Curing profile and marginal gap formation using a liner containing long-wavelength-absorbing photoinitiator: an in vitro study.

The aim was to evaluate the marginal-gap formation and curing profile of a new restorative technique using a liner with long-wavelength-absorbing photoinitiator (LWAP). Box-shaped preparations (6 mm × 4 mm × 4 mm) were made in third molars. All samples were treated with Clearfill SE Bond and divided into 4 groups (n = 5), according to restorative technique used: (1) incremental technique (INC-Technique); (2) camphorquinone-based liner (CQ-Liner) + bulk-fill resin composite; (3) LWAP-based liner (LWAP-Liner) + bulk-fill resin composite; and (4) bulk-fill technique without liner (BF-Technique). The marginal gaps (%) for all the samples were measured using micro-computed tomography. The restorations were cross-sectioned, and the degree of conversion (DC) and Knoop microhardness were evaluated at different depths (0.3, 1, 2, 3, and 4 mm). INC-Technique, CQ-Liner, and LWAP-Liner groups showed significantly fewer marginal gaps than those from the BF-Technique group. The BF-Technique specimens had the lowest DC and microhardness in depth. All the other techniques presented similar degree of conversion and microhardness at all the depths. The use of liners, regardless of the photoinitiator system, decreased the marginal-gap formation and improved the curing profile of bulk-filling restoration technique.

Using artificial intelligence to predict the final color of leucite-reinforced ceramic restorations.

OBJECTIVES: The aim of this study was to evaluate the accuracy of machine learning regression models in predicting the final color of leucite-reinforced glass CAD/CAM ceramic veneer restorations based on substrate shade, ceramic shade, thickness and translucency. METHODS: Leucite-reinforced glass ceramics in four different shades were sectioned in thicknesses of 0.3, 0.5, 0.7, and 1.2 mm. The CIELab coordinates of each specimen were obtained over four different backgrounds (black, white, A1, and A3) interposed with an experimental translucent resin cement using a calibrated spectrophotometer. The color change (CIEDE2000) values, as well as all the CIELab values for each one of the experimental groups, were submitted to 28 different regression models. Each regression model was adjusted according to the weights of each dependent variable to achieve the best-fitting model. RESULTS: Different substrates, ceramic shades, and thicknesses influenced the L, a, and b of the final restoration. Of all variables, the substrate influenced the final ceramic shade most, followed by the ceramic thickness and the L, a, and b of the ceramic. The decision tree regression model had the lowest mean absolute error and highest accuracy to predict the shade of the ceramic restoration according to the substrate shade, ceramic shade and thickness. CLINICAL SIGNIFICANCE: The machine learning regression model developed in the study can help clinicians predict the final color of the ceramic veneers made with leucite-reinforced glass CAD/CAM ceramic HT and LT when cemented with translucent cements, based on the color of the substrate and ceramic thicknesses.

Polyetheretherketone (PEEK) Post and Core Restorations: A 3D Accuracy Analysis between Heat-Pressed and CAD-CAM Fabrication Methods.

PURPOSE: The purpose of this study was to evaluate the accuracy of polyetheretherketone (PEEK) based post and core restorations using heat-pressed and computer-aided design and computer-aided manufacturing (CAD-CAM) methods. MATERIALS AND METHODS: Post and core patterns (n = 10) were fabricated using an acrylic pattern resin and each pattern was scanned to generate a resin pattern standard tessellation file (STL-R) to be used as the standard control group for the 3D profilometric analysis. The STL-R files were loaded into a computer-aided manufacturing (CAM) machine and a milling disk made of a modified PEEK-based polymer with 20% ceramic fillers was milled into post and core restorations. Each original post and core resin pattern was sprued, invested and pressed using pellets made of the same PEEK material and a PEEK pressing unit. The resulting post and core restorations from the CAD-CAM and heat-pressed methods were scanned to generate STL-M (milled) and STL-P (heat-pressed) files, respectively. STL-M and STL-P files were digitally aligned and compared to STL-R files using a 3D analysis software. The 3D spatial distribution deviation was exported, and the statistical analysis was performed using the 95% CI deviation distribution from the Gaussian function subtraction. The statistical outcome for each group was merged and a 3D color-coded map was created showing the average deviation (α = 0.05). RESULTS: The heat-pressed post and core restoration showed 79 ±6% of the areas within ±50 µm while the CAD-CAM post-and-core restoration showed 66 ±9%. The CAD-CAM post and core restorations show 6 ±5% of the areas above the ideal for marginal adaptation limit threshold of 200 µm, while only 0.7 ±0.7% was found for the heat-pressed. CONCLUSIONS: The heat-pressed method to manufacture PEEK-based post and core restorations showed higher accuracy than the CAD-CAM method.

