Clinical evaluation of bioactive resin-modified glass ionomer and giomer in restoring primary molars A randomized, parallel-group, and split-mouth controlled clinical study

Aim: This study aims to evaluate and compare the clinical performance of two restorative materials – bioactive resin-modified glass ionomer (ACTIVA BioACTIVE restorative) and giomer hybrid composite (Beautifil Flow Plus) in restoring class I carious primary molars. Materials and Methods: The split-mouth randomized controlled study was conducted on 100 primary molars from 50 children (28 – males, 22 – females) from 50 children in age range of 5-9 years (Mean-7.29±1.34) with at least two occlusal carious lesions on either maxillary or mandibular primary molars. Each child had both the control and the experimental teeth restored with respective restorative materials, Group I (Control, n = 50) ? Giomer, Group II (Experimental, n = 50) ? Bioactive resin-modified glass ionomer. The restorations were evaluated by two independent investigators using modified United State Public Health Service criteria at immediate postoperative, 6 months, and 12 months. The Chi-square test was used for the statistical analysis after collecting the data. Results: At the 12-month follow-up, 33 children (66 teeth) reported with an attrition rate of 33%. The color match between the groups was not statistically significant at all intervals. The marginal discoloration, marginal integrity, anatomic form, and retention had no significant difference at 6 months. But at 12 months, there was a statistically significant difference between the groups with p value of 0.04,<0.001,<0.02 and <0.001 respectively. respectively. At 12 months, there was no postoperative sensitivity in both groups. Conclusion: Bioactive resin-modified glass ionomer with enhanced properties can be used as an effective restorative material, especially in children with excessive salivation.

Evaluation of Self-Adhering Flowable Composites on Repeated Bracket Bonding Process: An In Vitro Study

ABSTRACT@#Duration of orthodontic treatment becomes major concern. The present study compared shear bond strength (SBS) and adhesive remnant index (ARI) values of different adhesive systems with different application methods on rebonding process of retrieved orthodontic brackets. Eighty premolar teeth were equally divided into five groups. Transbond XT (TXT) which belongs to total-etch system was used in Group 1 as the control group. Nova Compo-SF (NC) and Vertise Flow (VF) (Kerr Dental, Italy) which are self-adhering flowable composites were used in Group 2 (NC+etch) and Group 3 (VF+etch) respectively with additional etching before application. Group 4 (NC) and Group 5 (VF) were used by following instructions of each brand. The brackets were debonded with a bracket removing plier and rebonded with the same procedures after sandblasting of the bracket and surface cleaning of the enamel. SBS and ARI were measured for each sample. Comparison between all groups was performed by Kruskal-Wallis test and chisquare test. The highest SBS was observed in NC+etch (median = 11.44, mean = 13.49±9.42), followed by NC (median = 10.17, mean = 11.35±6.55), TXT (median = 6.36, mean = 8.06±6.33), VF+etch (median = 5.68, mean = 6.75±4.58), and VF (median = 2.62, mean = 2.92±2.57), respectively. ARI 1 was observed in 81.3% of TXT whereas 62.5% of NC+etch. ARI 1, 2, and 3 were equally distributed in VF+etch group (31.3%). ARI 5 was observed in 37.5% of NC and 62.5% of VF. Analyses referred to statistically significant differences between five groups regarding both SBS and ARI (p < 0.001). As NC showed the highest SBS on rebonding process, it can be a promising alternative to TXT which is the gold standard.

Evaluation of fracture strength and total void amount in composite restorations on endodontically treated teeth / Resistencia a la fractura y la cantidad total de burbujas en resinas compuestas de dientes tratados endodónticamente

ABSTRACT: The aim of the study was to investigate the fracture strength of different composite resins and the quantity of voids in conventional posterior composite, high- flow flowable composite, bulk-fill flowable composite, and fiber-reinforced composite. Forty-four caries-free, freshly extracted mandibular premolars were used for this study. Teeth were prepared for cavity and root canal treatment. Subsequently, root canal treatment was applied to the teeth and cavities in order to prepare them for restorations. The specimens were then divided into four groups: group-1: Estelite Posterior; group-2: Estelite Flow Quick High Flow; group-3: Estelite Bulk-fill Flow; group-4: everX Posterior. One specimen from each experimental group was examined using micro-CT to perform measurement of voids. The fracture strength values of high-flow flowable, bulk-fill flowable, fiber-reinforced, and conventional micro- hybrid composites were found to be similar (p=0.497). EverX Posterior showed the highest fracture strength values (841.1±149.4 N), followed by Estelite Bulk-fill Flow (822.8±170.8 N). Volume of voids (%) obtained from Micro-CT analysis revealed that restorations with high-flow liner or bulk-fill flowable exhibited more voids. The fiber-reinforced composite showed the lowest percentage volume of incorporating voids and the highest fracture strength results.

