Self-adhesive Cement Research Articles

Análise comparativa da resistência de união de um cimento convencional e um cimento autoadesivo após diferentes tratamentos na superfície de pinos de fibra de vidro

Resumo Introdução Os pinos de fibra de vidro são uma alternativa aos núcleos metálicos e apresentam vantagens, tais como: estética, módulo de elasticidade semelhante à dentina e cimentação imediata após o término do tratamento endodôntico. Ainda, apresentam a capacidade de aderir ao cimento resinoso e este, à dentina, por meio de técnicas adesivas. Objetivo Comparar a adesão de um cimento resinoso convencional e um autoadesivo a pinos de fibra de vidro, e os efeitos de diferentes tratamentos de superfície na resistência adesiva dos pinos. Material e método Trinta pinos foram divididos em três grupos: Controle: sem tratamento na superfície; Jateamento: jateamento com óxido de alumínio por 30 segundos, e Peróxido: imersão em peróxido de hidrogênio 24% por um minuto. Em seguida, corpos de prova foram obtidos a partir de cilindros de cimento resinoso contendo o pino de fibra posicionado no centro de seu longo eixo. Em cada grupo, cinco pinos foram associados ao adesivo Âmbar + cimento convencional AllCem Core e os outros cinco pinos, ao cimento autoadesivo RelyX U200. O conjunto pino/cimento foi segmentado e avaliado em relação à resistência de união (RU) por push-out. Os dados foram analisados estatisticamente pelos testes de ANOVA e Tukey (p<0,05). Resultado Os cimentos avaliados exibiram valores de RU semelhantes. Em relação aos tratamentos de superfície, os maiores valores de RU foram encontrados no grupo Jateamento. Conclusão O cimento convencional, AllCem Core, e o cimento autoadesivo, RelyX U200, mostraram valores de resistência de união semelhantes. Ainda, o jateamento com óxido de alumínio favoreceu a adesão dos pinos aos cimentos.

Effect of Curing Mode on Shear Bond Strength of Self-Adhesive Cement to Composite Blocks.

To overcome the disadvantages of computer-aided design/computer-aided manufacturing (CAD/CAM) processed indirect restorations using glass-ceramics and other ceramics, resin nano ceramic, which has high strength and wear resistance with improved polish retention and optical properties, was introduced. The purpose of this study was to evaluate the shear bond strength and fracture pattern of indirect CAD/CAM composite blocks cemented with two self-etch adhesive cements with different curing modes. Sand-blasted CAD/CAM composite blocks were cemented using conventional resin cement, Rely X Ultimate Clicker (RXC, 3M ESPE, St. Paul, MN, USA) with Single Bond Universal (SB, 3M ESPE, St. Paul, MN, USA) for the control group or two self-adhesive resin cements: Rely X U200 (RXU, 3M ESPE, St. Paul, MN, USA) and G-CEM Cerasmart (GC, GC corporation, Tokyo, Japan). RXU and GC groups included different curing modes (light-curing (L) and auto-curing (A)). Shear bond strength (SBS) analyses were performed on all the specimens. The RXC group revealed the highest SBS and the GC A group revealed the lowest SBS. According to Tukey’s post hoc test, the RXC group showed a significant difference compared to the GC A group (p < 0.05). For the curing mode, RXU A and RXU L did not show any significant difference between groups and GC A and GC L did not show any significant difference either. Most of the groups except RXC and RXU L revealed adhesive failure patterns predominantly. The RXC group showed a predominant cohesive failure pattern in their CAD/CAM composite, LavaTM Ultimate (LU, 3M ESPE, St. Paul, MN, USA). Within the limitations of this study, no significant difference was found regarding curing modes but more mixed fracture patterns were showed when using the light-curing mode than when using the self-curing mode.

