Effect of Curing Light and Exposure Time on the Polymerization of Bulk-Fill Resin-Based Composites in Molar Teeth.

OBJECTIVES: This study examined the influence of different light-curing units (LCUs) and exposure times on the microhardness across bulk-fill resin-based composite (RBC) restorations in a molar tooth. METHODS AND MATERIALS: Tip diameter, radiant power, radiant exitance, emission spectra, and light beam profile were measured on two single-emission-peak LCUs (Celalux 3 and DeepCure-S) and two multiple-peak LCUs (Bluephase 20i and Valo Grand). A mold was made using a human molar that had a 12-mm mesial-distal length, a 2.5-mm deep occlusal box, and two 4.5-mm deep proximal boxes. Two bulk-fill RBCs (Filtek Bulk Fill Posterior and Tetric EvoCeram Bulk Fill) were photoactivated for 10 seconds and for 20 seconds, with the light guide positioned at the center of the occlusal surface. Microhardness was then measured across the transverse surface of the restorations. The light that reached the bottom of the proximal boxes was examined. Data were statistically analyzed with the Student t-test, two-way analysis of variance, and the Tukey post hoc test (α=0.05). RESULTS: The four LCUs were different regarding all the tested characteristics. Even when using LCUs with wide tips and a homogeneous beam profile, there were significant differences in the microhardness results obtained at the central and proximal regions of the RBCs (p<0.05). LCUs with wider tips used for 20 seconds produced higher microhardness values (p<0.05). The multiple-peak LCUs produced greater hardness values in Tetric EvoCeram Bulk Fill than did the single-emission-peak LCUs (Celalux 3 and DeepCure-S). Results for the light measured at the bottom of proximal boxes showed that little light reached these regions when the light tip was positioned at the center of restorations. CONCLUSIONS: Curing lights with wide tips, homogeneous light beam profiles, and longer exposure times are preferred when light-curing large MOD restorations. Light curing from more than one position may be required for adequate photopolymerization.

Characterization and Comparative Analysis of Voids in Class II Composite Resin Restorations by Optical Coherence Tomography.

PURPOSE: This study aimed to characterize and analyze the number of voids and the percentage of void volume within and between the layers of class II composite restorations made using the bulk fill technique or the incremental technique by optical coherence tomography (OCT). METHODS AND MATERIALS: Class II cavities (4×4×2 mm) were prepared in 48 human third molars (n=24 restorations per group, two class II cavities per tooth). Teeth were divided into four groups and restored as follows: group 1 (FOB), bulk filled in a single increment using Filtek One Bulk Fill (3M Oral Care); group 2 (FXT), incrementally filled using four oblique layers of Filtek Z350 XT (3M Oral Care); group 3 (FBF+FXT), bulk filled in a single increment using Filtek Bulk Fill Flowable Restorative (3M Oral Care) covered with two oblique layers of Filtek Z350 XT (3M Oral Care), and group 4 (FF+FXT), incrementally filled using Filtek Z350 XT Flow (3M Oral Care) covered with two oblique layers of Filtek Z350 XT (3M Oral Care). After the restorative procedure, specimens were immersed into distilled water and stored in a hot-air oven at 37°C. Forty-eight hours later, thermal cycling was conducted (5000 cycles, 5°C to 55°C). Afterward, OCT was used to detect the existence of voids and to calculate the number of voids and percentage of voids volume within each restoration. Data were submitted to chi-square and Kruskal-Wallis tests (α=0.05). Comparisons were made using the Dunn method. RESULTS: Voids were detected in all groups, ranging from 0.000002 (FBF+FXT and FF+FXT) to 0.32 mm3 (FBF+FXT). FF + FXT presented voids in all of the restorations and had a significantly higher number of voids per restoration when compared to the other groups (p<0.05), but restorations with the presence of voids were significantly higher only when compared to FXT (p<0.05). FBF + FXT presented a significantly higher percentage of voids volume than that of FXT (p<0.05). When comparing restorations made using high-viscosity resin-based composites (FOB and FXT), no significant differences regarding number of voids or percentage of voids volume were detected (p≥0.05). CONCLUSIONS: The use of flowable resin-based composites can result in an increased number of voids and percentage of voids volume in restorations, and this appears to be more related to voids present inside the syringe of the material than to the use of incremental or bulk fill restorative techniques.

