Abstract Bulk-fill composites were introduced in dentistry to accelerate clinical procedures while providing adequate outcomes. Concerns regarding the use of bigger composite increments rely on the polymerization shrinkage and shrinkage stress, which may generate gaps on the adhesive interface and result in a reduced success rate. Objective: To evaluate the polymerization shrinkage stress of different bulk-fill resin composites and their elastic modulus. Materials and Methods: Fourteen specimens were made for each of the nine different resin composites (seven with 12 mm3 and seven with 24 mm3): Surefill SDR flow (SDR), X-tra Base (XB), Filtek Bulk Fill Flowable (FBF), Filtek Z350XT Flow (Z3F); Tetric Evo Ceram Bulk Fill (TBF), X-tra Fil (XF), Filtek Bulk Fill (FBP), Admira Xtra Fusion (ADM) and Filtek Z350 XT (Z3XT). Linear shrinkage stress was evaluated for 300 s with the aid of a linear shrinkage device adapted to a Universal Testing Machine. For each composite group, seven additional specimens (2x2x25 mm) were made and Young's modulus was evaluated with a 3-point bending device adapted in a Universal Testing Machine with 0.5 mm/min crosshead speed and 50 KgF loading cell. Results: For 12 mm3 specimens, three-way ANOVA showed that only SDR and TBF generated lower stress after 20 s. Considering 300 s, TBF, SDR, and XF generated the lowest stress, followed by ADM, FBP, XB, and FBF, which were similar to Z3XT. Z3F generated the highest stress values for all time points. Considering 24 mm3 specimens after 20 s, all bulk fill composites generated lower stress than Z3XT, except XB. After 300 s, SDR, FBP, and ADM generated the lowest stress, followed by TBF and XF. For elastic modulus, one-way ANOVA showed that FBF, SDR, Z3F, and ADM presented the lowest values, followed by XB and TBF. FBP, Z3XT, and XF presented the highest elastic modulus among the evaluated composites. Conclusions: Bulk-fill resin composites presented equal to lower shrinkage stress generation when compared to conventional composites, especially when bigger increments were evaluated. Bulk-fill composites showed a wide range of elastic modulus values, but usually similar to “regular” composites.

Abstract Objectives: The aim of this in vitro study was to evaluate the bonding strength of non-simplified dentin bonding systems (DBS) to dentin irradiated with a diode laser (970 nm) immediately and after 12 months of water storage following either primer or bond application. Material and methods: The experimental design included three different factors: DBS type [AdperTM Scotchbond Multipurpose (MP) and Clearfil™ SE Bond (CSE)], irradiation [without irradiation - control (C), irradiation after primer application (AP), and irradiation after bond application (AB)], and time [initial (I) and after 12 months of water storage (12 m)]. Sixty sound human third molars (n = 10) were obtained, and their flat occlusal dentin areas were prepared and standardized. Laser irradiation was performed in the contact mode perpendicular to the dental surface over an automatically selected scanning area at a pulse energy of 0.8 W, frequency of 10 Hz, and energy density of 66.67 J/cm2. After 7 days of treatment, the specimens were cut, and half of them were subjected to microtensile testing (500 N/0.05 mm/min), whereas the remaining sticks were examined after 12 months of water storage. The obtained data were analyzed by three-way analysis of variance (ANOVA) followed by a Tukey test (p<0.05). The observed fracture modes were investigated using a portable digital microscope with a magnification of 40x. Results: Among the utilized DBS, MP generally exhibited higher bond strengths, but did not always differ from CSE under similar conditions. The irradiation factor was statistically significant only for the MP/AB groups. After 12 months of storage, all groups demonstrated a significant reduction in the bond strength, whereas the results of fracture analysis showed a predominance of the adhesive type. Conclusions: The laser treatment of non-simplified DBS was not able to stabilize their bonding characteristics after 12 months.

