Microleakage of new crown and fixed partial denture luting agents

Microleakage Under Orthodontic Brackets Bonded Using a Conventional Adhesive System, Nanocomposites, and Nanoionomers: A Comparative Study

Background Microleakage under orthodontic brackets has a role in early bracket debonding and white spot lesions due to the ingress of oral fluids in the bracket-adhesive-tooth interface. This in vitro study aimed to evaluate and compare the microleakage under orthodontic brackets bonded with the conventional adhesive system, nanocomposites, and nanoionomers. Materials and methods Forty-five human premolars were extracted for therapeutic reasons and collected for this study. Teeth were randomly assigned to three groups: Group A: conventional etching with conventional adhesive, Group B: conventional etching with nanocomposite, and Group C: conventional etching with nanoionomer. Stainless steel premolar brackets were used for bonding. After thermocycling, the extracted teeth were submerged in a 0.5% solution of basic fuchsine for 24 hours. They were then cut longitudinally. A stereomicroscope was used to assess microleakage along the occlusal and gingival interfaces. Results To compare the microleakage scores between gingival and occlusal aspects within each group, the student's t-test was performed. Analysis of variance (ANOVA) and the post-hoc Tukey test were applied to the data for intergroup comparison of microleakage scores. On comparing the microleakage scores, the gingival side of interfaces depicted higher microleakage than the occlusal side gingival side across all groups, demonstrating statistically significant results (P <0.05).On intergroup comparison, the occlusal bracket adhesive interface and gingival tooth adhesive interface revealed significantly higher microleakage values for Group B followed by Group C with Group A the least. However, there was no significant difference in the microleakage scores between Group B and Group C on intergroup comparison of mean microleakage scores (P <0.05). Conclusion The gingival side showed higher microleakage scores than the occlusal side. Nanoionomers showed microleakage values higher than the Transbond XT but lower than nanocomposites. Based on the results of the present study, in terms of microleakage, Transbond XT demonstrated lower microleakage when compared to nanoionomers and nanocomposites.

Three-body wear of luting composites and influence of the ACTA wheel material

The aim of the study was to investigate the wear of luting materials (Variolink Esthetic LC/DC, Multilink Automix, Panavia V5 paste) compared to a resin composite (Tetric EvoFlow) with an ACTA-machine (three-body-wear simulator) using steel and 3D-printed polymer wheels. Wear was measured (software Match3D) and statistically analyzed (ANOVA). Worn surface was examined with a field-emission-scanning-electron-microscope. Finite element analysis was carried out to analyze differences in the mechanical stress of the two different sample wheels. Using the steel wheel, Variolink Esthetic DC exhibited significantly less wear than Tetric EvoFlow after 200,000 cycles (p=0.037). Luting composites on polymer wheels exhibited significantly lower wear values compared to the steel wheels (p<0.001). Finite element analysis showed higher stresses for the steel wheel compared to the polymer wheel. Mechanical properties of the sample wheels had a high influence on wear properties. Dual- or auto-polymerizing materials seem to have a small advantage over the light-curing materials.

Comparing the marginal leakage and retention of implant-supported restorations cemented by four different dental cements

BACKGROUND

Despite the wide use of implants in dentistry, there is insufficient information about the ideal cement for retention.

PURPOSE

To determine the cement bond strength and marginal leakage of crown and partial denture cemented to implant abutments by four different types of cement.

MATERIALS AND METHODS

Eighty-four direct abutments were divided into eight groups (n = 7). Fifty-six crown and bridge restorations were cemented using zinc phosphate (ZM), temporary cement (TM), resin-modified glass-ionomer cement (GM), and self-adhesive resin cement (RM). After cementation, thermal cycling and incubation in basic fuchsin dye was applied. The maximum load to failure, marginal leakage, and fracture modes were evaluated.

RESULTS

The mean of retention strength for the bridges (874 N) was higher than the crown samples (705 N) (P = .005). The mean of retention strength for each cement group was ZM = 1298, RM = 1027, GM = 646, and TM = 187 N (P ≤ .0001). Marginal leakage was recorded in majority of the samples; the highest incidence was detected for ZM samples. The cement fracture was mostly adhesive in nature.

CONCLUSION

Self-adhesive resin and resin-modified glass ionomer cement had better mechanical properties to retain implant supported restorations.

Evaluation of marginal adaptation of Co-Cr-Mo metal crowns fabricated by traditional method and computer-aided technologies

Background/purpose

The purpose of this study was to evaluate the marginal gaps of dental restorations manufactured using conventional loss wax and casting, computer-aided design/computer-aided manufacturing (CAD/CAM), and 3D printing methods.

Materials and methods

A zirconia master die model with an upper right first molar resin crown was prepared as a standardized model. A total of 30 resin master die models were duplicated from this standard model. Simultaneously, 10 Co—Cr—Mo metal crowns were individually obtained using the conventional loss wax and casting method (Group A), selective laser sintering (Group B), and CAD/CAM (Group C), respectively. The marginal gaps between the crowns fabricated conventional and digital methods with master die models were calculated using a 3D replica and mapping technique.

Results

Statistical analyses revealed there were significant differences in the marginal gaps in the group A with group B and C (p < 0.05). The mean marginal gaps between dental crowns with die models were 76 ± 61 μm, 116 ± 92 μm, and 121 ± 98 μm for groups A, B, and C, respectively.

Conclusion

Within the limitations of this study, the marginal gaps were clinical acceptable in conventional and digital techniques.

To Compare and Evaluate the Sorption and Solubility of Four Luting Cements after Immersion in Artificial Saliva of Different pH Values

Introduction

The word 'luting' is derived from a latin word 'Lutum' which means 'mud'. 'Luting' is a word that is often used to describe the use of a mouldable substance to seal a space or to cement two components together. Therefore in view of the clinical importance of dissolution of luting cements in the oral environment, an in vitro study was designed to compare the sorption and solubility of commercially available luting cements mainly zinc phosphate, Glass Ionomer cement, Resin Modified Glass Ionomer Cement and Resin Cement after immersion in artificial saliva of different ph values of 5 and 7.

Aim

To Compare and Evaluate the sorption and solubility of four luting cements after immersion in artificial saliva of different pH values.

Materials and Method

A total of 120 test samples were prepared of which 30 samples of each luting cement were prepared for the purpose of assessing the water solubility and sorptionThese luting cements were grouped as: GROUP- A (Zinc Phosphate cement), GROUP- B (Glass Ionomer Cement), GROUP-C (Resin Modified Cement), GROUP- D (Resin Cement) In these groups, based on immersion of artificial saliva of acidic pH 5 and neutral pH7, the luting cement specimens were subdivided into 2 groups of 15 samples each. The volume (V) of each specimen was calculated using mathematical formula.

Conclusion

Resin cement had the highest resistance to solubility and sorption followed by resin modified GIC, Conventional GIC, and Zinc Phosphate which exhibited the least resistance to solubility in both artificial saliva of pH 5 and pH 7.

Evaluation of the marginal and internal gap of metal-ceramic crown fabricated with a selective laser sintering technology: two- and three-dimensional replica techniques

PURPOSE

One of the most important factors in evaluating the quality of fixed dental prostheses (FDPs) is their gap. The purpose of this study was to compare the marginal and internal gap of two different metal-ceramic crowns, casting and selective laser sintering (SLS), before and after porcelain firing. Furthermore, this study evaluated whether metal-ceramic crowns made using the SLS have the same clinical acceptability as crowns made by the traditional casting.

