In Vitro Evaluation of the Color Variation of Two Bulk Fill Resin Composites Immersed in Four Different Pigmented Beverages: A Comparative Study

This study aimed to evaluate the effects of polywave and monowave light-emitting diode curing units on the microtensile bond strength and failure types of three bulk-fill resin composites. This in vitro experimental study was performed on 180 microbars obtained from human third molars and were distributed into 12 groups according to the type of bulk-fill resin composite and the light-curing unit. Third molars were restored using Filtek One Bulk Fill Restorative, Tetric® N-Ceram Bulk Fill, and Opus Bulk Fill resin composites was light-cured with Elipar Deep Cure L and Valo in three modes: standard, high power, and extra power. Subsequently, microtensile analysis was carried out with a universal testing machine and the type of failure with an optical stereomicroscope. For statistical analysis, the Kruskal-Wallis H-test was used, with the Bonferroni post hoc test and Fisher's exact test, considering a significance of p<0.05. There were significant differences in the microtensile bond strength between the Filtek One Bulk Fill restorative and Opus Bulk-Fill (p = 0.042) when light was cured with the polywave unit at standard power. On the other hand, the Filtek One Bulk Fill Restorative and Opus Bulk Fill resins showed significant differences in microtensile bond strength when light was cured with the monowave unit compared with the polywave unit (p<0.05). The presence of alternative photoinitiator systems that are more reactive than camphorquinone produced higher microtensile bond strength in Tetric N-Ceram Bulk Fill and Opus Bulk Fill resins when light-cured with a high and standard polywave unit, respectively, compared to Filtek One Bulk Fill resins. Finally, Tetric N-Ceram Bulk Fill and Opus Bulk Fill resins had the highest percentage of mixed failures, while Filtek One Bulk Fill resin had adhesive failures, which was related to its lower microtensile bond strength.

The aim of this study was to assess the microhardness and surface roughness of bulk-fill resin composites treated with and without the application of an oxygen-inhibited layer (OIL) and a polishing system. This in vitro experimental study consisted of 72 resin composite blocks divided into three groups: Tetric N-Ceram Bulk Fill, Opus Bulk Fill APS, and Filtek Bulk Fill. Each resin composite group was further divided into two subgroups: with and without OIL control. Subsequently, surface roughness and microhardness were measured before and after polishing. A t-test was used to compare independent and related measures. For the intergroup comparison of variation before and after polishing, the Kruskal–Wallis test with Bonferroni post hoc was used considering a significance level of p < 0.05. When comparing surface roughness, significant differences were observed between Opus Bulk Fill resin composite with and without OIL control (p = 0.003) before polishing. The same occurred when comparing Tetric N-Ceram resin composite with and without OIL control (p = 0.039) after polishing. In addition, the surface roughness of Filtek Bulk Fill, Opus Bulk Fill, and Tetric N-Ceram Bulk Fill resin composites, with and without OIL control, decreased significantly after polishing (p < 0.001), while surface microhardness significantly increased (p < 0.05), with the exception of Opus Bulk Fill resin with OIL control (p = 0.413). In conclusion, OIL control and polishing significantly improved the surface roughness and surface microhardness of Filtek Bulk Fill and Tetric N-Ceram Bulk Fill resin composites. However, in the case of Opus Bulk Fill resin composite, only its surface roughness was significantly improved.

