Indirect resin composites

Evaluating mechanical and surface properties of zirconia-containing composites: 3D printing, subtractive, and layering techniques

This study assessed the monotonic and fatigue flexural strength (FS), elastic modulus (E), and surface characteristics of a 3D printed zirconia-containing resin composite compared to subtractive and conventional layering methods. Specimens, including discs (n = 15; Ø = 15 mm × 1.2 mm) and bars (n = 15; 14 × 4 × 1.2 mm), were prepared and categorized into three groups: 3D printing (3D printing - PriZma 3D Bio Crown, Makertech), Subtractive (Lava Ultimate blocks, 3M), and Layering (Filtek Z350 XT, 3M). Monotonic tests were performed on the discs using a piston-on-three-balls setup, while fatigue tests employed similar parameters with a frequency of 10 Hz, initial stress at 20 MPa, and stress increments every 5000 cycles. The E was determined through three-point-bending test using bars. Surface roughness, fractographic, and topographic analyses were conducted. Statistical analyses included One-way ANOVA for monotonic FS and roughness, Kruskal-Wallis for E, and Kaplan-Meier with post-hoc Mantel-Cox and Weibull analysis for fatigue strength. Results revealed higher monotonic strength in the Subtractive group compared to 3D printing (p = 0.02) and Layering (p = 0.04), while 3D Printing and Layering exhibited similarities (p = 0.88). Fatigue data indicated significant differences across all groups (3D Printing < Layering < Subtractive; p = 0.00 and p = 0.04, respectively). Mechanical reliability was comparable across groups. 3D printing and Subtractive demonstrated similar E, both surpassing Layering. Moreover, 3D printing exhibited higher surface roughness than Subtractive and Layering (p < 0.05). Fractographic analysis indicated that fractures initiated at surface defects located in the area subjected to tensile stress concentration. A porous surface was observed in the 3D Printing group and a more compact surface in Subtractive and Layering methods. This study distinguishes the unique properties of 3D printed resin when compared to conventional layering and subtractive methods for resin-based materials. 3D printed shows comparable monotonic strength to layering but lags behind in fatigue strength, with subtractive resin demonstrating superior performance. Both 3D printed and subtractive exhibit similar elastic moduli, surpassing layering. However, 3D printed resin displays higher surface roughness compared to subtractive and layering methods. The study suggests a need for improvement in the mechanical performance of 3D printed material.

Fracture Resistance of Direct versus Indirect Restorations on Posterior Teeth: A Systematic Review and Meta-Analysis

The aim of this systematic review and meta-analysis was to compare static compression forces between direct composite resin restorations and indirect restorations for posterior teeth. All studies comparing mechanical properties of direct versus indirect restorations of posterior teeth were included from 2007 up to February 2024. A meta-analysis was conducted for static compression fracture resistance. Medline, Central, and Embase databases were screened. Twenty-four articles were included in the qualitative synthesis, and sixteen studies were finally included in the quantitative synthesis. There was no difference in terms of fracture resistance between direct and indirect restorations for posterior teeth (p = 0.16 for direct and indirect composite resin restorations and p = 0.87 for direct composite resin restorations and indirect ceramic restorations). Also, sub-group analysis with or without cusp coverage in each group revealed no discernable difference. Based on this study, it can be concluded that the choice between direct and indirect restoration approaches may not significantly impact fracture resistance outcomes. There was no statically significant difference between direct and indirect restorations for posterior teeth in all cases of restorations with or without cusp coverage and no matter the used materials. However, to better evaluate these materials, further studies are warranted.

Biofilm Formation on Hybrid, Resin-Based CAD/CAM Materials for Indirect Restorations: A Comprehensive Review

Hybrid materials are a recent addition in the field of restorative dentistry for computer-aided design/computer-aided manufacturing (CAD/CAM) indirect restorations. The long-term clinical success of modern dental restorative materials is influenced by multiple factors. Among the characteristics affecting the longevity of a restoration, the mechanical properties and physicοchemical interactions are of utmost importance. While numerous researchers constantly evaluate mechanical properties, the biological background of resin-based CAD/CAM biomaterials is scarcely investigated and, therefore, less described in the literature. This review aims to analyze biofilm formation on the surfaces of novel, hybrid, resin-based CAD/CAM materials and evaluate the methodological protocols followed to assess microbial growth. It is demonstrated that the surface structure, the composition and the finishing and polishing procedures on the surface of a dental restorative material influence initial bacterial adhesion; however, most studies focus on in vitro protocols, and in vivo and/or in situ research of microbiomics in CAD/CAM restorative materials is lacking, obstructing an accurate understanding of the bioadhesion phenomenon in the oral cavity.

Semidirect Resin Composite Veneers in a Patient with Bruxism

This case report details the esthetic rehabilitation of a 32-year-old male patient suffering from sleep bruxism, primarily manifesting as a fracture and significant loss of tooth structure in the anterior maxillary central incisors. To address these concerns, the patient underwent a restorative treatment involving the application of semidirect resin composite veneers on the maxillary incisors and direct resin composite restoration on the incisal regions of the maxillary canines. This approach not only restored the functional integrity of the teeth but also significantly enhanced the patient's esthetic appearance.

Determination of the degree of conversion, the diffuse reflectance, and the color stability after different aging processes of gingiva-colored composite resins

PURPOSE

To determine the degree of conversion (DC) and spectral diffuse reflectance of four different gingiva-colored composites and to evaluate their color stability after various aging processes.

MATERIALS AND METHODS

The gingiva-colored composites were assigned to four experimental groups (Anaxgum (AG), Crea.lign paste Gum (CB), Gradia Gum (GR), SR Nexco Gum (NC)). A total of 120 disc-shaped specimens (10 × 2 mm) (n = 30/group) were polymerized in a Teflon mold. The nature of chemical bonding was studied by Fourier transform infrared spectroscopy (FTIR). Diffuse reflection spectra of the polymerized specimens were gathered using an ultraviolet-visible-near infrared (UV-Vis-NIR) spectrophotometer. Specimens subjected to aging methods were divided into three subgroups (n = 10): ultraviolet aging, hydrothermal aging, and autoclave aging. Color differences (ΔE*ab and ΔE00 ) were determined by colorimetry before and after aging. The statistical analysis was done using a two-way ANOVA along with paired sample t-test and Bonferroni's post hoc test.

RESULTS

Conversion degrees varied between 26.9% and 59.7% and all groups showed 3 or 4 maxima at different positions in the visible region of the spectrum. Both ΔE*ab and ΔE00 values were significantly different from the groups of different brands for all types of aging processes. Similarly, there were significantly different ΔE*ab and ΔE00 values according to the aging procedure for all groups of particular brands, except for ΔE00 of SR Nexco Gum (NC).

CONCLUSIONS

The aging procedures resulted in significant color differences between similar shades of four commercial gingiva-colored composites. The composite resins showed different degrees of conversion and diffuse reflectance spectra. The aging conditions tested affected the color stability. Patients with gingiva-colored indirect restorations should be informed about time-dependent discoloration.

