Thermal Stability and Monomer Elution of Bulk Fill Composite Resins Cured from Different Irradiation Distances.

Objectives : This study aimed to evaluate the thermal stability and monomer elution of bulk fill composite resins cured at different irradiation distances. Materials and Methods: Forty cylindrical-shaped (3×4mm) specimens were fabricated from two composite resins (X-tra fil, X-tra base) and cured from 0 and 7mm distances. In 9 specimens, the degree of conversion was determined by the release of monomers. For this purpose, after curing of composites, they were immersed in 5 mL of 99.9% methanol and stored at 37°C for 24h. The eluted monomer was then analyzed by gas chromatography (GC). Also, thermal stability of one sample from each group was assessed by thermogravimetric analysis (TGA) at a rate of 10°C/min. Data were analyzed using two-way ANOVA and Tukey's post-hoc test (P<0.05). Results: X-tra fil had significantly higher degree of conversion than X-tra base (P=0.001). Specimens cured at 7mm distance had significantly lower degree of conversion compared with those cured at 0 mm distance (P=0.001). The interaction effect of composite type and distance of light curing unit from the surface of samples was statistically significant (P=0.001). Regarding the TGA results, the lowest and the highest percentages of weight loss were detected in X-tra fil cured at 0 mm distance and X-tra base cured at 7mm distance, respectively. Conclusion: X-tra fil composite cured at 0mm distance had the highest degree of conversion and thermal stability, and X-tra base composite cured at 7mm distance had the lowest values.

Influence of Varying Dentin and Enamel Layer Thicknesses of Nano-Composite Resins on Color Match between Lithium Disilicate Dental Ceramic and Composite Resins.

Objectives: The aim of this study was to evaluate the influence of varying dentin and enamel layer thicknesses of two nano-composite resins on color match of composite resins and lithium disilicate dental ceramic. Materials and Methods: Twenty-six specimens of two types of nano-composite resins, Opallis and Vittra, were fabricated using the two-layered technique with different thickness ratios of enamel and dentin composites (A2 shade) with a total thickness of 1.2mm. Thirteen discs of the same shade and thickness of IPS e.max Press LT (low translucency) lithium disilicate dental ceramic were also fabricated. Specimen color was measured with a spectrophotometer. The difference in color (ΔE00) of composite and ceramic specimens, and the translucency parameter (TP) of all specimens were calculated. Data were analyzed using multi-factor ANOVA (P<0.05). Results: The color difference (ΔE00) values of composites and ceramic were not clinically acceptable in any areas of either of the two composites (ΔE00>2.25). But ΔE00 between the two composite resins was in the clinically acceptable range (ΔE00<2.25). The mean TP value of IPS e.max Press was greater than that of Vittra and lower than that of Opallis. Conclusion: In similar thicknesses, composite resins with any enamel/dentin thickness ratio could not successfully simulate the color and translucency of IPS e.max Press LT ceramic.

The effect of pre-heating on monomer elution from bulk-fill resin composites.

BACKGROUND: The present study was aimed to evaluate the effect of pre-heating of bulk -fill resin composites on monomer elution from them. MATERIAL AND METHODS: Three different types of resin composites were used including Tetric N-Ceram Bulk Fill, X-tra Fill and X-tra Base. 10 cylindrical samples were prepared from each resin composites. Before light curing, 5 samples were pre-heated until reaching 68˚C, then 5 other samples were polymerized at room temperature. After 24 hours, release of UDMA, TEGDMA and BIS-GMA monomers were measured by High-Performance Liquid Chromatography analysis. Data analysis was performed by two-way ANOVA test, Games-Howell and Sidak post hoc tests. RESULTS: Pre-heating did not have any statistically significant effect on the mean values of UDMA, TEGDMA and Bis-GMA elution (p>0.05). The greatest amount of released Bis-GMA and UDMA was obtained from Tetric N-Ceram Bulk-fill composite. The greatest amount of released TEGDMA was obtained from X-tra Fill composite. X-tra Base composite showed the lowest amount of monomer release (P<0.001). CONCLUSIONS: Pre-heating did not have any effect on monomer release from bulk-fill resin composites. Moreover, the amount and the type of monomers released from various bulk-fill resin composites were not similar. Key words:Bulk fill composite resin, elution, HPLC, residual monomer, temperature.