MATERIALS AND METHODS

The 10 study models were produced using stone. The 20 specimens were produced using the casting and the SLS methods; 10 samples were made in each group. After the core gap measurements, 10 metal-ceramic crowns in each group were finished using the conventional technique of firing porcelain. The gap of the metal-ceramic crowns was measured. The marginal and internal gaps were measured by two-dimensional and three-dimensional replica techniques, respectively. The Wilcoxon signed-rank test, the Wilcoxon rank-sum test and nonparametric ANCOVA were used for statistical analysis (α=.05).

RESULTS

In both groups, the gap increased after completion of the metal-ceramic crown compared to the core. In all measured areas, the gap of the metal cores and metal-ceramic crowns produced by the SLS was greater than that of the metal cores and metal-ceramic crowns produced using the casting. Statistically significant differences were found between cast and SLS (metal cores and metal-ceramic crown).

CONCLUSION

Although the gap of the FDPs produced by the SLS was greater than that of the FDPs produced by the conventional casting in all measured areas, none exceeded the clinically acceptable range.

An evaluation of marginal fit of three-unit fixed dental prostheses fabricated by direct metal laser sintering system

OBJECTIVES

This in vitro study aimed to evaluate and compare marginal fit of three-unit fixed dental prostheses (FDPs) fabricated using a newly developed direct metal laser sintering (DMLS) system with that of three-unit FDPs by a conventional lost wax technique (LW) method.

METHODS

Ten cobalt-chromium alloy three-unit FDPs using DMLS system and another ten nickel-chromium alloy FDPs using LW method were fabricated. Marginal fit was examined using a light-body silicone. After setting, the silicon film was cut into four parts and the thickness of silicon layer was measured at 160× magnification using a digital microscope to measure absolute marginal discrepancy (AMD), marginal gap (MG) and internal gap (IG). A repeated measure ANOVA for statistical analysis was performed using the SPSS statistical package version 12.0 (α=0.05).

RESULTS

The mean values of AMD, MG, and IG were significantly larger in the DMLS group than in the LW group (p<0.001). Means of AMD, MG and IG in the first molars were 83.3, 80.0, and 82.0μm in the LW group; and 128.0, 112.0, and 159.5μm in the DMLS group, respectively. No significant difference between measurements for premolars and molars was found (p>0.05).

SIGNIFICANCE

The marginal fit of the DMLS system appeared significantly inferior compared to that of the conventional LW method and slightly larger than the acceptable range. For clinical application further improvement of DMLS system may be required.

Sealing properties of three luting agents used for complete cast crowns: a bacterial leakage study

OBJECTIVE

To assess the sealing properties of three different luting materials used for cementation of full cast crowns on extracted human premolars.

METHODS

Thirty noncarious human premolars were prepared in a standardized fashion for full cast crown restorations. All margins were placed in dentin. After impressions of the preparations, stone dies were fabricated on which copings were waxed, which were cast in type III alloy using standardized laboratory methods. Teeth were randomly assigned to three groups of 10 samples each (n=10), for which the following cements were used: 1) a resin-modified glass ionomer cement, Rely X Luting Plus (3M ESPE, St Paul, MN, USA); 2) a self-adhesive resin cement, Maxcem Elite (Kerr Corporation, Orange, CA, USA); and 3) a glass ionomer cement, Ketac Cem (3M ESPE), the latter used as control. After cementation the samples were allowed to bench-set for 10 minutes, stored in water at 37°C, subjected to thermal cycling (2000×, between 5°C and 55°C, dwell time 35 seconds), and then stored in sterile phosphate buffer for seven days at 37°C. Subsequently, the occlusal surface was carefully reduced until the dentin was exposed. Finishing on wet sand paper removed the gold flash caused by grinding. After sterilization, the specimens were subjected to bacterial microleakage in a dual chamber apparatus for 60 days. Bacterial leakage was checked daily. Data were analyzed using the Kaplan-Meier survival test. Significant pairwise differences were analyzed using the log-rank test followed by Fisher exact test at a p<0.05 level of significance.

RESULTS

Rely X Luting Plus showed the lowest microleakage scores, which statistically differed significantly from Maxcem Elite and Ketac Cem (p<0.05).

CONCLUSIONS

Rely X Luting Plus cement displayed significantly lower microleakage scores than a self-adhesive resin-based and conventional glass ionomer cement.

Evaluation of bond strength of resin cements using different general-purpose statistical software packages for two-parameter Weibull statistics

OBJECTIVES

This study evaluated and compared Weibull parameters of resin bond strength values using six different general-purpose statistical software packages for two-parameter Weibull distribution.

METHODS

Two-hundred human teeth were randomly divided into 4 groups (n=50), prepared and bonded on dentin according to the manufacturers' instructions using the following resin cements: (i) Variolink (VAN, conventional resin cement), (ii) Panavia21 (PAN, conventional resin cement), (iii) RelyX Unicem (RXU, self-adhesive resin cement) and (iv) G-Cem (GCM, self-adhesive resin cement). Subsequently, all specimens were stored in water for 24h at 37°C. Shear bond strength was measured and the data were analyzed using Anderson-Darling goodness-of-fit (MINITAB 16) and two-parameter Weibull statistics with the following statistical software packages: Excel 2011, SPSS 19, MINITAB 16, R 2.12.1, SAS 9.1.3. and STATA 11.2 (p≤0.05). Additionally, the three-parameter Weibull was fitted using MNITAB 16.

RESULTS

Two-parameter Weibull calculated with MINITAB and STATA can be compared using an omnibus test and using 95% CI. In SAS only 95% CI were directly obtained from the output. R provided no estimates of 95% CI. In both SAS and R the global comparison of the characteristic bond strength among groups is provided by means of the Weibull regression. EXCEL and SPSS provided no default information about 95% CI and no significance test for the comparison of Weibull parameters among the groups. In summary, conventional resin cement VAN showed the highest Weibull modulus and characteristic bond strength.

SIGNIFICANCE

There are discrepancies in the Weibull statistics depending on the software package and the estimation method. The information content in the default output provided by the software packages differs to very high extent.

Comparison of 3 luting agents on retention of implant-supported crowns on 2 different abutments

BACKGROUND

For fixed prostheses, retention is one of the most important factors for clinical success. It is unknown whether grooves that increase surface area of implant abutment while retaining the diameter and wall height provide greater uniaxial retention force. The purpose of this study was to determine the retention of 3 different cements on 2 implant abutments with different surface configurations.

MATERIALS AND METHODS

Thirty samples on 2 different abutments (a total of 60 crowns) with different margin and axial walls configuration and surface area were used. Metal crowns were fabricated on the abutment and cemented with 3 different (zinc-phosphate [ZP], glass ionomer [GI], or eugenol-free zinc oxide [ZO]) cements. After cementation, implant-abutment-casting assemblies were thermal cycled 1000 times with 1-minute dwell-time between 5°C and 55°C then subjected to tensile test with universal testing machine until decementation occurred. The mean force required to dislodge castings from abutment was determined.

RESULTS

The luting agents influenced retention of castings on implant abutments, whereas different surface configurations and total surface area of the abutments did not influence the uniaxial retention forces. Among the cements tested, ZP exhibited higher values of retention, followed by GI and eugenol-free ZO.

CONCLUSIONS

The increase in surface area of abutment did not result in improved retention. The present results suggest using ZP rather than GI and eugenol-free ZO in implant-supported crowns to provide higher retention.

