Monomer conversion and shrinkage force kinetics of low-viscosity bulk-fill resin composites.

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.

Efficacy of ozone on microorganisms in the tooth root canal.

The aim of this study was to examine the effect of ozone gas on the remaining bacteria after chemomechanical instrumentation of tooth root canal. The study was carried out at the Department of Endodontics and Restorative dentistry, School of Dental Medicine, University of Zagreb. A total of 37 tooth root canals from 23 teeth (10 incisors, 2 canines, 8 premolars and 3 molars) with a diagnosis of chronic apical periodontitis (17 untreated teeth and 6 retreatments) from 20 adult patients (11 females and 9 male) were selected. Endodontic samples consisted of 74 swabs from 37 canals. The first root canal swab was taken following a completed chemomechanical instrumentation by a sterile paper point after rinsing the root canal with a sterile saline solution. The canal was dried and treated with ozone gas for 40 seconds (HealOzone, Kavo, Germany). After the ozone treatment the canal was rinsed with a sterile saline solution a second swab was taken. The swabs were stored in transport media until cultivation. Microbiological identification was performed by macromorphological, micromorphological, commercial biochemical test microbiological analysis and bacteria count. A significant decrease in the number of bacteria (p < 0.001) was found after the ozone treatment: the total number of bacteria was 82%, 67% of aerobic and 93% of anaerobic bacteria. When analysing individually, a significant decrease was found for Streptococcus mitis and Propionibacterium acnes (p < 0.05). The results of this study shows the efficacy of ozone on the bacterial count reduction in the root canal treatment.

Detection of Leachable Components from Conventional and Dental Bulk-Fill Resin Composites (High and Low Viscosity) Using Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) Method.

The aim of this study was to investigate leachable components (monomers) in high and low viscosity dental bulk-fill resin composites and conventional resin composite materials after polymerization. Six bulk-fill and six conventional dental resin composite materials were used in this study. The samples of each material (three sets of triplicates) were cured for 20 s with irradiance of 1200 mW/cm2 with a LED curing unit and immersed in a 75% ethanol solution at 37 °C. The eluates from each triplicate set were analyzed after 24 h, 7 days or 28 days using liquid chromatography coupled with triple quadrupole tandem mass spectrometry (LC-MS/MS). Detectable amounts of 2-Hydroxyethyl methacrylate (HEMA) were found in both Gradia materials and the amount observed across different time points was statistically different (p ˂ 0.05), with the amount in solution increasing for Gradia and decreasing for Gradia Direct flo. Bisphenol A diglycidildimethacrylate (BIS GMA) was found in Filtek and Tetric materials. Triethylene glycol dimethacrylate (TEGDMA) was detected in all materials. On the other hand, there were no statistically significant differences in the amounts of TEGDMA detected across different time points in either of the tested materials. Monomers HEMA, TEGDMA, 4-dimethylaminobenzoic acid ethyl ester (DMA BEE) and BIS GMA in bulk-fill and conventional composites (high and low viscosity) can be eluted after polymerization. The good selection of composite material and proper handling, the following of the manufacturer's instructions for polymerization and the use of finishing and polishing procedures may reduce the elution of the unpolymerized monomers> responsible for the possible allergic and genotoxic potential of dental resin composites.

Water-Induced Changes in Experimental Resin Composites Functionalized with Conventional (45S5) and Customized Bioactive Glass.

The aim of the study was to evaluate microhardness, mass changes during 1-year water immersion, water sorption/solubility, and calcium phosphate precipitation of experimental composites functionalized with 5-40 wt% of two types of bioactive glass (BG): 45S5 or a customized low-sodium fluoride-containing formulation. Vickers microhardness was evaluated after simulated aging (water storage and thermocycling), water sorption and solubility were tested according to ISO 4049, and calcium phosphate precipitation was studied by scanning electron microscopy, energy dispersive X-ray spectroscopy, and Fourier-transform infrared spectroscopy. For the composites containing BG 45S5, a significant reduction in microhardness was observed with increasing BG amount. In contrast, 5 wt% of the customized BG resulted in statistically similar microhardness to the control material, while higher BG amounts (20 and 40 wt%) resulted in a significant improvement in microhardness. Water sorption was more pronounced for composites containing BG 45S5, increasing 7-fold compared to the control material, while the corresponding increase for the customized BG was only 2-fold. Solubility increased with higher amounts of BG, with an abrupt increase at 20 and 40 wt% of BG 45S5. Calcium phosphate was precipitated by all composites with BG amounts of 10 wt% or more. The improved properties of the composites functionalized with the customized BG indicate better mechanical, chemical, and dimensional stability without compromising the potential for calcium phosphate precipitation.

