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Abdel-Maksoud HB, Eid BM, Hamdy M, Abdelaal HM. Optimizing fracture resistance of endodontically treated maxillary premolars restored with preheated thermos-viscous composite post-thermocycling, a comparative study. Part I. BMC Oral Health 2024; 24:295. [PMID: 38431585 PMCID: PMC10909284 DOI: 10.1186/s12903-024-03959-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/30/2024] [Indexed: 03/05/2024] Open
Abstract
PURPOSE This research aimed to investigate fracture resistance of endodontically treated maxillary premolars restored using preheated thermo-viscous and fiber-reinforced bulk fill resin composite, in vitro. METHODOLOGY Sixty sound human maxillary premolars were selected and divided randomly into 6 groups of ten teeth each (n = 10). Group 1; is the positive control with sound unprepared teeth (P), Group 2; is the negative control in which Mesio-occluso-distal (MOD) cavities were left unrestored (N), Group 3; includes the teeth restored by incremental packing with conventional nanohybrid composite (ChP), Group 4; includes teeth restored with short fiber reinforced bulk fill composite (EF), Group 5; includes teeth restored with preheated thermo-viscous bulk fill composite (VB), and Group 6; includes teeth restored using packable bulk fill composite (XF) Tested restorative materials were bonded with a universal adhesive in self-etch mode. Teeth were kept in distilled water for 24 h at 37 °C proceeded by thermocycling (5- 55 °C, 1200×). Teeth were then exposed to compressive load till fracture at a crosshead speed of 1 mm/min. One-way ANOVA followed by Tukey post-hoc test was implemented to compare between more than two groups in non-related samples. The significance level was established at α = 0.05 for both tests. RESULTS Intact teeth significantly recorded the highest fracture resistance values among all groups. A significant difference was recorded among all the tested groups, with the EF recording the highest values, followed by the VB group then the XF group and ChP that recorded the lowest data. Negative control premolars significantly recorded the lowest fracture. CONCLUSIONS After thermocycling, endodontically treated maxillary premolars restored with pre-heated thermos-viscous composite did not exhibit an increase in fracture resistance. Notably, our findings indicate that short fiber-reinforced composite demonstrated significantly higher fracture resistance compared to other types of composites assessed in this study. This suggests the potential superiority of short fiber-reinforced composite in enhancing the overall structural integrity of endodontically treated teeth subjected to occlusal forces.
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Affiliation(s)
- Heba B Abdel-Maksoud
- Restorative Dentistry Department, Faculty of Dentistry, Suez Canal University, Ismailia, 41611, Egypt.
- Restorative Dentistry Department, King Abdulaziz University, P.O. Box 80209, Jeddah, 21589, Saudi Arabia.
| | - Bassem M Eid
- Restorative Dental Sciences Department, College of Dentistry, Gulf Medical University, Ajman, UAE
| | - Mai Hamdy
- Endodontic Department, Faculty of Dentistry, King Salman International University, El Tur, Egypt
- Endodontic Department, Faculty of Dentistry, Suez Canal University, Ismailia, 41611, Egypt
| | - Heba M Abdelaal
- Restorative Dental Sciences Department, College of Dentistry, Gulf Medical University, Ajman, UAE.
