Three methods to measure the photopolymerization kinetics for different radiant emittance and composite type.

Photopolymerization kinetics affects the curing time, degree of conversion, polymerization shrinkage, and mechanical properties of composites. The aim of this study was to compare three methods (temperature, heat flow, and polymerization shrinkage) for photopolymerization kinetics measurement of composites. The photopolymerization kinetics of four composites (2 packable and 2 flowable) were measured with an LED light for 20 s (radiant emittance: 2,100 mW/cm2). For the two packable composites, photopolymerization kinetics was measured with varying the radiant emittance and exposure time. For each measurement method, peak times were determined as the time when maximum temperature rise, heat flow, and shrinkage rate occurred, respectively. The photopolymerization kinetics differed among the measurement methods. The photopolymerization kinetics of composites changed as the radiant emittance and composite type varied. In clinical practice and research on the composite restoration, the kinetics should be considered comprehensively with the complementary use of various measurement methods.

Effect of translucency and absorbance of composite on temperature change during photopolymerization.

This study investigated the effect of translucency and absorbance of conventional (FiltekTM-Z350-XT) and bulk-fill (Tetric®-N-Ceram) composites on temperature change during photopolymerization, using a non-contact infrared sensor. Three shades from each composite were selected to prepare disk-shaped specimens (n=3), which then photopolymerized with LED-light for 20 s. A second light exposure was performed on the photopolymerized specimens. The first peak temperature rise during composite photopolymerization (ΔTtotal), second peak temperature rise by the light (ΔTlight), and net peak temperature rise by composite curing heat (ΔTcomposite) were obtained from the temperature change vs. time curve. The changes in ΔTtotal and ΔTlight with varying the composite shade were greater than those in ΔTcomposite. The conventional composite showed higher ΔTtotal and ΔTlight than bulk-fill composite. ΔTtotal and ΔTlight increased as translucency parameter decreased, and absorbance increased. The potential risk for heat-induced pulpal damage should be considered when selecting a composite shade, especially for deep cavities.

Effect of radiant emittance of an LED curing light on the cuspal deflection of a simulated tooth cavity in bulk-fill composite restoration: A novel simulation method.

In this study, a novel method for simulating human teeth was developed, with which the effect of radiant emittance of an LED curing light on the cuspal deflection was investigated. A mesio-occluso-distal (MOD) cavity was replicated using a heat-pressed ceramic and lost wax technique, and the cuspal compliance and cuspal deflection of the replicated ceramic teeth and extracted human teeth were evaluated. The replicated ceramic teeth were restored using a nano bulk-fill composite and photopolymerized using three different protocols. Data were analyzed with t-test and one-way ANOVA (α=0.05). The cuspal compliance and cuspal deflection of the replicated ceramic teeth and extracted human teeth were similar. Cuspal deflections did not differ significantly among the tested photopolymerization protocols. Thus, the replicated ceramic teeth were an effective simulation of human teeth. During bulk-fill composite restoration of the MOD cavity, cuspal deflection was not affected by changing the radiant emittance of the LED light.

Real-time measurement of transmittance changes during photo-polymerization of conventional and bulk-fill composites.

This study investigated transmittance changes during photo-polymerization of composites in real-time. The transmittance changes of one conventional micro-hybrid, three conventional nano-hybrid, and four bulk-fill composites were measured before, during, and after photo-polymerization, and the maximum rate of transmittance change was compared with that of polymerization shrinkage. A significant difference in transmittance of composite between before and after photo-polymerization was observed. The transmittance of composites except for one bulk-fill composite increased during photo-polymerization. There was a correlation between the maximum rate of transmittance change and the maximum rate of polymerization shrinkage. The transmittance analysis of composites gives very important information to know for the final aesthetic restoration and allows to evaluate polymerization kinetics.

Effects of wall compliance and light-curing protocol on wall deflection of simulated cavities in bulk-fill composite restoration.

