Dragica Manojlovic

Monomer elution from nanohybrid and ormocer-based composites cured with different light sources

OBJECTIVES To study monomer elution from four resin-based composites (RBCs) cured with different light sources. METHODS Twenty-eight premolars were randomly allocated to four groups. Standardized cavities were prepared and restored with a nanohybrid (Filtek Supreme XT or Tetric EvoCeram), an ormocer (Admira) or a microhybrid RBC (Filtek Z250) which served as control. Buccal restorations were cured with a halogen and oral restorations with an LED light-curing unit. Elution of diurethane dimethacrylate (UDMA), Bisphenol A diglycidylether methacrylate (BisGMA), triethylene glycol dimethacrylate (TEGDMA) and 2-hydroxyethyl methacrylate (HEMA) was analyzed using high-performance liquid chromatography (HPLC) 1h to 28 days post-immersion in 75% ethanol. Data were analyzed using multivariate and repeated measures analysis of variance (α = 0.05). RESULTS The greatest elution of UDMA and BisGMA occurred from Tetric EvoCeram and the least from Filtek Z250 (p < 0.05). LED and halogen light-curing units gave similar results for all RBCs (p > 0.05) except Tetric EvoCeram which showed greater elution for the LED unit (p < 0.05). TEGDMA was below the limit of quantification. HEMA eluted in similar concentrations from Filtek Supreme and Tetric EvoCeram (p > 0.05). SIGNIFICANCE The two nanohybrid RBCs eluted more cross-linking monomers than the ormocer and the control microhybrid RBC. Continuous elution over 28 days indicates that RBCs act as a chronic source of monomers in clinical conditions. Light source may affect monomer elution since differences were found for one out of four RBCs. Mathematical models for elution kinetics of UDMA and BisGMA indicated two elution mechanisms.

Effects of a low-shrinkage methacrylate monomer and monoacylphosphine oxide photoinitiator on curing efficiency and mechanical properties of experimental resin-based composites.

This study investigated the degree of conversion, depth of cure, Vickers hardness, flexural strength, flexural modulus and volumetric shrinkage of experimental composite containing a low shrinkage monomer FIT-852 (FIT; Esstech Inc.) and photoinitiator 2,4,6-trimethylbenzoyldiphenylphosphine oxide (TPO; Sigma Aldrich) compared to conventional composite containing Bisphenol A-glycidyl methacrylate (BisGMA) and camphorquinone-amine photoinitiator system. The degree of conversion was generally higher in FIT-based composites (45-64% range) than in BisGMA-based composites (34-58% range). Vickers hardness, flexural strength and modulus were higher in BisGMA-based composites. A polywave light-curing unit was generally more efficient in terms of conversion and hardness of experimental composites than a monowave unit. FIT-based composite containing TPO showed the depth of cure below 2mm irrespective of the curing light. The depth of cure of FIT-based composite containing CQ and BisGMA-based composites with either photoinitiator was in the range of 2.8-3.0mm. Volumetric shrinkage of FIT-based composite (0.9-5.7% range) was lower than that of BisGMA-based composite (2.2-12% range). FIT may be used as a shrinkage reducing monomer compatible with the conventional CQ-amine system as well as the alternative TPO photoinitiator. However, the depth of cure of FIT_TPO composite requires boosting to achieve clinically recommended thickness of 2mm.

Mathematical modeling of cross-linking monomer elution from resin-based dental composites †

Elution of potentially toxic substances, including monomers, from resin-based dental composites may affect the biocompatibility of these materials in clinical conditions. In addition to the amounts of eluted monomers, mathematical modeling of elution kinetics reveals composite restorations as potential chronic sources of leachable monomers. The aim of this work was to experimentally quantify elution of main cross-linking monomers from four commercial composites and offer a mathematical model of elution kinetics. Composite samples (n = 7 per group) of Filtek Supreme XT (3M ESPE), Tetric EvoCeram (Ivoclar Vivadent), Admira (Voco), and Filtek Z250 (3M ESPE) were prepared in 2-mm thick Teflon moulds and cured with halogen or light-emitting diode light. Monomer elution in ethanol and water was analyzed using high-performance liquid chromatography up to 28 days postimmersion. The mathematical model was expressed as a sum of two exponential regression functions representing the first-order kinetics law. Elution kinetics in all cases followed the same mathematical model though differences in rate constants as well as the extent of monomer elution were material-, LCU-, medium-dependent. The proposed mechanisms of elution indicate fast elution from surface and subsurface layers and up to 100 times slower monomer extraction from the bulk polymer.

Local deformation fields and marginal integrity of sculptable bulk-fill, low-shrinkage and conventional composites.

