Evaluation of Cleaning Methods on Lithium Disilicate Glass Ceramic Surfaces After Organic Contamination.

The purposes of this study were to 1) evaluate the effectiveness of different cleaning methods from a previously etched and silanized lithium disilicate glass ceramic (EMX) surface after contact with organic fluids (saliva or human blood) and 2) assess the effect of applying a new silane layer after the cleaning methods on the microshear bond strength (mSBS) of resin cement to EMX. EMX discs were etched with 5% hydrofluoric acid (HF) and properly silanized. Three control groups were created (n=10): control (without contamination), saliva positive, and human blood positive. Later, after new contaminations, the samples were distributed into four groups according to the cleaning method (n=20): air-water spray (AWS), 35% phosphoric acid, 70% alcohol, or Ivoclean cleaning paste. After the cleaning methods, subgroups were submitted to a new silane layer application, or not (n=10). All samples received a thin layer of a bonding agent and, subsequently, three light-cured resin cement cylinders were prepared on each EMX surface for the mSBS test. This test was performed on a universal testing machine at a vertical speed of 1 mm/minute until rupture. Contaminated and cleaned silanized EMX surfaces were assessed by scanning electron microscopy (SEM) (n=1). The noncontaminated control group showed an average mSBS of 18.7 MPa, and the positive saliva and human blood control groups yielded a 34% and 42% reduction in bond strength, respectively, compared to the uncontaminated control (p<0.05). For saliva-contaminated surfaces, all cleaning methods were effective and not different from one another or the control group (p>0.05). However, for human blood contamination, only Ivoclean cleaning paste was effective in restoring µSBS to uncontaminated control group levels (p>0.05). SEM images showed a clean surface (ie, with no contaminant residues) after the cleaning methods, regardless of the organic contaminant type. All the assessed cleaning methods were effective in removing saliva from the silanized EMX surface; however, only Ivoclean was able to restore the adhesion quality when the silanized EMX surface was contaminated with human blood.

Two-Year Follow-Up of Self-Etching Ceramic Primer as Surface Treatment for Feldspathic Veneers: A Clinical Case Review.

The two-step approach of applying hydrofluoric acid followed by silane is deemed the gold-standard surface treatment protocol before bonding to glass ceramics. Given hydrofluoric acid is a toxic conditioning agent and with the intention to simplify this step, the dental company Ivoclar Vivadent (Schaan, Lietchtenstein) released a self-etching ceramic primer, Monobond Etch & Prime in 2015, claiming that hydrofluoric acid and silane application would no longer be required prior to luting glass ceramics. Therefore, this clinical case report and retrospective analysis describes the replacement of unsatisfactory anterior veneers due to clinical failures for new feldspathic glass ceramic veneers, using the aforementioned self-etching ceramic primer. After two years, feldspathic glass ceramics presented satisfying clinical performance with absence of debonding, tooth sensitivity, recurrent carious lesions, or marginal infiltration.