Color Stability, Gloss Retention, and Surface Roughness of 3D-Printed versus Indirect Prefabricated Veneers

The long-term color stability and surface properties of anterior laminate veneers are among the crucial factors affecting the clinical longevity of aesthetic restorations. Novel 3D-printed materials are being introduced as definitive restorative treatment. In light of the existing variety of indirect yet minimally invasive composite resin veneers, research on their surface properties is warranted. This in vitro study evaluated the effect of artificial aging by immersion in different staining solutions on the color changes, gloss, and surface roughness (Ra) of 3D-printed veneers compared to the prefabricated resin composite veneer systems (PRCVs) manufactured by Componeer and Edelweiss. Moreover, this study compared the effects of two methods for stain removal: repolishing with Sof-Lex disks and in-office bleaching with 40% hydrogen peroxide. The veneers (n = 24) were randomly divided according to the immersion solutions used, i.e., tea and coffee. Colorimetric measurements, surface roughness, and surface gloss were determined before and after staining and surface treatment with either in-office bleaching or surface polishing. The data were statistically analyzed using two-way ANOVA followed by the Tukey's post hoc test (α = 0.05). Artificial aging with immersion in staining solutions led to significant color changes, increased surface roughness, and gloss reduction in all materials (p  <  0.05). The 3D-printed veneers showed higher ΔE values (coffee = 10.112 ± 0.141) and (tea = 10.689 ± 0.771) compared to baseline after 7 days of aging. The 3D-printed veneers had a statistically significant surface roughness Ra (0.574 µm ± 0.073). The gloss was >70% in all groups at baseline; these values dropped in all groups after 7 days of artificial aging. After the stain-removing procedures, the ΔE values decreased in all tested veneers. That being said, they failed to return to the baseline values, and both stain-removing methods were found to have an adverse effect on surface roughness and gloss retention in all tested veneers.

Effect of immediate dentin sealing on the fracture strength of indirect overlay restorations using different types of luting agents (A comparative in vitro study)

Objective

This study evaluates the effects of immediate dentin sealing (IDS) on the fracture resistance of lithium disilicate overlays using three different types of resin-luting agents (preheated composite, dual-cure adhesive resin, and flowable composite).

Materials and Methods

Forty-eight maxillary first premolars of equal size were prepared using a butt joint preparation design. The teeth were separated into two primary groups, each with 24 teeth: Group DDS - delay dentin sealing (DDS) (non-IDS) teeth were not treated. Group IDS - dentin sealing was applied immediately after teeth preparations. Each group was subsequently separated into three separate subgroups of eight teeth. Subgroups DDS+Phc and IDS+Phc - cemented with preheated composite (Enamel plus HRi, Micerium, Italy), subgroups DDS+Dcrs and IDS+Dcrs - cemented with dual-cured resin cement (RelyX Ultimate, 3M ESPE, Germany), and subgroups DDS+Fc and IDS+Fc - cemented with flowable composite (Filtek Supreme Flowable, 3M ESPE, USA). The fracture resistance of each sample was evaluated using a test of a single load till failure, which was automatically recorded in Newton by a computer-controlled universal testing system.

Results

The fracture resistance of the subgroup IDS+Phc was the highest mean value, in which the overlay was cemented with preheated composite (1954 N), and the lowest mean was noted in the subgroup DDS+Fc, by which the overlay cemented with flowable composite without IDS (887 N). All IDS subgroups had a high mean fracture load. Both the Bonferroni test and the one-way ANOVA test identified a significant difference between all groups of 0.05.

Conclusion

In general, teeth with IDS were stronger than teeth without IDS. When the preheated composite is used as a luting agent improves overall fracture resistance, followed by resin cement and flowable composite, respectively. However, the result showed that the ceramic overlays with and without IDS are strong enough to withstand the normal mastication force. Overlays was failed in a more catastrophic, irreparable mode of fracture than the clinical situation.

The efficacy of lining materials in the reduction of microleakage in class II composite resin restoration using the sandwich technique: A stereomicroscopic study

Background

The sealing ability of different liners under composite restorations in the reduction of microleakage.

Aim

To evaluate the effects of three different liners in sandwich techniques on gingival microleakage of class II composite restorations.

Materials and Methods

Standardized Class II box cavities were prepared on forty premolar teeth and randomly divided into four groups, n = 10: Group A, no liner (control); Group B, Polofil NHT Flow; Group C, Ionolux; and Group D, Fuji VII. The etching, bonding, and process for restoring the whole remaining mass of the cavities with G-aenial composite were the same, with the sandwich material expectations. Dye penetration was evaluated using a stereomicroscope.

Statistical Analysis

Duncan's Post hoc analysis and Friedman's test.

Results

Group A showed the highest microleakage followed by Group D, Group C, and Group B.

Conclusion

Polofil NHT Flow seems to be a promising liner for gingivally deep class II cavities.

Comparative Evaluation of Two Different Fiber-Reinforced Composite Materials in Class 1 Post-Endodontic Restorations in Molars-A Randomized Clinical Study

This study aimed to evaluate and compare two different fiber-reinforced composite materials in class I post-endodontic restoration in molars. A total of 50 patients were randomly assigned into two groups (n = 25 for each group); group A: everX Posterior (packable composite) with a top layer of solareX (nano-hybrid composite) and group B: everX Flow (flowable composite) with a top layer of G-aenial universal injectable (flowable composite). Patients were evaluated immediately after the procedure (baseline), at 6 months, and at 1 year time intervals based on the modified USPHS criteria. The statistical analysis using a chi-square test showed no statistically significant difference in the clinical performance of group A and group B. Clinical performance of the combination of everX Flow with overlying G-aenial universal injectable composite proved to be comparable with everX Posterior with overlying solareX composite as post-endodontic restorations in class I lesions in permanent molars.

Effect of Different Indirect Composite Onlay and Core Materials on Fracture Resistance of Endodontically Treated Maxillary Premolars

PURPOSE

To compare and evaluate the effects of different indirect composite onlay and/or core buildup materials on the fracture resistance and fracture mode of restored endodontically treated premolars.

METHODS

Two conventional handmade indirect composite resins (SR Nexco (NC) and Ceramage (CM)) and two core buildup materials, dual-cure composite resin (MultiCore Flow (MC)), and short fiber-reinforced composite resin (EverX Posterior (EXP)), were selected. Sixty maxillary premolars were randomly divided into six groups (n=10). Group 1 included intact teeth (INT; negative control). Mesio-occluso-distal cavity preparation and endodontic treatment was performed on the remaining premolars. Group 2 was restored with polymer-reinforced zinc oxide eugenol intermediate restorative material (IRM; positive control), whereas the experimental groups (groups 3-6) were restored with core buildup material and indirect composite onlay (MC_NC, MC_CM, EXP_NC, and EXP_CM). The specimens received compressive loading using a universal testing machine, at 45° to the long axis with a crosshead speed of 0.5 mm/min until fracture. Fracture modes were visually analyzed. Fracture resistance was measured and statistically analyzed using two-way and one-way ANOVA (α=0.05).

RESULTS

Only the type of indirect composite onlay affected the fracture resistance of the experimental groups (P=0.009). The MC_CM group showed the highest fracture resistance, which was significantly higher than that of the MC_NC group (P=0.031). No statistically significant differences were found between the INT group and other experimental groups(P>0.05). All groups had a greater incidence of restorable than unrestorable failures.

