The effects of different opacifiers on the translucency of experimental dental composite resins.

OBJECTIVE: The aim of this study was to evaluate the effects of different opacifiers on the translucency of experimental dental composite-resins. METHODS: Three metal oxides that are used as opacifiers were tested in this study: titanium oxide (TiO2), aluminium oxide (Al2O3) and zirconium oxide (ZrO2). Experimental composite-resins were fabricated containing 25wt.% urethane dimethacrylate (UDMA)-based resin matrix and 75% total filler including different concentrations of metal oxides (0, 0.25, 0.5, 0.75 and 1wt.%) blended into silane treated barium-silicate filler. The specimens (15.5mm diameter and 1mm thickness) were light-cured and tested in the transmittance mode using a UV/VIS spectrophotometer at wavelengths from 380 to 700nm under a standard illuminant D65. The color differences (ΔE* ab) between different concentrations of opacifiers were also measured in transmittance mode based on their Lab values. RESULTS: Statistical analysis by ANOVA and Tukey's test showed a significant decrease (p<0.05) in light transmittance with the addition of opacifiers to the experimental composite-resins. There was a linear correlation between different concentrations of TiO2 and Al2O3 and total transmittance. Total transmittance was also found to be wavelength dependent. The color differences for the concentrations of 0-1wt.% of the opacifiers were above 1 ΔE* unit, with Al2O3 showing the smallest color shift. SIGNIFICANCE: The type and the amount of the opacifiers used in this study had a significant effect on the translucency of the experimental UDMA-based dental composite resins. The most effective opacifier was TiO2, followed by ZrO2 and Al2O3 in decreasing order, respectively.

ADM guidance-Ceramics: all-ceramic multilayer interfaces in dentistry.

This guidance document describes the specific issues involved in dental multilayer ceramic systems. The material interactions with regard to specific thermal and mechanical properties are reviewed and the characteristics of dental tooth-shaped processing parameters (sintering, geometry, thickness ratio, etc.) are discussed. Several techniques for the measurement of bond quality and residual stresses are presented with a detailed discussion of advantages and disadvantages. In essence no single technique is able to describe adequately the all-ceramic interface. Invasive or semi-invasive methods have been shown to distort the information regarding the residual stress state while non-invasive methods are limited due to resolution, field of focus or working depth. This guidance document has endeavored to provide a scientific basis for future research aimed at characterizing the ceramic interface of dental restorations. Along with the methodological discussion it is seeking to provide an introduction and guidance to relatively inexperienced researchers.

ADM guidance-Ceramics: guidance to the use of fractography in failure analysis of brittle materials.

OBJECTIVES: To provide background information and guidance as to how to use fractography accurately, a powerful tool for failure analysis of dental ceramic structures. METHODS: An extended palette of qualitative and quantitative fractography is provided, both for in vivo and in vitro fracture surface analyses. As visual support, this guidance document will provide micrographs of typical critical ceramic processing flaws, differentiating between pre- versus post sintering cracks, grinding damage related failures and occlusal contact wear origins and of failures due to surface degradation. RESULTS: The documentation emphasizes good labeling of crack features, precise indication of the direction of crack propagation (dcp), identification of the fracture origin, the use of fractographic photomontage of critical flaws or flaw labeling on strength data graphics. A compilation of recommendations for specific applications of fractography in Dentistry is also provided. SIGNIFICANCE: This guidance document will contribute to a more accurate use of fractography and help researchers to better identify, describe and understand the causes of failure, for both clinical and laboratory-scale situations. If adequately performed at a large scale, fractography will assist in optimizing the methods of processing and designing of restorative materials and components. Clinical failures may be better understood and consequently reduced by sending out the correct message regarding the fracture origin in clinical trials.

ADM guidance-Ceramics: Fracture toughness testing and method selection.

