Aging-Dependent Changes in Mechanical Properties of the New Generation of Bulk-Fill Composites

The influence of copper-doped mesoporous bioactive nanospheres on the temperature rise during polymerization, polymer cross-linking density, monomer release and embryotoxicity of dental composites

OBJECTIVES

Composites with copper-doped mesoporous bioactive nanospheres (Cu-MBGN) were developed to prevent secondary caries by imparting antimicrobial and ion-releasing/remineralizing properties.

METHODS

Seven experimental composites containing 1, 5 or 10 wt% Cu-MBGN, the corresponding inert controls (silica) and bioactive controls (bioactive glass 45S5) were prepared. The temperature rise during light curing, cross-linking density by ethanol softening test, monomer elution and their potential adverse effects on the early development of zebrafish Danio rerio was investigated.

RESULTS

Materials combining Cu-MBGN and silica showed the highest resistance to ethanol softening, as did the bioactive controls. Cu-MBGN composites showed significant temperature rise and reached maximum temperature in the shortest time. Bisphenol A was not detected, while bis-GMA was found only in the control materials and TEGDMA in the eluates of all materials. There was no increase in zebrafish mortality and abnormality rates during exposure to the eluates of any of the materials.

CONCLUSIONS

The composite with 5 wt% Cu-MBGN combined with nanosilica fillers showed the lowest ethanol softening, indicating the polymer's highest durability and cross-linking density. Despite the TEGDMA released from all tested materials, no embryotoxic effect was observed.

Effect of polymerisation protocols on water sorption, solubility and hygroscopic expansion of fast-cure bulk-fill composite

OBJECTIVE

This study examines the effect of two light-curing protocols from a LED polywave light curing unit (LCU) on water sorption, solubility, and hygroscopic expansion of fast and conventional bulk-fill resin-based composites (RBCs) aged in distilled water for 120 d.

METHODS

Three bulk-fill RBCs materials were studied: Tetric PowerFill® (fast photo-polymerised composite) (TPF), Tetric EvoCeram bulk-fill (EVO), and GrandioSo x-tra bulk-fill (GSO) (conventional photo-polymerised composites). Specimens were prepared within a 3D-printed resin mold (8-mm diameter x 4-mm height) and light-cured from one side only with 2 modes of polywave LCU (Bluephase® PowerCure): 3 s mode and for 20 s in "Standard" mode. Water sorption and solubility were measured at fixed time intervals for 120 d of distilled water storage, then reconditioned to dry to measure desorption for 75 d, all at 37 ± 1 °C. Hygroscopic (volumetric) expansion was recorded at the same time intervals up to 120 d. Data were analysed through SPSS using Two-way ANOVA, One-way ANOVA, independent t-tests, and Tukey's post-hoc correction tests (p < 0.05).

RESULTS

TPF, when irradiated for 3 s demonstrated minimal water sorption (0.83%), solubility (1.01 μg/mm3), and least volumetric expansion (1.64%) compared to EVO and GSO. While EVO showed the highest water sorption (1.03%) and solubility (1.95 μg/mm3) at 3 s. GSO had the lowest sorption (0.67%) and (0.56%) in 3 s and 20 s protocols, respectively. Nevertheless, all the sorption and solubility data were within the ISO 4049 limits.

SIGNIFICANCE

For TPF, fast (3 s) polymerisation did not increase either water sorption or solubility, compared with 20 s irradiation. However, with the two comparative bulk-fill composites, fast cure increased water sorption by 15-25% and more than doubled solubility. These findings were consistent with the lesser volumetric expansions observed for Tetric PowerFill at both the fast and standard protocols, indicating its relative stability across polymerisation protocols.

Effect of Polywave and Monowave Light Curing Units on the Microtensile Bond Strength and Failure Types of Different Bulk-Fill Resin Composites: An in vitro Study

Aim

This study aimed to evaluate the effects of polywave and monowave light-emitting diode curing units on the microtensile bond strength and failure types of three bulk-fill resin composites.

Materials and Methods

This in vitro experimental study was performed on 180 microbars obtained from human third molars and were distributed into 12 groups according to the type of bulk-fill resin composite and the light-curing unit. Third molars were restored using Filtek One Bulk Fill Restorative, Tetric® N-Ceram Bulk Fill, and Opus Bulk Fill resin composites was light-cured with Elipar Deep Cure L and Valo in three modes: standard, high power, and extra power. Subsequently, microtensile analysis was carried out with a universal testing machine and the type of failure with an optical stereomicroscope. For statistical analysis, the Kruskal-Wallis H-test was used, with the Bonferroni post hoc test and Fisher's exact test, considering a significance of p<0.05.

