Influence of Incorporating Zirconium- and Barium-based Radiopaque Filler Into Experimental and Commercial Infiltrants.

OBJECTIVES: To evaluate how adding different concentrations of particles (barium or zirconium oxide 25%/45% by weight) to a commercial infiltrant (Icon) and an experimental infiltrant influences cohesive strength (CS), degree of conversion (DC), water sorption (WS), solubility (SL), radiopacity, and penetration depth. METHODS AND MATERIALS: Microtensile CS (n=10) was evaluated using a universal testing machine. DC (n=5) was evaluated in a Fourier-transform infrared spectrometer. Polymerized samples were dissected, weighed, and stored to obtain the final mass for WS and SL tests (n=10). Radiopacity analysis (n=5) was performed using a digital radiography system. Penetration depth analysis (n=5) was performed by confocal laser scanning microscopy. Analyses were performed using the R program, with a significance level of 5%, except for the penetration depth analyses, which were evaluated only qualitatively. RESULTS: The groups with 45% zirconium showed greater CS values, regardless of the infiltrant. Among the groups with no particle addition, those of the experimental infiltrant presented higher DC than those of Icon. The experimental infiltrant presented lower WS than Icon. All groups had SL below the ISO recommended levels. Radiopacity higher than 2.24 mmAl (enamel radiopacity) was observed only in the groups with 45% zirconium. All the groups achieved similar penetration depth, but the groups containing experimental infiltrant appear to have had longer tag extensions. CONCLUSIONS: Addition of 45% of zirconium presented good results for CS and WS, as well as SL below the ISO recommended standard, adequate radiopacity, and penetration depth similar to the other groups.

Effect of curing-light attenuation on color stability and physical and chemical properties of resin cements containing different photoinitiators.

This study aimed to evaluate the effect of light attenuation by ceramic veneers on the degree of conversion (DC), flexural strength (FS) and color change (CC) of resin cements containing different photoinitiators. Thus, samples included resin cements containing different photoinitiators: (a) camphorquinone (CQ)/ethyl 4-(dimethylamino)benzoate (EDMAB); (b) CQ/4-(N,N-dimethylamino) phenethyl alcohol (DMPOH); (c) CQ/2(dimethylamino) ethyl methacrylate (DMAEMA); (d) CQ/ethyl 4-(dimethylamino)benzoate (EDMAB) + diphenyl(2,4,6-trimethylbenzoyl)-phosphine oxide (TPO); (e) TPO; and (f) phenylbis(2.4.6-trimethylbenzoyl)phosphine oxide (BAPO). Ceramic veneers (10 × 10 mm) were 0.4 mm, 0.7 mm, 1.0 mm or 1.5 mm thick. The light irradiance of a multiple-peak LED through ceramic veneers was measured (n = 5) using a spectrometer. DC (micro-Raman spectrometer) and FS (Bar-shaped specimens) were tested in cements with and without the veneers. Color change was evaluated before and after UV artificial aging. Data were submitted to ANOVA and Tukey's test (α = 0.05). The violet spectrum showed the lowest irradiance values through the veneer, considering all thicknesses. BAPO had the highest DC values for all veneers. CQ/EDMAB + TPO, CQ + EDMAB, and CQ + DMPOH showed similar DC values concerning all thicknesses. TPO (1.0 mm) showed the lowest DC and FS values. CQ + TPO and CQ/amines showed similar FS values. CQ + EDMAB and CQ + DMAEMA showed the highest color change values while TPO showed the lowest. It was concluded that the physical and chemical properties of the resin cement were improved with BAPO. CQ/EDMAB + TPO showed the greatest color stability, considering all veneer groups and control, without affecting the other properties assessed.

Effect of Beam Profiles From Different Light Emission Tip Types of Multiwave Light-emitting Diodes on the Curing Profile of Resin-based Composites.

