Effect of primer compositions on the bond strength of resin cement to ceramic materials.

PURPOSE: To investigate the effect of different chemical compositions of primers on the bond strength between nano-ceramic, polymer-infiltrated ceramic, and zirconia ceramic materials and dual-cure cement. METHODS: Fifty 2 mm-thick specimens were prepared from Vita Enamic, Cerasmart, and Katana Zirconia UTML. The specimens were embedded in acrylic blocks. To standardize the surfaces, 600 grit silicon carbide abrasives were applied underwater for 60 seconds. Then, each section underwent grit-blasting using Al2O3 with a particle size of 50 µm at 10 mm and a pressure of 2 bar for 10 seconds. Each prepared sample from the experimental groups received the appropriate primer (Z-PRIME Plus, G-Multi Primer, Alloy Primer, Clearfil Primer Plus) according to the manufacturers' instructions. Subsequently, the prepared CAD-CAM specimens underwent cementation using Duo-Link Universal Adhesive Resin Cement with a cylinder mold of 2.6 mm diameter and 3 mm height. The cement was light-cured for 20 seconds from both sides. The specimens obtained were stored in distilled water at 37°C for 24 hours. The shear bond strength test of the specimens was performed using a Bisco Shear Bond Tester device. The data were statistically analyzed using ANOVA and the Kruskal-Wallis test (P< 0.05). RESULTS: The highest bond strength was observed in Z-Prime Plus applied specimens, regardless of material differences (Cerasmart 11.60±4.61; Vita Enamic 12.93±3.86; Katana Zirconia 13.85±4.00). The lowest bond strength, showing differences according to materials (P< 0.05), was found for Clearfil Ceramic Primer Plus-Cerasmart (7.88±3.90), Alloy Primer-Vita Enamic (7.90±2.14), and G Multi Primer-Katana Zirconia UTML (4.98±3.67). CLINICAL SIGNIFICANCE: Failure of the restoration usually occurs at the weakest point in this three-element structure, thus correct primer selection according to material type is important. Additionally, for all CAD-CAM materials used in the study, Z-Prime Plus showed significantly greater adhesion strength than other systems so it may be more appropriate for use in clinics.

Effect of different decontamination agents on the bond strength of CAD/CAM blocks and repair composite materials / Efecto de diferentes agentes descontaminantes sobre la resistencia de unión de bloques CAD/CAM y resinas compuestas

Abstract The purpose of this study was to examine the effect of different decontamination agents on the bond strength of saliva-contaminated CAD/CAM blocks and repair composite materials. Two hunderd eighty 3-mm-thick specimens were prepared from four different CAD/CAM materials: Katana Zirconia UTML disc, IPS e.max CAD block, Shofu block, and Vita Enamic block. Each material was divided into seven different subgroups (N=70). Group 1 had a clean surface. The other groups were comprised of the samples, which were contaminated with human saliva: group 2: negative control (non-cleaned); group 3: cleaned with water spray; group 4: cleaned with 70% ethanol; group 5: cleaned with Ivoclean; group 6: cleaned with Katana Cleaner; and group 7: cleaned with phosphoric acid. After the decontamination protocols, the resin composite cylinders were bonded to the CAD/CAM surfaces with a thin layer of dual-cured resin cement. The samples were stored for 24 hours at 37°C in distilled water. Then, they were subjected to a shear bond strength test (SBS). The values were recorded, and fracture types were evaluated using a microscope. Data were analyzed using two-way ANOVA and Tukey's post-hoc test. Generally, all decontaminating agents improved the SBS of composites to Katana Zirconia UTML, IPS e.max, and Vita Enamic materials (p<0.05). However, for Shofu materials, group 6 samples exhibited significantly higher bond strength values as compared with group 2 samples (p=0.026). The highest SBS values were seen in the phosphoric acid-treated group in Katana zirconia materials (26.45 ± 9.38 MPa), whereas the lowest values were seen in group 2 samples in Shofu materials (13.17±3.40 MPa). Each decontaminant agent improved the bond strength of composites to the contaminated CAD/CAM materials. If saliva is not cleaned before adhesive procedure, SBS values may decrease. All decontamination agents can be used safely on zirconia, lithium-disilicate glass-ceramic, hybrid ceramic, and polymer-infiltrated ceramic surfaces.

