Are polywave light-emitting diodes more effective than monowave ones in the photoactivation of resin-based materials containing alternative photoinitiators? A systematic review.

OBJECTIVE: This systematic review aimed to analyze if using polywave light-emitting diodes (LED) to photoactivate resin-based materials (resin composites, adhesive systems, and resin cements) containing alternative photoinitiators provide better physicochemical properties than monowave ones. MATERIAL AND METHODS: Inclusion criteria were in vitro studies that evaluated the degree of conversion, microhardness and flexural strength in resin-based materials containing alternative photoinitiators and light-activated with mono and polywave LEDs. Exclusion criteria were studies that evaluated the physicochemical properties of composites through any material interposed between the LED and the resin composite and studies that exclusively compared different modes and/or light activation times. Selection of studies, data extraction, and risk-of-bias analysis was performed. Data from selected studies were qualitatively analyzed. A systematic search was performed in June 2021 using PubMed/Medline, Embase, Scopus, and ISI Web of Science databases and grey literature without language restriction. RESULTS: A total of 18 studies were included in the qualitative analysis. Nine studies used diphenyl (2,4,6-trimethylbenzoyl) phosphine oxide (TPO) as an alternative photoinitiator for resin composite. Polywave LED improved the degree of conversion of resin composite compared to monowave in 9 of the included studies. Polywave LED improved the microhardness of resin composite compared to monowave in 7 of the included studies. Polywave LED improved the degree of conversion for 11 studies and microhardness of resin composite compared to monowave for 7 included studies. No differences in the flexural strength medium between poly and monowave LEDs were observed. The evidence was graded as low quality due to the high risk of bias for 11 studies. CONCLUSION: The existing studies, with their limitations, revealed that the polywave light-emitting diode maximizes activation, resulting in a higher degree of double-bond conversion and microhardness of resin composites containing alternative photoinitiators. However, the flexural strength of these materials is not influenced by the type of light activation device.

Dual-cured adhesive system improves adhesive properties of dentin cavities restored with a bulk-fill resin composite

Aim: To evaluate the impact of a dual-cured adhesive system on the in situ degree of conversion (DC), bond strength (BS) and failure mode (FM) of adhesive interfaces in dentin cavities restored with a bulk-fill resin composite. Methods: 4-mm-deep dentin cavities with a 3.1 C-factor were created in 68 bovine incisors (n = 17 per group). The lightcured (Scotchbond™ Universal) or the dual-cured (Adper™ Scotchbond™ Multi-purpose Plus) adhesive system was applied to the cavities, which were then restored with a bulkfill resin composite (Filtek™ Bulk Fill). In situ DC analysis was performed by means of micro Raman spectroscopy at the top and bottom interfaces. Push-out BS was measured in a universal testing machine after 24-h or 6-month water storage. FM was determined with a stereomicroscope. Data of in situ DC and BS were analyzed by two-way analysis of variance (ANOVA) and Tukey test (p<0.05), while the FM was analyzed descriptively. Results: The groups that received the dual-cured adhesive system showed statistically higher in situ DC and BS than those that received the light-cured adhesive system. Cohesive failure mode was the most frequent in all conditions. Conclusion: In situ DC and BS were influenced by the curing strategies of the adhesive systems with better performance of the dual-cured material

Avaliação in vitro da razão base/topo de dureza e da resistência de união push-out entre uma resina composta contendo diatomita e uma resina composta bulk-fill / In vitro evaluation of the base/top hardness ratio and push-out bond strength between a diatomite-containing composite resin and a bulk-fill composite resin

