Resin composites: Modulus of elasticity and marginal quality

OBJECTIVE To investigate how the modulus of elasticity of resin composites influences marginal quality in restorations submitted to thermocyclic and mechanical loading. METHODS Charisma, Filtek Supreme XTE and Grandio were selected as they were found to possess different moduli of elasticity but quite similar polymerization contraction. MOD cavities (n=30) were prepared in extracted premolars, restored and then subjected to thermocyclic and mechanical loading. Marginal quality of the restorations before and after loading was analyzed on epoxy replicas under a scanning electron microscope. The percentage of gap-free margins and occurrence of paramarginal fractures were registered. Modulus of elasticity and polymerization contraction were analyzed with parametric and margins with nonparametric ANOVA and post hoc Tukey HSD or Wilcoxon rank-sum tests, respectively. The number of paramarginal fractures was analyzed with exact Fisher tests (α=0.05). RESULTS Grandio demonstrated significantly more gap-free enamel margins than Charisma and Filtek Supreme XTE, before and after loading (p<0.01), whereas there was no difference between Charisma and Filtek Supreme XTE (p>0.05). No significant effect of resin composite (p=0.81) on the quality of dentine margins was observed, before or after loading. Deterioration of all margins was evident after loading (p<0.0001). More paramarginal enamel fractures were observed after loading in teeth restored with Grandio when compared to Charisma (p=0.008). CONCLUSIONS The resin composite with the highest modulus of elasticity resulted in the highest number of gap-free enamel margins but with an increased incidence of paramarginal enamel fractures. CLINICAL SIGNIFICANCE The results from this study suggest that the marginal quality of restorations can be improved by the selection of a resin composite with modulus of elasticity close to that of dentine, although an increase in paramarginal enamel fractures can result as a consequence.

Influence of increment thickness on microhardness and dentin bond strength of bulk fill resin composites

OBJECTIVES To investigate the influence of increment thickness on Vickers microhardness (HV) and shear bond strength (SBS) to dentin of a conventional and four bulk fill resin composites. METHODS HV and SBS were determined on specimens of the conventional resin composite Filtek Supreme XTE (XTE) and the bulk fill resin composites SDR (SDR), Filtek Bulk Fill (FBF), x-tra fil (XFIL), and Tetric EvoCeram Bulk Fill (TEBF) after 24h storage. HV was measured either as profiles at depths up to 6mm or at the bottom of 2mm/4mm/6mm thick resin composite specimens. SBS of 2mm/4mm/6mm thick resin composite increments was measured to dentin surfaces of extracted human molars treated with the adhesive system OptiBond FL, and the failure mode was stereomicroscopically determined at 40× magnification. HV profiles and failure modes were descriptively analysed whereas HV at the bottom of resin composite specimens and SBS were statistically analysed with nonparametric ANOVA followed by Wilcoxon rank sum tests (α=0.05). RESULTS HV profiles (medians at 2mm/4mm/6mm): XTE 105.6/88.8/38.3, SDR 34.0/35.5/36.9, FBF 36.4/38.7/37.1, XFIL 103.4/103.9/101.9, TEBF 63.5/59.7/51.9. HV at the bottom of resin composite specimens (medians at 2mm/4mm/6mm): XTE (p<0.0001) 105.5>85.5>31.1, SDR (p=0.10) 25.8=21.9=26.0, FBF (p=0.16) 26.6=25.3=28.9, XFIL (p=0.18) 110.5=107.2=101.9, TEBF (p<0.0001) 63.0>54.9>48.2. SBS (MPa, medians at 2mm/4mm/6mm): XTE (p<0.0001) 23.9>18.9=16.7, SDR (p=0.26) 24.6=22.7=23.4, FBF (p=0.11) 21.4=20.3=22.0, x-tra fil (p=0.55) 27.0=24.0=23.6, TEBF (p=0.11) 21.0=20.7=19.0. The predominant SBS failure mode was cohesive failure in dentin. SIGNIFICANCE At increasing increment thickness, HV and SBS decreased for the conventional resin composite but generally remained constant for the bulk fill resin composites.

5-year results comparing mineral trioxide aggregate and adhesive resin composite for root-end sealing in apical surgery

INTRODUCTION Recent meta-analyses of the outcome of apical surgery using modern techniques including microsurgical principles and high-power magnification have yielded higher rates of healing. However, the information is mainly based on 1- to 2-year follow-up data. The present prospective study was designed to re-examine a large sample of teeth treated with apical surgery after 5 years. METHODS Patients were recalled 5 years after apical surgery, and treated teeth were classified as healed or not healed based on clinical and radiographic examination. (The latter was performed independently by 3 observers). Two different methods of root-end preparation and filling (primary study parameters) were to be compared (mineral trioxide aggregate [MTA] vs adhesive resin composite [COMP]) without randomization. RESULTS A total of 271 patients and teeth from a 1-year follow-up sample of 339 could be re-examined after 5 years (dropout rate = 20.1%). The overall rate of healed cases was 84.5% with a significant difference (P = .0003) when comparing MTA (92.5%) and COMP (76.6%). The evaluation of secondary study parameters yielded no significant difference for healing outcome when comparing subcategories (ie, sex, age, type of tooth treated, post/screw, type of surgery). CONCLUSIONS The results from this prospective nonrandomized clinical study with a 5-year follow-up of 271 teeth indicate that MTA exhibited a higher healing rate than COMP in the longitudinal prognosis of root-end sealing.

Poly(ethylene oxide)-b-poly(3-sulfopropyl methacrylate) block copolymers for calcium phosphate mineralization and biofilm inhibition.

Poly(ethylene oxide) (PEO) has long been used as an additive in toothpaste, partly because it reduces biofilm formation on teeth. It does not, however, reduce the formation of dental calculus or support the remineralization of dental enamel or dentine. The present article describes the synthesis of new block copolymers on the basis of PEO and poly(3-sulfopropyl methacrylate) blocks using atom transfer radical polymerization. The polymers have very large molecular weights (over 10(6) g/mol) and are highly water-soluble. They delay the precipitation of calcium phosphate from aqueous solution but, upon precipitation, lead to relatively monodisperse hydroxyapatite (HAP) spheres. Moreover, the polymers inhibit the bacterial colonization of human enamel by Streptococcus gordonii, a pioneer bacterium in oral biofilm formation, in vitro. The formation of well-defined HAP spheres suggests that a polymer-induced liquid precursor phase could be involved in the precipitation process. Moreover, the inhibition of bacterial adhesion suggests that the polymers could be utilized in caries prevention.