Light-cured Composite Resin Research Articles

Temperature Rise at the Pulp-Dentin Junction for a Multi-Layered Composite Restoration using the Finite Element Method

Objectives: During the light-curing process of composite restoration, excessive heat can be produced, which can potentially lead to pulp necrosis (death). In this study, we aimed, based on the Finite Element Method (FEM), to assess the risk of pulp damage during the light-curing process by investigating the influence of light-curing devices, under various irradiation regimes, on the temperature increase at the pulp-dentin junction, during a one-layer or multi-layered deep composite restoration. Methods: A Three-dimensional finite element method model of typical geometry and material properties, as commonly reported in the literature, was employed in COMSOL Multiphysics simulations in order to determine the temperature increase in the pulp. Various combinations of light intensities, durations, and irradiation regimes were investigated for the two cases, of shallow and deep multi-layered composite restoration. Results: Results of light-curing composite resins within enamel; indicate that the temperature rise during the curing process was within the safety margins. Results of light-curing composite resin restorations closer to the pulp with thin remaining dentin, indicate a temperature increase that could be sufficient to cause thermal injury in the pulp. Modulating the light output marginally, reduced the temperature rise while reducing the intensity and increasing the curing duration which was consistently more effective in this respect. Conclusion: The results clearly demonstrate that with currently adopted standard procedures, there exists a risk of thermal injury during multi-layered composite restorations with thin remaining dentin; it is thus important to establish appropriate curing regimes that would lead to minimal temperature increase during deep composite restorations and hence reduce the risk of thermal injury to the pulp.

Accuracy and Feasibility of a Zero-Setup Implant Guide System Made of a Light-Cured Composite Resin with Simultaneous Flapless Sinus Augmentation: A Pilot Study

The aim of this study was to evaluate the accuracy and feasibility of flapless implant placement using a light-cured surgical template made of composite resin comprising dimethacrylate and diurethane, performed simultaneously with crestal sinus augmentation. This pilot study was a prospective, single-armed, controlled clinical trial. Four patients having an edentulous region in the posterior maxilla with 4 to 8 mm of residual ridge height were enrolled. Flapless fully-guided implant placement was performed using a zero-setup surgical template with simultaneous crestal sinus graft. Horizontal, vertical, and angular deviations of the placed implants from the planned positions were measured. Clinical observations were made, and implant stability was measured up to 3 months postoperatively. All four implants were placed and maintained successfully without complication. The mean deviations of the four implants were 1.27 and 1.85 mm horizontally at platform and apex, respectively, 0.84 mm vertically at apex, and 4.76° in angle. Satisfactory implant stability was obtained in all implants at placement and 3 months. Fully-guided implant placement and crestal sinus graft using a zero-setup surgical template can be a safe and feasible method with acceptable accuracy. A randomized controlled trial should be performed in the future to validate its clinical performance in terms of surgical time, accuracy, and patient-reported outcomes.

Accuracy of Dental Implant Placement by a Novel In-House Model-Free and Zero-Setup Fully Guided Surgical Template Made of a Light-Cured Composite Resin (VARO Guide®): A Comparative In Vitro Study.

Background: This in vitro study mainly aimed to compare VARO Guide® to the surgical guide fabricated by CAD/CAM (NAVI Guide®) in terms of accuracy and efficacy of the implant surgery held in the dentiform model. Methods: Twenty surgeons, 10 dentists in the beginner group and 10 dentists in the expert group, participated in the study. Each surgeon conducted fully guided surgery in dentiform models twice, once with VARO Guide® (VG surgery) and the other time with a conventional type of templates, NAVI Guide® (NG surgery). Based on the superimposition of presurgical and postsurgical STL files, the positional deviations between the virtually planned and actually placed implants and the time spent on presurgical preparation and surgical procedures were estimated and compared. Results: All dimensional deviations were similar between the two groups (p > 0.05), and there was no significant difference between the expert and beginner groups regardless of the guide system. The total procedure time (mean (median)) of the VG surgery (26.33 (28.58) min) was significantly shorter than that of the NG surgery (378.83 (379.35) min; p < 0.05). While the time spent only for the fully guided implant surgery (from the start of the surgical guide sitting onto the dentiform model to the final installation of the implant fixture) was comparable (p > 0.05), the presurgical preparation time spent on virtual implant planning and surgical guide fabrication in the VG surgery (19.63 (20.93) min) was significantly shorter compared to the NG surgery (372.93 (372.95) min; p < 0.05). Conclusions: Regardless of experience, both VG and NG surgery showed reliable positional accuracy; however, the total procedure time and the preparation time were much shorter in the VG surgery compared to the NG surgery.

