Effect of Ceramic Thickness on the Bond Strength to Resin-Luting Agents before and after Thermal Cycling

Abstract This study investigated microshear bond strength (µSBS) of two (2) dual-cured resin-luting agents (RelyX™ Ultimate and RelyX™ U200) when photoactivated through varying thicknesses of lithium disilicate, with or without thermal cycling. Discs of IPS e.max Press of 0.5, 1.5, and 2 mm in thickness were obtained. Elastomer molds (3.0 mm in thickness) with four cylinder-shaped orifices 1.0 mm in diameter, were placed onto the ceramic surfaces and filled with resin-luting agents. A Mylar strip, glass plate, and load of 250 grams were placed over the filled mold. The load was removed and the resin-luting agents were photoactivated through the ceramics using a single-peak LED (Radii Plus.) All samples were stored in distilled water at 37oC for 24 h. Half of the samples were subjected to thermal cycling (3,000 cycles; 5ºC and 55ºC). All samples were then submitted to µSBS test using a universal testing machine (Instron 4411) at a crosshead speed of 0.5 mm/min. Data were submitted to three-way ANOVA and Tukey post-hoc test (α=0.05). The mean µSBS at 24 h was significantly higher than after thermal cycling (p<0.05). No statistical difference was found between resin-luting agents (p > 0.05). The mean µSBS for groups photoactivated through 0.5 mm ceramic were significantly higher than 1.5 mm and 2.0 mm (p < 0.05). In conclusion, increased ceramic thicknesses reduced the bond strength of tested resin-luting agents to lithium disilicate. No differences were found between resin-luting agents. Thermal cycling reduced the bond strength of both resin-luting agents.

Resumo: Este estudo investigou a resistência de união ao microcisalhamento (RUµC) de dois (2) agentes de cimentação de resina dual (RelyX™ Ultimate e RelyX™ U200) quando fotoativados através de diferentes espessuras de dissilicato de lítio, com ou sem ciclagem térmica. Discos do IPS e.max Press de 0,5, 1,5 e 2 mm de espessura foram obtidos. Moldes de elastômero (3,0 mm de espessura) com quatro orifícios cilíndricos de 1,0 mm de diâmetro foram colocados sobre as superfícies cerâmicas e preenchidos com agentes de cimentação de resina. Uma tira Mylar, placa de vidro e carga de 250 gramas foram colocadas sobre o molde preenchido. A carga foi removida e os agentes de cimentação resinosos foram fotoativados através da cerâmica usando um LED de pico-único (Radii Plus). Todas as amostras foram armazenadas em água deionizada a 37oC por 24 h. Metade das amostras foi submetida a ciclagem térmica (3.000 ciclos; 5ºC e 55ºC). Todas as amostras foram então submetidas ao teste de RUµC usando uma máquina de teste universal (Instron 4411) com velocidade de 0,5 mm/min. Os dados foram submetidos à Análise de Variância três fatores e ao teste post-hoc de Tukey (α = 0,05). A média de RUµC em 24 h foi significativamente maior do que após a ciclagem térmica (p < 0,05). Não houve diferença estatística entre os cimentos resinosos (p > 0,05). As médias de RUµC para grupos fotoativados através de cerâmica de 0,5 mm foram significativamente maiores do que 1,5 mm e 2,0 mm (p < 0,05). Em conclusão, o aumento da espessura da cerâmica reduziu a resistência de união dos agentes de cimentação resinosos ao dissilicato de lítio. Não foram encontradas diferenças entre os agentes de cimentação resinosos. A ciclagem térmica reduziu a resistência de união de ambos os agentes de cimentação resinosos.

Reparación de fractura aislada del mango del martillo con cemento ionomérico vidrioso autocurado / Repair of a malleus handle fracture using glass ionomer luting cement

Resumen La fractura aislada del mango del martillo es una entidad clínica poco habitual, pero frecuentemente subdiagnosticada. Lo fundamental es la sospecha clínica. El diagnóstico se confirma con la otoscopia neumática o la otomicroscopia con maniobra de Valsalva, en la cual se observa una movilidad anormal del mango del martillo. El rasgo de fractura se puede demostrar con tomografía computada de alta resolución o cone beam. Existen diferentes opciones de tratamiento como interposición de cartílago o uso de prótesis de reemplazo osicular así como cemento óseo. El cemento ionomérico vidrioso autocurado, muy utilizado en odontología, se ha usado en distintas cirugías otológicas con buenos resultados y biocompatibilidad. A nuestro saber no se ha usado en esta patología por lo que presentamos esta serie de tres casos en los cuales se ha usado esta novedosa técnica con buenos resultados clínicos.

Abstract Isolated fracture of the manubrium of the malleus is a rare clinical entity. Clinical suspicion is paramount. The usual clinical presentation is acute otalgia followed by tinnitus and fluctuating hearing loss after a brisk introduction and withdrawal of a finger into the external auditory canal. On physical examination, the eardrum looks normal on otoscopy. Only in pneumatic otoscopy or otomicroscopy with Valsalva an abnormal motility of the manubrium could bee seen. High-resolution computed tomography (CT) or cone beam CT is able to show the fracture line. Several treatment options have been proposed, such as interposition of bone or cartilage between the manubrium and the incus, total or partial ossicular replacement prosthesis; and the use of bone cement. Glass ionomer luting cement, with wide use in dentistry, has been used in several otological procedures with good biocompatibility and results, however, to our best knowledge, it has not been used to repair this type of fractures, so we present this novel material in three cases.