Mechanical properties of bulk-fill composite resin with or without a final layer of conventional composite resin.

The objective of this in vitro study was to evaluate the mechanical properties of different bulk-fill composite resins with or without a final layer of conventional composite resin. The null hypothesis was that the mechanical properties of the material would not change regardless of the addition of a layer of conventional composite. Bar-shaped specimens (25 × 2 × 2 mm) were made from 4 different bulk-fill composites (Filtek One Bulk Fill, Filtek Bulk Fill Flowable, Tetric EvoCeram Bulk Fill, and Tetric EvoCeram Bulk Fill Flow) with or without a final layer of a conventional composite of the same brand (Filtek Supreme for the Filtek materials and Tetric EvoCeram for the Tetric materials). Each specimen was light cured at 2 equidistant points using a multiwave curing light with a power output of 20 J/cm2. All of the specimens were subjected to a 3-point bending test in a universal testing machine at a crosshead speed of 0.75 ± 0.25 mm/min and a load rate of 50 ± 16 N/min, and the flexural strength and elastic modulus were calculated. The mean flexural strength and elastic modulus values were analyzed using 1-way analysis of variance, and then the Tukey test was applied for multiple comparisons between groups (α = 0.05). When a final layer of a conventional composite of the same brand was added, the mean flexural strength of the Tetric groups slightly decreased, while that of the Filtek groups did not change. Application of a final layer of conventional composite resulted in a slight increase in the mean elastic modulus of the Filtek groups and either no change or a slight decrease in the Tetric groups. The addition of a final layer of conventional composite resin did not seem to improve the mechanical properties of any of the tested bulk-fill materials. The addition of a final layer of conventional composite resin can affect the mechanical properties of bulk-fill materials; however, it seems these effects are dependent on the type of conventional composite resin used for the final layer.

Effect of Different In Vitro Aging Methods on Color Stability of a Dental Resin-Based Composite Using CIELAB and CIEDE2000 Color-Difference Formulas.

PURPOSE: To evaluate the effect of different in vitro aging methods on color change (CC) of an experimental dental resin-based composite using CIELAB (ΔEab ) and CIEDE2000 (ΔE00 ) color-difference formulas. MATERIALS AND METHODS: The CC was evaluated with a spectrophotometer (CM700d, Konica Minolta, Tokyo, Japan) according to the CIE chromatic space. Disk-shaped specimens (Φ = 5 × 1 mm thick) (N = 10) were submitted to different in vitro aging methods: 30 days of water aging (WA); 120 hours of ultraviolet light aging (UVA); or 300 hours of an accelerated artificial aging (AAA) method with cycles of 4 hours of UV-B light exposure and 4 hours of moisture condensation to induce CC. The temperature was standardized at 37°C for all aging methods. CC was evaluated with ΔEab and ΔE00 formulas. Differences in individual Lab coordinates were also calculated. Data for the individual color parameters were submitted to one-way analysis of variance and Tukey's test for multiple comparisons (α = 0.05). RESULTS: All in vitro aging methods tested induced CC, in the following order: WA: ΔEab = 0.83 (0.1); ΔE00 = 1.15 (0.1) < AAA: ΔEab = 5.64 (0.2); ΔE00 = 5.01 (0.1) < UVA: ΔEab = 6.74 (0.2); ΔE00 = 6.03 (0.4). No changes in L* or a* coordinates were ≥1; the methods with UV aging showed a yellowing effect due a large positive change in b*. CONCLUSIONS: All in vitro aging methods tested induced a CC, but to different extents. Changes in color followed similar trends, but with different absolute values when calculated with the CIELAB and the CIEDE2000 formulas. CLINICAL SIGNIFICANCE: Establishing the efficacy of different artificial aging methods and differences between color change using CIELAB and CIEDE2000 formulas are important to standardize color stability evaluations and facilitate the comparison of outcomes from different studies in the literature.

