Preparation of Al-doped mesoporous silica spheres (Al-MSSs) for the improvement of mechanical properties and aging resistance of dental resin composites.

OBJECTIVE: The purpose of this study was to synthesize Al-doped mesoporous silica spheres (Al-MSSs) and evaluate the effect of them as functional fillers on the mechanical properties and aging resistance of dental resin composites. METHODS: Al-MSSs were prepared by a two-step method. The effect of Al-MSSs on the performance of the composites was evaluated using neat resin matrix, commercial composites 3M Z350XT and samples containing mesoporous silica spheres (MSSs) and nonporous silica spheres (NSSs) as control. The neat resin matrix consisted of resin monomer (Bisphenol A glycerolate dimethacrylate/triethylene glycol dimethacrylate, 49.5/49.5, wt%) and photoinitiator (camphor quinone/Ethyl-4-dimethylaminobenzoate, 0.2/0.8, wt%). The mechanical properties (flexural strength, flexural modulus, compressive strength and microhardness) of them were evaluated by a universal testing machine and microhardness tester. The mechanical stabilities of the prepared composites in wet environment were evaluated by immersing them in deionized water at 37 °C. In addition, we evaluated the effect of Al-MSSs on other properties of the dental resin composites such as polymerization shrinkage, degree of conversion, curing depth, contact angle, water sorption and solubility according to ISO 4049: 2019. RESULTS: The synthesized Al-MSSs possessed good dispersibility with an average particle size of about 505 ± 16 nm. The mechanical properties of resin composites gradually increased with the increase of the loading amounts of inorganic fillers. The reinforcing effect of Al-MSSs was similar to that of MSSs and better than that of the NSSs groups at the same filler loading. After aging in deionized water at 37 °C for 30 days, the mechanical properties of all resin composites decreased. However, the decrease percentage of the composites filled with Al-MSSs was significantly lower than the other groups, indicating that the stability of the dental composites in wet environments was significantly improved by the Al-MSSs fillers. Furthermore, Al-MSSs had no obvious influence on the biocompatibility and other properties of dental resins. SIGNIFICANCE: The prepared Al-MSSs could effectively improve the mechanical properties and aging resistance without sacrificing other physic-chemical properties of dental resin composites.

Characterization of dental light-curing resin composites incorporating multiple modified low-shrink monomers.

OBJECTIVE: Polymerization shrinkage poses a significant challenge in dental resin composites. The objective of this study is to introduce spiroorthocarbonate monomer 3,9-dimethylene-1,3,5,7-tetraoxa-spiro[5,5]undecane (BMSOC) and epoxy resin monomer 3,4-epoxycyclohexylmethyl-3,4-epoxycyclohexane carboxylate (ECHM-ECHC) into bisphenol-S-bis(3-methacrylato-2-hydroxy propyl)ether (BisS-GMA) based resin composites to develop composites with reduced shrinkage properties. METHODS: BMSOC and BisS-GMA were synthesized and thoroughly mixed with ECHM-ECHC, followed by inorganic fillers and photoinitiators. Based on the composition of the resin matrix, five groups of experimental composites were prepared, with traditional bisphenol A-dimethacrylate glycidyl ester (Bis-GMA)/triethylene glycol dimethacrylate (TEGDMA) based composite serving as the control. The polymerization properties, including degree of conversion (DC) and polymerization shrinkage (PS), as well as marginal microleakage, wettability, flexural strength (FS), flexural modulus (FM), and biocompatibility were evaluated. RESULTS: The results demonstrated that compared with the control group, the PS of BisS-GMA based composites containing BMSOC and ECHM-ECHC were significantly reduced (P < 0.05), and the lowest PS (0.96 ± 0.08 %) was observed when the ratio of BisS-GMA: (Epoxy + BMSOC) was 4:6. Additionally, the experimental composites also exhibited improved DC, minimal microleakage, low hydrophilicity, enhanced mechanical properties, qualified in vivo biocompatibility, and slight/moderate in vitro biocompatibility. SIGNIFICANCE: The resin composites incorporating multiple modified low-shrink monomers are promising for dental applications to prevent various clinical problems caused by PS and extend restoration longevity.

Influence of cavity wall thickness on the color adjustment potential of single-shade resin composites.

