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Ismail HS, Ali AI, El Mehesen R, Garcia-Godoy F, Mahmoud SH. Clinical evaluation of subgingival open sandwich restorations: 3-year results of a randomized double-blind trial. J ESTHET RESTOR DENT 2024; 36:573-587. [PMID: 37902283 DOI: 10.1111/jerd.13158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/21/2023] [Accepted: 10/12/2023] [Indexed: 10/31/2023]
Abstract
OBJECTIVES To provide a 3-year follow-up of previously treated patients to assess and compare the periodontal responses and clinical performance of proximal subgingival open sandwich restorations. MATERIALS AND METHODS Ninety-five adults participated in the study, with a combined total of 120 compound Class II cavities. These cavities had gingival margins located below the CEJ. Four different restorative materials were used to elevate the dentin/cementum gingival margins of the cavities: resin-modified glass ionomer, glass hybrid, flowable bulk-fill composite, or ion-releasing material, which were then completed with the same overlaying composite. Different periodontal and clinical evaluations, based on the criteria set by the World Dental Federation (FDI) criteria, were performed at different time intervals, including baseline, 6 months, 1, 2, and 3 years. RESULTS The type of base material did not affect the periodontal evaluations. There were no statistically significant differences between different time intervals or base material groups in any of the evaluated FDI parameters. However, the ion-releasing material scored significantly worse in the radiographic evaluation than any of the other groups. CONCLUSIONS All tested materials are suitable for proximal subgingival open sandwich restorations, as long as the restoration/tooth margin is at least 2-mm away from the bone crest. CLINICAL SIGNIFICANCE Clinicians can confidently choose any of the tested materials for proximal subgingival open sandwich restorations, as they have shown good outcomes from both periodontal and clinical perspectives.
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Affiliation(s)
- Hoda S Ismail
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Ashraf I Ali
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Rabab El Mehesen
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Franklin Garcia-Godoy
- Professor, Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA
- Adjunct Faculty, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Salah H Mahmoud
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Ismail HS, Morrow BR, Ali AI, Mehesen REE, Mahmoud SH, Garcia-Godoy F. Effect of different storage media on elemental analysis and microhardness of cervical cavity margins restored with a bioactive material. Restor Dent Endod 2024; 49:e6. [PMID: 38449501 PMCID: PMC10912542 DOI: 10.5395/rde.2024.49.e6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 12/26/2022] [Accepted: 01/12/2023] [Indexed: 03/08/2024] Open
Abstract
Objectives This study aimed to investigate the elemental analysis and microhardness of a bioactive material (Activa) and marginal tooth structure after storage in different media. Materials and Methods Fifteen teeth received cervical restorations with occlusal enamel and gingival dentin margins using the tested material bonded with a universal adhesive, 5 of them on the 4 axial surfaces and the other 10 on only the 2 proximal surfaces. The first 5 teeth were sectioned into 4 restorations each, then stored in 4 different media; deionized water, Dulbecco's phosphate buffered saline (DPBS), Tris buffer, and saliva. The storage period for deionized water was 24 hours while it was 3 months for the other media. Each part was analyzed by scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS) analysis for different substrates/distances and the wt% of calcium, phosphorus, silica, and fluoride were calculated. The other 10 teeth were sectioned across the restoration, stored in either Tris buffer or saliva for 24 hours or 3 months, and were evaluated for microhardness of different substrates/areas. Data were analyzed using analysis of variance and Tukey's post hoc test. Results Enamel and dentin interfaces in the DPBS group exhibited a significant increase in calcium and phosphorus wt%. Both silica and fluoride significantly increased in tooth structure up to a distance of 75 μm in the 3-month-media groups than the immediate group. Storage media did not affect the microhardness values. Conclusions SEM-EDS analysis suggests an ion movement between Activa and tooth structure through a universal adhesive while stored in DPBS.
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Affiliation(s)
- Hoda Saleh Ismail
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Brian Ray Morrow
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Ashraf Ibrahim Ali
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | | | - Salah Hasab Mahmoud
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Franklin Garcia-Godoy
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
- The Forsyth Institute, Cambridge, MA, USA
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Raza MA, Khan JA, Akhtar H, Farooqui WA, Faraz H, Hasan A. Comparison of two composite resin materials for splinting of dental luxation injuries: A double blind randomized controlled trial. Dent Traumatol 2024; 40:44-53. [PMID: 37615239 DOI: 10.1111/edt.12883] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/11/2023] [Accepted: 08/09/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND/AIM Luxation is a common traumatic dental injury treated with a wire composite (WC) splint. However, bulk-fill flowable composite and conventional packable composite have not been compared for retaining these splints. Therefore, the objectives of this randomized controlled trial were (1) to compare retention of WC splints, and (2) to compare adhesive point dimension, application and removal time, and effect on tooth mobility between the two WC splints. MATERIALS AND METHODS In this parallel group, non-inferiority double blind randomized controlled trial, a total of 90 patients, aged 16-50 years participated. They were randomly allocated into two groups, the packable composite group (PC) n = 45 and the bulk-fill flowable composite group (BF-FC) n = 45 by lottery method. Following measurements were taken at the splint application appointment. Horizontal tooth mobility measured via Periotest, splint application time, and frontal images of splinted teeth to measure the percentage composite adhesive point area. After 2 weeks, splints were visually inspected for retention, whereas mobility and removal times were also recorded. Statistically, comparisons were made using independent samples sample T-test, Fisher's exact test, and Mann-Whitney U at p ≤ .05. RESULTS A total of 88 patients with 156 luxated teeth completed the trial, as two patients were lost to follow-up. Two patients in the PC group reported with completely de-bonded splints while none de-bonded in the BF-FC group. Both groups were similar in terms of splint retention (p = .352), reduction of mobility (p = .426), and splint removal times (p = .372). The BF-FC group performed significantly better in adhesive point dimension percentages (p < .001) and splint application time (p < .001). CONCLUSION Both groups were comparable in most parameters of the study. However, for BF-FC group application time and adhesive point dimension were significantly less.