The prevalence of proximal fractures of dental crowns with amalgam fillings.

The purpose of this paper was to determine the prevalence and impact of various etiological factors on marginal ridge fractures of teeth with amalgam fillings. 50 subjects participated in this research, 172 teeth restored with amalgam were examined out of which 28 premolars and 144 molars of both jaws. Data used in the research was obtained by nonaggressive exploration of oral cavity and by checking dental charts and radiographic charts of patients. Patients were divided in three gendered age groups. Etiological factors used in the research were: the position of teeth in jaws, classification of amalgam fillings according to Black, the duration of fillings, the presence of caries on proximal surfaces not included in restoration and tooth vitality. Also, Angle Class, habits and presence of fixed prosthetic appliances in opposite jaw were taken into consideration. Results for each patient were separately written in the questionnaire. Statistical analysis was carried out by Pearson's chi2-test. According to obtained results 51% of teeth with amalgam fillings have a fracture of marginal ridge. Statistically significant factors that influenced the occurrence of fractures of proximal surfaces in this research were classification of amalgam fillings according to Black, the patient's age and the existence of caries on proximal surface.

Dimensional Changes of Glass Ionomers and a Giomer during the Setting Time.

OBJECTIVES: The aim of this study was to evaluate dimensional changes of conventional glass ionomer cements, resin-modified glass-ionomer cement, and a giomer during the setting time using digital laser interferometry. Additionally, the influence of different curing modes ("high", "soft", and "low") of a light-emitting diode (LED) curing unit on dimensional changes was evaluated. MATERIALS AND METHODS: Linear curing shrinkage of conventional glass ionomer cements (CGICs): Fuji IX Extra (F9E), Fuji IX Fast (F9F), Ketac Molar Aplicap (KM), Ketac Molar Quick Aplicap (KMQ), resin-modified glass ionomer cement (RM GIC): Fuji II LC (F2LC) and giomer: Beautifil II (B2) was analyzed. All tested materials were of shade A3, while all of the GIC were encapsulated. Discoid specimens (n=10, d=10 mm, h=0.85 mm) were prepared for each tested material and each curing mode (for light-curable materials) according to the manufacturer's instructions. Light-curable specimens were cured with LED curing unit (Bluephase G2, Ivoclar-Vivadent, and Schaan, Liechtenstein). Dimensional changes during curing were recorded in real-time. The results were analyzed by ANOVA, and Tukey post hoc test was used for multiple comparisons (α˂ 1%). RESULTS: All tested materials showed an initial setting expansion and a subsequent setting shrinkage. KM and KMQ had significantly lower setting shrinkage than RM GIC polymerized using any of the three curing modes. B2 showed lower shrinkage compared to F2LC. CONCLUSIONS: The extent of curing shrinkage in RM GIC measured in this study can affect longevity of restorations.

Visualization of marginal integrity of resin-enamel interface by holographic interferometry.

This study determined whether it was possible to detect deformations and fractures in dental hard tissues or in composite material from internal stresses using double-exposure holographic interferometry. On the proximal side of eight intact human permanent premolars, a direct Class II cavity was prepared and restored with a self-etching adhesive (Clearfil SE Bond) and Tetric Ceram, a resin composite. In five of the specimens, Tetric Flow was used as an elastic layer. The samples were illuminated using a helium-neon laser beam, and the holograms of samples were recorded using Agfa 10E75 photographic plates. Hologram reconstructions were captured with an 8-bit monochrome CCD camera and qualitatively analyzed. Deformations and fractures appeared as fringe patterns on all interferograms, where the distribution of fringes provided location information, while the density of fringes gave the amplitude information. Greater fringe densities were observed in samples treated without a flowable composite.

Prevalence of periodontal diseases in Zagreb population, Croatia, 14 years ago and today.

