Objective: Clinical data indicate an increased trend in material fracture as reason for failure in composite restorations, questioning whether modern resin-based composites (RBCs) are able to fulfil the rising aesthetical demands and to provide at the same time a sufficient mechanical stability also in larger cavities. Nano-hybrid RBCs are promoted as materials with improved mechanical properties. The aim of this study was to analyse differences in mechanical properties within and between modern flowable and non-flowable nano-hybrid and micro-hybrid RBCs by measuring mechanical properties at macro- and micro-scale.
Methods: Thirty-four RBCs with traditional and new monomer formulation or photo-polymerization initiator technology-15 nano-hybrid, nine micro-hybrid and ten flowable-were therefore considered. Flexural strength, flexural modulus (E(flexural)), indentation modulus, Vickers hardness (HV) and creep were measured after the samples had been stored in water for 24 h at 37°C. Differences within the materials as well as within material categories were statistically analysed using one-way ANOVA with Tukey HSD post hoc test (α = 0.05) as well as partial eta-square statistics.
Results: The category of micro- and nano-hybrid RBCs performed in all properties superior compared to the flowable RBCs. The former two categories differ significantly only with regard to three parameters, with nano-hybrid RBCs showing higher HV respectively lower E(flexural) and filler weight. The micro-mechanical parameters proved to be more sensitive to differences in filler amount and RBCs type than the macro-mechanical properties.
Clinical relevance: Only few differences were found between nano-hybrid and micro-hybrid RBCs as a material category and thus, from laboratory tests, no clear advantages in the mechanical stability in stress-bearing areas of nano-hybrid RBCs are expected clinically. Similar is valid for materials with new monomer formulation or photo-polymerization initiator technology. However, several of the measured nano-hybrid RBCs showed consistently higher mechanical properties than the mean values of the micro-hybrid RBCs.