Rheological and Mechanical Properties of Resin-Based Materials Applied in Dental Restorations

Resin-based materials have been prevalent for dental restorations over the past few decades and have been widely used for a variety of direct and indirect procedures. Typically, resin-based dental materials are required to be flowable or moldable before setting and can provide adequate mechanical strength after setting. The setting method may include, but is not limited to, light-curing, self-curing or heating. In this review, based on different indications of resin-based dental materials (e.g., dental filling composite, dental bonding agent, resin luting cement), their rheological and mechanical properties were reviewed. Viscous and flexible properties were focused on for materials before setting, while elastic properties and mechanical strength were focused on for materials after setting. At the same time, the factors that may affect their rheological and mechanical properties were discussed. It is anticipated that the insightful information and prospections of this study will be useful to the future development and fabrication of resin-based dental restorative materials.

The influence of zirconia veneer thickness on the degree of conversion of resin-matrix cements: an integrative review

OBJECTIVE

The main aim of this study was to conduct an integrative review on the influence of the zirconia veneer thickness on the degree of conversion of resin-matrix cements.

MATERIALS AND METHOD

An electronic search was performed on PubMed using a combination of the following search items: zirconia, thickness, veneer, degree of conversion, resin cement, light curing, and polymerization. Articles published in the English language, up to July 2020, were included regarding the influence of ceramic veneer thickness on the degree of conversion of resin-matrix cements. Randomized controlled trials and prospective cohort studies were also evaluated.

RESULTS

Of the 21 selected studies, 9 investigated the light-curing effect, while five other articles evaluated the ceramic translucency. Three studies evaluated the degree of conversion of the resin-matrix cement while four articles assessed the veneer thickness. Results revealed a significant decrease of light transmission through the zirconia with a thickness ranging from 0.1 up to 1.5 mm. However, the ultra-thin thickness around 0.1 and 0.3 mm allowed a full polymerization of the dual-curing resin-matrix cement resulting in the integrity of the interface properties. The light-curing process of resin-matrix cements is also affected by the shade, chemical composition, and microstructure of zirconia and resin cement. Optimal conditions of light-curing are required to reach the threshold intensity of light and energy for polymerization of resin-matrix cements.

CONCLUSIONS

The increase in zirconia veneer thickness negatively affects the degree of conversion of resin-matrix cements. Also, shade and microstructure are key factor to improve the light curing of resin cements.

CLINICAL RELEVANCE

Clinicians should consider the zirconia thickness on resin-based cementation since a higher veneer thickness can negatively affect the light irradiation intensity towards the dual-curing resin-matrix cement. Thus, the degree of conversion of the resin-matrix cement can decrease leading to a low chemical stability (e.g., color instability) and poor mechanical properties.

Long-Term Stability of a RAFT-Modified Bulk-Fill Resin-Composite under Clinically Relevant Versus ISO-Curing Conditions

The addition of RAFT (reversible addition-fragmentation chain transfer) agents to the matrix formulation of a bulk-fill resin composite can significantly decrease the required curing time down to a minimum of 3 s. Evaluating the long term-stability of this resin composite in relation to varied curing conditions in an in-vitro environment was this study’s goal. Specimens were produced according to either an ISO or one of two clinical curing protocols and underwent a maximum of three successive aging procedures. After each one of the aging procedures, 30 specimens for each curing condition were extracted for a three-point bending test. Fragments were then stereo-microscopically characterized according to their fracture mechanism. Weibull analysis was used to quantify the reliability of each aging and curing combination. Selected fragments (n = 12) underwent further testing via depth-sensing indentation. Mechanical values for either standardized or clinical curing were mostly comparable. However, changes in fracture mechanism and Weibull modulus were observed after each aging procedure. The final procedure exposed significant differences in the mechanical values due to curing conditions. Curing conditions with increased radiant exposure seemingly result in a higher crosslink in the polymer-matrix, thus increasing resistance to aging. Yet, the clinical curing conditions still resulted in acceptable mechanical values, proving the effectiveness of RAFT-polymerization.

Curing Depth and Degree of Conversion of Five Bulk-Fill Composite Resins Compared to a Conventional Composite

Background:

Limited curing depth and its effect on the degree of conversion are among the challenges of working with light-cure composite resins. The use of bulk-fill composites is one strategy to overcome these limitations.