Aim: This study aimed to evaluate the effect of polymerization with either a monowave (MW) or a polywave (PW) light-curing unit (LCU) on the degree of conversion (DC) and marginal adaptation following thermomechanical aging of an ormocer bulk-fill resin composite (RC) (Admira fusion X-tra Bulk Fill – AB), a methacrylate-based bulk-fill RC (Tetric N-Ceram Bulk Fill – TB) and a conventional RC (Tetric N-Ceram – TC). Methods: DC was assessed in five samples of each RC using Fourier transform infrared spectroscopy. For determination of marginal adaptation, standard preparations were made in 60 bovine incisors, divided into three groups, according to the RC. The bulk-fill RC was inserted in a single increment of 4 mm. In contrast, the conventional RC was inserted in three increments. Marginal gap was evaluated after thermomechanical aging. Data were analyzed using a two-way analysis of variance (ANOVA) and Tukey’s tests for multiple comparisons (α = 0.05). Results: The two-way ANOVA showed a significant effect (p<.05) of the RC factor but not of the LCU factor. The Tukey test showed that TB had the significantly lowest DC followed by TC, and with AB having the significantly highest DC. For the marginal adaptation, a significant effect was found for the LCU factor and the for the interaction RC × LCU (p<.05). Groups light-cured with PW showed significantly wider marginal gaps than MW. TC presented wider marginal gaps (17.36 µm) when cured with PW than when cured with MW (13.05 µm). The two bulk-fill RC resulted in similar marginal gap formation to each other. Conclusion: The ormocer-based bulk-fill RC showed a higher DC than the methacrylate-based bulk-fill RC but similar marginal adaptation. The LCU, MW or PW, had no significant influence on the DC, and no relevance on the marginal adaptation.

BackgroundSurface microhardness (SM) is a desirable property of any restorative material because it allows it to resist masticatory forces and any chemical challenges encountered in the oral environment. Therefore, the aim of this study was to evaluate the in vitro surface microhardness of three Bulk Fill resins previously exposed to five types of carbonated beverages at different times.MethodsThis in vitro experimental study consisted of resin composite discs (n = 180), distributed in three groups: Tetric N-Ceram Bulk-fill, Opus Bulk Fill APS and Filtek Bulk Fill, each immersed in distilled water (control), Fanta®, Sprite®, Coca-Cola®, Inca-Kola® and Pepsi®. Surface microhardness was measured before and after immersion in beverages for 1 day and 7 days. Data were subjected to statistical analysis using Games Howell’s robust ANOVA with post hoc and Friedman’s test with Bonferroni’s post hoc. Statistical significance was set at p < 0.05.ResultsAfter 1 day of immersion, the Tetric N-Ceram Bulk Fill resin significantly decreased its surface microhardness after immersion in Fanta, Sprite, Coca-Cola, Inca-Kola and Pepsi (p < 0.05), while the Filtek Bulk Fill resin significantly decreased its SM after immersion in Pepsi and Sprite (p < 0.05); however, the Opus Bulk Fill resin showed no significant SM differences (p = 0.141). On the other hand, after 7 days of immersion, the three Bulk Fill resins significantly decreased their SM, compared to the control group (p < 0.001), after being immersed in the five carbonated beverages. Finally, distilled water did not significantly affect the surface microhardness of the three Bulk Fill resins over time (p < 0.05).ConclusionThis study highlights the susceptibility of Bulk Fill resin composites to acidic degradation caused by carbonated beverages. While short-term exposure resulted in variable effects depending on the resin type, prolonged immersion consistently led to a reduction in surface microhardness across all materials tested. These findings suggest that the chemical composition of each resin influences its resistance to erosive challenges. Although this is an in vitro study, the results may provide a basis for future investigations into how acidic diets could influence the long-term performance of Bulk Fill composites in the oral environment.

Analisar a profundidade de cura das resinas do tipo Bulk Fill (Fluida e Pasta) alterando a fonte de luz. 10 tipos de resinas foram analizadas: (P) Pasta: FiltekTM One Bulk Fill (F1), Tetric N-Ceram Bulk Fill (T1); Aura Bulk Fill (A1); OPUS Bulk Fill (O1) e (F) Fluida: FiltekTM Bulk Fill Flow (F2); Tetric N-Flow Bulk Fill (T2); SDR® Plus Bulk Fill Flowable (S2); OPUS Bulk Fill Flow (O2). Foram confeccionados três discos para cada grupo seguindo ISO 4049/2000, através de molde (4x10mm), que foi totalmente preenchido com resina e fotoativado num tempo de 20s, sendo variado a fonte de luz entre Gnatus (G) e Kavo (K). Imediatamente depois as amostras foram removidas e a parte não polimerizada foi retirada com espátula de plástico. A mensuração foi realizada com um micrômetro de precisão ± 0,1mm. Os dados foram analisados usando ANOVA One-Way e ANOVA Two-Way e teste-t com significância de 0,05. Os grupos T1-K, S1-K, F1-K, F1-G, F2-G e T1-G mostraram resultados de profundidade de polimerização compatíveis com recomendações de fabricante. As fontes de luz G e K não apresentaram diferença (p = 0,068), mas entre os grupos (O2-G) (O2-K) (p = 0,004) houve diferença. Não foram encontradas diferenças entre as resinas (P-K p = 0,059), mas houve: grupo (F-K p =&lt; 0,050), entre resinas-K (p =&lt; 0,050), entre grupos (P-G) (F-G) e resinas-G (p =&lt; 0,050). Resinas fluidas (S2 e T2) apresentaram resultados de profundidade de cura superior a outras. A composição do material, assim como o comprimento de onda, pode ter influenciado nos resultados.

