Polymerization stress of dental resin composite continues to develop 12 hours after irradiation.

OBJECTIVE: This study assessed the development of stress from polymerization of light-cured dental resin composites for 24 hours after irradiation. MATERIALS AND METHODS: Initial cracks were made near the edge of a cylindrical hole in glass, and crack lengths were measured. Revolution Formula 2, Kalore and Venus Diamond were polymerized in the hole. Crack lengths were measured at several intervals after irradiation up to 24 hours. Stresses at the composite-glass interface were calculated using the crack lengths. Elastic moduli of the composites were measured at the same time intervals. RESULTS: Interfacial stress and elastic modulus were significantly related to material and time. Stress continued to increase up to 12 hours after irradiation. Significantly lower stresses were measured in Kalore and Venus Diamond than Revolution Formula 2 throughout 24 hours. Stress at 24 hours was two times greater than the stress at 30 minutes. The increase in elastic modulus from 30 minutes to 24 hours ranged from 8 to 24%, which was less than the increase in stress over the same time period. CONCLUSIONS: Interfacial stress and elastic modulus of the composites demonstrated the average increases of 155% and 14%, respectively, from 30 minutes to 24 hours after irradiation. CLINICAL SIGNIFICANCE: Since the elastic modulus is a measure of stiffness and resistance to load, clinicians might consider advising their patients to avoid heavy occlusal function until the elastic modulus has reached a plateau, which would be 60 minutes for Venus Diamond, 12 hours for Kalore, and 24 hours for Revolution Formula 2.

Contraction stresses in dental composites adjacent to and at the bonded interface as measured by crack analysis.

The objective of this study was to calculate stresses produced by polymerization contraction in regions surrounding a dental resin composite restoration. Initial cracks were made with a Vickers indenter at various distances from the edge of a cylindrical hole in a soda-lime glass disk. Indentation crack lengths were measured parallel to tangents to the hole edge. Resin composites (three brands) were placed in the hole and polymerized (two light irradiation protocols) at equal radiation exposures. The crack lengths were re-measured at 2 and 10 min after irradiation. Radial tensile stresses due to polymerization contraction at the location of the cracks (σ(crack)) were calculated from the incremental crack lengths and the fracture toughness K(c) of the glass. Contraction stresses at the composite-glass bonded interface (σ(interface)) were calculated from σ(crack) on the basis of the simple mechanics of an internally pressurized thick-walled cylinder. The greater the distance or the shorter the time following polymerization, the smaller was σ(crack). Distance, material, irradiation protocol and time significantly affected σ(crack). Two-step irradiation resulted in a significant reduction in the magnitude of σ(interface) for all resin composites. The contraction stress in soda-lime glass propagated indentation cracks at various distances from the cavity, enabling calculation of the contraction stresses.

A dynamic light scattering approach for monitoring dental composite curing kinetics.

OBJECTIVES: The purpose of this study was to develop and evaluate a dynamic light scattering-based method for monitoring the polymerization reaction of a light activated dental composite. METHODS: Laser light back-scattered from thin disk-shaped composite samples was used to study the curing reaction kinetics. Samples were irradiated simultaneously on opposite surfaces with a 633 nm laser beam and a halogen curing lamp (320, 160, or 100 mW/cm(2)). Dynamic laser speckle patterns were imaged onto a CCD camera at a rate of 32 frames/s for 2 min. The intensity decorrelation rate calculated from sequential speckle patterns was used to assess the rate of motion within the samples during the reaction. RESULTS: Motion within the composite increased immediately upon the onset of light exposure for all trials. This was followed by a brief period characterized by a relatively constant high rate of motion. Finally the rate of motion decreased exponentially. The reaction acceleration, deceleration, and maximum rate were dependent upon the irradiance of the curing light source. SIGNIFICANCE: This method monitors reaction rate and the change in reaction rate at high temporal resolution without contact. Reaction kinetics was shown to begin immediately after light exposure suggesting limited opportunity for viscous flow and stress relief.

Facilitating preceptor and student communication in a dental school teaching clinic.

