/home/opencode/cpanel/stomaeduj_hacked/uploads/2019/12/Article_6_4_1-Ozan-Hande.pdf RESTORATIVE DENTISTRY EFFECTS OF ACIDIC/ALCOHOLIC BEVERAGES ON THE SURFACE ROUGHNESS OF Original Articles COMPOSITE RESINS LIGHT-CURED FOR TWO DIFFERENT PERIODS OF TIME Günçe Ozan1a , Meltem Mert Eren2b , Sevda Ozel Yildiz3a , Hande Șar Sancakli1c* , Esra Yildiz1d 1 Department of Restorative Dentistry Faculty of Dentistry, Istanbul University, TR-34390 Fatih / Istanbul, Turkey 2 Department of Restorative Dentistry, Faculty of Dentistry, Altınbaș University, TR-34218 Bakirkoy / İstanbul, Turkey 3 Department of Biostatistics, Faculty of Medicine, Istanbul University, TR-34093 Fatih / Istanbul, Turkey a DDS, PhD, Research Assistant b DDS, PhD, Assistant Professor c DDS, PhD, Associate Professor d DDS, PhD, Professor ABSTRACT DOI: https://doi.org/10.25241/stomaeduj.2019.6(4).art.1 Introduction: The purpose of this study was to evaluate the surface roughness values OPEN ACCESS This is an Open Access article under the CC BY-NC 4.0 of various resin-based composites (RBC) regarding exposure time and immersion in license. alcoholic and acidic beverages. Peer-Reviewed Article Methodology: A total of 240 disc-shaped specimens (8 mm x 2 mm) were prepared Citation: Ozan G, Mert Eren M, Ozel Yildiz S, Șar from two microhybrid, one nanofilled and one nanohybrid RBC. Specimens Sancakli H, Yildiz E. Effect of acidic/alcoholic beverages on the surface roughness of compo- were divided into two groups, according to the exposure time; 20 or 40 seconds site resins light-cured in different times. Stoma Edu J. 2019;6(4):221-229 and immersed for 10 min/day during one month in either non-alcoholic (Coca Cola), alcoholic (red wine) beverages, or distilled water (n=10). Surface roughness Received: October 11, 2019 Revised: November 04, 2019 was measured after 24 hours, one week, and one month. Results were analyzed Accepted: November 18, 2019 Published: December 10, 2019 statistically using parametric and nonparametric test. Results: The roughness values (Ra) measured at 1-month immersion were signi- *Corresponding author: Associate Professor Dr. Hande ȘAR SANCAKLI, ficantly higher than those measured at 24 hours. There was no statistically significant Department of Restorative Dentistry Faculty of Dentistry Istanbul University difference due to exposure time (20 or 40 seconds) (p>0.05). Structure of RBC and Millet St. 4th Floor TR-34093 Capa, Istanbul presence of alcohol and phosphoric acid in the immersion solutions caused a Turkey Tel/Fax: +902124142020 / 30369 statistically significant difference among baseline and 1-month immersion intervals e-mail: handesar@hotmail.com (p<0.05). Among all RBCs, lowest Ra was observed in the microhybrid RBC Charisma Copyright: © 2019 the Editorial Council for Classic group. the Stomatology Edu Journal. Conclusion: Immersion in both acidic and alcoholic beverages altered the surfaces of all RBCs and generated significant surface roughness changes. All analyzed RBCs showed unacceptable changes in surface roughness. Keywords: Resin-based composites; Exposure time; Surface roughness; Aging. 1. Introduction incorporated in the monomer matrix leading to Resin-based composits (RBC) are successfully used for higher surface quality and superior polish retention the direct restoration of anterior and posterior teeth [4,8], associated with low wear rates and increased due to their simplified adhesive protocols, improved wear resistance. Besides the filler, the degree of cure esthetic and adequate physical properties. Moreover, of the monomer matrix may also affect the polish patients’ priorities have shifted to highly esthetic ability of a RBC [9]. Under ideal polymerization restorations in both the anterior and posterior conditions, less residual monomers are evidenced region. Considering that the posterior region has its and consequently a lower monomer release. own characteristics regarding the masticatory loads, On the contrary, monomers that were not involved chewing forces and possible parafunctional habits, in the polymerization reactions are able to alter the RBCs challenge certain shortcuts when used in the restorative material, due