Bonding effectiveness of adhesive luting agents to enamel and dentin

Touch-cure activation by marketed universal resin luting cements of their associated primer to dentin

PURPOSE

The aim of this study was to investigate the dentin shear bond strength (SBS) and bonding interface of three recently developed "universal" resin luting cements based on different modalities.

METHODS

The dentin SBS and interfacial analysis of three recently launched "universal" resin luting cements, namely, G-Cem One, RelyX Universal and Panavia SA cement universal, were studied. All bonding protocols, including the previous use of their dedicated primer or universal adhesive in touch-cure mode or light-cure mode were performed. Variolink Esthetic LC used in conjunction with Scotchbond Universal Plus was used as a control group. For each group (n = 9), 10 specimens were tested for dentin SBS and two were examined by scanning electron microscopy. SBS were analyzed by two-way ANOVA followed by Dunnett's test.

RESULTS

SBS values showed that the three "universal" resin luting cements tested exhibit different adhesive behaviors. G-Cem One with its touch-cure activated primer had a greater SBS to dentin (25.5 MPa) than that of the control group (22.1 MPa).

CONCLUSION

"Universal" resin luting cements have variable efficacy when used in self-curing mode. The touch-curing mode is also of concern but may show high potential for some formulations.

Comparative clinical evaluation between self-adhesive and conventional bulk-fill composites in class II cavities: A 1-year randomized controlled clinical study

OBJECTIVE

This randomized controlled clinical trial compared the clinical efficacy of self-adhesive bulk-fill Surefil One with a traditional bulk-fill composite in class II restorations.

MATERIALS AND METHODS

Sixty-four direct class II composite restorations were categorized into two groups. Group I, control group (n = 32): cavities were restored by Filtek One bulk-fill composite with Scotchbond Universal (SBU) adhesive in self-etch mode, Group II, test group (n = 32): cavities were restored by Surefil One self-adhesive bulk-fill composite. The study involved a follow-up period of 1 year, during which restorations were assessed at baseline (BL), 6 months, and 12 months using Federation Dentaire Internationale (FDI) criteria. Data analysis was performed using nonparametric tests. A comparison of restoration characteristics was performed utilizing the chi-square test (X2). The significance level was set at 0.05.

RESULTS

Filtek One and Surefil One bulk-fill composites revealed clinically acceptable FDI scores over 12-month recalls. Thirty-two patients (64 restorations) were available for all follow-up visits; 100% of the restorations survived. For esthetic properties, Filtek One was far better than Surefil One at all time points. However, in terms of functional and biological properties, both restorations demonstrated comparable performances.

CONCLUSIONS

Filtek One bulk-fill restorations were superior in terms of surface luster, surface staining, color match, and translucency, but Surefil One restorations performed well and were similar to Filtek One restorations; however, additional advancements and research are needed to obtain better esthetics. Furthermore, longitudinal studies with extended follow-up periods are needed to assess the clinical potential of both materials.

CLINICAL SIGNIFICANCE

Both Filtek One and Surefil One met the FDI criteria, with Filtek One demonstrating superior esthetic and functional qualities and similar performance regarding biological criteria. Both innovative restorative materials show potential for clinical use. Trial registered on ClinicalTrials.gov under registration number; NCT06120868:07/11/2023.

A comprehensive review of resin luting agents: Bonding mechanisms and polymerisation reactions

The field of dentistry is constantly evolving and increasingly embracing minimally invasive approaches. One such approach, which is bonding to the tooth structure, particularly enamel, has been shown to offer the most predictable outcomes. However, there are instances where significant tooth loss may limit treatment options for a restorative dentist. In these scenarios, indirect restoration might be the preferred treatment option. This literature review provides a comprehensive examination of the currently available resin luting agents and their bonding requirements. It provides valuable insights for dental professionals seeking an in-depth understanding of the current state of the field and the future prospects of dental adhesion.

Influence of using different translucent composite resins for customizing fiber post on the bond strength of self-adhesive cement to root dentin

This study evaluated the influence of different translucent resins (Z350 and Opallis) for customizing fiber posts and light-curing the cementation system using different LED equipment (V, Valo or R, Radii-Cal) on the bond strength and adhesive failure pattern at 24 h and 6 months. Eighty roots were prepared and divided into 4 groups (n=20): ZV (Z350 resin and LED Valo), ZR (Z350 resin and LED Radii-Cal), OV (Opallis resin and LED Valo), OR (Opallis resin and LED Radii-Cal). After post space preparation, the fiber post was customized and cemented with self-adhesive cement and light-curing using V or R LED equipment. Bond strength values were submitted to 2-way ANOVA test. ZV and ZR showed higher bond strength values than the other groups at 6 months of evaluation (p<0.05). The Z350 resin has a favorable influence on the bond strength of self-adhesive cement to root dentin, regardless of the LED polymerization equipment used.

Bond Strength of Two Resin Cements with Leucite-reinforced Ceramic Using Different Bonding Agents

AIM

To compare the bond strength of two resin cements to leucite-reinforced ceramics using three different boding agents and evaluate the compatibility of bonding agents.

MATERIALS AND METHODS

Twenty extracted sound human molars were sectioned horizontally 2-3 mm above the cementoenamel junction (CEJ). CAD/CAM ceramic blocks for inLab were also sectioned to create 4 mm thick and bonded to the dentin. The adhesive groups assigned were divided into four adhesive groups: Group I: Variolink II dual-cure resin cement and Scotchbond Multi-Purpose Plus adhesive, group II: Multilink Automix dual-cure resin cement and Multilink primers, group III: Multilink Automix and Clearfil SE bond 2 (CSE2) adhesive, group IV: Multilink Automix and CSE2 with light curing after adhesive application. Five specimens of each group were sectioned perpendicular to obtain six microsticks of 1 × 1 mm width from each sample. Microtensile bond strength data were expressed in MPa. Fracture modes (FrMs) analyzed for the surfaces were divided into six patterns. Microtensile bond strength data were statistically analyzed with one-way ANOVA and Tukey post hoc tests (α = 0.05). T-test was performed at the 5% significance level to analyze groups III and IV with and without light curing.

RESULTS

Group I showed the highest μTBS average of 13.67 MPa, group IV showed 12.26 MPa, group III showed 12.15 MPa, and group II showed the lowest average of 10.84 MPa. No significant differences were found between the bonding agents. However, the six types of failure modes, although all observed, were characterized by the adhesive system: Type I: adhesive failure of laminated dentin and ceramic; type II: adhesive failure of laminated ceramic; type III: adhesive failure of laminated dentin; type IV: cohesive failure of luting agent; type V: cohesive failure of dentin, and type VI: mixed failure of adhesion and cohesion. As a result, the FrM most commonly observed was the adhesive failure at the luting cement-ceramic block interface.

CONCLUSION

The combination of resin cements and bonding agents did not significantly affect the bond strength of CAD/CAM ceramic restorations and dentin.

CLINICAL SIGNIFICANCE

Several universal bonding agents are currently available for direct and indirect bonding, and using the same bonding agent for direct and indirect restorations could simplify inventory and benefit routine clinical practice. How to cite this article: Aida N, Koi K, Amaya-Pajares SP, et al. Bond Strength of Two Resin Cements with Leucite-reinforced Ceramic Using Different Bonding Agents. J Contemp Dent Pract 2023;24(11):859-863.

Influence of the Fiber Post Length on the Fracture Strength of Endodontically Treated Teeth

Background and Objectives: Although fiber posts are widely used in the restoration of endodontically treated teeth (ETT), their ideal cementation depth into the root canal is still debated in literature. The aim of the present study was to evaluate whether the different intra-radicular insertion lengths of the fiber posts influence the fracture strength of ETT. Materials and Methods: A total of 10 permanent human lower incisors with straight roots of similar length and volume extracted for periodontal reason were sectioned 2 mm above the cement-enamel junction (CEJ) to a total length of 18 mm and endodontically treated in the same manner, then randomly divided into two groups of five each (Groups 1 and 2, n = 5). Two sound incisors, with no endodontic treatment, were used as the control group (Group 3, n = 2). After one week of storage in a humid environment, spaces for fiber post no. 1 (Reforpost, Angelus, Londrina, PR, Brazil) were prepared in the first two groups at a depth of 5 mm (Group 1) and 7 mm (Group 2), and the fiber posts were adhesively cemented using self-adhesive resin cement (Maxcem Elite, Kerr GmbH, Herzogenrath, Germany). After 7 days, the samples were vertically positioned and fixed in a self-curing transparent acrylic resin, up to 2 mm below the CEJ level, and mechanically tested in compression after another week of storage using a displacement-controlled testing machine up to each sample's fracture. The force-displacement curves were recorded for each sample, the means were calculated for each group and a statistical comparative analysis between groups was conducted. Results: Although no statistically significant differences between groups were observed, the highest mean fracture force (N) was recorded in Group 2 (1099.41 ± 481.89) in comparison to Group 1 (985.09 ± 330.28), even when compared to the sound, non-treated teeth (1045.69 ± 146.19). Conclusions: Within the limitations of this in vitro study, teeth where fiber posts were placed deeper into the root canal (7 mm) recorded slightly higher fracture forces in comparison with shorter lengths (5 mm). However, similar biomechanical performances obtained in the mechanical tests showed no statistical differences between the 7 mm and the 5 mm inserted posts.

