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This study aimed to compare the fracture toughness of molars with wide mesio-occlusal-distal (MOD) cavities restored with regular and flowable bulk-fill resin composite and a conventional resin composite after 250,000 mechanical cycles of chewing simulation. Thirty-two extracted mandibular third molars were selected and class II MOD cavities involving 2/3 of the intercuspal width and 4 mm depth were prepared. Teeth were divided into four groups based on resin composite type and insertion technique (n=8): (1) CT, unprepared teeth (control); (2) CV, conventional resin composite (Tetric N-Ceram, Ivoclar Vivadent) with incremental technique; (3) R-BF, regular bulk-fill resin composite (Tetric N-Ceram Bulk Fill, Ivoclar Vivadent) with a single increment; and (4) F-BF, flowable bulk-fill resin composite (Tetric N-Flow Bulk Fill, Ivoclar Vivadent) with a single increment, except for a 1-mm-thick layer at the occlusal surface, restored with conventional resin composite (Tetric N-Ceram). All specimens were evaluated to detect the presence and propagation of enamel cracks using a LED transilluminator before and after 250,000 mechanical cycles (SD Mechatronic GmbH). After a chewing simulation, they were subjected to a compressive force in a universal testing machine (DL-2000, EMIC) until fracture. The maximum fracture load of the specimens was measured (N) and the fracture patterns were classified based on the fracture site (above or below the cementoenamel junction [CEJ]). Data were statistically analyzed with one-way ANOVA. All specimens survived after 250,000 mechanical cycles, and no statistically significant differences among groups were observed regarding the fracture toughness (p<0.05). The fracture analysis demonstrated that failures below the CEJ were more common in CV (75%), while CT, R-BF, and F-BF showed this type of failure in 38%, 63%, and 63% of the specimens, respectively. The results of the crack analysis showed that the occurrence of new cracks and crack propagation was also higher in CV (33.3%), followed by R-BF, F-BF, and CT (14%, 14%, and 11% of the specimens, respectively). Teeth restored with regular and flowable bulk-fill composites showed similar fracture toughness after the chewing simulation compared to those restored with the conventional resin composite and unprepared teeth. Furthermore, teeth restored with both regular and flowable bulk-fill composites showed a lower incidence of enamel cracks and fractures below the CEJ compared to those restored with the conventional resin composite.

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This investigation aimed at developing micropatterned silica thin films (MSTFs) containing nanohydroxyapatite (nano-HA) microaggregates that were not completely covered by silica so that they could directly interact with the surrounding cells. The objectives were 1) to evaluate the effect of the presence of 2 films (MSTF with or without nano-HA addition) on the characteristic strength (σ0) and Weibull modulus ( m) of a yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) and 2) to evaluate the effect of these 2 films, as applied onto the Y-TZP surface, on the morphology, orientation, and proliferation of MG63 cells. Sol-gel process and soft lithography were used to apply the MSTF onto the Y-TZP specimens. Three experimental groups were produced: Y-TZP, Y-TZP + MSTF, and Y-TZP + MSTF + sprayed nano-HA. All surfaces were characterized by scanning electron microscopy and energy-dispersive X-ray spectroscopy and tested for 4-point flexural strength ( n = 30) in water at 37 °C. Weibull analysis was used to determine m and σ0 (maximum likelihood method). In vitro biological behavior was performed with human osteoblast-like cells (MG63). Y-TZP was successfully coated with MSFT and MSFT + nano-HA. Scanning electron microscopy micrographs indicated that the microaggregates of nano-HA were not entirely covered by the silica. There was no statistically significant difference among the experimental groups for σ0 and m. In the groups containing the films, the cells were elongated and aligned along the lines. The MSFT + nano-HA group showed significantly higher cell metabolic activity than that obtained for the Y-TZP group at day 7. This investigation was successful in producing an MSTF containing nano-HA microaggregates that remained exposed to the environment. The developed films did not jeopardize the structural reliability of a commercial Y-TZP, as confirmed by the Weibull statistics. The MG63 cells seeded over the films became elongated and aligned along the films' micropatterned lines. Y-TZP specimens coated with MSTF and nano-HA showed a higher cell metabolic activity and proliferation after 7 d of culture when compared with uncoated Y-TZP.

