Factors Involved in the Development of Polymerization Shrinkage Stress in Resin-Composites: A Systematic Review

Department of Dental Materials, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, São Paulo, SP 05508-900, Brazil.
Dental Materials (Impact Factor: 3.77). 11/2005; 21(10):962-70. DOI: 10.1016/
Source: PubMed


Polymerization shrinkage stress of resin-composite materials may have a negative impact on the clinical performance of bonded restorations. The purpose of this systematic review is to discuss the primary factors involved with polymerization shrinkage stress development.
According to the current literature, polymerization stress of resin composites is determined by their volumetric shrinkage, viscoelastic behavior and by restrictions imposed to polymerization shrinkage. Therefore, the material's composition, its degree of conversion and reaction kinetics become aspects of interest, together with the confinement and compliance of the cavity preparation.
Information provided in this review was based on original scientific research published in Dental, Chemistry and Biomaterials journals. Textbooks on Chemistry and Dental Materials were also referenced for basic concepts.
Shrinkage stress development must be considered a multi-factorial phenomenon. Therefore, accessing the specific contribution of volumetric shrinkage, viscoelastic behavior, reaction kinetics and local conditions on stress magnitude seems impractical. Some of the restorative techniques aiming at stress reduction have limited applicability, because their efficiency varies depending upon the materials employed. Due to an intense research activity over the years, the understanding of this matter has increased remarkably, leading to the development of new restorative techniques and materials that may help minimize this problem.

