Anton J. de Gee

Clinical significance of polymerization shrinkage of composite resins

The volumetric polymerization shrinkage of some composite resin restorative materials was measured with a modified dilatometer. It is emphasized that only the shrinkage from the start of the gelation, the rigid contraction of the material, is of clinical relevance. The amount of gelation was determined with an instrument that indicates the first moment at which the setting material is rigid enough to exert tensile forces. In addition, the influences of storage, testing conditions, and mixing ratio on the rigid contraction were studied for one light-cured as well as some chemically cured composite resins.

Polymerization contraction stress in thin resin composite layers as a function of layer thickness

OBJECTIVES In the present study, the effect of layer thickness on the curing stress in thin resin composite layers was investigated. Since the value of the contraction stress is dependent on the compliance of the measuring equipment (especially for thin films), a method to determine the compliance of the test apparatus was tested. METHODS A chemically initiated resin composite (Clearfil F2, Kuraray) was inserted between two sandblasted and silane-coated stainless steel discs in a tensilometer. The curing contraction of the cylindrical samples was continuously counteracted by feedback displacement of the tensilometer crosshead, and the curing stress development was registered. After 20 min, the samples were loaded in tension until fracture. The curing stress was determined for layer thicknesses of 50, 100, 200, 300, 400, 500, 600, 700 microns, 1.4 mm and 2.7 mm. The compliance of the apparatus was calculated with the aid of a non-linear regression analysis, using an equation derived from Hookes Law as the model. RESULTS None of the samples fractured due to contraction stress prior to tensile loading. The contraction stress after 20 min decreased from 23.3 +/- 5.3 MPa for the 50 microns layer to 5.5 +/- 0.6 MPa for the 2.7 mm layer. The compliance on the apparatus was 0.029 mm/MPa. SIGNIFICANCE A measuring method was developed which was found to be suitable for the determination of axial polymerization contraction stress in this films of chemically initiated resin composites. The method makes it possible to estimate the stress levels that occur in resin composite films in the clinical situation.

Microtensile bond strength testing of luting cements to prefabricated CAD/CAM ceramic and composite blocks

OBJECTIVES To investigate the Microtensile bond strength (microTBS) and failure mode of resin cements bonded to composite and ceramic CAD/CAM blocks following various surface treatments. METHODS Paradigm composite blocks and Cerec Vitablocs received three surface treatments following the control treatment of surface grinding with 600 SiC grit. (1) Application of adhesive resin (Adh), (2) etching with hydrofluoric acid and silanization (HF+S) or (3) combination of the previous two treatments (HF+S+Adh). Three resin cements (Tetric Flow, Nexus 2, RelyX ARC) were applied to these surfaces and built-up in layers. After 24 h water storage at 37 degrees C, the non-trimming version of microTBS test was used to produce 1 mm(2) microbars. The Microbars were subjected to a tensile load using a modified testing device. The broken specimens were examined with a stereomicroscope and SEM to determine the failure mode. RESULTS All control and adhesive treated groups of the ceramic substrate showed premature debonding during cutting. The overall mean microTBS for the three resin cements bonded to ceramic following HF+S and HF+S+Adh surface treatment, was 27 and 29.2 MPa and for the resin cements bonded to composite substrate was 42.3 and 54.2 MPa, respectively. The mode of failure was 98% adhesive with composite as a substrate and 68% mixed failures with ceramic as a substrate. CLINICAL SIGNIFICANCE CAD/CAM restorations fabricated from processed composite blocks may have advantage over the ceramic blocks with regard to the higher bond strength with resin cements.

The effect of curing light variations on bulk curing and wall-to-wall quality of two types and various shades of resin composites

OBJECTIVES This study evaluated the influence of light intensity and irradiation time variations on the curing efficacy of two types and various shades of resin composites and the effect of reduced light intensity on the preservation of wall-to-wall continuity. MATERIALS AND METHODS Three microfilled composites (in three different shades) and one hybrid composite were used in this study. Polymerization shrinkage, and the hardness and adaptation of adhesive restorations in dentin cavities were determined at light intensities of 175 and 700 mW/cm2 and irradiation times of 10 and 60 s. Data were compared using in a general linear model analysis. RESULTS Shrinkage measurements were the indication of conversion and conversion rate. Reduced intensity slowed down the rate of polymerization but did not reduce the conversion as long as an irradiation time of 60 s was employed. High-energy irradiation caused increased separation of the composite from the tooth structure. On the basis of obtaining optimal conversion and adaption, it was demonstrated that the irradiation time to be more effective than irradiation energy. SIGNIFICANCE Light-cured composites require an understanding of their structure, pigmentation and irradiation parameters to obtain optimal performance. High intensity light-curing does not necessarily lead to optimal quality.