A escassez de dados científicos que validem os benefícios da diatomita para as propriedades físicas da resina composta Zirconfill® torna imperioso a realização de novos estudos, principalmente no tocante a utilização dessa resina contendo diatomita em restaurações semidiretas. Objetivo: Avaliar in vitro a polimerização e resistência de união entre uma resina composta contendo diatomita e de uma resina composta bulk-fill após 24 horas e após 06 meses de envelhecimento em água. Materiais e métodos: Foram utilizados 28 incisivos bovinos para produzir cavidades dentinárias cônicas (4,8 mm de diâmetro maior x 2,8 mm de diâmetro menor x 4 mm de espessura) e fator C de magnitude 3,1. Esses preparos cavitários (n=28) foram restaurados com as resinas compostas Filtek™ One Bulk-fill (BF) (3M ESPE) ou Zirconfill ® (ZF) (BM4), através da técnica semidireta, utilizando o sistema adesivo Single Bond Universal (3M ESPE) e o cimento resino dual Relyx™ Ultimate (3M ESPE). A análise da polimerização foi realizada através da razão base/topo (B/T) de dureza Vickers. E a resistência de união RU foi realizada através do teste de extrusão push-out em máquina de ensaio universal. As amostras foram armazenadas em água destilada a 37 ºC por 24 horas ou 06 meses, mas apenas a RU avaliou as amostras após 06 meses de envelhecimento. Os dados da B/T e da RU foram submetidos à análise de variância (ANOVA) a um e a dois critérios, respectivamente, com pós-teste de Tukey (p <0.05). Resultados: Não houve diferença estatisticamente significativa entre as resinas compostas na B/T. Para a RU, a resina composta ZF mostrou valores maiores do que a resina BF em ambos os tempos avaliados. Não houve diferença estatisticamente significativa de nenhuma resina na avaliação ao longo do tempo. Conclusão: A resina composta contendo diatomita mostrou-se promissora quando utilizada em restaurações semidiretas, visto que obteve resultados similar e até superior a resina composta bulk-fill (AU).

The scarcity of data validating scientific diatomite benefits for physical properties of Zirconfill® resin composite makes essential to develop new studies, especially regarding the use of this resin composite containing diatomite in semi-direct restorations. Aim: To evaluate in vitro the cure and bond strength between a resin composite containing diatomite and a bulk-fill resin composite after 24 hours and after 06 months of water storage. Materials and methods: Twenty-eight bovine incisors (n=28) were used to produce conical dentinal cavities (4,8 mm of larger diameter x 2,8 mm of smaller diameter x 4 mm of thickness) and C-factor of magnitude 3.1. These cavities were restored with Filtek™ One Bulk-Fill (BF) (3M ESPE) or Zirconfill® (ZF) (BM4) resin composites, through the semi-direct technique, using Scotchbond™ Universal (3M ESPE) adhesive system and Relyx™ Ultimate (3M ESPE) dual resin cement. The cure analysis was performed through bottom-to-top (B/T) ratio of vickers hardness, while bond strength (RU) was performed through the push-out test in a universal testing machine. The specimens were stored in distilled water at 37 ºC for 24 hours or 06 months, but only RU analyzed the specimens after 06 months aging. B/T and RU data were, respectively, submitted to one-way and two-way analysis of variance (ANOVA) with Tukey's post-test (p <0.05). Results: There was no statistically significant difference between the composite resins in B/T. For RU, the ZF composite resin showed higher values than the BF resin at both evaluated times. However, there was no statistically significant difference in resin composites over time. Conclusion: The resin composite containing diatomite showed promise when used in semi-direct restorations since it obtained similar or even superior results to bulk-fill resin composite (AU).

Direct and semi-direct resin composite restoration in large cavity preparations: analysis of dentin bond strength stability and bottom/top microhardness ratio in a cavity model.

To evaluate the influence of the restorative approach and aging time on dentin bond strength (BS), failure mode (FM), and bottom/top microhardness ratio (B/T) in a large dentin cavity model. A total of 102 bovine incisors were used to produce models of conical dentin cavities (4.0 mm thickness × 4.8 mm top diameter × 2.8 mm bottom diameter), which were restored using semi-direct filling (SDF) (Filtek™ Z250 XT + Scotchbond™ Universal/RelyX™ Ultimate luting system), direct bulk filling (DBF) (Filtek™ One Bulk Fill), and direct incremental filling (DIF) (Filtek™ Z250 XT) techniques. B/T, BS, and FM (n = 17) were analyzed in a microhardness tester, a universal testing machine, and a stereomicroscope, respectively, after 24 h and 6 months of water storage. BS and B/T data were analyzed using two-way ANOVA/Tukey post-hoc test (p < 0.05), while FM data were analyzed descriptively. There was a statistically significant difference in BS between the restorative techniques, and BS was influenced by aging time in the DBF and SDF groups. Mixed failure was predominant for the SDF technique in both aging times. There was no statistically significant difference in B/T among the restorative approaches regardless of the aging time (p > 0.05). Although all restorative approaches provided similar B/T, the semi-direct technique showed better performance on the material bond strength to dentine in large cavities.