Influence of Emission Spectrum and Irradiance on Light Curing of Resin-Based Composites.

PURPOSE: This study examined the influence of different emission spectra (single-peak and broad-spectrum) light-curing units (LCUs) delivering the same radiant exposures at irradiance values of 1200 or 3600 mW/cm2 on the polymerization and light transmission of four resin-based composites (RBCs). METHODS AND MATERIALS: Two prototype LCUs that used the same light tip, but were either a single-peak blue or a broad-spectrum LED, were used to deliver the same radiant exposures to the top surfaces of the RBCs using either standard (1200 mW/cm2) or high irradiance (3600 mW/cm2) settings. The emission spectrum and radiant power from the LCUs were measured with a laboratory-grade integrating sphere coupled to a spectrometer, and the light beam was assessed with a beam profiler camera. Four RBCs (Filtek Supreme Ultra A2, Tetric EvoCeram A2, Tetric EvoCeram T, and TPH Spectra High Viscosity A2) were photoactivated using four different light conditions: single-peak blue/standard irradiance, single-peak blue/high irradiance, broad-spectrum/standard irradiance, and broad-spectrum/high irradiance. The degree of conversion (N=5) and microhardness at the top and bottom of 2.3-mm-diameter by 2.5-mm-thick specimens (N=5) were analyzed with analysis of variance and Tukey tests. The real-time light transmission through the RBCs was also measured. RESULTS: For all light conditions, the 2.3-mm-diameter specimens received a homogeneous irradiance and spectral distribution. Although similar radiant exposures were delivered to the top surfaces of the RBCs, the amount of light energy emitted from the bottom surfaces was different among the four RBCs, and was also greater for the single-peak lights. Very little violet light (wavelengths below 420 nm) reached the bottom of the 2.5-mm-thick specimens. The degree of conversion and microhardness results varied according to the RBC (p<0.05). The RBCs that included alternative photoinitiators had greater microhardness values at the top when cured with broad-spectrum lights, while at the bottom, where little violet light was observed, the results were equal or higher when they were photoactivated with single-peak blue lights. With the exception of the microhardness at the top of TPH, equivalent or higher microhardness and degree-of-conversion values were achieved at the bottom surface when the standard (1200 mW/cm2) irradiance levels were used compared to when high irradiance levels were used. CONCLUSIONS: Considering the different behaviors of the tested RBCs, the emission spectrum and irradiance level influenced the polymerization of some RBCs. The RBCs that included alternative photoinitiators produced greater values at the top when cured with broad-spectrum lights, while at the bottom, results were equal or higher for the RBCs photoactivated with single-peak blue lights.

Influence of Finishing and Polishing Techniques and Abrasion on Transmittance and Roughness of Composite Resins.

The aim of this study was to evaluate the influence of finishing and polishing systems and toothbrush abrasion on transmittance (T) and surface roughness (Ra) of three composite resins (Filtek Z350 XT, Tetric N-Ceram, and IPS Empress Direct). Eighteen resin disks (10 mm diameter × 2 mm thick) finished by polyester strips had initial surface smoothness recorded, representing phase 1 (P1). Specimens were divided into three groups (n=6) according to the finishing/polishing instrument used (OneGloss, TopGloss, and Sof-Lex) to compose phase 2 samples (P2). Then specimens were subjected to 514 cycles of toothbrush simulation using a toothpaste slurry, with a constant load applied to soft bristles, and were then washed (phase 3=P3). After each phase, the specimens were examined by an optical profiler and spectrophotometer to measure Ra and T. Data were analyzed by analysis of variance, Tukey and Pearson tests. T values were statistically influenced by composite resin ( p=0.000) and phase of measurement ( p=0.000) factors, while the finishing/polishing system used ( p=0.741) did not affect T. On the other hand, Ra values were statistically affected by the factor finishing/polishing system ( p=0.000), but not by composite resin ( p=0.100) and phase of measurement ( p=0.451). Tetric N-Ceram and Empress Direct presented higher values of roughness when polished by OneGloss, while TopGloss and Sof-Lex showed a lower roughness. It can be concluded that composite resins transmitted more light after dental abrasion. Transmittance of composite resins was not modified by the distinct roughness created by finishing/polishing instruments.