to a softening effect of posterior region. However, with the highlighted the polymer matrix, thus making the RBC prone to improvements in resin and filler technology, various wear and negatively affecting the surface qualities. types of RBCs have become available allowing for a Therefore, the curing units used for polymerization clinically successful placement also in the posterior as well the exposure time and distance may have a areas [1,2]. direct effect on the properties of the RBCs and their The mostly used RBC categories placed in the surface. Apart from an improvement in the filler posterior areas include microhybrid [3], nanohybrid system, modifications in the chemical composition [4] and nano [5] RBCs [4]. To increase the esthetic of the monomer system are identified as well in aspect, progressively smaller particles have been modern RBCs. Besides traditional monomers such Stomatology Edu Journal 221 EFFECTS OF ACIDIC/ALCOHOLIC BEVERAGES ON THE SURFACE ROUGHNESS OF COMPOSITE RESINS LIGHT-CURED FOR TWO DIFFERENT PERIODS OF TIME Table 1. Composition of the analyzed RBCs. Original Articles Lot/Ref. Name Brand Type Shade Content Number Aelite Bis-EMA, TEGDMA, Bis-GMA, Glass filler, Aesthetic Bisco Nanohybrid A2 H-852A2 silica-glass filers (0.04 – 5.0μm) (73 wt%) Enamel Bis-GMA, UDMA, Bis-EMA, TEGMA, silica Filtek filler (20 nm), non-agglomerated/ non- Ultimate 3M Nanofilled A2 N441522 aggragated zirconia filler (4-11 nm) and Body aggragated zirconia/silica cluster filler (0.6-10 µm) (78.5 wt%, 63.3 vol%) UDMA, prepolymerized fillers containing strontium and lanthan, prepolymerized G-aenial GC Microhybrid A2 1405161 fillers containing silica (16-17 µm), pyrogenic silica (< 100 nm) (81 wt%) Bis-GMA, TEGMA, Ba-Al-B-F-Si-Glass fillers Charisma Kulzer Microhybrid A2 010718A (0.7-2 µm), pyrogenic silica (0.01-0.07 µm) Classic (78 wt%, 68 vol%) Abbreviations: Bis-GMA = Bisphenol A glycidylmethacrylate ; UDMA = Urethane-dimethacrylate; TEGDMA = Triethylene glycol dimethacrylate ; Bis-EMA = Ethoxylated bisphenol A dimethacrylate. Table 2. Properties of the beverages used in the study. Brand pH Red wine Villa Doluca 3.72 (14% alcohol) Coca Cola 2.5 Coca-Cola Company as Bisphenol A glycidylmethacrylate (Bis-GMA), success of restorations. Consuming certain types Urethane-dimethacrylate (UDMA), or Triethylene of beverages may change the surface texture glycol dimethacrylate (TEGDMA), novel monomers of RBC restorations. The chemical properties of such as modified aromatic (AUDMA = aromatic beverages, such as their acidity, may affect the urethane dimethacrylate) and aliphatic (Bis-EMA surface properties leading to wear, softening, severe = ethoxylated bisphenol A glycol dimethacrylate) degradation, and staining [14]. Likewise, ethanol methacrylates have been included in organic (present in alcoholic beverages) has the potential to matrices [10,11] to reduce viscosity [11], water plasticize the organic matrix of RBCs, thus lowering sorption, and solubility [10], thus preventing resin the physical and mechanical properties [15]. Thus, matrices from being softened and degraded [5]. the effects of alcoholic and acidic beverages on the Apart from the content of the resins, the surfaces surface properties of RBCs need to be analyzed. The of RBCs are expected to degrade according to the purpose of this study was to evaluate the surface dynamics of the oral environment [12]. Excessive roughness values of various RBCs as a function of the surface degradation by means of oral conditions exposure time and the immersion in alcoholic and may not only lower the physical properties of RBCs acidic beverages. but also cause plaque accumulation, discoloration, The null hypotheses were that (1) the exposure time and secondary caries [13]. Therefore, maintaining would not affect the surface roughness of the various a smooth surface is important to the long-term analyzed RBCs and (2) the analyzed RBCs would have 222 Stoma Edu J. 2019;6(4): 221-229 www.stomaeduj.com EFFECTS OF ACIDIC/ALCOHOLIC BEVERAGES ON THE SURFACE ROUGHNESS OF COMPOSITE RESINS LIGHT-CURED FOR TWO DIFFERENT PERIODS OF TIME Original Articles similar surface properties after