Marginal integrity and physicomechanical properties of a thermoviscous and regular bulk-fill resin composites.

OBJECTIVES: To evaluate the marginal integrity (MI%) and to characterize specific properties of a thermoviscous bulk-fill resin composite, two regular bulk-fill resin composites, and a non-bulk-fill resin composite. MATERIALS AND METHODS: VisCalor bulk (VBF), Filtek One Bulk Fill (OBF), and Aura Bulk Fill (ABF) were evaluated. Filtek Z250 XT (ZXT) was used as non-bulk-fill control. MI% was evaluated in standardized cylindrical cavities restored with the composites by using a 3D laser confocal microscope. The following properties were characterized: volumetric polymerization shrinkage (VS%), polymerization shrinkage stress (Pss), degree of conversion (DC%), microhardness (KHN), flexural strength (FS), and elastic modulus (EM). Data were analyzed by one-way and two-way ANOVA, and Tukey HSD post-hoc test (α = 0.05). RESULTS: VBF presented the highest MI% and the lowest VS% and Pss (p < 0.05). DC% ranged from 59.4% (OBF) to 71.0% (ZXT). ZXT and VBF presented similar and highest KHN than OBF and ABF (p < 0.05). ABF presented the lowest FS (p < 0.05). EM ranged from 5.5 GPa to 7.7 GPa, with the values of ZXT and VBF being similar and statistically higher than those of OBF and ABF (p < 0.05). CONCLUSIONS: Thermoviscous technology employed by VisCalor bulk was able to improve its mechanical behavior comparatively to regular bulk-fill resin composites and to contribute to a better marginal integrity in restorations built up in cylindrical cavities with similar geometry to a class I cavity as well. Although presenting overall better physicomechanical properties, Z250 XT presented the worst MI%. CLINICAL RELEVANCE: The marginal integrity, which is pivotal for the success of resin composite restorations, could be improved using VisCalor bulk-fill. The worst MI% presented by Z250 XT reinforces that non-bulk-fill resin composites shall not be bulk-inserted in the cavity to be restored.

In vitro comparison of one-step, two-step, and three-step polishing systems on the surface roughness and gloss of different resin composites.

OBJECTIVES: This laboratory study evaluated the effect of three polishing systems on the surface roughness and gloss of resin composites. MATERIALS AND METHODS: Thirty specimens (6 mm Ø × 8 mm) were fabricated from each of three resin composites: Z 350 XT (nanofill), Harmonize (nanohybrid), and Estelite Omega (supranonofill). All specimens were photopolymerized using a multi-peak LED curing unit (VALO-Standard mode), having a exitance irradiance of approximately 1000 mW/cm2 against a polyester strip (PS). 2 mm was then removed from the irradiated end (finished) using #320 abrasive paper (F). Specimens were then randomly polished (P) using a one-step (1S) (OneGloss), two-step (2S) (EVE Diacomp Twist Basic CA), or 3-step (3S) (Astropol P) system (n = 10). For PS, F, and P groups, surface roughness (Ra) was measured using a surface roughness tester, and surface gloss was measured with a glossmeter. For each specimen, the percent recovery to the PS value (%R) of surface roughness and surface gloss were calculated. Data were analyzed using two-way ANOVA, followed by Tukey's test. Surface roughness and gloss values were submitted to Pearson's correlation test (α = 0.05). All statistical testing was performed using a pre-set alpha of 0.05. RESULTS: The interaction term [resin composite × polishing system] was significant for both surface roughness (p = 0.001) and gloss (p = 0.0001). For all resin composites, the 2S and 3S systems provided a higher %R of surface roughness and gloss compared to those of the 1S system. There was a negative correlation between surface roughness and gloss, but only a few combinations showed strong correlations. CONCLUSIONS: The 2S and 3S polishing systems provided surfaces having greater smoothness and gloss compared to the 1S system. The ability to recover surface roughness and gloss was dependent on type of resin composite filler classification. CLINICAL SIGNIFICANCE: The 3S and 2S polishing systems were more effective in achieving PS values than was the 1S system for all tested resin composites. However, individual polishing systems performed differently depending on type of resin composite.