Effect of Spondias mombin L. extract on the wettability, roughness, color and morphology of bovine enamel

Although Spondias mombin L. extract has an excellent antimicrobial effect against oral microorganisms, it should be clarified how it affects enamel surface properties. Aim: To evaluate the color change, wettability/contact angle, surface roughness and morphology of bovine enamel submitted to the Spondias mombin L. extract. Methods: Thirty bovine teeth were distributed into the following groups: 0.12% chlorhexidine digluconate, 1:32 Spondias mombin L. extract and distilled water. Color change (CC) was evaluated after immerging specimens into the solutions for 14 days. Surface roughness (Ra) was measured using a roughness meter; wettability/contact angles (CA) were determined by the sessile drop method, and scanning electron microscopy images were obtained to characterize the morphology (SMA). The pH of the solutions was evaluated using a pHmeter. The Ra, CA, and CC data were parametric (Kolmogorov-Smirnov; p>0.05). Two-way ANOVA (for Ra and CA) and one-way ANOVA (for CC) with Tukey's posthoc tests at a significance level of 5% were used. SMA was analyzed descriptively. Results: The Spondias mombin L. extract revealed an acidic pH, and when in contact with the bovine teeth, it increased the wettability, but it did not cause statistically significant differences in the Ra. Spondias mombin L. extract caused the highest color change. The SEM images showed differences in the specimens' surface submitted to the extract compared to the other groups. Conclusion: Spondias mombin L. extract provided negative effects on bovine enamel's surface, including a high color change and a more wettable substrate

Impact of additional polishing method on physical, micromorphological, and microtopographical properties of conventional composites and bulk fill.

The objective of this study was to evaluate the surface roughness (SR), contact angle (CA), depth distribution of the charge particles (DDCP), mapping of chemical elements, 3D microtopography (3DM), and the micromorphology of the composites (MOR) of conventional and bulk fill after additional polishing. The specimens were prepared from Filtek Bulk Fill (FBF), Tetric N-Ceram Bulk Fill (TNCBF), Opus Bulk Fill (OBF), X-tra Fil (XTFL), Filtek Z250 XT (XT), Grandioso (GRA), Tetric N-Ceram (TNC), Vittra APS (VT), according to three additional techniques (n = 10): without finishing and polishing, finishing and polishing with abrasive rubbers (Astropol), finishing and polishing with Astropol plus additional polishing with silicon carbide brush. The SR and CA were measured using a profilometer and adapted goniometer, respectively; 3DM used atomic force microscopy (AFM); the micromorphology and DDCP by scanning electron microscopy (SEM) and the MOR by means of X-ray dispersive energy spectroscopy (EDS). The SR and CA were analyzed by ANOVA-two factors and Tukey test (p < .05); the others data were analyzed descriptively. The DDCP of all the resins had an organic matrix rich surface layer and a particulate rich subsurface layer of smaller dimensions. Additional polishing: reduced SR of FBF, VT, TNCBF, and XTFL resins; increased the CA value of the XTFL and decreased of XT. In the analyzes for 3DM, smoother and more uniform surfaces were observed in all a resins. The elements: carbon (predominant), oxygen, silicon, zirconia, and aluminum were present in all composite resins. Therefore, additional polishing improved the surface properties of the resins studied.

Sistemas adesivos de cura dual em cavidades dentinárias de 4 mm: efeito sobre propriedades físicas de interfaces adesivas / Dual cure adhesive systems in 4 mm dentin cavities: effect on physical properties of adhesive interfaces