exposure to alcoholic the center of the specimen surface. The profilometer, and acidic beverages. which was calibrated against a standard after each measurement, was set to a cutoff value of 0.8 mm, 2. Materials and methods a transverse length of 0.8 mm and a stylus speed of 240 disc-shaped samples (8 mm in diameter and 0.1 mm/s. Measurements were taken directly after 2 mm in thickness) from four RBCs were prepared polishing the specimens (baseline) as well as after with a custom made stainless steel mold: the one week and one month. microhybrid Charisma Classic (Kulzer, Wehrheim, Germany), the microhybrid G-eanial (GC, Tokyo, 2.4. Statistical Analysis Japan), the nanohybrid Aelite Aesthetic Enamel Statistical analysis was performed using Statistical (BISCO Dental Products, Schaumburg, IL, USA) and Package for Social Sciences (SPSS) for Windows the nanofilled RBC Filtek Ultimate (3M, St. Paul, MN, 21.0. The normal distribution of the values was USA). The composition of the materials is shown in verified by Shapiro-Wilks tests. Acording to data Table 1. distribution, both parametric (repeated measures) and non-parametric (Friedmann) tests were used for 2.1. Specimen Preparation statistical analysis. A percentage roughness increase Specimens were prepared by inserting materials (%) after one month of immersion was calculated in one increment into a mold and placing a glass using following formula: plate on the top and bottom of the mold, with a Percentage roughness increase = Mylar strip in between. A constant pressure (with (R - one month a – R-Baseline a )/ R-Baseline a 1 kg weight) was applied on the glass plate for 15 With a = exposure time (20 or 40 seconds); seconds to allow the excess material to escape, thus R = Roughness, obtaining a flat specimen surface without bubbles. p values less than 0.05 were considered statistically Sixty specimens were prepared for each of the four significant. RBCs. After removal of the weight and the glass plate, the specimens were polymerized with a LED (Light 3. Results Emitted Diode) LCU (Light curing unit, SmartLite The mean values of the surface roughness (Ra) of the Max, Dentsply, Pennsylvania, USA, 1600 mW/cm2) RBCs cured for 20 or 40 seconds and immersed in for 20 seconds and 40 seconds. The LCU’s tip was varied beverages are shown in Table 3. positioned perpendicularly to specimens’ surfaces and the distance between the tip and specimen was 3.1. Comparisons of alterations in Ra values of RBCs by standardized using a glass microscope slide (1 mm time and beverages. thickness). All specimens were stored in distilled water at Table 3 shows that the groups exhibit higher 37±1°C for 24 hours to allow for post-polymerization. roughness values (Ra) after one week immersion The top surface of each specimen was polished compared to the baseline, except for the nanohybrid with flexible aluminum oxide discs (Sof-Lex; 3M) RBC (Aelite - 20 seconds polymerization) immersed under running water for 30 seconds. Polishing was in distilled water and the microhybrid RBC (Charisma performed by one operator to eliminate operator- Classic - 40 seconds polymerization) immersed in red dependent variability, and the discs were renewed wine. The mentioned specimens of the nanohybrid after their 5th use. RBC show no surface roughness change during storage, and the microhybrid specimens showed 2.2. Exposure to alcoholic and acidic beverages smoother surfaces after one - week of immersion in Specimens from each group (n = 10) were stored red wine. for 10 min/day during one month in one of the Regarding the one month results, except for following media: alcoholic (red wine-RW), acidic the groups microhybrid (G-aenial - 20 seconds non-alcoholic (Coca Cola-CC), and distilled water polymerization), microhybrid (Charisma Classic (DW) as control (Table 2). All of the beverages were - 40 seconds polymerization) and nanohybrid (Aelite used at room temperature and were renewed during - 20 seconds polymerization) RBCs, all other groups every period. The specimens were kept immersed in exhibit highest roughness (Ra) values. Microhybrid distilled water at 37±1°C between cycles. (G-aenial) specimens immersed in distilled