Effect of butylated hydroxytoluene (BHT) concentrations on polymerization shrinkage stress and other physicochemical properties of experimental resin composites.

The present study examined different concentrations of the butylated hydroxytoluene (BHT) inhibitor on the kinetics of conversion, polymerization shrinkage stress, and other correlated physicochemical properties of experimental resin composites (ERC). A model composite was formulated with 75 wt% filler containing 0.5 wt% camphorquinone and 1 wt% amine with BHT concentrations of 0.01 wt% (BHT-0.01); 0.1 wt% (BHT-0.1); 0.25 wt% (BHT-0.25); 0.5 wt% (BHT-0.5); 1 wt% (BHT-1), and control (no BHT). They were tested on polymerization shrinkage stress (PSS; n = 5), degree of conversion (DC; n = 3), maximum polymerization rate (RpMAX; n = 5), water sorption (Wsp; n = 0), and solubility (Wsl; n = 10), flexural strength (FS; n = 10), flexural modulus (FM; n = 10), Knoop microhardness (KH; n = 10), and microhardness reduction (HR; n = 10). Data concerning these tests were submitted to one-way ANOVA and Tukey's test (α = 0.05; ß = 0.2). BHT-0.25, BHT-0.5, and BHT-1 showed a gradually significant decrease in PSS (p = 0.037); however, BHT-1 demonstrated a decrease in the physicochemical properties tested. Thus, within the limitations of this study, it was possible to conclude that BHT concentrations between 0.25 and 0.5 wt% are optimal for reducing shrinkage stress without affecting other physicochemical properties of ERCs.

The role of protective liners and glass ionomer in managing pulp temperature during light curing.

Background: To evaluate the thermal insulation of protective liners and glass ionomer cement during light-curing procedures. Material and Methods: Human third molars underwent Class I preparations with dimensions 5 mm long × 4 mm wide × 4 mm deep in a standardized manner ensured a consistent ±0.5 mm dentin thickness at the pulpal floor. The teeth were attached to a customized oral cavity chamber simulator with a circulating bath at a standardized temperature of 34.2 ± 1oC. The temperature variations at the pulpal floor were captured in real-time by video using an infrared thermal camera (FLIR ONE Pro, FLIR Systems). The materials evaluated were: Dycal (Dentsply), TheraCal LC (Bisco), Activa (Pulpdent), and Fuji II LC (GC). All light-activation procedures were performed with the same light-curing unit (Valo Grand, Ultradent) in standard mode, 1000 mW/cm2, and time of exposure following manufacturer instructions. A power analysis was conducted to determine the sample size considering a minimal power of 0.8, with α=0.05. Statistical analyses were performed using ANOVA and Tukey's test for multiple comparisons. Results: The temperature at the pulpal floor increased above the 5.5 ºC safety threshold difference for clinical scenarios tested. None of the materials provided proper thermal insulation for light-curing procedures (p = 0.25). The higher the number of light-cured steps, the longer the pulp remained above the 5.5 ºC temperature threshold. Conclusions: The materials tested provided improper thermal insulation (Δ > 5.5 ºC). Thus, prolonged or multiple light-curing exposures can be harmful to the pulp tissues. Therefore, for indirect pulpal capping procedures, self-cured materials or a reduced number of steps requiring light curing must be adopted to reduce the amount of time the pulp remains above the 5.5 ºC safety temperature threshold. Key words:Dental Pulp Capping, Calcium hydroxide, Bioactive, Thermal Damage.

Linear Accuracy of Intraoral Scanners for Full-Arch Impressions of Implant-Supported Prostheses: A Systematic Review and Meta-Analysis.

