• Journal of dental hygiene science
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• v.23 no.2
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• pp.123-131
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• 2023

Background: As a restorative material used to treat dental caries, the light-curing type resin is widely used, but it has the disadvantage of polymerization shrinkage. The Bulk-Fill composite resin was developed to solve these shortcomings, but the existing research mainly focused on comparing the physical properties of a composite resin and a Bulk-Fill resin. A study on the light curing time and distance of the Bulk-Fill resin itself tend to be lacking. Methods: This study compares the surface microhardness of specimens prepared by varying the light curing time and distance of smart dentin replacement (SDR) as a flowable Bulk-Fill resin and Tetric N-ceram as a packable Bulk-Fill resin, and confirms the polymerization time and distance that becomes the optimum hardness. To determine the hardness of the specimen, it was measured using the Vickers Hardness Number (Matsuzawa MMT-X, Japan). Results: In SDR, the surface microhardness decreased as the distance increased in all time groups in the change distance from the curing tip. In the change of light curing time with respect to the distance from curing tip, the surface microhardness increased as the time increased. In Tetric N-ceram, the surface microharness showed no significant difference in the change of the distance of curing tip in the group of 20 and 60 second. But in the group of 10 and 40 seconds, decreased as the distance increased. The surface microharness increased as the light curing time increased in all distance groups. Conclusion: When using SDR and Tetric N-ceram in clinical practice, it is considered that as the distance from the polymerization reactor tip increases, a longer light curing time than the polymerization time recommended by the manufacturer is required.

• Restorative Dentistry and Endodontics
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• v.40 no.2
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• pp.128-135
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• 2015

Objectives: This study evaluated the effects of the resin thickness on the microhardness and optical properties of bulk-fill resin composites. Materials and Methods: Four bulk-fill (Venus Bulk Fill, Heraeus Kulzer; SDR, Dentsply Caulk; Tetric N-Ceram Bulk Fill, Ivoclar vivadent; SonicFill, Kerr) and two regular resin composites (Charisma flow, Heraeus Kulzer; Tetric N-Ceram, Ivoclar vivadent) were used. Sixty acrylic cylindrical molds were prepared for each thickness (2, 3 and 4 mm). The molds were divided into six groups for resin composites. The microhardness was measured on the top and bottom surfaces, and the colors were measured using Commission Internationale d'Eclairage (CIE) $L^*a^*b^*$ system. Color differences according to the thickness and translucency parameters and the correlations between the microhardness and translucency parameter were analyzed. The microhardness and color differences were analyzed by ANOVA and Scheffe's post hoc test, and a student t-test, respectively. The level of significance was set to ${\alpha}=0.05$. Results: The microhardness decreased with increasing resin thickness. The bulk-fill resin composites showed a bottom/top hardness ratio of almost 80% or more in 4 mm thick specimens. The highest translucency parameter was observed in Venus Bulk Fill. All resin composites used in this study except for Venus Bulk Fill showed linear correlations between the microhardness and translucency parameter according to the thickness. Conclusions: Within the limitations of this study, the bulk-fill resin composites used in this study can be placed and cured properly in the 4 mm bulk.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.4
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• pp.446-454
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• 2017

Recently, there have been many studies on bulk-fill resin composites. However, studies on the proper materials for pediatric patients are rare. The aim of this study was to compare the cavity wall adaptation of bulk-fill resin composites with conventional resin composite in class II cavities of primary molars using microcomputed tomography (micro-CT). Standardized class II slot cavities were prepared in 80 exfoliated primary molars and randomly divided into 4 groups. The control group was restored with conventional resin composite, Filtek Z-350 XT (FZ), and the three groups were restored with bulk-fill resin composites, Filtek bulk-fill posterior (FB), Tetric N-Ceram Bulk Fill (TNC), Filtek bulk-fill flowable (FBF). All specimens were thermocycled and then immersed in 50% silver nitrate ($AgNO_3$) solution. Micro-CT was used to measure the penetration volume of the total silver nitrate and the degree of cervical marginal leakage and the number, size, and position of the voids were evaluated. The results revealed that the volume of silver nitrate were significantly different between FB and FZ (p < 0.05). The results also revealed that the penetration length of silver nitrate FBF showed statistically lower than the FZ and FB (p < 0.05). There was no significant difference between the groups in number and size of voids. In conventional resin composite, most of the voids were present inside the restoration (83.3%), but the voids in the bulk-fill resin composites incidence were higher in the gingivoaxial angle. The cavity wall adaptation demonstrated in class II restorations of primary molar by new bulk fill resin composites was similar to conventional incremental technique. Bulk-fill resin composites might be an clinical option for a faster restoration in deciduous teeth.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.3
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• pp.184-193
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• 2016

