Synthesis and characterisation of microcapsules for self-healing dental resin composites.

AIM: The purpose of this study was to i) synthesise TEGDMA-DHEPT microcapsules in a laboratory setting; ii) characterise the resultant microcapsules for quality measures. MATERIALS & METHODS: Microcapsules were prepared by in situ polymerization of PUF shells. Microcapsules characterisation include size analysis, optical and SEM microscopy to measure the diameter and analyse the morphology of PUF microcapsules. FT-IR spectrometer evaluated microcapsules and benzyl peroxide catalyst polymerization independently. RESULT: Average diameter of TEGDMA-DHEPT microcapsules was 120 ± 45 µm (n: 100). SEM imaging of the capsular shell revealed a smooth outer surface with deposits of PUF nanoparticles that facilitate resin matrix retention to the microcapsules upon composite fracture. FT-IR spectra showed that microcapsules crushed with BPO catalyst had degree of conversion reached to 60.3%. CONCLUSION: TEGDMA-DHEPT microcapsules were synthesised according to the selected parameters. The synthesised microcapsules have a self-healing potential when embedded into dental resin composite as will be demonstrated in our future work.

The effect of water storage on nanoindentation creep of various CAD-CAM composite blocks.

BACKGROUND: To study the effect of water storage (3 months) on the creep deformation of various CAD-CAM composite structures at the nanoscale and compare it to that at the macroscale. METHODS: Seven CAD-CAM blocks were investigated: five resin-composite blocks (RCB), one polymer-infiltrated ceramic network (PICN) block, and one ceramic-filled polyetheretherketone (PEEK) block. Specimens of each material (n = 6) were separated into two groups (n = 3) according to their storage conditions (24 h dry storage at 23˚C and 3 months storage in 37˚C distilled water). Nano-indentation creep measurements were undertaken (creep depth measured in µm) using a nanoindenter (Nanovea) equipped with Berkovich three-sided pyramidal diamond tip. The machine was set for the chosen parameters: a load of 20 gf, a pause of 20 s, and the material type. Thirty indentations on 3 samples were made for each material for each test. Data were analysed using two-way ANOVA followed by one-way ANOVA and Bonferroni post hoc tests and independent t-test (< 0.05) for comparisons between the materials. RESULTS: The nanoindentation creep depth after 24 h storage ranged from 0.09 to 0.33 µm and increased after 3 months storage in distilled water to between 0.28 and 3.46 µm. There was a statistically significant difference in nanoindentation creep behaviour between the two storage conditions for each investigated material (independent t-test) and between all materials (Bonferroni post hoc). There was a non-significant negative correlation between nanoindentation creep (µm) and filler weight% at 24 h dry storage but a significant correlation at 3 months of water storage. A further non-significant positive correlation between nanoindentation creep (µm) and bulk compressive creep (%) was found. CONCLUSION: The PICN material showed superior dimensional stability in terms of nanoindentation creep depth in both storage conditions. Other composite blocks showed comparable performance at 24 h dry condition, but an increased nanoindentation creep upon water storage.

Analysis of the effectiveness of the fiber-reinforced composite lingual retainer: A systematic review and meta-analysis.

INTRODUCTION: Orthodontic fixed retainers are preferred as they depend less on patient compliance. Recently, researchers tried to use fiber-reinforced composite (FRC) to replace the multistranded stainless-steel wire (MSW) of the fixed retainers to enhance the mechanical properties and esthetics. This systematic review aimed to analyze the effectiveness of the FRC retainers. METHODS: We searched the electronic databases (May 1, 2021), including Medline, the Cochrane Library, EMBASE, PubMed, Web of Science, and CINAHL. We applied no language or date restrictions in the searches of the databases. Only randomized controlled trials (RCTs) and prospective clinical controlled trials were included. The revised Cochrane risk of bias tool for randomized trials and risk of bias in nonrandomized studies of interventions were used to evaluate the risk of bias in RCTs and non-RCTs, respectively. The outcomes were pooled using Review Manager 5.4. The primary outcome of this review was teeth relapse, and the secondary outcomes were bonded retainer failure rate, adverse effect on oral health, and patient's satisfaction. RESULTS: Eleven out of 99 studies, which included 873 participants, were used in this review, with the follow-up ranging from 6 months to 6 years. Ten studies compared the FRC retainers with MSW retainers, and 1 study compared FRC retainers with a different fiber material. Ten studies were RCT, and 1 was non-RCT. There was 0.39 less relapse with the FRC retainers than with MSW retainers (mean difference, -0.39; 95% confidence interval [CI], -0.41 to -0.37; P <0.00001). There was no statistically significant difference in the failure rate between the FRC and MSW with the whole retainer as an outcome unit risk ratio of 1.72 (95% CI, 0.57-5.14; P = 0.33) or with the teeth an as outcome unit risk ratio of 0.85 (95% CI, 0.47-1.52; P = 0.58). There was insufficient evidence to conduct the meta-analysis of the adverse effect on oral health and patient satisfaction. CONCLUSIONS: Low-quality evidence is available to suggest that the effectiveness of the FRC is comparable to the MSW with no significant difference in the failure rate. However, we have very low certainty on these results. It is worth conducting future robust clinical studies to assess the effectiveness of FRC retainers with long follow-up.

