Composite Luting Agents Research Articles

Degree of conversion of dual-cured composite luting agents: The effect of transition metal-based touch-cure activators

PurposeThe aim of the study was (a) to assess the effect of universal adhesives and tooth primers with novel touch-cure activators on the conversion of dual-cured resin composite luting agents (RLAs) polymerized under the self-curing mode, and (b) to investigate the source of the catalytic effect exerted by the activators. Materials and MethodsThe materials selected were the adhesive RLAs Panavia V5/Tooth Primer (PV5/TP5), Variolink Esthetic DC/Adhese Universal DC (VLE/ADC), and the self-adhesive RLAs GCem ONE/AE Primer (GCO/AEP), RelyX Universal/Scotchbond Universal Plus (RXU/SUP) and Panavia SA Universal/Clearfil Universal Bond Quick (PSU/CUQ), the later serving as a control with an aryl-sulfinate activator. Coronal dentin specimens were prepared (n = 5/material), treated with the corresponding primers/adhesives (non-irradiated) and covered with a 100 μm-thick RLA layer (SC+A group). Three specimen series were additionally prepared (n = 3 × 5/material): A self-cured without the primers/adhesives (SC group), a dual-cured (20 s irradiation) with the corresponding primers/adhesives (DC+A group) and a dual-cured without primers/adhesives (DC group). All specimens were stored for 15 min (37 °C/dark/60 %RH). After demolding the degree of C = C conversion (DC%, top RLA surfaces) was measured by ATR-FTIR spectroscopy. The primer/adhesive liquids were further analyzed by ICP-MS and the microbrush tips of ADC by SEM-EDS. ResultsThe touch-cure activators increased the DC% in all self-cured RLAs but failed to reach the values of the corresponding dual-cured RLAs. The effect of the activators in dual-cured specimens was negligible. The ICP-MS analysis showed the presence of V (AEP, TP5, ADC) and Cu (SUP) transitional metals in the activators, with V been located at the free ends of ADC tip bristles. The V activators demonstrated the highest DC% improvement in self-cured specimens. ConclusionThe new touch-cure activators significantly increased the conversion of the self-cured RLAs. Therefore, this step should be considered as universally applicable and not selective, as currently proposed for the self-adhesive luting agents by the manufacturers.

Clinical performance of computer-aided design/computer-aided manufacture lithium disilicate ceramic endocrown restorations: A 2-year study.

Optimal restoration methods for endodontically treated teeth (ETTs) have always remained an ongoing discussion among physicians in this day and age. ETTs have a tendency to fracture when chewing, compared to initial teeth. From the perspective of biology, preserving and restoring tooth structure is critical to maintaining biomechanical, functional, and esthetic harmony. Dental bonding techniques have lessened the necessity for post-and-core restorations in ETTs with severe substance loss. A minimally invasive endodontic restoration technique called "endocrown" was initially introduced by Bindl and Mörmann in 1999. The aim of the study was to clinically evaluate all-ceramic mandibular molar endocrowns made using computer-aided design/computer-aided manufacturing (CAD/CAM) following 2 years of follow-up. This unblinded study contains 56 patients with 56 mandibular molars, which had severe substance loss. After teeth preparation, lithium disilicate ceramic endocrowns were manufactured with the CEREC CAD/CAM system, and cementation was performed using a composite luting agent. The endocrowns were assessed using the modified United States Public Health Service criteria at baseline, 6 months, 1 year, and 2 years following placement. Patient satisfaction was evaluated using a questionnaire. This study used descriptive statistics, including mean, standard deviation, and 95% confidence intervals. Data were processed using STATA version 14.0 (StataCorp LLC, USA). Two endocrowns (3.6%) failed throughout the period of observation. The high clinical rating criteria (96.4%, count of 54) and the increased satisfaction percentage (94.6%, count of 53) remained practically stable during the follow-up assessments at 6 months and after 1-2 years. Endocrown offers a less invasive treatment option that may be a better method for endodontically treated mandibular molars. With contemporary CAD/CAM technology and new materials, time in the chair and esthetics optimally improved, bringing satisfaction to the patient.

