Filtek Supreme Research Articles

Flexural Strength of Modern CAD/CAM Restoratives After Artificial Aging.

Before clinical trials are initiated, studying the mechanical performance of modern CAD/CAM restorative materials exposed to aging conditions would provide insights on their performance in service. This study evaluated the impact of thermomechanical aging on various resin composite, ceramic, hybrid, and nano-filled resin composite materials after two polymerization modes. Specimens (3 × 4 × 14 mm3) were fabricated using (n = 12 per group) a universal composite (Filtek Supreme XTE photo-polymerized for either 40 s or 120 s per layer), hybrid ceramics (BRILLIANT Crios, GC Cerasmart, Lava Ultimate, VITA ENAMIC), glass ceramics (IPS e.max CAD, VITA Suprinity PC, Straumann n!ce), or feldspar ceramics (VITABLOCS Mark II, GC Initial LRF). In each group, half of the specimens underwent thermomechanical aging. A three-point bending test was applied to all specimens and the results were statistically analyzed (α = 0.05). Glass ceramics and hybrid ceramics presented higher flexural strength values than feldspar ceramics and the universal composite before and after aging (p < 0.05). Thermomechanical cycling affected the flexural strength of all materials (p < 0.05) except Lava Ultimate, Straumann n!ce, and GC Initial (p > 0.05). The highest decrease in flexural strength after aging was found in the universal composite (40 s polymerization) (p < 0.001) and Vita Enamic (p < 0.001), while the lowest decrease was in the hybrid ceramics, Cerasmart and Lava Ultimate (p < 0.05). Extending polymerization duration reduced the aging effect on the universal composite tested. Thermomechanical aging affected the flexural strength of most materials tested. Universal composites and feldspar ceramics presented similar flexural strength values.

Effects of minimally invasive endodontic access cavity in molar teeth on polymerization, porosity and fracture resistance

Minimally invasive access cavities have been proposed in the last decade to reduce tooth tissue loss during endodontic treatment and mitigate compromised fracture resistance of endodontically treated teeth. Fracture resistance of molars with different types of access cavity design may be affected by restorative materials and aging. Insufficient literature data exist on the effect of cavity design and type of restorative materials on restorative aspects such as material adaptation or photo-polymerization in restricted access cavities. This study analyses quality of polymerization, material adaptation and fracture resistance of molars with different types of access cavities restored with glass-ionomer, high-viscosity fiber-reinforced bulk-fill and nanofilled resin composite. Plastic molar teeth with truss (TREC) and traditional endodontic access cavity (TEC) were restored with nanofilled composite (Filtek Supreme), glass-ionomer Fuji IX and Filtek or fiber-reinforced everX Posterior and Filtek. Porosity was determined using microcomputer tomography and the degree of conversion of resin-based materals using micro-Raman spectroscopy. Human molars prepared and restored in the same way were used for fracture resistance testing at baseline and after thermocycling. The results demonstrate that high-viscosity fiber-reinforced composite was difficult to adapt in TREC cavity leading to greater porosity than Filtek or Fuji. TREC design did not affect composite polymerization and led to higher fracture resistance of restored molars compared to TEC but also more unrestorable fractures.

Mechanical Properties of Newly Developed Flowable Composite Derived from Rice Husk at Different Monomer Ratios

An ideal flowable composite (FC) requires good mechanical properties to fulfill its role as a dental restorative material and ensure durability and clinical efficacy, with these properties being influenced by different monomer ratios. The study aimed to evaluate the mechanical properties of the newly developed FC on Vickers hardness, flexural strength, and flexural modulus at different monomer ratios. The newly developed FC employed nanohybrid silica from rice husk and zirconia as fillers, and the ratio of urethane dimethacrylate to triethylene glycol dimethacrylate (UDMA:TEGDMA) at 20:80, 30:70, 50:50, 60:40, 80:20 and 90:10 as monomers. Filtek Supreme Ultra Flowable Restorative, Revolution Formula 2, and G-aenial Universal Flo served as control groups. The data were statistically analyzed using one-way ANOVA with post-hoc Bonferroni test. Generally, the higher UDMA ratio in the newly developed FCs exhibited higher mechanical properties. All newly developed FCs demonstrated a significant decrease in Vickers hardness than control groups. The flexural strength values at ratios of 50:50, 60:40, 80:20, and 90:10 were comparable with control groups and passed the International Organization for Standardization 4049 requirement. Meanwhile, the flexuralmodulus of the newly developed FC at the ratio of 90:10 was comparable to Revolution Formula 2. In summary, the differences in monomer ratios affect the mechanical properties of the newly developed FCs. The improved mechanical properties at ratios of 80:20 and 90:10 could potentially substitute sustainable dental restorative materials, subjected to further investigations.

