The achievement of predictable and long lasting adhesive restorations in posterior teeth have always been a major objective of studies in the context of materials and techniques development. The use of bulk fill composites could provide better outcomes, but it is important to assess their physico-mechanical properties, responsible for their clinical behavior. The purpose of the present study was to assess the mechanical and physical properties of bulk fill composites. The composites were divided into 2 groups according to their viscosity. For low viscosity composites, the present study assessed: Surefill SDR flow (SDR), X-tra Base (XB), Filtek Bulk Fill Flowable (FBF), and Filtek Z350XT Flow (Z3F- control); and for high viscosity composites: Tetric Evo Ceram Bulk Fill (TBF), X-tra Fil (XF), Filtek Bulk Fill (FBP), Admira Fusion x-tra (ADM) and Filtek Z350 XT (Z3XT- control). Composites were assessed through shrinkage stress test (using 12 and 24mm3 of composite in a custom device adapted in an Universal Testing Machine); volumetric shrinkage (using 64mm3 of composite placed on a Teflon mold and scanned in a micro computed tomography/CT); Youngs modulus (through a 3-point bending test device adapted in an Universal Testing Machine); microhardness and depth of cure tests (using longitudinal Knoop microhardness). All data was evaluated regarding their homogeneity using Shapiro-Wilk test. For polymerization stress, 3-way Variance Analysis (ANOVA) was used. Considering Volumetric Shrinkage, Youngs Modulus, Microhardness and Depth of Cure, one-way ANOVA was used. All ANOVA tests were followed by Tukeys test and 5% was adopted as significance level. Shrinkage stress test with 12mm3 showed SDR, TBF and XF generating the lowest stress after 300s, followed by other high viscosity composites (ADM, FBF, XB and FBP/Z3XT). The regular low viscosity composite (Z3F) generated the highest stress for all assessed times. Considering the same test, with 24mm3, after 300s, SDR, FBP and ADM generated similar stress, followed by TBF and XF. Low viscosity bulk fill composites generated lower stress than Z3F. Considering Youngs modulus, low viscosity composites (SDR, FBF, XB and Z3F) showed the lowest values, followed by ADM and TBF. The other high viscosity composites (Z3XT, FBP and XF) showed the highest values. For microhardness test, all low viscosity composites showed lower values (FBF being the lowest). For high viscosity composites, Z3XT showed the highest values, followed by XF, FBP/TBF and ADM. Assessing depth of cure, regular composites showed lower values when compared with bulk fill composites. All bulk fill composites showed adequate depth of cure over 4.5mm (microhardness 80% of initial reading). SDR and XB showed the highest depth of cure. All high viscosity bulk fill composites generated lower volumetric shrinkage than regular composites. All low viscosity bulk fill composites showed similar volumetric shrinkage when compared to the regular composites (Z3F and Z3XT). Bulk fill composites show characteristics that allow their use in larger increments (i.e. volumetric shrinkage and polymerization stress similar or lower when compared with regular composites). Nonetheless, the mechanical properties of bulk fill composites were widely variable, being important to individually assess each material previously to its clinical application. / A obtenção de restaurações adesivas previsíveis e duradouras em dentes posteriores sempre foi objetivo de estudos na área de desenvolvimento de materiais e técnicas. O uso de resinas compostas do tipo bulk fill pode possibilitar melhores resultados, porém é importante o estudo de suas propriedades físico-mecânicas, responsáveis por seus comportamentos clínicos. O objetivo do presente estudo foi o de avaliar as propriedades físicas e mecânicas das resinas bulk fill. As resinas foram divididas em 2 grupos de acordo com sua viscosidade. Para resinas de baixa viscosidade, o presente estudo avaliou: Surefill SDR flow (SDR), X-tra Base (XB), Filtek Bulk Fill Flowable (FBF) e Filtek Z350XT Flow (Z3F-controle); e, para alta viscosidade: Tetric Evo Ceram Bulk Fill (TBF), X-tra Fil (XF), Filtek Bulk Fill (FBP), Admira Fusion x-tra (ADM) e Filtek Z350 XT (Z3XT-controle). As resinas foram avaliadas em relação à tensão de polimerização (utilizando 12 e 24mm3 de resina adaptadas em um dispositivo adaptado a uma máquina de testes universal); contração volumétrica (utilizando 64mm3 de resina composta inserida em um molde de Teflon e escaneada em um micro-tomógrafo/CT), modulo de Young (através de um dispositivo de flexão em 3 pontos adaptado a uma máquina de testes universal), microdureza e profundidade de polimerização (utilizando microdureza Knoop). Todos os resultados foram avaliados em relação à homogeneidade utilizando o teste de Shapiro-Wilk. Para avaliação da tensão de polimerização, foi empregada a Análise de Variância (ANOVA) a 3 critérios. Para as analyses de contração volumétrica, Módulo de Young, microdureza e profundidade de polimerizaçao, ANOVA a um critério foi empregada. Todas as Análises de Variância foram seguidas pelo teste de Tukey e 5% foi adotado como nível de significância. A tensão de polimerização com 12mm3 demonstrou que SDR, TBF e XF geraram valores significantemente mais baixos após 300s, seguidas por outras resinas de alta viscosidade (ADM, FBF, XB e FBP/Z3XT). A resina convencional de baixa viscosidade (Z3F) gerou valores de tensão significantemente mais elevados para todos os tempos avaliados. Considerando o mesmo teste, com 24mm3, após 300s, SDR, FBP e ADM geraram valores estatisticamente inferiores, seguidas por TBF e XF. As resinas bulk fill de baixa visocidade geraram menor tensão de polimerização que a Z3F. Considerando o modulo de Young, resinas de baixa viscosidade (SDR, FBF, XB e Z3F) apresentaram valores significantemente inferiores, seguidas por ADM e TBF. As outras resinas de alta viscosidade (Z3XT, FBP e XF) apresentaram valores significantemente mais elevados. Para o teste de microdureza, todas as resinas de baixa viscosidade apresentaram valores inferiores (FBF apresentou o menor). Para as resinas de alta viscosidade, Z3XT apresentou os valores mais elevados, seguida por XF, FBP/TBF e ADM. Para profundidade de polimerização, resinas compostas convencionais apresentaram valores signifixantemente mais baixos quando comparadas com resinas bulk fill. Todas as resinas bulk fill apresentaram profundidade de polimerização adequada até pelo menos 4,5mm (microdureza 80% da leitura inicial/superfície). SDR e XB apresentaram os valores mais altos de profundidade de polimerização. Todas as resinas bulk fill de alta viscosidade geraram menor contração volumétrica que resinas compostas convencionais. Todas as resinas bulk fill de baixa viscosidade apresentaram contração volumétrica similar às resinas convencionais (Z3F e Z3XT). Resinas compostas bulk fill apresentaram características que possibilitam sua indicação para serem empregadas em grandes incrementos (contração volumétrica e tensão de polimerização similar ou inferiores às resinas convencionais, além de maior profundidade de polimerização). No entanto, as propriedades mecânicas variaram grandemente entre as resinas estudadas sendo importante uma avaliação individual de cada material previamente ao seu uso clínico.