BACKGROUND: The color adjustment potential of resin composites depends on the specific characteristics of the surrounding structures. The authors evaluated the influence of cavity wall thickness on CIEDE2000 color adjustment potential (CAP00) of single-shade composites using the CIEDE2000 color difference (ΔE00) formula. METHODS: Two types of specimens were produced: single, using Vittra APS color DA3 (FGM Dental), Vittra APS Unique (VU) (FGM Dental), and Omnichroma (Tokuyama Dental) composites; and dual, using Vittra APS color DA3, but with cavity wall thicknesses of 3, 2, or 1 mm, restored with VU or Omnichroma. CIEL∗a∗b∗ color coordinates were obtained from digital photographs of the specimens at different locations, and ΔE00 and CAP00 were calculated. Statistical analysis included 2-way analysis of variance, Kruskal-Wallis, Holm-Sidak, Student-Newman-Keuls, Wilcoxon signed rank, and paired t tests (α = 5%). RESULTS: Cavity walls 1-mm-thick had higher ΔE00 values and lower CAP00 values, particularly for VU (P < .05). Restorations matched better with the control at the periphery than the central area (P < .001). Overall ΔE00 means exceeded the color perceptibility threshold (ie, 0.8) and the acceptability threshold (ie, 1.8). Color differences (between center of restoration and control composite) were moderately unacceptable for 3-mm and 2-mm thicknesses and extremely unacceptable for 1-mm thickness. Both composites had a ΔE00 color shift predominately determined by means of the lightness difference. Positive CAP00 values were found for VU and Omnichroma. CONCLUSIONS: Wall thickness, especially at 1 mm, negatively impacted the color of single- shade composites. This effect was more pronounced for VU, affecting mainly the restoration's central area. PRACTICAL IMPLICATIONS: Color matching ability depends on the structural and material characteristics, and clinicians should be attentive to these factors when using single-shade resin composites.

The visual and instrumental analyses of different single-shade resin composites / Análisis visual e instrumental de diferentes resinas compuestas omnicromáticas

Abstract The purpose of this study was to evaluate the color adaptation of single-shade resin composites applied to different tooth shades. A total of 108 class III preparations (n=6) were performed on the acrylic denture maxillary incisors (2mm depth and 2mm height). 5 single-shade resin composites (Vittra APS Unique, Omnichroma, ZenChroma, Clearfil Majesty ES-2 Universal, Charisma Topaz One) and 1 multishade resin composite (Estelite Asteria) were placed in the cavities and polished. I performed visual and instrumental color analyses. The CIEDE2000 formula was used to assess the shade differences (ΔE) between teeth and restorations. The obtained ΔE values were recorded and statistically analyzed. For the instrumental analysis, ZenChroma in A1 shade groups showed statistically significant higher differences (p<0.05). Among all tested materials, A3 shade groups showed lower ΔE values (p<0.05). For the visual analysis, there were no significant differences between materials and scores in A1 and A3 shade groups (p>0.05). There were statistically significant differences between the materials and the scores in A2 shade groups (p<0.05). As a result of this study, it was concluded that, making esthetic restorations with single-shade resin composites promises proper color adaptation, but their properties still need improvement. Single-shade resin composites can reduce chair-time and technical sensitivity with good color matching.

Resumen El objetivo de este estudio fue evaluar la adaptación del color de resinas compuestas omnicromáticas. Se realizaron un total de 108 preparaciones de clase III (n=6) en los incisivos superiores de prótesis acrílicas (2mm de profundidad y 2mm de altura). Se colocaron cinco resinas compuestas omnicromáticas (Vittra APS Unique, Omnichroma, ZenChroma, Clearfil Majesty ES-2 Universal, Charisma Topaz One), además de una resina multitono (Estelite Asteria) en las cavidades y se pulieron. Se realizó el análisis de color visual e instrumental. Se utilizó la fórmula CIEDE2000 para evaluar las diferencias de tono (ΔE) entre dientes y restauraciones. Los valores de ΔE obtenidos se registraron y analizaron estadísticamente. Para el análisis instrumental, ZenChroma en los grupos de color A1 mostró diferencias mayores estadísticamente significativas (p<0,05). Entre todos los materiales probados, los grupos de tonos A3 mostraron valores de ΔE más bajos (p<0.05). Para el análisis visual, no hubo diferencias significativas entre materiales y puntuaciones en los grupos de color A1 y A3 (p>0,05). Hubo diferencias estadísticamente significativas entre los materiales y las puntuaciones en los grupos de color A2 (p<0,05). Como resultado de este estudio, se concluyó que la realización de restauraciones estéticas con resinas compuestas omnicromáticas promueve una adecuada adaptación del color, pero aún necesitan mejorar sus propiedades. Las resinas compuetas omnicromáticas pueden reducir el tiempo de atención clínica y la sensibilidad técnica con una adecuada combinación de colores.

Real-time imaging and quantitative analysis of internal gap formation in bulk-fill and conventional resin composites: An OCT evaluation.

BACKGROUND: This study used optical coherence tomography (OCT) to observe real-time internal gap formation in both bulk-fill and conventional resin composites. It aimed to provide a quantitative analysis of variations, addressing the inconclusive nature of microleakage assessment caused by differences in testing methods. METHODS: Fifty extracted third molars prepared with Class I cavities, were divided into five groups (n = 10). Conventional resin Filtek Z350 XT (FZX) was applied with a double-layer filling of 2 mm per layer. Bulk-fill resins X-tra fil (XTF), Filtek Bulk Fill Posterior Restorative (FBP), Surefil SDR Flow + (SDR), and Filtek Flowable Restorative (FFR) were applied with a single-layer filling of 4 mm. Real-time OCT imaging was conducted during light curing. Post-curing, the entire sample was OCT-scanned. Following this, ImageJ software was used to measure the gap (G1 %). Subsequently, thermal cycling (TC) (5000 times, 5 °C-55 °C) was applied, followed by OCT scanning to calculate the gap (G2 %) and ΔG%. Data were analyzed using two-way repeated measures ANOVA, Kruskal-Wallis test, and Duncan's test (α=0.05). RESULTS: There was no significant difference in G1 % among the groups (p > 0.05). Following TC, FZX exhibited the highest G2 %, succeeded by FFR, FBP, XTF, and SDR, with SDR demonstrating the lowest G2 % (p < 0.05). FZX showed the highest ΔG% (p < 0.05), while SDR exhibited the lowest ΔG% (p < 0.05). CONCLUSION: OCT proves to be a promising tool for detecting microleakage. TC exerted a more significant negative impact on conventional resin. Surefil SDR Flow + displayed the least microleakage, both before and after TC.

