The formation of cariogenic plaque to contemporary adhesive restorative materials: an in vitro study.

The research exploiting the ability of dental materials to induce or prevent secondary caries (SC) development still seems inconclusive. Controlling bacterial adhesion by releasing bacteriostatic ions and improving the surface structure has been suggested to reduce the occurrence of SC. This paper analyses the impact of five distinctively composed dental materials on cariogenic biofilm formation. Forty-five specimens of three composites (CeramX Spectra ST, Admira Fusion, Beautifil II) and two glass-ionomers (Fuji II LC, Caredyne Restore), respectively, were incubated in bacterial suspension composed of Streptococcus mutans, Lactobacillus acidophilus, Streptococcus mitis, Streptococcus sanguinis, and Streptococcus salivarius at pH 7.0 and 5.5. Coverslips were used as a control. Adhered bacteria were collected after 2, 4, 6, 12, 24, and 48 h and analyzed using quantitative polymerase chain reaction (qPCR). Fluoride leakage was measured at each collection. The specimens' surface topography was assessed using interferometry. In the present study, surface roughness seemed to have a partial role in bacterial adhesion and biofilm formation, together with chemical composition of the materials tested. Despite differences in fluoride leakage, biofilm accumulation was similar across materials, but the number of adhered bacteria differed significantly. A release of other ions may also affect adhesion. These variations suggest that certain materials may be more prone to initiating secondary caries.

Inhibition of tooth demineralization caused by Streptococcus mutans biofilm via antimicrobial treatment using hydrogen peroxide photolysis.

OBJECTIVES: An antimicrobial technique utilizing hydroxyl radicals generated by the photolysis of 3% H2O2 has been developed recently. The present study aimed to evaluate the effect of H2O2 photolysis treatment on tooth demineralization caused by Streptococcus mutans biofilm. MATERIALS AND METHODS: To induce tooth demineralization, S. mutans biofilm was allowed to form on the maxillary first molars collected from Wistar rats via 24-h culturing. The samples were immersed in 3% H2O2 and irradiated with 365-nm LED (H2O2 photolysis treatment). Viable bacterial counts in the biofilm were evaluated immediately after treatment and after an additional 30-h culturing by colony counting. The acidogenicity of the biofilm, re-established 30 h after treatment, was assessed by measuring the pH. The effect of H2O2 photolysis treatment on tooth demineralization was assessed by measuring the depth of the radiolucent layer in micro-CT images. RESULTS: H2O2 photolysis significantly reduced viable bacterial counts in the biofilm to 3.7 log colony forming units (CFU)/sample, while the untreated group had 7.9 log CFU/sample. The pH of the biofilm re-established after treatment (6.6) was higher than that of the untreated group (5.3). In line with the pH measurement, the treatment group had a significantly lower depth of radiolucent layer in dentin than the untreated group. CONCLUSIONS: H2O2 photolysis treatment was effective not only in killing the biofilm-forming S. mutans but also in lowering the acidogenicity of the biofilm. Thus, this technique could inhibit tooth demineralization. CLINICAL RELEVANCE: H2O2 photolysis can be applicable as a new dental caries treatment.

Opportunities for caries prevention using an ion-releasing coating material: a randomised clinical study.

Ion-releasing materials (containing fluoride and boron, for example) have shown caries-preventive effects in vitro. The purpose of the present study was to investigate the impact of multi-ion-releasing coating material on pH stabilisation, plaque accumulation and the bacterial composition of dental plaque during a time period of 90 days. The null hypothesis tested here was that the evaluated material would not show any differences in pH stabilisation, plaque accumulation or bacterial composition compared with control material.The study was carried out as a double-blind, split-mouth, randomised, controlled clinical trial in 28 volunteers. Over the evaluation period (days 4, 30, 60 and 90), pH measurements, plaque index and plaque sampling for bacterial analyses were conducted in a calibrated, standardized manner. The study received ethical permission and was carried out in accordance with the Helsinki Declaration.A significant difference was observed, with less plaque accumulation over time in the subjects in whom the ion-releasing material was applied in comparison to the non-active group. No significant difference was evident in terms of either pH stabilisation or plaque levels of mutans streptococci.The null hypothesis relating to plaque accumulation was rejected, with a lower plaque index shown for the test group up to 60-90 days. No adverse effects during the observation period were observed. Since the studied cohort was healthy from a caries perspective, more clinical studies are needed to further evaluate the caries-prevention potential of the ion-releasing material in other patient groups.

