# Synergistic Effects of Simulated Energy Drink Exposure and Fatigue Loading on Bioactive and Conventional Resin Composites

## TL;DR

This study examines how energy drinks and chewing stress affect dental resin materials, finding that citric acid exposure and cyclic loading reduce their durability and strength.

## Contribution

The study introduces a novel in vitro simulation combining energy drink exposure and cyclic fatigue loading to evaluate dental resin composites.

## Key findings

- Activa Presto had the lowest fatigue survival in both water and citric acid.
- Tetric Ceram showed the highest flexural strength among surviving specimens.
- Citric acid exposure and cyclic loading negatively impacted all materials' mechanical performance.

## Abstract

The consumption of energy and sports drinks is on the rise globally, exposing dental restorations to more frequent low-pH challenges, which affect degradation. This in vitro study simulated the combined effect of energy drink exposure and cyclic fatigue loading on the fatigue survival rate and flexural strength of three direct dental resin restorative materials with distinct chemistries: a bioactive ionic resin (Activa Presto), a giomer (Beautifil Flow Plus F00) and a conventional nano-hybrid composite (Tetric Ceram). Bar-shaped specimens (25 × 2 × 2 mm) were fabricated according to ISO 4049 and stored for 24 h in either distilled water or 0.2 M citric acid (pH ≈ 2.5), simulating an energy drink (n = 10/group). The samples then underwent chewing simulation (40 N, 100,000 cycles, 1.6 Hz) using a steel antagonist; surviving specimens were tested via three-point bending to determine their flexural strength. All the materials were affected by storage conditions: Activa Presto showed the lowest fatigue survival (20% in water; 0% in citric acid), Tetric N-Ceram moderate survival (40% in both solutions) and Beautifil Flow Plus F00 the highest and most stable survival (90% in water; 40% in citric acid). Among the surviving specimens, Tetric Ceram exhibited the highest flexural strength, followed by Beautifil Flow Plus F00 and then Activa Presto. Citric acid exposure and cyclic loading adversely affected the mechanical performance of all the materials within the limitations of this study.