UNIVERSIDADE FEDERAL FLUMINENSE FACULDADE DE ODONTOLOGIA
AVALIAÇÃO DA TEXTURA SUPERFICIAL E ESTABILIDADE DE COR DE COMPÓSITOS AUTO-ADESIVOS APÓS ABRASÃO POR ESCOVAÇÃO
Niterói 2015
UNIVERSIDADE FEDERAL FLUMINENSE FACULDADE DE ODONTOLOGIA
AVALIAÇÃO DA TEXTURA SUPERFICIAL E ESTABILIDADE DE COR DE COMPÓSITOS AUTO-ADESIVOS APÓS ABRASÃO POR ESCOVAÇÃO
CAROLINE VEIGA MALAVASI
Dissertação apresentada à Faculdade de Odontologia da Universidade Federal Fluminense, como parte dos requisitos para obtenção do título de Mestre, pelo Programa de Pós-Graduação em Odontologia.
Área de Concentração: Dentística Orientador: Profa. Dra. Larissa Maria Assad Cavalcante
Niterói 2015
FICHA CATALOGRÁFICA
M239 Malavasi, Caroline Veiga
Avaliação da textura superficial e estabilidade de cor de compósitos
auto-adesivos após abrasão por escovação / Caroline Veiga Malavasi;
orientadora: Profª Larissa Maria Assad Cavalcante. – Niterói: [s.n.],
2015.
36 f.; il.
Inclui gráficos e tabelas.
Dissertação (Mestrado em Odontologia). – Universidade Federal
Fluminense, 2015. Bibliografia: f. 29-32.
1. Material dentário. 2. Sistemas adesivos. I. Cavalcante, Larissa Maria Assad [orient.]. ll. Título.
BANCA EXAMINADORA
Prof(a). Dr(a). Larissa Maria Assad Cavalcante Instituição: Universidade Federal Fluminense
Decisão: _________________________Assinatura: __________________
Prof(a). Dr(a). Priscila Paganini Costa
Instituição: União Educacional do Planalto Central, FACIPLAC
Decisão: _________________________Assinatura: __________________
Prof. Dr(a). Celso Queiroz
Instituição: Universidade Veiga de Almeida
DEDICATÓRIA
À Deus, que sempre está comigo. Me fortalece, me orienta e ilumina o meu caminho nos momentos mais difíceis.
Aos meus pais, Celso e Lúcia. Muito obrigada por toda dedicação e apoio, por sempre incentivar a busca de meus sonhos ... Com vocês eu aprendi que as dificuldades podem anteceder nossas conquistas, e que somos fortes o suficiente para vencer qualquer obstáculo.
À minha irmã, Luciana e à minha tia Francis, grandes amigas e companheiras que estão sempre comigo, compartilhando avanços e conquistas pessoais e
profissionais.
Ao meu namorado, Raphael, por toda paciência e compreensão SEMPRE. Obrigada por fazer os meus dias mais felizes!
Essa conquista é nossa. Obrigada por tudo!
Em primeiro lugar, agradeço à minha orientadora Profa Larissa Maria Assad Cavalcante, a quem eu tanto admiro como pessoa e profissional. Muito obrigada por toda dedicação, por todo tempo dedicado a mim e a este trabalho. Obrigada por guiar todos os meus passos nessa caminhada, por me dar oportunidades e por depositar sua confiança em mim. Tenho certeza que aprendi muito com você.
Agradeço a todos os Professores da Disciplina de Dentística da Universidade Federal Fluminense. Eduardo, José Guilherme, Laiza, Glauco, Cristiane e Luis Felipe. Todos me servem de inspiração e exemplo profissional. Foram extremamente importantes para meu amadurecimento, desde os tempos de Graduação e Especialização.
Aos meus colegas de Mestrado que me acompanharam e que fazem parte desta intensa jornada, agradeço o carinho de todos, vocês foram essenciais. Agradeço em especial, Sarah, Alice, Keyla, Fabio e Marcos, obrigada por fazer meus dias mais leves, pela ajuda diária e por todas as experiências vividas e divididas nesses anos.
Às alunas de Iniciação Científica, Elisa e Karol, que participaram e que fazem parte da elaboração deste trabalho. Obrigada por toda disponibilidade e empenho.
Aos funcionários da Dentística, Zé Maria e Cleide. Obrigada pela atenção e pela grande disposição em ajudar os alunos, sempre.
A todos, obrigada por permitir que essa dissertação seja realidade.
Malavasi CV. Avaliação da textura superficial e estabilidade de cor de compósitos auto-adesivos após abrasão por escovação [dissertação]. Niterói: Universidade Federal Fluminense, Faculdade de Odontologia; 2015.