CONCLUSION

The type of indirect composite onlay affected the fracture resistance of restored endodontically treated maxillary premolars.

Comparison of surface roughness and color stability of different denture characterizing composite resins: the effect of different surface treatments

PURPOSE

This study aimed to investigate the effect of surface treatment and type of composite resin material on the color stability and surface roughness of different denture characterizing composites.

MATERIALS AND METHODS

Two nanohybrids [Gradia Plus Gum, (GP) and SR Nexco Paste Gingiva, (SR)] and one microhybrid gingiva-colored composite resin (Amaris Gingiva, (AG)] were investigated. A total of 120 disk-shaped samples were prepared, 40 of each material. Samples were divided into two groups (n = 20) for each material according to the surface treatment applied: conventional polishing (control) and coated with a sealant in addition to the surface polishing. All groups were thermocycled. The surface roughness (Ra) was measured using a profilometer after thermal cycling. The samples were then divided into 2 subgroups (n = 10) and stored for 7 days in distilled water or coffee solution. Color differences (ΔE₀₀ ) were calculated with a spectrophotometer. Results were evaluated with Kruskal-Wallis and Mann-Whitney U statistical analysis.

RESULTS

The type of denture characterizing composite material and surface treatment method revealed statistically significant differences for the ΔE₀₀ (after immersion both in coffee and distilled water) and the Ra values of denture characterizing composite (p < 0.001 for both). All sealed groups showed significantly higher Ra than the all polished groups. Both in the polished groups and the sealant applied groups, the GP had the highest mean Ra values (0.29 ±0.05 μm and 0.47 ±0.09 μm, respectively). It was followed by SR (0.23 ±0.06 μm and 0.41 ±0.10 μm, respectively), and AG groups (0.20 ±0.06 μm and 0.39 ±0.09 μm, respectively). According to the mean ΔE₀₀ results, all composite groups showed significantly higher ΔE₀₀ values immersed in coffee solutions compared to distilled water. In coffee solutions, the highest ΔE₀₀ was observed in the polished GP (1.90 ±0.40), and the lowest ΔE₀₀ was observed in the polished SR (0.97 ±0.36). The sealed groups showed higher ΔE₀₀ than the polished groups, except for GP.

CONCLUSIONS

The surface roughness value of sealant applied groups were significantly higher than those of their polished groups. The surface sealant application significantly increased the staining of all composite groups compared to conventional polishing, except for GP. This article is protected by copyright. All rights reserved.

Physico-mechanical properties and bacterial adhesion of resin composite CAD/CAM blocks: An in-vitro study

Background

The recent introduction of CAD/CAM technology has been strongly impacting the workflow in dental clinics and labs. Among the used CAD/CAM materials, resin composite CAD/CAM blocks offer several advantages. The aim of this study was to evaluate the physico-mechanical properties and bacterial adhesion of a recently introduced nanoceramic hybrid material (Grandio Blocs) comparing it to a nanoceramic CAD/CAM material (Lava Ultimate).

Material and Methods

A total of 82 specimens were prepared; 41 specimens from each material. For flexural strength testing, bar shaped specimens were sectioned from each material and flexural strength was evaluated using a three point bending test. For surface hardness, specimens with 2 mm thickness were prepared, polished and tested using Vickers micro-hardness tester. For wear evaluation, specimens were tested in a block on ring tribometer and the amount of weight loss was determined. A stylus profilometer was used to evaluate the surface roughness of disc shaped specimens in three directions. For the bacterial adhesion, the same specimens from the roughness test were used to evaluate the adhesion of Streptococcus mutans to the surface of each material after incubation for 24 hours. The correlation between surface roughness and bacterial adhesion was also investigated.

Results

The nano-ceramic hybrid CAD/CAM material exhibited significantly higher flexural strength and surface hardness than the nano-ceramic CAD/CAM material. It also showed significantly lower surface roughness and surface bacterial adhesion and lower wear that was not significantly different. A positive correlation was found between surface roughness and bacterial adhesion of both materials.

Conclusions

The nano-ceramic hybrid CAD/CAM material showed better physico-mechanical properties compared to the nano-ceramic CAD/CAM material which could be attributed to the use of nanohybrid filler system and an enhanced resin matrix structure. Key words:CAD/CAM blocks, nano-ceramic hybrid, flexural strength, wear, surface hardness, surface roughness, bacterial adhesion.

Ceramic Inlay Bonded Interfaces in Minimally Invasive Preparations: Damage and Contributing Mechanisms in Sliding Contact

BACKGROUND

In the preparation of inlay cavities, a choice must be made between conventional standard and minimally invasive preparation designs; in the long run, this choice can affect the integrity of the bonded interface.

PURPOSE

To evaluate the effect of minimally invasive cavity preparation designs on the extent and contributing mechanisms of damage to ceramic inlay bonded interfaces.

METHODS AND MATERIALS

Tooth blocks with 90°, 120° and 75° marginal angles were prepared, representing tooth cavities with conventional standard and minimally invasive preparations with large divergence and convergence angles and bonded to monolithic ceramic (IPS e.max CAD). Vickers indentations were placed at various distances from the bonded interface. The indentation morphology and crack length were observed. Reciprocating wear tests were performed on the bonded interface with a 20-newton (N) vertical load. The wear depth and wear-scar morphology were characterized after increments of cyclic sliding contact.

RESULTS

The 120° group exhibited longer indentation cracks in the ceramic, whereas the 75° group showed larger indentations in the enamel when compared to the 90° group (p<0.001). Consistent with the weaker edge crack resistance, the 120° group experienced the greatest wear (p=0.008), and the wear depth in the enamel of the 75° group exceeded that of the 90° group (p<0.001) in the early stage (5×102 cycles). However, no significant difference in the wear depth (p>0.147) and morphology were found at the later wear stage among the three groups.

CONCLUSION

Within the limitations of this study, minimally invasive preparations with 120° and 75° marginal angles can result in early sever damage at the ceramic inlay bonded interface but show comparable wear behaviors to the conventional 90° group at the later stage.

Clinical Longevity of Indirect Composite Resin Inlays and Onlays: An Up to 9-Year Prospective Study

Objective This clinical study evaluated the clinical performance of composite resin inlays and onlays over 9 years.

Materials and Methods Sixty composite resin inlays and onlays were placed in 32 patients, aged 20 to 60 years, by a single operator using the same clinical procedure. The restorations were examined for fracture rate; esthetics; and patient acceptance and marginal integrity, including caries, marginal discoloration, tooth integrity, and surface texture. All restorations were evaluated at the time of placement and 3, 6, and 9 years after placement by using the modified U.S. Public Health Service criteria.

Results At the 3-year follow-up, an Alpha score was given to 88.4% of restorations, while a Bravo score was given to the remaining 11.6%. There was not any failure. At the 6-year follow-up, the success rate of the restorations was 100% without failure. None of the restorations was scored with Delta (D). An Alpha score was given to 60% of the restorations, a Bravo score was assigned to 35%, and a Charlie score was 5% of the restorations. Overall, the success rate of the restorations at 9-year follow-up was 85% and the failure rate was 15%. An Alpha score was given to 15% of the restorations, a Bravo score was given to 50%, a Charlie score was assigned to 20%, and a D score was given to 15% of the restorations.

