is possible to conclude that using RMGIC as an intermediary base provided lower microleakage, indicating better sealing of the tooth-restoration interface.

Influence of fiber inserts, type of composite, and gingival margin location on the microleakage in Class II resin composite restorations

This study evaluated the influence of fiber inserts, type of composites, and location of the gingival seat on microleakage in Class II resin composite restorations. Fifty noncarious human third molars were selected for the study. Standardized Class II box type cavities were prepared on the mesial and distal side of 45 teeth. The gingival margin was placed above the cementoenamel junction (CEJ) on the mesial side and below the CEJ on the distal side. The remaining five teeth received no cavity preparations. The prepared samples were divided randomly on the basis of type of composite and presence or absence of fiber inserts, into four experimental groups of 10 teeth each and two control groups of five teeth each. The groups were defined as follows: group I (n=10) - Z350 XT; group II (n=10) - Z350 XT with fibers; group III (n=10) - P90; group IV (n=10) - P90 with fibers; and group V (n=5) - positive controls, cavities were not restored; group VI (n=5) - negative controls, no cavities were prepared. The samples were stored in distilled water in incubator at 37°C for 24 hours and then subjected to 500 cycles of thermocycling (5°C and 55°C) with a dwell time of 15 seconds. They were then placed in a 2% methylene blue dye solution for 24 hours at 37°C. Samples were sectioned longitudinally and evaluated for microleakage at the occlusal and gingival margin under a stereomicroscope at 20× magnification. Kruskal-Wallis and Mann-Whitney U-tests were used to compare the mean leakage scores. Restorations with gingival margins in enamel showed significantly less microleakage. Significant reduction in microleakage was observed in groups restored with P90 composite than those restored with Z350 XT. No improvement in microleakage was observed with the use of fiber inserts (p>0.05).

Six-month evaluation of a resin/dentin interface created by methacrylate and silorane-based materials

OBJECTIVES

This study aimed to compare the micro-tensile bond strength of methacrylate resin systems to a silorane-based restorative system on dentin after 24 hours and six months water storage.

MATERIAL AND METHODS

The restorative systems Adper Single Bond 2/Filtek Z350 (ASB), Clearfil SE Bond/Z350 (CF), Adper SE Plus/Z350 (ASEP) and P90 Adhesive System/Filtek P90 (P90) were applied on flat dentin surfaces of 20 third molars (n=5). The restored teeth were sectioned perpendicularly to the bonding interface to obtain sticks (0.8 mm2) to be tested after 24 hours (24 h) and 6 months (6 m) of water storage, in a universal testing machine at 0.5 mm/min. The data was analyzed via two-way Analysis of Variance/Bonferroni post hoc tests at 5% global significance.

RESULTS

Overall outcomes did not indicate a statistical difference for the resin systems (p=0.26) nor time (p=0.62). No interaction between material × time was detected (p=0.28). Mean standard-deviation in MPa at 24 h and 6 m were: ASB 31.38 (4.53) and 30.06 (1.95), CF 34.26 (3.47) and 32.75 (4.18), ASEP 29.54 (4.14) and 33.47 (2.47), P90 30.27 (2.03) and 31.34 (2.19).

CONCLUSIONS

The silorane-based system showed a similar performance to methacrylate-based materials on dentin. All systems were stable in terms of bond strength up to 6 month of water storage.

Pulpal and Periapical Response After Restoration of Deep Cavities in Dogs' Teeth With Filtek Silorane and Filtek Supreme XT Systems

Objective:

This study evaluated, histopathologically, the pulpal and periapical response to a silorane-based resin (Filtek Silorane) and a methacrylate-based nanoparticle resin (Filtek Supreme XT) in deep cavities in dogs, having zinc oxide and eugenol-based cement (ZOE) as a control.

Methods:

The tooth/bone blocks were collected after 10 and 90 days and processed for microscopic analysis of the dentin, pulp, and periapical tissues using a score system. Data were analyzed statistically by Kruskal-Wallis and Dunn post-test (α=0.05).

Results:

At 10 days, the pulp, connective tissue, and periodontal ligament showed normal characteristics. No resorption areas were observed. Both resins caused significantly less (p&lt;0.05) periapical and pulpal inflammatory response than ZOE. At 90 days, for all materials, the connective pulp tissue was healthy and dense, with a normal blood vessel system. The apical and periapical region had normal structure and thickness.

Conclusions:

The use of the Filtek Silorane and the Filtek Supreme XT resins caused no adverse pulpal and periapical reactions after restoration of deep dentin cavities in vivo.

Comparative evaluation of microleakage in class II cavities restored with Ceram X and Filtek P-90: An in vitro study

Context:

Polymerization shrinkage in composite resins is responsible for microleakage. Methacrylate-based composite resins have linear reactive groups resulting in high polymerization shrinkage. A recently introduced composite resin Filtek P90 is based on siloxanes and oxiranes which polymerize by cationic “ring opening” polymerization resulting in reduced polymerization shrinkage.

