A.C. Shortall

Photoinitiator type and applicability of exposure reciprocity law in filled and unfilled photoactive resins.

OBJECTIVES To test the influence of photoinitiator type and filler particle inclusion on the validity of exposure reciprocity law. MATERIALS AND METHODS 50/50 wt% Bis-GMA/TEGDMA resins were prepared with equimolar concentrations of camphorquinone/DMAEMA (0.20/0.80 mass%) (CQ) or Lucirin-TPO (0.42 mass%), and were used either unfilled or filled to 75 mass%. Specimens were cured with a halogen Swiss Master Light (EMS, Switzerland) using four different curing protocols: 400 mW/cm² for 45 s as reference protocol (18 J/cm²), 1500 mW/cm² for 12 s (18 J/cm²), 3000 mW/cm² for 6 s (18 J/cm²) and 3 s (9 J/cm²). Degree of conversion (DC) was measured in real time for 70 s by FT-NIRS and temperature rise using a thermocouple. Depth of cure was determined with a penetrometer technique. RESULTS With respect to DC and depth of cure, exposure reciprocity law did not hold for any tested material, except for the depth of cure of filled CQ-based materials. At similar radiant exposure, DC was significantly higher (p<0.05) for all unfilled and filled TPO-based materials compared with CQ-based materials. As exposure time was reduced and irradiance increased, TPO-based materials exhibited higher DC whilst an opposite trend was observed for CQ-based materials (p<0.05). For similar curing regimes, depth of cure of CQ-based materials remained significantly greater than that of TPO-based materials. Adding fillers generally reduced DC, except at higher irradiance for CQ-based materials where a positive effect was observed (p<0.05). SIGNIFICANCE The validity of exposure reciprocity law was dependent on several factors, among which photoinitiator type and filler content were important. Lucirin-TPO is a highly reactive and efficient photoinitiator, which may allow the potential for a reduction in curing time of TPO-based photoactive materials in thin sections.

Potential countersample materials for in vitro simulation wear testing

OBJECTIVES Any laboratory investigation of the wear resistance of dental materials needs to consider oral conditions so that in vitro wear results can be correlated with in vivo findings. The choice of the countersample is a critical factor in establishing the pattern of tribological wear and in achieving an efficient in vitro wear testing system. This research investigated the wear behavior and surface characteristics associated with three candidate countersample materials used for in vitro wear testing in order to identify a possible suitable substitute for human dental enamel. METHODS Three candidate materials, stainless steel, steatite and dental porcelain were evaluated and compared to human enamel. A variety of factors including hardness, wear surface evolution and frictional coefficients were considered, relative to the tribology of the in vivo situation. RESULTS The results suggested that the dental porcelain investigated bore the closest similarity to human enamel of the materials investigated. SIGNIFICANCE Assessment of potential countersample materials should be based on the essential tribological simulation supported by investigations of mechanical, chemical and structural properties. The selected dental porcelain had the best simulating ability among the three selected countersample materials and this class of material may be considered as a possible countersample material for in vitro wear test purposes. Further studies are required, employing a wider range of dental ceramics, in order to optimise the choice of countersample material for standardized in vitro wear testing.

Two-body in vitro wear study of some current dental composites and amalgams

STATEMENT OF PROBLEM Wear resistance of restorative materials is a major concern in clinical practice for restorations involving occlusion. The relatively poor wear resistance of dental composites in stress-bearing posterior situations has restricted even wider clinical application of this type of restorative material. PURPOSE This in vitro study compared the relative wear resistance of a selection of current dental composites and amalgams under cyclic loading to explore the wear mechanisms operating on these materials and to assess their relative potential clinical wear resistance under variable masticatory loads. MATERIAL AND METHODS A 2-body in vitro wear test was undertaken on a selection of 2 Ultrafine Compact-Filled composites, 1 microfilled composite, and 3 dental amalgams. An alternating sine curve load (0.5 to 15 N) was applied to the wear surface through a rotating countersample with a purpose-built system to simulate the variable loading pattern that occurs during mastication. RESULTS Under conditions simulating the repetitive cyclic loading pattern that may occur intraorally in high stress occlusal contact situations, the Ultrafine Compact-Filled composites exhibited a delamination wear pattern and had a significantly lower wear resistance than the amalgams. By comparison, the microfilled composite (Silux Plus) displayed an improved wear resistance that was superior to some amalgams. Dispersalloy had the best wear resistance among the materials selected. CONCLUSION The wear of Ultrafine Compact-Filled composite and microfilled composite differed and reflect different operative wear mechanisms. For amalgams, the size, shape, and composition of the particles had an effect on the wear resistance of the materials.