Effect of Activation Mode on Flexural Strength and Elasticity Modulus of Dual Cure Resin Cements

Objective: This study evaluated the effect of the activation mode on flexural strength and elasticity modulus of four dual cure resin-based cements. Methods: Two self-adhesive resin cements (Clearfil SA Cement (CSA) and RelyX U100 (U)) and two conventional resin cements (Clearfil Esthetic Cement (CE)and RelyX ARC (ARC)) were used to produce a total of 45 bar specimens (7x2x2 mm) using three different activation modes (n=15): Direct light-cure (D), Indirect light-cure using a 2mm composite resin barrier (I) and Self-cure (S). Three-point flexural tests were performed after 24 hours water storage at 37° C, using a universal testing machine (Instron) at a cross-speed of 0.5 mm/min until fracture. Flexural strength (MPa) and elasticity modulus values were subjected to ANOVA and Tukey’s Test (=0.05). Results: Data revealed that light polymerized groups presented statistically higher flexural strength (CSA/D=113.63 ± 19.65; CSA/I=80.66 ± 23.74; U/D=101.33 ± 9.8; U/I=94.96 ± 36.9; CE/D=219.08 ± 39.94; CE/I=226.42 ± 34.59; ARC/D=150.03 ± 26.15; ARC/I=111.78 ± 14.28) and also elasticity modulus values (CSA/D = 2.9 ± 0.6; CSA/I = 1.5 ± 0.4; U/D = 2.9 ± 0.5; U/I = 2.6 ± 1.4; CE/D = 6.5 ± 1.3; CE/I = 5.8 ± 1.0; ARC/D = 4.2 ± 0.93; ARC/I = 2.5 ± 0.5) compared to self-cured groups (flexural strength: CSA/S=65.81 ± 21.84; U/S=53.62 ± 28.73; CE/S=129.02 ± 51.67; ARC/S=77.98 ±19.61 and elasticity modulus: CSA/S = 1.4 ± 0.5; U/S = 1.2 ± 0.7; CE/S = 2.2 ± 1.5; ARC/S = 1.0 ± 0.5). The usage of a composite resin barrier only affected the mechanical properties of ARC and CSA. Conventional resin cements presented higher flexural strength values than the self-adhesive cements. CE presented the highest values compared to all other cements. No statistical difference was observed between self-adhesive cements. Conclusion: Light-curing of resin luting cements produced higher flexural strength for all tested materials. Similar mechanical behavior was observed for the tested self-adhesive cements.

Mechanical Properties and Sliding-impact Wear Resistance of Self-adhesive Resin Cements.

The present study determined the mechanical properties and impact-sliding wear characteristics of self-adhesive resin cements. Five self-adhesive resin cements were used: G-CEM LinkAce, BeautiCem SA, Maxcem Elite, Clearfil SA Automix, and RelyX Unicem 2. Clearfil Esthetic Cement was employed as a control material. Six specimens for each resin cement were used to determine flexural strength, elastic modulus, and resilience according to ISO specification #4049. Ten specimens for each resin cement were used to determine the wear characteristics using an impact-sliding wear testing apparatus. Wear was generated using a stainless-steel ball bearing mounted inside a collet assembly. The maximum facet depth and volume loss were determined using a noncontact profilometer in combination with confocal laser scanning microscopy. Data were evaluated using analysis of variance followed by the Tukey honestly significantly different test (α=0.05). The flexural strength of the resin cements ranged from 68.4 to 144.2 MPa; the elastic modulus ranged from 4.4 to 10.6 GPa; and the resilience ranged from 4.5 to 12.0 MJ/m(3). The results for the maximum facet depth ranged from 25.2 to 235.9 μm, and volume loss ranged from 0.0107 to 0.5258 mm(3). The flexural properties and wear resistance were found to vary depending upon the self-adhesive resin cement tested. The self-adhesive cements tended to have lower mechanical properties than the conventional resin cement. All self-adhesive resin cements, apart from G-CEM LinkAce, demonstrated significantly poorer wear resistance than did the conventional resin cement.

Inorganic characterizations and filler particles morphology of self-adhesive cements

This study evaluated the thermal and morphological filler characteristics of self-adhesive resin cements. The cements (Embrace WetBond, MaxCem Elite, Bifix SE, G-Cem, and RelyX U200) were manipulated according to the manufacturers׳ instructions. Thermogravimetric analysis and differential thermal analysis were performed to obtain the glass transition temperature (Tg) and weight loss. Specimens were also obtained to characterize the zeta potential, the mean particle size and distribution, and the polydispersity by dynamic light scattering. An elemental analysis of the fillers was also conducted using X-ray spectroscopy analysis and micromorphology under SEM. MaxCem Elite contained the least organic matrix, followed by G-Cem, Bifix SE, RelyX U200, and Embrace WetBond. Bifix SE presented the highest Tg and G-Cem the lowest. Bifix SE presented the broadest filler size distribution, exhibiting lower zeta potentials and mobility. G-Cem was found to be a highly filler loaded cement with the lowest effective diameter, highest zeta potential and mobility. RelyX U200 presented chromium in the composition and G-Cem presented fluorine. Differences in the nature and chemistry of inorganic fractions seemed to dictate the morphology of the filler content and also the thermal behavior of the materials tested and, may consequently influence the clinical performance of self-adhesive resin cements.

