WJD

10.5005/jp-journals-10015-1580
Composite Diametral Tensile Strength
ORIGINAL RESEARCH

Composite Diametral Tensile Strength

1
Ali AR Al-Shekhli, 2Isra’a Al Aubi

ABSTRACT How to cite this article: Al-Shekhli AAR, Aubi IA. Composite
Diametral Tensile Strength. World J Dent 2018;9(6):457-461.
Aim: The aim of this study was to evaluate and compare the
diametral tensile strength (DTS) of 4 types of composite mate- Source of support: Nil
rials including bulk fill type (tetric evo ceram) cured with two Conflict of interest: None
different curing intensities.
Materials and methods: Four types of light-activated compos-
ite materials of A3 shade were selected for this study: Tetric INTRODUCTION
Evo Ceram-Ivoclar Vivadent; Ceram X.mono- Dentsply; Nano
Ceram-Bright-DMP; Estelite Sigma Quick-Tokuyama. Twenty One of the most important discoveries in the history
specimens of each composite material were prepared: ten of operative dentistry was the improvement of light-
specimens were cured with high intensity 1200 mW/cm2 (n = 10) activated composite resin for direct restorations, and
(high-intensity group) for 20 seconds and ten specimens were this material has revolutionized this field in a way that
cured with low intensity 650 mW/cm2 (n = 10) (low intensity
group) for 20 seconds. Specimens were prepared following the today restorative dentistry cannot be imagined without
ISO 4049 and ADA/ANSI 27 Specifications in which cylindrical dental composite.1,2
specimens (n = 20 of each material) of 4 mm in depth and 6 mm The demand for lifelike appearance makes the
in diameter were prepared and stored in distilled water for patients looking for tooth-colored restorations in ante-
24 hours at 37°C. The DTS test was performed using the univer-
rior and posterior teeth similarly.3 Skinner in 1959 wrote,
sal testing machine (Testometric/UK) with a crosshead speed
of 1.0 mm/minute. The specimens were placed with their long “the esthetic quality of restoration may be as important
axes perpendicular to the surface of the applied compressive to the mental health of the patient as the biological and
load until failure. Values of the DTS in MPa were calculated and technical qualities of the restoration are to his physical
statistically analyzed by one way analysis of variance (ANOVA)
or mental health.” And till today esthetic considerations
and Tukey tests at 95% level of significance.
are still the primary reason for demanding dental treat-
Results: The mean of DTS in the high-intensity group ranged ment.3
from 38.49 to 48.79 MPa, whereas the mean of DTS in the low-
intensity group ranged from 24.58 to 38.15 MPa. The p values
Requirements for filling materials include the physical
of statistical tests were all less than 0.05. One-way analysis of properties and wear resistance should be close to that of
variance (ANOVA) tests for DTS values of all the four composite the tooth structure, good optical properties, detectable
groups cured with high intensity at 1200 mW/cm2 and for DTS on X-ray, easy to handle and to polish, have the ability
values of all the four composite groups cured with low intensity
to bound to tooth structure, should be tasteless and bio-
at 650 mW/cm2 revealed that there were statistically significant
differences (p ≤ 0.05). compatible, and many more of these requirements are
recorded in the ISO (4049) standards.4
Conclusion: Within the limitations of the study we can conclude
that high-intensity curing significantly resulted in higher DTS For a successful composite restoration, properties like
values in all the composites being tested in this study due to a diametral tensile strength, compressive strength, flexural
better degree of conversion and composite composition also strength, the linear coefficient of thermal expansion,
significantly influences its DTS values. water sorption, wear resistance, surface texture, radio-
Clinical significance: Diametral tensile strength (DTS) of opacity, modulus of elasticity, solubility, must be optimal.3
any restorative material is an essential test that simulates the Such mechanical properties affect dental composite,
tensile behavior of the restorative material during function in
whether to be used in the anterior or posterior region.5
the oral cavity which is an indicator for the general strength
and durability of the restoration in oral service. Because of the improvement of this material, it gives
us the advantages to be used for restoring posterior stress-
Keywords: Composite resin, Diametral tensile strength,
Mechanical properties.
bearing cavities, and as an alternative to amalgam.6 The
first attempt to put composite in posterior teeth was not
successful because of inadequate mechanical properties,
1,2
Department of Restorative Dentistry, College of Dentistry, such as inadequate resistance to wear, fracture within the
Ajman University, Fujairah Campus, UAE body of the restoration, and microleakage due to polymer-
Corresponding Author: Ali AR Al-Shekhli, Department of ization shrinkage, were the most common cause of failure
Restorative Dentistry, College of Dentistry, Ajman University, in posteriors teeth, but some of those disadvantages have
Fujairah Campus, UAE, e-mails: a.razook@ajman.ac.ae, been greatly overcomed in the last few years. Improve-
alirazooki@yahoo.com
ments in the material properties along with the clinical
World Journal of Dentistry, November-December 2018;9(6):457-461 457
Ali AR Al-Shekhli, Isra’a Al Aubi

