Comparison of two test designs for evaluating the shear bond strength of resin composite cements

The impact of various surface treatments and Er-YAG laser irradiation on the bond strength of resin matrix CAD/CAM ceramics to resin cement

PURPOSE

The aim of the study was to assess the impact of various surface treatments, including an Er: YAG laser with different power outputs, on the shear bond strength (SBS) of different resin matrix CAD/CAM ceramic materials to resin luting cement.

MATERIALS AND METHODS

Specimens from Lava Ultimate (LU) and Vita Enamic (VE) were categorized based on the surface treatment: no treatment, sandblasting (Sb), 10% hydrofluoric acid (Ac) etching, sandblasting followed by acid etching (Sb + Ac), and Er: YAG laser irradiation at 2 W and 3 W (L1, L2). Scanning electron microscopy (SEM) evaluation and roughness measurement of the samples were performed. Silane was applied to half of the specimens, resin cement was bonded and SBS testing was performed.

RESULTS

The SBS did not differ depending on the material (P = 0.081), but varied according to the surface treatment (P < 0.001). The highest mean SBS value was observed in the Sb + Ac (15.20) group. The highest roughness median was in Sb of VE, which was similar to Sb + Ac and Sb of all materials.

CONCLUSION

Applying Sb and Ac together was more effective than applying them separately. Although 2 W and 3 W Er-YAG applications were ineffective for treating VE's surface, 2 W Er-YAG applications can be suggested for LU.

CLINICAL RELEVANCE

The combined application of Sb and Ac is more effective than their individual applications and laser irradiation in terms of resin matrix CAD/CAM ceramics retention.

Bond strength of conventional resin-based adhesive cement and self-adhesive resin cement to CAD-CAM restorative materials

PURPOSE

The aim of this study was to compare the shear bond strengths of four distinct CAD/CAM restorative materials using conventional resin-based adhesive cement and self-adhesive resin cement.

MATERIALS AND METHODS

Specimens (14 mm × 18 mm × 2 mm) were obtained for each restorative material: IPS e.max CAD (Ivoclar Vivadent (LEICHTENSTEIN), GC Cerasmart (GC-Corp. JAPAN), Vita-Enamic (Vita-ZahnFabrik, GERMANY), and Cerec Blocks (Dentsply Sirona, USA) (n = 12). Ceramic surfaces were applided with both conventional resin-based adhesive cement (LF) (GC-LinkFORCE, GC Corp., JAPAN) and self-adhesive resin cements (CO) (G-Cem One, GC Corp., JAPAN). The shear bond strength test of 96 specimens were calculated and other 96 specimens were measured this test following thermal cycles (10000 thermal cycles at 5-55 oC (SD Mechatronik THERMOCYCLR, Gmbh). Shear bond strength results were statistically analyzed by independent samples t test, one-way ANOVA, two-way ANOVA, four-way ANOVA and for one and all test Post Hoc Tukey HSD test.

RESULTS

After thermal cycles, a significant difference was observed between the shear bond strength of LF and CO cements to all ceramics except IPS e.max CAD ceramic (p < 0.05). After thermal cycling, LF cement had the strongest shear bond strength values with GC Cerasmart and the weakest bond values with Vita Enamic. CO cement had the strongest shear bond values with Cerec Blocks ceramics and the weakest bond values with GC Cerasmart. Cohesive type fractures were the most prevalent and adhesive type fractures were the least frequent both before and after thermal cycle. The type of material had a significant effect on the type of fracture after thermal cycle application (p < 0.05).

CONCLUSIONS

Thermal cycle application caused a decrease in the shear bond strength values of two kind of resin cements to all ceramics. It can be concluded that self-adhesive composite resin cement (G-CemONE) are suitable for leucite-reinforced glass-ceramic and lithium disilicate ceramics, and conventional resin-based adhesive cement (GC-LinkFORCE) is suitable for resin nanoceramic material and polymer-infiltrated glass-ceramic material types.

Effects of a Two-Step Silver Diamine Fluoride Varnish on Shear Bond Strength of Restorations, Dentin and Enamel Hardness, and Biofilm Formation

INTRODUCTION

Dental caries are a limiting factor in maintaining dental and medical readiness in the military. Untreated dental caries can lead to dire health consequences. Consistent and comprehensive access to dental care is often limited due to the intensive operational demands on our nation's warfighters. The standard of care for dental caries is a surgical model where diseased tooth tissue is surgically removed and restored with appropriate restorative materials. While effective, it is not practical in the military operational environment, especially under time constraints. Dental restoratives offer military personnel a simple and preventive treatment of dental caries and are suitable as self-applied first aids. The purpose of this study was to measure the shear bond strengths of two dental restorative materials to human teeth paired with two different fluoride treatments and the hardness and biofilm formation on teeth after applying the fluoride varnishes.

MATERIALS AND METHODS

Specimens were made of human molar teeth treated with each of the following four materials: glass ionomer cement GC Fuji II LC Capsules, Filtek Z250, Riva Star steps 1 and 2, or Mark3 NaF varnish. Step 1 of Riva Star consists of silver diamine fluoride and step 2 contains potassium iodide. On human molar slabs, 10 circular specimens of 5 cm in diameter were prepared with restoratives according to manufacturer procedures. Etch-Rite and a proprietary aluminum chloride-based cavity conditioner were used as etchants on tooth surfaces for the Filtek Z250 and glass ionomer cement, respectively. After at least 24 hours underwater, each assembly was removed, and the shear bond strength of the adhesive was measured according to International Organization for Standardization (ISO) 29022.The hardness was measured according to ISO 14233. Hardness measurements were performed before varnish application, then after storage in an incubator at 37 °C for 4 hours in a demineralization solution (pH = 4.5), and after 1 day in a mineralization solution (pH = 7). A crystal violet staining assay was used to measure biofilm formation of Streptococcus mutans bacteria on human molar teeth after the application of fluoride varnish.

