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OBJECTIVES: To investigate the effect of rapid high-intensity light-curing on the marginal integrity of four bulk-fill composites, including two materials specifically designed for high-intensity curing. METHODS: Class V cavities were prepared on buccal surfaces of intact human molars with simulated pulpal pressure, filled in a single increment and light-cured using a conventional (10 s @ 1,340 mW/cm2) or high-intensity (3 s @ 3,440 mW/cm2) protocol. The restorations were subjected to thermo-mechanical loading (TML) comprising 1,200,000 mechanical loading cycles and 3,000 thermocycles. Quantitative margin analysis was performed before and after TML using a scanning electron microscope, and the marginal integrity was expressed as percentage of continuous margin (PCM). RESULTS: All PCM values measured before TML were statistically similar regardless of the material and curing protocol (p>0.05). A statistically significant effect of the curing protocol (p = 0.021) was identified only after TML for one material. PCM was significantly diminished by TML (p<0.001) for most combinations of material and curing protocol. The PCM values of the sculptable composites after TML were statistically similar regardless of the curing protocol (p>0.05). Compared to these values, significantly lower PCM after TML was identified for the flowable composites cured with the high-intensity protocol (p = 0.001-0.045). CONCLUSION: In most cases, high-intensity and conventional curing generally led to similar marginal integrity. Although all of the investigated composites initially performed similarly well, the flowable composites light-cured using the high-intensity protocol showed a significantly inferior marginal integrity compared to the sculptable composites after loading. CLINICAL SIGNIFICANCE: Rapid high-intensity light-curing cannot be recommended for flowable bulk-fill composites since it may compromise the tooth-restoration interface.

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OBJECTIVES: To evaluate the degree of conversion, light transmittance, and depth of cure of two experimental light-curable bioactive glass (BG)-containing composite series based on different resin systems. METHODS: Experimental composite series based on either Bis-EMA or UDMA resin were prepared. Each series contained 0, 5, 10, 20, and 40wt% of BG 45S5. Reinforcing fillers were added up to a total filler load of 70wt%. The degree of conversion was evaluated using Raman spectroscopy, while light transmittance was measured using visible light spectroscopy. The depth of cure was estimated from the degree of conversion data and using the ISO 4049 scraping test. RESULTS: Replacement of reinforcing fillers with BG can diminish the degree of conversion, light transmittance, and depth of cure. The effect of BG on the aforementioned properties was highly variable between the experimental series. While in the Bis-EMA series, the degree of conversion was significantly impaired by BG, all of the composites in the UDMA series attained clinically acceptable degree of conversion values. The reduction of the degree of conversion in the Bis-EMA series occurred independently of the changes in light transmittance. The UDMA series showed better light transmittance and consequently higher depth of cure than the Bis-EMA series. The depth of cure for all composites in the UDMA series was above 2mm. SIGNIFICANCE: While the Bis-EMA series demonstrated clinically acceptable curing potential only for 0-10wt% of BG loading, an excellent curing potential in the UDMA series was observed for a wide range (0-40wt%) of BG loadings.

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Resin composites containing reinforcing inert glass fillers combined with bioactive glass (BG) can aid in the prevention of secondary caries, which is a major cause of failure of contemporary composite restorations. A series of previous studies on experimental resin composites filled with BG 45S5 has demonstrated that methacrylate resin polymerization can be impaired by the addition of unsilanized BG, leading to lower degrees of conversion (DC). In order to distinguish whether the polymerization inhibition is caused by a direct (temperature-independent) effect of BG or an indirect (temperature-dependent) effect of restricted mobility of reactive species, this study used Raman spectroscopy to evaluate the DC values of experimental composites post-cured at 37 °C and 150 °C. The potential of BG to adversely affect DC was highly dependent on the resin system. The highest DC reduction was observed in the resin system based on ethoxylated bisphenol A dimethacrylate (Bis-EMA), followed by bisphenol A glycidyl methacrylate (Bis-GMA). In contrast, the DC for urethane dimethacrylate (UDMA) was not compromised by BG. Increasing the mobility of reactive species by heating at 150 °C showed limited potential for increasing the DC in the Bis-EMA and Bis-GMA resin systems, indicating a direct inhibitory effect of BG on polymerization.

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OBJECTIVES: To evaluate the effect of excitation laser power in Raman spectrometry by comparing the spectra and the degree of conversion (DC) values obtained using excitation powers between 300 and 1000mW. METHODS: Five commercial and three experimental resin composites were light cured at 1200mW/cm2 for 10-20s from a commercial blue-violet LED dental curing unit. Raman spectra were collected from composite specimens within 9min after light-curing. The excitation laser (1064nm) was focused on the spot of 0.4mm in diameter. The following powers were used for specimen excitation (mW): 300, 400, 600, 800, and 1000. From Raman spectra, the DC values were calculated and compared among different laser powers. Also, vector-normalized Raman spectra collected using the lowest excitation power (300mW) were compared to those collected using the maximum excitation power (1000mW). RESULTS: Varying the excitation laser power between 300 and 1000mW resulted in statistically significant differences in both the DC values and the intensity of particular spectral features. The effect of varying laser power on Raman spectra and obtained DC values was material-dependent. The DC values measured within an individual material using different laser powers varied between 3.2 and 7.2% (absolute DC difference). The spectral bands affected by variations in laser power were assigned to symmetric and asymmetric stretching of -CH2 (2900-3100cm-1), symmetric stretching of aliphatic CC (1640cm-1) and scissoring of C-H (1458cm-1). SIGNIFICANCE: The DC can be artificially elevated through increasing excitation laser power. This effect should be considered in Raman spectroscopic evaluations of DC in specimens during ongoing post-cure polymerization.