Methods:

Ever X Posterior (EXP), Filtek Bulk-Fill Posterior (FBP), Sonic Fill 2 (SF2), Tetric N-Ceram Bulk-Fill (TNB), and X-tra Fil (XF) bulk-fill and Filtek Z250 conventional composite were evaluated in this in vitro experimental study. Six samples for the assessment of microhardness and three samples for the evaluation of DC were fabricated of each composite. After light curing and polishing, the samples were incubated at 37°C for 24 hours. Microhardness was measured by a Vickers hardness tester three times and the mean value was calculated. DC of the top and bottom surfaces was determined using Fourier-Transform Infrared Spectroscopy (FTIR). Data were analyzed using one-way ANOVA and Tukey’s test.

Results:

Microhardness and DC were significantly different among the groups (P<0.001). XF and Z250 equally showed the highest bottom-to-top surface microhardness ratio (0.97 ± 0.01) and significantly higher DC in the top (P<0.001) and bottom (P<0.005) surfaces compared to other groups. TNB showed the lowest microhardness ratio (0.88 ± 0.04) and DC (68.66 ± 1.52 and 61.00 ± 2.00); the difference in DC of the bottom surface was statistically significant (P<0.003).

Conclusion:

It appears that bulk-fill composites evaluated in this study are adequately polymerized at 4 mm depth. Their DC was optimal and within the range of conventional composites.

Shrinkage stress and elastic modulus assessment of bulk-fill composites

Bulk-fill composites were introduced in dentistry to accelerate clinical procedures while providing adequate outcomes. Concerns regarding the use of bigger composite increments rely on the polymerization shrinkage and shrinkage stress, which may generate gaps on the adhesive interface and result in a reduced success rate. Objective: To evaluate the polymerization shrinkage stress of different bulk-fill resin composites and their elastic modulus. Materials and Methods: Fourteen specimens were made for each of the nine different resin composites (seven with 12 mm³ and seven with 24 mm³): Surefill SDR flow (SDR), X-tra Base (XB), Filtek Bulk Fill Flowable (FBF), Filtek Z350XT Flow (Z3F); Tetric Evo Ceram Bulk Fill (TBF), X-tra Fil (XF), Filtek Bulk Fill (FBP), Admira Xtra Fusion (ADM) and Filtek Z350 XT (Z3XT). Linear shrinkage stress was evaluated for 300 s with the aid of a linear shrinkage device adapted to a Universal Testing Machine. For each composite group, seven additional specimens (2x2x25 mm) were made and Young's modulus was evaluated with a 3-point bending device adapted in a Universal Testing Machine with 0.5 mm/min crosshead speed and 50 KgF loading cell. Results: For 12 mm³ specimens, three-way ANOVA showed that only SDR and TBF generated lower stress after 20 s. Considering 300 s, TBF, SDR, and XF generated the lowest stress, followed by ADM, FBP, XB, and FBF, which were similar to Z3XT. Z3F generated the highest stress values for all time points. Considering 24 mm³ specimens after 20 s, all bulk fill composites generated lower stress than Z3XT, except XB. After 300 s, SDR, FBP, and ADM generated the lowest stress, followed by TBF and XF. For elastic modulus, one-way ANOVA showed that FBF, SDR, Z3F, and ADM presented the lowest values, followed by XB and TBF. FBP, Z3XT, and XF presented the highest elastic modulus among the evaluated composites. Conclusions: Bulk-fill resin composites presented equal to lower shrinkage stress generation when compared to conventional composites, especially when bigger increments were evaluated. Bulk-fill composites showed a wide range of elastic modulus values, but usually similar to “regular” composites.

Variation in composite degree of conversion and microflexural strength for different curing lights and surface locations

BACKGROUND

Lack of irradiance-beam profile uniformity across the emission area of light-curing units (LCUs) may result in suboptimal properties of composite restorations. The authors' objective for this study was to assess the variation in local cure of 1 composite at 3 different LCU emission area locations cured with 3 different LCUs by means of testing the degree of conversion (DC) and microflexural strength.