Compressive strength evaluation of thin occlusal veneers from different CAD/CAM materials, before and after acidic saliva exposure

In the present study are depicted valuable observations for practitioners, obtained from an in vitro study which aims to evaluate the compressive strength of occlusal veneers fabricated from 3 type of restorative materials, before and after 1 month of acidic artificial saliva exposure (pH = 2.939). In this context, 90 extracted human molars were prepared to receive computer-aided design/computer-aided manufacturing (CAD/CAM) occlusal veneers. The restorative materials considered in this study were: Cerasmart; Straumann Nice and Tetric CAD. The occlusal veneers were designed, milled and cemented with an adhesive dual-cure resin cement. From all the extracted human molars, only sixty specimens were immersed in acidic artificial saliva, for 1 month, at 37 °C ± 1 °C and part of this specimens were also thermo-cycled, between 5 and 55 °C ± 2 °C, before compressive strength test. The results showed a lower compressive strength for both the samples exposed to acidic artificial saliva as well as for the samples exposed to acidic artificial saliva and thermo-cycled. Scanning electron microscopy (SEM) showed that after compressive strength, all the specimens non-exposed to acidic artificial saliva, present extensive cracks formation at the surface of the restorations, and after exposure to acidic artificial saliva for 1 month, the surface damage was characterized by longitudinal and profound fractures of the restoration, as well as the fracture of the tooth structure. Between CAD/CAM materials tested, nanoceramic resin shows more favorable fracture patterns, both before and after acidic artificial saliva exposure.

Examination of the Shear Force Resistance of Laminate Veneers Adhered with Different Resin Cements

OBJECTIVES: This study investigated the mechanical properties of laminate veneers to determine their resistance to the shear force of three different types of cement used in the restorations. MATERIAL and METHODS: Laminate veneers were prepared using the standard tooth preparation methods for 30 extracted maxillary central incisors. To standardize the depth, guide burs were used to prepare a depth of 0.5 mm from the buccal angle. The samples were allocated into three randomized groups (n = 10): Group A (resin using the total etch method and Variolink Esthetic DC resin cement; Group B (resin using the PANAVIA F2.0 self-etch method; and Group C (self-adhesion bonded with Rely X U200 resin cement). The prepared specimens were stored in distilled water for one week before a shear test was used to determine the resistance of the veneers to the bonding. The obtained data were evaluated statistically. RESULTS: The values of the shear bond strength were statistically significant depending on the type of resin cement that was applied (p ˂ 0.05). The specimens that were cemented using the total-etch method (18.79±4.48 MPa) had the lowest shear force value. The obtained data were evaluated statistically by Tukey multiple comparison test (p > 0.05). CONCLUSIONS: The cement is a highly effective factor in the bonding between fixed prosthetic restorations and the abutment tooth, and the cement used must have sufficient resistance to shear forces.

Randomized clinical split-mouth study on a novel self-adhesive bulk-fill restorative vs. a conventional bulk-fill composite for restoration of class II cavities - results after three years

OBJECTIVES

This randomized prospective split-mouth study evaluated the clinical performance of a novel, tooth-colored, self-adhesive bulk-fill restorative (SABF, 3M) for restoration of class II cavities as compared to a conventional bulk-fill composite (Filtek One, 3M; FOBF) over 36 months. The null-hypothesis was that both materials perform equally regarding clinical success and performance according to the FDI clinical criteria and scoring system.

METHODS

30 patients received one SABF and one FOBF restoration each. For FOBF, Scotchbond Universal (3M) was used as adhesive (self-etch mode), whereas SABF was applied without adhesive. Two blinded examiners evaluated the restorations at baseline, 24 and 36 months using FDI criteria. Data were analyzed non-parametrically (χ²-tests; α=0.05).

RESULTS

29 patients were available for the 24- and 36-month examinations. Clinical success rate was 96.6% for both materials at 36-mo (one restoration failure due to secondary caries each). All other restorations revealed clinically acceptable FDI scores at all recalls. FOBF performed significantly better than SABF at all time points regarding surface lustre (p<0.001) and color match and translucency (p<0.001) and regarding marginal staining at 36-months (p=0.008). Marginal staining and marginal adaptation deteriorated significantly over time for both materials (both p<0.001).

CONCLUSIONS

The null-hypothesis could only partially be rejected. Both materials performed similarly regarding clinical success and performance within 36 months of clinical service, but SABF exhibited significantly inferior, but clinically fully acceptable esthetic properties as compared to FOBF. Both restorative materials showed clinically fully acceptable results over 36 months of clinical service and thus may be recommended for clinical use.

CLINICAL SIGNIFICANCE

The novel tooth-colored self-adhesive bulk-fill restorative exhibited clinically fully acceptable results over 36 months of clinical service, similarly to a conventional bulk-fill restorative used with a universal adhesive, but with slight shortcomings in esthetic properties. Therefore, both restorative materials may be recommended for clinical use.

Effect of Different Desensitizers on Shear Bond Strength of Self-Adhesive Resin Cements to Dentin

The sealing and bonding characteristics of luting cements may be affected by the application of desensitizers containing ingredients that induce chemical interaction with dentin organic matrix. This study evaluated the effect of different desensitizers on the immediate and long-term shear bond strength (SBS) of a self-adhesive resin cement (SARC) to dentin. Healthy bovine dentin specimens were used for the study. Gluma® Desensitizer, Desensibilize Nano P®, and Soothe® desensitizer were used in study groups, while the control group did not receive any treatment. Next, SARC (RelyXTM U200) in cylindrical mold was applied to the sample surface. All specimens were stored at 37 °C for 24 h or six months and tested for SBS. Additionally, water contact angle was measured using an optical tensiometer. Results were analyzed by analysis of variance and Student-t tests (p ˂ 0.05). Application of the different types of desensitizers had no significant influence on immediate or long-term SBS of SARC to dentin (p > 0.05). Differences for water contact angle were not statistically significant among the tested groups (p = 0.450). Within the limitations of the present study, it can be concluded that the application of the different types of desensitizers had no significant influence on the SBS of a SARC to dentin.

Physical, Mechanical, and Adhesive Properties of Novel Self-Adhesive Resin Cement

Objective

To evaluate a newly developed self-adhesive resin cement on physical, mechanical, and adhesive properties and compare it with other commercial self-adhesive resin cements.

Materials and Methods

Experimental self-adhesive resin cement (SARC) was formulated by our proprietary adhesive resin and filler technology. Maxcem Elite, RelyX Unicem 2, SpeedCem Plus, SmartCEM 2, and Calibra Universal 2 were selected for comparison. Working and setting times, film thickness, water sorption and solubility, flexural strength, and modulus were measured in accordance with ISO-4049. Consistency was tested according to modified ISO 4823. Shear bond strengths were conducted according to ISO 29022. The data were analyzed by one-way ANOVA and post hoc Tukey's tests (p ≤ 0.05).

Results

All cements showed about 2–4 min working time and about 3–6 min setting time except that RelyX Unicem 2 has a longer working time (9'58”) and setting time (10'18”). All cements meet ISO standards for film thickness (≤50 µm), water sorption (≤40 µg/mm³) except Maxcem Elite (46.19 µg/mm³), and water solubility (≤7.5 µg/mm³) except SmartCEM 2 (11.35 µg/mm³) and Calibra Universal (9.87 µg/mm³). Experimental SARC showed significantly higher flexural strength and modulus than other cements (p < 0.001). For self-curing, Experimental SARC has statistically higher bond strength than other cements (p < 0.001) except statistically the same as RelyX Unicem 2 (p > 0.05). For light-curing, Experimental SARC showed significantly higher bond strength than other cements (p < 0.001) except statistically the same as Maxcem Elite and RelyX Unicem 2 (p > 0.05). For dual-curing, the bond strength of Experimental SARC is significantly higher than that of other cements (p < 0.001).