Effect of proximal box elevation on fracture resistance and microleakage of premolars restored with ceramic endocrowns.

BackgroundRestoration of endodontically treated premolar is in high risk for biomechanical failure, and often presents with subgingival margins. Proximal box elevation (PBE) has been used to relocate subgingival cavity outlines.ObjectiveTo evaluate the influence of PBE on fracture resistance and gingival microleakage of premolars with endodontic access cavities following ceramic endocrown.MethodsEighty sound maxillary premolars with standardized Class II cavities on mesial surfaces were randomly assigned to four groups (n = 20 in each group). Groups E1, E2 and E3, with proximal margins located in dentin/cementum, 2 mm below the cemento-enamel junction (CEJ), simulated subgingival location. Group E4 (supragingival group), with proximal margins located in enamel, 1 mm above the CEJ, was used as the positive control. For margin elevation of the proximal cavities, bulk-fill Smart Dentin Replacement (SDR), a visible light cured resin composite, was applied in group E1, and conventional resin composite (3M Z350 XT, a light-activated composite) was placed in group E2. Group E3 was only treated with a ceramic crown and served as the negative control. In all groups, computer-aided design (CAD) ceramic endocrowns were adhesively inserted, and fracture resistance, failure mode and microleakage were evaluated.ResultsA higher fracture resistance value was observed in PBE groups E1 and E2, regardless of the materials used (P = 0.038, and 0.010, respectively, vs E3), and fracture resistance in group E1 was higher than that in group E2. In teeth without PBE, the percentage of catastrophic failures reached 70%. Compared to group E3, a lower frequency distribution of microleakage was detected in supragingival group E4 (P = 0.031). No increased percentage of microleakage was observed in groups treated with PBE.ConclusionFor endodontically treated maxillary premolars restored with ceramic endocrowns, PBE increases fracture resistance but not microleakage.

Influence of Alumina Nanoparticles on the Mechanical Properties of a Bioresin Composite

The aim of this study is to characterize (wettability, surface roughness and gloss) and test (microhardness and diametral compression) four types of light-cured composite resins, one of which is commercial. The first lab-made composite is the reference, obtained by mechanical mixing of three monomers, in equal concentrations. The following two lab-made materials can be considered nanocomposites because they were mechanically mixed in the base solution (Bis-GMA/TEGDMA/Bis-EMA) with α-Al2O3 nanopowders, with a concentration of 5 wt.% for one solution and 10 wt.% for the other. The benchmark material comparison for these lab-made composite and nanocomposite resins is the bioresin system, Filtek™ Supreme Ultra Universal Restorative. Results were promising, especially for the 10 wt.% Al2O3/Bis-GMA/TEGDMA/Bis-EMA system, characterized by mechanical improvment in comparison with the reference composite.

Dental Restorative Materials for Elderly Populations.

The incidence of dental caries, especially root caries, has risen in elderly populations in recent years. Specialized restorative materials are needed due to the specific site of root caries and the age-related changes in general and oral health in the elderly. Unfortunately, the restorative materials commonly used clinically cannot fully meet the requirements in this population. Specifically, the antibacterial, adhesive, remineralization, mechanical, and anti-aging properties of the materials need to be significantly improved for dental caries in the elderly. This review mainly discusses the strengths and weaknesses of currently available materials, including amalgam, glass ionomer cement, and light-cured composite resin, for root caries. It also reviews the studies on novel anti-caries materials divided into three groups, antimicrobial, remineralization, and self-healing materials, and explores their potential in the clinical use for caries in the elderly. Therefore, specific restorative materials for caries in the elderly, especially for root caries, need to be further developed and applied in clinical practice.

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.

