Short-term effect of adhesive system on clinical performance of bulk fill composite

Aim: Although bulk fill composites have been widely used as restorative material, there is no consensus regarding the best clinical protocol in terms of composite technique and adhesive system. Therefore, this clinical trial evaluated the clinical performance of bulk fill composites for class I restorations under different protocols. Methods: A randomized clinical trial including 155 class I restorations was conducted using different adhesive systems: conventional technique (phosphoric acid + conventional three-step adhesive system) (Group 1, 2 and 3); or self-etching adhesive system (Groups 4, 5 and 6). Control groups 1 and 4 were restored with conventional composite; groups 2 and 5 with low viscosity bulk fill and conventional composite as occlusal coverage; groups 3 and 6 with high viscosity bulk fill. The FDI criteria was used for clinical evaluation at baseline and after 6 months. Results: All groups showed good clinical performance. At baseline, the adhesive system did not affect postoperative hypersensitivity. After 6 months, group 5 showed a significant reduction in color and translucency; group 6 a reduction in terms of anatomical form and for postoperative sensitivity and an improvement in patient satisfaction (p<0.05). Considering the same restorative technique, the use of the self-etching adhesive system showed a significant decrease in color and translucency (p<0.05). Conclusion: All groups showed favorable clinical performance, and promising results were found for the conventional adhesive system and high viscosity bulk fill protocol.

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Impact of Resin Composite Viscosity and Fill-technique on Internal Gap in Class I Restorations: An OCT Evaluation

Operative Dentistry ◽

10.2341/20-144b-l ◽

2021 ◽

Author(s):

KR Kantovitz ◽

LL Cabral ◽

NR Carlos ◽

AZ de Freitas ◽

DC Peruzzo ◽

...

Keyword(s):

Repeated Measures ◽

Resin Composite ◽

Oral Care ◽

High Viscosity ◽

Class I ◽

Low Viscosity ◽

Significant Difference ◽

Before And After ◽

Internal Adaptation ◽

Internal Gap

SUMMARY The aim of this in vitro study was to quantitatively evaluate the internal gap of resin composites of high-and low-viscosity used in single- and incremental-fill techniques in Class I cavities exposed to thermal cycling (TC) using optical coherence tomography (OCT). Cavities of 4-mm depth and 3-mm diameter were prepared in 36 third molars randomly distributed into four groups, according to viscosity of restorative resin-based composite (high or low viscosity, all from 3M Oral Care) and technique application (bulk or incremental fill) used (n=9): RC, high-viscosity, incremental-fill, resin-based composite (Filtek Z350 XT Universal Restorative); BF, high-viscosity, bulk-fill, resin-based composite (Filtek One Bulk Fill); LRC, low-viscosity, incremental-fill, resin-based composite (Filtek Z350 XT Flowable Universal Restorative); and LBF, low-viscosity, bulk-fill, resin-based composite (Filtek Flowable Restorative). Single Bond Universal Adhesive system (3M Oral Care) was used in all the experimental groups. The incremental-fill technique was used for RC and LRC groups (2-mm increments), and a single-layer technique was used for BF and LBF groups, as recommended by the manufacturer. The internal adaptation of the resin at all dentin walls was evaluated before and after TC (5000 cycles between 5°C and 55°C) using OCT images. Five images of each restored tooth were obtained. Images were analyzed using ImageJ software that measured the entire length of the gaps at the dentin–restoration interface. The length of gaps (μm) was analyzed using two-way repeated measures ANOVA and the Tukey tests (α=0.05). There was a significant interaction between material types and TC (p=0.006), and a significant difference among all material types (p<0.0001), before and after TC (p<0.0001). Increased internal gaps at the dentin–restoration interface were noticed after TC for all groups. RC presented the lowest value of internal gap before and after TC, while LBF showed the highest values of internal gap after TC. In conclusion, TC negatively affected the integrity of internal gap, whereas high-viscosity, incremental-fill, resin-based composite presented better performance in terms of internal adaptation than low-viscosity, bulk-fill materials in Class I cavities.

