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.

Pre-Heating effect on the microhardness and depth of cure of Bulk-Fill composite resins / Efecto del precalentamiento de las resinas compuestas Bulk-Fill en la microdureza y la profundidad de curado

Abstract The aim of this study was to investigate the effect of preheating three bulk-fill and one conventional composite resin on the Vickers microhardness and depth of cure of these composites. In this study, three bulk-fill composites- SDR Plus (SDR), Estelite BULK FILL Flow (EST), Admira® Fusion x-tra (AFX), and one conventional composite resin G-ænial POSTERIOR (GP) were used as the control group. The samples were obtained at room temperature (24°C) and at 55°C in T2 mode after being placed in a heating device for 10 minutes. The samples were divided into eight groups (n=10) according to the type of material and heating process that was utilized (preheated and nonheated). All samples were tested with a Vickers microhardness (VHN) tester on the bottom and top surfaces. The first measurements were obtained at baseline; the second set of measurements was performed after the samples were stored in distilled water at 37°C for 24 hours. The depth of cure was calculated using a bottom/top hardness ratio of measurements. Statistical analysis was performed utilizing the SPSS V23 and Shapiro-Wilk tests. Lastly, the Duncan test was used for multiple comparisons (p<0.05). While the VHN increased after the preheating procedure in bulk-fill composites, it decreased in GP. There was no difference between the baseline and the 24-hour VHN values in SDR and GP. After 24 hours, while the VHN of EST increased, the VHN of AFX decreased. There was no difference between the hardness ratios of the AFX and EST samples (p<0.001) and hardness ratios were greater than GP and SDR. When comparing the baseline and the 24- hour values, the VHN depended on the type of materials. Sufficient curing depth was obtained in all groups with a thickness of 2mm.

Resumen El objetivo fue investigar el efecto del precalentamiento de tres resinas Bulk-fill, una resina compuesta convencional sobre la microdureza Vickers y la profundidad de curado de estas resinas. Se utilizaron tres composites Bulk-Fill-SDR Plus (SDR), Estelite BULK FILL Flow (EST), Admira® Fusion x-tra (AFX), y una resina compuesta convencional G-ænial POSTERIOR (GP) como grupo de control. Las muestras se obtuvieron a temperatura ambiente (24°C) y a 55°C en modo T2 después de haber sido colocadas en un dispositivo de calentamiento durante 10 minutos. Se dividieron en ocho grupos (n=10) según el tipo de material y el proceso de calentamiento que se utilizó (precalentado y no calentado). Se probaron con un medidor de microdureza Vickers (VHN) en las superficies inferior y superior. Las primeras mediciones se obtuvieron en la línea de base; la segunda se realizó después de que las muestras se almacenaran en agua destilada a 37°C durante 24 horas. La profundidad de curado se calculó utilizando una relación de dureza inferior/ superior de las mediciones. El análisis estadístico se realizó utilizando el SPSS V23 y las pruebas de Shapiro-Wilk. Por último, se utilizó la prueba de Duncan para las comparaciones múltiples (p<0,05). VHN aumentó tras el procedimiento de precalentamiento en las resina Bulk-Fill, disminuyó en los GP. No hubo diferencias entre los valores de VHN de referencia y de 24 horas en SDR y GP. Después de 24 horas, mientras que el VHN de EST aumentó, el VHN de AFX disminuyó. No hubo diferencias entre los ratios de dureza de las muestras de AFX y EST (p<0,001) y los ratios de dureza fueron mayores que los de GP y SDR. Al comparar los valores de referencia y los de 24 horas, el VHN dependió del tipo de materiales. Se obtuvo una profundidad de curado suficiente en todos los grupos con un grosor de 2mm.

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.

