Composite cements benefit from light-curing

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.

Influence of Immediate Dentin Sealing on Bond Strength of Resin-Based CAD/CAM Restoratives to Dentin: A Systematic Review of In Vitro Studies

Immediate dentin sealing (IDS) is a method of improving the bond strength of indirect dental restorative materials to dentin and belongs to the biomimetic protocols of contemporary dentistry. The purpose of this systematic review was to evaluate the effect of IDS on the bond strength of resin-based CAD/CAM materials to dentin. PubMed and MEDLINE, Scopus, and the Web of Science were searched by two individual researchers, namely for studies that have been published in English between 1 January 2005 and 31 December 2023 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The inclusion criteria encompassed articles related to in vitro studies, measuring the bond strength through microtensile bond strength (μ-TBS), micro-shear bond strength (μ-SBS), tensile bond strength (TBS) or shear bond strength (SBS) tests after the use of the IDS technique. The included restorative materials comprised resin-based CAD/CAM materials bonded to dentin. A total of 1821 studies were identified, of which 7 met the inclusion criteria. A meta-analysis was not deemed appropriate due to the high level of diversity inthe publications and techniques. The use of IDS yielded higher bond strength outcomesin various experimental conditions and resin-based CAD/CAM materials. Overall, IDS in CAD/CAM restorations may contribute to better clinical outcomesand improved restoration longevity due to this property.

Effect of universal adhesives and self-etch ceramic primers on bond strength to glass-ceramics: A systematic review and meta-analysis of in vitro studies

STATEMENT OF PROBLEM

To simplify dental procedures, multicomponent products such as universal adhesives and self-etch ceramic primers have been recommended for glass-ceramic bonding; however, studies have shown a wide range of results.

PURPOSE

The purpose of this systematic review and meta-analysis was to analyze the in vitro bond strength promoted by hydrofluoric acid+silane-containing universal adhesives and a self-etch ceramic primer to glass-ceramics and compare it with that of conventional treatments.

MATERIAL AND METHODS

A systematic search was conducted in the PubMed/Medline, Scopus, LILACS, and ISI Web of Science databases up to April 2021. In vitro studies assessing the resin-mediated bond to glass-ceramics by using a self-etch ceramic primer and hydrofluoric acid+silane-containing universal adhesives and/or compared with traditional hydrofluoric acid+glass-ceramic primers were included. Selection of studies, data extraction, and risk-of-bias analysis were performed. Statistical analysis was performed by using a review management software program using a random effects model (α=.05).

RESULTS

A total of 33 studies were included in the qualitative analysis and 26 studies in the quantitative analysis. Bond strength to lithium disilicate ceramic was higher when a hydrofluoric acid+glass-ceramic primer was used than when using a hydrofluoric acid+silane-containing universal adhesive (P<.05), except when 9% to 10% acid concentration was used in combination with static aging (P=.100). A self-etch ceramic primer promoted bond strength values to lithium disilicate that were similar to those of the hydrofluoric acid+glass-ceramic primer (P>.100).

CONCLUSIONS

Hydrofluoric acid+silane-containing universal adhesive was not as effective as the hydrofluoric acid+glass-ceramic primer in promoting bond strength to glass-ceramic. Bond strength values generated by a self-etch ceramic primer to glass-ceramic were similar to those generated by the conventional treatment.

Influence of different curing modes on the bonding effectiveness of self-adhesive resin luting cements in combination with universal adhesives

OBJECTIVES

This study aimed to investigate the immediate dentin bond performance and bond durability of self-adhesive resin luting cements (RLCs) in combination with universal adhesives in different curing modes.

METHODS

Two self-adhesive RLCs were used with universal adhesives as primers. They were also used alone as self-adhesive RLCs. Two multiple-step RLC systems were used as comparison materials. To measure the shear bond strength (SBS) in different curing modes, 12 specimens were prepared for each group. Stainless-steel rods were bonded to bovine dentin, and the bonded specimens were assigned to the baseline group (stored for 24 h) and artificially aged group (thermal cycling [TC], 10,000 cycles). After each storage period, the SBS of the bonded specimens was measured. The Knoop hardness number (KHN) of the cured RLCs was measured with or without primer application in different curing modes at 24 h and after 10,000 TC. The representative RLC/dentin interfaces were observed using scanning electron microscopy (SEM).

RESULTS

Dentin SBS was significantly influenced by the RLC system but not by the curing mode. Self-adhesive RLCs alone showed significantly lower SBS values than self-adhesive RLCs with primer regardless of the curing mode or storage period. The storage period, curing mode, and RLC system significantly influenced the KHN.

SIGNIFICANCE

The use of universal adhesives as a primer may help enhance the immediate dentin bond performance and bond durability of self-adhesive RLCs.

Shear bond strength of dual-cured resin cements on zirconia: The light-blocking effect of a zirconia crown

Abstract Background/purpose

The presence of restorative material between resin cement and the light-curing unit can reduce light transmission. This study aimed to evaluate the effect of the light-blocking effect of zirconia crown on shear bond strength (SBS) between three dual-cured resin cements and the zirconia surface.

Materials and methods

Sixty zirconia specimens were prepared and divided into three groups according to the type of resin cement [RXU (RelyX Ultimate); SC2 (SmartCem2); MEC (Maxcem Elite Chroma)]. Each group was further divided into two subgroups, with or without a 1-mm-thick zirconia crown (n = 10). The specimens were light-cured from five different directions for 20 s each. All specimens were thermocycled 5000 times and subjected to SBS testing, followed by scanning electron microscope examination.

Results

The presence of a 1-mm-thick zirconia crown had no significant effect on the SBS in all resin cements. However, the SBS was significantly affected by type of resin cement. RXU showed the highest SBS (8.35 MPa with crown; 8.57 MPa without crown), followed by SC2 (5.48 MPa with crown; 5.57 without crown) and then MEC (3.37 MPa with crown; 4.04 MPa without crown. Fractured surfaces exhibited varying degrees of mixed failure patterns.

Conclusion

A 1-mm-thick zirconia crown material between the light source and the dual-cured resin cement did not significantly influence the SBS of the resin cements on the zirconia substrates. RXU exhibited the highest SBS regardless of zirconia crown coverage. With sufficient light-curing, dual-cured resin cements can be a good choice for zirconia crown cementation.

In vitro performance of an autocured universal adhesive system in bonding to dentin

BACKGROUND

The successful integration of resin-based dental adhesives significantly impacts restorative dentistry, providing efficient and aesthetically pleasing caries treatments. Among various adhesives, one-step self-etching adhesives (1-SEAs) have gained popularity due to their simplicity and short application time. However, concerns have been raised regarding their bonding performance and marginal adaptation characteristics, which differ from two-step self-etching adhesives (2-SEAs) and three-step etch-and-rinse adhesives. Additionally, light-cured bonding materials may encounter challenges in deep cavities and inaccessible areas, necessitating extended light irradiation time. Autocured bonding materials are a potential solution, but limited comparative studies have been conducted on their performance.

METHODS

In this in vitro study, we evaluated a new autocured universal bonding material (Bondmer Lightless 2) and compared the results with recent light-cured bonding materials. Microshear bond strength (μSBS) tests were performed on 25 human molars using five different combinations of adhesives and composite resins: Bondmer Lightless 2 with Estelite Bulk Fill Flow (BE group), Bondmer Lightless 2 with a prototype composite resin (BO group), Prime&Bond Universal with SDR flow + (PS group), Scotchbond Universal with Filtek Bulk Fill (SF group), and G-Premio Bond with Gracefil BulkFlo (GG group). The bond strengths and failure modes were assessed using a universal testing machine and scanning electron microscope (SEM), respectively. Marginal adaptation was evaluated using swept-source optical coherence tomography (SS-OCT) and confocal laser scanning microscopy (CLSM) on 40 sound bovine maxillary incisors.

