Luting Procedure Research Articles

Feldspar Ceramic Strength and The Reinforcing Effect by Adhesive Cementation Under Accelerated Aging.

This study evaluated the effect of the accelerated artificial aging (AAA) on feldspar ceramic strength and the reinforcing effect promoted by adhesive cementation with resin luting agent. One hundred twenty feldspar ceramic disks were obtained. Sixty disks were acid-etched, silanized, and coated with an experimental resin luting agent simulating the adhesive luting procedures. Four groups were created (n=30): uncoated ceramic (control group), uncoated ceramic submitted to AAA, ceramic coated with resin luting agent, and coated ceramic submitted to AAA. Biaxial flexural testing with ball-on-ring setup was carried out. Biaxial flexural strength (s bf , MPa), characteristic strength (s 0 , MPa), and Weibull modulus (m) were calculated for axial positions z=0 (ceramic surface) and z=-t2 (luting agent surface). Data of s bf at positions z=0 and z=-t2 were separately submitted to statistical analyses (a=0.05). The uncoated ceramic submitted to AAA had no significant difference in s bf and s 0 compared with the control group. Resin coating of the ceramic increased s bf and s 0 at z=0. The AAA increased the s bf and s 0 for the resin-coated ceramic specimens at z=0 and also the s 0 at axial position z=-t2. The structural reliability at z=0 and z=-t2 was not influenced by the variables tested. In conclusion, resin coating improved the mechanical strength of the feldspar ceramic. The AAA procedure was not effective in aging the uncoated or resin-coated feldspar ceramic specimens.

Nonretentive Bonded Ceramic Partial Crowns: Concept and Simplified Protocol for Long-lasting Dental Restorations.

Adhesively luted partial ceramic crowns have been documented to be clinically more durable than direct composite restorations when minimally invasively restoring large defects (replacing two cusps or more) in posterior teeth. The clinical longevity of such restorations is largely determined by the tooth-preparation design, material selection and adhesive luting procedure. The most frequently recorded failure in medium- to long-term clinical trials is fracture of the restoration. The clinical protocol of adhesively luted partial ceramic crowns can be optimized by taking the etiology of these restoration fractures into account. In this article, a simplified nonretentive bonded ceramic partial crown concept is presented that aims to achieve an adhesively luted ceramic restoration - composite cement - residual tooth structure biomechanical unit that maximally resists functional aging. Therefore, the three primary components of the bonded restoration-cement-tooth complex must function in synergy. Methods, Results and Discussion: The clinical protocol starts with a tooth preparation designed to optimally absorb chewing stress. A stable, internally rounded and gently sloping tooth-preparation design with all outer margins inclined towards the tooth center assures a favorable and homogenous stress distribution with low cyclic fatigue subjected to the adhesive interface. This preparation form additionally enables the dental technician to fabricate a well-seating and -fitting ceramic restoration of uniform thickness. As restoration material, monolithic lithium-disilicate glass ceramic is sufficiently strong for the partial crown indication and preferred in order to decrease the fracture risk. Clinically essential for a long-lasting restoration is the optimal bond that can be obtained by combined micromechanical interlocking and chemical bonding of composite cement to hydrofluoric acid-etched and silanized glass ceramic. The clinical effectiveness of this nonretentive bonded ceramic partial crown concept is confirmed by the overall high success rate as well as the very low fracture and debonding rate, as was recorded in long-term clinical trials.