RESULTS

We report a 16% increase in shear bond strength of the Filtek Z250/Riva Star coupled treatment compared to the Filtek Z250/Mark3 NaF coupled treatment. We also demonstrate a significant 84% decrease in bond strength with a GC Fuji II LC/Mark3 NaF treatment compared to control (P = .0002), while Riva Star remains statistically unchanged. Enamel and dentinal hardness are significantly improved when Riva Star is applied compared to NaF varnish. A 25%-35% (P < .0001) decrease in oral biofilm formation was observed on samples where a Riva Star or NaF varnish was applied.

CONCLUSIONS

Mechanical and antimicrobial testing indicated Riva Star, compared favorably with and in some cases, performed better in the laboratory than a Mark3 NaF varnish. Hardness measurements indicated Riva Star is more effective in dentin tubule occlusion compared to NaF varnish. Our findings help provide practical suggestions to dental treatment, particularly to the unique dental environments seen in the military. Riva Star may be used as an adjunctive treatment prior to placing a final restoration. This study supports the use of Riva Star in conjunction with GC Fuji II LC or Filtek Z250 restorative materials, making it a promising treatment in military dental applications.

Influence of the Application Time of Silane for the Bonding Performance between Feldspar or Lithium Disilicate Ceramics and Luting Resin Composites

A correct silanization time is essential for successful surface functionalization and sufficient bonding to dental ceramics. The shear bond strength (SBS) of lithium disilicate (LDS) and feldspar (FSC) ceramics and luting resin composite was investigated with respect to different silanization times, taking into account the physical properties of the individual surfaces. The SBS test was performed with a universal testing machine, and the fracture surfaces were evaluated by stereomicroscopy. The surface roughness of the prepared specimens was analyzed after etching. Changes in surface properties due to surface functionalization were evaluated by surface free energy (SFE) via contact angle measurement. Fourier transform infrared spectroscopy (FTIR) was used to determine the chemical binding. The roughness and SBS of the control group (no silane, etched) were higher for FSC than for LDS. Regarding the SFE, the dispersive fraction increased and the polar fraction decreased after silanization. FTIR confirmed the presence of silane on the surfaces. The SBS of LDS showed a significant increase from 5 to 15 s, depending on the silane and luting resin composite. For FSC, cohesive failure was observed for all samples. For LDS specimens, a silane application time of 15 to 60 s is recommended. Based on clinical conditions, no difference between the silanization times was observed for FSC specimens, indicating that etching alone produces sufficient bonding.

Comparison of the Micro-Shear Bond Strength of Resin Cements to CAD/CAM Glass Ceramics with Various Surface Treatments

This study aimed to compare the effect of acid etching, sandblasting, or silica coating on the micro-shear bond strength of dual-cured resin cements to computer-aided design and computer-aided manufacturing (CAD/CAM) glass ceramic materials. Feldspathic, lithium disilicate, and zirconia-reinforced CAD/CAM ceramics were divided into four groups: control group (C), no surface treatment; hydrofluoric (HF) group, 5% HF acid-etched; sandblasting (SB) group, abraded with 50 µm aluminum oxide (Al₂O₃) particles; silica-coated (CJ) group, abraded with 30 µm silica-modified Al₂O₃ particles. Roughness values were obtained by using a profilometer. The cements were condensed on the surface-treated specimens and a micro-shear bond test was conducted. The ceramic material (p < 0.001) and surface treatment type (p < 0.001) significantly affected the micro-shear bond strength values. HF acid etching can be recommended for the surface pretreatment of feldspathic, lithium disilicate, and zirconia-reinforced CAD/CAM ceramics. Better bond strengths can be obtained with HF acid etching than with sandblasting and silica coating.

Current Protocols for Resin-Bonded Dental Ceramics

Resin-bonded ceramic restorations are common treatment options. Clinical longevity of resin-bonded ceramic restorations depends on the quality and durability of the resin-ceramic bond. The type and composition of the specific ceramic determines the selection of the most effective bonding protocol. Such protocol typically includes a surface pretreatment step followed by application of a priming agent. Understanding of fundamental ceramic properties and chemical compositions enables the clinician to make proper material selection decisions for clinically successful and long-lasting restorations. Based on research accrued over the past decades, this article reviews and discusses current resin-bonding protocols to most commonly used dental ceramics.

Adhesion to a Zirconia-reinforced Lithium Silicate Ceramic: Effects of Ceramic Surface Treatments and Resin Cements

OBJECTIVE

This study had the objective to test the effect of ceramic surface treatments on the microshear bond strength (μSBS) of different resin cements to a zirconia-reinforced lithium silicate (ZLS).

METHODS AND MATERIALS

ZLS blocks were sectioned, embedded in acrylic resin, and then allocated into nine groups considering two study factors: "ceramic surface treatment" (HF - hydrofluoric acid; EP - self-etching primer; TBS - tribochemical silica coating) and "resin cements" (nMDP - without MDP monomer; MDP - with MDP monomer; SA - self-adhesive). Starch tubes (n=36) were placed on the treated ceramic surface and the cement was applied. Starch tubes were removed after 24 hours of storage, and the specimens were thermocycled (5,000×; 5°C-55°C). Next, the μSBS test was performed using the wire-loop technique, and topographic and failure analyses were performed.

RESULTS

The factors "ceramic surface treatment" and "resin cement" statistically influenced the μSBS results. Considering the surface treatment factor, the TBS produced statistically lower values when the MDP resin cement was applied, being only similar to the MDP plus EP group. For the resin cement factor, no difference was found for nMDP and SA groups, apart from the surface treatments. Failure analysis showed that the groups treated with EP had a greater number of pre-test failures. The surface treatments induced noteworthy topographic alterations when compared to control (no treatment).