BACKGROUND/PURPOSE: Cuspal deflections in composite restoration have been investigated with considering wall compliance of human tooth cavity and light-curing protocol. The purpose of this study was to investigate effects of mold wall compliance and radiant emittance of LED light on the wall deflection of simulated aluminum mold cavities restored with a bulk-fill composite. MATERIALS AND METHODS: Sixty aluminum molds simulating a class II mesio-occluso-distal (MOD) cavity (6 W × 8 L × 4 D mm; W, width; L, length; D, Depth) were prepared and allocated to three groups with varying mold wall thicknesses of 1, 2, and 3 mm. The molds were bulk-filled with a bulk-fill composite and photo-cured. Four light-curing protocols were used: three duty ratios/exposure times: 100%/20 s, 50%/40 s, or an increasing mode (0 → 100%)/40 s with a pulse width modulated (PWM) LED curing light and one 20 s exposure time with a commercial LED light. RESULTS: Mean mold wall deflection at 2000 s decreased with increasing mold wall thickness (1, 2, and 3 mm) (p < 0.05). Wall deflections with 1- and 2-mm-thick molds exhibited no statistically significant differences among light-curing protocols (p > 0.05). However, in the 3-mm-thick mold, wall deflections with low radiant emittance were significantly lower than those with high radiant emittance (p < 0.05). CONCLUSION: In composite restoration of class II MOD cavities, lowering the radiant emittance of LED light can reduce the mold wall deflection only in low compliance cavities.

Effects of cuspal compliance and radiant emittance of LED light on the cuspal deflection of replicated tooth cavity.

The aim was to investigate effects of compliance and radiant emittance on cuspal deflection. A mesio-occluso-distal cavity was replicated using a flowable composite and steel rods with different diameters. To investigate the effect of cuspal compliance on deflection, the replicated tooth and extracted human tooth cavities were bulk-filled with a micro-hybrid composite. The replicated cavities with 2.0-mm-diameter steel rods were restored with bulk-filling of the micro-hybrid or a nano bulk-fill composite and photo-cured with four protocols. The cuspal deflection was the highest in the replicated tooth without steel rod, followed by with 1.0-, 1.5-, and 2.0-mm steel rods, and significantly lower in the human tooth. Cuspal deflections showed no significant differences among light-curing protocols, and that in the micro-hybrid composite were higher than the nano bulk-fill composite. To reduce cuspal deflection of a high compliance cavity, selecting the proper composite based on physical properties is more important than light-curing protocol.

Shockwave application enhances the effect of dentin desensitizer.

OBJECTIVES: The purpose of this study was to develop a new device that can improve the effect of desensitizer using shockwaves and to verify its efficacy. METHODS: A micro-shockwave generator was developed using a piezoelectric actuator (PIA-1000, piezosystem jena GmbH, Jena, Germany), an Arduino Uno microcontroller (Arduino, Torino, Italy), and a high voltage pulser (HVP-1000, piezosystem jena GmbH) at 700 V (400 A) and 100 µs. The occlusal surfaces of 20 extracted human upper and lower third molars without caries or restoration were reduced to expose the occlusal dentin, and the prepared occlusal surfaces were acid-etched with 32% phosphoric acid to remove the smear layer. The tooth specimens were connected to a fluid flow measurement instrument (nanoFlow, IB SYSTEMS, Seoul, Korea), permeability through dentin via dentinal fluid flow (DFF) was measured for 300 s, and the average DFF rate (Baseline DFF rate) was calculated. A desensitizer (SuperSeal, Phoenix Dental, Fenton, MI, USA) was applied to the acid-etched occlusal dentin surface of 10 randomly selected tooth specimens, left for 10 s, and rubbed with a microbrush for 30 s (Group 1). For the remaining teeth, the desensitizer was applied, and a shockwave (100 µm stroke, 10,000 G) was applied for 10 s (2 shots/s) and rubbed with a microbrush for 30 s (Group 2). After desensitizer application, subsequent DFF was measured for 600 s, and the average DFF rate was calculated (post-application DFF rate). DFF was continuously measured in real-time at 25 ±â€¯0.5 ℃ under a hydrostatic pressure of 25 cm. The percentage reduction in DFF rate after desensitizer application (with or without shockwave) was calculated with respect to baseline DFF rate. Data were analyzed with independent t-test (α = 0.05). RESULTS: For all tooth specimens, DFF rate decreased after desensitizer application irrespective of the presence of shockwaves. The percentage reduction in DFF rate of SuperSeal with shockwave (Group 2) was 42.8 ±â€¯19.0%, which was significantly higher than the 26.2 ±â€¯13.6% of the SuperSeal only group (Group 1) (p < 0.05). SIGNIFICANCE: Measurement of DFF change in real-time shows that shockwaves can help reduce dentin permeability beyond that SuperSeal dentin desensitizer produced alone.

