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Objective To investigate both genotoxicity and hardening of bulk-fill composite materials applied in 4-mm layer thickness and photo-activated for different exposure times. Methods Three flowable bulk-fill materials and one conventional flowable composite were filled in molds (height: 4 mm) and irradiated for 20 or 30 s. The top (0 mm) and bottom (4 mm) specimen surface were mechanically scraped, and eluates (0.01 g composite in 1.5 ml RPMI 1640 cell culture media) prepared for each material, surface level and irradiation time. Genotoxicity was assessed in human leukocytes using both the alkaline comet assay and cytokinesis-blocked micronucleus assay, and Knoop hardness (KHN) was measured at the top and bottom specimen surface (n = 8). Results At both irradiation times, none of the bulk-fill composites significantly affected comet assay parameters used in primary DNA damage assessment or induced significant formation of any of the scored chromatin abnormalities (number of micronuclei, nuclear buds, nucleoplasmic bridges), whether eluates were obtained from the top or bottom surface. Furthermore, no decrease in KHN from the top to the bottom surface of the bulk-fill materials was observed. On the other hand, the conventional composite irradiated for 20 s showed at 4-mm depth a significant increase in the percentage of DNA that migrated in the tail and a significant increase in the number of nuclear buds, as well as a significant decrease in KHN relative to the top surface. Significance Bulk-fill resin composites, in contrast to conventional composite, applied in 4-mm thickness and photo-activated for at least 20 s do not induce relevant genotoxic effects or mechanical instability. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the influence of pre-heating of high-viscosity bulk-fill composite materials on their degree of conversion and shrinkage force formation.Methods: Four bulk-fill composite materials (Tetric EvoCeram Bulk Fill-TECBF, x-tra fil-XF, QuixFil-QF, SonicFill-SF) and one conventional nano-hybrid resin composite (Tetric EvoCeram-TEC) were used. The test materials were either kept at room temperature or pre-heated to 68°C by means of a commercial heating device, before being photoactivated with a LED curing unit for 20s at 1170mW/cm(2). Shrinkage forces (n=5) of 1.5-mm-thick specimens were recorded in real-time for 15min inside a temperature-controlled chamber at 25°C (simulating intraoral temperature after rubber dam application) with a custom-made stress analyzer. Degree of conversion (n=5) was determined at the bottom of equally thick (1.5mm) specimens using Fourier transform infrared spectroscopy. Data were analyzed with Student's t-test, ANOVA and Tukey's HSD post-hoc test (α=0.05).Results: Composite pre-heating significantly increased the degree of conversion of TECBF, but had no effect on monomer conversion of the other materials investigated. For each of the test materials, pre-heated composite generated significantly lower shrinkage forces than room-temperature composite. At both temperature levels, TECBF created the significantly highest shrinkage forces, and QF caused significantly higher shrinkage forces than both XF and TEC.Conclusions: Both the composite material and the pre-cure temperature affect shrinkage force formation. Pre-heating of bulk-fill and conventional restorative composites prior to photoactivation decreases polymerization-induced shrinkage forces without compromising the degree of conversion.Clinical Significance: Composite pre-heating significantly reduces shrinkage force formation of high-viscosity bulk-fill and conventional resin composites, while maintaining or increasing the degree of monomer conversion, dependent upon the specific composite material used. [ABSTRACT FROM AUTHOR]

Objective. To investigate the subsurface degree of conversion (DC) and shrinkage force formation of low-viscosity (flowable) bulk-fill composite materials. Materials and methods. Three flowable bulk-fill resin composites [SureFil SDR flow (SDR; Dentsply DeTrey), Venus Bulk Fill (VB; Heraeus Kulzer) and x-tra base (XB; VOCO)] and one conventional flowable control composite material [EsthetX flow (EX; Dentsply DeTrey)] were tested. The materials were photoactivated for 20 s at an irradiance of 1170 mW/cm2 and the DC ( n = 5) was recorded at 0.1-, 1.5- and 4-mm depth using Fourier transform infrared spectroscopy. Shrinkage forces ( n = 5) of 1.5-mm-thick specimens were continuously recorded for 15 min using a custom-made stress analyzer. Data were statistically analyzed by ANOVA, Tukey's HSD and Bonferroni's post-hoc tests ( α = 0.05). Results. SDR generated the significantly lowest shrinkage forces (22.9 ± 1.4 N), but also attained the significantly lowest DC at 1.5-mm depth (67.5 ± 0.8%). The conventional flowable composite EX generated the significantly highest shrinkage forces (40.7 ± 0.7 N) and reached a significantly higher DC (74.4 ± 1.3%) compared to SDR and XB at 1.5-mm depth. The shrinkage force values of VB (29.4 ± 1.1 N) and XB (28.3 ± 0.6 N) were similar ( p > 0.05). All materials attained significantly higher DC at 4-mm depth than at the near-surface. Conclusion. The tested low-viscosity bulk-fill materials show lower shrinkage force formation than a conventional flowable resin composite at high levels of degree of conversion up to 4-mm incremental thickness. [ABSTRACT FROM AUTHOR]

This study investigated the influence of modulated photo-activation on axial polymerization shrinkage, shrinkage force, and hardening of light- and dual-curing resin-based composites. Three light-curing resin composites ( SDR bulk-fill, Esthet X flow, and Esthet X HD) and one dual-curing material ( Rebilda DC) were subjected to different irradiation protocols with identical energy density (27 J cm−2): high-intensity continuous light ( HIC), low-intensity continuous light ( LIC), soft-start ( SS), and pulse-delay curing ( PD). Axial shrinkage and shrinkage force of 1.5-mm-thick specimens were recorded in real time for 15 min using custom-made devices. Knoop hardness was determined at the end of the observation period. Statistical analysis revealed no significant differences among the curing protocols for both Knoop hardness and axial shrinkage, irrespective of the composite material. Pulse-delay curing generated the significantly lowest shrinkage forces within the three light-curing materials SDR bulk-fill, Esthet X flow, and Esthet X HD. High-intensity continuous light created the significantly highest shrinkage forces within Esthet X HD and Rebilda DC, and caused significantly higher forces than LIC within Esthet X flow. In conclusion, both the composite material and the applied curing protocol control shrinkage force formation. Pulse-delay curing decreases shrinkage forces compared with high-intensity continuous irradiation without affecting hardening and axial polymerization shrinkage. [ABSTRACT FROM AUTHOR]

Objectives To investigate chemo-mechanical effects of incorporating alkaline bioactive glass nanoparticles into a light-curable dental resin matrix. Methods An unfilled Bis-GMA/TEGDMA material was infiltrated with up to 20wt% of ultrafine SiO2-Na2O-CaO-P2O5-Bi2O3 particles. The unfilled and filled resins were investigated regarding their viscosity before setting and compared to commercially available materials. Set specimens were immersed for 21 days in phosphate buffered saline at 37°C. Water uptake, pH, Knoop hardness, and degree of conversion of freshly polymerized and stored samples were investigated. Resin surfaces were viewed and mapped in a scanning electron microscope for the formation of calcium phosphate (Ca/P) precipitates. In addition, Raman spectroscopy was performed. Numeric values were statistically compared (p<0.01). Results Viscosity increased with particle loading, but remained below that of a flowable dental composite material. Water uptake into and pH induction from the polymerized samples also increased with particle loading (p<0.01). The addition of 20wt% nanoparticles had no significant influence on microhardness, yet it slightly (p<0.01) increased the degree of conversion after 21 days. Ca/P precipitates formed on specimens filled with 20wt% of the particles, while they were scarce on counterparts loaded with 10wt%, and absent on unfilled resin surfaces. Significance The results of the current study show that a Bis-GMA-based resin can be functionalized using alkaline nanoparticles. A material with bioactive properties and similar hardness as the unfilled resin was obtained by incorporating 20wt% of ultrafine SiO2-Na2O-CaO-P2O5-Bi2O3 particles into the resin matrix. [ABSTRACT FROM AUTHOR]