Effect of preheating on the cytotoxicity of bulk-fill composite resins.

Background. Due to the effect of pre-heating on the degree of conversion of composite resins and the possible effect on cytotoxicity, the effect of pre-heating of bulk-fill composite resins was investigated on cytotoxicity in this study. Methods. In this study, three different types of composite resin were used, including Tetric N-Ceram Bulk-Fil, Xtrafil, and Xtrabase. From each composite resin, 10 cylindrical samples (5 mm in diameter and 4 mm in height) were prepared, with five samples preheated to 68°C, and the other five samples polymerized at room temperature (25°C). Twenty-four hours after polymerization, cytotoxicity was assessed by MTT assay on human fibroblasts. Statistical analysis of data was carried out with two-way ANOVA and Sidak Post-Hoc. The significance level of the test was determined at 0.05. Results. There was no statistically significant difference between the mean percentage of cytotoxicity in terms of pre-heating (P>0.05), but the cytotoxicity of the studied composite resins was significantly different (P<0.001). The cytotoxicity of Tetric N-Ceram Bulk-fil composite resin was higher than that of the two other composite resins. Conclusion. Pre-heating of bulk-fill composite resin did not affect their cytotoxicity. In addition, the cytotoxicity of different bulk-fill composite resins was not the same.

Factors affecting marginal integrity of class II bulk-fill composite resin restorations.

Background. Bulk-fill composite resins are a new type of resin-based composite resins, claimed to have the capacity to be placed in thick layers, up to 4 mm. This study was carried out to evaluate factors affecting gap formation in Cl II cavities restored using the bulk-fill technique. Methods. A total of 60 third molars were used in this study. Two Cl II cavities were prepared in each tooth, one on the mesial aspect 1 mm coronal to the CEJ and one on the distal aspect 1 mm apical to the CEJ. The teeth were divided into 4 groups: A: The cavities were restored using the bulk-fill technique with Filtek P90 composite resin and its adhesive system and light-cured with quartz tungsten halogen (QTH) light-curing unit. B: The cavities were restored similar to that in group A but light-cured with an LED light-curing unit. C: The cavities were restored using the bulk-fill technique with X-tra Fil composite resin and Clearfil SE Bond adhesive system and light-cured with a QTH curing unit. D: The cavities were restored similar to that in group C but light-cured with an LED light-curing unit. The gaps were examined under a stereomicroscope at ×60. Data were analyzed with General Linear Model test. In cases of statistical significance (P<0.05), post hoc Bonferroni test was used for further analyses. Results. The light-curing unit type had no effect on gap formation. However, the results were significant in relation to the composite resin type and margin location (P<0.001). The cumulative effects of light-curing unit*gingival margin and light-curing unit*composite resin type were not significant; however, the cumulative effect of composite rein type*gingival margin was significant (P=0.04) Conclusion. X-tra Fil composite exhibited smaller gaps compared with Filtek P90 composite with both light-curing units. Both composite resins exhibited smaller gaps at enamel margins.

The effect of repeated preheating of dimethacrylate and silorane-based composite resins on marginal gap of class V restorations.