Real-time nanoleakage and the flow characteristics of calcium silicate root canal filling materials.

This study aimed to investigate the real-time nanoleakage and flow characteristics of calcium silicate-based (Ca-Si) root canal filling materials. Extracted human teeth (n = 30) were decoronated and standardized in their inner and outer dimensions. After root canal enlargement, the roots were filled with gutta-percha (GP) and AH26 sealer, GP and EndoSeal MTA sealer, or Biodentine. The roots were connected to a Nanoflow device (IB Systems) under hydrostatic pressure (40 cm∙H2O) and fluid flow was traced through the filled roots. Data were detected at the nanoscale twice per second and automatically recorded in units of nL/s. Leakage was quantified as the mean slope until the curve plateaued over time, and all static flow intervals lasting longer than 1 s were analyzed to identify any increase in flow and duration. Data were statistically analyzed using the Kruskal-Wallis test. The calculated leakage values were 0.0670 ± 0.0516 nL/s for GP/AH26, 0.1397 ± 0.1579 nL/s for GP/EndoSeal MTA, and 0.0358 ± 0.0538 nL/s for Biodentine, with no statistically significant differences among the root filling materials (P > 0.05). An analysis of real-time flow data for 1000 s to identify spot trends and the overall tendency of flow until a plateau was reached revealed a stepwise increase in the roots filled with Ca-Si material, whereas the GP/AH26-filled roots showed a linear increase. Real-time measurements under hydrostatic pressure with the Nanoflow device enabled precise fluid flow tracing through the root canal filling material. In terms of nanoleakage, the tested root canal filling materials showed no significant differences, while the real-time flow patterns of roots filled with Ca-Si material showed different characteristics from those of GP/AH26-filled roots.

Effect of pulse-width-modulated LED light on the temperature change of composite in tooth cavities.

OBJECTIVE: The purpose of this study was to investigate the effects of the radiant emittance and cure time of pulse width modulation (PWM)-controlled LED light on the temperature change of composite and dentin. METHODS: Class I cavities (M-D 6mm, B-L 4mm, Depth 2.5mm) were prepared on 30 extracted human molars and vertically sectioned to expose the mesial side of the cavity and tooth. Cavities were filled with Bulk Fill Posterior Restorative (BFP, 3M ESPE) and cured with an LED light. The duty ratio (% of time the light is on) and cure time of the LED light were controlled using an Arduino UNO microcontroller (PWM) as follows (6 groups, n=5): 10%/100 s, 30%/33.3s, 50%/20s, 100%/10s, Increase mode (0→100%)/20s, and Decrease mode (100→0%)/20s. All measurements were performed at 100Hz PWM with the constant total radiant exposure. Thermograms of the specimens were recorded using an infrared thermal camera (VarioCamhr head 700, InfraTec GmbH) for a pre-cure time of 20s, cure time, and a post-cure time of 100s at room temperature of 30±0.5°C. Temperature change data on the composite and dentin surfaces were collected at incremental distances of 0.625mm and 1mm from the top of the cavity to the pulp. Data were statistically analyzed using two-way ANOVA and Tukey's post-hoc test at α=0.05. RESULTS: A rapid temperature increase occurred within the cavity during light curing. The maximum temperature rises (ΔTmax) were observed at 0.625mm apical from the top and middle of the cavity. The ΔTmax ranged from 7.62 to 16.74°C at 0.625mm apical from the top, 4.83 to 11.39°C at the floor of the cavity, and 3.16 to 8.09°C in the dentin 1mm beneath the cavity base. The ΔTmax of composite and dentin increased and the time to reach ΔT=5°C decreased with increasing duty ratio at constant radiant exposure. In the Increase mode, ΔTmax was lower than that of 50%/20s mode. The ΔTmax in the Decrease mode was similar to that of 100%/10s mode. SIGNIFICANCE: The PWM-LED curing light system controlled by a microcontroller provided a useful tool of varying the radiant emittance and cure time with constant radiant exposure to evaluate temperature change of composite and dentin. These result will be helpful to determine proper curing modes with varying radiant emittance of the LED curing light for decreasing temperature change of composite and dentin. At constant radiant exposure and cure times, the Increase mode showed lower and slower temperature rises than the 50%/20s and Decrease mode. Within the limitations of this in vitro study, when radiant exposure is constant, a curing light with lower radiant emittance can induce relatively low thermal transfer, thereby decreasing the risk of pulpal damage.

