Surface properties and Streptococcus mutans biofilm adhesion of ion-releasing resin-based composite materials.

OBJECTIVE: To evaluate the adhesion of Streptococcus mutans (S. mutans) and related surface properties of ion-releasing resin-based composite (RBC) restorative materials. METHODS: Two ion-releasing RBCs, Activa (ACT) and Cention-N (CN), were compared to a conventional RBC (Z350) and a resin-modified glass ionomer cement (Fuji-II-LC). Ten disk-shaped specimens were fabricated for each material (n = 40). After standardized surface polishing procedure, the surface properties of the specimens were evaluated using surface roughness measurements by a profilometer and hydrophobicity using water contact angle measurements. To assess bacterial adhesion, the number of S. mutans bacteria was calculated from colony-forming units (CFU). Confocal laser scanning microscope analysis was done for qualitative & quantitative assessment. The data were analyzed using One-way ANOVA followed by Tukey's post-hoc test to compare the mean values of surface roughness, water contact angle and CFU values. To compare the mean dead cell percentage Kruskal-Wallis rank test and Conover test were used. A p-value of ≤ 0.05 was used to report the statistical significance. RESULTS: Z350 and ACT had the smoothest surfaces, followed by CN, and the roughest surface was seen in FUJI-II-LC. The lowest water contact angles were seen in CN, and Z350, and the highest were in ACT. S. mutans counts were the highest in ACT and the lowest in Z350 and CN. CN and Fuji-II-LC registered the highest percentage of dead bacterial cells, while the lowest were in ACT. SIGNIFICANCE: Surface properties did not significantly influence bacterial adhesion. More S. mutans bacteria accumulated on ACT than on the nanofilled composite and on CN. CN had antibacterial effects against Streptococcus mutans biofilms.

Ion releasing direct restorative materials: Key mechanical properties and wear.

OBJECTIVES: To investigate the depth of cure (DoC), fracture toughness (KIC) and wear of ion releasing resin-based composite (RBC) restorative materials. METHODS: Two ion releasing RBCs, Activa (ACT) and Cention-N (CN) were compared to a conventional RBC (Z350) and a resin-modified glass ionomer cement (Fuji-II-LC). The DoC was measured in a 10-mm deep semi-circular metal mold with a 2-mm internal radius (n = 8). The molds were irradiated from one end for 20-s. The Knoop hardness (KH) was measured at 0.5-mm intervals from the surface after the specimens had been stored at 37 °C for 24-h. To measure the KIC, single-edge-notched specimens (n = 15/group) were prepared (25×5x2.5-mm) for a 3-point bending test and then stored for either 1 or 30-days in water at 37 °C. Disk-shaped specimens (n = 10) were subjected to 250,000-load cycles of 49-N using a chewing simulator against spherical steatite antagonists. DoC and wear data were analyzed by one-way ANOVA and Tukey post hoc tests (p ≤ 0.05). KIC data were analyzed by two-way ANOVA and one-way ANOVA, and the Tukey post hoc test (p ≤ 0.05). In addition, an independent t-test was used to determine if storage time had any effect (α = 0.05) on the KIC of each material. RESULTS: Maximum hardness value was the highest for Z350 and the lowest for ACT. The depth at which 80% of the maximum KH, was the highest for CN (9.2 mm) and the lowest for Z350 (2 mm). All tested materials met the manufacturers' claims for DoC. After 1-day, the highest KIC values were recorded for ACT and the lowest for Fuji-II-LC. Water storage (30-days) significantly reduced the KIC value for all materials except Fuji-II-LC. The highest wear rate values were recorded for CN followed by ACT. SIGNIFICANCE: All tested materials met their manufacturers' claims for DoC. Water storage for 30-days significantly reduced the fracture toughness for ACT and CN. Wear was significantly higher for ACT and CN.

Factors affecting polymerization of resin-based composites: A literature review.

AIM: The aim of this review was to help clinicians improve their understanding of the polymerization process for resin-based composites (RBC), the effects of different factors on the process and the way in which, when controlled, the process leads to adequately cured RBC restorations. METHODS: Ten factors and their possible effects on RBC polymerization are reviewed and discussed, with some recommendations to improve that process. These factors include RBC shades, their light curing duration, increment thickness, light unit system used, cavity diameter, cavity location, light curing tip distance from the curing RBC surface, substrate through which the light is cured, filler type, and resin/oral cavity temperature. CONCLUSION: The results of the review will guide clinicians toward the best means of providing their patients with successfully cured RBC restorations.

Effects of delivering the same radiant exposures at 730, 1450, and 2920 mW/cm2 to two resin-based composites.

