Shear bond strength of three dual-cured resin cements to dentin analyzed by finite element analysis.

OBJECTIVES: To determine the shear bond strength to bovine dentin of dual-cured resin cements cured in different circumstances, the contraction stress and volumetric shrinkage in both polymerization modes, and to review the failure stress distribution at the cement-tooth interface with finite element analysis. METHODS: The volumetric shrinkage of RelyX Unicem, Panavia F 2.0 and DC Core Automix was determined by mercury dilatometry. Polymerization contraction stress was determined using a constraint tensilometer set-up. For the shear bond strength test, cement discs on bovine root dentin (self-cured and dual-cured), composite discs cemented to dentin (self-cured and dual-cured), and dentin cemented to dentin (self-cured) specimens were fabricated. Specimens were stored in water for 24h (37°C, 100% humidity) and tested (crosshead speed 1mmmin(-1)). FE modeling of the specimens was carried out in order to calculate the maximum shear stresses in the cement-dentin interface. Differences between groups were determined using two-way ANOVA with Tukey post hoc tests, and paired samples t-tests (α<0.05). RESULTS: Panavia F2.0 showed significantly lower volumetric shrinkage than the other cements. Dual-curing lead to higher contraction stresses for all tested cements compared to self-curing. RelyX Unicem showed higher volumetric shrinkage when dual-cured. Shear bond strength and maximum shear stress was positively influenced by dual-curing. DC Core Automix performed best and Panavia F2.0 worst in terms of shear bond strength and maximum shear stress. SIGNIFICANCE: Curing mode may play an important role in the final bond strength to dentin of indirect restorations, depending on the material used.

Influence of polymerization mode and C-factor on cohesive strength of dual-cured resin cements.

OBJECTIVES: The aim of this study is to determine the influence of the C-factor and the mode of polymerization on the cohesive strength of various dual-cure resin cements. METHODS: Three curing conditions were tested; chemical curing with free shrinkage conditions (C=0), and constraint shrinkage conditions (C=25), and dual-curing with free shrinkage conditions (C=0). Opaque polyethylene, brass (pretreated with Clearfil SE bond), and transparent polyethylene tubes respectively, were filled with the different cements. The tubes were 20mm long with an inner diameter of 1.6 or 1.8mm. Five cements, DC Core Automix, Panavia F 2.0, Maxcem, Multilink, and RelyX Unicem, were tested with ten specimens per group. The specimens were trimmed to an hour-glass shape with a neck diameter of 1mm, stored in water (37°C, 24h), and subjected to microtensile testing (1mmmin(-1)). SEM analysis was carried out on chemically cured samples of DC Core Automix C=0 and C=25. Data were statistically analyzed (Two-way ANOVA, Tukey's post hoc test, p<0.05). RESULTS: Most cements showed no significant differences between the curing modes. A high C-factor negatively influences the cohesive strength of some cements. SEM analysis shows that chemical curing of DC Core Automix in a high C-factor environment leads to more and larger microvoids in the cement. SIGNIFICANCE: Constraint shrinkage conditions, i.e. a high C-factor, can negatively influence the physical properties of a dual-cured resin cement, which would clinically be the case in the confined space of a root canal or post space preparation.

Nickel release from orthodontic retention wires-the action of mechanical loading and pH.

UNLABELLED: Nickel (Ni) is a potent sensitizer and may induce innate and adaptive immune responses. Ni is an important component of orthodontic appliances (8-50 wt%). Due to chemical and mechanical factors in the oral environment, Ni is released from these appliances. Retention wires are in situ for a long period of time. OBJECTIVES: To quantitatively evaluate the influence of mechanical loading and pH on the nickel release from orthodontic retention wires. METHODS: Five different types of multi-stranded wires (Original Wildcat, Noninium, Lingual retainer, Dentaflex 3-s, Dentaflex 6-s), were submersed for 24 h in either 10 ml of distilled water or lactic acid, both submitted to cyclic loading in a 3-point bending test (0×, 1000×, 10,000×). The solutions were analyzed by Inductively Coupled Plasma Mass Spectroscopy (ICP-MS), and the data was statistically analyzed (ANOVA, p<0.05). RESULTS: Mechanical loading has a strong effect on the Ni release from orthodontic retention wires, especially in distilled water. Acidity has more impact on Ni release when compared to mechanical loading. Manganese-steel "Ni-free" wires released quantifiable amounts of Ni due to trace elements of Ni within the wire. SIGNIFICANCE: All investigated wires release considerable amounts of Ni to which exposure may have biological implications.

