56-month clinical performance of Class I and II resin composite restorations

Objective: This study evaluated the 56-month clinical performance of Class I and II resin composite restorations. Filtek P60 was compared with Filtek Z250, which are both indicated for posterior restorations but differ in terms of handling characteristics. The null hypothesis tested was that there is no difference in the clinical performance of the two resin composites in posterior teeth. Material and Methods: Thirty-three patients were treated by the same operator, who prepared 48 Class I and 42 Class II cavities, which were restored with Single Bond/Filtek Z250 or Single Bond/Filtek P60 restorative systems. Restorations were evaluated by two independent examiners at baseline and after 56 months, using the modified USPHS criteria. Data were analyzed statistically using Chi-square and Fisher's Exact tests (alpha=0.05). Results: After 56 months, 25 patients (31 Class I and 36 Class II) were analyzed. A 3% failure rate occurred due to secondary caries and excessive loss of anatomic form for P60. For both restorative systems, there were no significant differences in secondary caries and postoperative sensitivity. However, significant changes were observed with respect to anatomic form, marginal discoloration, and marginal adaptation. Significant decreases in surface texture were observed exclusively for the Z250 restorations. Conclusions: Both restorative systems can be used for posterior restorations and can be expected to perform well in the oral environment.

Impact of filler size and distribution on roughness and wear of composite resin after simulated toothbrushing

Objectives: Nanofilled composite resins are claimed to provide superior mechanical properties compared with microhybrid resins. Thus, the aim of this study was to compare nanofilled with microhybrid composite resins. The null hypothesis was that the size and the distribution of fillers do not influence the mechanical properties of surface roughness and wear after simulated toothbrushing test. Material and methods: Ten rectangular specimens (15 mm x 5 mm x 4 mm) of Filtek Z250 (FZ2), Admira (A), TPH3 (T), Esthet-X (EX), Estelite Sigma (ES), Concept Advanced (C), Grandio (G) and Filtek Z350 (F) were prepared according to manufacturer's instructions. Half of each top surface was protected with nail polish as control surface (not brushed) while the other half was assessed with five random readings using a roughness tester (Ra). Following, the specimens were abraded by simulated toothbrushing with soft toothbrushes and slurry comprised of 2: 1 water and dentifrice (w/w). 100,000 strokes were performed and the brushed surfaces were re-analyzed. Nail polish layers were removed from the specimens so that the roughness (Ra) and the wear could be assessed with three random readings (mu m). Data were analyzed by ANOVA and Tukey's multiple-comparison test (alpha = 0.05). Results: Overall outcomes indicated that composite resins showed a significant increase in roughness after simulated toothbrushing, except for Grandio, which presented a smoother surface. Generally, wear of nanofilled resins was significantly lower compared with microhybrid resins. Conclusions: As restorative materials suffer alterations under mechanical challenges, such as toothbrushing, the use of nanofilled materials seem to be more resistant than microhybrid composite resins, being less prone to be rougher and worn.

Water sorption of CH3- and CF3-Bis-GMA based resins with additives

Objectives: To evaluate the effect of additives on the water sorption characteristics of Bis-GMA based copolymers and composites containing TEGDMA, CH(3)Bis-GMA or CF(3)Bis-GMA. Material and methods: Fifteen experimental copolymers and corresponding composites were prepared combining Bis-GMA and TEGDMA, CH(3)Bis-GMA or CF(3)Bis-GMA, with aldehyde or diketone (24 and 32 mol%) totaling 30 groups. For composites, barium aluminosilicate glass and pyrogenic silica was added to comonomer mixtures. Photopolymerization was effected by 0.2 wt% each of camphorquinone and N,N-dimethyl-p-toluidine. Specimen densities in dry and water saturated conditions were obtained by Archimedes' method. Water sorption and desorption were evaluated in a desorption-sorption-desorption cycle. Water uptake (%WU), water desorption (%WD), equilibrium solubility (ES; mu g/mm(3)), swelling (f) and volume increase (%V) were calculated using appropriate equations. Results: All resins with additives had increased %WU and ES. TEGDMA-containing systems presented higher %WU, %WD, ES, f and %V values, followed by resins based on CH(3)Bis-GMA and CF(3)Bis-GMA. Conclusions: Aldehyde and diketone led to increases in the water sorption characteristics of experimental resins.

