Using a professional DSLR camera to measure total shrinkage of resin composites

Abstract This study evaluated the optical method for measuring free total shrinkage using a Digital Single Lens Reflex (DSLR) camera. Eight composites were evaluated, conventional, bulk fill and low-shrinkage: Z100 (3M Oral Care), Gradia Direct Anterior (GC corporation), Spectra Smart (Dentsply), Filtek Z350 XT (3M Oral Care), Aura Bulk Fill (SDI), Vittra APS (FGM), Opus Bulk Fill APS (FGM), and Beautifil II LS (Shofu Inc.). The samples (6 mm diameter and 1.5 mm thick, n = 10) were placed on a polyvinylsiloxane impression material. An image of the uncured sample was captured using a DSLR camera with 105 mm macro lens and a ring flash. Samples were light cured with a 700 mW/cm2 LED light-cure unit for 40s. Post-polymerization images were captured at 2, 10 and 60 min. Projected circumferential areas of the specimens were drawn using the ImageJ software. Volumetric total shrinkage was calculated from the ratio of the areas obtained from pre- and post-curing. Results were analyzed using One-way ANOVA (α = 0.05) and Tukey test. Volumetric total shrinkage values were significantly different among the composite materials (p < .001). The volumetric shrinkage (%) mean and results of Tukey test at 60 min were: Z100: 3.45±0.30 (A); Gradia Direct Anterior: 3.00 ± 0.23 (B); Spectra Smart 2.89 ± 0.35 (B); Filtek Z350 XT: 2.65 ± 0.37 (BC); Aura Bulk Fill: 2.42 ± 0.25 (CD); Vittra APS: 2.14 ± 0.35 (DE); Opus Bulk Fill APS: 1.91 ± 0.24 (E); Beautifil II LS: 1.18 ± 0.16 (F). The optical method using a DSLR camera, was suitable for total shrinkage evaluation and will allow assessment of total shrinkage without the need for specialized equipment.

Numeric Evaluation of Innovate Spring Machined Nickel-Titanium Rotary Instruments: A 3-dimensional Finite Element Study.

INTRODUCTION: The purpose of this study was to investigate if machined springs in nickel-titanium (NiTi) rotary instruments can improve their mechanical properties. The bending and torsion properties were assessed using finite element (FE) model analysis. METHODS: A basic 3-dimensional file model without a spring was created with apical size #25, 25-mm full length, and 16-mm cutting flutes. Three other models were created with a spring machined into their shaft portion with different numbers of spring coils: standard (STspr), 10% more (INspr), and 10% less (DEspr). To compare the mechanical responses among the 4 FE models, file bending and torsion were simulated using FE analysis. RESULTS: Spring machined NiTi rotary instruments showed higher torsional resistance and less bending stiffness than the same instrument without. The spring machined models required more torque to bend or rotate the DEspr model than was required for the STspr and INspr models; however, the STSpr and INSpr models were similar. CONCLUSIONS: Within the limitations of this study, the FE analysis indicated that machining a spring into the shaft of NiTi rotary instruments improved torsional resistance and bending flexibility. Therefore, spring machining has the potential to increase the durability of the NiTi rotary instruments.

Influence of bone defect position and span in 3-point bending tests: experimental and finite element analysis.

Three-point bending test is the most common mechanical test used for quantifying the biomechanical quality of bone tissue and bone healing in small animals. However, there is a lack of standardization for evaluation of bone repair by cortical perforation. The aim of this study was to determine the influence of bone defect position in the proximal metaphysis of rat tibias during load application and different span configuration on the three-point bending test outcomes. Cortical defects with 1.6 mm diameter were created at a standardized location on the medial surface of 60 tibias of male Wistar rats. The animals were euthanized 7 days after surgery. Five specimens were used to create 3D models for finite element analysis using high-resolution micro-CT images. Two spans (6 and 10mm) and three positions of the bone defect in relation to the load application (upward, frontal and downward) were evaluated experimentally (n = 10) and in finite element analysis (n = 5). Maximum load (N) and stiffness (N/mm) were statistically analyzed with 2-way ANOVA and Tukey test (α = 0.05). The results demonstrated that span and orientation of the bone defect significantly influenced the fracture pattern, stress distribution and force versus displacement relation. Therefore, reliable outcome can be achieved creating the bone defect at 8 mm from the extremity of the proximal epiphysis; placing a 10 mm distance span and downward facing defect position to allow a better distribution of stress and more fracture patterns that reached the bone defect target area with less intra-group variability.