Benefits of a two-step cementation procedure for prefabricated fiber posts.

PURPOSE: To determine whether two-step cementation of prefabricated fiber posts leads to higher bond strengths. MATERIALS AND METHODS: Forty-eight human canine teeth were divided into six groups and fiber posts were cemented with DC Core, RelyX Unicem and Panavia F2.0, according to a one-step or two-step procedure. Per root, four cross-sections were prepared. The differences in push-out strength between procedure, cement and location within the root were determined. RESULTS: For all cements, the push-out strengths for the two-step procedure were significantly higher than for the one-step procedure (p < 0.001). Differences between the cements for both the one-step and two-step procedure were not statistically significant (p = 0.05). CONCLUSION: The reduction of the C-factor by means of a two-step cementation, a procedure equivalent to the layering technique of composite restorations, resulted in significantly higher bond strengths. The increase of 60% in bond strength may be beneficial to the retention of post and core restorations.

Effect of long-term repeated deflections on fatigue of preloaded superelastic nickel-titanium archwires.

INTRODUCTION: The aim of this in-vitro study was to investigate the changes in force delivery of superelastic nickel-titanium archwires used in combination with a self-ligating bracket system after dynamic fatigue-loading in a 3-bracket model under controlled temperature. METHODS: Samples of 2 superelastic nickel-titanium (active austenitic) wires, a conventional nickel-titanium wire, and a stainless steel wire, all 0.014-in round, were divided into 2 groups: static deflection and dynamic deflection. The static specimens were under a constant deflection of 3.0 mm. The dynamic specimens had the same constant deflection of 3.0 mm but were subjected to additional repeated deflections of 0.5 mm, applied by a fatigue tester. The test situation simulates a patient's archwire under deflection and subjected to occlusal contact during 1, 100, 10,000, and 100,000 cycles. Fatigue changes were assessed with a 3-point bending test. RESULTS: Type of wire, loading or unloading, and number of cycles as within-subject factors were statistically significantly different. No statistically significant difference between the test condition, static vs dynamic, was found. The repeated deflections of 0.5 mm were not enough to induce an extra effect of fatigue. CONCLUSIONS: Occlusal forces transferred to a considerably deflected archwire, such as in the large malalignments in the early stages of orthodontic treatment, will have no fatigue effect on the unloading force of that archwire.

Fracture toughness determination of two dental porcelains with the indentation strength in bending method.

OBJECTIVE: This study was to investigate the influence of the bending test configurations and the crosshead displacement speeds on the fracture toughness (K(Ic)) of dental porcelains obtained with the indentation strength in bending (ISB) method. METHODS: The strength of the dental veneering porcelains Duceram and Sintagon Zx, Vickers' indented at a load of 2 kg was measured at a crosshead speed of 0.5mm/min with three test configurations, which were 3-point, 4-point, and biaxial bending. Two more groups of Sintagon Zx were tested the same way, but at speeds of 0.1, and 0.05 mm/min, respectively. Both porcelains, the three crosshead speeds, and the three test configurations were compared statistically. RESULTS: Duceram had a higher toughness than Sintagon Zx with all three test configurations and there was no significant difference between three test configurations with either porcelain. Within the crosshead speed groups of Sintagon Zx, a significant difference was found only in the 0.5mm/min group between the 3-point, and 4-point configurations. Within the configuration groups, significant differences were found between all speeds with the 3-point configuration and only between the highest and lowest speed with the 4-point and the biaxial tests. CONCLUSION: The crosshead displacement speed can cause statistically different results of fracture toughness obtained with the ISB method.

Fracture toughness comparison of three test methods with four dental porcelains.

