RelyX Ultimate Research Articles

Effect of immediate dentin sealing on the fracture strength of indirect overlay restorations using different types of luting agents (A comparative in vitro study).

This study evaluates the effects of immediate dentin sealing (IDS) on the fracture resistance of lithium disilicate overlays using three different types of resin-luting agents (preheated composite, dual-cure adhesive resin, and flowable composite). Forty-eight maxillary first premolars of equal size were prepared using a butt joint preparation design. The teeth were separated into two primary groups, each with 24 teeth: Group DDS - delay dentin sealing (DDS) (non-IDS) teeth were not treated. Group IDS - dentin sealing was applied immediately after teeth preparations. Each group was subsequently separated into three separate subgroups of eight teeth. Subgroups DDS+Phc and IDS+Phc - cemented with preheated composite (Enamel plus HRi, Micerium, Italy), subgroups DDS+Dcrs and IDS+Dcrs - cemented with dual-cured resin cement (RelyX Ultimate, 3M ESPE, Germany), and subgroups DDS+Fc and IDS+Fc - cemented with flowable composite (Filtek Supreme Flowable, 3M ESPE, USA). The fracture resistance of each sample was evaluated using a test of a single load till failure, which was automatically recorded in Newton by a computer-controlled universal testing system. The fracture resistance of the subgroup IDS+Phc was the highest mean value, in which the overlay was cemented with preheated composite (1954 N), and the lowest mean was noted in the subgroup DDS+Fc, by which the overlay cemented with flowable composite without IDS (887 N). All IDS subgroups had a high mean fracture load. Both the Bonferroni test and the one-way ANOVA test identified a significant difference between all groups of 0.05. In general, teeth with IDS were stronger than teeth without IDS. When the preheated composite is used as a luting agent improves overall fracture resistance, followed by resin cement and flowable composite, respectively. However, the result showed that the ceramic overlays with and without IDS are strong enough to withstand the normal mastication force. Overlays was failed in a more catastrophic, irreparable mode of fracture than the clinical situation.

Effect of curing mode on polymerization kinetics, mechanical properties, and dentin adhesion of self-adhesive and conventional resin cements

Objectives The objective was to evaluate the effect of curing mode on polymerization kinetics, biaxial flexural strength (FS) and modulus (MO), and dentin bond strength (BS) of self-adhesive and conventional resin-based cements. Materials and methods Two materials were evaluated: one self-adhesive G-Cem LinkAce (GC) and one conventional resin cement RelyX Ultimate (RU). Polymerization kinetics was followed by infrared spectroscopy (n = 5). Disc specimens of light-activated or self-cured materials were tested for FS and MO (n = 10). Extracted human molars were divided into 4 groups (n = 10) according to resin cement, curing mode, and evaluation time (24 hs and 1 year). Composite discs were used to simulate indirect restoration which bonded to occlusal dentin with the resin cements, and light-activated or allowed to self-cure, and restored teeth were tested for microtensile BS. Data were submitted to statistical analysis at 5% significance level. Results A rapid rise in conversion was observed when materials were light-activated. When self-cured, RU demonstrated a slower polymerization rate and lower conversion than GC. Dual curing yielded higher FS, MO, and BS than self-curing mode to RU cement, while no significant differences were observed for GC. Conclusions Light-activation influences polymerization kinetics of resin-based cement, but it did not influence the mechanical properties and adhesion of the self-adhesive cement tested (GC).

Microleakage in indirect onlay restorations cemented with three different types of adhesives: An in vitro study.