OBJECTIVES: The objective is within the scope of the Academy of Dental Materials Guidance Project, which is to provide dental materials researchers with a critical analysis of fracture toughness (FT) tests such that the assessment of the FT of dental ceramics is conducted in a reliable, repeatable and reproducible way. METHODS: Fracture mechanics theory and FT methodologies were critically reviewed to introduce basic fracture principles and determine the main advantages and disadvantages of existing FT methods from the standpoint of the dental researcher. RESULTS: The recommended methods for FT determination of dental ceramics were the Single Edge "V" Notch Beam (SEVNB), Single Edge Precracked Beam (SEPB), Chevron Notch Beam (CNB), and Surface Crack in Flexure (SCF). SEVNB's main advantage is the ease of producing the notch via a cutting disk, SEPB allows for production of an atomically sharp crack generated by a specific precracking device, CNB is technically difficult, but based on solid fracture mechanics solutions, and SCF involves fracture from a clinically sized precrack. The IF test should be avoided due to heavy criticism that has arisen in the engineering field regarding the empirical nature of the calculations used for FT determination. SIGNIFICANCE: Dental researchers interested in FT measurement of dental ceramics should start with a broad review of fracture mechanics theory to understand the underlying principles involved in fast fracture of ceramics. The choice of FT methodology should be based on the pros and cons of each test, as described in this literature review.

The Effect of Lucite Glass Reinforcement on the Properties of Conventional Glass-Ionomer Filling Materials.

STATEMENT OF THE PROBLEM: The usage of glass ionomer cements (GICs) restorative materials are very limited due to lack of flexural strength and toughness. PURPOSE: The aim of this study was to investigate the effect of using a leucite glass on a range of mechanical and optical properties of commercially available conventional glass ionomer cement. MATERIALS AND METHOD: Ball milled 45µm leucite glass particles were incorporated into commercial conventional GIC, Ketac-Molar Easymix (KMEm). The characteristics of the powder particles were observed under scanning electron microscopy. The samples were made for each experimental group; KMEm and lucite- modified Ketac-Molar easy Mix (LMKMEm) according to manufacturer's instruction then were collected in damp tissue and stored in incubator for 1 hour. The samples were divided into two groups, one stored in distilled water for 24 hours and the others for 1 week.10 samples were made for testing biaxial flexural strength after 1 day and 1 week, with a crosshead speed of 1mm/min, calculated in MPa. The hardness (Vickers hardness tester) of each experimental group was also tested. To evaluate optical properties, 3 samples were made for each experimental group and evaluated with a spectrophotometer. The setting time of modified GIC was measured with Gillmore machine. RESULT: The setting time in LMKMEm was 8 minutes. The mean biaxial flexural strength was LMKMEm/ 1day: 24.13±4.14 MPa, LMKMEm/ 1 week: 24.22±4.87 MPa KMEm/1day:28.87±6.31 MPa and KMEm/1 week: 26.65±5.82 MPa which were not statistically different from each other. The mean Vickers hardness was LMKMEm: 403±66 Mpa and KMEm: 358±22 MPa; though not statistically different from each other. The mean total transmittance (Tt) was LMKMEm: 15.9±0.7, KMEm: 22.3±1.2, the mean diffuse transmittance (Td) was LMKMEm: 12.2±0.5, KMEm: 18.0±0.5 which were statistically different from each other. CONCLUSION: Leucite glass can be incorporated with a conventional GIC without interfering with setting time. Yet, it did not improve the mechanical and optical properties of the GIC.

The use of acetone to enhance the infiltration of HA nanoparticles into a demineralized dentin collagen matrix.

OBJECTIVES: This study investigates the role of acetone, as a carrier for nano-hydroxyapatite (nano-HA) in solution, to enhance the infiltration of fully demineralized dentin with HA nanoparticles (NPs). METHODS: Dentin specimens were fully demineralized and subsequently infiltrated with two types of water-based nano-HA solutions (one containing acetone and one without). Characterization of the dentin surfaces and nano-HA particles was performed using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The surface wettability and infiltration capacity of the nano-HA solutions were quantified by means of contact angle measurements and energy dispersive X-ray spectroscopy (EDS), respectively. Contact angle measurements were taken at baseline and repeated at regular intervals to assess the effect of acetone. The P and Ca levels of infiltrated dentin specimens were measured and compared to sound dentin and non-infiltrated controls. RESULTS: The presence of acetone resulted in an eight-fold decrease in the contact angles of the nano-HA solutions recorded on the surface of demineralized dentin compared to nano-HA solutions without acetone (one-way ANOVA, p<0.05). Perfect wetting of the demineralized dentin surface was achieved 5min after the application of the nano-HA solution containing acetone. Infiltration of demineralized dentin with the nano-HA solution containing acetone restored the lost mineral content by 50%, whereas the mean mineralization values for P and Ca in dentin treated with the acetone-free nano-HA solution were less than 6%. SIGNIFICANCE: Acetone was shown to act as a vehicle to enhance the capacity to infiltrate demineralized dentin with HA NPs. The successful infiltration of dentin collagen with HA NPs provides a suitable scaffold, whereby the infiltrated HA NPs have the potential to act as seeds that may initiate heterogenous mineral growth when exposed to an appropriate mineral-rich environment.

