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Synopsis Presentation

Presented ByDr Rajeshwar Singh

First Year Postgraduate studentGuide : Head of Department :

Dr. Suparna Ganguly Saha Dr. Suparna Ganguly Saha Professor & HOD Professor & HOD

DEPARTMENT OF CONSERVATIVE DENTISTRY & ENDODONTICSCOLLEGE OF DENTAL SCIENCES AND HOSPITAL

RAU (INDORE)

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Title of Research

• Evaluation of Marginal integrity and Depth of Cure for three ‘bulk fill’ composites : SDR, Tetric Evoceram Bulk Fill Composite and EverX Posterior Bulk Fill Composite - An In Vitro study

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Aim of study

• The aim of this study is to evaluate, in vitro, the marginal adaptation and depth of cure of three ‘bulk fill’ composites

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Objectives of study 1- Evaluation of marginal integrity of bulk fill composites and

a standard flowable composite (control) for restoration of class II cavities prepared in human premolars.

2- Determination of the depth of cure for three bulk fill composites using Vickers Hardness Number (VHN).

3- Determination of the depth of cure for three bulk fill composites using ISO 4049 method.

4- Comparative evaluation of depth of cure obtained by the Vickers hardness test and ISO 4049 method.

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Materials• Bulk-Fill Composites

a) Smart Dentin Replacement (Dentsply) b) Tetric Evoceram Bulk Fill composite (Ivoclar Vivadent)

c) EverX Posterior (GC EUROPE)

• Filtek flowable composite (3M)

• Adhesives Tetric-N-Bond (Ivoclar Vivadent) • 37% phosphoric acid for total etching

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• Custom Fabricated Brass Mold with internal diameter of 10mm and depth of 4mm

• VHN Indentation machine

• Plastic tube with internal diameter of 6mm and height of 4mm

• Digital Vernier Calliper instrument

• 1% Methylene blue dye

• Stereo microscope

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Sample size

• For Marginal adaptation – 40 (extracted human premolars)

• For depth of cure by Vickers Hardness Number – 40

• For depth of cure by ISO 4049 standard method - 40

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Inclusion Criteria(for Marginal Integirty)

• Teeth extracted for therapeutic reasons• Sound teeth with good dentinal support• Teeth with complete root formation and

mature apex• Non-carious teeth

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Exclusion Criteria(for Marginal Integirty)

• Carious teeth• Fractured teeth• Teeth with root resorption

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Method of StudyEvaluation of Marginal Integrity by Dye Penetration

Class II cavity preparation with dimensions -2mm width for the pulpal wall

-4 mm depth along lateral wall

-3mm length for the approximal wall

Finishing and polishing of the cavities with diamond points with rounding off the internal line angles

Total etch using 37% Phosphoric Acid followed by Adhesive procedure with Tetric –N-Bond

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Prepared tooth will be mounted on wax molds and adaptation of matrix band.

Randomization of the teeth to four groups (n=10)

Group ISmart Dentin Replacement

Group IITetric Evoceram bulk fill composite

Group IIIEverX Posterior bulk fill composite

Group IVFiltek Flowable composite

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Slicing of the restoration parallel to the occlusal surface (mesio-distally) Evaluation of the samples for dye penetration

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Graphic model of microleakage assessment on the trasnverse cross section

Sample for assessment of micro leakage by dye penetration method

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Stereo-Microscope Assesment

Magnification 20x

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Marginal Integrity assesment using five- grade scale

(0) - No dye penetration into the filling material or along the filling tooth interface(1) - Dye penetration into the filling material or along the filling tooth interface up to half of the lateral wall (buccal or lingual)(2) -Dye penetration into the filling material or along the filling tooth interface along all lateral wall buccal or lingual (till bottom of the cavity, pulpal wall)(3) -Dye penetration into the filling material or along the filling-tooth interface up to half of both lateral walls(4) - Dye penetration into the filling materials or along the filling-tooth interface along both lateral walls buccal and lingual ( till the bottom of cavity , pulpal wall)

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Evaluation of depth of cureby Vickers Hardness number

Sample fabrication using custom made brass mold

Measurement of the top and the bottom surface hardness of each sample using Vickers micro hardness instrument

Calculation of B/T ratios for the sample

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Custom Fabricated brass mold

Vickers Hardness Indentation Setup

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Evaluation of depth of cure by ISO 4049 method

Fabrication of composite samples using plastic tube

Removal of samples from plastic tube after polymerisation and scraping of uncured bottom surface with a plastic spatula

Measurement of the remaining length with a digital vernier calliper and dividing the average length by 2 to obtain the result

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Statistical analysis

• Comparison of mean values between the groups will be done using One-way ANOVA along with Post-hoc Tukey.

• Comparison of median values between the groups will be done using Kruskal-Wallis test.

• A p-value of <0.05 will be considered significant

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References

• Orlowski M, Tarczydlo B, Chalas R. Evaluation of marginal Integrity of Four Bulk-Fill Dental Composite Materials: In vitro Study. The Scientific World Journal 2015;0-8.

• Agarwal RS, Hiremath H, Agarwal J, et al. Evaluation of cervical marginal and internal adaption using newer bulk fill composites: An in vitro study. Journal of conservative dentistry 2015;18:56-61.

• Benetti AR,Havndrup- Pederson C, Honore D, et al. Bulk-fill resin composites: polymerisation contraction, depth of cure, and gap formation. Operative Dentistry 2015;40:190-200.

• Jang JH, Park SH, Hwang IN. Polymerisation shrinkage and depth of cure of bulk-fill resin composites and highly filled flowable resin. Operative dentistry 2015;40:172-180.

• Abouelleil H, Pradelle N, Villat C, et al. Comparison of mechanical properties of a new fiber reinforced composite and bulk filling composites. Restorative Dentistry and Endodontics 2015; 1-9.

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• Campos EA, Ardu S, Lefever D, et al. Marginal adaptation of class II cavities restored with bulk-fill composites. Journal of dentistry 2014;42:575-81.

• Zhao XY, Li SB, Gu LJ, et al. Detection of marginal leakage of class V restorations In Vitro by micro-computed tomography. Operative dentistry 2014;39: 174-180.

• Garcia D, Yaman P, Dennison J, et al. Polymerization Shrinkage and Depth of Cure of Bulk Fill Flowable Composite Resins. J. Oper Dent. 2014 Jul-Aug;39:441-8

• Flury S, Peutzfeldt, Lussi A. Influence of increment thickness on microhardness and dentin bond strength on bulk fill resin composites. J. Dent Mater. 2014 ;30:1104-12.

• Moore BK, Platt JA, Borges G, et al. Depth of cure of dental resin composites: ISO 4049 depth and micro-hardness of types of materials and shades. Operative dentistry 2008;33:408-12.

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Thank You