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Heat Treatment Influences Monomer Conversion and Bond Strength of

Indirect Composite Resin Restorations

Article  in  The journal of adhesive dentistry · December 2015

DOI: 10.3290/j.jad.a35258

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Heat Treatment Influences Monomer Conversion
and Bond Strength of Indirect Composite Resin
Restorations
Pascal Magnea / Daniel Alexandre Menezes Pedrosa Maltab / Reyes Encisoc /
Sylvio Monteiro-Juniord

Purpose: To assess the resin microtensile bond strength (MTBS) and the degree of conversion (DC) of indirect
composite resin restorations polymerized with light and heat.
Materials and Methods: Two direct (Filtek Z100 and Premise) and one indirect (Premise Indirect) composite
resins were polymerized with a combination of light and heat (138°C for 20 min). For MTBS, 42 cylinders were
fabricated (n = 7). After the surface treatment, cylinders were bonded to each other using adhesive resin (Opti-
bond FL). Specimens were stored in water for 24 h. Another 15 cylinders (n = 5) were fabricated for determining
degree of conversion using Fourier Transform Infrared Spectrometry immediately and at 24 h. The MTBS and the
DC was submitted to two-way ANOVA. The interaction with existing data was explored with univariate ANOVA and
two-way ANOVA. Tukey’s HSD post-hoc test was used to detect pairwise differences (α = 0.05).
Results: The MTBS to light and heat polymerized Z100 was 75.7 MPa, significantly higher than that to Premise
(58.6 MPa) and Premise Indirect (63.9 MPa). The immediate DC for Z100, Premise, and Premise Indirect were
51.0%, 68.7%, and 61.8%, respectively. The DC at 24 h ranged from 53.4% (Z100) to 72.8% (Premise Indirect)
and significantly increased for Premise Indirect only. Comparison with previously published data revealed that
the heat treatment increased both MTBS and DC of Premise and Premise Indirect.
Conclusion: Z100 showed better bond strength but lower DC. Heat treatment and a 24-h delay before delivery
can benefit DC of Premise Indirect. The increase in DC of Premise and Premise Indirect did not affect their bond
strength.
Keywords: adhesion, bond strength, direct composite resin, dental materials, indirect composite resin, degree
of conversion.

J Adhes Dent 2015; 17: 559–566. Submitted for publication: 26.02.15; accepted for publication: 22.10.15
doi: 10.3290/j.jad.a35258

biomimetic restorative dentistry.5,18,22,23,26,42 Compos-

D ue to the improvement of bonding protocols, filler
technology, polymerization, and physicomechanical
properties of resin systems, composite resin restor-
ations have become the cornerstone of esthetic and
a Professor, Division of Primary Oral Health Care, Ostrow School of Dentistry
of USC, University of Southern California, Los Angeles, CA, USA. Wrote the
manuscript, performed some experiments, proofread the manuscript.
b Interim Professor, Department of Dentistry, Federal University of Santa Cata-
rina, Florianópolis, Santa Catarina, Brazil. Wrote the manuscript, performed
the experiments.
c Professor, Division of Public Dental Health and Pediatric Dentistry, Ostrow
School of Dentistry, University of Southern California, Los Angeles, CA, USA.
Wrote the manuscript, performed statistical evaluation.
d Professor, Department of Dentistry, Federal University of Santa Catarina,
Florianópolis, Santa Catarina, Brazil. Proofread the manuscript.
Correspondence: Dr. Daniel Malta, Universidade Federal de Santa Catarina,
Centro de Ciências da Saúde, Departamento de Odontologia, Disciplina de
Dentística, Campus Universitário Trindade, Florianópolis, Santa Catarina,
Brazil 88040-970. Tel: +55-48-3721-9880. e-mail: dmdanielmalta@gmail.com
ite resins not only present high survival rates but also
less risk of tooth/restoration fracture and cracking when
compared to amalgam.32 When used for indirect restor-
ations, they represent an acceptable, economical alter-
native to the more costly ceramic materials.15,27,28,40
With indirect restorations, better proximal contacts,
excellent occlusal morphology, good marginal adapta-
tion with lower polymerization shrinkage of resin luting
agents, good flexural strength, and easy manipulation
and polishing can also be achieved.16,36,44,45
Composite resin inlays and onlays can be fabricated
with materials originally intended for direct use (light po-
lymerized) by the dentist or with specific indirect mater-
ials for laboratory use only (light and heat polymerized).
Post-cure heating of light-polymerized composite resin is
a common technique in fabrication. Studies indicate that
enhanced physical properties are derived from the post-
cure heating process.3 Increases in hardness,33,49 ten-
sile strength,12,33,49 and color stability50 are also demon-

