Effect of ultra-fast high-intensity light-curing on the properties of a new bulk-fill restorative resin composite system: A Scoping Review.

Background: This scoping review aims to analyze the impact of rapid high-intensity light-curing on a new bulk-fill resin-based composites (RBCs) designed for this type of polymerization. Material and Methods: This scoping review was reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and Joanna Briggs Institute Manual of Evidence Synthesis. The methods were registered on the Open Science Framework (). The literature search was conducted in PubMed/MEDLINE, Embase, Web of Science, Scopus and Cochrane Library databases. Eligibility was considered for in vitro and clinical studies evaluating the effects of ultra-fast high-intensity light-curing on a new system of bulk-fill RBCs. Results: Of 1.688 articles identified, 27 were included in the qualitative synthesis. All studies were conducted in vitro. A total of 2.432 specimens were evaluated. The studies have shown that shortness light-curing may result in similar properties (stress generated by polymerization shrinkage, marginal integrity, and bond strength to dental interface) for the new bulk-fill RBCs. Conclusions: Therefore, the new bulk-fill RBCs can be light-cured with a short exposure time and high intensity, providing a time-saving benefit in clinical practice, with similar results to standard light-curing in conventional composites, although, its use should be approached with caution in the flowable composite. Key words:Resin composites, polymerization, dental materials, review.

Assessment of Surface Roughness, Color, and Bonding Efficacy: Self-Adhesive vs. Conventional Flowable Resin.

This in vitro study aimed to analyze the surface roughness (Ra) and color stability (ΔEab, ΔE00) following simulated mechanical brushing and to evaluate the microtensile (µTBS) of self-adhering resin flowable (SARF) to dentin. The selected materials were Constic, Yflow AS, and Tetric N flow (TNF/control). Thirty composite resin cylinders were fabricated for surface property evaluation. Ra and color were assessed both before and after simulated brushing. The thresholds of 50:50% perceptibility and acceptability of color differences in the evaluated resins were assessed. For µTBS analysis, fifteen molars were selected, sectioned to expose flat dentin surfaces, and restored according to the manufacturers' instructions for microtensile testing. There were statistically significant differences in Ra among the groups, with Constic exhibiting the highest Ra value (0.702 µm; p < 0.05), whereas Yflow AS presented the lowest Ra value (0.184 µm). No statistically significant difference in color was observed among the groups (p > 0.05). The 50:50% perceptibility and acceptability thresholds were set at 1.2 and 2.7 for ΔEab and 0.8 and 1.8 for ΔE 00. All the results fell within the acceptable limits. The mean µTBS values of Constic, Yflow AS, and TNF were 10.649 MPa, 8.170 MPa, and 33.669 MPa, respectively. This study revealed increased Ra and comparable color stability among all the tested composite resins after abrasion. However, the SARF exhibited lower µTBS compared to conventional using an adhesive system.

Color Stability of Single-Shade Resin Composites in Direct Restorations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The objective was to compare the color match and color stability behavior of single- and multi-shade resin-based composites (RBCs) used for direct restorations. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized clinical trials evaluating the shade performance of single-shade RBCs in direct restorations were included. A search of the scientific literature was performed in five databases (April 2024). The meta-analysis was performed using RevMan 5.4, calculating the risk difference (RD) and 95% confidence interval (CI) of the dichotomous outcome using a random effects model. Bias was assessed using the RoB 2.0 tool, and certainty of evidence was assessed using the GRADEpro tool. Four studies were selected, with 263 restorations analyzed. The results showed comparable performance between single-shade RBCs and multi-shade RBCs in terms of color match and color stability over 12 months. Three studies had a low risk of bias with all expected results, and one study had some concerns. The certainty of evidence for color stability was considered low for all follow-up periods due to the small number of events and sample size. According to the United States Public Health Service Evaluation (USPHS) and the World Dental Federation (FDI), there is comparable clinical color performance between single-shade and multi-shade RBCs over 12 months.

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

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

Thirty-six-month clinical evaluation of posterior high-viscosity bulk-fill resin composite restorations in a high caries incidence population: interim results of a randomized clinical trial.

OBJECTIVES: This study compared the clinical performance of two bulk-fill (BF) and one conventional resin composite in a population with a high caries incidence. MATERIALS AND METHODS: A total of 138 class I and II restorations were performed and randomly divided into three groups (n = 46) with equal allocation: Filtek BF (FBF; 3M ESPE), Tetric EvoCeram BF (TBF; Ivoclar Vivadent), and control Filtek Z250 (Z250; 3M ESPE). The evaluations were performed using the USPHS and FDI criteria at baseline and after 12 and 36 months by a previously calibrated evaluator. The Friedman and Wilcoxon tests for paired data were used for statistical analysis (α = 0.05). RESULTS: The DMFT index at baseline was 9.44, with 87% from the decayed component. After 36 months, 108 restorations (n = 36) were evaluated. Two failures were observed for TBF at marginal adaptation and recurrence of caries, resulting in a survival rate of 94.44% and an annual failure rate (AFR) of 1.26%. No equivalence was observed between the criteria for surface roughness, marginal adaptation, and discoloration. CONCLUSIONS: The 36-month clinical performance of high-viscosity BF resin composites was comparable to conventional incremental-filled resin composites. The FDI criteria better presented the restorations' clinical success. However, in the case of failure, both criteria provided the same result. CLINICAL RELEVANCE: High-viscosity bulk-fill resin composites showed excellent performance after 36 months in a high caries incidence population. It can be considered a simplified alternative restoration method that reduces operating time and minimizes possible operator errors.

