Effect of polymerization mode on shrinkage kinetics and degree of conversion of dual-curing bulk-fill resin composites.

OBJECTIVES: To assess the behavior of dual-cure and conventional bulk-fill composite materials on real-time linear shrinkage, shrinkage stress, and degree of conversion. MATERIALS AND METHODS: Two dual-cure bulk-fill materials (Cention, Ivoclar Vivadent (with ion-releasing properties) and Fill-Up!, Coltene) and two conventional bulk-fill composites (Tetric PowerFill, Ivoclar Vivadent; SDR flow + , Dentsply Sirona) were compared to conventional reference materials (Ceram.x Spectra ST (HV), Dentsply Sirona; X-flow; Dentsply Sirona). Light curing was performed for 20 s, or specimens were left to self-cure only. Linear shrinkage, shrinkage stress, and degree of conversion were measured in real time for 4 h (n = 8 per group), and kinetic parameters were determined for shrinkage stress and degree of conversion. Data were statistically analyzed by ANOVA followed by post hoc tests (α = 0.05). Pearson's analysis was used for correlating linear shrinkage and shrinkage force. RESULTS: Significantly higher linear shrinkage and shrinkage stress were found for the low-viscosity materials compared to the high-viscosity materials. No significant difference in degree of conversion was revealed between the polymerization modes of the dual-cure bulk-fill composite Fill-Up!, but the time to achieve maximum polymerization rate was significantly longer for the self-cure mode. Significant differences in degree of conversion were however found between the polymerization modes of the ion-releasing bulk-fill material Cention, which also exhibited the significantly slowest polymerization rate of all materials when chemically cured. CONCLUSIONS: While some of the parameters tested were found to be consistent across all materials studied, heterogeneity increased for others. CLINICAL RELEVANCE: With the introduction of new classes of composite materials, predicting the effects of individual parameters on final clinically relevant properties becomes more difficult.

Impact of Copper-Doped Mesoporous Bioactive Glass Nanospheres on the Polymerisation Kinetics and Shrinkage Stress of Dental Resin Composites.

We embedded copper-doped mesoporous bioactive glass nanospheres (Cu-MBGN) with antibacterial and ion-releasing properties into experimental dental composites and investigated the effect of Cu-MBGN on the polymerisation properties. We prepared seven composites with a BisGMA/TEGDMA (60/40) matrix and 65 wt.% total filler content, added Cu-MBGN or a combination of Cu-MBGN and silanised silica to the silanised barium glass base, and examined nine parameters: light transmittance, degree of conversion (DC), maximum polymerisation rate (Rmax), time to reach Rmax, linear shrinkage, shrinkage stress (PSS), maximum PSS rate, time to reach maximum PSS rate, and depth of cure. Cu-MBGN without silica accelerated polymerisation, reduced light transmission, and had the highest DC (58.8 ± 0.9%) and Rmax (9.8 ± 0.2%/s), but lower shrinkage (3 ± 0.05%) and similar PSS (0.89 ± 0.07 MPa) versus the inert reference (0.83 ± 0.13 MPa). Combined Cu-MBGN and silica slowed the Rmax and achieved a similar DC but resulted in higher shrinkage. However, using a combined 5 wt.% Cu-MBGN and silica, the PSS resembled that of the inert reference. The synergistic action of 5 wt.% Cu-MBGN and silanised silica in combination with silanised barium glass resulted in a material with the highest likelihood for dental applications in future.

Bulk Fill Composites Have Similar Performance to Conventional Dental Composites.

The aim of the study was to perform comprehensive characterization of two commonly used bulk fill composite materials (SDR Flow (SDR) and Filtek™ Bulk Fill Flowable Restorative (FBF) and one conventional composite material (Tetric EvoCeram; TEC). Eleven parameters were examined: flexural strength (FS), flexural modulus (FM), degree of conversion, depth of cure, polymerisation shrinkage (PS), filler particle morphology, filler mass fraction, Vickers hardness, surface roughness following simulated toothbrush abrasion, monomer elution, and cytotoxic reaction of human gingival fibroblasts, osteoblasts, and cancer cells. The degree of conversion and depth of cure were the highest for SDR, followed by FBF and TEC, but there was no difference in PS between them. FS was higher for bulk fill materials, while their FM and hardness were lower than those of TEC. Surface roughness decreased in the order TEC→SDR→FBF. Bisphenol A-glycidyl methacrylate (BisGMA) and urethane dimethacrylate were found in TEC and FBF eluates, while SDR released BisGMA and triethylene glycol dimethacrylate. Conditioned media accumulated for 24h from FBF and TEC were cytotoxic to primary human osteoblasts. Compared to the conventional composite, the tested bulk fill materials performed equally or better in most of the tests, except for their hardness, elastic modulus, and biocompatibility with osteoblasts.