Stability of the Dentin-Bonded Interface Using Self-Etching Adhesive Containing Diacrylamide after Bacterial Challenge.

Purpose/Aim: Acrylamides are hydrolytically stable at pH lower than 2, and were shown to preserve bonded interface integrity with two-step, total etch adhesives. The objective of this study was to leverage those two characteristics in self-etching primers containing the acidic monomer 10-MDP and test the microtensile bond strength before and after incubation with S. mutans incubation. Materials and Methods: Acidic primers (10 wt % 10-methacryloyloxydecyl dihydrogen phosphate─10-MDP; 45 wt % N,N-diethyl-1,3-bis(acrylamido)propane─DEBAAP, or 2-hydroxyethyl methacrylate─HEMA; 45 wt %, glycerol-dimethacrylate─GDMA) and adhesives (DEBAAP or HEMA/10-MDP/UDMA 45/10/45 wt %) were made polymerizable by the addition of 0.2 wt % camphorquinone, 0.8 wt % ethyl-4-dimethylaminobenzoate, 0.4 wt % diphenyliodonium hexafluorophosphate, and 0.1 wt % butylhydroxytoluene. Nonsolvated materials were characterized for flexural strength (FS), modulus (E), toughness, water sorption/solubility (WS/SL), contact angle, and vinyl conversion (DC). Viscosity was evaluated after adding 20 and 40 vol % ethanol to the primer and adhesive, respectively. The experimental materials or Clearfil SE Bond (CC─commercial control) were used to bond a commercial composite (Filtek Supreme) to the flat surface of human dentin. Microtensile bond strength (MTBS) was tested in 1 mm2 sticks for the 5 primer/bond combinations: CC (Clearfil Bond Primer and Bond), HH (HEMA/HEMA), DD (DEBAAP/DEBAAP), HD (HEMA/DEBAAP), and DH (DEBAAP/HEMA). Prior to testing, sticks were stored in water or biofilm-inducing culture medium with S. mutans for 1 week. Confocal images and FTIR-ATR evaluation evaluated the hybrid layer of the adhesives. Results were analyzed using Student's t-test (WS, SL, DC, contact angle, FS, E, toughness), one-way ANOVA/Tukey's test for viscosity, and two-way ANOVA/Tukey's test for MTBS (95%). Results: HEMA-based materials had lower contact angle (p = 0.004), higher WS (p < 0.001), and similar SL values compared to DEBAAP (p = 0.126). FS (p = 0.171) and E (p = 0.065) dry values were similar, but after one week of water storage, FS/E dropped more significantly for HEMA materials. Dry and wet toughness was greater for DEBAAP (p < 0.001), but it also had the greatest drop (46%). Clearfil bonds had the highest viscosity, followed by DEBAAP and HEMA, respectively (p = 0.002). For the primers, HEMA had the lowest viscosity (p = 0.003). As far as MTBS, all groups tested in water were statistically different when compared with HH (p < 0.001). After storage in biofilm, DH had the highest MTBS value, being statistically different from HH (p = 0.002), CC (p = 0.015), and DD (p = 0.027). Conclusions: The addition of a diacrylamide and its association with HEMA in self-etching adhesive systems provided greater bonding stability after bacterial challenge.

Effect of acidic media on surface characteristics of highly filled flowable resin-based composites: An in vitro study.

To analyze and compare the impact of acidic media on the surface characteristics of highly filled flowable resin-based composites. Two hundred fifty-six specimens were divided into four groups: GUF (G-aenial Universal Flo), GUI (G-aenial Universal Injectable), TEF (Tetric EvoFlow), and FSF (Filtek Supreme Flowable Restorative). Surface characteristics were analyzed before (T0) and after specimens immersion in different media, such as gastric juice (GJ), fizzy drink (FD), citric juice (CJ), or artificial saliva (AS), for 9 h (T1) and 18 h (T2). The analyses included surface roughness (SR) measurements, where average roughness (Ra) was obtained, scanning electron microscopy (SEM) analysis, and surface hardness (SH) evaluation, with Vickers numbers (HV) reported. The differences in values among groups/subgroups within the same stage were assessed using two-way ANOVA and Tukey's post hoc test, whereas repeated measures ANOVA with Bonferroni post hoc test was performed to compare the changes in values through the stages. Data were presented as mean ± standard deviation (SD). At T0, GUI and GUF revealed lower Ra values (p < 0.05), more evenness in SEM micrographs, and higher HV values (p < 0.05) than FSF and TEF. At T1 and T2, specimens of all groups/subgroups demonstrated an increase in Ra and a decrease in HV compared with T0 (p < 0.05), as well as the changes in surface morphology on SEM micrographs. The lowest Ra and highest HV values were observed in GUI group, in contrast to FSF group, and in specimens immersed in GJ. GUI revealed lower SR and higher SH compared to GUF and FSF both before and after exposure to acidic media. The presence of acidic media, especially GJ, significantly increases SR and decreases SH of tested materials. Information on the changes in the surface characteristics of highly filled resin-based composites after exposure to acidic media may be essential for the longevity of restorations like composite veneers fabricated from these materials.