O objetivo deste estudo foi avaliar a textura superficial e a estabilidade de cor de dois compósitos auto-adesivos de baixa viscosidade e compará-los com um compósito nanoparticulado, antes e após o procedimento de envelhecimento através da abrasão por escovação dental. Os compósitos Vertise Flow (Kerr), Fusio Liquid (Jeneric Pentron) e Filtek Z350 XT(3MESPE) foram divididos em 3 grupos experimentais (n=6). Confeccionou-se discos de 12 mm de diâmetro e 2 mm de espessura. Todos os materiais foram fotoativados com uma fonte de luz LED por 40 segundos. As análises de rugosidade superficial, retenção de brilho e estabilidade de cor, foram realizadas 24 horas após fotoativação e novamente após 20.000 ciclos de escovação simulada. Os resultados foram submetidos à Análise de Variância de 2 fatores e ao teste de Tukey (95%). Em relação à rugosidade superficial, nenhuma diferença estatística foi observada antes da abrasão por escovação em qualquer material (p> 0,05), porém os três compósitos avaliados apresentaram propriedades ópticas alteradas após o procedimento abrasivo (p<0,05). A resina Filtek Z350 XT apresentou o melhor comportamento em valores de retenção de brilho (G.U). Na avaliação de rugosidade superficial, não houve diferença estatística entre os valores obtidos para as resinas Fusio Líquid Dentin e Filtek Z350 XT (p> 0,05). No parâmetro de estabilidade de cor, a resina Vertise Flow apresentou menor variação de ∆E, possuindo os melhores resultados. A hipótese testada de que a resina nanoparticulada Filtek Z350 XT apresentaria uma maior resistência à abrasão foi aceita, porém, essa resina não produziu os melhores resultados em todos os aspectos relacionados a textura e qualidade da superfície. Não se esperava que a resistência à abrasão encontrada em Fusio Liquid Dentin fosse similar à Filtek Z350 XT, e que a resina Vertise Flow apresentasse melhor estabilidade de cor. Esses resultados sugerem que o desenvolvimento constante de novos materiais, buscando uma maior simplificação da técnica, parece ser um atrativo inovador para a rotina clínica do cirurgião-dentista, porém, maiores estudos são necessários para prover a todos um melhor entendimento e aprimoramento da ação e eficácia dessa nova classe de materiais.
ABSTRACT
Malavasi CV. Surface texture and optical properties of self-adhering composite materials after toothbrush abrasion [dissertation]. Niterói: Universidade Federal Fluminense, Faculdade de Odontologia; 2015
This study evaluated the surface texture and optical properties of two self-adhesive composite and a nanofilled composite before and after toothbrush abrasion.
Vertise Flow (Kerr), Fusio Liquid (Pentron Clinical) and Filtek Z350 XT (3M ESPE) composites were divided into 3 groups (n = 6). Discs of 12 mm diameter and 2 mm thick were made. All materials were light-cured with a LED light source for 40 seconds. Analyses of surface roughness, gloss retention and color stability were performed 24 hours after light curing and after 20,000 brushing cycles. Data were analyzed with analysis of variance (ANOVA) and Tukey's test (α=5%). Results: Tukey´s test ascertained that toothbrush abrasion resulted in rougher and matte surfaces for all composites tested. Filtek Z350 presented better gloss retention after abrasion. On surface roughness evaluation, there was no statistical difference between Fusio Liquid Dentin and Filtek Z350 resins (p>0,05). Vertise Flow resin showed better color stability (ΔE), than the other two materials. Conclusions: Nanofilled material presented better gloss retention but it did not produce the best results in aspects related to surface roughness and color stability compared to self-adhering composites. Clinical Significance: A simulation of degradation process by using toothbrush abrasion produced a rougher and matte surface in all composites tested. Although, the surface texture wasn´t only related to filler’s amount present in the materials, but also with the organic matrix composition. The results suggested that the constant development of new materials, seeking for a technical simplification, seems an innovative attraction for dentist’s clinical routine, even though larger studies are necessary to promote to everyone a better understanding and improvement of action and effectiveness of this new class of materials.
Keywords: Laboratory research; Self-adhesive composite; self-adhering composites; Self-adhesive materials; Optical properties; surface texture, toothbrush abrasion.
1 - INTRODUÇÃO
Desde o desenvolvimento do monômero de Bisfenol A-glicidilmetacrilato (Bis-GMA) sintetizado em 1956 por Bowen, as resinas compostas têm passado por diversas e progressivas mudanças tecnológicas ao longo dos anos. Até pouco tempo atrás, as alterações mais importantes envolveram o reforço dos materiais com partículas de carga. Essas partículas foram reduzidas em tamanho a fim de produzir materiais que apresentassem melhores propriedades mecânicas e estéticas, como por exemplo, polimento mais fácil, eficaz e ainda menor degradação hidrolítica.1
Hoje em dia, essas mudanças parecem estar focadas na matriz polimérica do material, desenvolvendo sistemas com menor contração de polimerização, simplificando e facilitando sua técnica. Buscando esses objetivos, recentemente uma nova categoria de materiais foi lançada na mercado, os chamados compósitos auto-adesivos. Esses compósitos de baixa viscosidade foram desenvolvidos prometendo proporcionar uma redução do tempo clínico, bem como, uma possível diminuição da sensibilidade da técnica, encontrada nos sistemas adesivos convencionais de condicionamento ácido total. 2-4
As formulações encontradas nesses materiais são baseadas em sistemas metacrilato convencionais, mas que incorporam monômeros ácidos tipicamente encontrados nos sistemas adesivos autocondicionantes. Monômeros acídicos como o dimetacrilato de glicerolfosfato (GPDM) e 4-metacriloxietil trimelitato (4-MET) utilizados, são capazes de gerar adesão através de interações mecânicas e químicas com a estrutura do dente, resultando em uma rede inter-penetrante formada entre os monômeros polimerizados, fibras colágenas e camada de esfregaço.5,6
Os compósitos de baixa viscosidade foram lançamento no mercado no final da década de 90. A característica de fácil escoamento desses materiais pode ser atribuída à redução no teor do conteúdo de carga, o que reduz significativamente as propriedades mecânicas do material e aumenta a contração de polimerização, ou, por adição de outros agentes modificadores, tais como agentes surfactantes, que são capazes de melhorar o fluxo e impedem que haja uma grande redução no teor de carga.7 Usados principalmente como um forro ou um material de reparo, sabe-se
que os compósitos fluidos também podem ser aplicados como material de preenchimento em preparos conservadores classe I ou classe V.8,9
Os compósitos fluidos auto-adesivos recentemente desenvolvidos, podem ser considerados como uma nova classe de sistema simplificado. 2,3,10,11 Não obstante, parece interessante que as propriedades mecânicas desses materiais sejam avaliadas inicialmente ou após qualquer tipo de procedimento de envelhecimento. Afinal, sabe-se que a rugosidade de superfície, a retenção do brilho e a estabilidade da cor estão entre as mais importantes características de textura de superfície, sendo capazes de influenciar o aspecto das resinas compósitas e o desempenho clínico das mesmas.1,12-15
A estabilidade da cor e a retenção de brilho dos materiais restauradores, são considerados atributos essenciais na aparência visual,16 sendo estes, elementos vitais para a longevidade de restaurações diretas em áreas esteticamente importantes. Alguns estudos in vitro, 17-20 mostraram que os compósitos resinosos são suscetíveis a manchas e descoloração com o passar do tempo, e estudos clínicos confirmaram estes achados in vitro.
