Quemadura química por ácido fluorhídrico: mecanismos fisiopatológicos de la lesión / Hydrofluoric acid burn: pathophysiological mechanisms of injury / Queimadura química por ácido fluorídrico: mecanismos fisiopatológicos da lesão

Resumen: Las quemaduras por exposición a químicos son una forma de lesión poco frecuente; sin embargo, los efectos secundarios se pueden considerar catastróficos a corto, mediano y largo plazo. El ácido fluorhídrico es una sustancia química perteneciente a los ácidos, tiene aplicación industrial y doméstica, y se encuentra en diferentes concentraciones. El fluoruro de hidrógeno está formado por un ion hidrógeno y un ion fluoruro, que al entrar en contacto con el agua adquiere su estado ácido, característica que le confiere mayor lesión de tejidos al entrar en contacto con ellos. Reportes describen lesiones de 1% de superficie corporal quemada, en una concentración al 50% capaz de generar toxicidad local y sistémica, que deriva en la muerte en cuestión de horas si no recibe un manejo oportuno encaminado a frenar el mecanismo de lesión, el cual se asocia a disminución de electrolitos calcio y magnesio, así como elevación de potasio, no sin dejar de lado la lesión corrosiva a nivel local que condiciona la aparición de necrosis licuefactiva. El objetivo de este trabajo es dar a conocer al personal médico y paramédico el mecanismo de lesión del ácido fluorhídrico, sus implicaciones clínicas y las alternativas terapéuticas.

Abstract: Chemical exposure burns are a rare form of injury; however, side effects can be considered catastrophic, in the short, medium and long term. Hydrofluoric acid is a chemical substance belonging to acids, it has industrial and domestic application, being in different concentrations. Hydrogen fluoride is made up of a hydrogen ion and a fluoride ion, which, when in contact with water, acquires its acid state, a characteristic that it acquires gives it greater tissue damage when in contact with them. Literary reports described injuries of 1% of the burned body surface, in a concentration of 50% capable of generating local and systemic toxicity, which leads to death in a matter of hours, if the patient does not receive timely management aimed at stopping the mechanism of injury. which is associated with a decrease in calcium and magnesium electrolytes, as well as an increase in potassium, not without neglecting the corrosive lesion at the local level that conditions the appearance of liquefactive necrosis. The objective of this work is to make known to the personal physician and paramedic the mechanism of injury of hydrofluoric acid, its clinical implications and the therapeutic alternatives.

Resumo: As queimaduras por exposição química são uma forma rara de lesão, porém, os efeitos secundários podem ser considerados catastróficos, a curto, médio e longo prazo. O ácido fluorídrico é uma substância química pertencente aos ácidos, possui aplicação industrial e doméstica, sendo encontrado em diferentes concentrações. O fluoreto de hidrogênio é formado por um íon hidrogênio e um íon fluoreto, que quando em contato com a água adquire seu estado ácido, característica que lhe confere maior dano tecidual quando em contato com eles. Relatos literários descrevem lesões de 1% da superfície corporal queimada, em concentração de 50% capaz de gerar toxicidade local e sistêmica, que leva à morte em questão de horas, se não receber tratamento oportuno visando coibir o mecanismo da lesão que está associada a uma diminuição dos eletrólitos de cálcio e magnésio, bem como a um aumento de potássio, não sem deixar de lado a lesão corrosiva a nível local que condiciona o aparecimento de necrose liquefativa. O objetivo deste trabalho é informar o pessoal médico e paramédico sobre o mecanismo de lesão causada pelo ácido fluorídrico, suas implicações clínicas e alternativas terapêuticas.

Surface treatment and adhesion approaches on polymer-infiltrated ceramic network: influence on the bond strength to resin cement

Aim: To evaluate the effect of different surface treatments and adhesive approaches on the microshear bond strength of resin cement to a polymer-infiltrated ceramic network (PICN). Methods: PICN blocks were randomly assigned into 9 groups (n=10): CTRL: no treatment; HF: 5% hydrofluoric acid etching; HF-S: HF + silane; HF-S-A: HF-S + adhesive (Adper Single Bond 2); HF-UA: HF + universal adhesive (Single Bond Universal); SB: sandblasting with 50 µm Al2O3 particles; SB-S: SB + silane; SB-S-A: SB-S + adhesive; SB-UA: SB + universal adhesive. Resin cement microcylinders (Ø = 0.96 mm; height = 1 mm) (RelyX Ultimate) were built upon the PICN surface after roughness and contact angle measurements. Next, microshear bonding tests (µSBS) were performed (0.5 mm/min) after water storage (37ºC, 90 days) and thermocycling (12,000 cycles; 5ºC-55ºC). Failure modes were observed under stereomicroscope. Bond strength data were analyzed by two-way ANOVA/Tukey's test and t-tests. Kruskal-Wallis/Dunn's tests were conducted for roughness and contact angle data (α = 0.05). Results: A rougher surface and lower contact angles were observed for Sandblasting. HF-S (18.54 ± 2.03 MPa), SB-S (19.00 ± 1.66 MPa) and SB-UA (18.07 ± 2.36 MPa) provided the highest bond strength values, followed by the other treated groups. The CTRL group resulted in lower bond strength (7.18 ± 2.34 MPa). Conclusion: Hydrofluoric acid etching followed by silane application and sandblasting followed by silane or universal adhesive are useful clinical steps to enhance bonding to PICN. Adhesive applications after HF etching have no advantages in bonding to PICN

An evaluation of the effect of different veneer materials on fracture resistance of zirconia core / Avaliação dos diferentes efeitos de materiais de revestimento na resistência à fratura do núcleo de zircônia

Objectives: this in vitro study was done to evaluate the effect of packable P60 composite and Tetric N-Ceram composite veneer material on fracture strength of zirconia cores. Material and Methods:Twenty four zirconium cores (Vita, Germany) with 0.7 mm thickness were fabricated by CAD/CAM technology and then subjected to air abrasion with 50 µm of Al2O3. Cores were randomly divided into three groups according to veneering material (group A: control group sandblasted with 50 µm Al2O3 veneered by IPS E-max Ceram porcelain, group C: sandblasted with 50 µm Al2O3, etching with hydrofluoric acid and veneered with P60 composite, group E: sandblasted with 50 µm Al2O3, etching with hydrofluoric acid and veneered with Tetric N-Ceram composite). All crowns were subjected to fracture strength test in the testing machine, with load application by steel ball indenter and 0.5 mm/min. cross head speed. Results: statistical analysis was carried out utilizing one-way ANOVA, LSD. The results of fracture strength value test showed the highest mean value was registered for group (A), and the lowest mean for group (E). One-way ANOVA test represented that, there was a statistically high significant different among all groups. LSD results showed a high significant difference increase in fracture resistance for Group A at p value (*p < 0.001 High significant). Conclusions: Within the limitation of this study, sandblasting zirconia core with 50 µm Al2O3 and veneering with conventional ceramic produced restoration with acceptable fracture resistance value (AU)