Vol 17, No 6, 2015 559

Magne et al
Table 1 Materials and polymerization protocol
Material Polymerization protocol
Filtek Z100 40 s light polymerization + 20 min heat
Premise 40 s light polymerization + 20 min heat
Premise Indirect 40 s light polymerization + 20 min heat
strated as a result of this extraoral treatment of a regular
composite resin material.
Improved properties are attributed to increased mono-
mer conversion and stress annealing of polymerization
forces.21 A linear relationship should exist between heat
levels and degree of conversion. The degree of composite
curing is determined by the ratio of aliphatic to aromatic
C=C absorbance of the methacrylate materials as deter-
mined by Fourier transform infrared spectrometry, FT-IR.
Still, at higher heat levels, a relatively high proportion of
aliphatic carbon double bonds (C=C) remain unutilized
(30% to 50%). Some C=C units are present as pendant
methacrylate groups, covalently bonded to the polymer
network, and are incapable of leaching or evaporating.
Other C=C units are unreacted monomer, capable of leav-
ing the cured material. Heat treatment leads to the loss of
unreacted material at the composite surface by volatiliza-
tion. This would help make that area harder, denser, and
stronger. It would also help in reducing the leachability
of monomer into saliva following restoration bonding.3
However, bonding to this surface with a methacrylate-
based agent may be limited as a result of fewer C=C units
on the post-cure heated composite surface.4,24,33,48 A
strong bond between the luting composite resin and the
fitting surface of the restoration is required for the clinical
success of nonretentive preparations, such as for inlays,
onlays, and veneers.
The present study was designed to evaluate the degree
of monomer conversion and bond strength of composite
resins subjected to both light and prolonged heat poly-
merization. Previously published data about light curing
alone was included for comparison.29 The null hypothesis
is that there is no difference in bond strength and degree
of conversion between materials intended for direct or
indirect use, even when subjected to prolonged heat poly-
merization.
MATERIALS AND METHODS
Two direct composite resins, Filtek Z100 (3M ESPE; St
Paul, MN, USA) and Premise (Kerr; Orange, CA, USA),
and one indirect composite resin, Premise Indirect
(Kerr), were used in this study (Table 1). The composite
resins were polymerized with an LED unit (Valo Curing
Light, Ultradent; South Jordan, UT, USA) in standard
power mode with 1000 mW/cm2 intensity for 40 s, plus
additional heat treatment in a curing oven (Premise Indi-
rect Curing Oven, Kerr) at 138°C for 20 min. This poly-
merization protocol is termed “prolonged” in this study;
560
the polymerization protocol of the previously published
data (light only for Z100 and Premise, and light plus 10-
min heat polymerization for Premise Indirect) is termed
“standard” (Table 1).
Microtensile Bond Strength (MTBS) Test
