Filtek Supreme Research Articles

Wear of Bulk-fill Composite Resins After Thermo-mechanical Loading.

Wear of conventional composite resin presented many challenges when restoring posterior teeth and resulted in clinical complications. Bulk-fill composite resins have been proposed as a more suitable and wear-resistant alternative. To evaluate and compare the volumetric wear (mm3) of bulk-fill composite resins to a conventional composite resin and enamel after thermo-mechanical loading. Five composite resins (n=10) were evaluated: four bulk-fill composite resins (Filtek One Bulk Fill [3M Oral Care], Tetric EvoCeram Bulk Fill [Ivoclar Vivadent], Tetric PowerFill [Ivoclar Vivadent], SonicFill 3 [Kerr Corp]); and one conventional composite resin (Filtek Supreme Ultra [3M Oral Care]). Enamel from recently extracted human teeth was used as a control. Specimens were subjected to a 2-body volumetric wear evaluation using a chewing simulator (CS-4.8, Mechatronik). Disc-shaped specimens (10 mm in diameter × 3 mm in thickness) received 500,000 load cycles against steatite antagonists while simultaneously thermocycled (5000 cycles, 5-55°C). Volumetric wear (mm3) was measured using the Geomagic Control X software (3D Systems) based on digital scans of the specimens obtained before and after thermo-mechanical loading, with a Trios 3 (3Shape) digital scanner. Scanning electron microscopy analysis of wear facets and composite resin filler shape and size was performed. Volumetric wear was statistically analyzed using the one-way ANOVA and Tukey's post-hoc test (α=0.05). All tested composite resins wore at rates significantly higher than enamel (p<0.05). The mean volumetric wear of the composite resins ranged from 1.01 mm3 to 1.48 mm3, while enamel had a mean volumetric wear of 0.25 mm3. Bulk-fill composite resins showed higher wear resistance than the conventional composite resin (p<0.05). Bulk-fill composite resins showed higher wear resistance than the conventional composite resin, and both types of composite resin were not as wear-resistant as enamel.

Study of Streptococcus mutans in Early Biofilms at the Surfaces of Various Dental Composite Resins.

Biofilm deposit on the composite restoration is a common phenomenon and bacterial growth follows the deposition. The study aims to evaluate Streptococcus mutans (S. mutans) early biofilm formation on the surfaces of various dental composite resins by using the real-time quantitative polymerase chain reaction (qPCR) technique. Thirty-two discs, where eight discs were in each group of Filtek Supreme Ultra (FSU; 3M, St. Paul, MN), Clearfil AP-X (APX; Kuraray Noritake Dental Inc., Tokyo, Japan), Beautifil II (BE2; Shofu, Inc., Kyoto, Japan), and Estelite Sigma Quick (ESQ; Tokuyama Dental, Tokyo, Japan), were fabricated and subjected to S. mutans biofilm formation in an oral biofilm reactor for 12 hours. Contact angles (CA) were measured on the freshly fabricated specimen. The attached biofilms underwent fluorescent microscopy (FM). S. mutans from biofilms were analyzed using a qPCR technique. Surface roughness (Sa) measurements were taken before and after biofilm formation. Scanning electron microscopy (SEM), including energy dispersive X-ray spectrometer (EDS) analysis, was also performed for detecting relative elements on biofilms. The study showed that FSUdemonstrated the lowest CA while APXpresented the highest values. FMrevealed that condensed biofilm clusters were most on FSU. The qPCR results indicated the highest S. mutans DNA copies in the biofilm were on FSU while BE2was the lowest (p < 0.05). Sa test signified that APX was significantly the lowest among all materials while FSU was the highest (p < 0.05). SEM displayed areas with apparently glucan-free S. mutans more on BE2 compared to APX and ESQ, while FSU had the least. Small white particles detected predominantly on the biofilms of BE2 appeared to be Si, Al, and F extruded from the resin. Differences in early biofilm formation onto various composite resins are dependent on the differences in materialcompositions and their surface properties. BE2 showed the lowest quantity of biofilm accumulation compared to other resin composites (APX, ESQ, and FSU). This could be attributed to BE2 proprieties as a giomer and fluoride content.

Effect of different finishing and polishing procedures on surface roughness and microbial adhesion on highly-filled composites for injectable mold technique.