RESUMEN: El objetivo del estudio fue investigar la resistencia a la fractura de diferentes resinas compuestas y la cantidad de burbujas en resinas posteriores convencionales, resinas fluidas de alto flujo, resinas fluidas tipo bulk-fill y resinas reforzados con fibras. Cuarenta y cuatro premolares mandibulares libres de caries, recién extraídos, fueron usados para este estudio. Los dientes se prepararon para el tratamiento de conductos radiculares y las cavidades para prepararlos para las restauraciones. Los especímenes se dividieron en cuatro grupos: Grupo-1: Estelite Posterior; Grupo-2: Estelite Flow Quick High Flow; Grupo-3: Estelite Bulk-fill Flow; Grupo-4: everX Posterior. Un espécimen de cada grupo experimental fue examinado usando micro-CT para realizar la medición de las burbujas. Los valores de resistencia a la fractura de los compuestos de alto flujo, flujo de relleno, reforzados con fibra y microhíbridos convencionales fueron similares (p=0,497). EverX Posterior mostró los valores más altos de resistencia a la fractura (841,1±149,4 N), seguido de Estelite Bulk-fill Flow (822,8±170,8 N). El volumen de las burbujas (%) obtenido del análisis de Micro-TC reveló que las restauraciones con revestimiento de alto flujo o con flujo de relleno a granel presentaban más huecos. El compuesto reforzado con fibra mostró el menor porcentaje de volumen de incorporación de vacíos y los resultados más altos de resistencia a la fractura.

Evaluation of internal adaptation of flowable and bulk-fill resin-based composites

@#This study aimed to evaluate and compare the internal adaptation of bulk-fill resin-based composite restorative materials with flowable composites as lining materials using self-etch adhesive system. Class I cavities (2mmx4mm) were prepared on flattened occlusal surfaces of fifty extracted human premolars and randomly assigned into five groups (n=10) according to the materials used: Beautifil Bulk-fill Restorative (BR); Beautifil Bulk-fill Flowable (BF); Beautifil Flow Flowable F10 (BF10); and Self-etch adhesive (SEA). Group A: SEA+BR; Group B: SEA+BF10+BR; Group C: SEA+BF+BR; Group D: SEA+BF10+SEA+BR and Group E: SEA+BF+SEA+BR. The samples were thermocycled for 500 cycles, then sectioned mesiodistally, polished and pre-treated prior to scanning electron microscopy (SEM) evaluation. From SEM images, measurement of adhesive and cohesive adaptation failures was recorded at multiple sites of the pulpal floor and in between materials. Data were analysed using one-way ANOVA and post-hoc Tukey tests (p<0.05). Cohesive failure in SEA was observed at the pulpal floor with the lowest percentage in Group A (5.14%), and highest in Group C and E (>16%). However, there were no significant difference among all groups. Adhesive failure was seen at the pulpal floor between SEA+BF/BF10/BR and between SEA+dentine with the highest percentage of gaps formed in Group A between SEA+dentine (6.62%) and SEA+BR (5.30%). Nonetheless, no significant differences were observed among all groups with p=0.89 and p=0.70, respectively. With the use of BF/BF10 at the pulpal floor, adhesive failure was reduced but resulted in increased of cohesive failure. However, both adaptation failures were absent between materials (BF/BF10 and BR) regardless with or without application of SEA.

Clinical evaluation of bulk-fill composite resin combined with transparent preformed crown for aesthetic restoration of deciduous incisor / 口腔疾病防治