Results

There were significant differences in the microtensile bond strength between the Filtek One Bulk Fill restorative and Opus Bulk-Fill (p = 0.042) when light was cured with the polywave unit at standard power. On the other hand, the Filtek One Bulk Fill Restorative and Opus Bulk Fill resins showed significant differences in microtensile bond strength when light was cured with the monowave unit compared with the polywave unit (p<0.05).

Conclusion

The presence of alternative photoinitiator systems that are more reactive than camphorquinone produced higher microtensile bond strength in Tetric N-Ceram Bulk Fill and Opus Bulk Fill resins when light-cured with a high and standard polywave unit, respectively, compared to Filtek One Bulk Fill resins. Finally, Tetric N-Ceram Bulk Fill and Opus Bulk Fill resins had the highest percentage of mixed failures, while Filtek One Bulk Fill resin had adhesive failures, which was related to its lower microtensile bond strength.

Effect of Rapid High-Intensity Light-Curing on Increasing Transdentinal Temperature and Cell Viability: An In Vitro Study

BACKGROUND

This study investigated effects of rapid high-intensity light-curing (3 s) on increasing transdentinal temperature and cell viability.

METHODS

A total of 40 dentin discs (0.5 mm) obtained from human molars were prepared, included in artificial pulp chambers (4.5 × 5 mm), and subjected to four light-curing protocols (n = 5), with a Valo Grand light curing unit: (i) 10 s protocol with a moderate intensity of 1000 mW/cm2 (Valo-10 s); (ii) 3 s protocol with a high intensity of 3200 mW/cm2 (Valo-3 s); (iii) adhesive system + Filtek Bulk-Fill Flow bulk-fill composite resin in 10 s (FBF-10 s); (iv) adhesive system + Tetric PowerFlow bulk-fill composite resin in 3 s (TPF-3 s). Transdentinal temperature changes were recorded with a type K thermocouple. Cell viability was assessed using the MTT assay. Data were analyzed using one-way ANOVA and Tukey tests for comparison between experimental groups (p < 0.05).

RESULTS

The 3 s high-intensity light-curing protocol generated a higher temperature than the 10 s moderate-intensity standard (p < 0.001). The Valo-10 s and Valo-3 s groups demonstrated greater cell viability than the FBF-10s and TPF-3 s groups and statistical differences were observed between the Valo-3 s and FBF-10 s groups (p = 0.023) and Valo-3 s and TPF-3 s (p = 0.025), with a potential cytotoxic effect for the FBF-10 s and TPF-3 s groups.

CONCLUSIONS

The 3 s rapid high-intensity light-curing protocol of bulk-fill composite resins caused a temperature increase greater than 10 s and showed cell viability similar to and comparable to the standard protocol.

Monowave vs. Polywave Light - Curing Units: Effect on Light Transmission of Composite without Alternative Photoinitiators

Objective

The aim of this study was to compare the light transmission of monowave and polywave-curing devices by a bulk-fill composite containing only camphorquinone as a photoinitiator.

Materials and methods

Three light-curing devices were used to cure bulk-fill composite QuiXfil: one monowave (Translux® Wave) and two polywave (VALO Cordless and Bluephase® PowerCure. The NIST-calibrated spectrometer (MARC Resin Calibrator, BlueLight Analytics Inc.) was used to measure the incident and transmitted light through a 2-mm composite specimen over 20 s. Light transmittance was calculated from the ratio of the amount of transmitted and incident light. For data analysis (ANOVA, α = 0.05), total irradiation of the entire spectrum, irradiation with wavelengths of 360-420 nm for the violet spectrum, and 420-540 nm for the blue spectrum were selected.

Results

Monowave curing unit Translux® Wave had the lowest light transmission (13.78 ± 0.5%), similar to the violet light transmission of polywave devices (12.02 ± 0.94% and 13.81 ± 1.72% for Valo Cordless and Bluephase PowerCure, respectively). Blue light transmittance (32.15-23.70%) was more than twofold higher than for the wavelengths in the violet region of the spectrum (13.81-12.02%) for the two polywave devices. VALO Cordless showed the highest total and blue light transmission (p<0.001). There was no significant difference in the transmission of the violet part of the spectrum between VALO Cordless and Bluephase® PowerCure (p = 0.465).