Teachable moments in the dental clinic are rare and are not adequately exploited. Students often ask simple procedural questions, such as "What should I do next?" A preferred approach is one in which the clinic preceptor helps the dental student collect data about the patient's condition, analyze the data, and consider scientific evidence and the patient's profile in the formulation of diagnoses and treatment plans. The School of Dentistry at Oregon Health & Science University modified the one-minute preceptor method that was developed to instruct medical students in clinical office settings, using the acronym iCARE, which is an abbreviation for microskills that the dental preceptor and student follow when interacting in a dental clinic setting. From the preceptor's perspective, iCARE stands for Inquire, Cultivate, Advise, Reinforce, and Empower; from the student's perspective, iCARE is Initiate, Contribute, Apply, Reflect, and Execute. iCARE enhances the value achieved in preceptor and student interactions, promotes the student's critical thinking, and encourages the student's use of scientific evidence in formulating and supporting patient care decisions in the clinic.

Photoinitiator content in restorative composites: influence on degree of conversion, reaction kinetics, volumetric shrinkage and polymerization stress.

PURPOSE: To determine the influence of rate of polymerization, degree of conversion and volumetric shrinkage on stress development by varying the amount of photoinitiators in a model composite. METHODS: Volumetric shrinkage (with a mercury dilatometer), degree of conversion, maximum rate of reaction (RPmax) (with differential scanning calorimetry) and polymerization stress (with a controlled compliance device) were evaluated. Bis-GMA/TEGDMA (equal mass ratios) were mixed with a tertiary amine (EDMAB) and camphorquinone, respectively, in three concentrations (wt%): high = 0.8/1.6; intermediate = 0.4/0.8 and low = 0.2/0.4. 80 wt% filler was added. Composites were photoactivated (400 mW/cm2 x 40 seconds; radiant exposure = l6 J/cm2). A fourth experimental group was included in which the low concentration formulation was exposed for 80 seconds (32 J/cm2). RESULTS: For the same radiant exposure, conversion, RPmax and stress increased with photoinitiator concentration (P < 0.001). When the low concentration group exposed to 32 J/cm2 was compared with the high and intermediate groups (exposed to 16 J/cm2), RPmax still increased with the photoinitiator concentration between all levels (P < 0.001) but conversion and stress did not vary (P > 0.05). Shrinkage did not vary regardless of the photoinitiator concentration or radiant exposure. For the photoinitiator concentrations used in this study. Polymerization stress was influenced by conversion but not by rate of reaction.

Calculation of contraction stresses in dental composites by analysis of crack propagation in the matrix surrounding a cavity.

OBJECTIVES: Polymerization contraction of dental composite produces a stress field in the bonded surrounding substrate that may be capable of propagating cracks from pre-existing flaws. The objectives of this study were to assess the extent of crack propagation from flaws in the surrounding ceramic substrate caused by composite contraction stresses, and to propose a method to calculate the contraction stress in the ceramic using indentation fracture. METHODS: Initial cracks were introduced with a Vickers indenter near a cylindrical hole drilled into a glass-ceramic simulating enamel. Lengths of the radial indentation cracks were measured. Three composites having different contraction stresses were cured within the hole using one- or two-step light-activation methods and the crack lengths were measured. The contraction stress in the ceramic was calculated from the crack length and the fracture toughness of the glass-ceramic. Interfacial gaps between the composite and the ceramic were expressed as the ratio of the gap length to the hole perimeter, as well as the maximum gap width. RESULTS: All groups revealed crack propagation and the formation of contraction gaps. The calculated contraction stresses ranged from 4.2 MPa to 7.0 MPa. There was no correlation between the stress values and the contraction gaps. SIGNIFICANCE: This method for calculating the stresses produced by composites is a relatively simple technique requiring a conventional hardness tester. The method can investigate two clinical phenomena that may occur during the placement of composite restorations, i.e. simulated enamel cracking near the margins and the formation of contraction gaps.

Alternative photoinitiator system reduces the rate of stress development without compromising the final properties of the dental composite.