O Brilho presente nos materiais é originado a partir da distribuição geométrica da luz refletida pela superfície.21 Diferenças existentes na retenção de brilho do material restaurador, dente e estrutura circundante, podem ser detectadas mesmo quando as cores são correspondentes.
Sabe-se que a estabilidade de cor e o brilho também são influenciados pela rugosidade da superfície do material.18,22,23 Uma vez que, no ambiente oral, as superfícies resinosas são expostas a substâncias erosivas presentes em alimentos e bebidas e também aos efeitos abrasivos de cremes dentais durante a escovação. 24 Assim, é possível que o efeito sinérgico dos fenômenos de abrasão e erosão irá aumentar a rugosidade de todos os materiais resinosos ao longo do tempo, independentemente do seu tipo e partículas de carga.16
As características de durabilidade e qualidade da superfície do material também podem estar relacionadas com polimento e acabamento restaurador ideais.25 O acabamento/polimento inadequado das resinas compostas, leva ao aumento da retenção da placa, consequentemente à inflamação gengival, descoloração de restaurações e também ao desconforto do paciente.24
Jones et al26 relataram que uma rugosidade superficial de 0,3 mm, pode ser detectada pela língua do paciente. Portanto, superfícies lisas, com contorno
apropriado, suavidade e brilho elevado são capazes de produzir um dente com a aparência natural desejada pelo paciente.27 Variáveis, como tipo de resina composta, monômeros, concentração, tipo de partículas de carga e sistema utilizado para o acabamento/ polimento, parecem influenciar a superfície final das resinas compostas.24,27,28
Com base na importância da avaliação estética e buscando analisar o comportamento desta nova classe de materiais, o objetivo deste estudo foi avaliar a rugosidade da superfície, retenção de brilho e estabilidade de cor de duas resinas auto-adesivas, e compará-las com uma resina nanoparticulada convencional, antes e após o procedimento deenvelhecimento através da abrasão por escovação.
A hipótese testada é que a utilização dos compósitos auto-adesivos irá produzir menor resistência à abrasão quando comparados com a resina nanoparticulada, apresentando uma textura superficial com qualidade inferior. A hipótese nula é de que não há diferença entre a qualidade e textura superficial dos materiais, antes ou após o procedimento de abrasão por escovação.
2 - METODOLOGIA
2.1 Materiais:
Para o presente estudo foram utilizados compósitos odontológicos comerciais, conforme o Quadro 1:
Categoria Compósitos Composição
(% de carga inorgânica em peso / volume)
Compósito
Auto-adesivo Vertise Flow
GPDM, HEMA, Bis-GMA, cargas pré polimerizadas, nano partículas de fluoreto de itérbio, cargas de vidro de bário silanizadas,( 1µm), sílica coloidal nanométrica 70% em peso 48% vol Compósito Auto-adesivo Fusio Liquid Dentin UDMA,TEGDMA, HEMA, 4-MET,nano sílica amorfa,cargas de vidro de bário silanizadas, aditivos menores, sistema fotoativador 65% em peso 52%vol Compósito
Nanopartículado Filtek Z350 Bis-GMA, UDMA,
78,5% em peso 63,3% vol
TEGDMA, Bis-EMA, 20nm(0,02 µm) de cargas não-aglomeradas de sílica, 4 nm (0,04 µm) a 11 nm (0,011 µm) de cargas não-aglomeradas de zircônia e cargas agregadas de zircônia /sílica (20 nm (0,02 µm) de sílica e 4 a 11 nm (0,04 a 0,011 µm) de zircônia)
Quadro 1 – Composição dos materiais utilizados no estudo
2.2 Método:
Foram confeccionadas 6 amostras por grupo (n=6) com dimensões de 12 mm de diâmetro e 2 mm de espessura (Figura 1). Todos os materiais foram fotoativados com uma fonte de luz LED modelo Radiical (SDI) por 40 seg. A textura superficial foi mensurada através do teste de rugosidade e as propriedades ópticas pela avaliação da estabilidade de cor em um espectofotômetro e retenção de brilho em um glossmeter. As análises foram realizadas 24 horas após fototoativação e novamente após ciclos de escovação. Desta forma foram avaliados 3 grupos experimentais compostos pelos materiais descritos no Quadro 1.
