Shear Bond Strength of Resin Luting Materials to Lithium Disilicate Ceramic: Correlation between Flexural Strength and Modulus of Elasticity.

This study investigates the effect of the curing mode (dual-cure vs. self-cure) of resin cements (four self-adhesive and seven conventional cements) on their flexural strength and flexural modulus of elasticity, alongside their shear bond strength to lithium disilicate ceramics (LDS). The study aims to determine the relationship between the bond strength and LDS, and the flexural strength and flexural modulus of elasticity of resin cements. Twelve conventional or adhesive and self-adhesive resin cements were tested. The manufacturer's recommended pretreating agents were used where indicated. The shear bond strengths to LDS and the flexural strength and flexural modulus of elasticity of the cement were measured immediately after setting, after one day of storage in distilled water at 37 °C, and after 20,000 thermocycles (TC 20k). The relationship between the bond strength to LDS, flexural strength, and flexural modulus of elasticity of resin cements was investigated using a multiple linear regression analysis. For all resin cements, the shear bond strength, flexural strength, and flexural modulus of elasticity were lowest immediately after setting. A clear and significant difference between dual-curing and self-curing modes was observed in all resin cements immediately after setting, except for ResiCem EX. Regardless of the difference of the core-mode condition of all resin cements, flexural strengths were correlated with the LDS surface upon shear bond strengths (R2 = 0.24, n = 69, p < 0.001) and the flexural modulus of elasticity was correlated with them (R2 = 0.14, n = 69, p < 0.001). Multiple linear regression analyses revealed that the shear bond strength was 17.877 + 0.166, the flexural strength was 0.643, and the flexural modulus was (R2 = 0.51, n = 69, p < 0.001). The flexural strength or flexural modulus of elasticity may be used to predict the bond strength of resin cements to LDS.

Shear bond strength of resin cement on moist dentin and its relation to the flexural strength of resin cement.

We sought to compare the bond strength of resin cement on moist dentin to that on dry dentin, and determine the relationship between the bond strength and flexural strength of resin cement. The water content of the moist and dry dentins was estimated using infrared spectroscopy. Four adhesive and three self-adhesive resin cements were used. At three times of immediately, after one-day storage, and after 20,000 thermocycles (TC 20k), the shear bond strengths were measured. For all resin cements, both the shear bond strength and the flexural strength were the lowest immediately after setting; however, after one day of water storage or TC 20k, these resin cements had the highest values. Regardless of the condition of the dentin surface upon shear bond strength, the flexural strength of each resin cement was correlated with the shear bond strength of the dentin surface.

Relationships between Flexural and Bonding Properties, Marginal Adaptation, and Polymerization Shrinkage in Flowable Composite Restorations for Dental Application.

To evaluate the flexural and bonding properties, marginal adaptation, and polymerization shrinkage in flowable composite restorations and their relationships, four new generation flowable composites, one conventional, and one bulk-fill flowable composite were used in this study. Flexural properties of the composites and shear bond strength to enamel and dentin for flowable restorations were measured immediately and 24 h after polymerization. Marginal adaptation, polymerization shrinkage, and stress were also investigated immediately after polymerization. The flexural properties, and bond strength of the flowable composites to enamel and dentin were much lower immediately after polymerization than at 24 h, regardless of the type of the composite. Polymerization shrinkage and stress varied depending on the material, and bulk-fill flowable composite showed much lower values than the others. The marginal adaptation and polymerization shrinkage of the composites appeared to have a much stronger correlation with a shear bond strength to dentin than to enamel. The weak mechanical properties and bond strengths of flowable composites in the early stage after polymerization must be taken into account when using them in the clinic. In addition, clinicians should be aware that polymerization shrinkage of flowable composites can still lead to the formation of gaps and failure of adaptation to the cavity regardless of the type of composite.

Phosphate group adsorption capacity of inorganic elements affects bond strength between CAD/CAM composite block and luting agent.

