Correlation between polymerization shrinkage stress and C-factor depends upon cavity compliance

Objectives. The literature reports inconsistent results regarding using configuration factor (C-factor) as an indicator to reflect the generation of polymerization shrinkage stress (PS) from dental restorative composites due to the constraint of cavity configuration. The current study aimed at unraveling the complex effects of C-factor on PS based on analytical and experimental approaches together, such that the reported inconsistency can be explained and a significance of C-factor in clinic can be comprehensively provided. Methods. Analytical models based on linear elasticity were established to predict PS measured in instruments (testing systems) with different compliances, and complex effects of C-factor on PS were derived. The analyses were validated by experiments using a cantilever beam-based instrument and systematic variation of instrumental compliance. Results. For a general trend, PS decreased with increasing C-factor when measured by instruments with high compliance. However, this trend gradually diminished and eventually reversed (PS became increased with increasing C-factor) by decreasing the system compliance. Significance. Our study indicates that the correlation between PS and C-factor are highly dependent on the compliance of testing instrument for PS measurement. This suggests that the current concept on the role of C-factor in the stress development and transmission to tooth structures, higher C-factor produces higher PS due to reduced flow capacity of more confined materials, can be misleading. Thus, the compliance of the prepared tooth (cavity) structure should also be considered in the effect of C-factor on PS. Published by Elsevier Ltd on behalf of Academy of Dental Materials.