This article compares the accuracy of intraoral scanners (IOSs) used in the digital impression of full arches to fabricate implant-supported complete prostheses. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in the Open Science Framework (DOI 10.17605/OSF.IO/CPM9K). Six electronic databases, gray literature databases, and a manual search were performed in April 2022. Studies that evaluated the accuracy of intraoral scan impressions compared with conventional impressions in full-arch impressions were included for complete implant-supported prostheses. In addition, an adapted checklist for reporting in vitro studies was used to assess the risk of bias. Meta-analysis was conducted using a random-effects Hunter- Schmidt model. Nine studies were included in the analysis. IOS impressions present higher accuracy (137.86 µm) than conventional impressions (182.51 µm) (p<0.001). The heterogeneity of the study's methodology was I2»18.34. However, impression accuracy varies significantly with scan body type, IOS type, scanning strategy, and modification technique. For most IOS systems, the acceptable clinical threshold of linear accuracy of 200 µm can be achieved, except for the True Definition Scanner in one of the studies. Based on the results of the included studies, digital impressions using IOS present similar or better linear accuracy than conventional impression techniques.

Ability of short exposures from laser and quad-wave curing lights to photo-cure bulk-fill resin-based composites.

OBJECTIVE: This study investigated the ability of a laser, and a 'quad-wave' LCU, to photo-cure paste and flowable bulk-fill resin-based composites (RBCs). METHODS: Five LCUs and nine exposure conditions were used. The laser LCU (Monet) used for 1 s and 3 s, the quad-wave LCU (PinkWave) used for 3 s in the Boost and 20 s in the Standard modes, the the multi-peak LCU (Valo X) used for 5 s in the Xtra and 20 s in the Standard modes, were compared to the polywave PowerCure used in the 3 s mode and for 20 s in the Standard mode, and to the mono-peak SmartLite Pro used for 20 s. Two paste consistency bulk-fill RBCs: Filtek One Bulk Fill Shade A2 (3 M), Tetric PowerFill Shade IVA (Ivoclar Vivadent), and two flowable RBCs: Filtek Bulk Fill Flowable Shade A2 (3 M), Tetric PowerFlow Shade IVA (Ivoclar Vivadent) were photo-cured in 4-mm deep x 4-mm diameter metal molds. The light received by these specimens was measured using a spectrometer (Flame-T, Ocean Insight), and the radiant exposure delivered to the top surface of the RBCs was mapped. The immediate degree of conversion (DC) at the bottom, and the 24-hour Vickers Hardness (VH) at the top and bottom of the RBCs were measured and compared. RESULTS: The irradiance received by the 4-mm diameter specimens ranged from 1035 mW/cm2 (SmartLite Pro) to 5303 mW/cm2 (Monet). The radiant exposures between 350 and 500 nm delivered to the top surface of the RBCs ranged from 5.3 J/cm2 (Monet in 1 s) to 26.4 J/cm2 (Valo X), although the PinkWave delivered 32.1 J/cm2 in 20 s 350 to 900 nm. All four RBCs achieved their maximum DC and VH values at the bottom when photo-cured for 20 s. The Monet used for 1 s and the PinkWave used for 3 s on the Boost setting delivered the lowest radiant exposures between 420 and 500 nm (5.3 J/cm2 and 3.5 J/cm2 respectively), and they produced the lowest DC and VH values. CONCLUSIONS: Despite delivering a high irradiance, the short 1 or 3-s exposures delivered less energy to the RBC than 20-s exposures from LCUs that deliver> 1000 mW/cm2. There was an excellent linear correlation (r > 0.98) between the DC and the VH at the bottom. There was a logarithmic relationship between the DC and the radiant exposure (Pearson's r = 0.87-97) and between the VH and the radiant exposure (Pearson's r = 0.92-0.96) delivered in the 420-500 nm range.

Effect of elastomeric urethane monomer on physicochemical properties and shrinkage stress of resin composites.