OBJECTIVE: To evaluate the effects of curing two resin-based composites (RBC) with the same radiant exposures at 730, 1450, and 2920 mW/cm2. MATERIALS AND METHODS: Two types of RBC, Filtek Supreme Ultra and Tetric-EvoCeram-Bulk Fill, were light-cured to deliver the same radiant exposures for 5, 10, or 20 s by means of a modified Valo light emitted diode light-curing unit with the light tip placed directly over each specimen. The RBC was expressed into metal rings that were 2.0 and 4.0 mm in thickness, directly on an attenuated total reflectance Fourier transform infrared plate heated to 33°C, and the degree of conversion (DC) of the RBC was recorded. The specimens were then removed and the Knoop microhardness (KHN) was tested at both the bottom and the top of each specimen. The KHN was tested again after 24 h and 7 days of storage in the dark at 37°C and 100% humidity. The DC and KHN results were analyzed with Fisher's protected least significant difference at α = 0.05. RESULTS: The DC values for the specimens cured at the three different irradiance levels were similar. However, at different depths, there were differences in the DC values. In general, there were no clear differences among the samples cured in the three different groups, and the KHN was always greater 24 h and 7 days later (P < 0.05). CONCLUSIONS: Despite the curing time, and as long as the samples were cured with the same radiant exposures, there were no significant effects on the DC and KHN of both RBCs.

Effects of Different Temperatures and Storage Time on the Degree of Conversion and Microhardness of Resin-based Composites.

OBJECTIVE: Dental materials are often made at room temperature, whereas clinically they are made in the mouth. This study evaluated the effects of temperature on the degree of conversion (DC) and Knoop microhardness (KHN). MATERIALS AND METHODS: Two types of resin-based composites (RBCs) were light-cured using a light-emitting diode (LED) light-curing unit. The resin specimens were centered on an Attenuated Total Reflectance Fourier transform infrared (FT-IR) plate heated to 23°C or 33°C. The DC of the resin was calculated after 120 seconds, the specimens were removed, and the KHN was tested at the bottom of the specimens both immediately, after 24 hours, and after 7 days storage in distilled water in complete darkness at 37°C. The effects of different temperatures on the DC and KHN with their storage time were compared by analysis of variance and Fisher's protected least significant difference post hoc multiple comparison tests (p < 0.05). RESULTS: Increasing the temperature had a significant and positive effect on the DC and KHN for immediate values of the RBCs. Greater conversion and hardness occurred when the curing temperature was increased from 23°C to 33°C. The KHN increased significantly after 24 hours of storage. There was a linear relationship between DC and KHN (R(2) = 0.86) within the range of DC and KHN studied. CONCLUSION: The physical properties of dental materials can be expected to be better when made in the mouth than when they are made in a laboratory at room temperature.

Effect of a broad-spectrum LED curing light on the Knoop microhardness of four posterior resin based composites at 2, 4 and 6-mm depths.

OBJECTIVE: To measure the Knoop microhardness at the bottom of four posterior resin-based composites (RBCs): Tetric EvoCeram Bulk Fill (Ivoclar Vivadent), SureFil SDR flow (DENTSPLY), SonicFill (Kerr), and x-tra fil (Voco). METHODS: The RBCs were expressed into metal rings that were 2, 4, or 6-mm thick with a 4-mm internal diameter at 30°C. The uncured specimens were covered by a Mylar strip and a Bluephase 20i (Ivoclar Vivadent) polywave(®) LED light-curing unit was used in high power setting for 20s. The specimens were then removed and placed immediately on a Knoop microhardness-testing device and the microhardness was measured at 9 points across top and bottom surfaces of each specimen. Five specimens were made for each condition. RESULTS: As expected, for each RBC there was no significant difference in the microhardness values at the top of the 2, 4 and 6-mm thick specimens. SureFil SDR Flow was the softest resin, but was the only resin that had no significant difference between the KHN values at the bottom of the 2 and 4-mm (Mixed Model ANOVA p<0.05). Although the KHN of SureFil SDR Flow was only marginally significantly different between the 2 and 6-mm thickness, the bottom at 6-mm was only 59% of the hardness measured at the top. CLINICAL SIGNIFICANCE: This study highlights that clinicians need to consider how the depth of cure was evaluated when determining the depth of cure. SureFil SDR Flow was the softest material and, in accordance with manufacturer's instructions, this RBC should be overlaid with a conventional resin.

Effect of exposure time on the polymerization of resin cement through ceramic.

