• Restorative Dentistry and Endodontics
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• v.46 no.2
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• pp.24.1-24.11
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• 2021

Objectives: The present study aimed to evaluate the survival rate and clinical performance of class 1 composite restorations restored with the Filtek Bulk Fill composite material using either the bulk fill technique or the incremental technique at baseline (1 week) and at 3, 6 and 12 months of follow-up. Materials and Methods: Forty-two patients with at least 2 carious teeth were selected. Following randomization, one tooth was restored with the Filtek Bulk Fill composite using the incremental fill technique, and the other tooth was restored with the same material using the bulk fill technique. Patients were recalled for follow-up at baseline (1 week) and 3, 6, and 12 months and evaluated using the FDI criteria. Results: The data were analyzed using the McNemar χ² test. No statistically significant differences were found between the scores of teeth restored with either technique. At baseline and at 3, 6, and 12 months of follow-up; there were no significant difference in the clinical status of both groups of restorations. Conclusions: Within the limitations of this study, using the bulk fill technique for restorations with the Filtek Bulk Fill material seems to be equally efficient to using the incremental fill technique.

• Restorative Dentistry and Endodontics
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• v.40 no.4
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• pp.262-269
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• 2015

Objectives: The aim of this study was to evaluate the mechanical and physical properties of a newly developed fiber reinforced dental composite. Materials and Methods: Fiber reinforced composite EverX Posterior (EXP, GC EUROPE), and other commercially available bulk fill composites, including Filtek Bulk Fill (FB, 3M ESPE), SonicFill (SF, Kerr Corp.), SureFil (SDR, Dentsply), Venus Bulk Fill (VB, HerausKultzer), Tetric evoceram bulk fill (TECB, Ivoclar Vivadent), and Xtra Base (XB, Voco) were characterized. Composite samples light-cured with a LED device were evaluated in terms of flexural strength, flexural modulus (ISO 4049, n = 6), fracture toughness (n = 6), and Vickers hardness (0, 2, and 4 mm in depth at 24 hr, n = 5). The EXP samples and the fracture surface were observed under a scanning electron microscopy. Data were statistically analyzed using one-way ANOVA and unpaired t-test. Results: EXP, FB, and VB had significantly higher fracture toughness value compared to all the other bulk composite types. SF, EXP, and XB were not statistically different, and had significantly higher flexural strength values compared to other tested composite materials. EXP had the highest flexural modulus, VB had the lowest values. Vickers hardness values revealed SF, EXP, TECB, and XB were not statistically different, and had significantly higher values compared to other tested composite materials. SEM observations show well dispersed fibers working as a reinforcing phase. Conclusions: The addition of fibers to methacrylate-based matrix results in composites with either comparable or superior mechanical properties compared to the other bulk fill materials tested.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.3
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• pp.184-193
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• 2016

Purpose: To evaluate marginal leakage of bulk fill flowable composite resin filling with different curing time by using microcomputed tomography technology. Materials and Methods: 30 previously extracted human molars were randomly divided into 6 groups based upon restorative system and different curing time. Class II cavities (vertical slot cavities) were prepared. An individual metallic matrix was used to build up the proximal wall. The SonicFill or SureFil SDR flow was inserted into the preparation by using 1 bulk increment, followed by light polymerization for different curing times. The different exposure times were 20, 40, and 60 seconds. All specimens were submitted to 5,000 thermal cycles for artificial aging. Micro-CT scanning was performed by using SkyScan 1272. One evaluator assessed microleakage of silver nitrated solution at the resin-dentin interface. The 3D image of each leakage around the restoration was reconstructed with CT-Analyser V.1.14.4. The leakage was analyzed with the Mann-Whitney test. Results: Significant differences were observed between the light curing times, but no significant differences were found between the bulk fill composite resins. Increasing in the photoactivation time resulted in greater microleakage in all the experimental groups. Those subjected to 60 seconds of light curing showed higher microleakage means than those exposed for 20 seconds and 40 seconds. Conclusion: Increasing the photoactivation time is factor that may increase marginal microlekage of the bulk fill composite resins. Further, micro-CT can nondestructively detect leakage around the resin composite restoration in three dimensions.

• Restorative Dentistry and Endodontics
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• v.48 no.4
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• pp.35.1-35.14
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• 2023

Objectives: The purpose of this study was to evaluate the impact of dentin roughening and the type of composite resin used (either bulk-fill flowable or nanohybrid) on the restoration of non-carious cervical lesions (NCCLs) with an 18-month follow-up period. Materials and Methods: This prospective split-mouth study included 36 patients, each with a minimum of 4 NCCLs. For each patient, 4 types of restorations were performed: unroughened dentin with nanohybrid composite, unroughened dentin with bulk-fill flowable composite, roughened dentin with nanohybrid composite, and roughened dentin with bulk-fill flowable composite. A universal bonding agent (Tetric N Bond Universal) was applied in self-etch mode for all groups. The restorations were subsequently evaluated at 6, 12, and 18 months in accordance with the criteria set by the FDI World Dental Federation. Inferential statistics were computed using the Friedman test, with the level of statistical significance established at 0.05. Results: The 4 groups exhibited no significant differences in relation to fracture and retention, marginal staining, marginal adaptation, postoperative hypersensitivity, or the recurrence of caries at any follow-up point. Conclusions: Within the limitations of the present study, over an 18-month follow-up period, no significant difference was present in the clinical performance of bulk-fill flowable and nanohybrid composite restorations of non-carious cervical lesions. This held true regardless of whether dentin roughening was performed.