Effect of immediate dentin sealing, bonding technique, and restorative material on the bond strength of indirect restorations / Efeito do selamento imediato da dentina, técnica de união e material restaurador na resistência de união de restaurações indiretas

Objective: The objective of this study was to evaluate the effect of immediate dentin sealing, bonding technique, and restorative material on the dentin bond strength of an indirect composite (Solidex) and a resin nanoceramic CAD/CAM block (LAVA Ultimate). Material and Methods: A total of 120 periodontally extracted human molar teeth were abraded horizontally and divided into two groups according to dentin sealing procedures (delayed dentin sealing [DDS] and immediate dentin sealing [IDS]). Next, all teeth were attached to a simulated pulpal pressure mechanism. The specimens were removed from the mechanism after a week. Teeth were subdivided into three groups based on the bonding technique and the type of cement used (Acid-etching + Single Bond Universal + RelyX Ultimate, Single Bond Universal + RelyX Ultimate, RelyX Unicem). Each subgroup was further divided into 2 subgroups according to the type of restorative material used (Solidex [n = 10], Lava Ultimate CAD/ CAM restorative material [n = 10]). Sixty cylindrical samples prepared using both the restorative materials were bonded to the tooth surface according to their group's bonding procedures. All specimens were embedded in chemically cured acrylic resin for shear bond strength test. The shear bond strength (SBS) of the specimens was determined by a universal testing machine with a headspeed of 0.5 mm/min. Results: Three-way ANOVA, independent-sample t test and post hoc Tukey comparison tests (α=0.05) were performed on all data. There were significant differences between the groups. It was found that IDS process significantly increased bond strength in all groups. When dentin bond strengths of tested luting cements were compared, the highest bond strength values were recorded in groups in which the specimens were luted with RelyX Ultimate cement using etch-and-rinse technique. The lowest bond strength values were obtained from groups that used RelyX Unicem as the luting cement. Conclusion: IDS improves bond strength of indirect restorations. Moreover, bonding techniques may have critical effects on the dentin bond strength of indirect restorative materials. The cements' specific affinity levels to both restorative materials and dentin could be considered as the reason of the situation.(AU)

Objetivo: O objetivo deste estudo foi avaliar o efeito do selamento imediato da dentina, da técnica adesiva e do material restaurador na resistência de união à dentina de um compósito indireto (Solidex) e um bloco CAD / CAM de resina nanocerâmica (LAVA Ultimate). Material e Métodos: Um total de 120 dentes molares humanos extraídos por razões periodontais foram desgastados horizontalmente e divididos em dois grupos de acordo com os procedimentos de selamento dentinário (vedação tardia da dentina [DDS] e vedação imediata da dentina [IDS]). Em seguida, todos os dentes foram conectados a um equipamento de pressão pulpar simulada. As amostras foram removidas do equipamento após uma semana. Os dentes foram subdivididos em três grupos, com base na técnica de união e no tipo de cimento utilizado (ataque ácido + Single Bond Universal + RelyX Ultimate, Single Bond Universal + RelyX Ultimate, RelyX Unicem). Cada subgrupo foi então dividido em 2 subgrupos de acordo com o tipo de material restaurador utilizado (Solidex [n = 10], material restaurador Lava Ultimate CAD / CAM [n = 10]). Sessenta amostras cilíndricas preparadas com os dois materiais restauradores foram coladas na superfície do dente de acordo com os procedimentos de adesão do grupo. Todas as amostras foram embebidas em resina acrílica quimicamente ativada para o teste de resistência ao cisalhamento. A resistência de união ao cisalhamento (SBS) das amostras foi determinada por uma máquina de teste universal com uma velocidade de 0,5 mm / min. Resultados: ANOVA de três fatores, teste t de amostra independente e testes de comparação post hoc de Tukey (α = 0,05) foram realizados em todos os dados. Houve diferenças significativas entre os grupos. Verificou-se que o processo IDS aumentou significativamente a força de união em todos os grupos. Quando as forças de união da dentina dos cimentos testados foram comparadas, os valores mais altos de força de união foram registrados nos grupos em que as amostras foram cimentadas com cimento RelyX Ultimate usando a técnica "condicione e lave". Os menores valores de resistência de união foram obtidos de grupos que usaram como cimento o RelyX Unicem. Conclusão: O IDS melhora a força de união das restaurações indiretas. Além disso, as técnicas de união podem ter efeitos críticos na resistência da união à dentina de materiais restauradores indiretos. Os níveis de afinidade específicos dos cimentos para materiais restauradores e dentina podem ser considerados o motivo da situação.(AU)

Evaluación in vitro de la fuerza de desprendimiento y de la filtración marginal de coronas provisorias fijadas con diferentes agentes cementantes / In vitro evaluation of retention force and marginal leakage of temporary crowns using different luting agents

