Evaluation of Micro-Shear Bond Strength of Self-Adhesive Flowable Giomer To Bovine Tooth.

Evaluation of micro-shear bond strength of a self-adhesive flowable giomer to dentin in different adhesive modes

BackgroundDental caries in the primary dentition remains a major concern, with Class II cavities in molars posing particular restorative challenges. BEAUTIFIL Flow Plus X, a giomer-based injectable composite, offers esthetic and mechanical benefits with fluoride release and easier placement in children, while EQUIA® Forte Fil HT, a glass hybrid restorative, provides enhanced strength for stress-bearing areas. Clinical evidence in primary teeth is still limited, and this study aimed to compare their performance in Class II restorations of primary molars to support material selection in pediatric dentistry.MethodsA total of 124 primary molars with Class II cavities were randomized with a 1:1 allocation ratio into two groups: Group I received (EQUIA FORTE HT Fil), while Group II received (BEAUTIFIL Flow Plus X F00). Restorations were placed according to manufacturer’s instructions and evaluated for their esthetic, functional, and biological properties using FDI criteria at 3-, 6-, and 12-month intervals. Restorations with total scores of 4 (repair) or 5 (replacement) were recorded as failures. The trial was approved by the Institutional Research Ethical Committee, Faculty of Dentistry, Ain Shams University. Statistical analyses included the Mann-Whitney U test for intergroup and Wilcoxon signed-rank test for intragroup comparisons. The significance level was set at p ≤ 0.05.ResultsAt 12 months, the clinical success rates were 88.3% for Equia Forte HT Fil and 93.4% for BEAUTIFIL Flow Plus X, with no statistically significant difference (p > 0.05). BEAUTIFIL Flow Plus X demonstrated superior esthetic outcomes, with statistically significant advantages in surface luster (p = 0.002) and color match (p < 0.001). Key functional FDI criteria, including fracture and retention as well as marginal adaptation, were comparable between groups, with no statistically significant differences. Biologically, both materials performed comparably with no significant differences and no observed recurrent caries or postoperative sensitivity in either group.ConclusionBoth restorative approaches demonstrated acceptable clinical performance in class II cavities of primary molars after 12 months. While functional and biological outcomes were comparable, BEAUTIFIL Flow Plus X provided superior esthetics.Trial registrationThis RCT was registered at Clinical Trial.gov with registration number (NCT06000085) on the date of 11/8/2023.

The purpose of this study was to examine toothbrush-induced abrasion of resin composite restorations fabricated with flowable resin composites of different viscosities in vitro. In this study, six types of flowable resin composites with different flowability (Beautifil Flow F02, F02; Beautifil Flow F10, F10; Beautifil Flow Plus F00, P00; Beautifil Flow Plus F03, P03; Beautifil Flow Plus X F00, X00; and Beautifil Flow Plus X F03, X03) were used. For the toothbrush abrasion test, the standard cavity (4 mm in diameter and 2 mm in depth) formed on the ceramic block was filled with each flowable resin composite (n = 10) and brushed for up to 40,000 strokes in a suspension containing commercial toothpaste under the conditions of 500 g load, 60 strokes/min, and 30 mm stroke distance. After every 10,000 strokes, the brushed surface of the specimen was impressed with a silicone rubber material. The amount of toothbrush-induced abrasion observed on each impression of the specimen was measured using a wide-area 3D measurement device (n = 10). The viscosity was determined using a cone-and-plate rotational measurement system. Because of the effect of different shear rates on viscosity and clinical use, the values 1.0 and 2.0 s−1 were adopted as data (n = 6). In this study, the results of the toothbrush abrasion test demonstrated no significant differences in the amount of toothbrush-induced abrasion among flowable resin composites used (p > 0.05). No significant correlation was reported between toothbrush-induced abrasion and viscosities of flowable resin composites.