Resumen El propósito de este estudio fue examinar el efecto de diferentes agentes descontaminantes sobre la fuerza de unión de bloques CAD/CAM contaminados con saliva y materiales compuestos de reparación. Se prepararon doscientas ochenta muestras de 3 mm de espesor a partir de cuatro materiales CAD/CAM diferentes: disco Katana Zirconia UTML, bloque IPS e.max CAD, bloque Shofu y bloque Vita Enamic. Cada material se dividió en siete subgrupos diferentes (N=70). El grupo 1 tenía una superficie limpia. Los otros grupos estaban compuestos por muestras que estaban contaminadas con saliva humana: grupo 2: control negativo (no limpio); grupo 3: limpiado con agua pulverizada; grupo 4: limpiado con etanol al 70%; grupo 5: limpiado con Ivoclean; grupo 6: limpiado con Katana Cleaner; y grupo 7: limpiado con ácido fosfórico. Después de los protocolos de descontaminación, los cilindros de composite de resina se adhirieron a las superficies CAD/CAM con una fina capa de cemento de resina de curado dual. Las muestras se almacenaron durante 24 horas a 37°C en agua destilada. Luego, fueron sometidos a una prueba de resistencia al corte (SBS). Se registraron los valores y se evaluaron los tipos de fracturas utilizando un microscopio. Los datos se analizaron mediante ANOVA de dos factores y la prueba post-hoc de Tukey. En general, todos los agentes descontaminantes mejoraron el SBS de los composites con los materiales Katana Zirconia UTML, IPS e.max y Vita Enamic (p<0,05). Sin embargo, para los materiales Shofu, las muestras del grupo 6 exhibieron valores de fuerza de unión significativamente más altos en comparación con las muestras del grupo 2 (p=0,026). Los valores más altos de SBS se observaron en el grupo tratado con ácido fosfórico en materiales de circonio Katana (26,45 ± 9,38 MPa), mientras que los valores más bajos se observaron en las muestras del grupo 2 en materiales Shofu (13,17 ± 3,40 MPa). Cada agente descontaminante mejoró la fuerza de unión de los composites a los materiales CAD/CAM contaminados. Si no se limpia la saliva antes del procedimiento adhesivo, los valores de SBS pueden disminuir. Todos los agentes descontaminantes se pueden utilizar de forma segura en superficies de circonio, cerámica de vidrio de disilicato de litio, cerámica híbrida y cerámica con infiltraciones de polímeros.

The visual and instrumental analyses of different single-shade resin composites / Análisis visual e instrumental de diferentes resinas compuestas omnicromáticas

Abstract The purpose of this study was to evaluate the color adaptation of single-shade resin composites applied to different tooth shades. A total of 108 class III preparations (n=6) were performed on the acrylic denture maxillary incisors (2mm depth and 2mm height). 5 single-shade resin composites (Vittra APS Unique, Omnichroma, ZenChroma, Clearfil Majesty ES-2 Universal, Charisma Topaz One) and 1 multishade resin composite (Estelite Asteria) were placed in the cavities and polished. I performed visual and instrumental color analyses. The CIEDE2000 formula was used to assess the shade differences (ΔE) between teeth and restorations. The obtained ΔE values were recorded and statistically analyzed. For the instrumental analysis, ZenChroma in A1 shade groups showed statistically significant higher differences (p<0.05). Among all tested materials, A3 shade groups showed lower ΔE values (p<0.05). For the visual analysis, there were no significant differences between materials and scores in A1 and A3 shade groups (p>0.05). There were statistically significant differences between the materials and the scores in A2 shade groups (p<0.05). As a result of this study, it was concluded that, making esthetic restorations with single-shade resin composites promises proper color adaptation, but their properties still need improvement. Single-shade resin composites can reduce chair-time and technical sensitivity with good color matching.