Objective. To test the durability of sealants applied for prevention of erosive dentine mineral loss under erosive/abrasive conditions. Methods. Forty-eight bovine dentine samples doped with 32P were randomly allocated to four groups (1-4). All samples performed a de- and remineralizations pre-cycling (6 × 1 min erosion in HCl: pH 3.0, mean time and overnight immersion in artificial saliva) for 1 day. Sealing was done as follows; (1) unsealed, (2) Seal & Protect, (3) K-0184 (experimental sealer) and (4) OptiBond FL. After sealing, samples were immersed in HCl for 3 h (baseline measurement). Then, the following erosive/abrasive and remineralisations cycling was performed for 8 days: 3 h/day erosion with HCl, 600 brushing strokes/day and storage in artificial saliva for the rest of the day. Sealer permeability was evaluated by assignation of 32P in the acid used for the erosive attacks. Results. At baseline, the significantly highest dentine loss was observed for the unsealed control group, while the mineral loss was not statistically significantly different between the sealed groups 2 and 3. At all days of the erosive/abrasive and remineralizations cycling and cumulatively the significantly highest mineral loss was observed for group 1, while the significantly lowest mineral loss was observed for the samples sealed with Seal & Protect (group 2) and K-0184 (group 3). In all groups, no significant increase in the 32P release was observed. Conclusion. Surface sealants are able to reduce the erosive dentine mineral loss and maintain this erosion-preventing efficacy over the whole duration (simulating 8 month in-vivo) of the erosive/abrasive cycling. [ABSTRACT FROM AUTHOR]

Objective. To investigate the abrasive wear of surface sealants (Seal&Protect and K-0184 (experimental sealant)) and the influence of pre-treatment with mineral deposit forming prophylaxis pastes (NUPRO Sensodyne and NUPRO) on this wear. Methods. One hundred and eight bovine dentine samples were randomly allocated to nine groups (1-9). Pre-treatment (10 s): groups 1-3: untreated, groups 4-6: NUPRO, groups 7-9: NUPRO Sensodyne. Sealing: groups 1, 4 and 7: unsealed, groups 2, 5 and 8: Seal&Protect, groups 3, 6 and 9: K-0184 (experimental sealer). Samples were then brushed with 12 000 brushing strokes (BS) with toothpaste slurry in an automatic brushing machine (120 BS/min; F = 2.5 N). Surface profiles were recorded at baseline, after pre-treatment and sealing and after each 2000 BS. Results. Total profile change (wear or gain due to pre-treatment, treatment and 12 000 BS): groups 1, 4 and 7 (no surface sealant) showed a not significantly different wear of 18.48 ± 2.63 µm, 24.98 ± 3.02 µm and 21.50 ± 5.47 µm, respectively. Remaining groups (sealed) showed a gain in height with no significant difference among each other. Wear in sealed groups (2, 3, 5, 6, 8 and 9) were not significantly different at all numbers of brushing strokes. Starting with 4000 BS, the wear in unsealed groups (1, 4 and 7) was statistically significantly higher compared to all other groups. Conclusion. Stability and wear resistance of surface sealants are not affected by pre-treatment of dentine with NUPRO Sensodyne. The surface sealants tested provide a stable protective surface layer on dentine, which lasts for at least 12 000 brushing strokes. [ABSTRACT FROM AUTHOR]

Objective. Application of SnCl2/AmF/NaF containing mouth rinse showed good protection against erosion. The aim of the study was to evaluate if this is due to the amount of KOH-soluble fluoride (KOHsF) formed or its resistance under erosive conditions. Methods. One hundred and fifty bovine enamel samples were allocated to five groups (n = 30) and were once eroded in 0.05 mol/l citric acid (5 min). Samples were stored in artificial saliva for 4 days. Samples of two groups (erosive-SnCl2 + erosive-NaF) were eroded 6 × for 5 min. The remaining samples were stored in aqua dest deionised water. Each day the samples were treated twice for 2 min with 1 ml SnCl2/AmF/NaF-solution (erosive-SnCl2;neutral-SnCl2/AmF/NaF) or NaF-solution (erosive-NaF;neutral-NaF). The fifth group remained untreated (control). On day 5, 10 samples of each group were used for determination of KOHsF (series 1). The remaining samples were again eroded (erosive-SnCl2 + erosive-NaF) or stored in artificial saliva (neutral-SnCl2 + neutral-NaF). KOHsF of another 10 samples of each group was measured (series 2). The last 10 samples of each group were also treated as described above and the amount of KOHsF was measured (series 3). Results. In each series 1-3 KOHsF in group erosive-SnCl2/AmF/NaF were significantly higher. No significant loss of KOHsF between the series 1-3 was observed (except for control). Conclusion. SnCl2/AmF/NaF containing mouth rinse revealed a better formation of KOH-soluble fluoride as the NaF-solution, although the applied fluoride compound has no influence on the stability of the KOHsF under erosive conditions, leading to the conclusion that the resistance of KOHsF is not responsible for the difference in the protection against dental erosion. [ABSTRACT FROM AUTHOR]

Objective. The purpose of the present survey was to evaluate the implementation and experience of a new method for posterior vertical bite reconstruction using direct resin composite restorations by private practitioners who attended a hands-on continuing education course on this technique. Materials and methods. In the years 2007 and 2008, 17 1-day continuing education courses on vertical bite reconstruction in the worn dentition by using direct resin composite restorations were attended by 310 participants. A 13-item questionnaire was posted to all course participants in April 2009 seeking information on the acceptance, implementation and experience of the presented technique in the private practice. Results. A total of 97 (31%) questionnaires were returned, whereas 67% of the respondents had used the presented technique. Analysis of the overall experience and satisfaction with the placed resin composite restorations using visual analog scale (VAS) revealed a mean VAS score of 7.2 ± 1.7 (0 = maximal unsatisfied, 10 = maximal satisfied). The direct resin composite restorations were predominantly rated 'good' within the assessed criteria surface texture, anatomical form, marginal integrity, marginal discoloration and color match. Ninety-eight percent of the private practitioners stated that they would continue to carry out vertical bite reconstructions according to this technique. The three most frequently observed clinical problems were related to marginal discolorations, bulk fractures and adhesive failures. Conclusion. The presented restoration method was well accepted by private practitioners who used this treatment approach at least once after course participation, even though some clinical problems were observed. [ABSTRACT FROM AUTHOR]

Objectives. This in-situ study aimed to investigate the potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) crème and fluoride mouth rinse to re-harden erosively softened enamel and to evaluate the influence of an intra-oral or extra-oral application. Methods. Ten volunteers performed five experimental series. Per series, four bovine enamel samples were extra-orally softened by immersion in Sprite light® (2 min) and subsequently worn intra-orally for 5 min in intra-oral appliances. Thereafter, samples were treated (3 min) with either 250 ppm AmF/SnF2 solution (Meridol) (series 1 and 3) or CPP-ACP crème (Tooth Mousse) (series 2 and 4). Application of the substances was performed extra-orally (series 1 and 2) or intra-orally (series 3 and 4). Untreated specimens served as control (series 5). The appliances were worn for 4 h afterwards. Knoop microhardness (KHN) measurement was performed at baseline, after softening and after completing of the respective run. Data were statistically analyzed by ANOVA and Bonferroni/Dunn post-hoc test. Results. No significant difference in baseline microhardness was observed, while immersion in Sprite light reduced the microhardness significantly. Significant re-hardening after intra-oral exposure occurred in all series, but baseline microhardness was not achieved. Microhardness in series 2 was significantly higher than that in series 1 and 5. No significant differences in KHN were detected between series 3, 4 and 5. The re-hardening ΔKHN (final microhardness - microhardness after erosion) was not significant different in all five series. Conclusion. Intra-oral application of CPP-ACP crème or fluoride solution provides no benefit regarding re-hardening of erosively softened enamel. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To test sealants to prevent erosive tooth wear caused by extrinsic and intrinsic acids under long-term exposition. Methods: 144 bovine enamel samples were randomly allocated to twelve groups (1–12). Samples of groups 1, 5 and 9 remained unsealed (positive controls), 2, 6 and 10 were sealed with Silicon Seal Nano Mix and 3, 7 and 11 with Seal&Protect. Groups 4, 8 and 12 were sealed with flowable composite (negative controls). Groups 1–4 were immersed in artificial saliva, 5–8 in hydrochloric acid and groups 9–12 in citric acid for 28 days, respectively. After 1, 2, 4, 7, 11, 14, 21 and 28 days, solutions were renewed and enamel wear was quantified by assignation of 32P in the solutions. Results: In all immersion solutions, lowest mineral loss was observed for the negative controls whilst highest loss was observed for unsealed positive controls. In artificial saliva and citric acid, the loss from samples sealed with Seal&Protect was not significantly different compared with negative controls whilst loss in groups sealed with Silicon Seal Nano Mix was significantly higher. In hydrochloric acid, loss from samples sealed with Seal&Protect was not different compared with that of negative controls up to 4 days. Except day 1, the mineral loss in the Seal&Protect group was significantly lower compared with that of the Silicon Seal Nano Mix group. Conclusion: The tested resin based surface sealant is able to significantly reduce the erosive demineralisation of enamel caused by hydrochloric and citric acid even under long-term exposition. [Copyright &y& Elsevier]

The article focuses on the study regarding the comparison of light curing and self-curing in the dual-cured core buildup material polymerization. The study employed resin-based dual-cured core buildup filled molds with self-cured materials as controls, which are tested for Knoop hardness number (KHN). Results show that the photoactivation of the dual-cured materials has no relevant benefit compared with self-curing materials in relation to microhardness.