To evaluate the effect of different finishing and polishing procedures on surface roughness and microbial adhesion and viability of Streptococcus mutans on novel highly-filled composites for injectable mold technique. One hundred sixty specimens were divided into four material groups: FSF (Filtek Supreme Flowable Restorative), TE (Tetric EvoFlow), GUI (G-aenial Universal Injectable) and GUF (G-aenial Universal Flo). Within each group, specimens were split regarding finishing and polishing (F/P) procedures into: SLD (Sof-Lex Discs), SLS (Sof-Lex Spirals), OG (OneGloss) and PG (PoGo). Surface roughness was analyzed using profilometer (Ra and Rz) and scanning electron microscopy (SEM) and Strep. mutans biofilm formation was analyzed using colony forming unit (CFU) and cell viability assay. Two-way analysis of variance (ANOVA) followed by Tukey's post hoc test were used for comparison among groups, Pearson's coefficient was applied for the correlation between Ra and CFU/ml and all data were presented as mean ± SD. Both materials and F/P procedures affect Ra, Rz and Strep. mutans CFU/ml values (p ≤ 0.05). Considering the Ra and Rz, GUI and GUF revealed lower values, compared to FSF and TE and SLD and SLS revealed lower values, compared to OG and PG. Considering the Strep. mutans CFU/ml and viability, GUI and TE presented lower values, compared to GUF and FSF and SLD and SLS presented lower values, compared to OG and PG. Moderate positive correlation was found between Ra and CFU/ml (r = 0.552). The smoothest surfaces possess GUI and GUF, among materials and SLD and SLS, among F/P procedures. GUI adhered the lowest amount of Strep. mutans, due to the smoothest surfaces. FSF and GUF revealed the highest amount of Strep. mutans, due to bis-GMA, bis-MEPP and TEGDMA in their composition. The findings of the present study may be beneficial for the proper selection of highly-filled composites and an adequate finishing and polishing procedure when performing the injectable mold composite resin veneer technique.

The Cracking Behavior of Two Dental Composite Materials Validated through Multifractal Analyzes.

The aim of this in vitro study was to analyze, both experimentally and theoretically, the mechanical behavior of two types of composite materials used in restoring dental integrity. The samples of each composite resin, namely Filtek Supreme XT (3M ESPE, St. Paul, MN, USA) and Filtek Z250 (3M ESPE, St. Paul, MN, USA), were experimentally analyzed by determining their compressive strength and fracture behavior. The fractured fragments of the samples were subjected to surface evaluation by scanning electron microscopy. The compressive stress-compressive strain dependencies revealed stronger cracking of the Filtek Supreme XT composite than Filtek Z250 prior to fracture. Theoretically, the evaluation was made by means of holographic implementations of such types of composite materials. A Hooke-type equation in a differential form is presented, which links the proposed theoretical model with the experimentally obtained data.

Evaluation of the effects of different composite materials and surface roughening techniques in bonding attachments of clear aligner on monolithic zirconia.

The aim of this study is to evaluate the bond strengths of two different composite types used in the production of clear aligner attachments on monolithic zirconia with three different surface roughening processes. Packable composite Filtek Z250 was used in one group (PC-G) and flowable composite Filtek Supreme Ultra Flowable was used in the other group (FC-G). PC-G and FC-G groups were also divided into three subgroups as diamond bur+silane (Group 1), 50μm aluminium oxide (Al2 O3 ) sandblasting+silane (Group 2) and 110μm Al2 O3 sandblasting+silane (Group 3). Scanning electron microscopy (SEM) analysis was performed. Clear aligner attachments were bonded to the monolithic zirconia specimens. Shear bond strength (SBS) values were measured. Statistical analysis was performed using two-way ANOVA and post-hoc Tukey's tests (P < .05). The highest SBS value was found in PC-G sandblasted with 110 μm Al2 O3 (P ≤ .001). The etching method with 110 μm sandblasting showed high SBS values in both composite types. The lowest SBS value gave FC-G in diamond bur roughening (P ≤ .001). For the bonding of clear aligner attachments on monolithic zirconia, roughening with 110 μm particle size sandblasting and the choice of packable composite could be recommended in terms of retention.

Effect of immediate dentin sealing on the fracture strength of indirect overlay restorations using different types of luting agents (A comparative in vitro study).