Introduction: The development of dental restorative materials has focused on improving mechanical and aesthetic qualities, with resin-based composites becoming widely used due to their ability to mimic natural teeth. These composites consist of a resin matrix, inorganic fillers, and a silane coupling agent, and their success depends on a high degree of polymerization. The degree of conversion (DC) affects the material's wear resistance, hardness, and longevity. To evaluate and compare the degree of conversion (DC) and microhardness of Activa Pronto and Beautifil Flow Plus composite resins.Materials and Methods: In this in vitro study, specimens of Activa Pronto (Pulpdent, USA) and Beautifil Flow Plus (Shofu, Japan) were prepared according to ISO 4049 standards. The degree of conversion was assessed using Fourier-transform infrared spectroscopy (FTIR), and microhardness was measured using the Vickers hardness test. A total of 30 discs per material were subjected to both tests, and the results were statistically analysed.Results: The degree of conversion was significantly higher for Activa Pronto (16.09%) compared to Beautifil Flow Plus (13.81%). Similarly, Activa Pronto demonstrated a significantly greater mean microhardness (34.98 VHN) than Beautifil Flow Plus (23.53 VHN), with p &lt; 0.001 for both comparisons.Conclusion: Activa Pronto exhibits superior polymerization and microhardness compared to Beautifil Flow Plus, suggesting that it is a more durable material suitable for stress-bearing restorations.

Objective: To assess the colour stability of two bioactive restorative materials Activa Pronto (Pulpdent, USA) and Beautifil Flow Plus (Shofu, Japan) when exposed to three commonly consumed beverages: coffee, tea, and Coca-Cola.Materials and Methods: 80 disc-shaped specimens were prepared, 40 samples each of the material and were divided into four groups based on the staining solution, which included: distilled water (control), coffee, tea, and Coca-Cola. The specimens were placed in the respective solution for 30 days. Solutions were replaced daily to avoid contamination. Color measurements were performed before (baseline) and after 30 days using a VITA Easyshade spectrophotometer, and the colour changes (ΔE) were calculated in the CIE Lab* system.Results: For the ΔE values, Activa Pronto showed significantly lower values than Beautifil Flow Plus in both coffee (p=0.001) and Coca-Cola (p=0.000) solutions. In the tea group, no significant difference was observed (p=0.223). Activa Pronto generally had more stable color, especially in acidic and staining solutions like coffee and Coca-Cola solutions.Conclusion: Activa Pronto presented greater color stability than Beautifil Flow Plus; therefore, it is a more suitable material for patients who would take much notice of the aesthetic appearances of their restorations in the long term. The most stained materials by Coca-Cola and coffee meant further investigation into the long-term clinical behaviour of these materials was essential.

To comparatively evaluate the elution of residual monomers (bis-GMA, bis-EMA, TEG-DMA, and HEMA) from two self-adhesive flowable resin composites, a giomer, and a nano-flowable resin composite over five different time intervals, using high-performance liquid chromatography (HPLC). Four flowable resin composites were investigated (Vertise Flow, Constic, Beautifil Flow Plus F03, and Filtek Z350 XT). Immediately after polymerization, each sample was immersed in 75% ethanol/water solution and stored in amber-colored bottles at room temperature. HPLC analysis was performed at predefined time intervals: 1 h, 24 h, 4 days, 8 days and 16 days. The extraction solution was changed after each analysis. Data were analyzed with repeated-measures ANOVA and one-way ANOVA with Tukey's post-hoc test at p < 0.05. The highest mean concentration of residual monomers was eluted from Beautifil, followed by Filtek, and both were significantly higher (p < 0.05) than the mean concentration of eluates from self-adhesive resin composites (Vertise Flow and Constic). Vertise Flow released significantly higher concentrations of HEMA than all the other tested materials. At 1 h post-immersion, 52.2% of monomers were eluted, and continued to elute at a reduced rate throughout the study duration. TEG-DMA was the fastest monomer to leach out, while bis-GMA exhibited significantly higher total mean concentration. The elution rate was significantly dependent on the molecular weight of the eluted monomers. No specific elution behavior can be attributed to self-adhesive RBCs. Elution of residual monomers is dependent on each material's composition, resin matrix characteristics, and the monomer's molecular weight.