An In Vitro Evaluation of the Microleakage under Complete Metal Crowns Using Three Adhesive Luting Cements

Despite the material advancements and precise laboratory techniques, cement lines are inevitable in fixed prosthodontics which leads to increased dependence on the integrity of the cement to maintain the marginal seal. The material class of luting agent is known to influence microleakage. Studies of cement dissolution and disintegration have produced varying results. Hence, this study was done to evaluate marginal leakage under complete metal crowns using three adhesive cements, two resin cements (one self cure, one dual cure) and a glass ionomer cement. Metal crowns were prepared on sixty intact extracted premolars and were randomly divided into three groups of twenty each, with each group using a different cement for luting. All the samples were then subjected to thermocycling and were sectioned using a diamond saw. Reflected Binocular Stereomicroscope at 100× magnification was used to study the extent of microleakage at both metal cement (MC) and tooth cement (TC) interface, at two opposite margins of each sectioned specimen. Data was analyzed with a one way analysis of variance. For comparison among the groups multiple comparison Bonferroni test was done. Within group data was analysed with independent student t test. Between three groups, metal crowns cemented with multilink cement showed significantly less microleakage at both the interfaces. Glass ionomer cement recorded maximum combined microleakage amongst three cements irrespective of the interfaces. Within group, glass ionomer and multilink cement showed more microleakage at MC interfaces than at TC interface. A complex interaction between variables related to dental restoration, luting agent and tooth structure probably influence microleakage. In vitro studies must always be followed by in vivo studies before definite conclusion can be drawn.

The effect of dentin desensitizer on shear bond strength of conventional and self-adhesive resin luting cements after aging

This study tested the impact of Gluma Desensitizer on the shear bond strength (SBS) of two conventional (RelyX ARC, Panavia 21) and two self-adhesive (RelyX Unicem, G-Cem) resin luting cements after water storage and thermocycling. Human third molars (N=880) were embedded in acrylic resin. The buccal dentin was exposed. Teeth were randomly divided into four main groups, and the following cements were adhered: 1) RelyX ARC, 2) Panavia 21, 3) RelyX Unicem, and 4) G-Cem. In half of the teeth in each group, dentin was treated with Gluma Desensitizer. In the conventional cement groups, the corresponding etchant and adhesive systems were applied. SBS of the cements was tested after 1 hour (initial); at 1, 4, 9, 16, and 25 days of water storage; and at 1, 4, 9, 16, and 25 days of thermocycling. SBS data were analyzed by one-way analysis of variance (ANOVA); this was followed by the post hoc Scheffé test and a t-test. Overall, the highest mean SBS (MPa) was obtained by RelyX ARC (ranging from 14.6 ± 3.9 to 17.6 ± 5.2) and the lowest by Panavia 21 in combination with Gluma Desensitizer (ranging from 0.0 to 2.9 ± 1.0). All tested groups with and without desensitizer showed no significant decrease after aging conditions compared with baseline values (p>0.05). Only the Panavia 21/Gluma Desensitizer combination showed a significant decrease after 4 days of thermocyling compared with initial values and 1 day thermocycling. Self-adhesive cements with Gluma Desensitizer showed increased SBS after aging conditions (ranging from 7.4 ± 1.4 to 15.2 ± 3) compared with groups without desensitizer (ranging from 2.6 ± 1.2 to 8.8 ± 2.9). No cohesive failures in dentin were observed in any of the test groups. Although self-adhesive cements with and without desensitizer presented mainly adhesive failures after water storage (95.8%) and thermocyling (100%), conventional cement (RelyX ARC) showed mainly mixed failures (90.8% and 89.2%, after water storage and thermocyling, respectively). Application of the Gluma Desensitizer to dentin before cementation had a positive effect on the SBS of self-adhesive cements.

Crown Cementing Strategy for Naval Divers

BACKGROUND

A large number of personnel working in hyperbaric environment such as divers and submariners during escape drills report to the out patient department with split teeth, displacement of restoration and pain during ascent after diving. These symptoms are probably attributable to dental barotraumas. Therefore, a need was felt to undertake a study in this area, with a specific interest for treating these patients.

METHODS

Sixty extracted single rooted premolar teeth were prepared and full cast crowns were cemented. Out of these, 20 were prepared with zinc phosphate, 20 with glassionomer and 20 with resin cement. After seven days of storage, each of the teeth in experimental group was pressure cycled 15 times to 3 atmospheres after which the force required to dislodge the crowns was tested on an Instron testing machine.

RESULT

A significant difference was found (student's t test p value < 0.01) between the force required to dislodge the crowns with zinc phosphate cemented control group (141.70 ± 38.62) and experimental group (16.92 ± 10.13). Similarly a significant difference was observed in the glassionomer cemented control group (184.33 ± 25.33) and experimental group (90.50 ± 34.07). On the other hand, no difference was found between the resin cemented control group (289.15 ± 81.48) and experimental (279.43±87.48) group.

CONCLUSION

Within the limitations of this study and based on the results, it was concluded that environmental pressure cycling affected the retention of crowns cemented with zinc phosphate and glassionomer cement. Panavia resin cement used in this study appeared to be unaffected by environmental pressure cycling. On the basis of the results of this study, dental surgeons should consider cementing fixed prosthesis with resin cements for patients who are exposed to marked variations in environmental pressure, such as divers and submariners during escape drills.

Microleakage and Marginal Gap of Adhesive Cements for Noble Alloy Full Cast Crowns

Very limited comparative information about the microleakage in noble alloy full cast crowns luted with different types of adhesive resin cements is available. The purpose of this study was to evaluate the microleakage and marginal gap of two self-adhesive resin cements with that of other types of adhesive luting cements for noble alloy full cast crowns. Fifty noncarious human premolars and molars were prepared in a standardized manner for full cast crown restorations. Crowns were made from a noble alloy using a standardized technique and randomly cemented with five cementing agents as follows: 1) GC Fuji Plus resin-modified glass ionomer cement, 2) Panavia F 2.0 resin cement, 3) Multilink Sprint self-adhesive resin cement, 4), Rely X Unicem self-adhesive resin cement with pretreatment, and 5) Rely X Unicem with no pretreatment. The specimens were stored in distilled water at 37°C for two weeks and then subjected to thermocycling. They were then placed in a silver nitrate solution, vertically cut in a mesiodistal direction and evaluated for microleakage and marginal gap using a stereomicroscope. Data were analyzed using a nonparametric Kruskal-Wallis test followed by Dunn multiple range test at a p&lt;0.05 level of significance. The Rely X Unicem (with or with no pretreatment) exhibited the smallest degree of microleakage at both tooth-cement and cement-crown interfaces. The greatest amount of microleakage was found for Panavia F 2.0 resin cement followed by GC Fuji Plus at both interfaces. No statistically significant difference in the marginal gap values was found between the cementing agents evaluated (p&gt;0.05). The self-adhesive resin cements provided a much better marginal seal for the noble alloy full cast crowns compared with the resin-modified glass ionomer or dual-cured resin-based cements.

The effect of dentin pretreatment on the microtensile bond strength of self-adhesive resin cements

STATEMENT OF PROBLEM

Self-adhesive cements have lower bond strength than conventional resin cements that rely on the application of etch-and-rinse adhesive systems.

PURPOSE

The purpose of this study was to evaluate the effect of tannic and polyacrylic acid on the microtensile bond strength of self-adhesive resin cements to dentin.

MATERIAL AND METHODS

Eighteen molar crowns were flattened to expose dentin and divided into 3 groups according to the dentin pretreatment: (1) control, without surface treatment; (2) 25% polyacrylic acid solution (Ketac Conditioner); (3) 20% tannic acid. Composite resin (Tescera) blocks were luted to dentin surfaces using 2 self-adhesive resin cements (RelyX Unicem or Maxcem Elite) (n=3). All specimens were stored in distilled water for 24 hours, sectioned into beams (1 mm(2)), and tested to failure using a microtensile method at a crosshead speed of 1 mm/min. The data were statistically analyzed using 2-way ANOVA and Fisher's PLSD tests (α=.05).