METHODS

The authors fabricated dual-photoinitiator composite specimens (n = 5), which were cured using either a quartz-tungsten-halogen, a multiple-emission peak, or a single-emission peak light-emitting diode LCU. The specimen's top surfaces received irradiation from either the center, 1.5 millimeters straight to the left of the center, or 1.5 mm straight to the right of the center of the LCU emission area. The authors measured irradiance and DC on top and bottom specimen surfaces using a spectrometer and attenuated total reflection-Fourier transform infrared spectroscopy, respectively. The authors performed micro 3-point bend tests using a universal mechanical testing machine. They used multifactorial analysis of variance (α = 0.05).

RESULTS

The irradiance ranged from 452 through 946 milliwatts per square centimeter, and DC ranged from 49.7% through 65.8% on top surfaces. Microflexural strength ranged from 313 through 458 megapascals.

CONCLUSIONS

The authors did not find correlations among the LCU irradiance-beam profile of the 3 emission area locations and the investigated material properties, although they found variations in the measured properties.

PRACTICAL IMPLICATIONS

The irradiance-beam profile from the different LCUs explored did not have a major influence on the DC and microflexural strength for the investigated composite.

Nanofilled Resin Composite Properties and Clinical Performance: A Review

The aim of this review was to compile recent evidence related to nanofilled resin composite materials regarding the properties and clinical performance. Special attention was given to mechanical properties, such as strength, hardness, abrasive wear, water sorption, and solubility. The clinical performance of nanocomposite materials compared with hybrid resin composites was also addressed in terms of retention and success rates, marginal adaptation, color match, and surface roughness. A search of English peer-reviewed dental literature (2003-2017) from PubMed and MEDLINE databases was conducted using the terms "nanocomposites" or "nanofilled resin composite" and "clinical evaluation." The list was screened, and 82 papers that were relevant to the objectives of this work were included in the review. Mechanical properties of nanocomposites are generally comparable to those of hybrid composites but higher than microfilled composites. Nanocomposites presented lower abrasive wear than hybrids but higher sorption values. Their clinical performance was comparable to that of hybrid composites.

Effect of Light-Curing Exposure Time, Shade, and Thickness on the Depth of Cure of Bulk Fill Composites

Purpose:

To investigate the effect of different light exposure times, shades, and thicknesses on the depth of cure (DOC) of bulk fill composites.

Methods and Materials:

Two bulk fill composites, Tetric EvoCeram Bulk Fill (TBF) and Sonic Fill (SF), and a conventional composite, Filtek Supreme Ultra (FSU), were evaluated. Samples (n=10) were made using two different shades (light and dark), thicknesses (2 and 4 mm) and exposure times (20 and 40 seconds). A Tukon 2100B-testing machine was used to obtain three Knoop hardness numbers (KHNs) measured at the top and bottom of each sample, and DOC was calculated as the bottom/top ratio. Statistical analysis was done using a Student t-test for comparisons between groups with a Bonferroni correction of p &lt; 0.004.

Results:

Top hardness values ranged from 79.79 to 85.07 for FSU, 69.49 to 91.65 for SF, and 51.01 to 57.82 for TBF. Bottom KHNs ranged from 23.54 to 73.25 for FSU, 45.74 to 77.12 for SF, and 36.95 to 52.51 for TBF. TBF had the lowest overall KHNs. Light-curing exposure time, shade, and material thickness influenced the DOC in most groups, especially at 4-mm depths. A higher bottom/top ratio was achieved when a 40-second cure was compared to a 20-second cure, when light shades were compared to dark shades, and when 2-mm increments were compared to 4-mm increments.

Influence of photoirradiation conditions on dentin bond durability and interfacial characteristics of universal adhesives

The influence of photoirradiation conditions on dentin bond durability and interfacial characteristics of universal adhesives was investigated. Universal adhesives were applied to the dentin surfaces and photoirradiated with 100 mW/cm² for 40 s, 200 mW/cm² for 20 s, and 400 mW/cm² for 10 s. A resin composite was bonded to dentin to determine shear bond strength after 24 h water storage and 30,000 thermal cycles, and water contact angle of cured adhesive were measured by the sessile drop method. Greater dentin bond strengths after 24 h water storage and 30,000 thermal cycles were achieved under these conditions at light intensity exceeding 200 mW/cm². Universal adhesives photoirradiated above 200 mW/cm² exhibited significantly higher water contact angles than those at 100 mW/cm². The results of this study suggested that the photoirradiation conditions affect the dentin bond durability and interfacial characteristics of universal adhesives even at the same total energy.