Bond Strength Evaluation of Bulk- fill Composites to Dentin Under Different Surface Treatments / Evaluación de la resistencia adhesiva de las resinas bulk-fill a la dentina con diferentes tratamientos de superficie

ABSTRACT: Purpose: The aim of this study is to compare the shear bond strength of three high-viscosity bulk-fill composite resins applied as single layers of 4mm thickness and of one microhybrid composite resin applied incrementally with a thickness of 2mm on dentin surfaces prepared with different surface preparation methods. Materials and Methods: A total of 132 caries-free human molars whose dentines had been exposed were used. Three groups, each containing 44 teeth, were formed. The acid group was etched with 32% phosphoric acid; laser group was etched with Er, Cr; YSGG laser and the control group was prepared with silicon carbid paper. Following the application of bonding agent, composite resin materials were applied on teeth using teflon moulds of 4x4mm. The samples were then subjected to shear bond strength tests. Two-way variance analysis and Tukey HSD multiple comparison test were applied on collected data. Results: There was a significant difference between surface treatment methods used regarding shear bond strength (P0.05). Conclusions: Laser etching of the dentin tissues is not as effective as acid etching. Bulk-fill composites had similar effects compared with conventional composite resins with regard to bonding strength. More in vitro studies supported with clinical data are required to investigate the performance of bulk-fill composites and laser.

RESUMEN: Propósito: El objetivo de este estudio es comparar la resistencia adhesiva al cizallamiento de tres resinas compuestas de relleno de alta viscosidad aplicadas como capas individuales de 4 mm de espesor y de una resina compuesta microhíbrida aplicada de forma incremental con un espesor de 2mm en superficies de dentina preparadas con diferentes métodos de preparación de la superficie. Materiales y métodos: Se utilizaron un total de 132 molares humanos sin caries cuyas dentinas habían sido expuestas. Se formaron tres grupos, cada uno con 44 dientes. El grupo ácido se grabó con ácido fosfórico al 32%; el grupo láser se grabó con Er, Cr; el láser YSGG y el grupo de control se preparó con papel de carburo de silicio. Después de la aplicación del agente adhesivo, se aplicaron materiales de resina compuesta en los dientes utilizando moldes de teflón de 4x4mm. A continuación, las muestras se sometieron a pruebas de resistencia adhesiva al cizallamiento. Se aplicó el análisis de varianza bidireccional y la prueba de comparación múltiple Tukey HSD a los datos recogidos. Resultados: Hubo una diferencia significativa entre los métodos de tratamiento de superficie utilizados en cuanto a la resistencia adhesiva al cizallamiento (P0,05). Conclusiones: El grabado láser de los tejidos de la dentina no es tan eficaz como el grabado al ácido. Las resinas de relleno bulk-fill tuvieron efectos similares en comparación con las resinas compuestas convencionales en lo que respecta a la rsistencia adhesiva. Se necesitan más estudios in vitro apoyados con datos clínicos para investigar el rendimiento de los composites de relleno y el láser.

Microhardness homogeneity of RBCs light-cured with a multiple-peak LED and surface characterization after wear

Abstract This in vitro study evaluated the effect of the beam homogeneity of a multiple-peak light-curing unit on the surface microhardness and the effect of toothbrushing wear on the microhardness, surface roughness, roughness profile, volume loss, and gloss retention of incremental and bulk-fill resin-based composites (RBCs). A LED light-curing unit (VALO) with four LEDs at the tip end (405, 445, 465A, and 465B nm emission peak) was used according to each manufacturer-recommended time to obtain disks (n=10) of six RBCs: Estelite Sigma Quick, Charisma Classic, Tetric EvoCeram Bulk Fill, Filtek Z250, Filtek Supreme Ultra, and Filtek Bulk Fill. Microhardness values were obtained according to each LED positioning of the light-curing unit on the top surface of the RBCs and were analyzed before and after toothbrushing regarding microhardness, surface roughness, roughness profile, volume loss, and gloss retention. Microhardness was considered homogeneous on the top surface regardless of the type of RBC or wavelength tested (p>0.05). Overall, toothbrushing did not reduce the microhardness of the RBCs but influenced the gloss values for most RBCs (p<0.001). Charisma Classic presented the greatest surface roughness and roughness profile after toothbrushing (p<0.05). Volume loss did not differ among RBCs (p>0.05). In conclusion, different wavelengths of the LED did not affect the top surface microhardness, regardless of the RBCs tested; and bulk-fill composites presented similar surface changes (microhardness, surface roughness, roughness profile, volume loss, and gloss retention) when compared to conventional composites after toothbrushing.