Factors controlling crystallization of miserite glass-ceramic.

OBJECTIVE: The purpose of this study was to investigate a range of variables affecting the synthesis of a miserite glass-ceramic (GC). METHODS: Miserite glass was synthesized by the melt quench technique. The crystallization kinetics of the glass were determined using Differential Thermal Analysis (DTA). The glasses were ground with dry ball-milling and then sieved to different particle sizes prior to sintering. These particle sizes were submitted to heat treatment regimes in a high temperature furnace to form the GC. The crystal phases of the GC were analyzed by X-ray diffraction (XRD). Scanning electron microscopy (SEM) was used to examine the microstructure of the cerammed glass. RESULTS: XRD analysis confirmed that the predominant crystalline phase of the GC was miserite along with a minor crystalline phase of cristobalite only when the particle size is <20 µm and the heat treatment at 1000°C was carried out for 4h and slowly cooled at the furnace rate. For larger particle sizes and faster cooling rates, a pseudowollastonite crystalline phase was produced. Short sintering times produced either a pseudowollastonite or xonotolite crystalline phase. SIGNIFICANCE: The current study has shown that particle size and heat treatment schedules are major factors in controlling the synthesis of miserite GC.

Evaluation of a novel multiple phase veneering ceramic.

OBJECTIVES: To produce a new veneering ceramic based on the production of a multiple phase glass-ceramic with improved performance in terms of strength and toughness. METHODS: A composition of 60% leucite, 20% diopside and 20% feldspathic glass was prepared, blended and a heat treatment schedule of 930°C for 5 min was derived from differential thermal analysis (DTA) of the glasses. X-ray diffraction (XRD) and SEM analysis determined the crystalline phases and microstructure. Chemical solubility, biaxial flexural strength (BFS), fracture toughness, hardness, total transmittance and coefficient of thermal expansion (CTE) were all measured in comparison to a commercial veneering ceramic (VITA VM9). Thermal shock resistance of the leucite-diopside and VITA VM9 veneered onto a commercial high strength zirconia (Vita In-Ceram YZ) was also assessed. Statistical analysis was undertaken using Independent Samples t-test. Weibull analysis was employed to examine the reliability of the strength data. RESULTS: The mean chemical solubility was 6 µg/cm(2) for both ceramics (P=1.00). The mean BFS was 109 ± 8 MPa for leucite-diopside ceramic and 79 ± 11 MPa for VITA VM9 ceramic (P=0.01). Similarly, the leucite-diopside ceramic demonstrated a significantly higher fracture toughness and hardness. The average total transmittance was 46.3% for leucite-diopside ceramic and 39.8% for VITA VM9 (P=0.01). The leucite-diopside outperformed the VITA VM9 in terms of thermal shock resistance. Significance This novel veneering ceramic exhibits significant improvements in terms of mechanical properties, yet retains a high translucency and is the most appropriate choice as a veneering ceramic for a zirconia base core material.

Effect of extraction media and storage time on the elution of monomers from four contemporary resin composite materials.