The achievement of predictable and long lasting adhesive restorations in posterior teeth have always been a major objective of studies in the context of materials and techniques development. The use of bulk fill composites could provide better outcomes, but it is important to assess their physico-mechanical properties, responsible for their clinical behavior. The purpose of the present study was to assess the mechanical and physical properties of bulk fill composites. The composites were divided into 2 groups according to their viscosity. For low viscosity composites, the present study assessed: Surefill SDR flow (SDR), X-tra Base (XB), Filtek Bulk Fill Flowable (FBF), and Filtek Z350XT Flow (Z3F- control); and for high viscosity composites: Tetric Evo Ceram Bulk Fill (TBF), X-tra Fil (XF), Filtek Bulk Fill (FBP), Admira Fusion x-tra (ADM) and Filtek Z350 XT (Z3XT- control). Composites were assessed through shrinkage stress test (using 12 and 24mm3 of composite in a custom device adapted in an Universal Testing Machine); volumetric shrinkage (using 64mm3 of composite placed on a Teflon mold and scanned in a micro computed tomography/CT); Youngs modulus (through a 3-point bending test device adapted in an Universal Testing Machine); microhardness and depth of cure tests (using longitudinal Knoop microhardness). All data was evaluated regarding their homogeneity using Shapiro-Wilk test. For polymerization stress, 3-way Variance Analysis (ANOVA) was used. Considering Volumetric Shrinkage, Youngs Modulus, Microhardness and Depth of Cure, one-way ANOVA was used. All ANOVA tests were followed by Tukeys test and 5% was adopted as significance level. Shrinkage stress test with 12mm3 showed SDR, TBF and XF generating the lowest stress after 300s, followed by other high viscosity composites (ADM, FBF, XB and FBP/Z3XT). The regular low viscosity composite (Z3F) generated the highest stress for all assessed times. Considering the same test, with 24mm3, after 300s, SDR, FBP and ADM generated similar stress, followed by TBF and XF. Low viscosity bulk fill composites generated lower stress than Z3F. Considering Youngs modulus, low viscosity composites (SDR, FBF, XB and Z3F) showed the lowest values, followed by ADM and TBF. The other high viscosity composites (Z3XT, FBP and XF) showed the highest values. For microhardness test, all low viscosity composites showed lower values (FBF being the lowest). For high viscosity composites, Z3XT showed the highest values, followed by XF, FBP/TBF and ADM. Assessing depth of cure, regular composites showed lower values when compared with bulk fill composites. All bulk fill composites showed adequate depth of cure over 4.5mm (microhardness 80% of initial reading). SDR and XB showed the highest depth of cure. All high viscosity bulk fill composites generated lower volumetric shrinkage than regular composites. All low viscosity bulk fill composites showed similar volumetric shrinkage when compared to the regular composites (Z3F and Z3XT). Bulk fill composites show characteristics that allow their use in larger increments (i.e. volumetric shrinkage and polymerization stress similar or lower when compared with regular composites). Nonetheless, the mechanical properties of bulk fill composites were widely variable, being important to individually assess each material previously to its clinical application. / A obtenção de restaurações adesivas previsíveis e duradouras em dentes posteriores sempre foi objetivo de estudos na área de desenvolvimento de materiais e técnicas. O uso de resinas compostas do tipo bulk fill pode possibilitar melhores resultados, porém é importante o estudo de suas propriedades físico-mecânicas, responsáveis por seus comportamentos clínicos. O objetivo do presente estudo foi o de avaliar as propriedades físicas e mecânicas das resinas bulk fill. As resinas foram divididas em 2 grupos de acordo com sua viscosidade. Para resinas de baixa viscosidade, o presente estudo avaliou: Surefill SDR flow (SDR), X-tra Base (XB), Filtek Bulk Fill Flowable (FBF) e Filtek Z350XT Flow (Z3F-controle); e, para alta viscosidade: Tetric Evo Ceram Bulk Fill (TBF), X-tra Fil (XF), Filtek Bulk Fill (FBP), Admira Fusion x-tra (ADM) e Filtek Z350 XT (Z3XT-controle). As resinas foram avaliadas em relação à tensão de polimerização (utilizando 12 e 24mm3 de resina adaptadas em um dispositivo adaptado a uma máquina de testes universal); contração volumétrica (utilizando 64mm3 de resina composta inserida em um molde de Teflon e escaneada em um micro-tomógrafo/CT), modulo de Young (através de um dispositivo de flexão em 3 pontos adaptado a uma máquina de testes universal), microdureza e profundidade de polimerização (utilizando microdureza Knoop). Todos os resultados foram avaliados em relação à homogeneidade utilizando o teste de Shapiro-Wilk. Para avaliação da tensão de polimerização, foi empregada a Análise de Variância (ANOVA) a 3 critérios. Para as analyses de contração volumétrica, Módulo de Young, microdureza e profundidade de polimerizaçao, ANOVA a um critério foi empregada. Todas as Análises de Variância foram seguidas pelo teste de Tukey e 5% foi adotado como nível de significância. A tensão de polimerização com 12mm3 demonstrou que SDR, TBF e XF geraram valores significantemente mais baixos após 300s, seguidas por outras resinas de alta viscosidade (ADM, FBF, XB e FBP/Z3XT). A resina convencional de baixa viscosidade (Z3F) gerou valores de tensão significantemente mais elevados para todos os tempos avaliados. Considerando o mesmo teste, com 24mm3, após 300s, SDR, FBP e ADM geraram valores estatisticamente inferiores, seguidas por TBF e XF. As resinas bulk fill de baixa visocidade geraram menor tensão de polimerização que a Z3F. Considerando o modulo de Young, resinas