Objetivo: Analizar mediante pruebas in vitro la fuerza de desprendimiento y la microfiltración marginal de restauraciones coronarias temporales, realizadas sobre premolares, confeccionadas con tres tipos de resinas acrílicas y cementadas con tres materiales de fijación. Materiales y métodos: Se utilizaron 108 premolares a los que se les tallaron pilares con paredes convergentes hacia oclusal (8°), desgaste de 0,8 mm y chánfer a nivel adamantino. Las muestras fueron distribuidas en dos grupos: 54 muestras, para pruebas de desprendimiento; y 54, para pruebas de filtración. Los materiales utilizados en la confección de las coronas fueron: grupo A, resina de acrílico reticulado con relleno de micropartículas (Sistema Cerec, Sirona), grupo B, resina Duralay (Reliance Dental) y grupo C, resina Luxatemp (DMG). Para el cementado se emplearon: subgrupo I, cemento de hidróxido de calcio (Dycal; Dentsply); subgrupo II, cemento de óxido de zinc con el agregado de fluoruros, clorhexidina y nitrato de potasio (GC Temp Advantage; American In); subgrupo III, cemento de ZnO con el agregado de silicona y silano (Temposil; Coltène). Se desarrolló el estudio in vitro de la fuerza de desprendimiento y se realizó un análisis de correlación entre la fuerza (N) requerida para el desalojo de las coronas y la superficie de unión corona-diente (mm2). El análisis de filtración fue efectuado con lupa estereoscópica Olympus (20X y 32X), posicionando las muestras sobre portaobjeto y accionando luz incidente blanca. Por contraste colorimétrico, se determinó el grado de filtración por la penetración longitudinal del colorante en la interfaz diente-restauración. Resultados: Se encontró correlación significativa entre la fuerza requerida para el desalojo de las coronas y la superficie de unión corona diente (correlación de Pearson: 0,423, P=0,0001). Los valores medios obtenidos de la fuerza de desprendimiento fueron: grupo A, 41,09 N; grupo B, 43,52 N; grupo C, 41,26 N, sin diferencias significativas (P=0,484). Con respecto al factor cemento, subgrupo I, 56,87 N; subgrupo II, 40,75 N; y subgrupo III, 28,25 N, y la diferencia fue estadísticamente significativa (P=0,0001). En relación con las pruebas de filtración marginal in vitro considerando solo el factor categoría corona, se observó que los valores de longitud de filtración estuvieron dentro de rangos similares en los tres grupos, aunque el grupo B registró los valores más altos. Teniendo en cuenta solo el factor cemento, el subgrupo II arrojó los valores más bajos, en tanto que los subgrupos I y III registraron valores semejantes y algo mayores, con una media de 0,94 mm y 1,00 mm, respectivamente. La combinación que arrojó menor penetración fue la del grupo A con el subgrupo II (media de 0,62 mm), en tanto que la combinación con valores de longitud o profundidad de filtración más elevados fue la del grupo B con el subgrupo III (media de 1,25 mm), aunque no se alcanzaron diferencias estadísticamente significativas. Conclusión: Se pudo observar que las coronas cementadas con hidróxido de calcio generan las mejores condiciones referidas a la fuerza de desprendimiento, y que las confeccionadas por el sistema Cerec Sirona, mediante tecnología CAD-CAM y cementadas con cemento de óxido de zinc con el agregado de fluoruros, clorhexidina y nitrato de potasio, podrían ofrecen mejores propiedades en cuanto a la filtración marginal (AU)

Aim: To in-vitro analyze the detachment force and the marginal leakage of bicuspid temporary crowns made with three types of acrylic resins and cemented with three luting agents, Materials and methods: 108 premolars were used to drill 0.8 mm depth preparations with 8° taper and chamfer at adamantine level. Half of the specimens were used for detachment tests and the other for leakage. Temporary crowns were fabricated using: group A, acrylic resin with microparticle fillers (Cerec System, Sirona); group B, Duralay resin (Reliance Dental); and group C, Luxatemp resin (DMG). Dycal calcium hydroxide cement (Dentsply)subgroup I, zinc oxide cement with added fluorides, chlorhexidine and potassium nitrate GC TempAdvantage (American In) subgroup II and zinc oxide cement with silicone aggregate and Temposil Silane (Coltène) subgroup III, were used as luting agents and the load required to detach each of the crowns was determined. A correlation analysis was performed between the force (N) required and the crown-tooth involved area (mm2). Microleakage was assessed using an Olympus stereomicroscope (20X and 32X), under white incident light. By colorimetric contrast, the degree of leakage was defined by the longitudinal penetration of a dye at the tooth-restoration interface. Results: Significant correlation (Pearson: 0.423, P=0.0001) was found between force of detachment and surface. Average values obtained from the detachment force were: group A, 41.09 N; group B, 43.52 N; group C, 41.26 N, without significant differences (P=0.484). The cement factor, subgroup I, 56.87 N; subgroup II 40.75 N; and subgroup III, 28.25 N, was found significant (P=0.0001). Leakage was similar in the three groups, although group B recorded the highest values. Taking into account only the cement factor subgroup II yielded the lowest values, while subgroups I and III recorded similar and somewhat higher values, with an average of 0.94 mm and 1,00 mm, respectively. The combination that showed the lowest penetration was that of group A with subgroup II (average 0.62 mm), while the combination with higher values was seen in group B with subgroup III (average 1.25 mm). Conclusion: Temporary crowns cemented with calcium hydroxide generated the best conditions related to the detachment strength and temporary crowns fabricated using Cerec System with CAD-CAM tecnology, luted with a zinc oxide cement with the addition of fluorides, chlorhexidine and potassium showed, although not significant statistically, better properties in terms of marginal leakage (AU)

Feldspar ceramic strength and the reinforcing effect by adhesive cementation under accelerated aging

Abstract 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.