Effect of orthodontic bracket type and mouthguard presence on the stress and strain during a frontal impact

Abstract The aim of this study was to analyze the influence of orthodontic bracket type (metallic or ceramic) and mouthguard on biomechanical response during impact. Two-dimensional plane-strain models of a patient with increased positive overjet of the maxillary central incisor was created based on a CT scan, simulating the periodontal ligament, bone support, gingival tissue, orthodontic brackets (metallic or ceramic) and mouthguard. A nonlinear dynamic impact finite element analysis was performed in which a steel object hit the model at 1 m/s. Stress distributions (Von Mises and Modified Von Mises) and strain were evaluated. Stress distributions were affected by the bracket presence and type. Models with metallic and ceramic bracket had higher stresses over a larger buccal enamel impact area. Models with ceramic brackets generated higher stresses than the metallic brackets. Mouthguards reduced the stress and strain values regardless of bracket type. Mouthguard shock absorption were 88.37% and 89.27% for the metallic and ceramic bracket, respectively. Orthodontic bracket presence and type influenced the stress and strain generated during an impact. Ceramic brackets generated higher stresses than metallic brackets. Mouthguards substantially reduced impact stress and strain peaks, regardless of bracket type.

Resumo O objetivo deste estudo foi analisar a influência da presença e tipo de bráquete ortodôntico (metálico ou cerâmico), e a presença de protetor bucal na resposta biomecânica durante impacto. Modelos bidimensionais em estado plano de deformação de paciente com incisivo central superior com overjet positivo acentuado foram criados baseados em tomografia computadorizada, simulando ligamento periodontal, suporte ósseo, tecido gengival, bráquetes ortodônticos (metálico e cerâmico) e o protetor bucal. Análise de elementos finitos não-linear de impacto foi realizada na qual uma esfera de aço atingiu o modelo a 1m/s. A distribuição de tensões (Von Mises e Von Mises modificado) e a deformação foram avaliadas. As distribuições de tensões foram afetadas pela presença e tipo de bráquete. Modelos com bráquete metálico e cerâmico produziram maiores valores de tensões sobre maior área do esmalte vestibular. Modelos com bráquetes cerâmicos geraram maiores tensões do que metálicos. O protetor bucal reduziu as tensões e deformações geradas independentemente do tipo de bráquete. A capacidade de absorção de choques foi de 88.37 e 89.27% para os bráquetes metálicos e cerâmicos, respectivamente. A presença e o tipo de bráquete influenciou a distribuição de tensões e deformações durante o impacto. Bráquetes cerâmicos geraram maiores valores de tensão do que metálicos. Protetor bucal reduziu significativamente os picos de tensão e deformação.

Buckling Resistance of Various Nickel-Titanium Glide Path Preparation Instruments in Dynamic or Static Mode.

INTRODUCTION: The aim of this study was to compare the buckling resistance of nickel-titanium (NiTi) instruments for glide path preparation depending on the test mode (static vs dynamic). METHODS: The conventional PathFile (PF; Dentsply Sirona, Ballaigues, Switzerland) and heat-treated ProGlider (PG, Dentsply Sirona) and WaveOne Gold Glider (WG, Dentsply Sirona) were evaluated. The instrument tips were placed in a small dimple prepared in an aluminum cube in a customized device. The file was then pushed in the axial direction at a 1.0-mm/s crosshead speed with rotation (dynamic mode) or without rotation (static mode). The dynamic mode of WG used its dedicated reciprocating rotation, whereas the others were rotated continuously at 300 rpm. The axial load and lateral buckling displacement were simultaneously measured. Data were analyzed statistically using 2-way analysis of variance (P = .05). RESULTS: The buckling resistance in the dynamic mode was higher than in the static mode for PG and WG (P < .05), whereas PF was not influenced by test modes (P > .05). In the dynamic mode, the PG required the highest buckling load followed by PF and WG (P < .05). In the static mode, the WG showed the lowest load (P < .05). The dynamic mode showed significantly more upper level lateral buckling displacement than in the static mode (P < .05). CONCLUSIONS: When the glide path preparation instruments moved in the dynamic mode as in clinical situations, the buckling resistance of the heat-treated NiTi glide path instruments was higher than in the static condition. The heat-treated instruments may have better buckling resistance than the conventional NiTi instrument in clinical situations.