Influence of viscosity and fiber reinforcement of resin composite on fracture strength and failure mode of restored molars.

To evaluate the fracture behavior of human molars with extensive MOD restorations using short-fiber-reinforced resin composite of varying viscosities. Human molars were randomly divided into seven groups (n = 12): intact teeth (control); restoration using conventional high-viscosity resin composite without (Filtek Z350XT, 3M) or with fibers (everX Posterior, GC); conventional low-viscosity resin composite without (Filtek Supreme Flowable, 3M) or with fibers (everX Flow Dentin Shade, GC); bulk-fill low-viscosity resin composite (Filtek Bulk Fill Flow, 3M) or with fibers (everX Flow Bulk Shade, GC). Restorations were performed on extensive MOD preparations, following the manufacturers' recommendations for each material. Specimens underwent fracture strength testing (N) and fracture pattern (%) categorized as repairable, possibly repairable, or non-repairable. Results were analyzed using a generalized linear model (N) and Fisher's exact test (%), with α = 0.05. Restorations performed with high-viscosity materials showed fracture strength values similar to the control and higher than those of restorations using low-viscosity resin composites (p < 0.0001), except for the bulk-fill low-viscosity resin composite with fibers (p > 0.05). Teeth restored using low-viscosity resin composite with fibers showed a higher % of repairable and possibly repairable fractures than the control (p = 0.0091). The viscosity of materials mediated the fracture strength, with restorations using high-viscosity resin composites promoting values similar to the intact tooth; however, the presence of fibers influenced the fracture pattern. Teeth with MOD cavities restored with high-viscosity resin composites showed similar fracture strength to intact teeth. Fiber-reinforced low-viscosity resin composite for the base of restoration resulted in a more repairable/possibly repairable fracture pattern.

Marginal integrity of prototype bioactive glass-doped resin composites in class II cavities.

This in vitro study examined the marginal integrity of experimental composite materials doped with bioactive glass (BG). Class-II MOD cavities were prepared and restored with one of the following composite materials: a commercial composite material as a reference (Filtek Supreme XTE), an experimental composite doped with BG 45S5 (C-20), and an experimental composite doped with a fluoride-containing BG (F-20). Six experimental groups (n = 8) were used, as each of the three composites was applied with (+) or without (-) a universal adhesive (Adper Scotchbond Multipurpose). All specimens were subjected to thermocycling (10,000 x, 5-55°C) and then additionally stored in artificial saliva for eight weeks. Scanning electron micrographs of the mesial and the distal box were taken at three time points (initial, after thermocycling, and after eight weeks of storage in artificial saliva). The margins were classified as "continuous" and "non-continuous" and the percentage of continuous margins (PCM) was statistically analyzed (α = 0.05). In most experimental groups, thermocycling led to a significant decrease in PCM, while the additional 8-week aging had no significant effect. F-20 + performed significantly better (p = 0.005) after 8 weeks storage in artificial saliva than the reference material with adhesive, while no statistically significant differences were observed at the other two time points. C-20 + exhibited significantly better PCM than the reference material with adhesive after thermocycling (p = 0.026) and after 8 weeks (p = 0.003). Overall, the experimental composites with BG showed at least as good marginal adaptation as the commercial reference, with an indication of possible re-sealing of marginal gaps. Maintaining or improving the marginal integrity of composite restorations is important to prevent microleakage and its likely consequences such as pulp irritation and secondary caries.

Effects of pre-heating on physical-mechanical-chemical properties of contemporary resin composites.

