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    Clinical evaluation of a low-shrinkage resin composite in endodontically treated premolars: 3-year follow-up
    (Springer Heidelberg, 2019) Gonulol, Nihan; Kalyoncuoglu, Elif; Ertas, Ertan; Misilli, Tugba
    ObjectivesThis study compared the 3-year clinical performance of a low-shrinkage silorane-based composite material with that of a methacrylate-based composite material in the restoration of endodontically treated premolar teeth.Materials and methodsA total of 70 patients requiring a Class II composite-resin restoration of a premolar tooth following root-canal treatment participated in the study. Cavities were restored with either a silorane-based restorative (Filtek Silorane+Silorane System Adhesive) or a methacrylate-based restorative (Filtek Z250+Clearfil SE Bond) system applied according to the manufacturer's instructions. Restorations were evaluated by two blinded observers at five different time intervals (baseline; 6months; 1, 2, and 3years) according to modified USPHS criteria. Pearson's chi-square tests were used to examine differences in the clinical performance of the materials (retention, color match, marginal discoloration, secondary caries, anatomical form, marginal adaptation, and surface roughness), and Friedman and Wilcoxon tests were used to compare changes between baseline and each recall time, with a level of 0.05 considered statistically significant.ResultsAfter 3years, no statistically significant differences in clinical performance were observed between the two materials (p>0.05). Intra-system comparisons revealed a statistically significant deterioration in color match, marginal discoloration, anatomical form, marginal adaptation, and surface roughness scores after 3years for both systems. Although the difference was not significant at 3years of follow-up, the level of deterioration in marginal adaptation and surface roughness was greater for the Filtek Silorane restoration than for the Filtek Z250 restoration at the 1year follow-up (p>0.05).ConclusionRestorations of both materials were clinically acceptable after 3years. The Filtek Silorane system did not appear to offer any clinical advantages over the methacrylate-based system when used in the restoration of Class II cavities in endodontically treated premolars.Clinical relevanceThe restoration of endodontically treated premolars with minor or moderate loss of tooth structure can be directly performed either with silorane or methacrylate-based composite resins.
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    Impact of coffee exposure on the color adjustment potential of universal-shade resin composites: an in vitro study
    (Spemd-Soc Portuguesa Estomatologia & Medicina Dentaria, 2025) Sezer, Berkant; Misilli, Tugba; Buldur, Mehmet
    Objectives: This study aimed to evaluate the color adjustment potential (CAP) of a universal- shade composite resin applied to acrylic teeth of different shades under various storage conditions and over different time intervals. Methods: A universal-shade composite (Omnichroma; Tokuyama, Tokyo, Japan) and acrylic molar teeth in three shades (A1, A2, D4) were used. Two types of samples were prepared: dual-shade (Class I restorations with 5-mm diameter and 2-mm depth in acrylic teeth) and single-shade (artificial tooth replicas). Specimens were stored in either distilled water or coffee. Color measurements were performed using a spectrophotometer at baseline, 1 day, 1 week, and 1 month. Color differences (Delta E-00) were calculated using the CIEDE2000 formula. Delta E-00 values were analyzed with two-way ANOVA and Tukey's tests. CAP(00) values were analyzed using the three-way ANOVA for intergroup comparisons and repeated measures ANOVA with Bonferroni tests to assess time-related effects. Results: At baseline, the Delta E-00 values were lowest in the A1 group for both sample types, followed by A2 and D4. After 1 month, coffee immersion led to significantly higher Delta E-00 values than distilled water in all groups. CAP(00) values significantly decreased between 1 week and 1 month in coffee-stored samples. All shade and storage subgroups showed a significant time-dependent increase in CAP(00) (p < 0.05). Conclusions: One-month storage in distilled water enhanced CAP in all groups. In turn, prolonged coffee exposure increased color differences and diminished the color harmony of restorations over time. (Rev Port Estomatol Med Dent Li & gcy; & mcy;& acy;& khcy; & tcy;& acy;& scy;. 2025;66(3):115-123) (c) 2025 Sociedade Portuguesa de Estomatologia e Medicina Dent & aacute;ria.Published by SPEMD. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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    Shear Bond Strength of Aged Composite Restorations Repaired with a Universal Injectable Composite
    (Pera Yayincilik Hizmetleri, 2019) Gonulol, Nihan; Almasifar, Lena; Cabadag, Ozge Gizem; Misilli, Tugba; Kalyoncuoglu, Elif
    Objective: The purpose of this study was to analyze the shear bond strength of a universal injectable composite used in the repair of aged composites. Methods: A total of 100 disk-shaped specimens (8 mmx2 mm) were produced using five different composites (n=20) (Gradia Direct Posterior, Tetric N Ceram BulkFill, Filtek Z250, SonicFill and Filtek BulkFill Posterior). Specimens were polymerized using an LED light curing unit for 20 s and stored at 37 degrees C in distilled water for 3 weeks. Specimens were subdivided into two groups per composite for repair using either the same composite used for the specimen or G-aenial Universal Flo. Following acid-etching and silane application, a universal adhesive (G-Premio BOND) was applied and light-cured. The repair materials were placed on the bonded surfaces of the specimens and polymerized in silicone molds (2 mmx2 mm). After thermocycling to simulate aging, shear bond strength (SBS) was tested using a universal testing machine at a crosshead speed of 1 mm/min. Failure modes were examined using a stereomicroscope at x40 magnification. Results: No statistically significant differences were found among the tested composites repaired with their own substrates. However, the SBS SonicFill and Filtek Bulk Fill Posterior groups had significantly lower bond strengths when repaired with G-aenial Universal Flo in comparison to repairs made with their own substrates (p<0.05). Conclusion: When repaired with their own substrates, reliable bond strengths were obtained for all the composites tested.