Effect of polymerisation protocols on water sorption, solubility and hygroscopic expansion of fast-cure bulk-fill composite.

OBJECTIVE: This study examines the effect of two light-curing protocols from a LED polywave light curing unit (LCU) on water sorption, solubility, and hygroscopic expansion of fast and conventional bulk-fill resin-based composites (RBCs) aged in distilled water for 120 d. METHODS: Three bulk-fill RBCs materials were studied: Tetric PowerFill® (fast photo-polymerised composite) (TPF), Tetric EvoCeram bulk-fill (EVO), and GrandioSo x-tra bulk-fill (GSO) (conventional photo-polymerised composites). Specimens were prepared within a 3D-printed resin mold (8-mm diameter x 4-mm height) and light-cured from one side only with 2 modes of polywave LCU (Bluephase® PowerCure): 3 s mode and for 20 s in "Standard" mode. Water sorption and solubility were measured at fixed time intervals for 120 d of distilled water storage, then reconditioned to dry to measure desorption for 75 d, all at 37 ± 1 °C. Hygroscopic (volumetric) expansion was recorded at the same time intervals up to 120 d. Data were analysed through SPSS using Two-way ANOVA, One-way ANOVA, independent t-tests, and Tukey's post-hoc correction tests (p < 0.05). RESULTS: TPF, when irradiated for 3 s demonstrated minimal water sorption (0.83%), solubility (1.01 µg/mm3), and least volumetric expansion (1.64%) compared to EVO and GSO. While EVO showed the highest water sorption (1.03%) and solubility (1.95 µg/mm3) at 3 s. GSO had the lowest sorption (0.67%) and (0.56%) in 3 s and 20 s protocols, respectively. Nevertheless, all the sorption and solubility data were within the ISO 4049 limits. SIGNIFICANCE: For TPF, fast (3 s) polymerisation did not increase either water sorption or solubility, compared with 20 s irradiation. However, with the two comparative bulk-fill composites, fast cure increased water sorption by 15-25% and more than doubled solubility. These findings were consistent with the lesser volumetric expansions observed for Tetric PowerFill at both the fast and standard protocols, indicating its relative stability across polymerisation protocols.

Properties of model E-glass fiber composites with varying matrix monomer ratios.

OBJECTIVE: To evaluate properties of fiber-reinforced-composites (FRC) containing Bis-EMA/UDMA monomers but identical dispersed phase (60% wt BaSi glass power +10% wt E-glass fibre). METHODS: A control (Group A), monomer mixture comprising 60% Bis-GMA, 30% TEGDMA, and 10% PMMA (typical FRC monomers) was used. The following monomer mass fractions were mixed: 50% bis-GMA plus 50% of different ratios of Bis-EMA+UDMA to produce consistent formulations (Groups B-E) of workable viscosities was also studied. Flexural strength (FS), fracture toughness (KIC), water sorption (SP), solubility (SL) and hygroscopic expansion (HE) were measured. FS and KIC specimens were stored for 1, 7 d, and 30 d in water at 37 °C. SP/SL specimens were water-immersed for 168d, weighed at intervals, then dried for 84 d at 37 °C. To analyze differences in FS, and KIC, a two-way ANOVA and Tukey post-hoc tests (α = 0.05) were conducted. For SP/SL, and HE, one-way ANOVA with subsequent Tukey post-hoc tests (α = 0.05) were utilized. RESULTS: FS and KIC for groups A, D, E decreased progressively after 1 d. Groups B and C (highest amounts of Bis-EMA) did not decrease significantly. The modified matrix composites performed significantly better than the control group for SP and HE. The control group outperformed the experimental composites only for SL with up to 250% higher SL for group E (6.9 µg/mm) but still below the maximum permissible threshold of 7.5 µg/mm. SIGNIFICANCE: EXPERIMENTAL: composites with highest amounts of Bis-EMA showed improved hydrolytic stability and overall enhancement in several clinically-relevant properties. This makes them potential candidates for alternative matrices to a semi-interpenetrating network in fiber-reinforced composites.