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The aim of this study was to evaluate water sorption and solubility of two series of experimental composites containing amorphous calcium phosphate (ACP) or bioactive glass (BG). Water sorption and solubility were measured for up to 287 days. The surface precipitation of calcium phosphates was evaluated by scanning electron microscopy. The ACP-series showed higher water sorption (223-568 µg/mm3) than the BG-series (40-232 µg/mm3). In contrast, the ACP-series had generally lower solubility (37-106 µg/mm3) than the BG-series (1-506 µg/mm3). The constant specimen mass for the ACP-series was attained after 14 days of water immersion, while the mass decrease due to long-term solubility in the BG-series lasted beyond 287 days. Calcium phosphates precipitated in composites with the BG filler loading of 10 wt% or more, as well as in all of the ACP-containing composites. The experimental composite series showed water sorption and solubility considerably higher than commercial materials.

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OBJECTIVE: To investigate the real-time temperature rise during light-curing of experimental composite materials containing bioactive glass 45S5 (BG) and compare it to the temperature rise in three commercial composites. MATERIALS AND METHODS: Five light-curable composite materials containing 0-40 wt% of BG and a total filler load of 70 wt% were prepared. Cylindrical composite specimens 6 mm in diameter and 2 mm thick were cured using Bluephase G2 (Ivoclar Vivadent) at 1200 mW/cm2 for 30 s. The rise in temperature during light-curing was measured at the bottom of the specimens using a T-type thermocouple at the data collection rate of 20 s -1. An additional illumination for 30 s was performed after the specimen temperature returned to the baseline in order to record the temperature rise due to the heating from the curing unit. Statistical analysis was performed using the one-way ANOVA and Pearson correlation analysis with α=0.05. RESULTS: Temperature rise during light-curing of experimental composites amounted to 12.2-14.0 °C and was comparable to that of the flowable commercial composite (12.5 °C) but higher than that of nano- and micro-hybrid commercial composites (9.6-10.3 °C). The temperature rise during the second illumination was similar for all composites (7.8-9.1 °C). In experimental composites, the temperature rise which was attributable to the polymerization exotherm amounted to 3.1-5.8 °C and was negatively correlated to the BG fraction (R2=0.94). Times at which temperature reached maximum values were in the range of 6.5-19.8 s and were positively correlated to the BG fraction (R2=0.98). CONCLUSIONS: Temperature rise during light-curing of experimental composites was comparable to that of commercial composites, suggesting that the amount of heat released is tolerable by dental pulp.

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OBJECTIVES: The aim of this work was to investigate the curing potential of an experimental resin composite series with the systematically varying amount of bioactive glass 45S5 by evaluating the degree of conversion, light transmittance and depth of cure. METHODS: Resin composites based on a Bis-GMA/TEGDMA resin with a total filler load of 70 wt% and a variable amount of bioactive glass (0-40 wt%) were prepared. The photoinitiator system was camphorquinone and ethyl-4-(dimethylamino) benzoate. The degree of conversion and light transmittance were measured by Raman spectroscopy and UV-vis spectroscopy, respectively. The depth of cure was evaluated according to the classical ISO 4049 test. RESULTS: The initial introduction of bioactive glass into the experimental series diminished the light transmittance while the further increase in the bioactive glass amount up to 40 wt% caused minor variations with no clear trend. The curing potential of the experimental composites was similar to or better than that of commercial resin composites. However, unsilanized bioactive glass fillers demonstrated the tendency to diminish both the maximum attainable conversion and the curing efficiency at depth. CONCLUSIONS: Experimental composite materials containing bioactive glass showed a clinically acceptable degree of conversion and depth of cure. The degree of conversion and depth of cure were diminished by bioactive glass fillers in a dose-dependent manner, although light transmittance was similar among all of the experimental composites containing 5-40 wt% of bioactive glass. CLINICAL SIGNIFICANCE: Reduced curing potential caused by the bioactive glass has possible consequences on mechanical properties and biocompatibility.

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OBJECTIVES: To investigate the long-term development of the post-cure degree of conversion (DC) for two flowable bulk-fill composites. MATERIALS AND METHODS: Tetric EvoFlow Bulk Fill (TEFBF) and SDR were chosen due to their distinct compositional modifications that enable the decrease of translucency during polymerization and lower polymerization rate, respectively. DC was assessed using FT-Raman spectroscopy at the post-cure times of 0 h, 24 h, 7 d and 30 d. The post-cure behavior was analyzed by a mixed model ANOVA and partial eta-squared statistics. RESULTS: DC ranged from 61.3-81.1% for TEFBF and 58.9-81.6% for SDR. The initial (0 h) DC was significantly lower at a depth of 4 mm than at a depth of 1 mm (4.9% for SDR and 11.1% for TEFBF). Both materials presented a significant post-cure DC increase, up to 16.4% for TEFBF and 20.6% for SDR. The post-cure DC development was depth-dependent for TEFBF, but not for SDR. The post-cure DC increase was observed during 24 h for TEFBF and 7 d for SDR. CONCLUSIONS: Some of the bulk-fill composites may need longer times than the commonly accepted 24 h to reach the final conversion. This may be attributed to their compositional modifications that are mostly undisclosed by manufacturers. Our findings imply that investigations commonly performed 24 h post-cure may underestimate some of the bulk-fill composite properties, if these are affected by the slowly-developing DC. Reactive species may also be available for leaching out of the restoration during an extended time period, with possible implications on biocompatibility.