Suboptimal light curing and direct exposure to water of two contemporary composites: degree of conversion, sorption, solubility, and Knoop hardness.

The water sorption and solubility of two polymer resin-based dental composite materials were assessed in order to evaluate the effects of immediate post-cure water exposure on the water sensitivity of the composites. Each material was tested with two different light curing setups. The radiant exposure of the two curing setups differed by a factor of 5. After exposure to water and subsequent drying, the Knoop surface hardness was measured. The change in the degree of conversion in both water and air storage medium within the first 24 h after curing was monitored by Raman spectroscopy. No significant differences in the degree of conversion were detected 24 h after curing. Samples exposed to the lower irradiation dose showed higher solubility and a lower surface hardness than the samples exposed to the higher irradiation dose. Early exposure to water did not cause detectable differences in the ongoing polymerization process. Increase in radiant exposure reduced the fraction of unbound constituents and increased the crosslink density, thereby reducing the plasticity of the material.

Airborne exposure to gaseous and particle-associated organic substances in resin-based dental materials during restorative procedures.

Dental composite dust has been shown to act as a vehicle for methacrylates in vivo/in vitro. The objective of this study was to assess airborne exposure of dental personnel to gaseous and particle-associated organic constituents from resin-based dental materials in a simulated clinic. Sampling of total aerosol fractions and gaseous substances was performed by dental students carrying particle filters and gas sorbents attached to a personal pump during preclinical restorative procedures in phantom models (n = 13). Water from the phantoms was sampled. Organic substances were extracted from the sampled water, particle filters, and gas sorbents. Qualitative and quantitative analyses were performed by gas chromatography-mass spectrometry (GC-MS) and ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MS). The methacrylates 2-hydroxyethyl methacrylate (HEMA) and triethylene glycol dimethacrylate (TEGDMA) and the additives camphorquinone (CQ), butylated hydroxytoluene (BHT), and ethyl 4-(dimethylamino)benzoate (DMABEE), were quantified in the gas and particle fractions sampled. A positive-control experiment was conducted. No methacrylates were detected in the gas or particle fractions sampled, whereas strong signals for methacrylates were detected in the positive controls, matching the analysis of the uncured material. In addition, TEGDMA and DMABEE were quantified in the sampled water. Airborne exposure to constituents in resin-based dental materials was below the detection limit. However, the extent of exposure is probably dependent on the procedure, preventive measures, and type of materials used.

Dose- and time-dependent effects of triethylene glycol dimethacrylate on the proteome of human THP-1 monocytes.

Triethylene glycol dimethacrylate (TEGDMA) is commonly used in polymer resin-based dental materials. This study investigated the molecular mechanisms of TEGDMA toxicity by identifying its time- and dose-dependent effects on the proteome of human THP-1 monocytes. The effects of different concentrations (0.07-5 mM) and exposure times (0-72 h) of TEGDMA on cell viability, proliferation, and morphology were determined using a real-time viability assay, automated cell counting, and electron microscopy, and laid the fundament for choice of exposure scenarios in the proteomic experiments. Solvents were not used, as TEGDMA is soluble in cell culture medium (determined by photon correlation spectroscopy). Cells were metabolically labeled [using the stable isotope labeled amino acids in cell culture (SILAC) strategy], and exposed to 0, 0.3 or 2.5 mM TEGDMA for 6 or 16 h before liquid chromatography-tandem mass spectrometry (LC-MS/MS) analyses. Regulated proteins were analyzed in the STRING database. Cells exposed to 0.3 mM TEGDMA showed increased viability and time-dependent upregulation of proteins associated with stress/oxidative stress, autophagy, and cytoprotective functions. Cells exposed to 2.5 mM TEGDMA showed diminished viability and a protein expression profile associated with oxidative stress, DNA damage, mitochondrial dysfunction, and cell cycle inhibition. Altered expression of immune genes was observed in both groups. The study provides novel knowledge about TEGDMA toxicity at the proteomic level. Of note, even low doses of TEGDMA induced a substantial cellular response.