Bond Strength, Microleakage, Microgaps, and Marginal Adaptation of Self-adhesive Resin Composites to Tooth Substrates with and without Preconditioning with Universal Adhesives.

PURPOSE: This study investigated and compared the bond strengths, microleakage, microgaps, and marginal adaptation of self-adhesive resin composites (SAC) to dentin with or without universal adhesives. MATERIALS AND METHODS: Dentin surfaces of 75 molars were prepared for shear and microtensile bond strength testing (SBS and µTBS). Silicon molds were used to build up direct restorations using the following materials to form 5 groups: 1. Surefil One; 2. Prime&Bond active Universal Adhesive + Surefil One; 3. Vertise Flow; 4. OptiBond Universal + Vertise Flow; 5. Scotchbond Universal + Filtek Z500 (control group). Bonded specimens were thermocycled 10,000x before being tested either for SBS or µTBS using a universal testing machine at a crosshead speed of 0.5 mm/min. Direct mesial and distal class-II cavities were created on 100 sound premolars, with the gingival margin of distal cavities placed below CEJ and restored according to the five groups. After thermocycling, microleakage scores were assessed following immersion of restored premolars in 2% methylene blue dye for 24 h, while marginal gaps and adaptation percentages were investigated on epoxy resin replicas under SEM at magnifications of 2000X and 200X, respectively. Results were statistically analyzed with parametric and non-parametric tests as applicable, with a level of significance set at α = 0.05. RESULTS: Bond strengths, microleakage scores, microgaps, and percent marginal adaptation of Surefil One and Vertise Flow were significantly (p < 0.001) inferior to the control group. Dentin preconditioning with universal adhesives significantly increased the study parameter outcomes of Surefil One and Vertise Flow, yet they were still significantly below the performance of the control group. CONCLUSION: Conventional resin composite outperformed the SAC whether applied solely or in conjunction with their corresponding universal adhesives.

Guidance on the assessment of biocompatibility of biomaterials: Fundamentals and testing considerations.

BACKGROUND: Assessing the biocompatibility of materials is crucial for ensuring the safety and well-being of patients by preventing undesirable, toxic, immune, or allergic reactions, and ensuring that materials remain functional over time without triggering adverse reactions. To ensure a comprehensive assessment, planning tests that carefully consider the intended application and potential exposure scenarios for selecting relevant assays, cell types, and testing parameters is essential. Moreover, characterizing the composition and properties of biomaterials allows for a more accurate understanding of test outcomes and the identification of factors contributing to cytotoxicity. Precise reporting of methodology and results facilitates research reproducibility and understanding of the findings by the scientific community, regulatory agencies, healthcare providers, and the general public. AIMS: This article aims to provide an overview of the key concepts associated with evaluating the biocompatibility of biomaterials while also offering practical guidance on cellular principles, testing methodologies, and biological assays that can support in the planning, execution, and reporting of biocompatibility testing.

Luting laminate veneers: Do resin-composites produce less polymerization stress than resin cements?

OBJECTIVES: Regular composites could produce less polymerization stress than resin cements when luting laminate veneers but there is no proper evidence to support this theory. The current study aimed to determine the degree of conversion, volumetric shrinkage, polymerization stress and the resultant elastic moduli of materials currently used for adhesive cementation and to determine possible correlations. METHODS: The study considered (i) regular resin composites (Admira Fusion, Gradia, Grandioso, Palfique, Sirius Z, Viscalor and Z100) at room and pre-warmed (PW) at 69ºC, (ii) flowable composites (Sigma Flow and Grandioso Flow); (iii) solely light-activated cements (AllCem Veneer, Variolink Esthetic and RelyX Veneer); and (iv) one dual-activated resin cement (SpeedCEM). Degree of conversion (DC, n = 3) was accessed with FTIR 1 h after irradiation. Bonded-disk and Bioman II instruments were used to access polymerization shrinkage strain and shrinkage stress, respectively, for 60 min at 23 ± 1◦C (n = 3). The elastic modulus was determined by 3-point bending flexural test (n = 6). The results were submitted to analyse s of variance, Tukey's, and correlation tests. RESULTS: For regular composites, the pre-warming did not affect DC, shrinkage and modulus but significantly increased the stress magnitude. Correlation tests indicated a significant relationship only between stress and polymerization shrinkage (r = 0.811343). SIGNIFICANCE: Regular composites can produce less polymerization stress than resin cements when luting laminate veneers. Polymerization stress was dependent on the shrinkage magnitude, but not on the degree of conversion nor the elastic modulus.