Properties of dental resins submitted to pH catalysed hydrolysis

Objectives: This study evaluated the surface microhardness (SM) and roughness (SR) alterations of dental resins submitted to pH catalysed degradation regimens. Methods: Thirty discs of each TPH Spectrum (Dentsply), Z100 (3M-ESPE), or an unfilled experimental bis-GMA/TEGDMA resin were fabricated, totaling 90 specimens. Each specimen was polymerized for 40 s, finished, polished, and individually stored in deionized water at 37 degrees C for 7 days. Specimens were randomly assigned to the following pH solutions: 1.0, 6.9 or 13, and for SM or SR evaluations (n = 5). Baseline Knoop-hardness of each specimen was obtained by the arithmetic mean of five random micro-indentations. For SR, mean baseline values were obtained by five random surface tracings (R-a). Specimens were then soaked in one of the following storage media at 37 degrees C: (1) 0.1 M, pH 1.0 HCl, (2) 0.1 N, pH 13.0 NaOCl, and (3) deionized water (pH 6.9). Solutions were replaced daily. Repeated SM and SR measurements were performed at the 3-, 7- and 14-day storage time intervals. For each test and resin, data were analysed by two-way ANOVA followed by Tukey's test (alpha = 0.05). Results: There was significant decrease in SM and increase in SR values of composites after storage in alkaline medium. TPH and Z100 presented similar behaviour for SM and SR after immersion in the different media, whereas unfilled resin values showed no significant change. Conclusion: Hydrolytic degradation of resin composites seems to begin with the silanized inorganic particles and therefore depend on their composition. Significance: To accelerate composite hydrolysis and produce quick in vitro microstructural damage, alkaline medium appears to be more suitable than acidic medium. Contemporary resin composite properties seem to withstand neutral and acidic oral environments tolerably well. (C) 2012 Elsevier Ltd. All rights reserved.

Effect of light sources and curing mode techniques on sorption, solubility and biaxial flexural strength of a composite resin

Adequate polymerization plays an important role on the longevity of the composite resin restorations. Objectives: The aim of this study was to evaluate the effect of light-curing units, curing mode techniques and storage media on sorption, solubility and biaxial flexural strength (BFS) of a composite resin. Material and Methods: Two hundred and forty specimens were made of one composite resin (Esthet-X) in a stainless steel mold (2 mm x 8 mm 0), and divided into 24 groups (n=10) established according to the 4 study factors: light-curing units: quartz tungsten halogen (QTH) lamp and light-emitting diodes (LED); energy densities: 16 J/cm(2) and 20 J/cm(2); curing modes: conventional (CM) and pulse-delay (PD); and permeants: deionized water and 75% ethanol for 28 days. Sorption and solubility tests were performed according to ISO 4049:2000 specifications. All specimens were then tested for BFS according to ASTM F394-78 specification. Data were analyzed by three-way ANOVA followed by Tukey, Kruskal-Wallis and Mann-Whitney tests (alpha=0.05). Results: In general, no significant differences were found regarding sorption, solubility or BFS means for the light-curing units and curing modes (p>0.05). Only LED unit using 16 J/cm(2) and PD using 10 s produced higher sorption and solubility values than QTH. Otherwise, using CM (16 J/cm(2)), LED produced lower values of BFS than QTH (p<0.05). 75% ethanol permeant produced higher values of sorption and solubility and lower values of BFS than water (p<0.05). Conclusion: Ethanol storage media produced more damage on composite resin than water. In general the LED and QTH curing units using 16 and 20 J/cm(2) by CM and PD curing modes produced no influence on the sorption, solubility or BFS of the tested resin.

Clinical strategies for esthetic excellence in anterior tooth restorations: understanding color and composite resin selection

Direct composite resin restorations have become a viable alternative for patients that require anterior restorative procedures to be integrated to the other teeth that compose the smile, especially for presenting satisfactory esthetic results and minimum wear of the dental structure. Technological evolution along with a better understanding of the behavior of dental tissues to light incidence has allowed the development of new composite resins with better mechanical and optical properties, making possible a more artistic approach for anterior restorations. The combination of the increasing demand of patients for esthetics and the capacity to preserve the dental structure resulted in the development of different incremental techniques for restoring fractured anterior teeth in a natural way. In order to achieve esthetic excellence, dentists should understand and apply artistic and scientific principles when choosing color of restorative materials, as well as during the insertion of the composite resin. The discussion of these strategies will be divided into two papers. In this paper, the criteria for color and material selection to obtain a natural reproduction of the lost dental structures and an imperceptible restoration will be addressed.

