Ronald L. Sakaguchi

Reduction of polymerization contraction stress for dental composites by two-step light-activation

OBJECTIVES The goal of this study was to assess the reduction of polymerization contraction stress of composites during a two-step light-activation process and to relate this reduction to the process of polymerization shrinkage and specimen thickness. METHODS Three test procedures were performed to compare two-step light-activation with delay with one-step continuous irradiation of composites: polymerization contraction stress using a closed-loop servohydraulic testing instrument, polymerization shrinkage by a mercury dilatometer, and degree of conversion by FTIR. For the one-step continuous curing method, the samples were light-activated for 60s at 330 mW/cm(2). For the two-step curing method, a 5s light exposure at 60 mW/cm(2) was followed by 2 min without light exposure, and then a second light exposure for 60s at 330 mW/cm(2). The same light parameters were used for measurements of stress, shrinkage, and degree of conversion. Three composites, Heliomolar, Herculite and Z100 were evaluated. The contraction stress experiments were repeated with varying thickness for Herculite using the one-step and two different two-step techniques. RESULTS Polymerization contraction stress 10 min after light-activation was significantly reduced (P<0.05) by the two-step method: 29.7% for Heliomolar, 26.5% for Herculite, and 19.0% for Z100. Total volumetric shrinkage and degree of conversion were not significantly different for composites cured by the two different techniques. Increasing the thickness of the composite sample reduced the measured contraction stress, especially for one of the two-step curing methods. SIGNIFICANCE A combination of low initial energy density followed by a lag period before a final high-intensity light irradiation provides a reduction of polymerization contraction stresses in dental composites. The stress reductions cannot be attributed to reductions in degree of conversion or unrestrained volumetric shrinkage.

Reduced light energy density decreases post-gel contraction while maintaining degree of conversion in composites

The objective of the study was to evaluate the relationship between curing light intensity and (1) linear post-gel polymerization contraction strain, and (2) degree of conversion of a dental composite. Cylindrical specimens of a dental resin composite were cured from a distance of 7 mm for 40 s at four attenuated light intensities (71%, 49%, and 34% of control intensity and for 20 s at 71% plus 20 s at 100% intensity). A group cured at full intensity served as a control. Degree of conversion (DC) was measured at the top and bottom and linear contraction strain was measured at the bottom of the composite samples. DC at the sample top was significantly different (P 0.05). All other groups were significantly different from each other (P 0.05). The sample cured with two intensities showed a 21.8% reduction from the contraction strain predicted by a light energy density calculation. Application of light at less than the maximum intensity of the curing light resulted in significant reduction of polymerization contraction strain without significantly affecting the degree of conversion.

Effect of energy density on properties and marginal integrity of posterior resin composite restorations

OBJECTIVES The purpose of this study was to determine the minimal extent of cure required by the base of a Class 2 resin composite restoration (Z250, 3M ESPE, St Paul, MN, USA) that allows it to support the rest of the restoration and maintain its marginal seal under simulated clinical conditions. METHODS Resin composite (Z250, 3M ESPE, St Paul, MN, USA) was placed incrementally or in bulk into Class 2 preparations in extracted human molar teeth and exposed to various light-curing energy densities. The restorations were subjected to 1000 thermal cycles (5-55 degrees C) and 500,000 fatigue cycles from 18 to 85 N using a stainless-steel sphere. Marginal integrity was evaluated using visual rating (ridit analysis) and microleakage. Degree of conversion (DC) and Knoop hardness (KHN) were determined at the occlusal and gingival surfaces using a reusable tooth template with identical preparation dimensions. Percentage of maximum DC and KHN were determined. Mechanical properties were tested in resin composite bars having similar KHN values as the resin composite at the gingival margins. RESULTS Energy density had a significant effect on gingival marginal defects as determined by ridit analysis but not on microleakage. Water had a significant dissolving effect on gingival margin integrity at very low degrees of conversion and energy densities (4000 mJ/cm2). There was no overall significant effect of thermal-mechanical stressing on gingival marginal defects or microleakage. SIGNIFICANCE Based on ridit analysis, a recommended lower limit of gingival margin acceptability in the bulk-filled Z250 resin composite restoration was created by 80% of maximum conversion, 73% of maximum hardness and approximately 70% of maximum flexural strength and modulus in the gingival marginal area.

Thermal expansion coefficient of dental composites measured with strain gauges.