Effect of pulse width modulation-controlled LED light on the polymerization of dental composites.

OBJECTIVES: The purpose of this study was to investigate the effects of radiant emittance and cure time of pulse width modulation (PWM)-controlled LED light on polymerization shrinkage/stress kinetics and surface hardness of dental composites. METHODS: A conventional (Filtek Z250) and a bulk-fill (Filtek Bulk Fill Posterior; BFP) composite were investigated. The duty ratio (% of time the light is on) and cure time of the LED light were controlled using an Arduino UNO microcontroller (PWM) as follows: 10%/100s, 20%/50s, 30%/33.3s, 40%/25s, 50%/20s, 100%/10s, Increase mode (0→100%)/20s, and Decrease mode (100→0%)/20s at 50Hz. The radiant exposure of each group was constant. Polymerization shrinkage/stress and Vickers hardness (HV) of composites were measured for each curing condition (n=5). Peak shrinkage/stress rate (Rsh/Rst) and time at peak shrinkage/stress rate (Tsh/Tst) were also determined. RESULTS: There was no significant difference in polymerization shrinkage or HV of composites with varying duty ratio. However, polymerization shrinkage stress, Rsh, and Rst increased and Tsh and Tst decreased with increasing duty ratio. The polymerization shrinkage stress and Rst of the Increase mode group were similar to those of the 50% duty ratio group, and the Tst of the Increase mode was delayed. The polymerization shrinkage/stress kinetics of the Decrease mode group were comparable to those of the 100% duty ratio group. Under the same light curing conditions, polymerization shrinkage/stress, Rsh, Rst, and HV of Z250 were higher than those of BFP, and the Tsh and Tst of Z250 were shorter than those of BFP. SIGNIFICANCE: With constant radiant exposure, evaluation of polymerization shrinkage/stress kinetics and their relationships could be performed by a PWM-controlled LED curing light. These results will be helpful to determine proper curing modes with varying radiant emittance of the LED curing light for decreasing polymerization shrinkage stress of dental composites. Within the limitations of this in vitro study, when radiant exposure is constant, polymerization shrinkage stress with low initial radiant emittance can be reduced compared to that with high initial radiant emittance.

Thermographic analysis of the effect of composite type, layering method, and curing light on the temperature rise of photo-cured composites in tooth cavities.

OBJECTIVES: The purpose of this study was to investigate temperature rise in the composite and dentin of a class I cavity in extracted human molars under different restoration conditions, including the use of different composite types, layering methods, and curing lights. METHODS: Open occlusal cavities were prepared on 28 extracted human molars. A conventional (Filtek Z250) and a bulk-fill (Filtek Bulk Fill Posterior; BFP) composite were used to restore the preparations. BFP was incrementally layered or bulk-filled. Bulk-filled BFP was cured with two different lights, the Elipar S10 and the BeLite. Each layer was illuminated for 20s, while thermograms of the specimens were recorded for 100s using an infrared thermal camera. Temperature changes on the composite and dentin surfaces were obtained at points of interest (POI) pertaining to successive incremental distances of 0.75mm from the top of the cavity to the pulp. The polymerization kinetics of each composite was determined using photo-differential scanning calorimetry. RESULTS: The greatest temperature rise was observed 0.75mm apical from the top of the cavity. All groups showed over 6°C maximum temperature rise (ΔTmax) at the pulpal side of the dentin. Upon curing, Z250 reached ΔT=5°C faster than BFP; however, ΔTmax of the two composites were comparable at any POI. Bulk filling showed greater ΔTmax than incremental filling at 0.75mm apical from the top and in the middle of the cavity. The Elipar S10 light generated faster temperature changes in the curing composite at all recorded positions throughout the depth of the cavity and greater ΔTmax in all POIs compared to BeLite. SIGNIFICANCE: Real-time thermographic analysis demonstrated that the composite type and layering method did not influence the temperature rise at the pulpal side of dentin during composite restoration of an occlusal preparation in a tooth. The amount and initial rate of temperature increase was most affected by the radiant exposure of the light curing unit. Within the limitations of this in vitro study, when irradiation time is constant, a curing light with higher radiant power can induce relatively high thermal transfer, thereby increasing the risk of pulpal damage.

Evaluation of dentin tubule occlusion after laser irradiation and desensitizing agent application.

