Effect of Using Manufacturer-recommended Exposure Times to Photo-activate Bulk-fill and Conventional Resin-based Composites.

OBJECTIVES: To analyze the effect of using the resin-based composite manufacturer's recommended exposure time on the degree of conversion (DC), Knoop hardness (KH), and elastic modulus (E) of conventional and bulk-fill resin-based composites (RBCs). METHODS: Three resin-based composites (RBCs) were tested: Tetric EvoCeram Bulk Fill (TET), Opus Bulk Fill APS (OPU), and RBC Vittra APS (VIT). They were photo-activated in 2 mm deep, 6 mm diameter molds for their recommended exposure times of 10 seconds, 20 seconds, or 40 seconds from four light-curing units (LCUs). Two delivered a single emission peak in the blue light region (Optilight Max and Radii-Cal) and two delivered multiple emission peaks in the violet and blue region (VALO Cordless and Bluephase G2). After 24 hours of dry storage at 37°C in the dark, the KH (Kgf/mm2), E (MPa) and DC (%) at the top and bottom surfaces of specimens (n=5) were measured and the results analyzed by 2-way analysis of variance (ANOVA) followed by a Tukey test (α=0.05). RESULTS: The irradiance (mW/cm2) and spectral irradiance (mW/cm2/nm) from the LCUs were reduced significantly (8-35%) after passing through 2.0 mm of RBC (p<0.001). The DC at the bottom of VIT and TET was less than at the top surface (p<0.001). OPU had the same DC at the top and bottom surface (p=0.341). The KH and E values at the top surface of VIT and TET were substantially higher than at the bottom (p<0.001). OPU exposed for 40 seconds achieved higher mechanical properties than TET that was photo-activated for 10 seconds (p<0.001). The opacity of different bulk-fill RBCs changed differently during the polymerization; OPU became more opaque, whereas TET became more transparent. When exposed for their recommended times, the 2 mm thick RBCs that used Ivocerin or the APS photoinitiator system were adequately photo-activated using either the single or multiple emission peak LCUs (p=0.341). CONCLUSION: After 24 hours' storage, all the 2 mm thick RBCs photo-cured in 6 mm diameter molds achieved a bottom-to-top hardness ratio of at least 80% when their recommended exposure times were used. TET, when photo-activated for 10 seconds, achieved lower mechanical properties than OPU that had been photo-activated for 40 seconds. The change in opacity of the RBCs was different during photo-activation.

Impact of the Porosity from Incremental and Bulk Resin Composite Filling Techniques on the Biomechanical Performance of Root-Treated Molars.

OBJECTIVES: To analyze the effect of the porosity caused by incremental and bulk resin composite filling techniques using low- and high-viscosity composite resins on the biomechanical performance of root-treated molars. METHODS: Forty intact molars received standardized mesio-occlusal-distal (MOD) cavity preparation, were root treated, and randomly divided into four groups with different filling techniques (n=10). The first involved two incremental filling techniques using VIT/Z350XT, a nanofilled composite resin (Filtek Z350XT, 3M ESPE) associated with a resin-modified glass ionomer cement, and resin-modified glass ionomer cement (RMGIC; Vitremer, 3M ESPE) for filling the pulp chamber. The second involved TPH/VIT, a microhybrid composite resin TPH3 Spectrum associated with Vitremer. The third and fourth involved two bulk-fill composite resins: SDR/TPH, a low-viscosity resin composite (Surefill SDR flow, Dentsply) associated with TPH3 Spectrum, and POST, a high-viscosity bulk-fill resin composite (Filtek Bulk Fill Posterior, 3M ESPE). The volume of the porosity inside the restoration was calculated by micro-CT. The cusp deformation caused by polymerization shrinkage was calculated using the strain-gauge and micro-CT methods. The cusp deformation was also calculated during 100 N occlusal loading and loading to fracture. The fracture resistance and fracture mode were recorded. Data were analyzed by one-way analysis of variance and Tukey test. The fracture mode was analyzed by the χ2 test. The volume of the porosity was correlated with the cusp deformation, fracture resistance, and fracture mode (a=0.05). RESULTS: Incremental filling techniques associated with RMGIC resulted in a significantly higher porosity than that of both bulk-fill techniques. However, no significant difference was found among the groups for the fracture resistance, fracture mode, and cusp deformation, regardless of the measurement time and method used. No correlation was observed between the volume of the porosity and all tested parameters. CONCLUSIONS: The porosity of the restorations had no influence on the cuspal deformation, fracture resistance, or fracture mode. The use of the RMGIC for filling the pulp chamber associated with incremental composite resins resulted in similar biomechanical performance to that of the flowable or regular paste bulk-fill composite resin restorations of root-treated molars.