Figura 1 - Matriz metálica 12mm X 2mm
2.2.1 Avaliação da retenção de brilho:
O brilho foi avaliado com um medidor de brilho (Gloss meter tri-angle – Zehntner) que foi calibrado de acordo com as instruções do fabricante (Figura 2A e 2B). Foram realizadas duas medidas na porção central de cada amostra (n = 2). As medidas em G.U. (unidades de brilho) foram feitas por meio de uma luz de tungstênio branca que atinge a superfície em um ângulo de 60°, 20º ou 85º dependendo do tipo de superfície a ser avaliada. Um detector fotoelétrico mede a intensidade de luz emitida pelo aparelho. A intensidade de luz refletida é então mensurada por uma fotocélula receptora no mesmo ângulo. As medidas em G.U. (unidades de brilho) foram feitas com ângulo de incidência de 60º.
2.2.2 Avaliação da rugosidade superficial:
Análise quantitativa:
Para o ensaio de rugosidade foi utilizado um rugosímetro (Mitutoyo). O aparelho fez a leitura através de uma ponta de diamante com velocidade constante de 1.00 mm/s e força aplicada de 6mN (Figura 3A e 3B). A ponta percorreu uma distância de 2 mm e foram feitas 6 avaliações por amostra. O parâmetro Ra (média aritmética dos picos e vales de uma superfície) foi utilizado.
Figura 3A e 3B - Rugosímetro (SJ-201 – Mitutoyo, Japão)
Análise qualitativa:
A análise 3D de uma amostra por grupo foi realizada antes e após o procedimento de envelhecimento em todos os espécimes com o uso de um perfilômetro, modelo Classe Taylor-Hobson de Talysurf Series (Figura 4). Um corte de 0,10 mm de aspereza e um corte de 0,50 mm de ondulação foram utilizados para fazer a varredura da superfície. Dados fornecidos pela topografia foram obtidos e analisados pelo software Talymap Universal, versão 3.0 (Taylor Hobson)
Figura 4 – Rugosímetro (Taylor-Hobson)
2.2.3 Avaliação da estabilidade de cor
Para a análise da estabilidade de cor será utilizado um espectofotômetro (CM2600d Minolta, EUA) empregando o parâmetro CIELab. Basicamente, o parâmetro CIELab é composto de três eixos (Figura 5):
1. Eixo L: avalia o grau de luminosidade, e pode variar de 0 (preto) à 100 (branco).
2. Eixo a: pode variar de valores negativos (verde) até valores positivos (vermelho).
3. Eixo b: pode variar de valores negativos (azul) até valores positivos (verde). O estudo das alterações de cor será realizado 24 horas após a fotoativação das amostras em ambiente seco. As amostras serão então submetidas a ciclos de escovação e as leituras de cor serão repetidas.
As leituras realizadas pelo espectofotômetro serão realizadas com as amostras posicionadas sobre uma superfície branca padronizada. Assim, a variação total (ΔE) de cor será determinada pela seguinte fórmula ΔE = [(ΔL)2 + (Δa)2
+ (Δb)2
]1/2, a qual considera a variação dos valores em cada eixo do parâmetro CIELab entre a primeira avaliação (logo após o procedimento de fotoativação) e a última leitura realizada após o procedimento de abrasão por meio de escovação.
Os resultados das avaliações de cor, retenção de brilho e rugosidade foram submetidos ao teste de análise de medidas repetidas no tempo. A diferença entre os valores iniciais e finais foram utilizados para realizar a comparação entre materiais.
Figura 5 - Espectofotômetro (CM2600d Minolta, EUA)
2.2.4 Procedimento de envelhecimento:
Um simulador de ciclos de escovação foi utilizado para abrasionar a superfície das amostras. Escovas dentais (Dr. Veit Soft, Dr. Veit Produtos Odontológicos, Brasil) foram acopladas à máquina de escovação de forma que apresentassem íntimo contato com a superfície das amostras (Figura 6). A simulação da escovação foi através da aplicação de uma carga vertical de 2.5N durante movimentos horizontais. Uma proporção de 2:1 (água: dentifrício fluoretado) foi utilizada como “slurry” de acordo com a norma da ISO/TS 1469-1. Para cada amostra 12 gramas de slurry foram utilizadas, todas as amostras foram submetidas a 20.000 ciclos de escovação.
Figura 6 - Simulador de escovação (MEV2 – ODEME, Brasil)
Após a abrasão, as amostras foram removidas da máquina de escovação, lavadas com água destilada e então secas. As medidas de rugosidade superficial, estabilidade de cor e brilho foram repetidas.
Na análise dos resultados, foram empregados os modelos estatísticos adequados à distribuição dos dados. Confirmada a normalidade da distribuição para cada variável estudada foi aplicado análise de variância e teste de Tukey (95%).