To compare shrinkage stress, cuspal strain and fracture load of weakened premolars restored with different conventional and bulk-fill composite resins and restorative techniques. Fifty premolars received a 4.0 x 3.5mm mesio-occlusal-distal (MOD) class II preparation. The lingual and buccal cups were internally weakened. Specimens were restored according to the following 5 groups: Filtek Z350 XT/10 increments; Filtek Z350 XT/8 increments (both 3M Oral Care); Filtek Bulk Fill Flowable Restorative + Filtek Z350 XT (both 3M Oral Care); SDR + Spectra Basic (Dentsply Sirona); and Tetric N-Ceram Bulk Fill (Ivoclar Vivadent). Cuspal strains were measured using strain gauges (n = 10). After restoration, specimens were submitted to thermal/mechanical cycles and fractured. Post-gel shrinkage of the composites was determined. Additionally, residual shrinkage strains and stresses were analyzed using three-dimensional finite element analysis (3D-FEA). The data were statistically analyzed using one-way ANOVA and Tukey's HSD (α = 0.05). One-way ANOVA revealed statistically significant differences among composite resins (p < 0.001) for the post-gel shrinkage. Filtek Z350 XT had the highest post-gel shrinkage and no difference was found between Spectra Basic and Tetric N-Ceram Bulk Fill (p = 0.110). The Filtek Z350 XT/10 increments, Filtek Z350 XT/8 increments and Filtek Bulk Fill Flowable Restorative/Filtek Z350 XT had statistically significantly higher cuspal deformation values when compared to the SDR/Spectra Basic and Tetric N-Ceram Bulk Fill techniques. 3D-FEA confirmed higher stress levels in the incrementally filled conventional restorations. Fracture loads were not statistically significantly different. The bulk-fill restoration techniques resulted in less cuspal strain and stress than the incremental technique with conventional composite resin. Fracture resistance was not affected by the restorative techniques.

To investigate effect of distilled alcoholic beverages on surface hardness, roughness, and erosion of bulk-fill resin composites. Sixty eight specimens of each bulk-fill resin composite (Filtek One Bulk Fill Restorative, SonicFill 2, and Tetric N-Ceram Bulk Fill) were prepared. Baseline data of surface hardness and roughness value were recorded. The specimens were divided into five groups: vodka, whisky, tequila, brandy, and deionized water (served as a control). Specimens were then alternately immersed in 25 ml of a storage agent for 5s and in 25 ml of artificial saliva for 5s over 10cycles. This process was repeated for 14 days. After immersion, specimens were subjected to evaluation of surface hardness, roughness, and erosion on days 7 and 14. The data were statistically analyzed by two-way repeated analysis of variance, Tukey's honestly significant difference, and a t test (p < 0.05). Distilled alcoholic beverages caused significant hardness decrement, roughness and erosion increment (p < 0.05), where the greatest degradation was found in brandy group. Tetric N-Ceram Bulk Fill had the most significant decrement in hardness and increment in roughness and erosion than the other resin composites (p < 0.05). Distilled alcoholic beverages affected hardness, roughness, and erosion of all the bulk-fill resin composites. Regarding the bulk-fill resin composites tested, Filtek One Bulk Fill Restorative was the most appropriate restorative material in patients who consume distilled alcoholic beverages.

