The Effects of Cavity Preparation and Composite Resin on Bond Strength and Stress Distribution Using the Microtensile Bond Test.

OBJECTIVES: To evaluate the effect of flowable bulk-fill or conventional composite resin on bond strength and stress distribution in flat or mesio-occlusal-distal (MOD) cavity preparations using the microtensile bond strength (µTBS) test. METHODS: Forty human molars were divided into two groups and received either standardized MOD or flat cavity preparations. Restorations were made using the conventional composite resin Z350 (Filtek Z350XT, 3M-ESPE, St Paul, MN, USA) or flowable bulk-fill (FBF) composite resin (Filtek Bulk Fill Flowable, 3M-ESPE). Postgel shrinkage was measured using the strain gauge technique (n=10). The Z350 buildup was made in two increments of 2.0 mm, and the FBF was made in a single increment of 4.0 mm. Six rectangular sticks were obtained for each tooth, and each section was used for µTBS testing at 1.0 mm/min. Polymerization shrinkage was modeled using postgel shrinkage data. The µTBS data were analyzed statistically using a two-way analysis of variance (ANOVA), and the postgel shrinkage data were analyzed using a one-way ANOVA with Tukey post hoc test. The failure modes were analyzed using a chi-square test (α=0.05). RESULTS: Our results show that both the type of cavity preparation and the composite resin used affect the bond strength and stress distribution. The Z350 composite resin had a higher postgel shrinkage than the FBF composite resin. The µTBS of the MOD preparation was influenced by the type of composite resin used. Irrespective of composite resin, flat cavity preparations resulted in higher µTBS than MOD preparations ( p<0.001). Specifically, in flat-prepared cavities, FBF composite resin had a similar µTBS relative to Z350 composite resin. However, in MOD-prepared cavities, those with FBF composite resin had higher µTBS values than those with Z350 composite resin. Adhesive failure was prevalent for all tested groups. The MOD preparation resulted in higher shrinkage stress than the flat preparation, irrespective of composite resin. For MOD-prepared cavities, FBF composite resin resulted in lower stress than Z350 composite resin. However, no differences were found for flat-prepared cavities. CONCLUSIONS: FBF composite resin had lower shrinkage stress than Z350 conventional composite resin. The µTBS of the MOD preparation was influenced by the composite resin type. Flat cavity preparations had no influence on stress and µTBS. However, for MOD preparation, composite resin with higher shrinkage stress resulted in lower µTBS values.

Influence of resin cement and post configuration on bond strength to root dentine.

AIM: To evaluate the effect of luting agent and fibreglass post design on bond strength to root dentine at different depths within the canal. METHODOLOGY: Ninety single-rooted teeth were root filled and prepared to receive either a parallel-sided and serrated fibreglass post (Reforpost no. 2) or a tapered and smooth fibreglass post (Exato Cônico). The posts were cemented with the following resin cements: dual-cured resin cement (Rely X ARC), two self-adhesive resin cements (Rely X Unicem and MaxCem) and a self-cured resin cement (Cement-Post). The roots were cross-sectioned to obtain two 1-mm-thick discs for each cervical, middle and apical third of the prepared root portion. The posts were submitted to a micropush-out test at a speed of 0.5 mm min(-1), and the bond strength values (MPa) were submitted to anova in a split-plot arrangement and Tukey's test (P < 0.05). RESULTS: The RelyX Unicem demonstrated significantly higher bond strength values (P < 0.001) along the root dentine. The RelyX ARC and Cement-Post had similar bond strength values in the cervical third; however, the bond strength decreased significantly (P < 0.001) in an apical direction for the RelyX ARC. Significantly lower bond strength values (P < 0.001), irrespective of canal region, were found for MaxCem cement. The bond strength was similar for both post configurations irrespective of the resin cement and canal region. CONCLUSIONS: The retention of glass fibre posts remained unaffected by surface roughness but was influenced by resin cement type. The self-adhesive cement RelyX Unicem yielded a significantly greater (P < 0.001) bond strength value when cementing the fibreglass posts.

Effect of gamma irradiation and restorative material on the biomechanical behaviour of root filled premolars.