The MTBS samples were made from 42 cylindrical
composite resin specimens using a plastic mold (8 mm
deep × 6 mm diameter) on a glass slide. The samples
were fabricated in pairs using two distinctive shades of
material (Table 2). Seven pairs (n = 7) were made for
each group (14 cylinders) and bonded to each other.
The different shades within each pair were necessary
to identify the adhesive interface and analyze the fail-
ure mode. For Filtek Z100 and Premise, cylinders were
produced by incremental layering (2-mm-thick layers,
light polymerized for 40 s each). For Premise Indirect, a
bulk placement technique was used because pilot tests
revealed lack of interlayer cohesion when using incre-
mental placement. All cylinders were light polymerized
for 240 s through the plastic mold (40 s, 6 times). The
cylinders were then removed from the plastic mold and
placed in the proprietary oven for 20 min at 138°C. All
specimens were then reduced to a 6-mm height with a
diamond saw (Diamond Wheel M4D220-N75M99-1/8,
Norton; Worcester, MA, USA) under water cooling on a
cutting machine (IsoMet Low Speed Saw, Buehler; Lake
Bluff, IL, USA). The fitting surface of each cylinder was
flatly wet ground with 400-grit silicon carbide paper (We-
tordry, 3M ESPE) for 5 s, followed by airborne particle
abrasion using a fine airborne particle abrasion unit
(Kavo RONDOFlex Plus 360, Kavo; Biberach, Germany)
for 15 s at 2 bar with 50-μm aluminum oxide (Danville;
San Ramon, CA, USA) at a distance of approximately
10 mm and a 90-degree angle. The surfaces were then
cleaned by etching with 35% phosphoric acid (Ultra-
Etch, Ultradent) and gentle scrubbing with a microbrush
for 1 min, followed by rinsing with water. Finally, the
samples were placed in an ultrasonic bath with distilled
water for 2 min and air dried. A silane (Silane, Ultradent)
was applied for 5 s, then air and heat dried for 1 min
(D.I.-500, Coltène Whaledent; Altstätten, Switzerland).
Seven pairs of cylinders of the same type of composite
resin but dissimilar shades were bonded together using
a coat of adhesive resin (Optibond FL Adhesive; Kerr)
on each fitting surface. A constant force of 1 kg was
applied to the blocks for 10 s before light polymerizing
for 40 s (2 × 20 s). The samples were stored in distilled
water for 24 h at room temperature before testing.
After storage, each specimen was individually secured
with sticky wax (Sticky Wax, Kerr) to a transparent plastic
sectioning block. Using the nontrimming technique de-
veloped by Shono et al (1999),41 multiple beams were
prepared with the resin-to-resin adhesive interface in the
center of the beam. To do so, specimens were vertically
sectioned into 1-mm-thick slabs using a low-speed dia-
mond saw. The slabs were sectioned again into beams
with approximately 1 mm2 cross-sectional areas. The
specimens were attached to a table-top material tester
(The Micro Tensile Tester, Bisco; Schaumburg, IL, USA)
The Journal of Adhesive Dentistry
 Magne et al

