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

• Restorative Dentistry and Endodontics
• /
• v.47 no.4
• /
• pp.45.1-45.10
• /
• 2022

Objectives: This study evaluated the relationship between the battery charge level and irradiance of light-emitting diode (LED) light-curing units (LCUs) and how these variables influence the Vickers hardness number (VHN) of a bulk-fill resin. Materials and Methods: Four LCUs were evaluated: Radii Plus (SDI), Radii-cal (SDI), Elipar Deep Cure (Filtek Bulk Fill, 3M Oral Care), and Poly Wireless (Kavo Kerr). Irradiance was measured using a radiometer every ten 20-second activations until the battery was discharged. Disks (4 mm thick) of a bulk-fill resin (Filtek Bulk Fill, 3M Oral Care) were prepared, and the VHN was determined on the top and bottom surfaces when light-cured with the LCUs with battery levels at 100%, 50% and 10%. Data were analyzed by 2-way analysis of variance, the Tukey's test, and Pearson correlations (α = 5%). Results: Elipar Deep Cure and Poly Wireless showed significant differences between the irradiance when the battery was fully charged versus discharged (10% battery level). Significant differences in irradiance were detected among all LCUs, within each battery condition tested. Hardness ratios below 80% were obtained for Radii-cal (10% battery level) and for Poly Wireless (50% and 10% battery levels). The battery level showed moderate and strong, but non-significant, positive correlations with the VHN and irradiance. Conclusions: Although the irradiance was different among LCUs, it decreased in half of the devices along with a reduction in battery level. In addition, the composite resin effectiveness of curing, measured by the hardness ratio, was reduced when the LCUs' battery was discharged.

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

• Restorative Dentistry and Endodontics
• /
• v.46 no.2
• /
• pp.24.1-24.11
• /
• 2021

Objectives: The present study aimed to evaluate the survival rate and clinical performance of class 1 composite restorations restored with the Filtek Bulk Fill composite material using either the bulk fill technique or the incremental technique at baseline (1 week) and at 3, 6 and 12 months of follow-up. Materials and Methods: Forty-two patients with at least 2 carious teeth were selected. Following randomization, one tooth was restored with the Filtek Bulk Fill composite using the incremental fill technique, and the other tooth was restored with the same material using the bulk fill technique. Patients were recalled for follow-up at baseline (1 week) and 3, 6, and 12 months and evaluated using the FDI criteria. Results: The data were analyzed using the McNemar χ² test. No statistically significant differences were found between the scores of teeth restored with either technique. At baseline and at 3, 6, and 12 months of follow-up; there were no significant difference in the clinical status of both groups of restorations. Conclusions: Within the limitations of this study, using the bulk fill technique for restorations with the Filtek Bulk Fill material seems to be equally efficient to using the incremental fill technique.

• Restorative Dentistry and Endodontics
• /
• v.44 no.4
• /
• pp.37.1-37.10
• /
• 2019

Objectives: This study evaluated the bond strength of various fiberglass post cementation techniques using different resin-based composites. Materials and Methods: The roots from a total of 100 bovine incisors were randomly assigned to 5 treatment groups: G1, post + Scotchbond Multi-Purpose (SBMP) + RelyX ARC luting agent; G2, relined post (Filtek Z250) + SBMP + RelyX ARC; G3, individualized post (Filtek Z250) + SBMP; G4, individualized post (Filtek Bulk-Fill) + SBMP; G5, individualized post (Filtek Bulk-Fill Flow) + SBMP. The samples were subjected to the push-out (n = 10) and pull-out (n = 10) bond strength tests. Data from the push-out bond strength test were analyzed using 2-way analysis of variance (ANOVA) with the Bonferroni post hoc test, and data from the pull-out bond strength test were analyzed using 1-way ANOVA. Results: The data for push-out bond strength presented higher values for G2 and G5, mainly in the cervical and middle thirds, and the data from the apical third showed a lower mean push-out bond strength in all groups. No significant difference was noted for pull-out bond strength among all groups. The most frequent failure modes observed were adhesive failure between dentine and resin and mixed failure. Conclusions: Fiberglass post cementation using restorative and flowable bulk-fill composites with the individualization technique may be a promising alternative to existing methods of post cementation.