INTRODUCTION: The purpose of this study was to examine the effect of different extraction media, including culture media, as well as storage times on the elution of monomers from modern dental composites. MATERIALS AND METHODS: FOUR CONTEMPORARY COMPOSITE MATERIALS WERE TESTED: (a) Clearfil Majesty Esthetic (Kuraray), (b) Esthet X (DENTSPLY), (c) Filtek Silorane (3M ESPE), and (d) Admira (Voco). Forty-eight specimens were made. The specimens were stored in 1 ml of (a) artificial saliva, (b) Dulbecco's Modified Eagle Medium (DMEM), (c) DMEM plus 10% fetal bovine serum (FBS), and (d) ethanol 75%. The specimens were analyzed after 24 hours and after 1 week of storage. HPLC Liquid Chromatography was performed to analyze the extracted solutions. The statistical package SPSS 18 was used for the statistical analysis of the results. RESULTS: All the materials tested released monomers that were consistent with the base composition of their resin matrix. Bisphenol-A (BPA) was detected in Clearfil Esthetic and EsthetX when ethanol 75% was used for storage. TEGDMA was released at a faster rate compared to the other monomers with most of the monomer eluted in the first 24 hours. The effect of storage solution and storage time on the elution of the same monomers varied between materials. CONCLUSIONS: There was a significant effect of time, storage solution, and material on the elution of the detectable unbound monomers. Unbound monomers were detected in culture media, which may lead to false-negative results in cytotoxicity tests of resin composite materials. BPA was detected in two of the tested materials.

Remineralization potential of fully demineralized dentin infiltrated with silica and hydroxyapatite nanoparticles.

OBJECTIVE: This study investigates the potential of a novel guided tissue regeneration strategy, using fully demineralized dentin infiltrated with silica and hydroxyapatite (HA) nanoparticles (NPs), to remineralize dentin collagen that is completely devoid of native hydroxyapatite. METHODS: Dentin blocks were fully demineralized with 4N formic acid and subsequently infiltrated with silica and HA NPs. The remineralizing potential of infiltrated dentin was assessed following a twelve week exposure to an artificial saliva solution by means of TEM, EDS and micro-CT. Measurements were taken at baseline and repeated at regular intervals for the duration of the study to quantify the P and Ca levels, the mineral volume percentage and mineral separation of the infiltrated dentin specimens compared to sound dentin and non-infiltrated controls. RESULTS: Infiltration of demineralized dentin with nano-HA restored up to 55% of the P and Ca levels at baseline. A local increase in the concentration of calcium phosphate compounds over a period of twelve weeks resulted in a higher concentration in P and Ca levels within the infiltrated specimens when compared to the non-infiltrated controls. Remineralization of demineralized dentin with silica NPs by immersion in artificial saliva was the most effective strategy, restoring 20% of the P levels of sound dentin. Micro-CT data showed a 16% recovery of the mineral volume in dentin infiltrated with silica NPs and a significant decrease in the mineral separation to levels comparable to sound dentin. SIGNIFICANCE: Demineralized dentin infiltrated with silica NPs appears to encourage heterogeneous mineralization of the dentin collagen matrix following exposure to an artificial saliva solution.

Fracture strength of machined ceramic crowns as a function of tooth preparation design and the elastic modulus of the cement.

OBJECTIVES: To determine, by means of static fracture testing the effect of the tooth preparation design and the elastic modulus of the cement on the structural integrity of the cemented machined ceramic crown-tooth complex. METHODS: Human maxillary extracted premolar teeth were prepared for all-ceramic crowns using two preparation designs; a standard preparation in accordance with established protocols and a novel design with a flat occlusal design. All-ceramic feldspathic (Vita MK II) crowns were milled for all the preparations using a CAD/CAM system (CEREC-3). The machined all-ceramic crowns were resin bonded to the tooth structure using one of three cements with different elastic moduli: Super-Bond C&B, Rely X Unicem and Panavia F 2.0. The specimens were subjected to compressive force through a 4mm diameter steel ball at a crosshead speed of 1mm/min using a universal test machine (Loyds Instrument Model LRX.). The load at the fracture point was recorded for each specimen in Newtons (N). These values were compared to a control group of unprepared/unrestored teeth. RESULTS: There was a significant difference between the control group, with higher fracture strength, and the cemented samples regardless of the occlusal design and the type of resin cement. There was no significant difference in mean fracture load between the two designs of occlusal preparation using Super-Bond C&B. For the Rely X Unicem and Panavia F 2.0 cements, the proposed preparation design with a flat occlusal morphology provides a system with increased fracture strength. SIGNIFICANCE: The proposed novel flat design showed less dependency on the resin cement selection in relation to the fracture strength of the restored tooth. The choice of the cement resin, with respect to its modulus of elasticity, is more important in the anatomic design than in the flat design.

Color reproduction for advanced manufacture of soft tissue prostheses.

