Post-gel shrinkage strain and degree of conversion of preheated resin composite cured using different regimens

Evaluation of pre-heated composite resins with soft-start polymerization and conventional composite restorations in class-I carious lesions - A randomized clinical trial

Background

By increasing fluidity and conversion, pre-heated composites enhance adaptability and strength, while soft-start polymerization decreases internal stresses.

Aim

Over a period of a year, this split-mouth design, randomized controlled clinical trial (RCT) compared pre-heated composites with soft-start polymerization to conventional composites in class-I lesions, with the goal of improving restoration outcomes.

Methods

and Findings: Immediately following ethical approval and registration with CTRI, 37 patients with in-formed permission who met specified inclusion and exclusion criteria for class-I lesions were chosen for enrollment. Using a 1:1 ratio, teeth were randomly assigned to Group-A (pre-heated composite with soft-start polymerization) or Group-B (traditional composite restoration). At three-time intervals, the evaluation was blinded and calibrated using Modified United States Public Health Service (USPHS) criteria: baseline, six-month, and one-year marks. Statistical analysis was performed using SPSS 21.0 and the Mann-Whitney U test for inter-group comparisons and the Friedman test for intra-group comparisons.

Interpretation

Pre-heated composites with soft-start polymerization performed better in terms of marginal adaptation with a statistically significant difference (p = 0.019) and in terms of color match they performed better clinically (p = 0.062) at 12 months. Other variables like marginal discolouration, sec-ondary caries, anatomic form, post-operative sensitivity, surface texture and retention showed no statistically significant difference (p < 0.05). Pre-heated composites with soft-start mode performed marginally better than nanofilled composites. However, both techniques can be used to successfully restore simple class-I carious lesions.

Impact of repeated preheating of bulk-fill resin composite on postoperative hypersensitivity; a randomized controlled clinical trial

BACKGROUND

This clinical study was conducted aiming to evaluate the impact of repeated preheating of bulk-fill resin composite on postoperative hypersensitivity.

METHODS

A total of 105 eligible, consenting adults were recruited. Patients had posterior teeth suffering from proximal decay with no signs of irreversible pulpitis. Patients were prepared for Class II restorations and restored with bulk-fill resin composite. Patients were randomized into three groups of 35 patients according to the number of preheating cycles for the resin composite syringe used; group I: no preheating; control group at room temperature, group II: Resin composite preheated once, and group III: Resin composite preheated ten cycles. Patients were assessed for postoperative dentin hypersensitivity using the visual analogue scale (VAS) at three-time intervals: day one, one week and by the end of one month after restorative treatment. Statistical analysis was performed; ANOVA with a single factor was used to test for significance at a p value ≤ 0.05. For nonparametric data, the Kruskal‒Wallis test was used to compare the three testing groups. Friedman's test was used to study the changes within each group. Dunn's test was used for pairwise comparisons when the Kruskal‒Wallis test or Friedman's test was significant.

RESULTS

The scores of the three groups through the three time intervals were almost zero except for the first day where VAS scores were recorded with maximum score of 3 for groups I and II. Groups II and III; there was no statistically significant change in hypersensitivity scores by time with P-values 0.135 and 0.368, respectively. However, for group I there was a significant difference from VAS score recorded on first day and the two following time intervals.

CONCLUSION

The repeated preheating cycles of bulk-fill resin composite prior to curing had no adverse effect on the patients regarding postoperative dentin hypersensitivity. This information could be of utmost significance, as the same resin composite syringe can undergo numerous preheating cycles clinically before it is completely consumed with the advantage of improvement on the handling properties.

TRIAL REGISTRATION

The protocol of the current study was registered at www.

CLINICALTRIALS

gov , with the identification number NCT05289479 on 21/03/2022. All procedures involving human participants were performed in accordance with the ethical standards of the Research Ethics Committee of the Faculty of Dentistry, Minia University, Egypt, under the approval number 73/440 on 11/09/2020.

3D-2D microleakage assessment of preheated bulk-fill composite resin applied with different parameters: a micro-CT analysis

This study evaluated microleakage from class II cavities filled with bulk-fill composite preheated to different temperatures, applied at different thicknesses, and with different polymerization modes. A total of 60 mesio-occlusal cavity were drilled into the extracted human third molars at 2 mm and 4 mm thickness. Preheated bulk-fill composite resin (Viscalor; VOCO, Germany) was applied to the cavities at 68 °C and 37 °C after the adhesive resin was applied, and cured using standard and high-power light-curing modes of a VALO light-curing unit. An incrementally applied microhybrid composite was used as the control. The teeth were subjected to 2000 cycles of heating to 55 °C and cooling to 5 °C with a 30-s hold time. Then, they were immersed in a 50% silver nitrate solution for 24 h and scanned with micro-computed tomography. Scanned data were processed using the CTAn software. Two (2D) and three (3D) dimensional analyses of leached silver nitrate were performed. The data's normality was assessed using the Shapiro-Wilk test before comparisons using a three-way analysis of variance. In both 2D and 3D analysis, bulk-fill composite resin preheated to 68 °C and applied at 2 mm thickness showed less microleakage. In the 3D analysis, restorations applied at 37 °C and 4 mm thickness in high-power mode showed significantly higher values (p < 0.001). Preheated bulk-fill composite resin can be applied at 68 °C and effectively cured at both 2 mm and 4 mm thickness.