de baixa viscosidade (SDR, FBF, XB e Z3F) apresentaram valores significantemente inferiores, seguidas por ADM e TBF. As outras resinas de alta viscosidade (Z3XT, FBP e XF) apresentaram valores significantemente mais elevados. Para o teste de microdureza, todas as resinas de baixa viscosidade apresentaram valores inferiores (FBF apresentou o menor). Para as resinas de alta viscosidade, Z3XT apresentou os valores mais elevados, seguida por XF, FBP/TBF e ADM. Para profundidade de polimerização, resinas compostas convencionais apresentaram valores signifixantemente mais baixos quando comparadas com resinas bulk fill. Todas as resinas bulk fill apresentaram profundidade de polimerização adequada até pelo menos 4,5mm (microdureza 80% da leitura inicial/superfície). SDR e XB apresentaram os valores mais altos de profundidade de polimerização. Todas as resinas bulk fill de alta viscosidade geraram menor contração volumétrica que resinas compostas convencionais. Todas as resinas bulk fill de baixa viscosidade apresentaram contração volumétrica similar às resinas convencionais (Z3F e Z3XT). Resinas compostas bulk fill apresentaram características que possibilitam sua indicação para serem empregadas em grandes incrementos (contração volumétrica e tensão de polimerização similar ou inferiores às resinas convencionais, além de maior profundidade de polimerização). No entanto, as propriedades mecânicas variaram grandemente entre as resinas estudadas sendo importante uma avaliação individual de cada material previamente ao seu uso clínico.

Diante da evolução da composição das resinas compostas e do lançamento de compósitos do tipo bulk fill, faz-se necessário o estudo do desempenho dessa nova classe de materiais. Para isso, o presente estudo teve como objetivo avaliar propriedades como grau de conversão (GC) , dureza Knoop (KHN), resistência à flexão (RF) e tenacidade à fratura (KIC) de sete compósitos bulk fill (EverX Posterior, EXP; Filtek Bulk Fill Flow, FBFF; Fill-Up!, FU; SonicFill, SF; Surefil SDR, SDR; Tetric EvoCeram Bulk Fill, TECBF; Venus Bulk Fill, VBF) e um compósito nanohíbrido convencional (Charisma Diamond, CD). De forma complementar, foi realizado tratamento térmico a 170 °C por 10 minutos para melhor compreensão do comportamento desses materiais quanto ao potencial de conversão e à indução de tensões na interface carga/matriz. A avaliação do GC (n=3) foi realizada através de espectroscopia FTIR, a leitura da dureza Knoop foi realizada nas superfícies do topo e da base (n=3), e os ensaios de RF de três pontos (n=10) e KIC (n=10) em máquina de ensaios universais. Os resultados obtidos foram submetidos à analise de variância (complementados pelo teste de Tukey) ou teste Kruskal-Wallis, com nível de significância de 5%. A análise do GC (%) revelou diferença entre os materiais testados, sendo que todas as resinas bulk fill apresentaram valores maiores que a resina convencional: SF (75,7) > VBF (66,7) = EXP (66,4) = SDR (62,8), sendo esta também semelhante a FU (60,0); FU, TECBF (56,6), FBFF (56,6) e CD (54,5) apresentaram conversão semelhante. Os valores de KHN variaram de acordo com o material e com a superfície: apenas SF apresentou KHN semelhante (na superfície do topo) a CD, entretanto não foi possível realizar a leitura da superfície da base deste último material; SF, TECBF e FBFF apresentaram valores de KHN diferentes nas superfícies topo e base; EXP, FU, SDR e VBF mantiveram os valores de dureza do topo semelhantes à superfície da base. Para a RF (MPa), os resultados variaram de acordo com o material: EXP (122,54) = SF (101,09) = CD (99,15), sendo estes dois últimos semelhantes a FU (83,86) e TECBF (82,71), os quais não diferiram da resina SDR (65,18); esta última também mostrou comportamento semelhante a FBFF (60,85) e VBF (59,90). Quanto ao KIC (MPa.mm0,5), EXP (3,35) apresentou o maior valor, semelhante a SF (2,42), que por sua vez também foi igual ao compósito convencional CD (2,01); CD apresentou KIC semelhante a SDR (1,74); SDR = VBF (1,59) = TECBF (1,57); TECBF, FU (1,54) e FBFF (1,37) apresentaram valores semelhantes. Na dependência do material, o tratamento térmico aumentou os valores dos parâmetros estudados, apontando limitações da reação de polimerização dos compósitos estudados. Com base nos resultados obtidos, podese concluir que: resinas bulk fill apresentam elevado GC, superior à resina convencional estudada; a nova classe de materiais restauradores é capaz de polimerizar em profundidade e alguns materiais apresentam KHN semelhantes no topo e na base de espécimes de 4 mm de profundidade; RF e KIC variaram de acordo com o material, e o compósito EXP apresentou os maiores valores para ambos os testes. / Facing the evolution of the resin composites and the release of the bulk-fill composite type, it is necessary to study the performance of this new class of materials. For this, the present study aimed to evaluate properties such as degree of conversion (DC), Knoop hardness (KHN), flexural strength (FS) and fracture toughness (KIC) of seven bulk-fill composites (EverX Posterior, EXP; Filtek Bulk Fill Flowable, FBFF; Fill-Up!, FU; SonicFill, SF; Surefil SDR, SDR; Tetric EvoCeram Bulk Fill, TECBF; Venus Bulk Fill, VBF) and a conventional nanohybrid composite (Charisma Diamond, CD). Complementarily, heat treatment was performed at 170 °C for 10 minutes for better understanding the behavior of these materials. Evaluation of DC (n=3) was performed by FTIR spectroscopy, the evaluation of Knoop hardness was made on the top and bottom surfaces (n=3), and three point bending test (n=10) and KIC (n=10) were evaluated on a universal testing machine. The results were submitted to analysis of variance (complemented by Tukey test) or Kruskal-Wallis test with 5% significance