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Objectives: To systematically compile data on the degree of conversion (DC) for bulk-fill composites using a network meta-analysis., Methods: A systematic search for in vitro studies of DC of bulk-fill composites was performed in PubMed, Web of Science, Scopus, and Open Grey. Risk of bias within studies and due to missing evidence was assessed using the Joanna Briggs Institute scoring system and ROB-MEN tool, respectively. The primary outcome was the DC of bulk-fill composites. Surface Under the Cumulative Ranking curve (SUCRA) was used to rank relative performance. Inconsistencies in the model were investigated to ensure its validity and the level of confidence in the network meta-analysis (CINeMA) was assessed., Results: A total of 28 studies were included in the quantitative analysis. The average DC values (%) for 0-h/top, 0-h/bottom, 24-h/top, and 24-h/bottom were 59.09, 57.14, 66.73, and 63.87, respectively. According to their SUCRA ranking, the best-performing composites were: SonicFill, Venus Bulk Fill, and SDR (0-h/top), Reveal HD, i-Flow Bulk Fill, and Venus Bulk- Fill (0-h/bottom), Venus Bulk Fill, SDR, and QuiXfil (24-h/top), and Venus Bulk Fill, Aura Bulk Fill, and i-Flow Bulk Fill (24-h/bottom). Incoherence between direct and indirect evidence was identified as the most significant factor affecting confidence., Conclusions: DC values of bulk-fill composites were within the range commonly reported for previous generations of "conventional" composites, with flowable composites tending to perform better than sculptable composites. High variability in DC data was observed, which may be attributed to incompletely understood methodological differences., Clinical Significance: DC is a fundamental parameter that influences multiple mechanical and biological properties of resin composites and is particularly relevant for the group of bulk-fill composites that are designed for use in thick layers., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: To prepare experimental composites with bioactive glass (BG) and investigate their release of calcium (Ca), phosphate (PO 4 ), and fluoride (F), as well as pH changes and apatite precipitation after immersion., Methods: Experimental composites were prepared with 0, 10, or 20 wt% of either BG 45S5 or a customized low-Na F-containing BG. Three commercial ion-releasing materials were used for reference. Material specimens were immersed in lactic acid (pH = 4.0) and artificial saliva (pH = 6.4). Ion concentrations (atomic absorption spectrometry for Ca, UV-vis spectrometry for PO 4 , and ion-selective electrode for F) and pH were measured after 4, 8, 12, 16, 20, 24, 28, and 32 days. After immersion, composite specimens were analyzed using scanning electron microscopy (SEM) and Fourier-transform infrared (FTIR) spectroscopy., Results: Material-dependent concentrations of Ca, PO 4 , and F were measured in the lactic acid solution, while a decrease of Ca and PO 4 concentrations was observed in artificial saliva. The uptake of ions from artificial saliva indicates their precipitation on specimen surfaces, which was supported by the results of SEM and FTIR investigations. In experimental composites functionalized with both bioactive glass types and a commercial "alkasite" material, apatite was precipitated not only in artificial saliva but also in the lactic acid solution., Conclusions: Experimental BG-containing composites and selected commercial restorative materials demonstrated the potential for releasing multiple ion types and increasing pH., Clinical Significance: The observed effects can be beneficial for preventing demineralization and promoting remineralization of dental hard tissues, while apatite precipitation can additionally help in sealing marginal discontinuities., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objectives: To investigate the effect of rapid high-intensity light-curing on the marginal integrity of four bulk-fill composites, including two materials specifically designed for high-intensity curing., Methods: Class V cavities were prepared on buccal surfaces of intact human molars with simulated pulpal pressure, filled in a single increment and light-cured using a conventional (10 s @ 1,340 mW/cm 2 ) or high-intensity (3 s @ 3,440 mW/cm 2 ) protocol. The restorations were subjected to thermo-mechanical loading (TML) comprising 1,200,000 mechanical loading cycles and 3,000 thermocycles. Quantitative margin analysis was performed before and after TML using a scanning electron microscope, and the marginal integrity was expressed as percentage of continuous margin (PCM)., Results: All PCM values measured before TML were statistically similar regardless of the material and curing protocol (p>0.05). A statistically significant effect of the curing protocol (p = 0.021) was identified only after TML for one material. PCM was significantly diminished by TML (p<0.001) for most combinations of material and curing protocol. The PCM values of the sculptable composites after TML were statistically similar regardless of the curing protocol (p>0.05). Compared to these values, significantly lower PCM after TML was identified for the flowable composites cured with the high-intensity protocol (p = 0.001-0.045)., Conclusion: In most cases, high-intensity and conventional curing generally led to similar marginal integrity. Although all of the investigated composites initially performed similarly well, the flowable composites light-cured using the high-intensity protocol showed a significantly inferior marginal integrity compared to the sculptable composites after loading., Clinical Significance: Rapid high-intensity light-curing cannot be recommended for flowable bulk-fill composites since it may compromise the tooth-restoration interface., (Copyright © 2021. Published by Elsevier Ltd.)