This study aimed to investigate whether inorganic elements of polymer-infiltrated ceramic (PIC) and microfilled resin (MFR) for CAD/CAM would affect initial bond strength to luting agent. Inorganic elements of PIC and MFR were different with shape and ingredient observed by SEM, STEM and EDS. Microtensile bond strengths (µTBS) value of PIC was increased by 10-methacryloyloxydecyl dihydrogen phosphate (MDP) and acetic acid (AA)- or MDP-activated silane treatment, and further increased by succeeding heat treatment (HT). The µTBS of MFR was increased by MDP and MDP-activated silane, but decreased by AA-activated silane without HT. The HT improved the µTBS of MFR with AA-activated silane, but conversely for MDP-activated silane. Only in MFR, phosphoric acid (PA) application before each surface treatment dramatically decreased the µTBS of AA-activated silane. FTIR peaks in MFR shifted according to phosphate group's peak. MFR would possess high phosphate group adsorption capacity, with MDP effectively improving its bonding capability.

Flexural Strength of Resin Core Build-Up Materials: Correlation to Root Dentin Shear Bond Strength and Pull-Out Force.

The aims of this study were to investigate the effects of root dentin shear bond strength and pull-out force of resin core build-up materials on flexural strength immediately after setting, after one-day water storage, and after 20,000 thermocycles. Eight core build-up and three luting materials were investigated, using 10 specimens (n = 10) per subgroup. At three time periods-immediately after setting, after one-day water storage, and after 20,000 thermocycles, shear bond strengths to root dentin and pull-out forces were measured. Flexural strengths were measured using a 3-point bending test. For all core build-up and luting materials, the mean data of flexural strength, shear bond strength and pull-out force were the lowest immediately after setting. After one-day storage, almost all the materials yielded their highest results. A weak, but statistically significant, correlation was found between flexural strength and shear bond strength (r = 0.508, p = 0.0026, n = 33). As the pull-out force increased, the flexural strength of core build-up materials also increased (r = 0.398, p = 0.0218, n = 33). Multiple linear regression analyses were conducted using these three independent factors of flexural strength, pull-out force and root dentin shear bond strength, which showed this relationship: Flexural strength = 3.264 × Shear bond strength + 1.533 × Pull out force + 10.870, p = 0.002). For all the 11 core build-up and luting materials investigated immediately after setting, after one-day storage and after 20,000 thermocycles, their shear bond strengths to root dentin and pull-out forces were correlated to the flexural strength in core build-up materials. It was concluded that the flexural strength results of the core build-up material be used in research and quality control for the predictor of the shear bond strength to the root dentin and the retentive force of the post.

Flexural properties, bond ability, and crystallographic phase of highly translucent multi-layered zirconia.

This study investigated the mechanical properties, bond ability, and crystallographic forms of different sites in a highly translucent, multi-layered zirconia disk. Flexural properties, bond ability to resin cement, and phase composition were investigated at three sites of a highly translucent, multi-layered zirconia disk: incisal, middle, and cervical. Flexural strength (FS) and flexural modulus (FM) were measured with static three-point flexural test. Shear bond strength (SB) to resin cement was measured after 24 h storage (37°C). Phase composition under mechanical stress was analyzed using X-ray diffraction. Without air abrasion, FS at the incisal site yielded the lowest value and was significantly lower than the middle and cervical sites. Air abrasion lowered the FS of each site. FM at the incisal site without air abrasion showed the significantly lowest value, and air abrasion increased its FM value. At the middle and cervical sites, their FM values were higher than the incisal site but were not significantly affected by air abrasion. SB value did not show significant differences among the sites. After sintering, cubic zirconia was detected at each site. Rhombohedral phase transformation occurred after mirror polishing. In highly translucent, multi-layered zirconia which was mainly composed of cubic zirconia, rhombohedral phase transformation occurred under mechanical stress and resulted in weakened mechanical properties.

Silane-coupling effect of a silane-containing self-adhesive composite cement.