This study evaluates the effects of immediate dentin sealing (IDS) on the fracture resistance of lithium disilicate overlays using three different types of resin-luting agents (preheated composite, dual-cure adhesive resin, and flowable composite). Forty-eight maxillary first premolars of equal size were prepared using a butt joint preparation design. The teeth were separated into two primary groups, each with 24 teeth: Group DDS - delay dentin sealing (DDS) (non-IDS) teeth were not treated. Group IDS - dentin sealing was applied immediately after teeth preparations. Each group was subsequently separated into three separate subgroups of eight teeth. Subgroups DDS+Phc and IDS+Phc - cemented with preheated composite (Enamel plus HRi, Micerium, Italy), subgroups DDS+Dcrs and IDS+Dcrs - cemented with dual-cured resin cement (RelyX Ultimate, 3M ESPE, Germany), and subgroups DDS+Fc and IDS+Fc - cemented with flowable composite (Filtek Supreme Flowable, 3M ESPE, USA). The fracture resistance of each sample was evaluated using a test of a single load till failure, which was automatically recorded in Newton by a computer-controlled universal testing system. The fracture resistance of the subgroup IDS+Phc was the highest mean value, in which the overlay was cemented with preheated composite (1954 N), and the lowest mean was noted in the subgroup DDS+Fc, by which the overlay cemented with flowable composite without IDS (887 N). All IDS subgroups had a high mean fracture load. Both the Bonferroni test and the one-way ANOVA test identified a significant difference between all groups of 0.05. In general, teeth with IDS were stronger than teeth without IDS. When the preheated composite is used as a luting agent improves overall fracture resistance, followed by resin cement and flowable composite, respectively. However, the result showed that the ceramic overlays with and without IDS are strong enough to withstand the normal mastication force. Overlays was failed in a more catastrophic, irreparable mode of fracture than the clinical situation.

Influence of polishing systems on surface roughness of four resin composites subjected to thermocycling aging

Background: Surface smoothness considered to be a significant part of the appearance and success of the restorative materials. The aim of this study was to assess the influence of four different polishing systems on surface roughness of four resin composite materials when subjected to thermocycling.Materials and Methods: This research was designed as a comparative study. Four resin composites were used which are: Nanofill composite (Filtek Supreme XT), nanohybrid composite (Tetric EvoCeram), microfill composite (Renamel Microfill), and microhybrid composite (Filtek Z250). Sixty disk-shaped specimens of each resin composite were prepared then divided into four groups according to the polishing system (n = 15); which were Sof-Lex Spiral, Diatech Shapeguard, Venus Supra, and Astropol. The specimens of each group were polished following the manufactures' instructions, then surface roughness, Ra values in μm were measured initially and after the specimens subjected to thermal cycling. The influence of resin composites, polishing systems, thermocycling, and their interaction effects on surface roughness (Ra mean values) was statistically analyzed mainly by using the repeated measures two-way analysis of variance test, whereas the Bonferroni''s post hoc test was applied for pair-wise comparisons. P ≤ 0.05 was used as the significant level.Results: The results of this study revealed that Filtek Supreme XT recorded significantly the lowest mean surface roughness (Ra) of 0.2533 ± 0.073 μm (P < 0.001). The Sof-Lex Spiral polishing system revealed significantly the lowest mean surface roughness (Ra) of 0.2734 ± 0.0903 μm (P = 0.004). Regardless of composite type and polishing system, there was a statistically significant increase in mean surface roughness values (Ra) in μm after thermocycling (0.2251 ± 0.0496 μm and 0.3506 ± 0.0868 μm, respectively) (P < 0.001).Conclusion: Resin composite type, polishing method, and thermocycling aging significantly affected the surface roughness of composites; Nanofill composite and Sof-Lex Spiral polishing system provided the lowest values of surface roughness which increased after thermocycling.

Shear bond strength of composite to demineralized enamel conditioned with resin infiltration