Effect of Storage Temperature on Selected Strength Parameters of Dual-Cured Composite Cements

Direct restorations are currently the most popular restorations used in dental prosthodontics. Due to the increased requirements for materials used in the fabrication of fixed restorations, there is a need for evaluation of strength parameters of these materials, including dental cements. The present study investigated the change in selected strength parameters of four dual-cured composite cements as a function of storage temperature. The following were investigated: three-point flexural strength (FS), flexural modulus in bending (FM), diametral tensile strength (DTS) and Vickers hardness (HV). Four dual-cured composite cements were tested, i.e., Multilink Automix (Ivoclar Vivadent), seT PP (SDI), MaxCem (Kerr), and Bifix Hybrid Abutment (VOCO). Each of the tested cements was stored for 7 days at one of the selected temperatures: 8 °C, 15 °C, 25 °C, or 35 °C, before the samples were made. Strength properties (DTS, FS) are not strongly dependent on the storage temperature in the range of 8-35 °C. Some statistical differences were observed between the hardness of MaxCem and Multilink Automix storage in various temperatures. FS and FM were lowest for Bifix Hybrid Abutment, MaxCem and Multilink Automix storage at 25 °C, and highest for Bifix Hybrid Abutment, MaxCem, and seT PP stored in 35 °C. The cement with the highest filler content (70% by weight) showed the highest FS and HV.

Effect of preheating on the physicochemical properties and bond strength of composite resins utilized as dental cements: An in vitro study

STATEMENT OF PROBLEM

Little is known regarding the use of preheated composite resins to bond indirect restorations and its impact on mechanical properties when compared with resin cements.

PURPOSE

The purpose of this in vitro study was to compare the chemical and physical properties and bond strength to enamel and ceramics of preheated composite resins and resin cements.

MATERIAL AND METHODS

Two composite resins, the microhybrid Filtek Z250XT and the nanoparticulate Z350XT were tested, and 2 commercially available resin cements, the dual-polymerized Rely-X ARC and the light-polymerized Rely-X Veneer were used as controls. A device (HotSet) was used to preheat the composite resins to 69 °C before light-polymerization. The following properties were tested: flexural strength, modulus of elasticity, fracture toughness, microshear bond strength to enamel and ceramics, degree of conversion, flow, sorption and solubility, and color stability. Statistical analysis was done with ANOVA and Holm-Sidak for multiple comparisons (α=.05).

RESULTS

Preheating had no significant effect on the degree of conversion, flexural strength, fracture toughness, solubility, or microshear bond strength to the enamel of the tested composite resins (P>.05). However, preheating increased the sorption and reduced the microshear bond strength to the ceramic (P<.05). The flowability of the composite resins increased with heating but showed lower values when compared with both resin cements (P<.05). Color stability was more affected in the preheated composite resins than in the resin cements.

CONCLUSIONS

The preheating process resulted in little to no benefit in the evaluated properties for the composite resins. Resin cements appear to be the best option for cementing indirect restorations.

Effect of Pre-Heating on the Monomer Elution and Porosity of Conventional and Bulk-Fill Resin-Based Dental Composites

The pre-heating of dental resin-based composites (RBCs) improves adaptability to cavity walls, reducing microleakages. However, the rapid cooling of the pre-heated RBC may change the polymerization kinetics, and thus the final network configuration of the RBC. It is well known that unreacted monomers remaining in the set RBC can leach into the oral cavity. However, it is still not clear how the pre-heating and cooling of RBCs alter monomer elution (ME). Thus, the purpose was to determine the ME from room-temperature and pre-heated RBCs, in addition to determining the closed porosity (CP) volume. Bulk-filled RBCs and layered conventional RBC samples were prepared. The pre-polymerization temperature was set at 24 °C and 55/65 °C. The ME from RBC samples was assessed with high-performance liquid chromatography using standard monomers. CP was measured with micro-computed tomography. ME decreased significantly from bulk fills and increased from layered samples as a result of pre-heating. Pre-heating was unfavorable in terms of CP in most RBCs. Based on the effect size analysis, ME and CP were greatly influenced by both material composition, pre-polymerization temperature, and their interaction. While the pre-heating of high-viscosity bulk-fill RBCs is advantageous from a clinical aspect regarding biocompatibility, it increases CP, which is undesirable from a mechanical point of view.

Composite Pre-heating: A Novel Approach in Restorative Dentistry

Resin composite pre-heating is a novel approach that might improve handling and marginal adaptation of the unset material paste in clinical application. The goal of this review article is to compile all laboratory experiments on resin composite preheating and see how it impacts the mechanical properties of the material. Results have shown that preheating composite resins improves the degree of conversion, stiffness, marginal adaptability, and microhardness. While flexural strength is unbothered, polymerization shrinkage is hindered, and the microleakage results are unknown.

Luting indirect restorations with resin cements versus composite resins: Effects of preheating and ultrasound energy on film thickness

OBJECTIVE

This study aims to evaluate and compare the film thickness obtained with a resin cement and two composite resins, preheated and/or ultrasonically vibrated, as luting agents.

MATERIALS AND METHODS

One hundred and twenty-six (126) pairs of resin discs were randomly assigned to six experimental groups (n = 21) according to luting agent (Variolink Esthetic LC, IPS Empress Direct or Estelite Omega) and cementation technique (preheating at 68°C and/or ultrasonic vibration). Specimens were luted by applying a controlled force. Following sectioning and film thickness measurement through field emission gun scanning electron microscopy, statistical analysis was carried out considering a 5% significance level.