Conclusion

Within the limitations of this study, we could conclude that polywave curing devices can be used for the polymerization of the bulk-fill composite with camphorquinone as the sole photoinitiator.

Repair of monolithic zirconia restorations with different direct resin composites: effect on the fatigue bonding and mechanical performance

OBJECTIVE

The study aims to evaluate the shear bond and flexural strength fatigue behavior of yttrium-stabilized zirconia (4YSZ) repaired using different resin composites.

MATERIALS AND METHODS

Cylindric specimens of 4YSZ were obtained for the bond strength (Ø = 6 mm, 1.5 mm of thickness) and biaxial flexural strength (Ø = 15 mm, 1 mm of thickness) fatigue tests and divided into 3 groups according to the repair resin composite: EVO (nanohybrid), BULK (bulk-fill), and FLOW (flowable). The zirconia surface was air-abraded with alumina particles, a 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) primer was applied, and the resin composite was build-up over the zirconia. Fatigue shear bond strength and flexural fatigue strength tests were performed (n = 15). One-way ANOVA and Tukey post hoc tests were carried out for both outcomes, besides scanning electron microscopy and finite element analysis.

RESULTS

The repair material affected the fatigue shear bond strength of zirconia ceramic. The BULK group (18.9 MPa) depicted higher bond strength values than FLOW (14.8 MPa) (p = 0.04), while EVO (18.0 MPa) showed similar results to both groups. No effect was observed for the mechanical behavior (p = 0.53). The stress distribution was similar for all groups.

CONCLUSION

The repair of yttrium-stabilized zirconia (4YSZ) ceramics with bulk-fill resin composites was the best option for high fatigue bond strength. However, the fatigue mechanical performance was similar regardless of the applied repair material.

CLINICAL RELEVANCE

The repair of yttrium-stabilized zirconia (4YSZ) monolithic restorations may be performed with nanohybrid and bulk-fill resin composites in order to promote longevity in the treatment.

Mechanical Behavior of Repaired Monolithic Crowns: A 3D Finite Element Analysis

This study evaluated the mechanical behavior and risk of failure of three CAD-CAM crowns repaired with different resin composites through a three-dimensional (3D) finite element analysis. Three-dimensional models of different cusp-repaired (conventional nanohybrid, bulk-fill, and flowable resin composites) crowns made of zirconia, lithium disilicate, and CAD-CAM resin composite were designed, fixed at the cervical level, and loaded in 100 N at the working cusps, including the repaired one. The models were analyzed to determine the Maximum Principal and Maximum Shear stresses (MPa). Complementary, an in vitro shear bond strength test (n = 10) was performed to calculate the risk of failure for each experimental group. The stress distribution among the models was similar when considering the same restorative material. The crown material affected the stress concentration, which was higher for the ceramic models (±9 MPa for shear stress; ±3 MPa for tensile stress) than for the CAD-CAM composite (±7 MPa for shear stress; ±2 MPa for tensile stress). The shear bond strength was higher for the repaired CAD-CAM resin composite (±17 MPa) when compared to the ceramics (below 12 MPa for all groups), while the repair materials showed similar behavior for each substrate. The stress distribution is more homogenous for repaired resin composite crowns, and a flowable direct resin composite seems suitable to repair ceramic crowns with less risk of failure.

Comparison between Different Bulk-Fill and Incremental Composite Materials Used for Class II Restorations in Primary and Permanent Teeth: In Vitro Assessments

INTRODUCTION

Several advantages, including improved aesthetics and conservative cavity preparation, made resin-based composite (RBC) a popular restorative material. However, several limitations come with RBC restorations such as the necessity for proper isolation of the tooth and an incremental layering for the material due to the limitations of the depth of cure. Despite these advantages and limitations, the usage of these restorative materials is increasingly being expanded due to the advancement made since their introduction. To overcome some of the limitations, several types of RBC restorations were developed.

MATERIALS AND METHODS

Four different RBC materials used for class II restorations in primary and permanent teeth were compared: Z350 XT Filtek™ Universal Restorative (ZXT), Filtek™ Bulk Fill Flowable Restorative (FBF), Beautifil-Bulk Flowable (BBF) and Tetric™ N-Flow (TNF). Flexure strength, elastic modulus, surface roughness, microhardness and microleakage were assessed using standard methods or previously published protocols. The data and differences between the groups were analyzed using One-way analysis of variance (ANOVA), Tukey's multiple comparisons, Kruskal-Wallis and Wilcoxon rank-sum (Mann-Whitney) tests.