Effect of the photoinitiator system on the polymerization of secondary methacrylamides of systematically varied structure for dental adhesive applications.

OBJECTIVE: The aim of this study was to investigate the influence of the photoinitiator system on the polymerization kinetics of methacrylamide-based monomers as alternatives to methacrylates in adhesives dental-based materials. METHODS: In total, 16 groups were tested. Monofunctional monomers (2-hydroxyethyl methacrylate) - HEMA; (2-hydroxy-1-ethyl methacrylate) -2EMATE, (2-hydroxyethyl methacrylamide) - HEMAM; and (N-(1-hydroxybutan-2-yl) methacrylamide) -2EM; were combined with bifunctional monomers containing the same polymerizing moieties as the monofunctional counterparts (HEMA-BDI; 2EMATE-BDI; HEMAM-BDI; and 2EM-BDI) at 50/50 M ratios. BHT was used as inhibitor (0.1 wt%) and the photoinitiators used were: CQ + EDMAB (0.2/0.8), BAPO (0.2), IVOCERIN (0.2), and DMPA (0.2), in wt%. The polymerization kinetics were monitored using Near-IR spectroscopy (∼6165 cm-1) in real-time while the specimens were photoactivated with a mercury arc lamp (Acticure 2; 320-500 nm, 300 mW/cm2) for 5 min, and maximum rate of polymerization (Rpmax, in %.s-̄1), degree of conversion at Rpmax (DC@Rpmax, in %), and the final degree of conversion (Final DC, in %) were calculated (n = 3). Initial viscosity was measured with an oscillating rheometer (n = 3). Data were analyzed using Two-way ANOVA for the polymerization kinetics and one-way ANOVA for the viscosity. Multiple comparisons were made using the Tukey's test (∝ = 0.05). RESULTS: There was statistically significant interaction between monomer and photoinitiator (p < 0.001). For the methacrylates groups, the highest Rpmax was observed for HEMA + DMPA and 2EMATE + BAPO. For methacrylamides groups, the highest Rpmax were observed for HEMAM and 2EM, both with DMPA. Final DC was higher for the methacrylate groups, in comparison with methacrylamide groups, independent of the photoinitiators. However, for the methacrylamide groups, the association with BAPO led to the lowest values of DC. In terms of DC@Rpmax, methacrylate-based systems showed significantly higher values than methacrylamide formulations. DMPA and Ivocerin led to higher values than CQ/EDMAB and BAPO in methacrylamide-based compounds. BAPO systems showed de lowest values for both HEMA and HEMAM formulations. For the viscosity (Pa.s), only 2EM had higher values (1.60 ± 0.15) in comparison with all monomers. In conclusion, polymerization kinetics was affected by the photoinitiators for both monomers. Viscosity was significantly increased with the use of secondary methacrylamide. SIGNIFICANCE: this work demonstrated the feasibility of using newly-synthesized methacrylamide monomers in conjunction with a series of initiator systems already used in commercial materials.

Effect of the addition of thiourethane oligomers on the solâ¿¿gel composition of BisGMA/TEGDMA polymer networks.