Aim: The aim of this in vitro study was to evaluate the influence of resin infiltration on bond-strength of composite resin to demineralized enamel. Methodology: Thirty bovine incisors were used in this study. Buccal enamel surfaces of bovine incisors were wet polished and then were divided into three groups: sound enamel; demineralized enamel; demineralized enamel infiltrated with a low-viscosity resin (ICON, DMG, Hamburg, Germany). After acid-etching with 37% phosphoric acid for 20 seconds, a two-step, total-etch adhesive (Single Bond 2, 3M ESPE, St. Paul, MN, USA) was applied using a microbrush for 20 seconds, followed by gentle air-drying for 5 seconds. The adhesive was light-cured for 10 seconds. Following the adhesive application, flowable composite resin (Filtek Supreme Flowable, 3M ESPE, St. Paul, MN, USA) was gently placed into a microtubule and was photopolymerized using an LED curing unit (Elipar Deep Cure; 3M ESPE, St. Paul, MN, USA). The microshear bond strength (µSBS) tests were performed using a microshear testing machine at a cross-head speed of 0.5 mm/min. One-way ANOVA and Bonferroni tests were used to analyze the data (5%). Results: Significant differences were found according to the ANOVA (p &lt; 0.05). Pair-wise comparison results of µSBS (mean ± SD) were: sound enamel (25.16 ± 2.3); demineralized enamel (17.93 ± 2.1); demineralized enamel infiltrated with a low-viscosity resin (28.51 ± 3.76). Conclusion: Resin infiltration applied to demineralized enamel before composite application increased the bond strength. No difference was found in the bond strength values obtained for sound enamel and resin infiltrated enamel. How to cite this article: Durukan SM, Gümüştaş B, Şişmanoğlu S. Shear bond strength of composite to demineralized enamel conditioned with resin infiltration. Int Dent Res 2022;12(Suppl.1):114-19. https://doi.org/10.5577/intdentres.441 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Effect of Water Storage and Bleaching on Light Transmission Properties and Translucency of Nanofilled Flowable Composite.

This study investigated the effect of water sorption and bleaching on light transmission properties (Straight-light transmission (G0), Light diffusion (DF) and Amount of transmitted light (AV)) and translucency parameters (TP) of nano-filled flowable composites. A total of 35 composite disks (0.5 mm thickness) were prepared using A2 shade of 5 nanofiller composites (n = 7/each); Beautifil Flow Plus X F03 (SHOFU INC), Clearfil Majesty ES Flow (Kuraray Noritake Dental), Estelite Universal Flow (EUF, Tokuyama Dental), Estelite Flow Quick (Tokuyama Dental) and Filtek Supreme Ultra Flowable Restorative (FSU, 3M ESPE). Then, they were cured by LEDs (VALO, Ultradent) on standard mood (1000 mW/cm2) for 20 s. Samples were tested for straight-line transmission (G0), diffusion (DF), the amount of transmitted light (AV) and (TP) immediately after 24 h (dry storage), after 1-week water storage and after each of the three cycles of in-office bleaching (HiLite, SHOFU INC). Result: G0, DF, AV and TP were significantly affected by different materials (p < 0.001). The AV of FSU increased significantly after the 1-week water storage, then after the second bleaching cycle (p < 0.001). The TP for EUF slightly decreased (p = 0.019) after 1-week water storage, then increased throughout bleaching. Conclusion: Ageing/bleaching conditions do not affect G0, DF, AV and TP. The compositional variation between nano-filler composites resulted in a significant difference between materials.

Determination of Water Content in Direct Resin Composites Using Coulometric Karl Fischer Titration

This study evaluated the water content and sorption of direct composites over 60 days using coulometric Karl Fischer titration (KFT). Plate-shaped specimens (10 × 10 × 1 mm3 of thickness) were built up using the composites Clearfil Majesty Posterior (CM), Grandio SO (GS), and Filtek Supreme XT (FS). Water contents were determined in non-stored specimens (control) or after storage in distilled water for up to 60 days (n = 5). The amount of water transferred from the specimens heated at 200 °C (isothermal mode) was measured in the Coulometer. The water content of non-stored specimens ranged from 0.28 to 1.69 wt% (5.6 to 31.2 μg/mm3) for GS and FS, respectively. The highest values of water sorption were observed for FS (25.3 μg/mm3 after 60 days). GS and CM showed similar water sorption after 60 days (≈9 μg/mm3), but an ultimate higher water content was observed for CM (0.9 wt%; 22.0 μg/mm3) than GS (0.7 wt%; 14.8 μg/mm3). Except for CM, no significant water sorption was observed between 21 and 60 days of storage. Since all composites presented some base water content, water sorption data alone do not account for the ultimate water content in direct resin-based composites.