The Effect of Gravity on Marginal Integrity of Different Flowable Bulk-Fill Resin Composites.

Background and Objectives: The aim of this quantitative research was to investigate the effect of gravitational forces on the marginal integrity of different bulk-fill composites by micro-CT imaging. Materials and Methods: Fifty caries-free human third molars extracted for prophylactic purposes were used in this study. Each tooth was prepared with two proximal box cavities, with dimensions of 3 mm × 3 mm × 5 mm. Five distinct groups, each comprising 20 cavities, thus totaling 100 cavities for this study: (1, Group CON): Clearfil Majesty Flow + Clearfil Majesty Esthetic (as the control); (2, Group FBR): Filtek Bulk-fill Flowable Restorative + Clearfil Majesty Esthetic; (3, Group XTB): Voco Extrabase + Clearfil Majesty Esthetic; (4, Group SDR): SDR + Clearfil Majesty Esthetic; and (5, Group SNC): Sonicfill. When restoring the mesial cavities, the occlusal surfaces of the teeth in the mold were positioned upwards, counteracting the force of gravity. In contrast, for the restoration of the distal cavities, the occlusal surfaces were aligned downwards, to be parallel with the gravitational pull. After restorative procedures, each tooth was treated with 5000 thermal cycles. A solution of ammoniacal silver nitrate (AgNO3) was employed as a tracing agent. The micro-CT scans were conducted and the total volume of silver nitrate and the total volume of restorations within the relevant region of interest were calculated in "mm3" with software. Two-way ANOVA and Tukey tests were performed at a significance level of p = 0.05 with Graphpad Prism v 8.2.1 software. Results: Both gravity effect and interaction showed no statistical differences (p > 0.05). Statistically significant differences were observed in the restorative materials (p < 0.05). Conclusions: Gravitational forces do not emerge as a major factor affecting the marginal integrity of flowable bulk-fill composites in class II restorations. The chemical composition of the composites plays a more crucial role, with the XTB composite showing higher microleakage ratios compared to the others.

Bond Strength, Microleakage, Microgaps, and Marginal Adaptation of Self-adhesive Resin Composites to Tooth Substrates with and without Preconditioning with Universal Adhesives.

PURPOSE: This study investigated and compared the bond strengths, microleakage, microgaps, and marginal adaptation of self-adhesive resin composites (SAC) to dentin with or without universal adhesives. MATERIALS AND METHODS: Dentin surfaces of 75 molars were prepared for shear and microtensile bond strength testing (SBS and µTBS). Silicon molds were used to build up direct restorations using the following materials to form 5 groups: 1. Surefil One; 2. Prime&Bond active Universal Adhesive + Surefil One; 3. Vertise Flow; 4. OptiBond Universal + Vertise Flow; 5. Scotchbond Universal + Filtek Z500 (control group). Bonded specimens were thermocycled 10,000x before being tested either for SBS or µTBS using a universal testing machine at a crosshead speed of 0.5 mm/min. Direct mesial and distal class-II cavities were created on 100 sound premolars, with the gingival margin of distal cavities placed below CEJ and restored according to the five groups. After thermocycling, microleakage scores were assessed following immersion of restored premolars in 2% methylene blue dye for 24 h, while marginal gaps and adaptation percentages were investigated on epoxy resin replicas under SEM at magnifications of 2000X and 200X, respectively. Results were statistically analyzed with parametric and non-parametric tests as applicable, with a level of significance set at α = 0.05. RESULTS: Bond strengths, microleakage scores, microgaps, and percent marginal adaptation of Surefil One and Vertise Flow were significantly (p < 0.001) inferior to the control group. Dentin preconditioning with universal adhesives significantly increased the study parameter outcomes of Surefil One and Vertise Flow, yet they were still significantly below the performance of the control group. CONCLUSION: Conventional resin composite outperformed the SAC whether applied solely or in conjunction with their corresponding universal adhesives.

Synthesis of a novel monomer "DDTU-IDI" for the development of low-shrinkage dental resin composites.