Effect of Bleaching Agents on the Nanohardness of Tooth Enamel, Composite Resin, and the Tooth-Restoration Interface.

This in vitro study aimed to evaluate the nanohardness of tooth enamel, composite resin, dental adhesive, and enamel hybrid layer exposed to 35% hydrogen peroxide-based bleaching agents and analyze the tooth-restoration interface using scanning electron microscopy (SEM). This study used 40 crowns of bovine incisors, which were embedded in epoxy resin. A 2 × 2 × 2-mm cavity was prepared in the medial third of the flattened buccal surface of each tooth and restored (two-step etch-and-rinse Adper Single Bond 2 + nanocomposite resin Filtek Z350 XT). The specimens were polished and divided into four groups (n=10), corresponding to each bleaching agent used (TB: Total Blanc Office, pH=7.22-6.33; HPB: Whiteness HP Blue, pH=8.89-8.85; HP: Whiteness HP, pH=6.65-6.04; PO: Pola Office, pH=3.56-3.8), applied in accordance with manufacturer protocols. The nanohardness of the substrates was measured before and immediately after the bleaching procedure and after 7-day storage in artificial saliva with an Ultra-Microhardness Tester (DUH-211S, Shimadzu). Loads used were 100 mN for tooth enamel and composite resin and 10 mN for adhesive and enamel hybrid layer. For SEM analysis, epoxy replicas were prepared through high-precision impressions of the specimens. For nanohardness, the statistical tests two-way analysis of variance and Tukey (p<0.05) revealed that the agent with the lowest pH value (PO) was the only one to decrease the nanohardness of enamel and the enamel hybrid layer immediately after its application; however, after 7-day storage in artificial saliva, the nanohardness levels of these substrates returned to their original values. SEM analysis revealed small gaps between tooth enamel and adhesive after the exposure to all bleaching agents; however, the most evident gap in the tooth-restoration interface was observed immediately after application of agent PO. No bleaching agent used changed the nanohardness of the composite resin and adhesive layer.

Effect of enamel preparation method on in vitro marginal microleakage of a flowable composite used as pit and fissure sealant.

OBJECTIVES: The aim of this in vitro study was to evaluate the microleakage in occlusal surfaces, after preparation with Er:YAG laser and compared to the diamond-bur conventional technique. METHODS: Thirty premolars were divided into three groups: I - high-speed handpiece + 37% phosphoric acid; II - Er:YAG laser (350 mJ, 4 Hz and 112 J/cm(2)) + 37% phosphoric acid; and III - Er:YAG laser (350 mJ, 4 Hz and 112 J/cm(2)) + Er:YAG laser (80 mJ, 4 Hz, and 25 mJ/cm(2)). All cavities received the same adhesive system and were restored with flowable composite according to manufacturer's instructions. Teeth were submitted to thermal cycling and immersed in 50% silver nitrate solutions for 8 h in total darkness. Specimens were sectioned longitudinally in the bucco-lingual direction, in slices of 1 mm thick. Each slice was immersed into photo developing solution and was photographed, and microleakage was scored from 0 to 7, by three calibrated examiners. RESULTS: A statistically significant difference (P < 0.0001) was observed between Er:YAG laser prepared and etched specimens and those in the other groups. CONCLUSIONS: It can be concluded that no significant difference was noted between the two types of enamel preparation when etching was performed. Preparing and treating the enamel surface exclusively by Er:YAG laser resulted in the highest degree of leakage.

[Bond strength to dentin of resin composites associated with filled and unfilled adhesive systems]. / Resistência de união à dentina de resinas compostas associadas a sistemas adesivos com e sem carga.

This study analyzed in vitro two brands of one-step adhesive systems of fourth generation (Optisolo--Kerr, filled; and Single Bond--3M, unfilled) and two composite resins (Prodigy--Kerr and Z100--3M), aiming at evaluating their bond strength to dentin. Eighty human extracted molars were embedded in acrylic resin and grounded until dentin was exposed in longitudinal direction. The specimens were divided in 4 groups. Composite resin cones were bonded to the specimens using the mentioned adhesive systems, following the instructions of the manufacturers. The test-specimens were submitted to tensile tests using a 4442 Universal Mini-Instron Machine with the speed of 0.5 mm/min. The results were converted into MPa, according to the area of adhesion, and submitted to statistical analysis with ANOVA. There was significant statistical difference (p < 0.01) between the adhesive systems (F = 7.24). Optisolo (m = 11.03 +/- 4.23) showed better bond strength than Single Bond (m = 8.37 +/- 4.54). There was no significant statistical difference (p > 0.05) between the composites (F = 0.43).