Objective@#To explore the clinical effect of bulk-fill composite resin combined with transparent preformed crowns for aesthetic restoration of deciduous incisor of children.@*Methods@#A predesigned clinical prospective randomized controlled research method was used to select 90 patients (123 teeth). The random number table method was divided into three groups: A, B, and C. Group A was treated with a bulk-fill composite resin of SF (SonicFill) combined with a transparent preformed crown (41 teeth in 30 cases), and group B was treated with a large block of Tetric N-Ceram Bulk Fill Composite resin combined with transparent preformed crowns (39 teeth in 29 cases). Group C was treated with 3M Z350 XT universal nano resin combined with transparent preformed crowns (43 teeth in 31 cases). The visual analog scale (VAS) and the modified USPHS standard were used to evaluate the completeness, marginal steps, marginal discoloration, surface condition, secondary caries and satisfaction of the parents with prostheses after 12 months.@*Results @#Twelve months after the operation, the evaluation indexes of group A were better than those of group B and group C, and the differences were statistically significant, including edge integrity (χ2=10.847, P=0.028), edge step (χ2=7.799, P=0.020), edge discoloration (χ2=10.391, P=0.034), surface state (χ2=11.476, P=0.021), and secondary caries (χ2=10.447, P=0.034). The satisfaction of parents in group A on the overall contour (χ2=10.238, P=0.037), shape and texture (χ2=11.521, P=0.021) were better than those in group B and group C, and the differences were statistically significant. There was no significant difference in the evaluation of color satisfaction among the three groups (χ2=0.990, P=0.610).@* Conclusion@#SonicFill bulk-fill composite resin combined with transparent preformed crown is good for short-term aesthetic restoration of deciduous incisor, and parental satisfaction is high.

Effect of ultrasonic vibration on microshear bond strength of flowable composite to enamel / Efeito de microcisalhamento com vibração ultrassônica na resistência de união de compósito fluido ao esmalte

Objective: The present study aimed to assess theinfluence of vibration effect on microshear bond strength (µSBS) of flowable composite to enamel. Material and Methods: Sixty non-cariousextracted human premolar teeth were collected and randomly divided into six groups (n = 10) after being trimmed to produce a smooth flat surface: Flowable composites [Wave (SDI), Wave HV (SDI) and Grandioflow (Voco)] were used as bonding agents without or with vibration using an ultrasonic scaler (Mini Piezon, EMS, Switzerland). Composite resin, with an internal diameter of 0.7mm and height of 1mm, was cured on the substrate. The specimens' µSBS was tested by a microtensile tester (Bisco, USA) at a crosshead speed of 0.5 mm/min. The bond strength values were analyzed using one-way ANOVA and post hoc Tukey test (p < 0.05). Results:Vibrationdid not lead to any significant difference in the µSBS values of Wave, Wave HV, and Grandio Flow µSBS values (P=0.690, P=1.000 and P=0.947, respectively). No significant difference was found between flowable composites in terms of micro shear bond strength to enamel (p > 0.05). Conclusions: The application of ultrasonicvibration might not be advantageous in terms of improving the shear bond strength of flowable composites to enamel. (AU)

Objetivo: Este estudo teve como objetivo avaliar a influência de microcisalhamento com efeito de vibração na resistência de união (µSBS) de compósito fluido ao esmalte. Material e Métodos: Sessenta dentes pré-molares humanos extraídos não cariados foram coletados e divididos aleatoriamente em seis grupos (n = 10) após serem desgastados para produzir uma superfície lisa e plana: Compósitos fluidos [Wave (SDI), Wave HV (SDI) e Grandioflow (Voco)] foram usados como agentes adesivos sem e com vibração através de um aparelho ultrassônico (Mini Piezon, EMS, Switzerland). Uma resina composta, com diâmetro interno de 0,7 mm e peso de 1 mm, foi polimerizada no substrato. Os espécimes de µSBS foram submetidos a teste de microtração (Bisco, USA) em uma velocidade de 0.5 mm/min. Os valores de resistência adesiva foram analisados através de testes de ANOVA a um critério e de Tukey post hoc (p < 0.05). Resultados: A vibração não levou a nenhuma diferença significativa nos valores de µSBS entre Wave, Wave HV, e Grandio Flow (P=0.690, P=1.000 e P=0.947, respectivamente). Não foi encontrada nenhuma diferença significativa entre os compósitos fluidos quanto à resistência de união ao esmalte quando sob microcisalhamento (p >0.05). Conclusões: A aplicação de vibração ultrassônica pode não ser vantajosa para uma melhora na resistência adesiva de compósitos fluidos ao esmalte frente a cisalhamento. (AU)

One-year evaluation of a new restorative glass ionomer cement for the restoration of non-carious cervical lesions in patients with systemic diseases: a randomized, clinical trial