OBJECTIVE To compare strain and displacement of sculptable bulk-fill, low-shrinkage and conventional composites as well as dye penetration along the dentin-restoration interface. METHODS Modified Class II cavities (N=5/group) were filled with sculptable bulk-fill (Filtek Bulk Fill Posterior, 3M ESPE; Tetric EvoCeram Bulk Fill, Ivoclar Vivadent; fiber-reinforced EverX Posterior, GC; giomer Beautifil Bulk, Schofu), low-shrinkage (Kalore, GC), nanohybrid (Tetric EvoCeram, Ivoclar Vivadent) or microhybrid (Filtek Z250, 3M ESPE) composites. Strain and displacement were determined using the 3D digital image correlation method based on two cameras with 1μm displacement sensitivity and 1600×1200 pixel resolution (Aramis, GOM). Microleakage along dentin axial and gingival cavity walls was measured under a stereomicroscope using a different set of teeth (N=8/group). Data were analyzed using analyses of variance with Tukeys post-test, Pearson correlation and paired t-test (α=0.05). RESULTS Strain of TEC Bulk, Filtek Bulk, Beautifil Bulk and Kalore was in the range of 1-1.5%. EverX and control composites showed 1.5-2% strain. Axial displacements were between 5μm and 30μm. The least strain was identified at 2mm below the occlusal surface in 4-mm but not in 2-mm layered composites. Greater microleakage occurred along the gingival than axial wall (p<0.05). No correlation was found between strain/displacements and microleakage axially (r2=0.082, p=0.821; r2=-0.2, p=0.605, respectively) or gingivally (r2=-0.126, p=0.729, r2=-0.278, p=0.469, respectively). SIGNIFICANCE Strain i.e. volumetric shrinkage of sculptable bulk-fill and low-shrinkage composites was comparable to control composites but strain distribution across restoration depth differed. Marginal integrity was more compromised along the gingival than axial dentin wall.

Cytotoxicity and genotoxicity of a low-shrinkage monomer and monoacylphosphine oxide photoinitiator: Comparative analyses of individual toxicity and combination effects in mixtures

OBJECTIVE To compare cytotoxicity and genotoxicity of novel urethane-based monomer FIT-852 and monoacylphosphine oxide photoinitiator (Lucirin TPO) with conventional Bisphenol A-glycidyl-methacrylate (BisGMA) and triethylene glycol dimethacrylate (TEGDMA) monomers and camphorquinone (CQ)/amine photoinitiator system, respectively. Moreover, we quantified and analyzed the combinatorial effects of individual substances in resin-based mixtures concerning the nature of the combinatorial effects. METHODS Cytotoxic and genotoxic effects of BisGMA, FIT, TEGDMA, CQ, DMAEMA and TPO and their combined toxicity in four clinically relevant mixtures (FIT/TPO, FIT/CQ, BisGMA/TPO, BisGMA/CQ) were tested on human fetal lung fibroblasts MRC-5 using MTT and Comet assays. We assessed combination effects of monomers and photoinitiators on overall toxicity from the measured concentration-effect relationships. Combination index (CI) was calculated on the basis of the median-effect equation derived from the mass-action law principle. RESULTS Individual substances showed decreasing cytotoxic effects in the following order: BisGMA>TPO>FIT>CQ>DMAEMA>TEGDMA. Experimental mixtures showed decreasing cytotoxic effects in the order BisGMA/TPO>BisGMA/CQ>FIT/CQ>FIT/TPO. FIT-based mixtures exhibited antagonistic cytotoxic effects between components while BisGMA-based mixtures demonstrated synergistic effects at ED50. TPO amplified both antagonistic and synergistic cytotoxic effects in mixtures. Pure substances showed genotoxicity in the following order: TPO>BisGMA>FIT>CQ>TEGDMA. We did not detect the genotoxic potential of DMAEMA. The rank of genotoxic concentrations of the mixtures was: BisGMA/TPO>BisGMA/CQ>FIT/CQ>FIT/TPO. SIGNIFICANCE Lower cytotoxicity and genotoxicity of FIT than BisGMA suggests its greater biocompatibility. Conversely, photoinitiator TPO was significantly more cytotoxic and genotoxic than both CQ and DMAEMA. CI values showed that components of FIT-based mixtures exhibit an antagonistic cytotoxic effect, while compontents of BisGMA-based mixtures show synergism.