RESULTS

The μSBS test showed no significant differences in bond strength among the tested groups. Most failure modes were observed at the bond interface between the adhesive and the dentin. The autocured bonding material demonstrated significantly higher marginal adaptation (SI%) than PS, SF, and GG. The CLSM images corresponded with gaps observed in the SS-OCT images, indicating improved marginal sealing in the autocured group.

CONCLUSIONS

The new autocured universal bonding material exhibited comparable bond strength to a conventional light-cured material while demonstrating a superior marginal adaptation level. This finding suggested that the autocured material could be a valuable alternative, especially when extended light irradiation would pose a challenge. Further clinical studies would be warranted to evaluate the performance of the autocured bonding material in actual restorative dental practice.

Fracture resistance of CAD/CAM blocks cemented on dentin using different cementation strategies

PURPOSE

To determine whether the fracture resistance of computer-aided design/computer-aided manufacturing (CAD/CAM) resin-based composites and polymer-infiltrated ceramic network materials cemented on dentin is influenced by the restoration thickness and composite cement application strategy.

METHODS

Disc-shaped specimens (Ø = 7 mm) of 0.8 mm and 1.5 mm thicknesses were milled from two CAD/CAM materials: resin-based composite (RBC, Cerasmart 270) and polymer-infiltrated ceramic network (PICN, Vita Enamic). The discs (n = 8 per group) were cemented on flattened dentin using three different cementation strategies: 1) self-adhesive composite cement (RelyX U200) in light-curing mode (LC-SAC), 2) universal adhesive (Single Bond Universal) with composite cement (RelyX Ultimate) in auto-curing mode (AC cement), and 3) adhesive and composite cement as in 2) but in light-curing mode (LC cement). The restorative surface was indented perpendicularly with a compressive load using a universal testing machine until fracture. The fracture resistance (N) of RBC and PICN was separately analyzed using two-way ANOVA and Tukey's post-hoc test (α = 0.05).

RESULTS

The fracture resistance of each material was significantly influenced by the material thickness and cementation strategy (P < 0.05). Irrespective of the material type and cementation strategy, thicker materials exhibit higher fracture resistance. For RBC, the fracture resistance of the LC cement group was significantly higher than that of AC cement only at 0.8 mm thickness. For PICN, the LC-cement cementation strategy produced superior fracture resistance, regardless of the restoration thickness.

CONCLUSIONS

The fracture resistance of Cerasmart 270 was higher for the thicker material; the fracture resistance of LC cement was higher than that of AC cement at 0.8 mm thickness cemented to dentin. In comparison, LC cement showed the highest fracture resistance for Vita Enamic for both material thicknesses.

Effects of Short-Term Exposure of Chloramine-T Solution on the Characteristics of Light-Cured and Chemical-Cured Adhesives

This study evaluated the effect of a 0.5% chloramine T solution on a chemical-cured universal adhesive by comparing the light-cured, one-step, self-etch adhesive for the bonding performance, mechanical properties, and resin-dentin interfacial characteristics. Caries-free human molars were randomly assigned into eight groups based on the bonding systems employed (Bond Force II, BF and Bondmer Lightless, BL), the immersion solutions used before bonding (0.5% chloramine T solution and distilled water), and the immersion durations (5 and 60 min). Microtensile bond strength (μTBS), nanoleakage evaluation, and nanoindentation tests were performed, and the surface morphology of the resin-dentin interface was examined using a focus ion beam/scanning ion microscopy system. Immersion in chloramine-T for 5 min significantly decreased the μTBS of Bondmer Lightless (from 22.62 to 12.87 MPa) compared with that in distilled water. Moreover, there was also a decreasing trend after immersing in chloramine-T for 60 min (from 19.11 to 13.93 MPa). Chloramine T was found to have no effect on the hardness, elastic modulus, or morphological characteristics of the ion-beam milled resin-dentin interfacial surfaces in the tested adhesives, suggesting that chloramine T might reduce the bond strength by interfering with the interaction and the sealing between the adhesive resin and dentin in the chemical-cured universal adhesive, albeit without affecting the mechanical properties.

Shear Bond Strength of Resin Luting Materials to Lithium Disilicate Ceramic: Correlation between Flexural Strength and Modulus of Elasticity

This study investigates the effect of the curing mode (dual-cure vs. self-cure) of resin cements (four self-adhesive and seven conventional cements) on their flexural strength and flexural modulus of elasticity, alongside their shear bond strength to lithium disilicate ceramics (LDS). The study aims to determine the relationship between the bond strength and LDS, and the flexural strength and flexural modulus of elasticity of resin cements. Twelve conventional or adhesive and self-adhesive resin cements were tested. The manufacturer's recommended pretreating agents were used where indicated. The shear bond strengths to LDS and the flexural strength and flexural modulus of elasticity of the cement were measured immediately after setting, after one day of storage in distilled water at 37 °C, and after 20,000 thermocycles (TC 20k). The relationship between the bond strength to LDS, flexural strength, and flexural modulus of elasticity of resin cements was investigated using a multiple linear regression analysis. For all resin cements, the shear bond strength, flexural strength, and flexural modulus of elasticity were lowest immediately after setting. A clear and significant difference between dual-curing and self-curing modes was observed in all resin cements immediately after setting, except for ResiCem EX. Regardless of the difference of the core-mode condition of all resin cements, flexural strengths were correlated with the LDS surface upon shear bond strengths (R² = 0.24, n = 69, p < 0.001) and the flexural modulus of elasticity was correlated with them (R² = 0.14, n = 69, p < 0.001). Multiple linear regression analyses revealed that the shear bond strength was 17.877 + 0.166, the flexural strength was 0.643, and the flexural modulus was (R² = 0.51, n = 69, p < 0.001). The flexural strength or flexural modulus of elasticity may be used to predict the bond strength of resin cements to LDS.

Adhesive application after ceramic surface treatment is detrimental to load-bearing capacity under fatigue of a lithium disilicate glass-ceramic

OBJECTIVE

To evaluate whether an adhesive application after surface treatment on a lithium disilicate ceramic (LD) has an influence on its load-bearing capacity under fatigue.

METHODS

LD discs (Ø= 10 mm; thickness= 1 mm) were allocated into 8 groups (n= 15), considering 3 factors: "ceramic surface treatment" - HF: hydrofluoric acid + universal primer application; or MEP: single-component ceramic primer; "adhesive application" - with or without; and "aging protocol" - baseline: 24 h to 7 days; or aging: 180 days of storage + 25,000 thermal cycles. The LD discs were adhesively bonded to glass fiber-reinforced epoxy resin discs (Ø= 10 mm; thickness= 2 mm) and stored according to the condition and each group. Cyclic fatigue testing (initial load= 100 N; step size= 100 N until600 N and after step size= 25 N to failure; 10,000 cycles/step; 20 Hz frequency) was performed. Fractographic and adhesive interface analyzes were also performed. The collected data were then analyzed by Kaplan Meier and Mantel-Cox tests and One-way ANOVA.

RESULTS

The adhesive application in the baseline condition had no influence on the load-bearing capacity under fatigue when the HF surface treatment was performed, however, adhesive application for the MEP treatment led to worse results than without it. The adhesive application in the aged condition showed worse fatigue outcomes for both treatments. All specimens presented radial cracks. MEP treatment followed by adhesive application presented the thickest luting layer.