OBJECTIVES A simple test method was developed to determine the coefficient of thermal expansion of prevailing restorative resin composites and to study the transient behavior as a function of temperature and repeated thermocycles. METHODS Strain gauges were used to determine the thermal expansion for seven commonly used restorative resin composites by measuring the instantaneous strain along with temperature change. The temperature was measured by means of a thermocouple, the tip of which was embedded in the composite. The differences among the test groups were analyzed using ANOVA, followed by Scheffés multiple comparisons test. RESULTS The coefficient of thermal expansion determined for the composites tested was: 22.5 +/- 1.4 x 10(-6)/degree C (Z-100), 23.5 +/- 1.4 x 10(-6)/degree C (P-50), 32.6 +/- 1.6 x 10(-6)/degree C (Herculite XR), 34.1 +/- 1.8 x 10(-6)/degree C (APH), 35.4 +/- 1.4 x 10(-6)/degree C (Conquest), 41.6 +/- 1.5 x 10(-6)/degree C (Silux Plus), 44.7 +/- 1.2 x 10(-6)/degree C (Heliomolar). The coefficient was almost linear in the considered temperature range (26-75 degrees C) for all composites (r > 0.99) and decreased with each consecutive thermocycle (p < 0.1). SIGNIFICANCE Thermally induced loads, introduced into restored teeth by the mismatch of the coefficient of thermal expansion of the tooth and the restorative material, may be related to microleakage and wear problems. A highly filled hybrid composite such as Z-100 had a coefficient of thermal expansion closest to that of the tooth crown, confirming other studies which demonstrated the benefits of high filler loading in matching the properties of the dental hard tissues.

Analysis of strain gage method for measurement of post-gel shrinkage in resin composites.

OBJECTIVE The objective of this study was to refine a strain gage method for measuring polymerization contraction of resin composites and to isolate the net post-gel contraction by identifying factors contributing to the measured strains. The hypothesis to be tested was that carefully controlled strain gage measurements of composite polymerization could isolate post-gel contraction events. METHODS Composite was placed on a biaxial strain gage and light-cured. This method enabled real-time registration of the progress of shrinkage strain, corresponding to elastic modulus development. Strain from the two axes of the strain gage were averaged and plotted as a function of time. A representative curve was calculated from the mean of ten measurements. The following factors influencing the total contraction measurement were evaluated: thermal expansion of the gage, thermal expansion of the composite due to the exothermic reaction and exposure to the curing light, and adhesion of the composite to the gage. These parameters were measured so that the net deformation of the composite during polymerization could be calculated. RESULTS Parametric studies of pre-cured and photointiator-free materials confirmed the hypothesis that strain gages measure post-gel contraction. Thermal artifacts were measured and subtracted from the total strain output. SIGNIFICANCE Strain gages are suitable for measuring the clinically significant phase of composite polymerization contraction.

Stress transfer from polymerization shrinkage of a chemical-cured composite bonded to a pre-cast composite substrate

OBJECTIVES (1) To develop and test a strain gauge-based method for evaluating the strain transferred through a bonded interface to a deformable substrate; and (2) to develop and test a finite element (FE) model for evaluating the stress development in a chemical-cured composite during polymerization. METHODS A generic light-cured resin composite was used to fabricate a rectangular plate with an internal slot filled with a chemical-cured composite. Strain gauges on the surface of the composite in the channel and on the plate adjacent to the channel-plate interface were used to record strain continuously up to 500 s after mixing the composite paste. A quadrant three-dimensional (3D) finite element model used strains measured on the channel to simulate the experimental conditions. The model was used to estimate stresses in the channel and at the bonded interface. RESULTS Strain in the plate reached a plateau 200 s after mixing the composite. Strain of the composite paste in the channel continued to rise with time but at a steadily decreasing rate. Maximum principal stress predicted by the FE model on top of the plate, on top of the channel and within the channel was 5.12 MPa, 3.78 MPa, and 5.26 MPa, respectively. SIGNIFICANCE Stresses were effectively transferred through the bonded interface in this test configuration, and results were in close agreement with previously reported literature values for polymerization contraction stresses generated in composite configurations with similar bonded to unbonded surface ratios.

Radicular Temperatures Associated with Thermoplasticized Gutta-Percha

Thermoplasticized gutta-percha has been used to obturate root canals. The continuous wave of condensation technique uses the System B Heat Source with the choice of different-sized pluggers. The purpose of this study was to measure the temperatures within the root canal and on the root surface at different radicular levels while using the System B Heat Source. Fine, Fine-Medium, and Medium pluggers were evaluated at temperature settings of 200 degrees C, 250 degrees C, and 300 degrees C. The Obtura II gutta-percha delivery system following the manufacturers instructions and ultrasonically thermoplasticized gutta-percha were used for comparative purposes. The highest mean temperature change on the internal root surface was 74.19 degrees C with the system B at the 6 mm level (6 mm coronal to working length) when the Fine-Medium plugger was set at 300 degrees C. The lowest mean temperature change on the internal root surface was 2.09 degrees C at the 0 mm level (at working length) when the F plugger was set at 200 degrees C. With the Obtura II, the lowest mean internal temperature change was 5.22 degrees C at the 0 mm level, whereas the highest mean internal temperature change was 26.63 degrees C at the 6 mm level. With ultrasonic lateral compaction the lowest mean internal temperature change was 5.01 degrees C at the 0 mm level, whereas the highest mean internal temperature change was 28.95 degrees C at the 6 mm level. At no time did the System B, the Obtura II, or ultrasonic delivery of warm gutta-percha exceed an increase of 10 degrees C at any thermocouple level on the external root surface.