A polimerização adequada do sistema adesivo influencia nas propriedades mecânicas e longevidade da restauração. Em restaurações mais profundas, os adesivos de cura dual podem ser uma alternativa viável em busca da completa polimerização. Objetivo: Avaliar a influência de diferentes estratégias adesivas no grau de conversão in situ da camada híbrida (GC), resistência de união (RU) e padrão de falha (PF) na interface adesiva de cavidades dentinárias. Métodos: Foram utilizados 153 incisivos bovinos (n = 17) para gerar cavidades com 4 mm de profundidade e fator C de magnitude 2,2, restauradas com os compósitos Filtek Z250 XT [XT], Filtek Bulk Fill [BF] e Filtek Bulk Fill Flow [FW], utilizando os adesivos Single Bond Universal [SB] e Adper™ Scotchbond™ Multi-Purpose Plus na estratégia fotoativada [MPf] ou sem fotoativação [MPd]. O GC utilizou espectroscopia micro-Raman em topo e base, a RU utilizou teste push out em Máquina de Ensaios Universal e o PF foi observado em lupa estereoscópica. Os dados do GC foram submetidos à análise de variância (ANOVA) três fatores com pós-teste de Tukey (p<0,05) e os dados da RU foram submetidos a ANOVA dois fatores com pós-teste de Tukey (p<0,05), enquanto o PF foi submetido a estatística descritiva. Resultados: Não houve diferença estatisticamente significativa entre as regiões de topo e base entre as resinas e entre os adesivos para o GC. Houve diferença estatisticamente significativa entre os adesivos (p<0,05) para o GC e a RU. Houve diferença estatisticamente significativa entre as resinas (p<0,05) para o GC e o RU. O padrão de falha registrou uma maior quantidade de falha coesiva nas amostras. Conclusão: As estratégias adesivas utilizando o adesivo Adper™ Scotchbond™ Multi-Purpose Plus com e sem fotoativação obtiveram aumento no grau de conversão e na resistência de união quando comparado ao adesivo universal Single Bond Universal. Além disso, a eficaz polimerização da base independente da resina utilizada assegura a boa polimerização dos sistemas adesivos na parede de fundo de cavidades de 4 mm indicadas para restaurações com resinas Bulk Fill (AU).

The proper polymerization of adhesive system influences the mechanical properties and longevity of restoration. In deeper restorations, dual cure adhesives may be a viable alternative in pursuit of complete polymerization. Objective: To evaluate the influence of different adhesive strategies on the degree of conversion on hybrid layer (DC), bond strength (BS) and failure pattern (FP) of adhesive interfaces of dental cavities. Methods: A total of 153 bovine incisors (n = 17) were used to create cavities with 4 mm depth and high C-factor C of magnitude 2.2,which were then restored with the composites Filtek Z250 XT [XT], Filtek Bulk Fill [FB] and Filtek Bulk Fill Flow [FF] with the adhesives Single Bond Universal [SB], Adper Scotchbond Multiuso Plus cured [MPf] or without photo-activation [MPd].The DC analysis was performed in micro Raman, the BS in a universal testing machine and the PF was done with stereoscopic magnifying glass. Data of DC were analyzed by three-way analysis of variance (ANOVA) and Tukey test (p<0.05) and data of BS by two-way ANOVA and Tukey test (p<0.05), while the FP were analyzed through descriptive statistics. Results: There was no statistically significant difference between top and bottom regions for resin and adhesive for the DC. There was a statistically significant difference between the adhesives (p<0.05) for DC and BS. There was a statistically significant difference between the resins (p<0.05) for the DC and BS. The failure pattern recorded a greater amount of cohesive failure in the samples. Conclusions: The Adper ™ Scotchbond ™ Multi-Purpose Plus Adhesive strategies with and without photoactivation increased the degree of conversion and bond strength compared to self-etch adhesive Single Bond Universal. Moreover, efficient polymerization of the base of sample assures a good polymerization of the adhesive systems on the bottom side of 4 mm cavities for restorations with Bulk Fill resins (AU).

