Monomer elution in relation to degree of conversion for different types of composite

Objectives: The aim of this study was to determine the degree of conversion (DC) and the monomer release of three composite types when employed following a layer- and bulk-filling technique.

Methods: The release of monomers from a 'conventional paste-like' (Filtek Z250), a 'conventional flowable' (Filtek Supreme XTE Flowable) and a 'bulk-fill' flowable composite (Filtek Bulk Fill Flowable) from the same manufacturer (3M ESPE, Seefeld, Germany) was determined. Ten cylindrical specimens per composite were built, either in two 2-mm layers or in one 4-mm bulk. DC was measured at the specimen top and bottom surface using micro-Raman spectroscopy, after which the specimens were immersed in 2 ml absolute ethanol for 24 h at 37 °C. This solution was refreshed weekly during six weeks and the concentration of BisGMA, BisEMA(6), BisPMA, UDMA, TEGDMA and BPA was determined by liquid chromatography/mass spectroscopy.

Results: DC at the specimen top and bottom was similar except for the bulk-fill technique, which resulted in significantly lower DC at the specimen bottom. The release of BisGMA and TEGDMA was initially very high, but rapidly dropped in the second week. In contrast, the release of BisPMA and UDMA increased initially, but then declined towards the sixth week. BisEMA(6) release was relatively steady over time. All composites released small amounts of BPA. The total monomer release was significantly lower for the layer- than the bulk-filling technique.

Conclusions: The slightly reduced degree of conversion at 4-mm depth resulted in a higher monomer elution when the composite was applied following a bulk-fill application method.

Clinical significance: Applying a flowable and a bulk-fill composite following a bulk-fill application method resulted in a significantly reduced degree of conversion at the bottom of polymerized composite specimens when compared to a layer-application method. This reduced polymerization degree was reflected in significantly increased monomer release.