Search Results (20)

Background: This study assessed the effect of solvent aging on Vickers microhardness (VHN) and fracture toughness (K_IC) of four resin composites: two high-strength flowable materials indicated for all cavity classes (GUF and CBF), a packable nanohybrid composite (XTE), and its flowable counterpart (XTEF). Methods: Disk specimens (n = 6 per group) were photocured and stored at 37 °C in distilled water or in a 75%/25% ethanol/water solution for 1 or 30 days. Vickers microhardness was recorded with a 300 g load applied for 15 s. Single-edge-notched beam (SENB) specimens (32 × 6 × 3 mm; n = 6 per group) were loaded in three-point bending for K_IC determination after 1 and 30 days of storage in water or ethanol/water. Data were analyzed by three-way ANOVA followed by Tukey’s post hoc test (α = 0.05). Results: At 1 day, the four composites separated into distinct VHN groups in the order XTE > GUF > CBF > XTEF (p ≤ 0.05). After 30 d, VHN decreased in all materials, with larger reductions in ethanol/water (17–30% relative to the 1 d water value) than in water alone (5–11%). At 1 day, K_IC values for XTE, GUF and CBF formed a single statistical group, all significantly higher than XTEF (p ≤ 0.05). Thirty-day water storage did not affect K_IC for any material (p > 0.05), whereas ethanol/water storage reduced K_IC by 21–26% in all four composites and produced four distinct material groups (p ≤ 0.05). Conclusions: The high-strength flowable composites showed greater hardness and toughness than a conventional flowable composite but did not match the mechanical performance of the highly filled packable composite. Ethanol/water aging markedly softened the composite surfaces and reduced fracture toughness, whereas prolonged water storage had a smaller effect on hardness and no measurable effect on K_IC. Full article

Background/Objectives: Bulk-fill (BF) resin-based composites (RBCs) have become increasingly popular due to their efficient placement. However, there is a lack of comprehensive performance comparisons among commercially available BF RBCs. In standardized curing conditions, this study aimed to compare the mechanical performance, water sorption and solubility, surface roughness, and color stability of commercially available BF RBCs with different consistencies (flowable and packable). Methods: Ten BF RBCs, along with a conventional RBC (control), were evaluated. Flexural strength and elastic modulus were measured using a three-point bending test. Water sorption and solubility were assessed after 28-day water storage. Color (ΔE₀₀) and surface roughness (ΔRa) changes were measured after 28-day immersion in water, Pepsi, or coffee. One-way ANOVA and Tukey’s tests analyzed the data. Results: 3M Flow, Shofu Bulk, and Ivoclar Flow revealed lower strength (p < 0.001) compared to 3M Bulk (132.17 ± 12.54 MPa) and the control (124.56 ± 15.60 MPa). Shofu Bulk (24.68 ± 12.55 µg/mm³) and Ivoclar Flow (27.11 ± 6.27 µg/mm³) were the least affected by water sorption. While Shofu Bulk (13.98 ± 11.39 µg/mm³), Ivoclar Flow (20.28 ± 6.64 µg/mm³), and SDR (20.84 ± 9.74 µg/mm³) exhibited the lowest solubility (p < 0.01). After water and Pepsi immersion, FGM Bulk showed a significant color change compared to 3M Bulk and Ivoclar Bulk (p < 0.05). Following coffee immersion, Shofu Bulk (17.38 ± 1.82) revealed significant color changes (p < 0.001). Increased surface roughness was observed in 3M Bulk and Ivoclar Bulk after water immersion, Shofu Bulk after Pepsi immersion, and FGM Bulk after coffee immersion. Conclusions: BF RBCs exhibit notable variability in their intrinsic properties. 3M Bulk and Control showed the highest strength, while Shofu Bulk had significant color changes. Full article

Resin-based restorative materials are widely used for direct dental restorations due to their versatility and esthetic appeal. However, selecting the most appropriate material involves multifactorial considerations, including clinical demands, practitioner preferences, and professional background. This pilot study aimed to investigate the factors influencing the selection of resin-based restorative materials among dental clinicians at the National and Kapodistrian University of Athens. A structured questionnaire comprising 23 closed-ended and 5 open-ended items was administered to 87 clinicians between October 2023 and January 2025. The survey assessed material preferences for anterior and posterior restorations, along with demographic, economic, and environmental influences. Data were analyzed using descriptive statistics, Spearman correlations, and Mann–Whitney U tests (SPSS v29). Findings revealed that clinicians with over five years of experience demonstrated significantly greater knowledge of material composition (r = 0.230) and shelf life (r = 0.223). These practitioners favored specialized materials, whereas those with less experience emphasized anatomical and esthetic attributes. For posterior restorations, 75.9% of respondents preferred packable composites. Involvement in procurement processes correlated positively with familiarity with ISO specifications (r = 0.254). While environmental concerns were noted, they were generally secondary, with gender-based differences observed in prioritization. These results underline the importance of targeted continuing education to enhance evidence-based material selection in restorative dentistry. Full article