RESULTS

The study found that BBF (86.24 ± 7.41 MPa) and ZXT (64.45 ± 11.52 MPa) had higher flexural strength than FBF (50.89 ± 8.44 MPa) and TNF (50.67 ± 9.40 MPa), while both exhibited the highest values of surface roughness. Elastic modulus was the highest with BBF, which was not statistically significant from FBF or ZXT (p > 0.05). ZXT (109.7 ± 7.83 VH) exhibited the highest value of microhardness, which was statistically significant from the other three materials (p < 0.0001). Microleakage was assessed after thermocycling for 20,000 cycles to simulate two years in the mouth. FBF (70%) exhibited the most resistance to microleakage.

CONCLUSIONS

Different types of RBC restorations exhibit different characteristics. The clinician needs to choose the most appropriate restorative material based on different clinical scenarios.

The Depth of Cure, Sorption and Solubility of Dual-Cured Bulk-Fill Restorative Materials

This study aimed to examine depth of cure (DoC), mass change, water sorption and solubility of dual-cured bulk-fill restorative materials (Surfil One and Activa) in comparison with a light-cured bulk-fill composite (Filtek One Bulk-Fill) and a resin-modified glass ionomer (Fuji II LC). Twenty specimens were prepared of each material using stainless steel molds designed with a slot (8 × 4 × 2 mm) and irradiated for either 20 or 40 s. The Vickers hardness (VHN) was measured at every 0.5 mm to assess the DoC after 24 h of storage at 37 °C. The depth of cure was reported as the depth corresponding to 80% of the maximum Vickers hardness. Disc-shaped specimens were prepared of each material (n = 5) to investigate mass change, sorption and solubility after 4 months of water storage. The data were analyzed using a two-way and one-way analysis of variance (ANOVA) followed by the Tukey post hoc test (p ≤ 0.05). Fuji II LC had the greatest DoC while Activa had the lowest. The two different irradiation times did not demonstrate a significant difference in DoC for all dual-cured materials (p > 0.05). Fuji II LC had the highest sorption while Filtek One showed the lowest. Surefil One and Fuji II LC had a negative solubility. This study concluded that dual-cured materials showed different depth of cure values despite having the same setting reaction. Both materials exhibited a high water sorption, which might jeopardize their dimensional stability and effect their clinical performance.

Effects of Bio-Aging on Mechanical Properties and Microbial Behavior of Different Resin Composites

Under challenging oral environments, the overall performance of resin composites is affected by bio-aging. This study investigated the effects of saliva biofilm-induced bio-aging on the mechanical properties and microbial behavior of composites with different filler types. Microhybrid, nanohybrid, nano-filled and nano-filled flowable composites were bio-aged with saliva biofilm for 30 days. Surface morphology, roughness, mechanical and aesthetic properties were determined. A 48 h saliva biofilm model was used to evaluate the microbial behavior of different composites in vitro. Biofilm metabolic activity, lactic acid production and live/dead bacterial staining were tested. Six volunteers were selected to wear intra-oral appliances with composite slabs for 24 h and biofilms were collected and analyzed using 16S rRNA sequencing to assess the biofilm formation over those materials in situ. Although there were increasing trends, surface roughness, water resorption and material solubility had no significant changes for all groups after bio-aging (p > 0.05). There were no significant changes in elastic modulus for all groups after aging (p > 0.05). However, a decrease in flexural strength in all groups was observed (p < 0.05), except for the nanoflow composite group (p > 0.05). The Vickers hardness remained stable in all groups after aging (p > 0.05), except for the nano-filled group (p < 0.05). The nanoflow composite showed distinct color changes compared to the micro-hybrid group after aging (p < 0.05). Biofilm metabolic activity and lactic acid production in vitro increased slightly after bio-aging in all groups, but with no statistical significance (p > 0.05). The Shannon index diversity of biofilms in situ decreased after aging (p < 0.05), while no significant difference was shown in species composition at the genus level in all groups (p > 0.05). Resin composites with different sized fillers displayed a relatively stable mechanical performance and uncompromised microbial behavior both in vitro and in situ after 30 days of bio-aging. Based on the results, composites with different filler types can be selected flexibly according to clinical needs. However, a longer time for bio-aging is still needed to confirm the mechanical properties and microbial behaviors of composites in the long run.