Changes in color and contrast ratio of resin composites after curing and storage in water

PurposeTo verify the color change and contrast ratio of resin composites after curing and after 30 days of storage in water. MethodsDentin A2 shades of different light-cured dental resin composites (Vittra APS, FGM, Brazil; Z350 XT, 3M ESPE, EUA; Tetric N-Ceram, Ivoclar Vivadent, Liechtenstein, and Charisma Diamond, Heraeus Kulzer, Germany) were tested. Ten rounded specimens (8 mm × 2 mm) were prepared for each material. Reflectance for all samples was obtained using a spectrophotometer (Minolta CM 3700d, Konica Minolta, Japan) before curing, immediately after curing, and after 30 days of storage in water. The color change (ΔE*lab) and contrast ratio (CR) data were analyzed using a one-way analysis of variance with Tukey's and paired t-tests (α = 1%). ResultsFor all materials tested, significant color changes were noticeable after curing and after 30 days in water (p < 0.01). Significant changes in the CR values before curing, after curing, and 30 days of storage in water were observed in the resin composites investigated (p < 0.01) except for Z350 (p > 0.01). ConclusionThe CR values and color changes after curing and 30 days of storage in water varied depending on the material tested. This study corroborates the clinical practice of curing a small amount of unpolymerized resin composite on the tooth surface to select the desired shade before undertaking esthetic restorative procedures.

Comparative study of free-volume changes in light-cured (dimeth)acrylate-type dental resin composites affected to artificial aging in dry-air and water-immersed mode

This research is intended to compare degradation processes in light-cured (dimeth)acrylate-type polymer/filler dental composites affected to aging in dry-air and water-immersed mode. The positron annihilation lifetime (PAL) spectroscopy has been employed to study changes in atomic-deficient structure in these composites under aging. Under light-curing polymerization initiating crosslinking of monomer chains, fragmentation of free-volume holes in resin matrix dominates over enhanced fraction of trapped positrons, since filler–particles assemblies get to be more tightly covered by surrounding polymer causing disappearing of interfacial voids at the filler–polymer surface. Therefore, the PAL spectra-transforming trend in light-cured composites obeys inverse positron-to-Ps trapping conversion. In contrast, the PAL spectra-transforming trend in these restoratives under aging obeys direct Ps-to-positron trapping conversion. After dry-air aging, the observed changes in the density of annihilation sites are ascribed to a strong agglomeration of Ps-decay holes in polymer sub-system accompanied by weaker agglomeration and appearance of positron traps in filler–polymer sub-system. Under the water aging, the agglomeration of Ps-decaying holes in the polymer sub-system is suppressed due to absorbed water molecules, this effect being slightly revealed at lower polymerization. New positron traps are observed at the filler–polymer interfaces in all light-cured composites. The agglomerated Ps-decay holes in a polymer matrix and positron traps inside filler–particles assemblies and filler–polymer interfaces of artificially aged composites cause their progressive microcracking.

The incorporation of phosphorylated chitosan/amorphous calcium phosphate nanocomplex into an experimental composite resin.

This study evaluated the effect of incorporating phosphorylated chitosan/amorphous calcium phosphate nanocomplex (Pchi/ACP) into an experimental light-cure composite resin on mechanical-chemical properties and human dentin remineralization. The results showed that the mechanical strength and contact angles of the resins decreased with the increase incorporation of Pchi/ACP. Release concentrations of calcium in saline solution were measured at different time points, showing the incorporation of Pchi/ACP significantly increased calcium release within 14 days, and kept steady thereafter. Finally, the demineralized dentin slabs treated with our resins for four weeks were characterized by SEM-EDS. Various amounts of apatite were formed on the dentin slabs which were treated with the resins containing Pchi/ACP, whereas no apatite was formed without Pchi/ACP. In conclusion, the Pchi/ACP-incorporating composite resin can be a promising dental material due to its favorable mechanical and remineralization properties.

