Filtek Supreme Ultra Research Articles

Effect of Tooth Brushing on the Surface of Enamel and Direct and Indirect CAD/CAM Restorative Materials

To determine the effects of tooth brushing on the surface roughness (Sa) and morphology, maximum relative depth (Rv), gloss (GU), and microhardness (MH) of four esthetic restorative materials and enamel. A light-curing composite resin (Filtek Supreme Ultra [FSU], 3M ESPE), two hybrid resin/ceramic CAD/CAM materials (Lava Ultimate [LAV], 3M ESPE, and VITA Enamic [VEN], VITA Zahnfabrik), and a CAD/CAM feldspathic ceramic (VITA Blocs Mark II [VMA], VITA Zahnfabrik) were evaluated. Bovine enamel (ENA) was used as a control group. All surfaces were polished in accordance with the manufacturer's instructions. Samples were analyzed before and after brushing (30,000 cycles) regarding Sa and Rv using a 3D laser-measuring microscope. GU was evaluated every 10,000 tooth brushing cycles. MH was also measured before and after tooth brushing. The surfaces were observed using scanning electron and laser measuring microscopies to determine the wear patterns. Data were analyzed by paired t test, one-way or two-way repeated measures analysis of variance, and Tukey test (α = .05), depending on the method performed. The Sa increased significantly after brushing for all materials, except for VMA, which showed the opposite effect. ENA and VEN showed higher Rv than VMA. After 30,000 tooth brushing cycles, VMA showed the highest GU, while FSU showed the lowest. Also, little surface topography changes were observed for VMA. MH did not change significantly after 30,000 brushing cycles, except for LAV. Brushing caused surface alterations in all tested materials except for feldspathic ceramic. The changes were more evident in resin-based materials.

Color matching ability of resin composites incorporating supra-nano spherical filler producing structural color

ObjectiveThe aim of this study was to evaluate the optical properties of supra-nano spherical fillers with different diameters and the color matching ability of resin composites (RC) incorporating these fillers. MethodsTwo types of SiO2–ZrO2 nano fillers with different diameters (150nm and 260nm) were used. The size distribution of each filler was measured and filler morphology was observed. The colors and spectral reflection spectra were measured by a spectral reflectometer. Experimental RCs incorporating ϕ150-nm/ϕ260-nm filler (D150RC/D260RC) were prepared. For the base dentin part, disc specimens (Estelite Astelia: A1B, A2B, A3B, A3.5B, or A4B) were prepared with a cylindrical cavity. Estelite Astelia with NE shade was layered on top as the enamel layer. Disk specimens with different cavity depths were prepared using A3B shade. Experimental RC was used to fill the cavity, and spectral reflection spectrums were obtained and analyzed. Filtek Supreme Ultra (FSU) with A3B shade was used (n=10) as a control. ResultsBoth ϕ150-nm and ϕ260-nm nano fillers showed uniform spherical shape and exhibited no aggregation. The maximum peaks of the spectral reflection spectra of the ϕ150-nm and ϕ260-nm nano fillers were 380nm and 580nm, producing structural colors close to blue and yellow, respectively. The spectral reflection spectrum of FSU had a broad peak at 540nm, and D150RC had a significant peak at 420nm. The D260RC specimen had a broad peak at 680nm. The peaks of D150RC and D260RC significantly decreased in accordance with the shift in base RC shade from A1B to A4B. There was no significant difference in the peak of the reflection spectral spectra among different cavity depths of D260RC. These results suggest that the experimental RC could reflect base RC colors via the matrix resin, and the amount of transmitted light from the base RC was not much different with cavity depth. SignificanceD260RC producing structural color demonstrated a broad spectrum and reduction in brightness and chromatic value by adapting to surrounding restorative materials, suggesting its ability to enhance the chameleon (blending) effects to improve color matching. D260RC showed better color matching ability than resin composite containing uniformly sized ϕ150-nm SiO2–ZrO2 supra-nano spherical filler.

The effect of temporary sealing materials and cleaning protocols on the bond strength of resin cement applied to dentin using the resin-coating technique.