Conclusion

The newly developed self-adhesive resin cement exhibited favorable bonding capability and physical and mechanical properties compared to other commercial self-adhesive resin cements and is a good option for cementation of indirect restorations with potential long-term clinical success.

Effectiveness of dentin pre-treatment on bond strength of two self-adhesive resin cements compared to an etch-and-rinse system: an in vitro study

Statement of problem

It has been shown that selective etching improves the bond strength of some self-adhesive resin cements to enamel. The same has yet to be determined with dentin pre-treatment.

Purpose

To evaluate the tensile bond strength of two self-adhesive resin cements after two dentin surface pre-treatments, and also to analyze the cement/dentin interface.

Material and Methods

One hundred and twelve human third molars were extracted. The teeth were distributed into seven groups (n = 16). Maxcem Elite Chroma (MAX) (Kerr, Scafati, Italy) and Relyx U200 (RLX) (3M ESPE, Neuss, Germany) were used without pre-treatment or with two dentin pre-treatments (polyacrylic acid or phosphoric acid). A conventional etch-and-rinse (EAR) luting cement, NX3 Nexus (NX3) (Kerr, Scafati, Italy), was used as an external control group. Before testing, all specimens were stored in distilled water for 24 hours. Three specimens from each group were prepared for scanning electron microscopy observation (SEM). A tensile bond strength test (TBS) was performed for the remaining samples. The data were statistically analyzed using the Kruskal–Wallis test and Pairwise comparisons using the Wilcoxon rank sum test.

Results

MAX without pre-treatment and with phosphoric acid etching attained statistically similar bond strengths to NX3 (P > 0.05). There was a statistical difference (P = 0.00488) between RLX without pre-treatment (5.62 MPa) and NX3 (10.88 MPa). Phosphoric acid pre-treatment increases the bond strength values of RLX to a strength that is comparable to NX3 (P > 0.05). The lowest tensile bond strength (TBS) was attained after the application of polyacrylic acid with MAX (1.98 MPa). No statistical differences were found between the RLX bond strength values after polyacrylic acid treatment and RLX without pre-treatment or NX3 (P > 0.05). SEM observations disclosed an enhanced potential of the self-adhesive cements to infiltrate into dentin tubules and form resin tags when applied after phosphoric acid pre-treatment. The failure mode was dominantly adhesive.

Conclusions

On dentin, the self-adhesive resin cement MAX might be an effective alternative to conventional resin cement. Etching the dentin with phosphoric acid does not have a negative effect on the bond strength of MAX to dentin. On the other hand, phosphoric acid improved the bond strength of RLX when compared to EAR cement.

The micro-shear bond strength of resin cements to aged laser bleached enamel after using different desensitizing agents

Objectives

To evaluate the micro‐shear bond strength of two resin cements to aged laser bleached enamel after the application of three different desensitizing agents.

Materials and methods

Forty extracted human central and lateral incisors were prepared and bleached using laser activation bleaching protocol. The teeth were assigned randomly into four groups for desensitization; G1: No post‐bleaching treatment, G2: GC MI Paste Plus, G3: Hydroxyapatite nanoparticles (n‐HAP) and G4: Flor‐Opal. Specimens were subjected to aging for 6 months. All groups were subdivided into two subgroups according to the resin cements used (dual‐curing resin cement and light‐curing resin cement).

Results

Flor‐Opal groups showed the highest statistically significant micro‐shear bond strength (MSBS), followed by GC MI Paste Plus and n‐HAP groups with no statistically significant difference between them. The light‐curing resin cement had statistically higher MSBS than dual‐curing resin cement in case of no‐post bleaching treatment and n‐HAP groups, and no statistical difference in case of GC MI Paste Plus and Flor‐Opal groups.

Conclusion

Usage of desensitizing agents containing, CPP‐ACP, n‐HAP or fluoride after laser bleaching can enhance the bond strength of the resin cements to enamel.

Clinical significance

The composition of the desensitizing agents applied after laser bleaching could interfere in bond strength values.

Limited Etching Time Increases Self-adhesive Resin Cement Adhesion to Enamel

AIM

To evaluate the influence of different enamel etching times on the bond strength of two self-adhesive resin cements (RCs) with and without thermocycling (TMC).

METHODS

One hundred twenty bovine teeth were used. Blocks of enamel (8×4×2mm) were obtained, polished, and randomly divided into two groups, according to the RC used: MaxCem Elite or RelyX U200. Groups were subdivided into four groups (n=16), according to the etching time: Control (0 seconds), 5 seconds, 10 seconds, and 20 seconds. Three RC cylinders (1-mm diameter) were built on each enamel block. The specimens were submitted to two storage conditions: 24 hours in distilled water or TMC (5000 cycles/5°C-55°C). Afterward, the specimens were submitted to the shear bond strength (SBS) test. The failure modes and adhesive interfaces were analyzed by scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). Data were analyzed with three-way analysis of variance (ANOVA) and Tukey test (α=0.05).

RESULTS

Etching increased the SBS for both the RCs,especially forthe groups etched for 5 and 10 seconds. TMC affected negatively the SBS of the control groups (p<0.05). No resin tags were observed in control groups, and the formation of tags was time dependent.

CONCLUSION

The 10 seconds etching time was more effective in increasing the enamel-resin bond strength. TMC negatively affected bond strength in specimens without acid etching.

Effect of Direct and Indirect Materials on Stress Distribution in Class II MOD Restorations: A 3D-Finite Element Analysis Study

The aim of this study is to investigate the stress distributions of different restoration options for class II mesio-occluso-distal (MOD) cavities. A class II MOD cavity with proximal box gingival floor 1 mm below cementoenamel junction was designed in a mandibular first molar tooth model. 3D finite-element analysis (FEA) and 3D-CAD modelling were used to examine the occlusal stresses distributed to the remaining buccal enamel (RBE), remaining lingual enamel (RLE), adhesive surfaces, and restorative materials by direct and indirect materials resulting from a 600 N of static occlusal load stimulating foodstuff. von Mises (VM) and maximum principal (Pmax) stresses were evaluated for two CAD/CAM materials and three direct materials. CAD/CAM materials exerted less stress than the direct restorative materials. Significant von Mises and Pmax stress value differences were seen among all restoration models on RBE. Reducing RLE and including it into the cavity would be a more effective option for this model in this scenario. As VM and Pmax stresses of PIHC CAD/CAM material for RBE and dentin were significantly lower than other tested materials, it may be the choice of material for indirect MOD restorations.

One-year results of a novel self-adhesive bulk-fill restorative and a conventional bulk-fill composite in class II cavities-a randomized clinical split-mouth study

Objectives

In the context of the phase-down of amalgam, development of easily applicable, permanent restorative materials is of high clinical interest. Aim of this study was to evaluate the clinical performance of a novel, tooth-colored, self-adhesive bulk-fill restorative (SABF, 3M Oral Care) and a conventional bulk-fill composite (Filtek One, 3M Oral Care; FOBF) for restoring class II cavities. The null-hypothesis tested was that both materials perform similar regarding clinical performance.

Materials and methods

In this randomized split-mouth study, 30 patients received one SABF and one FOBF restoration each. Scotchbond Universal (3M Oral Care) was used as adhesive for FOBF (self-etch mode), while SABF was applied directly without adhesive. Restorations were evaluated by two blinded examiners at baseline, 6 months and 12 months employing FDI criteria. Non-parametric statistical analyses and χ²-tests (α = 0.05) were applied.

Results

Thirty patients (60 restorations) were available for the 6- and 12-month recalls exhibiting 100% restoration survival. All restorations revealed clinically acceptable FDI scores at all time points and for all criteria. Only regarding esthetic properties, FOBF performed significantly better than SABF regarding surface lustre (A1) and color match and translucency (A3) at all time points and marginal staining (A2b) at 12 months.