Objetivo: o objetivo desse estudo in vitro foi avaliar o efeito dos compósitos P60 compactáveis e material laminado de compósitos Tetric-N Ceram na resistência à fratura de núcleos de zircônia. Material e métodos:Vinte e quatro núcleos de zircônia (Vita, Germany) com 0.7 mm de espessura fabricados por tecnologia de CAD/CAM e sinterizados em alta temperatura (1450ºC por 60 min) de acordo com as instruções do fabricante. Núcleos totalmente de zircônias foram submetidos a abração com 50 µm de Al2O3. Os núcleos de zircônia foram divididos de forma randomiza em três grupos de acordo com o material de revestimento (grupo A: grupo controle jateado com 50 µm Al2O3 folheado com porcelana IPS E-max Ceram, grupo C: jateado com 50 µm Al2O3 , coberto com concentração 9,5% de ácido fluorídrico e folheado com resina composta compatível, grupo E: jateado com 50 µm Al2O3 coberto com concentração 9,5% de ácido fluorídrico e folheado com porcelana IPS E-max Ceram. Todos os espécimes (coroas) foram submetidos a teste de resistência a fratura com máquina de teste universal, essa máquina utilizou para aplicação de carga bola de aço com 6mm de diâmetro 0,5 mm/min de velocidade da cruzeta. Resultados: análise estatística foi realizada utilizando One-way ANOVA, LSD. O resultado da resistência a fratura mostra que o maior valor médio foi registrado no grupo A e a menor média para o grupo E. O resultado do teste One-Way ANOVA representaram que houve uma diferença estatisticamente alta e significante entre todos os grupos. LSD foi executada para mostrar a fonte de significância. Os resultados do LSD mostraram um aumento da diferença significativa alta na resistência à fratura para o grupo A no valor de p (p < 0.001 signicancia alta). Conclusão: Dentro das limitações desse estudo o uso convencional de jateamento com 50 µm Al2O3 e estratificação com cerâmica convencional produziu restauração com valor aceitável de resistência a fratura (AU)

Research progress on tetrabutylammonium dihydrogen trifluoride as a substitute for hydrofluoric acid used for porcelain surface treatment / 口腔疾病防治

@#Hydrofluoric acid is a common surface treatment agent for glass ceramic restorations before bonding. However, the use of hydrofluoric acid has a high safety risk, so the search for hydrofluoric acid substitutes has been a research hotspot. Tetrabutylammonium dihydrogen trifluoride is a kind of fluoride, whose chemical activity is lower than that of hydrofluoric acid, so it’s safer, and the surface morphology changes on glass ceramics caused by it are smaller and more superficial. At present, the vast majority of laboratory studies and clinical case reports indicate that the mechanical strength and bonding strength of glass ceramics treated with tetrabutylammonium dihydrogen trifluoride can meet the clinical requirements. In the future, according to the research results, the performance of porcelain surface treatment agents containing tetrabutylammonium dihydrogen trifluoride can be further improved, and more hydrofluoric acid substitutes may be developed. In this review, the research progress of tetrabutylammonium dihydrogen trifluoride as a substitute for hydrofluoric acid is reviewed in terms of the influence of the surface morphology, mechanical strength, and bonding strength of glass ceramics.

Influence of Shear Bonding Strength of Lithium Disilicate to Enamel under Different Surface Treatments.

Accurate diagnosis and proper treatment planning should be established before making any prosthetic rehabilitation to restore the good appearance of the tooth, a better smile, phonetics, and to achieve perfect occlusion/mastication. We wanted to evaluate the changes of surface treatment protocols on the tensile bonding strength between enamel and ceramic restorations (lithium disilicate).METHODSA total of 20 freshly extracted, non-carious teeth were stored in normal saline solution at 25°C until used. Clean enamel surfaces 2 mm X 2 mm were obtained from the extracted teeth by using wheel diamond bur. Each enamel side received one E-max sprue, so four sprues of different surface treatment protocols per tooth (G1 TS: Etching, bonding, and curing. CS: Etching, monobond, curing, overall light cure) (G2 TS: Bonding, curing, self-etch / self-adhesive resin cement, overall light cure. CS: Monobond etch and prime) (G3 TS: Etching, bonding without curing. CS: Etching, monobond, curing, overall light cure) (G4 TS: Etching, bonding, curing. CS: Etching, monobond, bonding, curing, light-cure resin cement, overall light cure). Tensile bonding strength was measured using the Instron testing machine. One-way ANOVA test was used to analyse the data.RESULTSThe highest mean was observed in Group 3 (124.34±43.47) followed by Group 1 (104.29±50.09), which is control group. In contrast, the lowest mean was observed in Group 2 (83.64 ± 53.56) and Group 4 (94.14±57.91). The results of ANOVA test have shown a significant difference between the surface treatment groups at 5% significance level.CONCLUSIONSHydrofluoric acid and primer/silane coupling agent create a porous surface on the ceramic that allow a good interaction with silane coupling agent.

Hydrofluoric acid concentration, time and use of phosphoric acid on the bond strength of feldspathic ceramics

Abstract The objective of this study was to evaluate the influence of hydrofluoric acid (HF) concentration, etching time, and application of phosphoric acid (PA) followed by neutralization with sodium bicarbonate on the bond strength between a feldspar ceramic and resin cement. Thus, 80 blocks (10 x 12 x 2 mm) of glass ceramic (VM - Vita Mark II - Vita Zahnfabrik) were made and randomly assigned to eight groups (n = 10) according to the factors: HF concentration (5 and 10%), etching time (60 and 120 s), and use of phosphoric acid (PA) (with and without). According to the experimental group, 37% PA (Condac, FGM) was applied after HF etching for 60s. Afterwards, samples were immersed in sodium bicarbonate for 1 min then in an ultrasonic bath in distilled water (5 min) for cleaning. After surface bonding treatment, cylinders (Ø = 2 mm; h = 2 mm) of dual resin cement (AllCem / FGM) were made in the center of each block. The samples were then stored in water (37ºC) for 90 days and submitted to the shear bond test (50 KgF, 1 mm/min). Failure analysis was performed by stereomicroscope and scanning electron microscopy. Data (MPa) were analyzed with 3-way ANOVA and Tukey's test. Only the factor "HF concentration" was significant (p = 0.02). Most failures were of cohesive in ceramic (40%) and mixed types (42.5%). The 10% HF resulted in higher shear bond strength value than the 5% HF. Surface cleaning with phosphoric acid followed by sodium bicarbonate and HF time (60 or 120 seconds) did not influence the resin bond strength to feldspar ceramic.