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This study evaluated the effects of low-temperature aging on the surface topography, phase transformation, biaxial flexural strength, and structural reliability of a ground Y-TZP ceramic. Disc-shaped specimens were manufactured and divided according to two factors: "grinding" - without grinding (as-sintered, Ctrl), grinding with an extra-fine diamond bur (25 µm Xfine) and coarse diamond bur (181 µm Coarse); and "low-temperature-aging" (absence or presence). Grinding was performed using a contra-angle handpiece under water-cooling. Aging was performed in an autoclave at 134 °C, under 2 bar, over a period of 20 h. Surface topography analysis showed an increase in roughness based on grit-size (Coarse>Xfine>Ctrl), and aging promoted different effects on roughness (Ctrl AgCoarse). Grinding and aging promoted an increase in the amount of m-phase, although different susceptibilities to degradation were observed. Weibull analysis showed an increase in characteristic strength after grinding (Coarse=Xfine>Ctrl); however, distinct effects were observed for aging (CtrlCoarse Ag). Weibull moduli were statistically similar. Grinding promoted an increase in characteristic strength as a result of an increase in m-phase content; when the Y-TZP surface was ground by coarse diamond burs followed by aging, characteristic strength was reduced, meaning the low-temperature degradation appeared to intensify for rougher Y-TZP surfaces.

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OBJECTIVES: The residual stress profile developed within the veneering ceramic during the manufacturing process is an important predicting factor in chipping failures, which constitute a well-known problem with yttria-tetragonal-zirconia polycrystal (Y-TZP) based restorations. The objectives of this study are to measure and to compare the residual stress profile in the veneering ceramic layered on three different polycrystalline ceramic framework materials: Y-TZP, alumina polycrystal (AL) and zirconia toughened alumina (ZTA). METHODS: The stress profile was measured with the hole-drilling method in bilayered disk samples of 19 mm diameter with a 0.7 mm thick Y-TZP, AL or ZTA framework and a 1.5mm thick layer of the corresponding veneering ceramic. RESULTS: The AL samples exhibited increasing compressive stresses with depth, while compressive stresses switching into interior tensile stresses were measured in Y-TZP samples. ZTA samples exhibited compressive stress at the ceramic surface, decreasing with depth up to 0.6mm from the surface, and then becoming compressive again near the framework. SIGNIFICANCE: Y-TZP samples exhibited a less favorable stress profile than those of AL and ZTA samples. Results support the hypothesis of the occurrence of structural changes within the Y-TZP surface in contact with the veneering ceramic to explain the presence of tensile stresses. Even if the presence of Y-TZP in the alumina matrix seems to negatively affect the residual stress profiles in ZTA samples in comparison with AL samples, the registered profiles remain positive in terms of veneer fracture resistance.

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OBJECTIVES: This study evaluated the degree of conversion (DC) and working time (WT) of two commercial, dual-cured resin cements polymerized at varying temperatures and under different curing-light accessible conditions, using Fourier transformed infrared analysis (FTIR). MATERIALS AND METHODS: Calibra (Cal; Dentsply Caulk) and Variolink II (Ivoclar Vivadent) were tested at 25°C or preheated to 37°C or 50°C and applied to a similar-temperature surface of a horizontal attenuated-total-reflectance unit (ATR) attached to an infrared spectrometer. The products were polymerized using one of four conditions: direct light exposure only (600 mW/cm(2)) through a glass slide or through a 1.5- or 3.0-mm-thick ceramic disc (A2 shade, IPS e.max, Ivoclar Vivadent) or allowed to self-cure in the absence of light curing. FTIR spectra were recorded for 20 min (1 spectrum/s, 16 scans/spectrum, resolution 4 cm(-1)) immediately after application to the ATR. DC was calculated using standard techniques of observing changes in aliphatic-to-aromatic peak ratios precuring and 20-min postcuring as well as during each 1-second interval. Time-based monomer conversion analysis was used to determine WT at each temperature. DC and WT data (n=6) were analyzed by two-way analysis of variance and Tukey post hoc test (p=0.05). RESULTS: Higher temperatures increased DC regardless of curing mode and product. For Calibra, only the 3-mm-thick ceramic group showed lower DC than the other groups at 25°C (p=0.01830), while no significant difference was observed among groups at 37°C and 50°C. For Variolink, the 3-mm-thick ceramic group showed lower DC than the 1-mm-thick group only at 25°C, while the self-cure group showed lower DC than the others at all temperatures (p=0.00001). WT decreased with increasing temperature: at 37°C near 70% reduction and at 50°C near 90% for both products, with WT reduction reaching clinically inappropriate times in some cases (p=0.00001). CONCLUSION: Elevated temperature during polymerization of dual-cured cements increased DC. WT was reduced with elevated temperature, but the extent of reduction might not be clinically acceptable.

