In vitro wear of dual-cured bulkfill composites and flowable bulkfill composites.

OBJECTIVES: The objective of this study is to test the wear of dual-cured bulkfill and flowable bulkfill composites. MATERIALS AND METHODS: Six dual-cured bulkfill composites, Cention, Cention-Exp, Activa, Fill-up, Hyperfil Injectafill, and two flowable bulkfill composites Tetric Evoflow BulkFill and G-aenial Universal Flo were tested in this study (n = 8). Each composite was applied into an aluminum sample holder and cured with a Valo Grand (1230 mW/cm2 ) or self-cured according to manufacturer's recommendations, and stored in water for 3 weeks. The samples were subjected to 120 000 load cycles of 49 N (CS-4) against spherical steatite antagonists and simultaneously subjected to 4440 thermocycles (5°C-55°C). At intervals between load cycles, polyvinyl siloxane impressions were taken and scanned with a True Definition Laser Scanner. The volumetric wear was calculated using image software (Geomagic). Microscopic images of selected wear facets and their corresponding worn antagonists were obtained using SEM. All data were analyzed using analysis of variance (ANOVA) and Tukey post hoc test for multiple comparison (α = .05; ß = .2). RESULTS: The load cycles volumetric wear-increase was linear. Two-way ANOVA showed significant main effects (material and light-cured) and significant interactions. Self-cured materials (mean = 0.38 mm3 ) showed more wear than light-cured materials (mean = 0.35mm3 ). CONCLUSIONS: The bioactive materials except Activa light-cured showed significantly more wear than the flowable composites. CLINICAL SIGNIFICANCE: This study demonstrated that most of the dual-cured composites, if light-cured, showed the same wear as the flowable composites used as control. Therefore, to obtain adequate wear resistance the dual-cured composites should be routinely light-cured.

Acrylic Reinforcement with Off the Shelf Perforated Metal Plates.

To evaluate the effect of Dentaurum Grid Strengthener on flexural strength and modulus of two types of PMMA, 24 beams (75 mm x 10 mm x 2.5 mm) containing bonded and flattened Grid Strengthener and 24 beams without Grid Strengthener were subjected to a 3-point bending test at 5 mm/min. Flexural strength and modulus were calculated. Data were analyzed with a 2-way ANOVA. The highest mean strength and flexural modulus was measured for reinforced high impact resin (96.2±14.3 MPa and 3425±779 MPa, respectively). For flexural strength and modulus, resin and reinforcement had a significant effect. CLINICAL RELEVANCE: Independent of the resin used, the incorporation of a grid strengthener increases the strength and modulus, thus the fracture probability of dentures is reduced.

Bond strength of repaired amalgam restorations.

This in vitro study investigated the interfacial flexural strength (FS) of amalgam repairs and the optimal combination of repair materials and mechanical retention required for a consistent and durable repair bond. Amalgam bricks were created, each with 1 end roughened to expose a fresh surface before repair. Four groups followed separate repair protocols: group 1, bonding agent with amalgam; group 2, bonding agent with composite resin; group 3, mechanical retention (slot) with amalgam; and group 4, slot with bonding agent and amalgam. Repaired specimens were stored in artificial saliva for 1, 10, 30, 120, or 360 days before being loaded to failure in a 3-point bending test. Statistical analysis showed significant changes in median FS over time in groups 2 and 4. The effect of the repair method on the FS values after each storage period was significant for most groups except the 30-day storage groups. Amalgam-amalgam repair with adequate condensation yielded the most consistent and durable bond. An amalgam bonding agent could be beneficial when firm condensation on the repair surface cannot be achieved or when tooth structure is involved. Composite resin can be a viable option for amalgam repair in an esthetically demanding region, but proper mechanical modification of the amalgam surface and selection of the proper bonding system are essential.

Academic Performance Antecedent Scale: validation with native and recent immigrant children.