Light activation is an important clinical step for achieving success in restorative procedures. This study evaluated the influence of beam profile from different light emission tip types of multiwave light-emitting diodes (LEDs) on the curing profile of resin-based composites. Experimental composites were produced containing either camphorquinone (CQ) or diphenyl(2,4,6-trimethylbenzoyl)phosphine oxide (TPO) as a photoinitiator. Multiwave LEDs with either a bundle light guide tip (Bluephase G2, Ivoclar Vivadent) or a microlens tip (VALO Cordless, Ultradent) were characterized using a beam profiler. Block-shaped samples (5×5×3 mm depth) of the two composites were cured in a custom-designed mold with the multiwave LEDs positioned to compare the regions exposed to the 420-495 nm (blue) and 380-420 nm (violet) emittances. To map the curing profile, the degree of conversion (DC) of longitudinal thin cross sections from each block was evaluated using transmission FT-NIR. Radiant exposure transmitted through the composites during curing was evaluated at different thicknesses. Data were analyzed using analysis of variance and Tukey test (α=0.05; ß=0.2). The results indicated that there were differences in the beam profile and the overall radiant exposures transmitted through the composites using each multiwave LED (p<0.01, df=1 F=73.18). However, there were no differences in the curing profiles provided by the two multiwave LEDs (p=0.89, df=12 F=0.52), and similar effects were found according to the different LED emittance regions (p=0.09, df=5, F=2.11). When considering up to 1 mm in depth, no differences in the DC were found between the composites containing either photoinitiators. Starting at 2 mm in depth, the composite containing TPO showed a decrease in DC in the 420-495 nm emittance region, while the composite containing CQ showed a similar decrease in cure efficiency only at 3-mm depth under both 380-420 nm and 420-495 nm emittance regions. Thus, despite the fact that the nonuniform light beam emitted from the two multiwave LEDs was visually distinctly different when delivering 24 J/cm2, this difference did not seem to affect the curing profile of the composites. However, light transmission within 380-420 nm seems to be reduced with depth, directly affecting the curing profile of composites containing a photoinitiator with absorbance falling within this emission range.

The Combination of CQ-amine and TPO Increases the Polymerization Shrinkage Stress and Does Not Improve the Depth of Cure of Bulk-fill Composites.

OBJECTIVES: To evaluate the effect of combining camphorquinone (CQ) and diphenyl(2,4,6-trimethylbenzoyl)phosphine oxide (TPO) on the depth of cure and polymerization shrinkage stress of bulk-fill composites. METHODS AND MATERIALS: Experimental bulk-fill composites were produced containing equal molar concentrations of either CQ-amine or CQ-amine/TPO. The degree of in-depth conversion through each millimeter of a 4-mm-thick bulk-fill increment was evaluated by Fourier transform near-infrared microspectroscopy using a central longitudinal cross section of the increment of each bulk-fill composite (n=3). Light-transmittance of the multi-wave light-emitting diode (LED) emittance used for photoactivation (Bluephase G2, Ivoclar Vivadent) was recorded through every millimeter of each bulk-fill composite using spectrophotometry. The volumetric shrinkage and polymerization shrinkage stress were assessed using a mercury dilatometer and the Bioman, respectively. The flexural modulus was also assessed by a three-point bend test as a complementary test. Data were analyzed according to the different experimental designs (α=0.05 and ß=0.2). RESULTS: Up to 1 mm in depth, adding TPO to CQ-based bulk-fill composites increased the degree of conversion, but beyond 1 mm no differences were found. The light-transmittance of either wavelengths emitted from the multi-wave LED (blue or violet) through the bulk-fill composites were only different up to 1 mm in depth, regardless of the photoinitiator system. Adding TPO to CQ-based bulk-fill composites did not affect volumetric shrinkage but did increase the flexural modulus and polymerization shrinkage stress. CONCLUSION: Adding TPO to CQ-based bulk-fill composites did not increase the depth of cure. However, it did increase the degree of conversion on the top of the restoration, increasing the polymerization shrinkage stress.

The Use of Different Photoinitiator Systems in Photopolymerizing Resin Cements Through Ceramic Veneers.

