Clinical performance and margin analysis of ariston pHc versus Solitaire I as posterior restorations after 1 year

The resin composite Ariston pHc (pHc means pH control) was introduced as an alternative for fast amalgam replacement. The aim of the present study was to evaluate clinically the behaviour of this non-bonded resin composite material, promising the release of fluoride, calcium, and hydroxy ions, in comparison to a bonded resin composite (Solitaire I) in class I and II cavities. Ninety-nine cavities in 31 patients were restored in a controlled prospective clinical study. Fifty fillings were placed with Ariston pHc as per the manufacturer's instructions, i.e. neither with enamel etching nor with the use of rubber dam. The same patients received 49 Solitaire I restorations totally bonded with Solidbond using rubber dam. At baseline, after 6 months, and after 12 months, two investigators given the same instructions examined the restorations, according to modified USPHS codes and criteria. Forty selected restorations (20 Ariston, 20 Solitaire) were additionally analysed via replicas, using a stereo light microscope (SV 11, Zeiss, Germany) at 130x magnification. After 12 months, 95 restorations were rated clinically acceptable (6% failure rate for Ariston pHc; 2% for Solitaire). Statistically significant differences were computed for both materials regarding the criterion "filling integrity". Further statistically significant deterioration for Ariston pHc between the three evaluations has been detected for the criteria "tooth integrity" (enamel cracks) and "marginal adaptation" (gap formation/Friedman 2-way ANOVA; p<0.05). With Ariston the criterion "hypersensitivity" also increased significantly after 1 year in comparison to Solitaire. The microscopic margin analysis revealed significantly increasing marginal deficiencies over time for both materials regarding the criteria "perfect margin", "gap formation", and "negative step" (P<0.05; Friedman 2-way ANOVA).     

Hygroscopic expansion and solubility of composite restoratives.

OBJECTIVE: To quantify the changes of dimension (vol%), weight (microgram/mm(3)) and the solubility (microgram/mm(3)) of dental composite restorative materials after a period of 64 days immersed in de-ionized water or artificial saliva.METHOD: Six resin-based composite restorative materials were investigated. An organically modified ceramic (Definite((R))), an ion-leaching composite (Ariston pHc((R))), two high-density packable composites (Solitaire((R)) and SureFil((R))) and two sub-micron hybrid composites (Pertac II((R)) and Spectrum TPH((R))). Twelve disks of each test material were prepared, 10mm diameter by 1mm thickness. All specimens were kept dry for 48h during polymerization. Two control specimens of each group were kept in a desiccating chamber; five specimens in de-ionized water and five specimens in artificial saliva (Salivace((R)), Penn) at 37 degrees C. The diameter of each disc was measured automatically across 200 points by rotation through beam of a laser micrometer. These measurements, together with weight measurements, were carried out at intervals over a 64 day period. The equilibrium value at time infinity, the rate of change and the equilibrium solubility was calculated for each material.RESULTS: At 64 days, the mean dimensional change (vol%) after water immersion ranged between 0.15% (+/-0.05) for Pertac II((R)) to 2.39% (+/-0.6) for Ariston pHc((R)). Dimensional changes (vol%) values for specimens immersed in artificial saliva were significantly different only for the material Solitaire((R)) (p<0.05). Change in weight (microgram/mm(3)) values were significantly different (p<0.05), according to the immersing solution for the materials Solitarie((R)), Ariston pHc((R)) and Surefil((R)) At 64 days, all specimens gained weight with the exception of the material Ariston pHc((R)) that lost 20.57 microgram/mm(3) (+/-6.46). Only the specimens immersed in de-ionized water showed any significant dissolution of the material, with solubility values ranging up to 32.5 microgram/mm(3) (+/-2.7) for Ariston pHc((R)).SIGNIFICANCE: Currently available dental composite materials vary significantly in the post-placement expansion behavior demonstrating a lack of consensus view amongst developers as to the most desirable values that should be attained. The nature of the immersing solution in in vitro studies of this nature has a distinct effect on the results obtained for some materials.     