Bond strength of glass fiber posts submitted to different luting protocols

Objective: evaluate the effect of different luting protocols on the bond strength of glass fiber posts.Methods: Forty human canine teeth were randomly divided into four groups: Relyx U100/Endofill (R+E), Panavia F2.0/EndoFill (P+E), Relyx U100/Sealer 26 (R+S), Panavia F2.0/Sealer 26 (P+S). After the luting procedures, the samples were subjected to thermocycling (6.000 cycles; at 5±1 ºC and 55±1 ºC) and then sectioned in a precision cutting machine (Isomet 1000 Precision Saw) into 4 cuts of 2mm regarding to different deepness: Apical, Medium Apical, Medium Coronal, and Coronal. Next, the cuts were submitted to push-out test in a universal testing machine (EMIC) with load cell of 50N, at crosshead speed of 0.5mm/min.Results: They were obtained according to the different luting deepness (p≥0.05) (MPa): 1) apical – R+E (1.35±1.28), P+E (2.70±0.89), R+S (3.89±0.70), P+S (4.30±1.02); 2) medium apical – R+E (1.38±1.28), P+E (2.98±1.43), R+S (4.02±1.14), P+S (4.49±1.82); 3) medium coronal – R+E (2.46±0.73), P+E (3.72±0.78), R+S (4.85±0.71), P+S (6.14±0.73); 4) coronal R+E (5.59±1.08), P+E (5.74±1.06), R+S (6.71±1.07), P+S (7.40±1.51).Conclusion: There was a relationship between the luting protocol of the glass fiber post and the endodontic cement. Eugenol plays an important role inside the dentinal tubules by interfering negatively in the bond strength to root dentin.

Bonding of the Polymer Polyetheretherketone (PEEK) to Human Dentin: Effect of Surface Treatments.

Polyetheretherketone (PEEK) is a material suitable for frameworks of fixed dental prostheses. The effect of different surface treatments on the bond strength of PEEK bonded to human dentin was evaluated. One hundred PEEK cylinders (3 mm×3 mm) were divided into five groups according to surface treatment: silica coating, sandblasting with 45 μm Al2O3 particles, etching with 98% sulfuric acid for 5, 30 and for 60 s. These cylinders were luted with resin cement onto 50 human molars. First, each tooth was embedded in epoxy resin and the buccal dentin surface was exposed. Then, two delimited dentin areas (Æ:3 mm) per tooth were etched with 35% phosphoric acid and bonded with a two-step self-priming adhesive system. After the luting procedure the specimens were stored in water (24 h/37 °C). Shear bond strength (SBS) was tested using a universal testing machine (crosshead speed 0.5 mm/min; load cell 50 kgf) and failure types were assessed. Stress data (MPa) were analyzed using the Kruskal-Wallis test. Comparison of the proportions of different failure types was performed using the Bonferroni method (p<0.05). Kruskal-Wallis demonstrated that differences among groups were not significant (p=0.187). Mean SBS were as follows: silica coating, 2.12±1.12 MPa; sandblasting, 2.37±0.86 MPa; sulfuric acid 5 s, 2.28±1.75 MPa; sulfuric acid 30 s, 1.80±0.85 MPa; sulfuric acid 60 s, 1.67±0.94 MPa. Adhesive and mixed failures were predominant in all groups. Both physical and chemical surface treatments produced adhesion between PEEK, resin cement and dentin.

Relined Fiberglass Post: Effect of Luting Length, Resin Cement, and Cyclic Loading on the Bond to Weakened Root Dentin

This study evaluated the effects of luting length of the post, the resin cement, and cyclic loading on pull-out bond strength of fiberglass posts relined with composite resin in weakened roots. The canals of 80 bovine incisors were endodontically treated and weakened with diamond burs. The teeth were randomly divided into eight groups (n=10) according to the luting procedures of the relined fiberglass post (RFP): In groups 1, 2, 3, and 4, the RFPs were luted with RelyX ARC, and in groups 5, 6, 7, and 8 they were luted with RelyX U200. In groups 1, 3, 5, and 7, the RFPs were luted at a length of 5 mm, and in groups 2, 4, 6, and 8 they were luted at a length of 10 mm. Specimens from groups 3, 4, 7, and 8 were submitted to cyclic loading. Specimens were subjected to a pull-out bond strength test in a universal testing machine. The results (MPa) were analyzed by three-way analysis of variance and the Tukey post hoc test (α=0.05). Six human upper anterior teeth were used to analyze the bond interface by confocal laser scanning microscopy (CLSM). The pull-out bond strength of RFPs luted with RelyX U200 was statistically higher than that of RelyX ARC. Cyclic loading influenced the bond strength only for the luting length of 5 mm. CLSM analysis revealed the formation of resin cement tags for both materials. Luting length is an important factor in retaining RFPs in weakened roots when they are subjected to cyclic loading, and RelyX U200 resulted in greater bond strengths to the root canal in comparison with RelyX ARC.

Effect of adhesive luting on the fracture resistance of zirconia compared to that of composite resin and lithium disilicate glass ceramic.