Abstract Simplified dentin-bonding systems are clinically employed for most adhesive procedures, and they are prone to hydrolytic degradation. Objective This study aimed to investigate the effect of laser diode irradiation on the degree of conversion (DC), water sorption (WS), and water solubility (WSB) of these bonding systems in an attempt to improve their physico-mechanical resistance. Material and Methods Two bonding agents were tested: a two-step total-etch system [Adper™ Single Bond 2, 3M ESPE (SB)] and a universal system [Adper™ Single Bond Universal, 3M ESPE (SU)]. Square-shaped specimens were prepared and assigned into 4 groups (n=5): SB and SU (control groups – no laser irradiation) and SB-L and SU-L [SB and SU laser (L) – irradiated groups]. DC was assessed using Fourier transform infrared spectroscopy with attenuated total reflectance. Additional uncured resin samples (≈3.0 µL, n=5) of each adhesive were also scanned for final DC calculation. For WS/WSB tests, similar specimens (n=10) were prepared and measured by monitoring the mass changes after dehydration/water storage cycles. For both tests, adhesive fluids were dropped into standardized Teflon molds (6.0×6.0×1.0 mm), irradiated with a 970-nm laser diode, and then polymerized with an LED-curing unit (1 W/cm2). Results Laser irradiation immediately before photopolymerization increased the DC (%) of the tested adhesives: SB-L>SB>SU-L>SU. For WS/WSB (μg/mm3), only the dentin bonding system (DBS) was a significant factor (p<0.05): SB>SU. Conclusion Irradiation with a laser diode improved the degree of conversion of all tested simplified dentin bonding systems, with no impact on water sorption and solubility.

ABSTRACT The use of light sources in the bleaching process reduces the time required and promotes satisfactory results. However, these light sources can cause an increase in the pulp temperature. Objective The purpose of the present study was to measure the increase in intrapulpal temperature induced by different light-activated bleaching procedures with and without the use of a bleaching gel. Material and Methods A human maxillary central incisor was sectioned 2 mm below the cementoenamel junction. A K-type thermocouple probe was introduced into the pulp chamber. A 35% hydrogen peroxide bleaching gel was applied to the vestibular tooth surface. The light units used were a conventional halogen, a hybrid light (only LED and LED/Laser), a high intensity LED, and a green LED light. Temperature increase values were compared by two-way ANOVA and Tukey´s tests (p<0.05). Results There were statistically significant differences in temperature increases between the different light sources used and between the same light sources with and without the use of a bleaching gel. The presence of a bleaching gel generated an increase in intra-pulpal temperature in groups activated with halogen light, hybrid light, and high intensity LED. Compared to the other light sources, the conventional halogen lamp applied over the bleaching gel induced a significant increase in temperature (3.83±0.41°C). The green LED unit with and without gel application did not produce any significant intrapulpal temperature variations. Conclusion In the present study, the conventional halogen lamp caused the highest increase in intrapulpal temperature, and the green LED caused the least. There was an increase in temperature with all lights tested and the maximum temperature remained below the critical level (5.5°C). The addition of a bleaching gel led to a higher increase in intrapulpal temperatures.

Increased surface roughness and wear of resin cements may cause failure of indirect restorations. The aim of this study was to evaluate quantitatively the surface roughness change and the vertical wear of four resin cements subjected to mechanical toothbrushing abrasion. Ten rectangular specimens (15 × 5 × 4 mm) were fabricated according to manufacturer instructions for each group (n = 10): Nexus 3, Kerr (NX3); RelyX ARC, 3M ESPE (ARC); RelyX U100, 3M ESPE (U100); and Variolink II, Ivoclar/Vivadent (VL2). Initial roughness (Ra, µm) was obtained through 5 readings with a roughness meter. Specimens were then subjected to toothbrushing abrasion (100,000 cycles), and further evaluation was conducted for final roughness. Vertical wear (µm) was quantified by 3 readings of the real profile between control and brushed surfaces. Data were subjected to analysis of variance, followed by Tukey’s test (p < 0.05). The Pearson correlation test was performed between the surface roughness change and wear (p < 0.05). The mean values of initial/final roughness (Ra, µm)/wear (µm) were as follows: NX3 (0.078/0.127/23.175); ARC (0.086/0.246/20.263); U100 (0.296/0.589/16.952); and VL2 (0.313/0.512/22.876). Toothbrushing abrasion increased surface roughness and wear of all resin cements tested, although no correlation was found between those variables. Vertical wear was similar among groups; however, it was considered high and may lead to gap formation in indirect restorations.