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Affiliation(s)
- Misbah Ali Raza
- Department of Operative Dentistry, Dow Dental College, Dow University of Health Sciences Baba-e-Urdu Road Karachi, Karachi, Pakistan
| | - Javeria Ali Khan
- Department of Operative Dentistry, Dow Dental College, Dow University of Health Sciences Baba-e-Urdu Road Karachi, Karachi, Pakistan
| | - Hira Akhtar
- Department of Operative Dentistry, Dow Dental College, Dow University of Health Sciences Baba-e-Urdu Road Karachi, Karachi, Pakistan
| | | | - Hira Faraz
- Department of Operative Dentistry, Dow Dental College, Dow University of Health Sciences Baba-e-Urdu Road Karachi, Karachi, Pakistan
| | - Arshad Hasan
- Department of Operative Dentistry, Dow Dental College, Dow University of Health Sciences Baba-e-Urdu Road Karachi, Karachi, Pakistan
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Halkai R, Gopinagaruri S, Halkai KR. Evaluation of fracture resistance of maxillary premolars of different geometrical cavities restored with different composite resins incorporated with chitosan nanoparticles. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:180-185. [PMID: 38463474 PMCID: PMC10923228 DOI: 10.4103/jcde.jcde_264_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 11/29/2023] [Accepted: 12/11/2023] [Indexed: 03/12/2024]
Abstract
Background Composites with 0.2% chitosan nanoparticles (CSN) are used recently; however, this combination needs to be studied in different cavity designs. Aims The aim of the study was to compare the fracture resistance of maxillary premolars with different cavity geometries restored with different types of composite resins incorporated with 0.2% CSN. Methods About 130 extracted human single-rooted maxillary premolars were embedded in acrylic molds 2 mm below cementoenamel junction, divided into five groups for cavity preparations of standardized dimensions. Group 1: (control) intact teeth (n = 10), Group 2: Class I cavities (n = 40), Group 3: Class II mesio-occlusal (MO) (n = 40), Group 4: Class II mesio-occluso-distal (MOD) (n = 40). Groups 2, 3, and 4 were subdivided into four subgroups for composite restoration; A: Neo spectra ST-Universal (NST); B: Tetric N-Ceram Bulk-fill (TNC); C: NST + CSN; and D: TNC + CSN and tested for fracture resistance using universal testing machine. Statistical Analysis One-way analysis of variance and post hoc Tukey's tests were used for data analysis (P ≤ 0.05). Results In all groups, the highest fracture resistance was found in MOD cavities, followed by MO and least in Class I cavities. Subgroup D (TNC with CSN) showed the highest fracture resistance in all groups (P ≤ 0.05). Conclusion Tetric N-Ceramic bulk fill with 0.25% CSN showed high fracture resistance in cavities with different geometries.
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Affiliation(s)
- Rahul Halkai
- Department of Conservative Dentistry and Endodontics, Al-Badar Rural Dental College and Hospital, Kalaburgi, Karnataka, India
| | - Snigdhapriya Gopinagaruri
- Department of Conservative Dentistry and Endodontics, Al-Badar Rural Dental College and Hospital, Kalaburgi, Karnataka, India
| | - Kiran R. Halkai
- Department of Conservative Dentistry and Endodontics, Al-Badar Rural Dental College and Hospital, Kalaburgi, Karnataka, India
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Elgezawi M, Haridy R, Abdalla MA, Heck K, Draenert M, Kaisarly D. Current Strategies to Control Recurrent and Residual Caries with Resin Composite Restorations: Operator- and Material-Related Factors. J Clin Med 2022; 11:jcm11216591. [PMID: 36362817 PMCID: PMC9657252 DOI: 10.3390/jcm11216591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
This review addresses the rationale of recurrent and/or residual caries associated with resin composite restorations alongside current strategies and evidence-based recommendations to arrest residual caries and restrain recurrent caries. The PubMed and MEDLINE databases were searched for composite-associated recurrent/residual caries focusing on predisposing factors related to materials and operator’s skills; patient-related factors were out of scope. Recurrent caries and fractures are the main reasons for the failure of resin composites. Recurrent and residual caries are evaluated differently with no exact distinguishment, especially for wall lesions. Recurrent caries correlates to patient factors, the operator’s skills of cavity preparation, and material selection and insertion. Material-related factors are significant. Strong evidence validates the minimally invasive management of deep caries, with concerns regarding residual infected dentin. Promising technologies promote resin composites with antibacterial and remineralizing potentials. Insertion techniques influence adaptation, marginal seal, and proximal contact tightness. A reliable diagnostic method for recurrent or residual caries is urgently required. Ongoing endeavors cannot eliminate recurrent caries or precisely validate residual caries. The operator’s responsibility to precisely diagnose original caries and remaining tooth structure, consider oral environmental conditions, accurately prepare cavities, and select and apply restorative materials are integral aspects. Recurrent caries around composites requires a triad of attention where the operator’s skills are cornerstones.
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Affiliation(s)
- Moataz Elgezawi
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
- Correspondence: (M.E.); (D.K.); Tel.: +49-89-4400-59452 (D.K.); Fax: +49-89-4400-59302 (D.K.)
| | - Rasha Haridy
- Department of Clinical Dental Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
- Department of Conservative Dentistry, Faculty of Dentistry, Cairo University, Cairo 4240310, Egypt
| | - Moamen A. Abdalla
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Katrin Heck
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethe Str. 70, 80336 Munich, Germany
| | - Miriam Draenert
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethe Str. 70, 80336 Munich, Germany
| | - Dalia Kaisarly
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethe Str. 70, 80336 Munich, Germany
- Correspondence: (M.E.); (D.K.); Tel.: +49-89-4400-59452 (D.K.); Fax: +49-89-4400-59302 (D.K.)
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Toward a Clinically Reliable Class II Resin Composite Restoration: A Cross-Sectional Study into the Current Clinical Practice among Dentists in Saudi Arabia. Int J Dent 2022; 2022:2691376. [PMID: 35959095 PMCID: PMC9363216 DOI: 10.1155/2022/2691376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/11/2022] [Indexed: 12/03/2022] Open
Abstract
Objective The aim of this study was to evaluate the current clinical practice of general dentists in Saudi Arabia in restoring class II cavities using direct resin composites and to set evidence-based practice recommendations of concern. Methods An online survey formed of 20 questions and classified into four domains was developed. 500 dentists in 5 Saudi provinces were invited to join the survey anonymously and voluntarily using poster announcements and e-mail invitations. Descriptive statistics were used to analyze participants' responses. Results 343 responses were received. Dentists in Saudi Arabia vary in their clinical practices and techniques of insertion of resin composite in class II cavities. 67% of participants use cotton rolls for isolating the field while 32% use rubber dam isolation. 33% and 28% of respondents use circumferential matrix (Tofflemire) and AutoMatrix, respectively. Fracture, followed by recurrent caries and open proximal contacts, was the received main reason of failure of class II direct resin composite restorations. Conclusion Diversity of class II resin composite practices exists among dentists in Saudi Arabia. For ensuring optimum quality outcomes and high standards of restorative dentistry healthcare, several dentists in Saudi Arabia need to reconsider their clinical practice and modify their clinical procedures of direct class II resin composites. Several evidence-based practice guidelines are recommended to dentists in this article to improve their practice and enhance the clinical reliability and longevity of class II direct resin composite restorations.
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Ismail HS, Ali AI, Mehesen RE, Garcia-Godoy F, Mahmoud SH. In vitro marginal and internal adaptation of four different base materials used to elevate proximal dentin gingival margins. J Clin Exp Dent 2022; 14:e550-e559. [PMID: 35912027 PMCID: PMC9328484 DOI: 10.4317/jced.59652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/06/2022] [Indexed: 11/22/2022] Open
Abstract
Background There is still debate about the most appropriate restorative material category to relocate the proximal deep cervical margins, thus, this study aimed to compare the marginal and internal adaptation of four base materials used for deep margin elevation, and to evaluate each base material/overlying composite interface.