RESULTS

Statistically significant lower film thickness was observed in Variolink Esthetic LC group when compared to all composite resin groups (p < 0.001), except IPS Empress Direct preheated and ultrasonically vibrated group (p = 0.073). IPS Empress Direct with ultrasonic vibration yielded statistically lower film thickness values than Estelite Omega groups, regardless of luting technique (p < 0.05). Ultrasonically vibrated Estelite Omega groups showed statistically lower film thickness values than solely preheated groups (p < 0.05).

CONCLUSIONS

Both Variolink Esthetic LC and IPS Empress Direct preheated and ultrasonically vibrated provided the lowest film thickness. The addition of ultrasonic vibration during cementation proved to be effective in reducing film thickness of both tested composite resins.

CLINICAL SIGNIFICANCE

The cementation technique will have variable results depending on the luting material. Adhesive cementation protocols with composite resins should mainly consider ultrasonic vibration, but also preheating, as strategies for reducing film thickness. The tested resin cement, alongside with IPS Empress Direct composite resin preheated and ultrasonically vibrated, provided the lowest film thickness among the tested materials and techniques.

Effect of the Sample Preparation and Light-curing Unit on the Microhardness and Degree of Conversion of Bulk-fill Resin-based Composite Restorations

OBJECTIVE

To evaluate the effect of the sample preparation and light-curing units (LCUs) on the Knoop hardness (KH, N/mm2) and degree of conversion (DC, %) of bulk-fill resin-based composite restorations.

METHODS

Two molds were made using human molar teeth embedded in acrylic resin. One was a conventional tooth mold where the molar received a mesio-occluso-distal (MOD) preparation. In the other, the tooth was sectioned in three slices (buccal, middle, and lingual). The center slice received a MOD preparation similar to the conventional mold. Both tooth molds were placed in the second mandibular molar position in a Dentoform with a 44-mm interincisal opening. Restorations were made using Opus Bulk Fill (FGM) high viscosity bulk-fill resin-based composite (RBC) and light cured using two different lights: VALO Cordless (Ultradent) and Bluephase G2 (Ivoclar Vivadent). The RBC was placed in one increment that was light-cured for a total of 80 seconds (40 seconds at the occluso-mesial and occluso-distal locations). The RBC specimens were then prepared as follows: EmbPol - tooth mold specimen was embedded in polystyrene resin and polished before testing; Pol - tooth mold specimen was not embedded, but was polished before testing; NotPol - sectioned tooth mold, specimen not embedded nor polished before testing. The KH was measured in different depths and regions of the specimens, and the DC was measured using Raman spectroscopy.

RESULTS

The results were analyzed using a 2-way analysis of variance (ANOVA) or repeated measures followed by the Tukey posthoc test (α=0.05). The preparation method (p<0.001), depth of restoration (p<0.001), and the interaction between method and depth (p=0.003) all influenced the KH values. Preparation method (p<0.001), tooth region (p<0.001), and the interaction between method and tooth region (p=0.002) all influenced DC values. The KH values were reduced significantly from the top to the bottom of the restorations and also at the proximal box when compared with the occlusal region. This outcome was most significant in the proximal boxes. The NotPol method was the most effective method to detect the effect of differences in KH or DC within the restoration. A lower DC and KH were found at the gingival regions of the proximal boxes of the restorations. When the KH and DC values were compared, there were no significant differences between the LCUs (KH p=0.4 and DC p=0.317).

CONCLUSION

Preparation methods that embedded the samples in polystyrene resin and polished the specimens reduced the differences between the KH and DC values obtained by different preparation techniques. The NotPol method was better able to detect differences produced by light activation in deeper areas.

A Comparison of Microtensile Bond Strength, Film Thickness, and Microhardness of Photo-Polymerized Luting Composites

The aim of this study was to evaluate the effect of CAD/CAM composite thickness on micro-tensile bond strength (µTBS), microhardness (HV), and film thickness (FT) of different luting composites. Composite blocks (6.8 mm × 6.8 mm) were divided into 12 groups according to: CAD/CAM thickness and luting composite. For each group, 21 rods (1 mm × 1 mm) were tested in tension at crosshead speed of 1 mm/min. Fracture modes were categorized as adhesive, mixed, and cohesive. Microhardness (n = 5/group) was assessed using microhardness tester. Film thickness (12-rods/group) was evaluated using a stereomicroscope (×40). Data were analyzed using the two-way ANOVA/Tukey’s HSD test (p = 0.05). Parameters “thickness”, “cement”, and “thickness x cement” showed significant difference on µTBS and HV (p < 0.05). At 2 mm, heated x-tra fil composite showed the highest µTBS (45.0 ± 8.5 MPa), while at 4 mm thickness, Grandio Flow revealed the lowest µTBS (33.3 ± 6.3 MPa). Adhesive, mixed, and cohesive failures were reported. The HV of all composites decreased when photo-polymerized through 4 mm thickness (p < 0.05). Regardless of CAD/CAM thickness, photo-polymerized composites can be successfully used for luting CAD/CAM composite.

Effects of wall compliance and light-curing protocol on wall deflection of simulated cavities in bulk-fill composite restoration

Background/purpose

Cuspal deflections in composite restoration have been investigated with considering wall compliance of human tooth cavity and light-curing protocol. The purpose of this study was to investigate effects of mold wall compliance and radiant emittance of LED light on the wall deflection of simulated aluminum mold cavities restored with a bulk-fill composite.