Conclusions

The null-hypothesis could not be rejected. Both materials performed similarly regarding clinical performance within the first year of clinical service. SABF exhibited slightly inferior, but clinically fully acceptable esthetic properties as compared to FOBF.

Clinical relevance

Within the limitations of this study, the self-adhesive bulk-fill restorative showed promising results and may be recommended for clinical use.

Adhesive strength of fiberglass posts treated with thio-urethane-based experimental silanes

Purpose:

The aim of this study was to evaluate the adhesive bond strength of fiberglass posts treated with experimental silanes based on thio-urethane and submitted to thermo and mechanical cycles.

Materials and methods:

Bovine roots were divided into six groups: RX-RU2 (RelyX CP + RelyX U200); PETMP-HDDI-RU2 (PETMP-HDDI + RelyX U200); PETMP-BDI-RU2 (PETMP-BDI + RelyX U200); RX-RU (RelyX CP + RelyX Ultimate); PETMP-HDDI-RU (PETMP-HDDI + RelyX Ultimate); PETMP-BDI-RU (PETMP-BDI + RelyX Ultimate). One slice from each root third (n=10) was submitted to the push-out test and the values evaluated with R Program statistical analysis, while the failure pattern assessed in percentage.

Results:

Among root thirds, RX-RU2 promoted greater strength at the cervical and apical thirds; PETMP-HDDI-RU2 showed highest values at the three thirds; and PETMP-BDI-RU2 was strongest at the apical third. RX-RU presented higher strength at the apical third, and PETMP-HDDI-RU and PETMP-BDI-RU had similar values at the three thirds. In each root third, PETMP-HDDI-RU2 showed similar strength at all thirds, and similar strength at the apical third was observed for other associations. Mixed and adhesive failures predominated.

Conclusion:

Experimental silanes promoted different bond strength values in the adhesion of fiberglass posts to the root thirds, with better results for PETMP-HDDI silane. The root region did not influence the failure pattern and most slices showed mixed (MCDP) or adhesive (ADP) failure.

Influence of material type, thickness and storage on fracture resistance of CAD/CAM occlusal veneers

OBJECTIVES

The present study aimed to evaluate the effect of restoration thickness, CAD/CAM material, and 6 months of artificial saliva storage on the fracture resistance of occlusal veneers.

MATERIALS AND METHODS

A total of 84 intact maxillary molars were sectioned 4.0 mm occlusal to the cementoenamel junction to expose the dentine. The teeth were assigned into 3 main groups according to the type of restorative material (e.max CAD, Vita Enamic, and Lava Ultimate). In each group, the teeth were allocated into 2 subgroups (n = 14) according to restoration thickness (1.0 and 1.5 mm). The veneers were adhesively bonded using dual-cure self-adhesive luting agent. A total of 42 specimens comprising half the tested subgroups were stored in distilled water for 24-h before the test. The remaining half was stored in artificial saliva at 37 ± 1 °C in an incubator for 6 months. All specimens (n = 84) were subjected to 5000 thermal cycles between 5 and 55 °C ± 2 before the fracture resistance test. The maximum force at fracture was recorded in Newton. Failure mode was analyzed using a stereomicroscope. The results were analyzed using a parametric Three-way ANOVA test.

RESULTS

The results of the Three-way ANOVA test revealed that material type and restoration thickness significantly affected fracture resistance values (p < 0.5), while 6 months of storage in artificial saliva had no significant effect on mean fracture resistance values (p˃0.5). The most common failure patterns in CAD/CAM resin composite and polymer-infiltrated ceramics were scores I and score II. For glass ceramic groups, score IV and III were more dominant.

CONCLUSIONS

All the tested CAD/CAM restorations in both thicknesses exhibited fracture resistance values exceeding normal and parafunctional bite forces. Polymer-infiltrated ceramics and CAD/CAM resin composite veneers showed more favorable fracture patterns.

The Influence of Cement Layer Thickness on the Stress State of Metal Inlay Restorations-Photoelastic Analysis

The successful restoration of teeth requires a good connection between the inlay and natural tissue. A strong bond may improve retention and reinforce tooth structure. The purpose of this study was to evaluate the influence of cement layer thickness on contraction stress generated during photopolymerization, and to determine the changes in stress state of the cement occurring during aging in water (over 84 days). Two cements were used: resin composite cement (NX3) and self-adhesive resin cement (Maxcem Elite Chroma). A cylindrical sample made of CuZn alloy was used to imitate the inlay. The stress state was measured by photoelastic analysis. The contraction stress of the inlay restoration was calculated for cement layer thicknesses of 25 µm, 100 µm, 200 µm, and 400 µm. For both tested materials, the lowest contraction stress was observed for the thinnest layer (25 µm), and this increased with thickness. Following water immersion, a significant reduction in contraction stress was observed due to hygroscopic expansion. Applying a thin layer (approximately 25 µm) of composite and self-adhesive resin cements resulted in high levels of expansion stresses (over −6 MPa) after water aging.

Is Conventional Resin Cement Adhesive Performance to Dentin Better Than Self-adhesive? A Systematic Review and Meta-Analysis of Laboratory Studies

CLINICAL RELEVANCE

Conventional multistep resin cements presented higher adhesive performance to dentin than simplified self-adhesive cements, which is an important criterion for indirect restoration prognosis.

SUMMARY

This study aimed to conduct a systematic review of the literature on laboratory studies assessing bonding performance to dentin of conventional and self-adhesive resin cements, in cementing indirect restorations. This review was reported according to the PRISMA Statement. Of a total of 518 studies, 36 were screened full text and reviewed according to exclusion criteria. Nineteen papers were included in the systematic review and meta-analyses, according to the following inclusion criteria: studies that evaluated the bond strength to dentin of indirect restorations cemented with dual conventional or self-adhesive resin cements and those that presented bond strength data in MPa as an outcome. Statistical analyses were conducted using Rev-Man 5.1. Comparisons were performed with random effects models at 5% significance level. A global analysis comparing conventional and self-adhesive cements and three subgroup analyses comparing immediate and long-term results were performed. Global analysis showed a difference between groups, with conventional resin cements presenting higher bond strength results than self-adhesive resin cements, in immediate and long-term time periods (both p=0.03). Immediate and longterm bond strength results were different for self-adhesive cements, favoring immediate bond strength (p=0.03), but immediate and long-term bond strength results for conventional resin cements were not different (p=0.06). Medium or high risk of bias was found in all studies. Conventional multistep resin cements showed superior overall adhesive performance compared with simplified self-adhesive resin cements when used to cement indirect restorations to dentin.

Dentin microshear bond strength of various resin luting agents to zirconia-reinforced lithium silicate ceramics

STATEMENT OF PROBLEM

The performance of adhesive and resin luting cements used to bond zirconia-reinforced lithium silicate (ZLS) ceramics to dentin has not been well established.

PURPOSE

The purpose of this in vitro study was to examine the microshear bond strength (μSBS) of an etch-and-rinse adhesive system, a universal adhesive, and a self-adhesive resin cement that were used to bond ZLS to dentin.

MATERIAL AND METHODS

VITA Suprinity (VS) and Celtra Duo (CD) blocks were sectioned into 36 and 72 microbars (1×1×3 mm). All VS were crystallized, while half of CD were additionally fired and defined as fired-Celtra Duo (FCD). The others were defined as unfired-Celtra Duo (UCD). Each microbar was cemented to each flat occlusal dentin surface of a human first premolar, following the adhesive luting systems: Scotchbond Multi-purpose (SM), Single Bond Universal (SU) combined with RelyX Ultimate, and RelyX Unicem (U2) (n=12 per group). μSBS at 24 hours was then determined, and the data were analyzed by using 2-way ANOVA and a Tukey post hoc test (α=.05). Failure modes were analyzed under a stereomicroscope at ×40 magnification.

RESULTS

Two-way ANOVA revealed that the type of ZLS had no influence on μSBS (P=.699). However, the kinds of adhesive luting cements and their interaction had a statistically significant effect on μSBS (P<.001 and P=.002). U2 had a statistically significant lower mean μSBS, regardless of the type of ZLS, than SM and SU (P≤.05), while UCDU2 did not show a statistically significant difference in μSBS from UCDSU (P=.478).

CONCLUSIONS

Resin cement used with an etch-and-rinse and a universal adhesive agent demonstrates higher bond strength for the cementation of zirconia-reinforced lithium silicate ceramics to dentin than a self-adhesive resin cement.