OBJECTIVES: The objectives of this study were to develop a color reproduction system in advanced manufacture technology for accurate and automatic processing of soft tissue prostheses. METHODS: The manufacturing protocol was defined to effectively and consistently produce soft tissue prostheses using a 3D printing system. Within this protocol printer color profiles were developed using a number of mathematical models for the proposed 3D color printing system based on 240 training colors. On this basis, the color reproduction system was established and their system errors including accuracy of color reproduction, performance of color repeatability and color gamut were evaluated using 14 known human skin shades. RESULTS: The printer color profile developed using the third-order polynomial regression based on least-square fitting provided the best model performance. The results demonstrated that by using the proposed color reproduction system, 14 different skin colors could be reproduced and excellent color reproduction performance achieved. Evaluation of the system's color repeatability revealed a demonstrable system error and this highlighted the need for regular evaluation. The color gamut for the proposed 3D printing system was simulated and it was demonstrated that the vast majority of skin colors can be reproduced with the exception of extreme dark or light skin color shades. CONCLUSIONS: This study demonstrated that the proposed color reproduction system can be effectively used to reproduce a range of human skin colors for application in advanced manufacture of soft tissue prostheses.

Manufacture, characterisation and properties of novel fluorcanasite glass-ceramics.

OBJECTIVE: The aim of this study was to investigate the manufacture and characterisation of different compositions of fluorcanasite glass-ceramics with reduced fluorine content and to assess their mechanical and physical properties. METHODS: Three compositional variations (S80, S81 and S82) of a fluorcanasite glass were investigated. Differential thermal analysis (DTA) and X-ray diffraction (XRD) identified crystallisation temperatures and phases. X-ray fluorescence (XRF) determined the element composition in the glass-ceramics. Different heat treatments [2 h nucleation and either 2 or 4 h crystallisation] were used for the glasses. Scanning electron microscopy (SEM) examined the microstructure of the cerammed glass. The chemical solubility, biaxial flexural strength, fracture toughness, hardness and brittleness index of S81 and S82 fluorcanasite were investigated with lithium disilicate (e.max CAD, Ivoclar Vivadent) as a commercial comparison. Statistical analysis was performed using one-way ANOVA with Tukey's multiple comparison tests (P<0.05). Weibull analysis was employed to examine the reliability of the strength data. RESULTS: All compositions successfully produced glasses. XRD analysis confirmed fluorcanasite formation with the S81 and S82 compositions, with the S82 (2+2h) showing the most prominent crystal structure. The chemical solubility of the glass-ceramics was significantly different, varying from 2565 ± 507 µg/cm(2) for the S81 (2+2 h) to 722 ± 177 µg/cm(2) for the S82 (2+2 h) to 37.4 ± 25.2 µg/cm(2) for the lithium disilicate. BFS values were highest for the S82 (2+2 h) composition (250 ± 26 MPa) and lithium disilicate (266 ± 37 MPa) glass-ceramics. The fracture toughness was higher for the S82 compositions, with the S82 (2+2h) attaining the highest value of 4.2 ± 0.3 MPa m(1/2)(P=0.01). The S82 (2+2 h) fluorcanasite glass-ceramic had the lowest brittleness index. CONCLUSION: The S82 (2+2 h) fluorcanasite glass-ceramic has acceptable chemical solubility, high biaxial flexural strength, fracture toughness and hardness. CLINICAL SIGNIFICANCE: A novel glass-ceramic has been developed with potential as a restorative material. The S82 (2+2 h) has mechanical and physical properties that would allow the glass-ceramic to be used as a machinable core material for veneered resin-bonded ceramic restorations.

The biological seal of the implant-soft tissue interface evaluated in a tissue-engineered oral mucosal model.

For dental implants, it is vital that an initial soft tissue seal is achieved as this helps to stabilize and preserve the peri-implant tissues during the restorative stages following placement. The study of the implant-soft tissue interface is usually undertaken in animal models. We have developed an in vitro three-dimensional tissue-engineered oral mucosal model (3D OMM), which lends itself to the study of the implant-soft tissue interface as it has been shown that cells from the three-dimensional OMM attach onto titanium (Ti) surfaces forming a biological seal (BS). This study compares the quality of the BS achieved using the three-dimensional OMM for four types of Ti surfaces: polished, machined, sandblasted and anodized (TiUnite). The BS was evaluated quantitatively by permeability and cell attachment tests. Tritiated water (HTO) was used as the tracing agent for the permeability test. At the end of the permeability test, the Ti discs were removed from the three-dimensional OMM and an Alamar Blue assay was used for the measurement of residual cells attached to the Ti discs. The penetration of the HTO through the BS for the four types of Ti surfaces was not significantly different, and there was no significant difference in the viability of residual cells that attached to the Ti surfaces. The BS of the tissue-engineered oral mucosa around the four types of Ti surface topographies was not significantly different.