This study aims to assess the measurement invariance of the three subscales of the newly developed Academic Performance Antecedent Scale (APAS)--School Factors, Mother's Parenting Style, and Individual Factors--across native and new immigrant children in Taiwan. The study sample comprised 527 Grade 4 students (M age = 10.4 yr., SD = 0.6), 263 boys and 264 girls. The three groups were urban and rural children of Taiwanese natives (n = 343, 65.1%), and 184 children with non-Taiwanese mothers (34.9%). The four-factor structure of the School Factors Subscale, the three-factor structure of the Mother's Parenting Style Subscale, and the five-factor structure of the Individual Factors Subscale all showed at least acceptable fit for the groups. In addition, metric invariance was confirmed for the School Factors and Individual Factors Subscales. Metric invariance was partially obtained for the Mother's Parenting Style Subscale. The findings provide validity evidences for cross-cultural generalizability of the APAS.

What do microtensile bond strength values of adhesives mean?

PURPOSE: To test the hypothesis that stress distribution is more complex than generally assumed during microtensile testing by determining the stress level in the adhesive region of a virtual dentin-adhesive-composite stick using FEA (finite element analysis). MATERIALS AND METHODS: A 3D FEA model simulating a dentin-adhesive-composite stick was analyzed. The length of the composite and the dentin was 5.0 mm each and the thickness of the adhesive layer was 0.02 mm. For the stress analysis, either only one lateral side of the stick or both end surfaces were attached. A 20-N load was then exerted on the stick with its 1.0 mm2 cross-sectional area, and von Mises stresses were calculated. RESULTS: Large variations in stress levels existed. The highest stresses were located in the dentin and composite sections, near the adhesive interface. The stress level in these regions in the stick attached to one lateral side was more than 5 times higher than the 20 MPa stress calculated by dividing the force with the crosssectional area. For the specimen glued to the ends of the sticks, the stress level differences at the bonded interfaces were around 22 MPa, which decreased to 12 to 14 MPa in the center of the adhesive. Thus, this load condition yielded von Mises stress levels at the interface that were closer to the expected stress level than were the lateral-side attached specimens. CONCLUSION: The calculated stress levels were higher and more complex than the strength values obtained by dividing the load at failure by the cross-sectional area. Reported strength values from microtensile tests therefore do not represent the true bond strength values at either the dentin/adhesive or adhesive/composite interface. However, the high stress levels in dentin and composite may explain the cohesive failures reported in the literature.

Monocytes secrete CXCL7 to promote breast cancer progression.

Certain immune cells and inflammatory cytokines are essential components in the tumor microenvironment to promote breast cancer progression. To identify key immune players in the tumor microenvironment, we applied highly invasive MDA-MB-231 breast cancer cell lines to co-culture with human monocyte THP-1 cells and identified CXCL7 by cytokine array as one of the increasingly secreted cytokines by THP-1 cells. Further investigations indicated that upon co-culturing, breast cancer cells secreted CSF1 to induce expression and release of CXCL7 from monocytes, which in turn acted on cancer cells to promote FAK activation, MMP13 expression, migration, and invasion. In a xenograft mouse model, administration of CXCL7 antibodies significantly reduced abundance of M2 macrophages in tumor microenvironment, as well as decreased tumor growth and distant metastasis. Clinical investigation further suggested that high CXCL7 expression is correlated with breast cancer progression and poor overall survival of patients. Overall, our study unveils an important immune cytokine, CXCL7, which is secreted by tumor infiltrating monocytes, to stimulate cancer cell migration, invasion, and metastasis, contributing to the promotion of breast cancer progression.

Effect of metal selection and porcelain firing on the marginal accuracy of titanium-based metal ceramic restorations.