Light transmittance and polymerization kinetics of amorphous calcium phosphate composites.

OBJECTIVES: This study investigated light transmittance and polymerization kinetics of experimental remineralizing composite materials based on amorphous calcium phosphate (ACP), reinforced with inert fillers. MATERIALS AND METHODS: Light-curable composites were composed of Bis-EMA-TEGDMA-HEMA resin and ACP, barium glass, and silica fillers. Additionally, a commercial composite Tetric EvoCeram was used as a reference. Light transmittance was recorded in real-time during curing, and transmittance curves were used to assess polymerization kinetics. To obtain additional information on polymerization kinetics, temperature rise was monitored in real-time during curing and degree of conversion was measured immediately and 24 h post-cure. RESULTS: Light transmittance values of 2-mm thick samples of uncured ACP composites (2.3-2.9 %) were significantly lower than those of the commercial composite (3.8 %). The ACP composites presented a considerable transmittance rise during curing, resulting in post-cure transmittance values similar to or higher than those of the commercial composite (5.5-7.9 vs. 5.4 %). The initial part of light transmittance curves of experimental composites showed a linear rise that lasted for 7-20 s. Linear fitting was performed to obtain a function whose slope was assessed as a measure of polymerization rate. Comparison of transmittance and temperature curves showed that the linear transmittance rise lasted throughout the most part of the pre-vitrification period. CONCLUSIONS: The linear rise of light transmittance during curing has not been reported in previous studies and may indicate a unique kinetic behavior, characterized by a long period of nearly constant polymerization rate. CLINICAL RELEVANCE: The observed kinetic behavior may result in slower development of polymerization shrinkage stress but also inferior mechanical properties.

Cytogenetic damage in exfoliated oral buccal cells by dental composites.

PURPOSE: To evaluate the possible geno/cytotoxic effects of dental composite materials by assessing the frequency of micronuclei formation and other nuclear abnormalities in the exfoliated buccal epithelium. METHODS: Swabs were taken from the buccal mucosa of 85 young healthy subjects. All participants had healthy dentition or dentition restored only with composite materials. Genotoxicity and cytotoxicity was assessed by micronucleus assay. RESULTS: The results indicated no significant difference in number of oral mucosa cells with micronuclei in subjects with different numbers of composite restored tooth surfaces (P= 0.476). Also, the number of restored surfaces had no effect on nuclear alterations closely related to cytotoxicity, such as karyolysis (P= 0.572), karyorrehexis (P= 0.573) and picnosis (P= 0.765). CLINICAL SIGNIFICANCE: Despite doubts about the safe clinical use of resin composites, this study found no evidence that composite materials trigger long-term cytogenetic damage in the epithelial cells of buccal mucosa in humans. There is no objective and quantifiable evidence of genotoxicity induced by composite restorative materials in clinical practice.

Remineralizing amorphous calcium phosphate based composite resins: the influence of inert fillers on monomer conversion, polymerization shrinkage, and microhardness.