OBJECTIVES: Stress development during the polymerization process continues to be a major factor that limits predictability and longevity of resin composite restorations. This study evaluated the effect of the photoinitiator type on the maximum rate of polymerization (R(p)(max)), stress development (final stress and maximum rate, R(stress)(max)), degree of conversion (DC) and cross-link density (CLD) of materials containing camphorquinone (CQ), phenylpropanedione (PPD) or CQ/PPD. MATERIALS AND METHODS: R(p)(max) was evaluated via differential scanning calorimetry (DSC). Contraction force measurement was assessed with a single cantilever device for 5min. The samples were subsequently tested by infrared spectroscopy (FTIR) to evaluate the DC. After, samples were soaked in ethanol to evaluate the swelling coefficient (alpha) as a way to estimate the CLD. The results were analyzed by one-way ANOVA and Tukey's test (p=0.05). RESULTS: CQ showed the highest R(p)(max) and R(stress)(max). PPD produced the lowest DC and the highest alpha. The mixture CQ/PPD produced statistically lower R(p)(max) and R(stress)(max) than CQ alone, but similar DC and CLD. CONCLUSION: CQ/PPD reduced the R(p)(max) and R(stress)(max) without a reduction in DC and CLD. Therefore, the use of alternative photoinitiator systems could be a promising way to reduce the stress developed during the composite's polymerization without affecting the final properties.

Change of properties during storage of a UDMA/TEGDMA dental resin.

The aim of this study was to evaluate the changes in viscoelastic properties of a UDMA-based dental resin as a function of time after initial light exposure. Specimens of a UDMA/TEGDMA (70:30 wt%) resin were irradiated by a visible-light-curing unit. Immediately after the irradiation, the light-cured specimen was stored in the dark for different times from 1 to 120 h at 37 degrees C, and characterized by means of DMA, DSC, and FTIR spectroscopy. The irradiated specimen exhibited a bimodal shape in the form of two rapid declines in log E' corresponding to glass transition with a plateau between the two declines. Two distinct peaks were seen in tan delta versus temperature. The thermal reaction of the incompletely cured sample with residual groups trapped by the fast reaction during irradiation is responsible for the plateau. After storage, significant changes were observed in dynamic mechanical parameters, DSC exotherm, and degree of conversion. Storage modulus continued to increase during the 4 h of storage and leveled off thereafter. Peak heights of tan delta versus temperature were also influenced by storage. Degree of conversion increased from 75 +/- 2% immediately after irradiation to 87 +/- 3% after 120 h storage. The changes of the properties of this dental resin system when stored at 37 degrees C after irradiation are clinically important in terms of stability, durability, and performance after initial polymerization.

Effect of energy density on properties and marginal integrity of posterior resin composite restorations.

OBJECTIVES: The purpose of this study was to determine the minimal extent of cure required by the base of a Class 2 resin composite restoration (Z250, 3M ESPE, St Paul, MN, USA) that allows it to support the rest of the restoration and maintain its marginal seal under simulated clinical conditions. METHODS: Resin composite (Z250, 3M ESPE, St Paul, MN, USA) was placed incrementally or in bulk into Class 2 preparations in extracted human molar teeth and exposed to various light-curing energy densities. The restorations were subjected to 1000 thermal cycles (5-55 degrees C) and 500,000 fatigue cycles from 18 to 85 N using a stainless-steel sphere. Marginal integrity was evaluated using visual rating (ridit analysis) and microleakage. Degree of conversion (DC) and Knoop hardness (KHN) were determined at the occlusal and gingival surfaces using a reusable tooth template with identical preparation dimensions. Percentage of maximum DC and KHN were determined. Mechanical properties were tested in resin composite bars having similar KHN values as the resin composite at the gingival margins. RESULTS: Energy density had a significant effect on gingival marginal defects as determined by ridit analysis but not on microleakage. Water had a significant dissolving effect on gingival margin integrity at very low degrees of conversion and energy densities (4000 mJ/cm2). There was no overall significant effect of thermal-mechanical stressing on gingival marginal defects or microleakage. SIGNIFICANCE: Based on ridit analysis, a recommended lower limit of gingival margin acceptability in the bulk-filled Z250 resin composite restoration was created by 80% of maximum conversion, 73% of maximum hardness and approximately 70% of maximum flexural strength and modulus in the gingival marginal area.