Effect of aging and fiber-reinforcement on color stability, translucency, and microhardness of single-shade resin composites versus multi-shade resin composite.

OBJECTIVE: The purpose of this study was to evaluate the effect of aging and fiber-reinforcement on the color stability, translucency, and microhardness of single-shade resin composites versus multi-shade resin composite. MATERIALS AND METHODS: Four resin composites (Filtek Z250, Omnichroma, Vittra APS Unique, Zenchroma) were tested. Three subgroups of specimens were prepared for each of the composites: control, polyethylene fiber-reinforcement, and glass fiber-reinforcement- groups (n = 10/per group). The samples were subjected to aging for 10,000 thermal cycles. Color differences (ΔE00 ) were calculated after aging. Relative translucency parameter (RTP00 ) and microhardness values were calculated before and after aging. A two-way analysis of variance and the generalized linear model was used (p < 0.05). RESULTS: The lowest and highest ΔE00 values were found for Filtek Z250 (0.6 ± 0.2) and Omnichroma resin composites (1.6 ± 0.4), respectively. The ΔE00 value of the polyethylene fiber-reinforcement group (1.2 ± 0.6) was significantly higher than the ΔE00 value of the glass fiber-reinforcement group (1.0 ± 0.4, p < 0.001). The RTP00 value of the glass fiber-reinforcement group (1.92 ± 0.78) was significantly higher than the RTP00 value of the polyethylene fiber-reinforcement group (1.72 ± 0.77, p < 0.001). The highest microhardness values were found in glass fiber-reinforcement group (76.48 ± 17.07, p < 0.001). CONCLUSION: Single-shade resin composites were more translucent, had higher color change, and lower hardness than multi-shade resin composite. For relative translucency and microhardness, statistical significance was found in the material and fiber type interaction. The glass fiber-reinforcement provided higher translucency, lower color change and higher microhardness values than polyethylene fiber-reinforcement group after aging. Thermocycling had a significant impact on the color stability, translucency parameter, and microhardness of the tested resin composite materials. CLINICAL SIGNIFICANCE: Single-shade resin composite materials have greater color-changing potential. The glass fiber-reinforcement optimize resin material mechanical properties and color stability more than polyethylene fiber-reinforcement.

The Effect of Gravity on Marginal Integrity of Different Flowable Bulk-Fill Resin Composites.

Background and Objectives: The aim of this quantitative research was to investigate the effect of gravitational forces on the marginal integrity of different bulk-fill composites by micro-CT imaging. Materials and Methods: Fifty caries-free human third molars extracted for prophylactic purposes were used in this study. Each tooth was prepared with two proximal box cavities, with dimensions of 3 mm × 3 mm × 5 mm. Five distinct groups, each comprising 20 cavities, thus totaling 100 cavities for this study: (1, Group CON): Clearfil Majesty Flow + Clearfil Majesty Esthetic (as the control); (2, Group FBR): Filtek Bulk-fill Flowable Restorative + Clearfil Majesty Esthetic; (3, Group XTB): Voco Extrabase + Clearfil Majesty Esthetic; (4, Group SDR): SDR + Clearfil Majesty Esthetic; and (5, Group SNC): Sonicfill. When restoring the mesial cavities, the occlusal surfaces of the teeth in the mold were positioned upwards, counteracting the force of gravity. In contrast, for the restoration of the distal cavities, the occlusal surfaces were aligned downwards, to be parallel with the gravitational pull. After restorative procedures, each tooth was treated with 5000 thermal cycles. A solution of ammoniacal silver nitrate (AgNO3) was employed as a tracing agent. The micro-CT scans were conducted and the total volume of silver nitrate and the total volume of restorations within the relevant region of interest were calculated in "mm3" with software. Two-way ANOVA and Tukey tests were performed at a significance level of p = 0.05 with Graphpad Prism v 8.2.1 software. Results: Both gravity effect and interaction showed no statistical differences (p > 0.05). Statistically significant differences were observed in the restorative materials (p < 0.05). Conclusions: Gravitational forces do not emerge as a major factor affecting the marginal integrity of flowable bulk-fill composites in class II restorations. The chemical composition of the composites plays a more crucial role, with the XTB composite showing higher microleakage ratios compared to the others.