Physical analysis of an acrylic resin modified by metal and ceramic nanoparticles.

BACKGROUND: Nanoparticles (NPs) have gained significant attention in various fields due to their unique properties and potential applications. Polymethyl methacrylate (PMMA) is an acrylic resin widely used in dentistry and medicine. However, the effect of different types of NP fillers on the physical properties of PMMA-based resins has not been thoroughly explored in the literature. OBJECTIVES: The present study aimed to evaluate the effects of 3 different types of NP fillers on the physical properties of an experimental PMMA-based resin as a function of the NP content and concentration. MATERIAL AND METHODS: Ten groups (n = 10) were designed. The specimens were composed of an acrylic resin, silicon dioxide (SiO2), cerium dioxide (CeO2), and titanium dioxide (TiO2) at the following ratios (wt%): group 1 (G1) - control; group 2 (G2) - 0.5% SiO2; group 3 (G3) - 1% SiO2; group 4 (G4) - 3% SiO2; group 5 (G5) - 0.5% CeO2; group 6 (G6) - 1% CeO2; group 7 (G7) - 3% CeO2; group 8 (G8) - 0.5% TiO2; group 9 (G9) - 1% TiO2; and group 10 (G10) - 3% TiO2. Transmission electron microscopy (TEM) was used to assess the quality of NP dispersion. Thermal stability was assessed with thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC). The effects of the abovementioned NPs on the properties of the resin were evaluated using the Archimedes principle for density, the Vickers hardness (VH) test and the impact strength (IS) test. Data analysis employed the oneand two-way analysis of variance (ANOVA), followed by Duncan's post hoc test at a significance level of 0.05. RESULTS: Transmission electron microscopy showed partial NP dispersion. All types of NPs enhanced the mechanical properties of the acrylic resin except for IS, which was similar to that of the control group. Among the types of NPs, irrespective of the weight percentage, CeO2 showed higher thermal stability and higher IS for 0.5 wt% and 1 wt% as compared to other groups, as well as the highest values of density at 0.5 wt%, 1 wt% and 3 wt%. Titanium oxide at 1 wt% presented a higher VH as compared to other groups. The fracture pattern was the same for all groups. CONCLUSIONS: Incorporating the tested NPs into the acrylic resin resulted in enhanced physical properties, primarily attributed to a lower NP content.

Properties of A Model Self-Healing Microcapsule-Based Dental Composite Reinforced with Silica Nanoparticles.

AIM: The purpose of this study was to evaluate the mechanical properties of an experimental self-healing dental composite model (SHDC) composed of SiO2 nanoparticles with varying percentages of triethylene glycol dimethacrylate (TEGDMA) monomer and N,N-dihydroxyethyl-p-toluidine (DHEPT) amine microcapsules. MATERIALS AND METHODS: Microcapsules were prepared by in-situ polymerisation of PUF shells, as explained in our previous work. The model SHDC included bisphenol A glycidyl dimethacrylate (Bis-GMA:TEGDMA) (1:1), 1 wt% phenyl bis(2,4,6-trimethylbenzoyl) phosphine oxide (BAPO), 0.5 wt% benzoyl peroxide (BPO) catalyst, 20 wt% silanised silica dioxide (SiO2) (15 nm) and (0, 2.5, 5, 7.5, 10 wt%) of microcapsules (120 ± 45 µm). Light transmission, hardness, degree of conversion (DC), flexural strength and elastic modulus of the SHDC model were measured. RESULTS: The degree of conversion of the SHDC ranged from 73 to 76% 24 h after polymerisation. Hardness measurements ranged from 22 to 26 VHN (p > 0.05); however, the flexural strength was adversely affected from 80 to 55 MPa with increasing microcapsules of up to 10 wt% in the composites (p < 0.05). CONCLUSION: Only flexural strength decreased drastically ~30% with increasing microcapsules (>10 wt%) in the composites. All other measured properties were not significantly affected. Accordingly, we recommend a stronger composite material that could be created by increasing the filler content distribution in order to achieve a hybrid self-healing composite with enhanced mechanical properties.