- Restorative Dentistry Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
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Mesallum EE, Abd El Aziz PM, Swelem AA. Performance of bulk-fill versus conventional nanocomposite resin restorations supporting the occlusal rests of removable partial dentures: An in vitro investigation. J Prosthet Dent 2023:S0022-3913(23)00190-7. [PMID: 37100650 DOI: 10.1016/j.prosdent.2023.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 04/28/2023]
Abstract
STATEMENT OF PROBLEM Placing removable partial denture (RPD) rests on composite resin restorations has long been a debatable issue. Despite developments in composite resins such as nanotechnology and bulk-filling techniques, studies investigating the performance of composite resin restorations when used to support occlusal rests remain scarce. PURPOSE The purpose of this in vitro study was to investigate the performance of bulk-fill versus incremental (conventional) nanocomposite resin restorations when they are used to support RPD rests under functional loading. MATERIAL AND METHODS Thirty-five caries-free intact maxillary molars of similar coronal size were collected and divided into 5 equal groups (n=7): Enamel (Control) group: rest seats prepared entirely in enamel; Class I Incremental group: Class I cavities restored with incrementally placed nanohybrid resin composite resin (Tetric N-Ceram); Class II Incremental group: Mesio-occlusal (MO) Class II cavities restored with Tetric N-Ceram; Class I Bulk-fill group: Class I cavities restored with high-viscosity bulk-fill hybrid resin composite (Tetric N-Ceram Bulk-Fill); and Class II Bulk-fill group: MO Class II cavities restored with Tetric N-Ceram Bulk-Fill. Occlusal rest seats were prepared mesially in all groups, and clasp assemblies were fabricated and cast in cobalt-chromium alloy. Specimens with their clasp assemblies were subjected to thermomechanical cycling using a mechanical cycling machine (250 000 masticatory cycles) and 5000 thermal cycles (5 °C to 50 °C). Surface roughness (Ra) was measured with a contact profilometer before and after cycling. Fracture analysis was done using stereomicroscopy, and margin analysis was done with a scanning electron microscope (SEM) before and after cycling. Statistical analysis of Ra was conducted using ANOVA followed by the Scheffé test for between-group comparison and paired t test for within-group comparison. The Fisher exact probability test was used for fracture analysis. The Mann-Whitney test was used for between-group comparison and Wilcoxon signed rank test for within-group comparison for the SEM images (α=.05). RESULTS Mean Ra increased significantly after cycling in all groups. Significant differences in Ra were found between enamel and all 4 resin groups (P<.001), with no significant differences between incremental and bulk-fill resin groups for both Class I and II specimens (P>.05). No significant differences were found between the 2 resin groups with regard to fracture and margin analysis (P>.05). CONCLUSIONS The surface roughness of enamel was significantly lower than that of both incremental and bulk-fill nanocomposite resins before and after functional loading. Incremental and bulk-fill nanocomposite resins showed comparable performance in terms of surface roughness, fracture behavior, and marginal adaptation.
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Affiliation(s)
- Enas E Mesallum
- Assistant Professor, Oral and Maxillofacial Prosthodontic Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Possy M Abd El Aziz
- Lecturer, Conservative Dentistry, Faculty of Dentistry, Conservative Dentistry Department, Cairo University, Cairo, Egypt
| | - Amal A Swelem
- Professor, Prosthodontic Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
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Yang J, Silikas N, Watts DC. Polymerization and shrinkage kinetics and fracture toughness of bulk-fill resin-composites. Dent Mater 2022; 38:1934-1941. [PMID: 38709119 DOI: 10.1016/j.dental.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 10/14/2022] [Accepted: 10/14/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine degree of conversion (DC), maximum polymerization rate (RPmax), polymerization shrinkage (PS), maximum shrinkage rate (PS Rmax) and fracture toughness (KIC) of different types of bulk-fill (BF) composites plus the effect of viscosity reduction techniques. METHODS BF specimens were created in 2 mm deep molds: SonicFill 3 (SF3), Viscalor (VC), One Bulk Fill (OBF) and Beautifil Bulk (BBR). SF3 was applied via sonic insertion using a SonicFill handpiece (Kerr Corp. USA). Viscalor was pre-heated in a Caps Warmer in T3 mode (at 68 °C) for 30 s (T3-30 s) and 3 min (T3-3 min), respectively. Specimens were irradiated at zero distance from the upper surface with an Elipar S10 LED unit (3 M ESPE, USA) of mean irradiance 1200 mW/cm2 for 40 s. Real-time polymerization kinetics and DC at 5 min and 24 h post-irradiation (DC5 min and DC24 h) were measured using ATR-FTIR (n = 3). PS was measured up to 1 h on 1 mm thick discs via the bonded-disk technique (n = 3) and PS Rmax obtained by numerical differentiation (n = 3). For fracture toughness, single-edge-notched specimens (32 × 6 ×3 mm) of each BF composite were prepared and measured by three-point bending after 7 d water storage (n = 5). Data were analysed using One-way ANOVA, independent T-tests and Tukey post-hoc tests (p < 0.05). RESULTS SF3 showed the significantly highest DC5 min, DC24 h and RPmax (p < 0.05), followed by OBF (p < 0.05). Regardless of pre-heating, VC showed comparable conversion kinetics to BBR (p > 0.05). There was no significant difference in PS of these BF composites, except OBF had the highest PS (p > 0.05). However, PS Rmax significantly varied among materials (p = 0.047) and SF3 had the highest PS Rmax. Regarding fracture toughness, BBR had the lowest KIC (p < 0.05), whereas other composites showed similar KIC (p > 0.05). Strong correlations of filler content (wt%)-PS/KIC were found. Different pre-heating times had no significant influences on DC %, RPmax, PS, PS Rmax and KIC of VC (p > 0.05). SIGNIFICANCE Different types of bulk-fill composites showed comparable shrinkage. A highly filled BF giomer composite (BBR) had the lowest fracture toughness, whereas others had similar KIC. Pre-heating had no adverse effects on Viscalor properties. Sonication and pre-heating are beneficial techniques to enhance composite flowability without either increasing shrinkage or reducing fracture toughness.