Abstract Objective This randomized and clinical trial aimed to evaluate the performance of a new restorative Glass Ionomer Cement (GIC) for the restoration of non-carious cervical lesions (NCCLs) of patients with systemic diseases compared with a posterior resin composite after 12 months. Methodology 134 restorations were placed at 30 patients presenting systemic diseases by a single clinician. NCCLs were allocated to two groups according to restorative system used: a conventional restorative GIC [Fuji Bulk (GC, Tokyo Japan) (FB)] and a posterior resin composite [G-ænial Posterior (GC, Tokyo Japan) (GP)] used with a universal adhesive using etch&rinse mode. All restorative procedures were conducted according to manufacturer's instructions. Restorations were scored regarding retention, marginal discoloration, marginal adaptation, secondary caries, surface texture, and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after 1 week (baseline), 6, and 12 months. Descriptive statistics were performed using chi-square tests. Cochran Q and Mc Nemar's tests were used to detect differences over time. Results After 12 months, recall rate was 93% and the rates of cumulative retention failure for FB and GP were 4.9% and 1.6% respectively. Both groups presented similar alpha rates for marginal adaptation (FB 86.2%, GP 95.5%) and marginal discoloration (FB 93.8%, GP 97%) at 6-month recall, but FB restorations showed higher bravo scores than GP restorations for marginal adaptation and marginal discoloration after 12 months (p<0.05). Regarding surface texture, 2 FB restorations (3.1%) were scored as bravo after 6 months. All restorations were scored as alpha for secondary caries and postoperative sensitivity after 12 months. Conclusion Although the posterior resin composite demonstrated clinically higher alpha scores than the conventional GIC for marginal adaptation and discoloration, both materials successfully restored NCCLs at patients with systematic disease after a year. Clinical relevance Due to its acceptable clinical results, the tested conventional restorative GIC can be used for the restoration of NCCLs of patients with systemic diseases.

Shear Bond Strength of a 3-in-1 Flowable Composite Resin to Primary Teeth / 대한소아치과학회지

The purpose of this study was to compare the shear bond strengths of 3-in-1 flowable composite to the enamel and dentin of primary teeth to previous adhesive systems. 110 primary incisors were prepared and divided into two groups: Dentin group included 5 groups: 1) Scotch bond Multi-purpose plus(DSM), 2) Single-bond 2(DSB), 3) Clearfil SE bond(DSE), 4) All bond universal(DAB), 5) Constic(DC), and Enamel group included 6 groups: 1) Scotch bond Multipurpose plus(ESM), 2) Single bond 2(ESB), 3) Clearfil SE bond(ESE), 4) All bond universal(EAB), 5) Constic(EC), 6) Constic with additional etching(ECE). A cylinder of composite was bonded to the prepared surface, and the shear bond strength was measured. In the dentin groups, group DC had significantly lower shear bond strength than group DSE. No significant difference was found between group DC, group DSM, group DSB and group DAB. In the enamel groups, there was no significant difference between group EC, group ESE, and group EAB. This material showed lowest shear bond strength among all tested materials in both enamel and dentin groups, showing insignificant difference with some adhesive systems. Therefore, 3-in-1 flowable composite can be used for primary teeth restoration but further studies are needed.

Six-month bracket failure rate with a flowable composite: A split-mouth randomized controlled trial

ABSTRACT INTRODUCTION: The use of flowable composites as an orthodontic bonding adhesive merits great attention because of their adequate bond strength, ease of clinical handling and reduced number of steps in bonding. OBJECTIVE: The aim of this Randomized Controlled Trial was to comparatively evaluate over a 6-month period the bond failure rate of a flowable composite (Heliosit Orthodontic, Ivoclar Vivadent AG, Schaan) and a conventional orthodontic bonding adhesive (Transbond XT, 3M Unitek). METHODS: 53 consecutive patients (23 males and 30 females) who fulfilled the inclusion and exclusion criteria were included in the study. A total of 891 brackets were analyzed, where 444 brackets were bonded using Heliosit Orthodontic and 447 brackets were bonded using Transbond XT. The survival rates of brackets were estimated with the Kaplan-Meier analysis. Bracket survival distributions for bonding adhesives, tooth location and dental arch were compared with the log-rank test. RESULTS: The failure rates of the Transbond XT and the Heliosit Orthodontic groups were 8.1% and 6% respectively. No significant differences in the survival rates were observed between them (p= 0.242). There was no statistically significant difference in the bond failure rates when the clinical performance of the maxillary versus the mandibular arches and the anterior versus the posterior segments were compared. CONCLUSIONS: Both systems had clinically acceptable bond failure rates and are adequate for orthodontic bonding needs.