To determine the influence of light curing units (LCUs) and material viscosity on the degree of conversion (DC) of bulk-fill (BF) resin-based composites (RBCs) placed in deep cavity preparations. Four LCUs were tested: Valo cordless, Bluephase-G2, Poly wireless and Radii-cal. Light irradiance was determined at 0mm and 6mm distance to the reading sensor. The following RBCs were considered: Filtek BF, Filtek BF Flow, Opus BF, Opus BF Flow, Tetric N-Ceram BF and Surefil SDR Flow. Sirius-Z was used with the incremental technique. DC (n = 3) was evaluated by spectroscopy both at top and bottom regions of deep preparations with 6mm depth. The data were submitted to ANOVA and Tukey's test (α = 0.05). Pearson's correlation (95%) was used to verify the relation between the LCUs and the curing potential of RBCs. The DC at 6mm depth was reduced when Opus BF, Opus BF Flow and Tetric N-Ceram BF were activated with Radii-cal. There was a positive correlation between the LCU irradiance and the bottom/top conversion ratios. The materials' viscosities did not affect the curing potential. Bulk-fill composites did not present higher curing potential than the conventional composite used with the incremental technique; the most important aspect of the LCU was the irradiance ratio; and the materials' viscosity did not affect the curing potential as a function of depth. Radii-cal negatively impacted the degree of conversion at 6mm depth for most bulk-fill resin composites. Depending on the brand, bulk-fill composites may present reduced curing potential due to the light source when placed in deep cavities. Dentists should avoid LCU with acrylic tips to photoactivate bulk-fill resin-based composites.

Background Due to the increasing popularity of bulk fill resins, there is a concern that their components can be leached; this is because these are inserted in a single 4-5 mm increment. This in vitro study evaluated the microhardness, sorption, solubility, and color stability of three restorative bulk fill resins, namely: Filtek Bulk Fill (FBF), Tetric N-Ceram Bulk Fill (TNC), and Opus Bulk Fill (OBF). Material and MethodsCylindrical samples were fabricated to be 15 mm in diameter and 1 mm thick (n = 10). For the microhardness test, three random indentations were formulated on the samples using a micro-durometer with a load of 300 gf for 15 s. Sorption and solubility were then evaluated (ISO 4049: 2009). Color stability was analyzed with a digital spectrophotometer three times (initially, after 24 h, and after 7 d) during immersion in coffee and distilled water (control). The Shapiro-Wilk test was applied to analyze normality. The Mann-Whitney and Kruskal-Wallis tests were used to compare the groups and the immersion solution, with a significance level of 5%. ResultsThere were a significant difference in microhardness (p<0.001), with the FBF group showing a higher value compared to the other groups (56.38). The highest average of sorption scores was observed in the OBF group (16.9 µg / mm3), followed by FBF (16.8 µg / mm3) and TNC (11.3 µg / mm3). Solubility was lowest in the OBF group (-2.83 µg / mm3), with a significant difference (p = 0.031). There was also a significant difference after 24 h in the mean ∆E score of all groups (p<0.005). After one week of immersion, the group that pigmented most was OBF (p = 0.008).ConclusionsThe three bulk fill resins had acceptable hardness, sorption, and solubility values. However, all groups showed a high pigmentation rate after 7 d of immersion in coffee. Key words:Bulk fill, color stability, composite resins, microhardness, solubility, sorption.