CONCLUSION

The adhesive application after surface treatments of a lithium disilicate glass-ceramic is detrimental to its load-bearing capacity under fatigue when adhesively luted onto a supporting substrate.

Effects of Material Thickness and Pretreatment on the Interfacial Gap of Translucent Zirconia Restorations with Self-adhesive Resin Cement

Purpose

The first objective was to determine if the dual-curing of self-adhesive resin cement (SAC) with reduced light penetrating through zirconia had an effect on interfacial gap of zirconia restorations. The second purpose was to examine whether pretreatment methods for universal adhesive affected interfacial gap. The last aim was to compare the microhardness of SAC polymerized under different zirconia thicknesses.

Methods and Materials

This study evaluated self-adhesive resin cement (RelyX U200, 3M ESPE) after different pretreatment with universal adhesive (Single Bond Universal, 3M ESPE) under different polymerization conditions. CAD/CAM inlay cavities were prepared on extracted third molars. Translucent zirconia restorations were milled using Katana UTML (Kuraray). The teeth were divided into three groups: Groups I, II, and III in which the restoration thicknesses were 1, 2, and 3 mm. Each Group had three subgroups according to different pretreatment methods. For subgroup-1, no pretreatment was done on the prepared cavity. For subgroup-2, universal adhesive was applied and light-cured before cement placement (precure method). For subgroup-3, universal adhesive was applied; however, light-curing was done after cement placement (cocure method). After thermo-cycling, the interfacial gap at the restoration-tooth interface was investigated using swept-source optical coherence tomography imaging. Finally, microhardness was measured for SAC under different zirconia thicknesses. For statistical analysis, the interfacial gap was analyzed using two-way analysis of variance (ANOVA) to test the effect of cavity depth and pretreatment. In terms of each cavity depth and pretreatment, the interfacial gap was compared using one-way ANOVA and Scheffe’s test. One-way ANOVA was also performed for comparison of the Vickers hardness results.

Results

Different thicknesses of the restoration resulted in differences in interfacial gaps except between the precure method of Groups I and II (p&lt;0.05). The effect of universal adhesive pretreatment was different depending on the restoration thickness with exceptions in Groups I and III (p&lt;0.05). Vickers hardness number decreased as the low radiant exposure of light was applied (p&lt;0.05).

Conclusion

Interfacial gap of zirconia restorations can differ depending on the material thickness, pretreatment, and activation mode. Reduced light intensity penetrating through zirconia may lead to higher interfacial gap percentage and lower microhardness of the self-adhesive resin cement. Application of a universal adhesive showed similar or reduced interfacial gaps in the cement space.

Full mapping tensile bond strength of luting in search for differences due to centripetal curing shrinkage

OBJECTIVES

testing if hypothetical transverse centripetal strains due to polymerization contraction of luting materials produce differential alterations in its bonding to luted structures, depending on distances to the center of the luting mass, and if this effect is C-factor related. Two hypotheses were tested: (1) there is a statistically significant decreasing relationship between the bonding strength and the transverse distances to the center of the luting material, and (2) there is a statistically significant difference between bonding strengths among luting spaces with different configuration factors.

METHODS

10 PMMA (15 mm Ø) pairs of cylinders were cemented (Scotchbond Universal adhesive & Relyx Universal, both chemically cured) in a compliant setup under two (20 and 70 N) luting forces forming 2 groups (5 samples each), resulting in different C-factors. Whole samples were sectioned in x and y directions obtaining non-trimmed beams from all along the luting surfaces. Their relative positions in each sample were assessed before separating and categorized (10 categories) according to their distances to the center of the sample. All beams were tested in tension and, because of their uneven bonding areas and to balance its influence, UTS results were transformed into UTS_res. First hypothesis was tested trough a linear relationship between UTS_res and distances to vertical centers per samples. Second hypothesis was tested using Mann-Whitney U tests to compare UTS_res between groups, along all categories. Further Weibull analysis was applied.

RESULTS

ANOVA's p of the regression UTS_res - categories were statistically significant for all samples in group 70 N and for all except one in group 20 N: first hypothesis is partially maintained. Although Mann-Whitney tests p comparing UTS_res of both groups for all categories but the first were statistically significant this hypothesis was maintained relying in Weibull analysis.

SIGNIFICANCE

bonded attachment of cemented materials decreases from centers to outbounds in plane, extensive surfaces, and this decrease is C-factor related.

Influence of the resin-coating technique on the bonding performance of self-adhesive resin cements in single-visit computer-aided design/computer-aided manufacturing resin restorations

OBJECTIVE

This in vitro study investigated the influence of resin coating on the bonding performance of self-adhesive resin cements in single-visit computer-aided design (CAD)/computer-aided manufacturing (CAM) resin restorations.

MATERIALS AND METHOD

CAD/CAM resin (1.5-mm thick) was mounted on 20 noncoated and 20 resin-coated human dentin surfaces using dual-cured self-adhesive resin cements (Panavia SA Cement Plus or Panavia SA Cement Universal, Kuraray Noritake Dental) in either self-curing or dual-curing mode. These specimens were sectioned into beam-shaped sticks and subjected to microtensile bond strength tests after 24 h of water storage. The obtained data were statistically analyzed with three-way analysis of variance (ANOVA) and t tests (α = 0.05).

RESULTS

The three-way ANOVA results revealed the significant influence of resin coating, resin cement, and curing mode. Resin coating and light curing led to higher bond strengths in almost all groups. Resin-coated dentin with Panavia SA Cement Plus exhibited a mean bond strength greater than 35 MPa in both self-curing and dual-curing modes.

CONCLUSIONS

In single-visit CAD/CAM resin restorations, resin coating, resin cement selection, and curing mode influenced the bonding performance of self-adhesive resin cements. In addition, resin coating and light curing increased the bond strength of self-adhesive resin cements. Resin coating and light curing are encouraged for predictable bonding performance of dual-cured self-adhesive resin cements in single-visit CAD/CAM resin restorations.

Effect of Water Storage on Hardness and Interfacial Strength of Resin Composite Luting Agents Bonded to Surface-Treated Monolithic Zirconia

Background: Durable bonding between resin composite luting agents (CLA) and zirconia is still a matter of controversy. The purpose of this study was to evaluate the effect of water storage on hardness and interfacial strength of three CLA, a non-adhesive (Multilink Automix/ML), an adhesive (Panavia F 2.0/PF) and a self-adhesive (PermaCem 2.0/PC), bonded to polished (CL) and grit-blasted (AL: 50 μm alumina, SJ: Sil-Jet + Monobond Plus silane) monolithic zirconia surfaces. Methods: CLA specimens (n = 5/cement, condition) were prepared, stored under dry conditions or immersed in water, and Vickers hardness (VH) measurements were obtained at 1 h, 24 h, 1 week and 3 weeks intervals. Optical profilometry was used to determine the roughness parameters (Sa, Sz, Sdr, Sci) of zirconia surfaces (n = 5/treatment). A shear strength test (SBS, n = 10 × 2/cement) was performed to assess the strength and fractography of the cements bonded to zirconia after isothermal water storage and thermal-cycling (TC). Results: PF demonstrated significantly lower VHN after water storage at all time intervals, PC at 1 w, 3 w and ML at 3 w. SJ and AL showed significantly higher values from CL in all roughness parameters. Weibull analysis revealed the following significance in σ_ο ranking within the same material: AL, SJ, ALTC > SJTC, CL > CLTC (PF); SJ, SJTC, AL, ALTC > CL, CLTC (PC) and SJ, SJTC > AL > ALTC > CL, CLTC (ML). Within the same surface treatment subgroups, the significance in σ_o ranking was PC, ML > PF (before/after TC) for SJ; PC > PF > ML (before TC), PC, PF > ML (after TC) for AL, and PC > PF > ML (before/after TC) for CL. For the m ranking, the only significant difference within each material group was found in PC (AL > ALTC) and for the same surface treatment in AL (PC > ML). Conclusion: There are significant differences in the water plasticization susceptibility of the CLA tested; the materials with adhesive monomers were the most affected. Tribo-chemical silica coating combined with a silane coupling agent was the most efficient bonding treatment for the non-adhesive and the self-adhesive materials. The adhesive CLA performed better on alumina-blasted than on tribo-chemically coated surfaces.