This study evaluated the effect of temporary sealing materials and cleaning protocols on the bond strength of resin cement applied to dentin using resin-coating technique. Scotchbond Universal Adhesive and Filtek Supreme Ultra Flowable were applied to bovine dentin. Forty-five specimens were divided into the following three groups according to the temporary sealing materials: Cav-: CAVITON EX, Vas-: COCOA BUTTER and FIT SEAL, and Sep-: Washable SEP and FIT SEAL. Each material was placed on resin-coated dentin. After 1-week water storage, one of the following three cleaning protocols was performed: -WA: washed with water, -BR: brushed with PRESSAGE, and -AF: cleaned with AIR-FLOW. Microtensile bond strength test and EDS analysis were conducted. Irrespective of the cleaning protocol used, Washable SEP demonstrated less residual debris on resin-coated dentin, resulting in high bond strength. Regardless of the temporary sealing material applied, AIR-FLOW demonstrated less residual debris, resulting in high bond strength.

Effect of water storage and thermocycling on light transmission properties, translucency and refractive index of nanofilled flowable composites.

The effect of 1-week water storage and subsequent 10,000 thermal cycles on light transmission properties (straight-line transmission (G0), diffusion (DF), the amount of transmitted light (AV)), translucency parameter (TP) and refractive index (RI) of four nanofilled flowable composites was examined. The composites included Filtek Supreme Ultra Flowable Restorative (FSU), Estelite Flow Quick (EFQ), Estelite Universal Flow, (EUF), and Clearfil Majesty ES Flow (ESF), all of A3 shade. For composites with lower filler load (FSU, EFQ), water storage increased G0, AV and TP, but subsequent thermocycling decreased them. An opposite tendency was found for DF. Materials with higher filler load (EUF, ESF) were not significantly affected by aging conditions. RI of EFQ and EUF containing bisphenol A polyethoxy methacrylate (Bis-MPEPP) increased significantly after thermocycling. Additionally, morphological changes were observed using scanning electron microscopy which revealed cracks within nanocluster fillers and dislocation of particles in FSU and EFQ after thermocycling.

Risk assessment of predicted serum concentrations of bisphenol A in children and adults following treatment with dental composite restoratives, dental sealants, or orthodontic adhesives using physiologically based pharmacokinetic modeling

Bisphenol A (BPA) is a chemical used to manufacture bisphenol A glycidyl methacrylate (BisGMA). BisGMA has been used for decades in dental composite restoratives, sealants, and adhesives. Based on published studies, exposure to low concentrations of BPA are possible from dental and orthodontic devices. The serum BPA concentrations arising from such devices and oral doses were predicted using a PBPK model in children and adult females based on 1) published extraction data for cured and uncured 3M ESPE Filtek Supreme Ultra Flowable, 3M ESPE Filtek Bulk Fill Restorative, and 3M ESPE Clinpro Sealant and 2) published 20% ethanol/water and water rinsate data following orthodontic application with 3M ESPE Transbond MIP Primer and 3M ESPE Transbond XT Adhesive. Predicted oral exposure to BPA arising from these dental and orthodontic devices is low (median <10 ng/treatment) and predicted serum BPA concentrations were also low (<10−4 nM). Even the maximum predicted exposure in this study (533.2 ng/treatment) yields a margin of exposure of 7.5 relative to the EFSA t-TDI (4 μg/kg-day) and is only 2.8% of the daily BPA exposure for the US population in a 58-kg woman (15,660 ng/day). Therefore, the exposure to BPA arising from the 3M ESPE dental and orthodontic devices evaluated in this study is negligible relative to daily BPA exposure in the general population and these potential BPA sources do not constitute a risk to patients.

Optical properties of bisacryl-, composite-, ceramic- resin restorative materials: An aging simulation study.

Compare optical properties of a bisacryl-, composite-, and ceramic-resin restorative materials pre and post artificial aging. Bisacryl-resin (LuxaCrown [LC], DMG), resin-composite (Filtek Supreme Ultra, [Filtek SU] 3M ESPE), and ceramic-resin (Enamic, VITA Zahnfabrik) specimens were prepared. The L*, C*ab , and hab values were measured pre and post artificial aging to determine color stability (CIEDE2000) and changes in contrast ratio (CR), transmittance block, and relative translucency parameter. The datasets were analyzed using 2-way ANOVA followed by pairwise comparisons. Color difference data showed a significant interaction between materials and treatments [F(6:60)=375.04, P < .0001] with Enamic being most color stable material and coffee having most effect on color stability. CR data showed a significant interaction between materials and treatments [F(6:60)=4.12, P=.0016]. LC showing most change in CR values with coffee treatment. Change in transmittance blocked by Filtek SU and LC was greater for coffee treatment than that by each of the other treatments (P < .0001). Filtek SU and LC, coffee produced a greater decrease in relative translucency than that each of the other treatments (P < .0001). Resin-based materials demonstrate optical properties that encourage their use for direct/indirect restorative options. Color stability and translucency of these materials are proportionally related. Understanding the optical properties of resin-based materials provides help in material selection and provides insight into clinical performance and esthetic longevity. The optical stability of certain bisacryl-resin is better than what was previously determined for these restorative materials.