CONCLUSION

The ZLS ceramic surface treatment with tribochemical silica coating associated with the MDP-containing resin cement resulted in lower bond strength values.

Bonding CAD/CAM materials with current adhesive systems: An overview

Objective

Data sources

Results

Conclusion

A comprehensive in vitro study on the performance of two different strategies to simplify adhesive bonding

Objective

The purpose of this study is to compare the bonding performance and mechanical properties of two different resin composite cements using simplified adhesive bonding strategies.

Materials and methods

Shear bond strength of two resin composite cements (an adhesive cement: Panavia V5 [PV5] and a self‐adhesive cement: RelyX Universal [RUV]) to human enamel, dentin, and a variety of restorative materials (microfilled composite, composite, polymer‐infiltrated ceramic, feldspar ceramic, lithium disilicate and zirconia) was measured. Thermocycle aging was performed with selected material combinations.

Results

For both cements, the highest shear bond strength to dentin was achieved when using a primer (PV5: 18.0 ± 4.2 MPa, RUV: 18.2 ± 3.3 MPa). Additional etching of dentin reduced bond strength for RUV (12.5 ± 4.9 MPa). On enamel, PV5 achieved the highest bond strength when the primer was used (18.0 ± 3.1 MPa), while for RUV etching of enamel and priming provided best results (21.2 ± 6.6 MPa). Shear bond strength of RUV to restorative materials was superior to PV5. Bonding to resin‐based materials was predominantly observed for RUV.

Conclusions

While use of RUV with the selective‐etch technique is slightly more labor intensive than PV5, RUV (with its universal primer) displayed a high‐bonding potential to all tested restorative materials, especially to resin.

Clinical significance

For a strong adhesion to the tooth substrate, PV5 (with its tooth primer) is to be preferred because etching with phosphoric acid is not required. However, when using a wide range of varying restorative materials, RUV with its universal primer seems to be an adequate option.

Shear bond strength of ceramic laminate veneers to finishing surfaces with different percentages of preserved enamel under a digital guided method

Background

The purpose of this in vitro study was to evaluate the effect of the percentages of preserved enamel on ceramic laminate veneers’ (CLVs) shear bond strength (SBS).

Methods

Seventy extracted human maxillary central incisors were scanned and reconstructed into three-dimensional models. The extracted teeth were then embedded and randomly divided into seven groups (n = 10 per group). Based on digital analyses of the three-dimensional models, guided tooth preparation and bonding procedures were performed individually to form seven different percentages (100%, 80%, 60% 50%, 40%, 20% and 0%) of remaining enamel thickness on the bonding surface. Finally, the SBS test was performed, and the data were statistically analysed by one-way ANOVA with LSD post hoc test (α = 0.05).

Results

The complete enamel surface exhibited the highest SBS (19.93 ± 4.55 MPa), followed by 80% enamel (19.03 ± 3.66 MPa), 60% enamel (18.44 ± 3.65 MPa), 50% enamel (18.18 ± 3.41 MPa), 40% enamel (17.83 ± 3.01 MPa) and 20% enamel (11.32 ± 3.42 MPa) group. The lowest SBS (9.63 ± 3.46 MPa) was detected in 0% enamel group. No significant difference was observed among the 40–100% enamel groups, while the 20% or 0% enamel group demonstrated a significantly lower mean SBS than the 40% enamel group (p < 0.05).

Conclusion

The SBS value of CLVs bonded to 100% enamel on the finishing surfaces (nearly 20 MPa) was twice that which bonded to 0% enamel (nearly 10 MPa). Bonding to 100% enamel is the most reliable treatment. When dentin exposure is inevitable, enamel should be preserved as much as possible to maintain good bonding. In addition, 40% of preserved enamel on the bonding surface was the minimal acceptable value to fulfil the requirements of good bonding strength.

Evaluation of Micro-Shear Bond Strength of Four Different CAD-CAM Polymer-Infiltrated Ceramic Materials after Thermocycling

PURPOSE

To evaluate the bond strength of three monolithic hybrid ceramics/resin nanoceramics and a zirconia-reinforced lithium silicate to resin cement after thermocycling.

MATERIALS AND METHODS

Using four materials, including Vita Enamic (VITA Zahnfabrik), Lava Ultimate (3M ESPE), Crystal Ultra (Digital Dental), and Vita Suprinity (VITA Zahnfabrik), 64 specimens were prepared with dimensions of 4mm×3mm×1.5mm. Vita Suprinity samples were sintered at 840°C for 8 min. After polishing and cleaning all the samples in each group (n = 16), they were subjected to their recommended surface treatment: 10% hydrofluoric acid for Vita Enamic (60s) and Vita Suprinity (20s); air abrasion of Lava Ultimate and Crystal Ultra with 50μ Al₂ O₃ particles. Then, tygon tubes were filled with dual cure resin cement (Panavia F2.0), cured and then subjected to thermal cycling (2000 cycles; 5-55°C). The micro-shear bond strength was measured using micro-tensile testing machine. The data were analyzed using Welch and Games-Howell tests (α = 0.05). The mode of failure was also evaluated using a stereomicroscope.

RESULTS

The highest and the lowest mean micro-shear bond strength belonged to the Crystal Ultra (7.71 ±1.54 MPa) and Vita Suprinity (4.73 ±1.87 MPa) groups, respectively. The differences between groups were significant and Crystal Ultra had higher bond strength in comparison to all three materials (p<.05).

CONCLUSION

Hybrid ceramics showed higher bond strength to resin cements in comparison to resin nanoceramics and zirconia-reinforced lithium silicate materials. This article is protected by copyright. All rights reserved.