Proposition of New Testing Procedure for the Mechanical Properties of Bulk-Fill Materials

This study analysed flexural properties, microhardness, and the degree of conversion (DC) of five bulk-fill composites under clinically relevant conditions (4 mm thick specimens) in comparison to 2 mm specimens according to ISO 4049. Additionally, the effect of rapid polymerisation on 4 mm specimens was evaluated after accelerated aging. DC was measured using Fourier transform infrared spectrometry at 2 and 4 mm thick layers, while flexural properties and Vickers microhardness were tested using 16 × 2 × 2 mm or 16 × 2 × 4 mm specimens. Three polymerisation protocols were used: (I) "ISO": 2 mm thickness, 1000 mW/cm², double-sided; (II) "10 s": 4 mm thickness, 1000 mW/cm², one-sided; and (III) "3 s": 4 mm thickness, 2600 mW/cm², one-sided. Mechanical properties were tested after 1 day, after 10,000 thermocycles, and after 10,000 thermocycles followed by a 7-day immersion in absolute ethanol. The "ISO" protocol produced a higher DC and microhardness of all materials. Elastic modulus was significantly higher for the "ISO" protocol compared to the 4 mm specimens. The differences in flexural strength for all polymerisation protocols were equalised after thermocycling and immersion in absolute ethanol. All tested materials met the ISO 4049 flexural strength requirement (80 MPa) for all polymerisation methods and all aging conditions. Rapid polymerisation achieved nearly optimal properties (ISO), except for elastic modulus, which was significantly reduced in 4 mm samples.

Evaluation of Physical-Chemical Properties of Contemporary CAD/CAM Materials with Chromatic Transition "Multicolor"

The use of materials for computer-aided design/computer-aided manufacturing (CAD/CAM) has been rapidly increasing in daily practice. However, one of the main issues regarding modern CAD/CAM materials is their aging in the oral environment, which may lead to significant changes in their overall properties. The aim of this study was to compare the flexural strength, water sorption, cross-link density (softening ratio%), surface roughness, and SEM analysis of three modern CAD/CAM "multicolor" composites. Grandio (Grandio disc multicolor-VOCO GmbH, Cuxhaven, Germany), Shofu (Shofu Block HC-Shofu Inc., Kyoto, Japan), and Vita (Vita Enamic multiColor-Vita Zahnfabrik, Bad Sackingen, Germany) were tested in this study. They were prepared in stick-shaped specimens and submitted to different tests after several aging protocols, such as thermocycling and mechanical cycle loading challenge. Further disc-shaped specimens were also created and tested for water sorption, cross-link density, surface roughness, and SEM ultramorphology, before and after storage in an ethanol-based solution. For flexural strength and ultimate tensile strength, Grandio showed the greatest values both at baseline and after aging (p < 0.05). Grandio and Vita Enamic presented the highest modulus of elasticity and the lowest water sorption (p < 0.05). A significant reduction (p < 0.05) in microhardness after ethanol storage (softening ratio%) was observed especially in Shofu. Grandio had the lowest roughness parameters compared to the other tested CAD/CAM materials, while ethanol storage significantly increased the Ra and RSm values in Shofu (p < 0.05). Despite the comparable modulus of elasticity of Vita and Grandio, this latter showed greater flexural strength and ultimate tensile strength both at baseline and after aging. Hence, Grandio and Vita Enamic may be employed for the anterior teeth and for those restorations requiring load-bearing capacity. Conversely, aging seems to affect several properties of Shofu, so its use for permanent restorations should be well-pondered based on the clinical situation.

Surface hardness and flexural strength of dual-cured bulk-fill restorative materials after solvent storage

BACKGROUND

This study aimed to evaluate the surface hardness (VHN) and biaxial flexural strength (BFS) of dual-cured bulk-fill restorative materials after solvent storage.

METHODS

Two dual-cured bulk-fill composites (Surefil One® and Activa™ Bioactive), a light-cured bulk-fill composite (Filtek One Bulk-Fill) and a resin-modified glass ionomer (Fuji II LC) were investigated. Surefil One and Activa were used in the dual-cure mode, all materials were handled according to manufacturer's instructions. For VHN determination, 12 specimens were prepared from each material and measured after 1 h (baseline), 1 d, 7 d and 30 d of storage in either water or 75% ethanol-water. For BFS test, 120 specimens were prepared (n = 30/material) and stored in water for either 1, 7 or 30 d before testing. Repeated measures MANOVA, two-way and one-way ANOVA followed by the Tukey post hoc test (p ≤ 0.05) were used to analyze the data.