Resumo Este estudo avaliou o efeito do envelhecimento artificial acelerado (EAA) na resistência da cerâmica feldspática e o reforço promovido pela cimentação adesiva com cimento resinoso. Cento e vinte discos de cerâmica feldspática foram obtidos. Sessenta discos foram condicionados com ácido, silanizados, e recobertos com um cimento resinoso experimental simulando os procedimentos de cimentação adesiva. Quatro grupos foram criados (n=30): cerâmica sem recobrimento (grupo controle), cerâmica sem recobrimento submetida ao EAA, cerâmica recoberta com cimento resinoso, cerâmica recoberta com cimento resinoso submetida ao EAA. O teste de resistência à flexão biaxial foi realizado utilizando o dispositivo pistão-anel. Resistência à flexão biaxial (s fb , MPa), resistência característica (s 0 , MPa), e módulo de Weibull (m) foram calculados para as posições axiais z=0 (superfície da cerâmica) e z=−t2 (superfície do cimento). Os dados de s fb em z=0 e z=−t2 foram submetidos a análises estatísticas separadamente (a=0,05). A cerâmica não recoberta submetida ao EAA não teve diferença significante na s fb e s 0 comparada com o grupo controle. O recobrimento com cimento resinoso da cerâmica aumentou a s fb e s 0 em z=0. O EAA aumentou a s fb e s 0 para os espécimes de cerâmica recobertos com cimento resinoso em z=0 e também a s 0 em z=−t2. A confiabilidade em z=0 e z=−t2 não foi influenciada pelas variáveis testadas. Concluindo, o recobrimento com cimento resinoso melhorou a resistência mecânica da cerâmica feldspática. O procedimento de EAA não foi efetivo em envelhecer os espécimes de cerâmica feldspática recobertos ou não com cimento resinoso.

Influence of Zingiber officinale Extract on Push-Out Bond Strength of Glass-Fiber Post

Abstract The aim of this study was to evaluate in vitro the influence of 20% glycolic ginger extract on the bond strength of glass-fiber post cemented with etch-and-rinse or self-etching resin cement. Forty-eight bovine roots were standardized (17±0.5 mm) and randomly divided into two groups, according to irrigant used during biomechanical preparation: NaOCl: 1% sodium hypochlorite and GEN: 20% glycolic ginger extract. Root canal was prepared and randomly assigned to one of two subgroups (n=12), according to luting protocol: self-etching (RelyX U200) and etch-and-rinse (RelyX ARC). After 48 h, the roots were sectioned perpendicularly (4 in cervical third and 3 in middle third) and submitted to push-out bond strength test (50 kgf load cell, 1.0 mm/min). Failure mode was analyzed in SEM and stereomicroscopy. Data were analyzed by three-way ANOVA and Tukey tests (p<0.05). ANOVA revealed that there were no significant differences between U200 (2.01±0.17)B and ARC (1.93±0.12)B in GEN group, and at the cervical third for both irrigants, 2.69±0.16A and 2.54±0.17A, respectively. Middle third showed lower bond strength than cervical third, regardless the irrigant. Overall, the cervical third regardless the irrigant employed and the association between NaOCl and ARC, presented better adhesive performance.

Resumo O objetivo deste estudo foi avaliar in vitro a influência do extrato de gengibre 20% na resistência adesiva de pinos de fibra de vidro cimentados com cimentos resinosos convencional ou autocondicionantes. Quarenta e oito raízes bovinas foram padronizadas (17±0.5mm) e aleatoriamente divididas em dois grupos (n=24), de acordo com o irrigante utilizado durante o preparo biomecânico: NaOCl: hipoclorito de sódio 1%; e GEN: extrato glicólico de gengibre 20%. Os canais radiculares foram preparados e aleatoriamente distribuídos em dois subgrupos (n=12), conforme o protocolo de cimentação: autocondicionante (RelyX U200) e convencional (RelyX ARC). Após 48 h, as raízes foram seccionadas perpendicularmente (4 no terço cervical e 3 no terço médio) e submetidas ao teste de resistência adesiva push-out (50 kgf carga, 1.0 mm/min). O modo de falha foi analisado em MEV e estereomicroscopia. Os dados foram analisados pelos testes ANOVA 3-fatores e Tukey (p<0.05). ANOVA mostrou que não houve diferenças significativas entre U200 (2.01±0.17)B e ARC (1.93±0.12)B no grupo GEN, e no terço cervical para ambos os irrigantes (2.69±0.16A and 2.54±0.17A, respectivamente). O terço médio apresentou menor resistência adesiva que o terço cervical, independente do irrigante. Em geral, o terço cervical, independentemente do irrigante empregado, e a associação entre NaOCl e ARC apresentaram melhores desempenhos adesivos.

The effect of continuous application of MDP-containing primer and luting resin cement on bond strength to tribochemical silica-coated Y-TZP

OBJECTIVES: This study investigated the effect of continuous application of 10-methacryloyloxydecyldihydrogen phosphate (MDP)-containing primer and luting resin cement on bond strength to tribochemical silica-coated yttria-stabilized tetragonal zirconia polycrystal (Y-TZP). MATERIALS AND METHODS: Forty bovine teeth and Y-TZP specimens were prepared. The dentin specimens were embedded in molds, with one side of the dentin exposed for cementation with the zirconia specimen. The Y-TZP specimen was prepared in the form of a cylinder with a diameter of 3 mm and a height of 10 mm. The bonding surface of the Y-TZP specimen was sandblasted with silica-coated aluminium oxide particles. The forty tribochemical silica-coated Y-TZP specimens were cemented to the bovine dentin (4 groups; n = 10) with either an MDP-free primer or an MDP-containing primer and either an MDP-free resin cement or an MDP-containing resin cement. After a shear bond strength (SBS) test, the data were analyzed using 1-way analysis of variance and the Tukey test (α = 0.05). RESULTS: The group with MDP-free primer and resin cement showed significantly lower SBS values than the MDP-containing groups (p < 0.05). Among the MDP-containing groups, the group with MDP-containing primer and resin cement showed significantly higher SBS values than the other groups (p < 0.05). CONCLUSIONS: The combination of MDP-containing primer and luting cement following tribochemical silica coating to Y-TZP was the best choice among the alternatives tested in this study.