AIM: To determine if the addition of inert fillers to a bioactive dental restorative composite material affects its degree of conversion (DC), polymerization shrinkage (PS), and microhardness (HV). METHODS: Three amorphous calcium phosphate (ACP)-based composite resins: without added fillers (0-ACP), with 10% of barium-glass fillers (Ba-ACP), and with 10% of silica fillers (Si-ACP), as well as commercial control (Ceram•X, Dentsply DeTrey) were tested in laboratory conditions. The amount of ACP (40%) and the composition of the resin mixture (based on ethoxylated bisphenol A dimethacrylate) was the same for all ACP materials. Fourier transform infrared spectroscopy was used to determine the DC (n=40), 20 min and 72 h after polymerization. Linear PS and Vickers microhardness (n=40) were also evaluated. The results were analyzed by paired samples t test, ANOVA, and one-way repeated measures ANOVA with Student-Newman-Keuls or Tukey's post-hoc test (P=0.05). RESULTS: The addition of barium fillers significantly increased the DC (20 min) (75.84±0.62%) in comparison to 0-ACP (73.92±3.08%), but the addition of silica fillers lowered the DC (71.00±0.57%). Ceram•X had the lowest DC (54.93±1.00%) and linear PS (1.01±0.24%) but the highest HV (20.73±2.09). PS was significantly reduced (P<0.010) in both Ba-ACP (1.13±0.25%) and Si-ACP (1.17±0.19%) compared to 0-ACP (1.43±0.21%). HV was significantly higher in Si-ACP (12.82±1.30) than in 0-ACP (10.54±0.86) and Ba-ACP (10.75±0.62) (P<0.010). CONCLUSION: Incorporation of inert fillers to bioactive remineralizing composites enhanced their physical-mechanical performance in laboratory conditions. Both added fillers reduced the PS while maintaining high levels of the DC. Silica fillers additionally moderately improved the HV of ACP composites.

Microhardness of Bulk-Fill Composite Materials

The aim of the study was to determine microhardness of high- and low-viscosity bulk-fill composite resins and compare it with conventional composite materials. Four materials of high-viscosity were tested, including three bulk-fills: QuiXfi l (QF), x-tra fi l (XTF) and Tetric EvoCeram Bulk Fill (TEBCF), while nanohybrid composite GrandioSO (GSO) served as control. The other four were low-viscosity composites, three bulk-fill materials: Smart Dentin Replacement (SDR), Venus Bulk Fill (VBF) and x-tra base (XB), and conventional control material X-Flow (XF). Composite samples (n=5) were polymerized for 20 s with Bluephase G2 curing unit. Vickers hardness was used to determine microhardness of each material at the surface, and at 2-mm and 4-mm depth. GSO on average recorded significantly higher microhardness values than bulk-fill materials (p<0.001). The low-viscosity composite XF revealed similar microhardness values as SDR, but significantly lower than XB (p<0.001) and significantly higher than VBF (p<0.001). Microhardness of high-viscosity bulk-fill materials was lower than microhardness of the conventional composite material (GSO). Surface microhardness of low-viscosity materials was generally even lower. The microhardness of all tested materials at 4 mm was not different from their surface values. However, additional capping layer was a necessity for low-viscosity bulk-fill materials due to their low microhardness.

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

OBJECTIVE: To investigate the subsurface degree of conversion (DC) and shrinkage force formation of low-viscosity (flowable) bulk-fill composite materials. MATERIALS AND METHODS: Three flowable bulk-fill resin composites [SureFil SDR flow (SDR; Dentsply DeTrey), Venus Bulk Fill (VB; Heraeus Kulzer) and x-tra base (XB; VOCO)] and one conventional flowable control composite material [EsthetX flow (EX; Dentsply DeTrey)] were tested. The materials were photoactivated for 20 s at an irradiance of 1170 mW/cm2 and the DC (n=5) was recorded at 0.1-, 1.5- and 4-mm depth using Fourier transform infrared spectroscopy. Shrinkage forces (n=5) of 1.5-mm-thick specimens were continuously recorded for 15 min using a custom-made stress analyzer. Data were statistically analyzed by ANOVA, Tukey's HSD and Bonferroni's post-hoc tests (α=0.05). RESULTS: SDR generated the significantly lowest shrinkage forces (22.9±1.4 N), but also attained the significantly lowest DC at 1.5-mm depth (67.5±0.8%). The conventional flowable composite EX generated the significantly highest shrinkage forces (40.7±0.7 N) and reached a significantly higher DC (74.4±1.3%) compared to SDR and XB at 1.5-mm depth. The shrinkage force values of VB (29.4±1.1 N) and XB (28.3±0.6 N) were similar (p>0.05). All materials attained significantly higher DC at 4-mm depth than at the near-surface. CONCLUSION: The tested low-viscosity bulk-fill materials show lower shrinkage force formation than a conventional flowable resin composite at high levels of degree of conversion up to 4-mm incremental thickness.

Genotoxicity in gingival cells of patients undergoing tooth restoration with two different dental composite materials.