Direct resin composite restoration of endodontically-treated permanent molars in adolescents: bite force and patient-specific finite element analysis

Abstract Objective To evaluate the influence of three levels of dental structure loss on stress distribution and bite load in root canal-treated young molar teeth that were filled with bulk-fill resin composite, using finite element analysis (FEA) to predict clinical failure. Methodology Three first mandibular molars with extensive caries lesions were selected in teenager patients. The habitual occlusion bite force was measured using gnathodynamometer before and after endodontic/restoration procedures. The recorded bite forces were used as input for patient-specific FEA models, generated from cone-beam computed tomographic (CT) scans of the teeth before and after treatment. Loads were simulated using the contact loading of the antagonist molars selected based on the CT scans and clinical evaluation. Pre and post treatment bite forces (N) in the 3 patients were 30.1/136.6, 34.3/133.4, and 47.9/124.1. Results Bite force increased 260% (from 36.7±11.6 to 131.9±17.8 N) after endodontic and direct restoration. Before endodontic intervention, the stress concentration was located in coronal tooth structure; after rehabilitation, the stresses were located in root dentin, regardless of the level of tooth structure loss. The bite force used on molar teeth after pulp removal during endodontic treatment resulted in high stress concentrations in weakened tooth areas and at the furcation. Conclusion Extensive caries negatively affected the bite force. After pulp removal and endodontic treatment, stress and strain concentrations were higher in the weakened dental structure. Root canal treatment associated with direct resin composite restorative procedure could restore the stress-strain conditions in permanent young molar teeth.

Polymerization shrinkage stress of composite resins and resin cements - What do we need to know?

Abstract Polymerization shrinkage stress of resin-based materials have been related to several unwanted clinical consequences, such as enamel crack propagation, cusp deflection, marginal and internal gaps, and decreased bond strength. Despite the absence of strong evidence relating polymerization shrinkage to secondary caries or fracture of posterior teeth, shrinkage stress has been associated with post-operative sensitivity and marginal stain. The latter is often erroneously used as a criterion for replacement of composite restorations. Therefore, an indirect correlation can emerge between shrinkage stress and the longevity of composite restorations or resin-bonded ceramic restorations. The relationship between shrinkage and stress can be best studied in laboratory experiments and a combination of various methodologies. The objective of this review article is to discuss the concept and consequences of polymerization shrinkage and shrinkage stress of composite resins and resin cements. Literature relating to polymerization shrinkage and shrinkage stress generation, research methodologies, and contributing factors are selected and reviewed. Clinical techniques that could reduce shrinkage stress and new developments on low-shrink dental materials are also discussed.

The geometric effect of an off-centered cross-section on nickel-titanium rotary instruments: A finite element analysis study.

BACKGROUND/PURPOSE: Geometric design dictates the mechanical performance of nickel-titanium rotary instruments. Using finite element (FE) analysis, this study evaluated the effects of an off-centered cross-sectional design on the stiffness and stress distribution of nickel-titanium rotary instruments. MATERIALS AND METHODS: We constructed three-dimensional FE models, using ProTaper-NEXT type design (PTN) as well as three other virtual instruments with varied cross-sectional aspect ratios but all with the same cross-sectional area. The cross-sectional aspect ratio of the PTN was 0.75, while others were assigned to have ratios of 1.0 (square), 1.5 (rectangle), and 2.215 (centered-rectangle). The PTN center of the cross-section was 'k', while others were designed to have 0.9992k, 0.7k, and 0 for the square, rectangle, and centered-rectangle models, respectively. To compare the stiffness of the four FE models, we numerically analyzed their mechanical response under bending and torque. RESULTS: Under the bending condition, the square model was found to be the stiffest, followed by the PTN, rectangle, and then the centered-rectangle model. Under the torsion, the square model had the smallest distortion angle, while the rectangular model had the highest distortion angle. CONCLUSION: Under the limitation of this study, the PTN type off-centered cross-sectional design appeared the most optimal configuration among the tested designs for high bending stiffness with cutting efficiency while rotational stiffness remained similar with the other designs.