Analysis of organic components in resin-modified pulp capping materials: critical considerations.

The purpose of this study was to elucidate the organic composition and eluates of three resin-based pulp-capping materials in relation to their indications and safety data sheets. Uncured samples of Theracal LC, Ultra-Blend Plus, and Calcimol LC were investigated using gas chromatography-mass spectrometry (GC-MS) and ultra-performance liquid chromatography-mass spectrometry (UPLC-MS). Identification/quantification of 7-d leachables of cured samples was performed using GC-MS for 2-hydroxyethyl methacrylate (HEMA), 2-(dimethylamino)ethyl methacrylate (DMAEMA), camphorquinone (CQ), ethylene glycol dimethacrylate (EGDMA), ethyl-4-(dimethylamino)benzoate (DMABEE), and triethylene glycol dimethacrylate (TEGDMA). A similar organic composition was found for Ultra-Blend and Calcimol; however, only Ultra-Blend is indicated for direct pulp-capping. In contrast to the other materials analysed, Theracal contained substances of high molecular weight. The safety data sheets of all materials were incomplete. We detected HEMA, CQ, and TEGDMA in eluates from Ultra-Blend and Calcimol, and it was considered that HEMA might have originated from decomposition of diurethane dimethacrylate (UDMA) in the GC-injector. For Theracal, additives associated with light curing (DMABEE and CQ) were detected in higher amounts (4.11 and 19.95 µg mm-2 ) than in the other materials. Pores were quantified in all samples by micro-computed tomography (micro-CT) analysis, which could influence leaching. The organic substances in the investigated materials might affect their clinical suitability as capping agents, especially for direct capping procedures.

Light-curing units used in dentistry: factors associated with heat development-potential risk for patients.

OBJECTIVES: To investigate how heat development in the pulp chamber and coronal surface of natural teeth with and without cusps subjected to irradiance using light-emitting diode (LED)-light-curing units (LCUs) is associated with (i) irradiance, (ii) time, (iii) distance, and (iv) radiant exposure. MATERIALS AND METHODS: Three different LED-LCUs were used. Their irradiance was measured with a calibrated spectrometer (BlueLight Analytics Inc., Halifax, Canada). An experimental rig was constructed to control the thermal environment of the teeth. The LED-LCU tip position was accurately controlled by a gantry system. Tooth surface temperature was measured by thermography (ThermaCAM S65 HS, FLIR Systems, Wilsonville, USA) and pulp chamber temperature with a thermocouple. LED-LCU tip distance and irradiation times tested were 0, 2, and 4 mm and 10, 20, and 30 s, respectively. Ethical permission was not required for the use of extracted teeth. RESULTS: Maximum surface and pulp chamber temperatures were recorded in tooth without cusps (58.1 °C  ± 0.9 °C and 43.1 °C ± 0.9 °C, respectively). Radiant exposure explained the largest amount of variance in temperature, being more affected by time than irradiance. CONCLUSIONS: At all combinations of variables tested, repeated measurements produced consistent results indicating the reliability of the method used. Increased exposure time seems to be the factor most likely to cause tissue damage. CLINICAL RELEVANCE: Risk of superficial tissue damage at irradiances >1200 mW/cm2 is evident. There is a risk of pulp damage when only thin dentin is left at higher irradiances (>1200 mW/cm2). Clinicians should be aware of LED-LCU settings and possible high temperature generated.

Methods and terminology used in cell-culture studies of low-dose effects of matrix constituents of polymer resin-based dental materials.

General comprehension of terms and confounding factors associated with in vitro experiments can maximize the potential of in vitro testing of substances. In this systematic review, we present an overview of the terms and methods used to determine low-dose effects of matrix constituents in polymer resin-based dental materials in cell-culture studies and discuss the findings in light of how they may influence the comprehension and interpretation of results. Articles published between 1996 and 2015 were identified by searches in the Scopus, Web of Science, MEDLINE, PubMed, and Embase databases using keywords associated with low-dose effects, polymer resin-based materials, in vitro parameters, and dental materials. Twenty-nine articles were included. Subtoxic (n = 11), sublethal (n = 10), and nontoxic (n = 6) were the terms most commonly used to describe the low-dose effects of methacrylates. However, definition of terms varied. Most (82%) studies employed only one method to define the exposure scenario, and no agreement was seen between studies on the use of solvents. Prophylactic use of antibiotics was widespread, and mycoplasma screening was not reported. In conclusion, cell-culture conditions and tests used to define exposure scenarios have changed little in the last decades, despite development in recommendations. Nomenclature alignment is needed for a better understanding of possible biohazards of methacrylates.