Efficacy of bioactive materials in preventing Streptococcus mutans-induced caries on enamel and dentine.

The study investigated the ability of bioactive materials used to restore enamel and dentine specimens to prevent caries. Enamel (n = 50) and dentine (n = 50) specimens were obtained from bovine incisors, prepared, and randomly allocated to one of five groups according to the restorative treatment: alkasite without adhesive system; alkasite with adhesive system; high viscosity glass ionomer cement; resin composite; no restoration; negative control group. Specimens were restored, exposed to a thermal cycling aging protocol, sterilized, and exposed to a cariogenic challenge induced by Streptococcus mutans and then submitted to surface and subsurface microhardness tests and polarized light microscopy to verify the caries lesion development in enamel or dentine surrounding the restorative materials. Data were analyzed using one-way ANOVA. In enamel and dentine, glass ionomer cement, alkasite without and with adhesive system presented a lower percentage surface microhardness loss than resin composite and negative control. Enamel subsurface microhardness presented no statistically significant differences between glass ionomer cement, alkasite without and with adhesive system. Glass ionomer cement also did not present statistically significant differences from resin composite and the negative control. In dentine, glass ionomer cement showed the highest subsurface microhardness values. In conclusion, bioactive restorative materials provide greater protection to enamel and dentine against surface caries development than resin composite.

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.

Operator versus material influence on film thickness using adhesive resin cement or pre-heated resin composite.

OBJECTIVE: There is a growing interest in using pre-heated composites instead of dual-cured cements when luting indirect restorations. This study evaluated the film thickness obtained from two pre-heated composites and two resin cements, by two different operators. The influence of the materials and the level of expertise of the operator were analyzed. MATERIALS AND METHODS: Forty specimens of human dentin and composite discs were prepared and divided into four groups depending on the luting process. Each group was randomly equally divided to be handled by two operators with different levels of experience. Two of the initial four groups were luted using dual-cured cements and the two remaining groups using light-cured pre-heated composites. Specimen discs were cut after luting, and film thickness was measured using a Digital microscope. Data were analyzed using a 2-way ANOVA with the Holm-Sidak pairwise multiple comparison procedure (p < 0.05). RESULTS: Mean film thickness ranged from 156.16 ± 4.7 to 33.82 ± 0.7 µm. Significant differences (p < 0.001) were noticed between expert and novice results with pre-heated composites. CONCLUSION: Within the limits of this study, using pre-heated composites as a luting cement requires a better level of expertise to achieve a clinically acceptable film thickness. CLINICAL SIGNIFICANCE: Using pre-heated composites as luting agent for indirect restorations requires an experimented skill level to achieve a clinically recommended film thickness.

Engineered Peptides Enable Biomimetic Route for Collagen Intrafibrillar Mineralization.

Overcoming the short lifespan of current dental adhesives remains a significant clinical need. Adhesives rely on formation of the hybrid layer to adhere to dentin and penetrate within collagen fibrils. However, the ability of adhesives to achieve complete enclosure of demineralized collagen fibrils is recognized as currently unattainable. We developed a peptide-based approach enabling collagen intrafibrillar mineralization and tested our hypothesis on a type-I collagen-based platform. Peptide design incorporated collagen-binding and remineralization-mediating properties using the domain structure conservation approach. The structural changes from representative members of different peptide clusters were generated for each functional domain. Common signatures associated with secondary structure features and the related changes in the functional domain were investigated by attenuated total reflectance Fourier-transform infrared (ATR-FTIR) and circular dichroism (CD) spectroscopy, respectively. Assembly and remineralization properties of the peptides on the collagen platforms were studied using atomic force microscopy (AFM). Mechanical properties of the collagen fibrils remineralized by the peptide assemblies was studied using PeakForce-Quantitative Nanomechanics (PF-QNM)-AFM. The engineered peptide was demonstrated to offer a promising route for collagen intrafibrillar remineralization. This approach offers a collagen platform to develop multifunctional strategies that combine different bioactive peptides, polymerizable peptide monomers, and adhesive formulations as steps towards improving the long-term prospects of composite resins.