Shear Bonding Strength of Three Cements Luted on Pediatric Zirconia Crowns and Dentin of Primary Teeth / 대한소아치과학회지

The aim of this study was to evaluate the shear bond strength of three luting cements and to identify the effect of thermocycling.Zirconia discs were made similar to the inner surface of a preformed pediatric zirconia crown (NuSmile® ZR crown: ZRCr). The similarity between the zirconia discs and the inner surface of a ZRCr was confirmed by scanning electron microscope. Three luting cements were Ketac™ Cem Permanent Glass Ionomer Luting Cement (KGI), RelyX™ Luting Plus Cement (RLP), RelyX™ Unicem Self-Adhesive Universal Resin Cement (RUR). Three luting cements were bonded according to the manufacturer's instructions for 60 zirconia discs and 60 dentin of primary teeth. Total of 120 specimens were divided into two subgroups: One was not aged, and the other was tested with 5500 thermocycling. Shear bond strength was measured using a universal testing machine, and the fracture patterns were observed with SEM.On the zirconia discs and the dentin of primary teeth, shear bond strength of RUR was higher than that of KGI and RLP, and there were statistically significant differences by cement type. The shear bond strength differences for RUR were not statistically significant depending on thermocycling.

Effect of liners and primers on tensile bond strength between zirconia and resin-based luting agent

PURPOSE: The effect of silica-based glass-ceramic liners on the tensile bond strength between zirconia and resin-based luting agent was evaluated and compared with the effect of 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-containing primers. MATERIALS AND METHODS: Titanium abutments and zirconia crowns (n = 60) were fabricated, and the adhesive surfaces of the specimens were treated by airborne-particle abrasion. The specimens were divided into 5 groups based on surface treatment: a control group, 2 primer groups (MP: Monobond Plus; ZP: Z Prime Plus), and 2 liner groups (PL: P-containing Liner; PFL: P-free Liner). All specimens were cemented with self-adhesive resin-based luting agent. After 24-hour water storage and thermocycling (5,000 cycles, 5℃/55℃), the tensile bond strength was measured using a universal testing machine. Failure mode analysis and elemental analysis on the bonding interface were performed. The data were analyzed using Kruskal-Wallis test, Dunn's post hoc test, and Fisher's exact test. RESULTS: The liner groups and primer groups showed significantly higher tensile bond strengths than that of the control group (P < .05). PFL showed a significantly higher tensile bond strength than the primer groups (P < .05). The percentage of mixed failure was higher in the primer groups than in the control group (P < .001), and all the specimens showed mixed failure in the liner groups (P < .001). A chemical reaction area was observed at the bonding interface between zirconia and liner. CONCLUSION: The application of liner significantly increased the tensile bond strength between zirconia and resin-based luting agent. PFL was more effective than MDP-containing primers in improving the tensile bond strength with the resin-based luting agent.

Effects of abutment diameter, luting agent type, and re-cementation on the retention of implant-supported CAD/CAM metal copings over short abutments

PURPOSE: The aim of this study was to evaluate the effects of abutment diameter, cement type, and re-cementation on the retention of implant-supported CAD/CAM metal copings over short abutments. MATERIALS AND METHODS: Sixty abutments with two different diameters, the height of which was reduced to 3 mm, were vertically mounted in acrylic resin blocks with matching implant analogues. The specimens were divided into 2 diameter groups: 4.5 mm and 5.5 mm (n=30). For each abutment a CAD/CAM metal coping was manufactured, with an occlusal loop. Each group was sub-divided into 3 sub-groups (n=10). In each subgroup, a different cement type was used: resin-modified glass-ionomer, resin cement and zinc-oxide-eugenol. After incubation and thermocycling, the removal force was measured using a universal testing machine at a cross-head speed of 0.5 mm/min. In zinc-oxide-eugenol group, after removal of the coping, the cement remnants were completely cleaned and the copings were re-cemented with resin cement and re-tested. Two-way ANOVA, post hoc Tukey tests, and paired t-test were used to analyze data (α=.05). RESULTS: The highest pulling force was registered in the resin cement group (414.8 N), followed by the re-cementation group (380.5 N). Increasing the diameter improved the retention significantly (P=.006). The difference in retention between the cemented and recemented copings was not statistically significant (P=.40). CONCLUSION: Resin cement provided retention almost twice as strong as that of the RMGI. Increasing the abutment diameter improved retention significantly. Re-cementation with resin cement did not exhibit any difference from the initial cementation with resin cement.

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

OBJECTIVES: The 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 METHODS: The 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. RESULTS: The 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. CONCLUSIONS: The 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.