STATEMENT OF PROBLEM: Titanium is the most biocompatible metal used for dental casting; however, there is concern about its marginal accuracy after porcelain application since this aspect has direct influence on marginal fit. PURPOSE: The purpose of this study was to determine the effect that metal selection and the porcelain firing procedure have on the marginal accuracy of metal ceramic prostheses. MATERIAL AND METHODS: Cast CP Ti, milled CP Ti, cast Ti-6Al-7Nb, and cast Ni-Cr copings (n=5) were fired with compatible porcelains (Triceram for titanium-based metals and VITA VMK 95 for Ni-Cr alloy). The Ni-Cr alloy fired with its porcelain served as the control. Photographs of metal copings placed on a master die were made. Marginal discrepancy was determined on the photographs using an image processing program at 8 predetermined locations before airborne-particle abrasion for porcelain application, after firing of the opaque layer, and after firing of the dentin layer. Repeated-measures 2-way ANOVA was used to investigate the effect of metal selection and firing stage, and paired t tests were used to determine the effect of each firing stage within each material group (alpha=.05). RESULTS: ANOVA showed that both metal selection and firing stage significantly influenced the measured marginal discrepancy (P<.001), and there was interaction between the 2 variables (P<.001). Student-Newman-Keuls multiple comparison tests showed that there were significant differences between any 2 metals compared, at each stage of measurement. Paired t tests showed that significant changes in marginal discrepancy occurred with opaque firing on milled CP Ti (P=.017) and cast Ti-6Al-7Nb alloy (P=.003). CONCLUSIONS: Titanium copings fabricated by CAD/CAM demonstrated the least marginal discrepancy among all groups, while the base metal (Ni-Cr) groups exhibited the most discrepancy of all groups tested.

Enamel hardness after exposure to acidic drinks and brushing.

This study tested the hypothesis that short-term exposure to acidic drinks can reduce enamel surface hardness, and that subsequent brushing with toothpaste can cause detectable loss of enamel. Enamel specimens (three groups per storage medium) were immersed in one of four acidic drinks for five seconds, one minute, or 10 minutes. The pH values of all four drinks were measured. Six microhardness indentations were made on each specimen before immersion (baseline), after immersion, and after brushing with toothpaste. Changes in surface microhardness were expressed as the ratio of hardness values after each treatment to the baseline value of each specimen. Two-way ANOVA showed that both storage medium and duration of immersion influenced the ratio significantly. One-way ANOVA showed that the ratio was reduced significantly with increased time of immersion in drinks with a pH =2.8, but the ratio reduction was not significant in drinks with a pH =3.3. Subsequent brushing removed the softened layer and exposed intact surface underneath. Although short-term exposure (~5 seconds) did not significantly affect the surface hardness values, it left a lightly etched enamel surface among specimens immersed in acidic drinks with a low pH. Subsequent brushing could still cause detectable loss of enamel surface after multiple exposures.

Effects of synthetic glucocorticoids on breast cancer progression.

Glucocorticoids (GCs) are widely prescribed as adjuvant therapy for breast cancer patients. Unlike other steroid hormone receptors, the GC receptor is not considered an oncogene. Research in the past few years has revealed the complexity of GC-mediated signaling, but it remains puzzling whether GCs promote or inhibit tumor progression in different cancer types. Here we evaluated the potential of using a synthetic GC, dexamethasone (DEX), in the treatment of breast cancer. We found that the administration of low-dose DEX suppressed tumor growth and distant metastasis in the MCF-7 and MDA-MB-231 xenograft mouse model, whereas treatment with high-dose DEX enhanced tumor growth and metastasis, respectively. Treatment of breast cancer cells with DEX inhibited cell adhesion, migration, and invasion in a dose-dependent manner. The DEX-mediated inhibition of cell adhesion, migration, and invasion is partly through induction of microRNA-708 and subsequent Rap1B-mediated signaling in MDA-MB-231 cells. On the other hand, in MCF-7 cells, DEX-suppressed cell migration is independent from microRNA-708 mediated signaling. Overall, our data reveal that DEX acts as a double-edged sword during breast-cancer progression and metastasis: Lower concentrations inhibit breast cancer tumor growth and metastasis, whereas higher concentrations may play an undesired role to promote breast cancer progression.