OBJECTIVE: To evaluate the effect of different photoinitiator systems on photopolymerizing resin cements through ceramic veneers with different thickness on microshear bond strength (µSBS), flexural strength (FS), and ultimate tensile strength (UTS) and verify the light attenuation through these ceramic veneers. METHODS AND MATERIALS: Four photopolymerizing experimental resin cements were produced with the same resin matrix and associated with four different photoinitiator systems: camphorquinone (CQ), diphenyl(2,4,6-trimethylbenzoyl)phosphine oxide (TPO), Ivocerin, and TPO + Ivocerin. Eighty disc-shaped ceramic veneers (IPS Empress Esthetic, Ivoclar Vivadent) were fabricated (10-mm diameter) in two different thicknesses: 0.7 and 1.5 mm. A previously characterized multiwave LED (Bluephase G2, Ivoclar Vivadent) was standardized for 40 seconds of photoactivation. Light transmittance through each ceramic veneer thickness (n=5) was measured using a spectrometer (USB 2000, Ocean Optics). The µSBS of each resin cement (n=15) to the ceramic veneer was evaluated using 0.5-mm cylinders with 0.7-mm diameters photoactivated through the different ceramic veneer thicknesses. Samples for FS and UTS tests were made either with or without ceramics veneers (0.7 and 1.5 mm) fixed to the light-curing tip. Data were submitted to two-way analysis of variance and the Tukey test (α=0.05). RESULTS: The multiwave LED emitted higher irradiance into the blue wavelength spectra than into the violet wavelength spectra (p=0.0001). Light transmittance through the ceramic veneers was reduced in a systematic manner based on thickness regardless of the wavelength spectra emitted from the multiwave LED (p=0.00037). The µSBS was reduced in a systematic manner based on thickness regardless of the photoinitiator system (p<0.05). However, resin cements with CQ and Ivocerin showed higher bond strength values in comparison to the resin cement with TPO regardless of the ceramic veneer thickness (p<0.05). The FS and UTS means decreased (p<0.05) with the interposition of 0.7- and 1.5-mm ceramic veneers for all resin cements. The resin cement containing only TPO showed the lowest FS and UTS means (p<0.05) for all ceramic veneers. CONCLUSIONS: The thickness of the ceramic veneers reduced the irradiance of the multiwave LED in all wavelength spectra. Ivocerin alone or associated with TPO showed to be an effective alternative photoinitiator to substitute for CQ. The resin cement containing only TPO had lower bond strength values in comparison to resin cements with CQ, Ivocerin, and Ivocerin + TPO.

Light-emitting Diode Beam Profile and Spectral Output Influence on the Degree of Conversion of Bulk Fill Composites.

OBJECTIVES: To evaluate the beam profile and the spectral output of monowave and polywave light-emitting diodes (LEDs) and their influence on the degree of conversion (DC) of bulk fill composites. METHODS: A monowave LED (Smartlite Focus, Dentsply) and a polywave LED (Valo Cordless, Ultradent) were characterized using a resin calibrator and a laser beam profile analyzer. Two bulk fill composites, Sonic Fill 2 (SF) containing camphorquinone (CQ) and Tetric EvoCeram Bulk Fill (TEB) containing CQ associated with alternative photoinitiators, were placed in custom-designed molds (n=3) and photoactivated by the monowave or polywave LED with 20 J/cm2. To map the DC, longitudinal cross sections (0.5 mm thick) from the center of the restoration were evaluated using FT-NIR microscopy. SF and TEB light transmittances (n=3) through 4-mm-thick specimens were evaluated during curing. Data were analyzed using a split-plot analysis of variance and Tukey test (α=0.05; ß=0.2). RESULTS: The monowave LED had a radiant emittance of 20 ± 0.5 J/cm2 over 420-495 nm, and the polywave LED had an emittance of 15.5 ± 0.4 J/cm2 over 420-495 nm and of 4.5 ± 0.2 J/cm2 over 380-420 nm. The total radiant exposure at the bottom of TEB was 2.2 ± 0.2 J/cm2 with the monowave LED and 1.6 ± 0.3 J/cm2 with the polywave LED, and for SF it was 0.4 ± 0.1 J/cm2 for both LEDs. There were no differences in the curing profiles produced either by the monowave or the polywave LED (p=0.9), according to the regions under influence of blue and/or violet emission at the same depth. There was no statistical difference in the DC for SF using the monowave or polywave LED at any depth (p=0.29). TEB had a higher DC at up to 2 mm in depth when the polywave LED was used (p<0.004), but no differences were found when starting at 2.5 mm. CONCLUSIONS: Monowave and polywave LEDs emitted nonhomogeneous light beams, but this did not affect the DC homogeneity of bulk fill composites. For composites containing CQ associated with alternative photoinitiators, polywave LEDs had a higher DC, but only at the top part of the restoration; lower wavelength absorption photoinitiators were ineffective in deeper areas.