Materials and methods

Sixty aluminum molds simulating a class II mesio-occluso-distal (MOD) cavity (6 W × 8 L × 4 D mm; W, width; L, length; D, Depth) were prepared and allocated to three groups with varying mold wall thicknesses of 1, 2, and 3 mm. The molds were bulk-filled with a bulk-fill composite and photo-cured. Four light-curing protocols were used: three duty ratios/exposure times: 100%/20 s, 50%/40 s, or an increasing mode (0 → 100%)/40 s with a pulse width modulated (PWM) LED curing light and one 20 s exposure time with a commercial LED light.

Results

Mean mold wall deflection at 2000 s decreased with increasing mold wall thickness (1, 2, and 3 mm) (p < 0.05). Wall deflections with 1- and 2-mm-thick molds exhibited no statistically significant differences among light-curing protocols (p > 0.05). However, in the 3-mm-thick mold, wall deflections with low radiant emittance were significantly lower than those with high radiant emittance (p < 0.05).

Conclusion

In composite restoration of class II MOD cavities, lowering the radiant emittance of LED light can reduce the mold wall deflection only in low compliance cavities.

Pre-Heating Effect on Monomer Elution and Degree of Conversion of Contemporary and Thermoviscous Bulk-Fill Resin-Based Dental Composites

Detection of unreacted monomers from pre-heated resin-based dental composites (RBC) is not a well-investigated topic so far. The objectives were to determine the temperature changes during the application and polymerization, the degree of conversion (DC) and unreacted monomer elution of room temperature (RT), and pre-heated thermoviscous [VisCalor Bulk(VCB)] and high-viscosity full-body contemporary [Filtek One Bulk(FOB)] bulk-fill RBCs. The RBCs' temperatures during the sample preparation were recorded with a K-type thermocouple. The DC at the top and bottom was measured with micro-Raman spectroscopy and the amounts of eluted BisGMA, UDMA, DDMA, and TEGDMA were assessed with High-Performance Liquid Chromatography. The temperatures of the pre-heated RBCs decreased rapidly during the manipulation phase. The temperature rise during photopolymerization reflects the bottom DCs. The differences in DC% between the top and the bottom were significant. RT VCB had a lower DC% compared to FOB. Pre-heating did not influence the DC, except on the bottom surface of FOB where a significant decrease was measured. Pre-heating significantly decreased the elution of BisGMA, UDMA, DDMA in the case of FOB, meanwhile, it had no effect on monomer release from VCB, except TEGDMA, which elution was decreased. In comparison, RBC composition had a stronger influence on DC and monomer elution, than pre-cure temperature.

Evaluation of depth-wise post-gel polymerisation shrinkage behaviour of flowable dental composites

Short fibre reinforced flowable dental composites are gaining acceptance over particulate filled composites due to their competence to impart improved physio-mechanical properties and capability to prevent crack propagation. However, limited research exists to assess their overall post-gel shrinkage behaviour, which is an important factor to determine marginal seal around restoration and hence its longevity. In this paper, depth-wise post-gel shrinkage strain and the resulting factors such as degree of conversion and rheological behaviour of flowable fibre reinforced composite (FRC) containing 5% weight fraction of 5 μm diameter, 350 μm length S-Glass fibres in UDMA/TEGDMA mixture along with 50% strontium filler particles were investigated. Post-gel shrinkage strain was measured using an array of optical fibre Bragg grating sensors (FBGs) of diameter 250 μm and length 1 mm each embedded at three different depths (depth 0 mm, depth 2.5 mm and depth 5 mm from curing light tip) within the flowable dental composite samples. The rheological behaviour during the polymerisation process was carried out using dynamic oscillatory tests. To evaluate the conversion of CC during polymerisation, degree of conversion tests were conducted by using FTIR spectroscopy. The results obtained for FRC samples were further compared with that of particulate filled composite (PFC) samples, with 55% strontium filler particles only within the same resin system. The relationship between post-gel shrinkage strain at different depths, rheological behaviour and degree of conversion was also explored. The experimental results from the sensor embedded materials suggested that the post-gel shrinkage strain was higher at the top surface (depth 0 mm) and was 50% more than at the bottom surface (depth of 5 mm) for dental FRC as well as PFC samples. Further, similar flow behaviour and not significant different (p<0.05) degree of conversion (DC), post-gel shrinkage strain for dental PFC and FRC composites was observed, establishing a convincing positive relationship between all the key factors and further implying that replacement of fibres with fillers did not affect the overall post-gel polymerisation shrinkage behaviour in dental composites. This investigation has also demonstrated that fibre optic sensors-based shrinkage measurements can be an ideal technique to evaluate post-gel shrinkage performance of dental resins with PFCs or FRCs.

Effect of repeated heating and cooling cycles on the degree of conversion and microhardness of four resin composites

OBJECTIVE

This study evaluated the effect of repeatedly heating and cooling four resin-based composites (RBCs) for up to six cycles.

MATERIALS AND METHODS

Four commercial RBCs were heated to 68°C and cooled to room temperature for up to six cycles before photocuring at 30°C. Specimens spent a total of 0, 30, 60, 90, 120, 150 min, or 7 days at 68°C. The degree of conversion (DC) was measured at the bottom of the specimens immediately after photocuring. The Vickers microhardness was measured at the top and bottom of the RBC surfaces 24 h after photocuring. The data were analyzed using one-way analysis of variance, Dunnett's or Bonferroni post-hoc tests, and Spearman correlation analysis (α = 0.05).