water showed no changes in surface roughness and 2.3. Surface Roughness Measurements microhybrid specimens had a slightly rougher The roughness values for each specimen were surface after one month immersion in distilled water. measured with three consecutive readings, and Microhybrid specimens immersed in red wine had mean Ra values were calculated. Before the higher roughness values compared to the one week measurement, the top surface of each specimen was evaluation, but still showed better surfaces than the blotted dry using tissue paper, and the contact guide baseline. In addition, regarding the change of Ra of a surface profilometer (Taylor Hobson Surtronic values of the RBCs overall, there are no statistically 3+, Taylor Hubson, Leicester, UK) was positioned at significant differences between 20 or 40 seconds of Stomatology Edu Journal 223 EFFECTS OF ACIDIC/ALCOHOLIC BEVERAGES ON THE SURFACE ROUGHNESS OF COMPOSITE RESINS LIGHT-CURED FOR TWO DIFFERENT PERIODS OF TIME Table 3. Mean and standard deviations of Ra values of all RBCs polymerized with different curing times and Original Articles immersed in various beverages*. 20 seconds 40 seconds polymerization polymerization Base 1-week 1-month Base 1-week 1-month Bisco 0.28±0.05a 0.34±0.05b 0.38±0.06c 0.38±0.13A 0.48±0.09B 0.62±0.14B Coca Cola 3M 0.42±0.11a 0.48±0.13b 0.64±0.14c 0.41±0.20A 0.57±0.16B 0.72±0.19B GC 0.53±0.20a 0.61±0.17a 0.73±0.26b 0.43±0.07A 0.50±0.08B 0.57±0.08C (CC) Kulzer 0.33±0.03a 0.36±0.03b 0.44±0.09c 0.29±0.04A 0.33±0.02A 0.44±0.21B Bisco 0.44±0.11a 0.52±0.12b 0.68±0.21c 0.38±0.07A 0.47±0.13B 0.58±0.18B Red 3M 0.43±0.09a 0.50±0.08a 0.58±0.06b 0.26±0.09A 0.35±0.09B 0.45±0.11C GC 0.54±0.12a 0.64±0.09a 0.87±0.23b 0.51±0.13A 0.63±0.10A 0.73±0.15B Wine (RW) Kulzer 0.31±0.09 a 0.35±0.10 a 0.45±0.17b 0.39±0.08 A 0.28±0.04 B 0.36±0.08A Bisco 0.56±0.18a 0.56±0.18a 0.57±0.18 0.62±0.38A 0.64±0.37B 0.66±0.36C Distilled 3M 0.32±0.14a 0.35±0.13a 0.38±0.10b 0.39±0.26A 0.41±0.26A 0.44±0.25B GC 0.48±0.19a 0.49±0.18b 0.48±0.19c 0.46±0.14A 0.47±0.14B 0.50±0.14C Water (DW) Kulzer 0.37±0.07a 0.38±0.07a 0.40±0.08b 0.35±0.08A 0.37±0.08A 0.38±0.08B *Different letters in the same line show statististically significant difference (p<0.05). Groups polymerized for 40 seconds showed in capital letters and groups polymerized for 20 seconds showed in lower cases. curing (p>0.05). Statistically significant differences used curing unit (radiant emittance, spectral between Ra values measured after one month distribution etc) may directly be related to the immersion in different beverages are shown in Table polishing ability. The effects of the polishing systems 4 and Table 5. The tables indicated that the RBCs on the surface quality has already been analysed cured for 20 seconds and immersed in Coca Cola [7,18,19], however without involving the exposure exhibit all statistical similar roughness. Likewise, time. Prolonged curing time may increase the degree specimens of the microhybrid RBC (Charisma Classic of conversion, lower the residual monomers and – 40 seconds polymerization) immersed in red improving thus the surface quality of RBCs [20]. In wine had statistically significant lower roughness order to obtain sufficient curing, the type of the change than the nanofilled (Filtek Ultimate) and the curing unit used, either LED or QTH (Quartz Tungsten nanohybrid RBCs (Aelite). After immesion in distilled Halogen), was proved to have no direct influence on water, specimens of microhybrid RBC (G-aenial) the surface roughness of the RBCs [16]. This must had hardly changed their surface roughness values. also be the case for the curing conditions in the Therefore, specimens of microhybrid (Charisma present study, since no significant difference in Classic) and nanofilled (Filtek Ultimate) RBCs showed surface roughness was identified in any of the statistically higher roughness than the microhybrid analysed materials when increasing the exposure RBC (G-aenial). All of the RBC were affected by time from 20 seconds to 40 seconds. Therefore, the immersion in distilled water but the specimens had first null hypothesis is accepted. Regardless of the statistically significant lower