Fluoride release and uptake capacities of fluoride-releasing restorative materials

Many fluoride-releasing dental materials are being sold on the basis of their cariostatic properties. However, the amount fluoride release of these materials is still uncertain. This study investigated the fluoride release and uptake characteristics of four flowable resin composites (Heliomolar Flow, Tetric Flow, Wave, Perma Flo), one flowable compomer (Dyract flow), one conventional glass ionomer cement mixed with two different powder/liquid ratios (ChemFlex Syringeable and ChemFlex Condensable), one packable resin composite (SureFil), one ion-releasing composite (Ariston pHc) and one resin-modified glass ionomer cement (Vitremer). Seven discs (6-mm diameter and 1.5-mm height) were prepared for each material. Each disc was immersed in 3.5 ml of deionized water within a plastic vial and stored at 37 degrees C. The deionized water was changed every 24 hours and the release of fluoride was measured for 30 days. At the end of this period, the samples were recharged with 2 ml of 1.23% acidulated phosphate fluoride (APF) gel for four minutes. Then, all samples were reassessed for an additional 10 days. The fluoride release of all samples was measured with a specific fluoride electrode and an ionanalyzer. Statistical analyses were conducted using two-way repeated measure ANOVA and Duncan's multiple range tests. For all tested materials, the greatest fluoride release was observed after the first day of the study (p<0.01) but gradually diminished with time. During the test period, Tetric Flow released the lowest amount of fluoride; however, no statistically significant difference was found from Wave and Heliomolar Flow (p>0.05). Ariston pHc released the highest amount of fluoride, followed by ChemFlex Syringeable, Vitremer and ChemFlex Condensable. There were statistically significant differences among these materials (p<0.05). Fluoride release of all materials were significantly increased after the first day following refluoridation and Ariston pHc released the greatest among all materials (p<0.01). At the end of two days of refluoridation, the fluoride release rate for each material dropped quickly and stabilized within three days.     

Streptococcus mutans-induced secondary caries adjacent to glass ionomer cement, composite resin and amalgam restorations in vitro

The aim of this study was to define, in vitro, the potential to inhibit secondary caries of restorative materials currently used in dental practice. Standard cavities were prepared on the buccal and lingual surfaces of fifty extracted human third molars. The teeth were randomly divided into five groups, each one restored with one of the following materials: glass ionomer cement (GIC); amalgam; light-cured composite resin; ion-releasing composite; and light-cured, fluoride-containing composite resin. The teeth were thermocycled, sterilized with gamma irradiation, exposed to a cariogenic challenge using a bacterial system using Streptococcus mutans, and then prepared for microscopic observation. The following parameters were measured in each lesion formed: extension, depth, and caries inhibition area. The outer lesions developed showed an intact surface layer and had a rectangular shape. Wall lesions were not observed inside the cavities. After Analysis of Variance and Component of Variance Models Analysis, it was observed that the GIC group had the smallest lesions and the greatest number of caries inhibition areas. The lesions developed around Amalgam and Ariston pHc restorations had an intermediate size and the largest lesions were observed around Z-100 and Heliomolar restorations. It may be concluded that the restorative materials GIC, amalgam and ion-releasing composites may reduce secondary caries formation.     

Antibacterial activity of restorative dental biomaterials in vitro

This study investigated the antibacterial effects against Streptococcus mutans of a fine-hybrid resin composite (FH-RC; Tetric ceram), an ion-releasing resin composite (Ariston pHc), a self-curing glass ionomer cement (SC-GIC; Ketac-Molar), a resin-modified GIC (RM-GIC; Photac-Fil), and a zinc oxide eugenol cement (ZOE; IRM). In a novel assay, bacterial suspensions were placed into narrow 20-microl conical cavities within the materials. After 0, 4, 8, 24, 48 h and 1 week of incubation, the suspensions were removed from the restoratives and the numbers of viable bacteria were determined. After incubation periods of 8 h or more, all restorative materials except the FH-RC showed significant growth inhibition when compared with controls. The strongest antibacterial activity was observed with ZOE. The inhibitory effect of Ariston pHc was similar to that of the SC-GIC and the RM-GIC. In the second assay, growth inhibition was evaluated in liquid cultures by incubating eluates of the materials with suspensions of S. mutans. Bacterial growth was determined up to 6 h by measuring absorption at 600 nm. The most marked inhibitory effect was again observed with ZOE. The SC-GIC caused a significant inhibition at all time intervals but the FH-RC, the RM-GIC and Ariston pHc exhibited no significant antibacterial effects. It is recommended to employ more than one method for assessing the antibacterial potential of restorative materials. Long-term clinical trials are necessary to determine whether the antimicrobial effects of dental materials are able to reduce the risk of secondary caries formation.     