BackgroundThe structure of bulk-fill resin composites differs from that of their conventional counterparts, but how this difference affects the color stability of the former after staining and bleaching is unclear. Accordingly, this study was aimed at investigating color change in nine bulk-fill resin composites and one nanohybrid resin composite treated with hydrogen peroxide and carbamide peroxide after staining with tea, coffee, and red wine.MethodsEighty specimens were prepared from each resins [Clearfil Majesty Posterior (CMP), SDR flow+ (SDR), FiltekTMBulk-Fill Flowable Restorative (FBF), Reveal HD Bulk (RHD), Beautifil-Bulk Restorative (BBR), Tetric EvoCeram® Bulk Fill (TEC), SonicFill™2 (SF2), everX Posterior™ (eXP), X-tra base (XB), and Venus® Bulk Fill (VBF)]. Following baseline color measurements, the specimens were randomly divided into 4 groups according to immersion solutions and distilled water as the control. At the end of a 30-day test period, color measurements were repeated, and color change values (∆E00) were calculated. Each resin group was then divided into 2 subgroups (with 10 specimens per group) on the basis of bleaching agent (Opalescence Boost 40%, Opalescence PF 16%). Following bleaching application, ∆E00 and changes of whiteness (∆WID1 = WIDbleaching-WIDbaseline, ΔWID2 = WIDbleaching-WIDstaining) values were recorded. Two- and three-way analyses of variance and Tukey’s post hoc test were performed, with a P < 0.05 regarded as indicative of significance.ResultsAfter immersion in distilled water, tea, and red wine, the highest ΔE00 values were observed in eXP (P < 0.05). Resin materials immersed in coffee and tea exhibited statistically higher ∆E00 values than those immersed in red wine except for eXP, TEC, and FBF (P < 0.05). For eXP, the highest ∆E00 values were recorded in distilled water. For TEC and FBF, there was no statistically significant difference among the immersion solutions and distilled water (P > 0.05). For all the resins and staining beverages, no statistically significant difference in ∆WID1 and ∆WID2 values were detected between bleaching agents (P > 0.05). All the ΔWID1 values were above the whiteness perceptibility threshold.ConclusionThe bulk-fill materials were more resistant to discoloration and bleaching procedures than the conventional resin composites. Coffee and tea caused more staining than distilled water and red wine generally. The type of bleaching procedure had no effect on the whiteness of the tested materials.

Objectives: A systematic review was conducted to compare bulk fill resin composites with other contemporary composites when bonded to deep dentin cavities. Methodology: The systematic search was attained in seven electronic databases and the study's selection process was performed to meet the pre-set eligibility criteria. Five studies evaluating the microtensile bond strength (μTBSt) of bulk fill versus contemporary resin composites to cavity dentin were eligible to be included in the review, only four of them were assigned for the quantitative analysis. Data were extracted, tabulated, quality assessed and statistically analyzed using Comprehensive Meta-analysis version 2.2.048 software. Findings: The Meta-analysis forest plot revealed that, the effect size was preferential towards bulk fill composites with a statistical significance P-value <0.001. Applications/Improvements: Bulk fill resin composites could substantially solve the polymerization shrinkage and the degree of conversion inherent problems common in other contemporary resin composites specially when used in deep posterior cavities without harming its bond strength to dentin substrate. Clinical Significance: Bulk fill resin composites offers an easy, quick, convenient as well as promising clinical performance in restoration of deep posterior dental cavities.

Acidic conditions can cause hydrolysis and accelerate degradation of resin composites (RCs). Since there are limited and controversial data on the effect of acids on bulk-fill RCs, this study assessed the surface roughness (SR) and flexural strength (FS) of these RCs under simulated carious and erosion conditions. Bars of Filtek Bulk Fill (FBF, 3M/ESPE), X-tra fil (XTF, Voco), Tetric N-Ceram Bulk Fill (TBF, Ivoclar/Vivadent), and Aura Bulk Fill (ABF, SDI) and a conventional RC [Filtek Z350XT (FZ, 3M/ESPE)] were allocated (n=15) to undergo caries or erosion conditions. The control group was kept in artificial saliva (AS). The bars were evaluated for SR change (final-baseline) and for three-point FS. Data were analyzed using ANOVA and Tukey's test. At the baseline (p <0.001), the SR of RCs ranked as follows: (TBF = XTF) < FBF (none differed from FZ) < ABF. The interplay between RCs and conditions affected SR change (p = 0.025). While after storage in AS, there was no difference among RCs, following carious and erosive conditions, ABF showed higher SR change. For FS (p <0.001), XTF > (FBF = FZ) > (TBF = FZ) > ABF, with no difference among control, carious and erosive conditions (p = 0.148). Depending on the restorative bulk-fill RCs, carious and erosive conditions roughen the surface but do not affect the FS of these materials.