Radiopacity of restorative composites by conventional radiograph and digital images with different resolutions.

PURPOSE: This study was performed to evaluate and compare the radiopacity of dentin, enamel, and 8 restorative composites on conventional radiograph and digital images with different resolutions. MATERIALS AND METHODS: Specimens were fabricated from 8 materials and human molars were longitudinally sectioned 1.0 mm thick to include both enamel and dentin. The specimens and tooth sections were imaged by conventional radiograph using #4 sized intraoral film and digital images were taken in high speed and high resolution modes using a phosphor storage plate. Densitometric evaluation of the enamel, dentin, restorative materials, a lead sheet, and an aluminum step wedge was performed on the radiographic images. For the evaluation, the Al equivalent (mm) for each material was calculated. The data were analyzed using one-way ANOVA and Tukey's test (p<0.05), considering the material factor and then the radiographic method factor, individually. RESULTS: The high speed mode allowed the highest radiopacity, while the high resolution mode generated the lowest values. Furthermore, the high resolution mode was the most efficient method for radiographic differentiation between restorative composites and dentin. The conventional radiograph was the most effective in enabling differentiation between enamel and composites. The high speed mode was the least effective in enabling radiographic differentiation between the dental tissues and restorative composites. CONCLUSION: The high speed mode of digital imaging was not effective for differentiation between enamel and composites. This made it less effective than the high resolution mode and conventional radiographs. All of the composites evaluated showed radiopacity values that fit the ISO 4049 recommendations.

Effect of dentin pretreatment with potassium oxalate: analysis of microtensile bond strengths and morphologic aspects.

An effective and stable bond is the most desirable characteristic of contemporary adhesive systems. The aim of this study was to evaluate the effect of potassium oxalate on dentin/resin bond strength. Dentin on the occlusal surface of human premolars was exposed and etched with 35% phosphoric acid, to receive 3% monohydrated potassium oxalate and the following adhesive systems: Scotchbond Multipurpose (SMO; 3M/ESPE) and Prime & Bond NT (PBO; Dentsply), followed by the application of resin composite (Z250; 3M/ESPE). The control groups (SM and PB) did not receive potassium oxalate application. The prepared teeth were kept in distilled water at 37°C for 24 h and 12 months. They were then cut longitudinally into sticks with a bond area of ∼0.8 mm(2) for submission to the microtensile bond strength test. The data were analyzed by two-factor ANOVA, Tamhane's paired comparisons, and the Student t-test (α = 0.05). The hybrid layer formed was observed by scanning electron microscopy (SEM). SEM analysis of the surfaces treated with PB revealed shorter resin tags associated with the application of potassium oxalate, whereas SM showed tags similar to those without potassium oxalate. A significant difference was shown between the two storage times for each of the protocols. There was a significant difference among SMO, SM, and PBO (24 h), as well as among SM, SMO, and PBO, and between PB and PBO (12 months). The application of potassium oxalate before conventional adhesive systems may result in alteration of the bond strength between dentin and resin composite, depending on the material.

Nanohybrid versus nanofill composite in class I cavities: margin analysis after 12 months.

This study evaluates the margin of a nanofill, a nanohybrid, and a conventional microhybrid composite in restorations in occlusal cavities of posterior teeth after 12 months. Forty-one patients, each with three molars affected by primary caries or the need to replace restorations, participated in this research. The teeth were restored with a nanofill (Filtek Z350), a nanohybrid (Esthet-X), and a microhybrid as a control (Filtek Z250). Ten patients were selected randomly, and the three restorations were molded with a low-viscosity polyvinyl siloxane material. The molds were poured with epoxy resin, gold-sputter coated, observed by scanning electron microscopy, and classified as: "perfect margin," "marginal irregularity," "marginal gap," "marginal fracture," or "artifact." For statistical analysis, the Wilcoxon and Friedman nonparametric tests and paired-samples t-test were used (significance level of 5%). The performance of the three materials was compared after 1 week and 12 months. No statistically significant differences were detected for all criteria (P > 0.05). When each composite was compared over time, statistically significant differences were found for the criterion, perfect margins (Esthet-X and Filtek Z350, P < 0.05). The materials performed satisfactorily over the 12-month-observation period, but all composites under investigation showed a certain amount of deterioration relating to marginal quality over time.

30-Month randomised clinical trial to evaluate the clinical performance of a nanofill and a nanohybrid composite.

OBJECTIVE: To evaluate the clinical performance of a nanofill and a nanohybrid composite in restorations in occlusal cavities of posterior teeth in a randomised trial over 30 months. METHODS: Forty-one adolescents participated in the study. The teeth were restored with a nanofill (Filtek Z350, 3M ESPE), a nanohybrid (Esthet-X, Dentsply); Filtek Z250 (3M ESPE) was used as a control. After 30 months, the restorations were evaluated in accordance with the US Public Health Service (USPHS) modified criteria. The McNemar and Friedman tests were used for statistical analysis, at a level of significance of 5%. RESULTS: There were significant differences in the roughness of Filtek Z250 (p=0.008) and Filtek Z350 (p<0.001) when the four time periods (baseline, 6 months, 12 months and 30 months) were compared. There were significant differences in the marginal adaptation of Filtek Z250 (p=0.001), Filtek Z350 (p<0.001) and Esthet-X (p=0.011). Except for one of each composite restoration, all the modifications ranged from Alpha to Bravo. There were significant differences in the surface roughness (p=0.005) when the three composites were compared after 30 months. CONCLUSIONS: The materials investigated showed acceptable clinical performance after 30 months. Long-term re-evaluations are necessary for a more detailed analysis of these composites (CEP: #1252).