Short fiber‐reinforced composite restorations: A review of the current literature

A newly‐recommended method for restoring large cavities is the biomimetic approach of using short fiber‐reinforced composite (SFRC) as dentine‐replacing material. The aim of the current review was to present an overview of SFRC and to give the clinician a detailed understanding of this new material and treatment strategy based on available‐literature review. A thorough literature search was done up to December 2017. The range of relevant publications was surveyed using PubMed and Google Scholar. From the search results, articles related to our search terms were only considered. The search terms used were “short fiber‐reinforced composite”, “everX posterior”, and “fiber‐reinforced composite restorations”. Of the assessed articles selected (N = 70), most were laboratory‐based research with various test specimen designs prepared according to the ISO standard or with extracted teeth; only four articles were clinical reports. A common finding was that by combining the SFRC as a bulk base with conventional composite, the load‐bearing capacity and failure mode of the material combination were improved, as compared to plain conventional composite restoration. In the reviewed studies, the biomimetic restoration technique of using SFRC showed promising characteristics, and therefore, might be recommended as an alternative treatment option for large cavities.     

The effect of cycling deflection on the injection-molded thermoplastic denture base resins

Objective. The aim of this study was to evaluate the effect of cycling deflection on the flexural behavior of injection-molded thermoplastic resins. Materials and methods. Six injection-molded thermoplastic resins (two polyamides, two polyesters, one polycarbonate, one polymethyl methacrylate) and, as a control, a conventional heat-polymerized denture based polymer of polymethyl methacrylate (PMMA) were used in this study. The cyclic constant magnitude (1.0 mm) of 5000 cycles was applied using a universal testing machine to demonstrate plasticization of the polymer. Loading was carried out in water at 23ºC with eight specimens per group (n = 8). Cycling load (N) and deformation (mm) were measured. Results. Force required to deflect the specimens during the first loading cycle and final loading cycle was statistically significantly different (p < 0.05) with one polyamide based polymer (Valplast) and PMMA based polymers (Acrytone and Acron). The other polyamide based polymer (LucitoneFRS), polyester based polymers (EstheShot and EstheShotBright) and polycarbonate based polymer (ReigningN) did not show significant differences (p > 0.05). None of the materials fractured during the loading test. One polyamide based polymer (Valplast) displayed the highest deformation and PMMA based polymers (Acrytone and Acron) exhibited the second highest deformation among the denture base materials. Conclusion. It can be concluded that there were considerable differences in the flexural behavior of denture base polymers. This may contribute to the fatigue resistance of the materials.     

Bonding of fibre-reinforced composite post to root canal dentin

OBJECTIVE: The aim of this study was to determine bonding properties of two types of fibre-reinforced composite (FRC) posts cemented into root canals of molars. Serrated titanium posts served as reference. METHODS: Prefabricated carbon/graphite FRC posts with cross-linked polymer matrix and individually formed glass FRC posts with interpenetrating polymer network (IPN) polymer matrix were compared. The crowns of extracted third molars were removed and post space (diameter: 1.5mm) was drilled, etched and bonded. The posts were treated with dimethacrylate adhesive resin, light-polymerized and cemented with a dual-polymerizing composite resin luting cement. After thermocycling (6000x) the samples were cut into discs of thicknesses: 1, 2 and 4mm (n=12/group). Push-out force was measured by pushing the post from one end. Assessment of failure mode was made under a stereomicroscope (1, adhesive failure between post and cement; 2, cohesive failure of post-system; 3, adhesive failure between cement and dentin). RESULTS: The push-out force increased with increased height of dentin disc in all groups (ANOVA, p<0.001). In the 4mm thick dentin discs the individually formed glass FRC posts showed highest push-out force and the difference to that of the titanium posts was significant (ANOVA, p<0.001). The other differences were not statistically significant. None of the individually formed glass FRC posts showed adhesive failures between the post and the cement. CONCLUSIONS: Contrary to the other posts, there were no adhesive (post-cement) failures with the individually formed glass FRC posts, suggesting better interfacial adhesion of cement to these posts.     