The effect of different light curing units on Vickers microhardness and degree of conversion of flowable resin composites.

This study aimed to assess the influence of different light curing units (LCUs) on the polymerization of various flowable resin composites. Three LCUs (Optilux 501, Elipar™ DeepCure-L LED and Bluephase®20i) and eight flowable resin composites: MI FIL Flow, Estelite Flow Quick, Estelite Universal Flow (medium), Estelite Universal Flow (super low), Beautifil Flow Plus, Clearfil Majesty ES Flow, Filtek Supreme Ultra flowable and TetricEvo Flow were tested. For Vickers microhardness (VHN) test and degree of conversion (DC), specimens were prepared and polymerized for 20 s. VHN test was performed at top surfaces (3 indentations) and DC for each specimen was measured using Fourier transform infrared (FT-IR) spectroscopy after 24 h dry storage in dark at 37˚C. The data were analyzed with 2-way ANOVA and t-test with Bonferroni correction. DC and hardness values showed a relationship between materials and LCUs. The curing efficacy of LCU type may depend on the material composition.

Effect of Tribochemical Coating on Composite Repair Strength.

Tribochemical treatment of existing composite surfaces is highly effective for composite repair. When repairing an old composite restoration, the clinician should try to use the same composite originally used for the restoration. If the information about the original restoration is not known, a composite with strong mechanical properties should be used for the repair restoration. This study evaluated the effect of tribochemical coating on composite-to-composite repair interfacial fracture toughness (iFT). Sixty beam-shaped specimens (21×4×3 ± 0.2 mm) were prepared with a nanofill composite (Filtek Supreme Ultra [FSU]) and a nanohybrid composite (Clearfil Majesty ES-2 [CME]) and aged for 50,000 thermocycles (5°C-55°C, 20-second dwell time) and then sectioned in half. The resulting 120 hemispecimens (60 for each composite) were randomly assigned to different repair methods (n=10): universal adhesive (Clearfil Universal Bond Quick [CUB]), sand-blasting followed by CUB, or tribochemical coating (CoJet, CoJet sand, Espe-Sil, and Visio-Bond). The repair surface was prepared with a diamond bur (Midwest #471271), rinsed, and dried. Each aged composite brand (FSU, CME) was repaired with either the same composite or the opposite composite. All adhesives and composites were light cured with a high-irradiance LED curing light (Elipar DeepCure-S). After postrepair storage in 100% humidity and at 37°C for 24 hours, iFT was measured as KIc (MPa m½). Data were analyzed for statistical significance using two-way analysis of variance (ANOVA) and the Tukey honest significant difference post hoc test (α=0.05). Regardless of the substrate composite, ANOVA showed significant differences for surface treatment (p<0.0001) and repair composite (p<0.0001). Mean iFT values (SD) ranged from 0.91 (0.10) MPa·m½ to 2.68 (0.12) MPa·m½. Repairs made with FSU after CoJet resulted in significantly higher iFT (FSU: 2.68 MPa·m½; CME: 2.21 MPa·m½) when compared to the other experimental groups. The repair iFT was higher with CoJet treatment and when the nanofill composite FSU was used as the repair composite.