This study aimed to evaluate the effect of an elastomeric urethane monomer (Exothane-24) in different concentrations on physicochemical properties, gap formation, and polymerization shrinkage stress of experimental resin composites. All experimental composites were prepared with 50 wt.% of Bis-GMA and 50 wt.% of TEGDMA, to which 0 wt.% (control), 10 wt.%, 20 wt.%, 30 wt.%, and 40 wt.% of Exothane-24 were added. Filler particles (65 wt.%) were then added to these resin matrixes. Ultimate tensile strength (UTS: n = 10), flexural strength (FS: n = 10), flexural modulus (FM: n = 10), hardness (H: n = 10), hardness reduction (HR: n = 10), degree of conversion (DC: n = 5), gap width (GW: n = 10), and polymerization shrinkage stress in Class I (SS-I: n = 10) and Class II (SS-II: n = 10) simulated configuration. All test data were analyzed using one-way ANOVA and Tukey's test (α = 0.05;  = 0.2). Exothane-24 in all concentrations decreased the H, HR, DC, GW, SS-I, and SS-II (p < 0.05) without affecting the UTS, and FS (p > 0.05). Reduction in FM was observed only in the Exothane 40% and 30% groups compared to the control (p < 0.05). Exothane-24 at concentrations 20% and 30% seems suitable since it reduced GW and polymerization SS without affecting the properties of the composite resins tested, except for H.

Enhancing the Hydrophobicity and Antibacterial Properties of SiCN-Coated Surfaces with Quaternization to Address Peri-Implantitis.

Peri-implantitis is a major cause of dental implant failure. This disease is an inflammation of the tissues surrounding the implant, and, while the cause is multi-factorial, bacteria is the main culprit in initiating an inflammatory reaction. Dental implants with silicon carbonitride (SiCN) coatings have several potential advantages over traditional titanium implants, but their antibacterial efficiency has not yet been evaluated. The purpose of this study was to determine the anti-bacterial potential of SiCN by modifying the surface of SiCN-coated implants to have a positive charge on the nitrogen atoms through the quaternization of the surface atoms. The changes in surface chemistry were confirmed using contact angle measurement and XPS analysis. The modified SiCN surfaces were inoculated with Streptococcus mutans (S. mutans) and compared with a silicon control. The cultured bacterial colonies for the experimental group were 80% less than the control silicon surface. Fluorescent microscopy with live bacteria staining demonstrated significantly reduced bacterial coverage after 3 and 7 days of incubation. Scanning electron microscopy (SEM) was used to visualize the coated surfaces after bacterial inoculation, and the mechanism for the antibacterial properties of the quaternized SiCN was confirmed by observing ruptured bacteria membrane along the surface.

Dental Light-Curing-Assessing the Blue-Light Hazard.

This article focuses on the current understanding and concerns over the blue-light hazard when using dental light-curing units. It also provides information and safety protocols to guide the practitioner in making important decisions regarding dental personnel's health and the quality of dental restorations.

Depth of cure of 10 resin-based composites light-activated using a laser diode, multi-peak, and single-peak light-emitting diode curing lights.

OBJECTIVES: To evaluate the depth of cure (DOC) of ten contemporary resin-based composites (RBCs), light-cured using different LCUs and exposure times. METHODS: The power, radiant emittance, irradiance, radiant exposure (RE), and beam profiles from a laser (M, Monet), a multi-peak (V, Valo Grand), and single-peak (S, SmartLite Pro) LCU were measured. The DOC was measured using a 6-mm diameter metal mold and a solvent dissolution method to remove the uncured RBC. The length of the remaining RBC was divided by 2. The exposure times were: 1 s and 3 s for M, 10 s and 20 s for V, and 10 s and 20 s for S. Data were analyzed using: Bland-Altman distribution, Pearson's Correlation, and an artificial neural network (ANN) to establish the relative importance of the factors on the DOC (α=0.05; ß=0.2). RESULTS: Significant differences were found in the DOC achieved by the different LCUs and composites. The laser LCU emitted the highest power, radiant emittance is used above and in the tables and delivered the highest irradiance. However, this LCU used for 1 s delivered the lowest RE and produced the shortest DOC in all ten RBCs. The ANN demonstrated that the RE is the most critical factor for the DOC. Bland-Altman comparisons showed that the DOCs achieved with the laser LCU used for 1 s were between 17 and 34% shorter than the other conditions. CONCLUSIONS: Although the laser LCU cured all 10 RBCs when used for 1 s, it produced the shallowest DOC, and some RBCs did not achieve their minimum DOC threshold. The RE and not the irradiance was the most important factor in determining the DOC of these 10 RBCs. CLINICAL SIGNIFICANCE: Despite delivering high power and irradiance, the laser used for l s delivered a lower radiant exposure than the conventional LCUs used for 10 s. This resulted in a shorter DOC.

