Influence of the Compliance and Layering Method on the Wall Deflection of Simulated Cavities in Bulk-fill Composite Restoration

Abstract

The aim of this study was to investigate the effects of the layering method and compliance on the wall deflection of simulated cavities in bulk-fill and conventional composite restorations and to examine the relationships between the wall deflection and the polymerization shrinkage, flexural modulus, and polymerization shrinkage stress of composites. Six light-cured composites were used in this study. Two of these were conventional methacrylate-based composites (Filtek Z250 and Filtek Z350 XT Flowable [Z350F]), whereas four were bulk-fill composites (SonicFill, Tetric N-Ceram BulkFill, SureFil SDR Flow [SDR], and Filtek BulkFill). One hundred eighty aluminum molds simulating a mesio-occluso-distal cavity (6 Wx8 Lx4 D mm) were prepared and classified into three groups with mold wall thicknesses of 1, 2, and 3 mm. Each group was further subdivided according to the composite layering method (bulk or incremental layering). Linear variable differential transformer probes were used to measure the mold wall deflection of each composite (n=5) over a period of 2000 seconds (33.3 minutes). The polymerization shrinkage, flexural modulus, and polymerization shrinkage stress of the six composites were also measured. All groups with bulk filling exhibited significantly higher deflection compared with groups with incremental layering. The deflection decreased as mold wall thickness increased. The highest and lowest polymerization shrinkage stresses were recorded for Z350F (5.07 MPa) and SDR (1.70 MPa), respectively. The correlation between polymerization shrinkage and the mold wall deflection decreased with increasing wall thickness. On the other hand, the correlation between flexural modulus and the mold wall deflection increased with increasing wall thickness. For all groups, wall deflection correlated strongly with polymerization shrinkage stress.