RESULTS

Filtek One had the highest VHN, while Activa had the lowest. All materials exhibited a significant increase in VHN after 1d of storage in water, except for Surefil One. After 30 d of storage, VHN increased significantly in water except for Activa, while ethanol storage caused a significant time-dependent reduction in all tested materials (p ≤ 0.05). Filtek One showed the highest BFS values (p ≤ 0.05). All the materials, except for Fuji II LC, exhibited no significant differences between 1 and 30 d BFS measurements (p > 0.05).

CONCLUSIONS

Dual-cured materials had significantly lower VHN and BFS compared to the light-cured bulk-fill material. The low results of Activa VHN and Surefil One BFS, indicate that these materials should not be recommended in posterior stress-bearing areas.

Periodontopathic bacterial adhesion to different restorative materials used to elevate proximal subgingival margins

This study compared the periodontopathic bacterial adhesion to four restorative materials used for deep margin elevation at 2, 24, and 48-h after incubation. Discs were produced from four restorative materials: resin modified glass ionomer, glass hybrid, flowable bulk fill resin composite, and bioactive ionic resin. Root dentin was used as control. Specimens were coated with saliva and used to culture a biofilm comprised of three strains of periodontopathic bacteria; Porphyromonas gingivalis, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans. Bacterial adherence was assessed by colony count assay, crystal violet staining, and visualized using confocal laser scanning microscopy. Data were analyzed by two-way ANOVA followed by Tukey's post hoc tests. The adhesion values for the control specimens were significantly higher than for other materials, while those for the flowable bulk fill were significantly lower than for any other material within all evaluation assays. The 2-h incubation period showed the lowest adhesion values regardless of the group. The 48-h adhesion values were higher than the 24-h results in all groups except the flowable bulk fill. Microscopic imaging partially supported the findings of the measurements. In terms of periodontopathic bacterial adhesion, the tested flowable bulk fill may be preferable for subgingival use over other tested materials.

Damping Behaviour and Mechanical Properties of Restorative Materials for Primary Teeth

The energy dissipation capacity and damping ability of restorative materials used to restore deciduous teeth were assessed compared to common mechanical properties. Mechanical properties (flexural strength, modulus of elasticity, modulus of toughness) for Compoglass F, Dyract eXtra, SDR flow, Tetric Evo Ceram, Tetric Evo Ceram Bulk Fill, and Venus Diamond were determined using a 4-point bending test. Vickers hardness and Martens hardness, together with its plastic index (η_ITdis), were recorded using instrumented indentation testing. Leeb hardness (HLD) and its deduced energy dissipation data (HLD_dis) were likewise determined. The reliability of materials was assessed using Weibull analysis. For common mechanical properties, Venus Diamond always exhibited the significantly highest results and SDR flow the lowest, except for flexural strength. Independently determined damping parameters (modulus of toughness, HLD_dis, η_ITdis) invariably disclosed the highest values for SDR flow. Composite materials, including SDR flow, showed markedly higher reliabilities (Weibull modulus) than Compoglass F and Dyract eXtra. SDR flow showed pronounced energy dissipation and damping characteristics, making it the most promising material for a biomimetic restoration of viscoelastic dentin structures in deciduous teeth. Future developments in composite technology should implement improved resin structures that facilitate damping effects in artificial restorative materials.

Using Copper-Doped Mesoporous Bioactive Glass Nanospheres to Impart Anti-Bacterial Properties to Dental Composites

Experimental dental resin composites containing copper-doped mesoporous bioactive glass nanospheres (Cu-MBGN) were developed to impart anti-bacterial properties. Increasing amounts of Cu-MBGN (0, 1, 5 and 10 wt%) were added to the BisGMA/TEGDMA resin matrix containing micro- and nano-fillers of inert glass, keeping the resin/filler ratio constant. Surface micromorphology and elemental analysis were performed to evaluate the homogeneous distribution of filler particles. The study investigated the effects of Cu-MBGN on the degree of conversion, polymerization shrinkage, porosity, ion release and anti-bacterial activity on S. mutans and A. naeslundii. Experimental materials containing Cu-MBGN showed a dose-dependent Cu release with an initial burst and a further increase after 28 days. The composite containing 10% Cu-MBGN had the best anti-bacterial effect on S. mutans, as evidenced by the lowest adherence of free-floating bacteria and biofilm formation. In contrast, the 45S5-containing materials had the highest S. mutans adherence. Ca release was highest in the bioactive control containing 15% 45S5, which correlated with the highest number of open porosities on the surface. Polymerization shrinkage was similar for all tested materials, ranging from 3.8 to 4.2%, while the degree of conversion was lower for Cu-MBGN materials. Cu-MBGN composites showed better anti-bacterial properties than composites with 45S5 BG.