The aim of this in vitro study is to evaluate the effect of resin type and placement technique on the hardness of resin-based composites (RBCs). A total of 300 samples consisting of five RBCs (Filtek Z250 microhybrid, Filtek P60 packable, Tetric Ceram hybrid, Admira ORMOCER, and Tetric Flow flowable RBCs) were prepared. Each RBC was placed into Teflon molds with a 4 mm diameter and 2 or 8 mm depths with standard, bulk and incremental techniques and was polymerized by second-generation LED (Hilux Ledmax 1055, 229.153 mW/cm²) and UV (ELC-410, 26.106 mW/cm²) light-curing units (LCUs) in standard mode (n = 10). The Vickers hardness number (VHN) was measured from the top and bottom surfaces of the RBCs. Data were statistically analyzed with a one-way ANOVA. Multiple comparisons were made using the Tukey, Scheffe, and t-tests (p < 0.05). The VHN of the RBCs polymerized with LED and UV LCUs varied between 110.33 and 25.16 and between 104.86 and 34.20, respectively. The Tetric Flow RBC did not polymerize with the LCUs on either surface. The RBCs placed using the bulk technique could not polymerize with the UV LCU on the top surface, except for the Filtek P60 RBC, but showed a higher VHN on the bottom surface. These significant findings highlight that the hardness is specific to the RBC material and placement technique. Full article

Patient demands for aesthetic orthodontic brackets (OBs) has increased since orthodontic treatments are of long duration. Clinicians encounter old composite restorations frequently, against which OBs need to be bonded. This study aims to determine the shear bond strength (SBS) of two aesthetic OBs (ceramic and resin) against aged composite resins (flowable and packable) after standard surface treatment. A total of 96 disk-shaped specimens of two aged (A) composite resins [flowable (F) and packable (P)] were divided into eight groups, using ceramic (C) and plastic (P) brackets, out of which four subgroups served as the control [non-aged (N)FC, NPC, NFR, NPR] and four as experimental [AFC, APC, AFR, APR]. Surface treatment included mechanical [air abrasion] and chemical [Assure Plus and Transbond XT]. After 24 h of storage, the specimens were tested for SBS and observed for failure mode using adhesive remnant index scores. Mean values of SBS in each subgroup were analyzed statistically using a one-way analysis of variance test and Tukey post hoc test. All probability ‘p’ differences were significant at a value of 0.05 and less. All aged composite resin subgroups had decreased bond strength than controls, with all subgroups bonded with plastic brackets having the least bond strengths that were clinically nonacceptable [≤7 to 10 MPa]. Flowable composites when bonded with either ceramic or plastic brackets had higher strength than packable composites. Ceramic brackets had higher SBS than plastic brackets for both flowable and packable composites. Significant differences in bond strength were observed among subgroups of plastic brackets. Ceramic brackets were associated with a higher residue of adhesives on the composite surface. Aged composite resins exhibit significantly lower SBS than fresh composites, with ceramic brackets and flowable composites producing better bond strength values than plastic brackets and packable composites. Full article

Polyhydroxybutyrate (PHB) is a biopolymer produced by bacteria. This study aimed to implement the production process of experimental medical-grade PHB and to evaluate its morphology and biocompatibility compared to conventional resin-based composites (RBCs). PHB raw material was produced via biological process and then the membrane was generated via electrospinning specifically for this study and imaged with Micro-Computed Tomography (Micro-CT) and scanning electron microscopy (SEM). MTS assay was used to assess the cytotoxicity of PHB compared to other materials. Test groups included two packable resin composites (Point 4-Kerr, G-aenial anterior-GC), two flowable resin composites (Filtek Ultimate Flowable-3M ESPE, Nova Compo HF-Imicryl), a compomer (Nova Compomer-Imicryl), a fissure-sealant (Fissured Nova Plus-Imicryl), and the PHB membrane (Innovaplast Biotechnology Inc., Eskisehir, Turkey). A control group consisting of cells without any test material was also produced. To perform the MTS assay, disc-shaped specimens of the aforementioned materials were prepared and then incubated with mouse fibroblast cells (L929) for 24 and 48 h. Micro-CT and SEM images revealed a homogeneous and fibrillary structure of the PHB. MTS assay revealed the highest cell viability in the PHB, Nova Compomer, and Fissured Nova Plus groups after 24 h. PHB and Nova Compomer showed the highest viability rates at 48 h while other RBCs had rates below 25% (p < 0.05). Considering the cell viability data and its fibrillary structure, from a biological point of view, PHB seems a promising biopolymer that might have applications in the field of dental restorative materials. Full article