Objectives:

Aim of this study was to compare microleakage in class II cavities restored with a nanoceramic restorative (Ceram X) and a silorane composite (Filtek P90).

Materials and Methods:

Standardized class II box type cavities were prepared on mesial (Groups Ia and IIa) and distal (Groups Ib and IIb) surfaces of twenty extracted permanent molar teeth with gingival floor ending 1 mm coronal and apical to the cementoenamel junction, respectively. The teeth in Group Ia and Ib were restored with Ceram X and Group IIa and IIb with Filtek P90. The specimens were thermocycled and microleakage evaluated.

Statistical Analysis Used:

The data were statistically analyzed using Wilcoxon Signed-Rank test at the 0.05 level of significance.

Results:

Mean microleakage score of group la and lb was 1 ± 2.260 and 2.8 ± 1.229, respectively. And that of group Ila and llb was 0.2 ± .869 and 0.3 ± .588, respectively. When groups I and II were compared, results were statistically significant (P<0.05).

Conclusion:

It was concluded that silorane-based composite may be a better substitute for methacrylate-based composites.

Comparative evaluation of microleakage of silorane-based composite and nanohybrid composite with or without polyethylene fiber inserts in class II restorations: an in vitro study

AIM

To evaluate microleakage between nanocomposite and silorane composite in class II restorations with or without a polyethylene fiber insert.

METHODOLOGY

Standardized class II cavities were prepared on extracted molars and randomly divided into 4 groups (n=20 each): group 1, Ceram X mono; group 2, Ceram X mono + Ribbond; group 3, Filtek P90; and Group 4, Filtek P90 + Ribbond. All specimens were subjected to a thermocycling regime, immersed in 2% methylene blue dye for 24 hours, sectioned longitudinally, and examined under a stereomicroscope to assess dye penetration on a six-point scale. The score data were subjected to statistical analysis whereby Kruskal-Wallis analysis of variance was used for multiple group comparisons and the Mann-Whitney test for groupwise comparisons at a significance level of p≤0.05.

RESULTS

A statistically significant decrease in microleakage was found when Ribbond fiber was used with nanoceramic and silorane composite. A highly significant decrease in microleakage scores was found in silorane composite when compared to nanoceramic composite.

CONCLUSION

Use of polyethylene fiber and silorane composite reduces microleakage in class II composite restorations with gingival margins below the cemento-enamel junction.

The short-term clinical performance of a silorane-based resin composite in the proximal contacts of class II restorations

AIM

The aim of this randomized clinical trial was to compare the proximal contact of a silorane-based resin composite with a conventional methacrylate-based resin composite in class II restorations after a 6 months follow-up period.

MATERIALS AND METHODS

After obtaining informed consent, 33 patients were randomly allocated into a test group (Filtek P90/Adhesive System-3M ESPE) or control group (Filtek P60/ Adper SE Plus-3M ESPE), and 100 direct resin composite restorations (n = 50) were placed. A single operator performed the cavities and restorations. After rubber dam placement, a metal matrix and wooden wedge were placed. The restorative systems were applied according to the manufacturer's instructions. After 1 week, the restorations were finished and polished. The proximal contacts were assessed blindly and independently by two calibrated examiners (kW = 0.8) at the baseline and after 6 months according to a three-step grading criteria. Data were analyzed with the Mann-Whitney U-test and Wilcoxon signed Rank tests (a = 0.05).

RESULTS

After 6 months, 96% of the restoration contacts were present for evaluation. The frequencies of restorations classified as Bravo in control and test groups were 6 and 8% at the baseline, and 6.25 and 12.75% after 6 months. No significant difference was found between the restorative materials (p > 0.05; Mann-Whitney U-test) neither between baseline and 6 months period (p > 0.05; Wilcoxon signed Rank tests).

CONCLUSION

Both materials performed satisfactorily over 6 months follow-up period.

CLINICAL SIGNIFICANCE

The short-term clinical performance of a silorane-based resin composite in the proximal contacts of class II restorations was similar to the well-known methacrylate-based resin composite.

An in vitro evaluation of microleakage in class V preparations restored with Hybrid versus Silorane composites

Aim:

To compare the difference in microleakage values using conventional and new low-shrink Silorane composites using the dye penetration method.

Background:

With improvement in adhesive technology, problems associated with composites have been largely overcome. However, microleakage due to polymerization shrinkage still remains a challenge. New Silorane-based composites are alleged to have less than 1% polymerization shrinkage, which would potentially decrease the microleakage, and hence, resolve this longstanding issue.