Fatigue analysis of computer-aided design/computer-aided manufacturing resin-based composite vs. lithium disilicate glass-ceramic.

Resin-based composite molar crowns made by computer-aided design/computer-aided manufacturing (CAD/CAM) systems have been proposed as an inexpensive alternative to metal-ceramic or all-ceramic crowns. However, there is a lack of scientific information regarding fatigue resistance. This study aimed to analyze the fatigue behavior of CAD/CAM resin-based composite compared with lithium disilicate glass-ceramic. One-hundred and sixty bar-shaped specimens were fabricated using resin-based composite blocks [Lava Ultimate (LU); 3M/ESPE] and lithium disilicate glass-ceramic [IPS e.max press (EMP); Ivoclar/Vivadent]. The specimens were divided into four groups: no treatment (NT); thermal cycling (TC); mechanical cycling (MC); and thermal cycling followed by mechanical cycling (TCMC). Thermal cycling was performed by alternate immersion in water baths of 5°C and 55°C for 5 × 10(4) cycles. Mechanical cycling was performed in a three-point bending test, with a maximum load of 40 N, for 1.2 × 10(6) cycles. In addition, LU and EMP molar crowns were fabricated and subjected to fatigue treatments followed by load-to-failure testing. The flexural strength of LU was not severely reduced by the fatigue treatments. The fatigue treatments did not significantly affect the fracture resistance of LU molar crowns. The results demonstrate the potential of clinical application of CAD/CAM-generated resin-based composite molar crowns in terms of fatigue resistance.

Fracture resistance of computer-aided design/computer-aided manufacturing-generated composite resin-based molar crowns.

The aim of this study was to investigate whether different fabrication processes, such as the computer-aided design/computer-aided manufacturing (CAD/CAM) system or the manual build-up technique, affect the fracture resistance of composite resin-based crowns. Lava Ultimate (LU), Estenia C&B (EC&B), and lithium disilicate glass-ceramic IPS e.max press (EMP) were used. Four types of molar crowns were fabricated: CAD/CAM-generated composite resin-based crowns (LU crowns); manually built-up monolayer composite resin-based crowns (EC&B-monolayer crowns); manually built-up layered composite resin-based crowns (EC&B-layered crowns); and EMP crowns. Each type of crown was cemented to dies and the fracture resistance was tested. EC&B-layered crowns showed significantly lower fracture resistance compared with LU and EMP crowns, although there was no significant difference in flexural strength or fracture toughness between LU and EC&B materials. Micro-computed tomography and fractographic analysis showed that decreased strength probably resulted from internal voids in the EC&B-layered crowns introduced by the layering process. There was no significant difference in fracture resistance among LU, EC&B-monolayer, and EMP crowns. Both types of composite resin-based crowns showed fracture loads of >2000 N, which is higher than the molar bite force. Therefore, CAD/CAM-generated crowns, without internal defects, may be applied to molar regions with sufficient fracture resistance.

Cutting efficiency of diamond burs operated with electric high-speed dental handpiece on zirconia.

Zirconia-based dental restorations are becoming used more commonly. However, limited attention has been given to the difficulties experienced, concerning cutting, in removing the restorations when needed. The aim of the present study was to compare the cutting efficiency of diamond burs, operated using an electric high-speed dental handpiece, on zirconia (Zir) with those on lithium disilicate glass-ceramic (LD) and leucite glass-ceramic (L). In addition, evaluation of the cutting efficiency of diamond burs on Zir of different thicknesses was performed. Specimens of Zir were prepared with thicknesses of 0.5, 1.0, 2.0, and 4.0 mm, and specimens of LD and L were prepared with a thickness of 1.0 mm. Cutting tests were performed using diamond burs with super coarse (SC) and coarse (C) grains. The handpiece was operated at 150,000 rpm with a cutting force of 0.9 N. The results demonstrated that cutting of Zir took about 1.5- and 7-fold longer than cutting of LD and L, respectively. The SC grains showed significantly higher cutting efficiency on Zir than the C grains. However, when the thickness of Zir increased, the cutting depth was significantly decreased. As it is suggested that cutting of zirconia is time consuming, this should be taken into consideration in advance when working with zirconia restorations.