Touch-Cure Polymerization at the Composite Cement-Dentin Interface

Ceramic restorations are often adhesively luted onto the tooth prep. The so-called touch-cure concept was developed to yield optimum polymerization of composite cement at the restoration-cement-tooth interface for immediate bond stabilization. Although this touch cure is theorized to initiate polymerization at the interface when the accelerator in the primer makes contact with the cement, this process has not yet been proven. This study aimed to elucidate the mechanism of touch cure by measuring the degree of conversion (DC) of composite cement applied with or without an accelerator-containing tooth primer (TP) versus an accelerator-free primer using real-time Fourier-transform infrared spectroscopy (RT-FTIR) and attenuated total reflection (ATR)-FTIR. Interfacial bond strength was measured in shear mode, the accelerator composition confirmed by X-ray fluorescence analysis (XRF), and the interfacial interaction of TP and composite cement with dentin investigated by X-ray diffraction (XRD), focused-ion-beam scanning electron microscopy (FIB-SEM) with 3-dimensional interface reconstruction, and transmission electron microscopy (TEM). RT/ATR-FTIR revealed the significantly highest DC when the composite cement was applied with the accelerator-containing primer. XRF disclosed a vanadium compound as a novel chemical accelerator within TP, instead of a classic chemical curing initiator system, to set off touch cure as soon the cement contacts the previously applied primer. Although the TP contains the acidic functional monomer 10-MDP for adhesion to tooth tissue, touch cure using the accelerator-containing TP combined the fastest/highest DC with the highest bond strength. FIB-SEM and TEM confirmed the tight interfacial interaction at dentin with submicron hybridization along with stable 10-MDP also Ca-salt nanolayering.

Chitin Nanocrystals as an Eco-friendly and Strong Anisotropic Adhesive

To solve the damage to the environment and human body caused by organic solvent adhesives in the utilization process, chitin nanocrystal (ChNC) suspension is explored as a strong anisotropic adhesive, which is an eco-friendly and water-based adhesive with high adhesive strength. ChNCs extracted from crab shells are rod-like nanoparticles with high aspect ratios, which are mainly employed as reinforcing polymer nanocomposites and biomedicine nanomaterials. ChNC suspension sandwiched between substrates forms a long-range ordered superstructure by a self-assembly process. ChNC nanoglue exhibits high anisotropy adhesion strength, i.e., an in-plane shear strength (5.26 MPa) and an out-of-plane shear strength (0.46 MPa) for glass substrates. Moreover, the ChNC nanoglue is suitable to many substrates, such as glass, plastic, wood, metal, paper, etc. The ChNC nanoglue shows high biocompatibility toward the fibroblast cell and rat skin, proving their excellent biosafety. As an eco-friendly and high-performance adhesive, ChNC nanoglue shows promising applications in daily life and industrial fields.

CAD/CAM-fabricated inlay restorations: Can the resin-coating technique improve bond strength and internal adaptation?

This study assessed the effect of the resin-coating technique on the bond strength and internal adaptation of computer-aided design/computer-aided manufacturing (CAD/CAM)-fabricated inlays. Seventy-two mesio-occlusal-distal (MOD) cavities were prepared and distributed into 3 groups according to the resin-coating technique utilized: uncoated group, G-Premio Bond (1-step) group, and Clearfil SE Bond 2+Clearfil Majesty ES Flow (2-step+Flow) group. The MOD inlays were fabricated and cemented with RelyX Ultimate (RXU), G-CEM LinkForce (LinkForce), or Panavia V5 (PV5). After 5,000 thermal cycles, each specimen was sectioned and subjected to microtensile bond strength (MTBS) testing and an internal adaptation evaluation. For the uncoated group, RXU exhibited higher MTBS than LinkForce and PV5 (p<0.05). The MTBS of all 1-step and 2-step+Flow groups was greater than 30 MPa. Resin coating did not influence the MTBS of RXU, whereas resin coating increased the MTBS of LinkForce and PV5. More than 95% gap-free margins were found in all groups.

Effect of Pretreatment and Activation Mode on the Interfacial Adaptation of Nanoceramic Resin Inlay and Self-adhesive Resin Cement

OBJECTIVES

The first objective of this study was to determine if the luting material used for resin nanoceramic inlay affects interfacial adaptation. The second was to investigate whether pretreatment and the adhesive curing method before cementation affects interfacial adaptation. The final objective was to compare activation modes of luting material.

METHODS

Class I cavities were prepared on extracted human third molars. Resin nanoceramic inlays were fabricated using Lava Ultimate CAD/CAM block (3 M). For the control groups, inlays were cemented using Panavia V5 (Kuraray Noritake). For the experimental groups, teeth were randomly divided into five experimental groups with four subgroups using different self-adhesive cements (SACs). Cement in Group I was dual-cured without pretreatment. In Group II, the cement was dual-cured after polyacrylic acid treatment of the tooth cavity. In Groups III and IV, the cement was dual-cured after universal dentin adhesive treatment with pre-cure and co-cure methods. In Group V, the inlay was cemented in self-cure mode. After thermocycling, interfacial adaptation at the inlay-tooth interface was measured using swept-source optical coherence tomography (SS-OCT) imaging. Finally, polymerization shrinkage strain of the luting material was measured and compared.

RESULTS

Interfacial adaptation differed depending on the luting material. After application of a universal adhesive, some subgroups showed improved interfacial adaptation. Interfacial adaptation and polymerization shrinkage strain differed significantly depending on activation mode.

SIGNIFICANCE

Interfacial adaptation for a resin nanoceramic inlay can differ according to the type of SAC and activation mode. For some SACs, application of a universal adhesive before cementation improves interfacial adaptation.

Evaluation of bond strength of dual resin cements to CAD/CAM-created lithium disilicate ceramic

BACKGROUND

The objective was to examine the microshear bond strength values of different dual resin cements to computer-aided design (CAD)/computer-aided manufacturing (CAM)-created ceramics containing lithium disilicate, which underwent different surface treatments.

METHODS

Two dual resin cements (RelyX ARC and RelyX Ultimate) and three surface treatments of lithium disilicate ceramic blocks (Ceramic Primer (CP; containing silane) plus Adper Scotchbond Multipurpose (ASM) adhesive; CP plus Single Bond Universal (SBU) adhesive; and SBU adhesive alone) were tested. The SBU adhesive includes silane in its formulation. Each sample underwent a microshear test and bond strength values were subjected to analysis of variance (ANOVA) followed by Tukey's test (α=0.05). Fracture patterns were also observed with light microscopy.