ObjectivesThe purpose of this study was to evaluate the effect of adhesive luting on the fracture resistance of zirconia compared to that of a composite resin and a lithium disilicate glass ceramic.Materials and MethodsThe specimens (dimension: 2 mm × 2 mm × 25 mm) of the composite resin, lithium disilicate glass ceramic, and yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) were prepared. These were then divided into nine groups: three non-luting groups, three non-adhesive luting groups, and three adhesive luting groups, for each restorative material. In the non-luting groups, specimens were placed on the bovine tooth without any luting agents. In the non-adhesive luting groups, only zinc phosphate cement was used for luting the specimen to the bovine tooth. In the adhesive luting groups, specimens were pretreated, and the adhesive luting procedure was performed using a self-adhesive resin cement. For all the groups, a flexural test was performed using universal testing machine, in which the fracture resistance was measured by recording the force at which the specimen was fractured.ResultsThe fracture resistance after adhesive luting increased by approximately 29% in the case of the composite resin, 26% in the case of the lithium disilicate glass ceramic, and only 2% in the case of Y-TZP as compared to non-adhesive luting.ConclusionsThe fracture resistance of Y-TZP did not increased significantly after adhesive luting as compared to that of the composite resin and the lithium disilicate glass ceramic.

Interactions between resin-based temporary materials and immediate dentin sealing

Bonded indirect restorations require two appointments: one for provisional treatment and one for luting with resin cement and dentin bonding agents (DBA). The DBA layer may be accomplished during a delayed dentin sealing (DDS) step following the provisional phase or an immediate dentin sealing (IDS) step after tooth preparation and during final luting procedures. The purpose of this study was to compare the effect of resin-based provisional material (RBPM) on the tensile bond strength to human dentin developed using DDS and IDS procedures. Flat dentin surfaces were prepared on 48 molars for microtensile testing. The specimens were restored using a 3-step etch-and-rinse DBA and composite resin (CR). A set of control specimens (G1) was directly restored using DBA and CR, while the remaining samples were treated using a provisional restoration procedure for 2 weeks: DDS + acrylic resin (AR) + calcium hydroxide cement (CHC) (group G2), DDS + AR + eugenol-free cement (G3), DDS + RBPM (G4), IDS + glycerin + RBPM (G5), or IDS + RBPM (G6). After storage of the final restoration in water for 24 h, the specimens were serially sectioned to obtain bonded sticks 0.8 mm2 in area. The tensile strength was tested at a crosshead speed of 0.5 mm/min. The results were analyzed using ANOVA and Tukey’s post hoc tests (α = 0.05). The mean (standard-deviation) bond strengths for groups G1–G6 were 42.18 (±2.63); 40.14 (±3.46); 37.77 (±0.93); 37.16 (±2.61); 34.11 (±1.08) and 23.79 (±0.49) MPa. The mean bond strength of group G6 was significantly lower (p < 0.05), suggesting that adhesion to dentin is influenced by use of RBPM with IDS prior to placement of a definitive restoration.

The influence of intrinsic water permeation on different dentin bonded interfaces formation

ObjectivesTo determine the effects of intrinsic wetness on the formation of dentin bonding interfaces of four resin cement systems bonded to dentin under different pulpal pressures. MethodsThirty-six freshly extracted third molars were selected and processed for dentin μTBS. The teeth were randomly assigned into 12 experimental groups, according to the adhesive luting system [Adper Single Bond Plus (3M ESPE) combined with two luting agents RelyX ARC (3M ESPE) and heated Filtek Z250 Universal Restorative (3M ESPE), Clearfil CD Bond (Kuraray) combined with Clearfil Esthetic Cement (Kuraray), and RelyX Unicem 2 Automix (3M ESPE)] and pulpal pressure (0, 5, and 20cm of simulated pulpal pressure). Leucite-reinforced glass-ceramic slabs (IPS Empress CAD, Ivoclar Vivadent) of 3mm thickness were bonded to dentin. The samples were stored in distilled water for 24h and then sectioned in X/Y directions across the adhesive interface to obtain specimens with a cross section of 0.8±0.2mm2. All sticks were fractured by tension at a crosshead speed of 1.0mm/min and the data were submitted to Kruskal-Wallis and Mann-Whitney Tests (α=0.05). Ultrastructural analysis of the interfaces was performed using Confocal Laser Scanning Microscopy (CLSM) and Scanning Electron Microscopy (SEM). ResultsThe statistical analyses showed that pulpal pressure decreased μTBS for all groups. Significantly higher μTBS values were obtained in heated Z250 group restored without any pulpal pressure. CLSM showed that the uptake of water through the dentin tubuli and their anastomosis of lateral branches during the adhesive luting procedures prevented adequate formation of the dentin bonding interfaces. SEM showed that the luting film created is material- dependent and all adhesive failure occurred at the resin-dentin interface. ConclusionThe constant intrinsic wetness replenishment prevents adequate formation of the hybrid layer. Clinical significanceIntrinsic moisture during adhesive luting procedures significantly affects the interaction between luting materials and dentin subtract and decreases the quality and bonding strength of the resin-dentin bond.