Cleaning and Conditioning of Contaminated Core Build-Up Material before Adhesive Bonding

The objective of this study was to evaluate the effects of different cleaning and conditioning procedures after contamination on the tensile bond strength (TBS) of a luting resin to a core build-up composite resin. Specimens (n = 384) made of a core build-up material were stored for 3 weeks in 37 °C water. Half of the specimens were contaminated with saliva and a disclosing silicone and then cleaned either using phosphoric acid, a pumice suspension, air-abrasion with alumina or polishing powder. Surface conditioning was performed by either using a dentin adhesive, a silane containing primer or a composite resin primer, which resulted in 24 unique combinations of 16 specimens per group. Before measuring TBS, half of the specimens of each group were stored in 37 °C water for 3d or were artificially aged for 150 days. Results show that cleaning with pumice or air-abrasion are superior methods compared to using a polishing powder or phosphoric acid. Silane is an inferior conditioning agent compared to composite or dentin primers. Ideally, after contamination, bonding surfaces should be cleaned with a pumice suspension and conditioned with a dentin adhesive. Those surfaces could also be cleaned and conditioned with air-abrasion with alumina particles and a composite resin primer.

Effect of proanthocyanidin mediated immediate and delayed dentin sealing on the strength of premolars restored with composite resin inlay

Background

Immediate dentin sealing (IDS) with proanthocyanidin (PA) could be used before cementation with a self-adhesive (SA) cement. The aim of this study was to assess the effect of PA treatment on acid-etched dentin before adhesive application, in IDS and delayed dentin sealing (DDS), on the strengthening property of SA-cemented composite resin inlay in premolars.

Material and Methods

Eighty-four maxillary premolars were divided into 7 groups (n=12): 1) (Intact) Sound teeth served as controls; groups 2-7) After cavity preparation and fabrication of composite resin inlay, temporary inlays were made and cemented. After one week, the inlays were removed and composite inlays were luted with a self-adhesive resin cement as follows: 2) (SA) Without dentin- pretreatment; 3) (DDS) Etch-and-rinse adhesive before the cementation; 4) (DDS/PA) PA treatment of acid-etched dentin before the adhesive, followed by the cementation; 5) (Etch/PA) PA treatment of acid-etched dentin before the cementation; 6 and 7) (IDS and IDS/PA) Application of IDS without or with PA treatment, respectively, one week before the cementation. After thermo-mechanical aging, fracture resistance (FR) was tested. Data were analyzed using one-way ANOVA and Tamhane tests (α=0.05).

Results

There was a significant difference between the study groups (P<0.001). The IDS and IDS/PA groups yielded significantly higher FR compared to the SA group (P ≤ 0.003), but the DDS, DDS/PA and Etch/PA groups did not differ from the SA group (P>0.05). The effect of PA on FR in the IDS and DDS techniques was not significant.

Conclusions

IDS with or without PA treatment considerably improved the strength of premolars with self-adhesive-cemented inlay, while the value of only IDS with PA treatment reached the level of the sound teeth.

Key words:Delayed dentin sealing, fracture resistance, immediate dentin sealing, proanthocyanidin.

Bond strength and adhesive interfacial micromorphology of self-adhesive resin cements: Effect of reduced times of pre-etching

Background

Although acid-etching could increase enamel bond strength of self-adhesive (SA) cements, it may lead to negative effect on dentin. The aim of this study was to assess the effect of shortening of phosphoric acid pre-etching duration on enamel/ dentin shear bond strength (SBS) and interfacial microstructure of Panavia SA Luting Plus (PASA) and Bifix SE (BXSE).

Material and Methods

For both enamel and dentin, effect of pre-etching time was significant (p<0.001); however, effect of cement brand and the interaction of two factors was significant only for dentin (p≤0.008). Three pre-etching times increased SBS of both cements to enamel and BXSE to dentin. In case of dentin SBS of PASA, this improvement was significant only for 5 and 10 seconds (p<0.001). Adding acid-etching in the three times to both cements similarly improved interfacial adaptation, particularly for enamel.

Results

The evaluations of the biofilm elimination showed results that indicate that the 4% sodium hypochlorite group with positive pressure irrigation presented significant differences with the group that had irrigation with sodium hypochlorite activated with XP-endo Finisher and the chlorhexidine groups to 2% (P<0.05).

Conclusions

Interfacial bond strength and adaptation of SA cements used in this study were improved following addition of enamel/dentin etching step for a short time. This was not exceeded for longer times than 5-second.

Key words:Dentin bond strength, enamel bond strength, pre-etching time, self-adhesive cement.

Effects of Different Surface Treatments on Bond Strength of Resin Cement to Machined Pure Titanium

PURPOSE

To investigate the effects of grit blasting, acidic or alkaline/heat treatments, and metal primer application on the shear bond strength (SBS) of resin cement to machined commercially pure titanium (CP-Ti).

MATERIALS AND METHODS

Titanium plates were machined and received one of the following treatments: grit-blasting (GB), or grit-blasting followed by either acidic treatment (GB/AC) or alkaline/heat treatment (GB/AH). The specimens were randomly divided into 4 groups and treated with Rely X Ceramic Primer (RCP), Z Prime Plus (ZPP), and Alloy Primer (ALP), or without primer as the control. The pairs of titanium plates were cemented together with the Rely X Unicem cement. SBS was measured before and after thermocycling between 5°C and 55°C for 5000 cycles.

RESULTS

SEM observation showed that honeycomb-shaped pores formed on the surface of machined CP-Ti after GB/AC treatment, whereas a uniform net-like pattern formed after GB/AH treatment. In descending order, the surface roughness was GB, GB/AC, and GB/AH. The GB/AH group showed the highest SBS among all the treatments. As for primers, ALP group showed the highest SBS, while the RCP group showed the lowest. GB followed by ALP presented the highest SBS.

CONCLUSION

A fine, uniform network structure was formed on the surface of CP-Ti following GB/AH treatment, providing an effective micromechanical interlocking mechanism for resin bonding. At the same time, after AH treatment, the -OH formed on the surface of the machined CP-Ti triggered a chemical reaction with the acid monomers in the resin adhesives, creating a chemical bond. As a result, GB/AH treatment significantly improved the bond strength relative to GB/AC treatment. In addition, ALP treatment facilitated the formation of hydrogen bonds, which further improved the chemical bond strength. Finally, the combination of the effects mentioned above resulted in the most robust bond between machined CP-Ti and the resin adhesives.

Influence of bonding surface and bonding methods on the fracture resistance and survival rate of full-coverage occlusal veneers made from lithium disilicate ceramic after cyclic loading

OBJECTIVES

The purpose of this laboratory study was to evaluate the influence of bonding method and type of dental bonding surface on fracture resistance and survival rate of resin bonded occlusal veneers made from lithium disilicate ceramic after cyclic loading.

METHODS

Fourty-eight extracted molars were divided into three groups (N=16) depending on the preparation: within enamel, within dentin/enamel or within enamel/composite resin filling. Lithium disilicate occlussal veneers were fabricated with a fissure-cusp thickness of 0.3-0.6mm. Restorations were etched (5% HF), silanated and adhesively luted using a dual-curing luting composite resin. Test groups were divided into two subgroups, one using a only a self-etching primer, the other additionally etching the enamel with phosphoric acid. After water storage (37°C; 21d) and thermocycling (7500 cycles; 5-55°C), specimens were subjected to dynamic loading in a chewing simulator (600,000 cycles; 10kg/2Hz). Surviving specimens were loaded until fracture using a universal testing machine.

RESULTS

All specimens survived artificial aging, several specimens showed some damage. ANOVA revealed that enamel etching provided statistically significantly (p≤0.05) higher fracture resistance than self-etching when bonding to enamel and dentin. Self-etching provided statistically significant (p≤0.05) higher fracture resistance for the enamel-composite group than for the enamel group. Enamel etching provided statistically significant (p≤0.05) higher fracture resistance for the enamel and dentin group than for groups enamel and enamel-composite.

SIGNIFICANCE

Etching enamel improved the fracture resistance of occlusal veneers when bonding to dentin and enamel and increased the survival rate when bonding to enamel.