RESUMO INTRODUÇÃO: o uso de resinas compostas fluidas como agentes de cimentação em Ortodontia tem merecido grande atenção, em função de sua adequada capacidade adesiva, facilidade de uso clínico e número reduzido de etapas de colagem. OBJETIVO: o objetivo deste estudo randomizado controlado foi avaliar o índice de falhas nos 6 meses após a colagem com uma resina composta fluida (Heliosit Orthodontic, Ivoclar Vivadent AG, Schaan), em comparação com um adesivo ortodôntico convencional (Transbond XT, 3M Unitek). MÉTODOS: 53 pacientes consecutivos (23 homens e 30 mulheres) que se enquadravam nos critérios de inclusão adotados foram incluídos no presente estudo. No total, 891 braquetes foram analisados, sendo 444 colados com o Heliosit Orthodontic e 447 colados com o Transbond XT. As taxas de sobrevivência dos braquetes foram estimadas por meio da análise de Kaplan-Meier. As distribuições das taxas de sobrevivência dos braquetes em função do adesivo usado, do dente e da arcada dentária em questão foram comparadas por meio do teste de log-rank. RESULTADOS: os índices de falhas para os grupos Transbond XT e Heliosit Orthodontic foram, respectivamente, de 8,1% e 6%. Não foram observadas diferenças significativas entre os grupos quanto às taxas de sobrevivência dos braquetes (p= 0,242). Também não foram observadas diferenças estatisticamente significativas quanto aos índices de falhas quando se comparou a performance clínica nas arcadas dentárias superior e inferior, e nos segmentos anterior e posterior da boca. CONCLUSÕES: ambos os sistemas apresentaram índices de falhas clinicamente aceitáveis, podendo ser considerados adequados para a colagem ortodôntica.

The effects of Dyad Flow in the minimal invasive treatment of deciduous molar caries / 实用口腔医学杂志

Objective:To observe the effects of Dyad Flow self-adhering flowable composite in the minimal invasive treatment of decid-uous molar caries.Methods:31 7 deciduous molars caries of 206 patients were randomly divided into 3 groups and treated by minimal invasive method,the cavities of the molars were filled with Dyad Flow self-adhering flowable composite(group A,n =1 07),traditional flowable composite and self-etching adhesive(group B,n =1 04)and glass ion(group C,n =1 06)respectively.The children were fol-lowed up for 1 and 2 years after treatment.Results:1 year after treatment the success rate(%)of group A,B and C was 95.3,96.77 and 91 .84(P >0.05);2 years after treatment 89.1 9,90.67 and 79.45(P >0.05),respectively.Conclusion:Dyad Flow self-adhe-ring flowable composite is effective in the treatment of deciduous molar caries.

The Effect of Flowable Composite Lining Thickness With Various Curing Techniques On Internal Voids In Class ii Composite Restorations - An Invitro Study.

Aim of this study was to compare class II composite restoration using flowable composites as lining with various thickness and curing techniques by evaluating internal voids. Fifty intact molars, each prepared with two box-only class II cavities, were randomly divided into five groups: Group I, P 60 filling alone; Group II, ultra thin flowable composite lining (0.5-1mm) co-cured with overlying composite; Group III, thin lining (1-1.5) co-cured with overlying composite; Group IV, ultra thin lining (0.5-1mm) precured and Group V, thin lining (1-1.5) precured. Internal voids were recorded in the gingival interface, cervical and occlusal halves of restorations. Precured techniques for flowable composite lining showed the least number of interface and cervical voids where as the co-cured technique of flowable and packable composites showed the least number of occlusal voids

Recent Advances In Composite Resins- A Review.

The introduction of resin-based dental materials around the mid of the last century was a revolution in restorative dentistry. The early formulations were characterised by numerous problems like improper handling characteristics, polymerization shrinkage, improper marginal adaptation, inappropriate proximal contact and most importantly secondary caries and inadequate wear resistance. The need to improve shrinkage properties and wear resistance is obvious for dental composites and a vast number of attempts have been made to accomplish these aims. Based on recent clinical information, it appears that major successes have been achieved in reaching the goal. This article discusses the advances in resin restorative materials.