Background. One of the problems with composite resin restorations is gap formation at resin‒tooth interface. The present study evaluated the effect of preheating cycles of silorane- and dimethacrylate-based composite resins on gap formation at the gingival margins of Class V restorations. Methods. In this in vitro study, standard Class V cavities were prepared on the buccal surfaces of 48 bovine incisors. For restorative procedure, the samples were randomly divided into 2 groups based on the type of composite resin (group 1: di-methacrylate composite [Filtek Z250]; group 2: silorane composite [Filtek P90]) and each group was randomly divided into 2 subgroups based on the composite temperature (A: room temperature; B: after 40 preheating cycles up to 55°C). Marginal gaps were measured using a stereomicroscope at ×40 and analyzed with two-way ANOVA. Inter- and intra-group comparisons were analyzed with post-hoc Tukey tests. Significance level was defined at P < 0.05. Results. The maximum and minimum gaps were detected in groups 1-A and 2-B, respectively. The effects of composite resin type, preheating and interactive effect of these variables on gap formation were significant (P<0.001). Post-hoc Tukey tests showed greater gap in dimethacrylate compared to silorane composite resins (P< 0.001). In each group, gap values were greater in composite resins at room temperature compared to composite resins after 40 preheating cycles (P<0.001). Conclusion. Gap formation at the gingival margins of Class V cavities decreased due to preheating of both composite re-sins. Preheating of silorane-based composites can result in the best marginal adaptation.

Effect of pre-heating on the mechanical properties of silorane-based and methacrylate-based composites.

BACKGROUND: The use of composites in dental restoration has been commonly criticized, due to their underwhelming mechanical properties. This problem may be solved partially by preheating. The present research aims to determine the effect of preheating on the mechanical properties of two different classes of composites. MATERIAL AND METHODS: A Silorane-based (Silorane) and a Methacrylate-based (Z250) composite were preheated to different temperatures (25, 37, and 68 °C) and afterwards were tested with the appropriate devices for each testing protocol. The material's flexural strength, elastic modulus, and Vickers microhardness were evaluated. Two-way ANOVA, and Tukey's post hoc were used to analyze the data. RESULTS: Microhardness and elastic modulus increased with preheating, while flexural strength values did not increase significantly with preheating. Furthermore the methacrylate-based composite (Z250) showed higher values compared to the Silorane-based composite (Silorane) in all the tested properties. CONCLUSIONS: Preheating Silorane enhances the composite's microhardness and elastic modulus but does not affect its flexural strength. On the other hand, preheating Z250 increases its microhardness but does not change its flexural strength or elastic modulus. In addition, the Z250 composite shows higher microhardness and flexural strength than Silorane, but the elastic modulus values with preheating are similar. Therefore Z250 seems to have better mechanical properties making it the better choice in a clinical situation. Key words:Composite, elastic modulus, flexural strength, microhardness, preheating.

Antibacterial Effect of All-in-one Self-etch Adhesives on Enterococcus faecalis.

Background and aims. The aim of this study was to evaluate the antibacterial activity of one-step self-etch adhesives on Enterococcus faecalis on days 1, 7 and 14 with the use of modified direct contact test. Materials and methods. The modified directcontact test was used to evaluate the antibacterial effect of Adper Easy One, Bond Force, Clearfil S3 Bond, Futurabond M, G-Bond, iBond and OptiBond All-in-one adhesives on Enterococcus faecalis after aging the samples in phosphate-buffered saline for one, seven and fourteen days. Data were analyzed using one-way ANOVA and post hoc Tukey tests. Aging effect of each adhesive was evaluated by paired-sample test. In this study, P<0.05 was considered significant. Results. All the tested adhesives exhibited antibacterial activity after one day and had significant differences with the positive control group (P<0.05). After one week, OptiBond All-in-one, iBond and Futurabond M exhibited significant differences in bacterial growth from other groups (P<0.05). There were no significant differences between the groups in two weeks (P>0.05). Conclusion. iBond exhibited the highest antibacterial effect on E. faecalis after one week. Futurabond and OptiBond All-in-one exhibited antibacterial effects against E. faecalis for one week.

Comparison of shear bond strength of resin-modified glass ionomer and composite resin to three pulp capping agents.