Evaluation of resin composite materials. Part I: in vitro investigations

PURPOSE: To evaluate different resin-based composites using a variety of in vitro investigation methods to predict their clinical behavior. METHODS: Materials selected for this study were Heliomolar radiopaque (microfilled), Tetric Ceram, Pertac II (minifilled hybrids), Ariston pHc (ion releasing hybrid), and Solitaire I (hybrid with porous fillers). The evaluated in vitro criteria were three-body wear according to the ACTA method, microtensile bond strengths to enamel and dentin, flexural strength (four-point bending strength), flexural fatigue behavior (flexural fatigue limit), and calcium ion release (for Ariston pHc). RESULTS: Concerning wear resistance, Ariston pHc (20.5 microm after 200,000 cycles) was inferior to the other materials (13.7-15.9 microm). Microtensile bond strengths to dentin were similar for Heliomolar (32.0 MPa), Tetric Ceram (30.4 MPa; both bonded with Syntac Classic), and Pertac II (30.8 MPa; bonded with EBS Multi) being above Solitaire I (22.5 MPa; bonded with Solidbond) being above Ariston pHc (13.2 MPa; bonded with Ariston Liner). Enamel bond strengths for Heliomolar (40.0 MPa), Tetric Ceram (36.5 MPa), and Pertac II (38.9 MPa) were significantly higher than for Solitaire I (26.6 MPa) which was above Ariston pHc (7.2 MPa). Heliomolar, Tetric Ceram, and Pertac II revealed higher micro-TBS to enamel than to dentin, Ariston showed the contrary, and Solitare exhibited no difference between enamel and dentin micro-TBS. Solitaire I exhibited a lower initial flexural strength than the other materials, the computed fatigue strength of the material even dropped to the level of glass ionomer cements (17.9 MPa). Long-term calcium release data for Ariston exhibited a continuously high calcium release becoming lower at the end of the observation beyond 21 months.     

The effect of post-curing on Vickers Hardness of four light-cure resin composite materials.

The use of post-curing ovens to post-cure light-cured resin composite restorations leads to a decrease in the negative effects of polymerization shrinkage and an increase in the hardness and wear resistance of the material. The aim of this study was to compare the Vickers Hardness (VH) of four different light-cure resin composite materials. In one group, samples of the four materials, Z100, Tetric Ceram, F2000 and Heliomolar were light-cured only, and in the other group a similar set of samples were light-cured and also post-cured in a DI 500 post-curing oven. VH vests were then carried out on the samples. All samples in the post-cured group had higher VH values (p = 0.000) than the corresponding samples in the light-cured only group. Z100 and F2000 had, in both groups, significantly higher VH values (p = 0.000) than Tetric Ceram and Heliomolar.     

FLUORIDE RELEASE OF SIX RESTORATIVE MATERIALS IN WATER AND pH-CYCLING SOLUTIONS

The fluoride release of restorative materials in deionized water has been the subject of many studies, but the behavior of these materials under conditions of acid challenge that simulates the oral cavity, needs to be further explored. Therefore, the aim of this study was to evaluate the fluoride release of restorative materials in two storage protocols: deionized water and pH- cycling system (demineralizing solution-pH 4.3 and remineralizing solution-pH 7.0) for 15 days. Eight disks of each material (Vitremer™-positive control, Dyract AP, Ariston pHc, Definite®, Tetric®Ceram and Z100-negative control) were prepared (11.0 mm x 1.5 mm) and suspended individually in 4.0 mL of each solution, which were daily changed. Daily fluoride release was analyzed with an ion specific electrode (Orion 9609) by the direct method or after HMDS-facilitated diffusion, following 1, 7 and 15 days. The values obtained were converted into μgF/mm² and the data analyzed by ANOVA and Tukey''s test (p< 0.05). The results showed that all materials released more fluoride in the pH-cycling system, except for Ariston pHc which maintained a constant release during the experiment. The highest fluoride release was presented by the positive control, Vitremer™ in pH- cycling and by Ariston pHc, in deionized water. The negative control Z100 and the resins Definite® and Tetric®Ceram did not present statistically significant differences.     