Comparison between Hydrofluoric Acid and Single-Component Primer as Conditioners on Resin Cement Adhesion to Lithium Silicate and Lithium Disilicate Glass Ceramics

This study aimed at evaluating the effects of different surface conditionings on the microshear bond strength (µSBS) of a self-adhesive resin cement to VITA Suprinity (ZLS) and IPS e.max CAD (LD). Three surface conditioning protocols were performed on ZLS and LD before luting with a self-adhesive resin cement (RelyX Unicem 2, RXU): hydrofluoric acid (HF), HF + silane (HF + S), or Monobond Etch & Prime (EP). In each group, 15 cylindrical buildups of RXU were prepared on five milled bars and submitted to a µSBS test. Data were statistically analyzed with two-way ANOVA and Tukey’s post hoc test (p < 0.05). Failure modes were recorded and classified as adhesive, mixed, cohesive in resin, or ceramic, and statistically analyzed with Fisher’s exact test (p = 0.05). One additional bar per group was used for the morphological characterization of the conditioned surface by means of SEM. The material per se did not significantly influence adhesion (p = 0.744). Conditioning protocol was a significant factor: EP yielded significantly higher μSBS than HF (p = 0.005), while no significant differences emerged between EP and HF + S (p = 0.107), or HF + S and HF (p = 0.387). The material-conditioning protocol interaction was not statistically significant (p = 0.109). Significant intergroup differences were found in distribution of failure modes: mixed failures were predominant in the ZLS/EP group, while the other groups showed a prevalence of adhesive failures. The self-etching primer showed promising results in terms of immediate bond strength of a self-adhesive resin cement to lithium-silica-based glass ceramics, suggesting its alternative use to hydrofluoric acid and silane conditioning protocols.

Examining the effects of acid etching duration on the bond strength between two CAD/CAM materials and one composite resin

This study aimed to evaluate the effect of three hydrofluoric acid (HF) etching periods on the micro-tensile bond strength between two CAD-CAM ceramic systems [Vita Suprinity (VS) and feldspathic CEREC blocs (CB)] and a composite resin. The ceramics were categorized into six groups based on the surface conditioning protocol used, as follows: G1: CB-HF 5% for 20 s; G2: CB-HF 5% for 40 s; G3: CB-HF 5% for 60 s; G4: VS-HF 5% for 20 s; G5: VS-HF 5% for 40 s; G6: VS-HF 5% for 60 s. Scotchbond Universal was applied onto the pretreated ceramic surfaces and covered with Filtek Z350 XT composite resin. After 24 h, the specimens were cut into microbars (n = 16) and a micro-tensile bond strength test (μTBS) was carried out. An optical microscope was used to examine the fractured microbars. The results showed statistically significant differences between the factors tested (p < 0.01). Moreover, the mean MPa of G1(17.27), G2(13.03), G3(12.82), G4(15.83), G5(21.66), and G6(14.50) was seen to significantly differ. The predominant failure type observed was adhesive, and all three periods of HF etching produced satisfactory bonding between the composite resin and CB. An etching time of 40 s provided the highest μTBS value for VS.

Fatigue Behavior of Monolithic Zirconia-Reinforced Lithium Silicate Ceramic Restorations: Effects of Conditionings of the Intaglio Surface and the Resin Cements

OBJECTIVE

This study assessed the effect of conditioning of the intaglio surface and resin cements on the fatigue behavior of zirconia-reinforced lithium silicate ceramic (ZLS) restorations cemented to a dentin analogue.

METHODS

ZLS ceramic (Ø=10 mm, thickness=1.5 mm) and dentin analogue (Ø=10 mm, thickness=2.0 mm) discs were produced and allocated according to the study factors, totaling nine study groups: ceramic surface treatment (three levels: hydrofluoric acid etching [HF]; self-etching ceramic primer [EP]; tribochemical silica coating [TBS]) and resin cement (three levels: 10-methacryloyloxydecyl dihydrogen phosphate [nMDP]; MDP-containing conventional resin cement [MDP]; self-adhesive resin cement [SA]). The ceramic bonding surfaces were treated and cemented on the dentin analogue, and all the specimens were aged for 5000 thermal cycles (5°C-55°C) prior to fatigue testing. The stepwise fatigue test (20 Hz frequency) started with a load of 400 N (5000 cycles) followed by steps of 500, 600, and up to 1800 N (step-size: 100 N) at a maximum of 10,000 cycles each step. The specimens were loaded until failure (crack), which was detected by light transillumination and visual inspection at the end of each step. The fatigue failure load and number of cycles for failure data were analyzed by the Kaplan-Meier (log-rank test; α=0.05). Topographic and fractographic analyses were also performed.

RESULTS

HF- (973.33-1206.67 N) and EP- (866.67-1066.67 N) treated specimens failed at statistically similar loads and higher than TBS (546.67-733.33 N), regardless of the cement used. All the fractographical inspections demonstrated failure as radial crack.

CONCLUSION

The HF and EP treatments promoted better mechanical fatigue behavior of the ceramic restoration, while tribochemical silica coating induced worse fatigue results and should be avoided for treating the ZLS surface prior to bonding.

Flexural Strength of Resin Core Build-Up Materials: Correlation to Root Dentin Shear Bond Strength and Pull-Out Force

The aims of this study were to investigate the effects of root dentin shear bond strength and pull-out force of resin core build-up materials on flexural strength immediately after setting, after one-day water storage, and after 20,000 thermocycles. Eight core build-up and three luting materials were investigated, using 10 specimens (n = 10) per subgroup. At three time periods-immediately after setting, after one-day water storage, and after 20,000 thermocycles, shear bond strengths to root dentin and pull-out forces were measured. Flexural strengths were measured using a 3-point bending test. For all core build-up and luting materials, the mean data of flexural strength, shear bond strength and pull-out force were the lowest immediately after setting. After one-day storage, almost all the materials yielded their highest results. A weak, but statistically significant, correlation was found between flexural strength and shear bond strength (r = 0.508, p = 0.0026, n = 33). As the pull-out force increased, the flexural strength of core build-up materials also increased (r = 0.398, p = 0.0218, n = 33). Multiple linear regression analyses were conducted using these three independent factors of flexural strength, pull-out force and root dentin shear bond strength, which showed this relationship: Flexural strength = 3.264 × Shear bond strength + 1.533 × Pull out force + 10.870, p = 0.002). For all the 11 core build-up and luting materials investigated immediately after setting, after one-day storage and after 20,000 thermocycles, their shear bond strengths to root dentin and pull-out forces were correlated to the flexural strength in core build-up materials. It was concluded that the flexural strength results of the core build-up material be used in research and quality control for the predictor of the shear bond strength to the root dentin and the retentive force of the post.