Effect of hydrofluoric acid concentration and thermal cycling on the bond strength of brackets to ceramic

Abstract This study to evaluate the effects of different hydrofluoric acid (HF) concentrations and thermal cycling on the shear bond strength (SBS) of brackets to ceramic. Cylinders of ceramic were divided into 10 groups (n=15), according to HF concentrations: 1-1%;2-2.5%;3-5%;4-7.5%;5-10% (storage 24 h); 6-1%;7-2.5%;8-5%;9-7.5%; and, 10-10% (thermal cycling). All cylinders were etched for 60s and received one layer of silane. Metallic brackets were bonded to the cylinders using Transbond-XT, light activated for 40 s, using a LED (Radii Plus) and stored in deionized water at 37o C for 24h. The groups 6 to 10 were submitted to thermal cycling (7,000 cycles - 5o/55oC). SBS was performed in an Instron at crosshead speed of 1.0 mm/min. Data were submitted to two-way ANOVA and Tukey's post-hoc test (α=0.05). The Adhesive Remaining Index (ARI) was evaluated at 40x magnification. The different HF acid concentrations influenced on the SBS of the brackets to ceramic (p<0.05). The thermal cycling decreased the SBS of the brackets to ceramic for all acid concentrations (p<0.05). The ARI showed a predominance of scores 0 for all groups, with an increase in scores 1, 2 and 3 for the group storage for 24 h. In conclusion, the different HF acid concentrations 5.0%, 7.5% and 10% influenced on the SBS of brackets to ceramic. The thermal cycling decreased significantly the SBS of brackets to ceramic.

Resumo Este estudo avaliou os efeitos de diferentes concentrações de ácido hidrofluorídrico (HF) e ciclagem térmica na resistência de união ao cisalhamento (RUC) de bráquetes metálicos a cerâmica. Cilindros da cerâmica feldspática foram divididos em 10 grupos (n=15). De acordo com as concentrações do ácido HF: 1-1%;2-2,5%;3-5%;4-7,5%; e, 5-10% (armazenagem por 24 h); 6-1%;7-2,5%;8-5%;9-7,5%; e, 10-10% (ciclagem térmica). Todos os cilíndros foram condicionados por 60s e receberam uma camada de silano. Bráquetes metálicos foram colados aos cilíndros usando o transbond-XT, fotoativado por 40 s, usando o LED (Radii Plus; SDI) e armazenados em água deionizada a 37o C por 24 h. Os Grupos 6 a 10 foram submetidos à ciclagem térmica (7.000 ciclos - 5o/55oC). RUC foram realizadas na Instron a velocidade de 1.0 mm/min. Os dados foram submetidos à análise de variância dois-fatores e ao teste de Tukey's post-hoc (α=0,05). O Índice de Remanescente do Adesivo (IRA) foi avaliado com 40x de aumento. As diferente concentrações do ácido HF influenciou na RUC dos bráquetes na cerâmica (p<0,05). A ciclagem térmica diminuiu a RUC dos bráquetes na cerâmica para todas as concentrações do ácido (p<0,05). O IRA mostrou predominância de escores 0 para todos os grupos, com aumento de escores 1, 2 e 3 para os grupos armazenados por 24 h. Concluíndo, as concentrações do ácido HF 5,0%, 7,5% e 10% influenciaram na RUC de braquetes à cerâmica. A ciclagem térmica diminuiu significativamente a RUC do bráquetes à cerâmica.

Effect of self-etching primer associated to hydrofluoric acid or silane on bonding to lithium disilicate

Abstract To evaluate the effect of combining 5% hydrofluoric acid (HF) and silane (SI) with the self-etching ceramic primer on the immediate and after 1-year of water storage on bonding efficacy, conditioning pattern (CP) and chemical interaction (CI) to the lithium disilicate. A total of 16 CAD/CAM blocks of lithium disilicate (LD) were cut into four square sections (n=64). For bonding efficacy evaluation, the LD specimens were divided into 4 groups (n=10): 1) HF+SI; 2) self-etching ceramic primer (MEP); 3) HF+MEP; 4) MEP+SI. After each treatment, an adhesive system was applied and Tygon matrices were filled with a dual-cured resin cement followed by light curing. Cylinder specimens (0.8 mmx0.5mm) were stored in water (37 °C for 24 h or 1-year) and submitted to the μSBS test (2-way ANOVA and Tukey's test; a=0.05). CP and CI were only evaluated qualitatively. No significant difference on the μSBS was observed between groups (p=0.73), but reduced μSBS was observed after 1-year of water storage (p>0.0001). After application of HF+SI and MEP, reduction in a number of siloxane bonds was observed, suggesting the coupling of SI on the LD surface. HF or HF+MEP produced a higher dissolution of the glassy matrix than the use of MEP alone. The MEP can be an alternative to traditional ceramic treatment once the chemical interaction and long-term bond strength were similar between both groups. The association of hydrofluoric acid or silane with a self-etching ceramic primer did not add any benefits in terms of chemical interaction and bonding stability.

Resumo Avaliar o efeito da combinação de ácido fluorídrico ou silano com o primer autocondicionante de cerâmicas sobre a eficácia da união imediata e após 1 ano de armazenamento em água, padrão de condicionamento e interação química desses tratamentos com o dissilicato de lítio. Um total de 16 blocos CAD/CAM de dissilicato de lítio (DL) foram cortados em quatro seções quadradas (n=64). Os espécimes de DL foram divididos em 4 grupos: 1) ácido fluorídrico a 5% + silano (HF + SI); 2) primer autocondicionante de cerâmica (MEP); 3) HF + MEP; 4) MPE + SI. Após cada tratamento, o sistema adesivo foi aplicado e as matrizes Tygon foram preenchidas com cimento resinoso dual (Variolink® II), seguido de fotopolimerização. Espécimes em forma de cilindro (0.8 mmÆ x 0.5 mm), foram armazenados em água (37 °C por 24h ou 1 ano) e submetidos ao teste μSBS (ANOVA dois fatores e teste de Tukey; a=0,05). Para avaliação das interações químicas por Espectroscopia Raman, os espécimes de DL foram divididos em 3 grupos (n=4): 1) sem tratamento (DL); 2) HF + SI; e 3) MEP. Para avaliação do padrão de condicionamento da superfície cerâmica após os tratamentos por MEV, os espécimes de DL foram divididos em 3 grupos (n=3): 1) DL; 2) HF; 3) MEP; e 4) HF + MEP. Ambos os métodos foram avaliados apenas qualitativamente. Não foi observada diferença significativa na μSBS imediata entre os grupos (p=0,73), mas após 1 ano de armazenamento das amostras em água, reduziu μSBS (p>0,0001). HF ou HF + MEP produziram uma maior dissolução da matriz vítrea do que o uso de MEP sozinho. Após a aplicação de SI e MEP, observou-se redução de ligações de siloxano, sugerindo o acoplamento da camada de silano na superfície do DL. O primer autocondicionante cerâmico pode ser uma alternativa ao tratamento cerâmico tradicional, uma vez que a interação química e a resistência de união a longo prazo, quando comparada ao tratamento tradicional foram estatisticamente semelhantes. A associação de ácido fluorídrico ou agente de acoplamento silano com um primer autocondicionante de cerâmicas não agregou nenhum benefício em termos de interação química e estabilidade.