OBJECTIVE: The current dental resin composites often suffer from polymerization shrinkage, which can lead to microleakage and potentially result in recurring tooth decay. This study presents the synthesis of a novel monomer, (3,9-diethyl-1,5,7,11-tetraoxaspiro[5,5]undecane-3,9-diyl)bis(methylene) bis((2-(3-(prop-1-en-2-yl)phenyl)propan-2-yl)carbamate) (DDTU-IDI), and evaluates its effect in the formulation of low-shrinkage dental resin composites. METHODS: DDTU-IDI was synthesized through a two-step reaction route, with the initial synthesis of the required raw material monomer 3,9-diethyl-3,9-dihydroxymethyl-1,5,7,11-tetraoxaspiro-[5,5] undecane (DDTU). The structures were confirmed using Fourier-transform infrared (FT-IR) spectroscopy and hydrogen nuclear magnetic resonance (1HNMR) spectroscopy. Subsequently, DDTU-IDI was incorporated into Bis-GMA-based composites at varying weight percentages (5, 10, 15, and 20 wt%). The polymerization reaction, degree of conversion, polymerization shrinkage, mechanical properties, physicochemical properties and biocompatibility of the low-shrinkage composites were thoroughly evaluated. Furthermore, the mechanical properties were assessed after a thermal cycling test with 10,000 cycles to determine the stability. RESULTS: The addition of DDTU-IDI at 10, 15, and 20 wt% significantly reduced the polymerization volumetric shrinkage of the experimental resin composites, without compromising the degree of conversion, mechanical and physicochemical properties. Remarkably, at a monomer content of 20 wt%, the polymerization shrinkage was reduced to 1.83 ± 0.53%. Composites containing 10, 15, and 20 wt% DDTU-IDI exhibited lower water sorption and higher contact angle. Following thermal cycling, the composites exhibited no significant decrease in mechanical properties, except for the flexural properties. SIGNIFICANCE: DDTU-IDI has favorable potential as a component which could produce volume expansion and increase rigidity in the development of low-shrinkage dental resin composites. The development of low-shrinkage composites containing DDTU-IDI appears to be a promising strategy for reducing polymerization shrinkage, thereby potentially enhancing the longevity of dental restorations.

Urchin-like multiscale structured fluorinated hydroxyapatite as versatile filler for caries restoration dental resin composites.

Caries is one of the most prevalent human diseases, resulting from demineralization of tooth hard tissue caused by acids produced from bacteria, and can progress to pulpal inflammation. Filling restoration with dental resin composites (DRCs) is currently the most common treatment for caries. However, existing DRCs suffer from low fracture strength and lack comprehensive anti-caries bioactivity including remineralization, pulp protection, and anti-cariogenic bacteria effects. In this study, inspired by plant roots' ability to stabilize and improve soil, fluorinated urchin-like hydroxyapatite (FUHA) with a three-dimensional whisker structure and bioactive components of calcium, phosphorus, and fluorine was designed and synthesized by a dynamic self-assembly method. Furthermore, versatile FUHA particles with different loading fractions were used as functional fillers to fabricate methacrylate-based DRCs, where the urchin-like hydroxyapatite (UHA) filled DRCs and commercial DRCs (Z350XT and BEAUTIFIL II) served as the control groups. The results demonstrated that FUHA with 50 wt% loading in resin matrix endowed DRC (F5) with excellent physicochemical properties, dentin remineralization property, cell viability, promotion of dental pulp stem cells mineralization, and antibacterial properties. Meanwhile, F5 also presented good clinical handling and aesthetic characteristics. Therefore, structure/functional-integrated FUHA filled DRCs have potential as a promising strategy for tooth restoration and anti-caries bioactivity.

Composite Containing Calcium Phosphate Particles Functionalized with 10-MDP.

The phosphate ester monomer 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) is capable of bonding to hydroxyapatite and, for this reason, is a key component of several self-etch adhesives. In this study, dicalcium phosphate dihydrate particles (DCPD; CaHPO4.2H2O) were functionalized with 10-MDP and used to formulate an experimental composite with 50 vol% inorganic content (3:1 DCPD:silanated barium glass ratio) dispersed in a BisGMA/TEGDMA matrix. The tested hypothesis was that DCPD functionalization would improve the composite's mechanical performance without compromising Ca2+ release. Composites containing nonfunctionalized DCPD or only reinforcing glass (in both cases, with or without 10-MDP mixed in the resin phase) were used as controls. Materials were tested for degree of conversion (DC; by Fourier transform infrared spectroscopy), water sorption (WS) and solubility (SL; according to ISO 4049), biaxial flexural strength (BFS)/modulus (FM) after 24 h and 5 mo in water, and 28-d Ca2+ release in water (by plasma-coupled optical emission spectroscopy). Data were analyzed using analysis of variance/Tukey test (alpha: 5%). DCPD functionalization did not interfere with DC. The composite containing functionalized DCPD showed significantly lower WS and SL in comparison with the material formulated with nonfunctionalized particles. The presence of 10-MDP (as a functionalizing agent or dispersed in the resin phase) reduced the composite's initial BFS and FM. After 5 mo in water, the composite with functionalized DCPD and both glass-only composites were able to maintain their mechanical properties at levels statistically similar to what was observed after 24 h. Ca2+ release was significantly reduced in both formulations containing 10-MDP. In conclusion, DCPD functionalization with 10-MDP increased the composite's resistance to hydrolytic degradation, improving its mechanical stability after prolonged water storage. However, the impaired water transit at the particle-matrix interface led to a reduction in Ca2+ release.