Objective. To investigate the influence of time delay and duration of photo-activation on subsurface microhardness of a dual-cured resin composite. Material and methods . A commercially available dual-cured core build-up resin composite (Rebilda DC) was filled in cavities (diameter: 4.0 mm; height: 6.0 mm) of polystyrene molds and light-cured for 20 or 60 s either immediately after the filling procedure (time delay 0 s) or after a time delay of 30, 90, 180 or 300 s. Non-irradiated self-cured specimens served as a control group ( n = 15). Specimens were stored in complete darkness and at 100% relative humidity at 37°C for 2 weeks and cross-sectioned. Knoop Hardness Numbers (KHNs) were measured six times per depth and averaged at distances of 0.25, 0.50, 1.00, 2.00, 3.50 and 5.50 mm from the light-exposed surface. Data were statistically analyzed using one- and two-way ANOVA followed by Scheffé's post-hoc test at a level of significance of 0.05. Results . Mean hardness values in all experimental groups ranged between 54.3 ± 2.1 and 58.1 ± 2.3 KHN. Light-curing did not significantly increase composite KHN at any depth measured. Delaying light exposure had no influence on KHN, irrespective of depth. A longer light-exposure time (60 versus 20 s) resulted in significantly higher KHN only at depths of 3.50 and 5.50 mm. Conclusion. Photo-activation of the tested dual-cured resin composite provided no clinically relevant benefit compared to self-curing regarding the degree of hardening. [ABSTRACT FROM AUTHOR]

Tauböck TT, Bortolotto T, Buchalla W, Attin T, Krejci I. Influence of light-curing protocols on polymerization shrinkage and shrinkage force of a dual-cured core build-up resin composite. Eur J Oral Sci 2010; 118: 423–429. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci This study investigated the influence of time delay and duration of photo-activation on linear polymerization shrinkage, shrinkage force, and hardening of a dual-cured core build-up resin composite. The test material (Rebilda DC) was light-cured for 20 or 60 s either early (2 min) or late (7 min) after the start of mixing. Non-irradiated self-cured specimens served as controls. Linear shrinkage and shrinkage force were measured for 60 min using custom-made devices. Knoop hardness was determined at the end of the observation period. Self-cured controls, showing a linear shrinkage similar to that of specimens early light-cured for 20 s generated the lowest shrinkage force and hardness. A shorter light exposure time (20 s vs. 60 s) reduced linear shrinkage, shrinkage force, and hardness when early light-curing was performed, but did not affect the three properties in specimens light-cured late after the start of mixing. Late photo-activation increased linear shrinkage, irrespective of irradiation time, and resulted in a higher shrinkage force and hardness for short light exposure time. A moderate correlation was found between the two shrinkage properties studied ( r2 = 0.65). In conclusion, improvements in shrinkage behavior of the tested core build-up material were associated with inferior hardening, making it important to adapt curing protocols to the clinical situation. [ABSTRACT FROM AUTHOR]

Our aim was to evaluate the clinical performance of direct composite restorations placed in patients with severely worn dentitions at an increased vertical dimension of occlusion, after up to 11 years. One hundred and sixty-four teeth in 13 patients with severely worn dentitions had been reconstructed with either microhybrid (first cohort; n = 59) or nanofilled (second cohort; n = 105) composite restorations at increased vertical dimension of occlusion using a wax-up-based template-aided placement technique. From the dental records, information about repair and replacement of restorations was obtained. Patients were clinically examined after a mean follow-up time of 10.7 years (first cohort) or 5.2 years (second cohort) using United States Public Health Service (USPHS) criteria. Subjective patient satisfaction was also recorded using visual analogue scales (VAS). The overall quality of the restorations was good with predominantly 'Alpha' and 'Bravo' scores, respectively. Nanofilled composite showed less surface degradation and better margin qualities than microhybrid composite. Of the 59 restored teeth in the first cohort, 13 restorations showed unfavorable events after 10.7 years, of which ten could be repaired. In the second cohort, 23 of 105 restorations showed unfavorable events, which could all be repaired. VAS scores revealed high patient satisfaction with the treatment approach. In conclusion, direct composite restorations placed at an increased vertical dimension of occlusion show good clinical long-term performance in patients with severe tooth wear. [ABSTRACT FROM AUTHOR]

We embedded copper-doped mesoporous bioactive glass nanospheres (Cu-MBGN) with antibacterial and ion-releasing properties into experimental dental composites and investigated the effect of Cu-MBGN on the polymerisation properties. We prepared seven composites with a BisGMA/TEGDMA (60/40) matrix and 65 wt.% total filler content, added Cu-MBGN or a combination of Cu-MBGN and silanised silica to the silanised barium glass base, and examined nine parameters: light transmittance, degree of conversion (DC), maximum polymerisation rate (Rmax), time to reach Rmax, linear shrinkage, shrinkage stress (PSS), maximum PSS rate, time to reach maximum PSS rate, and depth of cure. Cu-MBGN without silica accelerated polymerisation, reduced light transmission, and had the highest DC (58.8 ± 0.9%) and Rmax (9.8 ± 0.2%/s), but lower shrinkage (3 ± 0.05%) and similar PSS (0.89 ± 0.07 MPa) versus the inert reference (0.83 ± 0.13 MPa). Combined Cu-MBGN and silica slowed the Rmax and achieved a similar DC but resulted in higher shrinkage. However, using a combined 5 wt.% Cu-MBGN and silica, the PSS resembled that of the inert reference. The synergistic action of 5 wt.% Cu-MBGN and silanised silica in combination with silanised barium glass resulted in a material with the highest likelihood for dental applications in future. [ABSTRACT FROM AUTHOR]

Objectives: This in vitro study examined the marginal integrity of experimental composite materials doped with bioactive glass (BG). Materials and methods: Class-II MOD cavities were prepared and restored with one of the following composite materials: a commercial composite material as a reference (Filtek Supreme XTE), an experimental composite doped with BG 45S5 (C-20), and an experimental composite doped with a fluoride-containing BG (F-20). Six experimental groups (n = 8) were used, as each of the three composites was applied with (+) or without (-) a universal adhesive (Adper Scotchbond Multipurpose). All specimens were subjected to thermocycling (10,000 x, 5–55 °C) and then additionally stored in artificial saliva for eight weeks. Scanning electron micrographs of the mesial and the distal box were taken at three time points (initial, after thermocycling, and after eight weeks of storage in artificial saliva). The margins were classified as “continuous” and “non-continuous” and the percentage of continuous margins (PCM) was statistically analyzed (α = 0.05). Results: In most experimental groups, thermocycling led to a significant decrease in PCM, while the additional 8-week aging had no significant effect. F-20 + performed significantly better (p = 0.005) after 8 weeks storage in artificial saliva than the reference material with adhesive, while no statistically significant differences were observed at the other two time points. C-20 + exhibited significantly better PCM than the reference material with adhesive after thermocycling (p = 0.026) and after 8 weeks (p = 0.003). Conclusions: Overall, the experimental composites with BG showed at least as good marginal adaptation as the commercial reference, with an indication of possible re-sealing of marginal gaps. Clinical relevance: Maintaining or improving the marginal integrity of composite restorations is important to prevent microleakage and its likely consequences such as pulp irritation and secondary caries. [ABSTRACT FROM AUTHOR]

This study aimed to investigate polymerization kinetics and curing light transmittance of two series of experimental dental resin composites filled with 0–40 wt% of either 45S5 bioactive glass (BG) or a customized low-Na F-containing BG. Polymerization kinetics in 0.1-mm and 2-mm thick layers were investigated through real-time degree of conversion measurements using a Fourier transform infrared (FTIR) spectrometer. FTIR spectra were continuously collected at a rate of 2 s−1 during light-curing (1340 mW/cm2). Light transmittance through 2-mm thick composite specimens was measured using a UV–Vis spectrometer at a rate of 20 s−1. Unlike BG 45S5, which led to a dose-dependent reduction in the rate and extent of polymerization, the customized low-Na F-containing BG showed a negligible influence on polymerization. The reduction in light transmittance of experimental composites due to the addition of the low-Na F-containing BG did not translate into impaired polymerization kinetics. Additionally, the comparison of polymerization kinetics between 0.1-mm and 2-mm thick layers revealed that polymerization inhibition identified for BG 45S5 was not mediated by an impaired light transmittance, indicating a direct effect of BG 45S5 on polymerization reaction. A customized low-Na F-containing BG showed favourable behaviour for being used as a functional filler in light-curing dental resin composites. [ABSTRACT FROM AUTHOR]