Effect of Hydrofluoric Acid Concentration and Etching Time on Bond Strength to Lithium Disilicate Glass Ceramic.

The aim of this study was to evaluate the influence of different concentrations of hydrofluoric acid (HF) associated with varied etching times on the microshear bond strength (µSBS) of a resin cement to a lithium disilicate glass ceramic. Two hundred seventy-five ceramic blocks (IPS e.max Press [EMX], Ivoclar Vivadent), measuring 8 mm × 3 mm thickness, were randomly distributed into five groups according to the HF concentrations (n=50): 1%, 2.5%, 5%, 7.5%, and 10%. Further random distribution into subgroups was performed according to the following etching times (n=10): 20, 40, 60, 120, and 20 + 20 seconds. After etching, all blocks were treated with a silane coupling agent followed by a thin layer of an unfilled resin. Three resin cement cylinders (∅=1 mm) were made on each EMX surface, which was then stored in deionized water at 37°C for 24 hours before testing. The µSBS was in a universal testing machine at a crosshead speed of 1 mm/min until failure. Data were submitted to two-way analysis of variance, and multiple comparisons were performed using the Tukey post hoc test (α=0.05). One representative EMX sample was etched according to the description of each subgroup and evaluated using scanning electron microscopy for surface characterization. The HF concentrations of 5%, 7.5%, and 10% provided significantly higher µSBS values than 1% and 2.5% (p<0.05), regardless of the etching times. For 1% and 2.5% HF, the etching times from 40 to 120 seconds increased the µSBS values compared with 20 seconds (p<0.05), but etching periods did not differ within the 5%, 7.5%, and 10% HF groups (p>0.05). The effect of re-etching was more evident for 1% and 2.5% HF (p<0.05). Different HF concentrations/etching times directly influenced the bond strength and surface morphology of EMX.

In situ surface biodegradation of restorative materials.

SUMMARY This study aimed to evaluate the surface characteristics of restorative materials (roughness, hardness, chemical changes by energy-dispersive spectroscopy [EDX], and scanning electron microscopy [SEM]) submitted to in situ biodegradation. Fifteen discs of each material (IPS e.max [EM], Filtek Supreme [FS], Vitremer [VI], Ketac Molar Easymix [KM], and Amalgam GS-80 [AM]) were fabricated in a metallic mold (4.0 mm × 1.5 mm). Roughness, hardness, SEM, and EDX were then evaluated. Fifteen healthy volunteers used a palatal device containing one disc of each restorative material for seven days. After the biodegradation, the roughness, hardness, SEM, and EDX were once again evaluated. Data obtained from the roughness and hardness evaluations were submitted to Kolmogorov-Smirnov and Tukey-Kramer tests (p<0.05). All esthetic restorative materials showed a significant increase in the roughness after biodegradation. Before biodegradation, significant differences in the hardness among the materials were seen: EM>AM>FS>KM>VI. After biodegradation, the hardness was significantly altered among the materials studied: EM>AM>FS=KM>VI, along with a significant increase in the hardness for AM, KM, and VI. SEM images indicated degradation on the surface of all materials, showing porosities, cracks, and roughness. Furthermore, after biodegradation, FS showed the presence of Cl, K, and Ca on the surface, while F was not present on the VI and KM surfaces. EM and AM did not have alterations in their chemical composition after biodegradation. It was concluded that the dental biofilm accumulation in situ on different restorative materials is a material-dependent parameter. Overall, all materials changed after biodegradation: esthetic restorative materials showed increased roughness, confirmed by SEM, and the ionomer materials and silver amalgam showed a significantly higher hardness. Finally, the initial chemical composition of the composite resin and ionomer materials evaluated was significantly altered by the action of the biofilm in situ.