Influence of Fit-checking Material and Cleaning Protocols on the Bond Strength of Lithium Disilicate Glass-ceramics.

OBJECTIVES: To evaluate the bond strength of a resin luting agent to a lithium disilicate glass-ceramic after the use of different fit-checking materials and cleaning protocols. METHODS AND MATERIALS: Two hundred and forty-two (242) ceramic specimens were etched with 5% hydrofluoric acid for 20 seconds and distributed into 22 groups (n=10), in total. Four (4) groups were created based on fit-checking material and that had no following cleaning protocol: no fit-checking material used (control group); articulating paper; articulating spray; and fit-checker liquid. For each fit-checking material (3), 6 cleaning protocols were tested creating an additional 18 groups (n=10): air/water spray; 70% alcohol (ethanol); acetone; 35% phosphoric acid; 5% hydrofluoric acid; and a commercially available cleaning paste (Ivoclean, Ivoclar Vivadent). Silane and bonding resin were applied to all ceramic surfaces. Resin luting agent cylinders (1 mm in diameter) were created using silicone matrices, light-cured, and specimens were stored in deionized water at 37°C for 24 hours. Microshear bond strength test (µSBS) was performed on a universal testing machine (DL 500, EMIC) at a crosshead speed of 1 mm/min until failure. Results were statistically analyzed using ANOVA and Tukey's test (α=0.05). RESULTS: Articulating paper and fit-checker liquid, when not properly removed, negatively affected the bond strength (p<0.05). None of the tested cleaning protocols were effective for articulating paper (p<0.05). There was no significant difference in bond strength after the cleaning protocols between articulating spray and fit-checker liquid when compared to the control group (no contamination) (p>0.05). CONCLUSION: The cleaning protocols tested can effectively restore the bond strength of resin luting agents to lithium disilicate ceramics that were exposed to articulating spray or fit-checker liquid. The use of articulating paper is not recommended for fit-checking indirect lithium disilicate restorations.

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.