The clinical performance of both conventional and flowable giomer restorative materials was particularly good in Class I restorations after three years of service. This study evaluated and compared the clinical performance of a flowable and a conventional giomer restorative material after three years. Forty-four pairs of restorations (total n=88) were placed in Class I cavities with either a flowable giomer (Beautifil Flow Plus F00; Shofu Inc, Kyoto, Japan) or a conventional giomer restorative material (Beautifil II; Shofu Inc) after the application of a dentin adhesive (FL-Bond II; Shofu Inc) and a flowable liner (Beautifil Flow Plus F03; Shofu Inc). After 3 years, 39 pairs of restorations were evaluated with the modified United States Public Health Service criteria, and digital color photographs of restorations were taken at each patient visit. The evaluation parameters were as follows: color match, marginal integrity, marginal discoloration, retention, secondary caries formation, anatomic form, surface texture, and postoperative sensitivity. Evaluations were recorded as a clinically ideal situation (Alpha), a clinically acceptable situation (Bravo), or a clinically unacceptable situation (Charlie). Data were analyzed with Fisher's exact and McNemar tests (α=0.05).None of the restorations showed retention loss, postoperative sensitivity, secondary caries, or color change. The performance of Beautifil II in terms of marginal integrity, marginal discoloration, and surface anatomic form was significantly lower at the 36-month follow-up than at baseline (p=0.007). There were no significant differences between the baseline and 36-month follow-up scores for the other criteria for Beautifil II (p>0.05). No differences were found between the baseline and the 36-month follow-up scores for any of the criteria for Beautifil Flow Plus F00 (p>0.05). No statistically significant difference in overall clinical performance was found between the 2 materials after 36 months (p>0.05).The three-year clinical performance of both restorative materials (Beautifil Flow Plus F00 and Beautifil II) was very good and not significantly different for any of the parameters evaluated.

The consumption of energy and sports drinks is on the rise globally, exposing dental restorations to more frequent low-pH challenges, which affect degradation. This in vitro study simulated the combined effect of energy drink exposure and cyclic fatigue loading on the fatigue survival rate and flexural strength of three direct dental resin restorative materials with distinct chemistries: a bioactive ionic resin (Activa Presto), a giomer (Beautifil Flow Plus F00) and a conventional nano-hybrid composite (Tetric Ceram). Bar-shaped specimens (25 × 2 × 2 mm) were fabricated according to ISO 4049 and stored for 24 h in either distilled water or 0.2 M citric acid (pH ≈ 2.5), simulating an energy drink (n = 10/group). The samples then underwent chewing simulation (40 N, 100,000 cycles, 1.6 Hz) using a steel antagonist; surviving specimens were tested via three-point bending to determine their flexural strength. All the materials were affected by storage conditions: Activa Presto showed the lowest fatigue survival (20% in water; 0% in citric acid), Tetric N-Ceram moderate survival (40% in both solutions) and Beautifil Flow Plus F00 the highest and most stable survival (90% in water; 40% in citric acid). Among the surviving specimens, Tetric Ceram exhibited the highest flexural strength, followed by Beautifil Flow Plus F00 and then Activa Presto. Citric acid exposure and cyclic loading adversely affected the mechanical performance of all the materials within the limitations of this study.

Objective. The aim of this study was to assess the effect of different polishing systems on the color stability of bioactive dental resin composites compared to a conventional composite. Materials and Methods. Two different bioactive dental resin composites (Beautifil Flow Plus F00 and Activa Presto) along with a nanohybrid composite (Filtek Z250 XT) were tested. A total of 20 samples per material were prepared and divided into four groups as per polishing protocol: Sof-Lex Diamond, Jiffy and TorVm polishing systems as well as a control group without polishing. A spectrophotometer was used to measure the color parameters before and after immersion in a coffee solution for 12 days. The color change (ΔE00) was calculated after immersion for each sample. Gloss was also measured at baseline and post immersion using a gloss meter. Results. There was a significant change in both ΔE00 and gloss in all materials (p &lt; 0.05). Z250 XT exhibited better color stability and gloss retention, particularly with the Jiffy system. Beautifil Flow Plus F00 demonstrated acceptable color stability and high gloss with the TorVm discs. Activa Presto showed significant color changes across all polishing systems. Conclusions. This work highlights the importance of understanding the effect of polishing systems on dental resin composites for optimal aesthetic outcomes. Despite the obvious benefits of bioactivity in both Beautifil Flow Plus F00 and Activa Presto, their performance regarding both color stability and gloss retention was lower than the inert Z250 XT. These findings emphasize the need for careful material and technique selection in clinical practice to ensure the longevity and esthetic quality of dental restorations.