Background and aims. Present study was designed to compare the bonding strength of resin-modified glass ionomer (RMGI) and composite resin to mineral trioxide aggregate (MTA), MTA mixed with Na2HPO4 (NAMTA), and calcium-enriched mixture (CEM). Materials and methods. Thirty specimens of each CEM, NAMTA, and MTA were prepared. Composite and RMGI restorations were then placed on the samples (15 samples in six subgroups). Shear bond strength was assessed using universal testing machine. Data were analyzed with two-way ANOVA and post-hoc Tukey test. To compare the bond strength in subgroups, one-away ANOVA was applied. Significance level was set at P < 0.05. Results. Bond strength was significantly higher to composite samples compared to RMGI samples (p<0.001). The difference in bond strength of composite samples between MTA and CEM subgroups (P=0.026) as well as MTA and NAMTA subgroups (P= 0.019) was significant, but the difference between NAMTA and CEM subgroups (P=0.56) was not significant. The differences in bond strength in subgroups of RMGI group were not significant (P>0.05). Conclusion. Regarding shear bond strength to the tested substrates, composite was shown to be superior to RMGI. The bond of resin composite to MTA was weaker than that to CEM and NAMTA.

Comparison of the Effect of Nd:YAG and Diode Lasers and Photodynamic Therapy on Microleakage of Class V Composite Resin Restorations.

BACKGROUND AND AIMS: Considering the importance of disinfecting dentin after cavity preparation and the possible effect of disinfection methods on induction of various reactions between the tooth structure and the adhesive restorative material, the aim of the present study was to evaluate microleakage of composite resin restorations after disinfecting the prepared dentin surface with Nd:YAG and Diode lasers and photodynamic therapy. MATERIALS AND METHODS: Standard Class V cavities were prepared on buccal surfaces of 96 sound bovine teeth. The samples were randomly divided into 4 groups based on the disinfection method: Group 1: Nd:YAG laser; Group 2: Diode laser; Group 3: photodynamic therapy; and Group 4: the control. Self-etch bonding agent (Clearfil SE Bond) was applied and all the cavities were restored with composite resin (Z100). After thermocycling and immersing in 0.5% basic fuchsin, the samples were prepared for microleakage evaluation under a stereomicroscope. Data was analyzed with Kruskal-Wallis and Wilcoxon signed-rank tests at P<0.05. RESULTS: There were no significant differences in the microleakage of occlusal and gingival margins between the study groups (P>0.05). There were no significant differences in microleakage between the occlusal and gingival margins in the Nd:YAG laser group (P>0.05). In the other groups, microleakage at gingival margins was significantly higher than that at the occlusal margins (P<0.05). CONCLUSION: Nd:YAG and Diode lasers and photodynamic therapy can be used to disinfect cavity preparations before composite resin restorations.

Fracture Resistance of Endodontically-treated Maxillary Premolars Restored with Composite Resin along with Glass Fiber Insertion in Different Positions.

BACKGROUND AND AIMS: The aim was to evaluate the effect of three methods of fiber insertion on fracture resistance of root-filled maxillary premolars in vitro. MATERIALS AND METHODS: Sixty extracted human maxillary premolars received endodontic treatment followed by preparation of mesioocclusodistal (MOD) cavities, with gingival cavosurface margin 1.5 mm coronal to the cementoenamel junction (CEJ). Subsequently, the samples were randomly divided into four groups: no-fiber group; occlusal fiber group (fiber was placed in the occlusal third); circumferential fiber group (fiber was placed circumferentially in the cervical third); and dual-fiber group (occlusal and circumferential fibers). Subsequent to restoring with composite resin and thermocycling, a compressive force was applied until fracture. Data was analyzed using one-way ANOVA and Tukey test at significance levels of P < 0.05 and P < 0.02, respectively. RESULTS: Fiber placement significantly increased fracture resistance. Fracture resistance in the dual-fiber group was significantly higher than that in the circumferential fiber group (P < 0.007); however, there were no significant differences between the dual-fiber and occlusal fiber groups (P = 0.706). The highest favorable fracture rate was observed in the circumferential fiber group (60%). CONCLUSION: Composite resin restoration along with glass fiber in the occlusal and gingival thirds can be an acceptable treatment option for restoring root-filled upper premolars.