The influence of working cast residual moisture and temperature on the fit of vacuum-forming athletic mouth guards.

STATEMENT OF PROBLEM: The comfort and effectiveness of athletic mouth guards are believed to depend on their degree of fit to oral tissues. Vacuum-forming machines are simpler and less expensive than pressure-forming machines. However, it is thought that vacuum-formed mouth guards often do not exhibit adequate adaptation. PURPOSE: The purpose of this study was to evaluate the effects of cast residual moisture and temperature on the fit of athletic mouth guards made with a vacuum-forming machine. MATERIAL AND METHODS: A metal master model simulating the cross section of the maxillary molar region was used to form 20 working plaster casts. The casts represented 4 (5 specimens each) conditions before the forming of the mouth guard specimens: storing in a wet environment at room temperature and storing in a dry environment at room temperature, 5 degrees C, and 40 degrees C. Mouth guard specimens were fabricated with ethylene vinyl acetate sheets (3.8-mm thick) with the use of a vacuum-forming machine. Test casts were created by pouring hand-mixed type III dental stone into each of the mouth guard specimens. The differences in the sagittal cross-sectional heights at the line angle area of the test casts and the working casts were compared. This was achieved by superimposing their 3-dimensional images scanned by a laser scanner. The air permeability was also measured for the hand-mixed stone casts under wet and dry conditions, the vacuum-mixed stone cast, and the high-strength stone specimen. This was achieved by measuring the volume of transmitted air passing through the specimen in the testing tube. One-way analysis of variance with the Scheffé post hoc test (P <.05) was applied to determine the conditions of the working cast required to achieve the best fit. RESULTS: With regard to the fit of the mouth guard specimens to the working cast, those with dry and heated working casts showed a significantly better fit than those with wet working casts (P<.05). A significantly larger volume of transmitted air was found in the dry stone specimen (P<.05) followed by the dry high-strength stone cast and then the wet stone cast. CONCLUSION: Within the limitations of this study, residual moisture in the working cast was the most critical factor in determining the fit of the mouth guard made by vacuum-forming machines. The best fit was achieved when the working cast was thoroughly dried and its surface temperature was elevated.

Dynamic mechanical analysis of storage modulus development in light-activated polymer matrix composites.

OBJECTIVES: The goal of this study was to evaluate the potential for using dynamic mechanical analysis of tubular geometry in a three-point flexure fixture for monitoring the storage modulus development of a light-activated polymer matrix composite. METHODS: Composite samples were inserted into PTFE tubes and tested in a three-point bend fixture in a dynamic mechanical analyzer (DMA) at 200 Hz with 20 microm amplitude. Samples were light activated for 60s (385 mW/cm(2) at the composite surface) and storage modulus (E') was measured continuously for the seven light-activated composites studied (one microfill, four hybrids and two unfilled resins). Cores of composite were removed from the PTFE sheath after 13.5 min and evaluated with the same parameters in the DMA. A finite element model of the test configuration was created and used to estimate operating parameters for the DMA. Degree of conversion (DC) was measured using micro-Fourier Transform Infrared (FTIR) spectroscopy for the microfilled composite samples and one hybrid 13.5 and 60 min after light activation. RESULTS: The E' for a generic hybrid and microfilled composite was 13,400+/-1100 and 5900+/-200 MPa, respectively, when cured within the tube and then removed and tested in the DMA. DC was 54.6% for the hybrid and 60.6% for the microfill. A linear regression of E' for the sheath and core vs core alone (r(2)=0.986) indicated a linear scaling of the sheath and core values for E' enabling a correction for estimated E' values of the composite core. SIGNIFICANCE: This method estimates the storage modulus growth during light-activated polymerization of highly filled dimethacrylates. Although the approach is phenomenological in that quantitative measurements of E' are not made directly from the DMA, estimates of early polymerization kinetics appear to be validated by three different approaches.