RESULTS

For two brands of RBC, the DC decreased at various time points; however, these decreases were small, and there was no correlation (negative or positive) between the number of heating cycles and the DC for any of the RBCs. Repeated heated and cooling resulted in small changes in the hardness (compared to the control) in both directions (Dunnett; p < 0.05). Two of the RBCs showed a significant, positive correlation between the number of heating cycles and their hardness at the bottom surface.

CONCLUSION

Repeated heating, cooling, and then reheating the RBCs for up to 1 week had little overall effect on their DC and microhardness values. The 2 mm thick specimens of all four RBCs achieved a bottom: top hardness ratio exceeding 0.8 after a 20 s exposure to light from a commercial LED curing light CLINICAL SIGNIFICANCE: Six repeated dry heating and cooling cycles of up to 1 week in duration had little effect on the DC and the microhardness of four commercial resin-based composites.

The effect of pre-heating on monomer elution from bulk-fill resin composites

Background

The present study was aimed to evaluate the effect of pre-heating of bulk -fill resin composites on monomer elution from them.

Material and Methods

Three different types of resin composites were used including Tetric N-Ceram Bulk Fill, X-tra Fill and X-tra Base. 10 cylindrical samples were prepared from each resin composites. Before light curing, 5 samples were pre-heated until reaching 68˚C, then 5 other samples were polymerized at room temperature. After 24 hours, release of UDMA, TEGDMA and BIS-GMA monomers were measured by High-Performance Liquid Chromatography analysis. Data analysis was performed by two-way ANOVA test, Games-Howell and Sidak post hoc tests.

Results

Pre-heating did not have any statistically significant effect on the mean values of UDMA, TEGDMA and Bis-GMA elution (p>0.05). The greatest amount of released Bis-GMA and UDMA was obtained from Tetric N-Ceram Bulk-fill composite. The greatest amount of released TEGDMA was obtained from X-tra Fill composite. X-tra Base composite showed the lowest amount of monomer release (P<0.001).

Conclusions

Pre-heating did not have any effect on monomer release from bulk-fill resin composites. Moreover, the amount and the type of monomers released from various bulk-fill resin composites were not similar.

Key words:Bulk fill composite resin, elution, HPLC, residual monomer, temperature.

Effect of preheating on the cytotoxicity of bulk-fill composite resins

Background. Due to the effect of pre-heating on the degree of conversion of composite resins and the possible effect on cytotoxicity, the effect of pre-heating of bulk-fill composite resins was investigated on cytotoxicity in this study. Methods. In this study, three different types of composite resin were used, including Tetric N-Ceram Bulk-Fil, Xtrafil, and Xtrabase. From each composite resin, 10 cylindrical samples (5 mm in diameter and 4 mm in height) were prepared, with five samples preheated to 68°C, and the other five samples polymerized at room temperature (25°C). Twenty-four hours after polymerization, cytotoxicity was assessed by MTT assay on human fibroblasts. Statistical analysis of data was carried out with two-way ANOVA and Sidak Post-Hoc. The significance level of the test was determined at 0.05. Results. There was no statistically significant difference between the mean percentage of cytotoxicity in terms of pre-heating (P>0.05), but the cytotoxicity of the studied composite resins was significantly different (P<0.001). The cytotoxicity of Tetric N-Ceram Bulk-fil composite resin was higher than that of the two other composite resins. Conclusion. Pre-heating of bulk-fill composite resin did not affect their cytotoxicity. In addition, the cytotoxicity of different bulk-fill composite resins was not the same.

The effect of preheating resin composites on surface hardness: a systematic review and meta-analysis

Objectives

This paper presents a systematic review and meta-analysis of the effect of preheating on the hardness of nanofilled, nanoceramic, nanohybrid, and microhybrid resin composites.

Materials and Methods

An electronic search of papers on MEDLINE/PubMed, ScienceDirect, and EBSCOhost was performed. Only in vitro studies were included. Non-English studies, case reports, clinical trials, and review articles were excluded. A meta-analysis of the reviewed studies was conducted to quantify differences in the microhardness of the Z250 microhybrid resin composite using the Comprehensive Meta-Analysis software.

Results

Only 13 studies met the inclusion criteria for this systematic review. The meta-analysis showed that there were significant differences between the non-preheated and preheated modes for both the top and bottom surfaces of the specimens (p < 0.05). The microhardness of the Z250 resin composite on the top surface in the preheated mode (78.1 ± 2.9) was higher than in the non-preheated mode (67.4 ± 4.0; p < 0.001). Moreover, the microhardness of the Z250 resin composite on the bottom surface in the preheated mode (71.8 ± 3.8) was higher than in the non-preheated mode (57.5 ± 5.7, p < 0.001).

Conclusions

Although the results reported in the reviewed studies showed great variability, sufficient scientific evidence was found to support the hypothesis that preheating can improve the hardness of resin composites.

Polymerisation Shrinkage Profiling of Dental Composites using Optical Fibre Sensing and their Correlation with Degree of Conversion and Curing Rate

Traditional polymerisation shrinkage (PS) measurement systems measure average PS of dental composites, but the true local PS varies along the length and breadth of the composite. The PS depends on the curing light intensity distribution, resultant degree of conversion (DOC) and the curing rate. In this paper, optical fibre Bragg grating (FBG) sensing based technology is used to measure the linear post-gel PS at multiple locations within dental composite specimens, and is correlated with DOC and curing rate. A commercial dental composite is used, and its post-gel PS and DOC are mapped using embedded fibre Bragg grating sensors at different curing conditions. The distance between the curing lamp and the composite specimen is varied which resulted in different intensity distribution across the specimen. The effect of curing light intensity distribution on PS, curing rate and DOC are investigated for demonstrating a relationship among them. It is demonstrated that FBG sensing method is an effective method to accurately profiling post-gel PS across the specimen.