RESULTS

RelyX ARC treated with CP+ASM or CP+SBU presented resistance values that were significantly higher than the same treatments for RelyX Ultimate. Conversely, for the blocks treated with SBU alone, the mean resistance value for RelyX Ultimate was higher than that of RelyX ARC. Regarding the different types of treatment for each resin, the mean resistance value of RelyX ARC treated with CP+ASM was significantly highest, followed by treatment with CP+SBU and SBU treatment alone. Meanwhile, RelyX Ultimate treated with CP+ASM or CP+SBU presented resistance values that were significantly higher than SBU treatment alone. In all of the groups, an adhesive fracture pattern was predominantly observed.

CONCLUSIONS

The present results indicate that silanization is important for ASM and SBU adhesives to be effective.

Silane-coupling effect of a silane-containing self-adhesive composite cement

OBJECTIVE

Hydrofluoric-acid etching followed by silanization is a routine clinical protocol for durable bonding to glass ceramics. Simplifying ceramic-bonding procedures, new technological developments involve the inclusion of a silane coupling agent in a self-adhesive composite cement. To investigate the effectiveness of the incorporated silane coupling agent, shear bond strength (SB) to ceramic and dentin, contact angle of water (CA), transmission electron microscopy (TEM), X-ray diffraction (XRD) and ²⁹Si nuclear magnetic resonance (NMR) assessments were correlatively conducted.

MATERIALS AND METHODS

SB to glass ceramic was measured without ('immediate') and with ('aged') 50K thermocycles upon application of (1) the silane-containing self-adhesive composite cement Panavia SA Cement Universal ('SAU'), being light-cured: 'SAU_light', (2) 'SAU_chem': chemically cured SAU, (3) 'SAP_light': light-cured Panavia SA Cement Plus ('SAP'), and (4) 'SAP_CP': SAP light-cured after separate silanization using Clearfil Ceramic Primer Plus ('CP'). CA was also measured on glass ceramic. The cement pastes before and upon mixing were characterized using ²⁹Si NMR. SB of SAU or SAP onto dentin was measured. Finally, the cement-dentin interface was characterized by TEM and XRD.

RESULTS

The immediate and aged SB to glass ceramic of SAU did not significantly differ from those of SAP_CP, while they were significantly higher than those of SAP. CA of SAU did not significantly differ from that of SAP_CP, but it was significantly higher than CA of SAP. ²⁹Si NMR revealed siloxane bonds after mixture. SB of SAU and SAP to dentin did not show any significant difference. SEM, TEM and XRD confirmed tight and chemical interaction, respectively.

SIGNIFICANCE

Incorporating silane in a 10-MDP-based self-adhesive composite cement combined efficient silane-coupling ability at the ceramic surface with effective bonding ability at dentin.

Dual-curing resin cement with colour indicator for adhesively cemented restorations to dental tissues: Change of colour by curing and some physical properties

The study was aimed to investigate a color indicator containing dual curing resin composite luting cement and to plot the color change to the time of solidification of the cement. In addition some physical properties were studied. Specimens were made of a dual-cure resin cement (Maxcem Elite™ Chroma, Kerr, Orange, CA, USA) and polymerized by autopolymerization only, or with light initiated polymerization. A spectrophotometer was used to quantify the color change of the cement as plotted with the curing time. The efficacy of the curing process was studied by measuring water sorption and the ultimate flexural properties of the cement. The results showed that the flexural strength of cement after autopolymerization was 27.3 MPa and after light initiated polymerization 48.1 MPa. Young’s modulus of bending was 2089.3 MPa and 3781.5 MPa respectively for the same cement samples. Water sorption after two weeks for the autopolymerization cement samples was −1.12 wt% and for the light initiated polymerization samples 0.56 wt%. Non-parametric Spearman’s correlation was measured for autopolymerized cement samples between variables for color and solidification load (N), which showed a strong correlation between curing process and color change (p < 0.05). There was a correlation between the color change and degree of monomer conversion of the dual curing resin composite luting cement which contained a color indicator system for polymerization reaction. The study also suggested that autopolymerization only resulted in suboptimal polymerization of the cement. By additional light curing considerably higher flexural properties were obtained.

Influence of Ambient Temperature and Light-curing Moment on Polymerization Shrinkage and Strength of Resin Composite Cements

Objective:

The purpose of this study was to establish a clinically appropriate light-curing moment for resin composite cements while achieving the highest indirect tensile strength and lowest polymerization shrinkage.

Methods and Materials:

Polymerization shrinkage of seven resin composite cements (Multilink Automix, Multilink Speed Cem, RelyX Ultimate, RelyX Unicem 2 Automix, Panavia V5, Panavia SA plus, VITA Adiva F-Cem) was measured at ambient temperatures of 23°C and 37°C. Testing was done for autopolymerized and light-cured specimens after light application at either 1, 5, or 10 minutes after mixing. Indirect tensile strength of all cements was measured after 24 hours of storage at temperatures of 23°C and 37°C, for autopolymerized and light-cured specimens after light application 1, 5, or 10 minutes after mixing. To illustrate filler size and microstructures, SEM images of all cements were captured. Statistical analysis was performed with one-way ANOVA followed by post hoc Fisher LSD test (α=0.05).

Results:

Final polymerization shrinkage of the resin composite cements ranged from 3.2% to 7.0%. An increase in temperature from 23°C to 37°C as well as the light-curing moment resulted in material dependent effects on the polymerization shrinkage and indirect tensile strength of the cements. Polymerization shrinkage of the cements did not correlate with the indirect tensile strength of the cement in the respective groups. Highest indirect tensile strengths were observed for the materials containing a homogeneous distribution of fillers with a size of about 1 μm (Multilink Automix, Panavia V5, VITA Adiva F-Cem).

Conclusion:

The magnitude of the effect of light-curing moment and temperature increase on polymerization shrinkage and indirect tensile strength of resin composite cements is material dependent and cannot be generalized.

Influence of abutment height and convergence angle on the retrievability of cement-retained implant prostheses with a lingual slot

PURPOSE

Cement-retained implant prostheses can lack proper retrievability during repair, and residual cement can cause peri-implantitis. The purpose of this in vitro study was to evaluate the influence of abutment height and convergence angle on the retrievability of cement-retained implant prostheses with lingual slots, known as retrievable cement-type slots (RCS).

MATERIALS AND METHODS

We fabricated six types of titanium abutments (10 of each type) with two different heights (4 mm and 6 mm), three different convergence angles (8°, 10°, and 12°), a sloped shoulder margin (0.6 mm depth), a rectangular shape (6 mm × 6.5 mm) with rounded edges, and a rectangular ledge (2 mm × 1 mm) for the RCS. One monolithic zirconia crown was fabricated for each abutment using a dental computer-aided design/computer-aided manufacturing system. The abutments and crowns were permanently cemented together with dual-curing resin cement, followed by 24 hours in demineralized water at room temperature. Using a custom-made device with a slot driver and torque gauge, we recorded the torque (N·cm) required to remove the crowns. Statistical analysis was conducted using multiple regression analysis and Mann-Whitney U tests (α=.05).

RESULTS

Removal torques significantly decreased as convergence angles increased. Multiple regression analysis showed no significant interaction between the abutment height and the convergence angle (Durbin-Watson ratio: 2.186).

CONCLUSION

Within the limitations of this in vitro study, we suggest that the retrievability of cement-retained implant prostheses with RCS can be maintained by adjusting the abutment height and convergence angle, even when they are permanently cemented together.