• Journal of dental hygiene science
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• v.23 no.2
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• pp.123-131
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• 2023

Background: As a restorative material used to treat dental caries, the light-curing type resin is widely used, but it has the disadvantage of polymerization shrinkage. The Bulk-Fill composite resin was developed to solve these shortcomings, but the existing research mainly focused on comparing the physical properties of a composite resin and a Bulk-Fill resin. A study on the light curing time and distance of the Bulk-Fill resin itself tend to be lacking. Methods: This study compares the surface microhardness of specimens prepared by varying the light curing time and distance of smart dentin replacement (SDR) as a flowable Bulk-Fill resin and Tetric N-ceram as a packable Bulk-Fill resin, and confirms the polymerization time and distance that becomes the optimum hardness. To determine the hardness of the specimen, it was measured using the Vickers Hardness Number (Matsuzawa MMT-X, Japan). Results: In SDR, the surface microhardness decreased as the distance increased in all time groups in the change distance from the curing tip. In the change of light curing time with respect to the distance from curing tip, the surface microhardness increased as the time increased. In Tetric N-ceram, the surface microharness showed no significant difference in the change of the distance of curing tip in the group of 20 and 60 second. But in the group of 10 and 40 seconds, decreased as the distance increased. The surface microharness increased as the light curing time increased in all distance groups. Conclusion: When using SDR and Tetric N-ceram in clinical practice, it is considered that as the distance from the polymerization reactor tip increases, a longer light curing time than the polymerization time recommended by the manufacturer is required.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.4
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• pp.446-454
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• 2017

Recently, there have been many studies on bulk-fill resin composites. However, studies on the proper materials for pediatric patients are rare. The aim of this study was to compare the cavity wall adaptation of bulk-fill resin composites with conventional resin composite in class II cavities of primary molars using microcomputed tomography (micro-CT). Standardized class II slot cavities were prepared in 80 exfoliated primary molars and randomly divided into 4 groups. The control group was restored with conventional resin composite, Filtek Z-350 XT (FZ), and the three groups were restored with bulk-fill resin composites, Filtek bulk-fill posterior (FB), Tetric N-Ceram Bulk Fill (TNC), Filtek bulk-fill flowable (FBF). All specimens were thermocycled and then immersed in 50% silver nitrate ($AgNO_3$) solution. Micro-CT was used to measure the penetration volume of the total silver nitrate and the degree of cervical marginal leakage and the number, size, and position of the voids were evaluated. The results revealed that the volume of silver nitrate were significantly different between FB and FZ (p < 0.05). The results also revealed that the penetration length of silver nitrate FBF showed statistically lower than the FZ and FB (p < 0.05). There was no significant difference between the groups in number and size of voids. In conventional resin composite, most of the voids were present inside the restoration (83.3%), but the voids in the bulk-fill resin composites incidence were higher in the gingivoaxial angle. The cavity wall adaptation demonstrated in class II restorations of primary molar by new bulk fill resin composites was similar to conventional incremental technique. Bulk-fill resin composites might be an clinical option for a faster restoration in deciduous teeth.

• Restorative Dentistry and Endodontics
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• v.40 no.2
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• pp.128-135
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• 2015

Objectives: This study evaluated the effects of the resin thickness on the microhardness and optical properties of bulk-fill resin composites. Materials and Methods: Four bulk-fill (Venus Bulk Fill, Heraeus Kulzer; SDR, Dentsply Caulk; Tetric N-Ceram Bulk Fill, Ivoclar vivadent; SonicFill, Kerr) and two regular resin composites (Charisma flow, Heraeus Kulzer; Tetric N-Ceram, Ivoclar vivadent) were used. Sixty acrylic cylindrical molds were prepared for each thickness (2, 3 and 4 mm). The molds were divided into six groups for resin composites. The microhardness was measured on the top and bottom surfaces, and the colors were measured using Commission Internationale d'Eclairage (CIE) $L^*a^*b^*$ system. Color differences according to the thickness and translucency parameters and the correlations between the microhardness and translucency parameter were analyzed. The microhardness and color differences were analyzed by ANOVA and Scheffe's post hoc test, and a student t-test, respectively. The level of significance was set to ${\alpha}=0.05$. Results: The microhardness decreased with increasing resin thickness. The bulk-fill resin composites showed a bottom/top hardness ratio of almost 80% or more in 4 mm thick specimens. The highest translucency parameter was observed in Venus Bulk Fill. All resin composites used in this study except for Venus Bulk Fill showed linear correlations between the microhardness and translucency parameter according to the thickness. Conclusions: Within the limitations of this study, the bulk-fill resin composites used in this study can be placed and cured properly in the 4 mm bulk.