Effect of prolonged application of single-step self-etching primer and hydrofluoric acid on the surface roughness and shear bond strength of CAD/CAM materials

This in vitro study aimed to assess the influence of different concentrations and durations of hydrofluoric acid (HF) and Monobond Etch & Prime (MEP) etching on the surface roughness (R_a ) of different CAD/CAM materials and on the shear bond strength (SBS) of a self-adhesive resin bonded to the materials. Seventy specimens of hybrid ceramic, leucite-based glass-ceramic, lithium disilicate glass-ceramic, and zirconia-reinforced lithium silicate glass-ceramic were prepared and divided into seven groups according to the surface treatments: Control (C); MEP etching for 60 (MEP₆₀ ) and 120 (MEP₁₂₀ ) s; 5% HF etching for 60 (HF-5%₆₀ ) and 120 (HF-5%₁₂₀ ) s; 9.5% HF etching for 60 (HF-9.5%₆₀ ) and 120 (HF-9.5%₁₂₀ ) s. The R_a was measured using a 3D profilometer. All groups were treated with a universal primer except for the C, MEP₆₀ , and MEP₁₂₀ groups. A self-adhesive resin cement was bonded to all specimens, and the bond strengths were measured using a universal testing machine. All surface treatments increased both R_a and SBS values compared to the control in each material. Neither the duration of surface treatments nor the HF acid concentrations had a statistically significant effect on SBS. Within the limitations of this experimental study, it can be concluded that Monobond Etch & Prime may be a preferable method to achieve high bond strength values.

Atomic layer deposition SiO2 films over dental ZrO2 towards strong adhesive to resin

Atomic layer deposition (ALD) is a self-limiting nanoscale film deposition technology with the advantages of good stability, consistency and conformability. In this study, we proposed to deposit silica (SiO₂) films over dental zirconium-oxide (ZrO₂) by ALD for better SiO₂ films and higher bond strength between ZrO₂ and resin. To investigate the superiority of film deposited by ALD, other surface modification methods such as sol-gel, vapor phase hydrolysis and electrostatic self-assembly were compared in terms of the short-term and long-term bond strength between ZrO₂ and resin, measured by universal testing machine. Meanwhile, the surface morphology and chemical elemental analysis were characterized by scanning electron microscopy (SEM), energy dispersive spectrometer (EDS) and Fourier transform infrared spectroscopy (FTIR). Results showed that the SiO₂ films deposited by ALD or electrostatic self-assembly were uniform and consistent while sol-gel and vapor phase hydrolysis formed SiO₂ films with cracks or pores, changing the morphology of ZrO₂. ALD had the best results among all methods and increased the bond strength to 16.49 ± 1.60 MPa and 13.44 ± 1.63 MPa before and after aging respectively, which is expected to improve the long-term success rate of clinical dental ZrO₂ prostheses.

Influence of Acid Etching and Universal Adhesives on the Bond Strength to Dentin

Abstract The purpose of this study was to evaluate the influence of the application mode of three universal adhesive systems on interfacial physical properties of indirect composite restorations adhesively cemented to dentin cavities. Seventy-eight bovine lower incisors were selected and a slice of dentin (thickness: 2 mm) between the buccal surface and pulp chamber was obtained for each tooth. Conical cavities were made on this surface. The internal walls of the cavities were then coated with a hydrophilic gel, filled with composite resin and photopolymerized. The dentin/cone sets were divided into 6 groups (n=10) according to type of universal adhesive (TETRI: Tetric N Bond, FUT: Futura Bond U, SBU: Single Bond Universal) and acid etching on dentin (A: with acid etching; WA: without acid etching). The acid etching and the adhesive systems were applied to the surface of the dentin. All composite resin cones were sandblasted (Al2O3, 20 s) and silanized. After surface treatment, the cones were cemented (RelyX Ultimate) into the dentin cavity and photopolymerized. After thermocycling (10,000 cycles), samples were submitted to marginal adaptation analysis (using caries detector dye), push-out test (0.5 mm/min), and failure mode analysis. Additional samples were prepared for nanoleakage analysis (SEM). The data (MPa) were analyzed by two-way ANOVA and Tukey’s post-test (5%). The groups in which the dentin was acid etched showed significantly lower bond strength values in the push-out test (p<0.01). Dentin acid etching significantly reduced the bond strength between universal adhesive systems and dentin in indirect restorative procedures.

Bonding to industrial indirect composite blocks: A systematic review and meta-analysis

OBJECTIVE

The aim of this systematic review and meta-analysis was to evaluate the effect of surface conditioning methods on the bond strength of industrial indirect composite blocks (ICs).

METHODS

Based on the PICOS strategy, the Medline via PubMed, Embase and Web of Science (ISI - Web of Knowledge) electronic databases were searched for peer-reviewed articles in both English and Chinese, with no publication year limit. In vitro studies evaluating the effects of surface conditioning on the bond strength of ICs were selected. The meta-analysis was conducted to calculate the mean difference between surface-conditioned ICs and unconditioned controls. Subgroup analysis was performed to evaluate the different surface conditioning methods, separately for polymer-infiltrated ceramic network (PICN) material and the ICs with dispersed fillers (ICDFs). Meta-analyses were performed with a random-effects model at a significance level of 0.05.