Background. Newly introduced bioactive resin composites are being used more often. Few studies have evaluated the influence of toothbrush abrasion on their surface characteristics. Methods. This study aims to assess the surface roughness (Ra) and gloss values (GU) of 3 bioactive composites and a conventional nanohybrid composite before and after simulated toothbrush abrasion. Five samples each of Filtek Z250 XT, Beautifil Flow Plus, Activa Presto and Predicta Bioactive Bulk were subjected to 10,000 cycles of simulated toothbrush abrasion. Ra and GU values were evaluated at baseline and after each 2,500 cycles. Results. Significant difference was found in both Ra and GU (P < 0.001). For each material, GU gradually decreased as the brushing cycles increased. GU values of Beautifil Flow Plus were significantly higher at the baseline, 2,500- and 5,000-cycles stages (P < 0.05). The GU values were 78.20 (7.20), 69.67 (6.17) and 63.30 (5.52) respectively. Activa Presto showed the lowest mean GU after 10,000 cycles. A significant increase in Ra at each of the measuring stages was observed in all materials compared to the baseline measurement (P < 0.001). No significant difference in Ra values of all four materials at the baseline and up to 5,000-cycles (P > 0.05). After 7,500 cycles, the mean Ra value of Activa Presto at 0.64 (0.14) was significantly higher than that of Z250 XT at 0.49 (0.03) (P < 0.001). At 10,000 cycles, Activa Presto had significantly higher Ra at 0.70 (0.10) when compared to Z250 XT at 0.52 (0.08), Beautifil Flow Plus at 0.56 (0.07) and Predicta Bioactive Bulk at 0.59 (0.10) (P < 0.001). Conclusion. All materials showed an increase in Ra and decrease in GU after simulated toothbrushing.

Three-year clinical evaluation of two nano-hybrid giomer restorative composites

Objective: To compare the resin-porcelain shear bond strengths and their durability using a modified 4-META based porcelain repair system and other current systems. Material and method: One hundred specimens were prepared from feldspathic porcelain. The specimens were bonded to resin with five porcelain repair systems (20 pieces each): Superbond C&amp;B (SB), Bondfill SB (BF), Single bond universal (SU), Heliobonds (HB) and Vertise flow (VF). In each group, shear bond strength of 10 specimens were tested after 24-h water storage, and the other 10 specimens were tested after 5,000 thermocycles. All data were statistically analyzed by two-way ANOVA and T-test (p&lt;0.05). All substrate surfaces were investigated their fracture modes by a stereomicroscope. Fracture surfaces were categorized as adhesive, cohesive or mixed failure. Results: The mean shear bond strength among 5 groups at 24-h water storage varied from 12.3 MPa to 28.8 MPa and they varied from 4.14 MPa to 25.1 MPa after thermocycling. There was no statistically significant different in bond strength before and after thermocycling in HB, SB and BF. The significant lower bond strength after thermocycling was statistically significant in SU and VF. The mean shear bond strength was influenced by the type of porcelain repair system and thermocycling. All group exhibited more mixed and adhesive failure, except HB group. Conclusions: A modified 4-META based porcelain repair system is an alternative choice for repairing porcelain.

This study evaluated the repair microshear bond strength (μSBS) of water stored CAD/CAM resin composite under eight different surface treatments using a silane-containing universal adhesive in etch-and-rinse and self-etching modes. In total, 48 CAD/CAM resin composite slices were prepared from Lava Ultimate CAD/CAM blocks and stored in water for 6 months. The slices were assigned into 8 main groups, according to surface treatments (no treatment, no-treatment/silane, surface grinding, surface grinding/silane, sandblasting, sandblasting/silane, silica coating and silica coating/silane). Each main group was divided according to the universal adhesive application mode (either the etch-and-rinse mode or the self-etch mode). Each slice received 6 resin composite micro-cylinders (0.8 × 1 mm). Micro-shear bond strength was run at 0.5 mm/min crosshead speed until failure. Treated surfaces were examined using SEM. Bond strength data were statistically analyzed using Two-Way ANOVA/Tukey HSD post hoc test. Only ‘surface treatment’ significantly affected the repair μSBS (p ˂ 0.001). Parameters ‘Adhesive application mode’ and ‘surface treatment × adhesive mode’ showed no significant effect on μSBS (p = 0.458 and p = 0.286 respectively). Regardless of the adhesive application mode, silica coating showed the highest μSBS (21.6 ± 6.8 MPa), while sandblasting/silane showed the lowest μSBS (13.0 ± 6.1 MPa). Regardless of adhesive application mode, the use of silica coating to treat the water-stored CAD/CAM resin composite surfaces is crucial to improve the repair bond strength.

