Effect of inorganic fillers on the light transmission through traditional or flowable resin-matrix composites for restorative dentistry.

OBJECTIVES: The aim of this in vitro study was to evaluate the light transmission through five different resin-matrix composites regarding the inorganic filler content. METHODS: Resin-matrix composite disc-shaped specimens were prepared on glass molds. Three traditional resin-matrix composites contained inorganic fillers at 74, 80, and 89 wt. % while two flowable composites revealed 60 and 62.5 wt. % inorganic fillers. Light transmission through the resin-matrix composites was assessed using a spectrophotometer with an integrated monochromator before and after light curing for 10, 20, or 40s. Elastic modulus and nanohardness were evaluated through nanoindentation's tests, while Vicker's hardness was measured by micro-hardness assessment. Chemical analyses were performed by FTIR and EDS, while microstructural analysis was conducted by optical microscopy and scanning electron microscopy. Data were evaluated using two-way ANOVA and Tukey's test (p < 0.05). RESULTS: After polymerization, optical transmittance increased for all specimens above 650-nm wavelength irradiation since higher light exposure time leads to increased light transmittance. At 20- or 40-s irradiation, similar light transmittance was recorded for resin composites with 60, 62, 74, or 78-80 wt. % inorganic fillers. The lowest light transmittance was recorded for a resin-matrix composite reinforced with 89 wt. % inorganic fillers. Thus, the size of inorganic fillers ranged from nano- up to micro-scale dimensions and the high content of micro-scale inorganic particles can change the light pathway and decrease the light transmittance through the materials. At 850-nm wavelength, the average ratio between polymerized and non-polymerized specimens increased by 1.6 times for the resin composite with 89 wt. % fillers, while the composites with 60 wt. % fillers revealed an increased ratio by 3.5 times higher than that recorded at 600-nm wavelength. High mean values of elastic modulus, nano-hardness, and micro-hardness were recorded for the resin-matrix composites with the highest inorganic content. CONCLUSIONS: A high content of inorganic fillers at 89 wt.% decreased the light transmission through resin-matrix composites. However, certain types of fillers do not interfere on the light transmission, maintaining an optimal polymerization and the physical properties of the resin-matrix composites. CLINICAL SIGNIFICANCE: The type and content of inorganic fillers in the chemical composition of resin-matrix composites do affect their polymerization mode. As a consequence, the clinical performance of resin-matrix composites can be compromised, leading to variable physical properties and degradation.

Toxicity of resin-matrix cements in contact with fibroblast or mesenchymal cells.

The main aim of this study was to perform an integrative review on the toxic effects of resin-matrix cements and their products in contact with fibroblasts or mesenchymal cells. A bibliographic search was performed on PubMed using the following search terms: "cytotoxicity" AND "fibroblast" OR "epithelial" OR "mesenchymal" AND "polymerization" OR "degree of conversion" OR "methacrylate" OR "monomer" AND "resin cement" OR "resin-based cement". The initial search in the available database yielded a total of 277 articles of which 21 articles were included in this review. A decrease in the viability of mouse fibroblasts ranged between 13 and 15% that was recorded for different resin-matrix cements after light curing exposure for 20 s. The viability of human fibroblasts was recorded at 83.11% after light curing for 20 s that increased up to 90.9% after light curing exposure for 40 s. Most of the studies linked the highest toxicity levels when the cells were in contact with Bis-GMA followed by UDMA, TEGDMA and HEMA. Resin-matrix cements cause a cytotoxic reaction when in contact with fibroblasts or mesenchymal cells due to the release of monomers from the polymeric matrix. The amount of monomers released from the resin matrix and their cytotoxicity depends on the polymerization parameters.

The influence of inorganic fillers on the light transmission through resin-matrix composites during the light-curing procedure: an integrative review.

PURPOSE: The objective of this study was to perform an integrative review on the effect the inorganic fillers on the light transmission through the resin-matrix composites during the light-curing procedure. METHOD: A bibliographic review was performed on PubMed using the following search terms: "fillers" OR "particle" AND "light curing" OR "polymerization" AND "light transmission" OR "light absorption" OR "light irradiance" OR "light attenuation" OR "light diffusion" AND "resin composite." The search involved articles published in English language in the last 10 years. RESULTS: Selected studies reported a decrease in biaxial strength and hardness in traditional resin-matrix composites in function of the depth of polymerization. However, there were no significant differences in biaxial strength and hardness recorded along the polymerization depth of Bulk-Fill™ composites. Strength and hardness were enhanced by increasing the size and content of inorganic fillers although some studies revealed a progressive decrease in the degree of conversion on increasing silica particle size. The translucency of glass-ceramic spherical fillers promoted light diffusion mainly in critical situations such as in the case of deep proximal regions of resin-matrix composites. CONCLUSIONS: The amount of light transmitted through the resin-matrix composites is influenced by the size, content, microstructure, and shape of the inorganic filler particles. The decrease of the degree of conversion affects negatively the physical and mechanical properties of the resin-matrix composites. CLINICAL RELEVANCE: The type and content of inorganic fillers in the chemical composition of resin-matrix composites do affect their polymerization. As a consequence, the clinical performance of resin-matrix composites can be compromised leading to variable physical properties and degradation. The polymerization mode of resin-matrix composites can be improved according to the type of inorganic fillers in their chemical composition.