Determination of relative in vivo osteoconductivity of modified potassium fluorrichterite glass-ceramics compared with 45S5 bioglass.

Potassium fluorrichterite (KNaCaMg(5)Si(8)O(22)F(2)) glass-ceramics were modified by either increasing the concentration of calcium (GC5) or by the addition of P(2)O(5) (GP2). Rods (2 × 4 mm) of stoichiometric fluorrichterite (GST), modified compositions (GC5 and GP2) and 45S5 bioglass, which was used as the reference material, were prepared using a conventional lost-wax technique. Osteoconductivity was investigated by implantation into healing defects in the midshaft of rabbit femora. Specimens were harvested at 4 and 12 weeks following implantation and tissue response was investigated using computed microtomography (µCT) and histological analyses. The results showed greatest bone to implant contact in the 45S5 bioglass reference material at 4 and 12 weeks following implantation, however, GST, GC5 and GP2 all showed direct bone tissue contact with evidence of new bone formation and cell proliferation along the implant surface into the medullary space. There was no evidence of bone necrosis or fibrous tissue encapsulation around the test specimens. Of the modified potassium fluorrichterite compositions, GP2 showed the greatest promise as a bone substitute material due to its osteoconductive potential and superior mechanical properties.

Infiltration of demineralized dentin with silica and hydroxyapatite nanoparticles.

OBJECTIVES: The management of demineralized dentin resulting from dental caries or acid erosion remains an oral healthcare clinical challenge. This paper investigates, through a range of studies, the ability of colloidal silica and hydroxyapatite (HA) nanoparticles to infiltrate the collagen structure of demineralized dentin. METHODS: Dentin samples were completely demineralized in 4 N formic acid. The remaining collagen matrix of the dentin samples was subsequently infiltrated with a range of nano-particulate colloidal silica and HA solutions. The effectiveness and extent of the infiltration was evaluated by scanning electron microscopy (SEM), transmission electron microscopy (TEM) and energy dispersive X-ray spectroscopy (EDS). RESULTS: Silica nanoparticles have the ability to penetrate dentin and remain embedded within the collagen matrix. It is suggested that particle size plays a major role in the degree of dentin infiltration, with smaller diameter particles demonstrating a greater infiltrative capacity. The infiltration of demineralized dentin with sol-gel HA nanoparticles was limited but was significantly increased when combined with the deflocculating agent sodium hexametaphosphate. The use of acetone as a transport vehicle is reported to enhance the infiltration capacity of sol-gel HA nanoparticles. SIGNIFICANCE: Collagen infiltrated with HA and silica nanoparticles may provide a suitable scaffold for the remineralization of dentin, whereby the infiltrated particles act as seeds within the collage matrix and given the appropriate remineralizing environment, mineral growth may occur.

Relationship between Color and Translucency of Multishaded Dental Composite Resins.

The aim of the present study was to compare the translucency of different shades of two highly aesthetic multilayered restorative composite resins. In total nine shades from Esthet.X and ten shades from Filtek Supreme composite resins were chosen. Discs of each shade were prepared (N = 3) and light-cured. Total and diffuse transmittance values for each sample were measured. Statistical analysis showed that the opaque dentine shades of both composites were the least translucent and the enamel shades had the highest translucency. There was a significant decrease in translucency from A2 to C2 of regular body shades and also from A4 to C4 of opaque dentine shades of Esthet.X composite resin. Grey enamel shade had a significantly higher diffuse translucency compared to clear and yellow enamel shades. There was a significant decrease in translucency from A2B to D2B and also in diffuse translucency from A4D to C6D shades of Filtek Supreme composite resin. It can be concluded that the color of the composite resins tested in this study had a significant effect on their translucency. Information on the translucency of different shades of composite resins can be very useful for the clinicians in achieving optimal esthetic restorative outcome.

