Biocompatibility and Performance of Dental Composite Restorations: A Narrative Review on Free Monomer Release, Concerns and Solutions †
Abstract
:1. Introduction
- Understand the primary mechanisms leading to free monomer release in dental composites.
- Assess the impact of this monomer release on the overall longevity and reliability of the dental restorations.
- Explore the potential health risks associated with the release of these monomers and how to overcome them.
2. Methodology
3. Types of Monomers Commonly Employed in Dental Composite Resins
4. Polymerization Kinetics
5. Degree of Monomer Conversion (DC)
6. Elution of Monomers
6.1. Adverse Effects and Health Risks of Monomer Elution
- Systemic effects: monomers, once absorbed, present potential systemic threats, including cytotoxicity and endocrine disruption, though real-world implications are still under study [7].
- Allergic reactions: some individuals may exhibit allergic reactions to specific monomers, such as dermatitis or respiratory issues [12].
6.2. Methods to Determine Residual Monomer Elution
- High-performance liquid chromatography (HPLC) is a primary quantitative method for separating and quantifying monomers [4].
- Gas Chromatography (GC), another quantitative method, is apt for volatile monomers [17].
- Fourier-Transform Infrared Spectroscopy (FTIR) identifies the chemical structures of eluted monomers [7].
- Nuclear Magnetic Resonance offers detailed molecular insights and quantification [12].
- Direct Contact Tests gauge the biological impact by observing cytotoxic effects on cell cultures [5].
7. Impact of Filler Loading on Free Monomer Release from Composites
8. Effect of Monomer Elution on the Mechanical Properties of Composites
- Strength and durability: a higher DC results in a denser polymer network, boosting mechanical strength and wear resistance [6].
- Reduction in polymerization shrinkage: an increased conversion minimizes unreacted monomers, reducing polymerization shrinkage and enhancing marginal adaptation [22].
- Decreased solubility and water absorption: well-converted composites resist water absorption and degradation, ensuring durability [23].
- Improved aesthetics: a higher DC also improves composite aesthetics, enhancing color stability and translucency [19].
9. Effect of Curing on the Free Monomer Release
10. Effect of Photoinitiators and Light Source
11. Post-Cure Heating of Composites
12. Free Monomer Release Due to Long-Term Degradation and Erosion of Composites
13. Chromatic Instability Due to Free Monomer Release
14. Secondary Caries as a Result of Free Monomer Release
15. Effect on Dental Pulp
16. Allergic Reactions to Residual Monomers
17. Genotoxic Effects
18. Estrogenic Effects
19. Methods to Counteract Free Monomer Content
19.1. Implications of Advanced Strategies in Dental Composites
- Altered curing protocols: Stepped or ramped curing enhances the cure depth and conversion but demands more practitioner time and precision. Incorrect curing can lead to post-operative issues [48].
- Optimized polymerization: using varied light wavelengths improves monomer conversion but may require specialized equipment, impacting finances.
- Alternate monomers: While promising higher reactivity, alternative monomers need extensive study for biocompatibility, aesthetics and material interaction. They may also alter handling properties.
19.2. Recent Advancements to Reduce the Monomer Release
- Optimized curing: stepped curing protocols increase the cure depth and conversion [48].
- Nanofiller tech: using nanofillers enhances conversion [49].
- Photoinitiators: advanced systems bolster polymerization and reduce elution [50].
- Additives: thio-urethanes fortify the polymer, improving conversion and minimizing leaching [46].
19.3. Potential Risks of Altered Curing and Alternate Monomers
20. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Dureja, A.; Acharya, S.R.; Kini, S.; Mayya, A.; Hedge, V. Biocompatibility and Performance of Dental Composite Restorations: A Narrative Review on Free Monomer Release, Concerns and Solutions. Eng. Proc. 2023, 59, 160. https://doi.org/10.3390/engproc2023059160
Dureja A, Acharya SR, Kini S, Mayya A, Hedge V. Biocompatibility and Performance of Dental Composite Restorations: A Narrative Review on Free Monomer Release, Concerns and Solutions. Engineering Proceedings. 2023; 59(1):160. https://doi.org/10.3390/engproc2023059160
Chicago/Turabian StyleDureja, Aastha, Shashi Rashmi Acharya, Sandya Kini, Arun Mayya, and Veena Hedge. 2023. "Biocompatibility and Performance of Dental Composite Restorations: A Narrative Review on Free Monomer Release, Concerns and Solutions" Engineering Proceedings 59, no. 1: 160. https://doi.org/10.3390/engproc2023059160