Intrapulpal Concentration of Hydrogen Peroxide of Teeth Restored With Bulk Fill and Conventional Bioactive Composites

• Published in: Operative dentistry Vol. 46; no. 3; pp. E158 - E170
• Main Authors: Silva, DP, Resende, BA, Kury, M, André, CB, Tabchoury, CPM, Giannini, M, Cavalli, V
• Format: Journal Article
• Language: English
• Published: 01-05-2021
• Subjects: Dentistry
• ISSN: 0361-7734; 1559-2863
• DOI: 10.2341/20-091-L

SUMMARY
This study evaluated intrapulpal concentration and hydrogen peroxide (HP) penetration at the interface of teeth restored with bioactive composites, using conventional or bulk-fill composites. Cylindrical cavities were prepared on the buccal surface of bovine incisor crowns (n=20) and restored with: resin modified glass-ionomer (RMGI, Riva Light Cure, SDI), non-bioactive bulk-fill composite (FB, Filtek Bulk, 3M Oral Care), non-bioactive conventional composite (FZ, Filtek Z350, 3M Oral Care), bioactive bulk-fill composite (AC, Activa BioActive, Pulpedent), and bioactive conventional composite (BII, Beautifil II, Shofu). After 5,000 thermal cycles, restorations (n=10) were exposed to high (35% HP [4 applications of 8 min/session-4 sessions]) or low (9.5% HP [30 min/day-14 days]) concentration bleaching protocols. After the last bleaching application, the HP intrapulpal concentration was determined. Additional teeth were restored, pigmented with rhodamine B solution, and HP penetration around the interface was observed under laser scanning confocal fluorescence microscopy (LSCFM, n=3). The presence of gaps at the interface was observed on replicas of the cross-sectioned samples under scanning electron microscopy (SEM, n=5). Data were submitted to one-way (gap analysis) and twoway analysis of variance (ANOVA; HP intrapulpal concentration) and Tukey test (α=0.05). The LSCFM images were qualitatively analyzed. The restored teeth submitted to 35% HP presented higher HP intrapulpal concentration than teeth submitted to 9.5% HP (p<0.05). No differences in HP intrapulpal concentration was observed among groups (p>0.05) when exposed to 9.5% HP. Lower HP intrapulpal concentration was observed for teeth restored with RMGI exposed to HP 35%, when compared with teeth restored with nonbioactive conventional (FZ; p=0.004) and bulk-fill composites (FB; p=0.01). No gap formation was observed at the outer enamel adhesive interface for all restorative materials. LSCFM images showed that 35% HP promoted greater degradation of rhodamine B at the enamel, except for RMGI. In this context, RMGI promoted lower HP intrapulpal concentration than non-bioactive conventional and bulk-fill composites.