Effect of preheat repetition on color stability of methacrylate- and silorane-based composite resins

Background. The aim of this study was to investigate the effect of preheating methacrylate- and silorane-based composite resins on their color stability up to 40 times at 55‒60°C.

Methods. Seventy-six methacrylate and silorane-based composite resin samples, with a diameter of 10 mm and a height of 2 mm, were divided into 4 groups (n=19). After the samples were prepared, their color parameters were determined using a reflective spectrophotometer. The composite resin samples were separately stored in a solution of tea for 40 consecutive days. Then the samples underwent a color determination procedure again using a spectrophotometer and color changes were recorded. Finally two-way ANOVA was used to study the effect of composite temperature on its staining (P<0.05). Independent-samples t-test was used to evaluate changes in conversion rates of preheated composite resin samples compared to non-heated samples at P=0.005 and P=0.029 for silorane-based and Z250 composite resin samples, respectively.

Results. Both composite resin type (P=0.014) and preheating (P<0.001) had significant effects on ΔE.

Conclusion. Repeated preheating of methacrylate- and silorane-based composite resin samples, up to 55‒60°C for 40 rounds, resulted in more color changes compared with unheated composite resin samples. After storage in a solution of tea the color change rate in the composite resin samples of silorane-based was higher than the Z250 composite resin samples.

Effect of pre-heating on the mechanical properties of silorane-based and methacrylate-based composites

BACKGROUND

The use of composites in dental restoration has been commonly criticized, due to their underwhelming mechanical properties. This problem may be solved partially by preheating. The present research aims to determine the effect of preheating on the mechanical properties of two different classes of composites.

MATERIAL AND METHODS

A Silorane-based (Silorane) and a Methacrylate-based (Z250) composite were preheated to different temperatures (25, 37, and 68 °C) and afterwards were tested with the appropriate devices for each testing protocol. The material's flexural strength, elastic modulus, and Vickers microhardness were evaluated. Two-way ANOVA, and Tukey's post hoc were used to analyze the data.

RESULTS

Microhardness and elastic modulus increased with preheating, while flexural strength values did not increase significantly with preheating. Furthermore the methacrylate-based composite (Z250) showed higher values compared to the Silorane-based composite (Silorane) in all the tested properties.

CONCLUSIONS

Preheating Silorane enhances the composite's microhardness and elastic modulus but does not affect its flexural strength. On the other hand, preheating Z250 increases its microhardness but does not change its flexural strength or elastic modulus. In addition, the Z250 composite shows higher microhardness and flexural strength than Silorane, but the elastic modulus values with preheating are similar. Therefore Z250 seems to have better mechanical properties making it the better choice in a clinical situation. Key words:Composite, elastic modulus, flexural strength, microhardness, preheating.

Five second photoactivation? A microhardness and marginal adaptation in vitro study in composite resin restorations

INTRODUCTION

Studies defining the characteristics of light curing units and photoactivation methods are necessary to allow the correct choices to be made in daily practice. This study aimed to determine whether different photoactivation protocols for composite resins [periodic level shifting (PLS) - 5 second and soft-start] are able to maintain or enhance the mechanical properties and marginal adaptation of restorations.

METHODS

Restorations were placed in bovine teeth using the following photoactivation methods: continuous light for 20 seconds (control group); PLS technology (PLS - 5 second group); and continuous light and a light guide tip distance of 6 mm after which the tip was placed at the surface of the restoration (soft-start group). The teeth were transversely sectioned in the incisal-cervical direction. Thirty halves were randomly selected for Knoop microhardness testing (n = 10). The other 30 halves were subjected to scanning electron microscopy analysis. The images obtained were measured to identify the highest marginal gap, and statistical tests for variance analysis were conducted.

RESULTS

Microhardness tests showed no statistically significant difference between the photoactivation methods analysed (P ≥ 0.01). The tests showed a difference among depths (P < 0.01), with the deeper layers being the hardest. In analysing marginal adaptation, no significant difference was identified between the higher marginal gap values in the continuous (mean = 10.36) and PLS - 5 second (mean = 10.62) groups, and the soft-start group (mean = 5.83) presented the lowest values (P < 0.01).

CONCLUSIONS

The PLS - 5 second and soft-start protocols did not alter the hardness of the restorations. Moreover, the PLS - 5 second protocol did not alter the marginal adaptation, whereas the soft-start protocol improved marginal adaptation.