Influence of Different Types of Resin Luting Agents on Color Stability of Ceramic Laminate Veneers Subjected to Accelerated Artificial Aging.

The aim of this study was to evaluate the influence of accelerated aging (AAA) on the color stability of resin cements for bonding ceramic laminate veneers of different thicknesses. The occlusal surfaces of 80 healthy human molars were flattened. Ceramic laminate veneers (IPS e-max Ceram) of two thicknesses (0.5 and 1.0 mm) were bonded with three types of luting agents: light-cured, conventional dual and self-adhesive dual cement. Teeth without restorations and cement samples (0.5 mm) were used as control. After initial color evaluations, the samples were subjected to AAA for 580 h. After this, new color readouts were made, and the color stability (ΔE) and luminosity (ΔL) data were analyzed. The greatest color changes (p<0.05) occurred when 0.5 mm veneers were fixed with light-cured cement and the lowest when 1.0 mm veneers were fixed with conventional dual cement. There was no influence of the restoration thickness when the self-adhesive dual cement was used. When veneers were compared with the control groups, it was verified that the cement samples presented the greatest alterations (p<0.05) in comparison with both substrates and restored teeth. Therefore, it was concluded that the thickness of the restoration influences color and luminosity changes for conventional dual and light-cured cements. The changes in self-adhesive cement do not depend on restoration thickness.

Bonding effectiveness of contemporary composite cements to dentin after 6-month water storage

Purpose: To evaluate the bonding effectiveness to dentin of eight dual-cure composite cements after 6-month water storage. Materials and Methods: This study is a follow-up of a recent study that investigated the 1-week bonding effectiveness of feldspathic ceramic blocks luted to dentin using the same composite cements and experimental protocol. The microtensile bond strength (μTBS) of different composite cements, including two etch-and-rinse cements (Calibra, Dentsply; Variolink II, Ivoclar-Vivadent), two self-etch cements (Panavia F2.0, Kuraray; Clearfil Esthetic Cement, Kuraray), and four self-adhesive cements (Unicem, 3M ESPE; Maxcem, Kerr; Monocem, Shofu; G-Cem, GC), was measured using a standardized μTBS protocol after 6-month water storage. As control, a two-step self-etch adhesive (Clearfil SE, Kuraray) combined with a microhybrid restorative composite (Clearfil AP-X, Kuraray) was used. Twenty-seven human third molars were used with specific preparation, and after 6-month water storage, microspecimens were prepared and subjected to a μTBS test. Results: The mean μTBS varied from 0 to 26.1 MPa, the latter being measured for the control adhesive composite combination. All specimens prepared using the self-adhesive composite cements Maxcem and Monocem failed during specimen processing. Most specimens failed at the dentin-cement interface, except the self-etch composite cement Panavia F2.0 that failed in 53% of the cases at the cement-ceramic interface and the control of which all specimens failed in the resin part of the microspecimens. Conclusion: The largely varying bonding effectiveness recorded for the different composite cements highlights the need for material specifications. Such specifications should also include a bond durability test as the specimens in the present study that were subjected to 6-month water storage. To lute ceramic restorations that allow light transmission to a sufficient degree, a conventional light-curable adhesive and composite should be considered.

Influence of the Cement Film Thickness on the Push-Out Bond Strength of Glass Fiber Posts Cemented in Human Root Canals.

The present study evaluated the influence of the cement film thickness on the push-out bond strength of glass fiber posts in the cervical, medium, and apical thirds of root canal spaces. Thirty roots were randomly divided into three groups, according to the fiber post system's drills: (G1) #2; (G2) #3; (G3) #4. The posts were cemented using a self-adhesive cement, and a small amount of powdered Rhodamine B was used as a stain. Images of both sides of each slice were obtained before and after the push-out test. To determine the cement thickness, a macro routine was developed using the software KS 400. The data were analyzed statistically using Kruskal-Wallis and Dunn's test. G2 (14.62 ± 5.15 MPa) showed statistically higher bond strength values than G1 (10.04 ± 5.13 MPa) and G3 (7.68 ± 6.14 MPa). All groups presented higher bond strength values in the apical third. The bur diameter significantly influenced the results of the shear bond strength for the push-out test. The slight increase in the cement thickness allowed an increase in the values of shear bond strength when compared to very thin or very thick cement films.