42 - Conversion of composite luting agents with touch-cure activators

42 - Conversion of composite luting agents with touch-cure activators

Immediate bond performance of resin composite luting systems to saliva-contaminated enamel and dentin in different curing modes.

The purpose of this study was to evaluate the immediate shear bond strength of resin composite luting systems to tooth with or without saliva contamination in different curing modes. The Knoop hardness number of the resin composite luting agents was measured. Four combinations of resin composite luting systems were used. The shear bond strength to bovine teeth was measured with and without saliva contamination in different curing modes at different storage periods. The Knoop hardness number of the resin composite luting agents was also evaluated. Significantly lower enamel and dentin shear bond strengths and Knoop hardness number values were observed in all resin composite luting systems at 5min versus 24 h, regardless of the curing mode or saliva contamination. The influence of the curing mode of the resin composite luting systems on shear bond strengths and Knoop hardness number was dependent on material. For the saliva contamination conditions, only G-CEM ONE EM did not show any significant difference in shear bond strength among the groups with and without saliva contamination, regardless of curing mode, storage period, or tooth substrate. All the resin composite luting systems showed lower shear bond strengths and Knoop hardness number values immediately after setting.

Degree of Conversion and Mechanical Properties of Modern Self-Adhesive Luting Agents

New self-adhesive resin composite luting agents have currently been developed, claiming improved properties. The study aimed to evaluate the composition, degree of conversion, and mechanical properties of Panavia SA Plus (PSP), Panavia SA Universal (PSU), SpeedCem Plus (SPC) and TheraCem Ca (THC), with the resin luting agent Panavia V5 (PV5) serving as a control. The structure of the materials was studied by FTIR spectroscopy and SEM/EDX spectrometry. Disk-shaped specimens were prepared from each material under dual- and self-curing modes (n = 5/mode and material). After a 3-week storage period (dark/37 °C/80%RH) the Martens hardness, indentation modulus, elastic index, and creep were determined by instrumented indentation testing (IIT), while the degree of conversion was assessed by FTIR spectroscopy. Statistical analysis was performed by 2-way ANOVA and post-hoc testing (α = 0.05). All materials were based on aromatic monomers, except for SPC. Fillers with potentially bioactive Ca-glasses were identified in SPC and THC, which showed the highest P/Si ratio. The dual-curing mode demonstrated superior performance in all properties. Differences between materials within each curing mode were limited to SPC, THC (highest conversion) and PSA, PSU, SPC (highest elastic index) for dual-curing, and THC (lowest hardness and elastic index). The results confirmed a lower self-curing conversion in these materials, which may affect some of the mechanical properties tested.

Effect of Water Storage on Hardness and Interfacial Strength of Resin Composite Luting Agents Bonded to Surface-Treated Monolithic Zirconia.

Background: Durable bonding between resin composite luting agents (CLA) and zirconia is still a matter of controversy. The purpose of this study was to evaluate the effect of water storage on hardness and interfacial strength of three CLA, a non-adhesive (Multilink Automix/ML), an adhesive (Panavia F 2.0/PF) and a self-adhesive (PermaCem 2.0/PC), bonded to polished (CL) and grit-blasted (AL: 50 μm alumina, SJ: Sil-Jet + Monobond Plus silane) monolithic zirconia surfaces. Methods: CLA specimens (n = 5/cement, condition) were prepared, stored under dry conditions or immersed in water, and Vickers hardness (VH) measurements were obtained at 1 h, 24 h, 1 week and 3 weeks intervals. Optical profilometry was used to determine the roughness parameters (Sa, Sz, Sdr, Sci) of zirconia surfaces (n = 5/treatment). A shear strength test (SBS, n = 10 × 2/cement) was performed to assess the strength and fractography of the cements bonded to zirconia after isothermal water storage and thermal-cycling (TC). Results: PF demonstrated significantly lower VHN after water storage at all time intervals, PC at 1 w, 3 w and ML at 3 w. SJ and AL showed significantly higher values from CL in all roughness parameters. Weibull analysis revealed the following significance in σο ranking within the same material: AL, SJ, ALTC > SJTC, CL > CLTC (PF); SJ, SJTC, AL, ALTC > CL, CLTC (PC) and SJ, SJTC > AL > ALTC > CL, CLTC (ML). Within the same surface treatment subgroups, the significance in σo ranking was PC, ML > PF (before/after TC) for SJ; PC > PF > ML (before TC), PC, PF > ML (after TC) for AL, and PC > PF > ML (before/after TC) for CL. For the m ranking, the only significant difference within each material group was found in PC (AL > ALTC) and for the same surface treatment in AL (PC > ML). Conclusion: There are significant differences in the water plasticization susceptibility of the CLA tested; the materials with adhesive monomers were the most affected. Tribo-chemical silica coating combined with a silane coupling agent was the most efficient bonding treatment for the non-adhesive and the self-adhesive materials. The adhesive CLA performed better on alumina-blasted than on tribo-chemically coated surfaces.