Influence of curing modes on conversion and shrinkage of dual-cure resin-cements.

OBJECTIVE: To explore the effect of curing modes of dual-cure resin cements on their degree of conversion (DC) and polymerization shrinkage (PS) over specific post-activation periods. METHODS: Five self-adhesive (PANAVIA SA, RelyX Universal Resin, RelyX Unicem 2, Bifix SE, and SpeedCEM Plus) and three conventional (PANAVIA V5, Nexus Third Generation, and RelyX Ultimate Universal) dual-cure resin cements were studied. Four specimens (n = 4) were made per curing mode (light/self-cure) to measure either DC or PS. FTIR was utilized to measure real-time DC (%) over 24 h. The Bonded Disk method was used to measure shrinkage at 23 °C over 1 h. The data were analyzed using one-way ANOVA, Tukey post-hoc tests and independent/ paired sample t-tests (a = 0.05). RESULTS: After 1 h post-activation, the DC of light-cured (LC) specimens ranged between 66.6% and 77.4%, whereas for self-cured (SC) specimens DC ranged between 44.4% and 73.2%. After 24 h, the DC of LC specimens ranged between 74.8% and 82.4% and between 62.7% and 81.7% for SC specimens. After 24 h, the DC of three cements (BSE, PV5, and RXU) were comparable between their curing modes (p > 0.05), whereas five cements (CEM, NX3, PSA, RXU2, RXL) had significantly lower DC for SC compared to LC specimens (p < 0.05). After 1 h post-activation, shrinkage ranged between 5.9% and 8.5% for LC and between 4.9% and 8.3% for SC specimens. Most cements were not significantly different between curing modes. However, light-cured PAS, RXL and RXU2 had significantly higher shrinkage (p < 0.05). After 1 h post-activation, a strong positive correlation existed between conversion and shrinkage (LC: r2 = 0.95 and SC: r2 = 0.93). SIGNIFICANCE: Whenever light access is possible, light-curing of resin-cements remains beneficial to the overall efficacy of their conversion and thus all factors that depend on that. Conversion and shrinkage behavior are intrinsically important factors in clinical selection of resin-cement products.

Influence of curing modes on monomer elution, sorption and solubility of dual-cure resin-cements.

OBJECTIVE: To explore the effect of two curing modes, for dual-cure resin cements, on their monomer elution, water sorption and solubility after 30 d water storage and 30 d dry reconditioning. METHODS: Eight dual-cure resin-cements were investigated (Bifix SE, Nexus Third Generation, PANAVIA SA, PANAVIA V5, RelyX Ultimate Universal, RelyX Unicem 2, RelyX Universal and SpeedCEM Plus). Six disk-shaped specimens were made per curing mode: light-cure (LC) versus self-cure (SC) to measure amounts of eluted monomers after 30 d of water storage at 37 °C. Ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC MS/MS) was performed to identify and quantify three eluted monomers (Bis-GMA, UDMA and TEGDMA). Water sorption/ solubility specimens were prepared according to ISO 4049. Specimens from each curing mode (LC/SC) were immersed separately in distilled water for 30 d and then reconditioned for 30 d; all at 37 °C. Mass change was measured at different time intervals. Data were analyzed via one-way ANOVA, Tukey post-hoc tests and independent sample t-tests (α = 0.05). RESULTS: After 30 d of water storage, the three monomers Bis-GMA, UDMA and TEGDMA were detected in water. All monomers showed a variable extent of elution into water and were significantly higher (p < 0.0001) with SC compared to LC curing modes. BSE had the highest quantity of eluted monomers. After 30 d of water sorption (µg/mm3), all rein-cements showed significantly higher sorption (p < 0.05) of SC compared to LC curing modes except for PV5, RXU and CEM (p > 0.05). After 30 d of water solubility (µg/mm3), all resin-cements showed significantly higher solubility (p < 0.0001) of SC compared to LC curing mode. BSE had the highest water sorption and solubility. The total amounts of eluted monomers correlated positively with solubility: r2 = 0.95 for LC and r2 = 0.93 for SC. SIGNIFICANCE: Whenever light access is possible, light curing remains beneficial to reduce the extent of resin degradation and related properties of dual-cure resin cements. BSE showed statistically the highest extent of eluted monomers, sorption and solubility.

Effect of Different Solutions on the Colour Stability of Nanoparticles or Fibre Reinforced PMMA.