CAD-CAM resin composites: Effective components for further development.

OBJECTIVE: This paper summarizes the effective components of computer-aided design and computer-aided manufacturing (CAD-CAM) resin composites that contribute to achieving greater mechanical properties and further development. METHODS: In silico multi-scale analysis, in silico nonlinear dynamic finite element analysis (FEA), and artificial intelligence (AI) were used to explore the effective components of CAD-CAM resin composites. The effects of the filler diameter and silane coupling ratio on the mechanical properties of CAD-CAM resin composites have been clarified through multi-scale analysis. The effects of the filler contents, and filler and monomer compositions have been investigated by AI algorithms. The fracture behavior of CAD-CAM composite crown was analyzed using in silico non-linear dynamic FEA. The longevity of CAD-CAM composite crown was assessed through step-stress accelerating life testing (SSALT). RESULTS: As the filler diameter decreases, there is an increase in elastic moduli and compressive strengths at the macroscale. At the nanoscale, a decrease in the filler diameter results in a decrease in the maximum value of the maximum principal strain. When the silane coupling ratio decreases, there is a decrease in the elastic modulus and compressive strength. According to the exhaustive search and feature importance analysis based on the AI algorithm, the combination of certain components was narrowed down to achieve a flexural strength of 269.5 MPa. The in silico non-linear FEA successfully detected the sign of the initial crack of the CAD-CAM composite molar crown. The SSALT revealed that CAD-CAM resin composite molar crowns containing nanofillers with a high fraction of resin matrix demonstrated great longevity. SIGNIFICANCE: This paper summarized the effective components of CAD-CAM resin composites for their further development. The integration of in vitro and in silico approaches will expedite the advancement of CAD-CAM resin composites, offering benefits such as time efficiency and reduction of material waste for researchers and manufacturers.

POSS hybrid bioactive glass dental composite resin materials: Synthesis and analysis.

INTRODUCTION: This study create a dental composite by hybirding polyhedral oligo-sesquioxide nano monomers and bioactive glass BG 45S5. METHODS: Make an experimental composite resin material with a 60 % filler content overall by substituting 20 % of the filler with BG 45S5. The experimental resins are grouped and named P0, P2, P4, P6 and P8 based on the reactive nanomonomer methacrylic acid-based multifaceted oligomeric sesquisiloxane (POSS) added by 2 %-8 % in the resin matrix portion of each group. Utilize a universal testing machine to analyze and compare the mechanical properties of these, then perform Fourier infrared spectrum analysis, double bond conversion analysis, and scanning electron microscope analysis. Based on this, after soaking the experimental materials artificial saliva solution or lactic acid solution for a while, the pH changes of the solution, the release of Ca2+ and PO43- ions, and the precipitation of apatite on the resin material's surface were tested and analyzed. Cell viability tests were used to assess sample cell viability and quantify the cytotoxicity of biological cells. The independent sample t-test was used to examine the group comparisons, and a difference was considered statistically significant at P<0.05. RESULTS: Outstanding mechanical and the double bond conversion are demonstrated by the nanocomposites when the POSS concentration hits 4 wt%. Agglomeration will cause the performance to deteriorate if the concentration beyond this threshold. In the P4 group, the double bond conversion, CS, and FS rose by a large margin, respectively, in comparison to the blank control group P0. Thankfully, the data demonstrate that adding POSS increases adhesive ability when compared to the blank group P0, however, there is no discernible difference between the other experimental groups. The acid neutralization capacity of the P4 group is essentially the same as that of the control group (P0). Ca2+ and PO43- ions are released in significant amounts following treatment with lactic acid solution, although this tendency is clearly less pronounced in artificial saliva. SEM and EDX data indicate that when the experimental resin is soaked in lactic acid solution and artificial saliva, apatite precipitation will happen on its surface. The results of the cell viability test indicated that there was no statistically significant difference between the experimental groups, and the viability of the cells increased after 24hours and 48 hours. CONCLUSIONS: POSS was included into the composite resin along with 20% bioactive glass as a filler. When the proportion of POSS is less than 4%, the indices of composite resin materials rise in a dose-dependent way. When this value is surpassed, performance begins to deteriorate. The inclusion of POSS has no influence on the biological activity of the composites, which means that the hybrid composite resin is capable of acid neutralization, ion release, and apatite precipitation. CLINICAL SIGNIFICANCE: The experimental composite resin can be used as an intelligent material in clinical treatment. It has the clinical application potential of preventing demineralization of tooth hard tissue, promoting remineralization, and improving edge sealing through apatite precipitation.

Effect of aging and fiber-reinforcement on color stability, translucency, and microhardness of single-shade resin composites versus multi-shade resin composite.

