Clinical Relevance Secondary caries are the main reason for the failure of restorations, class II being the most affected. Techniques that promote less gap percentage are important. Flowable bulk fill composites used at such locations have been shown to decrease gap formation while being a faster procedure than an incremental technique. SUMMARY Purpose: To evaluate gap formation of class II restorations, resin-filling techniques using microcomputed tomography (μCT) and scanning electronic microscopy (SEM) are discussed. Methods and Materials: Class II cavities were prepared in 30 third molars and analyzed in distal and mesial views. Prime&Bond Universal adhesive was applied in all teeth and divided into five groups (n=6): G1, SS+HIT (Spectra Smart+Horizontal Incremental Technique); G2, SS+OBL (Oblique Incremental Technique); G3, SDR+BFT (Surefil SDR+Bulk Fill Technique); G4, SDR+SS (SDR placed on cervical floors from mesial and distal boxes (not light cured), followed by incremental layering with SS and light curing incrementally with the horizontal technique); and G5, BEZ+BFT (Bulk EZ+BFT). All light-curing procedures were performed with high-mode/1200 mW/cm 2 , Bluephase Style 20i. Teeth were scanned twice (first scan, empty tooth; second scan, filled tooth after light curing) by μCT. Acquired μCT data were evaluated with software looking for gaps at the external mesial and distal margins and submitted to statistical analysis (one-way analysis of variance and least significant differences post hoc test). Validation of the μCT analysis was performed by SEM. Results: G5 showed the lowest gap formation percentage, similar to G4 ( p =0.20). G4 also showed statistical similarities to G1 and G3 ( p >0.05). G2 showed the highest percentages, similar to G1 ( p =0.10) but different from the rest of the groups ( p <0.05). SEM validated the μCT technique by showing qualitative similar images regarding external marginal gap. Conclusions: The dual-cure composite and the use of flowable nonpolymerized plus horizontal filling technique showed the best marginal adaptations. The μCT technique was validated for visualization of gap formation after being compared to the SEM technique.

Clinical Relevance Shortened light curing does not affect volumetric polymerization shrinkage or cohesive tensile strength but negatively affects the shear bond strength of some bulk-fill resin composites. When performing shortened light curing, clinicians should be aware of the light output of their light-curing units. SUMMARY Purpose: To evaluate volumetric polymerization shrinkage (VPS), shear bond strength (SBS) to dentin, and cohesive tensile strength (CTS) of bulk-fill resin composites (BFRCs) light activated by different modes. Methods and Materials: Six groups were evaluated: Tetric EvoCeram bulk fill + high mode (10 seconds; TEC H10), Tetric EvoFlow bulk fill + high mode (TEF H10), experimental bulk fill + high mode (TEE H10), Tetric EvoCeram bulk fill + turbo mode (five seconds; TEC T5), Tetric EvoFlow bulk fill + turbo mode (TEF T5), and experimental bulk fill + turbo mode (TEE T5). Bluephase Style 20i and Adhese Universal Vivapen were used for all groups. All BFRC samples were built up on human molar bur-prepared occlusal cavities. VPS% and location were evaluated through micro–computed tomography. SBS and CTS tests were performed 24 hours after storage or after 5000 thermal cycles; fracture mode was analyzed for SBS. Results: Both TEC H10 and TEE H10 presented lower VPS% than TEF H10. However, no significant differences were observed with the turbo-curing mode. No differences were observed for the same BFRC within curing modes. Occlusal shrinkage was mostly observed. Regarding SBS, thermal cycling (TC) affected all groups. Without TC, all groups showed higher SBS values for high mode than turbo mode, while with TC, only TEC showed decreased SBS from high mode to turbo modes; modes of fracture were predominantly adhesive. For CTS, TC affected all groups except TEE H10. In general, no differences were observed between groups when comparing the curing modes. Conclusions: Increased light output with a shortened curing time did not jeopardize the VPS and SBS properties of the BFRCs, although a decreased SBS was observed in some groups. TEE generally showed similar or improved values for the tested properties in a shortened light-curing time. The VPS was mostly affected by the materials tested, whereas the SBS was affected by the materials, curing modes, and TC. The CTS was not affected by the curing modes.