The aim was to investigate the influence of endodontic irrigation solutions and protocols on the micro-tensile bond strength (μTBS) to dentin using an etch-and-rinse (ER) or self-etch (SE) adhesive approach. Eighty extracted human molars were ground to dentin. After pretreating for 27 min (21 min–3 min–3 min) with five different endodontic irrigation protocols (Group 1: NaOCl–EDTA–NaOCl; Group 2: NaOCl–NaOCl–EDTA; Group 3: NaOCl–NaCl–NaOCl; Group 4: Dual Rinse–Dual Rinse–Dual Rinse; Group 5: NaCl–NaCl–NaCl), an ER (Optibond FL, Kerr) or a SE (Clearfil SE Bond, Kuraray) adhesive system was applied. After light-curing, composite build-ups were made and cut into dentin-composite sticks. μTBS and failure modes were analyzed. Nonparametric statistical analyses (α = 0.05) were performed for comparison of the five groups within each type of adhesive as well as between the two adhesive systems used. The use of an ER instead of a SE adhesive system resulted in significantly higher μTBS for all irrigation protocols except for group 1 (NaOCl–EDTA–NaOCl) and 2 (NaOCl–NaOCl–EDTA). A statistical difference between the five different endodontic irrigation protocols was only found within the SE adhesive group, where group 1 (NaOCl–EDTA–NaOCl) achieved highest values. The use of an ER adhesive system cancels out the effect of the endodontic irrigation solution. The highest μTBS was achieved when using a NaOCl–EDTA–NaOCl-irrigation protocol in combination with Clearfil SE Bond, which shows that the selection of the endodontic irrigation should match the corresponding SE adhesive system. [ABSTRACT FROM AUTHOR]

Objectives : To assess the behavior of dual-cure and conventional bulk-fill composite materials on real-time linear shrinkage, shrinkage stress, and degree of conversion. Materials and methods: Two dual-cure bulk-fill materials (Cention, Ivoclar Vivadent (with ion-releasing properties) and Fill-Up!, Coltene) and two conventional bulk-fill composites (Tetric PowerFill, Ivoclar Vivadent; SDR flow + , Dentsply Sirona) were compared to conventional reference materials (Ceram.x Spectra ST (HV), Dentsply Sirona; X-flow; Dentsply Sirona). Light curing was performed for 20 s, or specimens were left to self-cure only. Linear shrinkage, shrinkage stress, and degree of conversion were measured in real time for 4 h (n = 8 per group), and kinetic parameters were determined for shrinkage stress and degree of conversion. Data were statistically analyzed by ANOVA followed by post hoc tests (α = 0.05). Pearson's analysis was used for correlating linear shrinkage and shrinkage force. Results: Significantly higher linear shrinkage and shrinkage stress were found for the low-viscosity materials compared to the high-viscosity materials. No significant difference in degree of conversion was revealed between the polymerization modes of the dual-cure bulk-fill composite Fill-Up!, but the time to achieve maximum polymerization rate was significantly longer for the self-cure mode. Significant differences in degree of conversion were however found between the polymerization modes of the ion-releasing bulk-fill material Cention, which also exhibited the significantly slowest polymerization rate of all materials when chemically cured. Conclusions: While some of the parameters tested were found to be consistent across all materials studied, heterogeneity increased for others. Clinical relevance: With the introduction of new classes of composite materials, predicting the effects of individual parameters on final clinically relevant properties becomes more difficult. [ABSTRACT FROM AUTHOR]

The accumulation of caries-preventive compounds on sound enamel is crucial in order to improve the inhibition of carious lesion initiation. The aim of this research was to investigate the initial accumulation of cerium, oligopeptide p11-4, and fluoride from NaF or amine fluoride (AmF) on sound enamel in vitro by means of energy dispersive X-ray spectroscopy (EDX). Polished bovine enamel specimens (n = 120 from 60 teeth) were fabricated. Out of these, 12 specimens each were treated with CeCl3 (cerium(III) chloride heptahydrate 25%), oligopeptide p11-4 (Curodont Repair, Credentis), NaF (10,000 ppm F−), AmF (amine fluoride, Elmex Fluid, CP-GABA GmbH, 10,000 ppm F−), or Aqua demin (control). After rinsing with water, the surface elemental composition (Ce, N, F, Ca, P, O, Na, Mg) was measured (EDX; EDAX Octane Elect detector, APEX v2.0), expressed in atomic percent (At%) and analyzed (non-parametric statistics, α = 0.05, error rates method). Another 12 specimens per treatment group were fabricated and used for analyzing accumulation in cross-sections with EDX linescans and two-dimensional EDX-mappings. The surface median atomic percent of cerium (At%Ce) was 0.8 for CeCl3, but no Ce was found for any other group. N, specifically for oligopeptide p11-4, could not be detected. Fluorine could only be detected on fluoridated surfaces. The median atomic percent of fluorine (At%F) was 15.2 for NaF and 17.0 for AmF. The Ca/P ratio increased significantly compared to the control following the application of NaF and AmF (p < 0.001), but decreased significantly for CeCl3 (p < 0.001). In cross-sectioned specimens of the CeCl3-group, 12.5% of the linescans revealed cerium at the enamel surface, whereas 83.3% of the NaF linescans and 95.8% of the AmF linescans revealed fluorine at the enamel surface. Following the application of oligopeptide p11-4, no traces of N were detectable. In the depth of the samples, no signal was detected for any of the corresponding elements exceeding the background noise. Cerium and fluorine (from both NaF and AmF), but not the oligopeptide p11-4, precipitated on sound enamel. [ABSTRACT FROM AUTHOR]

This study investigated the influence of conventional (10 s at 1160 mW/cm2) and fast high-irradiance (3 s at 2850 mW/cm2) light curing on the micro-tensile bond strength (μTBS) of bulk-fill resin composites bonded to human dentin. Sixty-four extracted human molars were ground to dentin and randomly assigned into eight groups (n = 8 per group). After application of a three-step adhesive system (Optibond FL), four different bulk-fill composites (two sculptable and two flowable composites) were placed. Of these, one sculptable (Tetric PowerFill) and one flowable (Tetric PowerFlow) composite were specifically developed for fast high-irradiance light curing. Each composite was polymerized with the conventional or the fast high-irradiance light-curing protocol. The specimens were cut into dentin-composite sticks, μTBS was determined and failure modes were analyzed. Statistical analysis was performed using t-test for independent observations and one-way ANOVA. A statistical difference between the curing protocols was only found for Tetric PowerFlow, where the conventional protocol (23.8 ± 4.2 MPa) led to significantly higher values than the fast high-irradiance light-curing protocol (18.7 ± 3.7 MPa). All other composite materials showed statistically similar values for both polymerization protocols. In conclusion, the use of fast high-irradiation light curing has no negative influence on the μTBS of the investigated high-viscosity bulk-fill composites. However, it may reduce the dentin bond strength of flowable bulk-fill composite. [ABSTRACT FROM AUTHOR]

The aim of the study was to examine the applicability of bioactive and antibacterial nanoparticles to an experimental adhesive. The adhesive (60 wt% BisGMA, 15 wt% TEGDMA, 25 wt% HEMA) was mixed with combinations of 5 wt% methacryl-functionalized polyhedral oligomeric silsesquioxane (MA-POSS) and one kind of bioactive/antibacterial nanoparticles: 1 wt% core-shell silica-silver nanoparticle (SiO2@Ag), 1 wt% bioactive glass with bismuth (BAG-Bi) or 1 wt% calcium phosphate (CAP). Pure adhesive served as control. The physicochemical (degree of conversion (DC), linear shrinkage (LS), shear and complex viscosity, water sorption (WS), sol fraction (SF)), biological (antimicrobial effect) and bioactive (mineral precipitation) properties were investigated. DC and LS remained unchanged. The combination of BAG-Bi/MA-POSS resulted in a significantly increased WS and SF compared to control. In addition, the combination of CAP/MA-POSS slightly increased the shear viscosity of the adhesive. The addition of the nanoparticles did not influence the antimicrobial effects compared to the pure adhesive. Improved mineral inducing capacity could be detected in all nanoparticle combinations. The combination of bioactive and/or antibacterial nanoparticles showed improved mineral inducing capacity, but no antibacterial properties. The material properties were not or only slightly affected. [ABSTRACT FROM AUTHOR]