Caracterização interna de materiais restauradores indiretos com diferentes condicionamentos de superfície / Internal characterization of indirect restorative materials with different surface etching protocols

Objetivo: O objetivo do estudo foi avaliar o efeito da aplicação de ácido fluorídrico com diferentes tempos e concentrações na superfície de materiais restauradores indiretos obtidos a partir de blocos utilizados na tecnologia CAD-CAM. Materiais e Métodos: Amostras dos materiais restauradores indiretos medindo 4x4x0,8mm foram obtidos a partir de blocos CAD para cada material estudado: resina nanocerâmica Lava Ultimate (3M Espe), monossilicato de lítio reforçado por zircônia Celtra Duo (Dentsply) e cerâmica híbrida Vita Enamic (Vita). Os materiais foram submetidos à aplicação de ácido fluorídrico com concentração de 5% ou 10%, sendo o mesmo aplicado pelos tempos de 20, 40, 60 ou 90 segundos. Um grupo controle para cada material foi avaliado, sem nenhum tratamento de superfície, contabilizando nove grupos de cada material (n=10). As amostras foram avaliadas em relação à rugosidade de superfície (Ra e Rz), avaliadas em microscopia óptica confocal; ângulo de contato (θ), energia de superfície (s) e energia livre total de interação (∆G) avaliados em goniômetro, e resistência de união ao cimento resinoso avaliada através do teste de microcisalhamento. Imagens das amostras foram obtidas em microscopia eletrônica de varredura (MEV), microscopia óptica confocal e microscopia de força atômica. Os dados de rugosidade de superfície, ângulo de contato, energia de superfície, energia livre total de interação e resistência de união foram submetidos à ANOVA dois fatores e teste de Tukey (p<0,05). Resultados: Os resultados mostraram que, de maneira geral, o monosilicato de lítio reforçado por zircônia Celtra Duo apresentou melhores resultados quando submetido ao condicionamento com ácido fluorídrico 10% por 40 ou 60 segundos de aplicação. A resina nanocerâmica Lava Ultimate apresentou melhor performance quando condicionada com ácido fluorídrico 10% por 20 ou 40 segundos, enquanto que a cerâmica híbrida Vita Enamic apresentou melhores resultados quando condicionada com ácido fluorídrico 5% por 90 segundos. Conclusão: Cada material interagiu de maneira diferente ao condicionamento com ácido fluorídrico, sendo que o conhecimento do adequado protocolo para cada material é essencial para garantir melhorias nos processos de adesão e durabilidade das restaurações indiretas. Celtra Duo apresentou de maneira geral propriedades mecânicas superiores aos demais. Relevância clínica: Recomenda-se protocolos específicos de tratamento de superfície com ácido fluorídrico de acordo com a composição de cada material restaurador indireto(AU)

Purpose: The aim of this study was to evaluate the effect of different times and concentration of hydrofluoric acid etching on the surface of indirect restorative materials obtained from blocks used in CAD-CAM technology. Methods and Materials: Samples of indirect restorative materials measuring 4x4x0.8mm were obtained for each restorative material studied: Lava Ultimate nanoceramic resin (3M Espe), Celtra Duo zirconia-reinforced lithium silicate ceramic (Dentsply) and Vita Enamic polymer-infiltrated ceramic-network material (Vita). The materials were submitted to etching with 5% or 10% hydrofluoric acid for 20, 40, 60 or 90 seconds. A control group for each material was evaluated without any surface treatment, totaling nine experimental groups for each material (n = 10). The samples were evaluated in relation to surface roughness (Ra and Rz), evaluated by confocal optical microscopy; contact angle (θ), surface energy (s) and total free interaction energy (∆G) evaluated by goniometer; and microshear bond strength to resin cement. Sample images were obtained by scanning electron microscopy (SEM), confocal optical microscopy and atomic force microscopy. Data of surface roughness, contact angle, surface energy, total free interaction energy and bond strength were submitted to two-way ANOVA and Tukey test (p<0.05). Results: The results showed that, in general, the Celtra Duo zirconia-reinforced lithium silicate ceramic showed better results when subjected to etching with 10% hydrofluoric acid for 40 or 60 seconds. Lava Ultimate nanoceramic resin showed better performance when etched with 10% hydrofluoric acid for 20 or 40 seconds, while Vita Enamic polymer-infiltrated ceramic-network showed better results when etched with 5% hydrofluoric acid for 90 seconds. Conclusion: Each material showed different characteristics after etching with hydrofluoric acid, and the knowledge of the proper protocol for each material is essential to ensure improvements in the adhesion process and durability of indirect restorations. Celtra Duo presents general ways of mechanical properties superior to the others. Clinical relevance: Specific surface treatment protocols with hydrofluoric acid are recommended based on the different compositions of indirect restorative materials(AU)

Influence of surface treatments in flexural strength and superficial topography of a lithium disilicate ceramic / Influência dos tratamentos de superfície na resistência à flexão e na topografia superficial de uma cerâmica de dissilicato de lítio

Objective: The aim of the study was to evaluate the influence of different surface post-etching treatments in flexural strength, contact angle and surface roughness of a lithium disilicate ceramic. Material and Methods: 60 bars (16 x 2 x 4 mm) were divided in six groups (n=10): C, no treatment; HF, hydrofluoric acid for 20 s (HF) + washing (60 s), drying (30s); HFL, HF + washing (60 s), drying (30 s) and luting; HFNL, HF + washing (60 s) + neutralization with sodium bicarbonate (SB) for 40 s + washing (5s), drying (30 s) and luting; HFUL, HF + washing (60 s) + ultrasonic bath (UB) for 4 min, drying (30 s) and luting; HFNUL, HF + washing (60 s) + SB (40 s) + UB (4 min) and luting. The bars were submitted to three-points flexural strength test. 25 ceramic blocks (12 x 7 x 7 mm) were divided into five groups (n=5) to evaluate roughness and contact angle C - no treatment; HF - HF ; HFU - HF and UB for 5 min ; HFN - HF and SB; HFNU - HF, UB and SB. A scanning electron microscope (SEM) showed the surface of the samples. ANOVA one-way statistical analysis was done for comparison of results. Results: There was no statistical difference for flexural strength (p-value = 0.15) and for surface roughness (p-valor = 0.15). However, it was obtained statistically significant difference for contact angle (p-valor = 0.00). SEM images showed precipitates after the acid etching, which were removed by post-etching treatments. Conclusion: It can be concluded that the different post-etching surface treatments did not increase the flexural strength, surface roughness, but it influenced the ceramic wetting and SEM images (AU)