Resumen El objetivo de este estudio fue evaluar la adaptación del color de resinas compuestas omnicromáticas. Se realizaron un total de 108 preparaciones de clase III (n=6) en los incisivos superiores de prótesis acrílicas (2mm de profundidad y 2mm de altura). Se colocaron cinco resinas compuestas omnicromáticas (Vittra APS Unique, Omnichroma, ZenChroma, Clearfil Majesty ES-2 Universal, Charisma Topaz One), además de una resina multitono (Estelite Asteria) en las cavidades y se pulieron. Se realizó el análisis de color visual e instrumental. Se utilizó la fórmula CIEDE2000 para evaluar las diferencias de tono (ΔE) entre dientes y restauraciones. Los valores de ΔE obtenidos se registraron y analizaron estadísticamente. Para el análisis instrumental, ZenChroma en los grupos de color A1 mostró diferencias mayores estadísticamente significativas (p<0,05). Entre todos los materiales probados, los grupos de tonos A3 mostraron valores de ΔE más bajos (p<0.05). Para el análisis visual, no hubo diferencias significativas entre materiales y puntuaciones en los grupos de color A1 y A3 (p>0,05). Hubo diferencias estadísticamente significativas entre los materiales y las puntuaciones en los grupos de color A2 (p<0,05). Como resultado de este estudio, se concluyó que la realización de restauraciones estéticas con resinas compuestas omnicromáticas promueve una adecuada adaptación del color, pero aún necesitan mejorar sus propiedades. Las resinas compuetas omnicromáticas pueden reducir el tiempo de atención clínica y la sensibilidad técnica con una adecuada combinación de colores.

Effect of surface roughness and biofilm formation on the color properties of resin-infiltrated ceramic and lithium disilicate glass-ceramic CAD-CAM materials.

STATEMENT OF PROBLEM: Computer-aided design and computer-aided manufacturing (CAD-CAM) materials have become popular for dental restorations; however, which materials should be preferred in terms of surface properties after biofilm formation is unclear. PURPOSE: The purpose of this in vitro study was to investigate the effect of biofilm formation on the discoloration properties of resin-infiltrated ceramic and glass-ceramic CAD-CAM materials and human teeth and to examine the effect of the brushing procedure on color change. MATERIAL AND METHODS: One hundred and six 2-mm-thick specimens were prepared from IPS e.max CAD and Cerasmart, and a total of 53 intact human teeth were used. Five specimens from each group were used to measure the amount of live biomass in the biofilm. The remaining 48 specimens in each group were divided into 4 subgroups: kept in distilled water without the formation of dental biofilm (DW), kept in tea without the formation of dental biofilm (T), kept in distilled water after the formation of dental biofilm (DWB), and kept in tea after the formation of dental biofilm (TB) (n=12). After finishing and polishing the materials, initial color measurements were made using a spectrophotometer, and surface roughness measurements were made using noncontact profilometer. After creating a biofilm layer in DWB and TB, all specimens were kept in their solutions at 37 °C for 24 hours, and the color measurements were repeated. After the biofilm layer had been removed by brushing, a third color measurement was made. The data were statistically analyzed with one-way analysis of variance (ANOVA) and two-way ANOVA (α=.05). RESULTS: The lowest roughness value was observed in Cerasmart. Tooth-IPS e.max CAD gave similar results. The Cerasmart material had the most viable biomass, whereas the IPS e.max CAD material had the least. TB had the highest ΔE1 value for all materials and DW had the lowest (P<.05). The brushing procedure caused the materials to return to their initial colors or reduce the color change in most groups. CONCLUSIONS: The presence of biofilm on CAD-CAM materials immersed in distilled water caused an unacceptable degree of discoloration (ΔE>1.8), and immersion in tea led to greater color change. The adhesion of biofilm to restorative dental materials plays an important role in the coloring of these dental materials.

The radiographic evaluation of 11 different resin composites.

