The aim of this study was to compare the effects of conventional, sonic or pre-heating insertion techniques on internal void formation of bulk-fill composites with micro-computed tomography. Standardized cylindrical cavities were prepared in 160 human third molars. Four groups received different paste-like bulk-fill composites: SonicFill 2 (SF2); VisCalor Bulk (VCB); Filtek One Bulk-fill restorative (FBF); Tetric EvoCeram Bulk Fill (TEB); and a conventional posterior composite, Clearfil Majesty Posterior (CMP). A hybrid CAD/ CAM block was selected as a control (n=10). Composite restorations were built according to each resin composite type and insertion technique (n=10). Micro-CT was used to assess internal void rates. Data was analyzed with two-way ANOVA and Tukey's multiple comparisons test (α=0.05). CAD/CAM blocks were free of voids. For each composite, the highest void rates were observed for the sonic delivery method (p<0.05) except for SF2. SF2 was not affected by insertion techniques (p>0.05). Other composites showed the lowest void rates with pre-heating technique.

Objectives The aim of this study was to investigate the microshear bond strength (μSBS) of different universal adhesive systems applied to hybrid computer-aided design/computer-aided manufacturing (CAD-CAM) restorative materials repaired with a composite resin. Materials and Methods Four types of CAD-CAM hybrid block materials—Lava Ultimate (LA), Vita Enamic (VE), CeraSmart (CS), and Shofu Block HC (SH)—were used in this study, in combination with the following four adhesive protocols: 1) control: porcelain primer + total etch adhesive (CO), 2) Single Bond Universal (SB), 3) All Bond Universal (AB), and 4) Clearfil Universal Bond (CU). The μSBS of the composite resin (Clearfil Majesty Esthetic) was measured and the data were analyzed using two-way analysis of variance and the Tukey test, with the level of significance set at p < 0.05. Results The CAD-CAM block type and block-adhesive combination had significant effects on the bond strength values ( p < 0.05). Significant differences were found between the following pairs of groups: VE/CO and VE/AB, CS/CO and CS/AB, VE/CU and CS/CU, and VE/AB and CS/AB ( p < 0.05). Conclusions The μSBS values were affected by hybrid block type. All tested universal adhesive treatments can be used as an alternative to the control treatment for repair, except the AB system on VE blocks (the VE/AB group). The μSBS values showed variation across different adhesive treatments on different hybrid CAD-CAM block types.

The aim of this study was to quantify the internal void volume formation in bulk‐fill resin composites with using 3D micro‐computed tomography (μCT). Class II box cavities in 4‐mm depth were prepared and treated with Clearfil S3 Bond Plus (Kuraray Medical). Five resin composites were evaluated: one conventional paste‐like (Filtek Ultimate Universal Restorative‐as the control), one conventional flowable (Filtek Ultimate Flowable Restorative), two flowable bulk‐fill (Voco Extrabase, SDR), one paste‐like bulk‐fill (Filtek One BulkFill Restorative). Resin composites were light cured using a light‐emitting diode light‐curing unit (SDI Radii Plus, SDI Limited, Australia). Samples were evaluated by μCT, and data were imported into software The NRecon (ver. 1.6.10.4, SkyScan) and CTAn (ver. 1.16.1.0, SkyScan) for 3D reconstruction, from which the percentage of void volume was calculated. Data were analyzed using the Kruskal‐Wallis test and the Mann–Whitney U‐test at a significance level of 5%. All restorative tested materials showed different levels of voids. Filtek One BulkFill Restorative showed the least void formation, which was statistically less than that of the conventional flowable composite group (p < 0.05). All other restorative materials showed similar void formation. POLYM. COMPOS., 40:2984–2992, 2019. © 2018 Society of Plastics Engineers

Dental trauma can lead to a wide range of injuries of which crown and root fractures are examples. Crown-root fractures often need complex treatment planning. This case report describes the use of MTA in the multidisciplinary management of a patient with a horizontally fractured central incisor and luxation in a different central incisor. A 42-year-old female patient presented within 1 h of receiving direct trauma to her maxillary area. Clinical examination revealed that the right and left maxillary central incisors presented mobility and sensitivity to percussion and palpation but no sensitivity to thermal stimulations. Occlusal displacement with extrusion in the left maxillary central incisor and luxation in the right maxillary central incisor was observed. Radiographic examination revealed horizontal root fracture at the apical third of the left maxillary central incisor. Root fracture in the right maxillary incisor was not observed. Endodontic and aesthetic restorative treatments were completed. MTA showed a good long-term outcome when used in root-fractured and luxated teeth. In addition, composite resin restoration provided satisfactory aesthetic results even after 15 months.

Clinical Relevance The internal adaptation of resin composites that are recommended to be placed with the conventional insertion technique could be improved when the resin composites are preheated prior to their placement. SonicFill 2 and VisCalor bulk show the best internal adaptation when they are inserted as per the manufacurer's recommended techniques. SUMMARY Objective: To compare the effects of conventional (hand-placed), sonic, or preheated insertion techniques on the internal adaptation of bulk-fill resin composites. Methods and Materials: A total of 150 freshly extracted human third molars were used to prepare standardized cylindrical occlusal cavities. Teeth were divided into five main groups according to the resin composites: 1 incremental (Clearfil Majesty Posterior [CMP]) and four paste-like bulk-fill (SonicFill 2 [SF2], VisCalor bulk [VCB], Filtek One bulk-fill restorative [FBR], and Tetric EvoCeram bulk-fill [TEB]). Each main group was divided into three subgroups according to the placement technique: conventional, preheating, and sonic delivery (n=10). In the conventional placement technique, cavities were filled manually. In the sonic insertion technique, a specific handpiece (SonicFill Handpiece; Kerr Corporation) was used. In the preheating technique, a heating device (Caps Warmer, Voco, Cuxhaven, Germany) was used to warm the resin composites before placement. Internal voids (%) of the completed restorations were calculated with microcomputed tomography. Data was analyzed with two-way analysis of variacne followed by Tukey’s multiple comparisons test (α=0.05). Results: All resin composites showed fewer internal gaps with preheating compared with the conventional placement (p&lt;0.05). For all resin composites other than SF2, preheating provided fewer internal gaps than that of the sonic placement (p&lt;0.05). Sonic placement led to fewer internal gaps compared with the conventional placement, but only for SF2 and FBR (p&lt;0.05). For the conventional placement, the lowest gap percentage was observed with the incremental resin composite (CMP, p&lt;0.05). Among all groups, the lowest gap percentages were observed for preheated VCB followed by sonically inserted SF2 (p&lt;0.05). Conclusion: The best internal adaptation was observed in sonically inserted SF2 and preheated VCB, which were the manufacturers’ recommended insertion techniques. Preheating considerably improved the internal adaptation of all resin composites, except for that of SF2.