Effect of time on the post-irradiation curing of six resin-based composites

ObjectivesTo evaluate the effect of time on the Vickers microhardness (VH) at the top and bottom surfaces of six conventional resin-based composites (RBCs) up to twelve weeks after light curing. MethodsFive specimens of Filtek Supreme Ultra, Herculite Ultra, Mosaic Ultra, Tetric EvoCeram, TPH Spectra HV, and Venus Pearl were packed into opaque molds that were 2.3mm in diameter and 2.5mm deep. The uncured RBC specimens were covered by a polyester strip and photo-cured with an Elipar DeepCure-S light-curing unit (LCU) according to the manufacturer's instructions. After irradiation, the polyester strip was removed, and the Vickers microhardness was measured immediately at top and bottom surfaces. The hardness measurements were repeated after 30min, 1h, 2h, 4h, 24h, 1 week, 4 weeks, and 12 weeks. In between, the specimens were stored in dry and dark conditions at 37°C. Two-way ANOVA (α=0.05) followed by Tukey–Kramer post hoc multiple comparison tests were used to determine where statistically significant differences existed. ResultsThe micro-hardness values at the top surface always exceeded those at the bottom surface. A significant logarithmic increase of the micro-hardness due to post-irradiation curing took place between 30min and 24h (p<0.05). There was no significant increase in the VH after 24h. Depending on the RBC, compared to the immediate values the hardness 24h post-irradiation had increased by 11–27% at the top surface and by 21–58% at the bottom. SignificanceEven after 12 weeks, the bottom hardness values never reached the top microhardness values. The results of studies that wait 24h or longer before measuring the properties of RBC specimens will be significantly enhanced by the impact of post-irradiation curing. Especially within the first 4h, the time when specimens are measured is critical information and should be reported.

Effect of Preheating and Fatiguing on Mechanical Properties of Bulk-fill and Conventional Composite Resin.

Bulk-fill composite resins may have comparable mechanical properties to conventional composite resin. Preheating does not reduce the mechanical properties of composite resins.

Surface roughness and color stability of surface sealants and adhesive systems applied over a resin-based composite.

To evaluate coating materials regarding color and roughness changes when applied over a composite resin. Specimens were made using Filtek Supreme Ultra. Coating materials were applied over the specimens' surface: Control (CTRL); Adper Single Bond Plus (SB); Scotchbond Universal (US); Clearfil SE (CL); Ambar APS (APS); Bioforty (BF); Fortify (FF); PermaSeal (PS); G-CoatPlus (GC). Specimens were evaluated regarding color changes (∆E00 ) using spectrophotometer (n = 10); surface roughness (Ra), using optical profilometer (n = 10); surface topography, using scanning electron microscopy (n = 1); and thickness of material, using optical microscopy (n = 1). Analyses were made before and after 24, 72, and 168 hours of storage in wine, used as a staining solution. Data was statistically analyzed using analysis of variance, Tukey and Pearson tests (α:.05). None of the materials presented color stability. ∆E00 increased with increasing storage time at red wine, until 72 hours. BF, FF, PS, SB, and CTRL presented the lowest ∆E00 after 24 hours. APS presented the highest ∆E00 (32.59; P < .05). Regarding roughness, initially, surface sealants and APS presented the lowest values. After 168 hours, GC presented the lowest Ra (0.60; P < .05). All the materials presented color and roughness changes after storage in red wine. Some coating materials can be applied over the surface of RBC restorations without changing its color stability or surface roughness.

Properties of New Glass-Ionomer Restorative Systems Marketed for Stress-Bearing Areas.

The purpose of this study was to evaluate the properties (fracture toughness, surface hardness) of newer conventional glass-ionomer restorative materials that are marketed for posterior stress-bearing areas compared with more traditional glass-ionomer restorative materials marketed for non-load-bearing areas and composite-resin restorative materials. Notched-beam fracture toughness specimens were created in a mold with each tested material (Equia Forte, GC America, with and without a surface coating of Equia Forte Coat; Ketac Universal, 3M/ESPE; ChemFil Rock, Dentsply; Fuji IX GP Extra, GC; Ionostar Molar, VOCO; Filtek Z250, 3M/ESPE; Filtek Supreme Ultra, 3M/ESPE) and fractured using a universal testing machine after 24 hours of storage. Hardness values were determined on the surface of the fracture toughness specimens using a hardness tester. Data were analyzed with a one-way ANOVA and Tukey's post hoc test per property (alpha=0.05). The composite-resin restorative materials had significantly greater fracture toughness than the glass-ionomer materials. There was no significant difference in fracture toughness between the glass-ionomer materials. The use of a resin coating significantly increased the surface hardness of the newer glass ionomer marketed for stress-bearing areas. Fracture toughness was not improved with the newer glass-ionomer restorative materials marketed for stress-bearing areas compared to the conventional glass-ionomer materials, however a resin coating provided greater surface hardness.

Bonding Performance of Universal Adhesive Systems Applied in Etch-and-Rinse and Self-Etch Strategies on Natural Dentin Caries.