Influence of Titanium Surface Residual Stresses on Osteoblastic Response and Bacteria Colonization.

Grit basting is the most common process applied to titanium dental implants to give them a roughness that favors bone colonization. There are numerous studies on the influence of roughness on osseointegration, but the influence of the compressive residual stress associated with this treatment on biological behavior has not been determined. For this purpose, four types of surfaces have been studied using 60 titanium discs: smooth, smooth with residual stress, rough without stress, and rough with residual stress. Roughness was studied by optic interferometry; wettability and surface energy (polar and dispersive components) by contact angle equipment using three solvents; and residual stresses by Bragg-Bentano X-ray diffraction. The adhesion and alkaline phosphatase (ALP) levels on the different surfaces were studied using Saos-2 osteoblastic cultures. The bacterial strains Streptococcus sanguinis and Lactobacillus salivarius were cultured on different surfaces, determining the adhesion. The results showed that residual stresses lead to increased hydrophilicity on the surfaces, as well as an increase in surface energy, especially on the polar component. From the culture results, higher adhesion and higher ALP levels were observed in the discs with residual stresses when compared between smooth and roughened discs. It was also found that roughness was the property that mostly influenced osteoblasts' response. Bacteria colonize rough surfaces better than smooth surfaces, but no changes are observed due to residual surface tension.

Fitting of Different Intraradicular Composite Posts to Oval Tooth Root Canals: A Preliminary Assessment.

The purpose of the present study was to perform a preliminary analysis of the fitting of different fiber-reinforced composite (GFRC) posts to tooth root canals and determine the resin cement layer thickness. The following GFRC posts were assessed: bundle posts (Rebilda GTTM, VOCO, Germany), sleeve system (SAPTM, Angelus Ind, Brazil), and accessory posts (ReforpinTM, Angelus, Brazil). Twenty-four freshly extracted mandibular single-rooted pre-molars were endodontically treated and divided into six groups, according to the type of GFRC post and resin cement (self-adhesive or conventional dual-cured). Then, specimens were cross-sectioned and inspected by optical microscopy regarding the cement layer thickness and presence of defects such as pores, voids, or fissures were assessed. Bundle and accessory posts revealed a regular distribution of resin cement with a lower number of voids than found with sleeve systems. The sleeve system posts showed poor fitting at the apical portion of the root canals. The type of resin cement did not affect the thickness of the interface, although both bundle and accessory posts allow a better distribution of resin cement and fibers. The present preliminary study reveals interesting insights on the fitting of bundle and accessory posts to root dentin and resin cement layer thickness in oval-shape root canals. The sleeve system posts showed adequate fitting only at the coronal portion of the canals.

Light transmittance through resin-matrix composite onlays adhered to resin-matrix cements or flowable composites.

OBJECTIVE: The aim of this study was to evaluate the influence of the thickness of resin-matrix composite blocks manufactured by CAD-CAM on the light transmittance towards different resin-matrix cements or flowable composites. METHODS: Sixty specimens of resin-matrix composite CAD-CAM blocks reinforced with 89 wt% inorganic fillers were cross-sectioned with 2 or 3 mm thicknesses. The specimens were conditioned with adhesive system and divided in groups according to the luting material, namely: two dual-cured resin-matrix cements, two traditional flowable resin-matrix composites, and one thermal-induced flowable resin-matrix composite. Specimens were light-cured at 900 mW/cm2 for 40s. Light transmittance assays were preformed using a spectrophotometer with an integrated monochromator before and after light-curing. Microstructural analysis was performed by optical and scanning electron microscopy (SEM). Nanoindentation tests were performed to evaluate mechanical properties for indirect evaluation of degree of monomers conversion. RESULTS: Optical and SEM images revealed low thickness values for the cementation interfaces for the traditional flowable resin-matrix composite. The cement thickness increased with the size and content of inorganic fillers. The highest light transmittance was recorded for the onlay blocks cemented with the traditional flowable resin-matrix composites while a group cemented with the dual-cured resin-matrix cement revealed the lowest light transmittance. The elastic modulus and hardness increased for specimens with high content of inorganic fillers as well as it increased in function of the light transmittance. CONCLUSIONS: The light transmittance of flowable resin-matrix composites was higher than that for resin-matrix cement after cementation to resin-matrix composites blocks. The type, size, and content of inorganic fillers of the luting material affected the thickness of the cement layer and light transmittance through the materials. CLINICAL RELEVANCE: On chair-side light curing, the transmission of visible light can be interfered by the chemical composition and viscosity of the luting materials. The increase in size and content of inorganic fillers of resin-matrix composites and luting materials can decrease the light transmittance leading to inefficient polymerization.