RESULTS

The polyacrylic acid significantly improved the microtensile bond strength of RelyX Unicem (14.92 ±4.94 MPa) when compared to the control group (8.35 ±1.99 MPa) and tannic acid treatment (8.38 ±2.67 MPa) (P<.001). Dentin surface treatment did not affect the microtensile bond strength of Maxcem Elite cemented groups (control, 8.45 ±3.21 MPa; polyacrylic acid, 9.53 ±9.95 MPa; tannic acid, 6.89 ±4.45 MPa).

CONCLUSIONS

Dentin pretreatment with polyacrylic acid improved the microtensile bond strength of RelyX Unicem.

Microleakage between composite/wire and composite/enamel interfaces of flexible spiral wire retainers: direct versus indirect application methods

OBJECTIVE

The aim of this in vitro study was to compare the microleakage of flexible spiral wire retainers (FSWR) at composite/wire and composite/enamel interfaces produced by an indirect application method to that of a conventional direct application method.

MATERIALS AND METHODS

Forty freshly extracted human mandibular incisor teeth were randomly divided into two equal groups. Group 1 was bonded directly according to the manufacturer's recommendations. Group 2 consisted of 20 teeth bonded indirectly with Transbond LR as the adhesive and Sondhi Rapid Set A/B Primer (3M Unitek, Monrovia, CA, USA), a filled resin primer. After bonding, specimens were further sealed with nail varnish, stained with 0.5% basic fuchsine for 24 h, sectioned and examined under a stereomicroscope that measured microleakage at the composite/wire and composite/enamel interfaces from both mesial and distal margins. Statistical analyses were performed using Wilcoxon and Mann-Whitney U-tests with Bonferroni correction.

RESULTS

Statistical comparisons indicated that no statistically significant differences were observed between composite/wire and composite/enamel interfaces for direct vs. indirect application procedures (Direct method p = 0.630 and Indirect method p = 0.930). Comparisons of the microleakage scores between direct and indirect FSWR application groups at composite/wire and composite/enamel interfaces indicated no statistically significant microleakage differences at mesial or distal margins (Composite/enamel interface p = 0.361 and Composite/wire interface p = 0.270).

CONCLUSION

The type of FSWR application procedures (direct vs. indirect) did not significantly affect the amount of microleakage at the enamel/composite/wire complex.

Bi-axial flexural strength of dual-polymerizing agents cemented to human dentin after photo-activation with different light-curing systems

OBJECTIVES

This study aimed to assess the bi-axial flexural strength of two dual-polymerizing resin luting agents cemented to human dentin when photo-activated with different light-curing units.

MATERIALS AND METHODS

Two dual-cured resin cements: choice (CH) and Variolink II (VL) were tested. Hybrid composite resin (Z-250) discs (12 × 1.5 mm) were fabricated. Three types of light-curing units were used halogen-curing unit (QTH), light-emitting diode (LED) and plasma arc (PAC). Sixty dentin discs of 0.5 mm thickness were prepared from extracted human teeth. A circular mold (2.5 mm in height and 12 mm diameter) was utilized to create supporting structure for dentin, resin cement complex. The resin luting cement (0.5 mm) was placed on the previously prepared dentin discs and covered with the prefabricated composite discs. Photo-activation of cements was performed for 40 s with QTH and LED units and for 3 s with PAC. The specimens were divided into 12 groups (20 specimens for each light source). Six groups were kept in distilled water for 24 h and the rest were stored for 6 weeks. Bi-axial flexural strength was determined using Instron machine. The data was analyzed using two-way ANOVA and Tukey test for comparison.

RESULTS

The findings indicated that the bi-axial flexural strength values for both cements CH and VL were higher for 24 h over 6 weeks but not statistically significant when cured with QTH. Meanwhile, when LED light was used for photo-activation the cements, the flexural strength values reported were statistically higher of 24 h over 6 weeks storage at P = 0.4(E-6) However, PAC light did not record any statistically significant difference between two duration for the CH cement although when used for polymerization of VL the reported value for 6 weeks were statistically significantly higher value than 24 h duration at P = 0.002.

CONCLUSION

When high immediate flexural strength is preferred in clinical situation photo-activation the cements with LED reported the greatest value.

Microleakage under orthodontic brackets bonded with the custom base indirect bonding technique

The aim of this in vitro study was to compare microleakage of orthodontic brackets between enamel-composite and composite-bracket interfaces at the occlusal and gingival margins, bonded using indirect bonding systems with that of a conventional direct bonding method. Forty freshly extracted human maxillary premolar teeth were randomly divided into two groups. In group 1, the brackets were bonded to teeth directly according to the manufacturer's recommendations. Group 2 consisted of 20 teeth bonded indirectly with Transbond XT (3M-Unitek), as the adhesive, and Sondhi Rapid Set A/B Primer (3M-Unitek), a filled resin primer. After bonding, the specimens were further sealed with nail varnish, stained with 0.5 per cent basic fuchsine for 24 hours, sectioned and examined under a stereomicroscope, and scored for microleakage at the enamel-composite and composite-bracket interfaces from both the occlusal and gingival margins. Statistical analyses were performed using Kruskal-Wallis and Mann-Whitney U-tests with Bonferroni correction. The gingival sides of group 1 displayed a higher median microleakage score than the occlusal side at the enamel-composite interface but this was not statistically significant (P > 0.05). All occlusal margins in both groups showed no microleakage under orthodontic brackets at the enamel-composite or composite-bracket interfaces. Comparisons of the microleakage scores between the direct and the indirect bonding groups at the enamel-composite and composite-bracket interfaces indicated no statistically significant microleakage differences at the gingival and occlusal margins (P > 0.05). The type of bonding method (direct versus indirect) did not significantly affect the amount of microleakage at the enamel-composite-bracket complex.

Correlation between margin fit and microleakage in complete crowns cemented with three luting agents

Microleakage can be related to margin misfit. Also, traditional microleakage techniques are time-consuming. This study evaluated the existence of correlation between in vitro margin fit and a new microleakage technique for complete crowns cemented with 3 different luting agents. Thirty human premolars were prepared for full-coverage crowns with a convergence angle of 6 degrees, chamfer margin of 1.2 mm circumferentially, and occlusal reduction of 1.5 mm. Ni-Cr cast crowns were cemented with either zinc phosphate (ZP) (S.S. White), resin-modified glass-ionomer (RMGI) (Rely X Luting Cement) or a resin-based luting agent (RC) (Enforce). Margin fit (seating discrepancy and margin gap) was evaluated according to criteria in the literature under microscope with 0.001 mm accuracy. After thermal cycling, crowns were longitudinally sectioned and microleakage scores at tooth-cement interface were obtained and recorded at x100 magnification. Margin fit parameters were compared with the one-way ANOVA test and microleakage scores with Kruskal-Wallis and Dunn's tests (alpha=0.05). Correlation between margin fit and microleakage was analyzed with the Spearman's test (alpha=0.05). Seating discrepancy and marginal gap values ranged from 81.82 microm to 137.22 microm (p=0.117), and from 75.42 microm to 78.49 microm (p=0.940), respectively. Marginal microleakage scores were ZP=3.02, RMGI=0.35 and RC=0.12 (p<0.001), with no differences between RMGI and RC scores. The correlation coefficient values ranged from -0.27 to 0.30 (p>0.05).