PURPOSE: To evaluate the effects of lasers (Nd:YAG and Er:YAG) and of topical desensitizing agents on dentin tubule occlusion by measuring real-time dentin fluid flow (DFF). METHODS: 32 molars were prepared with V-shape cavity at the cervical area, acid-etched, water rinsed, blotted dry, and treated with (1) Nd:YAG laser; (2) Er:YAG laser; (3) SuperSeal, a desensitizing agent; (4) ClinproXT, a resin-modified glass-ionomer (RMGI) varnish (n = 8 each). A real-time fluid flow measuring instrument (nano-Flow) was used to measure the DFF throughout the procedures. The DFF rates before and after the treatment were compared. Moreover, the surface topography of dentin tubules after each desensitizing method was examined using SEM. RESULTS: DFF varied among the groups. The DFF rate was significantly reduced after laser irradiation/application of the desensitizing agents (P < 0.05). ClinproXT showed the greatest reduction of DFF rate (71.9%), followed by the SuperSeal (34.8%) and laser groups (P< 0.05). However, there was no significant difference between the Nd:YAG (24.1%) and Er:YAG (20.6%) groups (P > 0.05). In SEM images, narrowed dentin tubules were observed in both lased groups and SuperSeal group. In the ClinproXT group, the occluded dentin tubules by the RMGI covering were observed.

Real-Time Analysis of Temperature Changes in Composite Increments and Pulp Chamber during Photopolymerization.

OBJECTIVE: The aim of this study was to evaluate the temperature change at various sites within the composite and on the pulpal side of dentin during polymerization of two composite increments. MATERIALS AND METHODS: Class I cavities prepared in third molars were restored in two composite increments (n = 5). Temperatures were measured for 110 s using eight thermocouples: bottom center of cavity (BC), top center of 1st increment (MC), top center of 2nd increment (TC), bottom corner of cavity (BE), top corner of 1st increment (ME), top corner of 2nd increment (TE), pulpal side of dentin (PD), and center of curing light guide tip (CL). RESULTS: Maximum temperature values (°C) measured during polymerization of 1st increment were MC (59.8); BC (52.8); ME (51.3); CL (50.7); BE (48.4); and PD (39.8). Maximum temperature values during polymerization of 2nd increment were TC 58.5; TE (52.6); MC (51.7); CL (50.0); ME (48.0); BC (46.7); BE (44.5); and PD (38.8). CONCLUSION: Temperature at the floor of the cavity was significantly higher during polymerization of 1st increment compared to 2nd increment. Temperature rise was higher at the center than at the corner and at the top surface than at the bottom surface of each increment.

Temperature changes in bulk-fill resin composite during photopolymerization.

PURPOSE: To investigate the temperature changes at multiple sites within bulk-fill resin composites and in the pulp chamber during photopolymerization in the tooth cavity. METHODS: Class 1 cavities (n = 5) prepared in extracted third molars were filled with SureFil SDR Flow, a newly developed bulk-fill composite. After securing the specimens in a water bath at 36.5 degrees C, eight thermocouples were used to measure the temperature at the bottom center (BC), middle center (MC), top center (TC), bottom edge (BE), middle edge (ME), and top edge (TE) of the restoration; the pulpal aspect of the dentin (PD); and the center of the curing light tip (CL) during photopolymerization. RESULTS: The maximum temperature values (degrees C) differed among the measurement sites. TC exhibited the greatest temperature increase (72.3 ± 2.4), followed by MC, BC, TE, TE, ME, CL, and BE. The lowest temperature was observed at PD (41.1 ± 1.9). The peak temperatures within the composite were observed during the early stage of light-curing, while CL and PD exhibited the highest temperature at the end stage of light-curing.

Performance of universal adhesives on bonding to leucite-reinforced ceramic.