OBJECTIVE: Hydrofluoric-acid etching followed by silanization is a routine clinical protocol for durable bonding to glass ceramics. Simplifying ceramic-bonding procedures, new technological developments involve the inclusion of a silane coupling agent in a self-adhesive composite cement. To investigate the effectiveness of the incorporated silane coupling agent, shear bond strength (SB) to ceramic and dentin, contact angle of water (CA), transmission electron microscopy (TEM), X-ray diffraction (XRD) and 29Si nuclear magnetic resonance (NMR) assessments were correlatively conducted. MATERIALS AND METHODS: SB to glass ceramic was measured without ('immediate') and with ('aged') 50K thermocycles upon application of (1) the silane-containing self-adhesive composite cement Panavia SA Cement Universal ('SAU'), being light-cured: 'SAU_light', (2) 'SAU_chem': chemically cured SAU, (3) 'SAP_light': light-cured Panavia SA Cement Plus ('SAP'), and (4) 'SAP_CP': SAP light-cured after separate silanization using Clearfil Ceramic Primer Plus ('CP'). CA was also measured on glass ceramic. The cement pastes before and upon mixing were characterized using 29Si NMR. SB of SAU or SAP onto dentin was measured. Finally, the cement-dentin interface was characterized by TEM and XRD. RESULTS: The immediate and aged SB to glass ceramic of SAU did not significantly differ from those of SAP_CP, while they were significantly higher than those of SAP. CA of SAU did not significantly differ from that of SAP_CP, but it was significantly higher than CA of SAP. 29Si NMR revealed siloxane bonds after mixture. SB of SAU and SAP to dentin did not show any significant difference. SEM, TEM and XRD confirmed tight and chemical interaction, respectively. SIGNIFICANCE: Incorporating silane in a 10-MDP-based self-adhesive composite cement combined efficient silane-coupling ability at the ceramic surface with effective bonding ability at dentin.

Performance of Class I composite restorations when polished immediately or after one-day water storage.

This study investigated the effects on gap formation in Class I restorations (observed by vertical and horizontal forms of inspection) and on the mechanical properties of nine resin composite filling materials when the restorations were subject to finishing immediately after setting or after one-day water storage. Class I restorations with resin composite fillings were polished either immediately (3 min) after setting or after one-day water storage. Interfacial gap formation (observed by vertical inspection) was assessed using 14 gap measurement points along the interface between the restoration and cavity walls and floor (n = 10 per resin composite; total points measured per time point = 140). For marginal gaps formed at cavosurface margins in Class I cavities and in Teflon molds, marginal gap formation (observed by horizontal inspection) was assessed by measuring the maximum gap-width and opposing width (if any). Effects on mechanical properties were assessed by measuring shear bond strengths to enamel and dentin, flexural strength and modulus. After one-day storage, marginal gap-widths in Class I restorations were significantly decreased for all composites, alongside a significant increase in shear bond strengths to enamel and dentin, flexural strength and modulus. Resin composite-filled Class I restorations which were polished after one-day delay presented lower gap formation compared with finishing immediately after setting.

Sandblasting may damage the surface of composite CAD-CAM blocks.

OBJECTIVE: CAD-CAM blocks to fabricate semi-direct and indirect restorations are available in different sorts of ceramics as well as composite. In order to bond restorations prepared out of composite blocks into tooth cavities, it is recommended to gently sandblast the surface prior to the application of a primer/adhesive. Today, the effect of sandblasting composite block surfaces has not thoroughly been investigated. In this study, the ultra-structure of composite CAD-CAM blocks was investigated with special attention to the effect of sandblasting on the surface topography and of silanization on the bonding performance. METHODS: Five different composite CAD-CAM blocks were involved. We correlatively investigated their structural and chemical composition using X-ray diffraction (XRD), energy dispersion spectroscopy (EDS), scanning electron microscopy (SEM) and (scanning) transmission electron microscopy ((S)TEM). The effect of sandblasting was also imaged in cross-section and at the interface with composite cement. Finally, we measured the shear bond strength to the sandblasted block surface with and without silanization. RESULTS: All composite blocks revealed a different ultra-structure. Sandblasting increased surface roughness and resulted in an irregular surface with some filler exposure. Sandblasting also damaged the surface. When the sandblasted composite blocks were silanized, superior bonding receptiveness in terms of higher bond strength was achieved except for Shofu Block HC. SIGNIFICANCE: Sandblasting followed by silanization improved the bond strength to composite CAD-CAM blocks. However, sandblasting may also damage the composite CAD-CAM block surface. For the composite CAD-CAM block Shofu Block HC, the damage was so severe that silanization did not improve bond strength.