Fracture resistance of monolithic zirconia molar crowns with reduced thickness.

OBJECTIVES: The purpose of the present study was to analyze the relationship between fracture load of monolithic zirconia crowns and axial/occlusal thickness and to evaluate the fracture resistance of monolithic zirconia crowns with reduced thickness in comparison with that of monolithic lithium disilicate crowns with regular thickness. MATERIALS AND METHODS: Monolithic zirconia crowns (Lava Plus Zirconia, 3M/ESPE) with specified axial/occlusal thicknesses and lithium disilicate crowns (IPS e.max press, Ivoclar/Vivadent) with regular thickness were fabricated using a dental CAD/CAM system and a press technique, respectively. The crowns cemented onto dies were loaded until fracture. Based on measurements of the crown thickness made by micro-CT and the fracture load, multiple regression analysis was performed. RESULTS: It was revealed that the occlusal thickness significantly affected the fracture load (p < 0.01), but the axial thickness did not (p = 0.2828). Although the reduction of the occlusal thickness decreased the fracture resistance of the monolithic zirconia crowns, the fracture load of the zirconia crowns with the occlusal thickness of 0.5 mm (5558 ± 522 N) was significantly higher than that of lithium disilicate crowns with an occlusal thickness of 1.5 mm (3147 ± 409 N). CONCLUSION: Within the limitations of the present study, it is suggested that monolithic zirconia crown with chamfer width of 0.5 mm and occlusal thickness of 0.5 mm can be used in the molar region in terms of fracture resistance.

The influence of bis-EMA vs bis GMA on the degree of conversion and water susceptibility of experimental composite materials.

OBJECTIVE: The aim of this work was to assess the influence of the bis-EMA content on the degree of conversion (DC) and its effect on the water sorption and solubility. MATERIALS AND METHODS: In a polytetrafluorethylene (PTFE) mould, 30 samples (Ø = 5 mm, height = 2 mm) of four experimental dental composite resins were cured for 10 s, 20 s and 40 s. The DC was analysed by Fourier Transform (FT)-Raman spectroscopy. To analyse sorption and solubility, six samples (Ø = 15 mm and thickness = 1 mm) of each composite (n = 72) were stored in water at 37°C for different storage periods: 24 h, 7 days and 30 days. RESULTS: When cured for 20 or 40 s the DC increased with the increasing content of bis-EMA. However, the presence of 15 wt% of bis-GMA did not affect the DC, except when cured with 10 s irradiation time. This study also found a correlation between the content of bis-EMA and the reduced values for sorption and solubility, for all storage times used, when the materials were cured with 20 s. CONCLUSIONS: The DC of mixtures with higher content of bis-EMA is affected by the presence of bis-GMA at lower energy density delivered from the curing device, suggesting that the restrictions caused by the presence of hydrogen bonds is dependent of the irradiation time used.

Critical evaluations on the crystallographic properties of translucent dental zirconia ceramics stabilized with 3-6 mol% yttria.

OBJECTIVES: This study aimed to determine the crystalline phase composition of 3-6 mol% yttria-stabilized zirconia (3-6YSZ), specifically investigating the presence of tetragonal (t), cubic (c), and/or additional yttria-rich tetragonal (t') phase. METHODS: Laboratory-fabricated specimens comprising 3-5YSZ, resembling translucent dental zirconia ceramics (TZ specimens), and a blend of 3YSZ and 8YSZ, representing a c-phase reference, were prepared. Additionally, 25 dental zirconia products stabilized with 3-6 mol% yttria were analyzed. Whole X-ray diffraction (XRD) patterns were obtained for Rietveld analysis, complemented by fine scanning in the 2θ region from 72º to 76º for qualitative phase analysis. Moreover, yttria concentrations in each specimen were determined using X-ray fluorescence (XRF) spectroscopy. RESULTS: In the 2θ region from 72º to 76º, TZ and dental zirconia product specimens displayed four peaks attributed to t- and t'-phases, but the c-phase peak was absent. Rietveld analysis of the whole XRD patterns, utilizing a t-t' model, demonstrated the t-phase fraction ranging from 86 mass% in 3YSZ to 11 mass% in 6YSZ. Rietveld analysis appeared reliable, as the yttria contents calculated based on lattice parameters aligned well with those measured by XRF. This study established that dental 3-6YSZ consisted of yttria-lean t- and yttria-rich t'-phases. SIGNIFICANCE: The present study enhances understanding of the crystalline structure of dental zirconia ceramics. Future crystallographic analyses of these ceramics should consider the presence of t- and t'-phases.