Resumo Este estudo in vitro avaliou a homogeneidade do feixe de um fotopolimerizador de múltiplos picos na microdureza superficial e o efeito da escovação na microdureza, rugosidade superficial, perfil de rugosidade, perda de volume e retenção do brilho de compósitos a base de resina (RBCs) incrementais ou bulk-fill. Um fotopolimerizador LED (VALO) com quatro LEDs na ponteira (405, 445, 465A e 465B nm de pico de emissão) foi usado de acordo com o tempo recomendado por cada fabricante para obtenção de discos (n=10) de seis RBCs: Estelite Sigma Quick, Charisma Classic, Tetric EvoCeram Bulk Fill, Filtek Z250, Filtek Supreme Ultra e Filtek Bulk Fill. Os valores de microdureza foram obtidos seguindo o posicionamento de cada LED na superfície superior das amostras e foram analisados antes e após a escovação quanto a microdureza, rugosidade superficial, perfil de rugosidade, perda de volume e retenção do brilho. A microdureza foi considerada homogênea no topo da superfície, independentemente do tipo de RBCs ou comprimento de onda testados (p>0.05). No geral, a escovação não reduziu a microdureza das RBCs, mas influenciou o brilho para a maioria das RBCs (p<0.001). Charisma Classic apresentou os maiores valores de rugosidade superficial e perfil de rugosidade após a escovação (p<0.05). A perda de volume não diferiu entre as RBCs (p>0.05). Em conclusão, os diferentes comprimentos de onda do LED não alteraram a microdureza do topo da superfície, independentemente das RBCs testadas; e as resinas bulk-fill apresentaram alterações superficiais similares (microdureza, rugosidade superficial, perfil de rugosidade, perda de volume e manutenção do brilho) quando comparadas às resinas convencionais após a escovação.

Cytotoxic Effects of Bulk-Fill Composites on L929 Fibroblast Cells / Efeitos citotóxicos dos compósitos bulk-fill em células de fibroblastos L929

Objective: Unlike traditional composite resins, bulk-fill composite resins could be polymerized as thicker layers. This study aims to contribute to the field by investigating the cytotoxic effects of various bulk-fill composite resins on L929 mouse fibroblast cells in vitro. Material and Methods: In our study, six bulk fill and one conventional composite resin were used. Composite resin samples (8×4 mm) were prepared in a sterile cabinet by using a glass mod and polymerizing with a led light device (DTE LUX E, Germany). Composite samples (n:3) of which surface area was calculated according to ISO 10993-12: 2012 standards (3 cm2/ml), were kept in media for 24 h and 72 h in 37 oC incubator, their extracts were filtered in 1:1 and 1:2 proportion and were added on L929 mouse fibroblast cells. Cell viability was examined by the MTT assay and cell death by the LDH test. Cell viability results were evaluated using one-way analysis of variance (ANOVA) test (p<0.05). Results: When the 1:1 extracts from 4 mm thick bulk-fill composite samples were applied on L929 mouse fibroblast cells, cell viability rates showed significant differences compared to the control group at the end of 24 h and 72 h (except for Estelite Bulk Fill Flow). Although the extracts of the tested composite samples at 1:1 and 1:2 ratio at the end of 72 hours caused a decrease in L929 mouse fibroblast cell viability, the cell viability rate of only PRG-containing bulk fill composite and conventional composite remained below the cell viability ratio (70%) specified in ISO standards. Bulk fill composites did not produce toxic effects (except Beautifil Bulk Restorative) according to the LDH test. Conclusions: Despite decreasing in general the cell viability, bulk-fill composite resins used in 4 mm thick layers provided cell viability rates over the acceptability level, except PRG-containing bulk fill composite (Beautifil Bulk Restorative), which was cytotoxic to L929 mouse fibroblasts. (AU)