Effect of Intracanal Dentin Conditioning with Xylene, Phosphoric Acid and Chlorhexidine on Bond Strength to Glass Fiber Post with Self-Adhesive Cement

Effect of Intracanal Dentin Conditioning with Xylene, Phosphoric Acid and Chlorhexidine on Bond Strength to Glass Fiber Post with Self-Adhesive Cement

Effect of GLUMA desensitizer on the retention of full metal crowns cemented with Rely X U200 self-adhesive cement.

PURPOSEConsidering the importance of retention in the success and long-term clinical service of fixed partial dentures (FPDs) as well as the existing controversy regarding the effect of GLUMA desensitizer on the retention of full metal crowns cemented with RelyX U200 self-adhesive cement, this study aimed to assess the effect of GLUMA desensitizer on the retention of full metal crowns cemented using RelyX U200.MATERIALS AND METHODSIn this experimental study, 20 sound human premolars were prepared; a 0.5 mm chamfer finish line was prepared above the cementoenamel junction. The teeth were randomly assigned to two groups: a desensitizer group (n = 10, treated with GLUMA desensitizer) and a control (n = 10, no surface treatment). Full metal crowns were fabricated of base metal alloy and had a ring. All crowns were cemented with RelyX U200 and subjected to retention test by using a universal testing machine. The data were analyzed using SPSS version 20 and independent t-test.RESULTSThe mean tensile bond strength was significantly higher in the GLUMA desensitizer group (230.63 ± 63.8 N) compared to the control group (164.45 ± 39.3 N) (P≤.012).CONCLUSIONGLUMA desensitizer increases the tensile bond strength of RelyX U200 self-adhesive cement to dentin.

Influence of Temporary Cements on the Bond Strength of Self-Adhesive Cement to the Metal Coronal Substrate.

This research evaluated the influence of temporary cements (eugenol-containing [EC] or eugenol-free [EF]) on the tensile strength of Ni-Cr copings fixed with self-adhesive resin cement to the metal coronal substrate. Thirty-six temporary crowns were divided into 4 groups (n=9) according to the temporary cements: Provy, Dentsply (eugenol-containing), Temp Cem, Vigodent (eugenol-containing), RelyX Temp NE, 3M ESPE (eugenol-free) and Temp Bond NE, Kerr Corp (eugenol-free). After 24 h of temporary cementation, tensile strength tests were performed in a universal testing machine at a crosshead speed of 0.5 mm/min and 1 kN (100 kgf) load cell. Afterwards, the cast metal cores were cleaned by scraping with curettes and air jet. Thirty-six Ni-Cr copings were cemented to the cast metal cores with self-adhesive resin cement (RelyX U200, 3M ESPE). Tensile strength tests were performed again. In the temporary cementation, Temp Bond NE (12.91 ± 2.54) and Temp Cem (12.22 ± 2.96) presented the highest values of tensile strength and were statistically similar to each other (p>0.05). Statistically significant difference (p<0.05) was observed only between Provy (164.44 ± 31.23) and Temp Bond NE (88.48 ± 21.83) after cementation of Ni-Cr copings with self-adhesive resin cement. In addition, Temp Cem (120.68 ± 48.27) and RelyX Temp NE (103.04 ± 26.09) showed intermediate tensile strength values. In conclusion, the Provy eugenol-containing temporary cement was associated with the highest bond strength among the resin cements when Ni-Cr copings were cemented to cast metal cores. However, the eugenol cannot be considered a determining factor in increased bond strength, since the other tested cements (1 eugenol-containing and 2 eugenol-free) were similar.