Fracture resistance of fragmented incisal edges restored with fiber-reinforced composite

PURPOSE: The aim of this study was to determine the static load-bearing capacity of fractured incisors restored with the conventional adhesive-composite technique or by using fiber-reinforced composites (FRC). MATERIALS AND METHODS: Twelve extracted sound maxillary incisors per group were prepared by cutting the incisal (one-third) part of the crown horizontally. Restorations were made using three techniques. Group A (control group) was restored by reattaching the original incisal edge to the tooth. Group B was restored using particulate filler composite (PFC). Group C was restored with PFC and FRC by adding a thin layer of FRC on the palatal surface of tooth. The bonding system used was the conventional etch system with primer and adhesive. All restored teeth were stored in water at room temperature for 24 h before they were statically loaded until fracture in a universal testing machine. Data were analyzed using ANOVA (p = 0.05). Failure modes were visually examined. RESULTS: Group A (reattaching fractured incisal edge) revealed the lowest load-bearing values, whereas preparation of the new incisal part with PFC revealed 148% higher load-bearing values compared to Group A. Group C (teeth restored with FRC) revealed a 254% higher load-bearing capacity than the control group. ANOVA revealed that the restoration technique significantly affected load-bearing capacity (p < 0.001). The failure mode in Groups A and B was debonding of the restoration from the adhesive interface, while in group C, 50% of the teeth fractured below the cementoenamel junction. CONCLUSION: These results suggest that an incisally fractured tooth restored with a combination of PFC and FRC provide the highest load-bearing capacity.     

The effect of a novel silane blend system on resin bond strength to silica-coated Ti substrate

OBJECTIVES: The adhesive performance of 3-acryloyloxypropyltrimethoxysilane and a silane blend consisting of 3-acryloyloxypropyltrimethoxysilane and 1,2-bis(triethoxysilyl)ethane, adhering an experimental dendrimer-based resin to a silica-coated titanium surface, conditioned by CoJet method, was evaluated in vitro. METHODS: 3-Acryloyloxypropyltrimethoxysilane (1.0 vol%) and a blend of 3-acryloyloxy-propyltrimethoxysilane and 1,2-bis(triethoxysilyl)ethane (both 1.0 vol%) were prepared in acidified 95 vol% ethanol. A commercial 3-methcryloyloxypropyltrimethoxysilane (ESPE Si) was used as control. The silanes were applied onto tribochemically silica-coated titanium surfaces. Fresh silane solution hydrolysis (activation) was monitored by Fourier transform infrared (FTIR) spectrometry. Experimental dendrimer resin stubs were applied and photo-polymerized on titanium. The specimens were thermocycled (6000 cycles, 5-55 degrees C). Before measuring shear bond strength of the resin to titanium, surface imaging was carried out with a scanning electron microscope (SEM) with elemental analysis applying energy dispersive X-ray analysis (EDXA). RESULTS: Statistical analysis (ANOVA) showed that the highest shear bond was obtained with 1.0 vol% 3-acryloyloxypropyltrimethoxysilane+1.0 vol% 1,2-bis(triethoxysilyl)ethane blend (5.2+/-1.3 MPa), and the lowest result with fresh commercial 3-methacryloyloxypropyltrimethoxysilane, ESPE Sil (2.1+/-0.8 MPa). 3-Acryloyloxypropyltrimethoxysilane yielded 4.1+/-1.0 MPa. The type of silane affected significantly the shear bond strength (ANOVA, p<0.001). All silanes were activated according to the infrared spectra. The SEM/EDXA analysis revealed an uneven distribution of titanium, silicon, and aluminum on silica-coated Ti surfaces. CONCLUSION: Silanization with 3-acryloyloxypropyltrimethoxysilane might offer better bonding of a novel dendrimer resin to silica-coated titanium than using a pre-hydrolyzed 3-methacryloyloxypropyltrimethoxysilane.     