OBJECTIVES: Thiourethane oligomers have been shown to increase the fracture toughness and reduce the polymerization stress of methacrylate-based materials. However, network formation has not been elucidated in these materials yet. The aim of this study was to evaluate how the addition of a thiourethane oligomer (TU) influences the sol/gel composition and network structure of methacrylate-based materials using dynamic mechanical analysis and extraction methods. MATERIALS AND METHODS: BisGMA/TEGDMA at systematically varied mass ratios (20/80 to 80/20wt%) were mixed with pre-polymerized thiourethane oligomers at 0 (control) or 20wt%, synthesized by combining pentaerythritol tetra-3-mercaptopropionate with dicyclohexylmethane 4,4⿲-Diisocyanate, at 1:2 isocyanate:thiol. 0.1wt% of 2,2-Dimethoxy-2-phenylacetophenone was added as the photoinitiator and 0.3wt% of 2,6-di-tert-butyl-4-methylphenol was added as a free radical inhibitor. Disk specimens (0.8ÿ10mm in diameter, n=3) were photoactivated at 270mW/ (320â¿¿500nm) for 1min. The degree of conversion (DC) was measured in near-IR (Ë¿6165cmâ¿¿1). Specimens were immersed in two different solvents (water for 7 days or dicholoromethane for 48h). Water sorption (WS) and solubility (SL) were obtained according to ISO 4049. The leachates for both solutions were analyzed with 1H-NMR (400MHz, CDCL3). Bar specimens (1ÿ3ÿ25mm, photocured and then post-processed at 180°C for 8h to DC>95%) were subjected to dynamic mechanical analysis (â¿¿30 to 230°C) to obtain glass transition temperature (Tg), tan delta curves and crosslinking density (ν). Data was analyzed with two-way ANOVA/Tukeyâ¿¿s test (95%). RESULTS: In general, the presence of TU increased the overall conversion. The WS was similar for all groups, but the SL decreased by 2-fold with the addition of the TU oligomer for all compositions, except BisGMA/TEGDMA 80/20. The BisGMA concentration of the leachates increased with increasing BisGMA in the initial mixture, and with the presence of thiourethane. This compositional drift of the gel with the presence of TU was attributed to the preferential dissolution of TEGDMA into the TU network. Tg and ν decreased with the addition of TU, as expected. The addition of TU produced more homogeneous networks, as evidenced by narrower breadth of the tan delta curve. CONCLUSION: The addition of TU affected the composition of the sol/gel in crosslinked networks, which were more homogeneous and presented 2-fold less potentially toxic leachates than the methacrylate controls. CLINICAL SIGNIFICANCE: The addition of TU may produce less cytotoxic materials based on the increased conversion and reduced amount of unreacted extractables from its network after water storage.

Stress Distribution, Tooth Remaining Strain, and Fracture Resistance of Endodontically Treated Molars Restored Without or With One or Two Fiberglass Posts And Direct Composite Resin.

OBJECTIVES: To evaluate the effects of direct composite resin without a post or with one or two fiberglass posts on the restoration of severely compromised endodontically treated molars. METHODS AND MATERIALS: Forty-five molars with 2 mm of "remaining tooth structure" were divided into three groups: Wfgp, restored with Filtek Z350XT without a fiberglass post; 1fgp, restored with Z350XT with one fiberglass post in the distal root canal; and 2fgp, restored with Z350XT with two fiberglass posts, one in the distal root canal and the other in the mesial-buccal root canal. The teeth were load cycled. Tooth remaining strain was measured using strain gauges (n=10) at two moments: TrSt-100 N, during 100 N occlusal loading, and TrSt-Fr, at fracture load. Fracture resistance was calculated, and fracture mode was classified. The elastic modulus and Vickers hardness were calculated using dynamic indentation (n=5). Stress distribution was analyzed by three-dimensional finite element analysis. RESULTS: The use of two fiberglass posts resulted in lower fracture resistance than was noted in the groups with one fiberglass post and without fiberglass posts. The lingual surface of the remaining tooth had higher strain values than the buccal surface, regardless of the restorative technique and moment of evaluation. The absence of a fiberglass post resulted in significantly higher strain values and more irreparable fracture modes than were noted in the other groups. The use of one fiberglass post had a better strain/fracture resistance ratio. Stresses were concentrated in the occlusal portion of the post and in the furcation region. The presence of one fiberglass post resulted in better stress distribution in the entire distal root dentin, reducing stress on the critical areas. CONCLUSIONS: The use of one fiberglass post for restoring molars with direct composite resin resulted in higher fracture resistance than did the use of two fiberglass posts; it also resulted in better tooth remaining strain and stress distribution and more reparable fracture modes than were seen in the group without a fiberglass post.