Table 2 Composition, batch numbers, and manufacturers of the resins used in this study

Composite Shade/Batch Composition Filler content Average Manufacturer

resin particle size
Filtek Z100 A3,5/234295 Bis-GMA, TEG-DMA, zirconia, 85 wt%, 66 vol% 0.6 μm 3M ESPE; St Paul,
B2/240201 silica, camphorquinone MN, USA

Premise Opaque A3/3435851 Bis-GMA, TEG-DMA, barium, 84 wt%, 70 vol% 0.4 μm Kerr; Orange,
Opaque B1/346919 silica, camphorquinone CA, USA

Premise Primary Dentin A3,5/3461351 Bis-GMA, TEG-DMA, barium, 87% wt%, 72 vol% 0.4 μm Kerr
Indirect Primary Dentin B1/3364736 silica, camphorquinone, pro-
prietary heat initiator

Fig 1 Microtensile specimen before loading. Fig 2 Composite resin cylinder placed in measuring device for
FT-IR.

using cyanoacrylate glue (Professional Super Glue, Loctite
Henkel; Avon, Ohio, USA). A chemical accelerator (Zapit
Accelerator, DVA; Corona, CA, USA) was applied to the
cyanoacrylate glue with a microbrush. The specimens were
subjected to microtensile testing at a crosshead speed of
5.4 kg/min (Fig 1). After testing, the failure mode of each
beam was determined under a stereoscopic microscope
(MZ125, Leica Microsystems; Heerbrugg, Switzerland)
at 40X magnification. Failures were considered adhesive
when the fracture site was located entirely between the
adhesive and the composite resin, cohesive when the
fracture occurred exclusively within the composite resin,
or mixed when fragments of composite resin were de-
tected along the adhesive fracture.
Fourier Transform Infrared Spectrometry
The closest shade of each material was selected (B2
for Z100; Opaque B1 for Premise; and Primary Dentin
B1 for Premise Indirect) for this part of the experiment.
Cylindrical composite specimens (five per material) were
made in a metal matrix (3 mm deep × 6 mm diameter)
on a glass slide. The composite resin was put into the
matrix with a clean spatula in one bulk layer and cov-
ered with a sheet of clear plastic matrix. Another glass
slide was placed over the plastic and pressed to force
the composite to adapt to the metal matrix dimensions
and yield a flat, and smooth surface.
The percent monomer conversion of the samples was
collected between 1680 and 1550 cm-1 with the use of a
Fourier transform infrared spectrometer (Spectrum 100 FT-
IR Spectrometer, PerkinElmer; London, UK) using 4 scans
at a resolution of 2 cm-1. The baseline measurement was
obtained from unpolymerized material by carefully remov-
ing the glass slide and the plastic matrix and placing the
sample on the spectrometer. The same procedure was
repeated with polymerized samples (1000 mW/cm2 of
intensity for 40 s applied to top surface followed by heat
treatment by placing the assembly [metal matrix and com-
posite] into the proprietary oven for 20 min). The same
samples were then stored in water at a room temperature
until FT-IR measurements 24 h later (Fig 2).
Monomer degree of conversion (DC, in %) was calcu-
lated by standard methods from the absorbance intensi-
ties of the aliphatic:aromatic (C=C) ratio, ie, between the
nonpolymerized and polymerized composite resin spectra:
[Abs (aliphatic) / Abs (aromatic)]polymer
(%C=C) = × 100
[Abs (aliphatic) / Abs (aromatic)]monomer

Vol 17, No 6, 2015 561

Magne et al

Table 3 Two-way ANOVA (composite and polymerization) of bond strength data (MPa) yielded by standard vs pro-
longed polymerization

Source df Sum of squares Mean square F p

Composite 2 3209.196 1604.598 52.731 0.000

Polymerization 1 720.194 720.194 23.668 0.000

Composite × polymerization 2 125.931 62.966 2.069 0.141

Composite: Filtek Z100, Premise, and Premise Indirect. Standard polymerization: Filtek Z100 and Premise: 40 s of light polymerization; Premise Indirect:
40 s of light polymerization + 10 min heat (previous study). Prolonged polymerization: Filtek Z100, Premise, and Premise Indirect: 40 s of light polymerization
+ 20 min heat (present study).

Table 4 Two-way ANOVA (composite and time of measurement*) of degree of conversion data (%) of the present
study

Source df Sum of squares Mean square F p

Composite 2 1861.852 930.926 43.979 0.000

Time of measurement 1 225.667 225.667 10.661 0.003

Composite × time of measurement 2 114.352 57.176 2.701 0.087

Composite: Filtek Z100, Premise, and Premise Indirect. *Time of measurement: data collected immediately and after 24 h.

Table 5 Univariate analysis of variance (composite, time of measurment, and polymerization) of degree of conver-
sion data (%) of the comparison between standard and prolonged polymerization

Source df Sum of squares Mean square F p

Composite 2 1486.734 743.367 28.762 0.000

Time of measurement 1 590.634 590.634 22.853 0.000

Polymerization 1 602.871 602.871 23.326 0.000

Composite × time of measurement 2 97.142 48.571 1.879 0.164

Time of measurement × polymerization 1 9.354 9.354 0.362 0.550

Composite × polymerization 2 653.196 326.598 12.637 0.000

Composite × time of measure- 2 71.378 35.689 1.381 0.261

ment × polymerization

Composite: Filtek Z100, Premise and Premise Indirect. Time of measurement: degree of conversion data collected immediately and after 24 h. Standard
polymerization: Filtek Z100 and Premise: 40 s of light polymerization; Premise Indirect: 40 s of light polymerization + 10 min heat (previous study). Prolonged
polymerization: Filtek Z100, Premise, and Premise Indirect: 40 s of light polymerization + 20 min heat (present study).