performance encourage the practitioner to use composite intensity 650 mW/cm 2 (n = 10) (low-intensity group)
resin in posterior teeth as an alternative to amalgam.6 for 20 seconds. Eighty resin composite specimens were
Tensile strength is the force needed to break a material prepared (n = 20 of each type of composite material) by
when the material is subjected to two sets of forces that incremental (two increments) insertion of composite into
are directed away from each other in the same straight a circular nickel-chromium split mold with 6 mm in inner
line, diametral tensile strength testing was developed to diameter and 4 mm in height and cured using Blue phase
investigate brittle material such as, composite, with little G2 (Ivoclar, Vivadent) light curing unit for 20 seconds for
or no plastic deformation.5 each 2 mm increment of composite thickness except for
The aim of this study was to evaluate and compare Tetric Evo Ceram bulkfill composite the curing was done
the DTS of four types of light activated composite materi- for the whole thickness of the composite specimen for
als (Tetric Evo Ceram-Ivoclar Vivadent as a bulkfill type; 20 seconds (Fig. 1A). Following the ISO 4049 and ADA/
Ceram X.mono-Dentsply; Nano Ceram-Bright-DMP; ANSI 27 specifications for standardized DTS testing in
Estelite Sigma Quick-Tokuyama) cured with two different which cylindrical specimens of 6 mm in inner diameter
light activation intensities. and 4 mm in thickness have to be prepared (Fig. 1B).
The specimens then stored in distilled water for 24
MATERIALS AND METHODS hours at 37° C before the mechanical testing. The DTS
Four types of light-activated composite materials of A3 test was performed using the universal testing machine
shade were selected for this study: [Tetric Evo Ceram (Testometric/UK) with a crosshead speed of 1.0 mm/
(bulkfill)]–Ivoclar Vivadent; Ceram X.mono–Dentsply; minute. The specimens were placed with their long axes
Nano Ceram-Bright-DMP; Estelite Sigma Quick- perpendicular to the surface of the applied compressive
Tokuyama). Twenty specimens of each composite mate- load until failure (Fig. 1C).
rial were prepared: ten specimens were cured with high The DTS was calculated using the equation: DTS =
intensity 1200 mW/cm2 (n = 10) (high-intensity group) 2L/πDh, where L is the failure load, D the diameter,
for 20 seconds and ten specimens were cured with low and h the height of the specimen.

A B

Figs 1A to C: Devices and composite specimen used in this study. (A) Blue phase G2 light curing unit; (B) Cylindrical composite
specimen of 6 mm in diameter and 4 mm in height; (C) The universal testing machine (Testometric/UK)

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Composite Diametral Tensile Strength

Mean DTS values were expressed in MPa and data Tetric EvoCeram achieved the highest DTS mean values
were analyzed by t-test at the 0.05 level of significance. among all the composite groups being tested in this
study in both high and low-intensity groups while Nano
RESULTS Ceram-Bright composite achieved the lowest DTS mean
values among all the composite groups being tested in
Mean DTS values, standard deviations of the four com-
this study in both high and low-intensity groups Table 1
posites with high and low intensity curing in MPa are
and Graph 1.
presented in Table 1. Graph 1 represents the mean DTS
The results obtained from the study were supported
values of the four composites being tested with high and
by the findings of Koplin and Takahashi who found that
low intensity curing in MPa.
the values of the diametral tensile strength of Tetric Evo
One-way analysis of variance (ANOVA) tests for DTS
Ceram under high intensity to be 48 MPa.7,8 Moraes9
values of all the four composite groups cured with high
reported a mean value of 46 MPa for Tetric Evo Ceram
intensity at 1200 mW/cm2 and for DTS values of all the
under high-intensity curing. Probably the main reasons
four composite groups cured with low intensity at 650
behind the high mean values of diametral tensile
mW/cm2 revealed that, there were statistically significant
strength achieved by Tetric Evo Ceram bulk fill in this
differences (p ≤ 0.05) as shown in Tables 2 and 3, respec-
study might be attributed first to its resin composition
tively.
as it contains Bis-GMA, Bis-EMA and UDMA Table 5.
Further analysis of the data with t-test indicated that,
During the polymerization reaction, monomers are
there was a statistically significant difference in DTS
being converted into a long chain cross-linked polymer
values between all the 12 pairs of the four groups cured
matrix. The organic matrix phase of Tetric Evo Ceram
with high and low intensities (p ≤ 0.05) except between
composite makes about 21% of the total mass. Tetric
pairs no. 5, 7, 9 and 11 that showed no significant differ-
Evo Ceram composite is the result of a harmonious
ences between them as shown in Table 4.
optimized monomer matrix and fillers combination. The
DISCUSSION second reason might be attributed to its magic mixture
of different types of filler (two different mean particle
The main importance of diametral tensile strength testing
came from it gives an indication about the resistance to
fracture of restorative materials in clinical service, and
minimizing the clinical problems associated with it.5