Effect of Vegetable Juices on Properties of Two Resin Composites Used for Dental Caries Management.

Background and Objectives: Resin composites represent a class of materials widely used in restorative dentistry due to patient demands for better aesthetics. Colour changes in composite resins can occur due to intrinsic and extrinsic factors. Beverages, such as vegetable juices, can be some of these extrinsic factors. The purpose of this study was to investigate the colour stability and modification of microhardness of two resin composites before and after immersion in different vegetable juices. Materials and Methods: The colour of two resin composite materials (Gradia Direct Anterior-shade A2 and Valux Plus-shade A2) was measured before and after immersion in four different solutions: distilled water (as control), beetroot, carrot, and tomato juice. Colour values (L *, a *, b *) were measured over a white background with a colorimeter, using the CIE L *a *b * system. Colour change values were calculated after 1, 3, 5, and 7 days of immersion. Microhardness measurements were taken before and after seven days immersion in test media. Repeated measures analysis of variance (ANOVA) and independent t-tests were applied for statistical analysis. Results: All vegetable juices produced statistically different discolouration after immersion for 7 days (p < 0.05). Tomato juice produced the most discolouration for the Gradia Direct specimens, whereas beetroot juice and carrot juice produced the most discolouration for the Valux Plus specimens. Microhardness of the materials immersed for 7 days in vegetable juices was reduced compared to the ones immersed in distilled water. Conclusions: Vegetable juices, immersion time, and dental resin composites are significant factors that may affect colour stability and microhardness of composite resins.

SURVIVAL AND COMPLICATION RATES OF RESIN COMPOSITE LAMINATE VENEERS: A SYSTEMATIC REVIEW AND META-ANALYSIS.

OBJECTIVES: The aim of this systematic review was to evaluate the survival and complication rates of resin composite laminate veneers. METHODS: Randomized controlled trials and cohort studies with a minimum 2-year follow-up assessing survival and complication rates of resin composite laminate veneers on permanent dentition from 1998 to May 2022. Literature searches were conducted in MEDLINE (PubMed), Scopus, and the Cochrane Central Register of Controlled Trials electronic databases. References cited in the related reviews and included full-text articles were also hand-searched to further identify potentially relevant studies. RESULTS: A total of 827 articles were identified. Twenty-two studies were considered for full-text review after the title and abstract screening stage. After exclusion, 7 studies (3 randomized controlled trials and 4 cohort studies) were included in the systematic review. Three published scales were adopted for the quality and risk of bias assessment. At the survival rate threshold, the overall heterogeneity (I2) for randomized controlled trials was 50.5% (P = .108). The overall pooled survival rate of the randomized controlled trials was 88% (95% CI: 81%-94%), with the mean follow-up time ranging from 24 to 97 months. Surface roughness, color mismatch, and marginal discoloration were the most reported complications. CONCLUSION: Resin composite laminate veneers demonstrated moderately high survival rates for the entire sample and the direct laminate veneer group demonstrated higher survival rates than the indirect approach. Most of the complications were regarded as clinically acceptable with or without reintervention.

Five-year clinical performance of two fluoride-releasing giomer resin materials in occlusal restorations.

OBJECTIVE: To evaluate and compare the clinical performance of two nano-hybrid giomer restorative composite materials after 5 years. MATERIALS AND METHODS: Forty-four pairs of restorations (total n = 88) of a flowable giomer (Beautifil Flow Plus F00; Shofu Inc., Kyoto, Japan) and a conventional nano-hybrid giomer restorative material (Beautifil II; Shofu Inc.) were placed in Class I cavities after the application of a dentin adhesive (FL-Bond II; Shofu Inc.) and a flowable liner (Beautifil Flow Plus F03; Shofu Inc). After 5 years, 32 pairs of restorations were assessed using the modified United States Public Health Service criteria. Both tested materials were compared using Fisher's exact test and each tested clinical criterion for each material was analyzed separately with respect to different follow-up periods using Friedman's test (a = 0.05). RESULTS: None of the restorations showed complete retention loss, post-operative sensitivity, secondary caries or color change. There were no significant changes to any of the clinical criteria for each material during the 5-year evaluation period (p > 0.05) and no significant differences between the two materials in all clinical parameters after 5 years (p > 0.05). CONCLUSIONS: Five-year clinical performance of both two nano-hybrid giomer restorative materials was comparably acceptable and not significantly different for any of the parameters evaluated. CLINICAL SIGNIFICANCE: Nano-hybrid giomer-based materials are clinically acceptable for the restoration of occlusal cavities as they demonstrate excellent performance after 5 years.