Evaluation of sandblasting with acid etching versus acid etching alone in the preparation of enamel for rebonding orthodontic brackets: An in vitro study and a randomized controlled trial

BackgroundNo clinical studies have evaluated shear bond strength and the clinical failure rates of the rebonded metallic brackets following different enamel-reconditioning methods. The objective of the study was to compare the in vivo clinical failure rate and the in vitro rebond strength of bonded brackets following two enamel surface preparation methods. MethodsFor the in vitro study, 45 extracted human premolars were etched; brackets were bonded using light-cured composite resin. Forty-five premolars were divided into three groups (15 in each group): the initial bonding group (IB group), the rebonding group in which enamel was reconditioned using sandblasting before acid etching (SBE group), and the rebonding group in which enamel was reconditioned using acid etching only (E group). For the in vivo study, 80 premolars in 20 patients (13–18 years old) were rebonded using the same procedures in the SBE group and E group. The two methods were used in all patients using a split-mouth design. The number of failing brackets was quantified over 6 months. Differences were statistically analyzed by one-way analysis of variance, followed by post hoc tests. ResultsThe mean shear bond strength for the IB, SBE, and E groups was 19.38, 22.37, and 17.31 MPa, respectively. A significant difference was observed in the bond strength of the three evaluated groups (P < 0.001). The differences in the bond strength were significant between the IB group and the SBE group, as well as between the SBE group and the E group. The clinical failure rate for bonded brackets was 10% in the SBE group, and 25% in the E group and this difference was statistically significant (P < 0.001). ConclusionsReconditioning of enamel surfaces using both intraoral air abrasion and etching in the rebonding process led to higher rebond strength than using acid etching alone and even higher than the initial brackets bonding. This trial was retrospectively registered at ClinicalTrials.gov (ID: NCT04606043).

Efficacy of Platelet Rich Plasma and Platelet Rich Fibrin for Direct Pulp Capping in Adult Patients with Carious Pulp Exposure- A Randomised Controlled Trial.

ObjectiveThis study evaluated the effectiveness of Platelet Rich Plasma (PRP), Platelet Rich Fibrin (PRF) and Mineral Trioxide Aggregate (MTA) as direct pulp capping materials in patients with carious pulp exposure using cone beam computed tomography.MethodsThis parallel, triple blinded, randomised trial was done on 30 permanent posterior teeth chosen as candidates for direct pulp capping based on stringent inclusion and exclusion criteria. The samples were allocated based on sequentially numbered opaque sealed envelope method into three groups: MTA, PRP and PRF for direct pulp capping. The treated teeth were restored with Glass Ionomer cement liner and light-cured resin composite. Patients were followed up for a period of 12 months. Statistical analyses were performed with statistical software SPSS version 25. Data were analysed for normality using Shapiro Wilk’s test. Dentine bridge volume analysis across the groups were done using Kruskal Wallis test with the significance level at P=0.05. As the test revealed a significant difference, post hoc analysis was done with Dunn test.ResultsCBCT analysis revealed that the volume of dentine bridge formed by PRP and PRF was significantly higher than the volume of dentine bridge formed by MTA (P<0.001; CI: 90%). There was no significant difference in the efficacy between the three direct pulp capping agents based on clinical assessment. A total of 27 teeth (90%) showed positive response to pulp sensibility testing and evidence of dentine bridge formation in radiograph at 12 months. No adverse events were encountered.ConclusionPlatelet concentrates could be the future of vital pulp therapy for adult permanent teeth with reversible pulpitis.

Mechanical Properties of Nanohybrid Resin Composites Containing Various Mass Fractions of Modified Zirconia Particles.