To evaluate the in vitro degree of marginal microleakage in indirect Class II onlay restorations cemented with dual self-adhesive, universal adhesive and dual adhesive. In the present in vitro experimental study, a total of 54 human premolar teeth were prepared and divided into three equal groups (n = 18) for placement of onlay-type restorations cemented with A: Allcem™ dual-cure adhesive cement), B: RelyX™U200 dual-cure self-adhesive cement and C: RelyX™ Ultimate universal adhesive cement. All restorations were subjected to 10,000 thermocycles between 5°C and 55°C and immersed in a 1M silver nitrate solution for 6 hours. The crowns were then sectioned mesiodistally and observed under a stereo microscope to determine the degree of marginal microleakage in the cervical area. The onlay restorations cemented with RelyX Ultimate did not present microleakage in the majority of cases (77.8%). Restorations cemented with RelyX U200 showed predominantly microleakage up to the pulp floor in 83.3% of the total, being this significantly higher microleakage than in restorations cemented with RelyX Ultimate and Allcem Dual (p<0.001 and p<0.001 respectively). There was no significant difference in microleakage between the last two mentioned cements (p=0.255). Allcem dual adhesive cement and RelyX Ultimate universal adhesive showed significantly less microleakage than RelyX U200 dual-curing self-adhesive cement at the cervical level, with predominantly no microleakage and microleakage down to the enamel, respectively. The use of RelyX Ultimate cement in indirect restorations is recommended as it showed better marginal adaptation. Key words:Microleakage, human teeth, adhesion, adhesive cement, thermal cycling, onlay restoration.

Influence of different adhesion strategies on glass fiber post retention.

Failures in glass fiber post (GFP) retention may be associated with low adhesion achieved in root dentin. 55 single-rooted premolars were endodontically treated and distributed according to different adhesion strategies (n=11): G1: RelyX ARC (3M ESPE; etch-rinse strategy); G2: Relyx Ultimate (3M ESPE; etch-rinse strategy); G3: AllCem (FGM; etch-rinse strategy); G4: Relyx Ultimate (3M ESPE; self-etching strategy); G5: RelyX U200 (3M ESPE; self-adhesive strategy). For Bonding Strength (BS) analysis, the roots were sectioned in slices (1.0mm thickness) corresponding to each root third and submitted to push-out test. The type of failure was assessed by scanning electron microscopy (SEM). The highest BS averages were found in G2 and G3. However, in the middle and apical root thirds, G3 showed statistically similar results to G4 and G5. In the cervical and middle third, G1 was statistically similar to G4 and G5. The mixed type of failure was the most common in all groups. Self-etching (G4) and self-adhesive resin (G5) cements, showed similar BS results of immediate bonding in the cementation of GFP compared to conventional resin cements (G1, G2, G3). Key words:Dental Cements, Dentin-Bonding Agents, Post and Core Technique, Dental Bonding.

Fracture behavior of discontinuous fiber-reinforced composite inlay-retained fixed partial denture before and after fatigue aging.

To evaluate the fracture behavior of inlay-retained fixed partial dentures (IRFPDs) made of experimental short fiber-reinforced composite (SFRC) computer-aided design/computer-aided manufacturing (CAD/CAM) block before and after cyclic fatigue aging. Five groups (n=20/group) of three-unit posterior IRFPDs were fabricated. The first and second groups were CAD/CAM fabricated from experimental SFRC blocks or lithium-disilicate (IPS e.max CAD, IVOCLAR) materials, the third group comprised a three-dimensional-printed composite (Temp PRINT, GC), and the fourth and fifth groups comprised conventional laboratory flowable composite (Gradia Plus, GC) and commercial flowable SFRC (everX Flow, GC), respectively. All IRFPDs were luted into a metal jig with adhesive dual-cure resin cement (RelyX Ultimate, 3M ESPE). Half the IRFPDs per group (n=10) were subjected to fatigue aging for 10,000 cycles. The remaining half were statically loaded until fracture without fatigue aging. The load was applied vertically between triangular ridges of the buccal and lingual cusps. The fracture mode was visually examined using optical and scanning electron microscopy (SEM). Data were statistically analyzed using a two-way analysis of variance (ANOVA) followed by Tukey's HSD test. ANOVA revealed that IRFPDs made of experimental SFRC CAD/CAM had the highest (P<0.05) load-bearing capacity before (2624±463 N) and after (2775±297 N) aging among all groups. Cyclic fatigue aging decreased the load-bearing capacity (P>0.05) of all tested prostheses, except for the experimental SFRC CAD/CAM and conventional laboratory composite IRFPDs (P>0.05). SEM images showed the ability of discontinuous short fibers in the experimental SFRC CAD/CAM composite to redirect and hinder crack propagation. CAD/CAM-fabricated IRFPDs made of experimental SFRC blocks showed promising performance in clinical testing in terms of fracture behavior.