3 - ARTIGO PRODUZIDO
Surface texture and optical properties of self-adhering composite materials after toothbrush abrasion
Caroline Veiga Malavasi1 Elisa Maria Macedo1 Karoline da Costa Souza1 Guilherme Ferreira Rego1
Luis Felipe Jochims Schneider1,2 Larissa Maria Assad Cavalcante1,3
1. School of Dentistry, Federal Fluminense University - UFF, Niterói, RJ, Brazil. 2. School of Dentistry, Veiga de Almeida University - UVA, Rio de Janeiro, RJ, Brazil. 3. School of Dentistry, Salgado de Oliveira University - UNIVERSO, Niterói, RJ,
Brazil
*Correspoing author: Dr(a) Caroline Veiga Malavasi – Universidade Federal
Fluminense – Faculdade de Odontologia – Rua Mário Santos Braga nº 30 – Campus Valonguinho, Centro, Niterói, RJ, Brazil – CEP: 24040-110 – Phone: 55 21
995122812 - email: carolinemalavasi@msn.com
ABSTRACT
This study evaluated the surface texture and optical properties of two self-adhesive composite and a nanofilled composite before and after toothbrush abrasion.
Vertise Flow (Kerr), Fusio Liquid (Pentron Clinical) and Filtek Z350 XT (3M ESPE) composites were divided into 3 groups (n = 6). Discs of 12 mm diameter and 2 mm thick were made. All materials were light-cured with a LED light source for 40
seconds. Analyses of surface roughness, gloss retention and color stability were performed 24 hours after light curing and after 20,000 brushing cycles. Data were analyzed with analysis of variance (ANOVA) and Tukey's test (α=5%). Results: Tukey´s test ascertained that toothbrush abrasion resulted in rougher and matte surfaces for all composites tested. Filtek Z350 presented better gloss retention after abrasion. On surface roughness evaluation, there was no statistical difference between Fusio Liquid Dentin and Filtek Z350 resins (p>0,05). Vertise Flow resin showed better color stability (ΔE), than the other two materials. Conclusions: Nanofilled material presented better gloss retention but it did not produce the best results in aspects related to surface roughness and color stability compared to self-adhering composites. Clinical Significance: A simulation of degradation process by using toothbrush abrasion produced a rougher and matte surface in all composites tested. Although, the surface texture wasn´t only related to filler’s amount present in the materials, but also with the organic matrix composition. The results suggested that the constant development of new materials, seeking for a technical simplification, seems an innovative attraction for dentist’s clinical routine, even though larger studies are necessary to promote to everyone a better understanding and improvement of action and effectiveness of this new class of materials.
Keywords: Laboratory research; Self-adhesive composite; self-adhering composites; Self-adhesive materials; Optical properties; surface texture, toothbrush abrasion.
INTRODUCTION
Since the development of bisphenol A-glycidyl methacrylate (Bis-GMA) monomer in 1956 by Bowen, dental composites have undergone diverse and progressive technological changes over the years. These changes focus on filler sizes and polymeric matrix material in order to develop systems with better mechanical and aesthetic properties as well as low polymerization shrinkage.1
In order to simplify and make restoration technique easier, a new category of material has been launched, the self-adhering composites. This new category of
low-viscosity composites was developed to provide a reduced clinical time as well as a possible decrease in the sensitivity of the technique found in the conventional total-etching adhesive systems.2-4
The material´s formulations were based on conventional methacrylate systems, however they incorporated acidic monomers typically found in self-etching adhesives systems. Monomers such as glycerolphosphate dimeth acrylate (GPDM) and 4-methacryloxyethyl trimellitate (4-MET) are used and may be able to generate adhesion through mechanical and probably chemical interactions with tooth structure, resulting in an inter-penetrating network created between the polymerized monomers, collagen fibers and smear layer.5,6
Low-viscosity composites were released in the market in the end of 90’s decade. The flowability feature is attributed either to the reduction in the filler content, which reduces significantly the mechanical properties of the material and increases the polymerization shrinkage, or to adding other modifying agents such as surfactants that improve flow and prevent a great reduction in the filler content.7 Mainly used as a liner or a repair material, the flowable composites can also be applicable as filling material in conservative Class I or Class V preparations.8,9
The new developed self-adhering flowable composites may be considered as a sort of stepless system.2,3,10,11 The development of materials focusing on simplification of operative procedures seems to be the most logical next step for dental manufacturers.
Notwithstanding, mechanical properties of newly developed materials should be assessed initially or after any type of aging procedure. It is known that the surface roughness, gloss retention and color stability are among the most important characteristics of surface texture that influence the appearance of composite resins and clinical performance. 1,12-15
Color stability is vital for the longevity of direct restorations in esthetically important areas.16 In vitro studies,17-20 showed that resin-based composites are susceptible to staining and discoloration.
Gloss originates from the geometrical distribution of the light reflected by the surface and is an attribute of visual appearance.21 Differences in gloss between a restoration and the surrounding tooth structure can be detected even when colors are matched. Color stability and gloss are also influenced by surface roughness.18,22,23
In oral environment, resin surfaces are exposed to erosive substances present in food and beverage and to the abrasive effects of toothpastes and toothbrushing.24 Thus, it is possible that the synergistic effect of abrasion and erosion phenomena will roughen all resin materials over the time, regardless their type and filler particles.16
The durability and quality of material surface can also be related to ideal restorative polishing and finishing.25 The inadequate finishing/polishing of resin composites leads to increased plaque retention, gingival inflammation, discoloration of restorations and also leads to patient discomfort.24 Jones et al26 reported that a surface roughness of 0.3 µm can be detected by the tip of the patient’s tongue.
Proper contour, smoothness and high gloss can produce the appearance of natural tooth structure desired by patients.27 Therefore, it is of paramount importance to obtain smooth and glossy surfaces. Variables, such as the type of monomer, concentration and type of filler particles, finishing/ polishing system all influence the final surface polishing of resin composites.24, 27,28 Based on the importance of aesthetic evaluation and on the need of searching the behavior analysis of this new class of materials, the aim of this study was to evaluate the surface roughness, gloss retention and color stability of two self-adhesive resins composite, and compare them with a conventional nanofilled resin composite before and after toothbrush abrasion.