Effects of APF gel on the physical structure of compomers and glass ionomer cements

This study assessed the effect of an acidulated phosphate fluoride (APF) gel on the surfaces of eight modern esthetic restorative materials. Five specimens each of three high powder: liquid ratio conventional glass ionomer cements (ChemFlex, Fuji IX GP, Ionofil Molar), four polyacid-modified resin composites (compomers) (Compoglass F, Dyract AP, Freedom, F2000) and an alkaline glass filled resin composite (Ariston pHc) were prepared and immersed at 37 degrees C in 2 mL of artificial saliva for six weeks. The aged specimens were then coated with 1.23% APF gel for four minutes, rinsed and again immersed in artificial saliva for another six weeks. The immersed, fresh specimens for each material were then examined with SEM and surface profilometry. After APF gel application, mean surface roughness (Ra) measurements and SEMs showed that roughness increased significantly, generally from the resin composite and compomers to the conventional glass ionomer cements (p < 0.05).     

In vitro investigation of the performance of different restorative materials under cast circumferential clasps for removable dental prostheses

Objectives

The objective of this in vitro study was to investigate the behavior of different composite restorative materials under the load of cast circumferential clasps for removable dental prostheses (RDPs).

Methods

In 60 human molars, standardized mesial–occlusal–distal cavities were prepared. The cavities were restored with the following materials: Definite, Tetric Ceram, SureFil, Heliomolar RO, Ariston pHc, and Oralloy, and provided with a rest seat. The rest seats were subjected to 5,000 cycles of thermal cycling and 1,200,000 masticatory cycles in a mastication simulator via cobalt–chromium circumferential clasps cast to standardized frameworks in a laboratory model designed to simulate the biomechanics of a free-end denture base. Fracture analysis of the restorations was performed by light microscopy. Before and after loading, material wear was measured with a 3D-laser scanner, and an analysis of the marginal quality was performed in an SEM at ×200 applying the replica technique.

Results

No significant differences in the fracture behavior among the composite materials were found; the amalgam control group showed a significantly higher fracture resistance. Regarding the wear of the materials, the composites Definite and SureFil exhibited a behavior similar to that of amalgam. The other composites demonstrated higher wear rates. The initial marginal quality was significantly worse for Ariston pHc. The marginal adaptation decreased significantly after thermal and mechanical loading for Definite and Ariston pHc.

Conclusions

In terms of the investigated aspects of mechanical performance, the tested composites seemed to be inferior to amalgam. Further clinical studies are needed to evaluate the ability of composite restorations to provide support for RDP clasps.

Clinical relevance

The use of composites as direct restoration materials should be avoided in teeth, which serve as abutments for clasp-retained RDPs.     

Cytotoxicity evaluation of two different composites with/without fibers and one nanohybrid composite

In this study, cytotoxicity of two different composites with/without fibers (Adoro/Vectris and SculpturePlus/FiberKor) and one nanohybrid composite (Artglass) were investigated and compared. Composites used in the study were prepared as cylindrical discs of 2 mm depth and 8 mm diameter according to ISO 10993 recommendation. Adoro/Vectris and SculpturePlus/ FiberKor groups were divided into composite, fiber, and composite+fiber groups. Agar diffusion method was employed, and cytotoxicity rankings were determined using lysis index scores. For statistical analysis, Kruskal-Wallis and Mann-Whitney U tests were used. Amongst the composites, Adoro was found to be less cytotoxic than Sculpture Plus and Artglass materials--which were of the same cytotoxicity ranking. Between the fiber and composite materials, the former were found to be more cytotoxic than the latter; in particular, Vectris was found to be more cytotoxic than FiberKor. It was observed that upon combining with the fibers, the cytotoxic effect of the composites increased. This cytotoxicity enhancement was manifested as an additional effect in Adoro/Vectris group but as a synergistic effect in SculpturePlus/FiberKor group.     

Mechanical properties and wear behavior of light-cured packable composite resins.

