Modern Light-Cured Restorative Composites as Luting Agents: The Effect of Preheating on Conversion and Film Thickness

The aim of this study was to evaluate (a) the degree of conversion (DC%), (b) film thickness, and (c) the effect of film thickness on DC% in modern light-cured resin composite restoratives [Filtek Universal (F), Clearfil Majesty ES 2 Universal (M), Tetric EvoCeram (T) and Viscalor (V)] used for luting composite onlays before/after preheating. For (a), the luting composites placed at 150 μm film thickness under the onlays (4 mm thickness, 2.9% transmittance) were light-cured for 120 s (3 × 40 s top, buccal, lingual sites) before and after preheating (54 °C/5 min-F,M,T and 65 °C/30 s-V). The DC% was measured at central, middle and side locations along the median in-length axis by ATR-FTIR spectroscopy. Specimens polymerized without onlays (40 s, top) served as controls. For (b), film thickness was measured employing a modified ISO 4049 standard (37 °C plate temperature, 5 N load) before and after preheating, using a dual-cured resin luting agent as control. For (c), onlays were luted with preheated T at 150 and 350 μm film thickness and light-cured for 2 × (3 × 40) s and 3 × (3 × 40) s, employing directly irradiated specimens (60 s, 120 s) as controls. For (a), significant differences were found in F and T before and after preheating. Before preheating, significant differences were registered between F-T, F-M, F-V and V-T, whereas after they were registered between F-M, F-T and F-V. All these values were significantly lower than the controls. For (b), significantly lower film thickness was recorded after preheating (-16.1--33.3%, highest in V), with a ranking of F, M > V > T (before) and F, M > T, V (after). All values were significantly higher than the control. For (c), increased exposure improved DC% in the greater spacer group, with the controls providing superior values. It can be concluded that the use of modern highly filled composites as luting agents for low translucency onlays may result in suboptimal polymerization and film thickness, warranting caution.