Conclusion Indirect resin composite inlays and onlays showed acceptable long-term clinical results. The success rate of the restorations at 9-year follow-up was 85% and the failure rate was 15%.

Clinical Longevity of Indirect Composite Resin Inlays and Onlays: An Up to 9-Year Prospective Study

OBJECTIVE

 This clinical study evaluated the clinical performance of composite resin inlays and onlays over 9 years.

MATERIALS AND METHODS

 Sixty composite resin inlays and onlays were placed in 32 patients, aged 20 to 60 years, by a single operator using the same clinical procedure. The restorations were examined for fracture rate; esthetics; and patient acceptance and marginal integrity, including caries, marginal discoloration, tooth integrity, and surface texture. All restorations were evaluated at the time of placement and 3, 6, and 9 years after placement by using the modified U.S. Public Health Service criteria.

RESULTS

 At the 3-year follow-up, an Alpha score was given to 88.4% of restorations, while a Bravo score was given to the remaining 11.6%. There was not any failure. At the 6-year follow-up, the success rate of the restorations was 100% without failure. None of the restorations was scored with Delta (D). An Alpha score was given to 60% of the restorations, a Bravo score was assigned to 35%, and a Charlie score was 5% of the restorations. Overall, the success rate of the restorations at 9-year follow-up was 85% and the failure rate was 15%. An Alpha score was given to 15% of the restorations, a Bravo score was given to 50%, a Charlie score was assigned to 20%, and a D score was given to 15% of the restorations.

CONCLUSION

 Indirect resin composite inlays and onlays showed acceptable long-term clinical results. The success rate of the restorations at 9-year follow-up was 85% and the failure rate was 15%.

Unilateral Scissor Bite Managed with Prefabricated Functional Appliances in Primary Dentition—A New Interceptive Orthodontic Protocol

A unilateral scissor bite is a type of severe malocclusion in primary dentition that can influence the development of the mandible and face. The present case report describes an interceptive treatment on a 4-year-old girl with a unilateral scissor bite combined with an anterior crossbite, increased reverse overjet, and overbite on a skeletal Class III base. The patient was treated with a new Prefabricated Functional Appliance (PFA) which was modified from a Frankel-III appliance to induce a mandible to move backwards and relieve an occlusion discrepancy of the dental arch, and a functional dental rehabilitation with resin and myofunctional exercises with a PFA which was modified from an oral screen appliance were performed during the treatment. The total treatment time was 11 months and a satisfactory improvement of occlusion and facial esthetics was achieved. This case report presents a new PFA system and treatment protocol in primary dentition which results in a favorable outcome, and the clinical effectiveness of this appliance system warrants further investigation.

Characterisation of Microparticle Waste from Dental Resin-Based Composites

Clinical applications of resin-based composite (RBC) generate environmental pollution in the form of microparticulate waste. Methods: SEM, particle size and specific surface area analysis, FT-IR and potentiometric titrations were used to characterise microparticles arising from grinding commercial and control RBCs as a function of time, at time of generation and after 12 months ageing in water. The RBCs were tested in two states: (i) direct-placement materials polymerised to simulate routine clinical use and (ii) pre-polymerised CAD/CAM ingots milled using CAD/CAM technology. Results: The maximum specific surface area of the direct-placement commercial RBC was seen after 360 s of agitation and was 1290 m²/kg compared with 1017 m²/kg for the control material. The median diameter of the direct-placement commercial RBC was 6.39 μm at 360 s agitation and 9.55 μm for the control material. FTIR analysis confirmed that microparticles were sufficiently unique to be identified after 12 months ageing and consistent alteration of the outermost surfaces of particles was observed. Protonation-deprotonation behaviour and the pH of zero proton charge (pH_zpc) ≈ 5–6 indicated that the particles are negatively charged at neutral pH7. Conclusion: The large surface area of RBC microparticles allows elution of constituent monomers with potential environmental impacts. Characterisation of this waste is key to understanding potential mitigation strategies.

The physical properties and anticariogenic effect of experimental resin cement containing ursolic acid

The aim was to evaluate the physical properties and anti-bacterial activity of resin cement containing ursolic acid (UA) and determine the optimal concentration of UA. Five types of experimental resin cement were prepared according to UA concentration (0, 0.1, 0.5, 1.0, and 2.0 wt%). Flexural strength, film thickness and in vitro cytotoxicity were measured to confirm whether the resin was appropriate under International Organization for Standardization (ISO) criteria. Fifty extracted human molars were prepared, and indirect resin inlays were cemented with experimental resins. Acid-resistant nail varnish was applied, except for the 2-mm area around the restoration. Artificial caries were induced for 6 days through Streptococcus (S.) mutans (ATCC25175). Quantitative light-induced fluorescence (QLF) was used to evaluate the caries progression. One-way analysis of variance (ANOVA) followed by the Dunnett correction were used to statistically analyze the data. In all groups, the physical property of flexural strength, film thickness, and cytotoxicity were satisfied for ISO criteria (p > 0.05). On ∆F (-%) and ∆Q (-%⋅Px) values as QLF parameters, there was a tendency of being lower in groups of resin cement containing higher concentration of UA. Resin cement containing UA of greater than or equal to 0.5% significantly inhibited caries in the area around restoration (p < 0.05). There was no difference between the groups containing UA of greater than or equal to 0.5%. Resin cement containing 0.5% or more UA showed anti-carious effect in the limited range of 2% and satisfied the ISO criteria for flexural strength, film thickness and cytotoxicity.

Colour stability of sectional laminate veneers: A laboratory study

BACKGROUND

This study aimed to evaluate the colour stability of sectional laminate veneers (SLVs) fabricated with four and cemented with two different materials.

METHODS

Eighty SLVs were prepared with a thickness of 0.2-0.4 mm from IPS e.max CAD, Lava Ultimate, CEREC Blocs and IPS InLine and were cemented with Variolink Veneer and Variolink N to form eight groups (n:10). After cementation, specimens underwent 5000 thermocyles prior to immersion in a coffee solution.

RESULTS

Colour change before and after thermal cycling did not reveal significant differences (P > 0.05). After coffee immersion, significant colour change was observed in all groups (P > 0.05). Only IPS InLine cemented with Variolink Veneer was considered clinically acceptable (∆E < 3.3). According to observer scorings, marginal discolouration was higher in Lava Ultimate, while no discolouration was observed in IPS InLine. Dual or light-curing resin cements showed insignificant differences.

CONCLUSIONS

SLVs fabricated with different aesthetic materials underwent perceptible (∆E > 3.3) discolouration except for the IPS InLine cemented with light-curing resin cement. Cementation with either dual-curing or light-curing resin cements does not by itself affect colour stability. The highest marginal discolouration was in the Lava Ultimate group while no discolouration was detected in the IPS InLine group.