Purpose: To evaluate marginal leakage of bulk fill flowable composite resin filling with different curing time by using microcomputed tomography technology. Materials and Methods: 30 previously extracted human molars were randomly divided into 6 groups based upon restorative system and different curing time. Class II cavities (vertical slot cavities) were prepared. An individual metallic matrix was used to build up the proximal wall. The SonicFill or SureFil SDR flow was inserted into the preparation by using 1 bulk increment, followed by light polymerization for different curing times. The different exposure times were 20, 40, and 60 seconds. All specimens were submitted to 5,000 thermal cycles for artificial aging. Micro-CT scanning was performed by using SkyScan 1272. One evaluator assessed microleakage of silver nitrated solution at the resin-dentin interface. The 3D image of each leakage around the restoration was reconstructed with CT-Analyser V.1.14.4. The leakage was analyzed with the Mann-Whitney test. Results: Significant differences were observed between the light curing times, but no significant differences were found between the bulk fill composite resins. Increasing in the photoactivation time resulted in greater microleakage in all the experimental groups. Those subjected to 60 seconds of light curing showed higher microleakage means than those exposed for 20 seconds and 40 seconds. Conclusion: Increasing the photoactivation time is factor that may increase marginal microlekage of the bulk fill composite resins. Further, micro-CT can nondestructively detect leakage around the resin composite restoration in three dimensions.

• Restorative Dentistry and Endodontics
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• v.42 no.2
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• pp.118-124
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• 2017

Objectives: This study aimed to evaluate the color stability of bulk-fill and nanohybrid resin-based composites polished with 3 different, multistep, aluminum-oxide impregnated finishing and polishing disks. Materials and Methods: Disk-shaped specimens (8 mm in diameter and 4 mm in thickness) were light-cured between two glass slabs using one nanohybid bulk-fill (Tetric EvoCeram, Ivoclar Vivadent), one micro-hybrid bulk-fill (Quixfil, Dentsply), and two nanohybrid incremental-fill (Filtek Ultimate, 3M ESPE; Herculite XRV Ultra, Kerr) resin-based composites, and aged by thermocycling (between $5-55^{\circ}C$, 3,000 cycles). Then, they were divided into subgroups according to the polishing procedure as SwissFlex ($Colt\grave{e}ne/Whaledent$), Optidisc (Kerr), and Praxis TDV (TDV Dental) (n = 12 per subgroup). One surface of each specimen was left unpolished. All specimens were immersed in coffee solution at $37^{\circ}C$. The color differences (${\Delta}E$) were measured after 1 and 7 days of storage using a colorimeter based on CIE Lab system. The data were analyzed by univariate ANOVA, Mann-Whitney U test, and Friedmann tests (${\alpha}=0.05$). Results: Univariate ANOVA detected significant interactions between polishing procedure and composite resin and polishing procedure and storage time (p < 0.05). Significant color changes were detected after 1 day storage in coffee solution (p < 0.05), except Quixfil/Optidisc which was color-stable after 7 days (p > 0.05). Polishing reduced the discoloration resistance of Tetric EvoCeram/SwissFlex, Tetric EvoCeram/Praxis TDV, Quixfil-SwissFlex, and all Herculite XRV Ultra groups after 7 days storage (p < 0.05). Conclusions: Discoloration resistance of bulk-fill resin-based composites can be significantly affected by the polishing procedures.

• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.4
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• pp.353-361
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• 2019

The aim of this study was to evaluate the color stability of bulk-fill and conventional resin composites with respect to different storage media and thickness of composites. Filtek™ Z250 and Filtek™ Z350XT were evaluated as conventional resin composites. Filtek™ Bulk-fill Posterior Restorative and Tetric^® N-Ceram Bulk Fill were evaluated as bulk-fill resin composites. CIE L^*a^*b^* values of baseline were measured after 24 hours of storage in distilled water, and each resin composite group was divided into three subgroups and stored in distilled water, red wine, and coffee media respectively. Again after 1, 7 and 28 days of immersion, color changes (ΔE^*) were calculated using the CIE L^*a^*b^* values. The greatest ΔE^* was observed in red wine for all resin composites, and the mean color changes were ranked in the increasing order of distilled water, coffee, red wine. Filtek™ Z350XT exhibited the greatest color change in all media, followed by Filtek™ Bulk-fill Posterior Restorative. Filtek™ Z250 and Tetric^® N-Ceram Bulk Fill followed with similar mean color change values. According to the 2 different thicknesses of 2 mm and 4 mm of bulk-fill resin composites, there was no thickness-related difference on color changes.