This study investigated the bonding performance of three universal adhesive systems applied using etch-and-rinse (ER) or self-etch (SE) strategies on natural dentin caries. Sixty human third molars were selected for this study: 30 naturally carious (CAD) and 30 sound (SD) teeth. The dentin surfaces were exposed, and teeth were randomly assigned to each evaluated adhesive system: Scotchbond Universal (SBU), Futurabond U (FBU), and Prime&Bond Elect (PBE) and an adhesive strategy: ER or SE. The adhesive systems were applied following the manufacturer's instructions, and the teeth were restored using a resin composite (Filtek Supreme Ultra, 3M). After 24 hours (distilled water at 37°C), samples were sectioned and evaluated using microtensile bond strength analysis (μTBS), micro-Raman spectroscopy to evaluate the degree of conversion within the hybrid layer (DC), and scanning electronic microscopy (SEM) to describe the morphology of the hybrid layer. The μTBS and DC data were analyzed using three-way analysis of variance and Tukey's test for means comparison (α=0.05). The SEM images were analyzed qualitatively. Reduced μTBS values were observed when comparing CAD with SD, regardless of adhesive system or strategy (p<0.0001). SBU showed statistically higher μTBS for both dentin substrates and strategies (p<0.0001). Furthermore, SBU showed greater integrity of the hybrid layer and resin tag formation compared with FBU and PBE. Mean μTBS values for FBU were higher for SD in the SE mode, whereas higher mean μTBS values were observed for CAD in the ER mode, both compared with PBE (p<0.001). Bonding performance is reduced on a caries-affected substrate. The ER strategy was not able to improve the bonding performance on natural CAD for universal adhesive systems. Improved bonding performance was obtained when using the Scotchbond Universal system.

Analysis of transmittance and degree of conversion of composite resins.

The objective of this study was to evaluate and correlate light transmittance (T), initial degree of conversion (IDC), and degree of conversion after 24 hr (DC24) for 22 composite resins (CR) for enamel and dentin use. The transmittance (n = 10) was measured with a spectrometer at a wavelength of 468.14 nm. The degree of conversion (DC; n = 5) was measured with Fourier Transform Near-Infrared Spectroscopy before polymerization, immediately after photoactivation, and 24 hr after photoactivation. Both sets of values are provided as percentages. ANOVA and Games-Howell (α = 5%) tests showed that Filtek Supreme Ultra gave the highest T values of all enamel CRs, while Esthet-X HD presented the lowest. Meanwhile, Venus diamond gave the highest values of all dentin CRs, while Esthet-X HD gave the lowest. For IDC and DC24, ANOVA showed differences between individual CRs and the two CR types (p < .0001). Despite the limitations of this study, it can be concluded that there was no correlation between T and either IDC or DC24 (p > .05); however, IDC and DC24 were strongly correlated (p < .05) by Pearson's correlation. That being said, as a higher DC reflects better mechanical properties, certain conclusions can be drawn about overall performance. The best IDC values were observed for the Opallis enamel resin and the Opallis and Premise dentin resins. Meanwhile, the best DC24 values were observed for the Opallis, Charisma, and Premise enamel resins and the Opallis and Premise dentin resins. Degree of conversion and light transmittance showed differences between composite resin types (enamel and dentin) and brands. It is important to know at the moment of composite choice taking into account mechanical and optical properties.

Long-term nanomechanical properties and gelatinolytic activity of titanium tetrafluoride-treated adhesive dentin interface

ObjectiveThis study investigated the effects of dentin pretreatment with 2.5% titanium tetrafluoride (TiF4) on nanomechanical properties, and the in situ gelatinolytic activity of the dentin–resin interface, for up to 6 months. MethodsTwenty-four human teeth were prepared by exposing occlusal flat dentin surfaces, and were randomly assigned to experimental groups, according to application or non-application of a TiF4 pretreatment, and to the adhesive systems (Clearfil SE Bond or Scotchbond Universal). Resin composite (Filtek Supreme Ultra) was built up incrementally on the teeth in all the groups. Then, the specimens were sectioned and randomly selected for evaluation at 24h, 3 months and 6 months of storage time. The reduced modulus of elasticity (Er) and the nanohardness of the underlying dentin, as well as the hybrid layer and the adhesive layer were measured using a nanoindenter. Gelatinolytic activity at the dentin–resin interfaces was assessed by in situ zymography using quenched fluorescein-conjugated gelatin at 24h and 6 months. Statistical analyses were performed with ANOVA and Tukey’s tests. ResultsThere were no differences in Er and nanohardness values between adhesives systems and pretreatment (p=0.1250). In situ zymography showed significantly higher gelatinolytic activity after 6 months for all the experimental groups (p=0.0004), but no differences between the adhesive systems (p=0.7708) and the surface pretreatment (p=0.4877). Significance: Dentin pretreatment with 2.5% TiF4 followed by self-etching adhesive systems did not influence nanomechanical properties or gelatinolytic activity of the adhesive–dentin interface layers, over time.

