Adhesive luting to hybrid ceramic and resin composite CAD/CAM Blocks:Er:YAG Laser versus chemical etching and micro-abrasion pretreatment.

PURPOSE: To evaluate the effect of Er:YAG laser on the roughness, surface topography, and bond strength to resin luting cement based on chemical and micro-abrasion pretreatments of different computer-aided design/computer-aided manufacturing materials. METHODS: A polymer-infiltrated-ceramic-network (PICN) material (Vita Enamic, VE), three indirect resin composite (Cerasmart, CS; Shofu HC, SH; Lava Ultimate, LU), and one lithium disilicate ceramic (IPS e.max CAD, EM) blocks were subjected to one of the following pretreatments: no treatment (NC ), Er:YAG etching with one of two powers (either 3 or 6 W), hydrofluoric acid (HF) etching, self-etching ceramic primer (ME), or micro-abrasion (MA). The shear bond strength (SBS) of resin luting cement to pretreated materials was tested. Surface roughness was measured via atomic force microscopy, and surface topography was analyzed via scanning electron microscopy. Two-way analysis of variance, Tukey post-hoc test, and Pearson correlation were applied. RESULTS: Etching EM and VE with HF or the ME resulted in the highest SBS values in their groups (P < 0.05). LU, SH, VE, and CS indicated similar SBS values when treated with 3 W, 6 W, and MA. The highest surface roughness (Sa ) values were obtained for the LU, CS, and VE groups when treated with 6 W, whereas the lowest Sa values were obtained for CS when treated with the ME and EM when treated with the ME or 3 W. Only SH and CS indicated a significant correlation between surface rough ness and bond strength. CONCLUSIONS: Er:YAG laser etching is comparable to micro-abrasion when treating resin composite blocks and may induce fewer surface cracks. HF etching remains the gold standard for the treatment of glass-based ceramics and PICNs.

Effect of Load Cycling on the Fracture Strength/Mode of Teeth Restored with FRC Posts or a FRC Liner and a Resin Composite.

The aim of the study was to comparatively evaluate the fracture strength and mode of root canal treated teeth restored with resin composites with and without posts. The lingual cusps of root canal treated first upper premolars (n = 10/group) were removed down to cervical enamel and restored with the following: group A: glass-fiber post (Glassix) followed by a particulate-filled composite resin (PFC, G-aenial posterior, 3 × 2 mm layers); group B: glass-fiber reinforced composite bulk fill liner (EverX posterior, 4 mm layer) with the PFC (2 mm layer). Specimens were immersed in H2O (1 w/37°C), then subjected to load cycling (50 N/0.2 Hz/200k cycles), and fractured under compressive loading. Failure mode was characterized by stereomicroscopy. Statistical analysis was performed by Mann-Whitney (load) and Chi-square (mode) at a = 0.05. No statistically significant differences (p = 0.273) were found in fracture load between median values of groups A (860 N) and B (1059 N). In group A, 60% of the specimens demonstrated catastrophic root fractures and 40% mixed crown fractures (tooth cusp and restoration), whereas in group B, no root fractures were found, and the failure modes were equally distributed between mixed fractures as above and fracture of the buccal cusp. These differences were statistically significant (p = 0.004). The combination of the glass-FRC bulk fill liner with the PFC diminished the catastrophic root fractures induced by FRC posts, at a similar or higher fracture load.

Self-etching ceramic primer versus hydrofluoric acid etching: Etching efficacy and bonding performance.