OBJECTIVES: Determination of flexural strength, flexural modulus, fracture toughness and wear resistance of three packable composites (Solitaire, Surefil, ALERT) and a packable ormocer (Definite) in comparison with an advanced hybrid composite (Tetric Ceram) and an ion-releasing composite (Ariston pHc). METHODS: Flexural strength, flexural modulus and fracture toughness of each material were determined in three-point bending (each test n = 10). Single-edge notched-bend specimens were used to evaluate the fracture toughness (K1C). Wear of the materials (n = 8) was determined in a pin-on-block-design with a spherical Degusit antagonist at 50 N vertical load and quantified by a replica technique using a 3D-laser scanner. Replicas were made after 6000, 10,000, 30,000 and 50,000 load cycles. The mean wear rate (MWR (micron 3 cycle-1)) was obtained by a linear regression analysis in the steady-state of the time-wear-curve. All results were statistically analyzed with ANOVA and post hoc Tukey HSD tests (p < 0.05). RESULTS: ALERT exhibited the highest flexural modulus (12.5 +/- 2.1 GPa) and K1C (2.3 +/- 0.2 MN m-3/2), but the lowest wear resistance (8275 micron 3 cycle-1). Solitaire presented the highest wear resistance (1591 micron 3 cycle-1), but significantly lower flexural strength (81.6 +/- 10.0 MPa), flexural modulus (4.4 +/- 0.3 GPa), and K1C (1.4 +/- 0.2 MN m-3/2) than all other materials. Surefil revealed a significantly higher flexural modulus (9.3 +/- 0.9 GPa) and wear resistance (3028 micron 3 cycle-1) than Tetric Ceram (6.8 +/- 0.5 GPa; 5417 micron 3 cycle-1) and Ariston pHc (7.3 +/- 0.8 GPa; 7194 micron 3 cycle-1). SIGNIFICANCE: The tested packable composite resins differed significantly in their mechanical properties. This study suggested that fracture and wear behavior of the composite resins are highly influenced by the filler system. Overall, Surefil demonstrated good fracture mechanics parameters and a low wear rate.     

Initial in situ secondary caries formation: effect of various fluoride-containing restorative materials

This study evaluated the effects of various restorative materials (Ariston pHc; Dyract; Vitremer; Tetric Ceram; Compoglass F, F2000; Hytac and Ketac Molar) on initial secondary caries formation in situ. Eighty-eight enamel slabs from sound human molars were sterilized (ethylene dioxide) and embedded in epoxy resin. Standardized tooth preparations were filled with the various restorative materials according to manufacturers' recommendations. One specimen from each group was inserted into one of two buccal aspects of an intraoral appliance worn by 11 volunteers for four weeks, day and night. Oral hygiene was performed without additional fluoride application. During meals and oral hygiene procedures, the appliances were stored in sucrose solution (10%). After in situ exposure, the samples were prepared for microradiographic assessment. Mineral content and lesion depth were evaluated by a dedicated software package (TMR 1.24). Lesion depth and mineral loss of the carious lesions close to Ariston pHc was significantly lower when compared to distant parts of the same lesions (p < 0.05; t-test, Bonferroni-Holm correction). All other materials containing fluoride showed no caries protective effect on surrounding enamel (p > 0.05; t-test, Bonferroni-Holm correction). A hydroxyl-, calcium- and fluoride-containing restorative material hampers demineralization next to the restoration, whereas, fluoride release of various fluoride-containing restorative materials does not affect demineralization of adjacent enamel in situ.     

Effects of cyclic temperature changes on water sorption and solubility of composite restoratives

This study investigated the effects of cyclic temperature changes on the water sorption and solubility of four commercial composite resins (Silux Plus, Z100, Ariston pHc and Surefil). The methodology was based upon ISO 4049 procedures with modifications for specimen dimension and thermal-cycling. Eighteen disc specimens (10 +/- 1 mm diameter and 1 +/- 0.1 mm thick) were made for each composite and randomly divided into three groups. The specimens were stored in a desiccator maintained at 35 +/- 1 degrees C until a constant mass was achieved and treated as follows: Group 1--stored in distilled water at 356 degrees C for 178 hrs; Group 2--stored in distilled water at 35 degrees C for 173 hours and subjected to five hours of thermal-cycling with an upper temperature of 45 degrees C; and Group 3--stored in distilled water at 35 degrees C for 173 hours and subjected to five hours of thermal-cycling with an upper temperature of 60 degrees C. Mass after treatment was measured and specimens were re-conditioned to constant mass. The volume of the specimens was obtained and water sorption/solubility calculated. Data was analyzed using factorial ANOVA/Scheffe's post-hoc test at significance level 0.05. The effects of thermal-cycling on water sorption was material dependent. Thermal-cycling at an upper temperature of 60 degrees C significantly increased water sorption of Silux Plus. A significant increase in water sorption was also observed when Z100 was thermal-cycled at an upper temperature of 45 degrees C. The water sorption of Ariston pHc and Surefil was not affected by thermal-cycling. Thermal-cycling did not affect the solubility of all composites. For all treatment groups, Surefil had significantly lower water sorption than the other composites evaluated. The water sorption of Z100 and Surefil was significantly lower than Silux Plus and Ariston pHc.     