A Scoping Review on the Polymerization of Resin-Matrix Cements Used in Restorative Dentistry.

In dentistry, clinicians mainly use dual-cured or light-cured resin-matrix cements to achieve a proper polymerization of the organic matrix leading to enhanced physical properties of the cement. However, several parameters can affect the polymerization of resin-matrix cements. The main aim of the present study was to perform a scoping review on the degree of conversion (DC) of the organic matrix, the polymerization, and the light transmittance of different resin-matrix cements used in dentistry. A search was performed on PubMed using a combination of the following key terms: degree of conversion, resin cements, light transmittance, polymerization, light curing, and thickness. Articles in the English language published up to November 2022 were selected. The selected studies' results demonstrated that restorative structures with a thickness higher than 1.5 mm decrease the light irradiance towards the resin-matrix cement. A decrease in light transmission provides a low energy absorption through the resin cement leading to a low DC percentage. On the other hand, the highest DC percentages, ranging between 55 and 75%, have been reported for dual-cured resin-matrix cements, although the polymerization mode and exposure time also influence the DC of monomers. Thus, the polymerization of resin-matrix cements can be optimized taking into account different parameters of light-curing, such as adequate light distance, irradiance, exposure time, equipment, and wavelength. Then, optimum physical properties are achieved that provide a long-term clinical performance of the cemented restorative materials.

Microscopic Inspection of the Adhesive Interface of Composite Onlays after Cementation on Low Loading: An In Vitro Study.

PURPOSE: This study aimed to assess the layer thickness and microstructure of traditional resin-matrix cements and flowable resin-matrix composites at dentin and enamel to composite onlay interfaces after cementation on low loading magnitude. MATERIALS AND METHODS: Twenty teeth were prepared and conditioned with an adhesive system for restoration with resin-matrix composite onlays manufactured by CAD-CAM. On cementation, tooth-to-onlay assemblies were distributed into four groups, including two traditional resin-matrix cements (groups M and B), one flowable resin-matrix composite (group G), and one thermally induced flowable composite (group V). After the cementation procedure, assemblies were cross-sectioned for inspection by optical microscopy at different magnification up to ×1000. RESULTS: The layer thickness of resin-matrix cementation showed the highest mean values at around 405 µm for a traditional resin-matrix cement (group B). The thermally induced flowable resin-matrix composites showed the lowest layer thickness values. The resin-matrix layer thickness revealed statistical differences between traditional resin cement (groups M and B) and flowable resin-matrix composites (groups V and G) (p < 0.05). However, the groups of flowable resin-matrix composites did not reveal statistical differences (p < 0.05). The thickness of the adhesive system layer at around 7 µm and 12 µm was lower at the interfaces with flowable resin-matrix composites when compared to the adhesive layer at resin-matrix cements, which ranged from 12 µm up to 40 µm. CONCLUSIONS: The flowable resin-matrix composites showed adequate flowing even though the loading on cementation was performed at low magnitude. Nevertheless, significant variation in thickness of the cementation layer was noticed for flowable resin-matrix composites and traditional resin-matrix cements that can occur in chair-side procedures due to the clinical sensitivity and differences in rheological properties of the materials.

Methacrylic monomer derived from cardanol incorporated in dental adhesive as a polymerizable collagen crosslinker.

