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Objective To determine the nanohardness and elastic moduli of two bulk-fill resin based composites (RBCs) at increasing depths from the surface and increasing distances laterally from the center after light curing. Methods Two bulk-fill dental RBCs: Tetric EvoCeram Bulk Fill (TECBF) and Filtek Bulk Fill Flowable (FBFF) were light cured in a metal mold with a 6 mm diameter and a 10 mm long semi-circular notch. The RBCs were photo-polymerized for 10 s using a light emitting diode (LED) Bluephase Style curing light, with the original light probe that lacked the homogenizer. This light has two blue light and one violet light LED emitters. By changing the probe orientation over the mold, the light output from only two LEDs reached the RBC. Measurements were made using: (i) the light from one violet and one blue LED, and (ii) the light from the two blue LEDs. Five specimens of each RBC were made using each LED orientation (total 20 specimens). Specimens were then stored in the dark at 37 °C for 24 h. Fifty indents were made using an Agilent G200 nanoindentor down to 4 mm from the surface and 2.5 mm right and left of the centerline. The results were analyzed ( alpha = 0.05) using multiple paired-sample t -tests, ANOVA, Bonferroni post-hoc tests, and Pearson correlations. Results The elastic modulus and nanohardness varied according to the depth and the distance from the centerline. For TECBF, no significant difference was found between the spatial variations in the elastic modulus or hardness values when violet-blue or blue-blue LEDs were used. For FBFF, the elastic modulus and nanohardness on the side exposed to the violet emitter were significantly less than the side exposed to the blue emitter. A strong correlation between nanohardness and elastic modulus was found in all groups ( r 2 = 0.9512–0.9712). Significance Resin polymerization was not uniform throughout the RBC. The nanohardness and elastic modulus across two RBC materials were found to decline differently according to the orientation of the violet and blue light LED emitters within the curing light. [ABSTRACT FROM AUTHOR]

• A method is described that allows direct comparisons between elution from RBC specimens and from RBC-restored teeth prepared with cavities. • A direct comparison was made of elutable substances from an RBC product family. • GC/MS methods have been used to detect and quantify a range of dimethacrylate monomers in the eluent media and the kinetics of elution. • In addition to elutable (co)monomers, substantial amounts of plasticizers and a UV-stabilizer were found. • An overall assessment of the treatment with regard to elutable substances is recommended, considering the restorative material and adhesive. To develop a model for quantitative comparison of elutable substances by direct elution from resin-bonded composite (RBC) test specimens versus indirect elutability of substances from RBC-restored teeth. Furthermore, it was to be investigated whether the different composites of the Tetric® RBC product family release different types and amounts of substances. Four different composite materials from the Tetric® product family were studied. For each material subgroup ten human third molar teeth were prepared with standard Class-I occlusal cavities. These 'tooth group' specimens were provided with a three-step adhesive system (incorporating TEGDMA) and the respective composite restoration. Same sized control specimens, of each RBC restorative material, were prepared ('direct RBC' groups). All specimens were placed in individual elution chambers such that the elution media (ethanol/water, 3:1) only came into contact with either the tooth root or ¾ height of the 'direct RBC' materials. They were incubated at 37 °C for up to 7 d. Samples of the eluant were taken after 1, 2, 4 and 7 d and were analysed by high-temperature gas chromatography/mass spectrometry. Bisphenol A ethoxylate dimethacrylate (bisEMA), bisphenol A glycidyldimethacrylate (bisGMA), tetraethylene glycol dimethacrylate (TEEGDMA), decan-1,10-diol dimethacrylate (DDDMA) were mostly found in the eluates of the 'direct RBC' groups in statistically significantly greater amounts than in the eluates of the 'tooth groups'. Such quantitative differences were also the case with eluates containing bisphenol A (BPA), dicyclohexyl phthalate (DCHP) and drometrizole, which are common in the environment. In contrast to the behavior found with all the other monomers, up to 3 orders of magnitude more triethylene glycol dimethacrylate (TEGDMA) was found in the 'tooth groups' compared to the 'direct RBC' groups, evidently released by the adhesive system. The release of most of the substances was clearly delayed in the 'tooth groups' indicative of their chronic, rather than acute, elution to the oral environment. A barrier function of the residual dentin layer and the adhesion layer can be inferred. The different release patterns of substances from the various composites of the RBC product family is a manifestation of their different and indication-specific compositions. Consideration of an overall restorative care (RBC plus adhesive) system, when assessing the total amount of released substances, is emphasized. [ABSTRACT FROM AUTHOR]