SUMMARY New resin-based restorative materials have been developed, such as computer-aided design/computer-aided manufacturing (CAD/CAM) and bulk-fill composites, as an alternative to traditional layering techniques. This study evaluated the biaxial flexural strength (BFS) before and after thermocycling of five different resin composites: one hybrid resin/ceramic CAD/CAM indirect material, Lava Ultimate CAD-CAM Restorative (LU, 3M Oral Care); a conventional composite, Filtek Z350 XT (Z350, 3M Oral Care); two bulk-fill composites, Tetric N-Ceram Bulk Fill (TBF, Ivoclar Vivadent) and Filtek Bulk Fill (FBF, 3M Oral Care); and one bulk-fill flow resin composite, Filtek Bulk Fill Flow (FBFF, 3M Oral Care). Three hundred disc-shaped specimens (6.5 mm in diameter and 0.5 mm thick) were fabricated and divided into five groups (n=30 for each composite and condition). The BFS test was performed in a universal testing machine at a crosshead speed of 0.5 mm/min immediately (i, 24 hours) and after thermocycling (a, 500 thermal cycles of 5°C to 55°C with a 30-second dwell time). The Weibull modulus ( m ) and characteristic stress (η) were calculated, and a contour plot was used ( m vs η) to detect differences between groups (95% two-sided confidence intervals). Significantly higher characteristic stress was observed for LUi (286.6 MPa) and Z350i (248.8 MPa) compared to the bulk-fill groups (FBFi=187.9 MPa, FBFFi=175.9 MPa, TBFi=149.9 MPa), with no differences between LUi and Z350i. Thermocycling significantly decreased the characteristic stress of all groups with the highest values observed for LUa (186.7 MPa) and Z350a (188.9 MPa) and the lowest for FBFFa (90.3 MPa). Intermediate values were observed for FBFa (151.6 MPa) and TBFa (122.8 MPa). The Weibull modulus decreased only for FBFa compared to FBFi. Composition and thermocycling significantly influenced the biaxial flexural strength of resin composite materials.

SUMMARY Objectives: This study evaluated the effect of argon plasma treatment (PLA) and its combination with sandblasting (SAN), silanization (SIL), and hydrophobic bonding resin (HBR) application on the micro-shear bond strength of water-aged restorative resin composite to a newly placed composite, simulating restoration repair. Methods and Materials: Forty-five light-cured composite plates (20-mm long × 20-mm wide × 4-mm thick) were fabricated using a hybrid composite and stored at 37°C in distilled water for six months. The aged composite surfaces were treated according to the following experimental groups, varying both treatment and order of application: 1) SAN + SIL + HBR (control), 2) SAN + PLA for 30 seconds + SIL + HBR, 3) SAN + SIL + PLA + HBR, 4) PLA + SIL + HBR, 5) PLA + SIL, 6) PLA + HBR, 7) SIL + PLA + HBR, 8) SIL + PLA, and 9) PLA. After the surface treatments, four fresh resin composite cylinders (1.5-mm high × 1.5-mm diameter) of the same composite were built on each aged composite surface using a silicone mold. After water storage for 24 hours or one year, the specimens were submitted to shear bond strength testing. Data were statistically analyzed by two-way analysis of variance and Tukey's test (5%). Results: Groups 1, 2, and 4 presented significantly higher bond strength means at 24 hours, although group 4 did not differ from group 7. Groups 5, 8, and 9 demonstrated significantly lower means than the other groups. Even though groups 1 and 2 had a significant bond strength reduction after 1 year, they still demonstrated higher bond strength at one year of storage. Conclusions: While PLA application combined with surface treatment methods demonstrated high bond strength results, this treatment alone was not as beneficial as other methods that included SAN, SIL and HBR.

