Abstract
The aim of the study was to perform comprehensive characterization of two commonly used bulk fill composite materials (SDR Flow (SDR) and Filtek™ Bulk Fill Flowable Restorative (FBF) and one conventional composite material (Tetric EvoCeram; TEC). Eleven parameters were examined: flexural strength (FS), flexural modulus (FM), degree of conversion, depth of cure, polymerisation shrinkage (PS), filler particle morphology, filler mass fraction, Vickers hardness, surface roughness following simulated toothbrush abrasion, monomer elution, and cytotoxic reaction of human gingival fibroblasts, osteoblasts, and cancer cells. The degree of conversion and depth of cure were the highest for SDR, followed by FBF and TEC, but there was no difference in PS between them. FS was higher for bulk fill materials, while their FM and hardness were lower than those of TEC. Surface roughness decreased in the order TEC→SDR→FBF. Bisphenol A-glycidyl methacrylate (BisGMA) and urethane dimethacrylate were found in TEC and FBF eluates, while SDR released BisGMA and triethylene glycol dimethacrylate. Conditioned media accumulated for 24 h from FBF and TEC were cytotoxic to primary human osteoblasts. Compared to the conventional composite, the tested bulk fill materials performed equally or better in most of the tests, except for their hardness, elastic modulus, and biocompatibility with osteoblasts.
Highlights
The reason for the prevalence of composite resins as restorative materials in dentistry is that, in addition to providing superior aesthetics, they allow long manipulation and, unlike amalgams of glass ionomers, they provide unlimited working time for placing a filling
Conditioned media accumulated for 24 h from FBF and Tetric EvoCeram (TEC) were cytotoxic to primary human osteoblasts
The conventional composite used as a reference was Tetric EvoCeram (TEC; Ivoclar Vivadent, Schaan, Liechtenstein)
Summary
The reason for the prevalence of composite resins as restorative materials in dentistry is that, in addition to providing superior aesthetics, they allow long manipulation and, unlike amalgams of glass ionomers, they provide unlimited working time for placing a filling. Bulk fill composite resins were designed to facilitate this procedure, since they enable dentists to use thicker layers of composite filling materials, in increments of 4–5 mm [2,3] This has been achieved by several compositional modifications, one of them being the utilisation of a lower filler volume load and larger filler particles with smaller specific surface areas, ensuring less light scattering and better light transmission through the restoration material. High-molecular-weight monomers are incorporated into some bulk fill materials to diminish polymerisation shrinkage (PS) and mitigate the negative effects of PS stress, which results in a combination of deep curing and adequate marginal adaptation [4,5] It seems that some manufacturers, rather than radically modifying a material’s chemical composition, have reduced the quantity of pigments and used larger filler particles to enhance its translucency [6]
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