This study evaluated the flexural properties of an experimental composite series functionalized with 5–40 wt% of a low-Na F-containing bioactive glass (F-series) and compared it to another experimental composite series containing the same amounts of the conventional bioactive glass 45S5 (C-series). Flexural strength and modulus were evaluated using a three-point bending test. Degree of conversion was measured using Fourier-transform infrared spectroscopy. Weibull analysis was performed to evaluate material reliability. The control material with 0 wt% of bioactive glass demonstrated flexural strength values of 105.1–126.8 MPa). In the C-series, flexural strength ranged between 17.1 and 121.5 MPa and was considerably more diminished by the increasing amounts of bioactive glass than flexural strength in the F-series (83.8–130.2 MPa). Analogously, flexural modulus in the C-series (0.56–6.66 GPa) was more reduced by the increase in bioactive glass amount than in the F-series (5.24–7.56 GPa). The ISO-recommended "minimum acceptable" flexural strength for restorative resin composites of 80 MPa was achieved for all materials in the F-series, while in the C-series, the materials with higher bioactive glass amounts (20 and 40 wt%) failed to meet the requirement of 80 MPa. The degree of conversion in the F-series was statistically similar or higher compared to that of the control composite with no bioactive glass, while the C-series showed a declining degree of conversion with increasing bioactive glass amounts. In summary, the negative effect of the addition of bioactive glass on mechanical properties was notably less pronounced for the customized bioactive glass than for the bioactive glass 45S5; additionally, mechanical properties of the composites functionalized with the customized bioactive glass were significantly less diminished by artificial aging. Hence, the customized bioactive glass investigated in the present study represents a promising candidate for functionalizing ion-releasing resin composites. [ABSTRACT FROM AUTHOR]

Experimental dental resin composites containing copper-doped mesoporous bioactive glass nanospheres (Cu-MBGN) were developed to impart anti-bacterial properties. Increasing amounts of Cu-MBGN (0, 1, 5 and 10 wt%) were added to the BisGMA/TEGDMA resin matrix containing micro- and nano-fillers of inert glass, keeping the resin/filler ratio constant. Surface micromorphology and elemental analysis were performed to evaluate the homogeneous distribution of filler particles. The study investigated the effects of Cu-MBGN on the degree of conversion, polymerization shrinkage, porosity, ion release and anti-bacterial activity on S. mutans and A. naeslundii. Experimental materials containing Cu-MBGN showed a dose-dependent Cu release with an initial burst and a further increase after 28 days. The composite containing 10% Cu-MBGN had the best anti-bacterial effect on S. mutans, as evidenced by the lowest adherence of free-floating bacteria and biofilm formation. In contrast, the 45S5-containing materials had the highest S. mutans adherence. Ca release was highest in the bioactive control containing 15% 45S5, which correlated with the highest number of open porosities on the surface. Polymerization shrinkage was similar for all tested materials, ranging from 3.8 to 4.2%, while the degree of conversion was lower for Cu-MBGN materials. Cu-MBGN composites showed better anti-bacterial properties than composites with 45S5 BG. [ABSTRACT FROM AUTHOR]

This study investigated polymerization kinetics, linear shrinkage, and shrinkage stress development for six contemporary composite materials of different viscosities cured using radiant exitances of 1100–2850 mW/cm2. Real-time measurements of degree of conversion, linear shrinkage, and shrinkage stress were performed over 5 min using Fourier-transform infrared spectrometry, a custom-made linometer, and a custom-made stress analyzer, respectively. For most tested variables, the factor "material" had a higher effect size than the factor "curing protocol". Maximum polymerization rate and maximum shrinkage stress rate were the most affected by changes in curing conditions. In contrast, no significant effects of curing conditions were identified within each material for shrinkage stress values measured at the end of the 5 min observation period. Linear shrinkage and shrinkage stress values measured after 5 min were closely correlated (R = 0.905–0.982). The analysis of polymerization kinetics suggested that the two composites specifically designed for rapid light-curing responded to higher radiant exitances differently than other composites. Polymerization kinetics and shrinkage stress behavior of contemporary restorative composite materials of different viscosities were overall more affected by material type than differences in curing conditions. Subtle differences in polymerization kinetics behavior shown by the two composites specifically designed for rapid high-intensity light-curing did not translate into significant differences in the development of polymerization shrinkage stress. [ABSTRACT FROM AUTHOR]

Bulk-fill composites enable timesaving and less technical-sensitive application of restorations. This study investigated and compared the marginal integrity of classical and bulk-fill composite restorations in primary and permanent molars before and after thermo-mechanical loading (TML). Two Class II cavities were prepared in each of 20 primary and 20 permanent molars. The molars were randomised in four groups for each molar type. Groups 1 and 5 were restored with a high-viscous bulk-fill composite (Tetric PowerFill), groups 2 and 6 were restored with a flowable bulk-fill composite (Tetric PowerFlow), groups 3 and 7 were restored with a high-viscous classical composite (Tetric Prime), and groups 4 and 8 were restored with a flowable classical composite (Tetric EvoFlow). In permanent molars, the flowable composites were covered with a 2-mm layer of high-viscous composite (groups 6 and 8). The restorations were subjected to TML in a custom-made chewing machine (5–50 °C, 2 min dwelling time, × 1000; 400 ,000 loading cycles, 1.7 Hz, 49 N), and quantitative marginal analysis was conducted using scanning electron microscopy. Marginal integrity of each restoration was calculated as a percentage of continuous margins before and after TML. The tested high-viscous bulk-fill restoration showed similarly high marginal integrity in primary and permanent molars as the classical restoration. The tested flowable bulk-fill restoration showed the lowest marginal integrity compared to all other restorations after TML. In contrast to flowable bulk-fill restorations, high-viscous bulk-fill restorations show similar marginal integrity as classical hybrid composite restorations after TML, in both primary and permanent molars. [ABSTRACT FROM AUTHOR]

To evaluate the influence of pretreatments on microtensile bond strength (μTBS) to eroded dentin when using a universal adhesive in self-etch mode. Forty-eight human molars were randomly assigned to six groups (G1–G6, n = 8) and ground down until dentin exposure. G2–G6 were eroded with citric acid (pH 2.6) for 10 × 2 min (within 12 h) on 5 consecutive days. G1 and G2 served as uneroded and eroded controls and were not pretreated. G3 and G4 were pretreated for 60 s with NaOCl (10% and 5%, respectively). G5 was airborne-particle abraded using Al 2 O 3 for 15 s, and G6 was roughened with a diamond bur. The universal adhesive Scotchbond Universal was applied in self-etch mode. After composite build-up, μTBS was determined. Control group G1 (uneroded) showed higher μTBS than G2 (eroded). The μTBS (mean MPa ±SD) of G5 (airborne-particle abrasion; 11.6 ± 4.6) and G6 (bur-roughening; 11.0 ± 3.3) did not differ significantly from the μTBS of G1 (12.4 ± 4.2). Significantly higher μTBS compared to all other groups was observed in G3 (NaOCl 10%; 17.6 ± 7.6). Pretreatment with NaOCl 5% (G4) achieved significantly lower μTBS (3.5 ± 2.6) than the other groups, except for G2 (8.8 ± 2.0). Pretreatment with 10% NaOCl, diamond bur roughening or airborne-particle abrasion can increase bond strength of the tested adhesive to eroded dentine. Pre-treatment with 5% NaOCl is not recommended. [ABSTRACT FROM AUTHOR]

This study investigated the potential of adhesive coating for hindering the reactivity of ion-releasing dental restorative materials. Experimental composites were prepared by replacing 10 or 20 wt% of reinforcing fillers with two types of bioactive glass. A glass ionomer, a giomer, and an alkasite were used as representatives of commercial ion-releasing materials. Restorative material specimens were coated with an etch-and-rinse adhesive, 1-step self-etch adhesive, 2-step self-etch adhesive, or left uncoated. The specimens were immersed in a lactic acid solution and ion concentrations were measured in 4 days intervals for 32 days (atomic absorption spectrometry for calcium, UV–Vis spectrometry for phosphate, ion-selective electrode for fluoride, and pH-meter for pH values). The adhesive coating reduced ion release between 0.3 and 307 times, in a significantly material- and adhesive-dependent manner. Fluoride release was most highly impaired, with the reduction of up to 307 times, followed by phosphate and calcium release, which were reduced up to 90 and 45 times, respectively. The effect of different adhesive systems was most pronounced for phosphate release, with the following rankings: uncoated ≥ 2-step self-etch adhesive ≥ 1-step self-etch adhesive ≥ etch-and-rinse adhesive. The differences among adhesives were less pronounced for calcium and fluoride. It was concluded that the resinous adhesive layer can act as a barrier for ion release and diminish the beneficial effects of remineralizing restorative materials. [ABSTRACT FROM AUTHOR]