Influence of different thermopolymerization methods on composite resin microhardness

Background

Additional heat polymerization in composite resins allows greater effective­ness of microhardness, flexural strength, fracture tough­ness, wear resistance, and increased color stability.

Material and Methods

150 composite resin specimens were made using a 4 mm diameter and 2 mm thick bipartite steel matrix. Five resins composed of different compositions were tested (Brilliant Everglow/Coltene, Filtek One BulkFill/3M, Filtek P60/3M, Filtek Z350XT/3M, Filtek Z250XT/3M), and for each of them three types of polymerization were tested: light curing only (n=50); photopolymerization + autoclave thermopolymerization (n=50) and photopolymerization + microwave thermopolymerization (n=50). Each specimen was submitted to three indentations by means of the Vickers microhardness test, applying a load of 300gf, associated with the time of 15s. Data were analyzed descriptively by means of statistics, standard deviation and coefficient of variation and inferentially by the F test (ANOVA) in the comparison between groups. The margin of error used in statistical test decisions was 5%.

Results

The highest vicker microhardness averages were from the Control group (light curing only) on P60 (82.16) and Z250 XT (79.61) resins. The lowest averages were all verified on Brilliant Everglow resin in all polymerization methods studied: Photopolymerization (37.32), with microwave (43.80) and autoclave (45.12), followed by Bulk Fill 3M resin, ranged from 52.23 to 59.15.

Conclusions

Both autoclave and microwave thermopolymerization methods showed similar behavior on the microhardness of the composites studied. Considering the resin type, there was a varied behavior compared to thermopolymerization, which increased the microhardness values for Brilliant Everglow resins (Coltene) and Filtek One Bulkfill (3M) and decreased for Filtek P60, Filtek Z350XT and Filtek Z250XT resins.

Key words:Dentistry, composite resins, polymerization.

Influence of different surface treatments and universal adhesives on the repair of CAD-CAM composite resins: An in vitro study

STATEMENT OF PROBLEM

The repairability of computer-aided design and computer-aided manufacturing (CAD-CAM) composite resins might be adversely affected by the high degree of matrix polymerization that occurs during their manufacturing process. However, information on their repairability is lacking.

PURPOSE

The purpose of this in vitro study was to evaluate the microtensile bond strength of CAD-CAM composite resins subjected to simulated repair procedures by using varying surface treatments and universal adhesives.

MATERIAL AND METHODS

Four different CAD-CAM blocks (Brilliant Crios, Lava Ultimate, Shofu Block HC, and Vita Enamic) were thermocycled (5000 times, 5/55 °C) and divided into 4 groups according to the surface treatment: control, 9% hydrofluoric acid etching, aluminum oxide airborne-particle abrasion, and tribochemical silica airborne-particle abrasion. After surface treatments, the surface roughness was measured with a nanoindenter and further examined with scanning electron microscopy. After the application of 3 different universal adhesives (Clearfil Universal Bond, Prime&Bond Universal, and Single Bond Universal), the specimens were subjected to a simulated repair process with composite resin. Bonded specimens were cut into 1 mm² beams, and microtensile bond strength values were determined until failure at a crosshead speed of 0.5 mm/min. The bond strength data were analyzed with 3-way analysis of variance, and surface roughness data were analyzed with 2-way analysis of variance tests. Pairwise analyses were performed with the Tukey test (α=.05).

RESULTS

All surface treatments effectively improved repair microtensile bond strength values compared with the control (P<.05). Aluminum oxide airborne-particle abrasion had similar mean bond strength values compared with tribochemical silica airborne-particle abrasion (P>.05). Among the CAD-CAM blocks treated with hydrofluoric acid etching, Vita Enamic had the highest mean bond strength values. The highest mean microtensile bond strength repair values with the highest cohesive failure rates were found with the silane-containing universal adhesive (Single Bond Universal).

CONCLUSIONS

Surface treatment with aluminum oxide airborne-particle abrasion and tribochemical silica airborne-particle abrasion produced successful repair results for aged resin nanoceramics, whereas hydrofluoric acid etching can be used for aged hybrid ceramic repair. Silane-containing universal adhesive reported increased bond strength. Application of universal adhesive after surface treatment is recommended to increase repair strength.

Evaluation of Fracture Resistance and Sites of Failure of Different Dowel Core Restorations: An In-Vitro Study

Background:

Dowel Cores are often required in endodontically treated tooth to aid retention and resistance for a final prosthetic crown. Studies concerning the role of post-core systems on the fracture resistance with different dowel material remain controversial.

Aim:

This experimental study aimed to investigate the fracture resistance strength and failure mode of 3 dowel systems (glass fiber, indirect resin, and prefabricated metal with resin core).

Methods:

Twenty-one extracted human maxillary central incisors were first endodontically treated and then separated into 3 equal groups randomly;1st group consisted of glass fiber dowel, 2nd group consisted of indirect resin dowel, and 3rd group consisted of the prefabricated metal dowel. All specimens were restored with resin core and indirect resin crown. A testing force was applied with a universal testing machine (at 135 o angle) at 3 mm from the incisal edge of crown and forces were measured. Statistical tests were done using One-way ANOVA and Chi-square Test.

Results:

There was no significant difference (P-value >0.05) of the fracture resistance among glass fiber dowel, indirect resin dowel and pre-fabricated dowel with indirect resin crown. The prefabricated metal dowel had maximum fracture resistance (566 ±157.771 N) followed by Glass fiber dowel (541.047 ±199.571 N) and indirect resin dowel and post (444.550 ±139.788 N).

Conclusion:

Glass fiber dowel, indirect resin dowel and prefabricated metal dowel with resin core and indirect resin crown systems showed statistically insignificant fracture strength values and mode of failure.

Simple and Low-Cost Thermal Treatments on Direct Resin Composites for Indirect Use

Abstract The aim of this study was to evaluate the influence of three low-cost additional thermal treatments, available in the dental office, on the mechanical, chemical and optical properties of a light-cured resin composite indicated for direct restorations but used as indirect restorative. The direct resin composite TPH3 (Dentsply) was light-polymerized using a light-emitting diode curing unit and submitted to three experimental additional thermal treatments: dry heat at 170 °C for 5 min, autoclave at 121 °C for 6 min, or microwave oven at 450 W for 3 min. The resin composite without any thermal treatment was used as negative control group. An indirect resin composite (Vita CM LC, Vita Zahnfabrik) was tested as a reference. Flexural strength, elastic modulus, microhardness, degree of C=C conversion, roughness before and after simulated toothbrush abrasion, translucency parameter and color difference (ΔE00) were evaluated. Data were analyzed at α=0.05. The indirect resin composite presented lower C=C conversion and mechanical performance. The flexural strength was significantly higher in the dry oven group compared with the control. The roughness was not different among groups before or after brushing, but the thermal treatments caused an increase in C=C conversion, microhardness, and elastic modulus without affecting the translucency parameter or showing visible color alteration (ΔE00<1.8). These results suggest that the use of additional thermal methods of polymerization represents an economical and simple alternative to enhance the mechanical and chemical properties of direct resin composites when used as indirect restoratives.

Fracture Resistance of Ceramic Crowns Supported with Indirect Chair-side Composite Cores

Aims and Objectives

To evaluate the influence of indirect chair-side polymerization of resin composite cores on the fracture resistance of overlaying IPS e.max Press crowns.