Comparing depth-dependent curing radiant exposure and time of curing of regular and flow bulk-fill composites.

The effect of restoration depth on the curing time of a conventional and two bulk-fill composite resins by measuring microhardness and the respective radiosity of the bottom surface of the specimen was investigated. 1-, 3- and 5-mm thick washers were filled with Surefil SDR Flow-U (SDR), Tetric EvoCeram Bulk Fill-IVA (TEC) or Esthet-X HD-B1 (EHD), and cured with Bluephase® G2 for 40s. Additional 1-mm washers were filled with SDR, TEC or EHD, placed above the light sensor of MARC®, stacked with pre-cured 1-, 3- or 5-mm washer of respective material, and cured for 2.5~60s to mimic 2-, 4- and 6-mm thick composite curing. The sensor measured the radiosity (EB) at the bottom of specimen stacks. Vickers hardness (VH) was measured immediately at 5 locations with triplicate specimens. Nonlinear regression of VH vs EB by VH=α[1-exp(-EB/ß)] with all thickness shows that the values of α, maximum hardness, are 21.6±1.0 kg/mm2 for SDR, 38.3±0.6 kg/mm2 for TEC and 45.3±2.6 kg/mm2 for EHD, and the values of ß, rate parameter, are 0.40±0.06 J/cm2 for SDR, 0.77±0.04 J/cm2 for TEC and 0.58±0.09 J/cm2 for EHD. The radiosity of the bottom surface was calculated when the bottom surface of each material attained 80% of α of each material. The curing times for each material are in agreement with manufacturer recommendation for thickness. It is possible to estimate time needed to cure composite resin of known depth adequately by the radiosity and microhardness of the bottom surface.

Repair strength of dental amalgams.

This study tested the hypothesis that newly triturated amalgam condensed vertically on old amalgam was essential for establishing a bond between the new and old amalgams. Twelve rectangular bars were prepared with Dispersalloy and Tytin to establish their baseline flexure strength values. An additional 12 specimens were made and separated into 24 equal halves. All fracture surfaces were abraded with a flat end fissure bur. Twelve surfaces were paired with the original amalgam, and the remaining 12 surfaces were repaired with a different amalgam. At first, freshly triturated amalgam was condensed vertically on the floor of the specimen mold (Group A). The majority of specimens repaired with Group A failed to establish bond at the repair interface. All repair surfaces were abraded again and prepared by a second method. A metal spacer was used to create a four-wall cavity to facilitate vertical condensation directly on the repair surface (Group B). The specimens were stored in ambient air for seven days prior to flexure testing. The strength of specimens repaired with Group B ranged from 26% to 54% of the baseline specimens. ANOVA showed that amalgams repaired with a different amalgam yielded higher strength values than those repaired with the original amalgam, and the baseline specimens exhibited significantly higher strength values than all the repaired specimens.

Four-year clinical evaluation of a self-etching primer and resin-based restorative material.

PURPOSE: To evaluate the performance of a universal resin-based restorative material (Beautifil) in combination with a self-etching primer (Fluorobond) for posterior restorations. METHODS: 61 restorations, 26 Class I and 35 Class II, were placed by two clinicians in 31 patients under rubber dam isolation. Two other calibrated clinicians evaluated the restorations using USPHS/Ryge criteria observing the following characteristics: color match, marginal adaptation, anatomy, roughness, marginal staining, interfacial staining, contact, secondary caries, and luster. Chi-Square and Fisher's Exact Test were used for statistical analysis (alpha=0.05). RESULTS: All the restorations were assessed at baseline and alpha scores predominated for all criteria. All restorations were examined at the 1-year recall examination. 58 restorations were examined at the 2-year recall (23 Class I and 35 Class II), 47 (16 Class I and 31 Class II) at the 3-year recall. The present 4-year report covers 39 restorations (12 Class I and 27 Class II). Marginal adaptation, staining, anatomy, and color matching constitute the majority of the recorded changes. Chi-Square and Fisher's Exact Test of the frequency of clinical rating of each characteristic showed that there were no statistically significant differences at each recall with respect to the baseline observations (P> 0.05), except for occlusal marginal stain. Statistical significance was detected for the occlusal marginal stain at 1-year (P= 0.06), 2-year (P= 0.01) and 4-year (P= 0.002) when compared to baseline data.