where Abs was the area of absorption band. Monomer
conversion was determined by subtracting the residual
percentage of aliphatic C=C from 100% (DC%=100-
[%C=C]).1,14,31,39
Statistical Analysis
The data were submitted to Lilliefors (bond strength)
and Kolmogorov-Smirnov (monomer conversion) normal-
ity tests. All data were considered normally distributed
(p > 0.05) and a parametric test was chosen.
Two-way ANOVA (composite and polymerization) was
conducted on the bond strength data to verify the interac-
tion between already published data29 and the present
study (Table 3).
The degree of conversion data of the present study
were submitted to two-way ANOVA (composite and imme-
diate vs 24-h DC) (Table 4). Then, the interaction between
“standard” and “prolonged” polymerization was explored
with univariate ANOVA with three fixed factors: composite
(3 levels, Filtek Z100, Premise and Premise Indirect), DC
(2 levels, immediate and after 24 h), and polymerization
method (standard and prolonged), and three interaction
terms (material × 24-h DC, material × polymerization, and
24-h DC × polymerization) (Tables 5 and 6).
When interactions were significant with the full facto-
rial model, Tukey’s HSD post-hoc test was used to detect
pairwise differences (α = 0.05).

562 The Journal of Adhesive Dentistry

 Magne et al

Table 6 Two-way analysis of variance (polymerization and time of measurement*) of the degree of conversion
data yielded by standard and prolonged polymerization for each material

Source df Sum of squares Mean square F p

Two-way ANOVA (polymerization and time of measurement) of Filtek Z100 degree of conversion data (%)

Polymerization 1 22.962 22.962 0.567 0.462

Time of measurement 1 65.197 65.197 1.610 0.223

Polymerization × time of measurement 1 7.069 7.069 0.175 0.682

Two-way ANOVA (polymerization and time of measurement) of Premise degree of conversion data (%)

Polymerization 1 407.163 407.163 18.719 0.001

Time of measurement 1 217.404 217.404 9.995 0.006

Polymerization × time of measurement 1 63.226 63.226 2.907 0.108

Two-way ANOVA (polymerization and time of measurement) of Premise Indirect degree of conversion data (%)

Polymerization 1 811.283 811.283 37.617 0.000

Time of measurement 1 425.042 425.042 19.708 0.000

Polymerization × time of measurement 1 15.771 15.771 0.731 0.405

* Time of measurement: data collected immediately and after 24 h. Standard polymerization: Filtek Z100 and Premise: 40 s of light polymerization; Premise
Indirect: 40 s of light polymerization + 10 min heat (previous study). Prolonged polymerization: Filtek Z100, Premise, and Premise Indirect: 40 s of light poly-
merization + 20 min heat (present study).

Standard polymerization* Prolonged polymerization**

100
Bond Strength (MPa)

80

60 72.24 75.69

Fig 3 Mean and standard deviation of

bond strength. *Previous study: for Filtek 40 48.43 58.61 52.67 63.91
Z100 and Premise, 40 s of light poly-
merization; for Premise Indirect, 40 s of 20
light polymerization + 10 min heat curing. Z100 Premise Premise Indirect
**Present study: for all materials, 40 s of Composite resins
light polymerization + 20 min heat curing.

RESULTS material or time of measurement (immediate or after

Results of the bond strength test are presented in Fig 3.
The MTBS for Filtek Z100 was 75.7 MPa, significantly
higher than that for Premise (58.6 MPa) and Premise
Indirect (63.9 MPa). The interaction among the polymer-
ization modes showed a significant increase in MTBS for
heat-treated Premise and Premise Indirect, but not for
Filtek Z100.
The monomer conversion at 24 h ranged from 53.4%
to 72.8% and was significantly increased only for Prem-
ise Indirect. The interaction between the polymerization
modes showed that all composite resins reached higher
values of degree of conversion at 24 h. Irrespective of
24 h), the high polymerization treatment showed sig-
nificantly higher degree of conversion than the standard
polymerization mode from the previous data. However,
Filtek Z100 showed the same behavior at both times,
with no statistical difference. The immediate monomer
conversion of Premise was significantly higher when us-
ing light and heat (vs light only), but at 24 h, the results
were statistically similar. Premise Indirect showed a
significant increase in monomer conversion when heat
treated for 20 min instead of 10 min at immediate and
24 h measurements (Fig 4).
Table 7 shows that adhesive failure was the most com-
mon failure mode in all groups of the present study.