RESULTS AND SIGNIFICANCE

From 802 relevant studies, 25 were selected for full-text analysis. Nineteen studies were eligible for inclusion in this systematic review, whereas 9 studies were included in the meta-analysis. A manual search of the principal periodicals specific to the area resulted in no additional articles. The meta-analysis indicated a significant difference in bond strength between the surface-conditioned ICs and controls under both non-aged and aged conditions. The combination of mechanical and chemical conditioning yielded the highest bond strength of ICs. This meta-analysis suggests that chemical etching followed by a universal primer and alumina air abrasion followed by a silane coupling agent could be considered the best strategy for optimizing the bond strength of PICN materials and ICDFs under aged conditions, respectively.

Comparison of Bond Strength of Monolithic CAD-CAM Materials to Resin Cement Using Different Surface Treatment Methods

Objective:

To compare the bond strength of monolithic CAD-CAM materials to resin cement using different surface treatment methods.

Materials and Methods:

Lithium disilicate glass ceramic (IPS e-max CAD), zirconia-reinforced lithium silicate ceramic (Vita Suprinity), resin nanoceramic (Lava Ultimate), and hybrid ceramic (Vita Enamic) were used. Five groups of CAD-CAM blocks were treated as follows: control (C), HF etching (HF), HF etching + silanization (HF + S), sandblasting (SB), and sandblasting + silanization (SB + S). After surface treatments, SEM analyses were conducted. Specimens were cemented with self-adhesive resin cement (Theracem) and stored in distilled water at 37°C for 24 h. Shear bond strength (SBS) was measured, and failure types were categorized. Results were analyzed using two-way ANOVA and the post-hoc Tukey test.

Results:

Statistical analysis revealed significant differences between SBS values obtained for different surface treatments and CAD-CAM block types ( P < .001). Among the CAD-CAM materials, the highest SBS was reported in the HF + S group for Vita Enamic. Although IPS e.max CAD, Vita Suprinity, and Vita Enamic showed higher bond strength when treated with HF + S, Lava Ultimate has the highest bond strength value when treated with SB + S.

Conclusions:

The bond strength of CAD-CAM materials was influenced by surface treatment. Additionally, silanization significantly improved the bond strength of all materials except Lava Ultimate.

HF etching of CAD/CAM materials: influence of HF concentration and etching time on shear bond strength

Background

The required pretreatment of CAD/CAM ceramic materials before resin composite cement application varies among studies. The aim of the present study was to evaluate the effect of hydrofluoric acid concentration and etching time on the shear bond strength (SBS) of two adhesive and two self-adhesive resin composite cements to different CAD/CAM ceramic materials.

Methods

SBS of two adhesive (Panavia V5, Kuraray, [PV5]; Vita Adiva F-Cem, Vita Zahnfabrik, [VAF]) and two self-adhesive (RelyX Unicem 2 Automix, 3 M Espe, [RUN]; Vita Adiva S-Cem, Vita, [VAS]) cements to four different CAD/CAM materials (Vitablocs Mark II, Vita, [VM]; Vita Enamic, Vita, [VE]; e.max CAD, Ivoclar Vivadent, [EC]; Vita Suprinity PC, Vita, [VS]) was measured. The effect of the surface pretreatment by using two different hydrofluoric acid products (HF5% Vita Ceramics Etch, Vita and HF9% buffered, Ultradent Porcelain Etch, Ultradent Products) were assessed at etching times of 0 s, 5 s, 15 s, 30s and 60s for each cement and restorative material combination (n = 10 per group, total n = 1440).

Results

Significant effects were found for the etching time and cement for all materials with highest shear bond strength for etching times of 60s = 30s = 15 s ≥ 5 s > 0 s and for RUN>PV5 = VAF > VAS (p < 0.05). Etching with HF5% for 5 s to 15 s resulted in higher SBS values, while no differences were observed between HF5% and HF9% buffered when the substrates were etched for 30s to 60s (p < 0.05).

Conclusions

Within the limitations of this study the recommended surface pretreatment of silicate ceramics is HF etching with concentrations of 5% or 9% for 15 s to 60s to achieve highest shear bond strength while the glassy matrix is sufficiently dissolved. The tested resin composite cements can be applied with all tested materials and suggested for clinical application.

Impact of Recently Developed Universal Adhesives on Tensile Bond Strength to Computer-aided Design/Manufacturing Ceramics

OBJECTIVES

The aim of this investigation was to test the tensile bond strength (TBS) between different computer-aided-design/manufacturing (CAD/CAM) ceramics after conditioning using different universal adhesive systems and resin composite cement.

METHODS AND MATERIALS

Substrates of four CAD/CAM ceramics-1) VITABLOCS Mark II, 2) Initial LRF, 3) Celtra Duo, and 4) IPS e.max CAD (N=648, n=162)-were fabricated. VITABLOCS Mark II and Initial LRF were etched using 9% hydrofluoric acid for 60 seconds, Celtra Duo for 30 seconds, and IPS e.max CAD for 20 seconds. Substrates for conditioning using Monobond Etch & Prime were untreated. The following adhesive systems were used: All-Bond Universal (ABU), Clearfil Universal Bond (CUB), G-Multi Primer (GMP), iBond Universal (IBU), Monobond Etch & Prime (MEP), Monobond Plus (MBP), One Coat 7 Universal (OCU), Prime&Bond Active (PBA), and Scotchbond Universal (SBU). Conditioned substrates were bonded using a resin composite cement (Variolink Esthetic DC), thermal cycled (20,000×, 5°C/55°C), and TBS was measured using a universal testing machine. Data were analyzed using univariate analysis with partial eta-squared, Kolmogorov-Smirnov, Kruskal-Wallis, Mann-Whitney U, and Spearman-Rho tests (α=0.05).