Effects of pulsed Nd:YAG laser radiation on marginal microleakage of porcelain-fused-to-metal crowns / 国际生物医学工程杂志

Objective To study the effects of pulsed Nd:YAG laser radiation on the marginal microleakage of porcelain-fused-to-metal crowns. Methods Twenty in vitro premolar teeth were selected and processed by standard porcelain crown preparation. The porcelain-fused-to-metal crowns were made based on the relevant repair technical requirements. The restorations were randomly divided into control group (group A) and experimental group (group B). The restorations in the group B were treated by external Nd:YAG laser irradiation with power of 1.25 W and irradiation time of 20 s. All the restorations were fixed with composite resin cement, and then put into normal saline under 37℃for 20 d, during which 300 times thermal cycling were performed. After that, the restorations were placed into 0.5％ pinkish red solution for 24 hours to dyeing, and then dissected along the longitudinal axis. The marginal microleakage of the restoration was observed by a stereomicroscopy. The data were processed by the SPSS 19.0 software. Results The degree of marginal microleakage of the restorations after Nd:YAG laser irradiation was significantly lower than that in the control group (P<0.05). Conclusions The pulsed Nd:YAG laser irradiation can effectively improve the adhesion between the resin and the hard tissue of the teeth, and reduce the marginal microleakage of the porcelain-fused-to-metal crowns.

Effect of cement type on the color attributes of a zirconia ceramic

PURPOSE: This in vitro study evaluated the effects of four different cements on the color attributes of a zirconia ceramic. MATERIALS AND METHODS: 40 zirconia ceramic disk specimens (0.5 mm thickness, 10 mm diameter, 0.1 mm cement space) were fabricated by a computer-aided design and computer-aided manufacturing system. The specimens were divided into 4 groups of 10 specimens and cemented to composite substrates using four different cements including: Glass Ionomer, Panavia F2.0, Zinc Phosphate, and TempBond. The L*, a*, and b* color attributes of the specimens were measured before and after cementation by a spectrophotometer. Additionally, ΔE values were measured to determine color changes for the groups and then compared with the perceptional threshold of ΔE = 3.3. Repeated Measures ANOVA, Tukey Post Hoc, Bonferroni, One-way ANOVA, and One-sample t-test tests were used to analyze the data. All tests were carried out at the 0.05 level of significance. RESULTS: Statistically significant differences were detected in the ΔE values for Zinc Phosphate (P<.0001) and TempBond (P<.0001) groups. However, there were no statistically significant differences in this respect for Glass Ionomer (P=.99) and Panavia F2.0 (P=1) groups. The means and standard deviations of the ΔE values for Glass Ionomer, Panavia F2.0, Zinc Phosphate, and Tempbond groups were 2.11±0.66, 0.94±0.39, 5.77±0.83, and 7.50±1.16 Unit, respectively. CONCLUSION: Within the limitations of this study, it was concluded that Zinc Phosphate and Tempbond cements affected the color attributes of the tested zirconia ceramic beyond the perceptional threshold. However, Glass Ionomer and Panavia F2.0 cements created acceptable color changes.

Comparative study of the radiopacity of resin cements used in aesthetic dentistry

PURPOSE: The aim of this study was to compare the radiopacity of 6 modern resin cements with that of human enamel and dentine using the Digora digital radiography system, to verify whether they meet the requirements of ANSI/ADA specification no. 27/1993 and the ISO 4049/2000 standard and assess whether their radiopacity is influenced by the thickness of the cement employed. MATERIALS AND METHODS: Three 3-thickness samples (0.5, 1 and 1.5 mm) were fabricated for each material. The individual cement samples were radiographed on the CCD sensor next to the aluminium wedge and the tooth samples. Five radiographs were made of each sample and therefore five readings of radiographic density were taken for each thickness of the materials. The radiopacity was measured in pixels using Digora 2.6 software. The calibration curve obtained from the mean values of each step of the wedge made it possible to obtain the equivalent in mm of aluminium for each mm of the luting material. RESULTS: With the exception of Variolink Veneer Medium Value 0, all the cements studied were more radiopaque than enamel and dentin (P<.05) and complied with the ISO and ANSI/ADA requirements (P<.001). The radiopacity of all the cements examined depended on their thickness: the thicker the material, the greater its radiopacity. CONCLUSION: All materials except Variolink Veneer Medium Value 0 yielded radiopacity values that complied with the recommendations of the ISO and ANSI/ADA. Variolink Veneer Medium Value 0 showed less radiopacity than enamel and dentin.

Correlation between clinical performance and degree of conversion of resin cements: a literature review

AbstractResin-based cements have been frequently employed in clinical practice to lute indirect restorations. However, there are numerous factors that may compromise the clinical performance of those cements. The aim of this literature review is to present and discuss some of the clinical factors that may affect the performance of current resin-based luting systems. Resin cements may have three different curing mechanisms: chemical curing, photo curing or a combination of both. Chemically cured systems are recommended to be used under opaque or thick restorations, due to the reduced access of the light. Photo-cured cements are mainly indicated for translucent veneers, due to the possibility of light transmission through the restoration. Dual-cured are more versatile systems and, theoretically, can be used in either situation, since the presence of both curing mechanisms might guarantee a high degree of conversion (DC) under every condition. However, it has been demonstrated that clinical procedures and characteristics of the materials may have many different implications in the DC of currently available resin cements, affecting their mechanical properties, bond strength to the substrate and the esthetic results of the restoration. Factors such as curing mechanism, choice of adhesive system, indirect restorative material and light-curing device may affect the degree of conversion of the cement and, therefore, have an effect on the clinical performance of resin-based cements. Specific measures are to be taken to ensure a higher DC of the luting system to be used.