Microhardness of Nd:YAG laser irradiated enamel surfaces.

Several studies have been conducted in order to verify effects of laser irradiation on dental structures. However, different settings and methods employed have led to inconclusive results. The aim of this study was to evaluate the effects of several settings of Nd:YAG laser irradiation on enamel microhardness. Fifteen groups of 10 human third molars each were submitted to Vickers microhardness indentations prior to and after laser irradiation. The data were submitted to the t-test for dependent samples (P < 0.05) for statistical evaluation. Lower total delivered energy (under 30 J) resulted in no statistically significant difference of microhardness between irradiated and non-irradiated samples, whereas higher energy settings decreased enamel surface microhardness significantly. This can be due to the significant temperature rise during irradiation. Thus, we conclude that laser irradiation, under the conditions of this study, is not suitable for improving enamel properties, because of decreased microhardness of irradiated samples.

Tensile bond strength of two dentin adhesive systems.

The tensile bond strength of one third-generation (XR Bond) and one fourth-generation (Optibond) adhesive system to dentin was compared. The influence of acid etching of dentin on the bond strength in the XR Bond system was also evaluated. In addition, two kinds of curing (photo and dual) of the Optibond system were evaluated. The Optibond system showed a statistically significant higher tensile bond strength to dentin than the XR Bond system. Etching of the dentin before application to XR Bond did not significantly improve the bond strength to dentin. Both photo and dual curing showed similar bond strengths two hours and seven days after sample preparation.

Bond strength to dentin with artificial carious lesions: influence of caries detecting dye.

PURPOSE: To evaluate the influence of dyes for caries detection on tensile bond strength of adhesive materials to artificial carious dentin. MATERIALS AND METHODS: Buccal and lingual enamel of human molars were removed leaving intact dentin surfaces. The entire surface of each specimen was covered with nail varnish, keeping a window area of 4 x 4 mm. Artificial carious lesions were induced with acidified gel. Three dyes (0.5% basic fuchsin; Caries Finder and Cari-D-Tect) were used according to manufacturers' recommendations. Specimens were etched with 35% phosphoric acid for 20 s, washed and dried, leaving a wet dentin surface. The adhesive system (Prime & Bond 2.0) was applied in two layers and light-cured. Restorative materials (TPH Spectrum, Dyract, Advance) were bonded using a 3-mm diameter inverted-cone mold. Control groups were made without dye. Eight samples were tested for each group. After 24 hrs of storage in distilled water, the samples were debonded using a testing machine at 0.5 mm/min crosshead speed. RESULTS: ANOVA and Tukey-Kramer test showed that TPH Spectrum (0.73 MPa) and Dyract (0.74 MPa) had similar bond strengths, and both were higher than Advance (0.0 MPa), which was statistically different (P < 0.01). The use of the dyes did not cause any changes in tensile bond strength for any tested materials.

Rugosimetric analysis of amalgam restorations polished using different techniques.

The objective of the present study was to submit specimens with amalgam restorations to 4 different polishing techniques and one control group without polishing. The specimens were then submitted to rugosimetric analysis and the differences compared.

Photopolymerized resins: surface hardness variation in relation to time of polymerization and setting.

The authors studied the superficial hardness of composite resins cured for two different times: 20 and 40 seconds of light exposure. The hardness values were read immediately and 24 hours after polymerization. A significant increase in hardness was observed with 40 s exposure as compared to 20 s. Hardness values were significantly higher at 24 h than immediately after polymerization.

Effect of the polishing technique at low or high speed on the micro-hardness of dental amalgam.

Dental cavities were prepared and restored with amalgam, using three different silver alloys. The surface of the restorations was finished 24 hours after condensation, with a rotatory instrument using a low- or high-speed handpiece. The specimens were then submitted to metallographic polishing and one of the margins of the amalgam restoration were then submitted to Vickers' micro-hardness test. Another micro-hardness test was accomplished 168 hours after condensation and the two sets of micro-hardness values were compared. No significant statistical differences were detected between the micro-hardness values obtained with low or high speed in the polishing technique.