Effects of surface sealing on the shear bond strength of the brackets / 实用口腔医学杂志

Objective: To investigate the effects of surface sealing on the shear bond strength(SBS) of the brackets. Methods: Twenty extracted premolars for orthodontics were cut into the buccofacial teeth pieces and etched by Transbond~TM Plus self-etching primers for 30 seconds firstly, then divided into two groups with 10 teeth pieces in each group randomly. ① experiment group, the buccal surface of the enamel was sealed with Filtek Flow 1400A3 flowable composite resin before bracket bonding;②control group, the bracket was bonded to the buccal surface of the enamel directly. All specimens were stored in deionized water at 37 ℃ for 48 h, thermocycled for 1 000 times at 30-second intervals between 5 ℃ and 55 ℃ water baths, and debonded with a universal testing machine. The amounts of resin remaining on the teeth pieces after debonding by using the resin remnant index (RRI), which were examined under 10×magnification stereo-microscope. Results: The SBS(MPa) between experiment group and control group was 8.08±1.38, 8.34±1.37 respectively, whereas the RRI was 2.80±1.03, 3.20±1.03 respectively. The SBS, RRI between experimental group and control group revealed no statistically significant differences. Conclusion: Surface sealing shows adequate bond strength, which is considered a clinically acceptable bond strength. The debonding of bracket is not affected by the surface sealing.

Use of flowable composite as intermediary layer in non-carious cervical lesions restored with composite resin: 48-month follow-up / Avaliação clínica de uma resina flow como uma camada intermediária em restaurações de lesões cervicais não cariosas: 48 meses

Purpose: In this case report, the clinical performance of a microhybrid resin composite placed with or without a flowable resin composite was compared, over a 48-month period. Case description: The patient of this case report presented 2 pairs of equivalent cervical abfraction lesions, under occlusion. Four restorations were placed in teeth 34, 35, 44 and 45. The restorations were divided into groups (Single Bond + Filtek-Flow + Filtek Z250 or Single Bond + Filtek Z250) and the materials were applied according to the manufactures instructions. Two previously calibrated operators placed the restorations and two other independent examiners evaluated the restorations at baseline and after 48 months, according to the USPHS criteria and modified criteria for color match. Conclusion: After 48 months of evaluation the lesions restored with Filtek-Flow as a liner under Filtek Z250 did not show better clinical performance than the restorations without Filtek-Flow. All restorations showed a trend toward dark yellowing after 48 months.

Objetivo: Este relato de caso compara o desempenho clínico após 48 meses de restaurações de lesões cervicais não cariosas com uma resina composta microhíbrida associada ou não a uma camada de resina flow como um agente intermediário. Descrição do caso: O paciente do presente caso apresentava 2 pares de lesões cervicais não cariosas ocasionadas por abfração sob oclusão. Nos elementos dentários 35 e 44 as restaurações foram feitas com Single Bond + Filtek-Flow + Filtek Z250 e nos elementos 45 e 34 com Single Bond + Filtek Z250, sendo os materiais empregados de acordo com as recomendações do fabricante. Dois operadores previamente calibrados colocaram as restaurações e dois outros examinadores avaliaram as restaurações no período imediato (baseline) e após 48 meses, de acordo os critérios USPHS modificado para o critério cor. Conclusão: Após 48 meses as lesões restauradas com a resina flow como uma camada intermediária não demonstraram melhor desempenho clínico em relação às restaurações sem a resina flow. Todos os grupos apresentaram uma tendência à descoloração após 48 meses de acompanhamento clínico.

Influence of flowable materials on microleakage of nanofilled and hybrid Class II composite restorations with LED and QTH LCUs.

Background: Class II composite restorations are more frequently being placed with margins apical to the cementoenamel junction (CEJ) and margins within the dentin are prone to microleakage. Aims: This in vitro study was used to evaluate the influence of flowable composite and flowable compomer as gingival liner on microleakage in Class II composite restorations and compare a light-emitting diode (LED) unit with a quartz tungsten halogen (QTH) unit for light-activating composite resins. Materials and Methods: Mesioocclusal and distoocclusal Class II cavity preparations were made in 72 sound extracted premolars. The buccolingual width was 2.5 mm and the gingival margins of all the cavities were placed 1.0 mm apical to the CEJ. The boxes were prepared 1.5 mm deep axially, making 144 slot cavities. Teeth were randomly divided into the following two groups (n = 72): (I) Universal Filtek Supreme XT; Universal Filtek Supreme XT + Flwable Filtek XT and Universal Filtek Supreme XT + Dyract Flow and (II) Filtek Z250; Filtek Z250 + Flwable Filtek XT and Filtek Z250 + Dyract Flow. Flowable materials were injected into the gingival floor of the cavity to a thickness of 1.0 mm. Each increment was cured for 20 s. One-half of the subgroups in each group were cured with QTH and the other half with LED light curing units (LCUs). After 1 week of incubation at 37°C, the specimens were thermocycled (5-55°C, x1500), immersed in 0.5% basic fuchsine dye for 24 h and sectioned and microleakage was evaluated at the gingival margin by two examiners using a 0-3 score scale. The data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests. Results: The groups utilizing flowable liners had significantly less microleakage (P < 0.05). No significant difference was identified between Universal Filtek Supreme XT and Filtek Z250 composites with and without flowable materials. There was no significant between utilizing flowable composite or flowable compomer and between each similar subgroup when polymerized with either the LED or the QTH LCUs. Conclusions: A layer of flowable materials at the gingival floor of Class II composite restorations may be recommended to improve the marginal seal of a restoration.

