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      Travel beyond Clinical Uses of Fiber Reinforced Composites (FRCs) in Dentistry: A Review of Past Employments, Present Applications, and Future Perspectives

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          Abstract

          The reinforcement of resins with short or long fibers has multiple applications in various engineering and biomedical fields. The use of fiber reinforced composites (FRCs) in dentistry has been described in the literature from more than 40 years. In vitro studies evaluated mechanical properties such as flexural strength, fatigue resistance, fracture strength, layer thickness, bacterial adhesion, bonding characteristics with long fibers, woven fibers, and FRC posts. Also, multiple clinical applications such as replacement of missing teeth by resin-bonded adhesive fixed dental prostheses of various kinds, reinforcement elements of dentures or pontics, and direct construction of posts and cores have been investigated. In orthodontics, FRCs have been used also for active and passive orthodontic applications, such as anchorage units, en-masse movement units, and postorthodontic tooth retention. FRCs have been extensively tested in the literature, but today the advances in new technologies involving the introduction of nanofillers or new fibers along with understanding the design principles of FRC devices open new fields of research for these materials both in vitro and in vivo. The present review describes past and present applications of FRCs and introduces some future perspectives on the use of these materials.

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          Flexural properties of acrylic resin polymers reinforced with unidirectional and woven glass fibers.

          Fiber-reinforced plastics for dental applications have been under development for some time. A major difficulty in using reinforcing fibers with multiphase acrylic resins, such as powderliquid resins, has been improper impregnation of fibers with the resin. The aim of this study was to describe and test a novel system to use polymer-preimpregnated reinforcing fibers with commonly used multiphase acrylic resins. Continuous unidirectional and woven preimpregnated glass fiber reinforcements (Stick and Stick Net) were used to reinforce heat-curing denture base and autopolymerizing denture base polymers. A temporary fixed partial denture polymer was also reinforced with Stick reinforcement material. Five test specimens were fabricated for unreinforced control groups and for Stick- and Stick Net-reinforced groups. A 3-point loading test was used to measure transverse strength and flexural modulus of the materials and ultimate strain at fracture was calculated. Cross-sections of test specimens were examined with a SEM to evaluate degree of impregnation of fibers with polymer matrix. Quantity of fibers in test specimens was determined by combustion analysis. Transverse strength of heat-curing denture base polymer was 76 MPa, Stick reinforcement increased it to 341 MPa, and flexural modulus increased from 2550 to 19086 MPa. Stick Net reinforcement increased transverse strength of heat-curing denture base polymer to 99 MPa and flexural modulus to 3530 MPa. Transverse strength of autopolymerizing denture base polymer was 71 MPa; Stick increased it to 466 MPa; and flexural modulus increased from 2418 to 16749 MPa. Stick Net increased the transverse strength of autopolymerizing denture base polymer to 96 MPa and flexural modulus to 3573 MPa. Transverse strength of temporary fixed partial denture polymer increased from 58 to 241 MPa and flexural modulus from 1711 to 7227 MPa. ANOVA showed that reinforcement type and polymer brand affected transverse strength and modulus (P <.001). Stick Net reinforcement increased the strain at fracture, whereas Stick reinforcement decreased the strain values. SEM examination revealed well-impregnated glass fibers with polymer matrix. Quantity of glass fibers varied from 6 to 28 vol-%, the lowest being with Stick Net reinforcement and the highest with Stick reinforcement. Novel glass fiber reinforcements may considerably enhance flexural properties of multiphase dental polymers, which is due to proper impregnation of fibers with polymer matrix. By using Stick or Stick Net reinforcement, the strain at fracture of the material can be modified.
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            Physical properties and depth of cure of a new short fiber reinforced composite.

            To determine the physical properties and curing depth of a new short fiber composite intended for posterior large restorations (everX Posterior) in comparison to different commercial posterior composites (Alert, TetricEvoCeram Bulk Fill, Voco X-tra base, SDR, Venus Bulk Fill, SonicFill, Filtek Bulk Fill, Filtek Superme, and Filtek Z250). In addition, length of fiber fillers of composite XENIUS base compared to the previously introduced composite Alert has been measured. The following properties were examined according to ISO standard 4049: flexural strength, flexural modulus, fracture toughness, polymerization shrinkage and depth of cure. The mean and standard deviation were determined and all results were statistically analyzed with analysis of variance ANOVA (a=0.05). XENIUS base composite exhibited the highest fracture toughness (4.6MPam(1/2)) and flexural strength (124.3MPa) values and the lower shrinkage strain (0.17%) among the materials tested. Alert composite revealed the highest flexural modulus value (9.9GPa), which was not significantly different from XENIUS base composite (9.5GPa). Depth of cure of XENIUS base (4.6mm) was similar than those of bulk fill composites and higher than other hybrid composites. The length of fiber fillers in XENIUS base was longer (1.3-2mm) than in Alert (20-60μm). The new short fiber composite differed significantly in its physical properties compared to other materials tested. This suggests that the latter could be used in high-stress bearing areas. Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
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              Resin-bonded, glass fiber-reinforced composite fixed partial dentures: a clinical study.

              Resin-bonded, glass fiber-reinforced composite fixed partial dentures (FPDs) have been under development for some time. There is a lack of data regarding the clinical usefulness of such prostheses. The clinical performance of 31 resin-bonded, glass fiber-reinforced composite fixed partial dentures was evaluated in a preliminary study. The prostheses were made to replace 1 to 3 missing maxillary or mandibular teeth in each of 31 patients. The prostheses had a framework made of continuous unidirectional E-glass fibers with multiphase polymer matrix and light-polymerized particulate composite resin veneering. The prostheses were examined after 6-month periods for up to 24 months (mean follow-up time was 14 months). Partial or total debonding of the prostheses or the framework fracture was considered a treatment failure. Two prostheses debonded during the follow-up period; 1 debonding was related to improper occlusal adjustment and the other to unknown reasons. Kaplan-Meier survival probability at 24 months was 93%. No framework fractures were observed. The results of this preliminary study suggest that the resin-bonded, glass fiber-reinforced FPDs may be an alternative for resin-bonded FPDs with a cast metal framework.
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                Author and article information

                Contributors
                Journal
                Biomed Res Int
                Biomed Res Int
                BMRI
                BioMed Research International
                Hindawi
                2314-6133
                2314-6141
                2018
                22 October 2018
                : 2018
                : 1498901
                Affiliations
                1Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Italy
                2Department of Biomaterial Science and Turku Clinical Biomaterials Centre (TCBC), Institute of Dentistry, University of Turku, Turku, Finland
                3City of Turku, Welfare Division, Turku, Finland
                4University of Zurich, Center for Dental and Oral Medicine, Dental Materials Unit, Clinic for Fixed and Removable Prosthodontics and Dental Materials Science, Zurich, Switzerland
                Author notes

                Academic Editor: Mirella Falconi

                Author information
                http://orcid.org/0000-0002-2760-0124
                http://orcid.org/0000-0002-3391-5165
                http://orcid.org/0000-0003-3445-3289
                Article
                10.1155/2018/1498901
                6217899
                30426003
                02036e3f-7164-41b0-b1e7-2f928720e0ae
                Copyright © 2018 Andrea Scribante et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 1 August 2018
                : 2 October 2018
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                Review Article

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