Academy of Dental Materials guidance-Resin composites: Part I-Mechanical properties

OBJECTIVE

The objective of this project, which was initiated from the Academy of Dental Materials, was to review and critically appraise methods to determine fracture, deformation and wear resistance of dental resin composites, in an attempt to provide guidance for investigators endeavoring to study these properties for these materials.

METHODS

Test methods have been ranked in the priority of the specific property being tested, as well as of the specific test methods for evaluating that property. Focus was placed on the tests that are considered to be of the highest priority in terms of being the most useful, applicable, supported by the literature, and which show a correlation with clinical findings. Others are mentioned briefly for the purpose of being inclusive. When a standard test method exists, including those used in other fields, these have been identified in the beginning of each section. Also, some examples from the resin composite literature are included for each test method.

RESULTS

The properties for evaluating resin composites were ranked in the priority of measurement as following: (1) Strength, Elastic Modulus, Fracture toughness, Fatigue, Indentation Hardness, Wear-abrasion (third body) and Wear-attrition (contact/two body), (2) Toughness, Edge strength (chipping) and (3) Wear determined by toothbrush.

SIGNIFICANCE

The following guidance is meant to aid the researcher in choosing the proper method to assess key properties of dental resin composites with regard to their fracture, deformation and wear resistance.

Characterization of Inorganic Filler Content, Mechanical Properties, and Light Transmission of Bulk-fill Resin Composites

OBJECTIVES

The aims of this study were to characterize inorganic content (IC), light transmission (LT), biaxial flexural strength (BFS), and flexural modulus (FM) of one conventional (layered) and four bulk-fill composites at different depths.

METHODS

Bulk-fill composites tested were Surefil SDR flow (SDR), Filtek Bulk Fill (FBF), Tetric EvoCeram Bulk Fill (TEC), and EverX Posterior (EXP). Herculite Classic (HER) was used as a control. Energy dispersive x-ray analysis and scanning electron microscopy were used to characterize filler particle composition and morphology. The LT through different composite thicknesses (1, 2, 3, and 4 mm) was measured using a laboratory-grade spectral radiometer system (n=5). For the BFS and FM tests, sets of eight stacked composite discs (0.5-mm thick) were prepared simulating bulk filling of a 4-mm-thick increment (n=8).

RESULTS

SDR demonstrated larger, irregular particles than those observed in TEC or HER. Filler particles in FBF were spherical, while those in EXP were composed of fiberglass strands. The LT decreased with increased composite thickness for all materials. Bulk-fill composites allowed higher LT than the HER. Furthermore, HER proved to be the unique material, having lower BFS values at deeper regions. SDR, FBF, and TEC bulk-fill composites presented reduced FM with increasing composite depth.

CONCLUSIONS

The bulk-fill composites investigated exhibited higher LT, independent of different filler content and characteristics. Although an increase in composite thickness reduced LT, the BFS of bulk-fill composites at deeper layers was not compromised.

Effect of a third-generation LED LCU on microhardness of tooth-colored restorative materials

OBJECTIVE

To assess the effects of different modes of a third-generation light-curing unit (LCU) (VALO) on the microhardness of restorative materials.

DESIGN

A microhybrid composite resin (Filtek(™) Z550), a giomer (Beautifil II), a compomer (Dyract eXtra) and a RMGIC (Photac(™) Fil) were used in the study. Three different modes of VALO were tested and a second-generation LCU (Elipar S10) was used as a control. The microhardness (VHN) was measured using a Vickers Hardness tester. Data were analyzed using two-way anova and post hoc Tukey's test (P < 0.05).

RESULTS

The Filtek Z550 group had the highest VHN values followed by Photac Fil, Beautifil II and the Dyract eXtra at both top and bottom surfaces, however the difference between Filtek Z550 and Photac Fil was not statistically significant for the bottom surfaces (P > 0.05). Of the different curing protocols tested, the VALO LCU in Mode 3 resulted in the lowest VHN values at both top and bottom surfaces (P < 0.05).

CONCLUSION

Based on the results of this study, it can be concluded that the high-power mode of the VALO LCU can be recommended for clinical applications especially in pediatric patients, as it can shorten the time required to adequately polymerize resin-based tooth-colored restorative materials.