A Novel Universal Cementation Technique for Implant-Supported Crowns with Subgingival Margins.

Restoration of implant crowns with subgingival margins has always been a challenge. If done precisely it leads to better treatment outcomes and prognosis. An incorrect technique and improper execution of the luting procedure are known to cause a high incidence of peri-implant disease due to incomplete elimination of the luting agent. Deep subgingival abutment margins are difficult to recognize, and cement removal in these cases becomes complicated if the sulcus depth is greater than 3 mm. Irrespective of the type of instrument used to remove the excess cement, scratches on the abutment and some cement remnants are consistently noticed. Therefore elimination of excess luting agent before the prosthesis is inserted intraorally is considered an effective technique to prevent complications due to excess luting agent. This article presents a chairside universal technique for cementation of implant crowns on abutments with deep subgingival margins. This technique attempts to minimize the amount of excess cement in peri-implant tissue.

Tensile Bond Strength of Self Adhesive Resin Cement After Various Surface Treatment of Enamel.

In self adhesive resin cements adhesion is achieved to dental surface without surface pre-treatment, and requires only single step application. This makes the luting procedure less technique-sensitive and decreases postoperative sensitivity. The purpose of this study was to evaluate bond strength of self adhesive resin after surface treatment of enamel for bonding base metal alloy. On the labial surface of 64 central incisor rectangular base metal block of dimension 6 mm length, 5mm width and 1 mm height was cemented with RelyX U200 and Maxcem Elite self adhesive cements with and without surface treatment of enamel. Surface treatment of enamel was application of etchant, one step bonding agent and both. Tensile bond strength of specimen was measured with universal testing machine at a cross head speed of 1mm/min. Least tensile bond strength (MPa) was in control group i.e. 1.33 (0.32) & 1.59 (0.299), Highest bond strength observed when enamel treated with both etchant and bonding agent i.e. 2.72 (0.43) & 2.97 (0.19) for Relyx U200 and Elite cement. When alone etchant and bonding agent were applied alone bond strength is 2.19 (0.18) & 2.24 (0.47) for Relyx U200, and 2.38 (0.27) 2.49 (0.16) for Max-cem elite. Mean bond strength was higher in case of Max-cem Elite as compared to RelyX U200 resin cement, although differences were non-significant (p > 0.05). Surface treatment of enamel increases the bond strength of self adhesive resin cement.

Effect of glycine pretreatment on the shear bond strength of a CAD/CAM resin nano ceramic material to dentin.

BackgroundThe purpose of this study was to evaluate the effect of glycine pretreatment on the shear bond strength between dentin and a CAD/CAM resin nano ceramic material (LavaTM Ultimate Restorative), bonded together with adhesive cements using three different luting protocols (total-etch; self-etch; self-adhesive).Material and MethodsThirty cylinders were milled from resin nano ceramic blocks with CAD/CAM technology. The cylinders were subsequently cemented to the exposed dentin of 30 bovine permanent mandibular incisors. The specimens were assigned into six groups of five teeth each according to luting procedure and dentin pretreatment. In the first two groups (A1, A2) 10 cylinders were cemented using a total-etch protocol; in groups B1 and B2, 10 cylinders were cemented using a self-etch protocol; in groups C1 and C2, 10 cylinders were cemented using a self-adhesive protocol; in groups A1, B1 and C1 the dentinal surface was also treated with glycine powder. All cemented specimens were submitted to a shear bond strength test. Statistical analysis was performed with Stata 9.0 software.ResultsANOVA showed the presence of significant differences among the various groups (P <0.0001).ConclusionsGlycine did not change the different bond strength demonstrated by the various luting protocols tested. Conventional resin composite cements used together with a self-etch adhesive reported the highest values. However the use of glycine seems to increase the bond strength of self-adhesive resin cements. Key words:Adhesive cements, CAD/CAM, glycine, luting system, resin nano ceramic, shear bond strength.