Laser irradiation after the immediate application of dentin bonding systems (DBSs) and prior to their polymerization has been proposed to increase bond strength. The objective of this study was to evaluate the effect of diode laser irradiation (λ = 970 nm) on simplified DBSs through microtensile bond strength tests. Forty healthy human molars were randomly distributed among four groups (n = 10) according to DBSs used [Adper™ SingleBond 2 (SB) and Adper™ EasyOne (EO)], and the respective groups were irradiated with a diode laser (SB-L and EO-L). After bonding procedures and composite resin build-ups, teeth were stored in deionized water for 7 days and then sectioned to obtain stick-shaped specimens (1.0 mm2). The microtensile test was performed at 0.5 mm/min, yielding bond strength values in MPa, which were evaluated by two-way ANOVA followed by Tukey’s test (p < 0.05) for individual comparisons. For both adhesive systems, diode laser irradiation promoted significant increases in bond strength values (SB: 33.49 ± 6.77; SB-L: 43.69 ± 8.15; EO: 19.67 ± 5.86; EO-L: 29.87 ± 6.98). These results suggest that diode laser irradiation is a promising technique for achieving better performance of adhesive systems on dentin.

Concern has been raised about the bonding of restorative procedures to an erosive lesion, given the change in organic and inorganic composition and structure of this substrate. This in vitro study evaluated the effect of erosive drinks and an enzyme inhibitor (2% chlorhexidine digluconate – 2% CHX) on bond strength to dentin. Sixty sound human third molars were selected, and the occlusal enamel was flattened, exposing the dentin surface. The specimens were randomly divided into three groups: AS-Artificial saliva (control group), RC- Regular Cola and ZC- Zero Cola. Twenty specimens were immersed in their respective solution for 1 minute, 3 times a day, over the course of 5 days. After acid etching and before bonding with Adper Single Bond 2, half of the samples of each group (n = 10) were treated with 2% CHX, whereas the other half (n = 10) were not, forming the control group (CONV). All the specimens were restored with Filtek Z250 composite resin filled in Tygon tubes (0.48 mm2), yielding six microcylinders for microshear bond strength testing. Three composite resin microcylinders of each specimen were tested after 1 month, and the remaining microcylinders were tested after 6 months. Failure modes were determined using a stereomicroscope (40x). The data were statistically analyzed by three-way ANOVA and Tukey tests (α = 0.05). Overall bonding was reduced after 6 months, regardless of treatment. The 2% CHX enhanced bond strength after 1 month only in the ZC group, and did not enhance bonding performance to demineralized dentin by erosive protocol after 6 months in any group.

