Effect of thickness on the degree of conversion, monomer elution, depth of cure and cytotoxicity of bulk-fill composites

Abstract

Today, bulk-fill composites are used as a single layer with a thickness of up to 4-5 mm. However, is proper polymerization achieved with this increased thickness? This study was designed to investigate the effect of thickness on the degree of conversion (DC) (n = 6), the elution of monomers (n = 6), depth of cure (DoC) (n = 10) and cytotoxicity (n = 6) of the bulk-fill composites SDR Flow Plus (SDR), SonicFill2 SingleFill (SF) and ACTIVA Bioactive Restorative (ACT) in comparison to the conventional G-aenial Posterior (GC). Two-way analysis of variance (ANOVA) was used to assess the interaction between materials and surfaces, and one-way ANOVA and Tukey tests were used to compare the degree of conversion, monomer elution and cytotoxicity values (P < 0.05). The highest DC was found at the top surface of SDR, while the lowest DC was found at SF. The V2 mm/V0 mm DoC ratios of the composites except ACTs were appropriate according to the threshold. None of the composites were cytotoxic on day 1. In bulk-fill composites, DC decreased and monomer elution increased with increasing depth. The V4 mm/V0 mm ratios of all bulk-fill groups were not appropriate. Additionally, only ACTs had a cell viability of <70% on day 7.