PurposeThe aim of this study was to investigate the effect of various mass fractions of 10-methacry-loyloxydecyl dihydrogen phosphate (MDP)-conditioned or unconditioned zirconia nano- or micro-particles with different initiator systems on the mechanical properties of nanohybrid resin composites.MethodsBoth light-cured (L) and dual-cured (D) resin composites were prepared. When the mass fraction of the nano- or micro-zirconia fillers reached 55 wt%, resin composites were equipped with dual-cured initiator systems. We measured the three-point bending-strength, elastic modulus, Weibull modulus and translucency parameter of the nanohybrid resin composites containing various mass fractions of MDP-conditioned or unconditioned zirconia nano- or micro-particles (0%, 5 wt%, 10 wt%, 20 wt%, 30 wt% and 55 wt%). A Cell Counting Kit (CCK)-8 was used to test the cell cytotoxicity of the experimental resin composites. The zirconia nano- or micro-particles with MDP-conditioning or not were characterized by transmission electron microscopy (TEM), Fourier infrared spectroscopy (FTIR), and X-ray photoelectron spectroscopy (XPS).ResultsResin composites containing 5–20 wt% MDP-conditioned or unconditioned nano-zirconia fillers exhibited better three-point bending-strength than the control group without zirconia fillers. Nano- or micro-zirconia fillers decreased the translucence of the nanohybrid resin composites. According to the cytotoxicity classification, all of the nano- or micro-zirconia fillers containing experimental resin composites were considered to have no significant cell cytotoxicity. The FTIR spectra of the conditioned nano- or micro-fillers showed new absorption bands at 1719 cm−1 and 1637 cm−1, indicating the successful combination of MDP and zirconia particles. The XPS analysis measured Zr–O–P peak area on MDP-conditioned nano- and micro-zirconia fillers at 39.91% and 34.89%, respectively.ConclusionNano-zirconia filler improved the mechanical properties of nanohybrid resin composites, but cannot be the main filler to replace silica filler. The experimental dual-cured composites can be resin cements with better opacity effects and a low viscosity.

Cytotoxicity evaluation of dental and orthodontic light-cured composite resins.

IntroductionThe aim of this study was to determine the cytotoxicity of light‐cured composite resins (Clearfil ES‐2, Clearfil ES Flow, Filtek Supreme XTE, Grengloo, Blugloo, Transbond XT, and Transbond LR) then to assess leachable components in contact with human gingival fibroblasts (GFs) and to quantity detected bisphenol A (BPA).MethodsLight‐cured composite resin discs were immersed for 24 hours in gingival fibroblastic medium (n = 3 for each product) and in control medium (n = 2 for each product) contained in plate. Cytotoxicity of the products (n = 95) was determined by the measure of cell viability using MTT assay after reading the optical densities of the plates. The analysis of leachable components was done by gas phase chromatography and mass spectrometry (GC–MS) and detected BPA was quantified. The limit of quantification was 0.01 μg/mL. Statistical analyses were performed by using IBM SPSS Statistics 20 and Kruskal–Wallis and Mann–Whitney U‐tests were applied.ResultsCell viabilities were between 85 and 90%. Many chemical compounds including triethylene glycol dimethacrylate (TEGDMA) and BPA were identified. The average concentrations were 0.67 μg/mL ± 0.84 in the control medium and 0.73 μg/mL ± 1.05 in the fibroblastic medium. Filtek Supreme XTE presented the highest concentration of BPA with 2.16 μg/mL ± 0.65 and Clearfil ES Flow presented the lowest with 0.25 μg/mL ± 0.35. No BPA was detected with Transbond XT and Transbond LR. Clearfil ES Flow, Filtek Supreme XTE, Grengloo and Transbond LR presented residual TEGDMA.ConclusionsLight‐cured composite resins are slightly cytotoxic opposite GFs and release many components including BPA and TEGDMA. Clinical precautions should be taken to decrease the release of these monomers.

Repair of temporary fixed dental prostheses using a flowable resin composite: Effect of material, bonding, and aging

ObjectivesAssessment of the effect of aging and bonding on the reparability of different temporary crown and bridge materials using a flowable resin composite. MethodsThe materials used included two bis-acryl and two polymethylmethacrylate materials. The materials were aged either dry, in distilled water, or in a 75% ethanol/water solution. Each group was divided into three subgroups (n = 6) according to the bonding method: application of a universal adhesive, application of a universal primer followed by a universal adhesive, or no bonding. Materials were repaired with a light-cure flowable resin composite; then, they were subjected to thermocycling and tested by shear bond strength. The data were analysed using three-way ANOVA, one-way ANOVA, and Tukey post hoc tests (α = 0.05). ResultsThe shear bond strength was significantly higher for bis-acryl compared to polymethylmethacrylate materials (p < 0.001). In terms of aging conditions, shear bond strength was in the order of 75% ethanol/water solution < dry < water. The application of bonding agents significantly increased the shear bond strength of polymethylmethacrylate-based materials (p < 0.001). The difference between water and dry storage was insignificant (p = 0.558); however, storage in a 75% ethanol/water solution showed significantly lower values compared to both dry and water storage in most of experimental groups (p < 0.001). Polymethylmethacrylate-based materials mainly demonstrated adhesive failure, while bis-acryl materials predominantly showed cohesive failure. ConclusionThe bond strength of a light-cure flowable resin composite is significantly higher with bis-acryl compared to that with polymethylmethacrylate-based substrates. Aging in water does not have a significant effect; however, the 75% ethanol/water solution tends to negatively affect repairability. The application of different bonding agents positively affects the repair strength, especially for polymethylmethacrylate-based substrates.