roughness changes curing time, the various types of RBCs analyzed in compared to immersion in Coca Cola and red wine. the present study reacted differently to storage in beverages with regard to their surface quality. This 4. Discussion confirms the results of previous studies published The surface quality of the RBC materials is dependent for the same materials [16]. The RBCs tested in the on the physical characteristics of the materials as present study were selected due to their specific well as the techniques used for finishing and filler properties. Regarding the differences in the polishing them. The application of nanotechnology filler content and size of the RBC that affect the in dental materials enables the incorporation of physical characteristics, polymerization quality and smaller particles with increased filler loading and surface roughness values were assumed to be results in lower polymerization shrinkage and better different. Moreover, microfilled RBCs have adequate physical and mechanical properties [4]. The polishability, thus they could mimic the surface polishability is also correlated, besides filler, to the smoothess of enamel greatly. However, these types polymerization quality [9]. The parameters affecting of RBCs had lower mechanical strength, so they are the quality of curing, such as the exposure time, the recommended for low-stress regions [3]. On the exposure distance or the curing characteristics of the contrary, microhybrid RBCs had higher mechanical 224 Stoma Edu J. 2019;6(4): 221-229 www.stomaeduj.com EFFECTS OF ACIDIC/ALCOHOLIC BEVERAGES ON THE SURFACE ROUGHNESS OF COMPOSITE RESINS LIGHT-CURED FOR TWO DIFFERENT PERIODS OF TIME Table 4. Roughness increase (%) and significance of RBCs cured for 20 seconds after one month immersion Original Articles in different beverages*. Charisma Classic Filtek Ultimate G-aenial Aelite (Microhybrid) (Nanofilled) (Microhybrid) (Nanohybrid) 20 seconds 20 seconds 20 seconds 20 seconds of curing of curing of curing of curing Coca Cola 33.3 A,a 52.4C.a 32.5D,a 35.7F,a Red Wine 45.1A.b 34.9C.b 61.1D,b 54.4F,b Distilled 8.1B,c 18.7C.c 0E,d 1.8G,c,d Water *Different uppercase letters in each RBC column indicate a statistically significant difference between the roughness values caused by beverages. Different lowercase letters in the rows indicate a statistically significant difference between the RBCs (p<0.05). strength but lower polishability [19]. Apart for the particle sizes, it needs to be classified as a microhybrid above mentioned RBC categories, nano RBCs could RBC. In the present study it showed the significantly be developed with not only excellent polishability lowest surface changes among the analysed RBCs but also with better mechanical and physical when cured for 20 seconds (Table 4). Evaluating the properties, including resistance to different media. acidic (CC) and alcoholic (RW) beverages, the ethanol This general remarks stay in contradiction to the concentration of red wine and the phosphoric acid results of the present study, since the analyzed in Coca Cola may lead to surface degradation. Add- microhybrid RBC, Charisma Classic, showed smo- itionally, ethanol could penetrate the organic matrix, other, while the nanohybrid RBC rougher surfaces. alter the polymeric structure [12], and eventually Thus, the second hypothesis was rejected. The affect the mechanical and physical properties of the present study was intended to ensure standardization RBCs. The effects of ethanol are thought to be more by selecting the ideal pair of materials and methods. significant than the prolonged exposure to water For instance, the size of specimens was designated [25]. In the present study, there is no significant with a diameter of 8 mm to match the tip of the difference among RBCs cured for 20 seconds. curing unit to use the light-curing unit only once and However, after 40 seconds of curing, the nanofilled eliminate the tip location from being a polymerization and nanohybrid RBCs showed significantly rougher variable. All of the RBCs were chosen in the same surfaces than the microhybrid RBCs. This could be shade to avoid different curing time requirement. attributed