Material and Methods Fifty six molars received class II cavities with dentin/cementum gingival margins. They were divided into four groups and their gingival margins were elevated using either; resin modified glass ionomer (RMGI), highly viscous conventional glass ionomer (HV-GIC), flowable bulk fill resin composite (Bulk Flow) and bioactive ionic resin (Activa). The rest of the cavities were completed with the same overlying composite. Half of each group was either; kept in sterile water for 1 week, or subjected to 18 months water storage and 15,000 thermal cycles. Base materials/gingival dentin interfaces were examined under a scanning electron microscope at different magnifications, and percentage of continuous margin (% CM) and maximum gap width (MGW) were analyzed, in addition to base materials/overlying composite interfaces evaluations. % CM values were statistically analyzed using Two-way analysis of variance, Tukey post hoc tests (at p<0.05) and Pearson’s correlation while MGW values were analyzed using Kruskal–Wallis, Mann–Whitney U tests and Spearmen correlation
Results Both Bulk Flow and Activa had better marginal integrity than RMGI and HV-GIC. All base materials were adversely affected by aging. All base materials/overlying composite interfaces were continuous and age defying.
Conclusions In terms of marginal integrity, Bulk Flow and Activa might be preferable for proximal dentin margin elevation under direct restoration compared to the other tested base materials. Key words:Deep proximal margin, interface analysis, marginal quality, open sandwich technique.
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Affiliation(s)
- Hoda S Ismail
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Ashraf I Ali
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Rabab El Mehesen
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Franklin Garcia-Godoy
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,The Forsyth Institute, Cambridge, MA, USA
| | - Salah H Mahmoud
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Ismail HS, Ali AI, Mehesen RE, Juloski J, Garcia-Godoy F, Mahmoud SH. Deep proximal margin rebuilding with direct esthetic restorations: a systematic review of marginal adaptation and bond strength. Restor Dent Endod 2022; 47:e15. [PMID: 35692223 PMCID: PMC9160765 DOI: 10.5395/rde.2022.47.e15] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/25/2021] [Accepted: 08/08/2021] [Indexed: 11/25/2022] Open
Abstract
This review aimed to characterize the effect of direct restorative material types and adhesive protocols on marginal adaptation and the bond strength of the interface between the material and the proximal dentin/cementum. An electronic search of 3 databases (the National Library of Medicine [MEDLINE/PubMed], Scopus, and ScienceDirect) was conducted. Studies were included if they evaluated marginal adaptation or bond strength tests for proximal restorations under the cementoenamel junction. Only 16 studies met the inclusion criteria and were included in this review. These studies presented a high degree of heterogeneity in terms of the materials used and the methodologies and evaluation criteria of each test; therefore, only a descriptive analysis could be conducted. The included studies were individually evaluated for the risk of bias following predetermined criteria. To summarize the results of the included studies, the type of restorative material affected the test results, whereas the use of different adhesive protocols had an insignificant effect on the results. It could be concluded that various categories of resin-based composites could be a suitable choice for clinicians to elevate proximal dentin/cementum margins, rather than the open sandwich technique with resin-modified glass ionomers. Despite challenges in bonding to proximal dentin/cementum margins, different adhesive protocols provided comparable outcomes.
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Affiliation(s)
- Hoda S. Ismail
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Egypt
| | - Ashraf I. Ali
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Egypt
| | - Rabab El. Mehesen
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Egypt
| | - Jelena Juloski
- Clinic for Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Serbia
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Franklin Garcia-Godoy
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
- The Forsyth Institute, Cambridge, MA, USA
| | - Salah H. Mahmoud
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Egypt
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Ismail HS, Ali AI, Garcia-Godoy F. Influence of Manual and Ultrasonic Scaling on Surface Roughness of Four Different Base Materials Used to Elevate Proximal Dentin-Cementum Gingival Margins: An In Vitro Study. Oper Dent 2022; 47:E106-E118. [PMID: 35405002 DOI: 10.2341/20-007-c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2021] [Indexed: 11/23/2022]
Abstract
AIM To evaluate and compare the effects of both manual and ultrasonic scaling on surface roughness of four different base materials, used for elevating dentin/cementum gingival margins of proximal cavities. METHODS AND MATERIALS Eighty human upper molars with compound Class II mesial cavities, with gingival margins 1 mm below the cemento-enamel junction (CEJ), were divided into four different groups according to the type of the base material used; resin-modified glass ionomer (RMGI), glass hybrid (HV-GIC), flowable bulk-fill resin composite (Bulk Flow) and bioactive ionic resin (Activa). This was followed by completing the restorations with the same resin composite. All materials were used according to the manufacturers' instructions. All groups were further subdivided into two subgroups according to the scaling technique: manual (hand) or ultrasonic. All restorative and scaling procedures were performed after fixation of specimens with acrylic beside neighboring teeth to simulate natural contact. The mean surface roughness (Ra, μm) of all specimens was measured quantitatively and qualitatively by a three-dimensional (3D) surface analyzer system at two stages; (1) after thermal cycling for 5000 cycles without scaling and (2) after scaling. Data were statistically analyzed using analysis of variance (ANOVA), Tukey post hoc tests, and paired sample t-tests (at α=0.05). RESULTS For baseline readings, the Bulk Flow group had the lowest Ra values, while HV-GIC group had the highest. RMGI and Activa groups had no statistical significant difference between their Ra values (p>0.05). For post scaling readings, hand scaling had significantly lower Ra values than ultrasonic scaling in all the material groups (p<0.05), except in the Bulk Flow group, where both scaling methods were not significantly different from each other (p>0.05). CONCLUSION Bulk Flow had the smoothest surfaces when cured against a matrix band compared with the other tested base materials. When hand and ultrasonic scaling methods were compared, the latter technique had more detrimental effect on the surface texture of the four tested base materials.