Early resin luting material damage around a circular fiber post in a root canal treated premolar by using micro-computerized tomographic and finite element sub-modeling analyses

This study utilizes micro-computerized tomographic (micro-CT) and finite element (FE) sub-modeling analyses to investigate the micro-mechanical behavior associated with voids/bubbles stress behavior at the luting material layer to understand the early damage in a root canal treated premolar. 3-dimensional finite element (FE) models of a macro-root canal treated premolar and two sub-models at the luting material layer to provide the void/bubble distribution and dimensions were constructed from micro-CT images and simulated to receive axial and lateral forces. The boundary conditions for the sub-models were determined from the macro-premolar model results and applied in sub-modeling analysis. The first principal stresses for the dentin, luting material layer and post in macro-premolar model and for luting material void/bubble in sub-models were recorded. The simulated results revealed that the macro-premolar model dramatically underestimated the luting material stress because the voids/bubbles at the adhesive layer cannot be captured due to coarse mesh and high stress gradient and the variations between sub- and macro-models ranging from 2.65 to 4.5 folds under lateral load at the mapping location. Stress concentrations were found at the edge of the voids/bubbles and values over 20MPa in sub-modeling analysis immediately caused the luting material failure/micro-crack. This study establishes that micro-CT and FE sub-modeling techniques can be used to simulate the stress pattern at the micro-scale luting material layer in a root canal treated premolar, suggesting that attention must be paid to resin luting material initial failure/debonding when large voids/bubbles are generated during luting procedures.

A systematic review of factors associated with the retention of glass fiber posts.

This study aimed to identify factors that can affect the retention of glass fiber posts to intra-radicular dentin based on in vitro studies that compared the bond strength (BS) of GFPs cemented with resin cements. Searches were carried out in PubMed and Scopus until December 2013. Bond strength values and variables as type of tooth, presence of endodontic treatment, pretreatment of the post, type of bonding agent (if present), type of cement and mode of cement application were extracted from the 34 included studies. A linear regression model was used to evaluate the influence of these parameters on BS. The presence of endodontic treatment decreased the BS values in 22.7% considering the pooled data (p = 0.013). For regular cement, cleaning the post increased BS when compared to silane application without cleaning (p = 0.032), considering cleaning as ethanol, air abrasion, or phosphoric acid application. Applying the cement around the post and into root canal decreased the resistance compared to only around the post (p = 0.02) or only into root canal (p = 0.041), on the other hand, no difference was found for self-adhesive resin cement for the same comparisons (p = 0.858 and p = 0.067). Endodontic treatment, method of cement application, and post pretreatment are factors that might significantly affect the retention of glass-fiber posts into root canals mainly when cemented with regular resin cement. Self-adhesive resin cements were found to be less technique-sensitive to luting procedures as compared with regular resin cements.

Effects of simulated pulpal pressure, mechanical and thermocycling challenge on the microtensile bond strength of resin luting cements