Does acid etching morphologically and chemically affect lithium disilicate glass ceramic surfaces?

BACKGROUND: This study evaluated the surface morphology, chemical composition and adhesiveness of lithium disilicate glass ceramic after acid etching with hydrofluoric acid or phosphoric acid. METHODS: Lithium disilicate glass ceramic specimens polished by 600-grit silicon carbide paper were subjected to one or a combination of these surface treatments: airborne particle abrasion with 50-µm alumina (AA), etching with 5% hydrofluoric acid (HF) or 36% phosphoric acid (Phos), and application of silane coupling agent (Si). Stainless steel rods of 3.6-mm diameter and 2.0-mm height were cemented onto treated ceramic surfaces with a self-adhesive resin cement (Clearfil SA Cement). Shear bond strengths between ceramic and cement were measured after 24-hour storage in 37°C distilled water. RESULTS: SEM images of AA revealed the formation of conventional microretentive grooves, but acid etching with HF or Phos produced a porous surface. Bond strengths of AA+HF+Si (28.1 ± 6.0 MPa), AA+Phos+Si (17.5 ± 4.1 MPa) and HF+Si (21.0 ± 3.0 MPa) were significantly greater than those of non-pretreated controls with Si (9.7 ± 3.7 MPa) and without Si (4.1 ± 2.4 MPa) (p<0.05). In addition, HF etching alone (26.2 ± 7.5 MPa) had significantly higher bond strength than AA alone (11.5 ± 4.0 MPa) (p<0.05). AA+HF, AA+Phos and HF showed cohesive failures. CONCLUSIONS: Etching with HF or Phos yielded higher bond strength between lithium disilicate glass ceramic and self-adhesive resin cement without microcrack formation.

Does 8-methacryloxyoctyl trimethoxy silane (8-MOTS) improve initial bond strength on lithium disilicate glass ceramic?

OBJECTIVES: Dental ceramic surfaces are modified with silane coupling agents, such as γ-methacryloxypropyl trimethoxy silane (γ-MPTS), to improve bond strength. For bonding between lithium disilicate glass ceramic and resin cement, the objective was to investigate if 8-methacryloxyoctyl trimethoxy silane (8-MOTS) could yield a similar performance as the widely used γ-MPTS. METHODS: One hundred and ten lithium disilicate glass ceramic specimens were randomly divided into 11 groups (n=10) according to pretreatment regime. All specimens were pretreated with a different solution composed of one or a combination of these agents: 10 or 20wt% silane coupling agent of γ-MPTS or 8-MOTS, followed by a hydrolysis solution of acetic acid or 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP). Each pretreated surface was luted to a stainless steel rod of 3.6mm diameter and 2.0mm height with resin cement. Shear bond strength between ceramic and cement was measured after 24-h storage in 37°C distilled water. RESULTS: 8-MOTS produced the same bonding performance as γ-MPTS. Both silane coupling agents significantly increased the bond strength of resin cement, depending on their concentration. When activated by 10-MDP hydrolysis solution, 20wt% concentration produced the highest values (γ-MPTS: 24.9±5.1MPa; 8-MOTS: 24.6±7.4MPa). Hydrolysis with acetic acid produced lower bond strengths than with 10-MDP. SIGNIFICANCE: Silane coupling pretreatment with 8-MOTS increased the initial bond strength between lithium disilicate glass ceramic and resin cement, rendering the same bonding effect as the conventional γ-MPTS.