This study aimed to evaluate the colour stability of polymethyl methacrylate (PMMA) denture base reinforced with ZrO2 nanoparticles, E-glass fibres, and TiO2 nanoparticles at various concentrations over 180-day storage in Steradent™ (STD) denture cleaner or coffee (CF). A total of 130 disc-shaped specimens were fabricated at various filler concentrations and divided into four main groups to measure the colour changes. Groups Z, T, and E consisted of PMMA reinforced with ZrO2 nanoparticles, TiO2 nanoparticles, or E-glass fibre, respectively, while Group C consisted of PMMA specimens without filler served as the control group (n = 10). The three reinforced groups were further subdivided according to the filler content (n = 10) added to the PMMA (1.5%, 3.0%, 5.0%, and 7.0% wt.%). Half of the specimens were stored in STD, while the other half was stored in CF for 180 days. A Minolta Chroma Meter was used to measure the colour changes (ΔE) at 7, 30, 90 and then 180 days. The results were assessed using two-way repeated-measures analysis of variance (RM-ANOVA) along with Bonferroni post hoc tests at a p ≤ 0.05 significance level. Significant different colour changes (ΔΕ) were observed between all tested groups and across different time points. TiO2-reinforced PMMA in STD/CF showed the lowest colour stability, while the E-glass fibre-reinforced PMMA in STD/CF showed the highest colour stability. Furthermore, coffee appeared to have the greatest impact on the colour change in comparison to the SteradentTM. The results indicated that the filler type and concentration, type of solution, and length of storage all affected the colour stability of the tested specimens.

Antimicrobial-free graphene nanocoating decreases fungal yeast-to-hyphal switching and maturation of cross-kingdom biofilms containing clinical and antibiotic-resistant bacteria.

Candida albicans and methicillin-resistant Staphylococcus aureus (MRSA) synergize in cross-kingdom biofilms to increase the risk of mortality and morbidity due to high resistance to immune and antimicrobial defenses. Biomedical devices and implants made with titanium are vulnerable to infections that may demand their surgical removal from the infected sites. Graphene nanocoating (GN) has promising anti-adhesive properties against C. albicans. Thus, we hypothesized that GN could prevent fungal yeast-to-hyphal switching and the development of cross-kingdom biofilms. Herein, titanium (Control) was coated with high-quality GN (coverage > 99%). Thereafter, mixed-species biofilms (C. albicans combined with S. aureus or MRSA) were allowed to develop on GN and Control. There were significant reductions in the number of viable cells, metabolic activity, and biofilm biomass on GN compared with the Control (CFU counting, XTT reduction, and crystal violet assays). Also, biofilms on GN were sparse and fragmented, whereas the Control presented several bacterial cells co-aggregating with intertwined hyphal elements (confocal and scanning electronic microscopy). Finally, GN did not induce hemolysis, an essential characteristic for blood-contacting biomaterials and devices. Thus, GN significantly inhibited the formation and maturation of deadly cross-kingdom biofilms, which can be advantageous to avoid infection and surgical removal of infected devices.

Enhancing the mechanical properties and providing bioactive potential for graphene oxide/montmorillonite hybrid dental resin composites.

This in vitro study synthetized hybrid composite nanoparticles of graphene oxide (GO) and montmorillonite MMt (GO-MMt) by ultrasound treatments. Samples were characterized by X-ray diffraction, FT-Raman, FTIR, TEM and SEM. The effect of their incorporation (0.3% and 0.5%) on the mechanical properties in a resin-based composite (RBC) and their bioactivity potential were evaluated. The specimens were characterized by evaluating their 3-point flexural strength (n = 6), modulus of elasticity (n = 6), degree of conversion (n = 6), microhardness (n = 6), contact angle (n = 3) and SEM analysis (n = 3). In vitro test in SBF were conducted in the RBCs modified by the hybrid. Overall, the synthetized hybrid composite demonstrated that GO was intercalated with MMt, showing a more stable compound. ANOVA and Tukey test showed that RBC + 0.3% GO-MMt demonstrated superior values of flexural strength, followed by RBC + 0.5% GO-MMt (p < 0.05) and both materials showed higher values of microhardness. All groups presented a contact angle below 90°, characterizing hydrophilic materials. RBCs modified by the hybrid showed Ca and P deposition after 14 days in SBF. In conclusion, RBCs composed by the hybrid showed promising results in terms of mechanical properties and bioactive potential, extending the application of GO in dental materials.

Effect of Air-Abraded Versus Laser-Fused Fluorapatite Glass-Ceramics on Shear Bond Strength of Repair Materials to Zirconia.