Effect of bioactive glass particles on mechanical and adhesion properties of resin cements.

The aim of this study is to evaluate the mechanical and adhesive properties of three different resin cements with bioactive glass (BAG) incorporated in two different ratios. BAG was added to different resin cements (3M Rely-X Ultimate, GC Link Ace, and GC Link Force) in different ratios (5% and 10% by weight). The three-point flexural strength, microhardness, and bond strength properties were evaluated. The fracture types of the groups were then analyzed using a stereo microscope. The data were analyzed using a multifactorial analysis of variance and Tukey's post-hoc tests (α < 0.05). The addition of BAG reduced the flexural strength of the resin cements (P < 0.05).The effect of BAG addition on the Vickers microhardness value was significantly different for each cement group (P < 0.05). In addition, with the exception of the GC link force group (10% BAG addition), the BAG addition decreased the bond strength of cements to dentin in all the groups (P = 0.171). The results of this study confirmed that different resin cements comprising different ratios of BAG exhibited different flexural strength, hardness, and bond-strength properties. Since the bond strength values increased with the addition of 10% BAG in the GC Link Force cement group, the effects of different BAG compositions could be worth investigating in future studies.

In vitro study of the film thickness of six resin cements

Objectives. Study the differences of the film thickness of six cements to determine that they comply with the standards. Methodology. Experimental, cross-sectional, in vitro study. Film thickness test of resinous cements using the standards of ISO 9917-1. 30 samples were made dividing them into 6 groups of 5 samples each. Group 1: Prime Dent, Group 2, iCem, Group 3: Relyx Ultimate, Group 4: MaxCem, Group 5: TheraCem, Group 6: BisCem. The thickness of two glass slab placed one on top of the other was measured, the resin cement was prepared by placing it (0.05 ± 0.005 ml) at the center of the glass slab with a 3 ml syringe, it was measured again. The weight was removed after 10 minutes, the thickness of both glass slad was measured. Film thickness was calculated by taking the difference between the thickness of the glass slab with and without the sample between them. Results: An ANOVA test was performed to obtain the statistical value; it was obtained that p=0.000, therefore there are statistically significant differences between the cements. Contribution. The application of dental cements for indirect restorations is used daily, so knowing the film thickness provides security when choosing the ideal material.

The Influence of Two Curing Protocols on the Colour Stability and Translucency of Resin Luting Agents

The colour properties of resin luting agents (RLAs) can influence the aesthetic of an indirect restoration. This in vitro study aims to evaluate the colour stability and translucency of RLAs cured using two different protocols by means of a spectrophotometer. Six RLAs were investigated: Enamel Plus Flow (MF), Enamel Plus (MH), light-cure Nexus Third Generation (NX3L), dual-cure Nexus Third Generation (NX3D), RelyX Veneer (RXL) and RelyX Ultimate (RXD). The samples were randomly divided into two groups (n = 5) according to the curing protocol used: the traditional protocol (P1), in which the samples were cured for 40 s, and the step luting protocol (P2), in which samples were cured for 5 s. Then, after 20 s, they were cured again for an additional 40 s. Colour changes and differences in translucency were calculated before (t0) and 1 day (t1) and 7 days (t7) after immersion of the samples in distilled water. Data were analysed using one-way ANOVA, Tukey’s test for multiple comparisons and a t-test for paired comparisons (α = 0.05). The colour and translucency of the RLAs changed between t0 and t7 (p &lt; 0.05). In particular, only RXD showed a visually perceptible difference in colour and translucency between P1 and P2 (p = 0.00). The results of this study suggest that, except for RXD, the curing protocol does not affect the colour or translucency of the tested RLAs, even if all these materials underwent perceptible changes in colour and translucency.

Polymerization Kinetics, Shrinkage Stress, and Bond Strength to Dentin of Conventional and Self-adhesive Resin Cements.