BACKGROUND: This study aimed to investigate the microshear bond strength of universal bonding adhesives to leucite-reinforced glass-ceramic. METHODS: Leucite-reinforced glass-ceramic blocks were polished and etched with 9.5% hydrofluoric acid for 1 min. The specimens were assigned to one of four groups based on their surface conditioning (n = 16): 1) NC: negative control with no further treatment; 2) SBU: Single Bond Universal (3M ESPE); 3) ABU: ALL-BOND Universal (Bisco); and 4) PC: RelyX Ceramic Primer and Adper Scotchbond Multi-Purpose Adhesive (3M ESPE) as a positive control. RelyX Ultimate resin cement (3M ESPE) was placed on the pretreated ceramic and was light cured. Eight specimens from each group were stored in water for 24 h, and the remaining eight specimens were thermocycled 10,000 times prior to microshear bond strength evaluation. The fractured surfaces were examined by stereomicroscopy and scanning electron microscopy (SEM). RESULTS: After water storage and thermocycling, the microshear bond strength values decreased in the order of PC > SBU and ABU > NC (P < 0.05). Thermocycling significantly reduced the microshear bond strength, regardless of the surface conditioning used (P < 0.05). Cohesive failure in the ceramic and mixed failure in the ceramic and resin cement were observed in the fractured specimens. The percentage of specimens with cohesive failure after 24 h of water storage was: NC (50%), SBU (75%), ABU (75%), and PC (87%). After thermocycling, the percentage of cohesive failure in NC decreased to 25%; however, yet the percentages of the other groups remained the same. CONCLUSIONS: Although the bond strength between resin and hydrofluoric acid-etched glass ceramic was improved when universal adhesives were used, conventional surface conditioning using a separate silane and adhesive is preferable to a simplified procedure that uses only a universal adhesive for cementation of leucite-reinforced glass-ceramic.

Comparison of photopolymerization temperature increases in internal and external positions of composite and tooth cavities in real time: Incremental fillings of microhybrid composite vs. bulk filling of bulk fill composite.

OBJECTIVES: This study evaluated temperature increases in the composite and pulpal side of dentin from incremental and bulk fillings in composite restorations. METHODS: Class-1 cavities (5 mm × 4 mm × 3 mm) were prepared in ten extracted third molars, filled with composite, and restored with two separate horizontal layers of Filtek Z250 (3M ESPE) in the incremental group or a single layer of SureFil SDR Flow (Dentsply) in the bulk-fill group (n=5). After placing the specimens in a 36.5°C water bath, temperatures were measured with eight thermocouples at the bottom center (BC), middle center (MC), top center (TC), bottom corner (BE), middle corner (ME), and top corner (TE) of the cavity, at the pulpal side of the dentin within the pulp chamber (PD), and in the curing light (CL) tip during light curing at 750 mW/cm(2) for 20s and then analyzed with one-way analysis of variance and Tukey's HSD tests (α=0.01). RESULTS: Maximum temperatures ranged from 39.0°C (PD 1st increment) to 60.0°C (MC 1st increment) in the incremental group and from 42.0°C (PD) to 74.9°C (TC) in the bulk-fill group. In the incremental group, temperatures were similar between the 1st and 2nd increments, except at MC and BC. CONCLUSIONS: Bulk-fill group exhibited a greater increase in temperature during composite restoration. Regardless of the filling technique, more heat was generated at the center than at the corner and at the top than at the bottom of the composite. PD temperatures increased by 3.1°C and 5.5°C in the incremental group and bulk-fill group, respectively. CLINICAL SIGNIFICANCE: Although bulk fillings save clinical chair time, clinicians should be aware of the greater heat that is generated with increasing amounts of composites during polymerization, which can jeopardize the pulpal health, especially when a large and deep cavity is being restored.

Epigenetics: general characteristics and implications for oral health.

Genetic information such as DNA sequences has been limited to fully explain mechanisms of gene regulation and disease process. Epigenetic mechanisms, which include DNA methylation, histone modification and non-coding RNAs, can regulate gene expression and affect progression of disease. Although studies focused on epigenetics are being actively investigated in the field of medicine and biology, epigenetics in dental research is at the early stages. However, studies on epigenetics in dentistry deserve attention because epigenetic mechanisms play important roles in gene expression during tooth development and may affect oral diseases. In addition, understanding of epigenetic alteration is important for developing new therapeutic methods. This review article aims to outline the general features of epigenetic mechanisms and describe its future implications in the field of dentistry.

Polymerization shrinkage, modulus, and shrinkage stress related to tooth-restoration interfacial debonding in bulk-fill composites.

