Objective To evaluate scientific evidence regarding depth of cure of bulk‐fill resin composites (BFRCs) and related factors. Material and Methods PubMed/Medline, Embase, Scopus, and ISI Web of Science databases were accessed from October 2016 to May 2017. Investigations published in English language, assessing depth of cure of BFRCs by microhardness test and/or degree of conversion (DC) were included. Studies using exclusively ISO 4049, employing specimens deepness less than 4 mm, as well as those not reporting exposure time and/or irradiance from light curing units (LCUs) were excluded. Results In total, 742 studies were found from which 33 were included. From 21 studies evaluating BFRCs microhardness, 10 showed acceptable bottom/top ratios (≥0.8) for all tested materials. However, material‐dependent results and non‐satisfactory bottom/top microhardness ratios (<0.8) were reported in 9 and 2 investigations, respectively. From 19 studies that assessed DC, 11 showed acceptable results (≥50%) for all tested BFRCs, while 8 studies reported material‐dependent outcomes. Overall, irradiance from LCUs ranged from 650 to 1330 mW/cm2 and exposure time from 5 to 60 seconds. Favorable depth of cure results were observed with the use of LCUs emitting irradiance ≥1000 mW/cm2 and exposure times ≥20 seconds. Conclusions High depth of cure rates by BFRCs, depends on some factors as material, irradiance and exposure time. Polywave LCUs were useful but not essential on polymerizing alternative photoinitiator‐containing BFRC. Clinical Significance LED curing devices (polywave or monowave) displaying an irradiance ≥1000 mW/cm2 and 20 seconds of exposure time are imperative to accomplish successful polymerization of most BFRCs.
This study aimed to evaluate the effect of various silane-containing solutions on bonding between resin cement and glass ceramic after 24 hours and after six months of water storage. Glass-ceramic plaques (IPS e.max CAD) were sandblasted with aluminum oxide, etched with 10% hydrofluoric acid (HF), and divided into five "silane treatment" groups: RelyX Ceramic Primer (RCP), RelyX Ceramic Primer and Single Bond Plus (RCP+SB), Scotchbond Universal (SBU), Clearfil Ceramic Primer (CP), and no solution (HF-only control). Each group was divided into two "storage time" subgroups: 24 hours or six months in 37°C water. Eighteen resin cement cylinders (RelyX Ultimate) were bonded to each treatment group substrate (n=18) and then subjected to microshear testing. Failure mode was analyzed using scanning electron microscopy. Debond data were analyzed using a two-way analysis of variance and the Tukey post hoc test (α=0.05) as well as Weibull distributions. The factors "silane treatment," "storage time," (p<0.0001), and their interaction were statistically significant (p<0.0010). Group means (MPa±SD), RCP (24 hours: 27.2±3.1; six months: 18.0±4.9), and HF-only control (24 hours: 21.1±3.4; six months: 15.7±5.8) showed a reduced bond strength after six months of water storage, while RCP + SB (24 hours: 23.4±4.4; six months: 22.2±5.4), SBU (24 hours: 18.8±3.0; six months: 17.2±3.6), and CP (24 hours: 21.7±4.3; six months: 17.4±4.8) remained constant. Weibull analysis revealed that more reliable bond strengths were obtained after six months for SBU and RCP + SB. Evaluation by scanning electron microscopy revealed that all groups demonstrated hydrolytic degradation at six months of storage, but RCP + SB and SBU indicated less. Use of a separate application of silane and adhesive system improved short and long-term ceramic/resin cement bond strength.
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