This research assessed the effects of pre-heating on the physical-mechanical-chemical properties of different resin composites. For this, resin composites were evaluated in 6 levels: Admira/ADM, Vitra/VIT, Filtek Supreme/FS, Filtek Supreme Flowable/FSF, Filtek One/FO, and Filtek Bulk Fill Flowable/FBF; temperature was evaluated in 4 levels using a composite heater: room temperature/22ºC, 37ºC, 54ºC, and 68ºC. Response variables were: degree of conversion/DC, flexural strength/FS and color stability/ΔE (immediately after light curing/LC, after 7days of dark-dry-storage, and after 24h and 3days of artificial aging in water at 60ºC). Data were subjected to 2-way ANOVA (DC and FR) and 3-way repeated measurements ANOVA (ΔE), all followed by Tukey's test (α = 5%). DC were similar (FBF, FS, and FSF) or increased (ADM, FO, and VIT) as the temperature increased. Results of FR were unchanged or increased for all composites except VIT and ADM. High-viscosity composites (VIT and FS) showed higher FR values than low-viscosity composite (FSF). For bulk-fill composites, FBF and FO showed similar results, but lower than high-viscosity composites. Results of color stability showed acceptable values up to 3days aging except for ADM and FSF. ΔE was not influenced by pre-heating and, overall, ΔE: FS < VIT < FO < FSF < ADM < FBF. Only VIT and FS showed ΔE ≤ 3.3 (clinical threshold). Therefore, the effects of pre-heating depend on the material. The tested materials generally showed similar or enhanced properties after pre-heating (except ADM and VIT).

The chemical and optical stability evaluation of injectable restorative materials under wet challenge

ObjectivesTo investigate and compare the chemical and optical stability of four restorative composite materials: two injectable resins, one flowable resin and one compomer. MethodsTwo injectable nano-filled composite resins: G-aenial Universal (GU) and Beautifil Injectable XSL (BI), a flowable composite resin: Filtek Supreme Flowable (FS) and a compomer: Dyract Flow (DF), in A2 shade were tested and compared. Water sorption and solubility were conducted according to ISO4049:2019 standard; ICP-OES and F-ion selective electrode were used to test the elemental release; Degree of conversion (DC) was obtained by using FTIR; water contact angle was obtained by static sessile drop method, and a spectrophotometer was used for optical properties (ΔE⁎, ΔL⁎ and TP). SPSS 28.0 was used for statistical analysis and the significant level was pre-set as α = 0.05. ResultsGU performed the best in water sorption and solubility, FS had the lowest elemental release, the best colour stability, and the highest DCIM and DC24-h. DF, the compomer had the lowest, and GU and BI, the injectable composites had the largest water contact angle, respectively. Correlations were found between water sorption and water solubility. ConclusionsThe four composite restorative materials showed different chemical and optical behaviours. Overall, composite resins performed better than compomer, while additional laboratory and in vivo tests are necessary to obtain a more comprehensive comparison between injectable and flowable composite resins. Wsp and Wsl are influenced by many common factors, and the values are highly positively related. Clinical SignificanceA comprehensive understanding of materials is crucial before selecting materials for clinical practice. Composite resins rather than compomers are recommended because of their exceptional properties, which make them eligible for a wide range of clinical applications and an elongated lifespan.

A Finite Element Method Study on a Simulation of the Thermal Behaviour of Four Methods for the Restoration of Class II Cavities.

The possibility of dental pulp damage during dental procedures is well known. According to studies, during finishing and polishing without cooling, temperatures of up to 140 °C or more can be generated. There are many studies that have analysed the influence of the finishing and polishing of fillings on the mechanical parameters, but the analysis of thermal parameters has led to uncertain results due to the difficulty of performing this in vivo. Background: We set out to conduct a study, using the finite element method, to determine the extent to which the type of class II cavity and the volume of the composite filling influence the duration of heat transfer to the pulp during finishing and polishing without cooling. Materials and Methods: A virtual model of an upper primary molar was used, with a caries process located on the distal aspect, in which four types of cavities were digitally prepared: direct access, horizontal slot, vertical slot and occlusal-proximal. All four cavity types were filled using a Filtek Supreme XT nanocomposite. Results: The study showed that the filling volume almost inversely proportionally influences the time at which the dental pulp reaches the critical temperature of irreversible damage. The lowest duration occurred in occlusal-distal restorations and the highest in direct access restorations. Conclusions: based on the results of the study, a working protocol can be issued so that finishing and polishing restorations without cooling are safe for pulpal health.

Influence of Layer Thickness and Shade on the Transmission of Light through Contemporary Resin Composites.