AIM: To investigate ex vivo the influence of gamma irradiation therapy and restorative material on fracture resistance, fracture mode and strain of root filled human premolars. METHODOLOGY: Sixty extracted human maxillary premolar teeth were randomly divided into six groups (n = 10) determined by two study factors: (i) restorative materials: sound teeth, root filled teeth restored with composite resin, root filled teeth restored with amalgam; (ii) gamma irradiation: irradiated (subjected to 60 Gy of gamma irradiation in daily increments of 2 Gy) and nonirradiated. For the strain gauge test, two strain gauges per sample were attached on the buccal and palatal cusp surfaces (n = 5). Strain values were recorded during loading of 0-150 N. Fracture resistance (N) was assessed in a mechanical testing machine (n = 10). Strain gauge for each cusp and fracture resistance data were analysed by two-way anova (3 × 2) followed by the Tukey's honestly significant difference test (α = 0.05). The failure mode was evaluated using an optical stereomicroscope and classified according to the location of the failure. RESULTS: Gamma radiation therapy significantly reduced the fracture resistance of intact teeth. The strain was higher for teeth restored with amalgam than for those restored with composite resin. The teeth restored with composite resin had similar strain values to sound teeth. Nonirradiated teeth had more restorable failures than irradiated teeth. CONCLUSIONS: Gamma irradiation significantly reduced fracture resistance and increased cusp strain. The use of composite resin resulted in better biomechanical behaviour than amalgam for restoring root filled teeth whether or not they were submitted to radiotherapy.

Effects of chlorhexidine and fluoride on irradiated enamel and dentin.

The effectiveness of mouthwash protocols in preventing gamma irradiation therapy damage to the ultimate tensile strength (UTS) of enamel and dentin is unknown. It was hypothesized that the use of chlorhexidine and fluoride mouthwash would maintain the UTS of dental structures. One hundred and twenty teeth were divided into 2 groups: irradiated (subjected to 60 Gy of gamma irradiation in daily increments of 2 Gy) and non-irradiated. They were then subdivided into 2 mouthwash protocols used 3 times per day: 0.12% chlorhexidine, 0.05% sodium fluoride, and control group (n = 10). The specimens were evaluated by microtensile testing. The results of the Tukey test (p < 0.05) indicated that the gamma irradiation therapy significantly reduced the UTS of the enamel, crown, and root dentin. Macromolecular alterations were suggested by optical retardation data in dentin. Structural alterations, in both substrates, were detected by scanning electron microscopy analysis. Mouthwash with 0.12% chlorhexidine partially prevented the damage to the mechanical properties of the irradiated crown dentin, whereas the 0.05% sodium-fluoride-irradiated enamel showed UTS similar to that of non-irradiated enamel.

Three-point bending testing of fibre posts: critical analysis by finite element analysis.

AIM: To evaluate the effect of taper, specimen supports and the isotropic and orthotropic properties of the posts on flexure and stress response during three-point bending using finite element analysis. METHODOLOGY: A three-dimensional finite element model of a fibre post was created. The occlusal portion was cylindrical whilst the apical portion was tapered. Five different support positions were evaluated during a simulated three-point bending test: M1 - support distance of 10 mm centralized and no tilt; M2 - 10 mm centralized with tilt; M3 - 10 mm not centralized and no tilt; M4 - 10 mm not centralized with tilt; M5 - 6 mm not centralized with no tilt. A sixth post model (M6) was a centralized post without tapered section. The applied properties were elastic and orthotropic. RESULTS: Tilting the tapered posts to level them in the test setup had little effect on the outcome. Flexure increased when 50% of the bent portion involved taper (M1, M2). If only 20% of the bent post involved taper (M3, M4), the flexure values were close to M6 (no taper). The orthotropic properties also caused increased flexure compared to an isotropic post. Maximum stresses were only a little higher when 50% of the bend structure involved taper, whilst the orthotropic properties had little effect. CONCLUSIONS: Regardless of levelling, the flexural stress determination with tapered fibre posts in the three-point bending test was valid as long as the tapered portion was limited in length.