OBJECTIVES: The aim of the present study was to measure the polymerization shrinkage, modulus, and shrinkage stress of bulk-fill and conventional composites during polymerization and to investigate the relationship between tooth-composite interfacial debonding and shrinkage stress of the composites. METHODS: Polymerization shrinkage, dynamic modulus, and shrinkage stress of two high-viscosity bulk-fill (SonicFill (SF)/Tetric N-Ceram Bulk-Fill (TNB)) and two low-viscosity bulk-fill composites (Filtek Bulk-Fill (FB)/SureFil SDR Flow (SDR)) as well as one high-viscosity conventional (Filtek Z250 (Z250)) and one low-viscosity conventional composite (Filtek Z350 XT Flowable (Z350F)) were measured using custom-made instruments. Acoustic emission (AE) analysis was performed to evaluate the tooth-composite interfacial debonding during polymerization of the composites in Class 1 cavities on extracted third molars. RESULTS: The low-viscosity composites exhibited higher shrinkage and lower modulus than the high-viscosity composites. Polymerization shrinkage at 10 min ranged between 2.05% (SF) and 3.53% (Z350F). Polymerization shrinkage stress values at 10 min ranged between 1.68MPa (SDR) and 3.51MPa (Z350F). The number of AE events was highest in Z350F and lowest in SDR. CONCLUSIONS: Composites that exhibited greater polymerization shrinkage stress generated more tooth-composite interfacial debonding. In contrast to similar outcomes among the high-viscosity composites (conventional: Z250, bulk-fill: TNB and SF), the low-viscosity bulk-fill composites (FB and SDR) demonstrated better results in terms of polymerization shrinkage stress and tooth-composite interfacial debonding than did the low-viscosity conventional composite (Z350F). CLINICAL SIGNIFICANCE: Despite the better performance by some of the bulk-fill composites, clinicians should be aware that the bulk-fill composites are not perfect substitutes for conventional composites.

Comparison of the rheological properties of four root canal sealers.

The flowability of a root canal sealer is clinically important because it improves the penetration of the sealer into the complex root canal system. The purpose of this study was to compare the flowabilities of four root canal sealers, measured using the simple press method (ISO 6876), and their viscosities, measured using a strain-controlled rheometer. A newly developed, calcium phosphate-based root canal sealer (Capseal) and three commercial root canal sealers (AH Plus, Sealapex and Pulp Canal Sealer EWT) were used in this study. The flowabilities of the four root canal sealers were measured using the simple press method (n=5) and their viscosities were measured using a strain-controlled rheometer (n=5). The correlation between these two values was statistically analysed using Spearman's correlation test. The flow diameters and the viscosities of the root canal sealers were strongly negatively correlated (ρ=-0.8618). The viscosity of Pulp Canal Sealer EWT was the lowest and increased in the following order: AH Plus

Acoustic emission analysis of the effect of simulated pulpal pressure and cavity type on the tooth-composite interfacial de-bonding.

OBJECTIVE: The aim of this study was to evaluate the influence of in vitro pulpal pressure and cavity type on the tooth-composite bonding interface by means of acoustic emission (AE) analysis. METHODS: Classes I and II cavities on extracted third molars were prepared and assigned to four groups of seven teeth each: (1) direct composite restoration without simulated pulpal pressure (SPP) in class I cavity, (2) direct composite restoration with SPP in class I cavity, (3) direct composite restoration without SPP in class II cavity, (4) direct composite restoration with SPP in class II cavity. The teeth were restored with Filtek Z250 composite and Adper Scotchbond Multi-Purpose adhesive system (3M ESPE, St. Paul, MN, USA). AE events were recorded for 2000s during light-curing. Groups 2 and 4 were subjected to 20 cm H2O hydrostatic pressure throughout the procedures. The data were analyzed with two-way ANOVA. After the AE test, teeth were sectioned longitudinally in mesio-distal direction, the tooth-composite interface was examined using SEM. RESULTS: SPP in Groups 2 (4.57 ± 1.40) and 4 (3.43 ± 1.13) yielded significantly higher AE events number than those of Groups 1 (3.43 ± 1.51) and 3 (1.71 ± 0.95) where the SPP was not applied (p<0.05). The number of AE events of class I cavity in Groups 1 and 2 were significantly higher than those of class II cavity in Groups 3 and 4 (p<0.05). SEM examination showed that all groups had intact enamel-composite interface, while micro-gaps were observed at the dentin-composite interface, mainly at the pulpal floor of the cavity. The class I cavities with SPP in Group 2 showed wider gaps more frequently than class II cavities without SPP in Group 3. SIGNIFICANCE: The SPP and class I cavity with high C-factor triggered more AE events, confirming its negative impact on the bonding interface.