The influence of water sorption on the development of setting shrinkage stress in traditional and resin-modified glass ionomer cements

OBJECTIVES The aim of this study was to determine the setting stress development for some traditional and resin-modified glass ionomer cements and to assess the effect of early water exposure to this stress. METHODS The development of the setting stress of the glass ionomer cements was determined in a tensilometer set-up as described earlier by Feilzer et al. (1987). RESULTS The results of this study show the influence of water sorption on the development of setting shrinkage stress in bonded glass ionomer cements. When curing took place under isolated conditions (no hydration or dehydration), all the traditional glass ionomer cements investigated fractured spontaneously, either adhesively and/or cohesively, due to the developing stress. Early exposure to water led to stress relief and prevented spontaneous fracturing. For the light-cured products, no spontaneous failures were observed under isolated conditions. Stress relief due to water sorption reversed the contraction stress into an expansion stress. SIGNIFICANCE Exposure of traditional glass ionomer cements to water at an appropriate time by the use of permeable matrix systems is advised. Whether the conversion of contraction stresses into expansion stresses as observed for the resin-modified products, is beneficial for a restoration requires further study.

Sealing ability of eight resin bonding systems in a Class II restoration after mechanical fatiguing.

OBJECTIVE The purpose of this in vitro study was to evaluate eight different adhesive systems to determine whether functional loading affects the marginal integrity of Class II restorations. METHODS In 80 extracted upper human premolars, Class II cavities were prepared and restored with eight different commercially available adhesive resin restorative systems. The occlusal margins were located in enamel and the gingival margins in dentin. During immersion in a dye solution, half of the restored teeth were exposed to a load-cycling procedure, after which all the specimens were sectioned, and the extent of dye penetration was visually examined using a stereo microscope. The results were analyzed statistically using the Mann-Whitney U-test and Wilcoxons Rank test. RESULTS Exposure of the restorations to load cycling significantly reduced the marginal integrity cervically. Perfect sealing was found practically at all occlusal margins. Significant differences (p < 0.05) were found in the cervical sealing quality of the various adhesive systems. SIGNIFICANCE The results of this study show that functional loading damages the cervical marginal seal of adhesive Class II restorations. For many adhesive systems, the setting shrinkage stress alone was not able to damage the marginal integrity cervically. Therefore, mechanical fatiguing distinguishes the sealing quality of adhesive systems in a more expressive way. There is a substantial difference in sealing quality between the various resin restorative systems tested.

Wear rates of composites, an amalgam, and enamel under stress-bearing conditions

This article describes an in vitro technique that, within in a few days, can predict the long-term occlusal wear of composites. The laboratory data of our study and the clinical observations of various authors correlate well. For 19 different products, the wear relative to an amalgam under stress-bearing conditions is given within statistically justified boundaries.

The influence of resin composite and bonded amalgam restorations on dentine permeability in Class II cavities in vitro

OBJECTIVES This study was conducted to measure and compare dentine permeability reduction in Class II preparations, after restoration with resin composite or bonded amalgam, using either a multi-step or one-bottle dental adhesive system. METHODS An in vitro fluid transport model was used to measure initial dentine permeability in Class II cavities with an intact smear layer in crown segments from extracted human premolars. One week and 3 months after restoration with resin composite or bonded amalgam, using either multi-step or one-bottle dental adhesive system, the measurements were repeated and the reduction in permeability was calculated as a percentage of the initial values. The data were analyzed statistically using a one-way ANOVA and Least Significant Difference tests. RESULTS After 1 week the resin composite with one-bottle dental adhesive system provided the highest reduction in dentine permeability, whereas after 3 months the bonded amalgam caused the highest reduction. At both time intervals the resin composite with multi-step adhesive system provided the lowest reduction. (P=0.036 at 1 week, P=0.016 at 3 months). After 3-months storage in water a significant increase in dentine permeability reduction was found in the bonded amalgam group only (P=0.017). The reduction in dentine permeability provided by resin composite with one-bottle dental adhesive system and bonded amalgam in Class II cavities was similar at both time intervals. (P=0.182 at 1 week, P=0.750 at 3 months). SIGNIFICANCE The results of this study indicated that on the basis of reducing dentine permeability in vitro, resin composite restorations with the investigated one-bottle adhesive system was superior to its multi-step equivalent and bonded amalgam can also be preferred in Class II restorations.

Polymerization contraction stress in dentin adhesives bonded to dentin and enamel

OBJECTIVE In a previous study on of polymerization contraction stress determinations of adhesives bonded to dentin a continuous decline of stress was observed after the adhesives had been light-cured. The decline was ascribed to stress relief caused by diffusion into the adhesive layer of water and/or solvents, left in the impregnated dentin surface after drying and/or evaporation in the application procedure. The purpose of the present study was to test the hypothesis that the contraction stress of adhesives bonded to enamel will not decline after light-curing, based on the assumption that water and/or solvents are more efficiently removed from impregnated enamel surfaces in the drying and/or evaporation step. MATERIALS AND METHODS Contraction stress was determined in a tensilometer for three total-etching adhesives Scotchbond multi-purpose, Single bond and One-step plus and four self-etching adhesives Clearfil SE Bond, Clearfil Protect Bond, AdheSE, and Xeno III. The adhesives were placed in a thin layer between a glass plate and a flat dentin or enamel surface pre-treated with phosphoric acid or self-etching primer and light-cured under constrained conditions. RESULTS All adhesives bonded to enamel showed a stress decline, but significantly less than for dentin with the exception of two self-etching adhesives. The greatest decline was found for the total-etching adhesive systems bonded to dentin. The presence of hydrophobic monomers in the adhesives had a significant influence on the decline. SIGNIFICANCE The experiments indicate that fluids are withdrawn from the resin impregnated tooth structures, which may result in small defects in the tooth-resin interfaces.