Effect of timing for core preparation, luting cement type and root level on adhesion of fiber posts to intraradicular dentin

This study assessed the effect of timing of core preparation and luting cement on adhesion of fiber-reinforced composite (FRC) posts on different levels of intraradicular dentin when cemented with either conventional dual-polymerized or self-adhesive resin cement. Single-rooted human teeth (N = 80) were endodontically treated and randomly divided into 2 groups (n = 40) according to resin cement: (a) Conventional dual resin cement (Variolink II, V) or (b) Self-adhesive resin cement (RelyX U200, R). They were further divided into two subgroups according to timing of core preparation (n = 20): (a) immediate (i) or (b) delayed (d). FRC posts (Cytec Blanco) were cemented and the roots were sliced into discs at the coronal, middle, and apical levels. Push-out tests were then performed in a Universal Testing Machine (1 mm/min). Data (MPa) were analyzed using three-way ANOVA and Tukey’s tests considering the factors ‘core preparation time’, ‘luting cement’, and ‘root level’ (α = 0.05). Type of luting cement (p < 0.001), time of core preparation (p < 0.001), and root level (p < 0.001) significantly affected the bond strength results. R cement was more significantly affected by core preparation time (Ri: 2.91 ± 1.1; Rd: 4.83 ± 1.68) compared to V cement (Vi: 2.92 ± 1.63; Vd: 2.65 ± 1.6) (p < 0.05). Coronal region demonstrated significantly higher bond strength values than those of middle and apical third in all groups (coronal: 4 ± 1.9; middle: 3.1 ± 1.4; apical: 2.4 ± 1.1) (p < 0.05). Adhesive failure between cement and dentin was the most frequent (64%) followed by adhesive failure between cement and post (18%). Delayed core preparation can improve bond strength of FRC posts to intraradicular dentin when cemented with self-adhesive cement compared to conventional dual-polymerized resin cement.

Effect of Adhesive Cementation Strategies on the Bonding of Y-TZP to Human Dentin.

This study evaluated the effects of different adhesive strategies on the adhesion of zirconia to dentin using conventional and self-adhesive cements and their corresponding adhesive resins. The occlusal parts of human molars (N=80) were sectioned, exposing the dentin. The teeth and zirconia cylinders (N=80) (diameter=3.4 mm; height=4 mm) were randomly divided into eight groups according to the factors "surface conditioning" and "cement type" (n=10 per group). One conventional cement (CC: RelyX ARC, 3M ESPE) and one self-adhesive cement (SA: RelyX U200, 3M ESPE) and their corresponding adhesive resin (for CC, Adper Single Bond Plus; for SA, Scotchbond Universal Adhesive-SU) were applied on dentin. Zirconia specimens were conditioned either using chairside (CJ: CoJet, 30 μm, 2.5 bar, four seconds), laboratory silica coating (RC: Rocatec, 110 μm, 2.5 bar, four seconds), or universal primer (Single Bond Universal-UP). Nonconditioned groups for both cements acted as the control (C). Specimens were stored in water (37°C, 30 days) and subjected to shear bond strength (SBS) testing (1 mm/min). Data (MPa) were analyzed using two-way analysis of variance and a Tukey test (α=0.05). While surface conditioning significantly affected the SBS values (p=0.0001) (C<RC=CJ=UP), cement type did not (p=0.148) (CC=SA). The interaction terms were significant (p=0.014). Failure types were predominantly adhesive. Air-abrasion and the use of the universal primer improved the bond strength of zirconia to dentin compared to the control group, regardless of the type of resin cement used.

Influence of cementation on in vitro performance, marginal adaptation and fracture resistance of CAD/CAM-fabricated ZLS molar crowns

ObjectivesThis study investigated the influence of conventional cementation, self-adhesive cementation, and adhesive bonding on the in vitro performance, fracture resistance, and marginal adaptation of zirconia-reinforced lithium silicate (ZLS) crowns. MethodsHuman molar teeth (n=40) were prepared and full-contour crowns of a ZLS ceramic (Celtra Duo, DeguDent, G, n=32) and a lithium disilicate ceramic (LDS; IPS e.max CAD, Ivoclar-Vivadent, FL, n=8) were fabricated and glazed. Four groups of ZLS crowns were defined (n=8/group) and cemented with different glass-ionomer cements, resin, and resin-modified self-adhesive luting materials. The LDS crowns served as reference group with adhesive bonding.A combined thermal cycling and mechanical loading (TCML: 3000×5°C/3000×55°C; 1.2×106 cycles à 50N) with human antagonists was performed in a chewing simulator. Fracture force of surviving crowns was determined. Marginal adaptation at the cement/tooth and cement/crown interface was investigated by scanning electron microscopy before and after TCML, and the share of perfect margins was determined. Data were statistically analyzed (one-way ANOVA; post hoc Bonferroni, α=0.05). ResultsOne crown of the adhesive group failed during TCML (879,000 cycles=3.7 years). No statistically significant (p=0.078) differences in fracture resistance were found between different cementations, although highest data in tendency were found for adhesive bonding. Shares of perfect margins at the cement/tooth (93.8±5.6–99.6±0.8%) and cement/crown (84.7±6.6–100.0±0.0%) interfaces did not differ significantly (p>0.05) between the different cementation groups. SignificanceMarginal adaptation and fracture forces of all tested groups are in a range, where no restrictions should be expected for clinical application.