Zirconia repair could be a feasible alternative option to total replacement in fractured zirconia-based restorations. Maximising the bond strength by enriching zirconia with fluorapatite glass-ceramics (FGC) powder has been addressed and compared to other surface treatments. Besides resin composite, other repair materials have been proposed and compared. Zirconia blocks received different surface treatments (A-sandblasting with tribochemical silica-coated alumina (CoJet). B-sandblasting with FGC powder (FGC), C-fluorapatite glass-ceramic coat+ neodymium-doped yttrium aluminum garnet laser irradiation (FGC + Nd: YAG), and D-no surface treatment). The surface roughness, topography, and crystallinity were investigated by a profilometer, scanning electron microscopy (SEM), and X-ray diffraction (XRD) analyses, respectively. For each surface treatment, three repair materials (feldspathic porcelain, lithium disilicate, and resin composite) were bonded to zirconia with 10, Methacryloyloxydecyl dihydrogen phosphate (MDP)-Monobond Plus/ Multilink Automix. Bonded specimens were thermocycled for 10,000 cycles and tested for shear bond strength (SBS) at a speed of 1 mm/min, followed by the analysis of the mode of failure. FGC + Nd: YAG laser group reported the highest surface roughness and monoclinic content compared to CoJet, FGC, and control groups. The highest mean SBS was found in FGC-blasted zirconia, followed by FGC + Nd: YAG laser and CoJet treated groups. However, the lowest SBS was found in control groups regardless of the repair material. Sandblasting zirconia with FGC powder increased SBS of resin to zirconia with lower monoclinic phase transformation compared to FGC + Nd: YAG or CoJet groups.

The Effects of Toothbrush Wear on the Surface Roughness and Gloss of Resin Composites with Various Types of Matrices.

OBJECTIVE: To evaluate and compare the surface roughness and gloss of a DMA-free composite and Bis-GMA-free composite with a DMA-based composite before and after toothbrushing simulation. MATERIALS AND METHODS: Fifteen dimensionally standardised composite specimens of three nano-hybrid resin composites (Tetric EvoCeram, Admira Fusion, and Venus Diamond) were used. Five specimens from each composite were polished and then subjected to a toothbrushing simulator. Surface roughness (Ra) and gloss were measured before toothbrushing and after 5000, 10,000, 15,000, and 20,000 toothbrushing cycles. The data was analysed using 5 × 3 ANOVA to assess surface roughness and gloss values and pairwise comparisons in the form of Tukey post hoc tests were performed to interpret main effects. RESULTS: For all tested materials, surface roughness increased, and gloss decreased after toothbrushing abrasion. Surface roughness (Ra) values ranged from 0.14 to 0.22 µm at baseline and increased to between 0.41 and 0.49 µm after 20,000 toothbrushing cycles. Gloss values ranged between 31.9 and 50.6 GU at baseline and between 5.1 and 19.5 GU after 20,000 toothbrushing cycles. The lowest initial Ra value was detected in Venus Diamond and the highest initial gloss value was detected in Tetric EvoCeram. CONCLUSIONS: Simulated toothbrushing abrasion led to an increase in surface roughness and a decrease in gloss for all tested materials. Venus Diamond had the smoothest surface and Tetric EvoCeram had the glossiest surface after polishing and following 20,000 cycles of toothbrushing abrasion. Admira Fusion demonstrated the roughest surface and had the lowest gloss values before and after toothbrushing abrasion.

Influence of curing modes on thermal stability, hardness development and network integrity of dual-cure resin cements.