Radiopacities of dental materials used in restorations are very important in making the radiographic diagnosis. Therefore, the aim of our study was to evaluate the radiopacity of five single-shade and six simplishade resin composites with digital technique. Five different single-shade (Charisma Topaz One, Omnichroma, Clearfil Majesty ES-2 Universal, Vittra APS Unique, ZenChroma) and six different simplishade resin composites (G-aenial A'CHORD, Essentia Universal, OptiShade, Estelite Asteria, Filtek Universal, Filtek Z250) were used. For each group, five disk-shaped resin composites of 1 mm and 2 mm thicknesses were prepared. As a control, tooth slices with 1 mm and 2 mm thicknesses and a 99.5% pure aluminum step-wedge were used. The samples, tooth slices, and a step-wedge were placed on a photostimulable phosphor plate. Digital radiographs were taken from 30 and 40 cm distances (70 kVp, 7 mA 0.28 ms). The images were analyzed using ImageJ software to measure the mean gray values. Data were analyzed using SPSS 22 package program and Kruskal-Wallis H Test (p < 0.05). The highest radiopacity was seen in Filtek Universal at both distances and thicknesses. Omnichroma had the lowest radiopacity in all parameters. All specimens showed higher radiopacity than dentin. Except for Omnichroma 1 and 2 mm thick, Clearfil Majesty ES-2 Universal 2 mm thick, samples showed higher radiopacities than enamel (p < 0.05). The restorative materials tested were found to be more radiopaque than dentin. The samples passed the International Organization for Standardization for radiopacity values. The radiopacity values were affected by thickness and type of materials.

Wear behavior of different materials used for pit and fissure sealing.

PURPOSE: To evaluate the wear of different materials used for pit and fissure sealing applied with non-invasive and invasive preparation techniques. METHODS: A total of 170 molar teeth were divided into two main preparation groups (non-invasive and invasive), each consisting of eight subgroups after a control group was separated for wear standardization. Eight subgroups included: nano-filled flowable composite (Filtek Ultimate Flow), nanohybrid flowable composite (GrandioSo Flow), micro-hybrid flowable composite (Majesty Flow), resin-based unfilled fissure sealant (ClinPro Sealant), resin-based filled fissure sealant (Fissurit FX), resin-based highly filled fissure sealant (GrandioSeal), giomer-based fissure sealant (BeautiSealant), and glass-ionomer-based fissure sealant (Fuji Triage) (n= 10). The materials were applied according to the manufacturers' instructions. The initial data were obtained for wear analysis. The specimens were subjected to 2-year thermocycling and brushing simulations. Final data were obtained, and the wear characteristics were evaluated digitally. Data were statistically analyzed (P< 0.05). RESULTS: There were no significant differences in wear between the non-invasive and invasive application groups (P< 0.05). In comparison of the materials, flowable composites presented the lowest wear (0.15 P± 0.13), and glass-ionomer-based fissure sealant presented the highest wear (0.66 P± 0.32). CLINICAL SIGNIFICANCE: The present study reported that the invasive preparation technique, which slightly abrades the enamel surfaces, did not adversely affect the wear of the sealant materials. Although the application of flowable composites as fissure sealants with a bonding agent is time-consuming and costly, it yielded better results in terms of wear.

Evaluation of the color stability of attachments made with different resin composites.

INTRODUCTION: Coloring solutions-such as coffee and cola, frequently consumed daily-cause coloration of attachments made with resin composites. This may reduce the motivation for clear aligner treatment, often preferred by patients with esthetic concerns. This study aimed to compare color changes of orthodontic attachments made with 3 different composite resins. METHODS: A total of 90 premolar teeth (n = 10) extracted for orthodontic reasons were used. All teeth were embedded in plaster models to imitate the arch shape and scanned with an intraoral scanner. Horizontal rectangular attachments were placed on each tooth by printing the attachment template obtained using digital models. Three composite resins: Omnichroma, GC Aligner Connect, and Tetric PowerFlow were used to prepare the attachments. The models prepared in arc-shaped in each composite group were divided into subgroups and kept in 3 different solutions (coffee, cola, and distilled water) in the incubator at 37 ± 1°C. The models were photographed at baseline and 28 days later with the Smile-Lite MDP device. L, a, and b values were obtained with Digital Color Meter (version 5.22; Apple, Cupertino, Calif). CIEDE2000 formula (ΔE00) was used to evaluate color changes. In addition, models were scanned for color determination at baseline and 28 days later with the 3Shape intraoral scanner. RESULTS: There were significant color differences between solutions (P <0.05). CONCLUSIONS: Attachments can be colored easily. Patients should be warned against coloring solutions at the beginning of the treatment, and their eating and drinking habits should be regulated.