Background/Objectives: The success of treatment and prevention for secondary caries hinges significantly on the techniques employed in Class II composite restoration. Additionally, the location of the restored tooth within the oral cavity has emerged as a potential factor determining the quality of the restoration. A comprehensive understanding of these interrelated variables is crucial for advancing the efficacy and durability of dental composite restorations. The aim of this study was to assess how various restoration techniques and the specific location of the tooth restoration in the oral cavity affect marginal sealing, verified by the gap created in the tooth–restoration interface. Methods: Sixty extracted human teeth that had been indicated for orthodontic extraction were collected and embedded into a custom-made holder that was located in one of the four quadrants of a laboratory phantom head. Class II resin composite restorations, using flowable and packable composites, were performed on all teeth using two techniques: Pre-cure and Co-cure. The aging of the restored teeth was conducted using cyclic loading and thermocycling. After aging, the teeth were examined under a scanning electron microscope to measure the gap within the tooth–composite interface. Kolmogorov–Smirnov tests were used to assess the data distribution. Unpaired T-tests were employed to compare the mean gaps between the Pre-cure and Co-cure techniques. Additionally, unpaired T-tests were utilized to compare the mean gaps between the mesial and distal parts of the teeth. The Kruskal–Wallis test was used to compare the mean gaps among the four quadrants. The statistical significance was set at p = 0.05. Results: No significant difference in the gaps between the Pre-cure and Co-cure techniques was found (p = 0.212). The tooth’s location did not generally affect the restoration’s gap interface (p = 0.136). Conclusions: Flowable composites aid in restoring the deep margins of Class II composite restoration. Thus, the potential for further microleakage is similar for both the Pre-cure and Co-cure restoration techniques. The marginal seal of Class II composite restorations is effective when using both Pre-cure and Co-cure techniques, and the restoration site within the oral cavity does not significantly influence the tooth–composite interface seal. Full article

The degree of conversion (DC) is crucial in determining the mechanical and clinical performance of resin-based composites (RBCs). This in vitro study aimed to evaluate the effect of the resin type and placement technique on the DC of RBCs (micro-hybrid, packable, hybrid, ormocer-based and flowable) polymerized with a second-generation LED light-curing unit (LCU). A total of 75 RBC samples were divided into three groups. Each RBC was placed into 4 mm diameter and 2 and 8 mm heigh Teflon molds with conventional standard, bulk, and incremental techniques (n = 5) and polymerized by LED LCU (229.153 mW/cm²) using the standard mode. After 24 h, DC was determined by FTIR spectrophotometry. The data were analyzed with two-way ANOVA and Tukey’s HSD test (p < 0.05). The DC of the RBCs varied between 62.8 and 29.2%. While the same DC was obtained for 2 mm samples at the top and the bottom surfaces, the DC of the 8 mm samples gradually diminished from the top surface to the bottom surface. Significant differences were observed in the DC of the RBCs. An optimal DC was obtained for packable, micro-hybrid and ormocer-based RBCs polymerized by LED LCU with the recommended curing times. Considering that the polymerization process is versatile, further in vitro studies are needed. Full article

Objective: To assess and compare the effects of two pediatric anti-asthmatic medication doses on the microhardness of enamel and microhardness, surface roughness and color of restorative materials. Methods: Human enamel samples and packable and flowable composite restorations were used. The samples were exposed to Salbutamol (0.6 mL/6 mL saline) and Budesonide (2 mL/2 mL saline) via a custom-made chamber connected to a nebulizer. Medication administration was conducted for 10 days. The samples were brushed with an electronic brush in a continuous and circular mode for 10 s after 10 min of medication administration. Assessments of microhardness, surface roughness and color were carried out at three different time intervals: baseline (T₀), 5 days (T₁) and 10 days (T₂). One-way analysis of variance (ANOVA), a two-sample t-test and a Bonferroni multiple comparison test were used to analyze the data and compare between the groups. Results: Both medications significantly (p < 0.05) decreased the microhardness of the enamel and composite samples after 10 days. Both medications lowered the surface roughness of both types of composite with a greater effect observed after 10 days of Budesonide administration (p < 0.05). Both medications had comparable detectable color change on both types of composite with a greater effect observed after 10 days of Budesonide administration (p < 0.05). Conclusion: Salbutamol and Budesonide significantly decreased microhardness in the enamel samples. Both medications affected the properties of packable and flowable composites. The packable composite showed more resistance to microhardness changes. Both medications showed a clinically detectable change in the color of packable and flowable composites. Full article