Effect of different polymerization times on color change, translucency parameter, and surface hardness of bulk-fill resin composites.

Background: Polymerization plays an important role in the optical and mechanical properties resin composite materials. Aim: The current study aimed to evaluate the effect of different polymerization times on the color change, translucency parameter (TP), and surface hardness of resin composites after thermocycling. Materials and Methods: Microhybrid resin composite (Filtek Z250; used in the control group) and bulk-fill resin composites (Filtek One Bulk-Fill Restorative, Tetric EvoCeram Bulk-Fill, and Tetric N-Ceram Bulk-Fill) were used. Each bulk-fill composite was placed as a single layer. Polymerization of the bulk-fill composites in the first group was completed in 20 s, and that in the second group was completed in 40 s (n = 10). Filtek Z250's polymerization was completed with 2 mm (20 s) + 2 mm (20 s). The color change (ΔE00) and translucency parameter (TP00) were calculated using the CIEDE2000 formula. Before and after thermocycling, the TP and surface hardness values were measured. The data were analyzed using one- and two-way analysis of variance, paired-samples t-test, and Tukey's test (P < 0.05). Results: After thermocycling, the ΔE00 values of the resin composite samples were 1.66-2.56. Compared to the control group, the Filtek One Bulk-Fill 20 s group exhibited the lowest color change values. The Filtek Z250 group exhibited lower TP and significantly higher microhardness values than the other bulk-fill resin groups before and after thermocycling (P < 0.05). There were no observed differences in the Tetric N-Ceram and Tetric EvoCeram groups before and after thermocycling. Conclusion: Under the conditions of 10,000 thermal cycles, different curing times did not affect the color change and hardness values of the bulk-fill materials. However, differences were observed among the composite materials. After thermocycling, the surface hardness and TP values decreased in all the resin composites. Depending on the material content, effective results can be obtained from the 20 s polymerization of bulk-fill resin composites.

Effect of thickness on shrinkage stress and bottom-to-top hardness ratio of conventional and bulk-fill composites.

This study evaluated the effect of the material thickness on shrinkage stress and bottom-to-top hardness ratio of conventional and bulk-fill composites. Six commercial composites were selected based on their different technologies: Two conventional (C1, C2), two high-viscosity bulk-fill (HVB1, HVB2), and two low-viscosity bulk-fill (LVB1, LVB2). Shrinkage stress was analyzed for five specimens with 2 mm thickness (C-factor 0.75 and volume 24 mm3 ) and five specimens with 4 mm thickness (C-factor 0.375 and volume 48 mm3 ) for 300 s in a universal testing machine. Bottom-to-top hardness ratio values were obtained from Knoop microhardness measurements in specimens with 2- and 4-mm thickness (n = 5). Thickness increase resulted in significantly higher shrinkage stress for all materials with the exception of HVB2 and LVB1. C1, C2, HVB2, and LVB1 showed lower bottom-to-top hardness ratios at 4 mm than at 2 mm. Only LVB2 presented a bottom-to-top hardness ratio lower than 80% at 2 mm, while HVB1 surpassed this threshold at 4 mm of depth. The results suggest that the increase of composite thickness affected the shrinkage stress values. Also, thickness increase resulted in lower bottom-to-top hardness ratio. HVB1 showed better behavior than other bulk-fill materials, with low stress and adequate bottom-to-top hardness ratio at 4 mm thickness.