Background and aimsTo assess the color, translucency and masking properties of novel flowable giomers.MethodsThree flowable giomers were used for the fabrication of 1-mm thick samples (n=126) in three different consistencies (Beautifil flow Plus X F00; Beautifil flow F02; Beautifil flow Plus X F03, Shofu Dental Corporation, Japan) and two shades (VITA Classical shade A2 and A3). The relative spectral reflectance was recorded over white, black, C3 (VITA Classical shade C3 simulating a severe tooth discoloration), and a tested-sample colored background. Lightness (L*), and color coordinates a* and b*, Relative Translucency parameter (RTP00) and masking capacity of C3 background were calculated; differences in color and translucency were compared with thresholds for perceptibility and acceptability (PT and AT). Statistical analyses used significance tests for paired samples.ResultsAll tested materials displayed increased values of L*: for A2 F00=86.16(±0.86), F02=86.39(±0.63), F03=86.40(±0.63); for A3: F00=84.24(±0.58), F02=83.34(±0.3), F03=84.19(±0.4), as well as of RTP: for A2 F00=30.34(±0.88), F02=31.37(±0.94), F03=31.11(±1.15), for A3 F00=29.64(±1.64), F02=30.79(±1.02), F03=30.1(±1.26). For A2 samples, the masking capacity was significantly different for all materials, whilst for A3 there were differences only between F00-F03 and F02-F03.ConclusionsThe tested flowable giomers proved high values of lightness and translucency. The color differences between the materials with the same designation and different consistencies were below the perceptibility threshold in most cases. In addition, the differences in relative translucency parameter ranged between the perceptibility and acceptability thresholds. However, all tested flowable giomers had an unacceptable masking capacity for a dyschromic background.

BackgroundThe temperature changes, chemical agents, and brushing activity that resin composite restorations are exposed to in the oral environment can cause changes in surface roughness. In this study, the aim was to investigate in vitro the clinical one-year surface roughness changes of different types of composites (flowable or conventional) from the same companies by subjecting them to immersion in solutions, brushing, and thermal cycling procedures to simulate intraoral conditions.MethodsFour different resin composite brands were included in the study using both their conventional (Charisma Smart, 3M Filtek Ultimate Universal, Omnichroma, Beautifil II) and flowable resin composites (Charisma Flow, 3M Filtek Ultimate Flowable, Omnichroma Flow, Beautifil Flow Plus F00), giving 4 groups with 2 types of resin composite in each. 40 samples were prepared for each group/resin type, for a total of 320 samples. After initial surface roughness measurements by a mechanical profilometer, the samples were divided into 4 subgroups (n = 10) and immersed in solutions (distilled water, tea, coffee, or wine) for 12 days. The samples were then subjected to 10,000 cycles of brushing simulation and 10,000 cycles of thermal aging. Surface roughness measurements were repeated after the procedures. For statistical analysis, the 3-way analysis of variance and the Tukey test were used (p < 0.05).ResultsIt was concluded that composite groups and types had an effect on surface roughness at time t0 (p < 0.001). At time t1, the highest surface roughness value was obtained in the Beautifil-conventional interaction. When the surface roughness values between time t0 and t1 were compared, an increase was observed in the Beautifil II and Beautifil Flow Plus F00, while a decrease was observed in the other composite groups.ConclusionComposite groups, types, and solutions had an effect on the surface roughness of resin composites. After aging procedures, it was concluded that the Beautifil group could not maintain the surface structure as it exceeded the threshold value of 0.2 μm for bacterial adhesion.