Adhesive Systems Used in Indirect Restorations Cementation: Review of the Literature

New technologies are changing the therapeutical options to do indirect restorations and new adhesive systems are continuously introduced to be used by clinicians. Different interactions between restorations, adhesive systems components, enamel and dentin require having criteria based on the selection of the adhesive system, ensuring the longevity of the restorations and the preservation of the biological remnant. The adhesion force to the dental tissue is one of the indicatives of the behavior of the adhesive systems and influences the behavior of the treatments with direct and indirect restorations. The objective of this search was to find the adhesive systems with the best results in terms of the adhesion strength of indirect restorations on the dental tissues. The search was conducted in two MEDLINE digital databases (PubMed), and the Cochrane Library with a search strategy based on the combination of MeSH (Medical Subject Headings) keywords. This systematic review used the PRISMA guide (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). According to this review, the 3-step adhesive systems were the best performing and still are the gold standard for the cementing of indirect restorations. In addition, it can be concluded that self-etched adhesive systems reduce the time spent in clinical practice, however at the interface level they behave as permeable membranes more susceptible to degradation.

Comparative evaluation of the shear bond strength of adhesive and self-adhesive resin luting agents to three commercially available composite core build-up materials: An in vitro study

Aim

The aim of the study was to evaluate the shear bond strength of adhesive and self-adhesive resin luting agents (RLAs) to three commercially available composite core build-up materials (CBMs).

Settings and Design

Comparative -invitro study.

Materials and Methods

Sixty samples, 20 each of self-cure (Incore, Medicept: Group I), light cure (Light-Core, Bisco: Group II), and dual cure (LuxaCore Z-Dual, DMG America: Group III) composite CBMs were made in the lower mold space of a customized stainless steel jig. They were further subdivided into subgroups A and B for bonding with the adhesive (RelyX Ultimate, 3M ESPE) and self-adhesive (RelyX Unicem, 3M ESPE) RLAs respectively. For specimens in subgroup A, the bonding agent (Scotchbond Universal Adhesive, 3M ESPE) was rubbed onto the surface for 20 s prior to bonding with the adhesive RLA. For specimens in subgroup B, no pretreatment of the surface was carried out. The CBM-luting agent sample was tested for the shear bond strength in a universal testing machine.

Statistical Analysis Used

ANOVA, Tukey's multiple comparison, and independent t-test.

Results

Adhesive RLA showed the highest shear bond strength to light cured composite CBM. Self-adhesive RLA showed the highest shear bond strength to dual-cured composite CBM. Adhesive RLA showed higher shear bond strength to all three composite CBMs as compared to the self-adhesive luting agent. This difference was statistically significant for the self-cure and light cure composite CBMs.

Conclusion

Adhesive RLA showed greater shear bond strengths to all the three groups of composite CBMs as compared to self-adhesive RLA.

Longevity of indirect restorations cemented with self-adhesive resin luting with and without selective enamel etching. A Systematic review and meta-analysis

OBJECTIVE

To investigate the influence of the selective etching in the survival rates of indirect restorations cemented with self-adhesive resin luting.

MATERIALS AND METHODS

The eligibility criteria were formulated based on PICOS strategy. The search without restrictions was performed in PubMed/Medline, the Cochrane Library, Web of Science, Scopus, LILACS databases and gray literature until May 2018. Cochrane Collaboration's tool was performed for assessing the risk of bias. According to the bias risk analysis, the studies were classified as low risk of bias and high quality of evidence. The systematic review was conducted according to PRISMA and registered in PROSPERO (CRD42018091202). The meta-analysis was performed using RevMan 5.3 software (RevMan, Copenhagen, Denmark) and the risk ration and confidence interval was obtained (p < 0.05).

RESULTS

After database screening, removal of duplicates and eligibility criteria application, two studies were selected for this systematic review, with 65 participants (34 in one and 31 in the other). The pooled meta-analysis demonstrated no statistically significant difference in clinical longevity for selective etching in indirect restorations (P > .05; I² = 0%) and risk ratio of 0.46 [0.19-1.09].

CONCLUSIONS

Based on the findings, the results of this systematic review suggest that the selective enamel etching prior to application of self-adhesive luting cements systems for indirect restoration do not influence the clinical longevity of indirect restorations.

CLINICAL SIGNIFICANCE

The knowledge of the clinical steps of adhesive procedures is fundamental to the success of adhesive restorations and their longevity. Self-adhesive resin cements simplify the luting procedure of indirect restorations. However, adding a step that could significantly improve long-term survival would be of great value. Thus, the results of this systematic review will provide data so that the decision making regarding materials used for adhesive cementation is conducted based on scientific evidence.

Glass fiber post treatment – does it influence resin cement bond strength?

Abstract Introduction Glass-fiber posts are used in order to improve the retention of restorations in endodontically treated teeth. Objective To evaluate the bond strength of glass-fiber posts submitted to different surface treatments and cemented to the root canal dentin with self-adhesive resin cement. Material and method Thirty roots of human canines were prepared and divided according to two factors: surface treatments (silane, 35% hydrogen peroxide, or sodium bicarbonate) and root thirds (cervical and middle thirds). The glass-fiber posts were cemented with self-adhesive resin cement (RelyX U200). After 24 h, the specimens were prepared for microtensile bond strength test (hourglass format), fracture pattern and micromorphological assessment by scanning electronic microscopy, in order to measure the cement line. Result The data (MPa and µm) were submitted to two-way ANOVA and Tukey’s test (α = 5%). The surface treatments influenced the bond strength of the posts cemented with self-adhesive resin cement (p<0.00). The mean bond strength (standard deviations) differed according to the region of root dentin (p<0.00): the cervical region (Control: 19.16MPa (3.71); Silane: 25.65MPa (4.04); Hydrogen peroxide: 24.43MPa (3.16); Sodium bicarbonate: 37.42MPa (8.27)) showed higher bond strength values than the middle third of the root (Control: 14.66MPa (4.65); Silane: 12.52MPa (5.03); Hydrogen peroxide: 10.64MPa (3.33); Sodium bicarbonate: 10.87MPa (2.49)). Conclusion Treatment of the glass-fiber post surface with chemical and physical agents increased the bond strength of the cement-post-dentin interface in the cervical third and the treatment with Sodium bicarbonate showed better results in bond strength.

Effect of Polyacrylic Acid Conditioning on the Longevity of Bonding of Self - Adhesive Resin Cement to Dentin

AbstractBonding of fiber posts using self-adhesive resin cement to radicular dentin is controversial. The aim was to evaluate the effect of conditioning of polyacrylic acid on the longevity of bonding of self adhesive resin cement to dentin. Thirty six single rooted pre molars were divided into 3 groups (n=12) ARC: ScotchBond Multi Purpose + RelyX™ARC; U: RelyX™U200; PU: 11.5% Polyacrylic acid + RelyX™U200. After conditioning of the dentin, the resin cement and the post were inserted and light-activated for 60s (1200mw/cm2) and stored in distilled water (24h/37ºC). Two discs of 1 mm thickness were obtained from each root-third and tested in push-out (0.5mm/min) after 24 hours and 6 months. For statistical purposes, the data from the root thirds were grouped and the bond strength (in MPa) was analyzed using Two-Way Analysis of Variance and Tukey’s post-hoc test at 5%. The power of the test was calculated. The bonding of the U at 6 months was higher than PU at both times (p<0.001). There were no differences for time (p=0.153) or for the interaction of treatment x time (p=0.090). Adhesive fractures between the cement and dentin were prevalent. The power test was 0.97. The bonding of the RelyX™U200 was influenced by the dentin pre-treatment with poliacrylic acid and the bonding of all groups remained stable for 6 months.Keywords: Dental Cements. Dentin. Shear Strength.ResumoA adesão de pino de fibra de vidro com cimento resinoso autoadesivo à dentina é controversa. Foi objetivo avaliar o efeito do condicionamento da dentina com ácido poliacrílico na longevidade da adesão de cimento resinoso autoadesivo. Trinta e seis raízes de pré-molares uni radiculados foram divididas em 3 grupos (n=12) ARC: ScotchBond Multi Purpose + RelyX™ARC; U: RelyX™U200; PU: Ácido poliacrílico 11,5% + RelyX™U200. Após condicionamento da dentina, o cimento resinoso e o pino de fibra de vidro foram inseridos, fotoativados por 60s (1200mw/cm2) e armazenados em água destilada (24h/37ºC). Dois discos de dentina de 1 mm de espessura foram obtidos de cada terço radicular e testados em push-out (0.5mm/min) após 24 houras e 6 meses. Para análise estatística, os dados dos terços radiculares foram agrupados e resistência adesiva (em MPa) analisada por Análise de Variância de dois fatores e teste de Tukey a 5%. O poder do teste foi calculado. A adesão de the U após 6 meses foi maior que a de PU nos dois períodos (p<0,001). Não houve diferença para o fator tempo (p=0,153) nem para a interação tratamento x tempo (p=0,090). Fraturas adesivas prevaleceram entre cimento e dentina. O poder do teste calculado foi de 0,97. A adesão do RelyX™U200 foi influenciada pelo pré-tratamento da dentina com ácido poliacrílico e a adesão de todos os grupos se manteve estável até 6 meses.Palavras-chave: Cimentos Dentários. Dentina. Resistência ao Cisalhamento.