Preocupação com a contração de polimerização de resinas compostas restauradoras também tem sido associada aos cimentos resinosos. O objetivo deste artigo foi avaliar a influência do volume e do modo de polimerização sobre as forças geradas durante a contração de polimerização (FGPS) de cimentos resinosos. Dois cimentos de ativação dual: Variolink II (VL - Ivoclar Vivadent) e Nexus 3 (NX - Kerr) e dois de ativação química: Multilink (ML - Ivoclar Vivadent) e Cement Post (CP - Angelus) foram inseridos entre as duas bases de aço retangulares (6x2 mm) com a distância ajustada em 0,1, 0,3 e 0,5 mm, estabelecendo uma variação no volume. Estas bases de aço foram fixadas a uma máquina de teste universal (Emic DL 500, com célula de carga de 50 kg) e as forças (N) foram registradas por 10 min. Os valores máximos de tensões geradas por cada material foram submetidas à ANOVA a dois critérios, seguido do teste de Tukey (p<0,05) para comparações individuais. VL, NX e CP desenvolveram maiores FGPS quando o volume de material aumentou, enquanto ML apresentou o comportamento inverso. Maiores volumes aumentam as FGPS mesmo com redução concomitante do Fator-C, a menos que o cimento resinoso apresente uma baixa taxa de geração de força em função do tempo associado a um baixo Fator-C, o que resulta em alívio das tensões e consequentemente menores valores de FGPS.

The concern with the polymerization shrinkage of restorative resin composites also applies to resin cements. The aim of this study was to evaluate the influence of volume and polymerization mode on forces generated during polymerization shrinkage (FGPS) of resin cements. Two light-cured resin cements - Variolink II (VL; Ivoclar Vivadent) and Nexus 3 (NX; Kerr) - and two self-cured resin cements - Multilink (ML; Ivoclar Vivadent) and Cement Post (CP; Angelus) - were inserted between two rectangular steel bases (6x2 mm) with distance set at 0.1, 0.3 and 0.5 mm, establishing a variation of volume. These steel bases were attached to a universal test machine with 50 kg load cell and forces (N) were registered for 10 min. Values of maximum forces generated by each material were subjected to two-way ANOVA and Tukey's test for individual comparisons (α=0.05). VL, NX and CP developed increasing FGPS as the volume of material increased, while ML presented the opposite behavior. It may be concluded that higher volume increases FGPS even with a concomitant decrease of C-factor, unless the resin cements present lower force generation rates as a function of time in combination with a low C-factor, resulting in stress relief and consequently lower values of FGPS.

OBJECTIVES: This study evaluated the influence of the cavity configuration factor ("C-Factor") and light activation technique on polymerization contraction forces of a Bis-GMA-based composite resin (Charisma, Heraeus Kulzer). MATERIAL AND METHODS: Three different pairs of steel moving bases were connected to a universal testing machine (emic DL 500): groups A and B - 2x2 mm (CF=0.33), groups C and D - 3x2 mm (CF=0.66), groups e and F - 6x2 mm (CF=1.5). After adjustment of the height between the pair of bases so that the resin had a volume of 12 mm³ in all groups, the material was inserted and polymerized by two different methods: pulse delay (100 mW/cm² for 5 s, 40 s interval, 600 mW/cm² for 20 s) and continuous pulse (600 mW/cm² for 20 s). Each configuration was light cured with both techniques. Tensions generated during polymerization were recorded by 120 s. The values were expressed in curves (Force(N) x Time(s)) and averages compared by statistical analysis (ANOVA and Tukey's test, p<0.05). RESULTS: For the 2x2 and 3x2 bases, with a reduced C-Factor, significant differences were found between the light curing methods. For 6x2 base, with high C-Factor, the light curing method did not influence the contraction forces of the composite resin. CONCLUSIONS: Pulse delay technique can determine less stress on tooth/restoration interface of adhesive restorations only when a reduced C-Factor is present.