Objectives To study the effect of resin matrix and maturation time (1 and 24 h) on the creep deformation of resin-composites, two of which have matrix-forming monomers that are either bis-GMA free or have an ormocer structure between the C C groups. Methods Five resin-composites: four commercial and one experimental were investigated. Six specimens were prepared for each material and were divided into two groups ( n = 3) according to the maturation time and condition. Group A was stored dry at room temperature for 1 h and Group B was stored for 24 h in distilled water to allow post-curing at 37 °C. Each specimen was loaded (20 MPa) for 2 h and unloaded for 2 h. The strain deformation was recorded continuously for 4 h. Statistical analysis was performed using one-way ANOVA and the Bonferroni post hoc test at a significance level of a = 0.05. Results The maximum creep-strain % after 1 h ranged from 1.32% to 2.50% and was reduced after 24 h post-cure to between 0.66% and 1.47%. Also, the permanent set after 1 h ranged from 0.70% up to 1.27% (Group A) and after 24 h ranged from 0.53% up to 1.20% (Group B). Significance Creep deformation and maximum recovery for all resin-composites decreased with time, demonstrating improvement in viscoelastic stability. However, there was no significant difference between the permanent set at different times, except for Herculite XRV Ultra. Composites with novel matrices showed comparable properties to existing bis-GMA based materials. [ABSTRACT FROM AUTHOR]

To investigate the influence of different resin composite and glass ionomer cement material combinations in a "bi-layer" versus a "single-layer" adhesive technique for class I cavity restorations in molars using numerical finite element analysis (FEA). Three virtual restored lower molar models with class I cavities 4 mm deep were created from a sound molar CAD model. A combination of an adhesive and flowable composite with bulk fill composite (model A), of a glass ionomer cement with bulk fill composite (model B) and of an adhesive with bulk fill composite (model C), were considered. Starting from CAD models, 3D-finite element (FE) models were created and analyzed. Solid food was modeled on the occlusal surface and slide-type contact elements were used between tooth surface and food. Polymerization shrinkage was simulated for the composite materials. Physiological masticatory loads were applied to these systems combined with shrinkage. Static linear analyses were carried out. The maximum normal stress criterion was adopted as a measure of potential damage. All models exhibited high stresses principally located along the tooth tissues–restoration interfaces. All models showed a similar stress trend along enamel–restoration interface, where stresses up to 22 MPa and 19 MPa was recorded in the enamel and restoration, respectively. A and C models showed a similar stress trend along the dentin-restoration interface with a lower stress level in model A, where stresses up to 11.5 MPa and 7.5 MPa were recorded in the dentin and restoration, respectively, whereas stresses of 17 MPa and 9 MPa were detected for model C. In contrast to A and C models, the model B showed a reduced stress level in dentin, in the lower restoration layer and no stress on the cavity floor. FE analysis supported the positive effect of a "bi-layer" restorative technique in a 4 mm deep class I cavities in lower molars versus "single-layer" bulk fill composite technique. [ABSTRACT FROM AUTHOR]

Objectives To assess conceptual designs of dental posts consisting of polyetherimide (PEI) reinforced with carbon (C) and glass (G) glass fibers in endodontically treated anterior teeth. Methods 3D tessellated CAD and geometric models of endodontically treated anterior teeth were generated from Micro-CT scan images. Model C-G/PEI composite posts with different Young’s moduli were analyzed by Finite Element (FE) methods post A (57.7 GPa), post B (31.6 GPa), post C (from 57.7 to 9.0 GPa in the coronal–apical direction). A load of 50 N was applied at 45° to the longitudinal axis of the tooth, acting on the palatal surface of the crown. The maximum principal stress distribution was determined along the post and at the interface between the post and the surrounding structure. Results Post C, with Young’s modulus decreasing from 57.7 to 9.0 GPa in the coronal–apical direction, reduced the maximum principal stress distribution in the restored tooth. Post C gave reduced stress and the most uniform stress distribution with no stress concentration, compared to the other C-G/PEI composite posts. Significance The FE analysis confirmed the ability of the functionally graded post to dissipate stress from the coronal to the apical end. Hence actual (physical) C-G/PEI posts could permit optimization of stress distributions in endodontically treated anterior teeth. [ABSTRACT FROM AUTHOR]