Restaurações de resinas compostas em dentes posteriores: controlando os efeitos da contração de polimerização / Composite resin restorations in posterior teeth: controlling the efects of the polymerization shrinkage

A contração de polimerização da resina composta pode desenvolver tensões na interface dente-restauração e estrutura dental remanescente, resultando em deformação de cúspide, sensibilidade pós-operatória e fenda marginal. Este artigo apresenta, por meio da associação de evidência científica e relato de caso, uma reflexão de como o clínico pode minimizar os efeitos da contração de resina composta em dentes posteriores. Ainda persistem dúvidas sobre resinas em dentes posteriores, um dos procedimentos mais prevalentes em saúde bucal. A associação de estudos laboratoriais e simulação computacional, por meio de elementos finitos, pode auxiliar na solução de problemas clínicos constantes. A odontologia baseada em evidências, que dá suporte à tomada de decisão, é fundamental para o sucesso clínico desses procedimentos...

The polymerization shrinkage of composite resin is responsible for developing stresses in the tooth/restoration interface and the remaining tooth structure, causing cusp deflection, pos-operative sensitivity and marginal gap. This article presents thoughts based in scientific evidence associated to a case report, on how clinicians may minimize the effects of the polymerization shrinkage in posterior teeth. There are still remaining doubts about posterior composite resin restorations, one of the most prevalent dental procedures. The association of laboratory studies and computer simulation using finite element analysis can assist clinicians to solve frequent problems. Evidence-based Dentistry supporting the decision-making process is critical to the clinical success of these restorative procedures...

Protetores bucais personalizados: aspectos clínicos e biomecânicos / Custom-Fitted mouthguards: clinical and biomechanical aspects

Protetores bucais são dispositivos utilizados com o objetivo de absorver as tensões geradas pelo impacto e prevenção de traumatismos dentoalveolares durante a prática esportiva. Este artigo apresenta, por meio de associação de evidência científica e relato de caso, uma abordagem crítica dos parâmetros envolvidos na confecção de protetor bucal personalizado em etileno vinil acetato (EVA) e funções durante o uso. A associação de ensaios laboratoriais e computacionais como método de elementos finitos é essencial para o entendimento do comportamento biomecânico dos protetores bucais. O presente estudo apresenta evidência científica sobre a eficiência de protetores bucais personalizados na absorção de choques e prevenção de traumas...

Mouthguards are devices used to absorb stresses generated by the impact and to prevent dental trauma during sport practice. This article presents the association of scientific evidence and a case report on critical parameters for the fabrication of a Ethylene Vinyl Acetate (EVA) custom-fitted mouthguard, and function during its use. The association of laboratory and computational tests such as the finite element method is essential to understand the biomechanical behavior of mouthguards. This study presents scientific evidence that proves the efficiency of EVA custom-fitted mouthguards os shock absorption and prevention of dental trauma...

Elastic limits in torsion of reciprocating nickel-titanium instruments.

INTRODUCTION: Reciprocating angle and torsional load at the superelastic limit were investigated for nickel-titanium (NiTi) instruments used with reciprocating movements. METHODS: Two reciprocating NiTi instruments (Reciproc R25 [VDW, Munich, Germany] and WaveOne Primary [Dentsply Maillefer, Ballaigues, Switzerland]) and ProTaper F2 (Dentsply Maillefer) were tested for 2 torsional conditions using a custom-designed testing device. Rotational angles were applied, and generated torque values were recorded. The first test condition fixed the files at 5 mm and repetitively rotated them with gradually increasing angles up to 250° (n = 10). The second test subjected the files to a single continuous rotation until fracture (n = 10). The superelastic limits of the instruments were determined from their torque-rotation curves. Statistical analysis was performed (Kruskal-Wallis) at a 95% significance level. The tested specimens were examined under a scanning electron microscope. RESULTS: It was found that the angle at the superelastic limit was higher for R25 and Primary files than the ProTaper file (P < .05). Repetitive torsional loading with a gradually increasing rotational angle reduced the torsional resistance compared with the single rotation motion. At the 5-mm fixation level all files had superelastic limit angles higher than the 170° set in the dedicated reciprocating motor. The scanning electron microscopic analysis showed features of torsional failure. CONCLUSIONS: Under the conditions of this study, the 170° set angle of dedicated motors for reciprocating file systems is safe at the 5-mm level. Reuse of reciprocating systems, even with the movements within the elastic limit, may cause deterioration of the instruments.