Thirty-six-month clinical evaluation of posterior high-viscosity bulk-fill resin composite restorations in a high caries incidence population: interim results of a randomized clinical trial.

OBJECTIVES: This study compared the clinical performance of two bulk-fill (BF) and one conventional resin composite in a population with a high caries incidence. MATERIALS AND METHODS: A total of 138 class I and II restorations were performed and randomly divided into three groups (n = 46) with equal allocation: Filtek BF (FBF; 3M ESPE), Tetric EvoCeram BF (TBF; Ivoclar Vivadent), and control Filtek Z250 (Z250; 3M ESPE). The evaluations were performed using the USPHS and FDI criteria at baseline and after 12 and 36 months by a previously calibrated evaluator. The Friedman and Wilcoxon tests for paired data were used for statistical analysis (α = 0.05). RESULTS: The DMFT index at baseline was 9.44, with 87% from the decayed component. After 36 months, 108 restorations (n = 36) were evaluated. Two failures were observed for TBF at marginal adaptation and recurrence of caries, resulting in a survival rate of 94.44% and an annual failure rate (AFR) of 1.26%. No equivalence was observed between the criteria for surface roughness, marginal adaptation, and discoloration. CONCLUSIONS: The 36-month clinical performance of high-viscosity BF resin composites was comparable to conventional incremental-filled resin composites. The FDI criteria better presented the restorations' clinical success. However, in the case of failure, both criteria provided the same result. CLINICAL RELEVANCE: High-viscosity bulk-fill resin composites showed excellent performance after 36 months in a high caries incidence population. It can be considered a simplified alternative restoration method that reduces operating time and minimizes possible operator errors.

Class II resin composite restorations-tunnel vs. box-only in vitro and in vivo.

PURPOSE: In a combined in vitro/in vivo approach, tunnel vs. box-only resin composite restorations should be evaluated using thermomechanical loading (TML) in vitro and a restrospective clinical trial in vivo. MATERIALS AND METHODS: For the in vitro part, box-only and tunnel cavities were prepared in 32 extracted human third molars under simulated intraoral conditions in a phantom head. Specimens were randomly assigned to four groups (n = 8; 16 box-only/16 tunnel) and received bonded resin composite restorations with Amelogen Plus (box A/tunnel A) or lining with Ultraseal and Amelogen plus (box B/tunnel B) both bonded using PQ1 (all Ultradent). Specimens were subjected to a standardized aging protocol, 1-year water storage (WS) followed by TML (100,000 × 50 N; 2500 × + 5/+ 55 °C). Initially and after aging, marginal qualities were evaluated using replicas at × 200 magnification (SEM). For the corresponding in vivo observational study, 229 patients received 673 proximal resin composite restorations. From 371 tunnel restorations, 205 cavities were filled without flowable lining (tunnel A), and 166 tunnels were restored using UltraSeal as lining (tunnel B). A total of 302 teeth received conventional box-only fillings. Restorations were examined according to modified USPHS criteria during routine recalls up to 5 years of clinical service. RESULTS: In vitro, all initial results showed 100% gap-free margins when a flowable lining was used. Tunnels without lining exhibited some proximal shortcomings already before TML and even more pronounced after TML (p < 0.05). After TML, percentages of gap-free margins dropped to 87-90% in enamel with lining and 70-79% without lining (p < 0.05). In vivo, annual failure rates for box-only were 2.2%, for tunnel A 6.1%, and for tunnel B 1.8%, respectively (p < 0.05). Tunnels had significantly more sufficient proximal contact points than box-only restorations (p < 0.05). Flowable lining was highly beneficial for clinical outcome of tunnel-restorations (p < 0.05). CONCLUSIONS: With a flowable lining, tunnel restorations proved to be a good alternative to box-only resin composite restorations. CLINICAL RELEVANCE: Class II tunnel restorations showed to be a viable alternative for box-only restorations, however, only when flowable resin composite was used as adaptation promotor for areas being difficult to access.

Color and translucency stability of contemporary resin-based restorative materials.