• Restorative Dentistry and Endodontics
• /
• v.46 no.3
• /
• pp.39.1-39.12
• /
• 2021

Objectives: This study analyzed the physical-chemical behavior of 2 bulk fill resin composites (BFCs; Filtek Bulk Fill [FBF], and Tetric-N-Ceram Bulk Fill [TBF]) used in 2- and 4-mm increments and compared them with a conventional resin composite (Filtek Z250). Materials and Methods: Flexural strength and elastic modulus were evaluated by using a 3-point bending test. Knoop hardness was measured at depth areas 0-1, 1-2, 2-3, and 3-4 mm. The translucency parameter was measured using an optical spectrophotometer. Real-time polymerization kinetics was analyzed using Fourier transform infrared spectroscopy. Results: Flexural strength was similar among the materials, while TBF showed lower elastic modulus (Z250: 6.6 ± 1.3, FBF: 6.4 ± 0.9, TBF: 4.3 ± 1.3). The hardness of Z250 was similar only between 0-1 mm and 1-2 mm. Both BFCs had similar hardness until 2-3 mm, and showed significant decreases at 3-4 mm (FBF: 33.45 ± 1.95 at 0-1 mm to 23.19 ± 4.32 at 3-4 mm, TBF: 23.17 ± 2.51 at 0-1 mm to 15.11 ± 1.94 at 3-4 mm). The BFCs showed higher translucency than Z250. The polymerization kinetics of all the materials were similar at 2-mm increments. At 4-mm, only TBF had a similar degree of conversion compared with 2 mm. Conclusions: The BFCs tested had similar performance compared to the conventional composite when used in up to 2-mm increments. When the increment was thicker, the BFCs were properly polymerized only up to 3 mm.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.31 no.4
• /
• pp.294-300
• /
• 2015

Purpose: The purpose of this study was to measure the color of low viscosity bulk-fill resin with a capping layer and to compare it with the color of microhybrid composite resin. Materials and Methods: A low viscosity bulk-fill resin (SDR) and microhybrid composite resin of shade A2 (A2) or A3 (A3) were fabricated to 4 mm thickness and light cured for 20 seconds. CIE $L^*a^*b^*$ values of the resin specimens were measured with a colorimeter. Then shade A2 and A3 microhybrid composite resin was capped over low viscosity bulk-fill resins in 2 mm thickness (SA2, SA3). The resin specimens were light cured for 20 seconds and the color was measured and analyzed (n = 10). Color differences (${\Delta}E$) between SA2 and A2, SA3 and A3 were also calculated. Results: $L^*$ value was highest in SDR followed by SA2 and SA3. $L^*$ value of A2 and A3 was the lowest. $a^*$ value was lowest in SDR followed by SA2 and SA3, and A2 and A3 was the highest. $b^*$ value was lowest in SDR followed by A2 and SA2, and A3 and SA3 was the highest. ${\Delta}E$ between A2 and SA2 (${\Delta}E=3.4$), and that between A3 and SA3 (${\Delta}E=3.1$) was lower than the perceptible color difference threshold of ${\Delta}E=3.7$. Conclusion: ${\Delta}E$ between low viscosity bulk-fill resin with a capping layer and microhybrid resin was lower than the perceptible color difference threshold.

• Restorative Dentistry and Endodontics
• /
• v.48 no.4
• /
• pp.35.1-35.14
• /
• 2023