This study aimed at comparing the microtensile bond strength (µTBS) of three simplified luting strategies after different aging processes. Sixty human molars were prepared to expose flat middle dentin surfaces which received the following luting procedures: (i) SB+ARC – two-step etch-and-rinse adhesive+conventional resin cement (Adper Singlebond 2+RelyX ARC, 3M-ESPE); (ii) S3+PAN – one-step self-etch adhesive+conventional resin cement (Clearfil S3+Panavia F2.0, Kuraray Medical); (iii) U200 – self-adhesive resin cement (RelyX U200,3M-ESPE). The specimens were finally restored by indirect resin composite procedures (Filtek Z100,3M-ESPE). The aging regimens were water storage at 37°C for one week (control), one week of 20cm H2O simulated pulpal pressure (SPP), 200,000 mechanical loading (ML) cycles, or 5000 thermal cycles (TC). The µTBS data was analyzed by two-way ANOVA and Tukey's test (α=0.05). SB+ARC showed significantly higher µTBS for control and all aging processes (p<0.001). Nevertheless, TC had no effect on the bond strength of SB+ARC. No difference in µTBS was observed between S3+PAN and U200 after SPP (p=0.251), but significant lower values were found for U200 after ML (p=0.010) besides being superior in the control groups (p<0.001). For U200, all ageing regimens induced significant reductions in the bond strength (p<0.001) with a more pronounced negative effect after ML. S3+PAN showed significant lower bond strength (p=0.010) only after ML aging. Two-step etch-and-rinse adhesive associated with dual-curing conventional resin cement may present the highest overall µTBS. However, the use of S3 one-step self-etch adhesive along with conventional resin cements may provide the most stable luting performance under the tested aging strategy.

Luting between Resin Cement and Dental Prosthetic Materials

Cementation is the last procedure and an important factor to access successful fixed prosthodontic treatment. Even though there are many kinds of luting materials in dental field, the resin cements are popularly used in now. Metals, polymers and ceramics are used as a material of fixed dental prosthesis. The bonding mechanisms between teeth and fixed restorations are composed of mechanical and chemical mechanism. In dentistry, we are relying on mechanical bonding, but we tried to get chemical bonding and many ways are introduced. So, we have to approach luting procedure differently by the materials of prosthesis for clinical success. In this article, let us think the proper cementation ways according to each prosthesis material.

Indirect composite restorations luted with two different procedures: A ten years follow up clinical trial.

Objectives: The aim of this clinical trial was to evaluate posterior indirect composite resin restoration ten years after placement luted with two different procedures. Study Design: In 23 patients 22 inlays/onlays (Group A) were luted using a dual-cured resin composite cement and 26 inlays/onlays (Group B) were luted using a light cured resin composite for a total of 48 Class I and Class II indirect composite resin inlays and onlays. The restorations were evaluated at 2 time points: 1) one week after placement (baseline evaluation) and 2) ten years after placement using the modified USPHS criteria. The Mann-Whitney and the Wilcoxon tests were used to examine the difference between the results of the baseline and 10 years evaluation for each criteria. Results: Numerical but not statistically significant differences were noted on any of the recorded clinical parameters (p>0.05) between the inlay/onlays of Group A and Group B. 91% and 94 % of Group A and B respectively were rated as clinically acceptable in all the evaluated criteria ten years after clinical function. Conclusions: Within the limits of the study the results showed after ten years of function a comparable clinical performance of indirect composite resin inlays/onlays placed with a light cure or dual cure luting procedures. Key words:Light curing composite, dual curing composite, indirect composite restoration, inlays/onlays, clinical trial.

Immediate postextraction implant with simultaneous buccal plate augmentation, restored with lithium disilicate abutment and veneer: A clinical report

To describe the successful use of biphasic calcium sulfate for improving the buccal plate thickness in an immediate postextraction implant, and its fi nal restoration with custom lithium disilicate abutment and veneer. A hopeless lateral incisor was replaced with an immediate postextraction implant in conjunction with a buccal plate augmentation based on biphasic calcium sulfate. Satisfactory soft tissue height and quality were maintained following healing. The fi nal restoration managed the severely reduced prosthetic space due to deep bite, and allowed an adhesive luting procedure.

Mechanical properties of components of the bonding interface in different regions of radicular dentin surfaces