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Fracture resistance of incisal tooth fragment reattached with different adhesive materials and retentive techniques

Revista Odonto Ciência ◽

10.15448/1980-6523.2017.4.28095 ◽

2018 ◽

Vol 32 (4) ◽

pp. 163

Author(s):

Fábio Herrmann Coelho-de-Souza ◽

Guilherme Fossá ◽

Flávia Ávila Pereira ◽

Celso Afonso Klein-Júnior ◽

Maria Carolina Guilherme Erhardt ◽

...

Keyword(s):

Bond Strength ◽

Fracture Resistance ◽

Shear Bond Strength ◽

Composite Resin ◽

Adhesive System ◽

Group 4 ◽

Group 3 ◽

Group 5 ◽

Adhesive Materials ◽

Group 1

OBJECTIVE: This study evaluated in vitro the shear bond strength of experimentally fractured human tooth fragments reattached with different adhesive materials and retentive techniques.METHODS: Forty-eight sound mandibular incisors were randomly divided into 6 groups (n=8). Their incisal edges were cut off in 5 groups, representing an enamel-dentin fracture. Intact teeth were used as control (Group 1). The fragment edges were reattached with adhesive system (Scotch Bond Multipurpose – 3M ESPE) (Group 2), adhesive system and composite resin (ICE – SDI) (Group 3), adhesive system and composite resin with circumferential bevel (Group 4), adhesive system and composite resin with internal dentin groove (Group 5), and adhesive system and composite resin with the circumferential bevel and internal dentin groove (Group 6). Shear bond strength was determined in a universal testing machine. Fracture modes were identified by light microscope. Kruskal-Wallis was used to analysis resistance to fracture and fracture patterns.RESULTS: The results showed statistically significant differences (p<0.05) among groups. The intact teeth (Group 1) showed higher fracture resistance than the other groups. Groups 2 and 6 did not differ and were statistically superior to other techniques. Group 4 presented statistically higher than in Group 5, which in turn was more resistant than Group 3.CONCLUSIONS: None of the fragment reattachment techniques was able to achieve the strength of sound teeth. Fragments reattached only with adhesive system or with adhesive system and composite resin with the circumferential bevel and internal dentin groove showed the best performance for resistance to fracture.

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Two-year Randomized Clinical Trial of Self-etching Adhesives and Selective Enamel Etching

Operative Dentistry ◽

10.2341/15-130-c ◽

2016 ◽

Vol 41 (3) ◽

pp. 249-257 ◽

Cited By ~ 6

Author(s):

CE Pena ◽

JA Rodrigues ◽

C Ely ◽

M Giannini ◽

AF Reis

Keyword(s):

Clinical Trial ◽

United States Public Health ◽

Clinical Effectiveness ◽

Adhesive System ◽

Single Step ◽

Cervical Lesions ◽

Randomized Controlled ◽

One Step ◽

Nanohybrid Composite ◽

Postoperative Sensitivity

SUMMARY Objective: The aim of this randomized, controlled prospective clinical trial was to evaluate the clinical effectiveness of restoring noncarious cervical lesions with two self-etching adhesive systems applied with or without selective enamel etching. Methods: A one-step self-etching adhesive (Xeno V+) and a two-step self-etching system (Clearfil SE Bond) were used. The effectiveness of phosphoric acid selective etching of enamel margins was also evaluated. Fifty-six cavities were restored with each adhesive system and divided into two subgroups (n=28; etch and non-etch). All 112 cavities were restored with the nanohybrid composite Esthet.X HD. The clinical effectiveness of restorations was recorded in terms of retention, marginal integrity, marginal staining, caries recurrence, and postoperative sensitivity after 3, 6, 12, 18, and 24 months (modified United States Public Health Service). Results: The Friedman test detected significant differences only after 18 months for marginal staining in the groups Clearfil SE non-etch (p=0.009) and Xeno V+ etch (p=0.004). One restoration was lost during the trial (Xeno V+ etch; p>0.05). Conclusions: Although an increase in marginal staining was recorded for groups Clearfil SE non-etch and Xeno V+ etch, the clinical effectiveness of restorations was considered acceptable for the single-step and two-step self-etching systems with or without selective enamel etching in this 24-month clinical trial.