level. Analysis of DC (%) revealed differences between tested materials, and all bulk-fill resins had higher values than the conventional resin: SF (75.7) > VBF (66.7) = EXP (66.4) = SDR (62.8), which was also similar to FU (60.0); FU, TECBF (56.6), FBFF (56.6) and CD (54.4) showed similar conversion. KHN values showed variations according to the material and the surface: only SF showed a similar KHN (on the top surface) to CD, however it was not possible to read the bottom surface of this latter material; SF, TECBF and FBFF presented different KHN values on the top and bottom surfaces; EXP, FU, SDR and VBF maintained top and bottom similar hardness values. For FS (MPa), the results varied according to the material: EXP (122.54) = SF (101.09) = CD (99.15), the latter two being similar to FU (83.86) and TECBF (82.71), which did not differ from SDR resin (65.18); the latter showed similar behavior to FBFF (60.85) and VBF (59.90). As for KIC (MPa.mm0.5), EXP (3.35) had the highest value, similar to SF (2.42), which in turn was also equal to the conventional composite CD (2.01); CD presented KIC similar to SDR (1.74); SDR = VBF (1.59) = TECBF (1.57); TECBF, FU (1.54) and FBFF (1.37) were similar. Depending on the material, heat treatment increased the values of the parameters, pointing limitations of polymerization reaction of the studied composites. Based on these results, it can be concluded that: bulk fill resins have high DC, higher than the conventional resin studied; the new class of restorative materials is capable of polymerizing in depth and some materials exhibited similar KHN at the top and bottom surfaces of 4 mm depth specimens; FS and KIC varied according to the material, and the EXP composite showed the highest values for both tests.

No description available.

Magister Scientiae Dentium - MSc(Dent) / Resin filled dental composite materials has been introduced into dental practice since mid-1960s as an aesthetic restorative material for anterior teeth (Bowen, 1962 cited in Peutzfeldt, 1997). Since then, they have undergone several developments in order to enhance the longevity and performance of these materials. Resin filled dental composites consist of three main components namely, organic resin matrix which consists of a monomer, an initiator system and a stabilizer system, inorganic filler such as quartz, silica, etc. and coupling agent such as organo-silane coupling agent that chemically bonds the inorganic fillers to the organic resin matrix (Phillips, 1973). The properties and the performance of the resin filled dental composites are basically dependent upon the components of the materials. Some properties are related to the resin matrix, whereas others are related to the inorganic fillers and coupling agent. Furthermore, properties such as polymerization shrinkage and water sorption are dependent on both the inorganic fillers and the organic resin matrix (Asmussen, 1975; Hashinger and Fairhust, 1984; Munksgaard et al., 1987). Aim and objectives: The aim and the objectives of this study was to compare the water sorption and solubility of four bulk-fill dental resin composite materials namely, two conventional viscosity bulk-fill (Surefil bulk fill composite and Tetric N Ceram Bulk Fill) and two low viscosity bulk-fill flowable dental composite materials (Filtek Bulk Fill flowable restorative and Surefil SDR Flow). Materials and methods: Four types of bulk-fill composite restorative materials (2 bulk-fill conventional viscosity (Surefil bulk fill composite and Tetric N Ceram Bulk Fill) and 2 bulk-fill flowable low viscosity (Filtek Bulk Fill flowable restorative and Surefil SDR Flow) were used to analyse the water sorption and solubility for each resin composite type. Thirty specimens for each type of material were prepared, giving the total number of specimens to be 120 (n=120). To standardize this study Vita shade A2 was used for all the material types. All specimens were prepared in a Teflon mould with internal diameter of 15±1mm and thickness of 1±0.1mm in accordance with ISO 4049. The light curing unit used for all specimens was Elipar™ S10, (3M ESPE, Germany) at an output of 1200 mW/cm2 and used according to the manufacturer’s instructions. Prior to curing, the intensity of the light was checked using Cure Rite visible curing light meter (Caulk, USA) to ensure light output consistency between specimens and was found to be 1200 mW/cm2 . All the specimens were first removed from the Teflon mould as prepared and described previously and placed in an oven at 37 ºC until their weights were constant and these weights were recorded as m1 by using an analytic balance (OHAUS, TS400D, USA). Ten specimens of each type of resin filled composite were then immersed individually in glass containers filled with 10 ml distilled water and placed in the oven at 37±1 ºC for 24 hours, 7 days, 14 days respectively. The specimens were removed; surface water was blotted with tissue paper until free from visible moisture and weighed using the analytic balance (OHAUS, TS400D, USA). The resultant weights were recorded as m2. The specimens were then placed in a desiccator containing silica gel (Associated Chemical Enterprises, ZA) and freshly dried for two hours in an oven at 58 ºC and then weighted to obtain m3. According to Oysaed and Ruyter formula (Oysaed and Ruyter, 1986), the water sorption and solubility was calculated using the following equation: i.Water sorption (SP) = m2 -m3 / v., ii.Water solubility (SI) = m1 -m3 / v - where v is the volume of the specimen. For monomer leakage high performance liquid chromatography (HPLC) was used to identify monomers. The water that contained stored specimens was transferred to a refrigerator immediately after the specimens were removed until