Wear Characteristics of Dental Ceramic CAD/CAM Materials Opposing Various Dental Composite Resins.

The aim of this study was to evaluate the wear properties of opposed dental ceramic restorative CAD/CAM materials and several posterior direct restorative composite resins. Three kinds of dental ceramics CAD/CAM materials (monolithic zirconia, lithium disilicate, leucite) and four dental composite resins—that is, MI Gracefil, Gradia Direct P, Estelite Σ Quick, and Filtek Supreme Ultra—were used in this study. For each of the 12 groups (three ceramics × four composite resins), five each of a canine-shaped ceramic specimen and a cuboidal shape opposing composite resin were prepared. All of the specimens were tested in a thermomechanical loading machine (50 N, 100,000 cycles, 5/55 °C). Wear losses of ceramic specimens and composite resin specimens were evaluated using a three-dimensional profiling system and an electronic scale, respectively. Statistical analyses were performed using the Kruskal–Wallis test and Mann–Whitney U test with Bonferroni’s correction. Zirconia showed significantly less volumetric loss than lithium disilicate or leucite regardless of composite resin type (p > 0.05/3 = 0.017), and that Estelite Σ Quick showed significantly more weight loss than Filtek Supreme Ultra, MI Gracefil, or Gradia Direct P regardless of ceramic type (p > 0.05/6 = 0.083). Zirconia showed less volumetric loss than lithium disilicate or leucite. Some composite resins opposing ceramics showed considerable weight loss.

Instrumental and visual evaluation of the color adjustment potential of resin composites.

To evaluate the instrumental and visual color adjustment potential (CAP-I, CAP-V), of resin composites. Resin composites tested were Omnichroma, Filtek Supreme Ultra, TPH Spectra, Herculite Ultra, and Tetric EvoCeram. Two types of specimens, "dual" and "single" were evaluated. For dual specimens, class I preparations (4 mm-diameter, 2 mm-depth), were created in denture teeth and restored with test resin composites. For single specimens, replications of denture teeth were created using the test resin composites (n = 5) and compared with unrestored denture teeth. Reflectance values were obtained using a spectroradiometer. CAP-I and CAP-V were calculated. Fisher PLSD intervals for comparison of means were calculated at the 0.05 level of significance. CAP-I ranged between 0.02 and 0.67. The Fisher PLSD interval for comparisons between single/dual color differences was 0.09 (P < .0001, power 1.0) and for comparisons between materials and shades 0.18 and 0.33, respectively (P < .0001, power 1.0). CAP-V ranged between 0.16 and 0.60. The Fisher PLSD interval for comparisons between single/dual visual color differences was 0.05 (P < .0001, power 1.0) and 0.08 and 0.14 for comparisons between materials and shades, respectively (P < .0001, except Herculite Ultra-Tetric EvoCeram and certain shade pairs). Instrumental color differences and visual rating of single specimens were the greatest for Omnichroma, indicating the largest mismatch, while the instrumental and visual color differences of dual specimens were the smallest. Omnichroma had the most pronounced CAP-I followed by Tetric EvoCeram>TPH Spectra = Filtek Supreme Ultra >Herculite Ultra. Similarly, Omnichroma exhibited the most pronounced CAP-V followed by Tetric EvoCeram>TPH Spectra = Herculite Ultra = Filtek Supreme Ultra. Resin composites with pronounced CAP blends with surrounding enamel and dentin, resulting in reduced color differences and therefore improving the esthetic appearance of the restoration, simplifying the shade matching and compensating for any color mismatch.

Influence of Polishing Systems on Surface Roughness of Composite Resins: Polishability of Composite Resins.