OBJECTIVE: To explore the effect of different curing modes of conventional and self-adhesive dual-cure resin cements on their rates of thermal decomposition, hardness development and network integrity. METHODS: Five self-adhesive (PANAVIA SA, RelyX Universal Resin, RelyX Unicem 2, Bifix SE and SpeedCEM Plus) and three conventional (PANAVIA V5, Nexus Third Generation and RelyX Ultimate Universal) dual-cure resin cements were investigated. Thermal decomposition stages, initial onset temperatures, the maximum rate of mass-loss and the filler mass-fraction of each resin cement were analysed by thermogravimetric analysis (TGA). Surface hardness was measured at 1h post-cure and after 24h of dry storage at 37°C. The relative network integrities were estimated from reductions in hardness after 168h of water storage. Data were analysed via one-way ANOVA, Tukey post-hoc tests and paired/independent sample t-tests (a=0.05). RESULTS: No difference was apparent between TGA data for self-cured and light-cured specimens. Numerical differentiation of mass-loss versus temperature showed either single or multiple peaks. For the set of 8 cements, the maximum rate of mass-loss (%/°C) correlated negatively with residual mass at 600°C. All dry-stored cements increased in hardness from 1 to 24h, ranging from 20.4% to 52.6% for light-cure mode and from 41.3% to 112.6% for self-cure. After 168h water storage, the hardness of cements decreased: by 18.5%-36.2% for light-cured and by 9.8%-17.9% for self-cured. Overall, surface hardness was greater for light-cured cements. The initial onset temperature (IOT) of thermal decomposition correlated negatively with the hardness decrease produced by water-storage: r2=0.77 for light-cure and r2=0.88 for self-cure. This provided the basis for a relative scale of composite network integrity, probably reflecting differences in cross-link density. SIGNIFICANCE: Light-curing, where possible, remains beneficial to the hardness and related properties of dual-cure resin cements. Combination of TG analysis and solvent softening experiments give an indication of relative network integrity - between materials - and their relative cross-link densities.

Analysis of Residual Ridge Morphology in a Group of Edentulous Patients Seeking NHS Dental Implant Provision-A Retrospective Observational Lateral Cephalometric Study.

A convenience sample of 154 edentulous patients referred for implant provision at a Regional National Health Service Dental Hospital in the North West of England were identified. The cephalometric radiographs that were taken as part of the patient baseline investigation were assessed. Digital tracing was used to measure the anterior maxillary and mandibular bone height and ridge angle with respect to the maxillary and mandibular planes. The mean height of the bone in the maxilla was found to be 14 mm, and the mean ridge angle for the anterior maxillary residual ridge is 104°. The mean height of bone in the mandible was 18 mm, while the mean ridge angle for the anterior mandibular residual ridge was 77°. Using the Cawood and Howell classification demonstrated that class VI mandibles were the most common. The cross-sectional shape of the mandible varied, with the triangular shape most common. Although there was adequate bone stock for implant placement in these cases, the mandibular residual ridge resorption presents a lingual inclination to the residual bone. The limited residual ridge position and inclination would dictate that conventional implant placement could be challenging.

Polymerization shrinkage and shrinkage stress development in ultra-rapid photo-polymerized bulk fill resin composites.

OBJECTIVE: To determine the polymerization shrinkage (%) and shrinkage stress (MPa) characteristics of ultra-rapid photo-polymerized bulk fill resin composites. METHODS: Two ultra-rapid photo-polymerized bulk fill (URPBF) materials: PFill and PFlow were studied, along with their comparators ECeram and EFlow. PFill contains an addition fragmentation chain transfer (AFCT) agent. The URPBR materials were irradiated using two different 3 s high irradiance protocols (3000 and 3200 mW/cm2 based on Bluephase PowerCure and VALO LCUs, respectively) and one 10 s standard protocol (1200 mW/cm2 based on a Bluephase PowerCure LCU). Bonded disk and Bioman II instruments were used to measure Polymerization shrinkage % and shrinkage stress MPa, respectively, for 60 min at 23 ± 1 °C (n = 5). Maximum shrinkage-rate and maximum shrinkage stress-rate were also calculated for 15 s via numerical differentiation. The data were analyzed via multiple One-way ANOVA and Tukey post-hoc tests (α = 0.05). RESULTS: PFill groups, regardless of their irradiance protocol, showed significantly lower PS than the comparator, ECeram (p < 0.05). However, PFlow irradiated via different protocols, was comparable to EFlow and ECeram (p > 0.05). PFill consistently produced stress results which were significantly lower than ECeram (p < 0.05) and were comparable for both high irradiance protocols (p > 0.05). PFlow only exhibited significantly higher shrinkage stress when polymerized with the 3 sVALO protocol (p < 0.05). The maximum shrinkage strain-rate (%/s) was significantly lower in PFill-10s and PFill-3s groups (using PowerCure LCU) compared to ECeram. However, no differences were seen between PFlow and EFlow (p > 0.05). The maximum shrinkage stress-rate of PFill and PFlow was comparable between different irradiation protocols, as well as to their comparator ECeram (p > 0.05). SIGNIFICANCE: High irradiation protocols over ultra-short periods led to slightly lower shrinkage strain but slightly higher stress, possibly due to reduced network mobility. The AFCT agent incorporated in PFill composite seemed to reduce shrinkage stress development, even with high irradiance protocols.