OBJECTIVE: To determine color and translucency stability of present-day resin-based restorative materials. MATERIALS AND METHODS: Disk-shaped (1.0 × 10 mm) resin composites (Filtek Universal, 3M ESPE; Spectra ST, Dentsply Sirona; Gradia Direct X, GC America; Estilite Quick, Tokuyama; Harmonize, Kerr; ACTIVA Bioactive-Restorative, Pulpdent) were prepared and divided into four staining groups (n = 5); coffee (55°C), grape juice (5°C), deionized water (25°C) and thermocycling (20 000 cycles, 5°C to 55°C with a 30-second dwell time). Spectrophotometer measurements were taken at baseline and 14 days for each group and the color stability (CIEDE2000) and changes in the translucency parameter (RTPCIEDE2000 ) and luminous transmittance of each composite were determined. A 2-way analysis of variance (ANOVA) using maximum likelihood estimations was used for analysis for these changes, with subsequent pairwise comparisons using Bonferroni-corrected Student's t tests and an experiment-wise α = 0.05. RESULTS: A significant interaction (P < .0001) between material and treatment was found for each change in the esthetic property tested over 14 days. Multiple significant differences between materials for each treatment and between treatments for each material were identified. CONCLUSIONS: The severity of color change and translucency of resin-based materials are dependent on their type, mostly affected by the coffee staining medium. Nano-filled resin composite is most resistant to color change and with stable translucency after artificial aging. CLINICAL RELEVANCE: Nano-filled resin composite may be the most esthetically durable resin- based restorative material. Micro-hybrid resin composite and resin-modified glass ionomer restorative material are susceptible to color change and losing their translucency. Hot coffee solution may shorten the esthetic lifespan of a resin-based material.

Ceramic laminate veneers: effect of preparation design and ceramic thickness on fracture resistance and marginal quality in vitro.

OBJECTIVES: The aim of the present study was to investigate the influence of five different preparation designs and two different ceramic thicknesses on margin quality and fracture resistance of ceramic laminate veneers after thermomechanical loading in vitro. MATERIALS AND METHODS: Eighty human central incisors were randomly assigned to 10 groups (n = 8) with five different preparation designs: non-prep (NP), minimally invasive (MI) = exclusively enamel-bonded, semi-invasive (SI) = 50% bonded in dentin, invasive (I) = 100% in dentin, and semi-invasive with two additional class III composite resin restorations (SI-C). IPS InLine veneers were fabricated in two thicknesses (L1 = 0.2-0.5 mm; L2 = 0.5-1.2 mm). After adhesive luting (OptiBond FL, Variolink Veneer) with light curing and polishing, specimens were stored in distilled water at 37 °C for 21 days, then thermocycled (2000 cycles between + 5 and + 55 °C), and finally mechanically loaded at the incisal edge at an angle of 45° for 2,000,000 cycles at 50 N und further 1,000,000 cycles at 100 N. Impressions were taken initially, after thermocycling, and after every 250,000 mechanical cycles in order to evaluate cracks and margin quality under a SEM. The veneers were evaluated in a light microscope (× 20) for cracks, chippings, partial, and catastrophic fractures. RESULTS: Margin quality after three million cycles revealed medians for continuous margin of 82-95% without significant differences among groups, neither at the ceramic/composite (p = 0.943) nor at the tooth/composite interface (p = 0.571). Visual inspection of veneers exhibited 22 cracks, 11 chippings, 4 partial and 4 catastrophic fractures in 38 of 80 veneers. The statistical ranking regarding fracture risk (p ≤ 0.05) was: IL1 = SIL1 = MIL1 = IL2 = CL1 = CL2, MIL2 = NPL1 = NPL2 = SIL2, IL2 = CL1 = CL2 = MIL2 = NPL1 = NPL2 = SIL2. CONCLUSIONS: Even after three million cycles with up to 100 N, all groups showed high survival rates. However, the fracture risk increases with thin veneers and preparations with medium to high dentin portions when compared to thicker veneers with preparations in enamel or partially in dentin (p ≤ 0.05). Preexisting resin composite restorations did not show any significant influence on margin quality and facture risk (p > 0.05). CLINICAL RELEVANCE: Ceramic laminate veneers are extremely durable with thin veneers and substantial enamel loss being main risk factors for fracture.