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Affiliation(s)
- H S Ismail
- *Hoda Ismail, assistant lecturer, Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - A I Ali
- Ashraf Ibrahim Ali, associate professor, Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura Egypt
| | - F Garcia-Godoy
- Franklin Garcia-Godoy, professor, Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA; adjunct professor, The Forsyth Institute, Cambridge, MA, USA
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Ismail HS, Morrow BR, Ali AI, Mehesen RE, Garcia-Godoy F, Mahmoud SH. Correlation between different methodologies used to evaluate the marginal adaptation of proximal dentin gingival margins elevated using a glass hybrid. RESTORATIVE DENTISTRY & ENDODONTICS 2022; 47:e36. [DOI: 10.5395/rde.2022.47.e36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/20/2022] [Accepted: 06/15/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Hoda S. Ismail
- Department of Operative Dentistry Faculty of Dentistry, Mansoura University, Mansoura, Egypt
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Brian R. Morrow
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Ashraf I. Ali
- Department of Operative Dentistry Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Rabab El. Mehesen
- Department of Operative Dentistry Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Franklin Garcia-Godoy
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
- Adjunct Faculty, The Forsyth Institute, Cambridge, MA, USA
| | - Salah H. Mahmoud
- Department of Operative Dentistry Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Effects of application method on shrinkage vectors and volumetric shrinkage of bulk-fill composites in class-II restorations. Dent Mater 2021; 38:79-93. [PMID: 34836696 DOI: 10.1016/j.dental.2021.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/10/2021] [Accepted: 10/29/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Upon initial proximal wall construction, the favorable C-factor of class-II cavities may become unfavorable. This study investigated the application method on bulk-fill resin composite polymerization shrinkage. METHODS Occluso-proximal class-II cavities were prepared in 40 molars and bonded with a self-etch adhesive (Adhese Universal). The study groups varied according to the resin composite application: group-1: bulk application, Tetric EvoCeram Bulk Fill (TBF); group-2: proximal wall construction (TBF) and occlusal cavity filling (TBF); group-3: thin flowable liner layer, Tetric EvoFlow Bulk Fill (TEF) and bulk filling (TBF); group-4: flowable liner (TEF), proximal wall (TBF), occlusal cavity (TBF); and group-5: bulk application, SDR (3 mm) and capping layer (TBF, 1 mm). Each resin composite increment was scanned twice using micro-CT (uncured, cured 40 s) at a resolution of 16 µm. Shrinkage vectors and volumetric polymerization shrinkage were evaluated and statistically analyzed (one-way ANOVA). SEM images were used to investigate the tooth-restoration interface. RESULTS Shrinkage vectors differed significantly among the groups and were greatest in gp5-fl/SDR (47.6 µm), followed by gp1-TBF (23.8 µm) and least in gp5-fl/SDR+TBF (11.1 µm). Volumetric shrinkage varied significantly with the use of SDR (gp5-fl/SDR: 2.6%) and TEF (gp4-fl/TEF: 2.5%) to TBF (gp4-fl/TEF+wl/TBF: 0.6%) in the incremental application. SIGNIFICANCE Building a proximal resin composite wall yielded smaller shrinkage vectors than the bulk application. Applying a thin flowable liner decreased the shrinkage vectors, even more when building a proximal wall. A thin flowable liner is recommended when building a proximal resin composite wall.
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Dietschi D, Curto FD, Di Bella E, Krejci I, Ardu S. In vitro evaluation of marginal adaptation in medium- and large size direct class II restorations using a bulk-fill or layering technique. J Dent 2021; 115:103828. [PMID: 34678337 DOI: 10.1016/j.jdent.2021.103828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 09/13/2021] [Accepted: 09/20/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES to test if cavity dimensions and restorative protocol have potential to influence in-vitro adaptation of class II restoration after simulated thermo-occlusal stressing. METHODS A total of 32 prepared teeth were randomly assigned to one of the 4 experimental groups depending on cavity size, composite system and filling technique; group 1: small cavity and multi-layered conventional restorative composite (Tetric Evo-ceram: TEC), group 2: small cavity and flowable bulk-filled composite (SDRFlow: SDR) + one single occlusal layer of conventional restorative composite (TEC), group 3: large cavity and multilayered conventional restorative composite (TEC) and group 4: large cavity and bulk-filled flowable composite (SDR) + one single occlusal layer conventional restorative composite (TEC). All specimens were submitted to 500'000 cycles of thermomechanical loading (50 N, 5 to 55 °C). The proximal tooth-restoration interface was analyzed quantitatively by SEM, prior and after thermomechanical loading. RESULTS Before loading, continuous enamel adaptation varied from 61.49% (Gr 1) to 68.39% (Gr 4) proximally and from 50.93% (Gr2) to 68.65% (Gr1) cervically, with no statistical difference among groups for both segments. After thermomechanical loading, continuous enamel adaptation varied from 36.6% (Gr2) to 46.6% (Gr1) proximally, without significant difference, and from 20.2% (Gr4) to 51.3% (Gr1) cervically; statistical differences in cervical enamel adaptation were found in-between groups 1 and 2 (p = 0.0479), 1 and 4 (P = 0.0116), 2 and 3 (p = 0.0028) and 3 and 4 (p = 0.001). Before loading, dentin continuous adaptation varied from 55.32% (Gr3) to 81.82% (Gr4) with statistical difference in-between those groups (p = 0.045); after loading, dentin continuous adaptation varied from 31.56% (gr2) to 51% (Gr4) with a statistical difference between those 2 groups (p = 0.019). The drop in adaptations values after loading was significant in all groups and segments. CONCLUSIONS The impact of the restorative technique and cavity size on marginal adaptation appeared essentially after simulated fatigue for enamel adaptation. Cervical enamel and dentin continuous adaption of small and large bulk-filled restorations dropped significantly while the change was lower in layered restorations made of conventional restorative composite. CLINICAL SIGNIFICANCE Restorations made with bulk-filled flowable composite behaved differently from layered ones using conventional resin composite, according to cavity size and loading.
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Affiliation(s)
- Didier Dietschi
- Department of Cariology, Endodontology & Pediatric Dentistry, School of Dentistry, University of Geneva, Geneva, Switzerland.
| | - Filipo Del Curto
- Department of Cariology, Endodontology & Pediatric Dentistry, School of Dentistry, University of Geneva, Geneva, Switzerland
| | - Enrico Di Bella
- Department of Political Sciences, University of Genoa, Genoa, Italy
| | - Ivo Krejci
- Department of Cariology, Endodontology & Pediatric Dentistry, School of Dentistry, University of Geneva, Geneva, Switzerland
| | - Stefano Ardu
- Department of Cariology, Endodontology & Pediatric Dentistry, School of Dentistry, University of Geneva, Geneva, Switzerland
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Kaisarly D, ElGezawi M, Haridy R, Elembaby A, Aldegheishem A, Alsheikh R, Almulhim KS. Reliability of Class II Bulk-fill Composite Restorations With and Without Veneering: A Two-year Randomized Clinical Control Study. Oper Dent 2021; 46:491-504. [PMID: 35486510 DOI: 10.2341/19-290-c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 11/23/2022]
Abstract
Bulk-fill composites are increasingly used in stress-bearing areas in posterior teeth, with a diversity of reports concerning their effectiveness and clinical reliability. The objective of this randomized clinical control study was to investigate the effectiveness of bulk-fill versus veneered bulk-fill Class II composite restorations. A double-blind split-mouth technique was employed in 80 subjects recruited for restoring Class II caries in one molar bilaterally in the same arch following respective inclusion and exclusion criteria and after obtaining written consent. While one molar was randomly restored with bulk-fill composite using the sealed-envelope technique, Tetric N-Ceram Bulk Fill (TBF), the contralateral was restored with a bulk-fill composite veneered with an increment of a heavy-body microhybrid composite-Tetric-Ceram HB (TBF/V). Box-only cavities were prepared and received etch-and-rinse adhesive bonding and Tetric N-Bond treatment before composite insertion. Restorations were assessed at 24 hours, 2 weeks, 6 months, 12 months, and 24 months for esthetic, functional, and biological quality employing the FDI ranking criteria. Friedman repeated-measures analysis of variance, the McNemar test, and the Cohen's kappa statistical test were used for statistical analysis. Over a 24-month interval, none of the test restorations were ranked as clinically unsatisfactory. In terms of functional criteria, clinically excellent restorations were significantly more prevalent in TBF/V than in TBF (p<0.05). For long-term satisfactory performance of Class II bulk-fill composites, an occlusal veneering increment of conventional heavy body microhybrid composite appears to be favorable.