Push-Out Bond Strength Evaluation of Glass Fiber Posts With Different Resin Cements and Application Techniques.

The purpose of this study was to evaluate the push-out strength of two different adhesive cements (total etch and self-adhesive) for glass fiber post (GFP) cementation using two different techniques (microbrush and elongation tip) of cement application. In addition, this study evaluated the effect of total-etch conditioning before the use of a self-adhesive cement. Sixty premolar specimens with a single root canal were selected, endodontically treated, and shaped for GFP cementation. The specimens were randomly placed into one of six groups according to the cement and technique used: RelyX ARC (ARC): ARC + microbrush, ARC + elongation tip; RelyX Unicem (RU): RU + microbrush, RU + elongation tip; or RelyX Unicem + 37% phosphoric acid (RUE): RUE + microbrush, RUE + elongation tip. Each specimen root was cut perpendicular to the vertical axis yielding six 1.0-mm-thick sections. Push-out strength test was performed, followed by statistical analysis using three-way analysis of variance and the Games-Howell test (p<0.05). Statistically significant differences between the groups were found (p< 0.05). The cervical third of the roots had the highest mean push-out strength values, while the apical third had the lowest mean values regardless of the technique used. The elongation technique produced higher mean push-out strength values compared to the microbrush technique. The self-etch adhesive cement had the highest mean push-out strength value in all thirds. The addition of a conditioning step before the self-etch adhesive cementation appears to be effective in enhancing push-out strength with GFPs.

Influence of Adhesive Core Buildup Designs on the Resistance of Endodontically Treated Molars Restored With Lithium Disilicate CAD/CAM Crowns.

To assess the influence of adhesive core buildup designs (4-mm buildup, 2-mm buildup, and no buildup/endocrown) on the fatigue resistance and failure mode of endodontically treated molar teeth restored with lithium disilicate computer-aided design/computer-aided manufacturing (CAD/CAM) complete crowns placed with self-adhesive cement. Forty-five extracted molars were decoronated at the level of the cementoenamel junction and endodontically treated. Specimens received different Filtek Z100 adhesive core buildups (4-mm buildup; 2-mm buildup; and no buildup endocrown preparation) and were restored with Cerec 3 CAD/CAM lithium disilicate crowns (IPS e.max CAD). The intaglio surfaces of restorations (n=15) were conditioned by hydrofluoric acid etching and silane, and prepared teeth were treated with airborne-particle abrasion, followed by cementation with RelyX Unicem 2 Automix. Specimens were then subjected to cyclic isometric loading at 10 Hz, beginning with a load of 200 N (×5000 cycles), followed by stages of 400, 600, 800, 1000, 1200, and 1400 N at a maximum of 30,000 cycles each. Specimens were loaded until failure or to a maximum of 185,000 cycles. The chewing cycle was simulated by an isometric contraction (load control) applied through a 10-mm in diameter composite resin sphere (Filtek Z100). Surviving specimens were axially loaded until failure or to a maximum load of 4500 N (crosshead speed 0.5 mm/min). The failure mode was assessed, and fractures were designated as catastrophic (tooth/root fracture that would require tooth extraction) or reparable (cohesive or cohesive/adhesive fracture of restoration only). Groups were compared using the life table survival analysis (log-rank test at p=0.05). Surviving specimens were loaded to failure and compared with one-way analysis of variance. The survival rates after the fatigue test were 100%, 93%, and 100% for 4-mm, 2-mm, and no buildup (endocrown), respectively and were not statistically different (only one specimen failed with a 2-mm buildup under a crown that cohesively fractured at 1,400 N). Postfatigue load to failure averaged 3181 N for 4-mm buildups (15 specimens), 3759 N for 2-mm buildups (12 specimens), and 3265 N for endocrowns (14 specimens). The 2-mm buildups were associated with higher loads to failure than endocrowns and 4-mm buildups, but no differences were found between 4-mm buildups and endocrowns (p<0.05.) One endocrown and 2 restorations with a 2-mm buildup survived the load-to-failure test (at 4500 N). Only catastrophic fractures occurred after the load-to-failure test. The buildup design influenced the performance of endodontically treated molars restored with lithium disilicate CAD/CAM complete crowns placed with self-adhesive resin cement. The 2-mm buildups were associated with higher loads to failure than the endocrown and the 4-mm buildup, but all restoration designs survived far beyond the normal range of masticatory forces.