Objetivo: Ao contrário das resinas compostas tradicionais, as resinas compostas bulk-fill podem ser polimerizadas como camadas mais espessas. Este estudo visa investigar in vitro os efeitos citotóxicos de várias resinas compostas bulk-fill em células de fibroblastos de camundongo L929.Material e Métodos: Em nosso estudo, seis resinas tipo bulk fill e uma resina composta convencional foram usadas. Amostras de resina composta (8 × 4 mm) foram preparadas em gabinete estéril usando um molde de vidro e polimerizado com um dispositivo de luz LED (DTE LUX E, Alemanha). Amostras compostas (n=3) cuja área de superfície foi calculada de acordo com os padrões ISO 10993-12:2012 (3cm2/ml), foram mantidas em meio e incubadas por 24 h e 72 h a 37 ºC, seus extratos foram filtrados na Proporção de 1:1 e 1:2 e foram acondicionados em cultura de células de fibroblastos de camundongo L929. A viabilidade celular foi examinada pelo ensaio MTT e a morte celular pelo teste LDH. Os resultados de viabilidade celular foram avaliados usando o teste de análise de variância (ANOVA) um fator (p <0,05). Resultados: Quando os extratos foram plaqueados na proporção 1:1 de amostras de compósito bulk-fill de 4 mm de espessura com as células de fibroblastos de camundongo L929, as taxas de viabilidade celular mostraram diferenças significativas em comparação com o grupo controle no final de 24 h e 72 h (exceto para Estelite Bulk Fluxo de enchimento). Embora os extratos das amostras compostas testadas na proporção de 1:1 e 1:2 ao final de 72 horas tenham causado uma diminuição na viabilidade das células de fibroblastos de camundongo L929, a taxa de viabilidade celular apenas do compósito de preenchimento total contendo PRG e o compósito convencional permaneceram abaixo a taxa de viabilidade celular (70%) especificada nas normas ISO. Os compósitos de preenchimento a granel não produziram efeitos tóxicos (exceto Beautifil Bulk Restorative) de acordo com o teste de LDH. Conclusão: Apesar de diminuir em geral a viabilidade celular, as resinas compostas bulk-fill usadas em camadas de 4 mm de espessura forneceram taxas de viabilidade celular acima do nível aceitável, exceto o compósito bulk fill contendo PRG (Beautifil Bulk Restorative), que foi citotóxico para fibroblastos de camundongos L929 (AU)

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.

The use of a liner under different bulk-fill resin composites: 3D GAP formation analysis by x-ray microcomputed tomography

Abstract Gap formation of composite resin restorations is a serious shortcoming in clinical practice. Polymerization shrinkage stress exceeds the tooth-restoration bond strength, and it causes bacterial infiltration within gaps between cavity walls and the restorative material. Thus, an intermediate liner application with a low elastic modulus has been advised to minimize polymerization shrinkage as well as gap formation. Objective: The purpose of this in vitro study was to assess gap formation volume in premolars restored with different bulk-fill composites, with and without a resin-modified glass-ionomer cement (RMGIC) liner, using x-ray micro-computed tomography (micro-CT). Methodology: Sixty extracted human maxillary premolars were divided into six groups according to bucco-palatal dimensions (n=10). Standardized Class II mesio-occluso-distal cavities were prepared. G-Premio Bond (GC Corp., Japan) was applied in the selective-etch mode. Teeth were restored with high-viscosity (Filtek Bulk Fill, 3M ESPE, USA)-FB, sonic-activated (SonicFill 2, Kerr, USA)-SF and low viscosity (Estelite Bulk Fill Flow, Tokuyama, Japan)-EB bulk-fill composites, with and without a liner (Ionoseal, Voco GmbH, Germany)-L. The specimens were subjected to 10,000 thermocycles (5-55°C) and 50,000 simulated chewing cycles (100 N). Gap formation based on the volume of black spaces at the tooth-restoration interface was quantified in mm3 using micro-computed tomography (SkyScan, Belgium), and analyses were performed. Data were analyzed using repeated-measures ANOVA and the Bonferroni correction test (p < 0.05). Results: The gap volume of all tested bulk-fill composites demonstrated that Group SF (1.581±0.773) had significantly higher values than Group EB (0.717±0.679). Regarding the use of a liner, a significant reduction in gap formation volume was observed only in Group SFL (0.927±0.630) compared with Group SF (1.581±0.773). Conclusion: It can be concluded that different types of bulk-fill composite resins affected gap formation volume. Low-viscosity bulk-fill composites exhibited better adaptation to cavity walls and less gap formation than did sonic-activated bulk-fill composites. The use of an RMGIC liner produced a significant reduction in gap formation volume for sonic-activated bulk-fill composites.