HPLC analysis was carried out to determine the amount of monomers that leached out of the cured composite specimens. Results: A significant difference between the materials (p<0.05, ANOVA Analysis of Variance) showed that Surefil SDR Flow composite had the lowest overall mean water sorption values (10.191) over the three time intervals (24 hrs, 7 days and 14 days) which was significantly smaller than the other means, followed by Filtek Bulk Fill flowable restorative composite (11.135) and Tetric N Ceram Bulk Fill composite (16.419). The highest water sorption mean value was recorded for Surefil bulk fill composite (21.515). The overall means of water solubility for the two bulk-fill flowables i.e. Filtek Bulk Fill flowable restorative and Surefil SDR Flow were smaller than bulk-fill conventional viscosity Surefil bulk fill and Tetric N Ceram Bulk Fill. However, all the test materials displayed no statistically significant increase in water solubility over the time period (p > 0.05 two way ANOVA test). The amounts of eluted monomers from bulk-fill conventional viscosity materials (Surefil bulk fill and Tetric N Ceram Bulk Fill) were higher than bulk-fill flowable materials (Surefil SDR Flow and Filtek Bulk Fill flowable restorative). Of all the monomers tested UDMA eluted more than Bis-GMA and TEGDMA. Overall UDMA monomer eluted the most, followed by Bis-GMA and the TEGDMA. Conclusion: Within the limitation of this study, the results of this study did not support the null hypothesis that there is no significant difference in the water sorption. The bulk-fill low viscosity flowables showed lower water sorption than the conventional viscosity bulk-fills. Surefil SDR Flow was significantly lower than the other materials followed by Filtek Bulk Fill flowable restorative and Tetric N-Ceram Bulk Fill and the highest overall means were recorded for Surefil bulk fill. For water solubility the overall means for the flowables of Filtek and SDR were smaller than Surefil and Tetric N-Ceram. For monomer elution three monomers were detected of which UDMA monomer eluted the most, followed by Bis-GMA and the TEGDMA. With regards to the elution of monomers, it was found that 3 monomers named UDMA eluted more than Bis-GMA and TEGDMA.

Indiana University-Purdue University Indianapolis (IUPUI) / Recently, the concept of “bulk-fill” resin-based composites (RBCs) has been re-emphasized, with claimed improvements in depth of cure (DOC) with similar mechanical properties and comparable adaptation to walls and margins relative to conventional composite. More research is needed to carefully examine the properties of these new materials. The objective of this study was to measure the light energy, microhardness (VHN), and elastic modulus across the depth of one conventional and three bulk-fill RBCs. Materials and Methods: Three commercially available bulk-fill RBCs (Tetric EvoCeram Bulk Fill [TE], SonicFill [SF], X-tra fill[XF]) and one conventional RBC (Premise [PR]) were evaluated (n = 10). DOC (using Vickers’s microhardness), elastic modulus (using atomic force microscopy), and the mean irradiance and total light energy transmitted through different thicknesses of RBC were measured by a spectrometer. The effects of group, location, and curing depth on VHN were analyzed using mixed-model ANOVA. Elastic modulus and light energy comparisons were made using two-way ANOVA, with a significance level of 5 percent. Results: There was a significant difference in the depths for the mean irradiance and total energy between different depths in all materials. All materials achieved the manufacturers’ claimed DOC. XF had the highest DOC with 7 mm and a light energy of 0.56± 0.02 J/cm2 at 7 mm. PR had the lowest DOC with 3 mm and a light energy of 0.84 ±0.12 J/cm2 at 3 mm. The elastic modulus showed significant variation in depth profiles that were different than the DOC. Significance: The manufacturers’ claims for bulk-fill DOC were achieved using a microhardness method. However, this method failed to detect the quality of the polymerization. Assessment of the elastic modulus using AFM is a promising method for greater understanding of the polymerization.

Background: Dental filling materials are used on a regular basis by dentists. Commonly used filling materials on the current market are resin composites and glass ionomers cements. However, new materials continue to be presented on the market with claimed improved physical and chemical properties, among them Predicta Bioactive Bulk.    Aim: The aim of this study was to investigate the surface roughness and ion release properties of a bioactive restorative material.   Methods: Surface roughness and ion release properties of a new material, Predicta Bioactive Bulk, was compared to Ceram.X Spectra ST and Fuji LC II. The results were analyzed using Microsoft Office Excel and IBM SPSS Statistics software.    Results: The material with the lowest surface roughness at baseline was Predicta Bioactive Bulk and Ceram.X Spectra ST had the highest value. After polishing/finishing CeramX showed the lowest surface roughness and Fuji II LC had the highest value. After the water aging-test, submerged for two weeks, Ceram.X Spectra ST exhibited the lowest value of surface roughness and Fuji II LC showed the highest value. The material with the highest fluoride release after two and seven days was Fuji II LC and Predicta Bioactive Bulk hade the lowest.    Conclusion: The surface roughness of Predicta Bioactive Bulk was comparable to CeramX in the test regarding surface roughness. Therefore, it can be concluded the surface roughness is neither better nor worse than CeramX. From the study it can also be concluded that Predicta Bioactive Bulk had very low fluoride ion release properties.