Effect of dental headlights spectrum on the polymerization and working time of light-cured resin composites.

Background: The use of dental headlights is a common practice to better illuminate the operatory field and achieve excellence in restorative dentistry. However, visible light-cured dental materials can have reduced working time under headlight illumination. The aim of this study was to evaluate the influence of the spectral irradiance power of two dental headlights on the degree of polymerization and working time of light-curable dental composites. Material and Methods: Two headlights, StarLight Nano 3 (StarMed) (SN) and Zeon Endevour XL (Orascoptic) (ZE) were characterized using a spectrophotometer coupled to an integrating sphere (MARC® Light Collector, BlueLight Analytics). The degree of conversion of the two composites, Filtek Supreme (3M) and Tetric Prime (Ivoclar Vivadent), was evaluated using an FTIR spectroscope (NicoletTM iS20, Thermo Fisher). Results: Both headlights emitted a significant amount of blue light. The Zeon headlamp without filter emitted a broader spectrum with lower blue intensity and higher CRI than the White LED of the Nano 3. The Zeon headlamp with the blue blocking filter emitted a broader spectrum than the Orange LED of the Nano 3. There were no differences in the degree of conversion and working time of the Filtek Supreme and Tetric Prime composites when illuminated by the different headlamps. Both Zeon and the White LED of the Nano 3 were capable to cure the composites within only 5-10 minutes of irradiation. There were no changes in the degree of conversion of the composites when the Orange LED of the Nano 3 or the blue blocking filter of the Zeon were used. Conclusions: Both headlights reduced the working time of light-cured materials. The use of orange filters prevented the composite polymerization and maintained the working time. Key words:Surgical Headlight, degree of conversion, working time, light-curing.

The effect of different pulp capping methods on the intrapulpal temperature when using light-cured procedures.

Background: To evaluate the intra-pulpal temperature during different direct pulp capping methods and light-cured procedures. Material and Methods: Class I preparations 5 mm long, 4 mm wide and 4 mm deep were performed in extracted third molars, leaving 0.5 mm of dentin at the pulpal floor with a 1 mm diameter of pulp exposure. Teeth were placed in a customized oral cavity chamber simulator in which the initial temperature was standardized at 36oC. The overall temperature variations (oC) in the pulp chamber during the light-activation processes were recorded live using an infrared camera (FLIR ONE PRO, FLIR Systems). The liners and bases evaluated were: Dycal (Dentisply), TheraCal LC (Bisco), Biodentin (Septodent), Vitrebond Plus (3M/ESPE), and Fuji IX GP (GC), followed by restoration with a bulk fill composite (EvoCeram Bulk Fill, Ivoclar Vivadent). All light-activation procedures were performed with the VALO Grand (Ultradent) light-curing unit. A power analysis was conducted to determine the sample size to provide a power of at least 0.8 with α=0.05. Statistical analyses were performed using ANOVA and Tukey's test for multiple comparisons. Results: The intrapulpal temperature increased above a 10oC to 20oC threshold difference for all liners and bases that were light cured. When added as second layers, neither of those could provide thermal insulation following additional light-activated procedures (p=0.25). The higher the number of procedures requiring light-activation, the longer the pulp temperature remained in those increased temperature thresholds. Conclusions: For direct pulp capping procedures, a reduced number light activation procedures should be indicated to reduce the time intra-pulpal temperature rises above a 10oC threshold. Key words:Liner, base, calcium hydroxide, glass ionomer, dental adhesive, bulkfill composite.

Color difference between the vita classical shade guide and composite veneers using the dual-layer technique.