Statement of problemThe mechanical properties of the adhesive materials used in intraradicular treatments could vary according to the interaction between the restorative material and dentin substrate. An evaluation of these properties is essential to determine the success of the luting procedures performed on glass-fiber posts. PurposeThe purpose of this study was to evaluate the mechanical properties of dentin adhesives, resin cements, and the dentin that underlies the bonding interface in different thirds of intraradicular dentin. Material and methodsForty extracted, single-rooted human teeth were used in this study. After the endodontic treatment of the post spaces, the teeth were divided into 5 groups (n=8): Adper Single Bond 2 + RelyX ARC, Excite DSC + RelyX ARC, Adper SE Plus + RelyX ARC, RelyX Unicem, and Set. The hardness and elastic modulus values were measured at the adhesive interface in different thirds of the radicular dentin by using an ultramicrohardness tester. The data were subjected to 2-way ANOVA and the Fisher protected least significant difference test (α=.05). ResultsIn the underlying dentin, the highest Martens hardness values were found in the apical region for all groups; the exceptions were the groups with the self-etching adhesive. In the adhesive layer, the highest Martens hardness values were obtained for the Adper SE Plus + RelyX ARC group; further, no statistical differences were found among the different regions for this group. RelyX ARC had the lowest Martens hardness and elastic modulus values in the apical regions when used with Adper Single Bond 2 and Adper SE Plus. No differences were found in the Martens hardness and elastic modulus values for the self-adhesive resin cement in the regions investigated. ConclusionThe mechanical properties of adhesive materials and the underlying dentin are influenced by the interaction between the two as well as by the depth of the analyzed intraradicular area.

Push-out bond strength and SEM evaluation of a new bonding approach into the root canal

ObjectiveThis study evaluated the performance of different adhesive systems in fiber post placement aiming to clarify the influence of different hydrophobic experimental blend adhesives, and of one commercially available adhesive on the frictional retention during a luting procedure. Material and MethodsOne luting agent (70 Wt% BisGMA, 28.5% TEGDMA; 1.5% p-tolyldiethanolamine) to cement fiber posts into root canals was applied with 4 different adhesive combinations: Group 1: The etched roots were rinsed with water for 30 s to remove the phosphoric acid, then rinsed with 99.6% ethanol for 30 s, and blotdried. A trial adhesive (base to catalyst on a 1:1 ratio) was used with an experimental luting agent (35% Bis-GMA, 14.37% TeGDMA, 0.5% eDMAB, 0.13% CQ); Group 2: A trial adhesive (base to catalyst on a 1:2 ratio) was luted as in Group 1; Group 3: One-Step Plus (OSP, Bisco Inc.) following the ethanol bonding technique in combination with the luting agent as in Group 1; Group 4: OSP strictly following the manufacturer's instructions using the luting agent as in Group 1. The groups were challenged with push-out tests. Posted root slices were loaded until post segment extrusion in the apical-coronal direction. Failure modes were analyzed under scanning electron microscopy. ResultsPush-out strength was not significantly influenced by the luting agent (p>0.05). No statistically significant differences among the tested groups were found as Group 1 (exp 1 - ethanol-wet bonding technique)=Group 2 (exp 2 - ethanol-wet bonding technique)=Group 3 (OSP - ethanol-wet bonding technique)=Group 4 (control, OSP - water-wet bonding technique) (p>0.05). The dominating failure modes in all the groups were cohesive/adhesive failures, which were predominantly observed on the post/luting agent interface. ConclusionsThe results of this study support the hypothesis that the proposal to replace water with ethanol to bond fiber posts to the root canal using highly hydrophobic resin is plausible, but this seems to be more the proof of a concept than a clinically applicable procedure.

Marginal discoloration of all-ceramic restorations cemented adhesively versus nonadhesively

The authors conducted a systematic review to correlate the clinical incidence of marginal discoloration of all-ceramic restorations with the mode of cementation (adhesive versus nonadhesive). The authors conducted a literature search by using electronic databases, relevant references, database citations and journal hand searches for clinical studies of marginal discoloration of all-ceramic restorations with a mean follow-up time of at least five years. The search period spanned January 1990 through February 2011. The authors reported and compared summary estimates and five-year event rates. The authors selected 16 studies for final analysis from an initial yield of 346 articles. The mean observation time ranged between five and 10 years. The majority of studies used adhesive luting procedures for definitive cementation. In only one study did investigators report regarding the incidence of marginal discoloration of both adhesively and nonadhesively cemented all-ceramic restorations, and the difference between the luting types in terms of discoloration was not statistically significant (P = .5). The results of this systematic review showed that there is a lack of studies with findings regarding marginal discoloration rates of nonadhesively luted all-ceramic restorations. Unacceptable marginal discoloration rates of adhesively luted all-ceramic prostheses were relatively low even at 10 years of service.