The volumetric fraction of inorganic particles and the flexural strength of composites for posterior teeth

OBJECTIVE: To evaluate the content of inorganic particles and the flexural strength of new condensable composites for posterior teeth in comparison to hybrid conventional composites. METHOD: The determination of the content of inorganic particles was performed by mass weighing of a polymerized composite before and after the elimination of the organic phase. The volumetric particle content was determined by a practical method based on Archimedes' principle, which calculates the volume of the composite and their particles by differential mass measured in the air and in water. The flexural strength of three points was evaluated according to the norm ISO 4049:1988. RESULTS: The results showed the following filler content: Alert, 67.26%; Z-100, 65.27%; Filtek P 60, 62.34%; Ariston pHc, 64.07%; Tetric Ceram, 57.22%; Definite, 54.42%; Solitaire, 47.76%. In the flexural strength test, the materials presented the following decreasing order of resistance: Filtek P 60 (170.02 MPa)>Z-100 (151.34 MPa)>Tetric Ceram (126.14 MPa)=Alert (124.89 MPa)>Ariston pHc (102.00 MPa)=Definite (93.63 MPa)>Solitaire (56.71 MPa). CONCLUSION: New condensable composites for posterior teeth present a concentration of inorganic particles similar to those of hybrid composites but do not necessarily present higher flexural strength.     

Fluoride release from esthetic restorative materials with and without adhesive.

OBJECTIVE: The purpose of this in vitro study was to compare the effect of surface coating containing fluoride on patterns and amounts of fluoride release from 5 esthetic restorative materials. METHOD AND MATERIALS: Twelve cylinders of each material were prepared in a plexiglass mold. The experimental groups (n = 6) were coated with 1 layer of fluoridated adhesive resin, Prompt L-Pop, while the control groups (n = 6) remained uncoated. Fluoride release into deionized water was measured on days 1, 2, 3, 7, 14, 21, and 28 using an ion analyzer. Results were evaluated statistically using repeated measure analysis of variance and Duncan test. RESULTS: In the uncoated materials, the highest fluoride-releasing material was a resin composite Ariston pHc (140.468 +/- 9.80) followed by Photac-fil (101.200 +/- 5.56), Ketac-fil (91.098 + 4.69), Hytac Aplitip (5.122 +/- 1.00), and Ecusit (0.310 +/- 0.18). Material-coating interaction was found to be significant, but the effect of surface coating was different for each material. Among the coated materials, conventional glass-ionomer cement Ketac-fil released the highest amount of fluoride (93.326 +/- 10.86), followed by Photac-fil (83.666 +/- 4.72), Ariston pHc (53.862 +/- 7.90), Hytac Aplitip (14.634 +/- 2.35), and Ecusit (1.355 +/- 0.29). CONCLUSION: Application of fluoridated adhesive affected fluoride release from each material in varying magnitudes.     

The suitability of packable resin-based composites for posterior restorations

BACKGROUND: Packable composites, promoted for the restoration of stress-bearing posterior teeth, have captured clinicians' interest. METHODS: The authors tested three packable composites (Alert, Jeneric/Pentron; Solitaire, Heraeus Kulzer, Wehrheim, Germany; SureFil, Dentsply De Trey, Konstanz, Germany); a new packable organically modified ceramic, or ormocer (Definite, Degussa AG, Hanau, Germany); a hybrid composite (Tetric Ceram, Ivoclar Vivadent, Schaan, Liechtenstein) and an ion-releasing composite (Ariston pHc, Ivoclar Vivadent, Schaan, Liechtenstein). They determined modulus of elasticity according to EN 24049:1993 of the European Committee for Standardization. They measured Vickers hardness using a 200-gram load for 40 seconds. To determine the materials' depth of cure, they used both a scraping method (International Standards Organization standard CD 4049:1997) and a hardness profiling method. RESULTS: The authors calculated means and standard deviations from 10 replications of each test and used one-way analysis of variance and post hoc Tukey tests (alpha = .05). The materials had significant differences (P < .001) in all characteristics. Solitaire had the significantly lowest elastic modulus and microhardness; Alert had the highest values for these characteristics. Ariston pHc exhibited the significantly lowest depth of cure. There was a significant correlation between the two methods of measuring depth of cure (r2 = 0.9945; P = .021). CONCLUSIONS: The material group of packable composites is rather inhomogeneous in terms of mechanical and physical data. Our data suggest that bulk curing of packable composites in deep cavities still is not recommendable. CLINICAL IMPLICATIONS: The clinician needs to select packable composites carefully, as it seems that not all of these materials quality for stress-loaded posterior restorations.     

