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El Gezawi, M.; Kaisarly, D.; Al-Saleh, H.; ArRejaie, A.; Al-Harbi, F.; Kunzelmann, K. H. (2016): Degradation Potential of Bulk Versus Incrementally Applied and Indirect Composites: Color, Microhardness, and Surface Deterioration. In: Operative Dentistry, Vol. 41, No. 6, E195-E208
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Abstract

This study investigated the color stability and microhardness of five composites exposed to four beverages with different pH values. Composite discs were produced (n=10);Filtek Z250 (3M ESPE) and Filtek P90 (3M ESPE) were applied in two layers (2 mm, 20 seconds), and Tetric N-Ceram Bulk Fill (TetricBF, Ivoclar Vivadent) and SonicFill (Kerr) were applied in bulk (4 mm) and then light cured (40 seconds, Ortholux-LED, 1600 mW/ cm(2)). Indirect composite Sinfony (3M ESPE) was applied in two layers (2 mm) and cured (Visio system, 3M ESPE). The specimens were polished and tested for color stability;Delta E was calculated using spectrophotometer readings. Vickers microhardness (50 g, dwell time=45 seconds) was assessed on the top and bottom surfaces at baseline, 40 days of storage, subsequent repolishing, and 60 days of immersion in distilled water (pH=7.0), Coca-Cola (pH=2.3), orange juice (pH=3.75), or anise (pH=8.5) using scanning electron microscopy (SEM). The materials had similar DE values (40 days, p>0.05), but TetricBF had a significantly greater DE than P90 or SF (40 days). The Delta E was less for P90 and TetricBF than for Z250, SonicFill, and Sinfony (60 days). Repolishing and further immersion significantly affected the DE (p<0.05) except for P90. All composites had significantly different top vs bottom baseline microhardnesses. This was insignificant for the Z250/ water, P90/orange juice (40 days), and Sinfony groups (40 and 60 days). Immersion produced variable time-dependent deterioration of microhardness in all groups. Multivariate repeated measures analysis of variance with post hoc Bonferroni tests were used to compare the results. DE and microhardness changes were significantly inversely correlated at 40 days, but this relationship was insignificant at 60 days (Pearson test). SEM showed degradation (40 days) that worsened (60 days). Bulk-fill composites differ regarding color-stability and top-to-bottom microhardness changes compared with those of other composites. P90 showed better surface degradation resistance. In conclusion, bulk-fill composites are not promising alternatives to incremental and indirect composites regarding biodegradation.