Effect of the region of the CAD/CAM block on the flexural strength and structural reliability of restorative materials

The aim of the study was to evaluate whether the region (internal or external) of the CAD/CAM block influences the mechanical performance of restorative materials. Blocks of different CAD/CAM materials (Composites: KAV – Katana Avencia; LULT – LULT Ultimate; Ceramics: ENAM – Vita Enamic; NICE - N!CE; EMP – IPS Empress CAD; VMII – Vita Mark II; EMAX – IPS e.max CAD) were selected, and direct resin composite blocks (APX - Clearfil AP-X; FSUP - Filtek Supreme) were built using the incremental technique on a mold from one of the CAD/CAM blocks. All blocks were sectioned into bar-shaped specimens (1 × 1 × 14 mm), which were separated into two groups according to the region of the block (inside or outside). 3-point bending tests were performed following ISO 6872:2015 and flexural strength data were analyzed using one-way ANOVA and Bonferroni post-hoc tests (p < 0.05). Weibull module and characteristic strength were also calculated. In general, the mean flexural strength values were not statistically different (p > 0.05) between the inside and outside regions of each material, except for LULT (inside > outside) and EMAX (outside > inside). Comparing the materials, a similar strength (only discrete variations) was observed for inside, outside or merged (inside and outside data assembled together) regions: EMAX > KAV = LULT > NICE = APX > EMP = ENAM = VMII ≥ FSUP (merged condition). Characteristic strength at 63.2% failure probability and at 5% failure probability generally corroborates such observations. There were no statistical differences for Weibull module data (inside, outside, or merged), except for KAV and NICE (outside > inside). Thus, the region from where the restoration is milled within the CAD/CAM block generally does not influence the mechanical performance hereof (flexural strength, failure probability, risk of premature failures, and mechanical reliability) of the material, except for LULT and EMAX.

Clinical evaluation of bulk-fill and universal nanocomposites in class II cavities: Five-year results of a randomized clinical split-mouth trial

AimEvaluating the clinical survival and quality parameters of class-II restorations using 3M™ FiltekTM Bulk Fill Posterior Restorative compared to 3M™ FiltekTM Supreme XTE Universal Restorative over a period of five years. Materials and methodsA longitudinal, randomized, prospective split-mouth study with 60 patients (29 female, 31 male; mean age 44 y; range 20-77 y) and a total of 120 load-bearing class II restorations (TEST: n=60 Filtek Bulk Fill Posterior Restorative; CONTROL: n=60 Filtek Supreme XTE Universal Restorative) was conducted. Clinical evaluation was performed by blinded evaluators according to FDI criteria. Kaplan-Meier method was used for survival analysis and an intergroup comparison (Mann-Whitney-U-Test) was carried out. A basic significance level of 0.05 was corrected by the Bonferroni method to account for multiple testing (significance after correction: p<0.00067). ResultsThe mean overall survival of restorations was 92% after 56.98±1.51 months in the TEST group (95 CI= 54.02;59.94) and 92% after 57.25±1.46 months (95 CI= 54.39; 60.12) in the CONTROL group (log-rank p=0.995). In total, four failures occurred in both TEST and CONTROL group during the observation period (mean annual failure rate: 1.6%). The most common reasons for failure were chipping-fractures, debonding, cracked-tooth-syndrome and recurrent decay. With regard to the FDI criteria, no significant differences between TEST and CONTROL material occurred for any of the evaluated variables. In the TEST group two restorations had to be repaired and two had to be replaced, in the CONTROL group four restorations had to be replaced. ConclusionBoth materials showed acceptable clinical performance and survival during the 5-year observation period. Clinical SignificanceThe use of a nanofilled bulk-fill composite proved to be an aesthetically, functionally and biologically satisfactory alternative in posterior dentition.

In Vitro Wear of Glass-Ionomer Containing Restorative Materials.

Advertisements of glass-ionomer-containing restorative materials recommend suitability as load-bearing permanent or semi-permanent restorations. Historically, unacceptably high wear rates limit clinical indications of glass-ionomer-containing restorations in this regard. To compare the in vitro wear of contemporary glass-ionomer-containing dental materials commercially advertised for use in permanent dentition as load-bearing restorations in a chewing simulator. Resin composite was tested as a control. A resin-modified glass ionomer (Ionolux, VOCO gmbH), a high viscosity glass-ionomer hybrid system (Equia Forte HT with Equia Coat, GC America), and a bioactive ionic resin with reactive glass filler (Activa Bioactive Restorative, Pulpdent) were evaluated. Filtek Supreme Ultra (3M ESPE) is a visible light-activated resin composite that served as a control. Standardized flat disk-shaped specimens (n=12/group) were submitted to 500,000 cycles with continuous thermal cycling against steatite antagonists. Volumetric wear was measured at 1000, 10,000, 200,000, and 500,000 cycles. There was a statistically significant difference in mean volumetric wear for Activa Bioactive Restorative (p=0.0081, 95% CI: 0.3973, 0.4982) and Equia Forte HT (p<0.001, 95% CI: 1.2495, 1.8493), but no statistically significant difference in mean volumetric wear for Ionolux (p=0.6653) compared to control. Activa Bioactive Restorative wore approximately 60% less than, and Equia Forte HT twice more than Filtek Supreme Ultra on average, respectively. Compared to a resin composite, contemporary glass-ionomer-containing restorative materials advertised for use as load-bearing restorations display measurably variable in vitro wear rates.