CONCLUSION

Margin fit parameters and microleakage showed no strong correlations; cast crowns cemented with RMGI and RC had lower microleakage scores than ZP cement.

Marginal and internal fit of metal-ceramic crowns fabricated with a new laser melting technology

OBJECTIVES

The purpose of this in vivo investigation was to evaluate the marginal and internal fit of metal-ceramic crowns fabricated with a new laser melting procedure (BEGO Medical, Bremen, Germany), and to investigate the influence of ceramic firing on the marginal and internal accuracy of these crowns.

METHODS

After tooth preparation, impression taking using polyvinylsiloxane and model casting, each preparation was contact less scanned by strip-light-projection. The finishing line and the virtual construction of the metal coping were defined by means of a computer. Using CAD/CAM software the metal copings were produced by BEGO Medical (Germany). A base metal alloy (Wirobond C) and a precious alloy (BioPontoStar, both: BEGO Medical) were used in this study with 14 restorations each. The internal and marginal accuracy of the specimens were examined using a silicone indicator paste (Fit Checker, GC, Japan). After setting, the silicone films were embedded in acrylic resin and sectioned four times. Each slice was photographed digitally at 60x magnification for marginal and at 15x magnification for occlusal adaptation, respectively. Using a light microscope the thickness of the silicone layer was measured at 10 reference points, a total of 3360 measurements. This procedure was repeated after the ceramic firing in the dental laboratory and after intraoral adjustment clinically.

RESULTS

No statistically significant differences between the two alloys were found at any time. The mean marginal discrepancies ranged from 74 to 99 microm for both alloys. The internal gaps ranged from 250 to 350 microm. Ceramic firing increased the marginal discrepancies while the internal gaps decreased especially at occlusal surface. However, only in one case a slight statistically significance could be determined (p=0.046).

SIGNIFICANCE

The results of this in vivo study show that crowns produced with laser melting technology exhibit a marginal and internal accuracy that is comparable to conventional production procedures.

Comparison of the Flexural Strength of Five Adhesive Resin Cements

STATEMENT OF PROBLEM

The increased use of adhesive resin cements in bonded prosthetic restorations has led to restorations debonding under function.

PURPOSE

This investigation evaluated the differences in the flexural strength of new adhesive resin cements as a function of specimen age and storage condition.

MATERIALS AND METHODS

Four new dual-cure cements were compared to C/B Metabond. Twenty specimens of each of the five cements were prepared in a rectangular glass mold (25 x 2 x 2 mm). The new cements were light-activated with a 550 mW/cm(2) lamp for 80 seconds on both the top and bottom surfaces. The auto-cured cement was allowed to set according to manufacturer's directions. Half the specimens were tested immediately after curing while the other half were stored in distilled water at 37 degrees C for 30 days. A three-point bending test was performed using an Instron at a crosshead speed of 1 mm/min. The results were analyzed by analysis of variance and Scheffé tests ( p < 0.05) to examine the effect of specimen age and storage condition.

RESULTS

RelyX ARC exhibited a significantly higher flexural strength compared with Calibra and Panavia F when tested immediately. The standard cement, C/B Metabond, deformed and did not fracture at the immediate test time. After storage, the flexural strength had significantly improved from the immediate test time for Calibra, Cement-It, Panavia F, and C/B Metabond. However, there were no significant differences in the flexural strength among the cements when tested after 30 days in water at 37 degrees C.

CONCLUSION

Immediately after curing, these new adhesive resin cements are not equivalent, as evidenced by the significant variability in the measured flexural strength. The distinctions among the cements diminish after aging in water, which may be due to residual polymerization or a plasticizing effect from water absorption.

CLINICAL SIGNIFICANCE

When light-cured, all the new adhesive resin cements have greater early strengths than the auto-cured cement; however, the wide variation in immediate bending strength suggests that some cements may be more appropriate for use in high-stress clinical situations such as resin-bonded fixed partial dentures.

Optimizing resin cement removal around esthetic crown margins

OBJECTIVE

To quantify luting cement at the crown-tooth interface of esthetic crowns fabricated using four different techniques and two methods of excess cement removal.

MATERIAL AND METHODS

Four methods of crown fabrication were used: the feldspathic porcelain and platinum foil technique, the feldspathic porcelain and refractory die technique, the resin composite crown and CAD/CAM technique, and the feldspathic porcelain crown and CAD/CAM technique. Half of the cemented crowns were allocated to Group A: removal of excess cement by flicking-off with a plastic instrument 3 min after initial polymerization, or Group B: removal of excess cement using a wiping action with cotton pellets. Morphologic measurements, using non-destructive digital profilometry, were made of the volume of excess cement (mm(3)), mean maximum and mean depth of excess cement (microm), and surface area of excess cement (mm(2)).

RESULTS

ANOVA and Duncan post-hoc tests revealed no statistical differences (p<0.05) between the four types of crown fabrication with respect to volume and mean depth of retained luting cement. There was a significantly greater volume, mean depth, and mean maximum depth of luting cement retained using the "flick off" method compared to the cotton pellet "wiping" method for excess cement removal, but no statistical differences in mean surface area between the two methods.

CONCLUSIONS

Following removal of excess luting cement, as judged clinically, using two methods, subclinical amounts of cement remained adherent to the tooth surface of all specimens at the crown-tooth interface.

Microleakage of various cementing agents for full cast crowns

OBJECTIVES

To evaluate microleakage and marginal gaps in full cast crown restorations bonded with six different types of cementing agents.

METHODS

Sixty non-carious human premolars and molars were prepared in a standardized manner for full cast crown restorations. The mesial and distal margins were located in dentin, while the vestibular and palatal/lingual margins were located in enamel. Crowns were made from a high-gold alloy using a standardized technique. The specimens were randomized to six groups of cementing agents: one zinc-phosphate cement (Harvard cement), one conventional glass-ionomer cement (Fuji I), one resin-modified glass-ionomer cement (Fuji Plus), two standard resin cements (RelyX ARC, Panavia F), and one self-adhesive universal resin cement (RelyX Unicem). After 4 weeks of storage in distilled water at 37 degrees C, the specimens were subjected to 5000 thermocycles ranging from 5 to 55 degrees C. Then, they were placed in a silver nitrate solution, embedded in resin blocks, and vertically cut in buccolingual and mesiodistal direction. Subsequently, the objects were evaluated for microleakage and marginal gap using a high-resolution digital microscope camera.

RESULTS

A number of inter-group differences were statistically significant. RelyX Unicem showed the smallest degree of microleakage both in enamel and in dentin. Panavia F und RelyX Unicem were associated with significantly larger marginal gaps than all other cementing agents. No association was observed between microleakage and marginal gap other than a weak direct correlation when using Harvard cement on enamel.

SIGNIFICANCE

The cementing agents investigated revealed different sealing abilities. These differences were not associated with specific types of materials.

In vitro dentine permeability: the relative effect of a dentine bonding agent on crown preparations

OBJECTIVE

The aim of this study was to determine whether a dentine bonding agent (DBA) had an effect in reducing fluid filtration under cemented provisional crowns.

METHODS

Crown preparations on 34 premolars, randomly allocated to two equal-sized test and control groups, were assessed for dentine permeability by a fluid filtration technique. In the test group, prepared crowns were acid-etched and then treated with a DBA (Prime & Bond NT). In the control group, no such DBA was applied. Provisional crowns were cemented on both groups of teeth using non-eugenol zinc oxide cement. Fluid filtration rates were measured repeatedly after crown preparation, at cementation, 1 h, 1 day, 1 week and 3 weeks following crown cementation for both groups. Filtration rates were also measured after acid-etching and dentine bonding for the test group.