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Affiliation(s)
- D Kaisarly
- *Dalia Kaisarly, BDS, MDSc, PhD, University of Munich, Munich, Germany; Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Saudi Arabia
| | - M ElGezawi
- Moataz ElGezawi, BDS, MDSc, DDSc, Department of Restorative Dental Sciences, College of Dentistry, Imam Abdul Rahman Bin Faisal University, Dammam, Saudi Arabia
| | - R Haridy
- Rasha Haridy, BDS, MScD, PhD, Department of Clinical Dental Sciences, Princess Nourah Bint Abdel Rahman University, Saudi Arabia
| | - A Elembaby
- Abeer Elembaby, BDS, MScD, PhD, Department of Restorative Dental Sciences, College of Dentistry, Imam Abdul Rahman Bin Faisal University, Dammam, Saudi Arabia
| | - A Aldegheishem
- Alhanooof Aldegheishem, BDS, MScD, PhD, Department of Clinical Dental Sciences, Princess Nourah Bint Abdel Rahman University, Saudi Arabia
| | - R Alsheikh
- Rasha Alsheikh, BDS, MScD, PhD, Department of Clinical Dental Sciences, Princess Nourah Bint Abdel Rahman University, Saudi Arabia
| | - K S Almulhim
- Khalid S. Almulhim BDS, MScD, PhD, Department of Clinical Dental Sciences, Princess Nourah Bint Abdel Rahman University, Saudi Arabia
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14
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GERULA-SZYMAŃSKA A, KACZOR K, LEWUSZ-BUTKIEWICZ K, NOWICKA A. Marginal integrity of flowable and packable bulk fill materials used for class II restorations —A systematic review and meta-analysis of in vitro studies. Dent Mater J 2020; 39:335-344. [DOI: 10.4012/dmj.2018-180] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Kinga KACZOR
- Doctoral Studies of the Faculty of Dentistry, Pomeranian Medical University in Szczecin
| | | | - Alicja NOWICKA
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin
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15
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Guo X, Cheng Q, Wang H, Yu G, Tian Z, Shi Z, Cui Z, Zhu S. Synthesis, characterization, and aging resistance of the polyurethane dimethacrylate layer for dental restorations. Eur J Oral Sci 2020; 128:89-99. [PMID: 32032451 DOI: 10.1111/eos.12674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2019] [Indexed: 01/22/2023]
Abstract
In this study, polyurethane dimethacrylate (PUDMA) was synthetized from different components and incorporated into a direct resin composite restoration system with the aim to buffer tooth-resin interfacial stresses and maintain the marginal adaptation. The tensile strength, elongation at fracture (ε), and thermal stability of the PUDMA layer were characterized, showing a tensile strength of 22 MPa, an ε of 112%, and a thermal decomposition temperature of about 282°C. In addition, the degree of conversion, water sorption/solubility, hydrophobicity, microtensile bond strength (μTBS), marginal leakage, and cytotoxicity in vitro were evaluated for the PUDMA layer. The data were analyzed using one-way ANOVA, except for leakage depths (which were analyzed using the Wilcoxon paired-rank test). The level of significance was set at 0.05. Compared with dental adhesives, PUDMA displayed a higher degree of conversion, lower water sorption/solubility, and improved hydrophobicity and biocompatibility in vitro. After thermocycling, the μTBS of the restoration system containing PUDMA had increased compared with the μTBS at 24 h. Restorations containing PUDMA showed lower leakage depths than those which did not contain PUDMA. In conclusion, because of its hydrophobic and elastic nature, the PUDMA layer, when used as an intermediate between tooth and resin restoratives, may buffer interfacial stresses, improve the stability and durability of the bonding interface, and reduce microleakage.
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Affiliation(s)
- Xiaowei Guo
- Department of Prosthetic Dentistry, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Qiuli Cheng
- State Key Lab of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun, China
| | - Han Wang
- Department of Prosthetic Dentistry, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Gaigai Yu
- Department of Prosthetic Dentistry, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Zilu Tian
- Department of Prosthetic Dentistry, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Zuosen Shi
- State Key Lab of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun, China
| | - Zhanchen Cui
- State Key Lab of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun, China
| | - Song Zhu
- Department of Prosthetic Dentistry, School and Hospital of Stomatology, Jilin University, Changchun, China
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16
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Clinical performance and chemical-physical properties of bulk fill composites resin -a systematic review and meta-analysis. Dent Mater 2019; 35:e249-e264. [PMID: 31421957 DOI: 10.1016/j.dental.2019.07.007] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/08/2019] [Accepted: 07/15/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The objective of this study was to perform a meta-analysis of clinical and laboratory studies to compare the performance of bulk-fill and conventional composite resins in terms of polymerization shrinkage, polymerization stress, cusp deflection, marginal quality, degree of conversion, microhardness, flexural strength, fracture strength and clinical performance. DATA One hundred three articles were included in this study, and the Peto method was used to compare the bulk-fill and conventional composites using the RevMan software. SOURCES Searches were performed in the PubMed and Scopus databases. STUDY SELECTION Laboratory studies and randomized clinical trials comparing one of the previous detailed outcomes between bulk-fill and control composites were included. CONCLUSIONS The bulk-fill composite resins showed less shrinkage, polymerization stress, cusp deflection and microhardness than conventional composites, while both materials presented a similar marginal quality, flexural strength and fracture strength. Also, bulk-fill materials with regular viscosity showed similar shrinkage. The conversion of bulk-fill materials with flowable consistency were similar to conventional composite resins with a thickness of up to 2mm and greater than conventional composites with a thickness greater than 2mm. Despite these in vitro differences, the clinical performance of bulk-fill and conventional composite resins was similar in randomized clinical trials, with one to ten years of follow up. In conclusion, the bulk-fill materials show better or similar performance to the conventional materials in clinical trials and laboratory studies in terms of volumetric shrinkage, polymerization stress, cusps deflection and marginal quality, with the only exception being the lower level of microhardness observed for bulk-fill composites with thickness up to 2mm.