OBJECTIVE: The aim of this study was to compare three fracture toughness test methods, using four commercial dental porcelains. MATERIALS AND METHODS: The fracture toughness test techniques involved were: the single-edge-notched beam (SENB), the indentation strength method (IS), and a rather convenient ASTM standard for advanced ceramics, which is still rarely used in dental ceramic research, the Chevron-notched beam method (CN). Duceram, Duceram LFC, Sintagon Zx and Carrara Vincent were chosen for study. Data was analyzed by two-way and paired ANOVA. RESULT: No statistical difference was found between the CN and SENB methods with four dental porcelains, but IS was not always in statistical agreement with SENB or CN. Statistical agreement among all three methods occurred only with Duceram LFC. CONCLUSION: The different test methods did not always lead to the same ranking or values of fracture toughness. Yet the toughness results of the SENB method were comparable to those of the CN method for all the four dental porcelains tested in this study.

Finite element analysis model to simulate the behavior of luting cements during setting.

OBJECTIVES: Besides the fixation of the restoration, an important function of dental luting cements is to seal the gap between tooth and restoration. However, as a result of adhesion, curing contraction is hindered, creating stresses. To maintain the seal these stresses neither exceed the bond nor the cohesive strength of the cement. The aim of this study was to evaluate a rather simple model, which mimics the setting behavior of luting cements based on the division of the setting process into a liquid, visco-elastic and elastic phase, for its suitability to predict in Finite Element Analysis (FEA) the magnitude of the setting stresses occurring clinically. METHODS: Commercial luting cement, RelyX ARC, was used in this study. In a dynamic test set-up the stresses, the elastic strain, and the shrinkage were determined. Two layers with different thicknesses and different ratios between bonded and free surface (C-factor) were examined. The parameters were used in three-dimensional FEA models. The experimental contraction stresses were compared with the results of the FEA. RESULTS: In cement layers with uniform layer thickness, it is possible to predict the contraction stresses with the found parameters. The smallest plastic deformations and contraction stresses were found in the thinnest layer. The studied model was reliable in predicting the experimental stresses. SIGNIFICANCE: The results of this study may be used for the prediction using FEA of the actual stresses occurring in dental restorations.

The influence of design parameters on the FEA-determined stress distribution in CAD-CAM produced all-ceramic dental crowns.

INTRODUCTION: Knowledge of factors, which influence stress and its distribution is of key importance to the successful production of durable all-ceramic restorations. The objective of this study was to evaluate, by finite element analysis (FEA), the influence of the shape of the preparation and the cement layer on the stress distribution in CAD-CAM produced all-ceramic crowns and in their cement layer. MATERIAL AND METHODS: The CAD models of multi-layer all-ceramic crowns for posterior tooth 46 of three patients produced with CAD-CAM-technology were translated into a three-dimensional FEA program. The stress distribution due to the combined influences of bite forces, residual stresses caused by the difference in expansion coefficient of the two ceramic layers, and the influence of shrinkage of the cement was investigated. RESULTS: The tensile stresses in the crown for the chamfer knife-edge preparation might put the integrity of the currently available ceramic materials at risk, while a non-uniform cement layer might result in stresses exceeding the bond strength. It was concluded that for long lasting restorations in the posterior region it is advisable to make a chamfer with collar preparation, the cement layer as uniform, and the difference in thermal expansion for the two ceramics as small as possible. SIGNIFICANCE: This study indicates that for full ceramic crowns in the posterior region, specific design rules should be followed, and that FEA utilizing CAD-CAM data can be a successful tool to develop design guidelines for all-ceramic restorations.

Influence of fatigue loading on the performance of adhesive and nonadhesive luting cements for cast post-and-core buildups in maxillary premolars.

PURPOSE: This study evaluated the influence of fatigue loading on the performance of an adhesive and a nonadhesive cement for cast post-and-core restorations in maxillary premolars. MATERIALS AND METHODS: The adhesive cement used was Panavia 21, a resin-based composite cement, and the nonadhesive cement was PhosphaCem/C, a zinc-oxy-phosphate cement. The coronal sections of single-rooted human maxillary premolars were removed at the level of the proximal CEJ. After endodontic treatment, a cast post and core was prepared for each tooth and cemented into the root canal with either Panavia 21 (n = 8) or PhosphaCem/C (n = 8). Half of the specimens from each cement group were exposed to fatigue loading almost perpendicular to the axial axis; the other half were used as controls. Three parallel transverse root sections were cut from each specimen and used for evaluation of the influence of fatigue loading. For each section, cement integrity was studied by SEM, and retention strength of the cemented post section was determined with a push-out test. RESULTS: For SEM evaluation and the push-out test, Panavia 21 proved significantly better than PhosphaCem/C. However, fatigue loading did not show any effect. CONCLUSION: Under the conditions of this study, fatiguing of cemented cast post-and-core restorations was not decisive as a single test to evaluate the quality of the cement.