AIM: This study assessed the effect of pretreatment of hybrid and glass ceramics using a self-etching primer on the shear bond strength (SBS) and surface topography, in comparison to pretreatment with hydrofluoric acid and silane. METHODS: 40 rectangular discs from each ceramic material (IPS e.max CAD;EM, Vita Mark II;VM, Vita Enamic;VE), were equally divided (n=10) and assigned to one of four surface pretreatment methods; etching with 4.8% hydrofluoric acid followed by Monobond plus (HFMP), Monobond etch & prime (Ivoclar Vivadent) (MEP), No treatment (NT) as negative control and Monobond plus (Ivoclar Vivadent) with no etching (MP) as positive control. SBS of resin cement (Multilink-N, Ivoclar Vivadent) to ceramic surfaces was tested following a standard protocol. Surface roughness was evaluated using an Atomic force microscope (AFM). Surface topography and elemental analysis were analyzed using SEM/EDX. Data were analyzed with two-way analysis of variance (ANOVA) and post-hoc Bonferroni test at a significance level of α=0.05. RESULTS: Pretreatment with HFMP resulted in higher SBS and increased surface roughness in comparison to MEP and MP. Regardless the method of surface pretreatment, the mean SBS values of EM ceramic was significantly higher (p<0.05) than those recorded for VM and VE, except when VE was treated with MEP, where the difference was statistically insignificant. Traces of fluoride ion were detected when MEP was used with VE and VM. CONCLUSION: Under limited conditions, using MEP resulted in comparable SBS results to HFMP; meanwhile HFMP remains the gold standard for pretreatment of glass ceramics for resin-luting cementation.

Cavity Adaptation of Water-Based Restoratives Placed as Liners under a Resin Composite.

Purpose. To investigate the cavity adaptation of mineral trioxide (ProRoot MTA/MT), tricalcium silicate (Biodentine/BD), and glass ionomer (Equia Fil/EF) cements used as liners and the interfacial integrity between those liners and a composite resin placed as the main restorative material. Materials and Methods. Standardized class I cavities (n: 8 per group) were prepared in upper premolars. Cavities were lined with a 1 mm thick layer of each of the tested materials and restored with Optibond FL adhesive and Herculite Precis composite resin. Cavity adaptation of the restorations was investigated by computerized X-ray microtomography. The regions of interest (ROI) were set at the cavity-liner (CL) interface and the liner-resin (LR) interface. The percentage void volume fraction (%VVF) in the ROI was calculated. The specimens were then sectioned and the interfaces were evaluated by reflection optical microscopy, to measure the % length (%LD) of the interfacial gaps. Selected samples were further evaluated by scanning electron microscopy. Statistical analysis was performed by two-way ANOVA and Student-Newman-Keuls multiple comparison test (a = 0.05). Results. MT showed significantly higher %VVF and %LD values in CL interfaces than BD and EF (p < 0.05). No significant differences were found among the materials for the same values at the LR interfaces. Conclusions. When used as a composite liner, ProRoot MTA showed inferior cavity adaptation at dentin/liner interface when compared to Biodentine and Equia Fil.

Evaluation of cavity wall adaptation of bulk esthetic materials to restore class II cavities in primary molars.

OBJECTIVES: The purpose of the study was to assess the cavity wall adaptation and gap formation of a bulk fill composite resin and reinforced conventional glass ionomer cement and a resin-modified glass ionomer cement in class II restorations on primary molars. MATERIALS AND METHODS: Standardized class II slot cavity preparations were prepared in exfoliating primary molars. Teeth were restored with one of the three tested materials (n = 10): SonicFill bulk fill composite resin (SF), EQUIA Fil conventional reinforced glass ionomer cement (EQF), and Vitremer resin-reinforced glass ionomer cement (VT). Cavity wall adaptation of the restorations was investigated by computerized X-ray micro-tomography and the percentage void volume fraction (%VVF) was calculated. Same specimens were sectioned and the interfaces were evaluated by reflection optical microscopy to measure the percentage linear length (%LD) of the interfacial gaps. Samples were further evaluated by environmental scanning electron microscopy (ESEM). RESULTS: EQF and SF showed significantly lower %VVF and %LD values than VT (p < 0.05). This was in accordance with ESEM findings where VT illustrated extended interfacial gaps. CONCLUSIONS: SF and EQF showed better cavity wall adaptation than VT in class II restorations on primary molars. CLINICAL RELEVANCE: High-strength conventional glass ionomer cement (GIC EQF) and bulk fill composite SF requiring fewer application steps and reduced operating time than the traditional composite resin materials showed good cavity wall adaptation. Short operating time and good cavity wall adaptation are advantages of the materials in restorative and pediatric dentistry, especially while working on children with limited attention span.