O presente estudo teve como objetivo avaliar as propriedades de dois compósitos convencionais [Charisma Diamond (CD) e Filtek Z250XT (FZ250XT)] e dois do tipo Bulk Fill [Aura Bulk Fill, (ABF) e Filtek Bulk Fill (FBF)] em função da profundidade de polimerização e modo de obtenção (O) dos espécimes submetidos ou não a tratamento térmico (TT, 170?C x 10 min)) e um protocolo de envelhecimento acelerado (C, 150000 ciclos, 14,7 N). Para a obtenção dos corpos de prova em forma de disco (10 mm diâmetro e 1 mm espessura) utilizou-se dois tipos de molde de poliéster (segmentado e não segmentado). Foram fotoativados (1000 mW/cm2 X 20 s) nas espessuras de 2 mm (convencionais) e 5 mm (Bulk Fill.). As propriedades avaliadas foram: Grau de conversão (GC), dureza (KHN) e resistência à flexão biaxial (RFB). A análise estatística do GC % para as resinas convencionais mostrou diferença no fator Condição (imediato 58,8 %, sem TT 24h 66,3 %, com TT 83,8 %), na interação Marca X Tratamento Térmico a CD com TT (88,1 %) > FZ250XT (79,6 %) mas nas outras condições foi semelhante. Quanto às resinas do tipo Bulk, a FBF (73,5 %) > ABF (71,8 %), o GC em função da profundidade diminuiu, os primeiros dois milímetros foram semelhantes 1 mm (77,0 %), 2 mm (77,4 %) > 3 mm ( 72,1 %) e 4 mm (70,8 %), semelhantes entre si, e o 5 mm obteve o menor GC (66,2 %). Comparado o 5 mm, a ABF (61,1 %) < FBF (71,4 %). No fator Condição o GC aumenta em 24 h (70,2 %) comparada com o imediato (61,7 %) e com o tratamento térmico aumenta ainda mais (86,2 %). Com o tratamento térmico, a FBF foi a que obteve o maior aumento (88,4 %), ABF (84,1 %), mas as duas sem tratamento térmico não apresentaram diferença significante ABF (69,9 %), FBF (70,5 %). Os valores de KHN tanto para as resinas convencionais como para as reinas do tipo Bulk Fill variaram em função da marca; resinas convencionais FZ250XT (64,8 KHN) > CD (50,8 KHN) e resinas do tipo Bulk Fill FBF (47,2 KHN) > ABF (33,1 KHN); em função da Forma de Obtenção, resinas convencionais Bloco-topo (61,7 KHN) < Fatia-topo (67,3 KHN), Bloco-base (54,0 KHN) > Fatia-base (48,2 KHN), e as resinas do tipo Bulk Fill Bloco-topo (44,5 KHN) < Fatia-topo (48,1 KHN), Bloco-base (38,0 KHN) > Fatia-base (29,9 KHN); e em função do Tratamento Térmico, resinas convencionais com TT (54,15 KHN) > sem TT (53,23 KHN) e resinas do tipo Bulk Fill com TT (44,4 KHN) > sem TT (35,9 KHN). Quanto à RFB, o fator Forma de Obtenção apresentou diferenças significativas para as quatro resinas; o Tratamento térmico aumentou à RFB nas 4 resinas estudadas, a porcentagem de aumento foi de 16,1 % para a resina CD, de 4,7 % para a FZ250XT, de 14,1 % para a ABF e de 28,3 % para a FBF. Com base nos resultados obtidos, pode-se concluir que: maior grau de conversão conduziu à maior resistência à flexão; O tratamento térmico conduziu a um aumento de todas as propriedades estudadas. A ciclagem mecânica, utilizada como protocolo de envelhecimento, permitiu a diferenciação dos materiais. / The aim of this study was to evaluate the properties of two conventional composites [Charisma Diamond (CD) e Filtek Z250XT (FZ250XT)] and two bulk fill composites Fill [Aura Bulk Fill, (ABF) e Filtek Bulk Fill (FBF)] regarding the depth of polymerization and the mode of acquisition (O) of the specimens which were submitted or not submitted to heat treatment (HT, 170 ?C x 10 min) and a protocol of accelerated aging (C, 150,000 cycles, 14.7 N). For the acquisition of the samples in disc format (10 mm in diameter and 1 mm in thickness) two different polyester molds were used (segmented and non-segmented). The samples were light cured in the thickness of 2 mm (conventional composites) and 5 mm (Bulk Fill composites). The properties evaluated were degree of conversion (DC %), hardness (KHN) and biaxial flexural strength (BFS). Statistical analyses of the DC % for the conventional composites showed differences for the factors Condition (immediate 58.8 % < without HT 24h 66.3 % < with HT 83.8 %), in the interaction Brand X Heat Treatment the group CD with HT (88.1 %) was higher than FZ250XT (79.6 %) but for all other conditions the results were similar. As for the Bulk Fill resins, the DC% for FBF (73.5 %) showed higher DC % when compared to ABF (71.8 %). The DC% in function of depth decreased: for the first two millimeters the results were similar: 1 mm (77.0 %) = 2 mm (77.4 %) > 3 mm (72.1 %) = 4 mm (70.8 %), and the 5 mm obtained the lowest DC % (66.2 %). Comparing the 5 mm level among brands, ABF (61.1 %) was lower than FBF (71.4 %). For the factor Condition the DC % increases in 24h (70.2 %) compared to immediate (61.7 %) and with the HT increases even more (86.2 %). With the HT FBF obtained the highest increase (88.4 %), ABF (84.1 %), but both without HT present no statistically significant difference: ABF (69.9 %), FBF (70.5 %). The KHN values for both the conventional composites and the bulk fill ones varied based on the brand; conventional composites: FZ250XT (64,8 KHN) > CD (50.8 KHN) and Bulk Fill resins: FBF (47,2 KHN) > ABF (33,1 KHN); for the mode of acquisition, conventional resins block-top (61.7 KHN) lower than slice-top (67.3KHN), block-base (54.0 KHN) higher than slice-base (48.2 KHN); the bulk fill resins presented the results block-top (44.5 KHN) lower than slice-top (48.1 KHN), block-base (38.0 KHN) higher than slice-base (29.9 KHN); and regarding the HT, conventional resins with HT (54.15 KHN) higher than no HT (53.23 KHN) and bulk fill resins with HT (44.4 KHN) higher than without HT (35.9 KHN). Regarding BFS the factor mean of acquisition presented statistically significant differences for the 4 composites; heat treatment increased the BFS for all resins tested. 16.1 % was the percentage of increase for the CD resin, 4.7 % for FZ250XT, 14.1 % for ABF and 28.3 % for FBF. Based on the results obtained it can be concluded that: the higher conversion rate led to higher flexural strength resistance; the heat treatment led to an increase of all properties evaluated. Mechanical cycling, used as aging protocol, permitted the differentiation of materials.