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    • "The monomer conversion of polymeric matrices increases volumetric shrinkage and the resulting elastic modulus simultaneously. In this way, materials with high DC undergo less deformation, because enhanced polymer chain entanglement and high cross-linking density hinders molecular movement within polymer network[38,44]. Few studies exist regarding the internal adaptation for bulk-fill composites, and most involve the evaluation of Class II restorations. When the clinical restorative environment is taken into consideration, the C-factor, restorative material volume, cavity geometry, and the angles formed at the cavosurface margin, as well as their interactions, all influence stress distribution[45]. "
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    ABSTRACT: Objective: To evaluate degree of conversion (DC), Knoop microhardness (KHN), internal marginal adaptation (IA), and polymerization shrinkage stress (PS) of one conventional and four bulk-fill composites. Methods: Bulk-fill composites tested were Surefil SDR (SDR), Filtek Bulk-Fill (FBF), Tetric EvoCeram Bulk-Fill (TEC), and EverX Posterior (EXP). The conventional composite Herculite Classic (HER) was tested using both incremental and bulk-fill insertion techniques. Standardized Class I preparations (4-mm-depth) were made in extracted molars and restored with each product system (N=5). After 1-week wet storage, restorations were cross-sectioned and DC and KHN were evaluated at four depths (1, 2, 3, and 4mm) using confocal Raman spectroscopy and KHN techniques, respectively. Epoxy resin replicas of restorations were evaluated using scanning electron microscopy for IA. PS was determined using composite bonded to acrylic rods attached to a universal testing machine (N=5). Results: Within bulk-fill products, only SDR and FBF demonstrated similar DC at all depths, and KHN values did not statistically differ among depths, except for TEC. Neither placement method nor depth affected KHN or DC, except the DC of HER bulk-fill at 4mm. Incrementally layered HER, and bulk-fills SDR and TEC demonstrated the lowest proportion of internal gaps. Highest and lowest PS values were measured for EXP and TEC, respectively. Significance: DC with depth was not uniform among all bulk-fill materials, although no difference in KHN was found. Higher PS correlated positively with higher proportion of interfacial gaps. The incremental technique using conventional composite showed reduced gap formation.
    No preview · Article · Nov 2015 · Dental materials: official publication of the Academy of Dental Materials
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    • "e l s e v i e r h e a l t h . c o m / j o u r n a l s / j d e n formation, but is also determined by the material's timedependent visco-elastic behavior, characterized by its flow capacity in the early stages of the curing reaction and by the elastic modulus acquired during polymerization [14] [15]. Therefore, theoretically, the use of pre-heated composite may not increase polymerization-induced shrinkage forces, if the reduction in viscosity due to heating would allow for increased viscous flow and polymer chain relaxation, and thus increased stress relief compared to room-temperature composite, compensating the effect of the higher volume contraction. "
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    ABSTRACT: To investigate the influence of pre-heating of high-viscosity bulk-fill composite materials on their degree of conversion and shrinkage force formation. Four bulk-fill composite materials (Tetric EvoCeram Bulk Fill-TECBF, x-tra fil-XF, QuixFil-QF, SonicFill-SF) and one conventional nano-hybrid resin composite (Tetric EvoCeram-TEC) were used. The test materials were either kept at room temperature or pre-heated to 68 °C by means of a commercial heating device, before being photoactivated with a LED curing unit for 20 s at 1170 mW/cm(2). Shrinkage forces (n = 5) of 1.5-mm-thick specimens were recorded in real-time for 15 min inside a temperature-controlled chamber at 25 °C (simulating intraoral temperature after rubber dam application) with a custom-made stress analyzer. Degree of conversion (n = 5) was determined at the bottom of equally thick (1.5 mm) specimens using Fourier transform infrared spectroscopy. Data were analyzed with Student's t-test, ANOVA and Tukey's HSD post-hoc test (α = 0.05). Composite pre-heating significantly increased the degree of conversion of TECBF, but had no effect on monomer conversion of the other materials investigated. For each of the test materials, pre-heated composite generated significantly lower shrinkage forces than room-temperature composite. At both temperature levels, TECBF created the significantly highest shrinkage forces, and QF caused significantly higher shrinkage forces than both XF and TEC. Both the composite material and the pre-cure temperature affect shrinkage force formation. Pre-heating of bulk-fill and conventional restorative composites prior to photoactivation decreases polymerization-induced shrinkage forces without compromising the degree of conversion. Composite pre-heating significantly reduces shrinkage force formation of high-viscosity bulk-fill and conventional resin composites, while maintaining or increasing the degree of monomer conversion, dependent upon the specific composite material used. Copyright © 2015. Published by Elsevier Ltd.
    Full-text · Article · Jul 2015 · Journal of dentistry
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    • "This will result in poor marginal adaptation, postoperative pain, and recurrent caries [30]. It has been claimed for many years that stress generation at tooth/resin composite interfaces and the resulting interfacial deficiencies remain one of the most important reasons for clinical failure [30] [31] [32]. "
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    ABSTRACT: The aim of this randomized controlled study was to evaluate the long term effectiveness of a reduced shrinkage stress resin composite in Class II restorations. The material was compared intra-individually with a microhybrid resin composite. Each of 50 patients with at least one pair of two similar sized Class II cavities participated (22 female, 28 male, mean age 43 years, range 18-64). Each participant received in each pair, in a randomized way, one Class II restoration performed with a reduced shrinkage stress resin composite (InTen-S) and the other restoration with a microhybrid resin composite restoration (Point 4). Both restorations were placed with an etch-and-rinse bonding system and an oblique layering technique. A total of 106 restorations, 33 premolar and 73 molars, were placed. The restorations were evaluated blindly each year using modified USPHS criteria. The overall performance of the experimental restorations was tested after intra-individual comparison using the Friedmańs two-way analysis of variance test. The hypothesis was rejected at the 5% level. At 15 years, 91 restorations were evaluated. The drop out frequency was 15 restorations (5 male, 3 female participants; 2 premolar and 13 molar restorations). Except for 2 participants, who reported slight symptoms during a few weeks after placement, no post-operative sensitivity was observed at the recalls. The overall success rate at 15 years was 77%. Twenty-one non acceptable restorations were observed during the 15 years follow up, 10 InTen-S (21.7%) and 11 Point 4 (24.4%) restorations (p>0.05). Annual failure rates for the resin composites were 1.5% and 1.6%, respectively. The main reasons for failure were secondary caries (8) and resin composite fracture (7). The differences between premolar vs. molar restorations and between restorations in male vs. female participants were not significant. Significant differences were observed between 2-surface vs. 3-surface restorations. During the 15-year follow up, the reduced shrinkage stress resin composite showed a good clinical durability in Class II cavities, but not significantly better than the control microhybrid resin composite. Secondary caries and material fracture were the main reasons of failure. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
    Full-text · Article · Jul 2015 · Dental materials: official publication of the Academy of Dental Materials
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