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The objectives of this study include comparing the cement thickness and microleakage of Class II ceramic inlays built with three ceramic systems and verifying whether there was a correlation between those two variables. The ceramic systems used include: 1) Heat-pressed (IPS-Empress); 2) CAD-CAM (CEREC 2) and 3) Sintered (Colorlogic). Standardized MOD Class II inlay cavities with one proximal box extending below and the other extending above the cement-enamel junction (CEJ) were prepared in 30 extracted human molars and randomly assigned to three groups. The ceramic inlays were constructed according to manufacturer's instructions and cemented using a dual-cure resin cement (Variolink II). All teeth were mechanically cycled (100,000 cycles, 78N) and thermocycled (700 cycles, 5 degrees C-55 degrees C). After immersion in silver nitrate, the inlays were sectioned mesial-distally and evaluated with an optical microscope (40x). The cement thickness obtained by the Colorlogic system (enamel: 113 +/- 25 microm; dentin: 118 +/- 23 microm) was significantly higher than that obtained by CEREC (enamel: 78 +/- 14 microm; dentin: 87 +/- 13 microm) and Empress (enamel: 65 +/- 15 microm; dentin: 89 +/- 14 microm). Regarding dye penetration, there was no statistical difference among the three ceramic systems in enamel. At the dentin margins, the Colorlogic system resulted in a significantly higher penetration depth compared to CEREC and Empress, which had similar average values. No correlation was found between cement thickness and microleakage either in enamel or dentin for any of the ceramic systems.

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Dual-cured cements have been studied in terms of the hardness or degree of conversion achieved with different curing modes. However, little emphasis is given to the influence of the curing method on other mechanical properties. This study investigated the flexural strength, flexural modulus and hardness of four proprietary resin cements. Materials tested were: Enforce and Variolink II (light-, self- and dual-cured), RelyX ARC (self- and dual-cured) and C & B (self-cured). Specimens were fractured using a three-point bending test. Pre-failure loads corresponding to specific displacements of the cross-head were used for flexural modulus calculation. Knoop hardness (KHN) was measured on fragments obtained after the flexural test. Tests were performed after 24 h storage at 37 degrees C. RelyX ARC dual-cured showed higher flexural strength than the other groups. RelyX ARC and Variolink II depended upon photo-activation to achieve higher hardness values. Enforce showed similar hardness for dual- and self-curing modes. No correlation was found between flexural strength and hardness, indicating that other factors besides the degree of cure (e.g. filler content and monomer type) affect the flexural strength of composites. No statistical difference was detected in the flexural modulus among the different groups.