Objetivo: O objetivo do estudo foi avaliar a influência de diferentes tratamentos pós-condicionamento na resistência à flexão, ângulo de contato e rugosidade superficial de uma cerâmica de dissilicato de lítio. Material e Métodos: 60 barras (16 x 2 x 4 mm) foram divididas em seis grupos (n = 10): C, sem tratamento; HF, ácido fluorídrico durante 20 s (HF) + lavagem (60 s), secagem (30 s); HFL, lavagem com HF + (60 s), secagem (30 s) e cimentação; HFNL, HF + lavagem (60 s) + neutralização com bicarbonato de sódio (SB) por 40 s + lavagem (5s), secagem (30 s) e cimentação; HFUL, HF + lavagem (60 s) + banho ultrassônico (UB) por 4 min, secagem (30 s) e cimentação; HFNUL, HF + lavagem (60 s) + SB (40 s) + UB (4 min) e cimentação. As barras foram submetidas ao teste de resistência à flexão de três pontos. 25 blocos cerâmicos (12 x 7 x 7 mm) foram divididos em cinco grupos (n = 5) para avaliação da rugosidade superficial e ângulo de contato C - sem tratamento; HF - HF; HFU - HF e UB por 5 min; HFN - HF e SB; HFNU - HF, UB e SB. Um microscópio eletrônico de varredura (MEV) foi utilizado para análise da superfície das amostras. A análise estatística unidirecional ANOVA-um fator foi realizada para comparação dos resultados. Resultados: Não houve diferença estatística para a resistência à flexão (p-valor = 0,15) e para a rugosidade superficial (p-valor = 0,15). No entanto, obteve-se diferença estatisticamente significante para o ângulo de contato (p-valor = 0,00). Imagens de microscopia eletrônica de varredura mostraram a formação de precipitados após o ataque ácido, que foram removidos pelos tratamentos pós-condicionamento. Conclusão: Pode-se concluir que os diferentes tratamentos de superfície pós-condicionamento não aumentaram a resistência à flexão, rugosidade da superfície, mas influenciaram na molhabilidade da cerâmica e nas imagens em MEV.(AU)

Bond strength to ZLS ceramics at different etching times and cementation protocols after aging / Influência da cimentação e da termociclagem na resistência de união da cerâmica de silicato de lítio reforçada com zircônia

Objective: To assess the influence of 5% hydrofluoric acid etching time (ET), cementation protocol (CP), and thermal cycling (TC) aging on the microshear bond strength (µSBS) of zirconia reinforced lithium silicate ceramic (ZLS) to adhesive resin cement. Material and Methods: Ten VITA Suprinity® ceramic blocks were cut in 120 slices (1.4 mm thickness) and randomly assigned to 12 groups (n = 10) according to the combination of factors (2x3x2 design): etching time (20 or 30 s), cementation protocol (silane + universal adhesive + resin cement; universal adhesive + resin cement; silane + resin cement) and thermal cycling (cycled or no-cycled). RelyX Ceramic Primer and Scotchbond™ Universal Adhesive were used respectively as silane (S) and universal adhesive (Ua). Ceramic surface was etched, and the cementation protocol performed on the delimited bonding area. Then, resin cement (RelyX™ Ultimate Cement [Rc]) cylinders were bonded and light cured. After, specimens were stored in deionized water at 37°C for 7 days and subjected to the µSBS test. Results: Data passed the normality test and three-way ANOVA analysis showed statistical difference (p < 0.01) for isolated; double (ET/TC) (p < 0.05), and triple (p < 0.05) factor interactions. Conclusion: The combination 30s etching-Ua-Rc presented higher adhesive bond strength after thermal aging. (AU)

Objetivo: Avaliar a influência do tempo de condicionamento com ácido fluorídrico 5% (ET), protocolo de cimentação (CP), e envelhecimento por termociclagem (TC) na resistência de união ao microcisalhamento (µSBS) da cerâmica de silicato de lítio reforçada com zircônia (ZLS) ao cimento resinoso adesivo. Material e Método: Dez blocos da cerâmica VITA Suprinity® foram cortados e 120 fatias (com espessura de 1,4 mm) e distribuídos aleatoriamente em 12 grupos (n=10) de acordo com o fator de combinação (2x3x2): tempo de condicionamento (20 ou 30 s), protocolo de cimentação (silano + adesivo universal + cimento resinoso; adesivo universal + cimento resinoso; silano + cimento resinoso) e ciclagem térmica (ciclado ou não ciclado). RelyX Ceramic Primer e adesivo Scotchbond™ Universal foram utilizados respectivamente como silano (S) e adesivo universal (Ua). A superfície cerâmica foi condicionada e o protocolo de cimentação aplicado sobre área de cimentação delimitada. Portanto, cilindros de cimento resinoso (cimento RelyX™ Ultimate [Rc]) foram cimentados e fotopolimerizados. Após, os espécimes foram armazenados em água deionizada a 37°C por 7 dias e submetidos ao teste de µSBS. Resultados: Após teste de normalidade, os dados foram analisados pelo teste ANOVA três critérios mostrando diferença estatística (p < 0.01) para a análise do fator isolado; para a interação entre dois fatores (ET/TC) (p < 0.05), e interação entre os três fatores (p < 0.05). Conclusão: A combinação 30s de condicionamento-Ua-Rc apresentou a maior resistência de união adesiva após a ciclagem térmica.(AU)

Comparative evaluation of lithium disilicate ceramic surface and bond strength to dentin surface after treatment with hydrofluoric acid and acidulated phosphate fluoride gel: An In Vitro study

Long-term retention of the restoration depends on strength and durability of the bond of the luting composite resin to the tooth and the porcelain substrates. Aims: This in vitro study was conducted to compare and evaluate the influence of hydrofluoric acid (HF) and acidulate phosphate fluoride (APF) gel-etched treatments on surface roughness and bond strength to dentin of a commercially available lithium disilicate ceramic (E-Max). Subjects and Methods: Sixty lithium disilicate ceramic disks measuring 5 mm in diameter and 2 mm thick were fabricated and divided into three groups: Group A (n = 24), Group B (n = 24), and Group C (n = 12) and were subdivided to Group A1, A2, and A3which were surface treated with 1.23% APF gel (pH = 3–4) at different time intervals 4, 7, and 10 min, respectively. Group B1, B2, and B3 were surface treated with 1% APF gel (pH = 1–2) at different time intervals 4, 7, and 10 min, respectively. Group C were surface treated with 9.6% HF (pH = 1–2) for 1 min. Morphological changes obtained with the surface treatments were analyzed using a surface profilometer. Statistical Analysis: All specimens were subjected to a tensile bond strength test using a tensometer, and the obtained data were statistically analyzed using Kruskal–Wallis test. Results: The surface roughness (μm) and bond strength (MPa) of lithium disilicate discs (samples) etched with 1.23% APF gel and 1% APF gel for 10 min and etched with 9.6% HF for 1 min showed no statistical significant difference among them. Conclusions: In this study, the lithium disilicate discs etched with 1.23% APF gel and 1% APF gel for 10 min showed similar surface roughness and bond strength to those etched with 9.6% HF for a minute.