Kinetic of water diffusion and color stability of a resin composite as a function of the curing tip distance

The influence of curing tip distance and storage time in the kinetics of water diffusion (water sorption-W SP, solubility-W SB, and net water uptake) and color stability of a composite were evaluated. Composite samples were polymerized at different distances (5, 10, and 15 mm) and compared to a control group (0 mm). After desiccation, the specimens were stored in distilled water to evaluate the water diffusion over a 120-day period. Net water uptake was calculated (sum of WSP and WSB). The color stability after immersion in a grape juice was compared to distilled water. Data were submitted to three-way ANOVA/Tukey's test (α = 5%). The higher distances caused higher net water uptake (p < 0.05). The immersion in the juice caused significantly higher color change as a function of curing tip distance and the time (p < 0.05). The distance of photoactivation and storage time provide the color alteration and increased net water uptake of the resin composite tested.

Development and modeling of thermally conductive resins for fuel cell bipolar plate applications

Thermally conductive resins are a class of material that show promise in many different applications. One growing field for their use is in the area of bipolar plate technology for fuel cell applications. In this work, a LCP was mixed with different types of carbon fillers to determine the effects of the individual carbon fillers on the thermal conductivity of the composite resin. In addition, mathematical modeling was performed on the thermal conductivity data with the goal of developing predictive models for the thermal conductivity of highly filled composite resins.

Influência de agentes clareadores na rugosidade de compósitos dentários

O clareamento dental é o meio disponível mais simples, comum e conservador para o cirurgião-dentista proporcionar aos pacientes o padrão de cor de seus dentes mais desejado. Em alguns casos, os dentes que vão ser clareados podem apresentar restaurações realizadas com compósitos dentais, que são mais suscetíveis a alterações químicas, quando comparados a outros materiais restauradores. Alguns estudos mostraram que diferentes concentrações de agentes clareadores levaram a um aumento significativo da rugosidade superficial e das porosidades em compósitos dentais. Este estudo avaliou o efeito de dois agentes clareadores (Whiteness HP Blue 20%, Whiteness HP Max) sobre a rugosidade superficial de dois compósitos dentais, um micro-híbrido (Esthet X, Denstply) e outro nanoparticulado (Z 350, 3M ESPE). Um total de oito corpos de prova (9 x 2 mm) foram confeccionados com auxílio de uma matriz de teflon, sendo divididos em 4 grupos (Esthet X + Whiteness HP Blue 20%; Esthet X + Whiteness HP Max; Z 350 + Whiteness HP Blue 20%; Z 350 + Whiteness HP Max), sendo n=2. Os corpos de prova foram armazenados em saliva artificial neutra e, após 24 horas, foram polidos com discos de óxido de Alumínio (Sof-lex, 3M ESPE). Após sete dias de imersão salivar, cada corpo de prova foi levado a um microscópio de força atômica para obtenção do valor inicial de rugosidade superficial (Ra em nm). Em seguida, sem remover o corpo de prova do microscópio, o agente clareador foi aplicado sobre a superfície do corpo de prova, segundo as instruções do fabricante, de modo que permitisse uma posterior observação da mesma área do corpo de prova observada inicialmente, para obtenção do valor final de rugosidade superficial. Imagens em duas e três dimensões foram obtidas de cada corpo de prova para observação de alterações da topografia. Os resultados foram tratados estatisticamente por ANOVA e pelo teste de contraste Student-Newman-Keuls (p < 0,05). Não houve alteração significativa na rugosidade superficial (Ra) dos corpos da prova de compósitos micro-híbrido e nanoparticulado, submetidos aos agentes clareadores Whiteness HP Blue 20% e Whiteness HP Maxx. No entanto, independente do agente clareador utilizado, foram observadas maiores alterações topográficas nas imagens de microscopia de força atômica da superfície do compósito micro-híbrido do que nas imagens do nanoparticulado.