Introduction: Several advantages, including improved aesthetics and conservative cavity preparation, made resin-based composite (RBC) a popular restorative material. However, several limitations come with RBC restorations such as the necessity for proper isolation of the tooth and an incremental layering for the material due to the limitations of the depth of cure. Despite these advantages and limitations, the usage of these restorative materials is increasingly being expanded due to the advancement made since their introduction. To overcome some of the limitations, several types of RBC restorations were developed. Materials and Methods: Four different RBC materials used for class II restorations in primary and permanent teeth were compared: Z350 XT Filtek™ Universal Restorative (ZXT), Filtek™ Bulk Fill Flowable Restorative (FBF), Beautifil-Bulk Flowable (BBF) and Tetric™ N-Flow (TNF). Flexure strength, elastic modulus, surface roughness, microhardness and microleakage were assessed using standard methods or previously published protocols. The data and differences between the groups were analyzed using One-way analysis of variance (ANOVA), Tukey’s multiple comparisons, Kruskal–Wallis and Wilcoxon rank-sum (Mann–Whitney) tests. Results: The study found that BBF (86.24 ± 7.41 MPa) and ZXT (64.45 ± 11.52 MPa) had higher flexural strength than FBF (50.89 ± 8.44 MPa) and TNF (50.67 ± 9.40 MPa), while both exhibited the highest values of surface roughness. Elastic modulus was the highest with BBF, which was not statistically significant from FBF or ZXT (p > 0.05). ZXT (109.7 ± 7.83 VH) exhibited the highest value of microhardness, which was statistically significant from the other three materials (p < 0.0001). Microleakage was assessed after thermocycling for 20,000 cycles to simulate two years in the mouth. FBF (70%) exhibited the most resistance to microleakage. Conclusions: Different types of RBC restorations exhibit different characteristics. The clinician needs to choose the most appropriate restorative material based on different clinical scenarios. Full article

This study aimed to evaluate and compare two different fiber-reinforced composite materials in class I post-endodontic restoration in molars. A total of 50 patients were randomly assigned into two groups (n = 25 for each group); group A: everX Posterior (packable composite) with a top layer of solareX (nano-hybrid composite) and group B: everX Flow (flowable composite) with a top layer of G-aenial universal injectable (flowable composite). Patients were evaluated immediately after the procedure (baseline), at 6 months, and at 1 year time intervals based on the modified USPHS criteria. The statistical analysis using a chi-square test showed no statistically significant difference in the clinical performance of group A and group B. Clinical performance of the combination of everX Flow with overlying G-aenial universal injectable composite proved to be comparable with everX Posterior with overlying solareX composite as post-endodontic restorations in class I lesions in permanent molars. Full article

The aim of this research was to evaluate the mechanical impact of different direct restorations in terms of fracture resistance, and subsequent fracture pattern, in occlusal high C-factor cavities. Furthermore, the adaptation of different direct restorations in the form of gap formation was also evaluated. Seventy-two intact mandibular molars were collected and randomly distributed into three groups (n = 24). Class I occlusal cavities with standardized dimensions were prepared in all specimens. After adhesive treatment, the cavities were restored with direct restorations utilizing three different materials. Group 1: layered conventional packable resin composite (Filtek Ultimate), Group 2: bulk-fill resin composite (SDR), Group 3: bulk-fill short fibre-reinforced composite (SFRC; everX Posterior) covered with packable composite occlusally. Half of the restored specimens underwent static load-to fracture testing (n = 12/group), while the rest underwent sectioning and staining for microleakage evaluation and gap formation analysis. Fracture patterns were evaluated visually among the mechanically tested specimens. The layered composite restoration (Group 1) showed significantly lower fracture resistance compared to the bulk fill groups (Group 2, p = 0.005, Group 3, p = 0.008), while there was no difference in fracture resistance between the other groups. In terms of gap formation values, the layered composite restoration (Group 1) produced significantly higher gap formation compared to the bulk-fill groups (Group 2, p = 0.000, Group 3, p = 0.000). Regarding the fracture pattern, SFRC (Group 3) produced the highest number, while SDR (Group 2) produced the lowest number of repairable fractures. The use of bulk-fill resin composite (fibre or non-fibre-reinforced) for occlusal direct restorations in high C-factor cavities showed promising achievements regarding both fracture resistance and microleakage. Furthermore, the use of short fibre-reinforced bulk-fill composite can also improve the fracture pattern of the restoration-tooth unit. Bulk-fill materials provide a simple and effective solution for restoring and reinforcing high C-factor occlusal cavities. Full article