pH stabilizing properties of a posterior light cured resin composite: an in vivo study

This study evaluated, in vivo, the pH stabilizing properties of a posterior resin composite (Ariston pHc, Vivadent Ets, Schaan/Liechtenstein). Fifteen human subjects with four or more active carious lesions were selected. Their salivary pH, in relation to the occlusal surface of these lesions, was recorded. The teeth were restored with resin composite, and the pH in relation to the restorations was recorded one day, one week, one month and two months postoperative. Results showed that the resin composite countered the acidic pH of saliva and maintained it at levels where demineralization would not occur.     

Cytotoxicity of composite resins polymerized with different curing methods

AIM: To compare the relative cytotoxicity of resin-based composite materials polymerized with three different curing methods on L 929 cells over a period of 1 week. METHODOLOGY: Ten discs of each material (Flowline, P 60 and Z 250) were cured from one side with either standard cure (Optilux 401), soft-start cure (Elipar Free Light) or fast cure (Hilux Ultra Plus). Then the samples were aged for 1, 2, 3, 5 and 7 days in Dulbecco's Modified Eagle Medium/Ham's F12 (DMEM/F12). After each ageing interval, cytotoxicity of the extracts to cultured fibroblasts (L 929) was measured by MTT assay. The degree of cytotoxicity for each sample was determined according to the reference value represented by the cells with a pure culture medium. Statistical significance was determined by one-way analysis of variance (anova), followed by the Student's Newman-Keuls test. RESULTS: Exposure of L 929 cells to the test materials resulted in a high survival fraction at 1 and 7 days. Flowline specimens, either cured with Optilux 401 or Elipar Free Light, had no toxic effect on the cells, whereas the other groups were moderately toxic on the 2-day interval. All experimental groups presented lower cell viability than the control at the 3- and 5-day intervals. CONCLUSIONS: The composite resins used in this study were cytotoxic after 48 h pre-incubation, but this toxicity disappeared after pre-incubation in a biological medium for 7 days. Curing did not have a significant effect on the cytotoxicity of the composite materials tested.     

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??Abstract: Objective To investigate the influence of light and chemical curing mode on polymerization capability (degree of polymerization and cross-link density) of dual cured flowable resin composites. Methods The plexiglas circles ( inner diameter: 5mm?? height:2mm ) were respectively injected and filled by dual cured flowable resin composite core build-up materials [ A ( Luxa Core ) ??B ( Clearfil DC Core )] and dual cured resin cement [ C ( DUOLINK )]?? then specimens for chemical curing mode were stored untreated at 37?? in the dark ??while specimens for light curing mode were immediately light-irradiated for 20 seconds before storage. Surface hardness numbers were detected at 0.5??24 and 120 hours post-curing time to compare degree of polymerization indirectly .After that the specimens were soaked in 100% ethanol for 24 hours and percentage of reduction of hardness was recorded to compare cross-link density indirectly. Data were analyzed by One-way ANOVA and independent T test. Results For the 3 materials hardness of both curing mode increased with the post-curing time (P<0.05) and attained to the maximum values at 120 hours post-curing time. Hardness of light-curing mode at 120 hours post-curing time was greater than that of chemical-curing mode [material A: light-cured mode (61.27 ± 2.14) MPa?? chemical-cured mode(39.26 ± 0.89) MPa?? P<0.05;material B: light-cured mode (66.94 ± 0.97)MPa?? chemical-cured mode( 44.18 ± 1.84) MPa?? P<0.05;material C??light-cured mode(64.21 ± 1.07)MPa?? chemical-cured mode(51.39 ± 1.22)MPa??P<0.05]. After soaking significant difference of percentage of reduction of hardness were detected between the 2 modes[material A: light-cured mode (19.58 ± 1.72)%?? chemical-cured mode (25.18 ± 2.82)%?? P<0.05;material B: light-cured mode (17.74 ± 1.75)%?? chemical-cured mode(24.56 ± 1.78)%?? P<0.05 ); material C : light-cured mode (23.10 ± 2.50)%?? chemical-cured mode(23.72 ± 1.65)%?? P = 0.658]. Conclusion For dual cured flowable resin composites?? curing mode exerts distinct influence on the degree of polymerization and cross-link density.