Abstract

The purposes of this study were to evaluate the efficacy of water–airborne-particle abrasion (WAPA) as pre-etching procedure for tooth surfaces to increase bond strength, and to compare the survival rate of WAPA vs. non-WAPA glass–ceramic restorations with a 15-year follow-up. The occlusal surfaces of 20 human molars were sectioned and flattened. The prepared surfaces areas were subdivided into two parts: one received WAPA treatment (prophy jet handpiece with 50 µm aluminium oxide particles) followed by acid etching (37% phosphoric acid for 20 s/3-step etch-and-rinse); the other one was only acid-etched. In total, 108 specimens were obtained from the teeth, of which 80 were used to measure the micro-tensile bond strength (μTBS) in the WAPA (n = 40) and control (n = 40) groups, while the remaining specimens (n = 28) were investigated via SEM to evaluate the micromorphology and roughness (Ra) before and after the different treatment steps. The survival rate (SR) was performed on 465 glass–ceramic restorations (131 patients) comparing WAPA treatment (n = 183) versus non-WAPA treatment (n = 282). The bond strength was 63.9 ± 7.7 MPa for the WAPA group and 51.7 ± 10.8 MPa for the control group (p < 0.001). The Ra was 98 ± 24 µm for the enamel control group, 150 ± 35 µm for the enamel WAPA group, 102 ± 27 µm for the dentin control group and 160 ± 25 µm for the dentin WAPA group. The Ra increase from the WAPA procedure for enamel and dentin was statistically significant (p < 0.05). Under SEM, resin tags were present in both groups although in the WAPA they appeared to be extended in a 3D arrangement. The SR of the WAPA group (11.4 years) was 94%, while the SR of the non-WAPA group (12.3 years) was 87.6% (p < 0.05). The WAPA treatment using aluminium oxide particles followed by a 3-step etch-and-rinse adhesive system significantly improved bioadhesion with an increased bond strength of 23.6% and provided superior long-term clinical performance of glass–ceramic restorations.

Highlights

  • Dental adhesive technology has had a great impact in direct and indirect restorative procedures, opening the way to metal-free adhesion and minimally invasive dentistry [1].For direct restorations, all procedures are usually performed during the same appointment, whereas for indirect restorations a provisional phase is necessary

  • Delayed dentin sealing is traditionally performed for indirect restorations, so the dentin is sealed after the provisional phase during the cementation appointment

  • Results of the microtensile bond strength test and roughness (Ra) analysis are collected in Table 1 and described

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Summary

Introduction

All procedures are usually performed during the same appointment, whereas for indirect restorations a provisional phase is necessary. Delayed dentin sealing is traditionally performed for indirect restorations, so the dentin is sealed after the provisional phase during the cementation appointment. This technique cannot provide optimal conditions for bonding procedures [2,3] due to tooth surface contamination by provisional cement, bacteria and even impression material [4]. Materials 2021, 14, 4966 nique cannot provide optimal conditions for bonding procedures [2,3] due to tooth surface contamination by provisional cement, bacteria and even impression material [4].

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Discussion
Conclusion

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