OBJECTIVES: Nanofilled composite resins are claimed to provide superior mechanical properties compared with microhybrid resins. Thus, the aim of this study was to compare nanofilled with microhybrid composite resins. The null hypothesis was that the size and the distribution of fillers do not influence the mechanical properties of surface roughness and wear after simulated toothbrushing test. MATERIAL AND METHODS: Ten rectangular specimens (15 mm x 5 mm x 4 mm) of Filtek Z250 (FZ2), Admira (A), TPH3 (T),Esthet-X (EX), Estelite Sigma (ES), Concept Advanced (C), Grandio (G) and Filtek Z350 (F) were prepared according to manufacturer's instructions. Half of each top surface was protected with nail polish as control surface (not brushed) while the other half was assessed with five random readings using a roughness tester (Ra). Following, the specimens were abraded by simulated toothbrushing with soft toothbrushes and slurry comprised of 2:1 water and dentifrice (w/w). 100,000 strokes were performed and the brushed surfaces were reanalyzed. Nail polish layers were removed from the specimens so that the roughness (Ra) and the wear could be assessed with three random readings (µm). Data were analyzed by ANOVA and Tukey's multiple-comparison test (α=0.05). RESULTS: Overall outcomes indicated that composite resins showed a significant increase in roughness after simulated toothbrushing, except for Grandio, which presented a smoother surface. Generally, wear ofnanofilled resins was significantly lower compared with microhybrid resins. CONCLUSIONS: As restorative materials suffer alterations under mechanical challenges, such as toothbrushing, the use of nanofilled materials seem to be more resistant than microhybrid composite resins, being less prone to be rougher and worn.

This study evaluated color change, stability, and tooth sensitivity in patients submitted to different bleaching techniques. MATERIAL AND METHODS: In this study, 48 patients were divided into five groups. A half-mouth design was conducted to compare two in-office bleaching techniques (with and without light activation): G1: 35% hydrogen peroxide (HP) (Lase Peroxide - DMC Equipments, São Carlos, SP, Brazil) + hybrid light (HL) (LED/Diode Laser, Whitening Lase II DMC Equipments, São Carlos, SP, Brazil); G2: 35% HP; G3: 38% HP (X-traBoost - Ultradent, South Jordan UT, USA) + HL; G4: 38% HP; and G5: 15% carbamide peroxide (CP) (Opalescence PF - Ultradent, South Jordan UT, USA). For G1 and G3, HP was applied on the enamel surface for 3 consecutive applications activated by HL. Each application included 3x3' HL activations with 1' between each interval; for G2 and G4, HP was applied 3x15' with 15' between intervals; and for G5, 15% CP was applied for 120'/10 days at home. A spectrophotometer was used to measure color change before the treatment and after 24 h, 1 week, 1, 6, 12, 18 and 24 months. A VAS questionnaire was used to evaluate tooth sensitivity before the treatment, immediately following treatment, 24 h after and finally 1 week after. RESULTS: Statistical analysis did not reveal any significant differences between in-office bleaching with or without HL activation related to effectiveness; nevertheless the time required was less with HL. Statistical differences were observed between the results after 24 h, 1 week and 1, 6, 12, 18 and 24 months (intergroup). Immediately, in-office bleaching increased tooth sensitivity. The groups activated with HL required less application time with gel. CONCLUSION: All techniques and bleaching agents used were effective and demonstrated similar behaviors.

OBJECTIVES: This in vitro study evaluated the fracture resistance of weakened human premolars (MOD cavity preparation and pulp chamber roof removal) restored with condensable resin composite with and without cusp coverage. MATERIAL AND METHODS: Thirty human maxillary premolars were divided into three groups: Group A (control), sound teeth; Group B, wide MOD cavities prepared and the pulp chamber roof removed and restored with resin composite without cusp coverage; Group C, same as Group B with 2.0 mm of buccal and palatal cusps reduced and restored with the same resin. The teeth were included in metal rings with self-curing acrylic resin, stored in water for 24 h and thereafter subjected to a compressive axial load in a universal testing machine at 0.5 mm/min. RESULTS: The mean fracture resistance values ± standart deviation (kgf) were: group A: 151.40 ± 55.32, group B: 60.54 ± 12.61, group C: 141.90 ± 30.82. Statistically significant differences were found only between Group B and the other groups (p<0.05). The condensable resin restoration of weakened human premolars with cusp coverage significantly increased the fracture resistance of the teeth as compared to teeth restored without cusp coverage. CONCLUSION: The results showed that cusp coverage with condensable resin might be a safe option for restoring weakened endodontically treated teeth.