Refractive indices of unfilled resin mixtures and cured composites related to color and translucency of conventional and low-shrinkage composites

This study correlated the refractive indices (RIs) of unfilled resin mixtures and resin-based composites (RBCs) with color and translucency of conventional and low-shrinkage RBCs. Unfilled resin mixtures based on different ratios of conventional monomers Bisphenol A-glycidyl-methacrylate (BisGMA)/triethyleneglycol-dimethacrylate (TEGDMA) and urethane-dimethacrylate (UDMA)/TEGDMA and a low-shrinkage monomer FIT-852 (FIT, Esstech Inc.)/TEGDMA were used to prepare model RBCs, containing 30 wt % of the organic matrix and 70 wt % of silanated barium-glass fillers (n = 1.553, Esstech Inc.). The RIs of resins were measured on an ABBE refractometer, those of cured RBCs using the Becke-line method in immersion oils. Color and translucency were determined using an AvaSpec-2048 (Avantes BV) spectrometer. The RIs of unfilled resin mixtures decreased with increasing amounts of TEGDMA. Cured RBCs had higher RIs than their respective resin mixtures. BisGMA-based composites were more translucent with significantly lower L* values than FIT- and UDMA-based RBCs. The RIs of unfilled resins positively correlated with cured RBCs (p = 0.001), as did the RIs with translucency (p = 0.001) and color (p = 0.008). Resin mixtures and corresponding RBCs based on UDMA and its modified low-shrinkage version, FIT, showed similar optical properties. The RIs of unfilled resins appeared to be good predictors of the RIs of cured RBCs.

Changes of Color and Fluorescence of Resin Composites Immersed in Beer

OBJECTIVE The aim of this study was to evaluate changes of color and fluorescence of resin based composite exposed to beer. MATERIALS AND METHODS 84 samples (13 mm in diameter and 1.5 mm thick) of microhybrid composite Gradia DirectTM extra bleach white were immersed in 5 different beers (dark and light) or distilled water. Color and fluorescence were measured prior and after 1-, 7-, and 14-day immersion by Spectrophotometer Thermo Evolution 600 and Fluorolog-3-221 spectrofluorometer. RESULTS Resin based composites changed color after immersion in beers of different types. Beers with higher optical absorption induced greater color changes. The fluorescence intensity of composites was decreased after immersion in beer, but the shape of fluorescence spectra was not changed. 14-day immersion in Bernard dark beer caused the greatest changes in optical properties of composite: ΔE*=9.0 and 57.6% reduced fluorescence. CONCLUSION Dark and light beers changed optical properties of resin based composite. The color change come exclusively from the change of chroma. CLINICAL SIGNIFICANCE To fully meet esthetic criteria when using dental materials in restoration it is crucial to match optical properties of teeth and dental restoration at the moment of placement, but also to keep the match over the time. Considering that staining in beer causes changes in color and fluorescence of composites and that discoloration is a frequent reason for replacement of composite restorations, the data and conclusions on discoloration of dental restorations caused by beer consumption should aid dental professionals when reaching for high esthetics of modern dentistry.(J Esthet Restor Dent 28:330-338, 2016).

Discoloration of resin based composites in natural juices and energy drinks

Background/Aim. Discoloration of dental restorations makes them aesthetically unacceptable and is a frequent reason for replacement of composite restorations. The aim of this study was to evaluate changes of color and fluorescence of resin-based composites (RBCs) exposed to natural juices and energy drinks. Methods. Microhybrid composite Gradia Direct Extra Bleach White disc-shaped specimens (n = 35) were immersed in three different natural juices and four different energy drinks. Absorption spectra of natural juices and energy drinks, diffuse reflection and fluorescence of composite samples were measured prior and after sevenday immersion by spectrophotometer Thermo Evolution 600 and spectrofluorometer Fluorolog-3-221. Composite’s color was calculated from diffuse reflection spectra and expressed in CIELAB color space (Commission International de l’Eclairage). Results. All natural juices and energy drinks induced color change of resin based composites, but to the different extent. Only aronia and carrot juices induced total color change considerably higher than clinically acceptable threshold, 9.3 and 6.2, respectively. All energy drinks and aronia juice induced notable decrease in fluorescence; the highest change of 28% was evidenced in the case of aronia juice. Conclusion. Change of color and fluorescence will appear differently with various solutions due to different chemical composition and concentration of colorant species in different beverages. Solutions with higher optical absorption induced higher total color change. Discoloration of composites in aronia and carrot juices is similar to those earlier reported for red wine, tea and coffee.

The effect of pH of the sodium hypochlorite on smear layer removal

Introduction. Canal irrigation is an important segment of endodontic treatment. The aim of this study was to assess the efficacy of 0.5% NaOCl solutions of different pH values on smear layer removal. Material and Methods. Thirty-two freshly extracted single rooted teeth with gangrenous pulp were used in the study. The samples were divided into four groups of eight teeth in each. Four solutions of 0.5% NaOCl having pH values 5, 7, 9 and 12 respectively, were used during chemomechanical instrumentation with hand instruments and using step back technique. SEM analysis was done to assess the quality of smear layer removal in apical, middle and coronal part of root canal. Presence and quantity of smear layer and detritus was quantified using the scale from 1 to 5. Results. SEM analysis results showed similar results for 0.5% NaOCl solutions of different pH values in root canal cleaning with no statistically significant differences. Conclusion. The most effective cleaning root canal was achieved with 0.5% NaOCl solution of pH 5.