To evaluate the kinetics of polymerization and shrinkage stress of resin cements, as well as their bond strength to dentin after 24-h or one-year water storage. Three conventional resin cements were evaluated: RelyX Ultimate (RUL), Panavia V5 (PNV), and Multilink N (MLN); and three self-adhesive resin cements: RelyX Unicem 2 (RUN), Panavia SA Cement Plus (PSA), and G-CEM LinkAce (GCL). Degree of conversion (DC), maximum polymerization rate (RPmax) and gel time values were obtained using Fourier-transform infrared spectroscopy (FTIR/ATR). Shrinkage stress values were determined with a tensiometer, using a universal testing machine (n=5). Indirect resin composite restorations (Solidex) were fabricated and cemented to the dentin surface using self-adhesive resin cements, or conventional resin cements with self-etching adhesive (n=5). Bonding performance was evaluated with the microtensile bond strength (µTBS) test after 24 h or one year of water storage. MLN exhibited a higher DC (76.7%), whereas the percentage of other materials differed slightly (ranging from 54% to 58.5%). The RPmax and shrinkage stress values differed significantly between the cements. PSA showed the longest gel time. Significantly higher µTBS were observed for conventional resin cements after 24-h and one-year storage; a decrease in µTBS was observed for MLN only. Self-adhesive resin cements may not perform as well as conventional resin cements. Although both categories of cements presented similar polymerization kinetics and shrinkage values, the self-adhesive resin cements showed lower µTBS compared to those of conventional resin cements. Nevertheless, storage time only affected the bonding performance of MLN.

Internal and Marginal Adaptation of Adhesive Resin Cements Used for Luting Inlay Restorations: An In Vitro Micro-CT Study.

Adequate internal adaptation and marginal sealing of resin luting cements are of particular importance for the success of cemented ceramic inlays. The purpose of this study was to investigate the initial adaptation of different resin cements at the tooth-inlay restoration interface at enamel versus dentin surfaces. Thirty-two extracted human molars were allocated to four groups. One Class II cavity was prepared in each tooth. In each group, half of the cavities’ gingival floors were on enamel while the other halves were on cementum. Lava Ultimate CAD/CAM inlays were luted to the cavities using the following adhesive systems: RelyX Unicem, RelyX Ultimate, eCement, and Variolink Esthetic DC. After staining teeth with silver nitrate solution, marginal and internal gap volumes were determined using micro-CT images. Statistical analyses were conducted by independent t test and one-way ANOVA followed by post hoc Tukey test (p < 0.05). The internal and marginal gap volume values were the highest for Variolink Esthetic DC at the dentin surface (0.629 ± 0.363) and (2.519 ± 1.007), respectively, and the lowest for RelyX Unicem at the enamel surface (0.005 ± 0.004) and (0.009 ± 0.003), respectively. The internal and marginal adaptation on the enamel surface for RelyX Unicem and RelyX Ultimate resin cements were comparable to each other and to eCement but significantly better than Variolink Esthetic DC cement. Regardless of the adhesive resin system used, adaptation on enamel is superior to that on dentin surfaces.

Effect of Bonding Protocols on the Performance of Luting Agents Applied to CAD-CAM Composites.

This in vitro study aimed to evaluate the effect of different bonding strategies on the micro-shear bond strength (μSBS) of luting agents to CAD–CAM composites. Surface scanning electron microscopy (SEM) and spectroscopy by energy-dispersive X-ray spectroscopy (EDS) were performed to analyze the surfaces of the composite before and after bonding treatment. Three CAD–CAM composites were evaluated: Lava Ultimate restorative (LU), Brava Blocks (BR), and Vita Enamic (VE). The LU and BR surfaces were sandblasted using aluminum oxide, while the VE surfaces were etched using a 5% hydrofluoric acid gel according to the manufacturers’ recommendations. All surfaces were subjected to the following bonding strategies (n = 15): adhesive with silane and MDP (ScotchBond Universal, 3M Oral Care, St Paul, MI, USA); adhesive with MDP (Ambar Universal, FGM, Joinville, Brazil); adhesive without silane or MDP (Prime&Bond Elect, Dentsply Sirona, Charlotte, NC, USA), pure silane without MDP (Angelus, Londrina, Brazil), and pure silane with MDP (Monobond N, Ivoclar Vivadent, Schaan, Liechtenstei). Afterwards, tygons were filled with RelyX Ultimate (3M Oral Care), AllCem (FGM), or Enforce (Dentsply Sirona), which were light-cured and subjected to the μSBS test. Data were analyzed using two-way ANOVA and Bonferroni’s post hoc test (α = 0.05). Additional blocks (n = 15) were subjected to scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) before and after the surface treatment. The μSBS values on VE surfaces were higher than those observed on LU and BR surfaces (p < 0.001). Silane without MDP (Allcem) promoted the highest μSBS values, while silane with MDP (RelyX Ultimate) provided the highest values among all bonding strategies (p < 0.001). Enforce promoted no significant difference in μSBS values. SEM and EDS analyses detected noticeable changes to the surface morphology and composition after the surface treatment. The effectiveness of the bonding strategy may vary according not only to the CAD–CAM composite but also to resin cement/bonding agent/silane used.