Effect of LED-LCU light irradiance distribution on mechanical properties of resin based materials

The objective of this study is to analyze the light power distribution along the tip end of the light guide of three LED-LCUs (Light Curing Units) and to evaluate its effect on the mechanical properties of a polymer based dental composite. Firstly, the light power distribution over the whole area of LED-LCU light guide surface was analyzed by three methods: visual projection observation, spectral measurement and optical spectral analysis (OSA). The light power distribution and the total irradiance were different for the three LEDs used, but the wavelength was within the camphorquinone absorption spectrum. The use of a blank sheet was quite on hand to make a qualitative analysis of a beam, and it is costless. Secondly, specimens of a hybrid composite with approximately 8mm diameter and 2mm thickness were produced and polymerized by 20s exposition time to each LED-LCU. Thirdly, the elastic modulus (E) and hardness (HV) were measured throughout the irradiated area by instrumented micro-indentation test (IIT), allowing to correlate localized power and mechanical properties. Both E and HV showed to be very sensitive to local power and wavelength dependent, but they followed the beam power profile. It was also shown that the mechanical properties could be directly correlated to the curing process. Very steep differences in mechanical properties over very short distances may impair the material performance, since residual stresses can easily be built over it.

Influence of a Repeated Preheating Procedure on Mechanical Properties of Three Resin Composites

The aim of this study was to assess the flexural strength, flexural elastic modulus and Vickers microhardness of three resin composites prepared at room temperature or cured after one or repeated preheating cycles to a temperature of 39°C. Three resin composites were evaluated: Enamel Plus HFO (Micerium), Opallis (FGM), and Ceram X Duo (Dentsply DeTrey). For each trial, one group of specimens of each material was fabricated under ambient laboratory conditions, whereas in the other groups, the composites were cured after 1, 10, 20, 30, or 40 preheating cycles to a temperature of 39°C in a preheating device. Ten rectangular prismatic specimens (25 × 2 × 2 mm) were prepared for each group (N=180; n=10) and subjected to a three-point bending test for flexural strength and flexural modulus evaluation. Vickers microhardness was assessed on 10 cylindrical specimens from each group (N=180; n=10). Statistical analysis showed that, regardless of the material, the number of heating cycles was not a significant factor and was unable to influence the three mechanical properties tested. However, a significant main effect of the employed material on the marginal means of the three dependent variables was detected.

Effects of prepolymerized particle size and polymerization kinetics on volumetric shrinkage of dental modeling resins

Dental modeling resins have been developed for use in areas where highly precise resin structures are needed. The manufacturers claim that these polymethyl methacrylate/methyl methacrylate (PMMA/MMA) resins show little or no shrinkage after polymerization. This study examined the polymerization shrinkage of five dental modeling resins as well as one temporary PMMA/MMA resin (control). The morphology and the particle size of the prepolymerized PMMA powders were investigated by scanning electron microscopy and laser diffraction particle size analysis, respectively. Linear polymerization shrinkage strains of the resins were monitored for 20 minutes using a custom-made linometer, and the final values (at 20 minutes) were converted into volumetric shrinkages. The final volumetric shrinkage values for the modeling resins were statistically similar (P > 0.05) or significantly larger (P < 0.05) than that of the control resin and were related to the polymerization kinetics (P < 0.05) rather than the PMMA bead size (P = 0.335). Therefore, the optimal control of the polymerization kinetics seems to be more important for producing high-precision resin structures rather than the use of dental modeling resins.

Temperature and curing time affect composite sorption and solubility

Objective:

This study evaluated the effect of temperature and curing time on composite sorption and solubility.

Material and Methods:

Seventy five specimens (8x2 mm) were prepared using a commercial composite resin (ICE, SDI). Three temperatures (10º C, 25º C and 60º C) and five curing times (5 s, 10 s, 20 s, 40 s and 60 s) were evaluated. The specimens were weighed on an analytical balance three times: A: before storage (M1); B: 7 days after storage (M2); C: 7 days after storage plus 1 day of drying (M3). The storage solution consisted of 75% alcohol/25% water. Sorption and solubility were calculated using these three weights and specimen dimensions. The data were analyzed using the Kruskal-Wallis and Mann-Whitney U Tests (α=5%).

Results:

The results showed that time, temperature and their interaction influenced the sorption and solubility of the composite (p<0.05). At 60º C, the composite sorption showed an inverse relationship with the curing time (p<0.05). The composite cured for 5 s showed higher sorption for the 40 s or 60 s curing times when compared with all temperatures (p<0.05). Curing times of 20 s and 40 s showed similar sorption data for all temperatures (p>0.05). The 60º C composite temperature led to lower values of sorption for all curing times when compared with the 10º C temperature (p<0.05). The same results were found when comparing 10º C and 25º C (p<0.05), except that the 20 s and 40 s curing times behaved similarly (p>0.05). Solubility was similar at 40 s and 60 s for all temperatures (p>0.05), but was higher at 10º C than at 60º C for all curing times (p<0.05). When the composite was cured at 25º C, similar solubility values were found when comparing the 5 s and 10 s or 20 s and 40 s curing times (p>0.05).

Conclusion:

In conclusion, higher temperatures or longer curing times led to lower sorption and solubility values for the composite tested; however, this trend was only significant in specific combinations of temperature and curing times.

Layering composites for ultimate aesthetics in direct restorations

A number of modern materials are available which allow placement of highly aesthetic anterior restorations. However, some systems are complex and technique sensitive. The authors describe a layering technique for the provision of direct aesthetic anterior composite restorations suitable for a general practice setting.

CLINICAL RELEVANCE

Aesthetic restorations can be provided directly and in a conservative manner using composite resin, often avoiding the need for more destructive indirect techniques.