OBJECTIVE: The purpose of this study was to evaluate the effect of aging and fiber-reinforcement on the color stability, translucency, and microhardness of single-shade resin composites versus multi-shade resin composite. MATERIALS AND METHODS: Four resin composites (Filtek Z250, Omnichroma, Vittra APS Unique, Zenchroma) were tested. Three subgroups of specimens were prepared for each of the composites: control, polyethylene fiber-reinforcement, and glass fiber-reinforcement- groups (n = 10/per group). The samples were subjected to aging for 10,000 thermal cycles. Color differences (ΔE00 ) were calculated after aging. Relative translucency parameter (RTP00 ) and microhardness values were calculated before and after aging. A two-way analysis of variance and the generalized linear model was used (p < 0.05). RESULTS: The lowest and highest ΔE00 values were found for Filtek Z250 (0.6 ± 0.2) and Omnichroma resin composites (1.6 ± 0.4), respectively. The ΔE00 value of the polyethylene fiber-reinforcement group (1.2 ± 0.6) was significantly higher than the ΔE00 value of the glass fiber-reinforcement group (1.0 ± 0.4, p < 0.001). The RTP00 value of the glass fiber-reinforcement group (1.92 ± 0.78) was significantly higher than the RTP00 value of the polyethylene fiber-reinforcement group (1.72 ± 0.77, p < 0.001). The highest microhardness values were found in glass fiber-reinforcement group (76.48 ± 17.07, p < 0.001). CONCLUSION: Single-shade resin composites were more translucent, had higher color change, and lower hardness than multi-shade resin composite. For relative translucency and microhardness, statistical significance was found in the material and fiber type interaction. The glass fiber-reinforcement provided higher translucency, lower color change and higher microhardness values than polyethylene fiber-reinforcement group after aging. Thermocycling had a significant impact on the color stability, translucency parameter, and microhardness of the tested resin composite materials. CLINICAL SIGNIFICANCE: Single-shade resin composite materials have greater color-changing potential. The glass fiber-reinforcement optimize resin material mechanical properties and color stability more than polyethylene fiber-reinforcement.

Effect of whitening concepts on surface roughness and optical characteristics of resin-based composites: An AFM study.

The aim of this study was to evaluate the effects of various whitening agents on the surface roughness and optical characteristics of different types of resin composite restorations. Fifty specimens were prepared for each resin [G-aenial Posterior (GP), SonicFill-2 (SF), Solidex (SDX), and Nova Compo HF (NC)]. Following baseline color and surface roughness (Ra) measurements, the specimens were randomly divided into 5 groups (n = 10/group) according to whitening concepts: control (distilled water), in-office bleaching [OB-(Opalescence Boost)], at-home bleaching [HB-(Opalescence PF)], whitening toothpaste [WT-(Signal White Now)], and whitening mouthwash [WM-(Listerine Advanced White)]. ∆E00 , ∆TP00 , and ∆WID values were calculated before and after the whitening procedure with a spectrophotometer using the CIEDE2000 formula. Surface roughness measurements were repeated. The surface topography was determined using atomic force microscopy. Two- and three-way analyses of variance and Tukey's post-hoc test were performed, with p < 0.05 regarded as indicative of significance. No significant differences were detected among the resin composite materials in terms of the ΔE00 values (p > 0.05). Color change of all resin materials was above the AT threshold (>1.8) and the PT threshold (>0.8). All restorative materials presented acceptable (AT<2.62) TP00 values. Solidex specimens demonstrated the lowest WID values compared to the other composites. There were significant differences among the whitening procedures with respect to ΔE00 , ΔTP00 , and WID values (p < 0.001). SF/WT combination showed the highest and clinically unacceptable ΔE00 values. The highest roughness values were observed in the SDX specimens and the combination of SDX/OB. The effect of whitening agents on the optical characteristics and surface roughness of restorative materials depends on the type of material, agent, and time. RESEARCH HIGHLIGHTS: Clinicians should be aware that long-term use of over-the-counter products due to the abrasive effects of their ingredients and repeated bleaching session applications may affect the color stability and surface roughness of resin composites.

Scoping review: Effect of surface treatments on bond strength of resin composite repair.

OBJECTIVE: to evaluate the existing evidence on surface treatment techniques employed in resin composite repair and their effect on the repair short- and long-term bond strength. DATA AND SOURCE: This scoping review was performed under the PRISMA-ScR guidelines for scoping reviews and registered on the Open Science Framework platform. STUDY SELECTION: A systematic search was conducted in PubMed, Embase, and Scopus and grey literature up to September 2022 without language or date restriction. In vitro studies comparing mechanical surface and/or chemical treatments on repair bond strength of resin composite were included. Studies evaluating experimental adhesive systems or resin composites were excluded. Selection of studies and data extraction were performed. Data from selected studies was qualitatively analyzed. RESULTS: A total of 76 studies were included in the qualitative analysis. Among the mechanical treatments, alumina blasting was the most frequently used, followed by silica coating and diamond bur. As for chemical treatments, dentin bonding systems were the most frequently evaluated, followed by universal adhesive systems and silane/ceramic primer. The combination of mechanical and chemical pre-treatments increased the repair bond strength of resin composite in both short- and long-term simulated aging scenarios. The evidence obtained from the included studies was classified as moderate quality, mainly due to the medium risk of bias observed across most of the studies. CONCLUSION: The techniques used to treat the surface of resin composites for repair are diverse. Incorporating a combination of mechanical and chemical pre-treatments resulted in superior repair bond strength of resin composite materials under both short- and long-term simulated aging conditions. CLINICAL SIGNIFICANCE: The analysis of evidence revealed significant variability among protocols for repairing resin composites. Utilizing both mechanical and chemical pre-treatment methods is important for enhancing the bond strength of resin composites during both short- and long-term simulated aging situations.

