The organic phase of resin composites is constituted by dimethacrylate resins, the most common monomers being the bisphenol A diglycidildimethacrylate (BisGMA), its ethoxylated version (BisEMA), triethylene glycol dimethacrylate (TEGDMA) and urethane dimethacrylate (UDMA). This study compared the homopolymers formed from the monomers used in restorative dental composites in terms of their degree of conversion (DC) and reaction kinetics (by near infra-red spectroscopy, n=3), mechanical properties (flexural modulus and strength in three point-bending, FM and FS, respectively, n=15), water sorption and solubility (WS and SL, respectively - ISO 4049, n=5). Materials were made photopolymerizable by the addition of camphoroquinone/dimethylamine ethyl methacrylate. TEGDMA showed the highest DC, followed by BisEMA, UDMA and BisGMA, both at 10 min and at 24h (p<0.001). UDMA showed the highest rate of polymerization, followed by TEGDMA, BisEMA and BisGMA (H0=13.254, p<0.001). UDMA and TEGDMA presented similar FM, significantly higher (p0.001). For FS, UDMA presented the highest value (p0.001). BisGMA showed the highest WS, and TEGDMA and BisEMA the lowest. UDMA was statistically similar to all (H0=16.074, p<0.001). TEGDMA presented the highest SL, followed by UDMA, BisGMA and BisEMA (p<0.001). The tested homopolymers presented different behaviors in terms of polymerization kinetics, flexural properties, water sorption and solubility. Therefore, the use of copolymers is justified in order to obtain high DC and mechanical properties, as well as good resistance to water degradation.

Polymerization shrinkage stress of resin-based materials have been related to several unwanted clinical consequences, such as enamel crack propagation, cusp deflection, marginal and internal gaps, and decreased bond strength. Despite the absence of strong evidence relating polymerization shrinkage to secondary caries or fracture of posterior teeth, shrinkage stress has been associated with post-operative sensitivity and marginal stain. The latter is often erroneously used as a criterion for replacement of composite restorations. Therefore, an indirect correlation can emerge between shrinkage stress and the longevity of composite restorations or resin-bonded ceramic restorations. The relationship between shrinkage and stress can be best studied in laboratory experiments and a combination of various methodologies. The objective of this review article is to discuss the concept and consequences of polymerization shrinkage and shrinkage stress of composite resins and resin cements. Literature relating to polymerization shrinkage and shrinkage stress generation, research methodologies, and contributing factors are selected and reviewed. Clinical techniques that could reduce shrinkage stress and new developments on low-shrink dental materials are also discussed.

Restorative composites have evolved significantly since they were first introduced in the early 1960s, with most of the development concentrating on the filler technology. This has led to improved mechanical properties, notably wear resistance, and has expanded the use of composites to larger posterior restorations. On the organic matrix side, concerns over the polymerization stress and the potential damage to the bonded interface have dominated research in the past 20 y, with many “low-shrinkage” composites being launched commercially. The lack of clinical correlation between the use of these materials and improved restoration outcomes has shifted the focus more recently to improving materials’ resistance to degradation in the oral environment, caused by aqueous solvents and salivary enzymes, as well as biofilm development. Antimicrobial and ester-free monomers have been developed in the recent past, and evidence is mounting for their potential benefit. This article reviews literature on the newest materials currently on the market and provides an outlook for the future developments needed to improve restoration longevity past the average 10 y.