The purpose of this study was to analyze the fracture resistance and marginal leakage of noncarious cervical lesion (NCCL) restorations made of different restorative materials. Eighty upper premolars were randomly divided into four groups (n = 20/group). Standardized NCCL cavity preparations were performed on the buccal surface of the teeth and then restored with four different materials. Group 1: Packable resin composite (PC); Group 2: Highly flowable resin composite (HF); Group 3: Low flowable resin composite (LF); Group 4: Resin modified glass ionomer cement (RMGIC). After restorations were completed, cyclic and static fracture behavior was evaluated using a loading testing machine. Extra restored teeth were sectioned and then stained (n = 5/group). The specimens were viewed under a stereo microscope and the percentage of microgaps at the tooth–restoration interface was calculated. All restored teeth survived after fatigue loading. There was no statistically significant (p > 0.05) difference between the tested restorations after the static loading test. NCCLs restored with highly filled flowable composite showed the least microleakage among the tested groups (p < 0.05). The investigated restorative materials are acceptable for NCCL restorations in terms of fracture resistance and microleakage. Full article

The aim of this research was to study the impact of using a short fiber-reinforced composite (SFRC) core on the fatigue performance and fracture behavior of direct large posterior composite restorations. Moreover, the influence of the consistency (flowable or packable) of occlusal composite coverage was assessed. A total of 100 intact molars were collected and randomly distributed into five groups (n = 20). Deep mesio-occlusal-distal (MOD) cavities were prepared in all groups. After adhesive treatment and rebuilding the missing interproximal walls with conventional composite, the specimens in four experimental groups were restored by an SFRC core (everX Flow), which was applied and cured either in bulk or in oblique layers (each 2 mm thick). Packable (G-aenial Posterior) or flowable (G-aenial Injectable) conventional composites were used as a final occlusal layer. The control group was restored with only packable conventional composite. Fatigue survival was measured for all specimens using a cyclic loading machine until a fracture occurred or a total of 25,000 cycles was achieved. Kaplan–Meyer survival analyses were conducted, followed by pairwise log-rank post hoc comparisons. The static load-bearing capacity of surviving teeth was tested using a universal testing machine. Fracture patterns were evaluated visually. There was no statistically significant (p > 0.05) difference in terms of survival between the tested groups. All groups for which flowable SFRC was used showed statistically significantly higher load-bearing capacities compared to the control group (p < 0.05). There were no significant differences regarding fracture resistance among the fiber-reinforced study groups. Regarding the fracture pattern during the survival analysis, all specimens that received SFRC showed a dominantly restorable type of fracture, while the control specimens presented a dominantly non-restorable type. The use of flowable SFRC as a reinforcing core for large MOD direct restorations showed promising achievements regarding fracture behavior. Full article

Dental Bulk-Fill Composites (BFCs) and Bulk-Fill Flowables (BFFs) were introduced in the market to facilitate efficient bulk filling of cavities up to 5 mm. The aim of this study was to synthesize the literature investigating their polymerization efficiency. A comprehensive search of PubMed and the Cochrane Library from 2010 to January 2019 was performed using the medical subject headings. Screening of the titles, abstracts and full text was performed. Data extraction for relevant information was done on the included studies. Clinically relevant parameters were selected to present the study estimates (meta-analysis) using a random effects model for polymerization efficiency (Degree of Conversion (DC) and Depth of Cure (DoC)). Twenty one studies fulfilled the inclusion criteria and were included in the analysis reporting seven BFCs and nine BFFs. Ten materials reported acceptable DC values of above 55% and ten materials reported adequate DoC values. Most of the stated materials reported adequate DC and DoC values in at least one investigation with BFFs showing higher and more acceptable values compared to packable BFCs. It is suggested that future studies be carried out using a standard methodology following the ISO 4049 standard and manufacturer’s instructions to compare results. Full article