Radiant Exitance of Old, New, and Damaged LED Light Curing Units.

This study aimed to determine the radiant exitance of new, damaged, and 16-year-old light-curing units (LCUs) with and without infection control barriers, and before and after removal of any debris. Old LCUs consisted of 62 SmartLite iQ2 lights (Dentsply Sirona, York, PA). New LCUs consisted of 58 SmartLite Focus (Dentsply Sirona) and 58 Valo Grand (Ultradent, South Jordan, UT, USA) LCUs. Each LCU was examined for damage and debris on its tip. A handheld radiometer (CheckUp with BlueLight Analytics app, Halifax, Nova Scotia, Canada ) was used to measure the radiant exitance using a 10-second exposure time. Measurements were made with and without infection control barriers. If debris was present, the radiant exitance was measured before and after removal of debris with and without the barriers. All measurements were repeated three times. The means of the measurements were used for statistical analyses, which consisted of paired t-tests, analysis of variance (ANOVA), and Tukey post-hoc analyses conducted with a 0.05 level of significance. Infection control barriers significantly reduced the radiant exitance of all LCUs, ranging from 4.35% to 6.91% depending upon the LCU and the presence of debris or damage. Clean undamaged SmartLite Focus (907 mW/cm2) and Valo Grand (Ultradent) LCUs (883 mW/cm2) with barriers had statistically higher radiant exitance than older clean undamaged SmartLite iQ2 (Dentsply Sirona) LCUs (719 mW/cm2) with barriers. All LCUs exceeded the recommended 400 mW/cm2 radiant power to cure 2 mm of Filtek Supreme Ultra shade A2 composite resin (3M ESPE, St Paul MN, USA). Infection control barriers, debris, damage, and age all significantly reduced radiant exitance of the lights.

Wear and Color Stability of Preheated Bulk-fill and Conventional Resin Composites.

Bulk-fill resin composite is commonly used in direct restorations. It is recommended that the high-viscosity version of these materials be preheated to improve flowability and adaptability. It is unknown what effects preheating (PH) might have on the wear resistance and color stability of these resin composites. This study compared the wear and color stability of high-viscosity bulk-fill and conventional resin composites with and without PH, using the CIEDE2000 formula. Thirty-two disc-shaped specimens (n=16, 10×3 mm) were prepared with Filtek One Bulk Fill Restorative (FOBFR; 3M ESPE) and Filtek Supreme Ultra (FSU, 3M ESPE) to determine wear. Each group was divided into subgroups based on preparation conditions, that is, PH and room temperature (RT) (n=8). Thermomechanical fatigue was applied to specimens, and volumetric material loss was calculated using a laser scanner (LAS-20, SD Mechatronik, Feldkirchen-Westerham, Germany) and three-dimensional imaging software (Geomagic, 3D Systems, Rock Hill, SC, USA). An additional 124 disc-shaped specimens (n=64, 10×1 mm) were prepared with FOBFR and FSU, and subgroups were formed based on preparation conditions (PH and RT, n=32). Specimens were aged for 14 days in coffee, grape juice, distilled water, and thermocycling (20,000 cycles, 5°C-55°C). To determine color change, the lightness (L), chroma (C), and hue (H) values were measured at baseline and after 14 days using the CIEDE2000 formula. All data were statistically analyzed, and a 95% significance level was set. In both the PH and RT groups, FSU exhibited greater wear than FOBFR (p<0.05). Both materials were subjected to increased wear as a result of PH. After aging, a significant difference in color change was observed (p<0.05) when controlling for time and resin composite type, except for deionized water and thermocycling (p>0.05). PH had no effect on the color stability of the resin composite at any time (p<0.05). The high-viscosity bulk-fill resin composite displayed superior wear resistance and similar color stability compared with its conventional counterpart. PH resin composite may increase its susceptibility to wear and has no effect on its color stability.