Comparación de la fuerza adhesiva de 2 sistemas de cementos de resina en diferentes regiones radiculares en la cementación de postes de fibra / Comparison of bond strength of two resin cement systems in different roots region on the cementation of fiber posts

La causa de fracaso más común de los postes de fibra es su desalojo, principalmente debido a la compleja adhesión dentro del conducto radicular. El principal objetivo de este estudio fue determinar si existe diferencia significativa en la resistencia adhesiva mediante el test push-out en la cementación de postes de fibra con RelyX U-200® (U200) y Core Paste XP® (CPX) en diferentes regiones radiculares. MATERIALES Y MÉTODOS Se seleccionaron 40 premolares, se seccionaron a 15 mm del ápice, fueron tratados endodóncicamente y fueron divididos aleatoriamente en 2 grupos de 20, a los cuales se les cementó un poste de fibra translúcido Exacto® con U200 y CPX. Después de 24 h cada muestra fue seccionada transversalmente a nivel cervical, medio y apical. Fueron sometidas al test de push-out mediante la máquina Tinius Olsen HK5-S para cuantificar la resistencia adhesiva en megapascales. Se utilizó el test Shapiro-Wilk, test de ANOVA de 2 factores y Tukey con un nivel de significación del 95%. RESULTADOS No hubo diferencia significativa de ambos cementos (p = 0,457), pero sí hubo diferencia cuando se comparó el tipo de cemento y la región; CPX presentó valor significativamente mayor en el tercio cervical (p < 0,05), mientras que U200 presentó un valor significativamente mayor en el tercio apical (p < 0,05). CONCLUSIONES No hubo diferencia significativa en el valor de adhesión cuando se comparó solo el factor cemento entre U200 y CXP, sin embargo hubo un mayor valor de CXP a nivel cervical y de U200 a nivel apical.

Loosening is the most common failure of fiber posts, mainly due to complex adhesion within the root canal. The main objective of this study was to determine if significant differences in adhesive resistance, using the push-out test, in the cementation of fiber posts with RelyX U-200® (U200) and Core Paste XP® (CPX) in different root regions. MATERIALS AND METHODS A selection of 40 premolars were sectioned 15 mm from the apex, treated endodontically and then randomly divided in two groups of 20, using an Exacto translucent fiber post with U200 and CPX, respectively. After 24 hours, each sample was sectioned into cervical, middle and apical. The test push-out test was performed using a Tinius Olsen HK5-S machine to quantify the adhesive strength in Mega Pascals. The test Shapiro-Wilk, two-factor Anova and Tukey tests were used with a significance level of 95% RESULTS There were no significant differences between the cements (P = .457) but if there was difference when comparing the type of cement and region. CPX showed a value significantly higher in the cervical third (P < .05), while U200 presented a value significantly higher in the apical third (P < .05). CONCLUSIONS There was no significant difference in the value of the adhesive strength in the comparison between U200 and CXP, however there was a higher value of CXP at cervical and U200 at apical level.

Electron Beam Irradiation of Resin Luting Agents - a Cytotoxic Evaluation on Dental Pulp Cells.

Aim: The aim of this study was to evaluate the cytotoxicity of three resin luting agents Rely X luting cement, Rely X luting 2 cement and Clearfil SA luting cement before and after electron beam irradiation. Materials and Methods: Growth and maintenance of cell cultures of human pulp cells was done in Dulbecco’s modified Eagle’s Medium (DMEM). The test samples were divided into two Categories: Irradiated Category and Non-radiated Category. Samples in Irradiated category were exposed to electron beam radiation at 200Gy. Three subgroups of radiated category and non radiated category were made. All the samples were subjected to MTT assay and spectrophotometric analysis and their cytotoxicity was assessed. Statistical analysis was done using t test. Results: Evaluation of Rely X luting Cement showed that radiated samples of powder, liquid and set cements showed decreased cell viability than non radiated samples. In Case of Rely X luting 2 cement, radiated samples showed increased cell viability for Paste A and Paste B samples. But in set material, irradiated samples showed decreased cell viability as compared to non radiated samples. For Clearfil SA luting Cement, Paste B showed increased cell viability for radiated samples. Paste A and Set cement of radiated samples showed decreased cell viability than non radiated samples. Conclusion: In the present study , the increased cytotoxicity of irradiated samples may be due to increase in the release of unbound monomers which may be due to chain breakage after irradiation and a reduction in the cytotoxicity which may be due to the cross linking of unbound monomers during irradiation.

In Vitro Tensile Strength of Luting Cements on Metallic Substrate

The aim of this study was to determine the tensile strength of crowns cemented on metallic substrate with four different types of luting agents. Twenty human maxillary molars with similar diameters were selected and prepared to receive metallic core castings (Cu-Al). After cementation and preparation the cores were measured and the area of crown's portion was calculated. The teeth were divided into four groups based on the luting agent used to cement the crowns: zinc phosphate cement; glass ionomer cement; resin cement Rely X; and resin cement Panavia F. The teeth with the crowns cemented were subjected to thermocycling and later to the tensile strength test using universal testing machine with a load cell of 200 kgf and a crosshead speed of 0.5 mm/min. The load required to dislodge the crowns was recorded and converted to MPa/mm2. Data were subjected to Kruskal-Wallis analysis with a significance level of 1%. Panavia F showed significantly higher retention in core casts (3.067 MPa/mm2), when compared with the other cements. Rely X showed a mean retention value of 1.877 MPa/mm2 and the zinc phosphate cement with 1.155 MPa/mm2. Glass ionomer cement (0.884 MPa/mm2) exhibited the lowest tensile strength value. Crowns cemented with Panavia F on cast metallic posts and cores presented higher tensile strength. The glass ionomer cement showed the lowest tensile strength among all the cements studied.