Evaluation of microleakage and the degree of conversion of three composite resins polymerized at different power densities / Avaliação da microinfiltração e do grau de conversão de três resinas compostas polimerizadas em diferentes densidades de potência

Objectives: This study aims to evaluate the degree of conversion (DC) and microlekage scores of three different composite resins polymerized with a LED curing device in standard and extra-power mode. Material and Methods: One bulk-fill (Tetric EvoCeram Bulk-Fill ­ TECBF) and two conventional composite materials (Clearfil Majesty Posterior ­ CMP and Tetric EvoCeram ­ TEC) were evaluated. A total of 30 specimens were prepared for six groups (N = 5). These groups were polymerized with a LED curing device as follows: TECBF-6: 3200mW/cm2 for six seconds, TECBF-20: 1000mW/cm2 for 20 seconds, CMP-6: 3200mW/cm2 for six seconds, CMP-20: 1000mW/cm2 for 20 seconds, TEC-6: 3200mW/cm2 for six seconds, TEC - 20: 1000 mW/cm2 for 20 seconds. After 24 hours of water storage, DC was measured by Raman spectroscopy. Microleakage scores of the six groups were bonded to various adhesive systems (Clearfil SE Bond or Adhese Bond Universal) were also evaluated at Class II box cavities (N = 10). Results: While the highest DC was found at the top (TECBF-20= 79.92% and TECBF-6= 79.02%) and bottom surfaces (TECBF-20 = 68.94% and TECBF-6= 71.04%) for TECBF groups, TEC groups (TEC-20top = 59.06%, TEC-6top=49.66%, TEC-20bottom = 43.72% and TEC-6bottom= 40.68%) showed the lowest DC for the both surfaces (p < 0.05). Polymerization of materials in standard or extra-power mode was similar to DC (p > 0.05). Microleakage scores were found to be similar (p > 0.05). Conclusion: According to the results of the study, different power densities of LED curing light did not affect the DC of composite resins and microleakage values of restorations at small Class II cavities (AU)

Objetivo: este estudo tem como objetivo avaliar os graus de conversão (DC) e microinfiltração de três diferentes resinas compostas polimerizáveis com um dispositivo de luz por LED nos modos padrão e no modo de alta-potência. Material e métodos: uma resina bulk-fill (Tetric EvoCeram Bulk-Fill - TECBF) e dois materiais resinosos convencionais (Clearfil Majesty Posterior - CMP e Tetric EvoCeram - TEC) foram avaliados. Um total de 30 espécimes foram preparados e divididos em seis grupos (N = 5). Esses grupos foram polimerizados com um dispositivo de luz de LED da seguinte forma: TECBF-6: 3200mW / cm2 por seis segundos, TECBF-20: 1000mW / cm2 por 20 segundos, CMP-6: 3200mW / cm2 por seis segundos, CMP20: 1000mW / cm2 por 20 segundos, TEC-6: 3200mW / cm2 por seis segundos, TEC - 20: 1000 mW / cm2 por 20 segundos. Após 24 horas de armazenamento em água, a DC foi medida por espectroscopia Raman. Os escores de microinfiltração dos seis grupos dos vários sistemas adesivos (Clearfil SE Bond ou Adhese Bond Universal) também foram avaliados nas cavidades Classe II (N = 10). Resultados: embora a maior CD tenha sido encontrada nas partes superior (TECBF-20 = 79,92% e TECBF-6 = 79,02%) e inferiores (TECBF-20 = 68,94% e TECBF-6 = 71,04%) para grupos TECBF, os grupos TEC (TEC-20top = 59,06%, TEC-6top = 49,66%, TEC-20bottom = 43,72% e TEC-6bottom = 40,68%) apresentaram as menores CD para as ambas as partes (p < 0,05). A polimerização de materiais no modo padrão ou alta-potência foi semelhante à DC (p > 0,05). Os escores de microinfiltração foram semelhantes (p > 0,05). Conclusão: de acordo com os resultados do estudo, diferentes densidades de potência da luz de LED não afetaram as CD das resinas compostas e os valores de microinfiltração das restaurações em pequenas cavidades da Classe II. (AU)