Shear bond strength vs interfacial fracture toughness — Adherence to CAD/CAM blocks

ObjectiveTo compare shear bond strength (SBS) and interfacial fracture toughness (IKIC) results when assessing the effect of surface roughness and thermocycling on the adherence of a resin composite luting agent (RCLA) to a CAD/CAM resin composite block (RCB). MethodsTetric CAD HT along with the recommended bonding system, Adhese Universal and Variolink Esthetic LC, were used. Surface roughness was achieved with 600/320/60 grit SiC papers. Samples were stored 24h in 37°C water or thermocycled 10000× (5°C–55°C) prior to testing. Results were analyzed by univariate ANOVA and Scheffé modified t-tests (α=0.05). Fractured specimens were viewed with a stereo microscope and selected specimens with a scanning electron microscope. ResultsSBS results showed a significant difference between the 60 grit group and the other groups, both after 24h and thermocycling. A large number of SBS samples showed cohesive fracture or subsurface damage in RCB. Thermocycling led to a significant decrease in SBS in all groups. IKIC results showed no significant differences due to surface preparation after 24h storage in 37°C. After thermocycling, there was a significant difference between the 60 and the 600 grit groups. All KIC samples fractured adhesively at the RCB surface. KIC of the RCLA was significantly higher than IKIC of all groups. SignificanceThe results endorse the use of fracture mechanics methodology for the assessment and characterization of adherence, while identifying difficulties in its implementation. The results suggest also that adherence to CAD/CAM RCB may be limited by the strength of the resin composite block — adhesive interface.

Porcelain thickness and cement shade effects on the colour and translucency of porcelain veneering materials

ObjectivePurposes of this in vitro study include evaluating colour changes in combinations of feldspathic porcelain and cement resulting from different thicknesses of porcelain and different shades of composite luting agent, and evaluating relative translucency parameter (RTP) values. Materials and methodsPorcelain discs of shade A1 at nominal thicknesses of 0.5 and 1.0mm were bonded to cements of three shades in a factorial design. Colours were calculated for CIE D65 Illuminant and Standard Human Observer on black, grey and white backings. A colour difference (CD) was calculated of each possible pair of different porcelain thickness values for the same cement shade and each possible pair of different cement shades for the same porcelain thickness. RTP was analyzed by ANOVA and selected pairwise comparisons. ResultsAll mean CDs studied were perceptible and most were at or greater than the clinical acceptability threshold, with the notable exception that the mean CDs and their confidence limits were below the clinical acceptability threshold for a change in porcelain thickness when utilizing the Clear cement shade. Variation in the shade of the resin luting cement will result in CDs which are near or beyond clinical acceptability. A decrease in porcelain thickness did significantly increase RTP when bonded to the resin cement shades studied. ConclusionChanges in porcelain thickness or cement shade may adversely affect basic aesthetic properties of these materials. Development of methods for analyzing aesthetic effects over greater ranges of thickness for these materials would improve the prognosis for using these materials.