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Affiliation(s)
- Jiawei Yang
- School of Medical Sciences, University of Manchester, Manchester, UK
| | - Nick Silikas
- School of Medical Sciences, University of Manchester, Manchester, UK
| | - David C Watts
- School of Medical Sciences, University of Manchester, Manchester, UK; Photon Science Institute, University of Manchester, Manchester, UK.
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Sfeikos T, Dionysopoulos D, Kouros P, Naka O, Tolidis K. Effect of a fiber-reinforcing technique for direct composite restorations of structurally compromised teeth on marginal microleakage. J ESTHET RESTOR DENT 2022; 34:650-660. [PMID: 35233926 DOI: 10.1111/jerd.12895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate if the marginal microleakage of extensive Class I composite resin restorations can be affected by applying ultra-high-molecular-weight polyethylene (UHMWPE) fibers with the wallpapering technique combined with different restorative materials and methods. MATERIALS AND METHODS A 120 human molars were selected and one extensive Class I cavity was prepared on the occlusal surface of each tooth. The specimens were divided into 12 groups (n = 10) according to the type of restorative material (Filtek Z550, Beautifil II LS or Beautifil Bulk Restorative), the use or not of reinforcing fibers (ribbond) and the applied restorative technique (incremental or bulk). The specimens were subjected to thermocycling and then immersed into a 50 wt% silver nitrate solution following a dying protocol. Subsequently, the teeth were prepared for SEM observations to evaluate the extent of marginal microleakage. RESULTS Three-way ANOVA revealed that the type of material, the use of ribbond fibers and the type of restorative technique significantly affected marginal microleakage (p < 0.001). Application of ribbond fibers decreased marginal microleakage to all tested restorative materials, regardless of the restorative technique, in a range of 31.2-81.4%. In the groups with no-use of ribbond fibers, among the materials there were no significant differences in microleakage when the teeth were restored with the incremental technique (p > 0.05). CONCLUSIONS The use of UHMWPE fibers with wallpapering technique in Class I composite restorations may be an effective method to reduce marginal microleakage, regardless of the selected restorative technique or the material. CLINICAL RELEVANCE Clinicians may be encouraged to utilize reinforcing fiber restorative techniques for direct restorations of structurally compromised teeth as a valid alternative to indirect restorations.
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Affiliation(s)
- Thrasyvoulos Sfeikos
- Department of Operative Dentistry, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Dionysopoulos
- Department of Operative Dentistry, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Pantelis Kouros
- Department of Operative Dentistry, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Olga Naka
- Department of Prosthodontics, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kosmas Tolidis
- Department of Operative Dentistry, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Leyton BS, Rached RN, Ignácio SA, Souza EM. Fracture strength of extended class I composite restorations with different restorative techniques. Odontology 2021; 110:269-277. [PMID: 34519962 DOI: 10.1007/s10266-021-00656-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 09/06/2021] [Indexed: 11/25/2022]
Abstract
To evaluate the fracture strength of extended Class I restorations with different restorative techniques using nanofilled and nanohybrid composites. Sixty extracted human third molars were prepared with extended Class I cavities and divided into six groups: groups FS-F (Filtek bulk-fill Flow + Filtek Supreme Ultra, 3 M) and GR-F (X-tra base + GrandioSO, VOCO), restored with a flowable bulk-fill composite as a base covered by a nanofilled or nanohybrid composite; groups FB (Filtek One Bulk-Fill, 3 M) and AF (Admira Fusion X-tra, VOCO), restored with a bulk-fill resin composite; and groups FS (Filtek Supreme Ultra, 3 M) and GR (GrandioSO, VOCO), restored incrementally with a nanofilled or nanohybrid composite. Sound extracted teeth (n = 10) were used as a control group (CTL). The specimens were axially loaded until failure. Data were analyzed using one-way ANOVA and Games Howell test (α = 0.05). Groups CTL and GR-F demonstrated significantly higher mean fracture strength when compared to FS, AF, and GR (p < 0.05). Group AF obtained more repairable fractures than the other groups. Restorations made with a nanofilled bulk-fill composite or with conventional resin composites associated with a flowable bulk-fill base were able to reestablish the fracture strength to that of sound teeth.