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17
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Zhou X, Huang X, Li M, Peng X, Wang S, Zhou X, Cheng L. Development and status of resin composite as dental restorative materials. J Appl Polym Sci 2019. [DOI: 10.1002/app.48180] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Xinxuan Zhou
- State Key Laboratory of Oral DiseasesSichuan University Chengdu 610041 Sichuan China
- National Clinical Research Center for Oral DiseasesSichuan University Chengdu 610041 Sichuan China
| | - Xiaoyu Huang
- State Key Laboratory of Oral DiseasesSichuan University Chengdu 610041 Sichuan China
- Department of Operative Dentistry and Endodontics, West China Hospital of StomatologySichuan University Chengdu 610041 Sichuan China
- National Clinical Research Center for Oral DiseasesSichuan University Chengdu 610041 Sichuan China
| | - Mingyun Li
- State Key Laboratory of Oral DiseasesSichuan University Chengdu 610041 Sichuan China
- National Clinical Research Center for Oral DiseasesSichuan University Chengdu 610041 Sichuan China
| | - Xian Peng
- State Key Laboratory of Oral DiseasesSichuan University Chengdu 610041 Sichuan China
- National Clinical Research Center for Oral DiseasesSichuan University Chengdu 610041 Sichuan China
| | - Suping Wang
- Department of Operative Dentistry and Endodontics & Stomatology CenterThe First Affiliated Hospital of Zhengzhou University Zhengzhou 540052 Henan China
| | - Xuedong Zhou
- State Key Laboratory of Oral DiseasesSichuan University Chengdu 610041 Sichuan China
- Department of Operative Dentistry and Endodontics, West China Hospital of StomatologySichuan University Chengdu 610041 Sichuan China
- National Clinical Research Center for Oral DiseasesSichuan University Chengdu 610041 Sichuan China
| | - Lei Cheng
- State Key Laboratory of Oral DiseasesSichuan University Chengdu 610041 Sichuan China
- Department of Operative Dentistry and Endodontics, West China Hospital of StomatologySichuan University Chengdu 610041 Sichuan China
- National Clinical Research Center for Oral DiseasesSichuan University Chengdu 610041 Sichuan China
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18
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Fidalgo TKDS, Americano G, Medina D, Athayde G, Letieri ADS, Maia LC. Adhesiveness of bulk-fill composite resin in permanent molars submitted to Streptococcus mutans biofilm. Braz Oral Res 2019; 33:e111. [DOI: 10.1590/1807-3107bor-2019.vol33.0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 10/24/2019] [Indexed: 11/21/2022] Open
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19
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Moda MD, Fagundes TC, Briso ALF, dos Santos PH. Analysis of the bond interface between self-adhesive resin cement to eroded dentin in vitro. PLoS One 2018; 13:e0208024. [PMID: 30475892 PMCID: PMC6258132 DOI: 10.1371/journal.pone.0208024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 11/11/2018] [Indexed: 12/03/2022] Open
Abstract
The purpose of this study was to evaluate the bonding interface between a self-adhesive resin cement to in vitro eroded dentin. Seventy-two third molars were used and divided into two groups: sound dentin and in vitro eroded dentin. The in vitro erosion was performed following a demineralization protocol, in which the specimens were immersed in a demineralizing solution for 2 minutes per cycle and remineralizing solution for 10 minutes per cycle for 9 days. Both groups were submitted to four dentin surface treatments: control group (without any treatment), 2% chlorhexidine, 20% polyacrylic acid, and 0.1 M EDTA (n = 9). Blocks of resin-based composite were bonded with RelyX U200 self-adhesive resin cement applied on the pretreated dentin surfaces. The teeth were sectioned into beams (1mm2) and submitted to microtensile bond strength testing to evaluate the bond strength of self-adhesive resin cement to dentin after 24 hours and 8 months of immersion in artificial saliva. Three specimens of each group were longitudinally cut and evaluated using confocal laser scanning microscopy to analyze the dentin/cement interface. Eroded dentin showed higher bond strength values when compared to sound dentin for the 2% chlorhexidine group (p = 0.03), 24 hours after adhesion. When considering eroded dentin, the 0.1M EDTA group showed higher bond strength values with a statistically significant difference only for the control group (p = 0.002). After 8 months of storage, the present results showed that there was no statistically significant difference between the two substrates for all experimental groups (p>0.05). Analysis of the microscopy confocal showed different types of treatments performed on dentin generally increased tags formation when compared to the control group. The eroded dentin showed a significant increase in density and depth of resinous tags when compared to sound dentin. The storage of samples for 8 months seems to have not caused significant degradation of the adhesive interface.
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Affiliation(s)
- Mariana Dias Moda
- Department of Restorative Dentistry, Araçatuba Dental School, UNESP—São Paulo State University, Araçatuba, SP, Brazil
| | - Ticiane Cestari Fagundes
- Department of Restorative Dentistry, Araçatuba Dental School, UNESP—São Paulo State University, Araçatuba, SP, Brazil
| | - André Luiz Fraga Briso
- Department of Restorative Dentistry, Araçatuba Dental School, UNESP—São Paulo State University, Araçatuba, SP, Brazil
| | - Paulo Henrique dos Santos
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP–São Paulo State University, Araçatuba, SP, Brazil
- * E-mail:
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20
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Kaisarly D, El Gezawi M, Nyamaa I, Rösch P, Kunzelmann KH. Effects of boundary condition on shrinkage vectors of a flowable composite in experimental cavity models made of dental substrates. Clin Oral Investig 2018; 23:2403-2411. [PMID: 30302605 DOI: 10.1007/s00784-018-2696-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 10/02/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Bond strength to enamel and dentin depends on the bonding approach or condition. This study investigated the effects of the boundary conditions, in terms of the bonding substrate and the bonding condition, on the shrinkage vectors of a flowable composite. MATERIALS AND METHODS An experimental cylindrical cavity (diameter = 6 mm, depth = 3 mm) consisting of the enamel floor and the surrounding dentin cavity walls was prepared for the "enamel-floor" group. Cylindrical cavities of the same dimensions were prepared with access from the occlusal enamel into dentin and served as controls. Each cavity model group was divided and bonded with two bonding conditions (n = 9): a self-etch (Adper Easy Bond, 3M ESPE) and a total-etch approach (OptiBond FL, Kerr). The composite (Tetric EvoFlow, Ivoclar Vivadent) was mixed with glass beads, applied to the cavity, scanned twice by micro-CT (uncured and cured states). The scans were evaluated by rigid registration, sphere segmentation, and registration for computing shrinkage vectors. RESULTS The free surface of all restorations moved downward. The shrinkage vectors in the experimental cavity model pointed downward towards the enamel cavity floor, and the net axial movement was downward. In the control group, shrinkage vectors additionally moved upward, away from the cavity floor. The effect of the bonding substrate and the bonding condition was investigated for the shrinkage vectors and the axial movement (univariate ANOVA). CONCLUSION The bonding substrate, enamel, influenced the shrinkage vectors' direction, while the bonding condition caused only variations in the magnitude. CLINICAL RELEVANCE Bonding to enamel influences shrinkage vectors' direction, while the bonding condition plays only a minor role. Graphical abstract ᅟ.