OBJECTIVES: Dental composite materials come into direct contact with oral tissue, especially gingival cells. This study was performed to evaluate possible DNA damage to gingival cells exposed to resin composite dental materials. MATERIALS AND METHODS: Class V restorations were placed in 30 adult patients using two different composite resins. The epithelial cells of the gingival area along the composite restoration were sampled prior to and after 7, 30, and 180 days following the restoration of the tooth. DNA damage was analysed by comet and micronucleus assays in gingival exfoliated epithelial cells. RESULTS: The results showed significantly higher comet assay parameters (tail length and % DNA in the tail) within periods of 30 and 180 days. The micronucleus test for the same exposure time demonstrated a higher number of cells with micronuclei, karyolysis, and nuclear buds. Results did not reveal any difference between the two composite materials for the same duration of exposure. CONCLUSION: Based on the results, we can conclude that the use of composite resins causes cellular damage. As dental composite resins remain in intimate contact with oral tissue over a long period of time, further research on their possible genotoxicity is advisable. CLINICAL RELEVANCE: Long-term exposure of gingival cells to two different composite materials demonstrated certain DNA damage. However, considering the significant decline in micronuclei frequency after 180 days and efficiency in the repair of primary DNA damage, the observed effects could not be indicated as biologically relevant.

Effect of silanized nanosilica addition on remineralizing and mechanical properties of experimental composite materials with amorphous calcium phosphate.

OBJECTIVES: Experimental composite resins with amorphous calcium phosphate (ACP) have the potential to regenerate demineralized tooth structures. The aim of the study was to investigate the effect of the addition of silanized silica nanofillers to the ACP-based composites on their mechanical properties and the kinetics of calcium and phosphate release. MATERIALS AND METHODS: The test materials comprised 5 wt% (5-ACP) or 10 wt% (10-ACP) of silanized silica admixed to the 40 wt% ACP and 50 or 55 wt% resin. The ACP control (0-ACP) contained 40 wt% ACP and 60 wt% resin. Additionally, composite material CeramX (Dentsply, Germany) was included as control. Three-point bending test was performed to calculate flexural strength and modulus of elasticity. Inductively coupled plasma atomic emission spectroscopy was used for measurement of ion release. The micromorphology of calcium phosphate depositions on composite samples has been qualitatively evaluated using a scanning electron microscope. The results were analyzed using Mann-Whitney and Wilcoxon rank sum tests (α < 0.05). RESULTS: Ion release was enhanced by the silica fillers, when compared to the 0-ACP. Although not statistically significant, flexural strength of 10-ACP was improved by 46 % compared to 0-ACP. Flexural modulus of 5-ACP was significantly higher than 0-ACP. CONCLUSIONS: The admixture of silanized fillers seems to be a promising approach for the improvement of mechanical and remineralizing properties of ACP composite resins. CLINICAL RELEVANCE: ACP-based composite resins with modified composition could serve as an effective remineralizing aid as base materials in restorative dental medicine.

In vitro detection of DNA damage in human leukocytes induced by combined effect of resin composites and adhesive systems.

PURPOSE: To simultaneously evaluate the genotoxicity of dental composites and adhesive systems in vitro using a cytogenetic assay, with respect to the influence of composite shade. METHODS: Genotoxicity assessment was carried out in human peripheral blood leukocytes using the comet assay. Three resin composite materials, two microhybrids and one nano-hybrid, in shade A1 and A3.5 were used with manufacturer-recommended four adhesive systems. Cultures were treated for 48 hours with samples after elusion for 1 hour, 1 day, 7 days or 30 days, in two different concentrations (4.16 mg/mL, 8.33 mg/mL). Kruskall-Wallis test was used for the statistical analysis (alpha = 0.05). RESULTS: For combinations of micro-hybrid composite (A3.5) with two self-etch adhesives (16.1 +/- 5.50 and 16.2 +/- 9.52) after exposure to samples eluted for 1 day, the incidence of primary DNA damage was significantly higher than for the corresponding negative control (14.7 +/- 2.85). Genotoxicity was also higher after treatment with samples eluted for 1 hour (15.3 +/- 4.70) and 1 day (15.3 +/- 9.10), comprised of nano-hybrid composite (A1) with self-etch adhesive in relation to the control (13.1 +/- 1.70). There was no clear trend of increased DNA damage in material combinations with darker shades of composites. Material composition and higher material concentrations showed greater influence on the genotoxicity.

Composite-induced toxicity in human gingival and pulp fibroblast cells.