to the higher amount (68 vol%) of smaller Varying particle sizes were also enrolled to evaluate fillers (0.01-0.07 µm) in the microhybrid RBC. The the differet resistance and responses to acidic/ present data confirmed thus the study of Tantanuch alcoholic beverages effects in terms of surface et al [23] which found out that nanofilled RBCs roughness. Physical, thermal and chemical factors in showed better surface properties than nanohybrid the oral environment play fundamental roles in the RBCs after being immersed in red wine.Furthermore, degradation process of RBC surfaces. The influence the acidity of the immersing solution may have a of these processes reflects a change in the surface direct effect on softening resin matrices, allowing roughness values [21]. In the present study, lower Ra filler to be pull-out and creating thus voids over the values were reached not only by aging specimens in surface, that may enhance roughness [23]. Red wine acidic and alcoholic beverages but also in distilled contains not only ethanol but may also act as an water. According to the results, all of the groups and acidic solution. Both analysed beverages are subgroups were similarly affected by distilled water. characterized by a low pH; however, in the present Exposure to water could result in the hydrolytic study, regardless of the curing time, there were not degradation of fillers’ silane coating, loss of chemical statistically significant differences between the bonding between fillers and plasticizing and roughness values of RBCs after immersion in Coca swelling of resin matrices [22,23]. Consequently, Cola and red wine. On the other hand, Ra scores fillers may be pulled out from the specimen’s surface above 0.2 μm have been reported to increase the after the organic matrix absorbs water, which could biofilm formation [26]. Ra values higher than 0.3 μm increase the surface roughness [23]. In this context, can be physically perceived by patients, which could RBCs containing TEGDMA, a hydrophilic monomer, lead to patient's dissatisfaction and an extra clinic are more susceptible to water degradation following sessions for polishing the restoration’s surface [27]. water uptake [24]. In the present study, all of the Although all of the specimens were polished with RBCs except the microhybrid (G-aenial contain discs (Sof-Lex), described as one of the best protocols TEGDMA in their organic matrix. The RBC G-eanial is to create low roughness scores in resin materials advertised as a microfilled RBC, but according to its [28], even at the baseline results, all of the RBCs Stomatology Edu Journal 225 EFFECTS OF ACIDIC/ALCOHOLIC BEVERAGES ON THE SURFACE ROUGHNESS OF COMPOSITE RESINS LIGHT-CURED FOR TWO DIFFERENT PERIODS OF TIME Table 5. Roughness increase (%) and significance of 40 seconds cured RBCs after one month immersion in Original Articles different beverages*. Charisma Classic Filtek Ultimate G-aenial Aelite (Microhybrid) (Nanofilled) (Microhybrid) (Nanohybrid) 40 seconds 40 seconds of 40 seconds of 40 seconds of of curing curing curing curing Coca Cola 51.2A,a 75.6B,a 37.8D,a 63.1F,a Red Wine -7.8A.b 73.1B,c 43.1D,b,c 52,6F,c Distilled 8.6A,d 12.8C.d 8.7E,d 6.4G,d Water *Different uppercase letters in each RBC column indicate a statistically significant difference between the roughness values caused by beverages. Different lowercase letters in the rows indicate a statistically significant difference between the RBCs (p<0.05). showed surface roughness values higher as the that the RBCs with barium glass fillers showed higher mentioned thresholds. The possible reasons could surface roughness. In the present study, the be related to the inner characteristics, such as microhybrid RBC was the only material containing polishing responses of the materials. RBCs made of Ba glass fillers, and results were not consistent with finer filler particles exhibit lower interspacing, less the above-mentioned study. It is reasonable to have filler pullout and thus, smoother surfaces [29]. conflicting results over fillers because the filler type Research has shown that nanohybrid RBCs in par- may have an effect on surface roughness