Alternativas de tratamientos de superficie para adhesión de cerámica de disilicado de litio / Alternatives of surface treatments for adhesion of lithium disilicate ceramics

Introduction: the clinical success of a restoration is strongly associated with the quality and durability of the ceramic-cement resin interface. In order to obtain an adequate union between these materials of different nature surface treatments are used and achieve mechanical retention or chemical interaction. Objectives: to check if any method promotes a true chemical bond between lithium disilicate ceramics and resin cement. As well as determineif there is any treatment that reports bonding values comparable to hydrofluoric acid and silane (gold standard). Methods: a systematic literature review was developed based on the PRISMA strategy, where the databases were searched: Science Direct, Pubmed (MEDLINE), EMBASE, Springer Journal, SciELO with MeSH and free terms from 2005 to November 2016 for articles in English and Spanish on surface treatments for lithium disilicate. Results: from 58 publications selected a sample of 21 articles. Two articles reported high risk of bias. Conclusions: hydrofluoric acid and silane continue to be the method with the highest and most reliable adhesion values in the literature. Universal adhesives are an alternative to promote chemical adhesion additional to the silane. Diamond burs, Nd: YAG and Er: YAG laser are not recommended as surface treatments(AU)

Introducción: el éxito clínico de una restauración se asocia fuertemente a la calidad y duración de la interface cerámica-cemento resinoso. Para que exista una adecuada unión entre estos materiales de distinta naturaleza se emplean tratamientos de superficie para lograr una buena retención mecánica o interacción química. Objetivos: revisar si algún método promueve una verdadera adhesión química entre la cerámica de disilicato de litio y el cemento resinoso, así como determinar si existe algún tratamiento que reporte valores de unión comparables al ácido fluorhídrico y silano (patrón de oro). Métodos: se desarrolló una revisión sistemática de literatura basada en la estrategia PRISMA, donde se buscó en las bases de datos: Science Direct, Pubmed (MEDLINE), EMBASE, Springer Journal, SciELO con términos MeSH y libres desde el 2005 a noviembre de 2016 para artículos en inglés y español sobre tratamientos de superficie para disilicato de litio. Resultados: de 58 publicaciones, se seleccionó una muestra de 21 artículos. Dos artículos reportaron riesgo de sesgo alto. Conclusiones: el ácido fluorhídrico y silano continúan siendo el método con los valores de adhesión más altos y confiables de la literatura. Los adhesivos universales son una alternativa para promover adhesión química adicional al silano. Fresas diamantadas, laser Nd: YAG y Er:YAG no se recomienda como tratamientos de superficie(AU)

Fate and toxicity of spilled chemicals in groundwater and soil environment I: strong acids

We reviewed the chemical/physical properties, toxicity, environmental fate, and ecotoxicity of strong acids in soil and groundwater environments. We recommend that sulfuric acid and hydrofluoric acid be classified as chemicals of priority control based on volumes used, toxicity, carcinogenicity, and past significant spill events. Understanding the behavior and transport of spilled strong acids in soil and groundwater environments requires a multi-disciplinary approach, as they can undergo a variety of geochemical and biochemical reactions with complex geomedia. The toxicity of spilled acid is dependent on the characteristics of the geomedia exposed to the acid and the amount of residual protons following acid–substrate interaction. Soil texture, cation exchange capacity, mineral composition, bedrock type, and aluminum content may be important factors affecting the toxicity of spilled acid in soil-groundwater environments. We expect that the results of this study will contribute preliminary data for future research on chemical spills.

The effect of hydrofluoric acid and resin cement formulation on the bond strength to lithium disilicate ceramic

Abstract To investigate how the hydrofluoric acid (HF) concentrations applied to a lithium disilicate glass-ceramic (EMX) affects the surface morphology and microtensile bond strength (μTBS) of ceramics to dentin, using light-cured resin cements with or without UDMA. Sixty-three EMX square ceramic blocks were etched for 20 seconds using different HF concentrations (1%, 5% and 10%) and luted to dentin using two types of resin cement combinations: BisGMA/TEGDMA and BisGMA/TEGDMA/UDMA (n = 10). Each bonded EMX-dentin block was sectioned to obtain 1 mm2 sticks for μTBS evaluation. Half of the sticks were tested after 24 hours and the other half was assessed after 6 months of water storage. Data were statistically assessed using split-plot three-way ANOVA and multiple comparisons were performed using the Tukey's post hoc test (α = 0.05). One EMX sample from each HF concentration was analyzed using field-emission scanning electron microscope (FE-SEM) to characterize the etching pattern. According to the FE-SEM images, increasing the concentration of HF from 1 to 5 and then to 10% led to increased removal of glassy matrix and greater exposure of lithium disilicate crystals. The 10% HF concentration yielded higher μTBS when compared to 1% for BisGMA/TEGDMA formulation (p < 0.05); whereas HF 1% and 5% showed similar μTBS values when compared to 10% HF for BisGMA/TEGDMA/UDMA resin matrix (p > 0.05) at both storage times. Water aging decreased the μTBS values (p < 0.05), except when 10% HF was associated with BisGMA/TEGDMA resin cement. Resin cement formulation and hydrofluoric acid concentrations can interfere with the immediate and long-term glass-ceramic bond strength to dentin.

Analysis on effects of modified dosage of calcium gluconate on patients with hydrofluoric acid burns not in hands or feet / 中华烧伤杂志

Objective@#To retrospectively explore the effects of modified dosage of calcium gluconate (CG) on the patients with hydrofluoric acid burns not in hands or feet.@*Methods@#One hundred and sixty patients with hydrofluoric acid burns not in hands or feet were hospitalized in our burn ward from January 2004 to December 2017. Based on the dosage of CG at different admission time, 76 patients hospitalized from January 2004 to December 2012 were included in traditional group, and 84 patients hospitalized from January 2013 to December 2017 were included in modified group. For patients in the two groups, subcutaneous injection of CG solution at one time was immediately conducted on admission in topical treatment. In traditional group, the injection was CG solution with mass concentration of 100 g/L. For wounds of superficial partial-thickness and above degree, CG solution was prescribed at the dosage of 50 mg/cm2. Wounds of superficial-thickness or mass fraction of hydrofluoric acid less than 20.0% did not receive injection. In modified group, the mass concentration of CG solution for injection was diluted with normal saline to 25 g/L. For wounds of deep partial-thickness and above degree, CG solution was prescribed at the dosage of (50×mass fraction of hydrofluoric acid) mg/cm2. For wounds of superficial partial-thickness, CG solution was prescribed at the dosage of (25×mass fraction of hydrofluoric acid) mg/cm2. For wounds of superficial-thickness, CG solution was prescribed at the dosage of 2.5 mg/cm2. For systemic treatment, the injection velocity of CG solution via venous access was adjusted according to the level of serum calcium namely total serum calcium of patients in traditional group. In modified group, serum ionized calcium was additionally detected through automatic blood gas analyzer by the bed to regulate the injection velocity of CG via venous access. The incidence rate of hypercalcemia and mortality of patients after treatment in the two groups, and the situation about treatment of survivors in the two groups were analyzed. Data were processed with chi-square test, Fisher′s exact probability test, t test, and Mann-Whitney U test.@*Results@#(1) After treatment, 9 patients (11.8%) had hypercalcemia, while the other 67 patients (88.2%) did not have hypercalcemia in traditional group. Two patients (2.4%) had hypercalcemia, while the other 82 patients (97.6%) did not have hypercalcemia in modified group. The incidence rate of hypercalcemia of patients in traditional group was significantly higher than that in modified group (χ2=5.579, P=0.02). (2) There were two deaths (2.6%) and 74 survivors (97.4%) in traditional group, while there were two deaths (2.4%) and 82 survivors (97.6%) in modified group. The mortalities of patients in the two groups were close (P>0.05). (3) The ratios of eschar excision and skin grafting and hyperplastic scar formation, wound healing time, and ratio of esophageal scar stenosis of survivors in the two groups were close (χ2=0.002, 0.054, Z=0.66, P>0.05).@*Conclusions@#Hydrofluoric acid is highly dangerous. The early management of patients with hydrofluoric acid burns emphasizing specialized dosage of CG for treatment can be helpful to reduce incidence of complications and improve the safety of treatment.