Table 1: Mean DTS values, standard deviations of the four

composites with high and low intensity curing in MPa
Intensity Groups composite DTS in MPa, (SD)
High intensity Tetric Evo Ceram 48.799, (1.8)
1200 mW/cm2 Bulk fill
Ceram X mono 45.777, (1.4)
Nanoceram – Bright 38.494, (3.7)
Estelite 44.805, (1.2)
Low intensity Tetric Evo Ceram 38.150, (2.1)
650 mW/cm2 Bulk fill
Ceram X mono 37.764, (1.9)
Nanoceram – Bright 24.582, (3.2)
Graph 1: Mean DTS values of the four composites with high and
Estelite 35.935, (1.07) low intensity curing in MPa

Table 2: One-way analysis of variance (ANOVA) for DTS of all the four composite groups cured with high intensity 1200 mW/cm2
Source SS df MS F p
Between-treatments 581.2351 3 193.745 41.40083 < 0.00001
Within-treatments 168.4706 36 4.6797 – –
Total 749.7057 39 – – –

Table 3: One-way ANOVA for DTS of all the four composite groups cured with low intensity 650 mW/cm2
Source SS df MS F p
Between-treatments 1268.3934 3 422.7978 52.69384 < 0.00001
Within-treatments 288.852 36 8.0237 – –
Total 1557.2454 39 – – –

World Journal of Dentistry, November-December 2018;9(6):457-461 459

Ali AR Al-Shekhli, Isra’a Al Aubi

Table 4: t-test of the DTS values between different pairs of the four groups cured with high and low light intensities
Intensity Pair no. Pair of groups t Critical value 2.101
1 G1 X G2 4.0203 Sig.
2 G1 X G3 8.5585 Sig.
3 G1 X G4 5.5453 Sig.
High intensity 1200 mW/cm2
4 G2 X G3 6.3833 Sig.
5 G2 X G4 1.5555 Not sig.
6 G3 X G4 -5.6666 Sig.
7 G1 X G2 0.4455 Not sig.
8 G1 X G3 10.9051 Sig.
9 G1 X G4 1.0797 Not sig.
Low intensity 650 mW/cm2
10 G2 X G3 10.8789 Sig.
11 G2 X G4 0.7868 Not sig.
12 G3 X G4 -7.9164 Sig.

Table 5: Comparison of materials properties provided by manufacturers

Materials Filler composition Matrix composition Shade and Batch
Tetric Evo Ceram Bulk Fill • Ba-glass, YbF3, mixoxide, PPF • Nano-Hybird Bis-GMA, Urethane • A3
Ivoclar-Vivadent (Schaan, • 76% dimethacrylate, Ethoxylated • R56348
Liechtenstein Bis-EMA, UDMA
Ceram X mono (Dentsply) • 76%. • Nano- Fill • A3
• Methacrylate modified polysiloxane • 1405000969
• Dimethacrylate resin
Nano Ceram–Bright • Barium glass, mixed oxide. • Nano–Hybrid, Bis-GMA, TEGDMA • A3
(DMP LTD) • 80%. • 630340
Estelite sigma quick • Silica-zirconia filler • Nano fill, Bis-GMA and Triethylene • A3
• 82% filler weight glycol dimethacrylate • E839