Background: The purpose of this in vitro study was to evaluate the color difference between the Vita Classical Shade Guide and composite veneers using the dual-layer technique. Material and Methods: Thirty samples were fabricated using a custom-made mold (Easy Layering Shade Guide Kit, 3M) using two resin composites: Filtek Supreme Ultra (3M); and Estelite Omega (Tokuyama) (n=3). The composite veneers were made by layering the different enamel and body or dentin shades from each composite. The color measurements were taken using a spectrophotometer (Vita Easyshade V®, Vita Zahnfabrik). The ΔE00 between the Vita Classical Shade Guide (Vita Zahnfabrik) and the composite veneers were calculated using the CIEDE2000 formula. Results: For the composite veneers using Filtek Supreme Ultra, the best match for A1 Vita shade was achieved layering either EA1 with DA2 or DA3; EA2 with DA1 or DA2 (ΔE00= 1.53 ~ 1.96 ± 0.4). For A2 Vita shade the best match would be EA3 with DA3 or EA3 with DA2 (ΔE00= 1.40 ~ 1.85 ± 0.1); or for A3 Vita shade the best match would be EA3 with DA2 2.50±(0.6). For the composite veneers using Estelite Omega, the were no best match for neither A1, A2 or A3 Vita shade (ΔE00> 2.5). Conclusions: The combination of enamel and dentin shades from Filtek Supreme Ultra provided acceptable color match for A1, A2 and A3 shades from the Vita Shade Guide, while Estelite Omega did not provide acceptable color match for any of the Vita Shade Guide standard shades tested. Key words:Color, color matching, optical properties, resin composite, layering.

Two-body wear resistance and fatigue survival of new Y-TZP and ATZ ceramics made with a new slip-casting method.

BACKGROUND: Dental zirconium oxide restorations are milled from pre-sintered blocks or disks which are produced either with high isostatic pressure (HIP) or, simpler, a slurry technique. The objective was to perform a fatigue test and an in vitro wear simulation of two ceramics, yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) ceramic and a hybrid zirconium oxide-aluminum oxide ceramic, (ATZ) both produced either the classical way using high isostatic pressure (HIP, control) or with a slurry technique. MATERIALS AND METHODS: Ten discs/group were subjected to a cyclic biaxial fatigue test using a staircase approach under water at 37 °C in a dynamic universal testing machine. The 2-body wear test was performed on eight lapped 12 mm thick cylindrical samples subjected to spherical (ø 6 mm) leucite ceramic antagonists in a CS-4 chewing simulator at 49 N force and 0.7 mm lateral movement for 600 k cycles and 4167 thermal cycles (5-55 °C). Volumetric wear was calculated based on laser-scanned surfaces. Selected samples of both tests were viewed in SEM. RESULTS: All the ceramic specimens produced using the HIP method survived up to 1.2 M cycles with the maximum load of the equipment (1000 N) loading the specimens up to 1527 MPa. The fatigue limit stress at 1.2 M cycles for the Slurry ATZ samples was 946 MPa. For the Slurry Y-TZP samples the fatigue limit stress at 1.2 M cycles was 658 MPa. At 600 k cycles, all zirconium oxide ceramics showed no measurable wear and had a highly polished appearance. The leucite ceramic antagonists wear developed in a linear way. There was no difference between the materials produced with the slurry and the HIP process. ATZ ceramic produced significantly more wear than 3Y- TZP ceramic. CONCLUSIONS: The HIP method provided higher fatigue strength than the Slurry manufacturing method. All HIP ceramics surpassed the limit threshold (1527 MPa) of the testing machine. The tested ceramics did not show any measurable wear but had worn the leucite reinforced glass ceramic antagonists for a considerable amount.

Beam Profiling of Dental Light Curing Units Using Different Camera-Based Systems.

OBJECTIVE: This study aimed to perform the beam profile of dental light-curing units (LCUs) using mirrorless and smartphone cameras and correlate it to a camera-based laser beam profiling system. MATERIALS AND METHODS: Three LCUs were evaluated (Radii Plus; Bluephase G2; and VALO Cordless). The spectral power of the LCUs was measured by using a spectrophotometer. The light emitted from the LCUs was projected onto a glass diffuser, and the images were recorded by using a mirrorless camera (NEX-F3), a smartphone (iPhone) and a camera-based beam profiler. Bandpass optical-filters were used, and for each LCU, the total spectral power output was integrated to calibrate the images. Statistical analysis was performed by digital image correlation (pixel by pixel) using Pearson's correlation (α = 0.05; ß = 0.2). RESULTS: The beam profile images showed nonuniform radiant emittance and spectral emission distributions across all the LCUs light tip. A strong correlation was found among cameras (Pearson's r = 0.91 ± 0.03 with 95% confidence interval [CI]: 0.88-0.94 for the NEX-F3 and Pearson's r = 0.88 ± 0.04 with 95% CI: 0.84-0.92 for the iPhone). CONCLUSION: The standard Ophir beam profile system presented the most accurate distribution, but the mirrorless and smartphone cameras presented a strong correlation in the irradiance distribution of the beam profile images. Alternative cameras can be used to perform light beam profile of dental LCUs, but caution is needed as the type of sensor, image bit depth, and image processing are important to obtain accurate results.