Materials and Methods

Root canals of 60 extracted premolars were prepared to receive #2 fiber posts after the crowns were sectioned 2 mm above the cervical line. In Groups 1-3 (n = 10 each), posts were luted to the prepared dowel spaces using self-adhesive resin cement. Resin composite cores were then bonded and incrementally built-up using Filtek Z250 XT, Filtek P60, and Filtek P90 resin composites. In Groups 4-6 (n = 10 each), the fabricated post-core systems were subjected to post-curing heat and pressure treatment before cementation to their respective teeth using self-adhesive resin cement. Another 10 sound premolars served as control. All teeth in the test and control groups were then subjected to standardized preparation to receive IPS e.max Press crowns before testing their fracture resistance and the mode of restorations' failure. The collected results were statistically analyzed using ANOVA, Kruskal-Wallis, and Tukey's tests on the past software used at α = 0.05 to stand on the significance of the detected differences.

Results

Significant differences were detected between the fracture resistance of teeth in different groups (ANOVA, P = 2.857E-35). Crowns in Groups 4-6 provided higher fracture resistance than those in Groups 1-3 (Tukey's test, P < 0.05). Crowns in Groups 4 and 6 provided higher fracture resistance than the control, while those in Groups 2 and 3 provided lower fracture resistance than the control (Tukey's test, P < 0.05).

Conclusion

Indirect composite cores improved the fracture resistance of IPS e.max Press crowns when compared to directly fabricated post and cores. The directly and indirectly polymerized nanohybrid, methacrylate-based composite (Filtek Z250 XT) cores yielded the highest fracture resistance for the utilized all-ceramic crowns.

Semidirect posterior composite restorations with a flexible die technique: A case series

BACKGROUND AND OVERVIEW

Besides indirect use in the laboratory and direct use for restorations, composites can be used in semidirect procedures. The authors describe the semidirect composite restoration technique by using a flexible die for large lesions in posterior teeth.

CASE DESCRIPTION

The authors present illustrations of the clinical steps and the outcomes immediately after the procedures. The authors placed chairside inlay, onlay, and overlay composite restorations. The final esthetic outcome, along with function and anatomic form recovery, demonstrated that this might be a viable cost-effective alternative technique to laboratory-fabricated indirect restorations.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

Clinicians can restore large preparations in posterior teeth successfully with semidirect composite restorations in a single appointment by using the flexible die technique, resulting in satisfactory function and esthetic outcome.

Microtensile bond strength of repaired indirect resin composite

PURPOSE

The objective of this study was to investigate the effect of surface treatments on microtensile bond strengths (MTBSs) of two types of indirect resin composites bonded to a conventional direct resin composite.

MATERIALS AND METHODS

Indirect resin composite blocks of Ceramage and SR Nexco were prepared in a plastic mold having a dimension of 10 × 10 × 4 mm. These composite blocks were divided into three groups according to their surface treatments: Group1: Sandblast (SB); Group2: Sandblast and ultrasonically clean (SB+UL); Group3: Sandblast plus silane (SB+SI). After bonding with direct resin composite, indirect-direct resin composite blocks were kept in distilled water for 24 hours at 37℃ and cut into microbars with the dimension of 1 × 1 × 8 mm. Microbar specimens (n = 40 per group) were loaded using a universal testing machine. Failure modes and compositions were evaluated by SEM. The statistical analyses of MTBS were performed by two-way ANOVA and Dunnett's test at α = .05.

RESULTS

Surface treatments and brands had effects on the MTBS without an interaction between these two factors. For SR Nexco, the MTBSs of SB and SB+SI group were significantly higher than that of SB+UL. For Ceramage, the MTBSs of SB and SB+SI were significantly higher than that of SB+UL. The mean MTBS of the Ceramage specimens was significantly higher than that of SR Nexco for all surface treatments.

CONCLUSION

Sandblasting with or without silane application could improve the bond strengths of repaired indirect resin composites to a conventional direct resin composite.

Reliability, failure probability, and strength of resin-based materials for CAD/CAM restorations

Objective:

This study investigated the Weibull parameters and 5% fracture probability of direct, indirect composites, and CAD/CAM composites.

Material and Methods:

Discshaped (12 mm diameter x 1 mm thick) specimens were prepared for a direct composite [Z100 (ZO), 3M-ESPE], an indirect laboratory composite [Ceramage (CM), Shofu], and two CAD/CAM composites [Lava Ultimate (LU), 3M ESPE; Vita Enamic (VE), Vita Zahnfabrik] restorations (n=30 for each group). The specimens were polished, stored in distilled water for 24 hours at 37°C. Weibull parameters (m= modulus of Weibull, σ0= characteristic strength) and flexural strength for 5% fracture probability (σ5%) were determined using a piston-on-three-balls device at 1 MPa/s in distilled water. Statistical analysis for biaxial flexural strength analysis were performed either by both one-way ANOVA and Tukey's post hoc (α=0.05) or by Pearson's correlation test.

Results:

Ranking of m was: VE (19.5), LU (14.5), CM (11.7), and ZO (9.6). Ranking of σ0 (MPa) was: LU (218.1), ZO (210.4), CM (209.0), and VE (126.5). σ5% (MPa) was 177.9 for LU, 163.2 for CM, 154.7 for Z0, and 108.7 for VE. There was no significant difference in the m for ZO, CM, and LU. VE presented the highest m value and significantly higher than ZO. For σ0 and σ5%, ZO, CM, and LU were similar but higher than VE.

Conclusion:

The strength characteristics of CAD/ CAM composites vary according to their composition and microstructure. VE presented the lowest strength and highest Weibull modulus among the materials.

Mechanical properties and DIC analyses of CAD/CAM materials

Background

This study compared two well-known computer-aided-design/computer-aided-manufactured (CAD/CAM) blocks (Paradigm MZ100 [3M ESPE] and Vitablocs Mark II [Vita] in terms of fracture toughness (Kic), index of brittleness (BI) and stress/strain distributions.

Material and Methods

Three-point bending test was used to calculate the fracture toughness, and the relationship between the Kic and the Vickers hardness was used to calculate the index of brittleness. Additionally, digital image correlation (DIC) was used to analyze the stress/strain distribution on both materials.

Results

The values for fracture toughness obtained under three-point bending were 1.87Pa√m (±0.69) for Paradigm MZ100 and 1.18Pa√m (±0.17) for Vitablocs Mark II. For the index of brittleness, the values for Paradigm and Vitablocs were 73.13μm-1/2 (±30.72) and 550.22μm-1/2 (±82.46). One-way ANOVA was performed to find differences (α=0.05) and detected deviation between the stress/strain distributions on both materials.

Conclusions

Both CAD/CAM materials tested presented similar fracture toughness, but, different strain/stress distributions. Both materials may perform similarly when used in CAD/CAM restorations.

Key words:Ceramic, CAD/CAM, hybrid materials, composite resin, fracture toughness.