Temperature rise in photopolymerized adhesively-bonded resin composite: A thermography study.

OBJECTIVES: To assess visually and quantitatively the contributions of the adhesive layer photopolymerization and the subsequent resin composite increment to spatio-temporal maps of temperature at five different cavity locations, subjected to two irradiance curing protocols: standard and ultra-high. METHODS: Caries-free molars were used to obtain 40, 2 mm thick dentin slices, randomly assigned to groups (n = 5). These slices were incorporated within 3D-printed model cavites, 4 mm deep, restored with Adhese® Universal bonding agent and 2 mm thick Tetric® Powerfill resin composite, and photocured sequentially, as follows: G1: control-empty cavity; G2: adhesive layer; G3 composite layer with no adhesive; and G4 composite layer with adhesive. The main four groups were subdivided based on two curing protocols, exposed either to standard 10 s (1.2 W/cm2) or Ultra high 3 s (3 W/cm2) irradiance modes using a Bluephase PowerCure LCU. Temperature maps were obtained, via a thermal imaging camera, and numerically analyzed at 5 locations. The data were analyzed using two-way ANOVA followed by multiple one-way ANOVA, independent t-tests and Tukey post-hoc tests (α = 0.05). Tmax, ΔT, Tint (integrated area under the curve) and time-to-reach-maximum-temperature were evaluated. RESULTS: Two-way ANOVA showed that there was no significant interaction between light-curing time and location on the measured parameters (p > 0.05), except for the time-to-reach-maximum-temperature (p < 0.05). Curing the adhesive layer alone with the 10 s protocol resulted in a significantly increased pulpal roof temperature compared to 3 s cure (p < 0.05). Independent T-tests between G3 and G4, between 3 s and 10 s, confirmed that the adhesive agent caused no significant increases (p > 0.05) on the measured parameters. The ultra-high light-curing protocol significantly increased ΔT in composite compared to 10 s curing (p < 0.05). SIGNIFICANCE: When the adhesive layer was photocured alone in a cavity, with a 2 mm thick dentin floor, the exothermal release of energy resulted in higher temperatures with a 10 s curing protocol, compared to a 3 s high irradiance. But when subsequently photocuring a 2 mm layer of composite, the resultant temperatures generated at pulpal roof location from the two curing protocols were similar and therefore there was no increased hazard to the dental pulp from the immediately prior adhesive photopolymerization, cured via the ultra-high irradiation protocol.

Properties of model E-glass fiber composites with varying matrix monomer ratios.

OBJECTIVE: To evaluate properties of fiber-reinforced-composites (FRC) containing Bis-EMA/UDMA monomers but identical dispersed phase (60% wt BaSi glass power +10% wt E-glass fibre). METHODS: A control (Group A), monomer mixture comprising 60% Bis-GMA, 30% TEGDMA, and 10% PMMA (typical FRC monomers) was used. The following monomer mass fractions were mixed: 50% bis-GMA plus 50% of different ratios of Bis-EMA+UDMA to produce consistent formulations (Groups B-E) of workable viscosities was also studied. Flexural strength (FS), fracture toughness (KIC), water sorption (SP), solubility (SL) and hygroscopic expansion (HE) were measured. FS and KIC specimens were stored for 1, 7 d, and 30 d in water at 37 °C. SP/SL specimens were water-immersed for 168d, weighed at intervals, then dried for 84 d at 37 °C. To analyze differences in FS, and KIC, a two-way ANOVA and Tukey post-hoc tests (α = 0.05) were conducted. For SP/SL, and HE, one-way ANOVA with subsequent Tukey post-hoc tests (α = 0.05) were utilized. RESULTS: FS and KIC for groups A, D, E decreased progressively after 1 d. Groups B and C (highest amounts of Bis-EMA) did not decrease significantly. The modified matrix composites performed significantly better than the control group for SP and HE. The control group outperformed the experimental composites only for SL with up to 250% higher SL for group E (6.9 µg/mm) but still below the maximum permissible threshold of 7.5 µg/mm. SIGNIFICANCE: EXPERIMENTAL: composites with highest amounts of Bis-EMA showed improved hydrolytic stability and overall enhancement in several clinically-relevant properties. This makes them potential candidates for alternative matrices to a semi-interpenetrating network in fiber-reinforced composites.

In vitro comparison of one-step, two-step, and three-step polishing systems on the surface roughness and gloss of different resin composites.