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A Two-year Clinical Comparison of Three Different Restorative Materials in Class II Cavities

Operative Dentistry ◽

10.2341/19-078-c ◽

2020 ◽

Vol 45 (1) ◽

pp. E32-E42 ◽

Cited By ~ 3

Author(s):

H Balkaya ◽

S Arslan

Keyword(s):

Composite Resin ◽

Clinical Performance ◽

Class Ii ◽

High Viscosity ◽

Glass Ionomer ◽

Secondary Caries ◽

Significant Difference ◽

Composite Resin Restorations ◽

Postoperative Sensitivity ◽

Resin Restorations

SUMMARY Objectives: The aim of this clinical study was to evaluate the clinical performance of Class II restorations of a high-viscosity glass ionomer material, of a bulk-fill composite resin, and of a microhybrid composite resin. Methods and Materials: One hundred nine Class II restorations were performed in 54 patients using three different restorative materials: Charisma Smart Composite (CSC; a conventional composite resin), Filtek Bulk Fill Posterior Restorative (FBF; a high-viscosity bulk-fill composite), and Equia Forte Fil (EF; a high-viscosity glass ionomer). Single Bond Universal adhesive (3M ESPE, Neuss, Germany) was used for both conventional and bulk-fill composite resin restorations. The restorations were evaluated using modified US Public Health Service criteria in terms of retention, color match, marginal discoloration, anatomic form, contact point, marginal adaptation, secondary caries, postoperative sensitivity, and surface texture. The data were analyzed using the chi-square, Fisher, and McNemar tests. Results: Eighty-four restorations were evaluated at two-year recalls. There were clinically acceptable changes in composite resin restorations (FBF and CSC). In addition, no statistically significant difference was observed between the clinical performances of these materials in terms of all criteria (p>0.05). However, there was a statistically significant difference between the EF group and the FBF and CSC groups in all parameters except for marginal discoloration, secondary caries, and postoperative sensitivity (p<0.05). Conclusions: The tested bulk-fill and conventional composite resins showed acceptable clinical performance in Class II cavities. However, if EF is to be used for Class II restoration, its use should be carefully considered.

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Clinical performance of class I occlusal composite resin restorations: a multicenter double-blinded randomized clinical trial

Brazilian Dental Science ◽

10.14295/bds.2018.v21i3.1593 ◽

2018 ◽

Vol 21 (3) ◽

pp. 288

Author(s):

Bruno Mendonça Lucena De Veras ◽

Geórgia Pires dos Santos Menezes ◽

Hugo Leonardo Mendes Barros ◽

Marcelya Chrystian Moura Rocha ◽

Aditonio De Carvalho Monteiro ◽

...

Keyword(s):

Clinical Trial ◽

Composite Resin ◽

Clinical Performance ◽

Dental Restoration ◽

Composite Resins ◽

Class I ◽

Color Match ◽

Marginal Integrity ◽

Composite Resin Restorations ◽

Resin Restorations

Objective: The objective of this study was to evaluate the 6-month clinical performance of class I occlusal composite resin restorations through a multicenter, randomized, double-blind, clinical trial. Material e Métodos: Two hundred and eighty class I occlusal restorations were performed in 70 patients (aged between 17 to 50 years). The restorations were divided into four groups: G1 (Filtek P60/3M ESPE); G2 (Rok/SDI); G3 (Filtek™ P90/3M ESPE); G4 (Evolux/Dentsply). Two pre-calibrated dental practitioners performed and evaluated the restorative procedures regarding to color match, marginal discoloration, recurrent caries, wear (anatomic form) and marginal integrity according to the USPHS criteria. Resultados: In 85.8% of the evaluated restorations was observed the ideal score (A) for color match; 91.4% for marginal discoloration; 100% for recurrent caries; 87.7% for wear (anatomic form) and 99.3% for marginal integrity. Conclusion: The composite resins used in this study presented satisfactory and similar clinical performance in a 6-month clinical evaluation.KeywordsDentistry; Composite resins; Permanent dental restoration; Molar; Bicuspid.