Various Effects of Sandblasting of Dental Restorative Materials.

BACKGROUND: Sandblasting particles which remain on the surfaces of dental restorations are removed prior to cementation. It is probable that adhesive strength between luting material and sandblasting particle remnants might exceed that with restorative material. If that being the case, blasting particles adhere to sandblasted material surface could be instrumental to increasing adhesive strength like underlying bonding mechanism between luting material and silanized particles of tribochemical silica coating-treated surface. We hypothesize that ultrasonic cleaning of bonding surfaces, which were pretreated with sandblasting, may affect adhesive strength of a resin luting material to dental restorative materials. METHODS: We therefore observed adhesive strength of resin luting material to aluminum oxide was greater than those to zirconia ceramic and cobalt-chromium alloy beforehand. To measure the shear bond strengths of resin luting material to zirconia ceramic and cobalt-chromium alloy, forty specimens of each restorative material were prepared. Bonding surfaces were polished with silicon abrasive paper and then treated with sandblasting. For each restorative material, 40 sandblasted specimens were equally divided into two groups: ultrasonic cleaning (USC) group and non-ultrasonic cleaning (NUSC) group. After resin luting material was polymerized on bonding surface, shear test was performed to evaluate effect of ultrasonic cleaning of bonding surfaces pretreated with sandblasting on bond strength. RESULTS: For both zirconia ceramic and cobalt-chromium alloy, NUSC group showed significantly higher shear bond strength than USC group. CONCLUSIONS: Ultrasonic cleaning of dental restorations after sandblasting should be avoided to retain improved bonding between these materials.

Functional monomer impurity affects adhesive performance.

OBJECTIVE: The functional monomer 10-MDP has been considered as one of the best performing functional monomers for dental adhesives. Different adhesives containing 10-MDP are commercially available, among which many so-called 'universal' adhesives. We hypothesize that the quality of the functional monomer 10-MDP in terms of purity may affect bonding performance. METHODS: We therefore characterized three different 10-MDP versions (10-MDP_KN provided by Kuraray Noritake; 10-MDP_PCM provided by PCM; 10-MDP_DMI provided by DMI) using NMR, and analyzed their ability to form 10-MDP_Ca salts on dentin using XRD. The 'immediate' and 'aged' micro-tensile bond strength (µTBS) to dentin of three experimental 10-MDP primers was measured. The resultant interfacial adhesive-dentin ultra-structure was characterized using TEM. RESULTS: NMR disclosed impurities and the presence of 10-MDP dimer in 10-MDP_PCM and 10-MDP_DMI. 10-MDP_PCM and 10-MDP_DMI appeared also sensitive to hydrolysis. 10-MDP_KN, on the contrary, contained less impurities and dimer, and did not undergo hydrolysis. XRD revealed more intense 10-MDP_Ca salt deposition on dentin induced by 10-MDP_KN. The adhesive based on the experimental 10-MDP_KN primer resulted in a significantly higher 'immediate' bond strength that remained stable upon aging; the µTBS of the experimental 10-MDP_PCM and 10-MDP_DMI adhesives significantly dropped upon aging. TEM revealed thicker hybridization and more intense nano-layering for 10-MDP_KN. SIGNIFICANCE: It was concluded that primer impurities and the presence of 10-MDP dimer affected not only hybridization, but also reduced the formation of 10-MDP_Ca salts and nano-layering. 10-MDP in a high purity grade is essential to achieve durable bonding.

Flexural properties of polyethylene, glass and carbon fiber-reinforced resin composites for prosthetic frameworks.