Analysis on clinical characteristics of 316 patients with hydrofluoric acid burns / 中华烧伤杂志

Objective@#To investigate the clinical characteristics of patients with hydrofluoric acid (HF) burns.@*Methods@#Clinical data of 316 patients with HF burns admitted to Zhejiang Quhua Hospital from January 2004 to December 2016 were retrospectively analyzed. Patients were divided into non and mild poisoning group (NMP, n=157), moderate poisoning group (MP, n=120), and severe and fatal poisoning group (SFP, n=39) based on the severity of poisoning. Occurrences of hypocalcemia, hypomagnesemia, hypokalemia, and hyperkalemia of patients within 24 hours after admission were recorded. Values of emergency urinary fluoride of patients on admission were recorded. Values of urinary fluoride of patients admitted to hospital in 4 hours post injury in groups MP and SFP at post injury hour 4, 12, and 24 and on post injury day 2, 3, 4, 5, 6, and 7 were also recorded. Electrocardiographic abnormalities of patients within 24 hours after admission were recorded. Data were processed with chi-square test, Kruskal-Wallis H test, and Mann-Whitney U test.@*Results@#(1) Hypocalcemia, hypomagnesemia, and hypokalemia occurred in some patients in each of the three groups, but no patient had hyperkalemia. Taking serum calcium namely total serum calcium as reference, the incidence rate of hypocalcemia of patients in group NMP was close to that in group MP (χ2=0.05, P>0.05). The incidence rate of hypocalcemia of patients in group SFP was significantly higher than that in group NMP or group MP (χ2=10.53, 7.92, P<0.01). The incidence rates of hypokalemia in the three groups were close (χ2=0.63, P>0.05). Taking serum ionized calcium as reference, the incidence ratio of hypocalcemia of patients in group NMP was close to that in group MP (χ2=0.01, P>0.05), while there were statistically significant differences in incidence ratio of hypocalcemia of patients between group SFP and each of group NMP and group MP (χ2=4.66, 4.47, P<0.05). Taking serum calcium as reference, the incidence rate of hypocalcemia of patients was 7.3% (23/316). Taking serum ionized calcium as reference, the incidence rate of hypocalcemia of patients was 60.0% (42/70), which was significantly higher than that of taking serum calcium as reference (χ2=113.74, P<0.01). The incidence rates of hypomagnesemia of patients in groups MP and NMP were close (χ2=0.02, P>0.05). The incidence rate of hypomagnesemia of patients in group SFP was significantly higher than that in group NMP or group MP (χ2=14.69, 9.94, P<0.01). (2) The urinary fluoride levels were tested in 288 patients, with the value of emergency urinary fluoride of patients on admission 0.2-590.0 mg/L. The values of urinary fluoride of 202 patients were above the normal value. The values of emergency urinary fluoride of patients in groups NMP, MP, and SFP were 2.15 (1.11, 4.30), 5.89 (1.72, 14.25), and 36.0 (13.2, 103.2) mg/L, respectively. The values of emergency urinary fluoride of patients in groups MP and SFP were significantly higher than the value in group NMP (χ2=23.28, 66.03, P<0.01). The value of emergency urinary fluoride of patients in group SFP was significantly higher than that in group MP (χ2=39.23, P<0.01). The value of urinary fluoride of 33 patients admitted to hospital within 4 hours post injury in groups MP and SFP reached the top at 4 hours post injury and then gradually declined, which returned to normal on about 5 days post injury. The values of urinary fluoride of patients in group SFP at 4, 12, and 24 hours post injury and on 2, 3, 4, 5, 6, and 7 days post injury were significantly higher than those in group MP (Z=-4.28, -4.15, -3.81, -4.21, -2.48, -2.06, -2.31, -2.68, -3.03, P<0.05 or P<0.01). (3) Twenty-seven patients had electrocardiographic abnormality. There were 12 patients with T wave changes (the most common), 8 patients with ST-T changes, 6 patients with ventricular arrhythmias, 6 patients with conduction block, and 1 patient with broadened QRS waveform. There was no patient with prolonged Q-T interval. The ratios of patients with the above electrocardiographic abnormalities in group SFP were higher than those in group NMP and group MP.@*Conclusions@#Clinical manifestations of patients with HF burn are hypocalcemia, hypomagnesemia, hypokalemia, and electrocardiographic abnormality. In addition to routine serum electrolyte and electrocardiogram monitoring, the levels of serum ionized calcium and urinary fluoride can be helpful to evaluate the severity of illness of the patients.

Fate and toxicity of spilled chemicals in groundwater and soil environment I: strong acids

We reviewed the chemical/physical properties, toxicity, environmental fate, and ecotoxicity of strong acids in soil and groundwater environments. We recommend that sulfuric acid and hydrofluoric acid be classified as chemicals of priority control based on volumes used, toxicity, carcinogenicity, and past significant spill events. Understanding the behavior and transport of spilled strong acids in soil and groundwater environments requires a multi-disciplinary approach, as they can undergo a variety of geochemical and biochemical reactions with complex geomedia. The toxicity of spilled acid is dependent on the characteristics of the geomedia exposed to the acid and the amount of residual protons following acid–substrate interaction. Soil texture, cation exchange capacity, mineral composition, bedrock type, and aluminum content may be important factors affecting the toxicity of spilled acid in soil-groundwater environments. We expect that the results of this study will contribute preliminary data for future research on chemical spills.