Can a single composite resin serve all purposes

The consensus view less than a decade ago was that direct posterior composites should be restricted to small restorations, preferably in premolar teeth with little, if any, occlusal function. Major advances in adhesive systems, materials and restorative techniques have combined to allow us to question this view and our increased clinical evidence base makes it appropriate to reconsider this viewpoint.

Light curing unit effectiveness assessed by dental radiometers.

OBJECTIVES The purpose of this investigation was to assess the effectiveness of five commercially available hand-held dental radiometers and a computer-based experimental radiometer. METHODS Light intensity of five visible light activation units was determined using the dental radiometers. The influence of curing light intensity on depth of cure of a hybrid composite material was determined using a digital penetrometer. RESULTS The radiometers evaluated varied with respect to sensor aperture diameter, scale readings (analogue or digital) and the units of measurement (arbitrary or mW cm2). The experimental computer-based radiometer allowed continuous recording of intensity against time; thus the light output could be monitored over the entire irradiation period. CONCLUSIONS When light intensity readings were normalized with regard to a standardized light sensing device aperture of 4 mm diameter, a linear relationship was found between depth of cure and the logarithm of the intensity of the light. The results of this investigation support the use of dental radiometers for periodically monitoring visible light activation units.

Effect of exposure intensity and post-cure temperature storage on hardness of contemporary photo-activated composites

OBJECTIVES The effect of variation in post-exposure storage temperature (18 vs. 37 degrees C) and light intensity (200 vs. 500mW/cm(2)) on micro-hardness of seven light-activated resin composite materials, cured with a Prismetics Mk II (Dentsply) light activation unit, were studied. METHODS Hardness values at the upper and lower surfaces of 2mm thick disc shaped specimens of seven light-cured resin composite materials (Herculite XRV and Prodigy/Kerr, Z100 and Silux Plus/3M, TPH/Dentsply, Pertac-Hybrid/Espe, and Charisma/Kulzer), which had been stored dry, were determined 24h after irradiation with a Prismetics Mk II (Dentsply) light activation unit. RESULTS Hardness values varied with product, surface, storage temperature, and curing light intensity. In no case did the hardness at the lower surface equal that of the upper surface, and the combination of 500mW/cm(2) intensity and 37 degrees C storage produced the best hardness results at the lower surface. CONCLUSIONS Material composition had a significant influence on surface hardness. Only one of the seven products (TPH) produced a mean hardness values at the lower surface >80% of the maximum mean upper surface hardness obtained for the corresponding product at 500mW/cm(2) intensity/37 degrees C storage temperature when subjected to all four test regimes. Despite optimum post-cure storage conditions, 200mW/cm(2) intensity curing for 40s will not produce acceptable hardness at the lower surface of 2mm increments of the majority of products tested.

Encapsulated verses hand-mixed zinc phosphate dental cement.

Zinc phosphate cements are commonly supplied as two components, powder and liquid, and the proportions of the constituents are determined by operator experience. A capsulated system which is mechanically mixed has been marketed and this study investigated the performance of the encapsulated cement system. The mean fracture strength, standard deviation and associated Weibull Moduli (m) of encapsulated cements were determined by compressive fracturing 20 cement specimens filled directly from the mixing syringe or from narrower cement tubes. Pore distribution within the cylindrical specimens was determined using image analysis to assess the influence of the method of mould filling with the cement. The strength data showed variation in magnitude and consistency ranging from 44.6+/-13.7 MPa (m = 3.18+/-0.71) for cements filled directly from the syringe to 61.0+/-7.8 MPa (m = 8.35+/-1.87) for cements filled from cement tubes. Larger pores were found in specimens consolidated directly from the cement syringe. Mechanical mixing of the encapsulated cement resulted in air entrapment in the cement mix which manifested itself as large pores (over 200 microm diameter) within the cylindrical specimens. The smaller orifice of the cement tube compared with the syringe was considered to be responsible for eliminating the majority of the air entrapped in the cement mass during mixing. Whilst mechanical mixing of encapsulated cements is quicker and more convenient, the encapsulated specimens consolidated according to the manufacturers instructions from the syringe offered no significant advantage in terms of reliability or strength over hand-mixed cements in this investigation.