OBJECTIVE: High flexural properties are needed for fixed partial denture or implant prosthesis to resist susceptibility to failures caused by occlusal overload. The aim of this investigation was to clarify the effects of four different kinds of fibers on the flexural properties of fiber-reinforced composites. MATERIALS AND METHODS: Polyethylene fiber, glass fiber and two types of carbon fibers were used for reinforcement. Seven groups of specimens, 2 × 2 × 25 mm, were prepared (n = 10 per group). Four groups of resin composite specimens were reinforced with polyethylene, glass or one type of carbon fiber. The remaining three groups served as controls, with each group comprising one brand of resin composite without any fiber. After 24-h water storage in 37°C distilled water, the flexural properties of each specimen were examined with static three-point flexural test at a crosshead speed of 0.5 mm/min. RESULTS: Compared to the control without any fiber, glass and carbon fibers significantly increased the flexural strength (p < 0.05). On the contrary, the polyethylene fiber decreased the flexural strength (p < 0.05). Among the fibers, carbon fiber exhibited higher flexural strength than glass fiber (p < 0.05). Similar trends were observed for flexural modulus and fracture energy. However, there was no significant difference in fracture energy between carbon and glass fibers (p > 0.05). CONCLUSION: Fibers could, therefore, improve the flexural properties of resin composite and carbon fibers in longitudinal form yielded the better effects for reinforcement.

Vertical and horizontal polymerization shrinkage in composite restorations.

OBJECTIVE: Polymerization shrinkage developed in vertical and horizontal directions after light activation of light-curing composite restorative materials. The purpose of this study was to examine the effects of vertical and horizontal polymerization shrinkage on: (a) dimensional changes of resin composites in tooth cavities; (b) shear bond strengths to enamel and dentin; and (c) marginal gap width in a non-reacting Teflon mold. METHODS: Vertical and horizontal polymerization shrinkage in tooth cavities were measured immediately (3 min) after light activation. With the same time lapse, shear bond strengths to enamel and dentin and marginal gap widths in Teflon mold were also measured. RESULTS: There was a significant correlation between vertical and horizontal polymerization shrinkage (r=0.647, p=0.043) in the tooth cavity. Composite materials which produced small vertical shrinkage also produced smaller horizontal shrinkage. Composite materials which produced small vertical shrinkage in the tooth cavity exhibited greater shear bond strengths to both enamel (r=-0.697, p=0.025) and dentin (r=-0.752, p=0.012). Composite materials which produced smaller horizontal shrinkage produced smaller marginal gap widths in the Teflon mold (r=0.829, p=0.003). No relationships were observed between horizontal shrinkage in the tooth cavity and shear bond strengths to both enamel and dentin (p>0.05). SIGNIFICANCE: During the early stage of setting (<3 min) in tooth cavities, the vertical shrinkage of light-activated composite restorative materials was correlated with horizontal shrinkage.

Adhesive interfacial interaction affected by different carbon-chain monomers.

OBJECTIVES: The functional monomer 10-methacryloxydecyl dihydrogen phosphate (10-MDP), recently used in more self-etch adhesives, chemically bonds to hydroxyapatite (HAp) and thus tooth tissue. Although the interfacial interaction of the phosphoric-acid functional group of 10-MDP with HAp-based substrates has well been documented, the effect of the long carbon-chain spacer of 10-MDP on the bonding effectiveness is far from understood. METHODS: We investigated three phosphoric-acid monomers, 2-methacryloyloxyethyl dihydrogen phosphate (2-MEP), 6-methacryloyloxyhexyl dihydrogen phosphate (6-MHP) and 10-MDP, that only differed for the length of the carbon chain, on their chemical interaction potential with HAp and dentin, this correlatively using X-ray diffraction (XRD) and transmission electron microscopy (TEM). Commercial 6-MHP and 10-MDP containing adhesives were investigated as well. RESULTS: XRD revealed that on HAp only 10-MDP produced monomer-calcium salts in the form of 'nano-layering', while on dentin all monomers produced 'nano-layering', but with a varying intensity in the order of 10-MDP>6-MHP>2-MEP. TEM confirmed that 10-MDP formed the thickest hybrid and adhesive layer. XRD and TEM revealed 'nano-layering' for all commercial adhesives on dentin, though less intensively for the 6-MHP containing adhesive than for the 10-MDP ones. SIGNIFICANCE: It is concluded that not only the phosphoric-acid group but also the spacer group, and its length, affect the chemical interaction potential with HAp and dentin. In addition, the relatively strong 'etching' effect of 10-MDP forms more stable monomer-Ca salts, or 'nano-layering', than the two shorter carbon-chain monomers tested, thereby explaining, at least in part, the better bond durability documented with 10-MDP containing adhesives.