Comparison of lithium disilicate-reinforced glass ceramic surface treatment with hydrofluoric acid, Nd:YAG, and CO2 lasers on shear bond strength of metal brackets.

To evaluate and compare the effects of different surface conditioning methods of lithium disilicate-reinforced ceramic on shear bond strength (SBS) of metallic brackets. Thirty-six lithium disilicate ceramic blocks mounted in acrylic resin blocks were assigned to 3 groups (n = 12): 9.6% hydrofluoric acid (HF); neodymium-doped yttrium aluminium garnet (Nd:YAG) laser; and carbon dioxide (CO2) laser. The glass ceramic surfaces were primed with a silane, and the brackets were bonded using a light-cured composite resin. SBS test was carried out in a universal testing machine at 0.5 mm/min crosshead speed until the brackets were debonded. The remaining adhesive was evaluated under a stereomicroscope in terms of the adhesive remnant index (ARI). The surface hardness was determined with a 100-gr force using a microhardness tester. Glass ceramic surface changes were evaluated using the scanning electron microscope. One-way ANOVA and post hoc Tamhane tests were used to compare microhardness values, and Kruskal-Wallis and Mann-Whitney U tests were used to analyze SBS values and ARI. The median and interquartile range of SBS values in 3 groups were 6.48 (1.56-15.18), 1.26 (0.83-1.67), and 0.99 MPa (0.70-2.10), respectively. Microhardness analysis revealed significant differences between the CO2 laser and intact porcelain groups (P = 0.003), without significant differences between the other groups. Group 1 exhibited the highest ARI. Neither CO2 nor Nd:YAG lasers resulted in adequate surface changes for bonding of brackets on ceramics compared with the samples conditioned with HF. CO2 laser decreased the microhardness of ceramics. Surface conditioning with HF resulted in clinically acceptable SBS values.

Technique for simple apatite coating on a dental resin composite with light-curing through a micro-rough apatite layer.

Tooth root surfaces restored with dental resin composites exhibit inferior biocompatibility. The objective of this study was to develop a simple technique for coating apatite onto a resin composite to improve its surface biocompatibility. First, we fabricated a polymer film coated with a micro-rough apatite layer and pressed it (coating-side down) onto a viscous resin composite precursor. As a result of light-induced curing of the precursor through the overlaid film, the micro-rough apatite layer was integrated with the resin composite and, thus, transferred from the polymer film surface to the cured resin composite surface as a result of the difference in interfacial adhesion strength. The transferred apatite layer attached directly to the cured resin composite without any gaps at the microscopic level. The adhesion between the apatite layer and the cured resin composite was so strong that the layer was not peeled off even by a tape-detaching test. The flexural strength of the resulting apatite-coated resin composite was comparable to that of the clinically used resin composite while satisfying the ISO requirement for dental polymer-based restorative materials. Furthermore, the apatite-coated resin composite showed better cell compatibility than the uncoated resin composite. The present apatite coating technique is well suited for dental treatment because the coating is applied during a conventional light curing procedure through simple utilization of the apatite-coated polymer film in place of an uncoated film. The proposed technique represents a practical evolution in dental treatment using light-curing resin composites, although further in vitro and in vivo studies are needed.