Alternative photoinitiator system reduces the rate of stress development without compromising the final properties of the dental composite

OBJECTIVES Stress development during the polymerization process continues to be a major factor that limits predictability and longevity of resin composite restorations. This study evaluated the effect of the photoinitiator type on the maximum rate of polymerization (R(p)(max)), stress development (final stress and maximum rate, R(stress)(max)), degree of conversion (DC) and cross-link density (CLD) of materials containing camphorquinone (CQ), phenylpropanedione (PPD) or CQ/PPD. MATERIALS AND METHODS R(p)(max) was evaluated via differential scanning calorimetry (DSC). Contraction force measurement was assessed with a single cantilever device for 5min. The samples were subsequently tested by infrared spectroscopy (FTIR) to evaluate the DC. After, samples were soaked in ethanol to evaluate the swelling coefficient (alpha) as a way to estimate the CLD. The results were analyzed by one-way ANOVA and Tukeys test (p=0.05). RESULTS CQ showed the highest R(p)(max) and R(stress)(max). PPD produced the lowest DC and the highest alpha. The mixture CQ/PPD produced statistically lower R(p)(max) and R(stress)(max) than CQ alone, but similar DC and CLD. CONCLUSION CQ/PPD reduced the R(p)(max) and R(stress)(max) without a reduction in DC and CLD. Therefore, the use of alternative photoinitiator systems could be a promising way to reduce the stress developed during the composites polymerization without affecting the final properties.

Calculation of contraction stresses in dental composites by analysis of crack propagation in the matrix surrounding a cavity.

OBJECTIVES Polymerization contraction of dental composite produces a stress field in the bonded surrounding substrate that may be capable of propagating cracks from pre-existing flaws. The objectives of this study were to assess the extent of crack propagation from flaws in the surrounding ceramic substrate caused by composite contraction stresses, and to propose a method to calculate the contraction stress in the ceramic using indentation fracture. METHODS Initial cracks were introduced with a Vickers indenter near a cylindrical hole drilled into a glass-ceramic simulating enamel. Lengths of the radial indentation cracks were measured. Three composites having different contraction stresses were cured within the hole using one- or two-step light-activation methods and the crack lengths were measured. The contraction stress in the ceramic was calculated from the crack length and the fracture toughness of the glass-ceramic. Interfacial gaps between the composite and the ceramic were expressed as the ratio of the gap length to the hole perimeter, as well as the maximum gap width. RESULTS All groups revealed crack propagation and the formation of contraction gaps. The calculated contraction stresses ranged from 4.2 MPa to 7.0 MPa. There was no correlation between the stress values and the contraction gaps. SIGNIFICANCE This method for calculating the stresses produced by composites is a relatively simple technique requiring a conventional hardness tester. The method can investigate two clinical phenomena that may occur during the placement of composite restorations, i.e. simulated enamel cracking near the margins and the formation of contraction gaps.

Contraction stresses in dental composites adjacent to and at the bonded interface as measured by crack analysis.

The objective of this study was to calculate stresses produced by polymerization contraction in regions surrounding a dental resin composite restoration. Initial cracks were made with a Vickers indenter at various distances from the edge of a cylindrical hole in a soda-lime glass disk. Indentation crack lengths were measured parallel to tangents to the hole edge. Resin composites (three brands) were placed in the hole and polymerized (two light irradiation protocols) at equal radiation exposures. The crack lengths were re-measured at 2 and 10 min after irradiation. Radial tensile stresses due to polymerization contraction at the location of the cracks (σ(crack)) were calculated from the incremental crack lengths and the fracture toughness K(c) of the glass. Contraction stresses at the composite-glass bonded interface (σ(interface)) were calculated from σ(crack) on the basis of the simple mechanics of an internally pressurized thick-walled cylinder. The greater the distance or the shorter the time following polymerization, the smaller was σ(crack). Distance, material, irradiation protocol and time significantly affected σ(crack). Two-step irradiation resulted in a significant reduction in the magnitude of σ(interface) for all resin composites. The contraction stress in soda-lime glass propagated indentation cracks at various distances from the cavity, enabling calculation of the contraction stresses.