Immediate vs delayed repair bond strength of a nanohybrid resin composite.

PURPOSE: To evaluate both the immediate and water-stored repair tensile bond strength (TBS) of a nanohybrid resin composite using different bonding protocols. MATERIALS AND METHODS: One hundred sixty half hourglass-shaped slabs were prepared. Eighty half-slabs were wet ground immediately after light curing using high-speed abrasive burs, while the other half-slabs were stored in water for one month (delayed) and then wet ground for repair. Each set of the 80 repaired slabs was split into two groups to be tested for TBS after 24 h or 1 month of water storage. For all repaired slabs, either immediate or delayed, four bonding procedures were used involving wet and dry bonding with a 3-step etch-and-rinse adhesive with or without silane pretreatment. TBS tests were performed at a crosshead speed of 0.5 mm/min. To determine the cohesive strength of the resin composite itself, which served as the reference, additional whole slabs were prepared and tested in tension after a 24-h (n = 10) and a 1-month storage period (n = 10). Failure modes were evaluated using a stereomicroscope at 40X magnification. Three-way ANOVA was run to test the effect of water storage, testing time, bonding protocols, and their interactions on the repair TBS, which was given as a percentage of the reference values. RESULTS: For the immediate repair groups, the repair TBS ranged from 40% to 61.9% after 24-h storage and from 26% to 53.1% after 1-month water storage compared to the TBS of the whole slabs. For the delayed repair group, the repaired TBS ranged from 47.2% to 63.6% for the 24-h repairs and from 32.2% to 44.2% for the test groups stored in water for 1 month. Three-way ANOVA revealed that water storage had no significant effect on the repair TBS (p = 0.619). Both testing time and bonding protocols had a significant effect on the repair TBS (p = 0.001). The interactions between the independent variables (water storage, testing time, and bonding protocols) had no significant effect (p = 0.067). CONCLUSION: The repair bond strength was consistently and highly significantly less than the cohesive strength of the composite. A delay of 1 month before carrying out the repair had no effect on the bond strength, irrespective of the bonding procedure used. Silane treatment did not improve the repair bond strength. In all instances, except for the immediate wet bonding plus silane procedure and delayed dry bonding, the bond strength of the repairs significantly dropped after 1 month of storage in water.

Interfacial fracture toughness of different resin cements bonded to a lithium disilicate glass ceramic.

OBJECTIVES: To evaluate the effect of HF acid etching and silane treatment on the interfacial fracture toughness of a self-adhesive and two conventional resin-based cements bonded to a lithium disilicate glass ceramic. METHODS: Lithium disilicate glass ceramic discs were prepared with two different surface preparations consisting of gritblasted with aluminium oxide, and gritblasted and etched with hydrofluoric acid. Ceramic surfaces with a chevron shaped circular hole were treated by an optimized silane treatment followed by an unfilled resin and then three different resin cements (Variolink II, Panavia F2, and Multilink Sprint). Specimens were kept in distilled water at 37°C for 24h and then subjected to thermocycling. The interfacial fracture toughness was measured and mode of failures was also examined. Data were analysed using analysis of variance followed by T-test analysis. RESULTS: No statistically significant difference in the mean fracture toughness values between the gritblasted and gritblasted and etched surfaces for Variolink II resin cement was found (P>0.05). For the gritblasted ceramic surfaces, no significant difference in the mean fracture toughness values between Panavia F2 and Variolink II was observed (P>0.05). For the gritblasted and etched ceramic surfaces, a significantly higher fracture toughness for Panavia F2 than the other cements was found (P<0.05). CONCLUSIONS: The interfacial fracture toughness for the lithium disilicate glass ceramic system was affected by the surface treatment and the type of luting agent. Dual-cured resin cements demonstrated a better bonding efficacy to the lithium disilicate glass ceramic compared to the self-adhesive resin cement. CLINICAL SIGNIFICANCE: The lithium disilicate glass ceramic surfaces should be gritblasted and etched to get the best bond when used with Panavia F2 and Multilink Sprint resin cements, whereas for the Variolink II only gritblasting is required. The best bond overall is achieved with Panavia F2.