Effect of Different Silane Treatments on Long-Term Bonding Between Non-Etched Glass-Ceramic and Resin Cement

he present study evaluated the bond strength between glass-ceramic and resin cement, using different silane treatments, performing no previous hydrofluoric acid (HF) etching on ceramic surface, after short- and long- term storage. One hundred and eighty glass-ceramic plaques (IPS e.max CAD®) were polished and divided into six groups (n=30) to receive different silane treatments: (1) RCP-RelyX Ceramic Primer® (one-bottle silane), (2) RCP+SB-RelyX Ceramic Primer and Adper Singlebond2® (silane plus separated adhesive), (3) SBU-Scotchbond Universal® (silane-containing universal adhesive), (4) CP-Clearfil Ceramic Primer® (silane/MDP primer), (5) NC-no-silane (negative control) and (6) PC-Previous HF etching (5%, 20s) plus RelyX Ceramic Primer® (positive control). Two resin cement cylinders (Rely X Ultimate®) were built on each plaque. Each group was divided into two sub-groups to be stored for 24 hours (24h) or 6 months (6mo) in distilled water at 37°C (n=15). Then microshear (µSBS) testing was performed. Failure mode was analyzed using scanning electron microscopy (SEM). Data were statistically analyzed by two-way ANOVA and Tukey´s test (α=0.05). Both factors and their interaction resulted statistically significant (p≤0.05). PC obtained the highest µSBS values (in MPa) at both storage times (24h: 28.11±2.44; 6mo: 19.10±3.85). After 24h storage, groups RCP+SB (10.86±3.62), SBU (8.37±4.33) and CP (8.05±3.62) were not statistically different from NC (8.00±2.51); only RCP (19.73±4.63) and PC obtained higher values. After 6 months, only PC showed higher values than NC (0.04±0.01). Cohesive failure in resin cement was more prevalent for RCP-24h and PC, while adhesive failure was more frequent among all other groups. Clinical relevance: None of the commercially available silane primers tested, improve long- term ceramic/cement bonding without performing HF etching on ceramic surface. Combination of HF acid and silane, remain as a gold standard treatment for glass-ceramic materials.

ste estudio evaluó la resistencia de unión entre cerámica vítrea y cemento resinoso, utilizando diferentes tratamientos de silano, sin realizar condicionamiento previo de la cerámica con ácido fluorhídrico (HF), después de almacenamiento en corto y largo plazo. Ciento ochenta placas de cerámica (IPS e.max CAD®) fueron pulidas y divididas en 6 grupos (n=30) para ser tratadas como sigue: (1) RCPRelyX Ceramic Primer® (silano de 1 frasco), (2) RCP+SB-RelyX Ceramic Primer y Adper Singlebond2® (silano más adhesivo separado), (3) SBU-Scotchbond Universal® (adhesivo universal conteniendo silano), (4) CP-Clearfil Ceramic Primer® (primer cerámico conteniendo silano y MDP), (5) NC-ningún silano (control negativo) y (6) PC-Condicionamiento con HF previo (5%, 20s) y silano (RelyX Ceramic Primer®) (control positivo). Dos cilindros de cemento resinoso (Rely X Ultimate®) fueron construidos en cada placa. Cada grupo fue dividido en 2 sub-grupos para ser almacenados por 24 horas (24h) y 6 meses (6mo) en agua destilada a 37°C (n=15). Luego fue realizada la prueba de microcizallamiento (µSBS). El tipo de fractura fue analizado con microscopio electrónico de barrido (SEM) y los datos analizados con las pruebas estadísticas ANOVA de dos factores y Tukey (α=0.05). Ambos factores y su interacción resultaron estadísticamente significativos (p≤0.05). PC presentó los valores más altos de µSBS (MPa) para ambos tiempos de almacenamiento (24h: 28.11±2.44; 6mo: 19.10±3.85). Luego de 24h, los grupos RCP+SB (10.86±3.62), SBU (8.37±4.33) y CP (8.05±3.62) no fueron estadísticamente diferentes del grupo control negativo (NC: 8.00±2.51); sólo RCP (19.73±4.63) y PC obtuvieron resultados mayores. Después de 6 meses de almacenaje, sólo el grupo PC obtuvo valores estadísticamente mayores que NC (0.04±0.01). Fractura cohesiva en el cemento fue más prevalente para RCP-24h y PC, mientras que el tipo adhesivo fue el más frecuente para todos los demás grupos. Relevancia Clínica: Ninguno de los tratamientos de silano evaluados, mejoró significativamente la adhesión a largo plazo entre cerámica vítrea no condicionada y cemento resinoso. La combinación de HF y silano, continúa siendo el tratamiento de preferencia para cerámica vítrea durante el proceso de cementación.

Effect of hydrofluoric acid concentration on the surface morphology and bonding effectiveness of lithium disilicate glass ceramics to resin composites / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study aimed at determining the influence of hydrofluoric acid (HF) in varied concentrations on the surface morphology of lithium disilicate glass ceramics and bond durability between resin composites and post-treated lithium disilicate glass ceramics.</p><p><b>METHODS</b>After being sintered, ground, and washed, 72 as-prepared specimens of lithium disilicate glass ceramics with dimensions of 11 mm×13 mm×2 mm were randomly divided into three groups. Each group was treated with acid solution [32% phosphoric acid (PA) or 4% or 9.5% HF] for 20 s. Then, four acidified specimens from each group were randomly selected. One of the specimens was used to observe the surface morphology using scanning electron microscopy, and the others were used to observe the surface roughness using a surface roughness meter (including Ra, Rz, and Rmax). After treatment with different acid solutions in each group, 20 samples were further treated with silane coupling agent/resin adhesive/resin cement (Monobond S/Multilink Primer A&B/Multilink N), followed by bonding to a composite resin column (Filtek™ Z350) with a diameter of 3 mm. A total of 20 specimens in each group were randomly divided into two subgroups, which were used for measuring the microshear bond strength, with one of them subjected to cool-thermal cycle for 20 000 times.</p><p><b>RESULTS</b>The surface roughness (Ra, Rz, and Rmax) of lithium disilicate glass ceramics treated with 4% or 9.5% HF was significantly higher than that of the ceramic treated with PA (P<0.05). The lithium disilicate glass ceramics treated with 9.5% HF also demonstrated better surface roughness (Rz and Rmax) than that of the ceramics treated with 4% HF. Cool-thermal cycle treatment reduced the bond strength of lithium disilicate glass ceramics in all groups (P<0.05). After cool-thermal cycle, the lithium disilicate glass ceramics treated with HF had higher bond strength than that of the ceramics treated with PA. The lithium disilicate glass ceramics treated with 4% HF had higher bond strength than that of the ceramics treated with 9.5% HF (P<0.05). During cool-thermal cycle, the lithium disilicate glass ceramics treated with 4% HF demonstrated higher reduction in bond strength than that of the samples treated with 9.5% HF (P<0.05).</p><p><b>CONCLUSIONS</b>The concentration of HF significantly affected the surface morphology of lithium disilicate glass ceramics and the bond durability between resin composites and post-treated lithium disilicate glass ceramics. The bond strength between resin composites and post-treated lithium disilicate glass ceramic was more efficiently maintained by treatment with 9.5% HF.</p>