Effect of luting agents on the tensile bond strength of glass fiber posts: An in vitro study

Fiber posts can fail because of loss of retention; and it is unknown which luting agent provides the highest bond strength. The purpose of this study was to investigate the tensile bond strength of glass fiber posts luted to premolar teeth with 6 resin composite luting agents. Ninety-six single-rooted extracted human mandibular premolars were sectioned 2 mm coronal to the most incisal point of the cementoenamel junction. Root canals were instrumented and obturated with laterally condensed gutta percha and root canal sealer (AH26). Gutta percha was removed from the canals to a depth of 8 mm and diameter post spaces with a 1.5 mm were prepared. The specimens were divided into the following 6 groups according to the luting agent used (n=16): Group V, Variolink II; Group A, RelyX ARC; Group N, Multilink N; Group U, RelyX Unicem; Group P, ParaCore; Group F, MultiCore Flow. Each specimen was secured in a universal testing machine and a separating load was applied at a rate of 0.5 mm/min. The forces required to dislodge the posts were recorded. A 1-way analysis of variance (ANOVA) was applied to the mean retentive strengths of various cement materials (α=.05). Significant differences were recorded among the 6 cement types (P<.001). Three materials provided statistically equivalent mean bond strengths (RelyX Unicem, Paracore, and MultiCore Flow) that were significantly greater than for the other 3 materials. Fiber posts luted with RelyX Unicem, Paracore, and MultiCore Flow demonstrated significantly higher bond strengths.

Dentin and Enamel Bond Strengths of Dual-Cure Composite Luting Agents Used With Dual-Cure Dental Adhesives

Abstract Objective The purpose of this in vitro study was to evaluate and compare dentin and enamel bond strengths obtained with dual-cure composite luting agents when used with dual-cure dental adhesives. Methods Human molars were ground flat to expose enamel ( n = 80) or dentin ( n = 80). Specimens in each substrate group were randomly assigned to eight treatment sub-groups, according to four adhesive-luting agent combinations and two test conditions (with or without thermocycling). Pre-polymerized composite resin posts (TPH Spectrum) were luted to either the enamel or dentin surfaces with one of the following adhesive-luting agent combinations: (1) Xeno IV Dual Cure (dual-cure self-etch adhesive) and Calibra (dual-cure luting agent); (2) Prime & Bond NT Dual Cure (dual-cure total-etch adhesive) and Calibra; (3) OptiBond All-in-One Dual Cure (dual-cure self-etch adhesive) and Nexus 2 Dual Syringe (dual-cure luting agent); (4) OptiBond Solo Plus Dual Cure (dual-cure total-etch adhesive) and Nexus 2 Dual Syringe. For each treatment sub-group, half the specimens ( n = 10) were tested after 24 h storage in water at 37 °C, and the other half ( n = 10) were tested after thermocycling for 1800 cycles between water baths held at 5 and 55 °C, with a dwell time in each bath of 30 s, and a transfer time of 10 s. Bond strengths were measured in shear mode, and expressed in MPa. The fracture mode (adhesive, cohesive, mixed) was examined. Data were analyzed for statistical significance with a factorial ANOVA and post hoc tests. Results Mean enamel bond strengths ranged from 8.4 MPa for non-thermocycled OptiBond All-in-One|Nexus 2 to 35.5 MPa for non-thermocycled Prime & Bond NT|Calibra. Mean dentin bond strengths ranged from 14.5 MPa for non-thermocycled OptiBond Solo Plus|Nexus 2 to 30.9 MPa for thermocycled Xeno IV|Calibra. The fracture mode was predominantly adhesive for all groups. Conclusions On enamel, the total-etch adhesives performed better than their self-etch counterparts, while in dentin, the opposite was found, i.e., the self-etch adhesives performed better than their total-etch counterparts. Thermocycling for 1800 cycles did not affect the SBS of the materials tested to dentin and enamel.