Cyclic fatigue resistance tests of Nickel-Titanium rotary files using simulated canal and weight loading conditions.

OBJECTIVES: This study compared the cyclic fatigue resistance of nickel-titanium (NiTi) files obtained in a conventional test using a simulated canal with a newly developed method that allows the application of constant fatigue load conditions. MATERIALS AND METHODS: ProFile and K3 files of #25/.06, #30/.06, and #40/.04 were selected. Two types of testing devices were built to test their fatigue performance. The first (conventional) device prescribed curvature inside a simulated canal (C-test), the second new device exerted a constant load (L-test) whilst allowing any resulting curvature. Ten new instruments of each size and brand were tested with each device. The files were rotated until fracture and the number of cycles to failure (NCF) was determined. The NCF were subjected to one-way ANOVA and Duncan's post-hoc test for each method. Spearman's rank correlation coefficient was computed to examine any association between methods. RESULTS: Spearman's rank correlation coefficient (ρ = -0.905) showed a significant negative correlation between methods. Groups with significant difference after the L-test divided into 4 clusters, whilst the C-test gave just 2 clusters. From the L-test, considering the negative correlation of NCF, K3 gave a significantly lower fatigue resistance than ProFile as in the C-test. K3 #30/.06 showed a lower fatigue resistance than K3 #25/.06, which was not found by the C-test. Variation in fatigue test methodology resulted in different cyclic fatigue resistance rankings for various NiTi files. CONCLUSIONS: The new methodology standardized the load during fatigue testing, allowing determination fatigue behavior under constant load conditions.

Flexural stiffness and stresses in nickel-titanium rotary files for various pitch and cross-sectional geometries.

INTRODUCTION: Shape is the main determinant of mechanical performance for nickel-titanium rotary instruments. This study evaluated how pitch and cross-sectional geometry affected flexural stiffness and stresses. METHODS: Finite element models of rotary instruments with 4 cross-sectional geometries (triangle, slender-rectangle, rectangle, square) and 3 pitches (5-, 10-, 15-threads) were created, featuring superelastic nickel-titanium properties. All models had the same length, taper, and external peripheral radius; cross-sectional area and/or center-core area varied. The clamped shaft was rotated axially, while the tip was deflected 5 mm. Flexural stiffness and maximum von Mises stresses were calculated. RESULTS: Stiffness and maximum stress decreased with decreasing pitch (increasing threads). Doubling or tripling the threads for the triangular or rectangular cross sections decreased the stiffness and stress 6% and 12%, respectively; square cross sections were less affected (1% and 3% decrease, respectively). Square cross sections (higher cross-sectional and center-core areas) had higher stiffness and stresses than other models with same deflection. Rectangular and triangular models with the same center-core areas had similar stresses, but the rectangular model was 30%-40% stiffer. The slender-rectangle had the smallest center-core area and the lowest stiffness and stresses. Both rectangular cross sections caused stiffness and stress variations with rotation angle (13% for slender-rectangle); larger pitch caused more variation. CONCLUSIONS: Under the same tip deflection (simulating canal curvature), flexural stiffness and stress correlated with center-core area. Increasing pitch increased flexural stiffness and stresses.

Comparison of torsional stiffness of nickel-titanium rotary files with different geometric characteristics.