OBJECTIVES: The aim of this study was to evaluate the influence on MMP inhibition, dentin adhesion and physicochemical properties of an adhesive system incorporated with polymerizable collagen crosslinker monomer derived from cardanol. METHODS: The intermediary cardanol epoxy (CNE) was synthesized through cardanol epoxidation, followed by synthesis of cardanol methacrylate through methacrylic acid solvent-free esterification. Zymographic analysis was performed to evaluate the substances' ability to inhibit gelatinolytic enzymes. Collagen crosslinkers were added into adhesives systems according to the following groups: Ybond Universal® (Control), Ybond® + 2 % proanthocyanidin (PAC), Ybond® + 2 % unsaturated cardanol (Cardanol) and Ybond® + 2 % cardanol methacrylate (CNMA). Degree of conversion (DC) of the adhesives was assessed by FT-IR. Disk-shaped specimens were prepared for water sorption (WS) and solubility (SL) tests. Human third molars were sectioned to expose medium dentin and restored according to the different adhesives used (n = 5). Then, the specimens were cut into 1 mm2 sticks to evaluate, after 24 h and 6-month aging, microtensile bond strength (µTBS) and nanoleakage by scanning electron microscopy. Data were analysed with ANOVA and Tukey's post-test (α = 0.05). RESULTS: CNMA and PAC completely inhibited all forms of gelatinolytic enzymes. Cardanol achieved a significantly lowest DC, while the other groups did not differ from each other (p > 0.05). PAC achieved significantly higher water sorption, while CNMA solubility was significantly lower when compared to the other adhesives (p < 0.05). PAC provided a statistically higher 24 h and 6-month aging bond strength. Intermediary similar µTBS were presented by control and CNMA (p = 0.108). All adhesives applied attained significantly reduced bond strength after aging (p < 0.05). Interfaces created using CNMA were almost devoid of silver deposits initially, however all groups showed large amounts of silver deposits on resin-dentin interface subjected to water aging. SIGNIFICANCE: Although CNMA was effective in inhibiting gelatinolytic enzymes, when incorporated into a universal adhesive it could not promote less degradation of the adhesive interface after water aging. Since it is a hydrophobic monomer, CNMA did not interact well with dentin collagen, however it reduced the solubility of the adhesive system besides not interfering in its polymerization.

Printing 3D models of canine jaw fractures for teaching undergraduate veterinary medicine.

PURPOSE: To develop 3D anatomical models, and corresponding radiographs, of canine jaw fractures. METHODS: A base model was generated from a mandibular bone scan. With this model it was possible to perform fracture planning according to the anatomical location. RESULTS: The 3D base model of the canine mandible was similar in conformation to the natural bone, demonstrating structures such as canine tooth crowns, premolars and molars, mental foramina, body of the mandible, ramus of the mandible, masseteric fossa, the coronoid process, condylar process, and angular process. It was not possible to obtain detail of the crown of the incisor teeth, mandibular symphysis, and the medullary channel. Production of the 3D CJF model took 10.6 h, used 150.1 g of filament (ABS) and cost US$5.83. CONCLUSION: The 3D canine jaw fractures models, which reproduced natural canine jaw fractures, and their respective radiographic images, are a possible source of educational material for the teaching of veterinary medicine.

A importância da odontogeriatria na formação de cirurgiões-dentistas

A formação do profissional da saúde, atualmente, busca torná-lo um indivíduo preocupado com o bem-estar geral e a qualidade de vida dos seus pacientes. A formação generalista de cirurgiões-dentistas possibilita o profissional a lidar com as mudanças que ocorrem no perfil sociodemográfico dos pacientes, pois, a medida que a população brasileira envelhece, o atendimento odontológico deve ser suficientemente abrangente para suprir as necessidades específicas da terceira idade. Assim, o estudo objetivou, por meio da revisão da literatura, analisar a importância do conhecimento e da prática em Odontogeriatria na formação de Cirurgiões-Dentistas, além do impacto da inclusão desta disciplina nos cursos de Graduação em Odontologia. Observou-se em diversos estudos a existência de relativo conteúdo sobre Odontogeriatria fragmentado dentre algumas disciplinas da graduação como Prótese Dentária, Periodontia e Estomatologia. Outro fato relevante é que, em estudo realizado nas regiões sul e centro-oeste do Brasil, os graduandos demonstraram preferência para o atendimento ao idoso e apontaram a necessidade de maior conhecimento, devido ao aumento da demanda na população. A inclusão de projetos de extensão universitária visando o atendimento odontológico domiciliar ou institucional de idosos também tem mostrado resultados satisfatórios para a promoção de saúde bucal do idoso, além de permitir ao aluno vivenciar as peculiaridades do cuidado e assistência dirigidos a população idosa. Deste modo, conclui-se que a Odontogeriatria deve apresentar-se como disciplina obrigatória nos cursos de graduação para formação de Cirurgiões-Dentistas capacitados para o mercado de trabalho atual que exige humanização no atendimento e resolutividade das ações em saúde.

Printing 3D models of canine jaw fractures for teaching undergraduate veterinary medicine

Abstract Purpose To develop 3D anatomical models, and corresponding radiographs, of canine jaw fractures. Methods A base model was generated from a mandibular bone scan. With this model it was possible to perform fracture planning according to the anatomical location. Results The 3D base model of the canine mandible was similar in conformation to the natural bone, demonstrating structures such as canine tooth crowns, premolars and molars, mental foramina, body of the mandible, ramus of the mandible, masseteric fossa, the coronoid process, condylar process, and angular process. It was not possible to obtain detail of the crown of the incisor teeth, mandibular symphysis, and the medullary channel. Production of the 3D CJF model took 10.6 h, used 150.1 g of filament (ABS) and cost US$5.83. Conclusion The 3D canine jaw fractures models, which reproduced natural canine jaw fractures, and their respective radiographic images, are a possible source of educational material for the teaching of veterinary medicine.