Objectives To investigate the influence of specific resin-composite, glass ceramic and glass ionomer cement (GIC) material combinations in a “multi-layer” technique to replace enamel and dentin in class II mesio-occlusal-distal (MOD) dental restorations using 3D-Finite Element Analysis (FEA). Methods Four 3D-FE models (A–D) of teeth, adhesively restored with different filling materials, were created and analyzed in comparison with a 3D model (E) of a sound lower molar. Models A, B & C had “multilayer” constructions, consisting of three layers: adhesive, dentin replacement and enamel replacement. Model A : had a low modulus (8 GPa) composite replacing dentin and a higher modulus (12 GPa) composite replacing enamel. Model B: had a GI cement replacing dentin and a higher modulus (12 GPa) composite replacing enamel. Model C : had a low modulus (8 GPa) composite replacing dentin and a very high modulus (70 GPa) inlay replacing enamel. Model D : had a lithium disilicate inlay replacing both dentin and enamel with a luting cement base-layer. Polymerization shrinkage effects were simulated and a load of 600 N was applied. All the materials were assumed to behave elastically throughout the entire deformation. Results Model A showed the highest stress distribution along all the adhesive interfaces of the shrinking resin-based materials with a critical condition and failure risk marginally and internally. Model D, by contrast, showed a more favorable performance than either of the multilayer groups (A–C). Stress and displacement plots showed an elastic response similar to that obtained for the sound tooth model. Model B and Model C performed according to their bilayer material properties. The use of a non-shrink dentin component simulating a GIC clearly affected the shrinkage stress at the basis of the Model B; while the bulk resin composite having a 12 GPa Young’s modulus and linear polymerization shrinkage of 1% strongly influenced the biomechanical response in the bucco-lingual direction. Significance Direct resin-based composite materials applied in multilayer techniques to large class II cavities, with or without shrinking dentin layers, produced adverse FEA stress distributions and displacements. An indirect lithium disilicate inlay used to replace lost dentin and enamel in posterior restored teeth generated lower stress levels, within the limits of the elastic FEA model. [ABSTRACT FROM AUTHOR]

Objectives To study the influence of resin based and lithium disilicate materials on the stress and strain distributions in adhesive class II mesio-occlusal-distal (MOD) restorations using numerical finite element analysis (FEA). To investigate the materials combinations in the restored teeth during mastication and their ability to relieve stresses. Methods One 3D model of a sound lower molar and three 3D class II MOD cavity models with 95° cavity-margin-angle shapes were modelled. Different material combinations were simulated: model A, with a 10 μm thick resin bonding layer and a resin composite bulk filling material; model B, with a 70 μm resin cement with an indirect CAD-CAM resin composite inlay; model C, with a 70 μm thick resin cement with an indirect lithium disilicate machinable inlay. To simulate polymerization shrinkage effects in the adhesive layers and bulk fill composite, the thermal expansion approach was used. Shell elements were employed for representing the adhesive layers. 3D solid CTETRA elements with four grid points were employed for modelling the food bolus and tooth. Slide-type contact elements were used between the tooth surface and food. A vertical occlusal load of 600 N was applied, and nodal displacements on the bottom cutting surfaces were constrained in all directions. All the materials were assumed to be isotropic and elastic and a static linear analysis was performed. Results Displacements were different in models A, B and C. Polymerization shrinkage hardly affected model A and mastication only partially affected mechanical behavior. Shrinkage stress peaks were mainly located marginally along the enamel-restoration interface at occlusal and mesio-distal sites. However, at the internal dentinal walls, stress distributions were critical with the highest maximum stresses concentrated in the proximal boxes. In models B and C, shrinkage stress was only produced by the 70 μm thick resin layer, but the magnitudes depended on the Young’s modulus (E) of the inlay materials. Model B mastication behavior (with E = 20 GPa) was similar to the sound tooth stress relief pattern. Model B internally showed differences from the sound tooth model but reduced maximum stresses than model A and partially than model C. Model C (with E = 70 GPa) behaved similarly to model B with well redistributed stresses at the occlusal margins and the lateral sides with higher stress concentrations in the proximal boxes. Models B and C showed a more favorable performance than model A with elastic biomechanics similar to the sound tooth model. Significance Bulk filling resin composite with 1% linear polymerization shrinkage negatively affected the mechanical behavior of class II MOD restored teeth. Class II MOD direct resin composite showed greater potential for damage because of higher internal and marginal stress evolution during resin polymerization shrinkage. With a large class II MOD cavity an indirect composite or a lithium disilicate inlay restoration may provide a mechanical response close to that of a sound tooth. [ABSTRACT FROM AUTHOR]

Objectives To investigate the sorption, solubility, mass change and hygroscopic expansion (solvent swelling) of resin-composites after long term storage in different solvents. Methods Eight materials were studied: two bulk-fill flowable materials (SDR and Venus bulk fill, V-BF), a packable bulk-fill material (Tetric Evoceram bulk-fill, TET-BF), a fiber reinforced material (Ever X posterior, EVX), a nano-hybrid conventional material (Tetric Evoceram, TET) and micro-hybrid conventional materials (G-aenial anterior, GA-P and posterior, GA-A). Three groups of disk shaped specimens were prepared using split stainless steel molds. Each group was stored, respectively, in: water, 75% ethanol/water and methyl ethyl ketone (MEK). The total storage time was 180 d plus a reconditioning time of 120 d. A non-contact laser scanning micrometer was used to measure the diametral changes. Results Significant differences were found in the sorption and solubility of the materials. Generally, MEK stored specimens had the highest values followed by 75% ethanol/water then water. A similar trend was found with the mass and volume changes (except for EVX). V-BF showed the highest sorption (98.1 μg/mm 3 ) and solubility (10 μg/mm 3 ) after MEK storage. Mass and volume changes showed near-linear correlation, with high Pearson coefficients (0.86–0.99). Significance Generally the materials were most greatly affected by MEK storage compared to the other two solvents. The glass-fiber-reinforced EVX, however, was most affected by water immersion. The pattern of change/recovery behavior of the materials, during solvent challenge, was similar to the pattern of viscoelastic creep/recovery behavior of resin-composite materials. [ABSTRACT FROM AUTHOR]