Radiopacidad de Materiales Utilizados Como Sustituto Dentinario / Radiopacity of Materials Used as Dentin Substitutes

El objetivo de este estudio fue comparar la radiopacidad de distintos materiales utilizados como sustitutos de la dentina según norma ISO 6876. Se utilizaron Biodentine-Septodont (a base de silicato de calcio), Equia Forte ­ GC Corporation (ionómero vítreo convencional), Sure Fill SDR Flow ­ Dentsply Sirona (composite bulk-fill), MTA Densell Reparative - Densell (a base de silicato de calcio). Se confeccionaron 12 probetas cilíndricas, tres por cada material, siguiendo las instrucciones de los respectivos fabricantes y se colocaron en estufa a 37°C durante su fraguado. Se tomaron radiografías oclusales digitales junto a una cuña de aluminio graduada según norma ISO 6876. En cada imagen se determinaron los valores de L de la escala CieLab (negro-blanco) con el programa Photoshop (Adobe). Los resultados se analizaron estadísticamente mediante ANOVA y prueba de Tukey (AU)

Factors influencing clinical application of bulk-fill composite resin / 华西口腔医学杂志

Bulk-fill composite resin are simple to operate, and they reduce polymerization shrinkage and microleakage compare to traditional resin-based composites. However, their clinical application could be affected by numerous factors, such as the material itself, light curing, placement techniques, storage condition, and preheating. This review aimed to summarize the definitions, classifications, indications, clinical properties, and influencing factors of the clinical application of bulk-fill resin-based composites and discuss the ways to improve their clinical effectiveness.

Comparative evaluation of the bond strength of self-adhering and bulk-fill flowable composites to MTA Plus, Dycal, Biodentine, and TheraCal: an in vitro study

OBJECTIVES: This study aimed to compare the shear bond strength (SBS) of a self-adhering flowable composite (Dyad Flow) and a bulk-fill flowable composite (Smart Dentin Replacement [SDR]) to several pulp-capping materials, including MTA Plus, Dycal, Biodentine, and TheraCal.MATERIALS AND METHODS: Eighty acrylic blocks with 2-mm-deep central holes that were 4 mm in diameter were prepared and divided into 2 groups (n = 40 each) according to the composite used (Dyad Flow or SDR). They were further divided into 4 sub-groups (n = 10 each) according to the pulp-capping agent used. SBS was tested using a universal testing machine at a crosshead speed of 1 mm/min. Data were analyzed using 2-way analysis of variance. A p value of < 0.05 was considered to indicate statistical significance.RESULTS: A statistically significant difference (p = 0.040) was found between Dyad Flow and SDR in terms of bond strength to MTA Plus, Dycal, Biodentine, and TheraCal.CONCLUSIONS: Among the 8 sub-groups, the combination of TheraCal and SDR exhibited the highest SBS.

Evaluation of Shear Bond Strength Between Orthodontic Brackets and Three Aged Bulk Fill Composites / Evaluación de la resistencia de la unión al cizallamiento entre brackets de ortodoncia y tres materiales compuestos de relleno a granel envejecidos