Residual stress associated with crystalline phase transformation of 3-6 mol% yttria-stabilized zirconia ceramics induced by mechanical surface treatments.

Monolithic dental prostheses made of 3-6 mol% yttria-stabilized zirconia (3-6YSZ) have gained popularity owing to their improved material properties and semi-automated fabrication processes. In this study, we aimed to evaluate the influence of mechanical surface treatments, such as polishing, grinding, and sandblasting, on the residual stress of 3-6YSZ used for monolithic prostheses in association with crystalline phase transformation. Plate specimens were prepared from five dental zirconia blocks: Aadva Zirconia ST (3YSZ), Aadva Zirconia NT (6YSZ), Katana HT (4YSZ), Katana STML (5YSZ), and Katana UTML (6YSZ). The specimens were either polished using 1, 3, or 9 µm diamond suspensions, ground using 15, 35, or 55 µm diamond discs, or sandblasted at 0.2, 0.3, or 0.4 MPa. The residual stress, crystalline phase, and hardness were analyzed using the cosα method, X-ray diffraction (XRD), and Vickers hardness test, respectively. Additionally, we analyzed the residual stress on the surfaces of monolithic zirconia crowns (MZCs) made of 4YSZ, 5YSZ, and 6YSZ, which were processed using clinically relevant procedures, including manual grinding, followed by polishing using a dental electric motor on the external surface, and sandblasting on the internal surface. Residual stress analysis demonstrated that grinding and sandblasting, particularly the latter, resulted in the generation of compressive residual stress on the surfaces of the plate specimens. XRD revealed that the ground and sandblasted specimens contained a larger amount of the rhombohedral phase than that of the polished specimens, which may be a cause of the residual stress. Sandblasting significantly increased the Vickers hardness compared to polishing, which may possibly be due to the generation of compressive residual stress. In the case of MZCs, compressive residual stress was detected not only on the sandblasted surface, but also on the polished surface. The difference in the residual stress between the plate and crown specimens may be related to the force applied during the automated and manual grinding and polishing procedures. Further studies are required to elucidate the effects of the compressive residual stress on the clinical performance of MZCs.

Influence of grain size and veneer firing process on the flexural strength of zirconia ceramics.

The aim of the present investigation was to study the influence of grain size on the strength of yttria-stabilized zirconia upon exposure to an additional heat treatment, mimicking the veneering process. The green bodies of zirconia discs prepared by cold isostatic pressing were sintered at 1,425, 1,500, or 1,575°C to customize the grain size. The disc-shaped specimens were highly polished and then processed with or without additional heat treatments (five times at 850-930°C). Ten specimens from each treatment group were subjected to a biaxial flexural strength test according to the ISO 6872 standard. The grain size of the specimens was analyzed by the mean linear intercept technique using scanning electron microscopy. It was demonstrated that the mechanical strength of zirconia ceramics was not reduced by the veneer firing processes when polished specimens were used, but the strength was found to decrease with increasing grain size. The raw materials and the sintering process used should be selected appropriately to avoid grain coarsening because it was found that the strength was influenced by large grains.

Influence of crystalline phase transformation induced by airborne-particle abrasion and low-temperature degradation on mechanical properties of dental zirconia ceramics stabilized with over 5 mol% yttria.