The objective was to evaluate new commercially available ion-releasing restorative materials and compare them to established anti-cariogenic materials. Four materials were tested: alkasite Cention (Ivoclar Vivadent) in self-cure or light-cure mode, giomer Beautifil II (Shofu), conventional glass-ionomer Fuji IX (GC), and resin composite Tetric EvoCeram (Ivoclar Vivadent) as a control. Flexural strength, flexural modulus, and Weibull modulus were measured one day, three months, and after three months with accelerated aging in ethanol. Water sorption and solubility were evaluated for up to one year. Degree of conversion was measured during 120 min for self-cured and light-cured Cention. In this study, Beautifil II was the ion-releasing material with the highest flexural strength and modulus and with the best resistance to aging. Alkasite Cention showed superior mechanical properties to Fuji IX. Weibull analysis showed that the glass-ionomer had the least reliable distribution of mechanical properties with the highest water sorption. The solubility of self-cured alkasite exceeded the permissible values according to ISO 4049. Degree of conversion of light-cured Cention was higher than in self-cure mode. The use of alkasite Cention is recommended only in the light-cure mode. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate whether experimental and commercial dental restorative materials with functional fillers can exert a protective anti-demineralizing effect on enamel that is not immediately adjacent to the restoration. Four experimental resin composites with bioactive glass and three commercial restorative materials were investigated. Enamel blocks were incubated in a lactic acid solution (pH = 4.0) at a standardized distance (5 mm) from cured specimens of restorative materials. The lactic acid solution was replenished every 4 days up to a total of 32 days. Surfaces of enamel blocks were periodically evaluated by Knoop microhardness measurements and scanning electron microscopy. The protective effect of restorative materials against acid was identified as enamel microhardness remaining unchanged for a certain number of 4-day acid addition cycles. Additionally, the pH of the immersion medium was measured. While enamel microhardness in the control group was maintained for 1 acid addition cycle (4 days), restorative materials postponed enamel softening for 2–5 cycles (8–20 days). The materials capable of exerting a stronger alkalizing effect provided longer-lasting enamel protection. The protective and alkalizing effects of experimental composites improved with higher amounts of bioactive glass and were better for conventional bioactive glass 45S5 compared to a fluoride-containing bioactive glass. Scanning electron micrographs evidenced the protective effect of restorative materials by showing a delayed appearance of an etching pattern on the enamel surface. A remotely-acting anti-demineralizing protective effect on enamel was identified in experimental composites functionalized with two types of bioactive glass, as well as in three commercial ion-releasing restorative materials. [ABSTRACT FROM AUTHOR]

This in vitro study examined the margin integrity of sculptable and flowable bulk-fill resin composites in Class II cavities of primary molars. Standardized Class II cavities were prepared in human primary molars and restored with the following resin composite materials after application of a universal adhesive: a sculptable bulk-fill composite (Tetric EvoCeram Bulk Fill (TEC) or Admira Fusion x-tra (AFX)), a flowable bulk-fill composite (Venus Bulk Fill (VBF) or SDR), or a conventional composite (Filtek Supreme XTE (FS)). The bulk-fill materials were applied in 4 mm layers, while the conventional composite was applied in either 2 mm (FS2, positive control) or 4 mm layers (FS4, negative control). The specimens were exposed to thermo-mechanical loading (TML) in a computer-controlled masticator. A quantitative margin analysis was performed both before and after TML using scanning electron microscopy, and the percentage of continuous margins (margin integrity) was statistically analyzed (α = 0.05). All composites showed a significant decline in margin integrity after TML. AFX exhibited the significantly highest margin integrity of all materials after TML (97.5 ± 2.3%), followed by FS2 (79.2 ± 10.8%), TEC (73.0 ± 9.1%), and FS4 (71.3 ± 14.6%). SDR (43.6 ± 22.3%) and VBF (25.0 ± 8.5%) revealed the lowest margin integrity. In conclusion, the tested sculptable bulk-fill materials show similar or better margin integrity in primary molars than the conventional resin composite placed in 2 mm increments. [ABSTRACT FROM AUTHOR]

Rapid high-intensity light-curing of dental resin composites is attractive from a clinical standpoint due to the prospect of time-savings. This study compared the effect of high-intensity (3 s with 3,440 mW/cm2) and conventional (10 s with 1,340 mW/cm2) light-curing on micromechanical properties of conventional and bulk-fill resin composites, including two composites specifically designed for high-intensity curing. Composite specimens were prepared in clinically realistic layer thicknesses. Microhardness (MH) was measured on the top and bottom surfaces of composite specimens 24 h after light-curing (initial MH), and after subsequent immersion for 24 h in absolute ethanol (ethanol MH). Bottom/top ratio for initial MH was calculated as a measure of depth-dependent curing effectiveness, whereas ethanol/initial MH ratio was calculated as a measure of crosslinking density. High-intensity light-curing showed a complex material-dependent effect on micromechanical properties. Most of the sculptable composites showed no effect of the curing protocol on initial MH, whereas flowable composites showed 11–48% lower initial MH for high-intensity curing. Ethanol/initial MH ratios were improved by high-intensity curing in flowable composites (up to 30%) but diminished in sculptable composites (up to 15%). Due to its mixed effect on MH and crosslinking density in flowable composites, high-intensity curing should be used with caution in clinical work. [ABSTRACT FROM AUTHOR]

• Curing potential of composites with 0–40 wt% of bioactive glass was evaluated. • Experimental composite series were prepared based on Bis-EMA and UDMA resins. • Bis-EMA series showed direct polymerization inhibition by bioactive glass. • No direct polymerization inhibition was identified in UDMA series. • UDMA series demonstrated markedly better curing potential than Bis-EMA series. To evaluate the degree of conversion, light transmittance, and depth of cure of two experimental light-curable bioactive glass (BG)-containing composite series based on different resin systems. Experimental composite series based on either Bis-EMA or UDMA resin were prepared. Each series contained 0, 5, 10, 20, and 40 wt% of BG 45S5. Reinforcing fillers were added up to a total filler load of 70 wt%. The degree of conversion was evaluated using Raman spectroscopy, while light transmittance was measured using visible light spectroscopy. The depth of cure was estimated from the degree of conversion data and using the ISO 4049 scraping test. Replacement of reinforcing fillers with BG can diminish the degree of conversion, light transmittance, and depth of cure. The effect of BG on the aforementioned properties was highly variable between the experimental series. While in the Bis-EMA series, the degree of conversion was significantly impaired by BG, all of the composites in the UDMA series attained clinically acceptable degree of conversion values. The reduction of the degree of conversion in the Bis-EMA series occurred independently of the changes in light transmittance. The UDMA series showed better light transmittance and consequently higher depth of cure than the Bis-EMA series. The depth of cure for all composites in the UDMA series was above 2 mm. While the Bis-EMA series demonstrated clinically acceptable curing potential only for 0–10 wt% of BG loading, an excellent curing potential in the UDMA series was observed for a wide range (0–40 wt%) of BG loadings. [ABSTRACT FROM AUTHOR]

Background. The authors conducted an in vitro study to investigate the influence of several internal bleaching regimens on the composite-to- composite shear bond strength of a dental core buildup material. Methods. The authors fabricated 72 specimens from a resin-based composite core buildup and assigned them randomly to six groups (four experimental and two control groups) (n = 12 per group), according to the following bleaching agents: sodium perborate mixed with distilled water (SP/W); sodium perborate mixed with 3 percent hydrogen peroxide (SP/HP-3); sodium perborate mixed with 30 percent hydrogen peroxide (SP/HP-30); 35 percent ' hydrogen peroxide (HP-35). After the 12-day bleaching procedures, the authors applied a calcium hydroxide dressing for two weeks. The two control groups consisted of unbleached specimens that either did not receive (Cl) or did receive (C2) the calcium hydroxide dressing. The authors cleaned and silanized the resin-based composite specimens and coated them with an intermediate adhesive resin before applying fresh composite material. They measured composite surface roughness and shear bond strength and performed statistical analyses of the data. Results. Unbleached specimens in groups Cl and C2 exhibited significantly lower composite-to-composite bond strength and significantly lower surface roughness than did specimens in groups SP/W and SP/HP-3. Bond strength in group HP-35 was significantly lower than that in group SP/W. Conclusion. Internal bleaching regimens that involve the use of sodium perborate mixed with water or 3 percent hydrogen peroxide might increase the composite-to-composite interfacial bond strength. Clinical Implications. None of the internal bleaching regimens in this study had an adverse effect on the composite-to-composite interfacial bond strength. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the effect of individual instructions and training of dental students on the amount of applied light irradiance before and after training using a patient simulator with integrated visual feedback. Furthermore, the effect on the degree of conversion of composite restorations placed by the dental students was assessed. Forty-two dental students, split into two groups, light-cured a simulated restoration in tooth 27 of a dental patient simulator for 20 s. The irradiance (mW/cm2) received by the detector was measured in real-time before and after individual instructions and training, and the energy delivered (J/cm2) was calculated for each student. The degree of conversion at the bottom of incrementally placed composite restorations prior to individual instructions (group 1) and after individual instructions (group 2) was assessed using Fourier-transform infrared (FTIR) spectroscopy. The irradiance and degree of conversion measurements were re-assessed after all students received individual instructions. Data were analyzed using Wilcoxon signed-rank test and Mann-Whitney U-test at an overall level of significance of α = 0.05. A significant increase (p < 0.001) in applied light irradiance could be observed after individual instructions for both groups, with notably reduced data scattering. However, no significant difference was detected for the degree of conversion of placed composite restorations before or after instruction and training. Neither gender nor age of the dental students affected the obtained results. Consistent light energy delivered by dental students could be achieved through individual instructions and training with a patient simulator, also leading to less scattered irradiance results. However, the improved light-curing performance after the training did not affect the degree of conversion of the placed class II composite restorations. [ABSTRACT FROM AUTHOR]