Effect of heat treatment on cytotoxicity of self-adhesive resin cements: Cell viability analysis

Objective

The aim of the study was to assess, in vitro, the influence on cytotoxicity of heat treatment applied before photopolymerization, while mixing three self-adhesive resin cements, in an NIH/3T3 fibroblast cell culture, based on cell viability measures.

Methods

Samples were divided into three groups: (1) no heat treatment while mixing (control), (2) 37°C, and (3) 60°C heat treatment while mixing. Cements were light-cured immediately after mixing and immersed in Dulbecco's Modified Eagle Media for the extraction of possibly uncured products after 24 h and 7 days. Cultures contained 0.5 mL of NIH/3T3 fibroblasts per well at a concentration of 0.4 × 10⁵ cells/mL and specific extracts for each sample.

Statistical Analysis Used

Data were statistically analyzed with ANOVA and post hoc Student-Newman-Keuls (significance of 5%).

Results

Cement cytotoxicity increased with time, as shown by the higher values observed at 7 days. There was a slight difference in intragroup cytotoxicity levels between 24 h and 7 days. Heat treatment at 60°C was associated with a major decrease in cytotoxicity levels in all three groups, both at 24 h and at 7 days, with no differences among the cements.

Conclusions

Heat treatment at 60°C should be considered as a strategy to reduce cytotoxicity of self-adhesive resin cements, as evidenced by the results observed at 24 h and 7 days of analysis.

Dental Cements for Luting and Bonding Restorations: Self-Adhesive Resin Cements

Self-adhesive resin cements combine easy application of conventional luting materials with improved mechanical properties and bonding capability of resin cements. The presence of functional acidic monomers, dual cure setting mechanism, and fillers capable of neutralizing the initial low pH of the cement are essential elements of the material and should be understood when selecting the ideal luting material for each clinical situation. This article addresses the most relevant aspects of self-adhesive resin cements and their potential impact on clinical performance. Although few clinical studies are available to establish solid clinical evidence, the information presented provides clinical guidance in the dynamic environment of material development.

Longevity of bond strength of resin cements to root dentine after radiation therapy

AIM

To evaluate the bond strength and adhesive interface between several resin cements and root dentine immediately and 6 months after radiotherapy.

METHODOLOGY

Sixty maxillary canines were selected and randomly assigned to two groups (n = 30): one group was not irradiated and the other one was subjected to a cumulative radiation dose of 60 Gy. The teeth were sectioned to obtain roots 16 mm long and the canals were prepared with the Reciproc system (R50) and filled using a lateral condensation technique with an epoxy resin sealer. Each group was divided into three subgroups (n = 10) according to the resin cement used for fibreglass fibre post cementation: RelyX-U200, Panavia-F2.0 and RelyX ARC. The posts were cemented in accordance with the manufacturer's recommendations. Three 1-mm-thick dentine slices were then obtained from each root third. The first two slices in the crown-apex direction of each third were selected for the push-out test. The failure mode after debonding was determined with a stereo microscope. The third slice from each root third was selected for scanning electron microscopy (SEM) analyses to examine the resin cement-dentine interface with 100, 1000, 2000 and 4000× magnification. Bond strength data were analysed by anova and Tukey's test (α = 0.05).

RESULTS

Significantly lower bond strength (P < 0.0001) was obtained after irradiation compared to nonirradiated teeth. RelyX-U200 cemented fibre posts had the higher bond strength (15.17 ± 5.89) compared with RelyX ARC (P < 0.001) and Panavia-F2.0 (P < 0.001). The evaluation after 6 months revealed lower bond strength values compared to the immediate values (P < 0.001) for irradiated and nonirradiated teeth. Cohesive failures occurred in the irradiated dentine. SEM revealed fractures, microfractures and fewer collagen fibres in irradiated root dentine. RelyX-U200 and Panavia-F2.0 were associated with a juxtaposed interface of the cement with the radicular dentine in irradiated and nonirradiated teeth, and for RelyX ARC, hybrid layer formation and tags were observed in both irradiated and nonirradiated teeth.

CONCLUSION

Radiation was associated with a decrease in the push-out bond strength and with lower resin cement/root dentine interface adaptation. Self-adhesive resin cement was a better alternative for fibre post cementation in teeth subjected to radiation therapy. The bond strength decreased after 6 months.

Effect of smear layer deproteinization on bonding of self-etch adhesives to dentin: a systematic review and meta-analysis

OBJECTIVES

The aim of this systematic review was to critically analyze previously published studies of the effects of dentin surface pretreatment with deproteinizing agents on the bonding of self-etch (SE) adhesives to dentin. Additionally, a meta-analysis was conducted to quantify the effects of the above-mentioned surface pretreatment methods on the bonding of SE adhesives to dentin.

MATERIALS AND METHODS

An electronic search was performed using the following databases: Scopus, PubMed and ScienceDirect. The online search was performed using the following keywords: 'dentin' or 'hypochlorous acid' or 'sodium hypochlorite' and 'self-etch adhesive.' The following categories were excluded during the assessment process: non-English articles, randomized clinical trials, case reports, animal studies, and review articles. The reviewed studies were subjected to meta-analysis to quantify the effect of the application time and concentration of sodium hypochlorite (NaOCl) and hypochlorous acid (HOCl) deproteinizing agents on bonding to dentin.

RESULTS

Only 9 laboratory studies fit the inclusion criteria of this systematic review. The results of the meta-analysis revealed that the pooled average microtensile bond strength values to dentin pre-treated with deproteinizing agents (15.71 MPa) was significantly lower than those of the non-treated control group (20.94 MPa).

CONCLUSIONS

In light of the currently available scientific evidence, dentin surface pretreatment with deproteinizing agents does not enhance the bonding of SE adhesives to dentin. The HOCl deproteinizing agent exhibited minimal adverse effects on bonding to dentin in comparison with NaOCl solutions.

Influence of Polishing Methods on the Bonding Effectiveness and Durability of Different Resin Cements to Dentin

The purpose of this study was to investigate the impact of polishing methods on the bonding effectiveness and durability of different resin cements to dentin. The dentin surfaces were either treated with a fine-grit diamond bur (polishing A) or further polished by polishing disks (polishing B), and then they were bonded with any one of the three resin cements, namely, etch-and-rinse, self-etch, and self-adhesive resin cements. After 24-hour or 2-year water storage, a microtensile bond strength (μTBS) test was performed. A scanning electron microscope (SEM) was used to observe the morphology of the smear layer as well as the resin-dentin bonding interface. The results indicated that a thinner smear layer thickness was created by polishing B compared with polishing A. Although self-etch and self-adhesive resin cements achieved a relatively high primary bond strength before water degradation, etch-and-rinse resin cement obtained a stable bond strength during water degradation. The application of an additional polishing procedure could improve the bond strength of self-etch and self-adhesive resin cements.

CO2 laser dentin surface treatment most effectively increased ceramic shear bond strength

BACKGROUND AND AIMS

The purpose of this study is to determine the effect of CO2 laser irradiation in comparison with sandblasting (Sb), hydrofluoric acid (Hf) and silane coupling agent (Si) on shear bond strength (SBS) of resin cement to CAD/CAM ceramics bonded to dentin.

MATERIAL AND METHODS

Forty-eight (CAD/CAM) ceramic discs were prepared and grouped by material, i.e. lithium disilicate (Emax CAD) and zirconia ceramic (Emax ZirCAD), distributed into four different groups: group A, lithium disilicate (Li) CO2/HF/Si; group B, Li: HF/Si; group C, zirconia (Zr) CO2/Sb/Si; group D, Zr: Sb/Si.