Effects of preheating and precooling on the hardness and shrinkage of a composite resin cured with QTH and LED

The aim of this study was to evaluate in vitro the hardness and shrinkage of a pre-cooled or preheated hybrid composite resin cured by a quartz-tungsten-halogen light (QTH) and light-emitting diode (LED) curing units. The temperature on the tip of the devices was also investigated. Specimens of Charisma resin composite were produced with a metal mold kept under 37°C. The syringes were submitted to 4°C, 23°C, and 60°C (n=20) before light-curing, which was carried out with the Optilux 501 VCL and Elipar FreeLight 2 units for 20 seconds. The specimens were kept under 37°C in a high humidity condition and darkness for 48 hours. The Knoop hardness test was carried out with a 50 gram-force (gf) load for 10 seconds, and the measurement of the shrinkage gap was carried out using an optical microscope. The data were subjected to analysis of variance and the Games-Howell test (α=0.05). The mean hardness of the groups were similar, irrespective of the temperatures (p>0.05). For 4°C and 60°C, the top surface light-cured by LED presented significantly reduced shrinkage when compared with the bottom and to both surfaces cured by QTH (p<0.05). It was concluded that the hardness was not affected by pre-cooling or preheating. However, polymerization shrinkage was slightly affected by different pre-polymerization temperatures. The QTH-curing generated greater shrinkage than LED-curing only when the composite was preheated. Different temperatures did not affect the composite hardness and shrinkage when cured by a LED curing unit.

Class II composite restorations and proximal concavities: clinical implications and management

Clinical experience supports the notion that the restoration of MOD cavities may pose a challenge to the practitioner. Proper placement of precontoured matrices and commercial wedges help the clinician to establish an optimal emergence profile and sufficient contours. However, the presence of proximal concavities in premolars or molars can turn the reproduction of previous cervical architecture into an even more demanding task. Wedges with customized form or adequate design can precisely conform the matrix to the cavosurface area and prevent any gap formation. This article presents two different options that allow for successful and predictable reestablishing of anatomically correct contours and optimal proximal contacts in posterior teeth with proximal concavities.

Dimethacrylate network formation and polymer property evolution as determined by the selection of monomers and curing conditions

OBJECTIVES

This overview is intended to highlight connections between monomer structure and the development of highly crosslinked photopolymer networks including the conversion dependent properties of shrinkage, modulus and stress.

METHODS

A review is provided that combines the polymer science and dental materials literature along with examples of relevant experimental results, which include measurements of reaction kinetics, photorheology as well as polymerization shrinkage and stress.

RESULTS

While new monomers are continually under development for dental materials applications, mixtures of dimethacrylate monomers persist as the most common form of dental resins used on composite restorative materials. Monomer viscosity and reaction potential is derived from molecular structure and by employing real-time near-infrared spectroscopic techniques, the development of macromolecular networks is linked to the evolution of polymerization shrinkage (measured by linometer), modulus (measured by photorheometer), and stress (measured by tensometer). Relationships between the respective polymer properties are examined.

SIGNIFICANCE

Through a better understanding of the polymer network formation and property development processes using conventional dimethacrylate monomer formulations, the rational design of improved materials is facilitated with the ultimate goal of achieving dental polymers that deliver enhanced clinical outcomes.

Effect of precuring warming on mechanical properties of restorative composites

To investigate the effect of prepolymerization warming on composites' mechanical properties, three composites were evaluated: Clearfil Majesty (CM) (Kuraray), Z-100 (3M/ESPE), and Light-Core (LC) (Bisco). Specimens were prepared from each composite at room temperature as control and 2 higher temperatures (37°C and 54°C) to test surface hardness (SH), compressive strength (CS), and diametral tensile strength (DTS). Data were statistically analyzed using ANOVA and Fisher's LSD tests. Results revealed that prewarming CM and Z100 specimens significantly improved their SH mean values (P < 0.05). Prewarming also improved mean CS values of Z100 specimens (P < 0.05). Furthermore, DTS mean value of CM prepared at 52° was significantly higher than that of room temperature specimens (P < 0.05). KHN, CS, and DTS mean values varied significantly among the three composites. In conclusion, Prewarming significantly enhanced surface hardness of 2 composites. Prewarming also improved bulk properties of the composites; however, this improvement was significant in only some of the tested materials.

Effect of preheating resin composite and light-curing units on the microleakage of Class II restorations submitted to thermocycling

This in vitro study evaluated microleakage in Class II cavities restored with dental composite and varying light-curing units and the temperature of the composite when subjected to a thermocycling test. Ninety cavities were prepared on the proximal surfaces of bovine teeth and randomly divided according to the light-curing mode (QTH-420 mW/cm2, LED 2nd generation-1100 mW/cm2, or LED 3rd generation-700 mW/cm2) and temperature of the resin composite (23°C, 54°C and 60°C). Following the restorative procedures and thermocycling, the samples were immersed in methylene blue for 12 hours. The samples were ground and the powder prepared for analysis in an absorbance spectrophotometer. All the results were statistically analyzed using the nonparametric tests of Kruskal-Wallis and Dunn (p ≤ 0.05). The results showed that there was no statistical difference between the light-curing modes at a temperature of 23°C. For 54°C, QTH showed a microleakage mean that was significantly lower than those of the LED groups, and for 60°C, QTH had a microleakage mean significantly lower than that of the LED 2nd generation group. There was no statistical difference between the temperatures of the resin composite when LEDs were used. For QTH, 54°C showed statistically lower microleakage than 23°C. The group preheated to 60°C showed no difference when compared to the group heated to 23°C. Preheating the resin composite (54°C and 60°C) did not improve the microleakage means when high-irradiance LED was used; however, it decreased the microleakage means when a QTH with low irradiance was used.