Evaluation of the Radiopacities of Bulk-fill Restoratives Using Two Digital Radiography Systems.

This study investigated the radiopacity values of bulk-fill restoratives by using two digital radiography systems. Nine bulk-fill restoratives and a conventional composite were used in the study. Six disc-shaped specimens were prepared from each of these materials, three each at thicknesses of 1 mm and 2 mm, and tooth slices with these same thicknesses were obtained. As a control, an aluminum step wedge varying in thickness from 0.5 to 10 mm in was used. Three specimens of each of the materials, together with the tooth slice and the aluminum step wedge, were placed over a complementary metal oxide semiconductor (CMOS) sensor and a storage photostimulable phosphor (PPS) plate system and exposed using a dental x-ray unit. The images were analyzed using a software program to measure the mean gray values (MGVs). Five measurements were obtained from each of the restorative materials, the enamel, the dentin, and the stepwedge. The MGVs were converted to the equivalent aluminum thicknesses. Three-way analysis of variance (ANOVA) was used to determine the significance of the differences among the groups. A Tukey test was applied for pairwise comparisons (p<0.05). All composite-based restoratives were found to have greater radiopacities than enamel or dentin. Equia Fil had the lowest radiopacity value. Radiopacity increased as the thicknesses of the restorative material increased. The CMOS system showed significantly higher radiopacity values than the PSP system. In conclusion, all investigated bulk-fill restoratives passed the International Organization for Standardization and American National Standard Institute/American Dental Association requirements for radiopacity values when evaluated with the two digital radiography systems.