OBJECTIVES: This laboratory study evaluated the effect of three polishing systems on the surface roughness and gloss of resin composites. MATERIALS AND METHODS: Thirty specimens (6 mm Ø × 8 mm) were fabricated from each of three resin composites: Z 350 XT (nanofill), Harmonize (nanohybrid), and Estelite Omega (supranonofill). All specimens were photopolymerized using a multi-peak LED curing unit (VALO-Standard mode), having a exitance irradiance of approximately 1000 mW/cm2 against a polyester strip (PS). 2 mm was then removed from the irradiated end (finished) using #320 abrasive paper (F). Specimens were then randomly polished (P) using a one-step (1S) (OneGloss), two-step (2S) (EVE Diacomp Twist Basic CA), or 3-step (3S) (Astropol P) system (n = 10). For PS, F, and P groups, surface roughness (Ra) was measured using a surface roughness tester, and surface gloss was measured with a glossmeter. For each specimen, the percent recovery to the PS value (%R) of surface roughness and surface gloss were calculated. Data were analyzed using two-way ANOVA, followed by Tukey's test. Surface roughness and gloss values were submitted to Pearson's correlation test (α = 0.05). All statistical testing was performed using a pre-set alpha of 0.05. RESULTS: The interaction term [resin composite × polishing system] was significant for both surface roughness (p = 0.001) and gloss (p = 0.0001). For all resin composites, the 2S and 3S systems provided a higher %R of surface roughness and gloss compared to those of the 1S system. There was a negative correlation between surface roughness and gloss, but only a few combinations showed strong correlations. CONCLUSIONS: The 2S and 3S polishing systems provided surfaces having greater smoothness and gloss compared to the 1S system. The ability to recover surface roughness and gloss was dependent on type of resin composite filler classification. CLINICAL SIGNIFICANCE: The 3S and 2S polishing systems were more effective in achieving PS values than was the 1S system for all tested resin composites. However, individual polishing systems performed differently depending on type of resin composite.

Effects of background color and restoration depth on color adjustment potential of a new single-shade resin composite versus multi-shade resin composites.

The objectives of this study was to evaluate the effects of background color and restoration depth on color adjustment potential of a new single-shade resin composite versus multi-shade resin composites. Two multi-shade resin composites (Spectrum TPH3 and Clearfil AP-X) marked A2 shade and a new single-shade resin composite (Charisma Diamond One) were tested. Four base shades (A1, A2, A3, and A3.5) of the same resin composite (Filtek Z250) were selected as different background colors. Dual specimens with 1-, 2-, and 3-mm restoration depth and single specimens of all materials were fabricated. CIE color coordinates were measured using a spectrophotometer, then color differences (∆E00) and translucency parameter (TP00) were calculated using the CIEDE2000 formula. Independent observers performed visual scoring. CAP-I and CAP-V values were calculated according to ΔE00 and visual scoring. The results revealed that CAP-I and CAP-V were significantly affected by resin composite type, background color, and restoration depth. CAP-I and CAP-V decreased as restoration depth increased at the same background color for all materials. Charisma Diamond One had the highest CAP-I and CAP-V values at all background colors and restoration depths, with the highest TP00 value. These findings demonstrated that color adjustment potential was dependent on resin composite type, background color, and restoration depth, so shade selection is indispensable for multi-shade resin composites. Charisma Diamond One exhibited the highest color adjustment potential and the most pronounced color shifting, contributing to simplifying the process of shade selection and improving the efficiency of clinical work.

SURVIVAL AND COMPLICATION RATES OF RESIN COMPOSITE LAMINATE VENEERS: A SYSTEMATIC REVIEW AND META-ANALYSIS.

OBJECTIVES: The aim of this systematic review was to evaluate the survival and complication rates of resin composite laminate veneers. METHODS: Randomized controlled trials and cohort studies with a minimum 2-year follow-up assessing survival and complication rates of resin composite laminate veneers on permanent dentition from 1998 to May 2022. Literature searches were conducted in MEDLINE (PubMed), Scopus, and the Cochrane Central Register of Controlled Trials electronic databases. References cited in the related reviews and included full-text articles were also hand-searched to further identify potentially relevant studies. RESULTS: A total of 827 articles were identified. Twenty-two studies were considered for full-text review after the title and abstract screening stage. After exclusion, 7 studies (3 randomized controlled trials and 4 cohort studies) were included in the systematic review. Three published scales were adopted for the quality and risk of bias assessment. At the survival rate threshold, the overall heterogeneity (I2) for randomized controlled trials was 50.5% (P = .108). The overall pooled survival rate of the randomized controlled trials was 88% (95% CI: 81%-94%), with the mean follow-up time ranging from 24 to 97 months. Surface roughness, color mismatch, and marginal discoloration were the most reported complications. CONCLUSION: Resin composite laminate veneers demonstrated moderately high survival rates for the entire sample and the direct laminate veneer group demonstrated higher survival rates than the indirect approach. Most of the complications were regarded as clinically acceptable with or without reintervention.