• Restorative Dentistry and Endodontics
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• v.47 no.1
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• pp.5.1-5.11
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• 2022

Objectives: This study aimed to assess the clinical longevity of a bulk-fill resin composite in Class II restorations for 3-year. Materials and Methods: Patient record files acquired from the 40 patients who were treated due to needed 2 similar sizes Class II composite restorations were used for this retrospective study. In the experimental cavity, the flowable resin composite SDR was inserted in the dentinal part as a 4 mm intermediate layer. A 2 mm coverage layer with a nano-hybrid resin composite (CeramX) was placed on SDR. The control restoration was performed by an incremental technique of 2 mm using the nano-hybrid resin composite. The restorations were blindly assessed by 2 calibrated examiners using modified United States Public Health Service criteria at baseline and 1, 2, and 3 years. The data were analyzed using non-parametric tests (p = 0.05). Results: Eighty Class II restorations were evaluated. After 3-years, 4 restorations (5%) failed, 1 SDR + CeramX, and 3 CeramX restorations. The annual failure rate (AFR) of the restorations was 1.7%. The SDR + CeramX group revealed an AFR of 0.8%, and the CeramX group an AFR of 2.5% (p > 0.05). Regarding anatomical form and marginal adaptation, significant alterations were observed in the CeramX group after 3-years (p < 0.05). The changes in the color match were observed in each group over time (p < 0.05). Conclusions: The use of SDR demonstrated good clinical durability in deep Class II resin composite restorations.

• The Journal of the Korean dental association
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• v.57 no.3
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• pp.162-168
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• 2019

Composite resin restorations in posterior teeth are increasing due to the aesthetic needs of patients and the development of materials. This trend will accelerate in line with domestic insurance policies. However, resin composites generate stresses due to their contraction during the polymerization process. To reduce the polymerization shrinkage stress of resin composites, incremental layering technique has been recommended for decades. This technique reduces stress at the cavity wall interface and allows a more efficient light curing of the material. Bulk-fill resin composites have been designed to simplify the restorative technique because they can be placed into cavities in a single increment of 4-5mm. The simplification of the operative procedures is desirable in clinical daily practice. In this context, bulk-fill resin composites are an attractive alternative for posterior restorations. However, a clearer understanding of the clinical performance of this relatively new class of materials in comparison to conventional resin composites is required. Based on previous studies, the aim of the current review was to present the clinical criteria for the use of bulk-fill composites in direct restorations of posterior teeth.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.4
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• pp.427-434
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• 2016

The aim of this study was to compare the mechanical properties of high viscosity bulk-fill resin composites, $Filtek^{TM}$ Bulk Fill Posterior Restorative (FBF) and $Tetric^{(R)}$ N-Ceram Bulk Fill (TBF), with conventional composite ($Filtek^{TM}$ Z-350 XT, Z-350). The Vickers hardness test which indicates the degree of conversion was performed and the dye penetration test was performed to measure the microleakage which indicates polymerization shrinkage amount. To minimize experimental error, the standardized 3D-printed molds and the bovine teeth were used. Obtained data were analyzed by the Kruskal-Wallis test and Mann-Whitney test with the confidence interval of 95%. In the microhardness test within 1 hour of polymerization, lower surface of FBF and TBF showed significantly lower value than that of Z-350 (p < 0.05). But after 24 hours, the microhardness of FBF had increased and showed no significant difference with Z-350 (p > 0.05). In top and 2 mm depth surface, mean microhardness values were in the following order: Z-350 > FBF > TBF (p < 0.05). The mean microleakage value of TBF was significantly lower than others (p < 0.05). For clinical application of bulk-fill resin composites, caution for applying masticatory forces during 24 hours after polymerization is advised and further studies to decrease microleakage should be conducted.

• Restorative Dentistry and Endodontics
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• v.45 no.1
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• pp.9.1-9.7
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• 2020

The restorative procedure in posterior teeth involves clinical steps related to professional skill, especially when using the incremental technique, which may fail in the long term. A recent alternative is bulk-fill resins, which can reduce polymerization shrinkage, decreasing clinical problems such as marginal leakage, secondary caries, and fracture. This scientific study aims to report a clinical case using bulk-fill resin with an occlusal matrix. As determined in the treatment plan, an acrylic resin matrix was produced to establish an improved oral and aesthetic rehabilitation of the right mandibular first molar, which presented a carious lesion with dentin involvement. The occlusal matrix is a simple technique that maintains the original dental anatomy, showing satisfactory results regarding function and aesthetic rehabilitation.