Vol 17, No 6, 2015 563

Magne et al
Immediate – Standard polymerization*
Immediate – Prolonged polymerization**
80
Monomer conversion (%)
70
60
50
53.17 56.77 51.02 53.45
40
Z100
Table 7 Analysis of fracture
Filtek Z100
Adhesive 86.59%
failure
Cohesive 12.20%
failure
Mixed failure 1.22%
DISCUSSION
The first part of the null hypothesis was partially re-
jected. The bond strength to Filtek Z100 was signifi-
cantly higher than Premise and Premise Indirect, which
showed similar behavior for both variables tested. The
second part of the null hypothesis was partially rejected,
because prolonged heat treatment positively influenced
the bond strength and monomer conversion of Premise
and Premise Indirect, but not that of Z100.
The present research was designed to determine the
bond strength and degree of monomer conversion of three
light- and heat-polymerized composite resins used as in-
direct restorations. Previously published data generated
by the same operator under identical conditions (which
includes the same batch of materials), but with a different
method of polymerization (light only for Z100 and Premise,
and only 10 min heat curing in proprietary oven for Prem-
ise Indirect) were included for comparison.29 Prolonged
heat treatment was used in the present study because it
may enhance radical mobility and polymerization rate, re-
sulting in a superior cross-linking density and final degree
of conversion.21,14,46 These in turn may lead to enhanced
physical properties.3 After the polymerization procedures,
the composite resins received the appropriate surface
treatment for indirect restorations, namely, airborne par-
ticle abrasion and silane application.33 Airborne particle
abrasion is important to produce strong bonds by expos-
ing the fillers and roughening the surface (increases the
surface area) for wetting and bonding.11,13,25,34,35,38,44,45
564
24 h – Standard polymerization*
24 h – Prolonged polymerization**
Fig 4 Mean and standard deviation of
monomer conversion (%).*Previous study:
for Filtek Z100 and Premise, 40 s of light
56.13 66.28 68.7 71.74 50.81 58.25 61.77 72.77 polymerization; for Premise Indirect, 40 s
of light polymerization + 10 min heat cur-
Premise Premise Indirect ing. **Present study: for all materials,
Composite resins 40 s of light polymerization + 20 min heat
curing.
The silane works like a primer, improving the chemical
reaction between the methacrylate and the filler by the
Premise Premise In- formation of siloxane bonds.33,44,48
direct The high bond strength achieved with Filtek Z100 (in
77.36% 83.58%
both methods of polymerization) may be explained by its
intrinsic mechanical properties and chemical composi-
tion, since heat treatment did not influence the monomer
22.64% 10.45% conversion or MTBS values. The filler and the monomer it-
self along with the monomer conversion play an important
– 2.99% role in the physical behavior of composite resins.2,7,8,10,37
For Filtek Z100, the volume percent of filler is slightly
lower than in Premise or Premise Indirect, and the major
filler is spheroidal zirconia-silica, instead of barium-silica
as in Premise and Premise Indirect. All materials tested
shared the same monomers, ie, bis-GMA and TEG-DMA.
The combination of zirconia, bis-GMA, and TEG-DMA might
be responsible for the high mechanical properties found
in Z100. The use of a resin matrix with 50% bis-GMA and
50% TEG-DMA was found to present the highest strength
and elastic modulus.2,43 Bis-GMA has high viscosity due
to the hydrogen bonding interactions that occur between
the hydroxyl groups on the monomer molecules. Thus, bis-
GMA must be diluted with TEG-DMA to decrease viscos-
ity and enhance copolymerization characteristics.2,18,24
Resin matrix strength is dependent upon monomer com-
position, being greatest when stiff bis-GMA molecules are
used and the monomer conversion of the methacrylate
groups is maximized.19 It appears that stiffness and hard-
ness of Filtek Z100 when only light cured exceeds that
of indirect light and heat-polymerized composite resins.7
The flexural strength of the Filtek Z100 was also reported
to be higher, approximately 180 MPa,7 compared to 128
and 158 MPa for Premise and Premise Indirect, respect-
ively (manufacturer’s information). It can be hypothesized
that the proprietary spheroidal filler provided improved
rheological properties and optimized bis-GMA:TEG-DMA
ratios in Filtek Z100. Its slightly lower volume percent of
filler might also explain the improved bond strength (more
resin matrix exposed).
Based on the data from the present study, it might
seem that an inverse correlation exists between the bond
strength and the amount of monomers available at the
surface of the composite (Z100 compared to Premise and
The Journal of Adhesive Dentistry