Objectives: To compare the effect of high-intensity (3 s with 3440 mW/cm 2 ) and conventional (10 s with 1340 mW/cm 2 ) light-curing on shrinkage properties and degree of conversion of conventional and bulk-fill resin composites, including two composites specifically designed for high-intensity curing., Methods: Real-time linear shrinkage and shrinkage force of 1.5 mm thick composite specimens were measured for 15 min after the start of light-curing using custom-made devices. From the shrinkage force data, maximum shrinkage force rate and time to achieve maximum shrinkage force rate were determined. Degree of conversion was measured using Fourier transform infrared spectrometry., Results: Flowable composites showed significantly higher linear shrinkage compared to sculptable composites (1.93-2.91 % vs. 1.15-1.54 %), as well as significantly higher shrinkage forces (18.7-24.4 N vs. 13.5-17.0 N). Degree of conversion amounted to 45.8-60.1 %. For high-intensity curing, degree of conversion was significantly lower in three out of seven composites, whereas shrinkage forces were either increased, decreased, or unchanged compared to conventional curing. For high-intensity curing, maximum shrinkage rates were 6-61 % higher, whereas times to achieve maximum shrinkage force rate were 15-53 % shorter compared to conventional curing. Composites specifically designed for high-intensity curing showed shrinkage parameters comparable to other investigated composites., Conclusion: Shrinkage behavior under conditions of high-intensity light-curing was material-dependent. Shrinkage force kinetics were more strongly affected by high-intensity curing than absolute values of linear shrinkage and shrinkage force., Clinical Significance: Despite being attractive for its convenience, high-intensity curing can lead to considerably faster development of shrinkage forces in the early stage of polymerization., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objectives: To analyse prescription of antibodies in emergency dental service according to antibiotic type, working diagnosis, patient visit time and patient demographic characteristics. Additionally, prescription practices among individual dentists were analysed., Methods: The data in this retrospective cohort study were collected from electronic medical records and analyzed using descriptive statistics. Statistical analyses were conducted using the chi-square test and the Z-test with post-hoc Bonferroni adjustment (α =0.05)., Results: The study covered 20,879 patient visits during a 1.5-year period (from 1 June 2015 to 1 December 2016). Antibiotics were prescribed in 10,188 (48.8%) visits. In 6,202 (29.7%) visits, no dental treatment was performed and only an antibiotic was prescribed. The antibiotics most frequently prescribed were from the penicillin group and also contained clavulanic acid (70.5%); the second most frequently prescribed antibiotic was clindamycin (15.0%). The most common diagnoses for which an antibiotic was prescribed were acute apical abscess, pericoronitis and retained root; for these diagnoses, an antibiotic was prescribed in 79.8%, 64.3% and 63.3% of visits, respectively. Prescription of an antibiotic was significantly more frequent during Sundays and holidays (55.6% of visits) than during working days (33.2% of visits). Prescription of an antibiotic increased from the age of 1 towards the age of 75 and decreased thereafter. Female dentists prescribed antibiotics slightly but significantly (P < 0.001) more frequently than male dentists (50.8% and 46.8% of visits, respectively). High heterogeneity was observed among dentists regarding their criteria for prescribing antibiotics; individual dentists prescribed antibiotics in 15.0%-72.1% of the total number of visits., Conclusion: Multiple possible issues in the prescription of antibiotics were observed, ranging from administration for inappropriate indications to noncritical and excessive prescription., (© 2019 FDI World Dental Federation.)