ENDOCROWN RESTORATION OF THE ENDODONTICALLY TREATED TEETH BY USING CAD/CAM: CASE SERIES

Aim: As a result of large coronal destruction in endodontically treated teeth, significant losses occur in the dentin tissue around the pulp and the need for prosthetic treatment occurs. In this case series, endocrown applications produced in a single session with CAD/CAM system are presented as an alternative to crown restoration traditionally applied to premolar and molar teeth with excessive crown destruction.&#x0D; &#x0D; Case Series: In first case, 38-years-old male patient number 25, 46-years-old female patient number 36 in our second case, 21-years-old female patient number 46 in our third case, 26-years-old male patient number 46 in our fourth case, and in the last case 52-years-old male patient tooth number 15 has been applied to root canal treatment. As a result of the clinical and radiological examinations of the patients, it was observed that there were no systemic diseases. Endocrown restoration was considered appropriate and recommended to patients with less dentin tissue. Firstly, teeth are prepared for endocrown restoration. Afterwards, the impressions were digitalized by scanning the jaws with an intraoral optical scanner (Cerec Omnicam, Dentsply Sirona, USA). The restorations were designed with the help of the CEREC 4.3 software (Dentsply Sirona, USA) and the milling process was carried out using the feldspathic ceramic block (Vita Mark II, Vita Zahnfabrik, Germany) in the same session by CEREC inLab MC XL (Dentsply Sirona, USA). Later, the restorations were glazed and cemented with dual polymerized resin cement (RelyX Ultimate, 3M ESPE, USA).&#x0D; &#x0D; Conclusion: Endocrown restorations are a minimally invasive, conservative treatment approach that provides mechanical adhesion to the pulp chamber and cavity walls with adhesive resin cement and allows the preservation of the remaining tooth structure. For this reason, it is a treatment option that can be preferred instead of post-core and crown application in teeth with root canal treatment.

Comparison of conventional fiberglass and splendor sap post systems

The aim of this study was to compare the effect of posts systems and the luting agent on bond strength. Thirty single-rooted bovine teeth were used. The specimens were randomly grouped into: Rely X Ultimate- shaped pin (ULT-M), ULT- accessory pin (ULT-A), ULT- Splendor SAP (ULT-S), Rely X U200 (U200-M), U200-A and U200-S. The specimens were sectioned (cervical, middle and apical thirds) and submitted to the push-out test using the universal testing machine EMIC DL200MF. The data obtained were submitted to the Kolmogorov-Smirnov test, and later to the analysis of variance (ANOVA), complemented by the Student-Newman-Kells (SNK) multiple comparison test. The proportions of the type of failure were compared using the Z test. The significance level was 5% for all tests. The interaction Rely-X U200 and Splendor SAP System was the only group with no statistically significant difference, in all thirds. With the use of the Rely-X U200, the modeled retainer performed better in the middle third. The lowest bond values were in the apical region. The use of accessory retainers promoted adequate values in the cervical and middle thirds. For Rely-X Ultimate, the modeled retainer had the lowest strength values. The same happened with the middle and apical third of the group with accessory pins. There is an influence of luting agents and posts systems on bond strength values. The failure pattern is directly related to the retention system*luting agents*root third interaction.

Bonding of Resin Cements to Ultra-Translucent Zirconia After Aging for 24 Hours and 1 Year.