Effect of thione and phosphate priming agents on the bonding to a gold alloy of three composite luting agents

Effect of thione and phosphate priming agents on the bonding to a gold alloy of three composite luting agents

Scanning electron microscopy analysis of dental cements

The aim of this study was to compare in vitro the characteristics of different types of luting cements (zinc phosphate, glass-ionomer and resin based composite cement) using scanning electron microscopy (SEM) analysis and microleakage for the quality range of materials. Dental cements were mixed in accordance with the manufacturer's instructions and formed with posts in dental root canals of extracted teeth. The quality of cement was determined by SEM observation on horizontal sectioned roots with fixed posts according to specific pore and marginal gap diameter. The microleakage was measured on specimens immersed in Lofler (methylene blue) solution. The mean values of the maximal diameter of pores, marginal gaps and microleakage of conventional cements are remarkably larger in comparison with composite luting agents. In conclusion, the quality and efficiency of composite luting agents in comparison with conventional cements are more successful in protecting the interior of tooth from penetration of oral fluids, bacteria and bacterial toxins into unprotected dentine.

Dentin and enamel bond strengths of dual-cure composite luting agents used with dual-cure dental adhesives

Objective The purpose of this in vitro study was to evaluate and compare dentin and enamel bond strengths obtained with dual-cure composite luting agents when used with dual-cure dental adhesives. Methods Human molars were ground flat to expose enamel ( n = 80) or dentin ( n = 80). Specimens in each substrate group were randomly assigned to eight treatment sub-groups, according to four adhesive-luting agent combinations and two test conditions (with or without thermocycling). Pre-polymerized composite resin posts (TPH Spectrum) were luted to either the enamel or dentin surfaces with one of the following adhesive-luting agent combinations: (1) Xeno IV Dual Cure (dual-cure self-etch adhesive) and Calibra (dual-cure luting agent); (2) Prime & Bond NT Dual Cure (dual-cure total-etch adhesive) and Calibra; (3) OptiBond All-in-One Dual Cure (dual-cure self-etch adhesive) and Nexus 2 Dual Syringe (dual-cure luting agent); (4) OptiBond Solo Plus Dual Cure (dual-cure total-etch adhesive) and Nexus 2 Dual Syringe. For each treatment sub-group, half the specimens ( n = 10) were tested after 24 h storage in water at 37 °C, and the other half ( n = 10) were tested after thermocycling for 1800 cycles between water baths held at 5 and 55 °C, with a dwell time in each bath of 30 s, and a transfer time of 10 s. Bond strengths were measured in shear mode, and expressed in MPa. The fracture mode (adhesive, cohesive, mixed) was examined. Data were analyzed for statistical significance with a factorial ANOVA and post hoc tests. Results Mean enamel bond strengths ranged from 8.4 MPa for non-thermocycled OptiBond All-in-One|Nexus 2 to 35.5 MPa for non-thermocycled Prime & Bond NT|Calibra. Mean dentin bond strengths ranged from 14.5 MPa for non-thermocycled OptiBond Solo Plus|Nexus 2 to 30.9 MPa for thermocycled Xeno IV|Calibra. The fracture mode was predominantly adhesive for all groups. Conclusions On enamel, the total-etch adhesives performed better than their self-etch counterparts, while in dentin, the opposite was found, i.e., the self-etch adhesives performed better than their total-etch counterparts. Thermocycling for 1800 cycles did not affect the SBS of the materials tested to dentin and enamel.

The impact of cement mixing and storage errors on the risk of failure of glass–ceramic crowns

This study evaluated the impact of different mixing ratios and wrongly stored blends of dual-curing composite cements on Empress2 glass-ceramic crowns by means of a flexural strength test and a fracture resistance test. Thermally damaged blends and fresh blends were mixed using different mixing ratios of dual-curing Panavia F and Variolink II composite cement (2:1; 1:1; 1:1.5; 1:1.75; base/catalyst). Sixteen groups of rectangular beams of both cements (two blends, four ratios, chemical-curing, light-curing) were constructed. Their flexural strength was determined in a three-point bending test. Furthermore, 64 Empress2 all-ceramic crowns were luted onto human molars, again using fresh and thermally damaged blends as well as different mixing ratios of the luting agents. After aging, fracture resistance was investigated. The flexural strength of dual-curing composite cements was influenced to a statistically significant extent by mixing ratios and storage conditions. In particular, the chemical curing mode of these cements was affected by the thermal damage of the blends. However, this study could not demonstrate a significant impact on the fracture resistance of Empress2 glass-ceramic crowns when different mixing ratios or wrongly stored cements were used. Dual-curing composite luting agents seem to tolerate a wide range of mixing errors, but their chemical curing mode may be affected by storage errors.