Objectives: To investigate the polymerization kinetics and the degree of conversion (DC) of experimental resin composites with varying amount of bioactive glass 45S5 (BG)., Methods: Experimental resin composites based on a photo-curable Bis-GMA/TEGDMA resin system were prepared. The composite series contained 0, 5, 10, 20, and 40 wt% of BG and reinforcing fillers up to the total filler amount of 70 wt%. Composite specimens were light cured with 1219 mW/cm 2 for 20 or 40 s and their DC was monitored during 5 min at the data collection rate of 2 s -1 using attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR)., Results: The 5-min DC values for experimental composites were in the range of 42.4-55.9% and 47.3-57.9% for curing times of 20 and 40 s, respectively. The differences in the 5-min DC between curing times of 20 s or 40 s became more pronounced in materials with higher BG amount. Within both curing times, a decreasing trend of the 5-min DC values was observed with the increasing percentage of BG fillers. The maximum polymerization rate also decreased consistently with the increasing BG amount., Conclusions: Unsilanized BG fillers showed a dose-dependent inhibitory effect on polymerization rate and the DC. Extending the curing time from 20 to 40 s showed a limited potential to improve the DC of composites with higher BG amount., Significance: The observed inhibitory effect of BG fillers on the polymerization of resin composites may have a negative influence on mechanical properties and biocompatibility., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objectives: The aim of this work was to investigate the curing potential of an experimental resin composite series with the systematically varying amount of bioactive glass 45S5 by evaluating the degree of conversion, light transmittance and depth of cure., Methods: Resin composites based on a Bis-GMA/TEGDMA resin with a total filler load of 70 wt% and a variable amount of bioactive glass (0-40 wt%) were prepared. The photoinitiator system was camphorquinone and ethyl-4-(dimethylamino) benzoate. The degree of conversion and light transmittance were measured by Raman spectroscopy and UV-vis spectroscopy, respectively. The depth of cure was evaluated according to the classical ISO 4049 test., Results: The initial introduction of bioactive glass into the experimental series diminished the light transmittance while the further increase in the bioactive glass amount up to 40 wt% caused minor variations with no clear trend. The curing potential of the experimental composites was similar to or better than that of commercial resin composites. However, unsilanized bioactive glass fillers demonstrated the tendency to diminish both the maximum attainable conversion and the curing efficiency at depth., Conclusions: Experimental composite materials containing bioactive glass showed a clinically acceptable degree of conversion and depth of cure. The degree of conversion and depth of cure were diminished by bioactive glass fillers in a dose-dependent manner, although light transmittance was similar among all of the experimental composites containing 5-40 wt% of bioactive glass., Clinical Significance: Reduced curing potential caused by the bioactive glass has possible consequences on mechanical properties and biocompatibility., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objectives: Remineralizing experimental composites based on amorphous calcium phosphate (ACP) were investigated. The impact of curing time (20 and 40s), curing depth (1, 2, 3 and 4mm) and addition of inert fillers (barium glass and silica) on the conversion and temperature rise during curing were examined., Methods: Five ACP-composites and two control composites were prepared based on the light-curable EBPADMA-TEGDMA-HEMA resin. For temperature measurements, a commercial composite was used as an additional control. Conversion was assessed using FT-Raman spectroscopy by comparing the relative change of the band at 1640 cm(-1) before and after polymerization. The temperature rise during curing was recorded in real-time using a T-type thermocouple., Results: At 1mm depth, the ACP-composites attained significantly higher conversion (77.8-87.3%) than the control composites based on the same resin (60.5-66.3%). The addition of inert fillers resulted in approximately 5% lower conversion at clinically relevant depths (up to 2mm) for the curing time of 40s. Conversion decline through depths depended on the added inert fillers. Conversion values higher than 80% of the maximum conversion were observed for all of the ACP-composites at depths up to 3mm, when cured for 40s. Significantly higher total temperature rise for the ACP-composites (11.5-13.1 °C) was measured compared to the control composites (8.6-10.8 °C) and the commercial control (8.7 °C)., Conclusions: The admixture of inert fillers represents a promising strategy for further development of ACP-composites, as it reduced the temperature rise while negligibly impairing the conversion., Clinical Significance: High conversions of ACP-composites are favorable in terms of mechanical properties and biocompatibility. However, high conversions were accompanied with high temperature rise, which might present a pulpal hazard., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objectives: To investigate the 24h post-cure polymerization and the effect of temperature on the post-cure polymerization of one conventional and three bulk-fill composite materials., Methods: A conventional composite GrandioSO (GR) and three bulk-fill composites: Tetric EvoCeram Bulk Fill (TECBF), Quixfil (QF) and X-tra fil (XF) were investigated. The samples were cured for 20s with irradiance of 1090mW/cm(2). Composite samples were divided into two groups: the "room-temperature" group (RT, n=5) and the "body-temperature" group (BT, n=5) and they were stored in dark at 20°C and 37°C, respectively. Measurements of degree of conversion (DC) were made immediately after curing (0h) and 24h post-cure (24h). To analyse the extent of post-cure DC increase, the DC values of 0h-RT/24h-RT and 0h-BT/24h-BT were compared. To analyse the difference in DC between RT and BT, the DC values of 0h-RT/0h-BT and 24h-RT/24h-BT were compared., Results: DC increase 24h post-cure was significant for all composites and ranged between 6.3% and 8.2% in RT and between 12.5% and 15.7% in BT. All composites demonstrated a higher DC in 24h-BT compared to 24h-RT. The difference was statistically significant for GR, TECBF and QF., Conclusions: All composites demonstrated a significant post-cure effect after 24h. Post-cure temperature increase from 20°C to 37°C yielded a higher post-cure DC increase., Clinical Significance: Due to the temperature effect on the final DC, studies performed at composite samples at room temperature may record more inferior properties than these attained in the oral cavity., (Copyright © 2014 Elsevier Ltd. All rights reserved.)