The use of an elastomeric methacrylate monomer (Exothane 24) to reduce the polymerization shrinkage stress and improve the two-body wear resistance of bulk fill composites.

OBJECTIVES: Characterize the chemical structure of an elastomeric monomer (Exothane 24) and evaluate the degree of conversion (DC), polymerization shrinkage stress (PSS), rate of polymerization (Rp), flexural strength (FStrenght), flexural modulus (FModulus), Vickers hardness (VHardness) and two-body wear resistance of dental bulk fill composites (BFCs) containing Exothane 24. METHODS: The Exothane 24 was characterized using mass spectroscopy, elemental analysis, 13C- and 1H NMR. BFCs were formulated containing Exothane 24 (E10, E25, and E50). Similar BFCs containing regular UDMA (U10, U25, and U50), commercial conventional, and BFCs were used as control groups. ATR-FTIR spectroscopy was used to measure DC and the Rp of the composites. The PSS was measured using the universal testing machine method. Specimen bars were used to assess the FStrenght, FModulus, and VHardness. RBCs were submitted to a two-body wear test using a chewing simulator machine; the rate and volumetric wear loss were evaluated using an optical scanner. Data were analyzed statistically with α = 0.05 and ß = 0.2. RESULTS: Exothane 24 is a urethane isophorone tetramethyl methacrylate monomer with polymerization stress-relieving properties. No differences were found in the DC up to 4 mm in depth for E25. All BFCs had similar FStrenght, except for E50. E25 had the lowest volumetric wear loss and wear rate. E25 had approximately 30% lower PSS and slower Rp than commercial BFCs with similar wear resistance to conventional commercial composites. SIGNIFICANCE: The Exothane 24 reduced the PSS and increased the wear resistance of BFCs; however, the formulation is important to optimize the properties of the BFCs.

Effect of light attenuation through veneers on bond strength of adhesives with photoinitiator combinations.

This study aimed to evaluate the effect of light attenuation through ceramic veneers and resin cement on degree of conversion (DC), cohesive strength (CS), and microshear bond strength (µSBS) of experimental adhesive systems. Experimental etch-and-rinse and self-etch adhesives were combined with different ratios of camphorquinone (CQ) and diphenyl(2,4,6-trimethylbenzoyl) phosphine oxide (TPO) photoinitiators: CQ-only; 3CQ:1TPO; 1CQ:1TPO; 1CQ:3TPO and TPO-only. Square-shaped ceramic veneer (IPS Empress Esthetic, Ivoclar Vivadent) (n = 10; 10mm long x 10mm wide x 0.5mm thick) and resin cement specimens (Variolink Esthetic LC, Ivoclar Vivadent) (n = 10; 10 mm long x 10 mm wide and 0.3 mm thick) were prepared. Light transmittance of a multiple-peak LED (Bluephase G2, Ivoclar Vivadent) was measured through restorative materials using a spectrometer (n = 5). Adhesive specimens were analyzed for DC, CS, and µSBS by light-curing the adhesive with or without (control) ceramic veneer, and with resin cement fixed to output region of the light-curing tip (n = 10). Data were submitted to ANOVA and Tukey's test (α = 0.05). Total light transmittance through the restorative materials was attenuated, and this attenuation was more evident for the violet spectrum. The DC for the TPO groups in ratios up to 1CQ:1TPO was similar to the control. 1CQ:3TPO showed lower values for CS. µSBS was reduced for all groups with light attenuation, but lower values were observed for 1CQ:3TPO and TPO-only. In conclusion, light transmission was reduced with interposed restorative materials. Adhesives combined with CQ and TPO up to 1CQ:1TPO showed greater cure efficiency and mechanical properties compared with a higher amount of TPO.