Effects of nanofillers on mechanical properties of fiber-reinforced composites polymerized with light-curing and additional postcuring

BACKGROUND

The purpose of the present study was to evaluate the effect of nanofillers on the mechanical properties of 2 sizes (diameters 0.6 and 0.9 mm) of conventional and nanofilled fiber-reinforced composites (FRCs) polymerized with conventional light-curing and additional postcuring.

METHODS

The FRCs samples were divided into 8 groups (10 specimens each). Conventional FRCs with glass fibers preimpregnated with polymethyl methacrylate (groups 1, 2, 3 and 4) and FRCs with impregnating solution containing 32% nanofilled resin (groups 5, 6, 7 and 8) were tested in 2 different sections (0.6 and 0.9 mm in diameter). Two different polymerizations were analyzed: hand light-curing for 40 seconds with an halogen light, and additional postcuring for 25 minutes in a light-curing oven. Each sample was evaluated with a 3-point bending test on a universal testing machine, after 48 hours of dry storage. All of the data were statistically analyzed.

RESULTS

After oven postcuring, nanofilled FRCs exhibited significantly higher load values than conventional FRCs. No significant differences were found when comparing conventional and nanofilled FRCs after hand light-curing. Moreover, 0.6-mm FRCs showed significantly lower load values than 0.9-mm FRCs, both for conventional and nanofilled FRCs.

CONCLUSIONS

Nanofilled FRCs showed higher load values after additional oven postcuring.

The effect of various sandblasting conditions on surface changes of dental zirconia and shear bond strength between zirconia core and indirect composite resin

PURPOSE

To measure the surface loss of dental restorative zirconia and the short-term bond strength between an indirect composite resin (ICR) and zirconia ceramic after various sandblasting processes.

MATERIALS AND METHODS

Three hundred zirconia bars were randomly divided into 25 groups according to the type of sandblasting performed with pressures of 0.1, 0.2, 0.4 and 0.6 MPa, sandblasting times of 7, 14 and 21 seconds, and alumina powder sizes of 50 and 110 µm. The control group did not receive sandblasting. The volume loss and height loss on zirconia surface after sandblasting and the shear bond strength (SBS) between the sandblasted zirconia and ICR after 24-h immersion were measured for each group using multivariate analysis of variance (ANOVA) and Least Significance Difference (LSD) test (α=.05). After sandblasting, the failure modes of the ICR/zirconia surfaces were observed using scanning electron microscopy.

RESULTS

The volume loss and height loss were increased with higher sandblasting pressure and longer sandblasting treatment, but they decreased with larger powder size. SBS was significantly increased by increasing the sandblasting time from 7 seconds to 14 seconds and from 14 seconds to 21 seconds, as well as increasing the size of alumina powder from 50 µm to 110 µm. SBS was significantly increased from 0.1 MPa to 0.2 MPa according to the size of alumina powder. However, the SBSs were not significantly different with the sandblasting pressure of 0.2, 0.4 and 0.6 MPa. The possibilities of the combination of both adhesive failure and cohesive failure within the ICR were higher with the increases in bonding strength.

CONCLUSION

Based on the findings of this study, sandblasting with alumina particles at 0.2 MPa, 21 seconds and the powder size of 110 µm is recommended for dental applications to improve the bonding between zirconia core and ICR.

Effect of elasticity on stress distribution in CAD/CAM dental crowns: Glass ceramic vs. polymer-matrix composite

OBJECTIVES

Further investigations are required to evaluate the mechanical behaviour of newly developed polymer-matrix composite (PMC) blocks for computer-aided design/computer-aided manufacturing (CAD/CAM) applications. The purpose of this study was to investigate the effect of elasticity on the stress distribution in dental crowns made of glass-ceramic and PMC materials using finite element (FE) analysis.

METHODS

Elastic constants of two materials were determined by ultrasonic pulse velocity using an acoustic thickness gauge. Three-dimensional solid models of a full-coverage dental crown on a first mandibular molar were generated based on X-ray micro-CT scanning images. A variety of load case-material property combinations were simulated and conducted using FE analysis. The first principal stress distribution in the crown and luting agent was plotted and analyzed.

RESULTS

The glass-ceramic crown had stress concentrations on the occlusal surface surrounding the area of loading and the cemented surface underneath the area of loading, while the PMC crown had only stress concentration on the occlusal surface. The PMC crown had lower maximum stress than the glass-ceramic crown in all load cases, but this difference was not substantial when the loading had a lateral component. Eccentric loading did not substantially increase the maximum stress in the prosthesis.

CONCLUSIONS

Both materials are resistant to fracture with physiological occlusal load. The PMC crown had lower maximum stress than the glass-ceramic crown, but the effect of a lateral loading component was more pronounced for a PMC crown than for a glass-ceramic crown.

CLINICAL SIGNIFICANCE

Knowledge of the stress distribution in dental crowns with low modulus of elasticity will aid clinicians in planning treatments that include such restorations.

A comparison of stresses in molar teeth restored with inlays and direct restorations, including polymerization shrinkage of composite resin and tooth loading during mastication

Polymerization shrinkage of composites is one of the main causes of leakage around dental restorations. Despite the large numbers of studies there is no consensus, what kind of teeth reconstruction--direct or indirect composite restorations are the most beneficial and the most durable.

OBJECTIVE

The aim was to compare equivalent stresses and contact adhesive stresses in molar teeth with class II MOD cavities, which were restored with inlays and direct restorations (taking into account polymerization shrinkage of composite resin) during simulated mastication.

METHOD

The study was conducted using the finite elements method with the application of contact elements. Three 3D models of first molars were created: model A was an intact tooth; model B--a tooth with a composite inlay, and model C--a tooth with a direct composite restoration. Polymerization linear shrinkage 0.7% of a direct composite restoration and resin luting cement was simulated (load 1). A computer simulation of mastication was performed (load 2). In these 2 situations, equivalent stresses according to the modified von Mises criterion (mvM) in the materials of mandibular first molar models with different restorations were calculated and compared. Contact stresses in the luting cement-tooth tissue adhesive interface around the restorations were also assessed and analyzed.

RESULTS

Equivalent stresses in a tooth with a direct composite restoration (the entire volume of which was affected by polymerization shrinkage) were many times higher than in the tooth restored with a composite inlay (where shrinkage was present only in a thin layer of the luting cement). In dentin and enamel the stress values were 8-14 times higher, and were 13 times higher in the direct restoration than in the inlay. Likewise, contact stresses in the adhesive bond around the direct restoration were 6.5-7.7 times higher compared to an extraorally cured restoration. In the masticatory simulation, shear contact stresses in the adhesive bond around the direct composite restoration reached the highest values 32.8 MPa and significantly exceeded the shear strength of the connection between the resin luting cement and the tooth structure.

SIGNIFICANCE

Equivalent stresses in the tooth structures restored with inlays and in the restoration material itself and contact stresses at the tooth-luting cement adhesive interface are many times lower compared to teeth with direct composite restorations. Teeth with indirect restorations are potentially less susceptible to damage compared to those with direct restorations. Composite inlays also ensure a better seal compared to direct restorations. Polymerization shrinkage determines stress levels in teeth with direct restorations, while its impact on adhesion in indirectly restored teeth is insignificant.