• Restorative Dentistry and Endodontics
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• v.42 no.2
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• pp.118-124
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• 2017

Objectives: This study aimed to evaluate the color stability of bulk-fill and nanohybrid resin-based composites polished with 3 different, multistep, aluminum-oxide impregnated finishing and polishing disks. Materials and Methods: Disk-shaped specimens (8 mm in diameter and 4 mm in thickness) were light-cured between two glass slabs using one nanohybid bulk-fill (Tetric EvoCeram, Ivoclar Vivadent), one micro-hybrid bulk-fill (Quixfil, Dentsply), and two nanohybrid incremental-fill (Filtek Ultimate, 3M ESPE; Herculite XRV Ultra, Kerr) resin-based composites, and aged by thermocycling (between $5-55^{\circ}C$, 3,000 cycles). Then, they were divided into subgroups according to the polishing procedure as SwissFlex ($Colt\grave{e}ne/Whaledent$), Optidisc (Kerr), and Praxis TDV (TDV Dental) (n = 12 per subgroup). One surface of each specimen was left unpolished. All specimens were immersed in coffee solution at $37^{\circ}C$. The color differences (${\Delta}E$) were measured after 1 and 7 days of storage using a colorimeter based on CIE Lab system. The data were analyzed by univariate ANOVA, Mann-Whitney U test, and Friedmann tests (${\alpha}=0.05$). Results: Univariate ANOVA detected significant interactions between polishing procedure and composite resin and polishing procedure and storage time (p < 0.05). Significant color changes were detected after 1 day storage in coffee solution (p < 0.05), except Quixfil/Optidisc which was color-stable after 7 days (p > 0.05). Polishing reduced the discoloration resistance of Tetric EvoCeram/SwissFlex, Tetric EvoCeram/Praxis TDV, Quixfil-SwissFlex, and all Herculite XRV Ultra groups after 7 days storage (p < 0.05). Conclusions: Discoloration resistance of bulk-fill resin-based composites can be significantly affected by the polishing procedures.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.4
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• pp.427-434
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• 2016

The aim of this study was to compare the mechanical properties of high viscosity bulk-fill resin composites, $Filtek^{TM}$ Bulk Fill Posterior Restorative (FBF) and $Tetric^{(R)}$ N-Ceram Bulk Fill (TBF), with conventional composite ($Filtek^{TM}$ Z-350 XT, Z-350). The Vickers hardness test which indicates the degree of conversion was performed and the dye penetration test was performed to measure the microleakage which indicates polymerization shrinkage amount. To minimize experimental error, the standardized 3D-printed molds and the bovine teeth were used. Obtained data were analyzed by the Kruskal-Wallis test and Mann-Whitney test with the confidence interval of 95%. In the microhardness test within 1 hour of polymerization, lower surface of FBF and TBF showed significantly lower value than that of Z-350 (p < 0.05). But after 24 hours, the microhardness of FBF had increased and showed no significant difference with Z-350 (p > 0.05). In top and 2 mm depth surface, mean microhardness values were in the following order: Z-350 > FBF > TBF (p < 0.05). The mean microleakage value of TBF was significantly lower than others (p < 0.05). For clinical application of bulk-fill resin composites, caution for applying masticatory forces during 24 hours after polymerization is advised and further studies to decrease microleakage should be conducted.

• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.4
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• pp.353-361
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• 2019

The aim of this study was to evaluate the color stability of bulk-fill and conventional resin composites with respect to different storage media and thickness of composites. Filtek™ Z250 and Filtek™ Z350XT were evaluated as conventional resin composites. Filtek™ Bulk-fill Posterior Restorative and Tetric^® N-Ceram Bulk Fill were evaluated as bulk-fill resin composites. CIE L^*a^*b^* values of baseline were measured after 24 hours of storage in distilled water, and each resin composite group was divided into three subgroups and stored in distilled water, red wine, and coffee media respectively. Again after 1, 7 and 28 days of immersion, color changes (ΔE^*) were calculated using the CIE L^*a^*b^* values. The greatest ΔE^* was observed in red wine for all resin composites, and the mean color changes were ranked in the increasing order of distilled water, coffee, red wine. Filtek™ Z350XT exhibited the greatest color change in all media, followed by Filtek™ Bulk-fill Posterior Restorative. Filtek™ Z250 and Tetric^® N-Ceram Bulk Fill followed with similar mean color change values. According to the 2 different thicknesses of 2 mm and 4 mm of bulk-fill resin composites, there was no thickness-related difference on color changes.