INTRODUCTION: The aim of this study was to evaluate the theoretical effect from pitch and cross-sectional geometry on torsional stiffness of nickel-titanium (NiTi) instruments. METHODS: Finite element models of NiTi rotary instruments with different cross-sectional geometries and different number of threads were made for comparison of torsional stiffness. Four cross-sectional shapes were tested: triangle, slender rectangle, rectangle, and square. Taper and external peripheral radius were the same for all models, whereas cross-sectional area and/or center core area were varied. Three pitch values (5, 10, and 15 threads) were tested for each type of cross-sectional geometry. The torsional stiffness of the 12 resulting finite element models was calculated by twisting the file shanks 20 degrees while holding the file tip at apical 4 mm. RESULTS: The file models with larger pitch (fewer threads) had lower torsional stiffness. The models with the rectangular cross section had higher torsional stiffness than models with the triangular cross section, even when the cross-sectional areas were the same or the center core area was smaller. File models with larger cross-sectional area had higher torsional stiffness. CONCLUSIONS: Torsional deformation and/or fracture of NiTi rotary files might be reduced by reducing the pitch (increasing the number of threads) and increasing the cross-sectional areas rather than the center core area.

Correlation between experimental cyclic fatigue resistance and numerical stress analysis for nickel-titanium rotary files.

INTRODUCTION: The aim of this investigation was to study cyclic fatigue resistance of various nickel-titanium (NiTi) rotary files under various root canal curvatures by correlating cyclic fatigue fracture tests with finite-element analysis (FEA). METHODS: Four NiTi rotary instruments with different cross-sectional geometries but comparable sizes were selected for this study: ProTaper (Dentsply Maillefer, Ballaigues, Switzerland), ProFile (Dentsply Maillefer), HeroShaper (Micromega, Besançon, France), and Mtwo (VDW, Munich, Germany). The ProFile and HeroShaper files were of size 30/.06 taper, the Mtwo was of size 30/.05 taper, and the ProTaper was F3. The cyclic fatigue test was conducted in a custom-made device that simulated canals with 25°, 35°, and 45° curvature. For the FEA, the file models were meshed, and 17-mm long curved canals were modeled to have same curvatures as the cyclic fatigue tests. Numerical analysis was performed to determine the stress distributions in the NiTi instruments while they rotated in the simulated curved canals. RESULTS: ProTaper (the stiffest instrument) showed the least cyclic fatigue resistance and highest stress concentration for all tested curvatures, whereas Mtwo showed the best cyclic fatigue resistance. A comparison between the FEA and fatigue results showed that when stresses increased, the number of instrument rotations to fracture decreased. Maximum stresses in the instruments predicted the approximate location of the fatigue fracture. CONCLUSIONS: The stiffer instrument had the highest stress concentration in FEA and the least number of rotations until fracture in the cyclic fatigue test. Increased curvature of the root canal generated higher stresses and shortened the lifetime of NiTi files. Finite-element stress analysis reflected cyclic fatigue fracture resistance.

Potential relationship between design of nickel-titanium rotary instruments and vertical root fracture.

INTRODUCTION: Nickel-titanium (NiTi) rotary files can produce cleanly tapered canal shapes with low tendency of transporting the canal lumen. Because NiTi instruments are generally perceived to have high fracture risk during use, new designs have been marketed to lower fracture risks. However, these design variations may also alter the forces on a root during instrumentation and increase dentinal defects that predispose a root to fracture. This study compared the stress conditions during rotary instrumentation in a curved root for three NiTi file designs. METHODS: Stresses were calculated using finite element (FE) analysis. FE models of ProFile (Dentsply Maillefer, Ballaigues, Switzerland; U-shaped cross-section and constant 6% tapered shaft), ProTaper Universal (Dentsply; convex triangular cross-section with notch and progressive taper shaft), and LightSpeed LSX (Lightspeed Technology, Inc, San Antonio, TX; noncutting round shaft) were rotated within a curved root canal. The stress and strain conditions resulting from the simulated shaping action were evaluated in the apical root dentin. RESULTS: ProTaper Universal induced the highest von Mises stress concentration in the root dentin and had the highest tensile and compressive principal strain components at the external root surface. The calculated stress values from ProTaper Universal, which had the biggest taper shaft, approached the strength properties of dentin. LightSpeed generated the lowest stresses. CONCLUSION: The stiffer file designs generated higher stress concentrations in the apical root dentin during shaping of the curved canal, which raises the risk of dentinal defects that may lead to apical root cracking. Thus, stress levels during shaping and fracture susceptibility after shaping vary with instrument design.