Material-dependent parameters have an important impact on the efficiency of light polymerization. The present in vitro study aimed to investigate the influence of the increment thickness and shade of nano- and nanohybrid resin composites on the transmission of curing light. Three contemporary resin composites were evaluated: Tetric EvoCeram® (TEC); Venus Diamond® (VD); and Filtek Supreme XTE® (FS XTE). Light transmission (LT) was recorded in accordance with the sample thickness (0.5 to 2.7 mm) and the shade. Polymerized samples were irradiated for 10 s each using the high-power LED curing light Celalux 2 (1900 mW/cm2). LT was simultaneously recorded using the MARC Patient Simulator (MARC-PS). LT was strongly influenced by the composite layer thickness. For 0.5 mm-thick samples, a mean power density of 735 mW/cm2 was recorded at the bottom side. For the 2.7 mm samples, a mean power density of 107 mW/cm2 was measured. Only LT was markedly reduced in the case of darker shades. From A1 to A4, LT decreased by 39.3% for FS XTE and 50.8% for TEC. Dentin shades of FS XTE and TEC (A2, A4) showed the lowest LT. The thickness and shade of resin composite increments strongly influences the transmission of curing light. More precise information about these parameters should be included in the manufacture manual.

Bonding performance and interfacial adaptation of modern bulk-fill restorative composites after aging in artificial saliva: an in vitro study.

This study aimed at comparing the microtensile bond strength (MTBS) and interfacial adaptation of a modern self-curing and a light-curing restorative bulk-fill composite to a conventional composite applied with the layering technique. Forty-eight occlusal cavities were divided in three main groups (16/group) based on tested materials: (i) STELA, bulk-fill self-curing restorative (STELA, SDI Ltd.); (ii) 3M-BULK, bulk-fill composite (Filtek One Bulk-Fill, 3M Oral Care); and (iii) 3M-CTR, a conventional composite (Filtek Supreme XTE, 3M Oral Care). These were used in combination with their adhesives in self-etch (SE) or etch-and-rinse (ER) mode. Specimens stored in artificial saliva (24h or 12months) were evaluated for MTBS and fractography. The interfacial analysis was performed through confocal microscopy. ANOVA and Fisher's LSD post hoc tests were performed with a level of significance of 5%. All the tested materials applied in ER mode presented (24h) greater bond strength than in SE mode. Although all materials showed a significant drop in the bond strength after prolonged storage, STELA showed the highest bonding performance and interfaces with few gaps. 3M-BULK had the lowest bond strength and an interface with several voids and gaps. All materials were affected by interface degradation and bonding reduction over prolonged aging. However, their use in combination with adhesives applied in ER mode may offer greater immediate bonding performance. The use of restorative light-curing bulk-fill composites may generate gaps at the bonding interface and voids. STELA may represent a suitable alternative to avoid such issues.

Bioceramic micro-fillers reinforce antibiofilm and remineralization properties of clear aligner attachment materials.

Introduction: Clear aligners, while offering a more hygienic alternative to fixed appliances, are still associated with challenges including plaque accumulation and enamel demineralization. The aim of the present study was to investigate the antibiofilm and remineralization effectiveness of innovative flowable composite attachments containing bioceramic micro-fillers. Methods: Four experimental attachments were formulated and bonded to human enamel specimens: 3M Filtek Supreme flowable composite (Filtek SF) + 10% bioactive glass 45S5 (BAG), Filtek SF + 30% BAG, Filtek SF + 10% Bredigite (BRT), Filtek SF + 30% BRT. Plaque biofilms were grown on the bonded enamel using a standardized protocol and the biofilm-killing effect was assessed by confocal laser scanning microscopy and scanning electron microscopy. Vickers microhardness was measured to evaluate the remineralization effect of the attachments containing bioceramic fillers after acid challenge. Shear bond test was performed to assess the bonding strength. Results: Attachments with bioceramic fillers significantly inhibited plaque biofilm growth in 3 weeks on enamel, contributing over 20% bacterial cell killing in 10% filler groups and over 30% killing in 30% filler groups. All four experimental groups demonstrated significantly higher microhardness values than the control group without fillers on the attachment side. The shear bonding strength was not compromised in the attachments with micro-fillers. Discussion: Proper incorporation of bioceramic micro-fillers in attachments provides an innovative approach for clear aligner therapy with reinforced antibiofilm and remineralization effects without weakening shear bonding strength.