To evaluate the effect of different luting techniques on the shear bond strength (SBS) of ultra-translucent multi-layered zirconia (UTML) after 24 hours and 1 year of water storage and to analyze the influence of primers on the wettability of the UTML MTU-6 surface. Four commercial resin cements were evaluated: Variolink Esthetic LC (Ivoclar Vivadent); RelyX Ultimate (3M); Estecem II (Tokuyama); and Panavia V5 (Kuraray Noritake). Panavia V5 was tested with and without Panavia V5 Tooth Primer (Kuraray Noritake). The SBS immediately after cement/primer application and after aging, scanning electron microscopy of the surfaces, and the contact angle of the primers on the UTML surfaces were analyzed. At 24 hours, Panavia V5 with Tooth Primer exhibited the highest SBS. After 1 year, the SBS of Variolink Esthetic LC and Panavia V5 with Tooth Primer decreased, and RelyX Ultimate increased. There was no statistical difference between RelyX Ultimate and Panavia V5 with Tooth Primer at 1 year. For all groups, the rate of adhesive failures increased after 1 year. The highest contact angle was observed on the control (no primer) group, and the lowest contact angles were obtained when the YSZ surface was treated with Scotchbond Universal and the combination of Clearfil Ceramic Primer Plus and Tooth Primer. Clinicians should prefer 10-MDP-based cementation systems that can be properly polymerized to achieve a stable long-term bond strength to YSZ restorations. Also, the use of ceramic primers improves the capability of the cement to establish an intimate contact with the intaglio of the restoration.

Retention of Manually or CAD/CAM-customized Fiberglass Posts Luted to Enlarged Root Canals with Different Resin Cements.

The aim of this laboratory study was to evaluate the pull-out force of a prefabricated fiberglass post (PP), relined fiberglass post (RP), or milled fiberglass post (MP) luted with Multilink N (MN), RelyX Unicem 2 (RXU2) or RelyX Ultimate (RU) to enlarged root canals. The thickness of the resin cements and the presence of voids in the resin cement film were observed. The root canals of 90 bovine incisors were enlarged, endodontically treated, and randomly divided into 9 groups (n=10) according to the post type and resin cement. The specimens were scanned using micro-CT to analyze the thickness of the resin cement and the presence of voids. The specimens were submitted to mechanical cyclic loading (500,000 cycles at 50 N load) and subjected to pull-out force testing. Two-way ANOVA and Tukey's test analyzed the pull-out force and resin cement thickness data. Kruskal-Wallis and Bonferroni tests analyzed the void scores. The interaction between factors (post × resin cement) was significant (p=0.0001) for the pull-out force. Higher pull-out forces were obtained for RP and MP compared to PP. The post factor was significant (p=0.0001) for resin cement thickness, which was higher for PP (1054 μm), followed by MP (301 μm) and RP (194 μm). More void formation occurred for PP, being less for RP, differing significantly among the posts. Post customization (RP and MP) decreased resin cement thickness and void formation, favoring a higher pull-out force. Resin cements requiring an adhesive application (MN and RU) favored higher pull-out force than self-adhesive resin cement (RXU2).

Immediate dentin sealing influences the fracture strength of ultrathin occlusal veneers made of a polymer-infiltrated ceramic network

ObjectiveThe objective of this laboratory study was to assess the effect of immediate dentin sealing (IDS) on the fracture strength of teeth restored with ultrathin occlusal veneers made of a polymer-infiltrated ceramic network (PICN – Vita Enamic) with different fissure/cusp thicknesses. MethodsForty third molars were identically prepared in the dentin and allocated into four groups (n = 10) according to the fissure/cusp thickness of the occlusal veneers (0.3/0.6 mm or 0.6/0.9 mm) and the application or not of the IDS technique. Ten sound third molars were used as the control group. IDS was performed using a universal adhesive system (Single Bond Universal). The prepared teeth were scanned (Cerec software, version 4.1), and the occlusal veneers were shaped following the occlusal anatomy of a right second molar. Blocks of PICN were milled in the unit inLab MC XL. Following luting with Single Bond Universal and RelyX Ultimate, the fracture strength of the specimens was obtained with a universal testing machine. The fractures were classified as reparable or irreparable. Fracture strength values were analyzed with 2-way and 1-way ANOVA (α = 0.05) and Tukey's test. ResultsOnly the IDS factor was significant (p = 0.001). The teeth restored with IDS (2875 ± 508 N) achieved significantly higher fracture strength than the teeth restored without IDS (2263 ± 354 N) (p < 0.05). The fracture strength of the specimens with IDS did not differ significantly from that of the sound teeth (3230 ± 620 N). The fractures were predominantly reparable. ConclusionIDS improved the fracture strength of ultrathin occlusal veneers made of PICN.