Effect of Single-liquid Acidic Primers on Bonding of a Composite Luting Agent Joined to a Prefabricated Alumina Coping Material

The aim of this study was to assess the effect of acidic primers on adhesive bonding to prefabricated alumina material designed for fixed restorations. High-purity alumina disks (Procera AllCeram) were primed with one of the following materials: Acryl Bond, All Bond II Primer B, Alloy Primer, Estenia Opaque Primer, M.L. Primer, MR. Bond, and Super- Bond Liquid. The specimens were bonded with a dualpolymerizing luting composite (Variolink II). Unprimed specimen was prepared as the control. Bond strengths were determined both before and after thermocycling. Average bond strength before thermocycling ranged from 12.0 to 39.1 MPa, whereas average bond strength after thermocycling varied from 0.0 to 26.9 MPa. The statistically highest post-thermocycling bond strength was obtained with the use of the Alloy Primer, Estenia Opaque Primer, and M.L. Primer agents. It can be concluded that the use of either the Estenia or Alloy Primer material, which contain 10- methacryloyloxydecyl dihydrogen phosphate (MDP), or the M.L. Primer, which contains 6-methacryloyloxyhexyl phosphonoacetate (6-MHPA), is recommended for bonding the Procera alumina copings with the Variolink II composite.

Bond Durability of Composite Luting Agents to Ceramic When Exposed to Long-term Thermocycling

This study evaluated the effect of thermocycling on the microtensile bond strength of four adhesive luting agents to GN-I CAD-CAM ceramic. The hypothesis tested was that thermocycling did not affect bonding effectiveness, irrespective of the luting agents used. Ceramic specimens of two different sizes (6x8x3 mm; 13x8x4 nm) were fabricated from GN-I CAD-CAM ceramic blocks (GC) using a low-speed diamond saw. Two different sized porcelain discs were bonded with one of the four composite luting agents (Linkmax [LM], Panavia [PN], RelyX Unicem [UN] and Variolink II [VL]) according to the manufacturer's instructions. The specimens were stored for 24 hours in distilled water at 37 degrees C and subjected to 0; 10,000; 20,000 and 40,000 thermocycles prior to microTBS testing. Two-way analysis of variance was used to test the influence of luting cement, thermocycling and interaction between both (p < 0.05). The Tukey HSD test determined statistical differences in microTBS for each luting composite between the different thermocycling conditions (p < 0.05). The mode of failure was determined at a magnification of 50x using a stereomicroscope (Wild M5A). Two-way ANOVA revealed that microtensile bond strength was affected by the luting cement, thermocycling and a combination of both. No difference in bond strength between Linkmax, Panavia F and Variolink II was noticed after 24 hours of water storage (LM: 47.6 MPa; PN: 41 MPa; VL: 36 MPa). RelyX Unicem scored significantly lower than Linkmax and Panavia F (UN: 24.2 MPa). The influence of thermocycling on bond strength was different for the four luting cements. Using Variolink II, the bond strength remained stable after 40,000 thermocycles (43.6 MPa). Linkmax showed a significant decrease in bond strength after 10,000 (26 MPa) and 40,000 thermocycles (14.8 MPa). Panavia F and RelyX Unicem were the most negatively influenced, as all specimens failed prior to testing (pre-testing failures) when the specimens were thermocycled 10,000 and 20,000 times or longer, respectively. Regarding the failure mode, there was a correlation between bond strength and type of failure. Initially, a combination of adhesive and mixed adhesive-cohesive failures was noticed. The percentage of adhesive failures increased, together with a decrease in bond strength. It was concluded that there were significant differences among the four resin composite cements in terms of their bonding effectiveness to CAD-CAM ceramic after thermocycling. The varying degrees of bonding effectiveness of these adhesive luting agents highlight the need for material specifications.