Effect of surface finish and resin cement on the bond strength to CAD-CAM ceramics for interim resin-bonded prostheses

Statement of problemResin-bonded prostheses, including interim resin-bonded prostheses, are effective in preserving tooth structure compared with other types of fixed dental prostheses for the replacement of missing teeth. However, loss of retention remains a notable concern with these types of prostheses. PurposeThe purpose of this in vitro study was to investigate the influence of glass-ceramic type, resin type, and surface finish on the shear bond strength (SBS) to the CAD-CAM ceramics used to fabricate interim resin-bonded prostheses. Material and methodsEighty 10×2-mm glass-ceramic disks were fabricated by using a diamond saw (IsoMet 1000), 40 from feldspathic porcelain blocks (Vita Mark II) and 40 from lithium disilicate blocks (IPS e.max CAD). Half of the specimens in each group were left with a dull or matte surface finish after cutting, while the other half were glazed with an add-on glaze (VitaAkzento Plus Glaze Spray and IPS e.max CAD Glaze Spray, respectively). The disks were mounted in acrylic resin, and each group was subdivided into 2, with 1 receiving a photopolymerized resin cement (RelyX Veneer) and the other receiving a flowable composite resin (Filtek Supreme Ultimate Flow) to form 2.38×2-mm cylinders. SBS was determined using a universal testing machine (Instron 4411) in accordance with the International Organization for Standardization (ISO) 29022:2013 standard, and failure modes were analyzed by using a stereomicroscope with ×40 magnification. The data were analyzed with a 3-way analysis of variance and Tukey post hoc analysis. The chi-squared test was used to analyze the failure mode (α=.05 for all tests). ResultsCeramic type, resin type, and surface finish significantly impacted SBS (P<.001, P=.003, P<.001, respectively). Lithium disilicate showed higher SBS than feldspathic porcelain, and flowable composite resin exhibited higher SBS than resin cement. Glazed surfaces displayed lower SBS compared with the dull or matte surfaces. The combinations among the 3 materials also impacted SBS (P=.03). In addition, the combinations between ceramic type and surface finish affected SBS (P<.001), regardless of resin cement type. No other combinations affected the SBS (P>.05). The mode of failure was different among the groups (P<.001). In comparison with all other groups, cohesive failures were most prevalent in feldspathic porcelain with a dull or matte surface finish, regardless of the resin type used. ConclusionsThe SBS to glass-ceramics was influenced by ceramic material, resin cement type, and surface finish. Flowable composite resin showed higher SBS than resin cement. A dull or matte surface finish exhibited greater bond strength than a glazed surface. Lithium disilicate had higher SBS than feldspathic porcelain.

Characterization of materials used for 3D printing dental crowns and hybrid prostheses.

To compare the filler weight percentage (wt%), filler and resin composition, flexural strength, modulus, and hardness of several 3D-printed resins to direct and indirect restorative materials. Four 3D-printed resins (C&B MFH, Ceramic Crown, OnX, and OnX Tough), one milled resin composite (Lava Ultimate), one conventional composite (Filtek Supreme), and one ceramic (IPS e.max CAD) were evaluated. Filler wt% was determined by the burned ash technique, and filler particle morphology and composition were analyzed by scanning electron microscopy and energy-dispersive spectroscopy, respectively. Organic resin composition was analyzed by Fourier transform infrared spectroscopy. Three-point bend flexural strength and modulus of the materials were determined by ISO 4049 or ISO 6872. Vickers microhardness was measured. Data were compared with a one-way analysis of variance (ANOVA) and Tukey post hoc analysis. Linear regression analysis was performed for filler wt% versus flexural strength, modulus, and hardness. 3D-printed resins were composed of various sized and shaped silica fillers and various types of methacrylate resins. Significant differences were found among filler wt% with some materials around 3% (C&B MFH), others between 33% and 38% (OnX Tough and OnX), others around 50% (Ceramic Crown), and some around 72% (Filtek Supreme and Lava Ultimate). All 3D-printed resins had significantly lower flexural strength, modulus, and hardness than the conventional and milled resin composites and ceramic material (p < 0.001). Filler wt% demonstrated a linear relationship with modulus (p = 0.013, R2 = 0.821) and hardness (p = 0.018, R2 = 0.787) but not flexural strength (p = 0.056, R2 = 0.551). 3D-printed resins contain from 3% to 50% filler content. Filler wt% alone does not affect flexural strength, but strength may be affected by resin composition as well. Although the 3D-printed resins had lower flexural strength, modulus, and hardness than milled and conventional composite and ceramic, they demonstrated nonbrittle plastic behavior. The properties of 3D-printed resins vary based on their composition, which affects their clinical applications.

Flexural Strength of Conventional or Bulk-fill Resin Composite Repaired with High- or Low-viscosity Restorative Materials.