OBJECTIVE: The most important requirement for a material to be used in medical applications is its biocompatibility. Dental composite materials come into direct contact with oral tissues, especially gingival and pulpal cells. This study was performed to evaluate possible DNA damage in cells of human origin exposed to dental composites in vitro using a cytogenetic assay. MATERIALS AND METHODS: Two composite resins (Vertise Flow, Kalore) were tested on human gingival and pulp fibroblasts using the acridine orange/ethidium bromide viability staining and alkaline comet assay. Cultures were treated with polymerized composites in two different concentrations (20 mg/ml, 40 mg/ml) for 14 days. Chi-square and Kruskall-Wallis non-parametric test were used for the statistical analysis (p < 0.05). RESULTS: Significant cytotoxicity was observed for 40 mg/ml of Vertise Flow in both cultures, while Kalore (40 mg/ml) showed cytotoxic effect only on human pulp fibroblasts. A significant level of DNA damage was detected for both materials and concentrations, in both cell cultures. CONCLUSION: If the two cell cultures are compared, the pulp cells were more sensitive to the cyto/genotoxic effects of dental composites. Based on the results, one can conclude that the use of tested materials may cause cellular damage in gingival and pulp fibroblasts in vitro.

Monowave vs. Polywave Light - Curing Units: Effect on Light Transmission of Composite without Alternative Photoinitiators.

Objective: The aim of this study was to compare the light transmission of monowave and polywave-curing devices by a bulk-fill composite containing only camphorquinone as a photoinitiator. Materials and methods: Three light-curing devices were used to cure bulk-fill composite QuiXfil: one monowave (Translux® Wave) and two polywave (VALO Cordless and Bluephase® PowerCure. The NIST-calibrated spectrometer (MARC Resin Calibrator, BlueLight Analytics Inc.) was used to measure the incident and transmitted light through a 2-mm composite specimen over 20 s. Light transmittance was calculated from the ratio of the amount of transmitted and incident light. For data analysis (ANOVA, α = 0.05), total irradiation of the entire spectrum, irradiation with wavelengths of 360-420 nm for the violet spectrum, and 420-540 nm for the blue spectrum were selected. Results: Monowave curing unit Translux® Wave had the lowest light transmission (13.78 ± 0.5%), similar to the violet light transmission of polywave devices (12.02 ± 0.94% and 13.81 ± 1.72% for Valo Cordless and Bluephase PowerCure, respectively). Blue light transmittance (32.15-23.70%) was more than twofold higher than for the wavelengths in the violet region of the spectrum (13.81-12.02%) for the two polywave devices. VALO Cordless showed the highest total and blue light transmission (p<0.001). There was no significant difference in the transmission of the violet part of the spectrum between VALO Cordless and Bluephase® PowerCure (p = 0.465). Conclusion: Within the limitations of this study, we could conclude that polywave curing devices can be used for the polymerization of the bulk-fill composite with camphorquinone as the sole photoinitiator.

One-Year Evaluation of High-Power Rapid Curing on Dentin Bond Strength.

This study investigated the effect of 3 s light-curing with a high-power LED curing unit on the shear bond strength of bulk-fill composites. Four bulk-fill composites were bonded to dentin with a universal adhesive (Scotchbond Universal Plus): two materials designed for rapid curing (Tetric PowerFill and Tetric PowerFlow) and two controls (Filtek One Bulk Fill Restorative and SDR Plus Bulk Fill Flowable). The 4 mm composite layer was light-cured with Bluephase PowerCure for 20 s at 1000 mW/cm2 ("20 s") or for 3 s at 3000 mW/cm2 ("3 s"). The samples were stored at 37 °C in distilled water and tested after 1, 6 and 12 months. The samples polymerised in the "3 s" mode had statistically similar or higher bond strength than the samples cured in "20 s" mode, except for the Tetric PowerFlow (1 month) and SDR+ (6 month). The flowable materials Tetric PowerFlow and SDR Plus initially showed the highest values in the "3 s" and "20 s" groups, which decreased after 12 months. The bond strength was statistically similar for all materials and curing protocols after 12 months, except for Tetric PowerFill cured with the "3 s" protocol (21.22 ± 5.0 MPa), which showed the highest value. Tetric PowerFill showed the highest long-term bond strength. While "3 s" curing resulted in equal or better shear bond strength, its use can only be recommended for a material with an AFCT agent such as Tetric PowerFill.