Effects of ceramic surface treatments on the bond strength of an adhesive luting agent to CAD–CAM ceramic

The objective of this study was to evaluate the effect of different surface treatments on the micro-tensile bond strength (microTBS) of an adhesive luting agent to CAD-CAM ceramic. The hypothesis tested was that neither of the surface treatments would produce higher bond strength of the adhesive luting agent to CAD-CAM ceramic. Ceramic specimens of two different sizes (6 mm x 8 mm x 3 mm; 13 mm x 8 mm x 4 mm) were fabricated from ProCAD ceramic blocs (Ivoclar-Vivadent) with a low-speed diamond saw. The ceramic blocks were divided into seven groups and submitted to the following surface treatments: group 1: no treatment; group 2: etching with 37% H(3)PO(4); group 3: etching with 37% H(3)PO(4)+silane; group 4: etching with 37% H(3)PO(4)+silane+adhesive resin; group 5: etching with 4.9% HF acid; group 6: etching with 4.9% HF acid+silane; group 7: etching with HF acid+silane+adhesive resin. After surface treatment, two differently sized porcelain disks were bonded together with a composite luting agent (Variolink II, Ivoclar-Vivadent). The specimens were stored for 24h in distilled water at 37 degrees C prior to microTBS testing. One-way analysis of variance was used to test the influence of surface treatment and Scheffe multiple comparisons test determined pair-wise statistical differences (p<0.05) in microTBS between the experimental groups. The mean microTBSs (standard deviation) are: group 1: 12.8 (+/-4.6)MPa; group 2: 19.1 (+/-5.0)MPa; group 3: 27.4 (+/-11.1)MPa; group 4: 34.0 (+/-8.9)MPa; group 5: 37.6 (+/-8.4) MPa; group 6: 34.6 (+/-12.8)MPa; group 7: 34.5 (+/-5.1)MPa. Statistical significant differences were found between group 1 and groups 3-7, and between group 2 and groups 4-7. All specimens of groups 1-4 exhibited adhesive failures, while a combination of adhesive and mixed (adhesive and cohesive) failures was observed in the specimens of groups 5-7. The results show that surface treatment is important to bond to ceramic and suggests that etching is needed preferably with hydrofluoric acid than with phosphoric acid.

Bond strength of a composite luting agent to alumina ceramic surfaces

Objective. The purpose of this study was to evaluate the shear bond strength (SBS) of a dental luting agent to alumina ceramics after different surface pretreatment. Material and Methods. Specimens (n=50) of pressed blocks (10×0×5 mm) of alumina ceramic (Procera AllCeram) were divided into untreated specimens (AF) as provided by the manufacturer and polished specimens (AP). Five groups of specimens (n=5×10) with different surface pretreatments were prepared. Groups 1 and 2: AF and AP without any pretreatment; Group 3: AF treated with silane, (AF-s); Group 4: AF treated with RF plasma spray (AF-RF); Group 5: AF treated with low fusing porcelain (AF-p) glass pearls. Composite cylinders (5×5 mm) were cemented to the test specimens with a resin luting agent. The specimens were loaded to failure in shear mode using a universal testing machine. Recorded loads were used to calculate SBS in MPa. The results were analyzed using one-way ANOVA and the Tukey HSD multiple comparison test at α = 0.05. Scanning electron microscopic micrographs (SEM) were used to characterize surfaces of interest. Results. Polished surfaces had significantly lower SBS (p < 0.05) compared with untreated specimens (AP vs AF). Silanated, non-polished surfaces (AF-s) revealed lower SBS, even though the result was not significantly different from that of AF-s without silane treatment. Plasma treatment improved SBS by a factor of 2 (p<0.05) and treatment with low-fusing porcelain micro pearls increased SBS by a factor of 3 compared to untreated surfaces (p<0.05). The layer of glass pearls did not exceed 5 µm (SEM). Conclusions. Within the limitation of the conditions of this study, treatment of alumina oxide ceramic surfaces with a plasma spray coating or a low-fusing porcelain pearl layer significantly increased the SBS of a resin luting agent to the ceramic surface.