RESULTS

ABU, MEP, and MBP obtained the significantly highest TBS, while CUB, IBU, and OCO resulted in the lowest, regardless of the CAD/CAM ceramic. SBU showed varying TBS results depending on the CAD/CAM ceramic used. ABU, MEP, and MBP showed no impact of CAD/CAM ceramic on TBS values. ABU, GMP, MEP, and MBP showed predominantly cohesive failure types in luting composite, while CUB and OCU demonstrated adhesive failure types.

Precision of different fatigue methods for predicting glass-ceramic failure

This study aimed to characterize the fatigue behavior using two fatigue methods, boundary and staircase, and to predict the probability of failure (Pf) of zirconia-reinforced lithium silicate glass-ceramic (ZLS). Bar-shaped specimens of ZLS (18 ×4 ×1.2 mm) were fabricated. Thirty specimens were subjected to a three-point flexural strength test using a universal testing machine with 0.5 mm/min crosshead speed, in 37 °C distilled water. Flexural strength data were analyzed with Weibull statistics. Eighty-six bars were subjected to cyclic fatigue using boundary and staircase methods. Fatigue tests were performed in a pneumatic cycling machine (2 Hz, 37 °C distilled water) for 10 ³ and 104 cycles. Fatigue data were analyzed using an inverse power law relationship and log normal-lifetime distribution. Fracture toughness (KIc) was determined using V-notched specimens (18 ×4 ×3 mm) and the short beam toughness method (n = 7). Vickers hardness (VH) was evaluated (4.9 N, 20 s). Fractographic and EDS analyses were also performed. ZLS showed a characteristic strength of 197 MPa, Weibull modulus of 4, VH of 6.67 GPa and KIc of 1.93 MPa m1/2. After 103 cycles, for both methods, there was a degradation of 78% of the initial strength. There was no significant degradation when the number of cycles increased from 103 to 104. Both methods resulted in similar Pf and precision at 40 MPa (~50% Pf). Yet, staircase shows good accuracy and precision in predicting the stress amplitude for a Pf near 50%; while boundary is also effective for Pf lower than 50%. The fatigue methods evaluated show similar accuracy and precision for predicting the Pf of a glass-ceramic when simulations were made in the range of stress levels and lifetimes used in the fatigue tests.

Assessment of Bonding Effectiveness of Adhesive Materials to Tooth Structure using Bond Strength Test Methods: A Review of Literature

Background

The rapid developments in the field of adhesive dental materials have led to improvements in many aspects of clinical dentistry. Adhesive bond strength plays an important role in determining the clinical performance and longevity of dental restorations. Nevertheless, bond strength tests have never been well-standardized, although a number of important recommendations have been made.

Objective

The aim of this paper is to critically review the validity of different bond strength testing methods for assessment of bonding effectiveness of adhesive materials to tooth structure and discuss factors that may affect bond strength measurement.

Data Collection

Relevant literature published between 1983 and 2018 was collected and reviewed from the PubMed database and Google scholar resources.

Review Results

Results of the current bond testing methods should be used to compare materials tested under the same laboratory settings, but they shouldn't be used to make direct inferences on their clinical behaviour. Shear and micro-shear tests, result in non-uniform stress distribution, stress concentration at the substrate area, and predominantly tensile stresses rather than shear stresses. Micro-tensile bond tests provide many advantages over the shear tests, although these methods are technique sensitive and labour intensive.

Conclusion

Bond strength testing methods should be well-standardized, but there are many factors that cannot be fully controlled which leads to variation and misinterpretation of the data about the bonding abilities of adhesives.

Clinical Significance

New adhesive materials should be subjected to a combination of testing protocols to properly assess their bonding effectiveness.

Repair bond strength of resin composite to bilayer dental ceramics

PURPOSE

The purpose of this study was to investigate the effect of various surface treatments (ST) on the shear bond strength of resin composite to three bilayer dental ceramics made by CAD/CAM and two veneering ceramics.

MATERIALS AND METHODS

Three different bilayer dental ceramics and two different veneering ceramics were used (Group A: IPS e.max CAD+IPS e.max Ceram; Group B: IPS e.max ZirCAD+IPS e.max Ceram, Group C: Vita Suprinity+Vita VM11; Group D: IPS e.max Ceram; Group E: Vita VM11). All groups were divided into eight subgroups according to the ST. Then, all test specimens were repaired with a nano hybrid resin composite. Half of the test specimens were subjected to thermocycling procedure and the other half was stored in distilled water at 37℃. Shear bond strength tests for all test specimens were carried out with a universal testing machine.

RESULTS

There were statistically significant differences among the tested surface treatments within the all tested fracture types (P<.005). HF etching showed higher bond strength values in Groups A, C, D, and E than the other tested ST. However, bonding durability of all the surface-treated groups were similar after thermocycling (P>.00125).

CONCLUSION

This study revealed that HF etching for glass ceramics and sandblasting for zirconia ceramics were adequate for repair of all ceramic restorations. The effect of ceramic type exposed on the fracture area was not significant on the repair bond strength of resin composites to different ceramic types.

Bonding Polycrystalline Zirconia With 10-MDP–containing Adhesives

Objective:

The objective of this study was to evaluate the influence of adhesives with different 10-MDP concentrations on the shear bond strength of a resin cement to zirconia.