RESULTS

There was insufficient evidence to suggest any statistically significant differences either between the two groups or, on average, across the five time points in each group in terms of the relative percentage of fluid filtration.

CONCLUSION

The DBA used did not seal dentinal tubules any more than did the smear layer and provisional crowns luted with a non-eugenol ZnO cement.

Comparison of microleakage of three acid-base luting cements versus one resin-bonded cement for Class V direct composite inlays

STATEMENT OF PROBLEM

Demineralized dentin beneath set cement may adversely affect microleakage under fixed restorations.

PURPOSE

Microleakage of direct composite inlays cemented with acid-base cements and a methyl methacrylate resin cement were evaluated to determine their effect on the integrity of the underlying hybridized dentin.

MATERIALS AND METHODS

Sixty Class V box preparations (3 mm x 3 mm x 1.5 mm) were precisely prepared in previously frozen bovine teeth with one margin in enamel and another margin in dentin. Direct composite inlays (EPIC-TMPT) for each preparation were divided into 4 groups of 15 specimens each and cemented with 3 acid-base cements (control group): Elite, Ketac-Cem, Hy-Bond Carbo-Cem, and 1 adhesive resin cement: C&B Metabond. All specimens were stored in distilled water for 24 hours at 37 degrees C before immersion in 0.5% basic fuchsin for 24 hours. The dye penetration was measured on the sectioned specimens at the tooth-cement interface of enamel and cementum margins and recorded with graded criteria under light microscopy (Olympus Vanox-T) at original magnification x 50, 100, and 200. A Kruskal-Wallis and the Mann-Whitney test at P<.05 were used to analyze leakage score.

RESULTS

All cementum margins of the 3 acid-base cements tested demonstrated significantly higher leakage scores than cementum margins for inlays cemented with the resin cement tested(P<.01). No leakage along the tooth-cement interface was found for inlays retained with the adhesive resin cement.

CONCLUSIONS

Within the limitations of this study, the 3 acid-base cements tested exhibited greater microleakage at the cementum margins than did the adhesive resin cement that was tested.

In vitro microleakage of luting cements and crown foundation material

STATEMENT OF PROBLEM

Microleakage is a concern for the long-term prognosis of a cemented crown and foundation.

PURPOSE

The aims of this investigation were, first, to evaluate microleakage of zinc phosphate cement and resin-reinforced glass ionomer cement under ideal (dry) versus contaminated (wet) conditions, and second, to compare 3 foundations under both ideal and contaminated conditions.

MATERIAL AND METHODS

One hundred forty extracted molar teeth were cleaned and mounted. Tooth preparations for complete veneer cast crowns were completed with a chamfer finish line. A mesial surface class II cavity preparation 4 mm wide buccolingually and 2 mm deep was made in each tooth. Seven restorative groups were formed: amalgam/cavity varnish, amalgam/dentinal bonding agent, and composite/dentinal bonding agent, each with dry and contaminated groups, and a seventh group of class II cavity preparations without foundations. Finish lines for crown margins were refined 1.5 mm gingival to the restoration. Artificial crowns were cast in type III gold. Treatment groups were divided into 4 cement groups: dry and contaminated zinc phosphate cement and dry and contaminated resin-reinforced glass ionomer cement. The specimens were thermocycled and immersed in erythrosine B solution for 24 hours. Subsequently, they were rinsed, and their coronal portions were embedded in clear resin. Teeth were sectioned mesiodistally, and standard photomicrographs were made. The microleakage of each restoration and crown was measured.

RESULTS

The least foundation microleakage was recorded for amalgam/dentinal bonding agents (ideal group) and composite/dentinal bonding agents (ideal group). The most microleakage was observed within the group without a foundation. In cement groups, the control and experiment sides were evaluated separately but displayed the same order of finding. The least leakage was recorded with resin-reinforced glass ionomer cement (ideal group); the most microleakage was noted with zinc phosphate cement (ideal group). An interaction was demonstrated on the experimental side between cements and the foundations (P=.0001).

CONCLUSION

Within the experimental conditions of this study, less microleakage was recorded with resin-reinforced glass ionomer cement (ideal or contaminated) than with zinc phosphate cement (ideal or contaminated). There also was less microleakage evident with a foundation of silver amalgam or composite when a dentinal bonding agent was used under ideal conditions.

Macromolecular leakage beneath full cast crowns: A two-year in vitro investigation

STATEMENT OF PROBLEM

Most microleakage studies have used low molecular weight dyes or isotopes rather than clinically relevant materials such as lipopolysaccharides (LPSs) or cell wall materials that have been shown to provoke inflammatory reactions in the dental pulp.

PURPOSE

This investigation evaluated the leakage (diffusion) of fluorescently labeled LPS and dextran beneath cast-gold crowns luted with 3 cements.

MATERIAL AND METHODS

Thirty extracted molars were prepared for crowns. Ten crowns with access ports (facial or lingual) were cast in gold and luted with zinc phosphate, glass ionomer, and an adhesive resin cement onto their preparations. Teeth and crowns with filters inserted into the ports were immersed in a solution of labeled macromolecules (TRITC-LPS, FITC-dextran) and evaluated for leakage every month for 24 months. Filters were retrieved and analyzed with fluorescent microscopy.

RESULTS

All filters retrieved from crowns luted with zinc phosphate, glass ionomer, and adhesive resin cements demonstrated no detectable leakage and were negative for both FITC-dextran and TRITC-LPS for all evaluation periods.

CONCLUSION

For the 24 months of this investigation, zinc phosphate, Ketac-Cem, and C&B-Metabond were equally effective at preventing leakage of detectable molecular concentrations of LPS and dextran to the level of the access ports.

Crown cementation and pulpal health

LITERATURE REVIEW

A direct result of the liquid continuum within the pulpo-dentine complex is the effect of restorative dentistry on the health of the dental pulp. Better understanding of the role of the complex in relation to restorative dentistry enables strategies to be devised in preserving pulp vitality. A review of the literature produced good laboratory evidence to support the prophylactic sealing of crown preparations with dentine bonding agents.

Retention of adhesive cement on the tooth surface after crown cementation

STATEMENT OF PROBLEM

Adhesive cements increase crown retention, but it is unknown if traces of cement remain undetected on the tooth surface after clinical removal of excess cement, which could exacerbate plaque retention.

PURPOSE

This study measured the surface area, volume, mean depth, and maximum depth of a resin composite and a compomer luting cement left adherent on the tooth surface after removal of excess cement, as judged clinically.

METHODS AND MATERIAL

Four groups of specimens (n = 48) were prepared for full coverage crowns: group AC bonding alloy with chamfer finish line, group G gold alloy with chamfer finish line, group PC porcelain with a chamfer finish line, and group PS porcelain with a shoulder finish line. Two profiles of the mesial and distal surfaces of the teeth were carried out: (1) tooth with crown seated but not cemented and (2) tooth with the crown cemented in place. Two cements and 2 methods of cement removal were studied.

RESULTS

A 4-way analysis of variance for cement, crown type, method of removal, and tooth surface morphology showed that significantly greater volumes and mean depth, but not surface areas, of resin composite cement remained adherent than compomer cement (P<.05). Among crown types, significant differences were found for cement volume (group G>AC, G>PC, G>PS), cement surface area (group AC>PC, G>PC, G>PS), and maximum cement depth (group G>AC). There was no significant difference between the 2 methods of cement removal. Significantly larger surface areas and maximum depths of cement were retained on the anatomically grooved mesial surface of the maxillary first premolars than on the ungrooved distal surface.