ABSTRACT Purpose: The purpose of this study is to evaluate the shear bond strength (SBS) of orthodontic brackets bonded to three different bulk fill composites which were previously aged. Materials and Methods: Three bulk fill composite materials were included in this study (Filtek Bulk Fill, Tetric N-Ceram bulk fill, SureFil SDR bulk fill). Each material group contained 12 samples (n=12); a total of 36 samples were bonded in the same way with maxillary premolar brackets (CB; Avex Mx, OPAL orth.). The same type brackets were bonded on each restored surface made with bulk fill composites. The SBS was examined after storing the specimens for 24 h at 37 ºC indistilled water, followed by thermal ageing (500 cycles between 5 ºC and 55 ºC). Data were analyzed statistically. The numeric data were analyzed using analysis of variance (ANOVA) with Tukey HSD post-hoc tests at α=.05. Results: There were no significant differences among the composite groups (p>0.001). However, SBS values for control group were significantly greater than shear bond strenght values for composite groups (p<0.001). Conclusion: Bond strength of orthodontic brackets on bulk fill composite surfaces was not found adequate. Therefore, this situation leads to bonding failure during orthodontic treatment. The presence of bulk fill composites on the surface to be bonded during orthodontic treatment requires an additional armamentarium.

RESUMEN Propósito: El propósito de este estudio es evaluar la resistencia al cizallamiento (SBS) de brackets de ortodonci unidos a tres compuestos de relleno masivo diferentes que fueron envejecidos previamente. Metodología: Se incluyeron tres materiales compuestos de relleno a granel en este estudio (Filtek Bulk Fill, Tetric N-Ceram bulk fill, SureFil SDR bulk fill). Cada grupo de material contenía 12 muestras (n = 12); un total de 36 muestras se unieron de la misma manera con soportes premolares maxilares (CB; Avex Mx, OPAL orth.). Los mismos soportes de tipo se unieron en cada superficie restaurada hecha con compuestos de relleno masivo. El SBS se examinó después de almacenar las muestras durante 24 horas a 37 ºC de agua no destilada, seguido de un envejecimiento térmico (500 ciclos entre 5 ºC y 55 ºC). Los datos fueron analizados estadísticamente. Los datos numéricos se analizaron mediante el análisis de varianza (ANOVA) con pruebas post hoc de Tukey HSD en α=.05. Resultados: No hubo diferencias significativas entre los grupos compuestos (p> 0,001). Sin embargo, los valores de SBS para el grupo de control fueron significativamente mayores que los valores de resistencia al cizallamiento para los grupos compuestos (p <0.001). Conclusión: La resistencia de de brackets de ortodonci en superficies compuestas de relleno en masa no se encontró adecuada. Por lo tanto, esta situación conduce a una falla de adhesión durante el tratamiento de ortodoncia. La presencia de compuestos de relleno a granel en la superficie a unir durante el tratamiento de ortodoncia requiere un arsenal adicional.

Restauração de dente posterior com resina Bulk Fill: relato de caso clínico / Posterior tooth restoration with a bulk fill composite: a case report

Objetivo: Demonstrar o uso da resina Bulk Fill como material de preenchimento em restaurações posteriores. Material e métodos: Paciente do sexo feminino, 28 anos, compareceu a clínica privada relatando incômodo nos dentes da região postero inferior esquerda. Após realização dos exames clínicos e radiográficos foi observada que havia restauração ocluso distal (OD) em resina composta com fratura da margem estendendo para face proximal e ausência de cárie no dente 35. Presença de cárie secundária sob a restauração de amálgama mesio ocluso distal (MOD) no dente 36 e restauração satisfatória em resina composta no dente 37. Como plano de tratamento foi proposta a substituição das restaurações dos dentes 35 e 36. Resultados: As restaurações dos dentes 35 e 36 foram removidas e após limpeza da cavidade, foi realizado tratamento dentinário com sistema adesivo autocondicionante e adaptação de matriz metálica. Inicialmente, o dente 35 foi restaurado com resina micro-híbrida e em seguida a restauração do dente 36 com a inserção da resina Bulk Fill com auxílio de um dispensador. A ponta do compule foi posicionada na parte mais profunda da cavidade e a resina injetada até o preenchimento de 4 mm. A restauração foi finalizada com incrementos de 2 mm da resina micro-híbrida na oclusal e polida após o período de 24 horas. Conclusões: A resina Bulk Fill pode ser utilizada como material de preenchimento em restaurações de dentes posteriores, permitindo a confecção de restaurações com maior praticidade e menor tempo clínico.