Methods and Materials:

Six experimental adhesives were prepared with the following composition: camphorquinone, 1,2-diaminobenzene, butylhydroxytoluene, diphenyliodonium hexafluorophosphate, 2-hydroxyethyl methacrylate triethylene glycol dimethacrylate, ethoxylated bisphenol A glycol dimethacrylate, urethane dimethacrylate, bisphenol A diglycidyl methacrylate, and ethanol. The 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) monomer was added at 0wt%, 3wt%, 6wt%, 9wt%, 12wt%, or 15wt%. Three commercially available adhesives were evaluated: Single Bond Universal, Single Bond 2, and Signum Zirconia Bond. Resin cement cylinders made with RelyX Ultimate were bonded to yttria-stabilized tetragonal zirconia polycrystal with one of the evaluated adhesives and were subjected to the shear bond strength evaluation. Failure modes were analyzed with a stereoscopic loupe. Statistical analyses were performed with one-way analysis of variance and the Tukey's Honestly Significant Difference test (α=0.05). Pearson's was used to correlate the percentage of 10-MDP in the experimental adhesives and shear bond strength.

Results:

There were significant differences between adhesives (p&lt;0.00001). The highest shear bond strength values were obtained with the Signum Zirconia Bond and Single Bond Universal. Single Bond 2 showed the lowest values. There were no differences between experimental adhesives. All groups showed adhesives failures. A nonlinear correlation was found between bond strength and percentage of 10-MDP in experimental adhesives (r=0.872).

Conclusions:

The commercially available adhesives indicated for bonding to zirconia showed the highest bonding values.

Influence of cement type and ceramic primer on retention of polymer-infiltrated ceramic crowns to a one-piece zirconia implant

STATEMENT OF PROBLEM

The best procedure for cementing a restoration to zirconia implants has not yet been established.

PURPOSE

The purpose of this in vitro study was to measure the retention of polymer-infiltrated ceramic crowns to zirconia 1-piece implants using a wide range of cements. The effect of ceramic primer treatment on the retention force was also recorded. The retention results were correlated with the shear bond strength of the cement to zirconia and the indirect tensile strength of the cements to better understand the retention mechanism.

MATERIAL AND METHODS

The retention test was performed using 100 polymer-infiltrated ceramic crowns (Vita Enamic) and zirconia implants (ceramic.implant CI) The crowns were cemented with either interim cement (Harvard Implant semipermanent, Temp Bond), glass-ionomer cement (Ketac Cem), self-adhesive cement (Perma Cem 2.0, RelyX Unicem Automix 2, Panavia SA), or adhesive cement (Multilink Implant, Multilink Automix, Vita Adiva F-Cem, RelyX Ultimate, Panavia F 2.0, Panavia V5 or Panavia 21) (n=5). Additionally ceramic primer was applied on the intaglio crown surface and implant abutment before cementation for all adhesive cements (Multilink Implant, Multilink Automix: Monobond plus; RelyX Ultimate Scotchbond Universal; Vita Adiva F-Cem: Vita Adiva Zr-Prime; Panavia F2.0, Panavia V5: Clearfil Ceramic Primer) and 1 self-adhesive cement containing 10-methacryloyloxydecyl dihydrogen phosphate (MDP) (Panavia SA: Clearfil Ceramic Primer). Crown debond fracture patterns were recorded. Shear bond strength was determined for the respective cement groups to polished zirconia (n=6). The diametral tensile strength of the cements was measured (n=10). Statistical analysis was performed using 1-way or 2-way analysis of variance followed by the Fisher LSD test (α=.05) within each test parameter.

RESULTS

Adhesive and self-adhesive resin cements had shear bond strength values of 0.0 to 5.3 MPa and revealed similar retention forces. Cements containing MDP demonstrated shear bond strength values above 5.3 MPa and displayed increased retention. The highest retention values were recorded for Panavia F 2.0 (318 ±28 N) and Panavia 21 (605 ±82 N). All other adhesive and self-adhesive resin cements attained retention values between 222 ±16 N (Multilink Automix) and 270 ±26 N (Panavia SA), which were significantly higher (P<.05) than glass-ionomer (Ketac Cem: 196 ±34 N) or interim cement (Harvard Implant semipermanent: 43 ±6 N, Temp Bond: 127 ±13 N). Application of manufacturer-specific ceramic primer increased crown retention significantly only for Panavia SA.

CONCLUSIONS

Products containing MDP provided a high chemical bond to zirconia. Self-adhesive and adhesive resin cements with low chemical bonding capabilities to zirconia provided retention force values within a small range (220 to 290 N).

Effect of surface treatments on shear bond strength of resin composite bonded to CAD/CAM resin-ceramic hybrid materials

PURPOSE

The purpose of this study was to assess the effect of surface treatments on shear bond strength of resin composite bonded to thermocycled and non-thermocycled CAD/CAM resin-ceramic hybrid materials.

MATERIALS AND METHODS

120 specimens (10×10×2 mm) from each material were divided into 12 groups according to different surface treatments in combination with thermal aging procedures. Surface treatment methods were airborne-particle abrasion (abraded with 50 micron alumina particles), dry grinding (grinded with 125 µm grain size bur), and hydrofluoric acid (9%) and silane application. According to the thermocycling procedure, the groups were assigned as non-thermocycled, thermocycled after packing composites, and thermocycled before packing composites. The average surface roughness of the non-thermocycled specimens were measured after surface treatments. After packing composites and thermocycling procedures, shear bond strength (SBS) of the specimens were tested. The results of surface roughness were statistically analyzed by 2-way Analysis of Variance (ANOVA), and SBS results were statistically analyzed by 3-way ANOVA.

RESULTS

Surface roughness of GC were significantly lower than that of LU and VE (P<.05). The highest surface roughness was observed for dry grinding group, followed by airborne particle abraded group (P<.05). Comparing the materials within the same surface treatment method revealed that untreated surfaces generally showed lower SBS values. The values of untreated LU specimens showed significantly different SBS values compared to those of other surface treatment groups (P<.05).

CONCLUSION

SBS was affected by surface treatments. Thermocycling did not have any effect on the SBS of the materials except acid and silane applied GC specimens, which were subjected to thermocycling before packing of the composite resin.