To evaluate the flexural strength of two types of high-viscosity resin composites (conventional or bulk-fill) that were repaired with either high-viscosity composites (conventional or bulk-fill) or low-viscosity composites (conventional or bulk-fill) of the same manufacturer (3M Oral Care, St Paul, MN, USA). Specimens (25 mm × 2 mm × 2 mm) of both conventional nanofilled resin (Filtek Z350XT), and bulk-fill nanofilled resin (Filtek One Bulk Fill) were prepared. After fracture of the specimens in the 3-point bending test (initial), half of the specimens were repaired immediately afterwards (24 hours), and the other half were repaired after 6 months of storage in distilled water. Repairs were performed with (n=15) high-viscosity resin composites (Filtek Z350XT, Filtek One Bulk Fill), or their low-viscosity versions (Filtek Supreme XT Flow, Filtek Bulk Fill Flowable Restorative). The repair was performed by roughening the surface and applying phosphoric acid, silane, and adhesive. The bending test (results reported in MPa) was performed in a universal testing machine, and the fracture pattern was determined. Data were evaluated by generalized linear models, chi-square test and the Fisher exact test (α=0.05). There was no significant difference between the former pair of high-viscosity resins in terms of initial flexural strength (p=0.42). The repairs performed with low-viscosity resin composites after 24 hours or 6 months obtained higher MPa values compared with those using high-viscosity composites (p=0.0006). There was a significant decrease in MPa values when the repair was performed after 24 hours and an increase after 6 months, regardless of the material (p<0.0001). After 6 months, fractures involving the old (conventional) resin were more frequent in the repair performed with bulk-fill resin composites compared with the conventional composites (p=0.02). Considering the tested products, the material to be repaired did not influence the flexural strength of the repair composite; however, the use of the low-viscosity resin composites resulted in greater flexural strength of the repaired material. The repair of the aged composite resulted in an increase in its flexural strength, regardless of the material repaired or used to perform the repair.

Effect of composite resin containing antibacterial filler on sugar-induced pH drop caused by whole saliva bacteria

Secondary caries around restorations is a major problem and can be attributed to bacteria invading microgaps formed at the tooth-restoration interface. An antibacterial composite resin containing quaternary ammonium silica (QASi) filler has been reported to inhibit enamel demineralization in situ. However, whether the prevention of enamel demineralization by QASi-containing composite resin is because of the reduced metabolic activity of acid-producing saliva bacteria is unclear. The purpose of this study was to compare the effects of QASi-containing composite resin and 2 other restorative materials on the viability of salivary bacteria and sugar-induced acid production. Whole saliva from each of the 30 study participants, 14 at high risk and 16 at low risk for caries, was brought into contact with quadruplicate specimens of 3 restorative materials, Infinix Flowable Composite, an anti-bacterial composite resin containing 1.5% QASi filler (Nobio), Filtek Supreme Flowable Restorative (3M), a conventional flowable composite resin, and dental amalgam (Silmet). Bacterial growth and sugar-induced acid production on each restorative material were measured every 20 minutes for 18 hours. Caries risk groups were compared using the t test and repeated measures analysis of variance (α=.05). When significant, Bonferroni multiple comparisons were used. On average, the saliva with the QASi-containing composite resin specimens maintained a near-neutral pH, not dropping below pH 6.0. The saliva associated with both conventional restorative materials exhibited a pH drop below 5.5 (P<.001), the critical threshold for tooth demineralization according to the Stephan curve. Virtually no growth was measured on the surface of the antibacterial composite resin, whereas bacteria grew on the conventional composite resin and dental amalgam (P<.001). No differences were observed between participants at high and low risk of caries. Unlike amalgam and conventional composite resin, the QASi-containing composite resin showed a near-complete shutdown of the metabolic activity of salivary bacteria upon contact and virtually no bacterial viability. This suggests that the prevention of tooth demineralization by QASi-containing restoratives is associated with a significant reduction in bacterial metabolic activity.

Comparative evaluation of three materials used for fragment reattachment in uncomplicated crown fracture-An in vitro study using bovine teeth.