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CLINICAL EVALUATION OF THE NANO HYBRID BULK FILL COMPOSITE AND NANO HYBRID FLOWABLE COMPOSITE IN CLASS I RESTORATIONS--- AN IN VIVO STUDY

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i2.1726 ◽

2021 ◽

Vol 5 (2) ◽

Author(s):

Anil K. Tomer ◽

Hysum Mushtaq ◽

Anila Krishna Saxena ◽

Megna Bhatt ◽

Ayush Tyagi ◽

...

Keyword(s):

Clinical Performance ◽

Retention Rate ◽

Resin Composite ◽

Adhesive System ◽

Recall Rate ◽

Class I ◽

In Vivo Study ◽

Marginal Adaptation ◽

Flowable Composite

Objectives: The aim of this study was to evaluate the clinical performance of a nano filled flowable and nano hybrid bulk fill resin composite in class I restorations. Methods and Materials: Twenty patients were selected for this in vivo study. Each patient received at least one pair of restorations, restored with nano hybrid bulk fill resin composite (IPS Empress direct [IED]) and nano hybrid Tetric N Ceram flowable composite [TNC]. Each restorative resin system was used with its respective adhesive system according to manufacturers’ instructions. A total of 40 class I restorations were placed by one operator. Restorations were blindly evaluated by two examiners at baseline and 3, 6, and 12 months respectively using modified US Public Health Service Ryge criteria. The data obtained was statistically analyzed using Chi square test to compare the two restorative materials for each category. Results: At 3, 6 and 12, months, recall rate was 100%, 95% and 85%, respectively, with a retention rate of 100%. There were statistically significant differences between the two restorative resins in terms of marginal adaptation and marginal discoloration (p<0.05). No differences were observed between the restorative resins in terms of retention (p<0.05). None of the restorations showed postoperative sensitivity, or loss of anatomic form. Conclusion: Within the limitations of this study, nano hybrid bulk fill composite resin viz. IPS EMPRESS DIRECT showed better clinical performance than nano filled flowable composite in terms of marginal discoloration and marginal adaptation. Keywords: direct composite, bulk, hybrid filled resin

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Response of dental pulp capped with calcium-silicate based material, calcium hydroxide and adhesive resin in rabbit teeth

Brazilian Journal of Oral Sciences ◽

10.20396/bjos.v21i00.8663816 ◽

2021 ◽

Vol 21 ◽

pp. e223816

Author(s):

Cynthia Kassis ◽

Pierre Khoury ◽

Karim Corbani ◽

Charbel Mansour ◽

Louis Hardan ◽

...

Keyword(s):