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STATEMENT OF PROBLEM: Fracture resistance, elastic modulus, and hydrolytic degradation resistance are important properties of indirect composite restorations. Composite systems developed specifically for indirect application are said to have enhanced mechanical properties due to their elevated monomer conversion. PURPOSE: This study evaluated the influence of shade and the effect of 30-day water storage on the flexural strength, flexural modulus, and hardness of 4 commercially available indirect composite systems and 1 composite used with the direct technique. MATERIAL AND METHODS: A variety of commercially available indirect resin composites (Artglass, Belleglass, Sculpture, and Targis) and 1 directly placed composite (Z100, control) were used. Specimens made with either incisal or dentin shade (n = 10) were fractured with a 3-point bending test. Pre-failure loads corresponding to specific displacements of the crosshead were used for flexural modulus calculation. Knoop hardness was measured on fragments (n = 3) obtained after the flexural test. Tests were performed after 24 hours and after a 30-day water storage at 37 degrees C. Flexural strength data were analyzed with the Weibull distribution. Flexural modulus and Knoop hardness data were analyzed with 3-way ANOVA and Tukey's post-hoc test (alpha=0.05). RESULTS: In general, the directly placed composite (Z100) demonstrated flexural strength similar to that of Artglass, Targis, and Sculpture. Belleglass presented the highest flexural strength (221.7 MPa for incisal shade after 24 hours storage; 95% confidence interval: 208.3-235.4). Z100 demonstrated the highest flexural modulus (range: 10.9 +/- 0.6 to 12.0 +/- 0.9 GPa) and Targis the lowest (range: 5.1 +/- 0.5 to 5.9 +/- 0.9 GPa). Sculpture was the only material that showed differences in flexural strength with respect to shade (incisal-24 hours: 149.8 MPa; incisal-30 days: 148.7 MPa; dentin-24 hours: 200.0 MPa; dentin-30 days: 177.9 MPa). The flexural modulus and hardness of the dentin shade of Sculpture were higher than those of the incisal shade after 30 days. Belleglass also showed a significant difference in flexural modulus (dentin-24 hours: 11.1 GPa; incisal-24 hours: 9.6 GPa). The effect of water storage was more evident on hardness since all composite systems softened after 30 days. Prolonged water storage decreased flexural strength only for Artglass-dentin and Z100, both incisal and dentin shades. Water aging did not affect the flexural modulus of any composite tested. CONCLUSION: In general, indirect composites did not show enhanced mechanical properties compared to the directly placed composite. Property differences due to shade were more evident for Sculpture. Prolonged water storage had a deleterious effect on the hardness of all composites tested. However, water storage did not affect the flexural strength of most of the indirect composites or the flexural modulus of any composite tested.

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PURPOSE: To determine the tensile bond strength of composite repairs applied to Artglass using different surface treatments. MATERIALS AND METHODS: Blocks of Artglass were embedded in PVC cylinders with self-cure acrylic resin and divided into 18 groups according to the surface treatment. Three mechanical treatments and six chemical treatments were combined. Mechanical treatments were: sandpaper, diamond bur and microetch. Chemical treatments were: Prime & Bond 2.1 (PB) only, phosphoric acid+PB, hydrofluoric acid (applied for 1 or 3 minutes) +PB, Artglass Liquid only and silane+PB. After surface treatment, a composite truncated cone (Charisma, shade A3) was built. Tensile test was carried out after 24 hrs storage in distilled water at 37 degrees C. Failure mode was assessed using a x 10 stereomicroscope. Artglass surfaces treated mechanically and their combination with phosphoric acid and hydrofluoric acid were analyzed by scanning electron microscopy (SEM). RESULTS: Two-way ANOVA revealed that there was no statistical difference in bond strength among the three mechanical treatments used, except for the groups where Artglass Liquid and silane were used. The use of phosphoric acid and Artglass Liquid did not improve the bond strength of the specimens compared to the groups where only PB was applied, regardless of the mechanical treatment. Hydrofluoric acid treatment for 1 and 3 minutes reduced the bond strength significantly compared to the other chemical treatments. The association of silane with microetching resulted in a statistically higher bond strength compared to all the other experimental groups. SEM analysis showed that the application of phosphoric acid failed to promote changes in mechanically treated samples. On the other hand, when hydrofluoric acid was associated to either diamond bur or microetching, the topography created by the mechanical treatment was at least partially destroyed.

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PURPOSE: To determine the tensile bond strength of three filled and two unfilled adhesives applied to bovine dentin. MATERIALS AND METHODS: Fragments of the labial dentin of bovine incisors were embedded in PVC cylinders with self-cure acrylic resin, and ground flat using 200 grit and 600 grit sandpaper. The following adhesive systems were tested (n=10): Prime & Bond NT, Prime & Bond NT dual cure, Prime & Bond 2.1, OptiBond Solo and Single Bond. A 3 mm-diameter bonding surface was delimited using a perforated adhesive tape. After etching with 37% phosphoric acid and adhesive application, a resin-based composite truncated cone (TPH, shade A3) was built. Tensile test was performed after 24 hrs storage in distilled water at 37 degrees C. Failure mode was accessed using a x10 magnification stereomicroscope. RESULTS: Weibull statistical analysis revealed significant differences in the characteristic strength between Single Bond and Prime & Bond NT dual cure, and between Single Bond and Prime & Bond 2.1. The Weibull parameter (m) was statistically similar among the five groups. Single Bond and Prime & Bond NT showed areas of dentin cohesive failure in most of the specimens. For OptiBond Solo, Prime & Bond NT dual cure and Prime & Bond 2.1 failure was predominantly adhesive.

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