Prewarming effect on adaptation, porosities, and strength of a composite resin

Warming composite resin before insertion to reduce viscosity is advocated for improving adaptation and reducing voids. This study evaluated how prewarming altered porosities, adaptation, and strength. Twenty composite restorations were placed in 2 increments in typodont teeth with a large Class II preparation. The composite was either at room temperature (control) or prewarmed to 68 °C (n = 10/group). Each increment was light-cured for 20s. After 24h, the restored teeth were sectioned and imaged under a stereomicroscope. Examiners ranked the quality of adaptation to walls and between increments, and the presence of voids on a 0-3 scale. Results were statistically analyzed using Mann-Whitney U Test. Diametral tensile strength of monolithic or incrementally-filled composite cylinders (6 mm diameter × 4 mm height; n = 10/group) made with room temperature or prewarmed composite were tested at 0.5 mm/min. Strength results were analyzed using ANOVA statistics followed by pairwise comparisons. Restorations made with prewarmed composite had significantly fewer large voids and better adaptation to cavity walls and between layers (P < 0.05). Strength of prewarmed composite was higher than room temperature composite, and was significantly higher in monolithic specimens (P < 0.05). It was concluded that prewarming conventional composite can improve its handling, making it handle more like a flowable composite without jeopardizing physical properties. The prewarmed composite was found to have better adaptation and fewer voids, and attained higher strength than composite that was not prewarmed.