O objetivo desta pesquisa foi avaliar o desempenho clínico de restaurações bulk fill em indivíduos com molares decíduos submetidos à RSTC (remoção seletiva de tecido cariado) durante 12 meses de acompanhamento. 62 indivíduos (idade média de 5.9 anos ± 1.74) com no mínimo um molar com lesão cavitada ativa profunda em dentina foram incluídos na pesquisa. 144 molares decíduos foram randomicamente divididos em 2 grupos de material restaurador: Resina Filtek Bulk Fill (grupo teste=FBF) ou Vitremer (grupo controle= CIVMR). Os procedimentos restauradores foram realizados por 2 dentistas especialistas em odontopediatria treinados para realização da técnica e calibrados para avaliação do diagnóstico da atividade da lesão e do desempenho da restauração. Um terceiro examinador também treinado, calibrado e contemplando princípio de cegamento, avaliou as radiografias durante o período de acompanhamento. Os critérios avaliados para determinar o sucesso clínico e radiográfico do tratamento de RSTC foram: ausência de dor espontânea e/ ou sensibilidade à pressão, ausência de sinais de pulpite irreversível, mobilidade anormal incompatível com o período de reabsorção radicular. O desempenho da restauração foi categorizado em cada grupo seguindo o critério da FDI para descoloração marginal, forma anatômica, fratura de material e retenção, adaptação marginal e recorrência de cárie, sendo a falha registrada. Os dentes foram reavaliados clinicamente e radiograficamente quanto o tratamento e desempenho da restauração em 6 e 12 meses. Características sociodemográficas foram registradas no baseline e características clínicas como índice ceod/CPOD, índice de placa visível e índice de sangramento gengival foram registrados durante os períodos de acompanhamento. Os dados foram analisados considerando o tipo de restauração, sintomas, número de faces envolvidas, tipo dente, experiência do operador e padrão de sucesso das restaurações. Para determinar as taxas de sucesso das restaurações foram geradas curvas de sobrevida com o estimador Kaplan-Meyer para cada grupo avaliado. O modelo de regressão de Cox com falhas compartilhadas foi realizado para avaliar diferenças nas taxas de sobrevida das restaurações de acordo com o tratamento e características clínicas e demográficas da amostra. Resultados: A taxa de sucesso das restaurações foi de 83,9% (85,9% para FBF e 81,9% para CIVMR, p = 0,675). Não houve diferenças no risco de falha de acordo com material restaurador. Das 23 falhas, três foram exclusivamente pulpar e uma pulpar e restauradora, e 100% da falha foram causadas por fratura de material. As restaurações oclusoproximais demonstraram a menor taxa de sucesso, aumentando em 4,12 vezes a probabilidade de ter uma falha restauradora em comparação com a restauração oclusal. Os pacientes com perfil “cárie ativos” foram associados a mais falhas do que pacientes “cárie controlados”. O grau de experiência do operador mostrou diferença significativa, e o menos experiente teve mais probabilidade de falhas restauradoras. As restaurações de resina filtek bulk fill realizadas em molares decíduos após a remoção seletiva da cárie mostraram uma sobrevida satisfatória de 85.9% após 12 meses de acompanhamento. / The purpose of this study was to evaluate the clinical performance of bulk-fill restorations in primary molars submitted to SCR (selective caries removal) at 12 months of follow-up. 62 (average age of 5.9 years ± 1.74) were included with at least one molar with active cavitated lesion in deep dentin.144 primary molars were randomly divided into 2 groups of restorative material: Filtek Bulk Fill Resin (test group = FBF) or Vitremer (control group = RMGIC). Restorative procedures were performed by 2 specialists in pediatric dentistry trained to perform the technique and calibrated to evaluate the diagnosis of lesion activity and restoration performance. A third examiner also trained, calibrated and contemplating the principle of blinding, evaluated the radiographs during the follow-up period. The criteria evaluated to determine the clinical and radiographic success of the SCR were: absence of spontaneous pain and / or sensitivity to pressure, absence of signs of irreversible pulpitis, abnormal mobility incompatible with the period of root resorption. Restoration performance was categorized in each group following the FDI criteria for marginal staining, anatomical form, fracture of material and retention, marginal adaptation and recurrence of caries, and the failure was recorded. The teeth were reassessed clinically and radiographically regarding the treatment and performance of the restoration at 6 and 12 months. Sociodemographic characteristics were recorded in the baseline and clinical characteristics such as DMFT index, visible plaque index and gingival bleeding index were recorded during the follow - up. The data were analyzed considering the type of restoration, symptoms, number of faces involved, tooth type, operator experience and success rate of the restorations. To determine the success rates of the restorations, survival curves were generated with the Kaplan-Meyer estimator for each group evaluated. The Cox regression model with shared failures was performed to assess differences in survival rates of restorations according to treatment and clinical and demographic characteristics of the sample. Results: Success rate of restorations was 83.9% (85.9% for FBF and 81.9% for RMGIC, p=0.675). There were no differences in the risk of failure according to the material restoration. Of the 23 failures, three failures were exclusive pulp and one pulp and restorative, and 100% of the failure were to due to fracture of material. Occlusoproximal restorations demonstrated the lowest success rate, increases 4.12 times the probability of having a restorative failure compared to occlusal restoration. Patients with "active caries" profile were associated with more failures than "controlled caries" patients. The degree of operator experience showed significant difference, and the less experienced operator had more restorative failures. Bulk Fill composite restorations performed in molar primary teeth after selective caries removal showed satisfactory survival of 85.9% after 12 months of follow-up.