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    The effect of curing lights and modes on dentin bond strength of bulk-fill composites applied in different thickness
    (Taylor & Francis Ltd, 2019) Misilli, Tugba; Gonulol, Nihan; Cabadag, Ozge Gizem; Almasifar, Lena; Misilli, Umut
    To investigate shear bond strength (SBS) to dentin of a conventional and three bulk-fill composites applied in different increment thickness and cured by mono- and multi-wave LED LCUs. Two hundred and fifty-two extracted sound human molars were prepared for SBS test. The teeth were divided into four groups according to the resin composites used. Conventional composite: Tetric N-Ceram (control); high-viscosity bulk-fills: Tetric N-Ceram Bulk Fill, X-tra Fil, and SonicFill. Each group was subdivided (n = 7) according to increment thickness (2, 4, and 6 mm) and cured by standard mode of a mono-wave LED or two different modes (standard and xtra power) of a multi-wave LED. The failure mode was stereomicroscopically determined at 40x magnification. Data were analyzed using Three-way ANOVA and further comparisons were assessed by Bonferroni's multiple comparison test. There were no significant differences within X-tra fil and Tetric N-Ceram Bulk Fill groups for any of the variables (p > 0.05). A significant decrease in SBS values with increase of layer thickness was observed for SonicFill and control groups. Also, curing mode had a significant effect on both composites at 6 mm thickness and standard mode of multi-wave LED caused the highest SBS value (p < 0.05). Adhesive failure was the most common fracture pattern especially at 6 mm thickness applications. Based on the results of this study, the bulk-fill composites can be safely applied in one-step with 4 mm increments, although the examined composites performed better at 2 mm thickness. The performance of the composites at 6 mm increment may show differences related to the curing lights and modes.
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    The impact of postoperative intracoronal bleaching on the microtensile bond strength at the composite-dentin interface
    (Japanese Soc Dental Materials Devices, 2025) Ayan, Gizem; Misilli, Tugba; Buldur, Mehmet; Dogan, Ayse Nur
    The study evaluated the effects of postoperative bleaching with HP and CP on microtensile bond strength (mu TBS) and nanoleakage of composite restorations using total-/self-etch protocols. Sixty incisors with Black V cavities were restored using a multimode adhesive in total-/self-etch mode and resin composite. Samples were divided into five groups: control, CPx2, CPx5, HPx2, HPx5. After bleaching, 1x1x8 mm composite blocks (n=10) were tested for mu TBS, and failure types were assessed. Two samples per group were analyzed for nanoleakage via scanning electron microscope (SEM). Two-way analysis of variance, Bonferroni correction, and stepwise linear regression were applied. CPx5 and HPx5 groups exhibited significantly reduced mu TBS compared to control, and the self-etch protocol resulted in lower values regardless of bleaching method. Regression analysis confirmed significant effects of adhesive (total-etch) and bleaching (CPx5, HPx5). A significant relationship was found between failure modes and bleaching methods for each adhesive protocol, with adhesive failures being the most frequent. SEM revealed nanoleakage in all groups.
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    The impact of remineralization agents on dental bleaching efficacy and mineral loss in bleached enamel
    (Wiley, 2022) Misilli, Tugba; Carikcioglu, Burak; Deniz, Yesim; Aktas, Cagatay
    This study evaluated the effect of remineralization agents on bleaching efficiency, enamel mineral changes, and post-bleaching color stability. A total of 112 enamel-dentin blocks were prepared from bovine teeth. Following initial color measurements, separate treatment regimens were carried out as follows: negative control (no treatment); positive control (bleaching only); bleaching, then NaF; bleaching + NaF (mix); bleaching, then CPP-ACPF; bleaching + CPP-ACPF (mix); bleaching, then nHAP+F; bleaching + nHAP+F (mix). Color measurements were repeated after immersion in distilled water for 7 days, and again after staining with coffee solution for 14 days. The CIELAB-based whiteness index was used to evaluate bleaching efficiency, and the CIEDE2000 color difference formula for color stability. Chemical investigation was performed using scanning electron microscopy with energy dispersive spectroscopy and X-ray diffraction analyses. The experimental groups showed significant increases in whiteness compared to the negative control, and the staining after bleaching did not result in statistically significant differences between the groups. Energy dispersive spectroscopic analysis revealed that bleaching protocols had no impact on elemental levels as well as the ratio of Ca/P. The combined use of bleaching agents with remineralization agents did not affect bleaching effectiveness but also did not provide an additional contribution.