Marginal seal of injection-molded ceramic crowns cemented with three adhesive systems

This in vitro investigation evaluated the marginal seal of an injection-molded ceramic crown system used in combination with three adhesive luting systems. One of these systems was a glass-ionomer cement and the other two were based on composite resin materials. One of the latter materials is claimed by the manufacturer to bond to tooth structure and also to porcelain. The final luting material was used in conjunction with a commercially available porcelain bonding system and specific dentin bonding pretreatments. Following thermocycling, the marginal seal of the crowns was tested by use of a chemical marker intrusion technique. The extent of leakage along the sectioned crown/luting agent/tooth structure interfaces was recorded by using digital imaging microscopy. Minimal microleakage was demonstrated with the composite luting cement used in association with specific porcelain and dentin bonding pretreatments.

The flexural properties of endodontic post materials

OBJECTIVES To measure the flexural strengths and moduli of endodontic post materials and to assess the effect on the calculated flexural properties of varying the diameter/length (D/L) ratio of three-point bend test samples. METHODS Three-point bend testing of samples of 2mm diameter metal and fiber-reinforced composite (FRC) rods was carried out and the mechanical properties calculated at support widths of 16 mm, 32 mm and 64 mm. Weibull analysis was performed on the strength data. RESULTS The flexural strengths of all the FRC post materials exceeded the yield strengths of the gold and stainless steel samples; the flexural strengths of two FRC materials were comparable with the yield strength of titanium. Stainless steel recorded the highest flexural modulus while the titanium and the two carbon fiber materials exhibited similar values just exceeding that of gold. The remaining glass fiber materials were of lower modulus within the range of 41-57 GPa. Weibull modulus values for the FRC materials ranged from 16.77 to 30.09. Decreasing the L/D ratio produced a marked decrease in flexural modulus for all materials. SIGNIFICANCE The flexural strengths of FRC endodontic post materials as new generally exceed the yield strengths of metals from which endodontic posts are made. The high Weibull modulus values suggest good clinical reliability of FRC posts. The flexural modulus values of the tested posts were from 2-6 times (FRC) to 4-10 times (metal) that of dentin. Valid measurement of flexural properties of endodontic post materials requires that test samples have appropriate L/D ratios.

Initial fracture resistance and curing temperature rise of ten contemporary resin-based composites with increasing radiant exposure.

OBJECTIVES The principal objective of this study was to determine whether the bulk fracture resistance of ten light activated composites varied over a clinically realistic range of radiant exposures between 5 and 40 J/cm(2). METHODS Ten operators were tested for clinically simulated radiant exposure delivery from a Bluephase(®) (Ivoclar Vivadent, Schaan, Liechtenstein) LED light to an occlusal cavity floor in tooth 27 in a mannequin head using a MARC(®)-Patient Simulator (Bluelight Analytics Inc., Halifax, NS) device. Notch disc test samples were prepared to determine the torque resistance to fracture (T) of the composites. Samples were irradiated with the same monowave Bluephase(®) light for 10s, 20s or 40s at distances of 0mm or 7 mm. After 24h, storage samples were fractured in a universal testing machine and torque to failure was derived. RESULTS Radiant exposure delivered in the clinical simulation ranged from 14.3% to 69.4% of maximum mean radiant exposure deliverable at 0mm in a MARC(®)-Resin Calibrator (Bluelight Analytics Inc., Halifax, NS) test device. Mean torque to failure increased significantly (P<0.05) with radiant exposure for 8 out of 10 products. The micro-fine hybrid composite Gradia Direct anterior (GC) had the lowest mean (S.D.) T between 10.3 (1.8)N/mm and 13.7 (2.2)N/mm over the tested radiant exposure range. Three heavily filled materials Majesty Posterior, Clearfil APX and Clearfil Photo-Posterior (Kuraray) had mean T values in excess of 25 N/mm following 40 J/cm(2) radiant exposure. Mean T for Z100 (3MESPE) and Esthet-X (Dentsply) increased by 10% and 91% respectively over the tested range of radiant exposures. CONCLUSIONS Individual products require different levels of radiant exposure to optimize their fracture resistance. Light activated composites vary in the rate at which they attain optimal fracture resistance. CLINICAL SIGNIFICANCE Unless the clinician accurately controls all the variables associated with energy delivery, there is no way of predicting that acceptable fracture resistance will be achieved intra-orally.