Work of adhesion of resin on treated lithia disilicate-based ceramic.

OBJECTIVE: This study is to test the hypothesis that chemical etching and silane coating of a ceramic surface will influence the work of adhesion (WA) of adhesive resin to dental ceramic. METHODS: A hot-pressed lithia disilicate-based ceramic was used as a model material to investigate the influence of probing media and surface treatments on WA using a dynamic contact angle analyzer. Eighty ceramic specimens were randomly divided into eight experimental groups and treated as follows: (1 and 3) as polished; (2 and 4) etched with 9.5% hydrofluoric acid (HF) for 1 min; (5) etched with 4% acidulated phosphate fluoride (APF) for 2 min; (6) silane coated; (7) etched with HF for 1 min and silane coated; (8) etched with APF for 2 min and silane coated. Advancing and receding contact angles (theta(a) and theta(r)) were measured using high purity water (gamma = 72.6 mN/m) for groups 1 and 2, and a liquid resin (gamma = 39.7) for groups 3-8 as probing liquids. RESULTS: The liquid resin medium yielded a lower WA than water. Silanization produced a significantly lower WA (p < 0.001) than non-silanated surfaces. Etching alone consistently yielded a greater WA for all surface treatments (p < 0.001). SIGNIFICANCE: The silanated ceramic surface exhibited a lower surface energy and did not enhance bonding to the liquid resin by work of adhesion.

Assessing fluoride concentration uniformity and fluoride release from three varnishes.

BACKGROUND: The authors investigated the fluoride content uniformity of three commercial fluoride varnishes, as well as their fluoride-release behaviors. METHODS: The authors examined 20 doses from each of two tubes of Duraphat (Colgate-Palmolive Co., New York) and Duraflor (Pharmascience Inc., Montreal), and 20 doses of individually packaged 0.25-milliliter and 0.40-mL units of CavityShield (OMNII Oral Pharmaceuticals, West Palm Beach, Fla.). Part of the dose was dissolved in chloroform, followed by fluoride extraction with distilled water. The authors painted the remaining varnish from five predetermined doses from each group onto plastic substrates for examination of fluoride release. Fluoride concentrations in the solutions were measured with a fluoride-selective ion electrode. RESULTS: One-way analysis of variance showed statistically significant differences between varnish groups. The fluoride content was more uniform in Duraphat and CavityShield than it was in Duraflor. The fluoride release profiles in terms of percentage of total fluoride released over time were different among different groups of varnishes and were similar among samples from the same test group. The authors found that Duraflor released consistently more fluoride in artificial saliva than did the other two varnishes. CONCLUSIONS: Fluoride content can vary between doses dispensed from the same tube. Uniformity also varies between different varnishes and affects the retention of fluoride in the varnish. CLINICAL IMPLICATIONS: Clinicians should be aware that the nonuniform appearance of fluoride varnish as squeezed out of the tube could indicate separation of ingredients, resulting in variation of fluoride content.

The effect of mechanical undercuts on the strength of composite repair.