O objetivo desta pesquisa foi avaliar o desempenho clínico de restaurações bulk fill em indivíduos com molares decíduos submetidos à RSTC (remoção seletiva de tecido cariado) durante 12 meses de acompanhamento. 62 indivíduos (idade média de 5.9 anos ± 1.74) com no mínimo um molar com lesão cavitada ativa profunda em dentina foram incluídos na pesquisa. 144 molares decíduos foram randomicamente divididos em 2 grupos de material restaurador: Resina Filtek Bulk Fill (grupo teste=FBF) ou Vitremer (grupo controle= CIVMR). Os procedimentos restauradores foram realizados por 2 dentistas especialistas em odontopediatria treinados para realização da técnica e calibrados para avaliação do diagnóstico da atividade da lesão e do desempenho da restauração. Um terceiro examinador também treinado, calibrado e contemplando princípio de cegamento, avaliou as radiografias durante o período de acompanhamento. Os critérios avaliados para determinar o sucesso clínico e radiográfico do tratamento de RSTC foram: ausência de dor espontânea e/ ou sensibilidade à pressão, ausência de sinais de pulpite irreversível, mobilidade anormal incompatível com o período de reabsorção radicular. O desempenho da restauração foi categorizado em cada grupo seguindo o critério da FDI para descoloração marginal, forma anatômica, fratura de material e retenção, adaptação marginal e recorrência de cárie, sendo a falha registrada. Os dentes foram reavaliados clinicamente e radiograficamente quanto o tratamento e desempenho da restauração em 6 e 12 meses. Características sociodemográficas foram registradas no baseline e características clínicas como índice ceod/CPOD, índice de placa visível e índice de sangramento gengival foram registrados durante os períodos de acompanhamento. Os dados foram analisados considerando o tipo de restauração, sintomas, número de faces envolvidas, tipo dente, experiência do operador e padrão de sucesso das restaurações. Para determinar as taxas de sucesso das restaurações foram geradas curvas de sobrevida com o estimador Kaplan-Meyer para cada grupo avaliado. O modelo de regressão de Cox com falhas compartilhadas foi realizado para avaliar diferenças nas taxas de sobrevida das restaurações de acordo com o tratamento e características clínicas e demográficas da amostra. Resultados: A taxa de sucesso das restaurações foi de 83,9% (85,9% para FBF e 81,9% para CIVMR, p = 0,675). Não houve diferenças no risco de falha de acordo com material restaurador. Das 23 falhas, três foram exclusivamente pulpar e uma pulpar e restauradora, e 100% da falha foram causadas por fratura de material. As restaurações oclusoproximais demonstraram a menor taxa de sucesso, aumentando em 4,12 vezes a probabilidade de ter uma falha restauradora em comparação com a restauração oclusal. Os pacientes com perfil “cárie ativos” foram associados a mais falhas do que pacientes “cárie controlados”. O grau de experiência do operador mostrou diferença significativa, e o menos experiente teve mais probabilidade de falhas restauradoras. As restaurações de resina filtek bulk fill realizadas em molares decíduos após a remoção seletiva da cárie mostraram uma sobrevida satisfatória de 85.9% após 12 meses de acompanhamento. / The purpose of this study was to evaluate the clinical performance of bulk-fill restorations in primary molars submitted to SCR (selective caries removal) at 12 months of follow-up. 62 (average age of 5.9 years ± 1.74) were included with at least one molar with active cavitated lesion in deep dentin.144 primary molars were randomly divided into 2 groups of restorative material: Filtek Bulk Fill Resin (test group = FBF) or Vitremer (control group = RMGIC). Restorative procedures were performed by 2 specialists in pediatric dentistry trained to perform the technique and calibrated to evaluate the diagnosis of lesion activity and restoration performance. A third examiner also trained, calibrated and contemplating the principle of blinding, evaluated the radiographs during the follow-up period. The criteria evaluated to determine the clinical and radiographic success of the SCR were: absence of spontaneous pain and / or sensitivity to pressure, absence of signs of irreversible pulpitis, abnormal mobility incompatible with the period of root resorption. Restoration performance was categorized in each group following the FDI criteria for marginal staining, anatomical form, fracture of material and retention, marginal adaptation and recurrence of caries, and the failure was recorded. The teeth were reassessed clinically and radiographically regarding the treatment and performance of the restoration at 6 and 12 months. Sociodemographic characteristics were recorded in the baseline and clinical characteristics such as DMFT index, visible plaque index and gingival bleeding index were recorded during the follow - up. The data were analyzed considering the type of restoration, symptoms, number of faces involved, tooth type, operator experience and success rate of the restorations. To determine the success rates of the restorations, survival curves were generated with the Kaplan-Meyer estimator for each group evaluated. The Cox regression model with shared failures was performed to assess differences in survival rates of restorations according to treatment and clinical and demographic characteristics of the sample. Results: Success rate of restorations was 83.9% (85.9% for FBF and 81.9% for RMGIC, p=0.675). There were no differences in the risk of failure according to the material restoration. Of the 23 failures, three failures were exclusive pulp and one pulp and restorative, and 100% of the failure were to due to fracture of material. Occlusoproximal restorations demonstrated the lowest success rate, increases 4.12 times the probability of having a restorative failure compared to occlusal restoration. Patients with "active caries" profile were associated with more failures than "controlled caries" patients. The degree of operator experience showed significant difference, and the less experienced operator had more restorative failures. Bulk Fill composite restorations performed in molar primary teeth after selective caries removal showed satisfactory survival of 85.9% after 12 months of follow-up.