however, it ticular create smaller voids after finishing and is clearly not the only parameter. Besides size, polishing procedures [23,29]. However, in the amount and distribution of the fillers, their chemical present study, the specimens cured for 40 seconds composition may indirectly affect the roughness, consisting of a nanofilled (Filtek Ultimate) and a since it determines the refractive index and thus may nanohybrid (Aelite Aesthetic Enamel) RBC showed have an effect on the degree of conversion of the statistically significant rougher surfaces than the polymer matrix. At a lower refractive index mismatch microhybrid RBC (Charisma Classic) after immersion between filler and matrix, less scattering occurs and in all beverages. Moreover, after 20 seconds curing the degree of conversion of the organic matrix may and immersion in red wine, Charisma Classic showed be increased. Marovic et al [31] showed that Ba fillers smoother surfaces as compared to the nano-RBCs. could increase the degree of conversion of the These results could be attributed to the type, size, organic matrix, while silica fillers may decrease it. number and distribution of fillers, which all have a However, it must be considered that scattering is not significant impact on the mechanical and physical only dependent on the refractive index mismatch characteristics of the RBCs [29]. There is clear between filler and matrix but essentially also on the evidence that the size and irregularity of fillers is filler size and its relation to the wavelength used for directly proportional to the surface roughness of a curing a RBC. In the present study, the tested RBCs RBC [30]. Smaller fillers were thought to be less contained differently formulated filler particles and prominent on the surface; thus, they were more sizes, so the effect of the chemical composition and resistant to wear because of their homogeneity in size on the Ra values cannot be properly discussed. the resin matrices [22]. Small fillers could reduce the The nanofilled RBC contains zirconia/silica clusters, spacing that provides resistance and protects the the microhybrid RBC pyrogenic made silica, the resin matrix [13]. In the present study, the microhybrid microhybrid (G-eanial) RBC contains besides RBC (G-aenial) and the nanofilled RBC (Filtek pyrogenic silica also prepolymerized filler based on Ultimate) had the largest fillers (16-17 µm and 0.6-10 silica while the nanohybrid RBC contains silica –glass µm, respectively) among the tested RBCs. That could particles. One study [4] found that, even though be one of the reasons for those RBCs having the nano particles create smaller gaps after polishing, highest roughness scores of almost all groups. nanoclustered particles are not pulled out from the Besides filler size, a low inorganic content com- resin matrices neither. Among the tested RBCs, only promises the surface smoothness [4]. The nanofilled the nanofilled RBC (Filtek Ultimate) had nano- RBC had the highest filler amount (63.3 vol%), which clustered particles, which could explain the superior could be one of the reasons it has smoother surfaces Ra results of the nanofilled RBC. The monomer type than microhybrid (G-eanial) and nanohybrid RBCs, is one of the main component of the RBCs affecting even having the largest filler particles overall. In surface quality, and it was demonstrated that the general, the influence of the size and type of fillers chemical composition of monomers is related to on the surface quality has been thoroughly preserve surface smoothness against the tough oral presented in the literature. Magdy et al [20] found conditions over time [22]. Bis-GMA and UDMA are 226 Stoma Edu J. 2019;6(4): 221-229 www.stomaeduj.com EFFECTS OF ACIDIC/ALCOHOLIC BEVERAGES ON THE SURFACE ROUGHNESS OF COMPOSITE RESINS LIGHT-CURED FOR TWO DIFFERENT PERIODS OF TIME Original Articles the most common monomers used in RBCs. 5. Conclusion Monomers, such as Bis-EMA, have been developed Nanofilled and nanohybrid RBCs (Aelite, to improve viscosity, lower the polymerization Filtek Ultimate) as well as one of the analyzed shrinkage and toughening the resin matrix. Bis-EMA microhybrid RBC (Charisma