Objective: To demonstrate the use of a Bulk Fill composite as a fill material in posterior restoration. Material and Methods: Female patient, 28 years old, was presented to a private clinic with complaints of her lower left teeth region. Clinical and radiographic examination revealed: (i) an occlusal-distal composite resin restoration on tooth 35 (lower left second premolar) with fractured margin extending to the proximal face, but no signs of carie; (ii) presence of secondary caries under a mesialocclusal- distal (MOD) amalgam restoration on tooth 36 (lower left first molar), and (iii) satisfactory composite resin restoration on tooth 37 (lower left second molar). As a treatment plan it was proposed the replacement of the restoration on teeth 35 and 36. Results: The restoration on the teeth 35 and 36 were removed and after cleaning the cavity, dentin treatment with a self-etching adhesive system and metal matrix adaptation were performed. The tooth 35 was initially restored with a micro-hybrid resin and then restoration of the tooth 36 was carried out using a Bulk fill resin with the aid of a dispenser. The tip of the dispenser was placed in the deepest part of the cavity and the resin injected to a 4-mm filling. The restoration was completed by adding 2-mm increments of micro-hybrid resin on the occlusal face of the tooth, followed by polishing after 24h. Conclusion: Bulk Fill resin can be used as a fill material in posterior tooth restoration, thereby allowing restoration to be made with greater convenience and shorter clinical time.

Depth Of Cure And Mechanical Properties Of Bulk-Fill Posterior Dental Composites

The objectives of this study were to compare the microhardness, flexural strength and compressivestrength of a new bulk-fill composite (SonicFill™) to a conventional nanohybrid composite (HerculitePrecis) and an established bulk-fill composite (Tetric N Ceram). In addition, the depth of cure of thetwo bulk-fill resin composites was also investigated. The materials were prepared and tested for themechanical properties following ISO 4049:2009. Microhardness and depth of cure were measured usingVickers hardness tester. Compressive and flexural strength were tested using a universal testing machine.To determine the depth of cure, microhardness of the bulk-fill composites were measured as a functionof selected depth of materials at 0.5 mm, 2.0 mm and 4.0 mm. Data were analyzed by either one-wayANOVA or Friedman test. Analysis demonstrated that SonicFill™ gave the highest microhardness value(101.8 + 4.6 VHN) compared to the other two groups. There were no significant differences among allgroups in flexural and compressive strength. The depth of cure decreased as the thickness of both bulkfillcomposites increased. In conclusion, SonicFill™ showed favorable mechanical properties comparedto other composites tested. In both bulk-filled groups, microhardness value decreased as the thicknessof the composite increased. The polymerization of the bulk-filled composites was effective only at 2 mmor less.

Effect Of Different Beverages On The Physical Properties Of Sonicfill Dental Composite

Objective: To evaluate the effect of several beverages on the physical properties of SonicFill (Kerr Corp.,USA), a new bulk-fill dental composite, over a period of time. Methods: A total of 28 discs (10 mm x 2mm) were prepared and randomly assigned into 4 groups (n=7) according to the beverages they wouldbe immersed in. The beverages chosen were Coca-Cola?, Nescafe? coffee, Lipton tea? and distilledwater (control). Surface roughness, microhardness and colour stability were evaluated using 3D opticalsurface texture analyser, Vickers microhardness tester and spectrophotometer respectively. Readingswere recorded at the time intervals of 24 hours, 1 week and 1 moth after immersion. The data obtainedwere analysed using one-way ANOVA, repeated measures ANOVA and MANOVA. Results: There weresignificant differences in surface roughness for only two pairs of groups (distilled water and Coca-Cola,distilled water and coffee). However, there was no significant difference between the groups within thechosen time. Statistical analysis showed significant difference in microhardness between time only forCoca-Cola, with significant differences between 24 hours and 1 week; and 24 hours and 1 month. Forthe colour evaluation, there was significant difference between the groups within time. Conclusions:All the beverages chosen were able to affect the physical properties of the SonicFill. However, noparticular beverage had a higher or lower impact on the surface roughness than the other beverages.Microhardness was affected by distilled water and Coca-Cola, in ascending order. Colour was affectedmost by coffee, followed by tea and Coca-Cola.