Microleakage of two self-adhesive cements in the enamel and dentin after 24 hours and two months

OBJECTIVE

Microleakage is a main cause of restorative treatment failure. In this study, we compared occlusal and cervical microleakage of two self-adhesive cements after 24 hours and two months.

MATERIALS AND METHODS

In this in-vitro experimental study, class II inlay cavities were prepared on 60 sound human third molars. Composite inlays were fabricated with Z100 composite resin. The teeth were randomly assigned to six groups. RelyX-Arc (control), RelyX-Unicem and Maxcem were used for the first three groups and specimens were stored in distilled water at 37°C for 24 hours. The same cements were used for the remaining three groups, but the specimens were stored for 2 months. The teeth were subjected to 500 thermal cycles (5°C and 55°C) and immersed in 0.5% basic fuchsin for 24 hours and then sectioned mesiodistally and dye penetration was evaluated in a class II cavity with occlusal and cervical margins using X20 magnification stereomicroscope. Data were analyzed using Kruskal Wallis and Mann-Whitney U tests.

RESULTS

After 24 hours, cements had significant differences only in cervical margin microleakage (P=0.0001) and microleakage of RelyX-Unicem and Maxcem was significantly more than that of RelyX-Arc (both P=0.0001). Cervical microleakage in RelyX-Unicem and Maxcem was greater than occlusal (P=0.0001 and P=0.001, respectively). Microleakage was not significantly different between the occlusal and cervical margins after 2 months.

CONCLUSION

Cervical microleakage was greater than occlusal in RelyX-Unicem and Maxcem after 24h. The greatest microleakage was reported for the cervical margin of RelyX-Unicem after 24 hours.

The Effect of Different Powers of Er:YAG Laser Treatment on Surface Morphology of an Indirect Composite Resin: SEM Evaluation

INTRODUCTION

Indirect composites are developed to overcome the shortcomings of direct composites but, the adhesion of resin cements to indirect composites is still difficult. The purpose of this study was to evaluate the surface morphology of indirect resin composite treated by different powers of Er:YAG laser using Scanning Electron Microscopy (SEM).

METHODS

indirect resin composite blocks (GC Gradia DA2, Japan) with 15× 10 × 10 mm dimensions were made according to manufacturer's instructions (n=7). The bonding surface of these blocks were polished, then the samples were divided to seven groups as follow: Erbium-Doped Yttrium Aluminum Garnet (Er:YAG)laser with output power of 2, 3, 4, 5, 6,7 W (frequency of 20 Hz, very short pulse) and no treatment. Then, the surfaces were evaluated by scanning electron microscope.

RESULTS

The surface treated by Er:YAG laser showed a porous surface. But the amount and pattern of these irregularities differ in each group which may produce micromechanical retention compared to control group with no treatment.

CONCLUSION

Er:YAG laser can be used as an alternative technique for surface treatment and roughening of indirect resin composites.

Marginal adaptation of ceramic and composite inlays in minimally invasive mod cavities

OBJECTIVES

This study aims to evaluate the effect of a minimally invasive mesial-occlusal-distal (mod) preparation on the marginal adaptation of ceramic and composite inlays with the aim of saving sound dental substance.

MATERIALS AND METHODS

Class II mod cavities were prepared in 50 extracted human molars and randomly allocated to five groups (n = 10). In all groups, the mesial-proximal box margins were located in the dentin, 1 mm below the cementoenamel junction (CEJ), while the distal box margins were 1 mm above the CEJ. In groups A and B, conventional standard preparations with a divergent angle of α = 6° were prepared. In groups C, D, and E, minimally invasive standard preparations with a convergent angle of α = 10° were prepared. In groups A and D, composite inlays and, in groups B and C, ceramic inlays were fabricated (chairside economical restoration of esthetic ceramics (CEREC)) and adhesively inserted. In group E, a direct composite filling using the incremental technique was placed. Replicas were taken before and after thermomechanical loading (1,200,000 cycles, 50/5 °C, max. load 49 N). Marginal integrity (tooth-luting composite, luting composite-inlay) was evaluated by scanning electron microscopy (× 200). The percentage of continuous margins in the different locations was compared between and within groups before and after cycling, using ANOVA and Scheffé post hoc test.

RESULTS

After the thermomechanical loading, no significant differences were observed between the different groups with respect to the interface of luting composite-inlay. At the interface of tooth-luting composite for preparations involving the dentin, groups A and B behaved significantly better compared to the control group E, which in turn were not different to groups C and D.

CONCLUSION

Composite and ceramic inlays inserted in minimally invasive prepared mod cavities result in margins not different from those of inlays placed in conventional mod preparations. Direct composite filling margins, however, were inferior to those attained by conventional indirect restorations.

CLINICAL RELEVANCE

Minimally invasive preparations for mod inlays with undercuts show marginal adaptation equal to that of conventional inlay preparation design.

Evaluation of gingival microleakage of class II resin composite restorations with fiber inserts: An in vitro study

Aims/Objectives:

To evaluate the effect of glass and polyethylene fiber inserts and flowable composite as a liner on the microleakage of Class II composite restorations with gingival margins on root surfaces.

Materials and Methods:

Class II slots were prepared on both the proximal sides of thirty freshly extracted mandibular molars and were divided into six groups, according to the type of fiber insert and use of flowable composite (Filtek Z350) as a liner. Filtek P-60 (3M/ESPE) posterior composite was used to restore all cavities. The specimens were thermocycled and stained with 2% Basic Fuchsin dye, and sectioned to evaluate the dye penetration under Stereomicroscope. Statistical analysis was done using Kruskalwallis test and Mann whitney U test.

Results and Conclusion:

This study showed that, fiber insert groups, with or without flowable liner, had reduced microleakage scores as compared to the control groups. However, statistically no significant difference was found between the groups with fiber inserts. Less microleakage was seen in Group IV (With flowable liner and without Fiber inserts) as compared to Group I (Without flowable liner and Fiber inserts).

Effect of fiber orientation and type of restorative material on fracture strength of the tooth

Aim:

To determine the effect of fiber and its orientation on the fracture resistance of composite restorations in root-filled premolars.

Materials and Methods:

50 sound human premolars were collected and assigned to five groups of ten specimens each. In group 1 (control), specimens were not root-filled. In the other four groups, MOD cavities were prepared and the cusps were reduced to 1.5 mm. In groups 2 and 3, the samples were filled with Z-250 and spectrum composites respectively without fiber reinforcement. Groups 4 and 5 were reinforced with Fiber-Ribbon-(Angelus) and restored with spectrum composite. Fibers were placed in the U-shaped design in group 4 while they were placed in the cross-shape in occlusal region in group 5. The fracture resistance was tested using a mechanical testing machine at crosshead speed of 1mm/min.

Results:

The fracture strength of control group was 1271.16±722.04 N while it was 952.05±330.16 N for group 2, 918.52±256.6 N for group 3, 857.13±184.58 N for group 4 and 1138.81±406.64 N for group 5. Fracture strength of group 5 was more than other groups except for group 1, there was no statistically significant differences.

Conclusions:

The reinforcement of composite with fiber does not increase fracture resistance of root-filled premolars significantly.