Improved Flexural Properties of Experimental Resin Composites Functionalized with a Customized Low-Sodium Bioactive Glass

This study evaluated the flexural properties of an experimental composite series functionalized with 5-40 wt% of a low-Na F-containing bioactive glass (F-series) and compared it to another experimental composite series containing the same amounts of the conventional bioactive glass 45S5 (C-series). Flexural strength and modulus were evaluated using a three-point bending test. Degree of conversion was measured using Fourier-transform infrared spectroscopy. Weibull analysis was performed to evaluate material reliability. The control material with 0 wt% of bioactive glass demonstrated flexural strength values of 105.1-126.8 MPa). In the C-series, flexural strength ranged between 17.1 and 121.5 MPa and was considerably more diminished by the increasing amounts of bioactive glass than flexural strength in the F-series (83.8-130.2 MPa). Analogously, flexural modulus in the C-series (0.56-6.66 GPa) was more reduced by the increase in bioactive glass amount than in the F-series (5.24-7.56 GPa). The ISO-recommended "minimum acceptable" flexural strength for restorative resin composites of 80 MPa was achieved for all materials in the F-series, while in the C-series, the materials with higher bioactive glass amounts (20 and 40 wt%) failed to meet the requirement of 80 MPa. The degree of conversion in the F-series was statistically similar or higher compared to that of the control composite with no bioactive glass, while the C-series showed a declining degree of conversion with increasing bioactive glass amounts. In summary, the negative effect of the addition of bioactive glass on mechanical properties was notably less pronounced for the customized bioactive glass than for the bioactive glass 45S5; additionally, mechanical properties of the composites functionalized with the customized bioactive glass were significantly less diminished by artificial aging. Hence, the customized bioactive glass investigated in the present study represents a promising candidate for functionalizing ion-releasing resin composites.

Post-Cure Development of the Degree of Conversion and Mechanical Properties of Dual-Curing Resin Cements

This study investigated the effect of different curing conditions on the degree of conversion and mechanical properties of contemporary dual-curing resin cements. The material specimens were either light-cured directly, light-cured through a 1-mm lithium disilicate glass-ceramic layer, or self-cured. The degree of conversion was measured in 0.1-mm films using Fourier-transform infrared spectroscopy 1 day, 7 days, and 28 days post-cure. Specimens used to study the flexural strength and modulus were prepared according to the ISO 4049 protocol, stored for 28 days post-cure, and subjected to accelerated aging by absolute ethanol immersion. The degree of conversion values ranged between 44.3–77.8%. Flexural strength varied between 11.4–111.1 MPa, while flexural modulus amounted to 0.7–5.5 GPa. The degree of conversion was significantly affected by material type, curing conditions, and post-cure time; however, variations in curing conditions were the least influential factor. A statistically significant effect of curing conditions on the degree of conversion was identified for only one of the five materials tested, whereas the flexural strength and modulus of all tested materials were significantly reduced in the experimental groups that were light-cured through a ceramic layer or self-cured. The effect size analysis showed that mechanical properties were most affected by the material type, while the differences in curing conditions were less influential. A comparison of the degree of conversion and mechanical properties indicated that different curing conditions may lead to significantly different flexural strength and modulus, which are not necessarily accompanied by identifiable variations in the degree of conversion.

Polymerization Kinetics and Development of Polymerization Shrinkage Stress in Rapid High-Intensity Light-Curing