Effect of spherical silica additions on marginal gaps and compressive strength of experimental glass-ionomer cements.

PURPOSE: To clarify the effects of the addition of silanized (S) and unsilanized (U) spherical silica filler to resin-modified glass-ionomer cement and of powder-liquid ratio on (1) the early marginal gap-width of restorations in both tooth cavities and Teflon molds, (2) the gap-formation of restorations in Class V cavities, and (3) the compressive strength of the cement. METHODS: Resin-modified glass-ionomer powder (Fuji II LC EM, GC) was modified by adding 5 and 10 wt% of powder respectively, of S and U, and then the powder-liquid ratio was increased up to 4.8. Human premolars, extracted for orthodontic reasons, were used for this study. Cylindrical cavities (1.5 mm deep, 3.5 mm in diameter; one cavity was prepared in each tooth in the coronal region and medial surface) were prepared in extracted human premolar teeth and restored with resin-modified glass-ionomer cements. Each restoration margin was inspected immediately after curing and polishing (as the immediate condition was the most severe), the maximum gap-width and the opposing width (if any) were determined microscopically (n = 10). An additional test was conducted in model Class V cavities. After finishing of restorations in model Class V cavities, each tooth was sectioned in a bucco-lingual direction through the center of the restoration, and the presence or absence of gaps along the cavity interface was evaluated (n = 10). Additionally, the maximum marginal gap-width and the opposing-width along margins of restorations in cylindrical Teflon molds were measured (n= 10). The compressive strengths of the restorative materials were determined immediately after light-activation (n = 10). RESULTS: Marginal gap (tooth cavity: 0.32 to 0.25-0.20%, P < 0.05; Teflon cavity: 0.94 to 0.6-0.8%, P < 0.05) and cavity adaptation (no gap in the Class V: 22 to 40-50%, P < 0.05) of the restorations improved with increasing powder-liquid ratio (3.0 to 4.4-4.8) and compressive strength increased (111 to 150-170 MPa, P < 0.05). Highly significant correlation coefficients were found for the relationships between powder-liquid ratio and (1) percentage of marginal gap width in the tooth cavity (r = -0.96, P = 0.002, n = 6), (2) gap-free tooth/cement interfaces (r = 0.90, P = 0.015, n = 6), (3) percentage of marginal gap widths in the Teflon mold (r = 0.98, P = 0.0004, n = 6) and (4) compressive strengths of the cements (r = 0.95, P = 0.004, n = 6).

Salivary stress biomarker levels during speech in patients with maxillectomy defect.

BACKGROUND: After resection of maxillofacial tumors, severe functional problems related to mastication, deglutition, and speech are observed in addition to the changes in appearance and psychosocial functioning. Although speech outcome is recovered with prosthetic treatments, patients sometimes complain of continued dissatisfaction with their speech. The purpose of this study was to evaluate the potential dissatisfaction of patients with maxillectomy defects during speech. METHODS: Sixteen patients with maxillary obturator were compared with a matched control group. Functional improvement by the maxillofacial prosthesis was confirmed using a speech intelligibility test, a chewing function score, and visual analogue scale on subjective satisfaction. Cortisol and chromogranin A (CgA) were evaluated after prescribed speech tasks. RESULTS: CgA in patients with maxillectomy defects was significantly higher than that in the control group (p < .05), even after the functional improvement by maxillofacial prosthesis. CONCLUSION: It was revealed that patients with maxillectomy defects have significant psychological stresses during speech, even when their maxillofacial prosthesis resulted in successful functional improvement.