The objective of this in vitro study was to compare, with a threshold value of 200 nm, the surface roughness obtained when using 12 different polishing systems on four different composite resins (microfill, nanofill, and two nanohybrids). A total of 384 convex specimens were made using Durafill VS, Filtek Supreme Ultra, Grandio SO, and Venus Pearl. After sandblasting and finishing with a medium-grit finishing disc, initial surface roughness was measured using a surface roughness tester. Specimens were polished using 12 different polishing systems: Astropol, HiLuster Plus, D♦Fine, Diacomp, ET Illustra, Sof-Lex Wheels, Sof-Lex XT discs, Super-Snap, Enhance/Pogo, Optrapol, OneGloss and ComposiPro Brush (n=8). The final surface roughness was measured, and data were analyzed using two-way analysis of variance. Pairwise comparisons were made using protected Fisher least significant difference. There were statistical differences in the final surface roughness between polishing systems and between composite resins (p<0.05). The highest surface roughness was observed for all composite resins polished with OneGloss and ComposiPro Brush. Enhance/Pogo and Sof-Lex Wheels produced a mean surface roughness greater than the 200-nm threshold on Filtek Supreme Ultra, Grandio SO, and Venus Pearl. Data showed that there was an interaction between the composite resins and the polishing systems. A single polishing system does not perform equally with all composite resins. Except for Optrapol, multi-step polishing systems performed generally better than one-step systems. Excluding Enhance/Pogo, diamond-impregnated polishers led to lower surface roughness. Durafill VS, a microfill composite resin, may be polished more predictably with different polishers.

In Vitro Evaluation of Surface Properties and Wear Resistance of Conventional and Bulk-fill Resin-based Composites After Brushing With a Dentifrice.

This study evaluated the effect of toothbrushing with a dentifrice on gloss, roughness profile, surface roughness, and wear of conventional and bulk-fill resin-based composites. Gloss and surface roughness of resin-based composites (RBCs; Admira Fusion X-tra, Aura Bulk Fill, Filtek Bulk Fill Flowable, Filtek Bulk Fill Posterior Restorative, Filtek Supreme Ultra, Herculite Ultra, Mosaic Enamel, SDR flow+, Sonic Fill 2, Tetric EvoFlow Bulk Fill and Tetric EvoCeram Bulk Fill) were analyzed before and after brushing; the roughness profile and wear were also determined after toothbrushing. Representative three-dimensional images of the surface loss and images comparing the unbrushed and brushed surfaces were also compared. Analysis of variance and Tukey post hoc tests were applied (α=0.05) to the gloss, surface roughness, roughness profile, and surface loss data. Pearson's correlation test was used to determine the correlation between gloss and surface roughness, surface loss and percentage of gloss decrease after brushing, and surface loss and surface roughness after brushing. For all RBCs tested after 20,000 brushing cycles, the gloss was reduced and the surface roughness increased (p<0.05). However, the roughness profile and the amount of surface loss were dependent on the RBC brand. Admira Fusion X-tra, Aura, Tetric EvoCeram Bulk Fill, and Tetric EvoFlow Bulk Fill showed the deepest areas of wear (p<0.05). A significant negative correlation was found between gloss and surface roughness, and a weak correlation was found between the decrease in gloss and the extent of surface loss, and any increase in surface roughness and the surface loss. Toothbrushing with a dentifrice reduced the gloss, increased the surface roughness, and caused loss at the surface of all the RBCs tested. Considering all the properties tested, Mosaic Enamel exhibited excellent gloss retention and a low roughness profile and wear, while Admira Fusion X-tra exhibited the greatest decrease in gloss, the highest roughness profile, and the most wear.

Molar incisor hypomineralization: supplementary, restorative, orthodontic, and esthetic long-term treatment.

This article describes the esthetic results in a paradigmatic case of hypomineralized enamel correction on both anterior and posterior teeth to establish a minimal intervention protocol for similar cases. Clinical considerations: The subject was initially provided with casein-calcium-phosphate mineral supplementation. Unpublished laboratory images collected as part of a previously published study depict the results of initial calcium-phosphate supplementation on molar incisor hypomineralization (MIH) molar enamel morphology and indicate that this procedure is mandatory in moderate/severe cases. Prior to defect restoration, in-office bleaching of the anterior segment was conducted with bioactivated Opalescence Boost. Filtek Supreme Ultra Universal Restorative was used as a masking agent, and Filtek A2 enamel was applied as the final layer. An 8-year follow-up period is necessary in most moderate/severe MIH cases involving orthodontics and bleaching.