O objetivo deste estudo foi determinar a resistência à tração de coroas cimentadas em substrato metálico com quatro diferentes tipos de agentes cimentantes. Vinte molares humanos maxilares com diâmetros semelhantes foram selecionados e preparados para receberem núcleos metálicos fundidos (Cu-Al). Após cimentação e preparo, os núcleos foram mensurados e a área da porção coronária foi calculada. Os dentes foram divididos em quatro grupos baseados no agente cimentante utilizado para cimentar as coroas: cimento de fosfato de zinco; cimento de vidro ionômero; cimento resinoso Rely X; e cimento resinoso Panavia F. Os dentes com as coroas cimentadas foram submetidos a termociclagem e logo à prova de resistência à tração usando a máquina de ensaios universal com uma célula de carga de 200 kgf e uma velocidade de 0,5 mm/min. A carga necessária para deslocar as coroas foi registrada e convertida a MPa/mm2. Os dados foram submetidos ao análise de Kruskal-Wallis com um nível de significância de 1%. Panavia F mostrou uma retenção significativamente maior nos núcleos fundidos (3,067 MPa/mm2), quando comparados com os outros cimentos. Rely X mostrou um valor médio de retenção de 1,877 MPa/mm2 e o cimento de fosfato de zinco com 1,155 MPa/mm2. O cimento de vidro ionômero (0,884 MPa/mm2) exibiu o menor valor de resistência à tração. As coroas cimentadas com Panavia F nos pinos e núcleos metálicos fundidos apresentaram maior resistência à tração. O cimento de ionômero de vidro mostrou o menor valor de resistência à tração entre todos os cimentos estudados.

Restauración postendodóntica en conductos radiculares amplios / Postendodontic restoration in wide root canals

Gracias al auge que tiene la implantología en la actualidad y al aumento del porcentaje de éxitos de la misma, los clínicos ahora, antes que intentar prolongar la vida del órgano dental afectado en la cavidad oral, prefieren realizar una extracción. Siguiendo los cánones de la odontología conservadora, ponemos a consideración una técnica que puede ayudar, como última opción, a mantener dientes tratados endodónticamente, antes de llevar a cabo su extracción. Esta técnica ya ha sido propuesta y debidamente investigada por algunos autores. Esta propuesta se aplica a dientes con conductos radiculares amplios, los cuales se han debilitado por restauraciones deficientes, desmineralización de la dentina, por filtraciones en la corona y poste radicular o simplemente conductos amplios en pacientes de corta edad. Tenemos la firme convicción que no podremos garantizar la permanencia de un órgano dental en la cavidad oral, pero sí podemos intentar alargarle su permanencia en el alvéolo. Por eso damos a conocer la técnica de rellenar previamente el conducto con ionómero de vidrio de alta densidad. Este material dental tiene un módulo de elasticidad similar a la dentina, lo que aumenta su integridad y mejora la técnica al colocar un poste con menor cantidad de cemento o al emplear un poste demasiado amplio.

With the boom in implantology in today’s dentistry and its undeniable success, many clinicians now prefer to perform an extraction rather than extend the life of the tooth. According to the standards of conservative dentistry, we propose a technique that could be useful as a final option before resorting to an extraction, for teeth on which a root canal has been performed in the past. This type of treatment has been described and properly researched by several authors. It can be applied in wide root canals that have been weakened by poor restorations or demin-eralization of the dentin caused by a filtration through the crown, or simply in young patients with wide canals. Whilst we cannot guarantee that a tooth be preserved indefinitely, we do believe we can make it last longer. For this reason, we describe the technique that involves first filling the root canal with high-density glass ionomer —a dental material that has a modulus of elasticity similar to that of dentin—, which increases its integrity. This makes for an improved technique when posts are inserted as less luting cement is used and eliminates the need to use a wider post.

Cimentação em cerâmicas: evolução dos procedimentos convencionais e adesivos / Cementation in ceramics: improvement of conventional and adhesive procedures

O objetivo deste estudo foi coletar dados científicos para revisão de literatura sobre cimentação de cerâmicas, ressaltando propriedades, técnicas, indicações e contraindicações. O agente cimentante ideal deve apresentar como principais características alta resistência à compressão, tração e cisalhamento, além de selamento marginal adequado, baixa solubilidade aos fluidos bucais e espessura mínima de película. Em relação à técnica, foi observado que diferenças na microestrutura e composição dos sistemas cerâmicos exigem protocolos específicos de preparo da peça cerâmica e da superfície dentária. Atualmente, os tipos de agentes cimentantes disponíveis são: fosfato de zinco, ionômero de vidro convencional e modificado por resina, cimentos resinosos e autoadesivos. A evolução desses materiais ocorre no sentido de melhorar propriedades e simplificar a técnica.

The objective of the study was to collect scientific data to perform a literature review of ceramic cementation, highlighting their properties, techniques, indications and contraindications. An ideal luting agent has to present as main characteristics high compressive strength, tensile and shear, adequate marginal sealing, low solubility to oral fluids and minimal thickness of film. Concerning the technique, it was observed that differences on microstructure and composition on ceramic systems require specific protocols on preparation for the ceramic structure and for the dental element surface. Nowadays, the available luting agents are: zinc phosphate, conventional and modified glass ionomer, resin cements and self adhesive cements. The evolution of these materials occurs to improve properties and to simplify technique.