Influence of Adhesion Promoter Primers on Polymerization Kinetics and Long-term Bond Strength of Composite Cements to Zirconia.

To investigate the influence of primers on polymerization kinetics of resin-based luting and its effect on the microhardness and bond strength to zirconia. Materials and Methods: Panavia V5 (PV; Kuraray Noritake) with Tooth Primer (TPprimer; Kuraray Noritake) or Clearfil Ceramic Primer (CPprimer; Kuraray Noritake), and RelyX Ultimate (RU; 3M Oral Care) with Scotchbond Universal (SUadhesive; 3M Oral Care) were evaluated. Polymerization kinetics of luting materials with or without primers (TPprimer or SUadhesive) were evaluated using Fourier transform near-infrared (FT-NIR) spectroscopy in self- and dual-curing modes (n = 5). Microhardness of luting materials was evaluated after 1, 12, and 24 h (n = 5). Shear bond strengths to zirconia ceramics (Katana Zirconia, Kuraray Noritake; and Lava Esthetic, 3M Oral Care) after 24 h and 1 year (n = 8) were assessed to determine the effect of the following surface treatments: no treatment, non-thermal atmospheric plasma, primer (CPprimer or SUadhesive), and the combination of plasma + primers. Statistical analyses were performed at a 5% significance level. PV achieved a significantly higher degree of conversion (DC) when TPprimer was used, while there was no increase in conversion for RU combined with SUadhesive. Light activation significantly improved polymerization, which also produced greater microhardness. CPprimer and SUadhesive significantly improved immediate bond strength to zirconia ceramics. However, after 1 year, only SUadhesive with RU was able to maintain the bond strength. Plasma surface treatment did not improve bonding to zirconia. The use of primers improved the DC for PV only. Light curing produced higher conversion and microhardness for both resin-based luting materials. Bond strength to zirconia was improved when primers were used. However, only RU demonstrated reliable long-term adhesion to zirconia.

Effect of surface pretreatment and artificial aging on the retention of lithium disilicate crowns cemented to zirconia implant abutments

Statement of problemRecent advancements in restorative dentistry have seen an increase in the use of ceramic restorations and zirconia implant abutments. However, how the pretreatment of a zirconia abutment and different artificial aging protocols affect the bond strength of a cemented, monolithic lithium disilicate crown is unclear. PurposeThe purpose of this in vitro study was to evaluate the effect of surface pretreatment on the retentive strength of milled lithium disilicate crowns bonded to custom zirconia implant abutments with different resin cements after thermocycling and long-term aging. Material and methodsA total of 144 crowns (n=8) were milled and bonded to 144 abutments. In the experimental groups, 72 abutments were airborne-particle abraded with 50-μm aluminum oxide before bonding. All specimens were stored at 37 °C in 100% humidity for 24 hours. Forty-eight specimens were subjected to thermocycling, and another 48 were subjected to aging for 6 months. Retentive strength was measured by using a pull-off test with a universal testing machine. Retentive strength values were calculated and compared with 3-way analysis of variance and a Tukey-Kramer post hoc test (α=.05). ResultsIn the 24-hour aging group, retention for all experimental groups was significantly higher (P<.05) than for the control group, except for Panavia 21 with Clearfil Ceramic Primer. In the thermocycling and long-term aging groups, all cements in the experimental group displayed significantly higher retention than the control. The airborne-particle abrasion of custom zirconia implant abutments with 50-μm aluminum oxide before bonding to lithium disilicate crowns significantly increased the bond strength of the Multilink Hybrid Abutment with Monobond Plus and RelyX Ultimate with Scotchbond Universal cements after 24-hour aging, but not of Panavia 21 with Clearfil Ceramic Primer. ConclusionsAirborne-particle abrasion significantly increased the bond strength of all 3 cements after thermocycling and long-term aging.