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Affiliation(s)
- Dalia Kaisarly
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse, 70 80336, Munich, Germany. .,Biomaterials Department, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.
| | - Moataz El Gezawi
- Department of Conservative Dentistry, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - Indra Nyamaa
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse, 70 80336, Munich, Germany
| | - Peter Rösch
- Faculty of Computer Science, University of Applied Sciences, Augsburg, Germany
| | - Karl-Heinz Kunzelmann
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse, 70 80336, Munich, Germany
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Wang C, Ou Y, Zhang L, Zhou Z, Li M, Xu J, Fan J, Fu B, Hannig M. Effects of regional enamel and prism orientations on bovine enamel bond strength and cohesive strength. Eur J Oral Sci 2018; 126:334-342. [PMID: 29939426 DOI: 10.1111/eos.12530] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study investigated the regional microtensile bond strength (MTBS) and cohesive strength of bovine enamel. The crowns of bovine incisors were sectioned, either horizontally along incisal and cervical thirds to produce horizontal and tangential segments, or longitudinally along the midline to produce longitudinal segments. Half of the horizontal and longitudinal segments were prepared using a 45° bevel. Then, the differently sectioned enamel surfaces were treated with one- or two-step self-etch adhesives (Clearfil SE Bond or Clearfil S3 Bond) and a composite resin (Clearfil Majesty) was placed. Resin-bonded enamel samples were cut into beams for use in the MTBS tests. Labial horizontal and longitudinal segments of pure enamel beams were prepared for cohesive strength tests. Enamel microstructures were analyzed by scanning electron microscopy. Three-way anova followed by Tukey's post-hoc HSD multiple comparisons procedure showed that a 45° bevel cut did not statistically significantly improve enamel MTBS, which varied with the different regions. The longitudinally sectioned resin-bonded enamel samples had the lowest MTBS, and the horizontal enamel cohesive strength was weaker than that of the longitudinal enamel. The scanning electron microscopy fractographs indicated that rows of parallel prisms were detached from the fractured surfaces. In conclusion, the regional enamel MTBS and the cohesive strength are strongly related to the enamel microstructures and prism orientations.
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Affiliation(s)
- Chaoyang Wang
- Hospital of Stomatology affiliated to Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory for Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Yangyan Ou
- Hospital of Stomatology affiliated to Zhejiang University School of Medicine, Hangzhou, China
| | - Ling Zhang
- Hospital of Stomatology affiliated to Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory for Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Zihuai Zhou
- Hospital of Stomatology affiliated to Zhejiang University School of Medicine, Hangzhou, China
| | - Mingxing Li
- Hospital of Stomatology affiliated to Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory for Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Jingqiu Xu
- Hospital of Stomatology affiliated to Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory for Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Jiayan Fan
- Hospital of Stomatology affiliated to Zhejiang University School of Medicine, Hangzhou, China
| | - Baiping Fu
- Hospital of Stomatology affiliated to Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory for Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Matthias Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University of Saarland, Homburg, Saarland, Germany
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22
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Effects of occlusal cavity configuration on 3D shrinkage vectors in a flowable composite. Clin Oral Investig 2017; 22:2047-2056. [PMID: 29248963 DOI: 10.1007/s00784-017-2304-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 12/07/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the effects of cavity configuration on the shrinkage vectors of a flowable resin-based composite (RBC) placed in occlusal cavities. MATERIALS AND METHODS Twenty-seven human molars were divided into three groups (n = 9) according to cavity configuration: "adhesive," "diverging," and "cylindrical." The "adhesive" cavity represented beveled enamel margins and occlusally converging walls, the "diverging" cavity had occlusally diverging walls, and the "cylindrical" cavity had parallel walls (diameter = 6 mm); all cavities were 3 mm deep. Each prepared cavity was treated with a self-etch adhesive (Adper Easy Bond, 3 M ESPE) and filled with a flowable RBC (Tetric EvoFlow, Ivoclar Vivadent) to which had been added 2 wt% traceable glass beads. Two micro-CT scans were performed on each sample (uncured and cured). The scans were then subjected to medical image registration for shrinkage vector calculation. Shrinkage vectors were evaluated three-dimensionally (3D) and in the axial direction. RESULTS The "adhesive" group had the greatest mean 3D shrinkage vector lengths and upward movement (31.1 ± 10.9 μm; - 13.7 ± 12.1 μm), followed by the "diverging" (27.4 ± 12.1 μm; - 5.7 ± 17.2 μm) and "cylindrical" groups (23.3 ± 11.1 μm; - 3.7 ± 13.6 μm); all groups differed significantly (p < 0.001 for each comparison, one-way ANOVA, Tamhane's T2). CONCLUSION The values and direction of the shrinkage vectors as well as interfacial debonding varied according to the cavity configuration. CLINICAL RELEVANCE Cavity configuration in terms of wall orientation and beveling of enamel margin influences the shrinkage pattern of composites.
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El Gezawi M, Haridy R, Abo Elazm E, Al-Harbi F, Zouch M, Kaisarly D. Microtensile bond strength, 4-point bending and nanoleakage of resin-dentin interfaces: Effects of two matrix metalloproteinase inhibitors. J Mech Behav Biomed Mater 2017; 78:206-213. [PMID: 29172125 DOI: 10.1016/j.jmbbm.2017.11.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/11/2017] [Accepted: 11/16/2017] [Indexed: 02/09/2023]
Abstract
Chronic degradation of hybrid layer collagen by matrix metalloproteinases (MMPs) jeopardizes resin-dentin interfacial integrity and limits the durability of dental restorations. The 4-point bending strength (BS) is a valid but uncommon method of testing the mechanical behavior of resin-dentin interfaces. The present study aims to analyze the influence of two matrix metalloproteinase inhibitors on microtensile bond strength (µTBS), BS and nanoleakage. A total of 48M were divided into three groups according to bonding procedure. Teeth were horizontally sectioned to produce a flat dentin surface. In the control group, etch-and-rinse Prime&Bond One (Dentsply) bonding was used; in the self-etch group, methacryloyloxydodecylpyridinium bromide (MDPB)-containing Clearfil SE Protect (Kuraray) was used; and in the benzalkonium chloride (BAC)-etch group, BAC-etchant (Bisco) was used. A Ceram.X-One (Dentsply) composite was built as three successive layers and was light-cured. Samples were sectioned to produce microrods that were randomly divided into two groups for analysis at baseline and after 6 months of water immersion (n = 32), plus one slab for nanoleakage analysis (n = 8) via scanning electron microscopy (SEM) and digital image analysis (Fiji). Data were analyzed using the Weibull distribution and a mixed-model ANOVA with a post hoc Tukey test. All groups showed deterioration of the initial bonds. The self-etch group had a worse baseline µTBS than the control but had the best BS after aging. BAC-etch did not improve bond stability of etch-and-rinse adhesive. The µTBS and BS test results after aging were moderately correlated. Mixed fractures prevailed with regard to µTBS, whereas adhesive fractures dominated with regard to BS. Nanoleakage was not eliminated in any group and increased after aging. MDPB self-etch resisted bond degradation better than etch-and-rinse adhesives, even after BAC-etching. Integrating BS in studies of µTBS and nanoleakage might provide more clinically relevant outcomes for predicting the performance of dental adhesives.
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Affiliation(s)
- Moataz El Gezawi
- Department of Restorative Dental Science, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Rasha Haridy
- Department of Conservative Dentistry, Faculty Oral and Dental Medicine, Cairo University, Egypt; Department of Clinical Dental Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Emad Abo Elazm
- Department of Restorative Dentistry, Suez Canal University, Egypt
| | - Fahad Al-Harbi
- Department of Substitutive Dental Sciences, Imam Abdulrahman bin Faisal University, Saudi Arabia
| | - Mariem Zouch
- Department of Mathematics, Imam Abdulrahman bin Faisal University, Saudi Arabia
| | - Dalia Kaisarly
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany; Biomaterials Department, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.