Internal Adaptation of Cusp-weakened Class I Preparations Restored with Bulk-fill, Bi-layered, and Incremental Restorative Techniques: A Micro-CT Analysis

The aim was to evaluate the internal adaptation of composite restorations in cusp-weakened Class I preparations restored by incremental, bi-layered, and bulk-fill techniques using a microcomputed tomography analysis (micro-CT). Sixty sound extracted human third molars were prepared with standardized cusp-weakened Class I cavity preparations and divided into six groups (n=10). Two groups were restored using an incremental oblique technique with a nanofilled (Filtek Supreme XT, 3M Oral Care, St Paul, MN, USA) and a nanohybrid composite (GrandioSO, VOCO, Cuxhaven, Germany). The other two groups were restored using a bi-layered technique with a bulk-fill flowable composite base (Filtek Bulk Fill Flowable, 3M Oral Care; X-tra Base bulk-fill flowable, VOCO) covered with the conventional composite of the same type. In the remaining groups, teeth were restored with a single-increment technique using bulk-fill full-body composites (Filtek Bulk Fill Posterior, 3M Oral Care; Admira Fusion, VOCO). All teeth were subjected to thermocycling (20,000 cycles, 5°C and 55°C) and mechanical loading (250,000 cycles, 2.5 Hz, 50 N) before analysis of internal adaptation by micro-CT. One-way analysis of variance (ANOVA) and the Games-Howell test were used to analyze the percentage and volume of internal gaps (p<0.05). There was found to be significantly higher internal adaptation for the nanofilled composite used incrementally or associated with a flowable base compared with the nanohybrid composite used incrementally (p=0.002). Bulk-fill and bi-layered techniques performed similarly in terms of internal adaptation for both types of composites. The incremental technique with the nanofilled composite demonstrated a higher internal adaptation than with the nanohybrid composite.

The Effect of Feldspathic Thickness on Fluorescence of a Variety of Resin Cements and Flowable Composites

(1) Background: The shade of resin-based materials and ceramic thickness influence the optical color of laminate restorations. The purpose of this study is to evaluate—in vitro—the effect of resin-based cement shade and ceramic thickness on fluorescence of feldspathic laminate veneers; (2) Methods: 180 samples of feldspathic ceramic A2 shade with two different thicknesses (0.5 and 0.8 mm) were obtained. The samples were cemented to composite resin substrates with one of the following materials in different shades (n = 10): resin cement (Variolink Esthetic in Light, Neutral and Warm shades; or RelyX Veneer in B0.5 /white, Translucent and A3 Opaque/yellow opaque shades); flowable composite resin (G-aenial Flo in A2 and A3 shades) or a pre-heated composite resin (Filtek Supreme XTE, A3 body shade). The fluorescence spectra were obtained by means of a spectrofluorometer. Two-way ANOVA, Tukey, and Student’s t-tests were performed (α = 0.05); (3) Results: Fluorescence values were significantly influenced by the resin-based agent tested (p &lt; 0.001), the thickness of ceramic (p &lt; 0.001), and their interaction (p &lt; 0.001). The lowest fluorescence values were achieved by RelyX Veneer resin cement regardless its shade and the ceramic thickness; (4) Conclusions: both the shade of resin-based agent and the feldspathic ceramic thickness influenced the fluorescence of laminate restorations.

Effects of bioflavonoid-containing mouth rinses on optical properties of tooth-coloured dental restorative materials

This study investigated differences in colour (ΔE00) and translucency parameter (ΔTP00) of nanofilled/microhybrid composites and a glass-ionomer cement following immersion in bioflavonoid (Citrox)- or chlorhexidine-based mouth rinses. Sixty disc-shaped specimens (N = 5/group) of Filtek Supreme (3M), Gradia Anterior (GC) and Fuji IX (GC) were exposed to Citrox/0.2%CHX (Perio+0.2, Curaprox), Citrox/0.09%CHX (Perio+0.09, Curaprox), 0.2%CHX (Savacol, Colgate-Palmolive) or distilled water by 2-min agitation daily for 28 days in an orbital shaker at 200 rpm at 37 °C. Colour recordings were performed using a clinical spectrophometer to obtain CIELab coordinates. General linear model, ANOVA, Tukey test (α = 0.05) and Pearson correlation test were used to analyse data. ΔE00 ranged between 0.33 (Gradia_Savacol_T28) and 6.35 (Fuji_Savacol_T28) (p < 0.001). ΔTP00 ranged between 0.36 (Fuji_ Perio+0.2) and 1.73 (Fuji_Savacol) (p < 0.05). Savacol resulted in higher ΔE00 of Filtek and Fuji and ΔTP00 of Filtek than Perio+0.09 and Perio+0.2 (p = 0.005). Perio+0.09 and Perio+0.2 resulted in higher ΔE00 at T7 than T28 (p < 0.05). There was no correlation between ΔTP00 and ΔE00 (r = 0.445, p = 0.147). Generally, Perio+0.2 and Perio+0.09 mouth rinses produced similar or lower ΔE00 and ΔTP00 than Savacol. GIC Fuji showed higher ΔE00 and similar or higher ΔTP00 than composites Filtek and Gradia. ΔE00 in all materials decreased in Perio+0.2 and Perio+0.09 over time.