Mechanical Properties of Alkasite Material with Different Curing Modes and Simulated Aging Conditions.

This study aimed to evaluate the micro-mechanical and macro-mechanical properties of self-cured and light-cured alkasite and to investigate how accelerated degradation in acidic, alkaline, and ethanol solutions affects the macro-mechanical properties of self-cured and light-cured alkasite. The specimens of the alkasite material (Cention Forte, Ivoclar Vivadent) were prepared according to the following three curing modes: (1) light-cured immediately, (2) light-cured after a 5-min delay, and (3) self-cured. Microhardness was tested before and after immersion in absolute ethanol to indirectly determine crosslink density, while flexural strength and flexural modulus were measured using a three-point bending test after accelerated aging in the following solutions: (1) lactic acid solution (pH = 4.0), (2) NaOH solution (pH = 13.0), (3) phosphate-buffered saline solution (pH = 7.4), and (4) 75% ethanol solution. The data were statistically analyzed using a two-way ANOVA and Tukey post hoc test. The results showed that the microhardness, flexural strength, and flexural modulus were significantly lower in self-cured specimens compared to light-cured specimens. A 5-min delay between the extrusion of the material from the capsule and light curing had no significant effect on any of the measured properties. A significant effect of the accelerated aging solutions on macro-mechanical properties was observed, with ethanol and alkaline solutions having a particularly detrimental effect. In conclusion, light curing was preferable to self-curing, as it resulted in significantly better micro- and macro-mechanical properties, while a 5-min delay between mixing the capsule and light curing had no negative effects.

Environmental implications of dental restorative materials on the zebrafish Danio rerio: Are dental chair drainage systems an emerging environmental threat?

This study aimed to evaluate the environmental impact of dental materials: commercial composite Tetric EvoCeram®, glass ionomer Equia Forte® HT Fil, laboratory-prepared composite, alkasite Cention® Forte, amalgam Amalcap® Plus, and samples from dental chair drainage systems (DCDS). Methacrylate monomers were detected in the eluates of experimental and commercials composites, and alkasite. In DCDS samples solely mercury was found at concentrations of 0.08-1.86 µg/L. The experimental composite (48 h incubation) exhibited the highest toxicity on zebrafish Danio rerio (LC50=0.70 g/L), followed by amalgam (LC50=8.27 g/L) < Tetric EvoCeram® (LC50=10.94 g/L) < Equia Forte® HT Fil (LC50=24.84 g/L) < Cention® Forte (LC50=32.22 g/L). Exposure of zebrafish to DCDS samples resulted in decreased larval body length and increased occurrences of edema and blood accumulation. The results obtained highlight the need for additional monitoring and further research on the release of unreacted monomers and mercury from dental materials and their environmental impact.

The influence of copper-doped mesoporous bioactive nanospheres on the temperature rise during polymerization, polymer cross-linking density, monomer release and embryotoxicity of dental composites.

OBJECTIVES: Composites with copper-doped mesoporous bioactive nanospheres (Cu-MBGN) were developed to prevent secondary caries by imparting antimicrobial and ion-releasing/remineralizing properties. METHODS: Seven experimental composites containing 1, 5 or 10 wt% Cu-MBGN, the corresponding inert controls (silica) and bioactive controls (bioactive glass 45S5) were prepared. The temperature rise during light curing, cross-linking density by ethanol softening test, monomer elution and their potential adverse effects on the early development of zebrafish Danio rerio was investigated. RESULTS: Materials combining Cu-MBGN and silica showed the highest resistance to ethanol softening, as did the bioactive controls. Cu-MBGN composites showed significant temperature rise and reached maximum temperature in the shortest time. Bisphenol A was not detected, while bis-GMA was found only in the control materials and TEGDMA in the eluates of all materials. There was no increase in zebrafish mortality and abnormality rates during exposure to the eluates of any of the materials. CONCLUSIONS: The composite with 5 wt% Cu-MBGN combined with nanosilica fillers showed the lowest ethanol softening, indicating the polymer's highest durability and cross-linking density. Despite the TEGDMA released from all tested materials, no embryotoxic effect was observed.

Genotoxic biomonitoring of flowable and non-flowable composite resins in peripheral blood leukocytes.