This study investigated polymerization kinetics, linear shrinkage, and shrinkage stress development for six contemporary composite materials of different viscosities cured using radiant exitances of 1100–2850 mW/cm². Real-time measurements of degree of conversion, linear shrinkage, and shrinkage stress were performed over 5 min using Fourier-transform infrared spectrometry, a custom-made linometer, and a custom-made stress analyzer, respectively. For most tested variables, the factor “material” had a higher effect size than the factor “curing protocol”. Maximum polymerization rate and maximum shrinkage stress rate were the most affected by changes in curing conditions. In contrast, no significant effects of curing conditions were identified within each material for shrinkage stress values measured at the end of the 5 min observation period. Linear shrinkage and shrinkage stress values measured after 5 min were closely correlated (R = 0.905–0.982). The analysis of polymerization kinetics suggested that the two composites specifically designed for rapid light-curing responded to higher radiant exitances differently than other composites. Polymerization kinetics and shrinkage stress behavior of contemporary restorative composite materials of different viscosities were overall more affected by material type than differences in curing conditions. Subtle differences in polymerization kinetics behavior shown by the two composites specifically designed for rapid high-intensity light-curing did not translate into significant differences in the development of polymerization shrinkage stress.

Long-Term Assessment of Contemporary Ion-Releasing Restorative Dental Materials

The objective was to evaluate new commercially available ion-releasing restorative materials and compare them to established anti-cariogenic materials. Four materials were tested: alkasite Cention (Ivoclar Vivadent) in self-cure or light-cure mode, giomer Beautifil II (Shofu), conventional glass-ionomer Fuji IX (GC), and resin composite Tetric EvoCeram (Ivoclar Vivadent) as a control. Flexural strength, flexural modulus, and Weibull modulus were measured one day, three months, and after three months with accelerated aging in ethanol. Water sorption and solubility were evaluated for up to one year. Degree of conversion was measured during 120 min for self-cured and light-cured Cention. In this study, Beautifil II was the ion-releasing material with the highest flexural strength and modulus and with the best resistance to aging. Alkasite Cention showed superior mechanical properties to Fuji IX. Weibull analysis showed that the glass-ionomer had the least reliable distribution of mechanical properties with the highest water sorption. The solubility of self-cured alkasite exceeded the permissible values according to ISO 4049. Degree of conversion of light-cured Cention was higher than in self-cure mode. The use of alkasite Cention is recommended only in the light-cure mode.

The Effect of a Green Smoothie on Microhardness, Profile Roughness and Color Change of Dental Restorative Materials

Acidic drinks are known to exert negative effects on the surface properties of dental restorative materials. However, the effect of increasingly popular green smoothie drinks has not been addressed so far. The present study investigated the effect of cyclic immersions (5 min daily over 30 days) in a green smoothie drink on the surface properties of contemporary dental restorative materials, including resin composites, an alkasite, and a glass hybrid. Vickers microhardness, profile roughness, and perceptible color change in the CIE L* a* b* color space were evaluated as clinically relevant properties of the material surface. After 30-day green smoothie immersion, microhardness values either decreased by 8–28% (for resin composites) or increased by up to 91% (for glass hybrid). The increase in profile roughness (Ra parameter) of smoothie-immersed specimens was 7–26 times higher compared to the control group. The perceptible color change (ΔE*) in the smoothie group was 3–8 times higher compared to the control group. Overall, this study demonstrated that daily exposure of dental restorations made from resin composites, alkasites, and glass hybrid materials to a green smoothie drink can significantly accelerate material degradation, which is reflected as surface softening, as well as higher roughness and higher perceptible color change.

Evaluation of the Surface Roughness of Bulk-Fill Composite Resins after Submission to Acidic and Abrasive Aggressions

This in vitro study aimed to assess the erosive effect of hydrochloric acid in association with toothbrushing procedure on the surface condition of three bulk-fill composite resins used for direct restoration. A total of 480 samples (160 from each composite resin): X-tra Fil (VOCO, Germany)—group A, Filtek Bulk-fill Posterior (3M-ESPE, St. Paul, MN, USA)—group B, G-aenial Posterior (GC Japan)—group C were prepared, submitted to chemical attack for 60 min with hydrochloric acid 30% and, subsequently, submitted to the abrasive effect of toothbrushing using 10,000 cycles with medium and hard bristles, at three different times (immediately and after 30 min after acid attack or without any chemical attack). The surface roughness of the samples was measured using a noncontact profilometer (Dektak XT, Bruker, Billerica, MA, USA). The values were analyzed using ANOVA and post hoc Bonferroni tests, with a p < 0.05. Chemical attack for 60 min associated with one year of toothbrushing with toothbrushes having medium or hard bristles increase the surface roughness of tested bulk-fill composite resins. No differences were recorded between toothbrushing with medium or firm bristles immediately or 30 min after acidic challenge for each of the three bulk-fill composite resins. Exposure to hydrochloric acid determines no effect on surface roughness of bulk-fill composite resins.