Superficial and internal adaptations of a new self-curing composite resin restored class Ⅴ cavity

Objective: To investigate the superficial and internal adaptations of a new self-curing composite resin in Class Ⅴ cavities. Methods: Class Ⅴ cavities were prepared in 56 caries-free human maxillary premolars (collected from Department of Oral and Maxillofacial Surgery, Capital Medical University School of Stomatology) extracted for orthodontic reasons, and these premolars were assigned into two groups (28 specimens each group). Experimental group were restored with a pretreating agent (Tooth primer) and a new self-curing composite resin (Bondfill SB). Control group were restored with a self-etching adhesive (Scotchbond Universal) and a light-curing composite resin (Z100). The restored teeth were subjected to a fatigue test to simulate temperature change and occlusal load in oral environment: mechanical cycles (1 200 000 cycles at 49 N with a frequency of 1 Hz) and thermocycles (3 000 cycles from 5 ℃ to 55 ℃ with a dwelling time of 1 min each). Before and after fatigue test, restored teeth were immersed in an 50% ammoniacal silver nitrate solution and reduced. Superficial perfect margin percentage value and length of silver deposit along the internal interface were quantified by scanning electron microscopy (SEM). Ultrastructure of dentin bonding interface was analyzed by transmission electron microscope (TEM). Results: Before fatigue test, superficial gaps at dentin side in the specimens in experimental group were narrower than those in control group, and length of silver deposit at enamel side [(0.67±0.15) μm] in specimens in the control group was significantly lower than that in the experimental group [(33.54± 10.27) μm] (P<0.05). After the fatigue test, control group showed higher perfect margin percentage value to enamel [(55.08±15.20)%] than experimental group [(25.15±12.47)%] did (P<0.05). After the fatigue test, cohesive failures could be more easily found in experimental group than in control group at surficial and internal interfaces. In TEM results, more silver deposits were found at dentin bonding interface in control group than in experimental group before the fatigue test. After the fatigue test, the deterioration at dentin bonding interface mostly happened at the bottom of the hybrid layer in control group, while in experimental group it could be found at the bottom of the hybrid layer and in the restorative material. Conclusions: When restored in Class Ⅴ cavity, the studied light-curing composite shows better superficial and internal adaptations for enamel than the new self-curing composite resin and the new self-curing composite resin shows good superficial and internal adaptations for dentin.

Study on a novel antibacterial light-cured resin composite containing nano-MgO

A new type of photocurable resin composite containing nano-MgO was synthesized in order to reduce the occurrence of secondary caries. Different mass ratios (0 %, 1 %, 2 %, 4 %, 8 %) of nano-MgO were added into resin composites. The antibacterial properties of nano-MgO powder and modified resin composites against Streptococcus mutans (S. mutans) were detected by antibacterial ring test and film contact test, respectively. Compressive strength (CS) and wear resistance were determined by a universal testing machine and an abrasion test machine. The results indicated that antibacterial activity and wear resistance of resin composites containing nano-MgO were superior to the control group (p < 0.05). The antibacterial rate reached as high as 99.4 % when the mass ratio of nano-MgO was 8 %. However, the CS values tended to decline as the content of nano-MgO increase. Hence, the addition of nano-MgO showed excellent antibacterial property to resin composites and enhanced wear resistance, but was detrimental to their mechanical properties.

Integration implantology, periodontics and prosthodontics in aesthetic rehabilitation: case report

Immediate implants are a current reality in the evolution of oral implant rehabilitation. This technique allows the implant to be installed in the socket immediately after the extraction, presenting optimization of the clinical time and preservation of the shape of the soft tissues surrounding the implant. The objective of this study was to report a protocol of immediate implant installation associated with connective tissue graft (ETC) and immediate loading in aesthetic region associated with root coverage of the homologous tooth. A female patient (41 years old) presented an oral rehabilitation clinic with an acute inflammation in tooth 11, which presented external root resorption in the cervical region of the root, periodontal pocket greater than 7 mm and painless mobility. After antibiotic therapy, the surgical procedure was performed: (1) Minimally traumatic extraction of the tooth in question; (2) Injury curettage; (3) Installation of the dental implant; (4) Removal of connective tissue of the palate and (5) ETC envelopment in the vestibular of the implant and recoating of the element 21 that suffered from gingival recession. Immediately after the surgical procedure and implant locking, a provisional crown was installed in Ucla (provisional) made with the patient's own tooth and held in the Ucla by light-cured composite resin. This set of measurements resulted in a gain in keratinized mucosa thickness and reestablishment of peri-implant tissue health and vitality, resulting in satisfactory rehabilitation of aesthetic region.