This study investigated the short- and long-term effects of dental adhesives doped with nano-sized bioactive glass 45S5 (BAG) on the resin–dentin interfacial bond strength. Two etch-and-rinse adhesives (Adper Scotchbond Multi-Purpose (ASB) and Solobond Plus (SB)) and one self-etch adhesive (Clearfil SE Bond (CF)) were doped with different concentrations of BAG (5, 10, and 20 wt%). The unmodified (0 wt% BAG) commercial adhesives served as control groups. Dentin of 120 molars (n = 10 per group) was treated with the different adhesives, followed by buildups with a conventional composite restorative material. From each tooth, 14 sticks were prepared for micro-tensile bond strength (µTBS) testing. The sticks were stored in simulated body fluid at 37 °C and tested after 24 h or six months for µTBS and failure mode. Data were analyzed using Kruskal–Wallis tests in combination with post-hoc Conover-tests and Wilcoxon signed-rank tests at a level of significance of α = 0.05. After 24 h and six months, both etch-and-rinse adhesives with a low BAG content (up to 10 wt% for ASB and 5 wt% for SB) showed similar µTBSs as their respective control groups (0 wt% BAG). CF showed a significant decrease in µTBS even after addition of 5 wt% BAG. At a high concentration of added BAG (20 wt%), all three adhesives showed a significant decrease in µTBS compared to the unmodified controls. The CF control group showed significantly lower µTBS after 6 months of storage than after 24 h. In contrast, the µTBS of all CF groups modified with BAG was unaffected by aging. In conclusion, the tested etch-and-rinse adhesives can be modified with up to 5 wt% (SB), or 10 wt% (ASB) of BAG without reducing their short- and long-term dentin bond strength. Moreover, the addition of nano-sized BAG may prevent long-term bond strength deterioration of a self-etch adhesive. [ABSTRACT FROM AUTHOR]

This study investigates the effect of defined working distances between the tip of a sandblasting device and a resin composite surface on the composite–composite repair bond strength. Resin composite specimens (Ceram.x Spectra ST (HV); Dentsply Sirona, Konstanz, Germany) were aged by thermal cycling (5000 cycles, 5–55 °C) and one week of water storage. Mechanical surface conditioning of the substrate surfaces was performed by sandblasting with aluminum oxide particles (50 µm, 3 bar, 10 s) from varying working distances of 1, 5, 10, and 15 mm. Specimens were then silanized and restored by application of an adhesive system and repair composite material (Ceram.x Spectra ST (HV)). In the negative control group, no mechanical surface pretreatment or silanization was performed. Directly applied inherent increments served as the positive control group (n = 8). After thermal cycling of all groups, microtensile repair bond strength was assessed, and surfaces were additionally characterized using scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX). The negative control group reached the significantly lowest microtensile bond strength of all groups. No significant differences in repair bond strength were observed within the groups with varying sandblasting distances. Composite surfaces sandblasted from a distance of 1 mm or 5 mm showed no difference in repair bond strength compared to the positive control group, whereas distances of 10 or 15 mm revealed significantly higher repair bond strengths than the inherent incremental bond strength (positive control group). In conclusion, all sandblasted test groups achieved similar or higher repair bond strength than the inherent incremental bond strength, indicating that irrespective of the employed working distance between the sandblasting device and the composite substrate surface, repair restorations can be successfully performed. [ABSTRACT FROM AUTHOR]

This study investigated the effect of over-etching and prolonged application time of a universal adhesive on dentin bond strength. Ninety extracted human molars were ground to dentin and randomly allocated into nine groups (G1–9; n = 10 per group), according to the following acid etching and adhesive application times. In the control group (G1), phosphoric acid etching was performed for 15 s followed by application of the universal adhesive Scotchbond Universal (3M) for 20 s, as per manufacturer's instructions. In groups G2–5, both the etching and adhesive application times were either halved, doubled, quadrupled, or increased eightfold. In groups G6–9, etching times remained the same as in G2–5 (7.5 s, 30 s, 60 s, and 120 s, respectively), but the adhesive application time was set at 20 s as in the control group (G1). Specimens were then restored with a nanofilled composite material and subjected to microtensile bond strength testing. Bond strength data were statistically analyzed by ANOVA and Tukey's post-hoc tests (α = 0.05). The relationship of bond strength with etching and adhesive application time was examined using linear regression analysis. Treatment of dentin with halved phosphoric acid etching and adhesive application times (G2) resulted in a significant bond strength decrease compared to the control group (G1) and all other test groups, including the group with halved acid etching, but 20 s of adhesive application time (G6). No significant differences in bond strength were found for groups with multiplied etching times and an adhesive application time of 20 s or more, when compared to the control group (G1). In conclusion, a universal adhesive application time of at least 20 s is recommended when bonding to over-etched dentin. [ABSTRACT FROM AUTHOR]

Good margin integrity with a tight seal of the adhesive interface is considered one of the key factors for the clinical success of composite restorations. This study investigated the effect of enamel etching with phosphoric acid on the margin integrity of self-etch bonded composite restorations in demineralized enamel. Crowns of bovine incisors were assigned into 14 groups (n = 10 per group) of which ten groups (groups 1–5 and 8–12) were demineralized (21 days, acid buffer, pH 4.95) to create artificial carious lesions. Standardized Class V cavities were prepared in all specimens. Demineralized groups were either etched with phosphoric acid for 10, 30, 60, or 120 s (groups 2–5 and 9–12), or no etching was performed (groups 1 and 8). The non-demineralized (sound) groups were etched for 10 s (groups 7 and 14) or remained non-etched (groups 6 and 13). Resin composite restorations were then placed using either a one-step (iBond Self Etch, groups 1–7) or two-step self-etch adhesive (Clearfil SE Bond, groups 8–14). Margin integrity of the restorations was assessed after thermocycling (5000×, 5–55 °C) using scanning electron microscopy, and the percentage of continuous margins (%CM) was statistically analyzed (α = 0.05). Phosphoric acid etching significantly increased %CM in both demineralized and sound enamel. For iBond Self Etch, a significant increase in %CM in demineralized enamel was observed with increased etching times. All etched groups treated with Clearfil SE Bond and those etched for 60 or 120 s and treated with iBond Self Etch showed similar %CM in demineralized enamel as in etched sound enamel, and significantly higher %CM than in non-etched sound enamel. In conclusion, enamel etching with phosphoric acid improves margin integrity of composite restorations in demineralized enamel when bonded with the examined adhesives. [ABSTRACT FROM AUTHOR]

Previous work has shown that partial replacement of reinforcing fillers with unsilanized silica particles can diminish polymerization shrinkage stress of dental resin composites. The aim of the present study was to investigate whether such an effect can be attained by using unsilanized bioactive glass (BG). Incorporating BG fillers into resin composites is interesting due to their potential for exerting caries-preventive effects. Experimental light-curable composites with a total filler load of 77 wt% were prepared. Reinforcing fillers were partially replaced with 0–60 wt% of BG 45S5 and an experimental low-sodium fluoride-containing BG. The following properties were investigated: linear shrinkage, degree of conversion, shrinkage stress, maximum shrinkage stress rate, and time to achieve maximum shrinkage stress rate. The diminishing effect of BG 45S5 on shrinkage stress was mediated by a decrease in degree of conversion caused by this BG type. In contrast, as the degree of conversion remained unaffected by the experimental BG, the resulting shrinkage behaviour was governed by the effect of varying amounts of silanized and unsilanized fillers on material's viscoelastic properties. The replacement of silanized reinforcing fillers with unsilanized BG did not reduce polymerization shrinkage stress unless the reduction was attained indirectly through a diminished degree of conversion. [ABSTRACT FROM AUTHOR]