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24
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Grandi VH, Berger SB, Fugolin APP, Gonini-Júnior A, Lopes MB, Consani S, Guiraldo RD. Microtensile Bond Strength and Microhardness of Composite Resin Restorations Using a Sonic-Resin Placement System. Braz Dent J 2017; 28:618-623. [PMID: 29215688 DOI: 10.1590/0103-6440201701469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 07/03/2017] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the efficacy of applying sonic energy on microtensile bond strength and microhardness after the restoration process. A total of 40 human third molars were extracted. Class II cavities were prepared and restored with composite SonicFill or Filtek Z350 XT with and without the application of sonic energy. After the teeth were stored in water for 24 h, the teeth were sectioned into sticks (1.0 mm2) and subjected to tensile testing. For a depth Knoop hardness test, the samples were cut and indentations were made sequentially from the surface of the samples to the bottom of the samples in three intervals of 1 mm each. The samples were then subjected to a load of 50 g for 10 s. The results from the tensile (factors: placement system and composite) and hardness (factors: placement system, composite and depth) tests were subjected to the Kolmogorov-Smirnov normality test, followed by analysis of variance and Tukey's test (5% significance). For the placement system factor, higher bond strength was observed for the cavities that were restored with sonic energy (p < 0.001). For depth Knoop hardness, the hardness at 1 mm depth was significantly greater than that at 3 mm depth just for the restorations with Filtek Z350 XT composite without the application of sonic energy. Therefore, the use of sonic energy during the restorative process improved bonding, yet it did not markedly affect the depth hardness for both composites.
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Affiliation(s)
- Victor Hugo Grandi
- Department of Restorative Dentistry, School of Dentistry, UNOPAR - Universidade Norte do Paraná, Londrina, PR, Brazil
| | - Sandrine Bittencourt Berger
- Department of Restorative Dentistry, School of Dentistry, UNOPAR - Universidade Norte do Paraná, Londrina, PR, Brazil
| | | | - Alcides Gonini-Júnior
- Department of Restorative Dentistry, School of Dentistry, UNOPAR - Universidade Norte do Paraná, Londrina, PR, Brazil
| | - Murilo Baena Lopes
- Department of Restorative Dentistry, School of Dentistry, UNOPAR - Universidade Norte do Paraná, Londrina, PR, Brazil
| | - Simonides Consani
- Department of Restorative Dentistry, Piracicaba Dental School, UNICAMP - Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Ricardo Danil Guiraldo
- Department of Restorative Dentistry, School of Dentistry, UNOPAR - Universidade Norte do Paraná, Londrina, PR, Brazil
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25
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Gamarra VSS, Borges GA, Júnior LHB, Spohr AM. Marginal adaptation and microleakage of a bulk-fill composite resin photopolymerized with different techniques. Odontology 2017; 106:56-63. [PMID: 28160094 DOI: 10.1007/s10266-017-0294-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 12/29/2016] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to investigate the marginal adaptation and microleakage of SonicFill composite with different photopolymerization techniques. Class II cavities were prepared in 40 premolars and divided into groups according to the photopolymerization technique (n = 10): G1:1200 mW/cm2 for 20 s; G2:1200 mW/cm2 for 40 s; G3:Soft-start with 650 mW/cm2 for 5 s and 1200 mW/cm2 for 15 s; G4:Soft-start with 650 mW/cm2 for 10 s and 1200 mW/cm2 for 30 s. The cavities were restored with OptiBond FL adhesive and SonicFill. Epoxy resin replicas were obtained before and after thermocycling. The occlusal and cervical margins were analyzed with scanning electron microcopy and expressed as the percentage of continuous margins (%CM). The specimens were submitted to microleakage with silver nitrate. ANOVA and Tukey's test revealed that the %CM at the linguo-occlusal margin for group 1 (83.19%) was significantly different from groups 2, 3 and 4, which had values over 95%. At the cervical margin, there was no statistically significant difference between the groups. After thermocycling, there was a significant decrease in %CM. The predominant score of microleakage was 1 in enamel and 3 in dentin. The SonicFill composite led to gap formation and microleakage, especially in the dentin at the cervical margin, regardless of the photopolymerization technique employed.
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Affiliation(s)
- Vania Stephanie Sánchez Gamarra
- Department of Restorative Dentistry, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Avenida Ipiranga, 6681, Porto Alegre, RS, 90616-900, Brazil
| | - Gilberto Antonio Borges
- Department of Restorative Dentistry, School of Dentistry, University of Uberaba, Avenida Nenê Sabino, 1801, Uberaba, MG, 38005-500, Brazil
| | - Luiz Henrique Burnett Júnior
- Department of Restorative Dentistry, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Avenida Ipiranga, 6681, Porto Alegre, RS, 90616-900, Brazil
| | - Ana Maria Spohr
- Department of Restorative Dentistry, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Avenida Ipiranga, 6681, Porto Alegre, RS, 90616-900, Brazil.
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26
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Suhasini K, Madhusudhana K, Suneelkumar C, Lavanya A, Chandrababu KS, Kumar PD. Clinical performance of Class I nanohybrid composite restorations with resin-modified glass-ionomer liner and flowable composite liner: A randomized clinical trial. J Conserv Dent 2016; 19:510-515. [PMID: 27994310 PMCID: PMC5146764 DOI: 10.4103/0972-0707.194030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Liners play a vital role in minimizing polymerization shrinkage stress by elastic bonding concept and increase the longevity and favorable outcome for composite restorations. Aims: The aim of this study was to evaluate the clinical performance of nanohybrid composite restorations using resin-modified glass-ionomer and flowable composite liners. Settings and Design: A single-centered, double-blinded randomized clinical trial, with split-mouth design and equal allocation ratio that was conducted in the Department of Conservative Dentistry and Endodontics. Materials and Methods: In forty patients, a total of eighty Class I restorations were placed with resin-modified glass-ionomer cement (RMGIC) liner (FUJI II LC, GC America) in one group and flowable composite liner (smart dentin replacement/SDR, Dentsply Caulk, Milford, DE, USA) in another group. All restorations were clinically evaluated by two examiners, immediately (baseline), 3, 6, and 12 months using US Public Health Service modified criteria. Statistical Analysis Used: Statistical analysis was performed using McNemar's test (P < 0.05). Results: There was no significant difference in the color match, marginal discoloration, surface roughness, and marginal adaptation. Restorations with RMGIC liner group show 20% Bravo scores on anatomic form at 12 months but are still clinically acceptable. Conclusion: Nanohybrid composite restorations with RMGIC (Fuji II LC) and flowable composite liner (SDR) demonstrated clinically acceptable performance after 12 months.
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Affiliation(s)
- Krishtipati Suhasini
- Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Koppolu Madhusudhana
- Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Chinni Suneelkumar
- Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Anumula Lavanya
- Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - K S Chandrababu
- Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Perisetty Dinesh Kumar
- Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
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27
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Polymerization shrinkage assessment of dental resin composites: a literature review. Odontology 2016; 104:257-70. [DOI: 10.1007/s10266-016-0264-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 07/15/2016] [Indexed: 10/21/2022]
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