Slumping tendency and rheological property of flowable composites / 대한치과보존학회지

The aim of this study was to develop a method for measuring the slumping resistance of flowable resin composites and to evaluate the efficacy using rheological methodology. Five commercial flowable composites (Aelitefil flow:AF, Filtek flow:FF, DenFil flow:DF, Tetric flow:TF and Revolution:RV) were used. Same volume of composites in a syringe was extruded on a glass slide using a custom-made loading device. The resin composites were allowed to slump for 10 seconds at 25degrees C and light cured. The aspect ratio (height/diameter) of cone or dome shaped specimen was measured for estimating the slumping tendency of composites. The complex viscosity of each composite was measured by a dynamic oscillatory shear test as a function of angular frequency using a rheometer. To compare the slumping tendency of composites, one way-ANOVA and Turkey's post hoc test was performed for the aspect ratio at 95% confidence level. Regression analysis was performed to investigate the relationship between the complex viscosity and the aspect ratio. The results were as follows. 1. Slumping tendency based on the aspect ratio varied among the five materials (AF < FF < DF < TF < RV). 2. Flowable composites exhibited pseudoplasticity in which the complex viscosity decreased with increasing frequency (shear rate). AF was the most significant, RV the least. 3. The slumping tendency was strongly related with the complex viscosity. Slumping resistance increased with increasing the complex viscosity. The slumping tendency could be quantified by measuring the aspect ratio of slumped flowable composites. This method may be applicable to evaluate the clinical handling characteristics of flowable composites.

Is an oxygen inhibition layer essential for the interfacial bonding between resin composite layers? / 대한치과보존학회지

This study was aimed to investigate whether an oxygen inhibition layer (OIL) is essential for the interfacial bonding between resin composite layers or not. A composite (Z-250, 3M ESPE) was filled in two layers using two aluminum plate molds with a hole of 3.7 mm diameter. The surface of first layer of cured composite was prepared by one of five methods as followings, thereafter second layer of composite was filled and cured: Group 1 - OIL is allowed to remain on the surface of cured composite; Group 2 - OIL was removed by rubbing with acetone-soaked cotton; Group 3 - formation of the OIL was inhibited using a Mylar strip; Group 4 - OIL was covered with glycerin and light-cured; Group 5 (control) - composite was bulk-filled in a layer. The interfacial shear bond strength between two layers was tested and the fracture modes were observed. To investigate the propagation of polymerization reaction from active area having a photo-initiator to inactive area without the initiator, a flowable composite (Aelite Flow) or an adhesive resin (Adhesive of ScotchBond Multipurpose) was placed over an experimental composite (Exp_Com) which does not include a photoinitiator and light-cured. After sectioning the specimen, the cured thickness of the Exp_Com was measured. The bond strength of group 2, 3 and 4 did not show statistically significant difference with group 1. Groups 3 and 4 were not statistically significant different with control group 5. The cured thicknesses of Exp_Com under the flowable resin and adhesive resin were 20.95 (0.90) um and 42.13 (2.09), respectively.