The clinical performance of CAD/CAM-generated composite inlays

The authors conducted a study to evaluate the longitudinal clinical performance of a resin-based composite (Paradigm, 3M ESPE, St. Paul, Minn.) for computer-aided design/computer-aided manufacturing (CAD/CAM)-generated adhesive inlays. The researchers used a CAD/CAM unit (CEREC 2, Sirona Dental Systems, Bensheim Germany) to fabricate 40 porcelain (Vita Mark II, Vita Zahnfabrik, Bad Säckingen, Germany) and 40 resin-based composite (Paradigm, 3M ESPE) inlays. Both restorative materials were cemented with a total-etch technique using Single Bond dental adhesive (3M ESPE) and a dual-cured resin cement (RelyX ARC Adhesive Resin Cement, 3M ESPE). Two examiners evaluated the inlays using modified U.S. Public Health Service (PHS) criteria at six months, one year, two years and three years. No sensitivity was reported for either material at any recall period. There was no significant difference between the two materials relative to margin adaptation at three years. Margin adaptation initially was very good for both materials, with an increase in margin detection due to apparent wear of the resin-based composite luting agent. There was a significant difference in color match between the two materials at three years, with 91.4 percent of the resin-based composite inlays and 58.8 percent of the porcelain inlays rated Alfa. The resin-based composite inlays had a significantly better color match at three years than did the porcelain inlays. Resin-based composite CAD/CAM inlays performed as well as porcelain CAD/CAM inlays after three years of clinical service.

Effect of an antibacterial adhesive on the bond strength of three different luting resin composites

Effect of a dentin adhesive system containing antibacterial monomer-MDPB (Clearfil Protect Bond) on the shear bond strength of all-ceramic-IPS Empress 2 restorations luted with three different dual-polymerizing systems (Variolink 2, RelyX ARC and Panavia F 2.0) to dentin was investigated. One hundred and eight all-ceramic discs (2 x 3mm; IPS Empress 2) were fabricated and ultrasonically cleaned. The buccal surfaces of 108 non-carious extracted human premolars were flattened to expose dentin and subsequently polished with 600-grit wet silicon carbide paper. Three dual-polymerizing luting systems had test groups and control groups consisting of 18 samples each. For the test groups Clearfil Protect Bond was applied to the exposed dentin surfaces. Control groups received the original bonding procedures of each adhesive system. After the all-ceramic samples were luted to the teeth, thermocycling was performed 5000 times. Shear bond strengths were tested using Shimadzu Universal Testing Machine until failure. Analysis of fractured dentin surfaces were performed using Optical Microscope at x10 and x1000 magnifications and the images were analyzed with Image Analyzer. Data was analyzed with one-way ANOVA and Bonferroni test at a significance level of p<0.05. Mean shear bond strength data of the groups in MPa were; Variolink: 20.45+/-4.75, Variolink+Clearfil Protect Bond:29.32+/-2.37, RelyX ARC:18.82+/-3.19, RelyX ARC+Clearfil Protect Bond:25.58+/-4.05, Panavia F 2.0:17.11+/-2.98, Panavia F 2.0+Clearfil Protect Bond:24.40+/-7.46. Application of the antibacterial adhesive increased the shear bond strengths of all three dual-polymerizing systems to dentin (p=0.00). The surface analysis showed that most of the specimens showed the adhesive failure mode between the dentin and the composite luting agent interface. The antibacterial adhesive system Clearfil Protect Bond can be safely used to prevent the potential risk of complications resulting from bacterial activity regardless of affecting the bond strength of IPS Empress 2 restorations luted with the dual-polimerizing systems used in this study.