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Ohlsson E, Bolay C, Arabulan S, Galler KM, Buchalla W, Schmalz G, Widbiller M. In-vitro-cytotoxicity of self-adhesive dental restorative materials. Dent Mater 2024; 40:739-746. [PMID: 38403539 DOI: 10.1016/j.dental.2024.02.015] [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: 08/18/2023] [Revised: 01/05/2024] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES Although the introduction of self-adhesive composites in restorative dentistry is very promising, the innovation of new materials also presents challenges and unknowns. Therefore, the aim of this study was to investigate the cytotoxicity of four different self-adhesive composites (SAC) in vitro and to compare them with resin-modified glass ionomer cements (RM-GIC), a more established group of materials. METHODS Samples of the following materials were prepared according to ISO 7405/10993-12 and eluted in cell culture medium for 24 h at 37 °C: Vertise Flow, Fusio Liquid Dentin, Constic, Surefil One, Photac Fil and Fuji II LC. Primary human pulp cells were obtained from extracted wisdom teeth and cultured for 24 h with the extracts in serial dilutions. Cell viability was evaluated by MTT assay, membrane disruption was quantified by LDH assay and apoptosis was assessed by flow cytometry after annexin/PI staining. RESULTS Two SAC (Constic and Vertise Flow) and one RM-GIC (Photac Fil) significantly reduced cell viability by more than 30% compared to the untreated control (p < 0.001). Disruptive cell morphological changes were observed and the cells showed signs of late apoptosis and necrosis in flow cytometry. Membrane disruption was not observed with any of the investigated materials. CONCLUSION Toxic effects occurred independently of the substance group and need to be considered in the development of materials with regard to clinical implications. CLINICAL SIGNIFICANCE SAC have many beneficial qualities, however, the cytotoxic effects of certain products should be considered when applied in close proximity to the dental pulp, as is often required.
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Affiliation(s)
- Ella Ohlsson
- Department of Operative Dentistry and Periodontology, Friedrich-Alexander-University Erlangen-Nürnberg, Glückstraße 11, 91054 Erlangen, Germany
| | - Carola Bolay
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Sevgi Arabulan
- Department of Pedodontics, Ege University, Ege University Campus, 35040 Izmir, Turkey
| | - Kerstin M Galler
- Department of Operative Dentistry and Periodontology, Friedrich-Alexander-University Erlangen-Nürnberg, Glückstraße 11, 91054 Erlangen, Germany
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Gottfried Schmalz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; Department of Periodontology, University of Bern, 3012 Bern, Switzerland
| | - Matthias Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany.
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Polymerization Shrinkage, Hygroscopic Expansion, Elastic Modulus and Degree of Conversion of Different Composites for Dental Application. JOURNAL OF COMPOSITES SCIENCE 2021. [DOI: 10.3390/jcs5120322] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: To characterize the mechanical properties of different resin-composites for dental application. Methods: Thirteen universal dentin shade composites (n = 10) from different manufacturers were evaluated (4 Seasons, Grandio, Venus, Amelogen Plus, P90, Z350, Esthet-X, Amaris, Vita-l-escence, Natural-Look, Charisma, Z250 and Opallis). The polymerization shrinkage percentage was calculated using a video-image recording device (ACUVOL—Bisco Dental) and the hygroscopic expansion was measured after thermocycling aging in the same equipment. Equal volumes of material were used and, after 5 min of relaxation, baseline measurements were calculated with 18 J of energy delivered from the light-curing unit. Specimens were stored in a dry-dark environment for 24 h then thermocycled in distilled water (5–55 °C for 20,000 cycles) with volume measurement at each 5000 cycles. In addition, the pulse-excitatory method was applied to calculate the elastic modulus and Poisson ratio for each resin material and the degree of conversion was evaluated using Fourier transform infrared spectroscopy. Results: The ANOVA showed that all composite volumes were influenced by the number of cycles (α = 0.05). Volumes at 5 min post-polymerization (12.47 ± 0.08 cm3) were significantly lower than those at baseline (12.80 ± 0.09 cm3). With regard to the impact of aging, all resin materials showed a statistically significant increase in volume after 5000 cycles (13.04 ± 0.22 cm3). There was no statistical difference between volumes measured at the other cycle steps. The elastic modulus ranged from 22.15 to 10.06 GPa and the Poisson ratio from 0.54 to 0.22 with a significant difference between the evaluated materials (α = 0.05). The degree of conversion was higher than 60% for all evaluated resin composites.