Effect of previous photoactivation of the adhesive system on the color stability and mechanical properties of resin components in ceramic laminate veneer luting

STATEMENT OF PROBLEM

The color stability and mechanical properties of luting agents influence the esthetics and longevity of ceramic restorations. However, studies evaluating the color changes and mechanical properties of luting agents under ceramic laminates activated by using different methods are lacking.

PURPOSE

The purpose of this in vitro study was to evaluate the effects of different modes of photoactivation on the nanohardness and elastic modulus of resin cements and dental adhesives and on the color stability of ceramic laminate veneers.

MATERIAL AND METHODS

Forty-four lithium disilicate blocks (7×8×0.6 mm) were cemented onto bovine enamel and divided into 4 groups according to the polymerization light (Radii-Cal or Valo) used and the mode of activation of the dental adhesive (no previous photoactivation or previous photoactivation). Single Bond Universal dental adhesive and RelyX Veneer resin cement were used in all experimental groups. Color stability was measured using a UV-2450 ultraviolet-visible spectrophotometer before and after ultraviolet-B artificial accelerated aging (n=8). The nanohardness and the elastic modulus of the adhesive and resin cement were measured using a nanohardness tester (n=3). The color stability and mechanical properties were measured and analyzed using ANOVA and the Tukey least significant difference test (α=.05).

RESULTS

No difference in color stability or mechanical properties of the resin cement among the polymerization lights was detected (P>.05). Specimens that underwent previous photoactivation of the adhesive using the Valo polywave unit exhibited higher elastic modulus values than those that did not undergo previous photoactivation (P<.001).

CONCLUSIONS

The Valo polywave polymerization light improved mechanical properties and color stability more than the Radii-Cal unit. Previous activation of the dental adhesive in the dental enamel with the Valo polywave polymerization light yielded more satisfactory results.

Effect of Different Adhesive Strategies and Time on Microtensile Bond Strength of a CAD/CAM Composite to Dentin

PURPOSE

The aim of this study was to evaluate the effect of adhesive strategy and time on the microtensile bond strength of a computer-aided design/computer-aided manufacturing (CAD/CAM) composite to dentin.

METHODS AND MATERIALS

Sixty CAD/CAM composite blocks were bonded to human dentin with simplified bonding agents using etch-and-rinse and self-etching approaches and amine-based and amine-free resin cements, with and without the application of a dual-cure activator (DCA; n=10): SBP-ARC (Adper Single Bond Plus + RelyX ARC), SBP-RXU (Adper Single Bond Plus + RelyX Ultimate), SBP-DCA-RXU (Adper Single Bond Plus + DCA + RelyX Ultimate), SBU-ARC (Scotchbond Universal + RelyX ARC), SBU-RXU (Scotchbond Universal + RelyX Ultimate), and SBU-DCA-ARC (Scotchbond Universal + DCA + RelyX ARC). Each specimen was light cured for 40 seconds under load and stored in distilled water at 37°C for seven days. Stick-shaped specimens (1.0 mm²) were obtained. Half of the specimens underwent microtensile bond strength testing, and the other half were subjected to the same tests after six months of storage. Failure mode was determined using an optical microscope (40×). The data were analyzed by a two-way analysis of variance followed by the Games-Howell test and Student t-test (preset alpha of 0.05).

RESULTS

After seven days, SBU-RXU presented the highest mean bond strength, statistically different from only SBU-ARC (p<0.05). Most of the groups exhibited a statistically significant reduction in bond strength after 6 months (p<0.05), except SBP-RXU and SBU-ARC (p>0.05).

CONCLUSION

The adhesive strategy, with different associations between adhesive systems and resin cements, as well as the use of a DCA, affected the bond strength of both amine-free and amine-based resin cements to a CAD/CAM composite.

Influence of pre-heating and ceramic thickness on physical properties of luting agents

PURPOSE

The objective of this in vitro study was to evaluate the influence of ceramic thickness and pre-heating of luting agents on their physical properties.

MATERIALS AND METHODS

The materials RelyX Arc, RelyX Ultimate, RelyX Veneer, and Filtek Z350 Flow were handled at different temperatures (23°C or 54°C), inserted into matrix, and photoactivated through ceramic disks (0.75 mm or 1.5 mm). The following tests were performed ( n=8): degree of conversion, Knoop Hardness, cross-link density, water sorption, solubility, and ultimate tensile strength. Data were analyzed using three-way analysis of variance and Tukey's test (α=0.05).

RESULTS

Regarding ceramic thickness, the thinnest ceramic resulted in higher values of Knoop Hardness ( p=0.027). The lowest temperature (23°C) resulted in a higher solubility ( p=0.0257), and water sorption ( p=0.0229) values. There was also statistical difference among the materials: RelyX Arc showed a higher degree of conversion and ultimate tensile strength, followed by RelyX Veneer, RelyX Ultimate, and Filtek Z350 Flow. For Knoop Hardness and cross-link density tests, RelyX Ultimate showed the highest values, followed by RelyX Arc, RelyX Veneer, and Filtek Z350 Flow. For water sorption and solubility, RelyX Veneer showed the highest values, followed by RelyX Arc, RelyX Ultimate, and Filtek Z350 Flow.

CONCLUSION

Pre-heating interfered with water sorption and solubility, whereas ceramic thickness only affected Knoop Hardness; the physical properties of the materials are dependent on their composition.

The strategies used for curing universal adhesives affect the micro-bond strength of resin cement used to lute indirect resin composites to human dentin

We evaluated the effect of different curing strategies for universal adhesives on micro-tensile bond strength (μTBS) between resin cement and dentin and/or between resin cement and indirect resin composite. Flat coronal dentin surfaces and composite resin disks were pretreated with silane-containing universal adhesives, with or without light-curing on the dentin-side and/or composite resin disk-side. Resin disks were luted onto the pretreated dentin surfaces with the corresponding dual-cure adhesive resin cements and light-cured, and cut into beams after 24-h water storage. After 0 or 10,000 thermocycles (5ºC/55ºC) in a water bath, the μTBS of the composite resin disk-dentin beam was tested. The μTBS was highest when universal adhesives were applied to both the dentin- and the indirect composite resin disk-side, followed by light-curing. Thermocycling decreased μTBS in all but the Scotchbond Universaltreated group, with light-curing on both sides. The effect of curing strategies is dependent upon the materials.

Influence of light activation of simplified adhesives on the shear bond strength of resin cements to a leucite-reinforced ceramic

Objective

This study aims to evaluate the influence of the light activation of simplified adhesives on the shear bond strength of resin cements to a glass-ceramic. Three factors were evaluated: (1) cement in two levels (light cured and dual cured); (2) adhesive in two levels (Single Bond 2 and Single Bond Universal), and (3) light activation in two levels (yes or no).

Materials and Methods

Thirty-two 1-mm thick slices of a leucite-reinforced glass-ceramic (IPS Empress CAD) were divided into eight groups according to adhesive (Single Bond 2 or Single Bond Universal), cement (AllCem Veneer or AllCem), and light activation of the adhesive before application of the cement (yes or no). Ceramic surfaces were etched for 60 s with 5% hydrofluoric acid, and adhesives were applied. Four cement cylinders were made over each ceramic slice (n = 16) and then submitted to shear bond strength tests.

Statistical Analysis

Data were analyzed with three-way ANOVA and Tukey (α = 0.05).

Results

There were significant differences between adhesives (P < 0.0001) and no differences between cements (P = 0.0763) and light activation (P = 0.4385). No interaction effect occurred (P = 0.05). Single Bond 2 showed higher bond strength than Single Bond Universal.