Monolithic dental prostheses fabricated from 5 mol% yttria-stabilized zirconia (5YZ) have been developed to improve the translucency of conventional 3 mol% yttria-stabilized zirconia. In this study, we aimed to evaluate the influence of airborne-particle abrasion (APA) and low-temperature degradation (LTD) on the mechanical properties of 5YZ in association with the crystalline phase transformation. In total, 120 disc-shaped specimens of two brands of 5YZ (Lava Esthetic and Katana UTML) were prepared. The specimens were divided into four groups (n = 15 for each group): (i) control, (ii) APA, (iii) LTD, and (iv) APA + LTD groups. APA was performed with 50 µm alumina particles, and LTD was induced by autoclaving at 134 °C for 50 h. The biaxial flexural strength of the specimens was assessed using a piston-on-three-ball test according to ISO 6872:2015, and Vickers hardness was determined using a microhardness tester. The crystalline phase was analyzed by the Rietveld refinement of X-ray diffraction patterns. APA significantly increased the flexural strength of the Lava Esthetic specimens, whereas LTD hardly affected the strength of both materials. APA and APA + LTD significantly increased the Vickers hardness of both materials. According to Rietveld analysis, the pseudocubic phase was predominant in both materials, i.e., 66 mass% and 81 mass% in the Lava Esthetic and Katana UTML specimens, respectively. APA induced the rhombohedral phase at approximately 37 mass% in both materials, while LTD induced the monoclinic phase at 2.8 mass% in the Lava Esthetic specimens and 0.9 mass% in the Katana UTML specimens. APA + LTD weakly affected the amount of the rhombohedral phase but slightly increased the amount of the monoclinic phase. These findings suggest that APA may improve the mechanical properties of 5YZ, particularly hardness, via the generation of the rhombohedral phase. In contrast, the influence of LTD on the mechanical and microstructural properties of 5YZ was limited.

Light-curing units used in dentistry: Effect of their characteristics on temperature development in teeth.

This study aimed to investigate pulp chamber and surface temperature development using different LED light curing units (LCUs). Eight brands of LED-LCUs were tested in a laboratory bench model. The pulp chamber and surface temperature were recorded with a type T thermocouple and infrared cameras, respectively. The highest pulp chamber and surface temperature increase was 6.1±0.3°C and 20.1±1.7°C, respectively. Wide-spectrum LED-LCUs produced higher pulp chamber temperature increase at 0 mm and 2 mm but lower at 4 mm. Narrow-spectrum LED-LCUs produced higher surface temperature increase. LED-LCU featuring modulated output mode resulted in lower increase in pulp chamber temperature but higher on surface temperature. LED-LCU with light guide tip delivering an inhomogeneous beam caused higher increase in temperature on the surface and in the pulp chamber. LED-LCUs with different spectral emission, output mode and light guide tip design contributed to different temperature development in the pulp chamber and at the surface of teeth.

Heat Development in the Pulp Chamber During Curing Process of Resin-Based Composite Using Multi-Wave LED Light Curing Unit.

OBJECTIVE: The study aimed to investigate factors contributing to heat development during light curing of a flowable bulk-fill resin-based composite (SDRTM, Lot # 602000876, Dentsply Sirona, Konstanz, Germany) (RBC). MATERIALS AND METHODS: Temperatures were measured with calibrated thermocouples. A multi-wave light-emitting diode (LED) light curing unit (LCU) was used (Ivoclar Vivadent, Schaan, Lichtenstein). In all experiments, the RBC was first cured (cured) for 30 s and, after 5 min of recovery time, received a second LCU irradiation (post-cured) for 30 s. The exothermic reaction was measured by calculating the Δ temperature between cured and post-cured RBC. In a cylinder-shaped polymer mold, temperature was recorded inside of RBC during curing (part 1) and light transmission through RBC during curing was investigated (part 2). Pulpal temperatures were assessed in an extracted third molar during light curing (part 3). Data were statistically analyzed using one-way ANOVA (α=0.05). RESULTS: Increased thickness of RBC led to decreased pulp chamber temperatures. Inside RBC, there was a large variation in heat development between the cured and post-cured groups (p<0.05). The cured group absorbed more LCU irradiation than the post-cured group. CONCLUSION: The irradiance of the LCU seemed to be a more important factor than exothermic reaction of RBCs for pulp chamber heat development. Flowable bulk-fill RBCs can act as a pulpal insulator against LCU irradiation, despite their exothermic curing reaction.