CONCLUSION

Subclinical cement retention occurred after crown cementation, which was influenced by cement, crown type, and tooth surface morphology but not method of cement removal.

Effect of tooth surface roughness on marginal seating and retention of complete metal crowns

STATEMENT OF PROBLEM

Retention and marginal adaptation factors have major influence on the failure of cemented complete veneer crowns.

PURPOSE

This study investigated the effect of axial surface roughness on the marginal seating and retention of silver-palladium crowns luted with zinc phosphate, glass ionomer, and resin cements.

MATERIAL AND METHODS

Coarse and fine diamond stones were used to create various surface roughnesses of premolars. A milling machine was used to control the height and angle of the axial walls of tooth preparations. Ten cast metal crowns in 6 subgroups were luted with 3 cements (Phosphacap, Fuji Cap I, and Panavia 21). Marginal seating was recorded with a Digimatic indicator. Retention was determined by measuring the tensile force required to remove a metal crown with a Lloyd testing machine.

RESULTS

Two-way analysis of variance revealed statistically significant differences (P <.001) in retention for both luting cements and surface roughness. No significant difference was recorded for marginal seating relative to roughness (P =.860) and interaction effects (P =.204). Tukey-HSD tests revealed substantial differences in retention among Phosphacap, Fuji Cap I, and Panavia 21 cements. Significant differences were not confirmed in marginal seating between Fuji Cap I and Phosphacap cements with coarse diamonds, and Phosphacap and Panavia 21 cements with fine diamonds.

CONCLUSIONS

The best retention for complete metal crown was demonstrated for tooth preparations ground with coarse diamonds and cemented with Panavia 21 cement. Differences in axial surface roughness had no effect on the marginal seating of the complete metal crowns.

Current status of luting agents for fixed prosthodontics

STATEMENT OF THE PROBLEM

The long-term clinical outcome of fixed prosthodontic treatment depends, in part, on the use of adhesives that can provide an impervious seal between the restoration and the tooth. There are several types of available luting agents, each possessing unique properties and handling characteristics. No one product is ideal for every type of restoration.

PURPOSE

The purpose of this article is to review available dental luting agents, discuss improvements and drawbacks in newly formulated adhesives, and present the indications for their use.

RESULTS

Each cement type is physically and chemically unique. A single adhesive will not suffice in modern day clinical practice.

Thermal cycling procedures for laboratory testing of dental restorations

OBJECTIVES

Exposure of restorations in extracted teeth to cyclic thermal fluctuations to simulate one of the many factors in the oral environment has been common in many tracer penetration, marginal gap and bond strength laboratory tests. Temperature changes used have rarely been substantiated with temperature measurements made in vivo and vary considerably between reports. Justification and standardization of regimen are required.

DATA, SOURCES AND STUDY SELECTION

An assessment of reports describing temperature changes of teeth in vivo is followed by an analysis of 130 studies of laboratory thermal cycling of teeth by 99 first authors selected from 25 journals. A clinically relevant thermal cycling regimen was derived from the in vivo information, and is suggested as a benchmark standard.

CONCLUSIONS

Variation of regimens used was large, making comparison of reports difficult. Reports of testing the effects of thermal cycling were often contradictory, but generally leakage increased with thermal stress, although it has never been demonstrated that cyclic testing is relevant to clinical failures. However, should this be done, the standard cyclic regimen defined is: 35 degrees C (28 s), 15 degrees C (2 s), 35 degrees C (28 s), 45 degrees C (2 s). No evidence of the number of cycles likely to be experienced in vivo was found and this requires investigation, but a provisional estimate of approximately 10,000 cycles per year is suggested. Thermal stressing of restoration interfaces is only of value when the initial bond is already known to be reliable. This is not the case for most current restorative materials.

Dentine permeability and tracer tests

OBJECTIVES

This paper reviews the evidence for dentine's permeability in order to clarify and emphasize its confounding effect on leakage test measurements, and hence the need to use special test designs to avoid its effects.

METHODS

The literature on the subject between 1887 and 1997, including 249 articles.

CONCLUSIONS

The prerequisite condition for any tracer penetration test is that unflawed specimens are themselves impermeable to tracer. Entry of tracer then can be used to indicate correctly the location or severity of flaws. The relative impermeability of intact dental enamel permits such testing of the enamel-restoration interface seal, but the same is not true when using dentine, which is usually frankly porous to most tracers through its tubules. False positive results are very likely. Recent intense interest in dentine bonding agents has increased the need and frequency of these tests with dentine, but this serious confounding factor has so far generally remained unstated, and has only been controlled adequately in one study. If tracer penetration test results are to be meaningful, then adequate control is required.

Macromolecular leakage beneath full cast crowns. Part III: The diffusion of lipopolysaccharide and dextran

STATEMENT OF PROBLEM

Most microleakage studies have used low molecular weight dyes or isotopes rather than clinically relevant materials, such as lipopolysaccharides or cell wall materials, that have been shown to provoke inflammatory reactions in the dental pulp.

PURPOSE

This study evaluated the leakage (diffusion) of lipopolysaccharide and dextran beneath cast gold crowns luted with 3 cements.

MATERIALS AND METHODS

Thirty extracted molars were prepared for crowns. Ten crowns with access ports (facial or lingual) were cast in gold and luted with zinc phosphate, glass ionomer, and an adhesive resin cement onto their preparations. Teeth and crowns with filters inserted into the ports were immersed in a solution of labeled macromolecules (TRITC-LPS, FITC-dextran) and evaluated for leakage at 2 weeks, and 1, 2, 3, 4, 5, and 6 months. Filters were retrieved and analyzed with fluorescent microscopy.

RESULTS

All filters retrieved from crowns luted with zinc phosphate, glass ionomer, and adhesive resin cements demonstrated no detectable leakage and were negative for both FITC-dextran and TRITC-lipopolysaccharide at all evaluation periods.

CONCLUSION

Leakage of lipopolysaccharides and dextran did not occur during the period of this study. For the length of this investigation, zinc phosphate, Ketac-Cem, and C&B-Metabond were equally effective at preventing leakage of detectable molecular concentrations of lipopolysaccharide and dextran to the level of the access ports.

Dental luting agents: A review of the current literature

STATEMENT OF PROBLEM

The practice of fixed prosthodontic has changed dramatically with the introduction of innovative techniques and materials. Adhesive resin systems are examples of these changes that have led to the popularity of bonded ceramics and resin-retained fixed partial dentures. Today's dentist has the choice of a water-based luting agent (zinc phosphate, zinc polycarboxylate, glass ionomer, or reinforced zinc oxide-eugenol) or a resin system with or without an adhesive. Recent formulations of glass ionomer luting agents include resin components (resin-modified glass ionomers), which are increasingly popular in clinical practice.

PURPOSE

This review summarizes the research on these systems with the goal of providing information that will help the reader choose the most suitable material.

MATERIAL

The scientific studies have been evaluated in relation to the following categories: (1) biocompatibility, (2) caries or plaque inhibition, (3) microleakage, (4) strength and other mechanical properties, (5) solubility, (6) water sorption, (7) adhesion, (8) setting stresses, (9) wear resistance, (10) color stability, (11) radiopacity, (12) film thickness or viscosity, and (13) working and setting times. In addition, guidelines on luting-agent manipulation are related to available literature and include: (1) temporary cement removal, (2) smear layer removal, (3) powder/liquid ratio, (4) mixing temperature and speed, (5) seating force and vibration, and (6) moisture control. Tables of available products and their properties are also presented together with current recommendations by the authors with a rationale.