Depth of Cure, Hardness, Roughness and Filler Dimension of Bulk-Fill Flowable, Conventional Flowable and High-Strength Universal Injectable Composites: An In Vitro Study.

(1) Objective: To evaluate and compare the depth of cure (DOC) of two bulk-fill flowable composites (Filtek Bulk Fill Flowable Restorative and Tetric EvoFlow Bulk Fill), two conventional flowable composites (Filtek Supreme XTE Flowable Restorative and G-ænial Flo X) and one high-strength universal injectable composite (G-ænial Universal Injectable). (2) Methods: specimens were placed in a stainless-steel mold with an orifice of 4 mm in diameter and 10 mm in depth and light-cured for 20 s using a light emitting diode (LED) light-curing unit (LCU) with an irradiance of 1000 mW/cm2; depth of cure was assessed using the ISO 4049 scrape technique, and the absolute length of the specimen of cured composite was measured in millimeters with a digital caliper. The same procedure was repeated with 14 samples for each material under investigation, for a total number of 70 test bodies. Material roughness and hardness results were also investigated using, respectively, a 3D laser confocal microscope (LEXT OLS 4100; Olympus) at ×5 magnification and a Vickers diamond indenter (Vickers microhardness tester, Shimadzu®, Kyoto, Japan) under 10-N load and a 30 s dwell time. SEM images at 3000 and 9000 magnification were collected in order to study the materials’ filler content. Statistical analysis were performed by a commercial statistical software package (SPSS) and data were analyzed using multiple comparison Dunnett’s test. (3) Results: The average DOC of both bulk-fill composites was more than 4 mm, as a range of 3.91 and 4.53 mm with an average value of 4.24 and 4.12 mm, while that of the conventional flowable composites was much lower, as a range of 2.47 and 2.90 mm with an average value of 2.58 and 2.84 mm; DOC of the high-strength injectable composite was greater than the one of traditional composites, but not to the level of bulk-fill materials, as a range of 2.82 and 3.01 mm with an average value of 3.02 mm. Statistical analysis revealed significant differences (p-values < 0.05) in the depth of cure between bulk fill flowable composites and other composites, while there was no difference (p-values > 0.05) between the materials of the same type. (4) Conclusions: Bulk-fill flowable composites showed significantly higher depth of cure values than both traditional flowable composites and high-strength injectable composites.

Alternative aesthetic treatment of dental agenesis: a case report

Objective: To restore the self-esteem of an adolescent patient with dental agenesis through an alternative conservative aesthetic treatment. Methodology: A case report. Demarcation of the gingival plasty area and determination of bleeding points for gingivoplasty with a periodontal probe, incision using the internal bevel technique with a 15c scalpel blade and Kirkland's gingivotome. Composite resin increment technique by conditioning the enamel with 37% phosphoric acid for 30 seconds, washing with water for 1 minute and drying with absorbent paper. Application of the Adhesive System Adapter Single Bond 2 and light curing for 20 seconds. Soon after, with the aid of a Uvenner matrix, the resin Z350xt filtek supreme color B1 enamel was used for a thin veneer, photoactivated 3 times for 20 seconds. Interproximal excesses were removed with sandpaper. Results: The treatment, based on a gingivoplasty and reanatomization in composite resin, restored the patient's smile and self-esteem directly and quickly. Conclusion: A multidisciplinary planning based on the principles of conservative restorative dentistry is capable of restoring the aesthetic patterns of the smile, thus restoring the patient's self-esteem and social well-being.