BACKGROUND: The authors conducted an in vitro study to test the hypothesis that undercuts prepared in old composite restorations could improve the strength between the restoration and a flowable composite as repair material. METHODS: The authors used three composites to fabricate cylinders as repair substrates. The etched-only group was ground, etched, dried and built up with a flowable composite. For the undercut group, the authors introduced arrays of fissures on the surfaces before preparing the specimens for subsequent buildup in the manner described for the etched-only group. They made nonrepaired cylinders for baseline measures of strength. They sliced all finished cylinders into slender bars with a diamond saw. Flexure strength values were determined by a three-point-bending test. RESULTS: Nonrepaired bars exhibited statistically significantly higher flexure strength values than did repaired bars, as determined by Wilcoxon rank sum test. Two-way general linear model showed that both material (P < .0001) and undercut (P = .0207) exhibited a statistically significant influence on the repaired flexure strength. Repair substrate with elastic modulus close to that of repair material exhibited a greater percentage of recovery of the respective cohesive strength. Compared with the etched-only group, the undercut group yielded a higher mean flexure strength with one composite but a lower mean flexure strength with the other two. Examination of the fractured surfaces showed that a significant number of undercuts were filled only partially. CONCLUSION: Flexure strengths of repaired specimens always were lower than the cohesive flexure strengths of the materials being repaired. Undercuts did not generally improve repair strength. CLINICAL IMPLICATIONS: Small undercuts on the surface of composite often are difficult to fill completely, resulting in areas of stress concentration that result in no improvement in the repair strength.

The effect of surface finishing and storage solutions on the color stability of resin-based composites.

BACKGROUND: The authors tested the hypothesis that surface-finishing treatments and the type of storage solutions significantly affected the staining of resin-based composites, or RBCs, and unfilled resins, or URs. METHODS: Fifty-four RBC and 54 UR disks were polymerized through a polyester film strip (Mylar, DuPont, Wilmington, Del.) and polished in one of three groups: 1-micrometer aluminum oxide, 15-microm diamond plate and no treatment (polyester film). All specimens were immersed in water for two days and then in coffee, cola or red wine for seven more days at 37 C. The authors recorded tristimulus color measurements before the immersions; after one and two days in water; and after one, two, three and seven days in the storage solutions. RESULTS: Most of the color changes occurred between day 2 in water and day 7 in the staining solution. Analysis of variance showed that the finishing treatment and storage solution significantly influenced the overall color change (deltaE), and interactions occurred between the finishing treatment and the storage solution (P < .0001) for both materials. RBC specimens generally exhibited greater color changes than did UR specimens. The polyester film finishing exhibited the greatest amount of color change, while the diamond finishing exhibited the least amount of color change. Immersion in wine caused the greatest color change for both materials; cola and coffee resulted in the smallest color change for RBC and UR specimens, respectively. CONCLUSIONS: Finishing treatments and storage solutions significantly affect the surface staining of RBC materials. Polyester film finishing and red wine produced the greatest color change after seven days for RBC specimens. CLINICAL IMPLICATIONS: Clinicians should remove the polyester film-finished surface and advise patients that drinking wine could intensify surface staining on RBC restorations.

Effect of surface finishing and storage media on bi-axial flexure strength and microhardness of resin-based composite.

This in vitro study tested the following null hypotheses: (1) surface finishing treatments do not significantly affect the biaxial flexure strength and microhardness of resin-based composites (RBC) and (2) storage media do not significantly affect these physical properties. Discs (81 RBC and 81 UR; 3M/ESPE) were prepared using a circular polyethylene mold (2.4-mm thick x 16.7 mm in diameter) that was polymerized through a Mylar strip and divided into three surface finishing treatment groups: 1 microm aluminum oxide slurry; 15 microm diamond and a Mylar strip. Randomly selected controls for each finishing group were stored at room temperature in individual vials. Test specimens were immersed in water, stored at 37 degrees C for two days and transferred for an additional seven days to one of three aqueous storage media at 37 degrees C: coffee (pH 5.1), cola (pH 2.4) or red wine (pH 3.7). Post immersion (nine days total), the specimens were tested for biaxial flexure strength (BFS) and Vicker's microhardness (VHN). ANOVA and Tukey's HSD test were used for statistical analysis. ANOVA results indicated that surface finishing treatments had a significant effect on the biaxial flexure strength and microhardness of the RBC and the UR specimens. BFS results for RBC specimens were AL>DD>ML (p<0.0001) and VHN results were AL, DD>ML (p<0.0001). Storage in wine medium reduced the VHN of UR specimens significantly. Both alternative hypotheses were accepted. In addition, the Mylar finishing group, because of the resin-rich surface layer, yielded the lowest mean values of BFS and VHN.