sizes, an “Isofiller“ with barium aluminum silicate glass, of the dental composite, but might lead to increase in
ytterbium fluoride and spherical mixed oxide) to achieve polymerization shrinkage.15,16
the preferred composite physical and mechanical prop- The findings of the current study is also in agree-
erties. Tetric Evo Ceram light activated composite has a ment with the findings of many other previous studies
standard filler content of approximately 61% by volume in that, the average DTS values for many conventional
and 17% “Isofillers” (Scientific Documentation Tetric dental composites are fallen within our range 34–45 MPa
Evo Ceram® Bulk Fill).10 The third reason might be attri­ (Table 1) when cured with full light intensity and also we
buted to its unique photoinitiator Ivocerin® –a dibenzoyl agreed with their justification for results obtained from
germanium derivative11,12 which plays an important their studies in that, “The diametral tensile strength
role in its optimum polymerization due to the optimal test may reveal different values for apparently similar
compatibility with Blue Phase G2 light curing unit as materials. However, this variation has been explained by
Ivocerin photoinitiator wavelength peak absorption the difference between the polymeric matrix, the size of
values is with Blue Phase G2 light curing unit which was fillers and bond between fillers and matrix.17 The matrix
specifically designed to cure Ivoclar Vivadent composite of most resins is composed of bisphenol-A glycidyl-
products . It allows optimal curing of posterior compos- methacrylate (Bis-GMA), which is an aromatic ester of
ite restorations in larger single increment thickness of a dimethacrylate, synthesized from an epoxy resin and
up to 4 mm, without affecting the optical properties of methyl methacrylate; thus, it is rigid yet presents high
the such as translucency or hue. The combined initiator viscosity. The viscosity of the polymeric matrix is reduced
system (camphorquinone) plus Ivocerin® results in a by the addition of other low molecular weight polymers
material featuring an absorption optimum in the blue such as urethane dimethacrylate (UEDMA) or triethyl-
light range from around 370 to 460 nm.13 eneglycol dimethacrylate (TEGDMA), as in the composite
The DTS of the high-intensity group was significantly Filtek Z-250, to improve the incorporation of fillers and
higher than that of the low-intensity group (Graph 1). increase the degree of conversion of composite resins.
These findings were consistent with findings of other Therefore, it has been reported that replacing BisGMA
research like Rueggeberg14 who concluded that the higher by TEGDMA increases the diametral tensile strength
the light intensity, the higher the degree of conversion, yet reduces the flexural strength, whereas replacing
which results in improvement in the general properties either Bis-GMA or TEGDMA by UEDMA increases the

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Composite Diametral Tensile Strength

diametral strength and flexural strength,17 which was 6. Manhart J, Kunzelmann K, Chen H, Hickel R. Mechanical
confirmed by the results in that study”. In the current properties and wear behavior of light-cured packable com-
posite resins. Dent Mater 2000;16(1):33-40.
study, we also found that, replacing either Bis-GMA or
7. Koplin C, Rodriguez G, Jaeger R. Multiaxial strength and
TEGDMA by UDMA or incorporation of UDMA resin stress forming behavior of four light-curable dental compos-
monomer in composite resin matrix composition) (Table 5) ites. J. Res. Pract. Dent. 2014;396766.
significantly increases the diametral tensile strength of 8. Takahashi H, Finger W, Endo T, Kanehira M, Koottathape
many conventional composites, as in Tetric Evo Ceram N, Komatsu M, et al. Comparative evaluation of mechanical
composite, which was confirmed by the results obtained characteristics of nanofiller containing resin composites.
American Journal of Dentistry. 2011;24(5):264-270.
in the current study and also explained why Nano Ceram-
9. Moraes RR, Goncalves LD, Lancellotti AC, Consani S, Correr-
Bright composite exhibited the least DTS mean values Sobrinho L, Sinhoreti MA. Nanohybrid resin composites:
among all the composite being tested in this study and nanofiller loaded materials or traditional microhybrid
supports and might be one of the main causes behind the resins?. Operative dentistry. 2009;34(5):551-557..
high DTS mean values of Tetric Evo Ceram composite as 10. The future of composite technology: Scientific Documenta-
it was mentioned before (Table 5).18-20 tion by Ivoclar Vivadent AG Research & Development Scien-
tific Service Bendererstrasse 2 FL - 9494 Schaan Liechtenstein
2014:1-42.
CONCLUSION 11. Burtscher P, Rheinberger V. Germanium based photoinitiator
as an alternative to camphorquinone/amine. IADR Abstract
Within the limits of this study, we can conclude:
2008; 1611.
• High light intensity significantly resulted in higher 12. Moszner N, Fischer U, Ganster B, Liska R, Rheinberger V.
DTS values in all the composites being tested than Benzoyl germanium derivatives as novel visible light pho-
the low light intensity. toinitiators for dental materials. Dent Mater. . 2008;24(7):
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using a halogen and two LED curing units. Clin Oral Invest.
CLINICAL SIGNIFICANCE 2008;12:45-51
14. Rueggeberg F A, Caughman W F, Curtis J W. Effect of light
Diametral tensile strength (DTS) of any restorative mate-
intensity and exposure duration on cure of resin composites.
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16. Dennison J, Yaman P, Seir R, Hamilton J. Effect of variable
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