Premise Indirect). Bond strength is dependent on uncov-
ered C=C double bonds in the resin, which may be attrib-
uted either to a low conversion rate or a high level of ma-
trix resin. The high degree of conversion makes the attach-
ment of a new composite material more difficult.4,24,33
However, the higher conversion rate of Premise and Prem-
ise Indirect following prolonged heat treatment did not
correlate with lower MTBS values. The explanation may lie
in the fact that increased mechanical properties resulting
from heat treatment ultimately influence the results of the
MTBS. Increases in diametrical tensile strength, compres-
sive strength, modulus of elasticity, toughness, improved
dimensional stability,49 wear,20,37 hardness, and color
stability49 have been observed following heat treatment.
The FT-IR analyses of this study showed degree of
conversion to range from 53.45% to 72.77%. This is in
total agreement with existing data about multifunctional
monomers used for dental restorations.1,14,20,24,37,46,48
The improvement in some of the properties (fracture
toughness, flexural modulus, and flexural strength) ob-
tained by heat treating light-polymerized composite resins
was found to be only short term, as it seems to be negated
by water sorption during aging.18 On the other hand, clinical
research by the same author showed that heat treatment
increased the wear resistance and decreased marginal
breakdown of the restorations.20 However, prolonged heat
treatment does provide immediate benefits: a) a signifi-
cant decrease in the amount of unreacted monomer, pre-
venting leaching of the toxic unreacted monomers;6,39,41
b) the acceleration of the chemical-curing process, allow-
ing the restoration to be delivered with an optimal conver-
sion rate on the same day of fabrication. For Premise, the
standard polymerization mode would require a 24-h delay
to reach maximum monomer conversion. The phenomenon
was even more significant in the case of Premise Indirect,
which reached its maximum average degree of conver-
sion (73%) in the present study only 24 h after prolonged
heat treatment. Restorations made with this material not
only require prolonged heat treatment, but also a delay of
24 h after fabrication before intaroral insertion. A positive
outcome of the present study is that the maximum mono-
mer conversion rates were not associated with decreased
MTBS (similar bond strength).
Another important factor in the high monomer conver-
sion rate achieved with Premise (72%) is that the mono-
mer conversion rates of direct composite resins have
been reported to vary not only with the composition of the
resin matrix but also curing-light intensity and duration of
irradiation.9,17 Manufacturers usually recommend light
polymerizing for 20 s with lighter shades and 40 s with
darker shades.51 In the present experiment, the com-
posite resins were light polymerized for 40 s, because
both light and dark shades were used. The light source
also needs to be considered, because newer LED units
can reach 4000 mW/cm2 of intensity, leading to higher
monomer conversion.30 Another parameter is the narrow
wavelength distribution of LED units, which coincides with
the maximum peak of absorption of camphorquinone.17,30
Consequently, it can be hypothesized that modern LED
units (with their combination of high intensity and narrow
Vol 17, No 6, 2015
Magne et al
wavelength range) have reduced the differences in mono-
mer conversion between light- and heat-curing materials.
However, it must be emphasized that the indirect compos-
ite resins requiring a heat initiator must be placed in a cur-
ing oven to eliminate benzoyl peroxide, which is toxic.18
CONCLUSION
Filtek Z100 showed the highest MTBS and lowest mono-
mer conversion rate. Comparison with previously pub-
lished data revealed that prolonged heat treatment was
advantageous in terms of improved MTBS and monomer
conversion for Premise and Premise Indirect.
ACKNOWLEDGMENTS
The authors wish to thank the Kerr Sybron Corporation and 3M
ESPE for supplying the composites and adhesive used in this
study. Moreover, a special thanks to Hector Garza and Al Kobash-
igawa from Kerr Sybron for assistance with FT-IR analysis.
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Clinical relevance: Premise Indirect restorations
should always be subjected to prolonged heat treat-
ment and a 24-hour delay before delivery. The higher
degree of monomer conversions of Premise and
Premise Indirect did not affect their bond strengths.
The Journal of Adhesive Dentistry