Conclusions

The light activation of the adhesive before the application of the resin cement did not influence the bond strength.

Influence of Photoinitiator on Accelerated Artificial Aging and Bond Strength of Experimental Resin Cements

Abstract The goal of this study was to evaluate in vitro the effect of the photoinitiator phenylpropanedione (PPD), alone or combined with camphorquinone (CQ), on color stability of photoactivated resin cements and their bond strength to ceramics using a micro-shear test. Four resin cements were used: a commercial brand cement (RelyX Veneer®) and 3 experimental cements with different types and concentration of photoinitiators. For color analysis, ceramic discs were cemented on bovine dentin specimens to simulate indirect restorations (n=8) and were exposed to UV for 120 h and tested for color alteration using a reflectance spectrophotometer and the CIEL*a*b* system. Data were analyzed by Anova and Tukey’s test at 5% significance level. The color test results did not present statistically significant difference for the ∆E for all the studied cements, neither for ∆L, ∆a and ∆b. For the bond strength, all the studied cements showed statistically significant differences to each other, with the highest result for the RelyX Veneer® (29.07 MPa) cement, followed by the cement with CQ (21.74 MPa) and CQ+PPD (19.09 MPa) cement; the lowest result was obtained by the cement using only PPD as a photoinitiator (13.99 MPa). So, based on the studied parameters, PPD was not advantageous as photoinitiator of resin cements, because it showed a low value of bond strength to the ceramics and no superior color stability.

Short- and Long-Term Bond Strength Between Resin Cement and Glass-Ceramic Using a Silane-Containing Universal Adhesive

This study aimed to evaluate the effect of various silane-containing solutions on bonding between resin cement and glass ceramic after 24 hours and after six months of water storage. Glass-ceramic plaques (IPS e.max CAD) were sandblasted with aluminum oxide, etched with 10% hydrofluoric acid (HF), and divided into five “silane treatment” groups: RelyX Ceramic Primer (RCP), RelyX Ceramic Primer and Single Bond Plus (RCP+SB), Scotchbond Universal (SBU), Clearfil Ceramic Primer (CP), and no solution (HF-only control). Each group was divided into two “storage time” subgroups: 24 hours or six months in 37°C water. Eighteen resin cement cylinders (RelyX Ultimate) were bonded to each treatment group substrate (n=18) and then subjected to microshear testing. Failure mode was analyzed using scanning electron microscopy. Debond data were analyzed using a two-way analysis of variance and the Tukey post hoc test (α=0.05) as well as Weibull distributions. The factors “silane treatment,” “storage time,” (p&lt;0.0001), and their interaction were statistically significant (p&lt;0.0010). Group means (MPa±SD), RCP (24 hours: 27.2±3.1; six months: 18.0±4.9), and HF-only control (24 hours: 21.1±3.4; six months: 15.7±5.8) showed a reduced bond strength after six months of water storage, while RCP + SB (24 hours: 23.4±4.4; six months: 22.2±5.4), SBU (24 hours: 18.8±3.0; six months: 17.2±3.6), and CP (24 hours: 21.7±4.3; six months: 17.4±4.8) remained constant. Weibull analysis revealed that more reliable bond strengths were obtained after six months for SBU and RCP + SB. Evaluation by scanning electron microscopy revealed that all groups demonstrated hydrolytic degradation at six months of storage, but RCP + SB and SBU indicated less. Use of a separate application of silane and adhesive system improved short and long-term ceramic/resin cement bond strength.

Dentin bond strength of two resin-ceramic computer-aided design/computer-aided manufacturing (CAD/CAM) materials and five cements after six months storage

The aim was to investigate dentin bond strength of two resin-ceramic materials and five cements after 24 h and six months storage. Cylinders (n=15/group) of Lava Ultimate (3M ESPE) and VITA ENAMIC (VITA Zahnfabrik) were cemented to mid-coronal dentin of 300 extracted human molars with RelyX Ultimate (3M ESPE), PANAVIA F2.0 (Kuraray), Variolink II (Ivoclar Vivadent), els cem (Saremco Dental), or Ketac Cem Plus (3M ESPE). Shear bond strength (SBS) was measured after 24 h or six months storage (37°C, 100% humidity) and statistically analyzed (significance level: α=0.05). SBS varied markedly between Lava Ultimate and VITA ENAMIC, between the five cements, and between storage of either 24 h or six months. After six months, SBS was highest when Lava Ultimate was cemented with RelyX Ultimate and when VITA ENAMIC was cemented with RelyX Ultimate or with Variolink II. Lava Ultimate was somewhat more sensitive to storage than was VITA ENAMIC.

Effect of Curing Mode on Shear Bond Strength of Self-Adhesive Cement to Composite Blocks

To overcome the disadvantages of computer-aided design/computer-aided manufacturing (CAD/CAM) processed indirect restorations using glass-ceramics and other ceramics, resin nano ceramic, which has high strength and wear resistance with improved polish retention and optical properties, was introduced. The purpose of this study was to evaluate the shear bond strength and fracture pattern of indirect CAD/CAM composite blocks cemented with two self-etch adhesive cements with different curing modes. Sand-blasted CAD/CAM composite blocks were cemented using conventional resin cement, Rely X Ultimate Clicker (RXC, 3M ESPE, St. Paul, MN, USA) with Single Bond Universal (SB, 3M ESPE, St. Paul, MN, USA) for the control group or two self-adhesive resin cements: Rely X U200 (RXU, 3M ESPE, St. Paul, MN, USA) and G-CEM Cerasmart (GC, GC corporation, Tokyo, Japan). RXU and GC groups included different curing modes (light-curing (L) and auto-curing (A)). Shear bond strength (SBS) analyses were performed on all the specimens. The RXC group revealed the highest SBS and the GC A group revealed the lowest SBS. According to Tukey's post hoc test, the RXC group showed a significant difference compared to the GC A group (p < 0.05). For the curing mode, RXU A and RXU L did not show any significant difference between groups and GC A and GC L did not show any significant difference either. Most of the groups except RXC and RXU L revealed adhesive failure patterns predominantly. The RXC group showed a predominant cohesive failure pattern in their CAD/CAM composite, Lava^TM Ultimate (LU, 3M ESPE, St. Paul, MN, USA). Within the limitations of this study, no significant difference was found regarding curing modes but more mixed fracture patterns were showed when using the light-curing mode than when using the self-curing mode.

The influence of intrinsic water permeation on different dentin bonded interfaces formation

OBJECTIVES

To determine the effects of intrinsic wetness on the formation of dentin bonding interfaces of four resin cement systems bonded to dentin under different pulpal pressures.

METHODS

Thirty-six freshly extracted third molars were selected and processed for dentin μTBS. The teeth were randomly assigned into 12 experimental groups, according to the adhesive luting system [Adper Single Bond Plus (3M ESPE) combined with two luting agents RelyX ARC (3M ESPE) and heated Filtek Z250 Universal Restorative (3M ESPE), Clearfil CD Bond (Kuraray) combined with Clearfil Esthetic Cement (Kuraray), and RelyX Unicem 2 Automix (3M ESPE)] and pulpal pressure (0, 5, and 20 cm of simulated pulpal pressure). Leucite-reinforced glass-ceramic slabs (IPS Empress CAD, Ivoclar Vivadent) of 3mm thickness were bonded to dentin. The samples were stored in distilled water for 24h and then sectioned in X/Y directions across the adhesive interface to obtain specimens with a cross section of 0.8 ± 0.2mm(2). All sticks were fractured by tension at a crosshead speed of 1.0mm/min and the data were submitted to Kruskal-Wallis and Mann-Whitney Tests (α=0.05). Ultrastructural analysis of the interfaces was performed using Confocal Laser Scanning Microscopy (CLSM) and Scanning Electron Microscopy (SEM).