Interaction between photoactivators and adhesive systems used as modeling liquid on the degree of conversion of a composite for bleached teeth / Interação entre fotoativadores e sistemas adesivos usados como líquido modelador no grau de conversão de um compósito para dentes clareados

Objective: This study analyzed the effect of two light emitting diodes (LEDs) on the degree of conversion (DC) of a composite resin for bleached teeth under the influence of adhesive systems used as modeling liquid. Material and Methods: A total of 60 samples of IPS Empress Direct resin (Ivoclar, Vivadent) in BL-L shade were made in a single increment and polymerized for 20 seconds. The treatments were: 1) Type of adhesive used as modeling liquid (Adper Single Bond 2; the bond component of Adper Scotchbond Multi-Purpose; or no adhesive systems used as modeling liquid were used in the control group); and 2) Type of LED (Bluephase, polywave; and Coltolux, monowave). The DC, percentage of monomers converted to polymer during polymerization, was evaluated using Fourier Transform Infrared Spectroscopy (FTIR) with 10 scans and wavenumber related to 1/λ for observation of the peaks at 1608 and 1638 cm-1. Data were statistically analyzed by two-way analysis of variance (ANOVA) with Tukey's test (p < 0.05). Results: There was no statistical difference between LEDs in comparison to the treatments (p > 0.05). However, there was a statistically significant increase in the DC for the adhesive systems tested in comparison to the control group (p < 0.05), with the highest values for Single Bond 2. Conclusion: It is concluded that the use of adhesives as modeling liquid of Empress Direct resin for bleached teeth shade increases the degree of conversion of the composite surface, and that curing with both kinds of LEDs does not interfere in this property (AU)

Objetivo: Esse estudo analisou o efeito de dois diodos emissores de luz (LEDs) no grau de conversão (GC) de uma resina composta para dentes clareados sob a influência de sistemas adesivos usados como líquido modelador. Material e Métodos: Um total de 60 amostras da resina IPS Empress Direct (Ivoclar, Vivadent) na cor BL-L foram feitas em incremento único e polimerizadas por 20 segundos. Os tratamentos foram: 1) Tipo de adesivo usado como líquido modelador (Adper Single Bond 2; o componente "bond" do Adper Scotchbond Multi-Purpose; ou nenhum dos sistemas adesivos usados como líquido modelador foram utilizados no grupo controle); e 2) Tipo de LED (Bluephase, polifásico; e Coltolux, monofásico). O GC, percentual de monômeros convertidos em polímero durante a polimerização, foi avaliado usando Espectroscopia de Infravermelho com Transformada de Fourier (FTIR) com 10 varreduras e número de ondas relacionado de 1/λ para a observação dos picos de 1608 e 1638 cm-1. Os dados foram analisados estatisticamente por análise de variância (ANOVA) a dois fatores com pós-teste de Tukey (p < 0,05). Resultados: Não houve diferença estatística entre os LEDs na comparação para os tratamentos (p > 0,05). Entretanto, houve um aumento estatisticamente significativo no GC para os sistemas adesivos testados em comparação com o grupo controle (p < 0,05), com os maiores valores para o Single Bond 2. Conclusão: Conclui-se que o uso de adesivos como líquido modelador da resina Empress Direct para dentes clareados aumenta o grau de conversão de superfície dos compósitos e que a fotoativação com ambos os tipos de LEDs não interfere nessa propriedade (AU)

Degree of conversion, translucency and intrinsic color stability of composites during surface modeling with lubricants

The tackiness presented by resins causes problems in performing the incremental technique, which can be improved by using lubricants in handling. Aim: To evaluate the influence of two adhesive systems as brush lubricants on the degree of conversion, translucency and intrinsic color stability of composite resins. Methods: Samples (n=10) were fabricated according to the composites (Filtek Z350 XT, IPS Empress Direct, and Esthet X HD), shades (bleach shade and A2), and lubricants used (Adper Single Bond 2, Adper Scotchbond Multi-Purpose bonding agent, and no lubricant). Single composite increments were inserted into a Teflon mold. The composite surface was then modeled using a brush dipped in an adhesive system. The control group was fabricated with no additional modeling. The surface degree of conversion (DC) was measured using Fourier transform infrared spectroscopy; translucency and intrinsic color stability were accessed using a spectrophotometer. Data were analyzed using three-way ANOVA and the Tukey test (p<0.05). Results: Scotchbond Multi-Purpose decreased the DC of all composites and shades in comparison with the control group (p<0.05), although it did not decrease color stability (p<0.05). The bleach shade of IPS Empress Direct and Esthet X HD showed higher translucency than the A2 shade when lubricated with the adhesive systems (p<0.05). Conclusion: Therefore, the two tested adhesive systems used as brush lubricants on composites promoted changes to the surface degree of conversion and aesthetic properties