Materials and Methods:

The teeth were randomly divided into three groups (A,B, and C). Group A was restored with conventional composite (Valux^™ Plus), with a total-etch protocol, Group B was restored with conventional composite, with a self-etch protocol, and group C were restored with a silorane-based composite (Filtek TMP90). Thermocycling at 200 cycles between 5 and 55°C ± 2°C with a dwell time of 60 seconds was conducted. The teeth were stained with methylene blue dye and then sectioned and viewed under a dissection microscope, afer which the microleakage was evaluated.

Results:

The interexaminer reliability was evaluated using the kappa score, which was acceptable (61 – 78%). The total-etch group performed statistically and significantly better (P < 0.001) at the occlusal margin and was marginally and statistically significant (P = 0.05) at the gingival margin compared to the self-etch conventional and Silorane groups.

Conclusions:

The Silorane composite did not perform better than the conventional composites, however, it may have its uses and requires further research.

Prediction and diagnosis of clinical outcomes affecting restoration margins

The longevity of dental restorations is largely dependent on the continuity at the interface between the restorative material and adjacent tooth structure (the restoration margin). Clinical decisions on restoration repair or replacement are usually based upon the weakest point along that margin interface. Physical properties of a restorative material, such as polymerisation shrinkage, water sorption, solubility, elastic modulus and shear strength, all have an effect on stress distribution and can significantly affect margin integrity. This review will focus on two aspects of margin deterioration in the oral environment: the in vitro testing of margin seal using emersion techniques to simulate the oral environment and to predict clinical margin failure and the relationship between clinically observable microleakage and secondary caries. The many variables associated with in vitro testing of marginal leakage and the interpretation of the data are presented in detail. The most recent studies of marginal leakage mirror earlier methodology and lack validity and reliability. The lack of standardised testing procedures makes it impossible to compare studies or to predict the clinical performance of adhesive materials. Continual repeated in vitro studies contribute little to the science in this area. Clinical evidence is cited to refute earlier conclusions that clinical microleakage (penetrating margin discoloration) leads to caries development and is an indication for restoration replacement. Margin defects, without visible evidence of soft dentin on the wall or base of the defect, should be monitored, repaired or resealed, in lieu of total restoration replacement.

Microleakage of silorane- and methacrylate-based class V composite restorations

The marginal integrity of class V restorations in a silorane- and a group of methacrylate-based composite resins with varying viscosities was tested in the present study. Different adhesives (OptiBond FL, KerrHawe; AdheSE One, Vivadent; or Silorane System Adhesive, 3M ESPE) were applied to 168 standardized class V cavities. The cavities (n = 12) were filled with a wide range of different viscous composite resins: Filtek Silorane, 3M ESPE; els and els flow, Saremco; Tetric EvoCeram and Tetric EvoFlow, Vivadent; Grandio, Voco; and Ultraseal XT Plus, Ultradent. Microleakage of the restoration was assessed by dye penetration (silver staining) on multiple sections with and without thermocycling and mechanical loading (TCML: 5,000 × 5-55°C; 30 s/cycle; 500,000 × 72.5 N, 1.6 Hz). Data were statistically analyzed with the Mann-Whitney U test and the Error Rates Method (ERM). The silorane-based composite resin yielded the lowest dye penetration after TCML. Microleakage of methacrylate-based composite restorations, in general (ERM), was statistically significantly influenced by the adhesive system, Moreover, dye penetration at enamel margins was significantly lower than dye penetration at dentin margins. The chemical basis of composite resins and adjacent tooth substance seems to strongly influence marginal sealing of class V restorations for methacrylate-based materials. Moreover, the steps of dental adhesives used affected marginal integrity. The silorane-based composite resin evaluated in the present study exhibits the best marginal seal. The three-step adhesive yielded better marginal sealing than the one-step adhesive for methacrylate-based class V composite restorations.

Microhardness of composite materials with different organic phases in deep class II cavities: an in vitro study

OBJECTIVE

This study compared the microhardness of three composite resins with different organic matrices in deep class II cavities.

MATERIALS AND METHOD

A total of 36 extracted molars were randomly assigned to six groups and standardized class II cavities were prepared. The cavity design comprised three steps in a mesiodistal direction with an increasing depth (2, 4, and 6 mm). Twelve cavities each were restored using Filtek Supreme (FS), Quixfil (QF), and Filtek Silorane (SI). The materials were applied in incremental layers of 2 mm and cured either with Halogen Translux Energy (HTE) (n=18) or LED Bluephase C8 (LED) (n=18). Subsequently, the specimens were cross-sectioned, and microhardness was determined in various depths and at two different distances from the matrix.

RESULTS

QF yielded the highest KHN microhardness values (92.67 ± 12.77), followed by FS (65.53 ± 19.52) and SI (57.67 ± 8.33). Composites cured with LED achieved higher KHN values. All materials showed the highest microhardness values within the superficial increments and at a distance of 1000 μm from the matrix.