Comparison of the Mechanical Properties and Push-out Bond Strength of Self-adhesive and Conventional Resin Cements on Fiber Post Cementation.

The purpose of this study was to compare the mechanical properties and push-out bond strength of self-adhesive resin cements (SACs) and a conventional resin cement (CRC). Eighty bovine incisors were divided into four groups for cementation of a fiberglass post (Whitepost - FGM Dental Group, Coral Springs, FL) with different resin cements: three SACs (Maxcem Elite, MAX - Kerr; Calibra Universal, CAL - Dentsply; and RelyX Unicem 2, RUN - 3M Oral Care) and one CRC (RelyX Ultimate, RXU - 3M Oral Care). The groups were subdivided into two groups each (n=10) for evaluation of the push-out bond strength test (POBS) after 24 hours of water storage or after thermal aging (5000 cycles), following 24 hours of storage. The failure modes were evaluated using a stereomicroscope. Flexural strength (FS) and modulus of elasticity (EM) were determined using a three-point bending. Also, pH of the cements was measured over 48 hours and filler morphology was observed by scanning electron microscopy. Appropriate statistical analyses were performed by SPSS 21.0 (SPSS Inc., Chicago, IL, USA), with a significance level set at 5%. Results: RXU presented the highest POBS at both evaluation times. Among the SACs, RUN and CAL presented significantly lower POBS than MAX in cervical and middle-thirds at the 24-hour evaluation, and in all root regions after thermocycling. Adhesive failure between the cement and dentin were the most prevalent fractures at both times evaluated. MAX presented the lowest FS and RUN showed the highest EM. The pH reached the minimal point at the 30-minute evaluation for RXU and MAX. For RUN and CAL, the minimal pH was observed at the 60-minute evaluation. RXU and RUN presented spherical and regular filler particles, while MAX and CAL presented irregularly shaped and sized filler particles. The mechanical behavior of SACs is not superior to CRC; however, among all the SACs evaluated, MAX presented the highest POBS and stability after thermocycling evaluation. MAX also reached the closest neutral pH after 48 hours. Therefore, SACs with low initial pH and strong neutralization reactions are recommended, because these characteristics may lead to better mechanical properties and stability.

Prospective Study on CAD/CAM Nano-Ceramic (Composite) Restorations in the Treatment of Severe Tooth Wear.

The aim of this prospective study was to evaluate the clinical performance of minimally invasive, CAD/CAM nano-ceramic (composite) restorations in patients with severe tooth wear, the effect of the restorative treatment on the oral health-related quality of life (OHRQoL), and the etiology of tooth wear as a risk factor for restoration failure. Patients with generalized severe tooth wear were included. Restorations (LAVA Ultimate, 3M Oral Care) were cemented (RelyX Ultimate, 3M Oral Care) on all teeth and were evaluated after 1 month and 1 year. OHRQoL was assessed via questionnaires at baseline and after 1 year. Differences were evaluated (paired t-test). Two mechanical tooth-wear lesions resulting from tooth-tooth contact, and 3 chemical tooth wear lesions resulting from intrinsic or extrinsic acids dissolving natural hard tooth substance, were evaluated to assess the etiology of tooth wear in association with restoration failure using multilevel logistic regression analyses (p < 0.05). Twenty-one patients (age: 41.7 ± 10.4 years) were evaluated after 1 year (13.5 ± 1.2 months). 568 indirect CAD/CAM restorations were placed. None were replaced or lost. Twelve were repaired and 10 were refurbished. Success rates were 100% to 97.2%. Questionnaires showed a significant positive impact of the treatment on OHRQoL (p < 0.001). The presence of mechanical lesions did not pose a higher risk for restoration failure (p = 0.78). The presence of chemical lesions showed a lower risk of restoration failure (p = 0.002). The use of minimally invasive, CAD/CAM nano-ceramic (composite) restorations in the restorative treatment of severely worn dentitions showed satisfactory results in the short term.