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Iaculli F, Salucci A, Di Giorgio G, Luzzi V, Ierardo G, Polimeni A, Bossù M. Bond Strength of Self-Adhesive Flowable Composites and Glass Ionomer Cements to Primary Teeth: A Systematic Review and Meta-Analysis of In Vitro Studies. MATERIALS 2021; 14:ma14216694. [PMID: 34772221 PMCID: PMC8586968 DOI: 10.3390/ma14216694] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/25/2021] [Accepted: 11/04/2021] [Indexed: 11/17/2022]
Abstract
Background: Conventional composites are largely used in pediatric restorative dentistry and demonstrate successful clinical outcomes. However, the need for simplification of operative steps in young or uncooperative children demands reliable alternatives. Therefore, the aim of the present systematic review and meta-analysis was to evaluate the in vitro bond strength of glass ionomer cements (GICs) and self-adhesive flowable composites (SFCs) on deciduous teeth. Methods: A comprehensive literature search according to the PRISMA checklist was manually and electronically performed by two independent reviewers through the following databases: MEDLINE/PubMed, Google Scholar, Scopus, and Embase, to include in vitro studies comparing GICs and SFCs bond strength values of restorations on primary teeth. In addition, three groups of meta-analyses were conducted using random-effects models. Results: Three articles meeting the inclusion criteria were selected and subjected to both qualitative and quantitative assessment. No statistically significant difference was found between SFC versus GIC; however, both groups significantly differed with conventional flowable composites (CFs). Conclusions: Despite the absence of significant difference in bond strength values, SFCs may be considered a valid alternative to GICs in the restoration of deciduous teeth, although CFs proved better in vitro performances.
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Affiliation(s)
- Flavia Iaculli
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy;
- Department of Oral and Maxillofacial Science, “Sapienza” University of Rome, 00161 Rome, Italy; (A.S.); (V.L.); (G.I.); (A.P.); (M.B.)
| | - Alessandro Salucci
- Department of Oral and Maxillofacial Science, “Sapienza” University of Rome, 00161 Rome, Italy; (A.S.); (V.L.); (G.I.); (A.P.); (M.B.)
| | - Gianni Di Giorgio
- Department of Oral and Maxillofacial Science, “Sapienza” University of Rome, 00161 Rome, Italy; (A.S.); (V.L.); (G.I.); (A.P.); (M.B.)
- Correspondence:
| | - Valeria Luzzi
- Department of Oral and Maxillofacial Science, “Sapienza” University of Rome, 00161 Rome, Italy; (A.S.); (V.L.); (G.I.); (A.P.); (M.B.)
| | - Gaetano Ierardo
- Department of Oral and Maxillofacial Science, “Sapienza” University of Rome, 00161 Rome, Italy; (A.S.); (V.L.); (G.I.); (A.P.); (M.B.)
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Science, “Sapienza” University of Rome, 00161 Rome, Italy; (A.S.); (V.L.); (G.I.); (A.P.); (M.B.)
| | - Maurizio Bossù
- Department of Oral and Maxillofacial Science, “Sapienza” University of Rome, 00161 Rome, Italy; (A.S.); (V.L.); (G.I.); (A.P.); (M.B.)
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Shaalan OO, Abou-Auf E. A 24-Month Evaluation of Self-Adhering Flowable Composite Compared to Conventional Flowable Composite in Conservative Simple Occlusal Restorations: A Randomized Clinical Trial. Contemp Clin Dent 2021; 12:368-375. [PMID: 35068835 PMCID: PMC8740796 DOI: 10.4103/ccd.ccd_600_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 07/27/2020] [Accepted: 08/14/2020] [Indexed: 11/04/2022] Open
Abstract
Background Self-adhering flowable composite (SAFC) simplified restorative procedures, especially when compared to conventional techniques. Self-adhering composite revolutionized restorative dentistry by merging advances of adhesive and restorative materials to generate the so-called "eighth generation." Aims The objective of this clinical trial was to assess the clinical performance of SAFC compared to conventional flowable composite in minimally invasive occlusal cavities. Settings and Design A total of 18 patients with conservative occlusal cavities received randomly two types of restorations in a split-mouth design. Materials and Methods Vertise™ Flow or Filtek™ Z350XT Flowable was applied according to the manufacturer's instructions. All restorations were evaluated at baseline and after 24 months, respectively, by two blinded assessors using modified USPHS criteria. Statistical Analysis Used Chi-square test was used for intragroup comparison between time points and intergroup comparison within each time point. A value of P ≤ 0.05 was considered statistically significant. Relative risk was used to determine the clinical significance. Results The results of the current study have revealed no statistically significant difference between both materials for all tested outcomes at baseline and after 24 months. Conclusions SAFC revealed satisfactory clinical performance in restoration of minimally invasive occlusal cavities after 24-month follow-up.