Introduction:Resin-based composites (RBCs), as restorative dental materials, have given a new dimension to conservative and esthetic dentistry. The objective of the present study is to evaluate and compare the depth of cure of RBC's for posterior use: Sculptable bulk-fill composite – Tetric N-Ceram bulk fill (TNCBF), Flowable bulk-fill composites-TetricEvoflow bulk fill (TEFBF), Surefil SDR bulk fill (SDRBF), Dual cure bulk fill-Fill-Up (FDCBF) with conventional RBC-Esthet-X flow (EXF) and Filtex Z250 (FZ).Materials and Methods:A standardized polyacrylic mold was bulk filled with each of the six composites and light-cured for 20 s, followed by 24 h storage in water. The surface hardness was measured on the top and the bottom by recording Vickers hardness number by Vickers hardness indenter.Results:The mean bottom surface hardness value (HV) of SDR and TEFBF exceeded 80% of the top surface HV (HV-80%). Low viscosity bulk-fill composites (SDR and Tetric Evoflow) were properly cured in 4-mm increments. The TNCBF, high-viscosity composite, and Fill-Up, dual-cure bulk fill were not sufficiently cured in 4-mm increments.Conclusion:With increase in incremental thickness, HV decreased for the conventional resin composite but generally remained constant for the bulk-fill resin composites.

Objective: To evaluate the fracture resistance of endodontically treated teeth restored with different high-viscosity bulk-fill resin composites. Material and Methods: Forty extracted human upper premolars were endodontically treated and divided into four groups based on the bulk-fill resin composite used: CO: Scothbond Multi-Purpose + Fütek Z3S0XT; SF: Scothbond Universal + Fütek Bulk Fill; SO: OptiBond All-in-one + SonicFill; and, TT: Tetric N- Bond Universal + Tetric N-Ceram Bulk Fill. Universal adhesive systems were applied using the self-etching technique. After 24 hours, specimens underwent compressive loading at lmm/min, and fracture patterns were evaluated. Data were statistically analyzed using one-way ANOVA and Tukey’s post-test (p&gt;O.OS), while fracture patterns were assessed with the chi-square test (p&lt;O.OS). Results: Fracture resistance was similar across groups (p&gt;O.OS), with favorable fractures observed in the CO and SF groups. Conclusion: The fracture resistance of endodontically treated teeth restored with bulk-fill resin composites does not differ from those restored with conventional nanohybrid resin composites.

ObjectivesThis study evaluated the effects of the resin thickness on the microhardness and optical properties of bulk-fill resin composites.MethodsFour bulk-fill (Venus Bulk Fill, Heraeus Kulzer; SDR, Dentsply Caulk; Tetric N-Ceram Bulk Fill, Ivoclar vivadent; SonicFill, Kerr) and two regular resin composites (Charisma flow, Heraeus Kulzer; Tetric N-Ceram, Ivoclar vivadent) were used. Sixty acrylic cylindrical molds were prepared for each thickness (2, 3 and 4 mm). The molds were divided into six groups for resin composites. The microhardness was measured on the top and bottom surfaces, and the colors were measured using Commission Internationale d'Eclairage (CIE) L*a*b* system. Color differences according to the thickness and translucency parameters and the correlations between the microhardness and translucency parameter were analyzed. The microhardness and color differences were analyzed by ANOVA and Scheffe's post hoc test, and a student t-test, respectively. The level of significance was set to α = 0.05.ResultsThe microhardness decreased with increasing resin thickness. The bulk-fill resin composites showed a bottom/top hardness ratio of almost 80% or more in 4 mm thick specimens. The highest translucency parameter was observed in Venus Bulk Fill. All resin composites used in this study except for Venus Bulk Fill showed linear correlations between the microhardness and translucency parameter according to the thickness.ConclusionsWithin the limitations of this study, the bulk-fill resin composites used in this study can be placed and cured properly in the 4 mm bulk.