The null hypotheses tested were that self adhering composites would produce: (i) rougher surfaces ; (ii) less gloss retention and (iii) less color stability after toothbrush abrasion than nanofilled.
MATERIALS AND METHODS
Two self-adhering commercial composites, Vertise Flow (VF - Kerr, Orange, CA, USA) and Fusio Liquid Dentin (FL - Pentron Clinical, Orange, CA, USA) and one nanofilled composite, Filtek Z350 XT (Z350 - 3M ESPE, St. Paul, MN, USA) were evaluated in this study (Table 1).
Six disc specimens (10 mm x 2 mm) were prepared from each product. The samples were irradiated for 40 s from each surface with a light curing unit LED model Radiical (SDI) operated in standard mode, emitting 1000 mW/cm2 irradiance.
Surface Gloss
The surface gloss was measured with a glossmeter (Gloss meter tri- angle - Zehntner) which was calibrated against a standard black glass provided by the manufacturer. Measurements were performed at 60º light incidence and reflection angles relative to the vertical axis. The measuring window was 2 x 2 mm.
Color stability
The color of all specimens was determined with a colorimeter (Minolta CM2600d, USA) according to the CIE-L*a*b* system. The readings were taken for each specimen while placedagainst a white-tile ceramic background. The colorimeter was set to make color measurements (L*, a* and b*) based on average daylight (D65) illumination. All measurements were repeated twice and means for the L*-, a*-, and b*- values were automatically calculated by the machine. The color changes, ΔE*, were calculated from the single color values L*, a* and b*, according to the following formula:
ΔE* = [(L*
1 - L*2)2 + (a*1 - a*2)2 + (b*1 - b*2)2]1/2
where (L*1, a*1, b*1)were the values before toothbrush abrasion and (L*2, a*2, b*2) after
toothbrush abrasion.
Surface roughness
Portable Surface Roughness Measurement instruments (SJ-201 – Mitutoyo, Japan) were used to measure the surface roughness. The diamond stylus had a radius of 5 μm, tip angle of 90º and was traversed at a constant speed of 1.00 mm/s across the surface with a force of 6 mN. Six line scans were performed per specimen surface, three in horizontal and three in perpendicular directions. The cut-off length was 0.25 mm and the measuring length 2 mm. The amplitude parameter Ra (the arithmetic mean of the absolute departures of the roughness profile from the mean line) was measured.
Qualitative analysis
3D analysis of one sample per group was carried out in all specimes before and after aging procedures with the use of a profilometer, Rank Taylor-Hobson model from Talysurf Series. A 0.10-mm-roughness cutoff and a 0.50-mm-waviness cutoff were used to scan the surface. Data provided by topography were obtained and analyzed by the software Talymap Universal, version 3.0 (Taylor Hobson).
Aging Procedure
A toothbrush simulating machine (MEV2 – Odeme, Brazil ) was used to abrade the samples surfaces. The toothbrush machine had six separate “stations” and six separate toothbrush holders which were driven by a motor. Hence six specimens were concurrently and individually subjected to an equal amount of toothbrush/dentifrice abrasion during each testing period. A toothbrush (Dr. Veit Soft, Regular, Dr, Veit Produtos, Rio de Janeiro, RJ) was fixed in the toothbrush holder so that all the bristles were in contact with the specimen. The testing machine was adjusted to apply 2.5 N vertical load on the specimen during horizontal movement throughout the test. A current dentifrice (Colgate Total, Colgate-Palmolive, Manchester, UK) was used to form the slurry (2:1, water: toothpaste) according to ISO/TS 1469-1. Each “station” of the machine was filled with 12 g of slurry. All
specimens were brushed with inverse strokes 20,000 times, as measured with an incorporated meter. The toothbrush and the slurry were replaced for each specimen.
After abrasion, specimens were removed from the machine, rinsed with tap water, cleaned in the ultrasonic bath with distilled water for 5 min, and gently air dried. All measurements were then repeated.
Data were submitted to analysis of variance (ANOVA) with repeated measures on time followed by Tukey’s test, at a 5% global level of significance.
RESULTS
Gloss retention (G.U.)
Gloss values ranged between 42.8 and 75.9 GU before and between 5.6 and 35.1 GU after toothbrush abrasion (Table 2). For all materials a statistically significant reduction in gloss was observed after toothbrush abrasion. Vertise Flow and Fusio Liquid Dentin exhibited poor gloss retention after toothbrushing.
Color Stability
ΔE* values ranged between 0.7 and 2.0 (Table 3). Vertise Flow showed significantly greater color changes than Fusio Liquid Dentin and Filtek Z350. No statistically significant differences were detected in color stability to Filtek Z350 and Fusio Liquid Dentin.
After toothbrush abrasion rougher surfaces were observed in all tested materials. It´s possible to see in Taylor Robson 3D analysis, the difference between the inicial and final mass after toothbrush abrasion (Figure 1, Figure 2 and Figure 3).
In quantitative analyzes, Ra values ranged from 0.02-0.04 µm before and from 0.13 to 0.24 µm after toothbrush abrasion. (Table 4).
Tukey´s post-hoc test revealed no significant differences among materials before abrasion. However, statistically significant mean differences in Ra values after toothbrush abrasion were detected. These differences were more prominent for the self-adhering composite Vertise Flow in comparison to Fusio Liquid Dentin and Filtek Z350 XT.