Stress distribution prevents ischaemia and bone resorption in residual ridge.

OBJECTIVE: Intensive mechanical stress and/or inflammation are known to induce alveolar bone resorption. This study investigated whether a distribution of mechanical stress would reduce residual ridge resorption or improve ischaemia. DESIGN: Thirty rats were divided into six experimental groups (n=5). The control group received no intentional stimulation, but rats in the experimental groups wore denture stimulators made of acrylic resin or a soft lining material. The stimulator transmitted masticatory pressure to the rats' palates for four weeks. The four types of soft lining materials investigated in this study dispersed the applied pressure, with compressive stress ranging from 20.8 to 90.8kPa. Volumes of blood flow and bone resorption of denture foundations were measured every week for 4 weeks. Statistical evaluation of these results was performed using two-way ANOVA and Holm-Sidak test within 5% error limits. RESULTS: Non-viscoelastic material clearly induced bone resorption and ischaemia of denture foundations, while viscoelastic materials reduced these phenomena to different extents according to their viscoelastic properties. Ischaemia in the alveolar ridge preceded residual ridge resorption, because the amount of residual ridge resorption and blood flow rate showed a simple linear regression. CONCLUSION: Animal model of this study suggested that a distribution or reduction of mechanical stress could improve blood flow and decrease alveolar ridge resorption.

Physical properties of dual-cured luting-agents correlated to early no interfacial-gap incidence with composite inlay restorations.

OBJECTIVES: The aims of this investigation were to investigate dual-cured luting-agents as to whether their bond strength, dimensional change and flexural modulus influence no interfacial-gap incidence parameters of composite inlay restorations during the early stages. The correlations of interest were between: (a) their shear bond strength to dentin, (b) their dimensional change on setting, (c) their flexural modulus, and (d) no interfacial-gap incidence with indirect restorations. METHODS: Seven dual-cured luting-agents, one self-adhesive resin cement, six resin cements and one resin-modified glass-ionomer for luting, were investigated with specimen sub-groups (n=10) for each property measured. The principal series of experiments were conducted in dentin cavities with interfacial polishing either immediately (3 min) after setting or after 1-day water-storage. After the finishing procedure, each tooth was sectioned in a buccolingual direction through the center of the restoration, and the presence or absence of interfacial-gaps was measured (and then summed for each cavity) at 14 points (each 0.5mm apart) along the composite inlay restoration interface (n=10 per group; total points measured=140), and was expressed by percentage of measured total points. The shear bond strengths to dentin, setting shrinkage-strain and flexural modulus were measured. To estimate the dimensional change of luting-agents, the maximum marginal gap-width and the opposing-width that occurred with luting-agents in a Teflon mold were measured. Moduli were measured in 3-point bending. RESULTS: For all composite inlay restorations, polished immediately after setting, an incidence of summed no-gaps of 69-88% was observed. For specimens polished after 1 day, a significantly (p<0.05) decreased number of 91-96% summed no-gaps occurred. After 1-day storage, shear bond strengths to dentin and flexural modulus increased highly significantly (p<0.001) for many materials, whereas dimensional changes in the Teflon mold were non-significantly different (p>0.05). There was a highly significant correlation between no interfacial-gap incidence and shear bond strength (r=0.702, p=0.002, n=16). As the dimensional change (shrinkage) within Teflon molds increased, the no interfacial-gap incidence of dentin/inlay interfaces with 'no-gaps' decreased (r=-0.574, p=0.02, n=16). Flexural moduli significantly correlated with no interfacial-gap incidence in the composite inlay restorations (r=0.695, p=0.003, n=16). SIGNIFICANCE: For three classes of luting-agents during the early stage of setting (<1 day), the shear bond strength to dentin, the dimensional change measured by marginal gaps in Teflon mold and flexural moduli correlated with no interfacial-gap incidence in the composite inlay restoration.