Objective Since bulk-fill (BF) resin composites should cure efficiently to a depth up to 4 mm, the aim of the study was to determine the time-dependence of degree of conversion (DC) at that depth during 24 h post-irradiation. Methods Eight representative BF resin composites were studied [x-tra base (XTB), Venus Bulk Fill (VBF), Tetric EvoCeram Bulk Fill (TECBF), Sonic Fill (SF), Filtek Bulk Fill (FBF), everX Posterior (eXP), Beautifil-Bulk Flowable (BBF), Beautifil-Bulk Restorative (BBR)]. Specimens were fabricated in white Delrin moulds of 4 mm height and 5 mm internal diameter directly on an attenuated total reflectance (ATR) accessory attachment of an (FTIR) spectrometer (Nicolet iS50, Thermo Fisher, Madison, USA). Upper specimen surfaces were irradiated in situ for 20 s with an LED curing unit (Elipar S10 with average tip irradiance of 1200 mW/cm 2 ). Spectra from the lower surface were recorded continuously in real-time for 5 min and then at 30 and 60 min and 24 h post irradiation. Results Mean ranges of DC 4mm (%) of the materials at 4 mm depth were 39–67; 48–75; 45–74; and 50–72 at 5, 30 and 60 min and 24 h respectively. DCs for XTB, VBF, TECBF, FBF, BBR increased significantly 30 min after irradiation ( p < 0.05) and were not affected by subsequent time up to 24 h ( p > 0.05). DC for SF was not affected by subsequent time after 5 min ( p > 0.05). For eXP and BBF, DC increased 24 h after irradiation ( p < 0.05). The data were described by the superposition of two exponential functions characterising the gel phase (described by parameters a, b) and the glass phase (described by parameters c and d). Significance Post polymerization impact of bulk-fill composites is material dependent. Five materials exhibited their maximum DC 4mm already 30 min after starting the irradiation while DC 4mm for two materials optimized after 24 h. BF materials were found to exhibit after 24 h a DC between 50 and 72% at 4 mm depth under the stated irradiation conditions. [ABSTRACT FROM AUTHOR]

Objectives In the revised version of ISO 7405 there are so far no detailed recommendations concerning temperature and humidity during specimen production for light curing and chemically setting dental materials. The main objective of the present study was to observe if different environmental conditions during specimen production influence cytotoxicity and degree of conversion of four post and core composite materials and to investigate if cytotoxicity of post and core materials is influenced by their corresponding bonding substances. Methods Specimens of four different post and core composite materials (LuxaCore – Dual, Core X-Flow, Flow White and MultiCore Flow) were produced in a climate test chamber at 23 °C/50% relative humidity or 37 °C/95% relative humidity and were dual-cured or self-cured, with or without their corresponding bonding substances. Specimens were added to cell cultures immediately after production or after preincubation for 7 days. Specimens were incubated with L-929 fibroblasts for 72 h and cell numbers determined by a flow cytometer. FTIR spectroscopic measurements of post and core materials were performed at the same temperature conditions as for the cytotoxicity assay (23 °C or 37 °C). Results Dual-cured specimens of all post and core composites exhibited less cytotoxicity under both environmental conditions than self-cured specimens. All self-cured specimens manufactured at 37 °C/95% showed less cytotoxicity than specimens produced at 23 °C/50%. All dual-cured specimens showed similar cytotoxicity at both environmental conditions. After 7 days of preincubation most dual-cured specimens produced at 23 °C/50% showed less cytotoxicity than self-cured specimens (with the exception of Flow White). Compared to fresh specimens, 7-day aged specimens of most materials showed reduced cytotoxicity. Materials already showing low cytotoxicity as fresh specimens did not further reduce their cytotoxicity after 7 days of preincubation. For dual-cured materials the degree of conversion was higher compared to self-cured materials. Significance Different temperatures during specimen production have an impact on cytotoxicity and degree of conversion of dual-curing composite materials. Detailed recommendations for standardization concerning environmental conditions during specimen production are required. [ABSTRACT FROM AUTHOR]