OBJECTIVE: Composite restorative materials represent one of the most important groups of materials in contemporary dental practice. However, their incomplete polymerization may lead to monomer-induced genotoxicity. The objective of this study was to evaluate the genotoxicity of three flowable (Filtek Supreme XT Flow, Tetric EvoFlow, Gradia Direct Flo) and three non-flowable dental composite materials (Filtek Z250, Tetric EvoCeram, Gradia Direct Posterior). MATERIALS AND METHODS: Genotoxicity assessment of composite materials was carried out in vitro in human peripheral blood leukocytes using the alkaline single-cell gel electrophoresis technique (comet assay). Prepared materials were eluted in saline solution for 1 h, 1 day and 5 days. Thereafter leukocyte cultures were treated with different concentrations of eluates obtained from each of the tested dental composite materials. Kruskall-Wallis non-parametric test was used for statistical analysis (p < 0.05). RESULTS: The tested materials did not show genotoxic effects after exposure of leucocytes to 1 h eluates. Culture treated with 1 day eluates of all tested materials, only at a highest concentration (10(-2)), affected the measured cytogenetic parameters. Of all tested materials, only Filtek Z250 and Filtek Supreme XT Flow did not exhibit a genotoxic effect in cultures that were under the influence of 5 day eluates. CONCLUSION: Tested materials exhibited limited genotoxic activity in peripheral blood leukocytes. Since the effect was observed only in leukocyte cultures treated by 1-day eluates at the highest concentration (10(-2)) and it decreases in cultures exposed to 5 day eluates, it should not pose a significant risk to the human genome.

Blue Laser for Polymerization of Bulk-Fill Composites: Influence on Polymerization Kinetics.

The objective of this study was to compare the polymerization kinetics of bulk-fill resin composites cured with a LED-curing device and a diode laser (449 nm). Three bulk-fill composites were light-cured with constant radiation exposure at 10 J/cm2 by varying radiant exitance and curing time. The following three light-curing protocols were used: (I) 3300 mW/cm2 for 3 s; (II) 2000 mW/cm2 for 5 s; and (III) 1000 mW/cm2 for 10 s. The degree of conversion (DC) was monitored in real time at a data acquisition rate of 2 spectra/s over a 5-min period and again after seven days using Fourier transform infrared spectroscopy. DC amounted to 30.9-61.7% at 4-mm depth after 5 min. DC values of two sculptable composites were significantly higher with the laser, regardless of the curing protocol used, but not for the flowable composite. The maximum polymerization rate (2.0-22.1%/s) was less affected by the type of curing device for one of the composites, while the other two composites achieved significantly higher values when cured with the laser. Laser curing generally increased the DC and the maximum polymerization rate while it shortened the onset of the maximum reaction rate. New handheld laser devices with adjustable power have the potential to be used as a photopolymerization light source for new generations of bulk-fill composites.

Proposition of New Testing Procedure for the Mechanical Properties of Bulk-Fill Materials.

This study analysed flexural properties, microhardness, and the degree of conversion (DC) of five bulk-fill composites under clinically relevant conditions (4 mm thick specimens) in comparison to 2 mm specimens according to ISO 4049. Additionally, the effect of rapid polymerisation on 4 mm specimens was evaluated after accelerated aging. DC was measured using Fourier transform infrared spectrometry at 2 and 4 mm thick layers, while flexural properties and Vickers microhardness were tested using 16 × 2 × 2 mm or 16 × 2 × 4 mm specimens. Three polymerisation protocols were used: (I) "ISO": 2 mm thickness, 1000 mW/cm2, double-sided; (II) "10 s": 4 mm thickness, 1000 mW/cm2, one-sided; and (III) "3 s": 4 mm thickness, 2600 mW/cm2, one-sided. Mechanical properties were tested after 1 day, after 10,000 thermocycles, and after 10,000 thermocycles followed by a 7-day immersion in absolute ethanol. The "ISO" protocol produced a higher DC and microhardness of all materials. Elastic modulus was significantly higher for the "ISO" protocol compared to the 4 mm specimens. The differences in flexural strength for all polymerisation protocols were equalised after thermocycling and immersion in absolute ethanol. All tested materials met the ISO 4049 flexural strength requirement (80 MPa) for all polymerisation methods and all aging conditions. Rapid polymerisation achieved nearly optimal properties (ISO), except for elastic modulus, which was significantly reduced in 4 mm samples.