DISCUSSION
Since the characteristics of durability and quality of material’s surface (roughness, gloss and color) might be related to abrasion resistance,15,18,22,29 in vivo, they are daily influenced by general factors, such as the pressure made by patient while brushing, the toothbrush bristle’s consistence, the brushing moment and the toothpaste abrasiveness.24,30,31
In order to obtain a better understanding and analysis of the behavior of the materials tested in this study, all of them were submitted to the same abrasive conditions, which consisted in a 20.000 cycle brushing aging procedure. This, according to some authors, corresponds to an average two year period of brushing in vivo.32,33
Our results were therefore influenced only by specific factors related to the individual characteristics of each material, such as the inorganic composition, considering the influence of filler’s morphology, size and content; organic matrix composition; quality of inorganic interface matrix/particle and the conversion degree of monomers into polymers during polymerization process.12,18,25,34-36
The abrasion process usually occurs through the gradual removal of organic matrix, which ends up leaving the fillers without support and susceptible to exfoliation.30 As a result, when particles of larger fillers are removed, a rougher surface is expected, hence materials with smaller fillers are more resistant to the
abrasive process. This might be related to its inter-filler spacing, which grows as the filler’s size grows.12
In this work, after the abrasive procedure, there was an increase in the superficial roughness values in all groups, which produced significant changes in the surface proprieties in all materials tested.
After the abrasive procedure, Vertise Flow resin had a rougher surface and showed a greater increase in Ra values (0,24 µm) compared to Fusio Liquid Dentin (0,15 µm) and Filtek Z350 (0,13 µm). This behavior might be justified, first of all, by the smaller volume of fillers (48% vol) found in this resin when compared to the other resins tested, Vertise Flow and Filtek Z350 (52% vol e 63,3% vol, respectively).
Secondly, we can justify this found by the organic matrix of the materials evaluated. According to some studies, a higher quantity of BisGMA offers less resistance to abrasion to the material,8,35 and the increase of monomers UDMA and TEGDMA in the composition of these materials can promote more resistance to abrasion.35,37,38
Therefore, the behavior of these monomers seems to follow the results obtained in this study, for Vertise flow contains Bis-GMA but does not contain UDMA and TEGDMA monomers, found in Fusion Liquid Dentin and Z350. Although there was a difference in the amount of filler particles (%vol), after the abrasive procedure there was no statistical difference in roughness values of Fusio Liquid Dentin and Filtek Z350.
When exposed to brushing, most nano-hybrids and micro-hybrids compounds maintain superficial roughness lower than 0,2µm, which, according to some studies, might be considered a threshold for plaque retention.14,22,24 Moreover, it has already been reported that a superficial roughness rate between 0,25 and 0,5µm can be detected by the patient’s tongue.26,30
Among the results obtained in this study, only Vertise Flow resin presented inferior results, with a roughness value on the sideline of this threshold for plaque retention.
Previous studies have already revealed a strong correlation between surface roughness and gloss.24,29 Since gloss is a visual feature produced by specular and selective reflation of incident light on a material’s surface, it is influenced by the material’s refraction index and by the angle of light incidence.39,40
The lighting angle affects the quantity of light reflected by the material.
According to Silkas e col13 in the 60º incident angle, light is considered more trustful to a clinical point of view, for it is closer to the observer’s perception of the teeth’s color. Higher gloss values indicate smother surfaces.14
According to some authors,14,41 by increasing the roughness it is possible to increase the reflex of random light, decreasing the gloss, which indicates an inverse relation between roughness and gloss in compound resin fillings. Even though, a study done by Takanashi30 did not demonstrate an association between these two factors. According to the author, gloss is also influenced by other additional factors besides surface roughness, such as the differences of refraction indexes of resin’s matrix, the differences of efficiency of matrix/filler interface bond,25 and the difference of intrinsic factors of the material itself (type, shape, size, hardness, and filler distribution).12,30
In all materials tested in this study, surface became statistically less glossy after the abrasive procedure. A reduction in gloss retention of 92% was observed for Vertise flow resin, 84% for Fusio Liquid Dentin and 53% for Filtek Z350. Although Fusio Liquid Dentin presented results for roughness statistically similar to Filtek Z350, in the gloss retention analysis the results were different.
Filtek Z350 resin presented higher values of gloss retention in G.U, and statistically there was no difference between the final values obtained for self-adhesive resins Fusio Liquid Dentin and Vertise Flow. The best performance of Filtek Z350 resin can be justified by the higher quantity of fillers (%vol) and also by the shape and size of its fillers. Small particles cause a decrease of diffuse reflex, resulting in a glossy outlook,29 and the spherical shape of the particles, like the ones found in Filtek Z350, can offer a high light reflex, improving the gloss of these materials.22
Although gloss is considered a more sensible characteristic for surface quality evaluation after brushing,1 in this study no direct relation between surface roughness and gloss of these materials was observed. This seems to agree with Takanashi’s30
study.
Concerning color stability, in this study the evaluation was made by comparing each material’s ΔE. It has been demonstrated in literature that ΔE values above 1 are perceptible by the naked eye,42 and ∆E values similar or superior to 3,3 are considered clinically unacceptable.43,44
After the abrasive procedure performed in this study, Vertise flow resin presented a smaller variation of ∆E (0,7). Superior results were found in resins Fusio Liquid Dentin (∆E 3,1) and Filtek Z350 (∆E 2,0), without statistical difference between the last two ones.