To investigate the effect of methacrylate polyhedral oligomeric silsesquioxane (POSS-8) particles on the polymerization process, dentin bond strength, and mineral precipitation of universal dental adhesives. Five universal adhesives (Adhese Universal, CLEARFIL Universal Bond, Futurabond U, iBOND Universal, Scotchbond Universal) were filled with POSS-8 particles (10 wt%, additionally 2 wt% and 5 wt% in Scotchbond Universal). The particle size and dispersion in ethanol and acetone were examined by dynamic light scattering. Degree of conversion, linear shrinkage, and shear bond strength to dentin treated with the filled and pure adhesives (controls) were measured. Growth of calcium phosphate (Ca/P) precipitates on the adhesive specimens immersed in artificial saliva for up to 28 days was analyzed by energy-dispersive X-ray spectroscopy and scanning electron microscopy. Statistical analyses were performed using ANOVA and Tukey's post-hoc tests (p < 0.05). The hydrodynamic radius of the particles in acetone (1.4 ± 0.4 nm) and ethanol (1.1 ± 0.4 nm) revealed their good dispersion. POSS-8 did not change the degree of conversion and dentin bond strength of any adhesive. Ca/P precipitates formed on iBOND Universal specimens doped with POSS-8 after 4 weeks of immersion, but were not detected on the unfilled adhesive. The mineral precipitation of all other adhesives was not improved by POSS-8. POSS-8 particles did not compromise polymerization and bonding of universal adhesives. Ca/P precipitation was stimulated by POSS-8 only in iBOND Universal. [ABSTRACT FROM AUTHOR]

This study introduced an experimental bioactive glass (BG) with a lower Na2O content than conventional BG 45S5 (10.5 wt% vs. 24.5 wt%), additionally containing CaF2 (12 wt%) and a network connectivity similar to that of BG 45S5. A series of experimental composites functionalized with 5–40 wt% of the novel BG was prepared and compared to a corresponding series of experimental composites functionalized with 5–40 wt% of BG 45S5. Commercial acid-neutralizing materials (alkasite, giomer, and glass ionomer) were used as references. The capabilities of the materials to neutralize hydrochloric acid (pH = 2.6) and lactic acid (pH = 4.5) were evaluated by real-time pH measurements over 1 h. The degree of conversion and precipitation of calcium phosphate were also investigated. Data were analyzed using one-way and Welch ANOVA at an overall level of significance of 0.05. The acid-neutralizing potential of the experimental BG incorporated into resin composites was generally comparable to that of BG 45S5, and better than that of a giomer and glass ionomer. Fluorine was identified in the precipitate that developed on the composites functionalized with the experimental BG, suggesting a capability of forming fluorapatite. Unlike the 45S5 composition, the experimental BG did not impair the degree of conversion of resin composites. The novel BG filler is therefore an interesting candidate for future investigations of caries-preventive resin composites, and their potential clinical applicability for restorative, preventive, and orthodontic purposes. [ABSTRACT FROM AUTHOR]

This study investigated the impact of a separate silanization step on the repair bond strength of composite substrates using a universal adhesive after various mechanical surface treatments. Composite specimens were aged and exposed to the following mechanical roughening treatments: diamond bur abrasion, aluminum oxide sandblasting, or silica coating. The specimens were then either left untreated or conditioned with universal adhesive (Scotchbond Universal), or a silane coupling agent was applied before the use of the universal adhesive or a conventional adhesive (Optibond FL). The conditioned surfaces and fresh substrate (positive control group) were covered with repair composite, and microtensile bond strength testing was performed. The significantly highest bond strength was obtained in the positive control group. Repair bond strength of the universal adhesive applied after a separate silanization step was similar to that without prior silanization, independent of the mechanical surface treatment. Moreover, after silica coating, no significant differences in the repair bond strength were detected among the different adhesive treatments. In conclusion, a separate silanization step before surface conditioning with the universal adhesive does not enhance the repair bond strength. On silica-coated composite substrates, repair bond strength values of the universal adhesive were similar to those of the conventional adhesive. [ABSTRACT FROM AUTHOR]

Bioactive resin composites can contribute to the prevention of secondary caries, which is one of the main reasons for failure of contemporary dental restorations. This study investigated the effect of particle size of bioactive glass 45S5 on chemical and physical composite properties. Four experimental composites were prepared by admixing the following fillers into a commercial flowable composite: (1) 15 wt% of micro-sized bioactive glass, (2) 15 wt% of nano-sized bioactive glass, (3) a combination of micro- (7.5 wt%) and nano-sized (7.5 wt%) bioactive glass, and (4) 15 wt% of micro-sized inert barium glass. Hydroxyapatite precipitation and pH rise in phosphate-buffered saline were evaluated during 28 days. Degree of conversion and Knoop microhardness were measured 24 h after specimen preparation and after 28 days of phosphate-buffered saline immersion. Data were analyzed using non-parametric statistics (Kruskal–Wallis and Wilcoxon tests) at an overall level of significance of 5%. Downsizing the bioactive glass particles from micro- to nano-size considerably improved their capability to increase pH. The effect of nano-sized bioactive glass on degree of conversion and Knoop microhardness was similar to that of micro-sized bioactive glass. Composites containing nano-sized bioactive glass formed a more uniform hydroxyapatite layer after phosphate-buffered saline immersion than composites containing exclusively micro-sized particles. Partial replacement of nano- by micro-sized bioactive glass in the hybrid composite did not impair its reactivity, degree of conversion (p > 0.05), and Knoop microhardness (p > 0.05). It is concluded that downsizing bioactive glass particles to nano-size improves the alkalizing potential of experimental composites with no negative effects on their fundamental properties. [ABSTRACT FROM AUTHOR]

This study investigated the effect of bioactive micro-fillers on the light transmittance and polymerization of three commercially available bulk-fill resin composites. These were mixed with 20 wt% bioactive glass 45S5, Portland cement, inert dental barium glass, or nothing (controls). Composites were photo-activated and light transmittance through 4 mm thick specimens was measured in real time. Moreover, degree of conversion (DC) and Knoop hardness (KHN) were assessed. Light transmittance of all bulk-fill composites significantly decreased (p < 0.05) with addition of 20 wt% bioactive glass 45S5 but not when inert barium glass was added. For bulk-fill composites modified with Portland cement, light irradiance dropped below the detection limit at 4 mm depth. The DC at the top surface of the specimens was not affected by addition of bioactive or inert micro-fillers. The bottom-to-top ratio of both DC and KHN surpassed 80% for bulk-fill composites modified with 20 wt% bioactive or inert glass fillers but fell below 20% when the composites were modified with Portland cement. In contrast to Portland cement, the addition of 20 wt% bioactive glass maintains adequate polymerization of bulk-fill composites placed at 4 mm thickness, despite a decrease in light transmittance compared to the unmodified materials. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The study aimed to analyze the shear bond strength of aged silorane composite repaired with the same substrate or a conventional methacrylate-based composite after different mechanical and adhesive surface treatments. Methods: Silorane composite specimens were aged by thermal cycling (5000 cycles, 5–55°C) and randomly assigned to different surface treatments (each group n =16): diamond bur abrasion, aluminum oxide sandblasting, silica coating, or hydrofluoric acid etching. Then, an adhesive system corresponding to the repair composite or a combination of silane agent and the respective adhesive was applied. Silorane composite or a nanofiller composite were adhered onto the conditioned surfaces. In the control group (n =16), silorane composite was adhered to fresh substrate (incremental build up). After further thermal cycling, shear bond strength was tested and failure modes were assessed. Data were analyzed by ANOVA/post hoc tests, Weibull statistics and Chi2-test (p ≤0.05). Results: Incremental shear bond strength (control group: 21.0±10.5MPa) was achieved by all groups except those etched with hydrofluoric acid or samples abraded with diamond bur and repaired with the nanofiller composite without silane application. Generally, the application of the silane agent improved repair bond strength of the nanofiller but not of the silorane composite. Cohesive failure was observed more frequently than adhesive failure when the silane agent was applied or when silorane composite was used for repair. Significance: Silorane composite can be repaired with either the same substrate or a methacrylate-based nanofiller composite but requires mechanical surface treatment and – in case of the methacrylate-based composite – silanization prior to adhesive application. [Copyright &y& Elsevier]