RESULTS

The statistical analyses showed that pulpal pressure decreased μTBS for all groups. Significantly higher μTBS values were obtained in heated Z250 group restored without any pulpal pressure. CLSM showed that the uptake of water through the dentin tubuli and their anastomosis of lateral branches during the adhesive luting procedures prevented adequate formation of the dentin bonding interfaces. SEM showed that the luting film created is material- dependent and all adhesive failure occurred at the resin-dentin interface.

CONCLUSION

The constant intrinsic wetness replenishment prevents adequate formation of the hybrid layer.

CLINICAL SIGNIFICANCE

Intrinsic moisture during adhesive luting procedures significantly affects the interaction between luting materials and dentin subtract and decreases the quality and bonding strength of the resin-dentin bond.

Correlation between clinical performance and degree of conversion of resin cements: a literature review

Resin-based cements have been frequently employed in clinical practice to lute indirect restorations. However, there are numerous factors that may compromise the clinical performance of those cements. The aim of this literature review is to present and discuss some of the clinical factors that may affect the performance of current resin-based luting systems. Resin cements may have three different curing mechanisms: chemical curing, photo curing or a combination of both. Chemically cured systems are recommended to be used under opaque or thick restorations, due to the reduced access of the light. Photo-cured cements are mainly indicated for translucent veneers, due to the possibility of light transmission through the restoration. Dual-cured are more versatile systems and, theoretically, can be used in either situation, since the presence of both curing mechanisms might guarantee a high degree of conversion (DC) under every condition. However, it has been demonstrated that clinical procedures and characteristics of the materials may have many different implications in the DC of currently available resin cements, affecting their mechanical properties, bond strength to the substrate and the esthetic results of the restoration. Factors such as curing mechanism, choice of adhesive system, indirect restorative material and light-curing device may affect the degree of conversion of the cement and, therefore, have an effect on the clinical performance of resin-based cements. Specific measures are to be taken to ensure a higher DC of the luting system to be used.

Influence of Photoinitiator and Light-Curing Source on Bond Strength of Experimental Resin Cements to Dentin

Abstract This study evaluated the bond strength (BS) of experimental resin cements formulated with different photoinitiators when activated by two kinds of light-curing units (LCUs) through a ceramic material. Seven resin blends with different camphorquinone (CQ) and/or phenylpropanedione (PPD) concentrations (weight) were prepared: C5: 0.5% CQ; C8: 0.8% CQ; P5: 0.5% PPD; P8: 0.8% PPD; C1P4: 0.1% CQ and 0.4% PPD; C4P1: 0.4% CQ and 0.1% PPD; C4P4: 0.4% CQ and 0.4% PPD. Two LCUs were used: one quartz-tungsten-halogen (QTH - 850 mW/cm²) and one light-emitting diode (LED - 1300 mW/cm²). The microtensile bond strength of each blend was assessed. Data were submitted to two-way ANOVA and Tukey's test (α=0.05). The BS values did not exhibit significant differences for LCUs, regardless of the photoinitiator type. Three cements showed significant differences: P5 and C5 had higher BS with QTH, and C4P1 with LED. For QTH, P5 showed the highest and C1P4 the lowest BS. For the LED, C4P1 showed the highest BS of all the cements. The results indicated that PPD was a viable alternative in the formulation of photocured resin cements, reducing or eliminating CQ that is yellowish without impairing the bond strength. Furthermore, both LED and QTH were effective in curing resin cements that contain PPD or CQ.

Cementation of Glass-Ceramic Posterior Restorations: A Systematic Review

Aim. The aim of this comprehensive review is to systematically organize the current knowledge regarding the cementation of glass-ceramic materials and restorations, with an additional focus on the benefits of Immediate Dentin Sealing (IDS). Materials and Methods. An extensive literature search concerning the cementation of single-unit glass-ceramic posterior restorations was conducted in the databases of MEDLINE (Pubmed), CENTRAL (Cochrane Central Register of Controlled Trials), and EMBASE. To be considered for inclusion, in vitro and in vivo studies should compare different cementation regimes involving a “glass-ceramic/cement/human tooth” complex. Results and Conclusions. 88 studies were included in total. The in vitro data were organized according to the following topics: (micro)shear and (micro)tensile bond strength, fracture strength, and marginal gap and integrity. For in vivo studies survival and quality of survival were considered. In vitro studies showed that adhesive systems (3-step, etch-and-rinse) result in the best (micro)shear bond strength values compared to self-adhesive and self-etch systems when luting glass-ceramic substrates to human dentin. The highest fracture strength is obtained with adhesive cements in particular. No marked clinical preference for one specific procedure could be demonstrated on the basis of the reviewed literature. The possible merits of IDS are most convincingly illustrated by the favorable microtensile bond strengths. No clinical studies regarding IDS were found.

Effect of dentin pretreatment and curing mode on the microtensile bond strength of self-adhesive resin cements

PURPOSE

The aim was to evaluate the effect of curing mode and different dentin surface pretreatment on microtensile bond strength (µTBS) of self-adhesive resin cements.

MATERIALS AND METHODS

Thirty-six extracted human permanent molars were sectioned horizontally exposing flat dentin surface. The teeth were divided into 12 groups (3 teeth/group) according to the dentin surface pretreatment methods (control, 18% EDTA, 10% Polyacrylic acid) and curing mode (self-curing vs. light-curing) of cement. After pretreatment, composite resin blocks were cemented with the following: (a) G-CEM LinkAce; (b) RelyX U200, followed by either self-curing or light-curing. After storage, the teeth were sectioned and µTBS test was performed using a microtensile testing machine. The data was statistically analyzed using one-way ANOVA, Student T-test and Scheffe's post-hoc test at P<.05 level.

RESULTS

For G-CEM LinkAce cement groups, polyacrylic acid pretreatment showed the highest µTBS in the self-cured group. In the light-cured group, no significant improvements were observed according to the dentin surface pretreatment. There were no significant differences between curing modes. Both dentin surface pretreatment methods helped to increase the µTBS of RelyX U200 resin cement significantly and degree of pretreatment effect was similar. No significant differences were found regarding curing modes except control groups. In the comparisons of two self-adhesive resin cements, all groups within the same pretreatment and curing mode were significantly different excluding self-cured control groups.

CONCLUSION

Selecting RelyX U200 used in this study and application of dentin surface pretreatment with EDTA and polyacrylic acid might be recommended to enhance the bond strength of cement to dentin.

Meta-analysis of Bonding Effectiveness to Zirconia Ceramics

Dental zirconia can no longer be considered un-bondable to tooth tissue. In literature, an increasing number of papers indeed report on the bonding effectiveness of different luting techniques to zirconia. We aimed to disclose general trends in bonding to zirconia by systematically collecting zirconia bond-strength data. A search in PubMed and EMBASE revealed 1,371 bond-strength tests reported on in 144 papers. A macro-shear bond-strength protocol was most frequently used; it revealed significantly lower bond strengths and was less discriminative than the other test methods. Regarding luting technique, the combination of mechanical and chemical pre-treatment appeared particularly crucial to obtain durable bonding to zirconia ceramics. The cement choice was not revealed as a determining factor after aging conditions, as long as composite cement was used. Regarding test protocol, a tensile test appeared more discriminative, particularly when combined with ‘water storage’ aging.