Effect of Cements at Different Temperatures on the Clinical Performance and Marginal Adaptation of Inlay-Onlay Restorations In Vivo.

To evaluate the clinical performance of inlays and onlays luted with two different resin cements, mixed at different temperatures and to evaluate the marginal adaptation of the restorations. One hundred IPS e.max restorations (82 onlays, 18 inlays; 84 molars, 16 premolars) were placed in 50 patients (28 females, 22 males, mean age, 33 years). The restorations were assigned to six groups according to the luting agent temperature (25°C, 37°C, and 54°C) and cement type (Variolink N high viscosity or G-Cem Automix). All restorations were evaluated after 1 week and 1 year by two examiners using modified USPHS criteria. Replicas of 30 selected onlay restorations (5 per group) were assessed for marginal quality under a scanning electron microscope (SEM) at 200×. Marginal adaptation was quantitatively evaluated in terms of percentage of gap formation, and marginal gap width was measured. After 1 year, the total survival rates of the Variolink N high viscosity group and G-Cem Automix group were 100% and 93.8%, respectively. Three debondings occurred with the G-Cem Automix group, one from each temperature group. For 1-year clinical service time, no significant difference was noticed in the marginal adaptation of Variolink N high viscosity groups and the 37°C G-Cem Automix group, while 25°C and 54°C G-Cem Automix groups' marginal adaptation scores decreased (p < 0.05). Regarding the SEM evaluations, Variolink N high viscosity cement groups showed better marginal adaptation than G-Cem Automix cement groups (p < 0.05). Cementation with the cements preheated to 37°C increased continuous margins in both enamel-cement and cement-ceramic interfaces, but these results were not statistically significant (p > 0.05). Cements at different temperatures did not have significant effects on marginal gap widths of the restorations. The restorations cemented with Variolink N high viscosity cement mixed at the three tested temperatures exhibited better treatment options than the self-adhesive groups. Preheating the self-adhesive cement (G-Cem Automix) to 37°C can be an effective method to have better marginal adaptation than the other self-adhesive groups (25°C, 54°C) tested in this study.

Fatigue resistance of ultrathin CAD/CAM complete crowns with a simplified cementation process

Statement of problemTraditional tooth preparation for complete crowns requires a substantial amount of hard tissue reduction. This is in contrast with the principles of minimally invasive dentistry. An ultrathin complete crown preparation is proposed instead. PurposeThe purpose of this in vitro study was to assess the fatigue resistance and failure mode of computer-aided design and computer-aided manufacturing (CAD/CAM) ultrathin complete molar crowns placed with self-adhesive cement. Different restorative materials (resin nanoceramic [RNC], feldspathic ceramic [FEL], and lithium disilicate [LD]) were compared. Material and methodsForty-five extracted molars with a standardized crown preparation were restored with the Cerec 3 CAD/CAM system using FEL, LD, or RNC (n=15). FEL and LD restorations were etched with hydrofluoric acid and silanated. RNC restorations and all preparations were treated with airborne-particle abrasion. All restorations (thickness=0.7 mm) were cemented with RelyX Unicem II Automix cement and submitted to cyclic isometric loading, beginning with a load of 200 N (5000 cycles) and followed by stages of 400, 600, 800, 1000, 1200, and 1400 N at a maximum of 30 000 cycles each. The specimens were loaded until failure or for a maximum of 185 000 cycles. The failure mode was categorized as “catastrophic,” “possibly reparable,” or “reparable.” The groups were compared using life table survival analysis (log rank test at α=.05). Previously published data from the same authors about traditional complete crowns (thickness 1.5 mm) using the same experimental design were included for comparison. ResultsAll specimens survived the fatigue test until the 600 N step. RNC, LD, and FEL failed at an average load of 1014 N (1 survival), 1123 N (2 survivals), and 987 N (no survivals), and no difference in survival rate was found. No catastrophic failures were reported after the fatigue test. Comparison with previously published data showed that 1.5-mm thick complete crowns demonstrated higher survival rates than the ultrathin restorations, independent of the material. ConclusionsThe fatigue resistance of ultrathin complete molar crowns (placed with a simplified cementation process) made of RNC, LD, and FEL was not significantly different. All materials survived the normal range of masticatory forces. All failures were re-restorable. Regular crowns of 1.5 to 2.0 mm thickness may present higher survival rates than ultrathin ones.