RESULTS

It was shown significant difference between irradiated and non-irradiated groups in terms of shear bond strength for zirconia ceramics (p value = 0.039).

CONCLUSION

CO2 laser irradiation increases shear bond strength for both CAD/CAM ceramics bonded to dentin.

Fracture Resistance of CAD/CAM-Fabricated Lithium Disilicate MOD Inlays and Onlays with Various Cavity Preparation Designs

PURPOSE

To examine the fracture resistance of premolars restored with CAD/CAM lithium disilicate mesio-occlusal-distal (MOD) inlays and onlays of different cavity designs.

MATERIALS AND METHODS

Two widths of occlusal isthmus (75%, 100% of intercuspal distance) and three designs of cuspal coverage (none, palatal, complete) were used for the preparation of MOD inlays and onlays in the extracted maxillary premolars. Sixty lithium disilicate restorations were milled and bonded into the cavities. After 24 hours of water storage, the specimens were loaded until fracture, and the fracture loads (N) were measured. Any evidence of cracks and fractures on the tested specimens were examined to classify failure patterns.

RESULTS

Mean fracture load values for the tested groups were as follows: 664.4 ± 214.7 N (group A), 659.3 ± 391.2 N (B), 681.9 ± 258.1 N (C), 938.1 ± 862.0 N (D), 841.7 ± 375.4 N (E), and 994.2 ± 486.3 N (F). The width of occlusal isthmus did not significantly affect the fracture loads among all the groups. Within groups with identical isthmus width, the fracture loads showed no significant difference depending on the designs of cuspal coverage. The majority of specimens showed either type III or IV fracture mode.

CONCLUSIONS

Within limitations of this study, the bonded restorations of premolars with CAD/CAM-generated lithium disilicate were reliable, regardless of cavity preparation design.

Comparison of the shear bond strength of self-adhesive resin cements to enamel and dentin with different protocol of application

AIM

The aim of the present study was to determine the shear bond strength of self-adhesive resin cements to enamel and dentin with and without surface treatments, and compare them with conventional resin cement as the control group.

METHODS

In this experimental study, buccal and lingual surface of the thirty sound human premolars were polished in order to obtain a flat surface of enamel (E) in buccal, and dentin (D) in lingual. Sixty feldspathic ceramic blocks (2×3×3 mm) were prepared and randomly divided into six groups (n=10). Each block was cemented to the prepared surface (30 enamel and 30 dentin surface) according to different protocol: E1 and D1; RelyX ARC as control group, E2, D2; RelyX Unicem, E3, D3; acid etching +RelyX Unicem. The specimens were termocycled and subjected to shear forces by a universal testing machine at a cross head speed of 0.5 mm/min. The mode of fracture were evaluated by stereomicroscope. Data were analyzed with descriptive statistical methods using SPSS version 15. One-way ANOVA, and post hoc Tukey tests were used to compare bond strengths between the groups with different adhesives at α=0.05.

RESULTS

Statistical analysis showed no significant differences within the enamel subgroups, but there were significant differences within the dentinal subgroups, and statistically significant differences were found between the groups D1and D3 (p=0.02). Comparison between similar enamel and dentinal subgroups showed that there was a significant difference just between the subgroups E3 and D3 (p=0.01).

CONCLUSION

Elective etching of enamel did not lead to significant increase in the shear bond strength of RelyX Unicem in comparison to RelyX ARC. On the other hand, elective etching of dentin reduces the bond strength of RelyX Unicem with the dentin.

Ultramorphology of pre-treated adhesive interfaces between self-adhesive resin cement and tooth structures

Abstract Introduction Convencional resin cements can be used in combination with a total-etch system in a conventional mode or as self-adhesive resin cements. The latter are less technique sensitive and able to bond to dental tissues without previous treatment or adhesive layer and requires only a single step to be applied to dental structures. Objective To compare qualitatively the adhesive interfaces of two self-adhesive resin cements and one conventional resin cement after different tooth surface treatments under scanning electron microscopy. Material and method 42 crowns of bovine incisors were sectioned and flattened exposing enamel (E) or dentine (D) substrate. Subgroups were defined according to conditioning type and time: E1—no treatment, E2—37% phosphoric acid for 15 seconds, E3—37% phosphoric acid for 30 seconds; D1—no treatment, D2—37% phosphoric acid for 5 seconds; D3—11.5% polyacrylic acid for 15 seconds. A resin block was bonded to each substrate using the self-adhesive resin cements RelyX U100 (3M ESPE) and RelyX U200 (3M ESPE). As a reference hybrid layer, six resin blocks were luted with RelyX ARC and Scotchbond Multi-Purpose adhesive system (3M ESPE) (enamel—EA; dentine—DA). After aging for 7 days in a moist environment at 37±1°C, samples were prepared for microscopy analysis. Result and Discussion In the ARC specimens, there was hybrid layer formation in both EA and DA. U100 E1 showed gaps at the adhesive interface, while E2 and E3 showed interaction for both self-adhesive cements. There was superficial interaction with bothU100 and U200 in D1, while in D2 and D3, resin tags were only observed in the case of U100. Conclusion It was concluded that substrate conditioning may enhance the interaction between self-adhesive resin cements and dental tissues, although this is not the case for RelyX U200 and dentine.

Universal cements: dual activated and chemically activated

Objective: The aim of the present study was to assess the bond strength of universal cements cured either dually or chemically only.

Methods: Three cements were assessed using different types of application: dual activated (DA) or chemically activated (CA). In total 80 dentin blocks were used, obtained through the enamel wear of the lingual and buccal surfaces of bovine incisors. Standard cone-shaped cavity preparations were created using diamond burs. Subsequently, indirect restoration blocks were designed with Filtek Z350 (3M ESPE) composite resin. The teeth were divided into two groups (DA and CA) and then subdivided into four subgroups (n = 10) prior to cementation with the respective products: Duo-Link (Bisco); RelyX Ultimate (3M ESPE); Nexus 3 (Kerr) and conventional RelyX ARC (3M ESPE) as the control. The cementation in the PA group was applied following the manufacturer’s instructions. The CA group was cemented in a darkroom to avoid exposure to light. They were stored in distilled water at 37 °C for 24 h and submitted to the push-out test. Data were analyzed by two-way ANOVA and Tukey’s post-hoc test (p < .05).

Results: The greatest bond strength results were obtained for photoactivated universal cements.

Conclusion: Chemical activation is not sufficient to ensure acceptable bond strength.

Novel multifunctional dental bonding agent for Class-V restorations to inhibit periodontal biofilms

We recently developed a dental bonding agent to bond restorations to teeth using nanoparticles of amorphous calcium phosphate (NACP) for remineralization with rechargeable calcium and phosphate ion release. The objectives of this study were to: (1) incorporate an antibacterial monomer dimethylaminohexadecyl methacrylate (DMAHDM) and a protein-repellent agent 2-methacryloyloxyethyl phosphorylcholine (MPC); and (2) investigate protein adsorption and periodontitis-related biofilms for the first time. A primer, used to prime tooth structures for bonding, was made with pyromellitic glycerol dimethacrylate (PMGDM) and 2-hydroxyethyl methacrylate (HEMA). An adhesive was made with PMGDM, ethoxylated bisphenol A dimethacrylate and HEMA. NACP, MPC and DMAHDM were incorporated. Streptococcus gordonii, Actinomyces naeslundii, Porphyromonas gingivalis, Fusobacterium nucleatum were cultured to form single and multi-species biofilms. Colony-forming units (CFU), live/dead, metabolic activity, and polysaccharide were measured. Adding DMAHDM, MPC and NACP into the bonding agent did not compromise the dentin bond strength (p > 0.1). Bonding agents with 5% MPC reduced protein adsorption to 1/15 that of the control (p < 0.05). Bonding agents with 5% DMAHDM + 5% MPC had much greater reduction in biofilms than DMAHDM or MPC alone (p < 0.05). Biofilm CFU was reduced by 3 to 4 log via DMAHDM + MPC. Metabolic activities and polysaccharide of biofilms were also substantially reduced (p < 0.05). In conclusion, a novel bonding agent was developed for dental restorations with inhibition of biofilms, reducing CFU by 3 to 4 log. Besides remineralizartion and acid-neutralization via NACP to inhibit caries as shown previously, the multifunctional adhesive is promising for root restorations with subgingival margins to suppress periodontal pathogens and protect the periodontium.