Calcium Hydroxide ◽

High Speed ◽

Adhesive System ◽

Conventional Technique ◽

Direct Pulp Capping ◽

Yag Laser ◽

Pulp Capping ◽

Diamond Bur ◽

The Difference ◽

Group 5

Direct pulp capping induces a local inflammatory process. Several biomaterials have been used for this procedure. The aim of this study was to compare the dentinal bridge thickness using three different pulp capping biomaterials with the conventional technique (high speed diamond bur) or Er-Yag laser, 1 month after pulp effraction. Materials and Methods: Forty two Class V cavities were prepared on the buccal surface of 4 maxillary incisors and 2 mandibular incisors of New Zealand rabbits. Specimens were divided into 6 treatment groups. Teeth were treated with: In Group 1: Er-Yag laser and Biodentine® (Septodont), in Group 2: Er: Yag laser and calcium hydroxide (Dycal® Dentsply), in Group 3: Er: Yag laser and adhesive system (Prime& Bond® NT Dentsply), in Group 4: high speed diamond bur and Biodentine® (Septodont), in Group 5: high speed diamond bur and calcium hydroxide (Dycal® Dentsply), and in Group 6: high speed diamond bur and adhesive system (Prime& Bond® NT Dentsply). The preparation was done with copious irrigation. The animals were sacrificed at 30 days and the teeth were extracted and prepared for histological analysis. Results: In the group of « laser Er-Yag », iatrogenic pulpal wounds treated with Biodentine® were covered with a thick hard tissue barrier after 1 month. The difference was not significant with the groups of Dycal® used with Er: Yag laser and high speed diamond bur. Prime& Bond® NT Dentsply specimens showed a thin dentinal bridge layer. Conclusion: At 1 month, Er-Yag laser proved to be useful with Biodentine® for direct pulp capping procedures.

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Flash-Free Orthodontic Adhesive System Bonded on CAD/CAM Produced Resin Restorations

Materiale Plastice ◽

10.37358/mp.18.4.5084 ◽

2018 ◽

Vol 55 (4) ◽

pp. 606-608

Author(s):

Denisa Maria Golban ◽

Radu Negru ◽

Camelia Szuhanek ◽

Meda Lavinia Negrutiu ◽

Liviu Marsavina ◽

...

Keyword(s):

Testing Machine ◽

Adhesive System ◽

Conventional Technique ◽

Free System ◽

Adhesive Remnant Index ◽

Cad Cam ◽

Group 2 ◽

Positioning Time ◽

Bracket Positioning ◽

Group 1

Flash-Free Orthodontic Adhesive System represents the latest technology in the field of orthodontics. In the present study the bonding technique is applied on CAD/CAM produced resin crowns. Ten resin blocks were shaped after an upper premolar crown design from the 3Shape Library, and they were divided ino two groups: on Group 1, control, Clarity Advanced braces (3M Unitek, Monrovia, CA, USA) were bonded using XT Adhesive Paste (3M Unitek, Monrovia, CA, USA), while on Groups 2 same aesthetic brackets were applied, using the APC Flash-Free Adhesive Coated Appliance System (3M Unitek, Monrovia, CA, USA). Bracket positioning time was recorded for each sample. Zwick Zoel Z005 testing machine was used to measure the shear bond strength (SBS) at which debonding takes place. Adhesive remnant index (ARI) was registered, as well as presence or absence of adhesive flash and accuracy of flash cleaning before curing. Group 1 showed a mean bonding time of 46.4 s, while Group 2 needed about 20.6 s for each bracket bonding. Mean SBS values for both groups are considered clinically acceptable (6.27 MPa for Group 1 and 7.77 MPa for Group 2). ARI scores were zero for all samples and after debonding, on group 1 can be observed the adhesive flash. In conclusion, APC Flash-Free Coated Appliance System showed reduced time for bracket positioning compared to the conventional technique. APC Flash-Free System showed acceptable SBS values, higher than the uncoated brackets. No composite was left on the resin crown after debonding, the adhesive flash resulted in the conventional technique remaining on the edges of the debonded brackets.

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A New Dual-cure Universal Simplified Adhesive: 18-month Randomized Multicenter Clinical Trial

Operative Dentistry ◽

10.2341/19-144-c ◽

2020 ◽

Vol 45 (5) ◽

pp. E255-E270

Author(s):

E Gomes de Albuquerque ◽

F Warol ◽

F Signorelli Calazans ◽

L Augusto Poubel ◽

S Soares Marins ◽

...