The apparent increase of the Young's modulus in thin cement layers.

OBJECTIVES: The bond of adhesive luting cements to the tooth tissues and restorative materials is expected to hinder their transverse contraction for the layer thickness applied in dental restorations. It was hypothesized that the hindering of the transverse deformation will influence the relation between stress and strain (the stiffness) in the direction perpendicular to the substrate surface. The aim of this study was to investigate the relation between cement layers with different ratio between bonded and free surface (C-factor) and the stiffness of these layers, i.e. an apparent increase of the Young's modulus of the dental luting cement. METHODS: A commercial luting cement RelyX ARC (3M, St Paul, MN, USA) was used in this study. The 'real" Young's modulus and the Poisson ratio were determined and these values were used in models with layers with different C-factors (0.5, 1.0, 2.0, 3.0, 4.0, 5.0 and 6.0) in a three-dimensional Finite Element Analysis program (FEMAP, E.S.P., Maryland Height, MO, USA). The apparent Young's modulus was measured for layers with thicknesses of 0.5 mm (C = 6.0) and 6.0 mm (C = 0.5) and compared with the results of the Finite Element Analysis (FEA) analysis. RESULTS: The apparent Young's modulus in the 0.5 mm layer was 20% higher than the apparent Young's modulus in the 6.0 mm layer. This result was confirmed by the results of the F.E. analysis. For very thin layers the stiffness will be 25% higher than the Young's modulus. SIGNIFICANCE: The hindering of the transverse contraction has to be taken into account studying the mechanical properties of dental luting cements because it influences the behavior of these luting cements in thin layers.

The influence of the veneering porcelain and different surface treatments on the biaxial flexural strength of a heat-pressed ceramic.

STATEMENT OF PROBLEM: The strength of all-ceramic restorations can be adversely affected by surface defects, leading to restoration failures. Additionally, when a 2-layer all-ceramic restoration is required for esthetic purposes, part of the stronger ceramic core material is replaced by veneering porcelain. PURPOSE: This study evaluated the effect of different surface treatments on the strength of a ceramic core material and veneering porcelain, as well as the influence of veneering porcelain on the strength of a 2-layer ceramic structure. MATERIAL AND METHODS: Fifty heat-pressed ceramic cores and 30 veneering porcelain discs (17 mm diameter x 2 mm) were made. From the ceramic core group, 20 discs were selected and reduced to a thickness of 1 mm and veneered with 1 mm of porcelain. These specimens were divided into 2 groups of 10 each. The remaining 30 ceramic core and the 30 veneering porcelain discs were divided into 2 sets of 3 equal sized groups (n=10). Ceramic core groups were prepared for testing having the following surfaces: airborne-particle abrasion, ground, and overglazed. Veneering porcelain groups were tested: as fired (no additional treatment), ground, and overglazed. Biaxial flexural strength was measured using the ball-on-ring test method. All specimens were loaded to fracture. One and 2-way analysis of variance were used to analyze the data (alpha=.05). RESULTS: The ceramic core discs were significantly (P=.001) stronger than the veneering porcelain discs for the airborne-particle abrasion, as-fired, and ground surface treatments (82 +/- 11 MPa vs 51 +/- 8 MPa and 93 +/- 14 MPa vs 60 +/- 6 MPa, respectively). For the overglazed treatment, there was not a significant difference between the core (115 +/- 1 4 MPa) and the veneer materials (107 +/- 14 MPa). The ground 1-layer core was significantly (P=.015) stronger (93 +/- 14 MPa) than the 2-layer with the core tested in tension (72 +/- 19 MPa). There was no significant difference between 1-layer veneer overglazed (107 +/- 14 MPa) and 2-layer discs when tested with the veneer in tension (105 +/- 16 MPa). CONCLUSION: The overglazed surface treatment significantly improved the strength of the materials tested, as well as the strength of 2-layer discs with the veneer in tension. The veneering porcelain influenced the strength of 2-layer specimens only when tested with the ground ceramic core surface in tension.