Objectives: The purpose of this study was to evaluate the impact of dentin roughening and the type of composite resin used (either bulk-fill flowable or nanohybrid) on the restoration of non-carious cervical lesions (NCCLs) with an 18-month follow-up period. Materials and Methods: This prospective split-mouth study included 36 patients, each with a minimum of 4 NCCLs. For each patient, 4 types of restorations were performed: unroughened dentin with nanohybrid composite, unroughened dentin with bulk-fill flowable composite, roughened dentin with nanohybrid composite, and roughened dentin with bulk-fill flowable composite. A universal bonding agent (Tetric N Bond Universal) was applied in self-etch mode for all groups. The restorations were subsequently evaluated at 6, 12, and 18 months in accordance with the criteria set by the FDI World Dental Federation. Inferential statistics were computed using the Friedman test, with the level of statistical significance established at 0.05. Results: The 4 groups exhibited no significant differences in relation to fracture and retention, marginal staining, marginal adaptation, postoperative hypersensitivity, or the recurrence of caries at any follow-up point. Conclusions: Within the limitations of the present study, over an 18-month follow-up period, no significant difference was present in the clinical performance of bulk-fill flowable and nanohybrid composite restorations of non-carious cervical lesions. This held true regardless of whether dentin roughening was performed.

• Restorative Dentistry and Endodontics
• /
• v.49 no.3
• /
• pp.24.1-24.13
• /
• 2024

Objectives: This study aimed to evaluate the clinical performance of an alkasite restorative material in molars that had undergone root canal treatment. Materials and Methods: The research was registered in Brazilian Registry of Clinical Trials. The randomized clinical trial involved 33 patients, each with at least 1 mandibular molar requiring restoration after receiving endodontic treatment. Patients were randomly assigned to receive either bulk-fill resin composite (Tetric N Ceram Bulk Fill, Ivoclar Vivadent) or the alkasite restorative material (Cention N, Ivoclar Vivadent). Upon completion of the restorations, 3 calibrated professionals utilized the United States Public Health Service criteria to assess various factors, including retention, secondary caries, marginal adaptation, restoration color, marginal pigmentation, and anatomical form. Evaluations were conducted at intervals of 7 days, 6 months, and 17 months. Additionally, the assessment encompassed the presence of radiolucent lines adjacent to the restoration, material deficiencies or excess, contact points, and caries recurrence. The data underwent analysis using the Friedman and Mann-Whitney tests (α = 0.05). Results: After 17 months, the results revealed that the alkasite restorative material exhibited greater wear of anatomical shape compared to the bulk-fill resin composite (p = 0.0189). Furthermore, the alkasite restorative material significantly differed from the natural tooth color in most cases (p = 0.0000). However, no other criteria displayed significant differences between the materials or over time (p > 0.05). Conclusions: The alkasite restorative material (Cention N) emerges as a viable option for restoring endodontically treated teeth, displaying clinically acceptable alterations after a 17-month evaluation period.

• Restorative Dentistry and Endodontics
• /
• v.46 no.4
• /
• pp.51.1-51.13
• /
• 2021

Objectives: This study aimed to evaluate the effect of improper positioning single-peak and multi-peak lights on color change, microhardness of bottom and top, and surface topography of bulk fill and incremental composites after artificial aging for 1 year. Materials and Methods: Bulk fill and incremental composites were cured using multi-peak and single-peak light-emitting diode (LED) following 4 clinical conditions: (1) optimal condition (no angulation or tip displacement), (2) tip-displacement (2 mm), (3) slight tip angulation (α = 20°) and (4) moderate tip angulation (α = 35°). After 1-year of water aging, the specimens were analyzed for color changes (ΔE), Vickers hardness, surface topography (Ra, Rt, and Rv), and scanning electron microscopy. Results: For samples cured by single-peak LED, the improper positioning significantly increases the color change compared to the optimal position regardless of the type of composite (p < 0.001). For multi-peak LED, the type of resin composite and the curing condition displayed a significant effect on ΔE (p < 0.001). For both LEDs, the Vickers hardness and bottom/top ratio of Vickers hardness were affected by the type of composite and the curing condition (p < 0.01). Conclusions: The bulk fill composite presented greater resistance to wear, higher color stability, and better microhardness than the incremental composite when subjected to improper curing. The multi-peak LED improves curing under improper conditions compared to single-peak LED. Prevention of errors when curing composites requires the attention of all personnel involved in the patient's care once the clinical relevance of the appropriate polymerization reflects on reliable long-term outcomes.