The recommended treatment for uncomplicated crown fractures is bonding the fractured fragment or the fragment reattachment. A paucity was identified regarding the studies comparing the efficacy of micro-hybrid and nanohybrid composites in fragment reattachment. Hence, the present study aimed to evaluate and compare three materials for bonding of fragments rehydrated by humidification in teeth with uncomplicated crown fractures. Eighty mandibular bovine incisors with similar dimensions and free of any structural deformities were fractured similar to the technique followed in previous studies. Fracture was simulated, fragments, and stumps were coded, stumps were stored in artificial saliva and the fragments were dehydrated at room temperature and pressure. They were randomly assigned to Group-1 (no rehydration), Group-2 (rehydrated and bonded by flowable nanohybrid composite-3M Filtek Supreme Syringe Flowable Composite Resin-A2, Sao Paulo, Brazil), Group-3 (rehydrated and bonded by flowable micro-hybrid composite- Ruby Flow, InciDental, England, United Kingdom), and Group-4 (rehydrated and bonded by light-cured Glass-Ionomer-Cement-Voco Ionoseal, Cuxhaven, Germany). The samples were subjected to a universal testing machine to evaluate the force required to fracture the bonded fragments. The highest median value of the force required to fracture was recorded for Group 2 (208.4 N) followed by Group 3 (195.2). The force required to fracture the bonded fragments was lowest in Group 4 (67.2 N) which was lower than the negative control (131.4 N). The differences between the observations in Groups 2 and 3 were not found to be statistically significant. The nano and micro-hybrid composites showed greater force required to fracture than fragments bonded by LC-GIC. Dehydrated fragments bonded using nanocomposites performed better than rehydrated fragments bonded by using LC-GIC.

Surface Analysis of a Universal Resin Composite and Effect of Preheating on its Physicochemical Properties.

This study was aimed at analyzing the surface properties of a universal resin composite and evaluating the effect of preheating on its physicochemical properties. Two commercial resin composites were used under two conditions: Filtek Universal Restorative (UR); UR preheated (URH); Filtek Supreme (FS) and FS preheated (FSH). The film thickness (FT) test (n = 10) was done using two glass slabs under compression. Flexural strength (FLS) and modulus (FLM) were evaluated using a three-point flexion test (n = 10). Polymerization shrinkage stress (PSS) was evaluated in a universal testing machine (n = 5). Gap width (GW) between composite and mold was measured in internally polished metallic molds (n = 10). The degree of conversion (DC) was evaluated by Fourier Transform Infrared spectroscopy (n = 3). The morphology of the filler particles was checked by scanning electron microscope (SEM) and EDX analysis. Surface gloss (SG) and surface roughness (SR) were evaluated before and after mechanical brushing (n = 10). The outcomes were submitted to 2-way ANOVA and Tukey's test (α = 0.05). Lower mean values of FT were observed for the preheated groups when compared to the non-preheated groups. URH and FSH showed higher mean values of FLS and FLM when compared with UR and FS. No differences were observed between groups in the PSS test. The GW was higher for the UR and FS groups when compared with URH and FSH. The DC was higher for preheated resin composites when compared to the non-preheated groups. The SR of the UR composite was higher than the FS after mechanical brushing, while the SG was higher for the FS groups. In conclusion, the universal resin composite tested generally presented similar physicochemical properties compared with the nanofilled resin composite and either similar or slightly inferior surface properties. The preheating improved or maintained all properties evaluated.

Study on the Restoration of Class II Carious Cavities by Virtual Methods: Simulation of Mechanical Behavior.

The restoration of class II cavities is predominantly carried out with composite materials. Due to the high failure rate in restoring this type of cavity, composite materials with much-improved properties and new application techniques have been promoted. The study aimed to analyze the mechanical behavior of several topical composite materials (nanocomposites, nanohybrids and ormocer) using different application techniques. In a lower second molar, a class II occlusal cavity was prepared. As filling materials, we used the following combinations: Admira Fusion and Admira Fusion Flow, Grandio and Grandio Flow, Filtek Supreme XT and Filtek Supreme Flow. These were applied using a snow plow, injection molded and Bichacho techniques. Three-dimensional scanning of the molar with the prepared cavity was performed, and then scanning of each layer of added composite material was performed, obtaining three-dimensional models. The virtual molar models were analyzed with software specific to the finite element analysis method, where their physical-mechanical properties were entered and assigned to the components of the virtual molar. Simulations at high forces specific to bruxism were then carried out and analyzed, and compared. The values of displacements and strain, for all six analyzed situations, are relatively small (range from 5.25 × 10-6-3.21 × 10-5 for displacement, 6.22 × 10-3-4.34 × 10-3 for strain), which validates all three methods and the materials used. As far as the stress values are concerned, they are similar for all methods (250-300 MPa), except for the snow plow and injection-molded techniques using Grandio and Grandio Flow composites, where the maximum von Mises stress value was more than double (approximately 700 MPa). When using the combination of Grandio and Grandio Flow materials, the 1 mm thickness of the fluid composite layer was found to have a major influence on occlusal forces damping as opposed to 0.5 mm. Therefore, the Bichacho technique is indicated at the expense of the snow plow and injection-molded techniques. The composite materials used by us in this study are state-of-the-art, with clear indications for restoring cavities resulting from the treatment of carious lesions. However, their association and application technique in the case of Class II cavities is of clinical importance for resistance to masticatory forces.