Effect of preheating and shade on surface microhardness of silorane-based composites

AIM

The aim of the present study was to evaluate the effect of preheating and shade on the surface microhardness of silorane-based composites.

METHODS

Three shades of two different types of composites were evaluated: a silorane-based composite and a methacrylate-based composite. The composites were tested at 23°C, and after preheating at 55°C. Five specimens were prepared for each experimental group. The top surface of the specimens was irradiated for 20 s using an LED unit. Vickers microhardness test was used to evaluate both top and bottom surfaces of the specimens, followed by 24-h storage in the dark. Statistical analysis was performed using one-way anova and Tukey's post-hoc test at a level of significance of α = 0.05.

RESULTS

There was a significant rise in microhardness as the temperature increased from 23 to 55°C for both the top and bottom surfaces of the tested composites (P < 0.05). The C2 shade of both composites exhibited the lowest microhardness (P < 0.05), while the A2 and A3 shades did not show significant differences compared to each other (P > 0.05) Filtek Silorane presented significantly lower microhardness than Filtek Z250 (P < 0.05), regardless of the temperature, shade, or depth of measurement.

CONCLUSIONS

Preheating, shade, and composition of the tested composite resins affected their surface microhardness.

Influence of successive light-activation on degree of conversion and Knoop hardness of the first layered composite increment

PURPOSE

To evaluate the influence of light-activation of second, third and fourth increments on degree of conversion (DC) and microhardness (KHN) of the top (T) and bottom (B) surface of the first increment.

MATERIALS AND METHODS

Forty samples (n = 5) were prepared. In groups 1-4, after each increment light-activation (multiple irradiation), T and B of the first increment were measured in DC and KHN. In groups 5-8, only the first increment was made (single irradiation) and measurements of DC and KHN were taken at 15 min intervals. The light-activation modes were (XL) 500 mW/cm(2) × 38 s (G1/G5); (S) 1000 mW/cm(2) × 19 s (G2/G6), (HP) 1400 mW/cm(2) × 14 s (G3/G7); (PE) 3200 mW/cm(2) × 6 s (G4/G8). Data for DC and KHN were analyzed separately by using PROC MIXED for repeated measures and Tukey-Kramer test (α = 0.05).

RESULTS

For KHN, B showed lower values than T. PE resulted in lower values of KHN in B surface. For single and multiple irradiations, T and B of first measurement showed the lowest KHN and the fourth measurement showed the highest, with significant difference between them. For single irradiation, first and second increments presented similar KHN, different from the third and fourth increment, which did not differ between them. For multiple irradiations, the second light-activation resulted in KHN similar to first, third and fourth increments. For DC, except QTH, T presented higher DC than B.

CONCLUSION

The light-activation of successive increments was not able to influence the KHN and DC of the first increment.

Two regression methods for estimation of a two-parameter Weibull distribution for reliability of dental materials

OBJECTIVES

Comparison of estimation of the two-parameter Weibull distribution by two least squares (LS) methods with interchanged axes. Investigation of the influence of plotting positions and sample size. Derivation of 95% confidence intervals (95%CI) for Weibull parameters applicable in the context of LS estimation. Preparation of a free available Excel template for computation of point estimates and 95%CI for Weibull modulus (m) and characteristic strength (s).

METHODS

Monte Carlo simulation covering a wide range of Weibull parameters and sample sizes. Mathematical derivation of formulae for computation of 95%CI according to a Menon-type approach for both m and s. Empirical proof that the practically observed coverage agrees with the nominal one of 95%.

RESULTS

Relative and absolute performance of LS estimators depended on sample size, plotting positions and parameter to be estimated. For most situations they outperformed the corresponding Maximum Likelihood (ML) estimator in terms of bias, while precision was almost the same. Naïve Wald-type 95%CI based on standard errors of LS regression coefficients did not reach targeted coverage. An easy-to-apply alternative based on asymptotic standard errors (Menon 95%CI) resulted in excellent coverage.

CONCLUSION

Accuracy of the LS methods for Weibull modulus and characteristic strength essentially depend on plotting position and sample size. Large sample sizes (n≥30) support a credible Weibull parameters estimation. An important complement of the point estimates of Weibull parameters is provided by the Menon 95%CI. A free available Excel template considerably facilitating computation of point and interval estimates of Weibull parameters is provided.