PURPOSE: This study measured the effects of using three different exposure times to cure one resin cement through two types of ceramic. MATERIALS AND METHODS: One light-curing resin cement (Variolink II, Ivoclar Vivadent) was exposed for 20 s, 40 s, or 60 s with a BluePhase G2 light (Ivoclar Vivadent) on the high power setting through 1.0 mm of either ZirPress (ZR) or Empress Esthetic (EST) ceramic (Ivoclar Vivadent). The degree of conversion (DC) of the resin was measured 100 s after light exposure. The Knoop microhardness (KHN) was measured 5 min after light exposure and again after 24 h. The DC and KHN results were analyzed with ANOVA followed by Scheffe's post-hoc multiple comparison tests at α = 0.05. RESULTS: Increasing exposure time had a significant effect on the KHN and DC values for the resins exposed through both ceramics. As exposure times increased, the influence of the ceramic was reduced; however, the microhardness values were greater for the cement exposed through EST ceramic. When the exposure time was increased from 20 s to 40 s, microhardness values for the resin increased by 39.6% through the EST ceramic. When exposed for 60 s, there were no differences between the 100-s DC values or 5-min KHN values using either ceramic (p > 0.05). There was an excellent correlation between the DC at 100 s and the microhardness values measured at 5 min. CONCLUSION: Resin polymerization was greater through EST than ZR ceramic. At least 40 s to 60 s from the Blue- Phase G2 on high power mode is required to cure this resin cement through 1.0 mm of ceramic.

Effects of single-peak vs polywave light-emitting diode curing lights on the polymerization of resin cement.

PURPOSE: This study examined the effect of selecting a single-peak blue vs a polywave blue/violet emission LED curing light on the degree of conversion (DC) and Knoop microhardness (KHN) of resin cements when light cured through a ceramic disk. MATERIALS AND METHODS: Two shades (A1 and A4) of resin cement (Variolink II) were placed in a 0.5-mm-thick ring. The top surfaces were covered with a Mylar strip and further covered with a disk of 1-mm-thick Empress Esthetic ceramic, shade A2. The specimens were light cured by means of an Elipar-S10 (3M ESPE, single-peak blue LED) or BluePhase-G2 (Ivoclar Vivadent, polywave blue/violet LED) curing light, both for 20 s, directly on the surface of an attenuated total reflectance FT-IR plate at 30°C. The DC of the resin was calculated after 100 s. The specimens were removed, and the Knoop microhardness was tested immediately and again after 24-h storage in the dark at 37°C and 100% humidity. Five specimens were made in each group. The DC and Knoop microhardness results were analyzed with ANOVA and Fisher's PLSD at α = 0.05. RESULTS: The choice of curing light had no significant effect on the DC and only a small effect on the immediate and 24-h KHN values. Shade A4 of the resin cement was harder and had a higher DC than shade A1. CONCLUSION: When light cured for 20 s, Variolink II resin cement can be light cured with either the single-peak or the polywave curing light. Shade A4 of the cement was slightly harder than A1.

The effects of different shades of resin luting cement on the color of ceramic veneers.

The purpose of this study was to quantitatively evaluate the effects of different shades of light-polymerized resin cement on the color of two different thicknesses (0.5 mm and 0.7 mm) of three different ceramic materials (Esthetic, e.max, and ZirPress). A spectrophotometer (Color Eye 7000A - CIE (L*a*b*) was used to measure the color of specimens on the control substrate without cement, and then on (Translucent, White Opaque, B0.5, A1, and A3 of RelyX™ Veneer cement). The mean values of color difference (ΔE) were higher for Esthetic, followed by ZirPress, with the lowest values for e.max. The mean values of ΔE decreased when the thickness of ceramic increased from 0.5 mm to 0.7 mm. It was observed that the White Opaque had significantly increased ΔE values when compared with (TR, B0.5, A1, and A3), whereas no significant difference between B0.5 and TR, and between B0.5 and A3.

Evaluation of light-curing units in rural and urban areas.

OBJECTIVES: To evaluate the distribution of light-curing units (LCU) used in an urban area (Riyadh) and a rural area (Kharj) of Saudi Arabia, and to compare their irradiance values. METHODS: The study involved three dental centers in urban areas and two in rural areas, all of which were parts of a single healthcare institution providing dental services. The light outputs (power mW) from 140 LCUs were measured by laboratory-grade spectrometry, and the irradiance (mW/cm(2)) was calculated from the tip area of each LCU. The minimum acceptable irradiance outputs for the quartz-tungsten-halogen (QTH) and light-emitting diode (LED) units were set at 300 and 600 mW/cm(2), respectively. The ages of these units and the protocol used to light-cure the resins were also determined. RESULTS: The total number of LCUs was 140, 112 (78%) in urban areas, and 28 (22%) in rural areas. In rural areas, only 7 of the 22 (32%) QTH units delivered irradiances greater than 300 mW/cm(2) and were therefore considered clinically acceptable, whereas 4 of the 6 (66.7%) LED units delivered values greater than 600 mW/cm(2). In urban centers, 43 of 61 (70.5%) LED units and 25 of 61 (49%) QTH units were considered clinically acceptable. Irradiance values for both QTH (P < 0.01) and LED (P < 0.05) units were significantly better in urban than in rural areas. CONCLUSIONS: Urban areas had a greater distribution of LCUs than rural areas. Overall, irradiance values were significantly higher in urban areas.