Keyword(s):

Clinical Trial ◽

Clinical Evaluation ◽

Clinical Performance ◽

Retention Rates ◽

Marginal Adaptation ◽

Cervical Lesions ◽

Universal Adhesive ◽

Etch And Rinse ◽

Self Etch ◽

Postoperative Sensitivity

Clinical Relevance Non-carious cervical lesion restorations using a dual-cure universal adhesive in self-etch and etch-and-rinse mode showed satisfactory clinical performance after 18 months. SUMMARY Objectives: The objective of this multicenter, double-blind, split-mouth randomized clinical trial was to evaluate the clinical performance of a new dual-cure universal adhesive system (Futurabond U, Voco GmBH) when applied using different strategies over a period of 18 months. Methods and Materials: Fifty patients participated in this study. Two hundred non-carious cervical lesions were restored using the adhesive Futurabond U according to four adhesive strategies (n=50 per group): only self-etch (SEE), selective enamel etching + self-etch (SET), etch-and-rinse with dry dentin (ERDry), and etch-and-rinse with wet dentin (ERWet). After the adhesive application, cavities were restored using Admira Fusion composite resin. These restorations were evaluated according to FDI World Dental Federation criteria for the following characteristics: retention/fracture, marginal adaptation, marginal staining, postoperative sensitivity, and caries recurrence. Results: After 18 months, only four patients (12 months: one patient, n=4 restorations; and 18 months: three patients, n=12 restorations) were not evaluated. Fourteen restorations were lost after 18 months of clinical evaluation (four for SEE, three for SET, three for ERDry, and four for ERWet). The retention rates for 18 months (95% confidence interval) were 92% (81%–97%) for SEE, 94% (83%–97%) for SET, 94% (83%–97%) for ERDry, and 92% (81%–97%) for ERWet (p>0.05). Thirty-eight restorations were considered to have minor discrepancies in marginal adaptation at the 18-month recall (13 for SEE, 13 for SET, six for ERDry, and six for ERWet; p>0.05). Fourteen restorations were detected as a minor marginal discoloration at the 18-month recall (six for SEE, six for SET, one for ERDry, and one for ERWet; p>0.05). However, all were considered clinically acceptable. No restorations showed postoperative sensitivity or caries recurrence at the time. Conclusion: The clinical performance of the Futurabond U did not depend on the bonding strategy used, and it was considered reliable after 18 months of clinical evaluation, although more marginal discrepancy was observed in the self-etch group.

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Flash-Free Orthodontic Adhesive System Compared with the Conventional Direct Bonding Method

Revista de Chimie ◽

10.37358/rc.18.11.6709 ◽

2018 ◽

Vol 69 (11) ◽

pp. 3193-3195

Author(s):

Camelia Szuhanek ◽

Denisa Maria Golban ◽

Radu Negru ◽

Meda Lavinia Negrutiu ◽

Liviu Marsavina ◽

...

Keyword(s):

Adhesive System ◽

Conventional Technique ◽

Bonding Time ◽

Control Group ◽

Orthodontic Materials ◽

The Difference ◽

Group 2 ◽

Bonding Method ◽

Bracket Base ◽

Group 1

The latest technology in the field of orthodontic materials is represented by the Flash-Free Orthodontic Adhesive System. In the present study this novel technique is compared with the conventional direct bonding method. Ten extracted human premolars were separated into two groups: in the Group 1, APC Flash-Free Adhesive Coated Appliance System (3M Unitek, Monrovia, CA, USA) was bonded, while in the control Group 2, Clarity Advanced braces (3M Unitek, Monrovia, CA, USA) were bonded using XT Adhesive Paste (3M Unitek, Monrovia, CA, USA) applied by the clinician on the bracket base. Bonding times were recorded for each sample. Shear bond strength (SBS) was recorded using Zwick Zoel Z005. After debonding, the adhesive remnant index (ARI) was established for both groups. Group 1 showed a mean bonding time of 21 s, while Group 2 needed about 45 s for each bracket bonding. Both groups had clinically accepted SBS values, but the difference between them was significant (10.97 MPa versus 8.23 MPa). ARI scores were equal to 1 for most samples. In conclusion, reducing the time for bracket placing, APC Flash-Free Coated Appliance System showed a brackets bonding time reduced to half compared to the conventional technique. This aspect, combined with significantly higher SBS values, makes this novel system better than the classical one. For both groups, more than half of the adhesive remained on the bracket base, which facilitates cleaning after debonding.

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