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Affiliation(s)
- Brenda S Leyton
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, Curitiba, PR, 80215-901, Brazil
| | - Rodrigo N Rached
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, Curitiba, PR, 80215-901, Brazil
| | - Sergio A Ignácio
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, Curitiba, PR, 80215-901, Brazil
| | - Evelise M Souza
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, Curitiba, PR, 80215-901, Brazil.
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Assessing Fracture Resistance of Restored Premolars with Novel Composite Materials: An In Vitro Study. Int J Dent 2021; 2021:5512708. [PMID: 34462637 PMCID: PMC8403034 DOI: 10.1155/2021/5512708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 08/12/2021] [Indexed: 11/17/2022] Open
Abstract
During restorative treatment, premolars restored with resin filling materials using the conventional incremental-fill technique take longer restoration time and undermine the integrity of the tooth. The aim of this study was to assess fracture resistance of premolars restored by various types of novel bulk-fill composite resin materials. Forty-eight (n = 48) freshly extracted sound maxillary first premolars were used in this in vitro study. The teeth were divided into six groups, each having 8 specimens. Group A (positive control) was allocated for the intact teeth. For specimens in Groups B to F, a large cavity (Class-II MOD) was prepared with a standardized dimension of cavity (3 mm depth on the pulpal floor, 4 mm at the gingival seat, and 3 mm cavity width). Group B represented prepared teeth without any restoration. Group C, Group D, Group E, and Group F were restored with Tetric EvoCeram® incremental-fill (conventional), Beautifil bulk-fill, Filtek posterior bulk-fill, and SonicFill 2 bulk-fill restorative materials, respectively. All samples were finished and polished with an enhanced finishing kit and stored in distilled water for a month before the fracture resistance testing. All the samples were exposed to the axial loading (the speed of crosshead was 1 mm/min) in a computer-controlled universal testing machine (LARYEE, China) via a steel bar (6 mm in diameter) and the maximum applied force in Newton was recorded as the fracture resistance. One-way analysis of variance (SPSS 21) was used to compare the fracture resistance within the groups, and Tukey's post hoc test was used to determine the difference between the groups. The lowest value of fracture resistance was recorded for Group B, and the highest value was recorded for Group A followed by the values of Group D, Group C, Group F, and Group E. One-way ANOVA revealed a statistically significant difference between the groups (P < 0.05). Nonsignificant difference was found between the premolars restored by bulk-fill and conventional composites. Among the bulk-fill restored specimens, Beautifil restorative demonstrated significantly higher fracture resistance in comparison with the other two bulk-fill restored specimen groups (SonicFill 2 and Filtek). Bulk-fill composite such as Beautifil could be an alternative option to conventional incremental-fill composite for premolar restoration.
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Clinical performance and chemical-physical properties of bulk fill composites resin -a systematic review and meta-analysis. Dent Mater 2019; 35:e249-e264. [PMID: 31421957 DOI: 10.1016/j.dental.2019.07.007] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/08/2019] [Accepted: 07/15/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The objective of this study was to perform a meta-analysis of clinical and laboratory studies to compare the performance of bulk-fill and conventional composite resins in terms of polymerization shrinkage, polymerization stress, cusp deflection, marginal quality, degree of conversion, microhardness, flexural strength, fracture strength and clinical performance. DATA One hundred three articles were included in this study, and the Peto method was used to compare the bulk-fill and conventional composites using the RevMan software. SOURCES Searches were performed in the PubMed and Scopus databases. STUDY SELECTION Laboratory studies and randomized clinical trials comparing one of the previous detailed outcomes between bulk-fill and control composites were included. CONCLUSIONS The bulk-fill composite resins showed less shrinkage, polymerization stress, cusp deflection and microhardness than conventional composites, while both materials presented a similar marginal quality, flexural strength and fracture strength. Also, bulk-fill materials with regular viscosity showed similar shrinkage. The conversion of bulk-fill materials with flowable consistency were similar to conventional composite resins with a thickness of up to 2mm and greater than conventional composites with a thickness greater than 2mm. Despite these in vitro differences, the clinical performance of bulk-fill and conventional composite resins was similar in randomized clinical trials, with one to ten years of follow up. In conclusion, the bulk-fill materials show better or similar performance to the conventional materials in clinical trials and laboratory studies in terms of volumetric shrinkage, polymerization stress, cusps deflection and marginal quality, with the only exception being the lower level of microhardness observed for bulk-fill composites with thickness up to 2mm.
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