The influence of composite resin restoration on the stress distribution of notch shaped noncarious cervical lesion; A three dimensional finite element analysis study / 대한치과보존학회지

The purpose of this study was to investigate the effects of composite resin restorations on the stress distribution of notch shaped noncarious cervical lesion using three-dimensional (3D) finite element analysis (FEA). Extracted maxillary second premolar was scanned serially with Micro-CT (SkyScan1072; SkyScan, Aartselaar, Belgium). The 3D images were processed by 3D-DOCTOR (Able Software Co., Lexington, MA, USA). ANSYS (Swanson Analysis Systems, Inc., Houston, USA) was used to mesh and analyze 3D FE model. Notch shaped cavity was filled with hybrid or flowable resin and each restoration was simulated with adhesive layer thickness (40 microM). A static load of 500 N was applied on a point load condition at buccal cusp (loading A) and palatal cusp (loading B). The principal stresses in the lesion apex (internal line angle of cavity) and middle vertical wall were analyzed using ANSYS. The results were as follows 1. Under loading A, compressive stress is created in the unrestored and restored cavity. Under loading B, tensile stress is created. And the peak stress concentration is seen at near mesial corner of the cavity under each load condition. 2. Compared to the unrestored cavity, the principal stresses at the cemeto-enamel junction (CEJ) and internal line angle of the cavity were more reduced in the restored cavity on both load conditions. 3. In teeth restored with hybrid composite, the principal stresses at the CEJ and internal line angle of the cavity were more reduced than flowable resin.

A comparative study between degree of conversion and flexural strength of composite resins / 대한치과보철학회지

Statement of problem. Although many studies have been carried out to investigate the correlation between the degree of conversion and the flexural strength of composite resins, there is minimal information in the literature attempting to compare degree of conversion, flexural strength and their correlation between restorative composite resins and flowable composite resins. Purpose. The purposes of this study were to measure the degree of conversion and flexural strength of composite resins with different rheological behavior and to correlate the two properties. Materials and methods. Four restorative (Vit-l-escence, Z-250, Tetric ceram, Esthet-X) and four flowable (Aeliteflo, Admiraflow, Permaflo, Revolution) light-curing composite resins were investigated. The degree of conversion(DC) was analyzed with Fourier transfer infra-red spectroscopy(FTIR) spectrum by a potassium bromide(KBr) pellet transmission method. The spectrum of the unpolymerized specimen had been measured before the specimen was irradiated for 60s with a visible light curing unit. The polymerized specimen was scanned for its FTIR spectrum. The flexural strength(FS) was measured with 3-point bending test according to ISO 4049 after storage in water at 37 degree C for 24 hours. The data were statistically analyzed by an independent sample t-test and one-way ANOVA at the significance level of 0.05. The dependence of flexural strength on the degree of conversion was also analyzed by regression analysis. Results. Mean DC and FS values ranged from 43% to 61% and from 84.7MPa to 156.7MPa respectively. DC values of the flowable composite resins were significantly higher than those of restorative composite resins (P < 0.05). The FS values of restorative composite resins were greater than those of flowable composite resins. No statistically significant correlation was observed between the DC and the FS tested in any of the composites. The dependence of FS on DC in restorative or flowable composite resins was not significant. Conclusion. It can be concluded that radical polymerization of the organic matrix is not a major factor in determining flexural strength of the commercially available composite resins.

Microleakage of posterior packable composite resin at the gingival margins of class II cavities / 대한치과보존학회지

The use of flowable composite resins as liners in class II packable composite restoration has been suggested by some manufacturers. However, the contributions of this technique are unproven. The purpose of this study was to compare the gingival microleakage in class II packable composite restorations with or without the use of flowable composite resins as liners. Slot cavities were prepared on both proximals of 80 extracted human molars and randomly assigned to 8 groups of 20 each. The gingival margins were located at 1mm above CEJ in 80 cavities (group1-4) and 1mm below CEJ in 80 cavities (group5-8). The prepared teeth were mounted in the customized tray with adjacent teeth to simulate clinical conditions and metallic matrix band (Sectional matrix) and wooden wedges were applied. After acid etching and application of Single Bond, each group was restored with the following materials using incremental placement technique: Group 1,5 (Filtek P60), group 2, 3, 4 and group 6, 7, 8 (AeliteFlo, TetricFlow, Revolution/Filtek P60). All specimens were thermocycled 500 times between 5degrees C and 55degrees C with 1 mimute dwell time, immersed 2% methylene blue dye for 24 hours and then rinsed with tab water. The specimens were embedded in clear resin and sectioned longitudinally through the center of restoration with a low speed diamond saw. Dye penetration at gingival margin was viewed at 20 magnification and analyzed on a scale of 0 to 4. Kruscal-Wallis One way analysis and Mann-Whitney Rank sum test were used to analyze the results. The results of this study were as follows. 1. The leakage values seen at the enamel margin were significantly lower than those seen at the dentin margin(P0.05). 3. On the dentin margin, four groups demonstrated moderate to severe leakage, and there were no significant differences in leakage values(P>0.05).