It is known that color variation may be caused by material’s intrinsic and extrinsic factors.16,17,45,46 Since in this study the specimens were not exposed to any coloring agent, the changes in optic properties resulted only from physic-chemical reaction occurred internally in the materials tested.
It has been reported in literature that the conversion degree of each material may be strongly related to the optic changes of themselves,18,47 once the presence of double carbon bonds that did not reacted during to polymerization process, it makes the resins more susceptible to degradation, which may create a variation of refraction index of these materials. This results in opacity changes, promoting color alteration and influencing the ∆E values over the time.38,48
A study done by Eliades49 analyzed some features concerning the resins Vertise Flow and Fusio Liquid Dentin, and compared them to other fluid resins. The observed result was that the conversion degree of self-adhesive resins was extremely high compared to others, 76,1% (VF) and 59,2% (FS). Possible explanations to the high conversion rate are related to the small and flexible monomers employed in the composition of these materials; the presence of HEMA, which, for being very reactive quickly interacts with residual C=C bonds; the effects of molecular orientation of hydrophilic monomers and acid monomers, which bring C=C bonds to a position that promotes the conversions,50 and finally, the higher quantity of catalysts and co-catalysts used in photopolymerizable systems with acidic monomers.51
The high value observed for conversion degree of self-adhesive resin Vertise Flow may justify the superior color stability found in this study. Besides that, the interior color stability found in Fusio Liquid dentin and Z350, may be also justified by the presence of TEGDMA monomer in the organic matrix of such materials. Due to the presence of three etoxi groups in its main chain, this monomer has a higher propensity to water absorption.16,38,48
CONCLUSION
The surface texture not only related to filler’s amount present in the materials, but also with the organic matrix composition.
Nanofilled material presented better gloss retention but it did not produce the best results in aspects related to surface roughness and color stability compared to self-adhering composites.
CLINICAL SIGNIFICANCE
A simulation of degradation process by using toothbrush abrasion produced a rougher and matte surface in all composites tested. The results suggested that the constant development of new materials, seeking for a technical simplification, seems an innovative attraction for dentist’s clinical routine, even though larger studies are necessary to promote to everyone a better understanding and improvement of action and effectiveness of this new class of materials.
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List of figures
Figure 1: Vertise Flow before and after toothbrush abrasion in 3D analysis
Figure 2: Fusio Liquid Dentin before and after toothbrush abrasion in 3D analysis Figure 3: Filtek Z350 XT before and after toothbrush abrasion in 3D analysis
List of tables
Table 1: Materials details and manufacturers specifications Table 2: Gloss values (G.U.) before and after toothbrushing Table 3: ΔE* values
Table 4: Surface roughness values (Ra parameter) before and after toothbrushing
Table 1. Materials details and manufacturers specifications
CATEGORY COMPOSITES Composition (% norganic filler
weight / volume)
Self-adhesive
composite Vertise Flow
GPDM, HEMA, Bis-GMA, pre-polymerized fillers, nano particles ytterbium fluoride, 1μm of barium glass filler, colloidal nano silica
70% wt 48% vol
Self-]adhesive
composite Fusio Liquid Dentin
UDMA,TEGDMA, HEMA, 4-MET, nano amorphous silica, silanized barium glass, minor additives, curing unit system
65% wt 52%vol
Nanofilled composite Filtek Z350 XT
GMA, UDMA, TEGDMA, Bis-EMA, 20nm (0.02 microns) of non-agglomerated silica fillers, 4 nm (0.04 microns) to 11 nm
(0.011 microns) of
non-78,5% wt 63,3% vol
agglomerated fillers Zirconia and and aggregated loads of zirconia / silica (20 nm (0.02 microns) of silica and 4 to 11 nm (from 0.04 to 0.011 microns) of Zirconia)
Table 2. Gloss values (G.U.) before and after toothbrushing
G.U. (standard deviation)
COMPOSITE Before toothbrushing After toothbrushing
Vertise Flow Aa 75.9 (7,8) Bb 5.6 (0,23)
Fusio Liquid Dentin Ab 42.8 (13,8) Bb 6.5 (0,30)
Filtek Z350 XT Aa 74.5 (17,58) Ba 35.1 (1,0)
* Uppercase horizontal and lowercase vertical (p≥0.005)
Table 3. ΔE* values
COMPOSITE ΔE* (standard deviation)
VERTISE FLOW B 0.7 (0,111)
FUSIO LIQUID DENTIN A 3.1 (0,659)
FILTEK Z350 XT A 2.0 (0,05)
* Uppercase vertically
Table 4. Surface roughness values (Ra parameter) before and after toothbrushing Ra (standard deviation)
COMPOSITE Before toothbruhing After toothbrushing
Vertise Flow Ba 0.04 (0,012) Aa 0.24 (0,088)
Fusio Liquid Dentin Ba 0.03 (0,022) Ab 0.15 (0,047)
Filtek Z350 XT Ba 0.02 (0,011) Ab 0.13 (0,061)
ANEXO A
Comprovante de publicação do artigo.
Revista The Journal of Contemporary Dental Practice – Mês de Outubro de 2015.
Malavasi CV, Macedo EM, da Costa Souza K, Rego GF, Schneider LFJ, Cavalcante LM. Surface Texture and Optical Properties of Self-Adhering Composite Materials after Toothbrush Abrasion. J Contemp Dent Pract 2015;16(10):775-782