Influence of Curing Units and Indirect Restorative Materials on the Hardness of Two Dual-curing Resin Cements Evaluated by the Nanoindentation Test.

To evaluate the hardness of a dual-curing self-adhesive resin cement (RelyX U200) and a conventional dual-curing resin cement (RelyX ARC) cured with different light curing units of different wavelengths (Elipar Freelight 2 LED [430 to 480 nm, conventional], Bluephase LED [380 to 515 nm, polywave], AccuCure 3000 Laser [488 nm]) by means of the nanoindentation test. Bovine incisors were cleaned and then sectioned at the cementoenamel junction to remove the crown. After embedding in acrylic, dentin surfaces of the specimens were exposed and ground flat to standardize the surfaces. To simulate clinically placing indirect restorations, ceramic (IPS e.maxPress/Ivoclar Vivadent) or indirect composite resin (SR Adoro/Ivoclar Vivadent) slabs were cemented on dentin surfaces. The specimens were sectioned longitudinally at low speed under constant irrigation and then polished. In the positive control group, the cement was light cured without the interposition of indirect restorative material; in the negative control group, after the indirect restorative material was cemented, no light curing was performed, allowing only chemical polymerization of the cement. All specimens were stored in distilled water at 37°C for 7 days. Nanoindentadion hardness of the cement layer was measured under a 100-mN load. Data were statistically analyzed using ANOVA and Tukey's test (p < 0.05). Although the self-adhesive cement is technically simple, conventional cement showed the best polymerization performance. The polywave LED technology did not differ significantly from other light-curing units. The hardness of the resin cements evaluated was negatively influenced by the interposition of an indirect restorative material; only the LEDs were able to maintain the same degree of cement polymerization when an indirect restorative material was used. The photoactivation step is required during the cementation of indirect restorations to ensure adequate polymerization of dual-curing resin cements.

Effect of thermal cycling and low pressure sandblasting on the bond strength of a self-adhesive cement to Y-TZP zirconia

The aim of this investigation was to assess the influence of several surface treatments on the shear bond strength (SBS) of a self-adhesive resin cement containing 10-methacryloxydecyl-dihydrogenphosphate monomer to densely sintered zirconia ceramic, before and after thermal cycles. Hundred densely sintered zirconia cylinders were divided into five groups (n = 20). Each of them received a different surface treatment: (1) control [No_T], with the zirconia surface unconditioned, (2) low pressure air abrasion [Sand_S], (50 μm, 1 bar), (3) standardized air abrasion [Sand_H], (50 μm, 2.8 bar), (4) standardized Rocatec™ Plus (silica-coated alumina oxide) air abrasion (2.8 bar) and silanization [Roc_H], (5) low pressure Rocatec™ Plus (silica-coated alumina oxide) air abrasion (1 bar) and silanization [Roc_S]. Five more surface-treated specimens were addressed to scanning electron microscope for qualitative observations. After specimen fabrication, subgroups of 10 bonded samples were stored in water either for 24 h (T1) or subjected to 5000 thermal cycles (T2); SBSs were determined with a universal testing machine at a crosshead speed of 1 mm/min. At T1, mean SBSs (MPa) obtained for the examined groups were: [Sand_H] 16.24 ± 2.95; [Sand_S] 16.01 ± 2.68; [Roc_H] 17.17 ± 1.64; [Roc_S] 15.92 ± 1.99. All surface treatments positively affected (p < 0.05) the initial self-adhesive cement adhesion to zirconia with respect to No_T (13.29 MPa). Artificial aging decreased the bond strength in all test groups significantly, but no spontaneous debonding was observed in [No_T]: at T2, SBS values ranged from 7.76 ± 2.37 (No_T) to 8.89 ± 1.74 (Sand_S), with no statistically significant difference between groups (p = 0.5293). Both air abrasion with alumina oxide and Rocatec™ universal bonding system, used with hard or low air pressure, produced comparable effects on cement–zirconia interface before and after thermal cycles. After artificial aging, minimal differences in bond strength values between sandblasted and control groups were not of statistical significance.