Deformation of restoration and fracture of luting cement film

OBJECTIVES

Functional occlusal loading can generate complicated stresses in the luting cement film between a restoration and its abutment. Such stresses may lead to cement fractures, which can promote cement dissolution and induce clinical problems. The purpose of this study is to determine the function of the cement film under loading, and to clarify the relationship between the deformation of the restoration and the cement fractures.

METHODS

Eccentric loads were applied onto model extension bridges which were cemented on brass dies with zinc phosphate cement. Strain measurements were recorded using of a strain gauge method, ultimate strength by tensile tests, leakage by dye penetration tests and cement fractures by ultrasonic microscopic analyses. Additionally, the bridges which were just seated on their dies without cementation were loaded, and strain measurements were recorded.

RESULTS

The cases for linear strain increment with loading showed high tensile strength and minimal dye penetration. The cases with non-linear strain behavior showed low tensile strength and considerable dye penetration. However, no fracture was observed in the occlusal cement film in both cases. The cement fracture first occurred at the opposite marginal region to the loading side.

CONCLUSIONS

One of the significant functions of the cement film is diminishing the deformation of restorations during loading. The deformation of the restoration affects initiation and propagation of the cement fracture considerably.

The effect of dentine surface treatment on pulpward pressure transmission during crown cementation: a laboratory study

Thirty extracted human premolars received standardised full crown preparations. The teeth were randomly assigned into three groups: smeared (control), etched (phosphoric acid gel), and bonded (Scotchbond MP). Each tooth was perfused with saline to establish perfusion rates at baseline for all groups, and the post-etching stage for etched and bonded groups, post-bonding stage for bonded group, and post-cementation stage for all groups. Crowns made with four layers of die-spacing were cemented with zinc phosphate cement at 100N. Pulpal pressures were measured with a pressure transducer. It was concluded that dentine bonding agents may have the potential to reduce pulpal damage caused by pressure transmission from cementation.

An in vitro evaluation of the integrity of stainless steel crown margins cemented with different luting agents

The elderly population is retaining more teeth which require extensive restorations. The purpose of this study was to identify a luting agent which had the least marginal breakdown when used with stainless steel crowns. Thirty-six caries-free molars were selected, prepared for stainless steel crowns, and embedded in acrylic to support the crown and tooth. The crowns (Unitek/3M) were cemented with 4 different luting agents: (A) Fleck's Cement, (B) Ketac-Cem, (C) All-Bond C & B Cement, and (D) Panavia EX Cement. All the restored teeth were thermocycled and divided into 3 experimental groups. Twelve teeth were stained. The remaining teeth were occlusally loaded and stained. The remaining 12 teeth were thermocycled and stained again. The stainless steel crowns were then sectioned and photographed at 7.5x mag. The dye penetration was evaluated by measurement of the percentage of dye penetration from the crown margin to the cusp tip on each side. Statistical analysis found that the least dye penetration was with All-Bond C & B Cement (p = 0.0001). The most extensive penetration was observed in Ketac-Cem Occlusal loading was a significant factor (p = 0.0001) increasing the dye penetration, but the crown-tooth gap was not.

Effects of adhesive primers for noble metals on shear bond strengths of resin cements

OBJECTIVES

The purpose of this study was to evaluate the durability and shear bond strengths of the different combinations of two adhesive primers and three resin cements to two types of noble metal alloys, silver-palladium copper-gold and type IV gold alloys.

METHODS

The adhesive luting agents Imperva Dual, Panavia 21 and Super-Bond C&B, and the adhesive primers Metal Primer and V-Primer were used. Two sizes of casting alloy disks were nonprimed or primed and cemented with each adhesive luting agent. The specimens were stored in 37 degrees C water for one day and then immersed alternately in 4 degrees C and 60 degrees C water baths for 1 min each for up to 100,000 thermal cycles before shear mode testing at a cross-head speed of 0.5 mm/min.

RESULTS

The application of Metal Primer was effective for improving the shear bond strengths between each of the three resin cements and both noble metal alloys compared with nonprimed specimens. When each noble metal alloy was cemented with Super-Bond C&B, there were no significant differences between the bond strengths with the use of Metal Primer and those with the use of V-Primer at 100,000 thermal cycles. However, V-Primer was ineffective for enhancing the shear bond strengths of Imperva Dual and Panavia 21 to noble metals.

CONCLUSION

Metal Primer and V-Primer are clinically useful for strongly bonding adhesive resin cements to noble metal alloys.

Fatigue of resin cement-base metal alloy bond strength

PURPOSE

Strong durable bonds between resin cements and metal alloys are critical to the success of resin-bonded, resin-veneered, or resin-retained prostheses. However, few comprehensive, comparative evaluations of materials or the fatigue effects of thermal cycling have been reported. The rate of strength loss may be a more important predictor of long-term success than bond strength. The purpose of this study was to investigate the effects of artificial aging by thermal cycling and resin cement type on the bond strengths to a base metal alloy.

MATERIAL AND METHODS

This study investigated the effect of the number of thermal cycles (0, 1, 10, 100, 1,000, and 10,000) on the bond strengths of nine fixed prosthodontic resin cements. Specimens were assigned randomly to thermal cycle number/cement type test groups. Cylinders of a base metal alloy were bonded in an end-to-end configuration. One end of each bonded specimen was insulated, and the specimen was thermal cycled. Then, the bonds were tested in shear and bond strengths calculated.

RESULTS

Two-way ANOVA revealed that the effects of cement type, the number of thermal cycles, and their interaction all significantly affected bond strength (p < .0001). Multiple range analysis showed that some cements had significant trends to lose bond strength with thermal cycling (p < .05), while others did not (p > .05).

CONCLUSIONS

Both the type of resin cement and the amount of thermal cycling influenced bond strength to a base metal alloy. Some materials displayed more rapid loss of bond strength than others.

Shear bond strengths of three resin cements used with three adhesive primers for metal

This study compared the durability and shear bond strengths of combinations of three adhesive primers and three resin cements bonded to silver-palladium-copper-gold (Ag-Pd-Cu-Au) and cobalt-chromium (Co-Cr) alloys. The adhesive luting cements Imperva Dual, Panavia 21, and Super-Bond C&B and the adhesive primers Metal Primer material, V-Primer material, and Cesead Opaque Primer material were used. The application of Metal Primer material was effective in improving the shear bond strengths between each of the three resin cements and Ag-Pd-Cu-Au alloy compared with nonprimed specimens. Co-Cr alloy primed with Cesead Opaque Primer, followed by cementation with Imperva Dual or Super-Bond C&B luting cements yielded the strongest shear bond strengths after 50,000 thermocycles, and Panavia 21 cement did not reveal any significant differences in bond strengths between nonprimed specimens and those primed with Cesead Opaque Primer at all thermocycles.

Marginal leakage of cast gold crowns luted with zinc phosphate cement: an in vivo study

Marginal gaps of cast restorations are filled with luting agents that are soluble in intraoral fluids. This study investigated the marginal openings in eight extracted teeth with cast crowns that had been intraoral for 20 years or more. These teeth were extracted either because of periodontal disease or to facilitate insertion of a removable partial denture. Initially, the roots of the teeth were sealed with two coats of fingernail polish within 2 mm of the crown-tooth interface. Next, the teeth were immersed in a 0.05% aqueous solution of basic fuchsin die for 24 hours. Finally, each tooth was sectioned at four locations 1 mm apart. At each of these four sections, cement film thickness between tooth and casting, and microleakage were determined. The results of this study showed a mean cement film thickness of 74 microns on the mesial surface and 57 microns on the distal surface. Mean microleakage values were 432 microns on the mesial surface and 274 microns on the distal surface.