Repair or replacement of amalgam restorations: decisions at a USA and a UK dental school.

Whereas replacement of failed restorations is the major treatment for adults in dental practice, repair is an important alternative with the potential to save tooth structure and increase the longevity of restorations at a lower cost. This in vitro study recorded the choices of treatment for the same set of teeth with defective Class II amalgam restorations by students and faculty at two dental schools (University of Manchester, UK and University of Florida, USA). Treatment options (monitor, refurbish, repair and replace) and reason(s) for the choice of treatment for 24 marked amalgam restorations were selected. Overall, participants more frequently chose replacement of restorations; whereas, repair was the least favored option. The reasons cited the most to replace restorations were secondary caries including unsightly appearance, partially lost restoration and tooth fracture; for repair, the major reasons included loss of part of the restoration and marginal ditching; and for refurbishment, the major reasons included poor anatomic form and marginal ditching. There was a significant difference between the students and faculties at the two sites in their choice of treatment (p<0.0001; Chi-square test). The treatment decision to "monitor" the restorations was more frequent for the Manchester site than the Florida site. Conversely, the combined treatment decisions to "refurbish, repair and replace" were more frequently chosen in Florida than in Manchester.

Replacement of resin-based composite: evaluation of cavity design, cavity depth, and shade matching.

OBJECTIVE: The aim of this study was to evaluate the effect of different cavity designs, cavity depths, and shade matching on the dimensions of Class I resin-based composite preparations during replacement of the restoration. METHOD AND MATERIALS: Forty Class I cavity preparations were prepared in extracted premolars. The occlusal depths varied from 1.5 to 2.5 mm. In 20 teeth, the buccal and lingual walls were perpendicular to the pulpal floor; in another 20, they were divergent to the pulpal floor. Impressions were made of all preparations. The cavities were restored with resin-based composite. All subgroups were further divided into another two subgroups (n = 5), in which half of the teeth were restored with shade that matched the tooth and the other half were restored with a resin composite that was three shades different from the tooth. After 168 hours in distilled water, the restorations were removed. New impressions were made, and a total of 80 stone casts were fabricated. The perimeter and area of the restorations were recorded with a video-based imaging system. The dimensions of the postoperative cavity preparations were compared to the initial cavity sizes. RESULTS: The depth of the original cavity preparation had a statistically significant effect on the change in cavity dimension, as measured by area and perimeter. The 2.5-mm-deep cavities showed greater loss of tooth structure. No statistically significant difference was found for different cavity designs or shade matching. CONCLUSION: Replacement of Class I resin-based composite restorations results in loss of tooth structure. The deeper the original cavity preparation, the greater the loss of tooth structure at the occlusal cavosurface margin during replacement.

Marginal gap repair with flowable resin-based composites.

This study was designed to test the hypothesis that the flowable/dentin interface has the weakest bond and highest frequency of failure when a resin-based composite is repaired using a flowable composite. Comparing three specific groups--dentin, flowable composite, and hybrid composite-under the Kruskal-Wallis test showed that the mean bond strength values at the flowable/dentin interface and within the dentin were significantly lower than those at the hybrid/flowable interface and within the flowable resin. Dentin near the pulp chamber yielded consistently lower bond strength values than dentin located at the dentino-enamel junction. Bonding at the flowable resin/dentin interface showed the weakest bond and highest frequency of failure.