Influência da variação da intensidade de luz, para uma mesma exposição radiante, no comportamento mecânico de uma resina convencional e de uma resina de baixa contração

O presente estudo teve como objetivo avaliar a influência da variação da intensidade de luz, para uma mesma exposição radiante, na resistência à flexão, na microdureza e na resistência à tração diametral de uma resina convencional e de uma resina de baixa contração. Para a confecção dos corpos de prova foram utilizadas as resinas Filtek Z250 (3M ESPE) e Filtek P90 LS (3M ESPE) fotoativadas por meio dos seguintes protocolos: Convencional (400mW/cm por 60 s), Média intensidade (700mW/cm por 34 s) e Alta intensidade (950mW/cm por 26 s). Todos os corpos de prova receberam a mesma exposição radiante de 24J/cm. A resistência à flexão foi avaliada por meio do ensaio de flexão três pontos. Para este ensaio foram confeccionados trinta corpos de prova de cada material (n=10) com dimensões de 10mm x 2mm x 1mm. A avaliação da microdureza Knoop foi obtida a partir de seis discos de cada resina com 5mm de diâmetro por 2mm de espessura (n=2), sendo realizadas cinco indentações em cada espécime. Trinta corpos de prova cílindricos de cada compósito (n=10) com 3mm de diâmetro por 6mm de altura foram confeccionados para a realização do teste de tração diametral. A análise estatística dos resultados obtidos foi realizada por meio do teste de análise de variância (ANOVA) e do teste de múltiplas comparações de Tukey (p < 0.05). A resistência à flexão da resina P90 não foi influenciada de forma significativa pelas diferentes formas de ativação, enquanto a Z250 obteve resultados significantemente maiores para o protocolo de alta intensidade em relação ao convencional. Em todas as intensidades de luz, os resultados da Z250 foram significativamente maiores que os da P90. A microdureza da resina P90 foi estatisticamente maior para o grupo de média intensidade em relação aos outros, já a Z250 não obteve resultados com diferença estatística em relação às formas de ativação. Para a mesma irradiância, a Z250 obteve maiores valores de microdureza do que a P90, com exceção para o protocolo de média intensidade em que não houve diferença estatística entre os materiais. Os valores de resistência à tração não foram influenciados de forma significativa nem pelas diferentes intensidades de luz, nem pelos materiais utilizados. A influência da variação da intensidade de luz depende do tipo de compósito utilizado e da propriedade mecânica avaliada.

Avaliação das propriedades mecânicas e microestrutura de um ionómero de vidro experimental reforçado com nano partículas

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária

Revisão bibliográfica

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária

Ionómero de vidro vs. resina composta em odontopediatria

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária

A revised classification for direct tooth-colored restorative materials

Composite resins and glass-ionomer cements were introduced to dentistry in the 1960s and 1970s, respectively. Since then, there has been a series of modifications to both materials as well as the development other groups claiming intermediate characteristics between the two. The result is a confusion of materials leading to selection problems. While both materials are tooth-colored, there is a considerable difference in their properties, and it is important that each is used in the appropriate situation. Composite resin materials are esthetic and now show acceptable physical strength and wear resistance. However, they are hydrophobic, and therefore more difficult to handle in the oral environment, and cannot support ion migration. Also, the problems of gaining long-term adhesion to dentin have yet to be overcome. On the other hand, glass ionomers are water-based and therefore have the potential for ion migration, both inward and outward from the restoration, leading to a number of advantages. However, they lack the physical properties required for use in load-bearing areas. A logical classification designed to differentiate the materials was first published by McLean et al in 1994, but in the last 15 years, both types of material have undergone further research and modification. This paper is designed to bring the classification up to date so that the operator can make a suitable, evidence-based, choice when selecting a material for any given situation.

Trends in material choice for direct restorations by final year students from University College Cork 2004-2009

Traditionally, undergraduate students in University College Cork (UCC) have been taught to use amalgam as the first choice material for direct restoration of posterior cavities. Since 2005 the use of composite resins has replaced amalgam as the first choice material. An audit was conducted of all direct restorations placed by final year students from UCC from 2004 until 2009. Results showed that over a six year period, final year UCC dental undergraduate students placed proportionately more direct composite resin restorations and significantly fewer amalgam restorations. The need for and undergraduate exposure to, provision of amalgam restorations may have to be revisited.