Fracture behavior of structurally compromised non-vital maxillary premolars restored using experimental fiber reinforced composite crowns

PURPOSE: To study the fracture behavior of direct resin composite crowns with or without experimental fiber reinforcement. METHODS: Clinical crowns of single-rooted maxillary premolars were cut off at the cemento-enamel junction. Canals were prepared with Gates Glidden drills up to size 4. No additional post-space preparations were made. Roots were embedded in acrylic and canal entrances were standardized (depth 2 mm, diameter 1.75 mm). Three groups of 14 samples were treated as follows: (1) custom-made glass FRC post (EverStick Post); fibers 5 mm deep in the canal, (2) similar post-system as (1) with incorporation of a new type of glass fiber fabric, (3) no fiber reinforcement (control). Posts were cemented with resin cement (Panavia F). Resin composite crowns (Filtek Z250) were made using an anatomically formed mold. Static load until fracture was applied using a universal loading device with a cylindrical bar (diameter 2 mm) with a crosshead speed of 5 mm/minute (loading angle: 30 degrees to the tooth long-axis). Failure modes were categorized as favorable and unfavorable failures. RESULTS: There was no significant difference in mean failure loads among the four groups (P > 0.05). Favorable failures occurred significantly more often in Group 2 than in the other groups (P < 0.05). The results suggest that an incorporated glass fiber fabric does not affect the load-bearing capacity of resin composite complete crowns on structurally compromised and non-vital premolars. Incorporation of a glass fiber fabric, however, has a beneficial effect on the failure mode.     

Fatigue performance of endodontically treated premolars restored with direct and indirect cuspal coverage restorations utilizing fiber-reinforced cores

Clinical Oral Investigations - The aim of this in vitro study was to investigate the fatigue survival and fracture behavior of endodontically treated (ET) premolars restored with different types of...     

Surface Integrity of Dimethacrylate Composite Resins with Low Shrinkage Comonomers

The goal of current research was to investigate the influence of adding low shrinkage “Phene” like comonomers hexaethylene glycol bis(carbamate-isoproply-α-methylstyrene) (HE-Phene) and triethylene glycol bis(carbamate-isoproply-α-methylstyrene) (TE-Phene) on the surface and color characteristics of composite resin. A range of weight fractions (0, 10, 20, 30, 40 wt.%) of HE/TE-Phene monomers were mixed with bisphenol A glycidyl methacrylate (GMA)/triethylene glycol dimethacrylate (TEGDMA) monomer. Experimental composite resins were made by mixing 71 wt.% of silica fillers to 29 wt.% of the resin matrix. A Vickers indenter and glossmeter were used for testing surface hardness (SH) and gloss (SG) at 60°. A chewing-simulator was used to evaluate the surface wear after 15,000 cycles. Color change (∆E) and translucency parameter (TP) were measured using a spectrophotometer. Data showed that HE/TE-Phene monomer had no negative impact (p > 0.05) on surface gloss, wear, color change and translucency of experimental composite resins. Surface hardness was in a reducing direction with the increas in HE/TE-Phene weight fraction (p < 0.05). The study results suggested that incorporating HE/TE-Phene monomers up to 30 wt.% with Bis-GMA/TEGDMA resin did not negatively influence the surface integrity of composite resins except for SH.     

Dendrimer/methyl methacrylate co-polymers: residual methyl methacrylate and degree of conversion

Dendrimer/methyl methacrylate co-polymers were studied for use in dental composites. The aim was to determine the effects of methyl methacrylate concentration in the resin mixture and polymerization method on the degree of conversion and residual monomer content of the copolymers. Two dendrimers were studied, D12 with 12 reactive methacrylate groups and D24 with 24 reactive groups. The concentration of methyl methacrylate varied from 20 wt% to 50 wt% of monomers. Camphorquinone (CQ) was used as the light-activation initiator and 2-(N,N-dimethylamino)ethyl methacrylate (DMAEMA) as the activator, both in the quantity of 3.0 wt%. Three polymerization methods were used: photo-polymerization, photo-polymerized immediately followed by post-polymerization at 120 degrees C for 15 min, and photo-polymerization followed by postpolymerization after 7 days. The degree of conversion was determined using FT-IR. Residual monomers were extracted with tetrahydrofuran and methanol and analyzed with HPLC. The highest degrees of conversion were 65 and 62%, and the lowest residual monomer contents 1.0 and 1.5% for D12 and D24, respectively. These were measured after heat-induced post-polymerization. For D12, increasing the proportion of methyl methacrylate decreased the degree of conversion and increased the residual monomer content after photo-polymerization. Post-polymerization enhanced the polymerization of the dendrimer co-polymers in respect of degree of conversion and residual monomer content. The present study suggested that the tested dendrimer/methyl methacrylate copolymers require heat-induced polymerization to reach the generally accepted levels of degree of conversion and residual monomers.