Colorimetric study about the stratification's effect on colour perception of resin composites.

To evaluate the influence of a different order of dentin and enamel layers on stratification appearance of different resin composites. 144 Dentin (D) and Enamel (E) composite samples (Clearfil Majesty ES-2 Premium, Brilliant EverGlow, Estelite Asteria), 1 mm thick, were divided into 12 configurations for each composite, with Enamel-Dentin-Dentin-Enamel (EDDE) assumed as target. The colour specification was conducted using a spectrophotometer, elaborating the results with the CIE L*a*b* colour coordinates and calculating the colour difference in terms of [Formula: see text] quantity. A value of this last major of 3.3 was considered not clinically acceptable. Moreover, data were analyzed using two-way analysis of variance and Tukey post hoc test (P < 0.05). For Clearfil Majesty ES-2 Premium and Brilliant EverGlow, six configurations showed [Formula: see text] > 3.3 compared to gold standard EDDE. [Formula: see text] was influenced especially by b* and L* coordinates (P < 0.05). EDED showed no visual difference (0 < [Formula: see text] < 1.1) for both composites. For Estelite Asteria, two configurations reported [Formula: see text] > 3.3 compared to EDDE. In particular, the L* coordinate influenced [Formula: see text] results (P < 0.05). EDDD was the best configuration (0 < [Formula: see text] < 1.1). Within the limits of a vitro study, Brilliant EG showed more dependence from order and thickness of stratification (resulting more similar to Clearfil Majesty ES-2 Premium); therefore, it could be indicated for more complex aesthetic restorations. Estelite Asteria seems to be able to balance small differences in thickness of dentin and enamel layers, and consequently, it is more indicated to different clinical situations.

The Effect of Selected Dental Materials Used in Conservative Dentistry, Endodontics, Surgery, and Orthodontics as Well as during the Periodontal Treatment on the Redox Balance in the Oral Cavity.

Oxidative stress (OS) is a redox homeostasis disorder that results in oxidation of cell components and thus disturbs cell metabolism. OS is induced by numerous internal as well as external factors. According to recent studies, dental treatment may also be one of them. The aim of our work was to assess the effect of dental treatment on the redox balance of the oral cavity. We reviewed literature available in PubMed, Medline, and Scopus databases, including the results from 2010 to 2020. Publications were searched according to the keywords: oxidative stress and dental monomers; oxidative stress and amalgam; oxidative stress and periodontitis, oxidative stress and braces, oxidative stress and titanium; oxidative stress and dental implants, oxidative stress and endodontics treatment, oxidative stress and dental treatment; and oxidative stress and dental composite. It was found that dental treatment with the use of composites, amalgams, glass-ionomers, materials for root canal filling/rinsing, orthodontic braces (made of various metal alloys), titanium implants, or whitening agents can disturb oral redox homeostasis by affecting the antioxidant barrier and increasing oxidative damage to salivary proteins, lipids, and DNA. Abnormal saliva secretion/composition was also observed in dental patients in the course of OS. It is suggested that the addition of antioxidants to dental materials or antioxidant therapy applied during dental treatment could protect the patient against harmful effects of OS in the oral cavity.

Application of Antimicrobial Polymers in the Development of Dental Resin Composite.

Dental resin composites have been widely used in a variety of direct and indirect dental restorations due to their aesthetic properties compared to amalgams and similar metals. Despite the fact that dental resin composites can contribute similar mechanical properties, they are more likely to have microbial accumulations leading to secondary caries. Therefore, the effective and long-lasting antimicrobial properties of dental resin composites are of great significance to their clinical applications. The approaches of ascribing antimicrobial properties to the resin composites may be divided into two types: The filler-type and the resin-type. In this review, the resin-type approaches were highlighted. Focusing on the antimicrobial polymers used in dental resin composites, their chemical structures, mechanical properties, antimicrobial effectiveness, releasing profile, and biocompatibility were included, and challenges, as well as future perspectives, were also discussed.