SUMMARY Objectives: The aim of this study was to quantify the internal void volume formation in commercially available, resin composites inserted using conventional or sonic insertion methods, and analyzed using three-dimensional (3D) micro-computed tomography (μCT). Methods and Materials: Four resin composites were evaluated: one conventional (Herculite, Ultra, Kerr Corporation, Orange, CA, USA), one flowable bulk fill (SureFil SDR Flow, Dentsply International, York, PA, USA), and two packable bulk fill (SonicFill, Kerr Corporation, and Tetric EvoCeram Bulk Fill, Ivoclar Vivadent Inc, Schaan, Liechtenstein). Eight groups were evaluated according to each resin composite type and insertion method (conventional or sonic; n=5). Forty ABS 3D-printed cylindrical molds, 5.0 mm in diameter and 4.0 mm in depth, were fabricated. For the conventional resin composite, the mold was filled incrementally (two layers), while for bulk-fill resin composites, insertion was performed in a single increment. The sonic insertion method was performed using a specific handpiece (SonicFill Handpiece, Kerr Corporation). Resin composites were light cured using a multipeak light-emitting diode light-curing unit (VALO, Ultradent Products Inc, South Jordan, UT, USA) in its regular mode. Samples were evaluated by μCT, and data were imported into software (Amira, version 5.5.2, VSG, Burlington, MA, USA) for 3D reconstruction, from which the percentage of void volume was calculated. Data were analyzed using two-way analysis of variance and Tukey post hoc test at a preset alpha of 0.05. Results: The conventional insertion method resulted in reduced porosity, compared with sonic insertion, for SureFil SDR Flow and Tetric EvoCeram bulk fill. The sonic insertion method did not demonstrate any influence on void formation for Herculite Ultra or SonicFill. Conclusion: Results suggest that the sonic insertion method might increase void formation during resin composite delivery, depending on restorative material brand.

SUMMARY The present study aimed to characterize the pattern and volume of polymerization shrinkage of flowable resin composites, including one conventional, two bulk fill, and one self-adhesive. Standardized class I preparations (2.5 mm depth × 4 mm length × 4 mm wide) were performed in 24 caries-free human third molars that were randomly divided in four groups, according to the resin composite and adhesive system used: group 1 = Permaflo + Peak Universal Bond (PP); group 2 = Filtek Bulk Fill + Scotchbond Universal (FS); group 3 = Surefil SDR + XP Bond (SX); and group 4 = Vertise flow self-adhering (VE) (n=6). Each tooth was scanned three times using a microcomputed tomography (μCT) apparatus. The first scan was done after the cavity preparation, the second after cavity filling with the flowable resin composite before curing, and the third after it was cured. The μCT images were imported into three-dimensional rendering software, and volumetric polymerization shrinkage percentage was calculated for each sample. Data were submitted to one-way analysis of variance and post hoc comparisons. No significant difference was observed among PP, FS, and VE. SX bulk fill resin composite presented the lowest values of volumetric shrinkage. Shrinkage was mostly observed along the occlusal surface and part of the pulpal floor. In conclusion, polymerization shrinkage outcomes in a 2.5-mm deep class I cavity were material dependent, although most materials did not differ. The location of shrinkage was mainly at the occlusal surface.

Clinical Relevance The use of a liquid polisher provided polished surfaces and reduced the surface roughness of tooth-colored restorative materials even when finishing procedures were performed solely with diamond burs. SUMMARY The main goal of the current study was to evaluate the surface roughness of tooth-colored restorative materials after different finishing/polishing protocols, including a liquid polisher (BisCover, BISCO, Schaumburg, IL, USA). The restorative materials tested included two nanofilled resin composites (Filtek Supreme, 3M Dental Products, St Paul, MN, USA and Grandio, Voco, Cuxhaven, Germany), one resin-modified glass ionomer cement (Vitremer, 3M Dental Products) and one conventional glass ionomer cement (Meron Molar ART, Voco). The finishing/polishing methods were divided into five groups: G1 (compression with Mylar matrix), G2 (finishing with diamond burs), G3 (Sof-Lex, 3M Dental Products), G4 (BisCover, BISCO, after diamond burs) and G5 (BisCover after Sof-Lex). Five cylindrical specimens of each material were prepared for each group according to the manufacturer's instructions. The finishing/polishing methods were performed by a single operator in one direction to avoid variations at low speed (15,000 RPM). The surface roughness was evaluated using a 3-D scanning instrument with two parameters considered (Ra and Rz). The data was analyzed using one-way ANOVA followed by a multiple comparison Tukey's test. The results showed that BisCover (BISCO) was capable of reducing surface roughness and provided polished surfaces for all materials, enhancing smoothness over already polished surfaces (Sof-Lex, 3M Dental Products) and achieving polishing after finishing with diamond burs.