The aim of this study was to assess prevalence of periodontal diseases within Zagreb adult population in 2000. The sample comprised of 412 examinees of both sexes and all age groups. World Health Organization (WHO) methodology and Community Periodontal Index (CPI), (1997) were used. The data gained was statistically assorted and compared with the data from previously conducted research in 1986. Results showed relatively high prevalence of periodontal diseases. No healthy periodontium was recorded in the 45-and-above age group. Shallow periodontal pockets was registered in 12% of nineteen-year-olds, whereas this symptom was very evident in 45-54 age group (45.7%) and in older than 65 (48.2%). Over 90% of participants had insufficient oral hygiene and 80% required initial periodontal therapy. Approximately 20% needed complex periodontal treatment. Comparison of this data with the previous 1986 research showed improvement of periodontal status in up-to-44 age group due to more healthy persons and more subjects with the initial stages of disease. The possible reason for periodontal health improvement in the last 14 years, evident specially in younger age groups, were the effects of large preventive program measures conducted on schoolchildren in Croatia in 1980-ties and terminated in 1990-ties when the war in Croatia started. Following studies are needed to monitor whether deterioration in oral health will occur regarding to absence of organized preventive programs since 1990-ties.

Esthetic reconstruction of teeth in patient with dentinogenesis imperfecta--a case report.

Dentinogenesis imperfecta (DI) is the result of a dominant genetic defect and affects both the deciduous and permanent dentitions. It is characterized by opalescent teeth composed of irregularly formed and undemineralized dentin which obliterates pulp chamber and root canal. DI can appear as a separate disorder or with osteogenesis imperfecta (OI). The teeth with DI show a grayish-blue to brown hue with dislodged enamel, dysplastic dentine with irregular dentinal tubules and interglobular dentine, short roots and pulpal obliteration, which all may lead to rapid and extensive attrition which require adequate crown reconstruction. The aim of this study was to show a reconstruction of frontal teeth in upper jaw with direct composite veneers in young adult patient with DI.

Long Term Degree of Conversion of two Bulk-Fill Composites.

OBJECTIVES: To investigate the long-term development of the post-cure degree of conversion (DC) for two flowable bulk-fill composites. MATERIALS AND METHODS: Tetric EvoFlow Bulk Fill (TEFBF) and SDR were chosen due to their distinct compositional modifications that enable the decrease of translucency during polymerization and lower polymerization rate, respectively. DC was assessed using FT-Raman spectroscopy at the post-cure times of 0 h, 24 h, 7 d and 30 d. The post-cure behavior was analyzed by a mixed model ANOVA and partial eta-squared statistics. RESULTS: DC ranged from 61.3-81.1% for TEFBF and 58.9-81.6% for SDR. The initial (0 h) DC was significantly lower at a depth of 4 mm than at a depth of 1 mm (4.9% for SDR and 11.1% for TEFBF). Both materials presented a significant post-cure DC increase, up to 16.4% for TEFBF and 20.6% for SDR. The post-cure DC development was depth-dependent for TEFBF, but not for SDR. The post-cure DC increase was observed during 24 h for TEFBF and 7 d for SDR. CONCLUSIONS: Some of the bulk-fill composites may need longer times than the commonly accepted 24 h to reach the final conversion. This may be attributed to their compositional modifications that are mostly undisclosed by manufacturers. Our findings imply that investigations commonly performed 24 h post-cure may underestimate some of the bulk-fill composite properties, if these are affected by the slowly-developing DC. Reactive species may also be available for leaching out of the restoration during an extended time period, with possible implications on biocompatibility.

Immediate post-traumatic upper incisor reconstruction using composite resin materials.

Single visit reconstruction of the fractured crown can be completed with composite resins if there is no bleeding due to the soft tissue injury. Clinical inspection revealed a complex crown fracture of the central incisor as well as a simple horizontal fracture of the lateral incisor crown of the enamel-dentin type. Vertical fracture separated the palatal enamel wall from the rest of the lateral incisor crown. After the completion of the endodontic sanitation, root canals were prepared for prefabricated composite posts and crown reconstructions were performed with the Finger Tip Technique by using composite resin materials. The advantage of this kind of reconstruction is preservation of the hard dental crown tissue removed in case of prosthetic therapy, especially in younger patients. Reconstruction can be finished in one visit, without the need for a dental technician and laboratory.