Classic) showed similar has fewer carbon-carbon double bonds that lead to surface roughness after curing for 20 seconds. a softer, less cross-linked organic matrix that could Charisma Classic showed better surface quality be affected by acidic or alcoholic beverages [4]. The than Aelite and Filtek Ultimate after 40 seconds of nanofilled and nanohybrid RBCs analyzed in the curing. Despite varying filler types and chemical present study contain Bis-EMA and tended to be composition of the monomer matrix, prolonged rougher than microhybrid RBCs based on Bis-GMA curing time had no significant effect on the surface and TEGDMA. Another monomer with a hydrophilic roughness. Yet, immersion in both acidic and character, TEGDMA, tends to degrade more quickly alcoholic beverages affected the surfaces of all [4]. In the analyzed RBCs (nanohybrid and nanofilled), RBCs and generated significant surface roughness both TEGDMA and Bis EMA were used, thus inferior changes. Thus, regardless of the curing time, all results of those RBCs could also be attributed to the analyzed RBCs showed unacceptable changes in softer matrices which might be degraded by acidic surface roughness. intake or water uptake. On the other hand, the Author Contributions nanofilled (Filtek Ultimate) and microhybrid GO: had the idea of the hypothesis and MME (G-aenial) RBCs containe UDMA in their resin designed the study. GO: collected the data and matrices. UDMA has lower water sorption and performed the experimental period with MME. solubility than TEGDMA, Bis-GMA and Bis-EMA [4]. SOY: prepared the statistical analysis. HSS: revised The microhybrid (G-aenial) contains only UDMA in the manuscript and corrected the language. the resin matrix that may lower the water uptake and EY: editted the whole manuscript. may be responsible for the less changes in roughness when immersed in distilled water after 20 seconds of Acknowledgment curing. There is no conflict of interest. References 1. Manhart J, Hickel R. Bulk-fill-composites. Modern application 10. Kerby RE, Knobloch LA, Schricker S, Gregg B. Synthesis and technique of direct composites for posterior teeth. Swiss Dent J. evaluation of modified urethane dimethacrylate resins with reduced 2014;124(1):19-37. water sorption and solubility. Dent Mater. 2009;25(3):302-313. [PubMed] Google Scholar Scopus [Full text links] [CrossRef] [PubMed] Google Scholar Scopus 2. Gönülol N, Yilmaz F. The effects of finishing and polishing 11. Moszner N, Fischer UK, Angermann J, Rheinberger V. 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[Full text links] [CrossRef] [PubMed] Google Scholar Scopus Günçe OZAN DDS, PhD, Research Assistant Department of Restorative Dentistry Faculty of Dentistry, Istanbul University Istanbul, Turkey CV Günçe Ozan received her DDS degree in 2011 from the Faculty of Dentistry at Istanbul University, Istanbul, Turkey. She immediately started her PhD at the Restorative Dentistry Department of the same university. After studying dental erosion and preventive dentistry, she had her PhD degree in 2017. She worked at the Young Dentists' Commission of the Turkish Dental Association for 2 years. She is now continuing her career at the Istanbul University as a Research Assistant. 228 Stoma Edu J. 2019;6(4): 221-229 www.stomaeduj.com EFFECTS OF ACIDIC/ALCOHOLIC BEVERAGES ON THE SURFACE ROUGHNESS OF COMPOSITE RESINS LIGHT-CURED FOR TWO DIFFERENT PERIODS OF TIME Questions Original Articles 1. Why are the novel monomers such as BIS-EMA, AUDMA developed? To reduce composites’… qa. Viscosity; qb. Water sorption; qc. Solubility; qd. All of the properties above. 2. Choose the most hydrophilic monomer above qa. UDMA; qb. AUDMA; qc. TEGDMA; qd. BIS-GMA. 3. Composites with smaller fillers show lower surface roughness values. Because… qa. They are less prominent when they are plugged out; qb. They have low modulus of elasticity; qc. They are highly soluble; qd. All of the statements above. 4. How could an acidic or alcoholic beverage affect composite resin? It could cause… qa. Organic matrix plasticizing; qb. Organic matrix softening; qc. Wear and degradation; qd. All of the statements above. Stomatology Edu Journal 229