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Affiliation(s)
- Omar Osama Shaalan
- Department of Conservative Dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Eman Abou-Auf
- Department of Conservative Dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Lin S, Huang L, Li J, Wen J, Mei L, Xu H, Zhang L, Li H. Assessment of preparation time and 1-year Invisalign aligner attachment survival using flowable and packable composites. Angle Orthod 2021; 91:583-589. [PMID: 33848325 DOI: 10.2319/063020-598.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 12/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To compare preparation time and 1-year Invisalign aligner attachment survival between a flowable composite (FC) and a packable composite (PC). MATERIALS AND METHODS Fifty-five participants (13 men and 42 women, mean age ± SD: 24.2 ± 5.9 years) were included in the study. Ipsilateral quadrants (ie, maxillary and mandibular right, or vice versa) of attachments were randomly assigned to the FC group (Filtek Z350XT Flowable Restorative) and the PC group (Filtek Z350XT Universal Restorative) by tossing a coin. The primary outcome was preparation time. The secondary outcome was time to the first damage of an attachment. Preparation times were compared using the paired t-test, and the survival data were analyzed by the Cox proportional hazards model with a shared frailty term, with α = .05. RESULTS The preparation times were significantly shorter with the FC (6.22 ± 0.22 seconds per attachment) than with the PC (32.83 ± 2.16 seconds per attachment; P < .001). The attachment damage rates were 14.79% for the FC and 9.70% for the PC. According to the Cox models, attachment damage was not significantly affected by the attachment material, sex, arch, tooth location, attachment type, presence of overbite, or occurrence of tooth extraction. CONCLUSIONS The use of a FC may save time as compared with the use of a PC. With regard to attachment survival, there was no significant difference between the two composites. None of the covariates of attachment materials (sex, arch, tooth location, attachment type, presence of overbite, oir occurrence of tooth extraction) affected attachment damage.
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Delgado AHS, Jamal H, Young A, Ashley P. Scoping review of trials evaluating adhesive strategies in pediatric dentistry: where do simplified strategies lie? BMC Oral Health 2021; 21:33. [PMID: 33468122 PMCID: PMC7816513 DOI: 10.1186/s12903-021-01395-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adhesive restorations allow a conservative approach to caries management and are increasingly used as a restorative option in pediatric dentistry. Placement can be difficult in children because of the cooperation required for multiple bonding steps. Due to this, it is vital to assess if novel, simpler strategies have been featured in clinical trials and if clinical trials are researching the different existing adhesive strategies. METHODS This review followed Preferred Reporting Items for Systematic Reviews and Meta-analysis adapted for Scoping Reviews (PRISMA-ScR) guidelines. PubMed/Medline, Cochrane Central, Scopus and EMBASE were used for systematic search, using free keywords and controlled search terms. Clinical trials of children requiring a restorative intervention which featured adhesive strategies were included. Only peer-reviewed trials of primary teeth restored with resin composites, published in the last 10-year period were eligible. Data charting was accomplished independently by two reviewers, and studies were summarized according to their date, type, intervention, sample size, observation period, outcomes and conclusions. Quality assessment was performed using Cochrane's Risk of Bias 2.0 tool. RESULTS 700 potentially relevant references were found, which after a rigorous inclusion scheme, resulted in a total of 8 eligible clinical trials. Out of these, 7 were randomized clinical trials. Most trials featured a split-mouth design and the observation period ranged from 12 to 36 months. The trials evaluated interventions of two self-adhesive composites, two bulk-fill composites, two novel composites, one compomer and eight adhesives from different strategies. Most studies (4/8) included were judged to raise some concerns regarding risk of bias, while two were classified as high risk and two as low. CONCLUSION Few studies comparing adhesive strategies were found, especially adhesives in sound substrates. The existing studies do not reflect all current approaches that could be used in pediatric dentistry. Further studies addressing bioactive composites and contemporary adhesives are necessary.
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Affiliation(s)
- António H. S. Delgado
- Department of Biomaterials and Tissue Engineering, Royal Free Hospital, UCL Medical School, UCL Eastman Dental Institute, Rowland Hill Street, Hampstead, London, NW3 2PF UK
| | - Hasan Jamal
- Unit of Paediatric Dentistry, Department of Craniofacial Growth and Development, UCL Eastman Dental Institute, London, UK
| | - Anne Young
- Department of Biomaterials and Tissue Engineering, Royal Free Hospital, UCL Medical School, UCL Eastman Dental Institute, Rowland Hill Street, Hampstead, London, NW3 2PF UK
| | - Paul Ashley
- Department of Biomaterials and Tissue Engineering, Royal Free Hospital, UCL Medical School, UCL Eastman Dental Institute, Rowland Hill Street, Hampstead, London, NW3 2PF UK
- Unit of Paediatric Dentistry, Department of Craniofacial Growth and Development, UCL Eastman Dental Institute, London, UK
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